Cognitive Problems Research Articles

Relationship between acne vulgaris and attention deficit hyperactivity disorder in adolescent: A cross-sectional study.

High androgen hormone exposure in intrauterine life is held to be responsible for the etiopathogenesis of both acne vulgaris (AV) and attention-deficit hyperactivity disorder (ADHD). In this study, we aimed to investigate the prevalence of ADHD in AV patients. Patients between the ages of 12 and 17, diagnosed with AV and a control group were included in the study. The Conners-Wells Adolescent Self-Report Scale-Long Form (CASS-L) was applied to both groups to determine the severity of the ADHD. Ninety-eight patients diagnosed with AV and 96 healthy controls participated in the study. All parameters of the CASS-L were found to be significantly higher in AV patients compared to the control group. In addition, with the severity of the Global Acne Grading System, a positive low level among conduct problems (r = 0.223), cognitive problems (r = 0.271), ADHD index (r = 0.238), inattention (r = 0.238), and a positive moderate level among hyperactivity (r = 0.349), hyperactivity-impulsivity (r = 0.414), and total score (r = 0.429). According to our results, patients diagnosed with AV were more prone to ADHD than the control group. Our study showed that adolescent patients diagnosed with AV were more prone to ADHD than people of similar age and gender without a diagnosis of AV. It should be noted that AV is not only a dermatological disease but may also be accompanied by psychiatric morbidities.

Neurocognitive function and medical care utilization in Veterans treated for substance use disorder

BackgroundVeterans with substance use disorder (SUD) are at high risk for cognitive problems due to neurotoxic effects of chronic drug and alcohol use coupled in many cases with histories of traumatic brain injury (TBI). These problems may in turn result in proneness to SUD relapse and reduced adherence to medical self-care regimens and therefore reliance on health care systems. However, the direct relationship between cognitive function and utilization of Veterans Health Administration (VHA) SUD and other VHA health care services has not been evaluated. We sought initial evidence as to whether neurocognitive performance relates to repeated health care engagement in Veterans as indexed by estimated VHA care costs.MethodsNeurocognitive performance in 76 Veterans being treated for SUD was assessed using CNS-Vital Signs, a commercial computerized cognitive testing battery, and related to histories of outpatient and inpatient/residential care costs as estimated by the VHA Health Economics Resource Center.ResultsAfter controlling for age, an aggregate metric of overall neurocognitive performance (Neurocognition Index) correlated negatively with total VHA health care costs, particularly with SUD-related outpatient care costs but also with non-mental health-related care costs. Barratt Impulsiveness Scale scores also correlated positively with total VHA care costs.ConclusionsIn Veterans receiving SUD care, higher impulsivity and lower cognitive performance were associated with greater health care utilization within the VHA system. This suggests that veterans with SUD who show lower neurocognitive performance are at greater risk for continued health problems that require healthcare engagement. Cognitive rehabilitation programs developed for brain injury and other neurological conditions could be tried in Veterans with SUD to improve their health outcomes.

Fatigue and depression at 8 weeks and 1 year after bacterial brain abscess and their relationship with cognitive status

ABSTRACT A bacterial brain abscess (BA) is a focal brain infection with largely unknown long-term implications. This prospective study assessed the frequency of fatigue and symptoms of depression at 8 weeks and 1 year after BA and examined the relationship between fatigue, depressive symptoms, and cognitive status. Twenty BA-patients (age 17–73; 45% female) were assessed for fatigue, depression, memory, and executive functions. Fatigue rates were 40-65% at 8 weeks and 25-33% at 1 year on various fatigue questionnaires. Patient Health Questionnaire indicated symptoms of depression in 10% at the 8-week follow-up only. Relevant comorbidities and vocational outcomes were not associated with fatigue or symptoms of depression. Mean fatigue scores improved significantly between the two-time points. Greater fatigue was related to subjective problems with working memory, inhibition, self-monitoring, and emotional control and worse objective verbal memory performance. Symptoms of depression were associated with one out of two fatigue measures. We conclude that fatigue is common in the first year after BA, and higher levels of fatigue are related to more cognitive problems. Symptoms of clinical depression were rare. These findings underscore fatigue as an important consequence of BA and emphasize the necessity for targeted rehabilitation interventions.

