Perseverative Responses Research Articles

Chanting and meditation: an 8-week intervention to promote executive functions in school-age children

The present study investigated the effectiveness of a newly developed 8-week meditation program, which included chanting and meditation, on executive functions (EFs) in school-age children. Twenty-five students assigned to an experimental group participated in the meditation program, engaging in daily and weekly activities for 8 weeks. Another 25 students served as a control group and participated in regular school activities. Pretest and posttest assessments included the n-back task for working memory, the go/no-go task for inhibition, and the Wisconsin Card Sorting Test (WCST) for cognitive flexibility. A mixed repeated measures ANOVA was conducted to analyze interaction effects, within-group differences, and between-group differences. The experimental group demonstrated greater improvement compared to the control group across several measures: (1) reaction time in the 1-back task, (2) correct responses in the no-go condition of the go/no-go task, and (3) percentage of correct responses, errors, perseverative errors, non-perseverative errors, perseverative responses, and conceptual level responses in the WCST (p < 0.001). These findings underscore the potential benefits of an 8-week school-based meditation program incorporating chanting and meditation for enhancing EFs in school-age children.

Attentional processing in the rat dorsal posterior parietal cortex

The human posterior parietal cortex (PPC) is known to support sustained attention. Specifically, top-down attention is generally processed in dorsal regions while bottom-up regulation occurs more ventrally. In rodent models, however, it is still unclear whether the PPC is required for sustained attention, or whether there is a similar functional dissociation between anatomical regions. Consequently, the aim of this study was to investigate the contribution of the rodent dorsal PPC (dPPC) in sustained attention. We used the five-choice serial reaction time task (5CSRTT) and compared rats with neurotoxic dPPC lesions to sham operated rats. We found that rats with dPPC lesions were less accurate and took longer to make correct choices, indicating impaired attention and reduced processing speed. This effect, however, was limited to the first few days of post-operative testing. After an apparent recovery, omissions became elevated in the lesion group, which, in the absence of reduced motivation and mobility, can also be interpreted as impaired attention. In subsequent challenge probes, the lesion group displayed globally elevated latency to make a correct response, indicating reduced processing speed. No differences in premature responses or perseverative responses were observed at any time, demonstrating that dPPC lesions did not affect impulsivity and compulsivity. This pattern of behavior suggests that while intact dPPC supports goal-driven (top-down) modulation of attention, it likely does not play a central role in processing stimulus-driven (bottom-up) attention. Furthermore, compensatory mechanisms can support sustained attention in the absence of a fully functioning dPPC, although this occurs at the expense of processing speed. Our results inform the literature by confirming that rodent PPC is involved in regulating sustained attention and providing preliminary evidence for a functional dissociation between top-down and bottom-up attentional processing.

An improved diagrammatic procedure for interpreting and scoring the Wisconsin Card Sorting Test: An update to Steve Berry’s 1996 edition

The Wisconsin Card Sorting Test (WCST) is a popular neuropsychological test that is complicated to score and interpret. In an attempt to make scoring of the WCST simpler, Berry (The Clinical Neuropsychologist 10, 117–121, 1996) developed a diagrammatic scoring procedure, particularly to aid scoring of perseverative responses. We identified key limitations of Berry’s diagram, including its unnecessary ambiguity and complexity, use of terminology different from that used in the standardized WCST manual, and lack of distinction between perseverative errors and perseverative responses. Our new diagrammatic scoring procedure scores each response one-by-one; we strongly suggest that the diagram is used in conjunction with the 1993 WCST manual. Our new diagrammatic scoring procedure aims to assist novice users in learning how to accurately score the task, prevent scoring errors when using the manual version of the task, and help scorers verify whether other existing computerized versions of the task (apart from the PAR version) conform to the Heaton et al. (1993) scoring method. Our diagrammatic scoring procedure holds promise to be incorporated into any future versions of the WCST manual.