A Framework for Best Practices and Readiness in the Advent of Anti-Amyloid Therapy for Early Alzheimer's Disease in Asia.

Advances in biomarker-based diagnostic modalities, recent approval of anti-amyloid monoclonal antibodies for early Alzheimer's disease (AD; mild cognitive impairment or mild dementia due to AD) and late-stage clinical development of other disease-modifying therapies for AD necessitate a significant paradigm shift in the early detection, diagnosis and management of AD. Anti-amyloid monoclonal antibodies target the underlying pathophysiological mechanisms of AD and have demonstrated a significant reduction in the rate of clinical decline in cognitive and functional outcome measures in patients with early AD. With growing recognition of the benefit of early interventions in AD, an increasing number of people may seek diagnosis for their subjective cognitive problems in an already busy medical system. Various factors such as limited examination time, lack of expertise for cognitive assessment and limited access to specialized tests can impact diagnostic accuracy and timely detection of AD. To overcome these challenges, a new model of care will be required. In this paper, we provide practical guidance for institutional readiness for anti-amyloid therapies for early AD in Asia, in terms of best practices for identifying eligible patients and diagnosing them appropriately, safe administration of anti-amyloid monoclonal antibodies and monitoring of treatment, managing potential adverse events such as infusion reactions and amyloid-related imaging abnormalities, and cross-disciplinary collaboration. Education and training will be the cornerstone for the establishment of new pathways of care for the identification of patients with early AD and delivery of anti-amyloid therapies in a safe and efficient manner to eligible patients.

Gulf War Illness Is Associated with Host Gut Microbiome Dysbiosis and Is Linked to Altered Species Abundance in Veterans from the BBRAIN Cohort.

Gulf War Illness (GWI) is a debilitating condition marked by chronic fatigue, cognitive problems, pain, and gastrointestinal (GI) complaints in veterans who were deployed to the 1990-1991 Gulf War. Fatigue, GI complaints, and other chronic symptoms continue to persist more than 30 years post-deployment. Several potential mechanisms for the persistent illness have been identified and our prior pilot study linked an altered gut microbiome with the disorder. This study further validates and builds on our prior preliminary findings of host gut microbiome dysbiosis in veterans with GWI. Using stool samples and Multidimensional Fatigue Inventory (MFI) data from 89 GW veteran participants (63 GWI cases and 26 controls) from the Boston biorepository, recruitment, and integrative network (BBRAIN) for Gulf War Illness, we found that the host gut bacterial signature of veterans with GWI showed significantly different Bray-Curtis beta diversity than control veterans. Specifically, a higher Firmicutes to Bacteroidetes ratio, decrease in Akkermansia sp., Bacteroides thetaiotamicron, Bacteroides fragilis, and Lachnospiraceae genera and increase in Blautia, Streptococcus, Klebsiella, and Clostridium genera, that are associated with gut, immune, and brain health, were shown. Further, using MaAsLin and Boruta algorithms, Coprococcus and Eisenbergiella were identified as important predictors of GWI with an area under the curve ROC predictive value of 74.8%. Higher self-reported MFI scores in veterans with GWI were also significantly associated with an altered gut bacterial diversity and species abundance of Lachnospiraceae and Blautia. These results suggest potential therapeutic targets for veterans with GWI that target the gut microbiome and specific symptoms of the illness.

Trial to assess the tolerability of using felodipine to upregulate autophagy as a treatment of Huntington’s disease (FELL-HD): a phase II, single-centre, open-label, dose-finding trial protocol

IntroductionHuntington’s disease (HD) is an autosomal dominant neurodegenerative disorder that presents with a progressive movement disorder along with cognitive and psychiatric problems. It is caused by a Cytosine-adenin-guanine (CAG) expansion...

Self-perceived cognitive impairment in the first year after breast cancer and the identification of at-risk patients

PurposeThis study investigated self-reported clinically relevant cognitive impairment of breast cancer patients in routine clinical care and assessed factors associated with new-onset clinically relevant cognitive impairment. MethodsCognitive functioning was assessed before start of any treatment (T0) and at 6 (T6) and 12 (T12) months after diagnosis. Cognitive functioning (CF) was measured on a scale of 0–100 with the EORTC QLQ-C30 questionnaire, and the EORTC pre-defined threshold for clinical importance. Multivariable logistic regression analyses was used to identify factors associated with new-onset clinically relevant cognitive impairment at T6 ((CF > 75 at T0 and CF < 75 at T6 and T12) or (CF > 75 at T0 and T6 and <75 at T12)). ResultsPre-treatment, 21% of patients reported clinically relevant cognitive impairment. At T12, percentage was 32%; 20% of patients reported new-onset clinically relevant cognitive impairment at T6 and/or T12. New-onset clinically relevant cognitive impairment was associated with chemo(immuno)therapy and impairment in role and emotional functioning. Younger patients and patients receiving chemo(immuno)therapy were more likely to report new-onset clinically relevant cognitive impairment post treatment. ConclusionOne in five breast cancer patients reported clinically relevant cognitive problems before start of treatment. This percentage further increased within the first year, particularly among patients treated with chemo(immuno)therapy. One in five patients reported new-onset clinically relevant cognitive impairment. Ultimately, these patients may benefit from systematic monitoring and potential referral to interventions.

STUDENTS’ PROBLEMS IN WRITING PARAGRAPH: STUDY AT THE BACHELOR STUDENTS’ ENGLISH EDUCATION

Writing skill is one of the most important language skill to be mastered in the language learning process, especially English. The writing process starts from writing a paragraph. Paragraph are important in writing skill. The purpose of this research was to find students’ problems in writing Paragraph and the dominant problem in Writing Paragraph at The Second Semester of English Education at Muhammadiyah Kotabumi University. This research employed descriptive qualitative research that examined 8 students in the second semester of English Education Study Program. The design of this research was descriptive qualitative research. The instrument used to collect the data were document of students writing tasks and interview guideline. The kind of interview that was used semi-structured interview. Based on theories of Bryne divides writing problems into three categories. The first is linguistic problems. Linguistic aspects such as grammar, vocabulary, Language use and choice of sentence in writing. The second is Physiology, namely content. The third is cognitive such as spelling, punctuation, capitalization and paragraph. Based on the findings, the results showed that the students' problems in writing paragraph indicate that students faced problems in 2 categories which consisted: linguistic and cognitive problems. Linguistic problems which consist of grammar is 49, vocabulary is 7, and choice of sentence is 2, and cognitive problems which consist of spelling is 1, punctuation is 26, capitalization is 29, and paragraphing is 3. Moreover, it also findthe dominant problem in writing paragraph was linguistic problems which consist grammar is 49 where student still experience problems in understanding the basic nature of grammar, namely problems in terms of the appropriateness of the placement of to be, and the correct pattern of verbs. Then, for the Physiology problem, namely content, there were no problems found on the results of the analysis of 8 students' writing documents at the second semester of English education at Muhammadiyah Kotabumi University.

Barriers to Progress Feedback Adoption in Outpatient Geriatric Mental Healthcare: Exploring Age-Related Factors - A Qualitative Study.