Cognitive flexibility predicts attitudes towards vaccination: evidence from a New Zealand sample

BackgroundVaccine hesitancy (the reluctance or refusal to vaccinate) poses a significant threat to public health worldwide, with declining vaccination coverage resulting in the resurgence of vaccine-preventable diseases (e.g., measles) in recent years. Despite efforts to combat vaccine hesitancy through information-based campaigns and other interventions, vaccine-hesitant attitudes persist. Given that such interventions likely expose individuals to information that conflicts with their own viewpoints about vaccination, cognitive flexibility – the ability to adapt one’s thoughts, attitudes, beliefs, or behavior in response to changing information or environmental demands – may play a role in vaccine hesitancy.MethodsThe current study investigated the relationship between cognitive flexibility and attitudes towards vaccination in a sample of New Zealand residents (N = 601). Cognitive flexibility was measured using perseverative responses in the Wisconsin Card-Sorting Task, and vaccination attitudes were measured using an adapted version of the Multidimensional Vaccine Hesitancy Scale (MVHS). Linear regression was used with MVHS scores as the dependent variable and cognitive flexibility and sociodemographic variables (age, gender, ethnicity, education level, religion) as predictors.ResultsCognitive flexibility predicted personal barriers to vaccination (e.g.,” vaccines go against my personal beliefs”), with participants with lower levels of cognitive flexibility reporting greater personal barriers. In contrast, there was no significant relationship between cognitive flexibility and external barriers to vaccination (e.g., “vaccines cost too much”). Additionally, religious participants reported overall higher levels of vaccine hesitancy than non-religious participants.ConclusionsThese findings join others demonstrating that individual differences in cognitive style are associated with attitudes towards vaccination, and tentatively suggest that interventions aiming to reduce vaccine hesitancy may be more effective if combined with techniques to increase cognitive flexibility. To be sure, future work is needed to test the causal relationship between cognitive flexibility and attitudes towards vaccination.

B - 66 Cognitive Dispersion Is Uniquely Associated with Executive Functions in HIV Disease

Abstract Objective Among persons living with HIV (PLWH), higher levels of intraindividual variability (IIV) across a battery of neuropsychological measures (i.e., dispersion) increase the risk of dependence in everyday functioning. Higher levels of dispersion are theorized to reflect lapses in executive aspects of attention, but few studies have directly evaluated the construct validity of dispersion. Method 72 PLWH completed the Cogstate battery (www.cogstate.com). Exclusion criteria were inability to provide informed consent, psychosis, active substance use disorders, and major neurological conditions. Dispersion was operationalized as a coefficient of variance (CoV) across age-adjusted scores on six tests from the Cogstate battery (i.e., intra-individual standard deviation divided by the intra-individual mean). The predictor variables were mean-level, demographically-adjusted performance scores from well-validated clinical measures of executive functions (Trailmaking Test B, WCST-64 Perseverative Responses, PASAT-50, and Verbal Fluency), psychomotor speed (WAIS-III Digit Symbol, Trailmaking Test A, Grooved Pegboard), and episodic memory (HVLT-R and BVMT-R Learning and Delayed Recall). Results A multiple regression analysis indicated that the three domain-level cognitive predictors explained 12.1% of the variance in Cogstate CoV (p = 0.03). Within this model, lower levels of executive functions were significantly associated with higher CoV on the Cogstate (p = 0.01), but the psychomotor and memory domains were not (ps &amp;gt; 0.05). Conclusion The findings from this cross-sectional study align with cognitive theory in demonstrating dispersion is uniquely associated with external measures of executive functions (e.g., cognitive flexibility) among PLWH. Future experimental studies are needed to determine the precise executive mechanism of dispersion.

On Metacognition: Overconfidence in Word Recall Prediction and Its Association with Psychotic Symptoms in Patients with Schizophrenia.

Fifty-one participants with a diagnosis of schizophrenia were evaluated. The Positive and Negative Syndrome Scale (PANSS) was used to assess the severity of psychiatric symptoms, and the subtest of metamemory included in the Executive Functions and Frontal Lobe-2 battery (BANFE-2) was used to evaluate overconfidence and underestimation errors, intrusion and perseverative response, total volume of recall, and Brief Functioning Assessment Scale (FAST) for social functioning. The strongest correlation is observed between overconfidence errors and the positive factor of the PANSS (r = 0.774, p < 0.001). For the enter model in the multiple linear regression (r = 0.78, r2 = 0.61; F = 24.57, p < 0.001), the only significant predictor was overconfidence errors. Our results highlight the relevance of a metacognitive bias of overconfidence, strongly correlated with psychotic symptoms, and support the hypothesis that metacognitive defects contribute to the failure to reject contradictory evidence. From our perspective, these findings align with current mechanistic models of schizophrenia that focus on the role of the prefrontal cortex.

Investigating gene-environment interaction on attention in a double-hit model for Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is a neurodevelopmental behavioral disorder characterized by social, communicative, and motor deficits. There is no single etiological cause for ASD, rather, there are various genetic and environmental factors that increase the risk for ASD. It is thought that some of these factors influence the same underlying neural mechanisms, and that an interplay of both genetic and environmental factors would better explain the pathogenesis of ASD. To better appreciate the influence of genetic-environment interaction on ASD-related behaviours, rats lacking a functional copy of the ASD-linked gene Cntnap2 were exposed to maternal immune activation (MIA) during pregnancy and assessed in adolescence and adulthood. We hypothesized that Cntnap2 deficiency interacts with poly I:C MIA to aggravate ASD-like symptoms in the offspring. In this double-hit model, we assessed attention, a core deficit in ASD due to prefrontal cortical dysfunction. We employed a well-established attentional paradigm known as the 5-choice serial reaction time task (5CSRTT). Cntnap2-/- rats exhibited greater perseverative responses which is indicative of repetitive behaviors. Additionally, rats exposed to poly I:C MIA exhibited premature responses, a marker of impulsivity. The rats exposed to both the genetic and environmental challenge displayed an increase in impulsive activity; however, this response was only elicited in the presence of an auditory distractor. This implies that exacerbated symptomatology in the double-hit model may situation-dependent and not generally expressed.

BK channel dysfunction disrupts attention-controlled behaviors and altered perseverative responses in murine instrumental learning

This study examined the effect of knockout of KCNMA1 gene, coding for the BK channel, on cognitive and attentional functions in mice, with an aim to better understand its implications for human neurodevelopmental disorders. The study used the 3-choice serial reaction time task (3-CSRTT) to assess the learning performance, attentional abilities, and repetitive behaviors in mice lacking the KCNMA1 gene (KCNMA1-/-) compared to wild-type (WT) controls. Results showed no significant differences in learning accuracy between the two groups. However, KCNMA1-/- mice were more prone to omitting responses to stimuli. In addition, when the timing of cue presentation was randomized, the KCNMA1-/- showed premature responses. Notably, these mice also demonstrated a marked reduction in perseverative responses, which include repeated nose-poke behaviors following decisions. These findings highlight the involvement of the KCNMA1 gene in managing attention, impulsivity, and potentially moderating repetitive actions.

Neurocognitive Functions After 6-Month Buprenorphine (Naloxone)-Based Opioid Agonist Maintenance Treatment: A Controlled Prospective Study.

Medications for opioid use disorder (OUD) may influence neurocognitive functions. Inadequate power, confounders, and practice effects limit the validity of the existing research. We examined the change in cognitive functions in patients with OUD at 6-month buprenorphine (naloxone) posttreatment and compared the cognitive performance of the buprenorphine-treated group with control subjects. We recruited 498 patients with OUD within a week of initiating buprenorphine. Assessments were done twice-at baseline and 6 months. Those abstinent from illicit opioids and adherent to treatment (n = 199) underwent follow-up assessments. Ninety-eight non-substance-using control subjects were recruited from the community. The neurocognitive assessments comprised the Wisconsin Card Sorting Test, Iowa Gambling Task, Trail-Making Tests A and B (TMT-A and TMT-B), and verbal and visual N-Back Test. We controlled for potential effect modifiers. Twenty-five of the 32 test parameters significantly improved with 6 months of buprenorphine treatment; 20 parameters withstood corrections for multiple comparisons (P < 0.001). The improved test domains spread across cognitive tests: Wisconsin Card Sorting Test (perseverative errors and response, categories completed, conceptual responses), TMTs (time to complete), verbal and visual N-Back Tests (hits, omission, and total errors). After treatment, OUD (vs control subjects) had less perseverative response and error (P < 0.001) and higher conceptual response (P = 0.004) and took lesser time to complete TMT-A (P < 0.001) and TMT-B (P = 0.005). The baseline neurocognitive functions did not differ between those who retained and those who discontinued the treatment. Cognitive functions improve in patients with OUD on buprenorphine. This improvement is unlikely to be accounted for by the practice effect, selective attrition, and potential confounders.

Dysfunction of circulating endothelial progenitor cells in major depressive disorder.