Monitoring treatment progress through progress feedback is recognized for its efficacy and demonstrated value. However, its integration and utilization within treatments still need to be improved. Insufficient understanding exists regarding the factors within geriatric mental healthcare influencing the adoption of progress feedback. This study aimed to explore the determinants impacting the utilization of progress feedback within outpatient geriatric mental healthcare, specifically focusing on age-related perspectives and patient group characteristics. This qualitative investigation employed semi-structured interviews involving clinicians (N = 14) selected from four outpatient geriatric teams. The findings revealed both inhibiting and facilitating perspectives concerning progress feedback. Clinicians preferred user-friendly, specific, and tailored measures. Challenges included organizational support, integration in work processes, training, and the digital progress feedback system. Age-related perspectives such as older adults' diverse issues, limited digital skills, and cognitive problems hindered implementation, particularly in the oldest generation of older patients. In outpatient geriatric mental healthcare, many factors and attitudes influencing progress feedback align with those observed in adult psychiatry literature. Moreover, this study highlights specific age-related factors that impede the adoption and implementation of progress feedback, shedding light on the specific barriers within this context.

Decoding IBS: a machine learning approach to psychological distress and gut-brain interaction

PurposeIrritable bowel syndrome (IBS) is a diagnosis defined by gastrointestinal (GI) symptoms like abdominal pain and changes associated with defecation. The condition is classified as a disorder of the gut-brain interaction (DGBI), and patients with IBS commonly experience psychological distress. The present study focuses on this distress, defined from reports of fatigue, anxiety, depression, sleep disturbances, and performance on cognitive tests. The aim was to investigate the joint contribution of these features of psychological distress in predicting IBS versus healthy controls (HCs) and to disentangle clinically meaningful subgroups of IBS patients.MethodsIBS patients (n=49\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$n = 49$$\\end{document}) and HCs (n=28\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$n = 28$$\\end{document}) completed the Chalder Fatigue Scale (CFQ), the Hamilton Anxiety and Depression Scale (HADS), and the Bergen Insomnia Scale (BIS), and performed tests of memory function and attention from the Repeatable Battery Assessing Neuropsychological Symptoms (RBANS). An initial exploratory data analysis was followed by supervised (Random Forest) and unsupervised (K-means) classification procedures.ResultsThe explorative data analysis showed that the group of IBS patients obtained significantly more severe scores than HCs on all included measures, with the strongest pairwise correlation between fatigue and a quality measure of sleep disturbances. The supervised classification model correctly predicted belongings to the IBS group in 80% of the cases in a test set of unseen data. Two methods for calculating feature importance in the test set gave mental and physical fatigue and anxiety the strongest weights. An unsupervised procedure with K=3\\documentclass[12pt]{minimal} \\usepackage{amsmath} \\usepackage{wasysym} \\usepackage{amsfonts} \\usepackage{amssymb} \\usepackage{amsbsy} \\usepackage{mathrsfs} \\usepackage{upgreek} \\setlength{\\oddsidemargin}{-69pt} \\begin{document}$$K = 3$$\\end{document} showed that one cluster contained 24% of the patients and all but two HCs. In the two other clusters, their IBS members were overall more impaired, with the following differences. One of the two clusters showed more severe cognitive problems and anxiety symptoms than the other, which experienced more severe problems related to the quality of sleep and fatigue. The three clusters were not different on a severity measure of IBS and age.ConclusionThe results showed that psychological distress is an integral component of IBS symptomatology. The study should inspire future longitudinal studies to further dissect clinical patterns of IBS to improve the assessment and personalized treatment for this and other patient groups defined as disorders of the gut-brain interaction. The project is registered at https://classic.clinicaltrials.gov/ct2/show/NCT04296552 20/05/2019.

Network analysis to prioritize issues for intervention to improve the health-related quality of life of people with HIV in Spain.