Despite mounting evidence demonstrates circulating endothelial progenitor cells (cEPCs) quantitative changes in depression, no study has investigated cEPC functions in major depressive disorder (MDD). We investigated the role of cEPC adhesive and apoptotic functions in MDD. We recruited 68 patients with MDD and 56 healthy controls (HCs). The depression symptoms, anxiety, psychosomatic symptoms, subjective cognitive dysfunction, quality of life, and functional disability were evaluated using the Hamilton Depression Rating Scale and Montgomery-Åsberg Depression Rating Scale, Hamilton Anxiety Rating Scale, Depression and Somatic Symptoms Scale (DSSS), Perceived Deficits Questionnaire-Depression, 12-Item Short Form Health Survey (SF-12), and Sheehan Disability Scale (SDS), respectively. Working memory and executive function were assessed using a 2-back task and Wisconsin Card Sorting Test (WCST). Inflammatory marker (soluble interleukin-6 receptor, C-reactive protein, and tumor necrosis factor-α receptor-1), cEPC adhesive, and apoptotic levels were measured using in vitro assays. The MDD patients showed significantly lower cEPC adhesive levels than the HCs, and this difference in adhesive function remained statistically significant even after adjusting for inflammatory marker levels. The cEPC adhesion levels were in inverse correlations with commission and omission errors in 2-back task, the percent perseverative response and percent perseverative errors in WCST, and the DSSS and SDS scores, but in positive correlations with SF-12 physical and mental component scores. cEPC apoptotic levels did not differ significantly between the groups. The findings indicate that cEPC adhesive function is diminished in MDD and impacts various aspects of cognitive and psychosocial functions associated with the disorder.

Evaluation of the impact of a comprehensive psychiatric rehabilitation program on the improvement of cognitive functions in patients of the Mental Health Support Centre in Tarnowskie Gory using the Wisconsin Card Sorting Test

Aim: The purpose of our study was check to how a 3-month program of physical, cognitive and social rehabilitation affected the cognitive functions of patients of the Mental Health Support Centre in Tarnowskie Gory by using the Wisconsin Card Sorting test Materials and Methods: The Wisconsin Card Sorting Test (WCST) was conducted twice among patients of the Mental Health Support Center in Tarnowskie Gory, who were undergoing a 3 month rehabilitation program that included physical, cognitive, and social rehabilitation. The test was conducted at the beginning and after the participation in the rehabilitation program. Results: The rehabilitation program led to a significant decrease in patients’ perseverative responses compared to the initial study. Other indicators were also assessed in the Wisconsin Card Sorting Test (WCST). There were no statistically significant differences between the results of the first and second studies. Conclusions: After completing the rehabilitation program, patients showed a significant decrease in perseverative responses, indicating improved speed in responding to changing task conditions. Cognitive flexibility, including the ability to respond to changing environmental conditions, is a key skill that enables adequate and adaptive actions.

A novel naïve Bayes approach to identifying grooming behaviors in the force-plate actometric platform

BackgroundSelf-grooming behavior in rodents serves as a valuable behavioral index for investigating stereotyped and perseverative responses. Most current grooming analyses rely on video observation, which lacks standardization, efficiency, and quantitative information about force. To address these limitations, we developed an automated paradigm to analyze grooming using a force-plate actometer. New methodGrooming behavior is quantified by calculating ratios of relevant movement power spectral bands. These ratios are input into a naïve Bayes classifier, trained with manual video observations. The effectiveness of this method was tested using CIN-d mice, an animal model developed through early-life depletion of striatal cholinergic interneurons (CIN-d) and featuring prolonged grooming responses to acute stressors. Behavioral monitoring was simultaneously conducted on the force-place actometer and by video recording. ResultsThe naïve Bayes approach achieved 93.7% accurate classification and an area under the receiver operating characteristic curve of 0.894. We confirmed that male CIN-d mice displayed significantly longer grooming durations than controls. However, this elevation was not correlated with increases in grooming force. Notably, the dopaminergic antagonist haloperidol reduced grooming force and duration. Comparison with existing methodsIn contrast to observation-based approaches, our method affords rapid, unbiased, and automated assessment of grooming duration, frequency, and force. ConclusionsOur novel approach enables fast and accurate automated detection of grooming behaviors. This method holds promise for high-throughput assessments of grooming stereotypies in animal models of neuropsychiatric disorders.