The objective is to assess the interconnectedness of a network of health-related quality of life (HRQoL) variables among people with HIV (PHIV) to identify key areas for which clinical interventions could improve HRQoL for this population. Between 2021 and 2023, we carried out a cross-sectional study within the Spanish CoRIS cohort. We conducted a weighted and undirected network analysis, which examines complex patterns of relationships and interconnections between variables, to assess a network of eight HRQoL dimensions from the validated Clinic Screening Tool for HIV (CST-HIV): anticipated stigma, psychological distress, sexuality, social support, material deprivation, sleep and fatigue, cognitive problems and physical symptoms. A total of 347 participants, predominantly male (93.1%), currently working (79.0%), self-reported homosexual (72.6%) and college-educated (53.9%), were included in the study. Psychological distress showed the highest centrality in the network, indicating its strong connections with sleep and fatigue, cognitive problems and social support within the HRQoL network. Psychological distress, sleep and fatigue, cognitive issues and social support were identified as key factors in an HRQoL network, indicating that interventions focused on these areas could significantly enhance overall well-being.

A study on the Application of Virtual Reality Technology in Children's Rehabilitation Therapy

This article discusses the value of virtual reality (VR) technology in paediatric rehabilitation therapy, which can create immersive, interactive and imaginative virtual environments and provide children with safe and interesting therapeutic modalities to effectively improve their cognitive, motor, speech and emotional problems. The article analyses the application of VR technology in different scenarios, such as attention training, motor training, verbal expression training and emotion recognition training, and points out that the advantages of VR technology are to increase the interest of treatment, enhance the patient's participation, and achieve personalised treatment. However, VR technology also has challenges such as technical limitations, evaluation difficulties and high equipment costs. With the continuous development and improvement of the technology, VR technology is expected to overcome these challenges and play a greater role in the field of children's rehabilitation therapy, bringing hope for the rehabilitation of more children.

‘Remote inhibition’ of motor cortex in Epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS): A TMS based cortical excitability study

ObjectivesThe study compared real-time motor cortex excitability using transcranial magnetic stimulation (TMS)-derived parameters between children with epileptic encephalopathy with spike-wave activation in sleep (EE-SWAS) and age-matched neurotypical controls. The EE-SWAS group received steroids as standard of care and were longitudinally followed for three months. Materials & MethodsChildren aged 5–12 years with immunotherapy-naive EE-SWAS (spike-wave-index≥50 %) and neurotypical controls were enrolled. Cognitive and behavioral assessments were performed using valid psychometric tools. Real-time motor cortex excitability was assessed by measuring resting motor threshold (RMT), short intra-cortical inhibition (SICI) and long intra-cortical inhibition (LICI) in both groups. In EE-SWAS group, a follow up evaluation with TMS at 4- and 12-week intervals, EEG, and neurobehavioral assessments at 12-weeks were performed to assess the effect of steroids on cortical excitability and to determine electroclinical outcome. ResultsForty-eight children with suspected EE-SWAS and 26 neurotypical controls were screened; 20 were enrolled in each group. Children with EE-SWAS (mean age: 8.05 ± 1.76 years) had cognitive and behavioral problems (20/20), and ongoing seizures (12/20). At baseline, the dominant motor cortex was significantly inhibited in the EE-SWAS group compared to neurotypical children{RMT(%)[86.3 ± 6.96 vs 58.05 ± 4.71(p < 0.0001)]; LICI(%)[55.05 ± 4.39 vs 73.9 ± 3.75(p < 0.0001)]; SICI(%)[39.2 ± 4.36 vs 55.45 ± 4.78(p < 0.0001)]}. Reversal of motor cortex inhibition was sequentially observed in EE-SWAS group at 4- and 12-week follow-ups{(RMT[4, 12 weeks]: 71.45 ± 9.83, 63.45 ± 8.48); (LICI[4, 12 weeks]: 66.00 ± 6.26, 74.50 ± 5.36); (SICI[4, 12 weeks]: 49.35 ± 6.24, 56.05 ± 5.57)}[repeated-measures ANOVA: p < 0.0001]. ConclusionMotor cortex is remotely inhibited in EE-SWAS, which may contribute to neurobehavioral impairment. Steroids can disinhibit/reverse the epilepsy-induced motor cortex inhibition leading to improvement in neurobehavior.