Investigating self-report and neuropsychological assessments of cognitive flexibility in people with and without persistent pain: An online, cross-sectional, observational study.

People with persistent pain experience problems modifying their cognition and behaviours when task or environmental demands change - abilities otherwise known as cognitive flexibility. However, limitations and inconsistent results of previous studies raise concerns over the quality of that evidence. We aimed to determine whether people with and without persistent pain differ on two assessments that are commonly used to assess cognitive flexibility. We also examined the relationship between the two assessments and explored whether people with and without persistent pain are distinguishable based on their scores on these assessments. Participant demographics and symptoms of anxiety and depression were assessed. Participants completed the Cognitive Flexibility Inventory (CFI) and the Wisconsin Card Sorting Test (WCST). Multiple linear regression on the two outcome variables: CFI (total score) and WCST (% perseverative responses) was applied using backward stepwise selection. Both outcomes were calculated as a standardised proportion of the outcome scale and log-odds transformed to meet the model assumptions. Correlation analysis and logistic regression were used to investigate our secondary and exploratory aims. Data were available from 128 participants with persistent pain and 68 pain-free controls. After adjusting for covariates, no differences were found between people with and without persistent pain on either assessment of cognitive flexibility. No significant correlations were detected between the two assessments in either group. The probability of having persistent pain was also not associated with scores on either or both assessments. 'Cognitive flexibility' appears similar in people with and without persistent pain.

Cognitive impairment in Chinese adult patients with type III spinal muscular atrophy without disease-modifying treatment.

Spinal muscular atrophy (SMA) is a neurodegenerative disorder characterized by the degeneration of motor neurons in the spinal cord. It remains uncertain whether the cognitive performance of adult patients with SMA is impaired. The objective of this study was to assess the cognitive profile of adult Chinese patients with SMA and the association between clinical features and cognitive ability, particularly executive function. This cross-sectional study included 22 untreated adult patients with type III SMA and 20 healthy subjects. The following variables were assessed: general intelligence, memory, attention, language, executive function, depression, anxiety, and other demographic and clinical parameters. In addition, physical function was evaluated using the Hammersmith Functional Motor Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM), and the 6-Minute Walk Test (6MWT). SMA patients had lower scores than healthy subjects in the Verbal Fluency Test, Stroop effect, Total Errors, Perseverative Responses, Perseverative Errors, and Non-perseverative Errors in the Wisconsin Card Sorting Test, showing impaired abilities of SMA patients in executive function. In the Attention Network Test (ANT), the results indicated that the SMA patients also had selective deficits in their executive control networks. Ambulant patients had better executive function test performance than non-ambulant ones. Compromised executive abilities in patients with SMA were correlated with a younger age at onset, poorer motor function, and higher levels of anxiety and depression. Our study presented the distribution of cognitive impairment in a Chinese cohort with SMA. Patients with type III SMA showed selective deficits in executive function, which may be associated with disease severity, physical impairment, depression and anxiety. Future cognitive studies, accounting for motor and emotional impairment, are needed to evaluate if executive impairment is driven by specific brain changes or by those confounding factors.

Functional-structural decoupling in visual network is associated with cognitive decline in patients with type 2 diabetes mellitus: evidence from a multimodal MRI analysis.

Type 2 diabetes mellitus (T2DM) and cognitive dysfunction are highly prevalent disorders worldwide. Although visual network (VN) alteration and functional-structural coupling are potential warning factors for mild cognitive impairment (MCI) in T2DM patients, the relationship between the three in T2DM without MCI is unclear. Thirty T2DM patients without MCI and twenty-nine healthy controls (HC) were prospectively enrolled. Visual components (VC) were estimated by independent component analysis (ICA). Degree centrality (DC), amplitude of low frequency fluctuation (ALFF) and fractional anisotropy (FA) were established to reflect functional and structural characteristics in these VCs respectively. Functional-structural coupling coefficients were further evaluated using combined FA and DC or ALFF. Partial correlations were performed among neuroimaging indicators and neuropsychological scores and clinical variables. Three VCs were selected using group ICA. Deteriorated DC, ALFF and DC-FA coefficients in the VC1 were observed in the T2DM group compared with the HC group, while FA and ALFF-FA coefficients in these three VCs showed no significant differences. In the T2DM group, DC in the VC1 positively correlated with 2 dimensions in the California Verbal Learning Test, including Trial 4 and Total trial 1-5. The impaired DC-FA coefficients in the VC1 markedly affected the Total perseverative responses % of the Wisconsin Card Sorting Test. These findings indicate that DC and DC-FA coefficients in VN may be potential imaging biomarkers revealing early cognitive deficits in T2DM.