Investigating the Effectiveness of Cogniplus Cognitive Training Program on Social Cognition (Theory of Mind) in 6- to 8-year-old Children With Autism Spectrum Disorder

Objective Autism is one of the most common neurodevelopmental disorders. It causes problems in social cognition, communication, and understanding of self and others’ feelings, and has a negative effect on the quality of a person’s life. The present study determines the effectiveness of the Cogniplus cognitive training program on the social cognition (theory of mind (ToM) of children with autism spectrum disorder (ASD). Materials &amp; Methods In a semi-experimental study with a pre-test, post-test design, and a control group with a two-month follow-up, 65 children (44 male and 21 female) from 6 to 11 years old with ASD were selected based on the convenience sampling method from individuals referred to one of autism rehabilitation centers in Shahr-e-Ray City, Iran. They were assessed by the autism spectrum screening questionnaire (ASSQ). Overall, 50 children (33 male and 17 female) with a score of 19 and above on the autism spectrum screening questionnaire were diagnosed with high-functioning autism. They entered into the study according to the inclusion criteria as follows: having speech ability, the absence of motor or intellectual disability, and visual and hearing impairments. Meanwhile, they were matched based on their age. They were randomly and equally assigned to two experimental and control groups. The parents completed the ToM test. The experimental group participated individually in 20 sessions (twice a week, 30 min per session), in the Cogniplus cognitive training program, but the control group only received mainstream services (occupational therapy, speech therapy, art therapy, and music therapy). The parents completed the ToM test in the last session and two months follow-up. The data were analyzed by the correlation analysis, analysis of regression, and generalized estimating equations in the SPSS software, version 27. Results The results of generalized estimating equations analysis showed that the Cogniplus cognitive training program improved social cognition (total, first level, and second level of ToM). Meanwhile, the β coefficient showed that 2.9, 3.08, and 0.96 of the variations, respectively, in the ToM levels as the first, the second, and the total, in children with ASD who received Cogniplus cognitive training program. Also, the variations lasted after a two-month follow-up. Conclusion Considering the positive effect of the Cogniplus cognitive training program on social cognition, the use of the Cogniplus cognitive training program can solve the need for therapists who have new cognitive insight into training. Also, the implementation of such programs can help to improve the social cognition of children with autism disorder with high functioning in real-life situations.

A Systematic Review of the Relationship Between Neonatal Hypoxic-Ischemic Encephalopathy and Long-Term Cognitive Outcomes: Where Do We Stand?

This study aims to systematically review the existing literature on long-term cognitive outcomes in neonates with hypoxic-ischemic encephalopathy (HIE). A thorough search of PubMed, MEDLINE, and Embase was conducted to find studies that satisfied the inclusion requirements. Rayyan (Qatar Computing Research Institute, Doha, Qatar) was utilized during the whole operation.Our results included seven studies with a total of 521 patients and 247 (47.4%) were females. All of the included participants were assessed for the incidence of cognitive functions following hypothermia therapy. Newborns with significant HIE are at high risk for neurodevelopmental complications even in the absence of magnetic resonance imagining (MRI) abnormalities, such as poor performance score and hearing-language score, functional status, delayed language skills, emotional processing, sensory movement, learning, and memory.Independent of motor deficits, participants with a history of HIE are susceptible to issues with cognition and executive function during late childhood and adolescence. It is crucial to keep an eye on their intellectual development after infancy since cognitive dysfunction and memory problems might manifest subtly or not at all in the early years of life, but they can cause problems in later childhood and adolescence. Long-term follow-up research is also required to ascertain whether the enhanced cognitive outcomes will continue throughout adolescence. Even in cases where overt neuromotor abnormalities are not evident, children with watershed injuries on brain MRIs should be closely monitored to evaluate cognitive function, particularly language development.

Sleep maintains excitatory synapse diversity in the cortex and hippocampus

Insufficient sleep is a global problem with serious consequences for cognition and mental health.1 Synapses play a central role in many aspects of cognition, including the crucial function of memory consolidation during sleep.2 Interference with the normal expression or function of synapse proteins is a cause of cognitive, mood, and other behavioral problems in over 130 brain disorders.3 Sleep deprivation (SD) has also been reported to alter synapse protein composition and synapse number, although with conflicting results.4,5,6,7 In our study, we conducted synaptome mapping of excitatory synapses in 125 regions of the mouse brain and found that sleep deprivation selectively reduces synapse diversity in the cortex and in the CA1 region of the hippocampus. Sleep deprivation targeted specific types and subtypes of excitatory synapses while maintaining total synapse density (synapse number/area). Synapse subtypes with longer protein lifetimes exhibited resilience to sleep deprivation, similar to observations in aging and genetic perturbations. Moreover, the altered synaptome architecture affected the responses to neural oscillations, suggesting that sleep plays a vital role in preserving cognitive function by maintaining the brain's synaptome architecture.

Cognitive and psychiatric relevance of dynamic functional connectivity states in a large (N > 10,000) children population.

Children's brains dynamically adapt to the stimuli from the internal state and the external environment, allowing for changes in cognitive and mental behavior. In this work, we performed a large-scale analysis of dynamic functional connectivity (DFC) in children aged 9~11 years, investigating how brain dynamics relate to cognitive performance and mental health at an early age. A hybrid independent component analysis framework was applied to the Adolescent Brain Cognitive Development (ABCD) data containing 10,988 children. We combined a sliding-window approach with k-means clustering to identify five brain states with distinct DFC patterns. Interestingly, the occurrence of a strongly connected state with the most within-network synchrony and the anticorrelations between networks, especially between the sensory networks and between the cerebellum and other networks, was negatively correlated with cognitive performance and positively correlated with dimensional psychopathology in children. Meanwhile, opposite relationships were observed for a DFC state showing integration of sensory networks and antagonism between default-mode and sensorimotor networks but weak segregation of the cerebellum. The mediation analysis further showed that attention problems mediated the effect of DFC states on cognitive performance. This investigation unveils the neurological underpinnings of DFC states, which suggests that tracking the transient dynamic connectivity may help to characterize cognitive and mental problems in children and guide people to provide early intervention to buffer adverse influences.

Prospective evaluation of the relationship between cognition and recovery outcomes after cardiac arrest

PurposeCognitive function is often impaired for cardiac arrest (CA) survivors due to hypoxic-ischemic brain injury. Whether cognitive impairment at hospital discharge is associated with recovery defined as functional status and fatigue measured at 1-month post-discharge is not known. MethodsConsecutive CA patients admitted at an academic center (May 14, 2021–June 23, 2023) were assessed for cognitive impairment (modified Telephone Interview for Cognitive Status, TICS-m < 33) and depressive symptoms (8-item Patient Health Questionnaire) at hospital discharge. Poor functional status (primary outcome; modified Rankin Scale, mRS > 3) and fatigue severity (patient-reported outcome; Modified Fatigue Impact Scale) were assessed 1-month post-discharge. Hierarchical regressions tested associations of cognitive function with outcomes. ResultsOf 112 participants (mean age 54.4 ± 14.8; 38% female; 43% White race, 20% Black race, 29% Hispanic ethnicity) completing discharge TICS-m, 63 (56%) had indicated cognitive impairment, and 68 (61%) had poor 1-month functional outcome. Worse discharge cognitive function was independently associated with a higher risk of poor 1-month functional outcome (OR = 0.88, 95% CI [0.79, 0.98], p = 0.02) after adjusting for age, education, sex, race, ethnicity, length of hospital stay, comorbidities, and depressive symptoms. Fatigue severity lacked significant associations with cognitive function, but was associated with depressive symptoms (B = 1.03 [0.00, 2.05], p = 0.04). ConclusionCognitive function at discharge after CA was significantly and independently associated with functional outcome 1 month after hospital discharge. Psychological distress contributed to fatigue severity. This highlights the need for screening and addressing cognitive and emotional problems pre-hospital discharge.