A - 126 Cognitive Performance in Individuals with Major Depressive Disorder and no Diagnosis.

To compare performance in neuropsychological assessments between a sample of individuals with Major Depressive Disorder (MDD) and those with no diagnosis. The MDD group (n = 77; Mage = 34.69, SD = 12.80; Med =13.41, SD = 2.45) had 41.6% male, 69.7% White, 10.5% Black, 17.1% Hispanic, and 2.6% other race). The undiagnosed group (n = 83, Mage = 33.39, SD = 11.82; Med =13.62, SD = 3.02) had 56.6% male, 56.6% White, 18.1% Black, 16.9% Hispanic, and 8.4% other. Participants were selected from a de-identified outpatient clinical database. The groups did not differ significantly in age, years of education, race, or gender (p values >0.05). No significant differences were found in intellectual functioning or memory ability as measured by the WAIS-IV and WMS-IV, respectively (p values >0.05). At the group level, individuals diagnosed with MDD completed significantly fewer categories [t(137) = -2.15, p = 0.02] and made more errors [t(137) = 1.99, p = 0.02] and perseverative responses [t(135) = 2.66, p = 0.004] on the WCST than undiagnosed participants. The increased number of errors and perseverative responses among individuals with MDD might be associated with difficulties sustaining attention, set-shifting, and abstract concept formation associated with depression. As expected, we did not observe differences in recognition memory or intellectual functioning, which tend to remain stable in the presence of mood disorders. Limitations of our study include the lack of a premorbid measure of intellectual functioning and MDD severity. Future research could explore the effect of MDD severity on cognitive performance.

The Role of Genetically Distinct Central Amygdala Neurons in Appetitive and Aversive Responding Assayed with a Novel Dual Valence Operant Conditioning Paradigm.

To survive, animals must meet their biological needs while simultaneously avoiding danger. However, the neurobiological basis of appetitive and aversive survival behaviors has historically been studied using separate behavioral tasks. While recent studies in mice have quantified appetitive and aversive conditioned responses simultaneously (Jikomes et al., 2016; Heinz et al., 2017), these tasks required different behavioral responses to each stimulus. As many brain regions involved in survival behavior process stimuli of opposite valence, we developed a paradigm in which mice perform the same response (nose poke) to distinct auditory cues to obtain a rewarding outcome (palatable food) or avoid an aversive outcome (mild footshoock). This design allows for both within-subject and between-subject comparisons as animals respond to appetitive and aversive cues. The central nucleus of the amygdala (CeA) is implicated in the regulation of responses to stimuli of either valence. Considering its role in threat processing (Wilensky et al., 2006; Haubensak et al., 2010) and regulation of incentive salience (Warlow and Berridge, 2021), it is important to examine the contribution of the CeA to mechanisms potentially underlying comorbid dysregulation of avoidance and reward (Sinha, 2008; Bolton et al., 2009). Using this paradigm, we tested the role of two molecularly defined CeA subtypes previously linked to consummatory and defensive behaviors. Significant strain differences in the acquisition and performance of the task were observed. Bidirectional chemogenetic manipulation of CeA somatostatin (SOM) neurons altered motivation for reward and perseveration of reward-seeking responses on avoidance trials. Manipulation of corticotropin-releasing factor neurons (CRF) had no significant effect on food reward consumption, motivation, or task performance. This paradigm will facilitate investigations into the neuronal mechanisms controlling motivated behavior across valences.

Effect of vortioxetine versus venlafaxine on cognitive functions in adults with major depressive disorder: A randomized-controlled trial.