Dementia awareness in Egypt: what do people really know?

BackgroundDementia is a pressing problem for families and society. In 2019, a total of 57.4 million people worldwide were estimated to be living with dementia, and this number will almost double every 20 years, especially in Africa and the Middle East. This study aimed to investigate knowledge about dementia among the Egyptian population. A cross-sectional online survey was conducted among a sample of adult Egyptians using a socio-demographics data sheet and a designed dementia knowledge questionnaire.ResultsNearly one-third (33.4%) had a poor knowledge score. The items most often answered incorrectly were the sudden onset of cognitive problems as characteristic of dementia (59.3%). The highest percentage of good knowledge was in the manifestations and prevention domains (62.20% and 67.18%, respectively). On the other hand, the lowest rate of good knowledge was in the treatment and life impact domains (35.23% and 25.70%, respectively). Not working in the medical field (OR 2.656, 95% CI: 1.504–4.688, p < 0.001), had no contact with dementia patients (OR 1.910, 95% CI: 1.229–2.970, p = 0.004), no previous knowledge on dementia (OR 3.184, 95% CI: 1.797–5.642, p < 0.001), or never heard about dementia "Marad Alkharaf" (OR 6.385, 95% CI: 4.127–9.878, p < 0.001) were significantly associated with poorer dementia knowledge.ConclusionThe findings of our study indicated variable levels of knowledge of dementia among Egyptians. Our recommendation is to encourage conducting campaigns for raising public awareness about dementia and through media that has an important and widespread effect in reaching the Egyptian population.

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome After SARS-CoV-2 Infection

Chronic symptoms reported following an infection with SARS-CoV-2, such as cognitive problems, overlap with symptoms included in the definition of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). To evaluate the prevalence of ME/CFS-like illness subsequent to acute SARS-CoV-2 infection, changes in ME/CFS symptoms through 12 months of follow-up, and the association of ME/CFS symptoms with SARS-CoV-2 test results at the acute infection-like index illness. This prospective, multisite, longitudinal cohort study (Innovative Support for Patients with SARS-CoV-2 Infections Registry [INSPIRE]) enrolled participants from December 11, 2020, to August 29, 2022. Participants were adults aged 18 to 64 years with acute symptoms suggestive of SARS-CoV-2 infection who received a US Food and Drug Administration-approved SARS-CoV-2 test at the time of illness and did not die or withdraw from the study by 3 months. Follow-up surveys were collected through February 28, 2023. COVID-19 status (positive vs negative) at enrollment. The main outcome was the weighted proportion of participants with ME/CFS-like illness based on the 2015 Institute of Medicine clinical case definition using self-reported symptoms. A total of 4378 participants were included in the study. Most were female (3226 [68.1%]). Mean (SD) age was 37.8 (11.8) years. The survey completion rates ranged from 38.7% (3613 of 4738 participants) to 76.3% (1835 of 4738) and decreased over time. The weighted proportion of participants identified with ME/CFS-like illness did not change significantly at 3 through 12 months of follow-up and was similar in the COVID-19-positive (range, 2.8%-3.7%) and COVID-19-negative (range, 3.1%-4.5%) groups. Adjusted analyses revealed no significant difference in the odds of ME/CFS-like illness at any time point between COVID-19-positive and COVID-19-negative individuals (marginal odds ratio range, 0.84 [95% CI, 0.42-1.67] to 1.18 [95% CI, 0.55-2.51]). In this prospective cohort study, there was no evidence that the proportion of participants with ME/CFS-like illness differed between those infected with SARS-CoV-2 vs those without SARS-CoV-2 infection up to 12 months after infection. A 3% to 4% prevalence of ME/CFS-like illness after an acute infection-like index illness would impose a high societal burden given the millions of persons infected with SARS-CoV-2.