Vortioxetine and venlafaxine are antidepressants which have shown established efficacy to treat major depressive disorder (MDD). There are no studies that compared them for their efficacy in cognitive symptoms of depression. The study aimed to compare the effect of vortioxetine and venlafaxine on the change in cognitive scores in adults with MDD. The present study was an open-label, active-controlled parallel design randomized clinical trial. After randomization, baseline clinical evaluations by Montgomery-Asberg Depression Rating Scale (MADRS) and Social and Occupational Functioning Assessment Scale (SOFAS) were done and coding (subset of WAIS-IV), WCST, TMT, Stroop test, PGI memory were used to assess cognition in 100 unmedicated MDD patients. They were reassessed after eight weeks of monotherapy with vortioxetine or venlafaxine. Primary cognitive measure (coding score) was found to be significantly higher (Mean Difference = 0.680; 95% CI:.202 to 1.158; P = 0.006) in vortioxetine in comparison with venlafaxine. Stroop test scores (word score, color score, color-word score) were also found to be significantly higher with vortioxetine. In other cognitive measures (WCST scores: total trials, total errors score, total perseverative responses score, total perseverative errors scores; TMT-A and B scores), a significant decrease in scores with vortioxetine in comparison with venlafaxine were observed. A significant decrease in MADRS and increase in SOFAS scores were observed with vortioxetine in comparison with venlafaxine. Both the drugs alleviated the symptoms of depression but vortioxetine was better tolerated. Our study findings suggest that improvement in cognitive scores is significantly higher with vortioxetine than venlafaxine over the eight weeks of monotherapy. CTRI/2020/07/026819 (Registered with Clinical Trials Registry- India).

Do executive functions differentiate Iranian children with attention-deficit/hyperactivity disorder with and without comorbid obesity?

To compare multiple dimensions of executive function between children with attention-deficit/hyperactivity disorder (ADHD) with and without comorbid obesity. Participants were 90 Iranian children (ages 8-13, 50% female) who were equally dispersed across three study groups: typically developing (TD), ADHD with obesity (ADHD+O), and ADHD without obesity (ADHD-O). Study participants were administered a comprehensive battery of Iranian-adapted "cool" executive function tasks including Digit Span from the Wechsler Intelligence Scale for Children-Fifth Edition (WISC-V), Victoria Stroop Test (VST), Wisconsin Card Sorting Test (WCST), Tower of London, and dot-probe task (i.e., a task of attentional bias). Parents completed the Children's Scale for Future Thinking Questionnaire, which assesses future-oriented cognition (e.g., saving, planning, episodic foresight, delay of gratification), aligning more with "hot" executive functions. Groups were compared using multivariate and post-hoc univariate general linear models. Significant group effects were observed for all executive function variables, broadly with the gradient pattern of TD > ADHD-O > ADHD+O. ADHD+O had poorer performances than ADHD-O for WISC-V Digit Span (d = -0.84), WCST Categories Completed (d = -0.55) and Perseverative Responses (d = 1.15), VST Interference Errors (d = 0.83) and Interference Time (d = 1.38), and Dot-Probe Task (d = 0.84). Relative to the ADHD-O group, ADHD+O had also poorer parent-reported Prospective Memory (d = -0.62), Episodic Foresight (d = -0.63), and Delay of Gratification (d = -0.54). Children with ADHD-O have poorer executive functioning than those without obesity. We observed stronger effects for "cool" rather than "hot" domains of executive function, though this could be due to the former being performance-based and the latter parent-reported.

Cognitive Flexibility in Hospitalized Patients with Severe or Extreme Anorexia Nervosa: A Case-Control Study.

To investigate whether cognitive inflexibility could be identified using the Wisconsin Card Sorting Test (WCST) in patients with severe and extreme anorexia nervosa (AN) compared to healthy control participants (HCs). We used the WCST to assess 34 patients with AN (mean age: 25.9 years, mean body mass index (BMI): 13.2 kg/m2) 3-7 days after admission to a specialized nutrition unit and 34 HCs. The Beck Depression Inventory II and the Eating Disorder Inventory 3 were distributed. The patients displayed more perseveration than HCs controlled for age and years of education, with moderate effect sizes (perseverative responses (%): adjusted difference = -7.74, 95% CI: -14.29-(-1.20), p-value: 0.021; perseverative errors (%): adjusted difference = -6.01, 95% CI: -11.06-(-0.96), p-value: 0.020). There were no significant relationships between perseveration and depression, eating disorder symptoms, illness duration, or BMI. Patients with severe and extreme AN demonstrated lower cognitive flexibility compared to HCs. Performance was not related to psychopathology or BMI. Patients with severe and extreme anorexia nervosa may not differ from less severe patients in cognitive flexibility performance. As this study exclusively focused on patients suffering from severe and extreme AN, potential correlations might be masked by a floor effect.