Reduced Processing Speed Research Articles

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.

Analyzing the relationship between processing speed impairment and Rey-15 item test performance

ABSTRACT Objective This study investigated the relationship between processing speed impairment severity and performance on the Rey 15-Item Test (RFIT) and RFIT + Recognition. Method Cross-sectional data from 285 examinees (228 valid/57 invalid) referred for neuropsychological assessment who were administered the RFIT, Weschler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Processing Speed Index (PSI), Brief Visuospatial Memory Test – Revised, Rey Auditory Verbal Learning Test, and three independent criterion PVTs were included. PSI bands were operationalized as Intact (≥85SS; n = 163), Reduced/Possibly Impaired (77-84SS; n = 36), or Impaired (≤76 SS; n = 29). Receiver operator characteristic (ROC) curve analyses tested the RFIT and RFIT + Recognition’s classification accuracy for detecting invalid performance for the overall sample and by PSI impairment status. Results Those with intact processing speed performed significantly better on the RFIT and RFIT + Recognition than those with reduced/possibly impaired and impaired processing speed. Though verbal/visual memory predicted RFIT scores independently, PSI contributed additional variance. ROC curves for RFIT and RFIT + Recognition were significant (AUC=.64-.84). Optimal cut-scores yielded modest sensitivity (30%-63%) and high specificity (89%-93%) among those with intact and reduced processing speed but yielded unacceptable accuracy in those with impaired speed (AUC=.59-.62). Conclusions Although the RFIT and RFIT + Recognition demonstrated acceptable classification accuracy in those with intact processing speed, accuracy diminished with increasing speed impairment. This finding was more pronounced for RFIT + Recognition compared to the traditional RFIT. As such, the RFIT may have limited clinical utility in examinees with more significant processing speed deficits.

Cognitive reserve as residual variance in cognitive performance: Latent dimensionality, correlates, and dementia prediction.

Cognitive reserve (CR) is typically operationalized as episodic memory residualized on brain health indices. The dimensionality of more generalized models of CR has rarely been examined. In a sample of N = 113 dementia-free older adults (ages 62-86 years at MRI scan; 58.4% women), the domain-specific representation of general cognition (COG) before vs. after residualization on brain indices (brain volume loss, cerebral blood flow, white matter hyperintensities) was compared (i.e., COG vs. CR). COG and CR were assessed by 15 tasks spanning five domains: processing speed, verbal memory, visuospatial memory, fluid reasoning, and vocabulary. Measurement invariance and item-construct representation were tested in a series of structural factor analyses. COG and CR were then examined in relation to 22 risk and protective factors and dementia status at time of death. Item-factor loadings differed such that CR more strongly emphasized fluid reasoning. More years of education, higher occupational class, more hobbies/interests, and fewer difficulties with personal mobility similarly predicted better COG and CR. Only the sub-domain of visuospatial memory (both before and after residualization) was associated with conversion to dementia by end-of-life (r = -.30; p = .01). Results provide tentative support for the role of fluid reasoning (intelligence) as a potential compensatory factor for age- and/or neuropathology-related reductions in processing speed and memory. Intellectually stimulating work, efforts to preserve personal mobility, and a diversity of hobbies and interests may attenuate age- and/or pathology-related reductions in cognitive functioning prior to dementia onset.

Cognitive frailty in older adults: examining the impact of frailty criteria on neuropsychological profile, functional outcomes, activity levels, and quality of life.

Cognitive frailty (CF) is the co-existence of cognitive impairment and physical frailty without dementia, conferring greater risks of adverse clinical outcomes compared to either condition alone. However, the impact of physical frailty components on cognitive performance remains unclear. This study aims to evaluate CF by determining the neuropsychological profiles, functional outcomes, activity levels, and quality of life across the Fried Frailty Phenotype (FFP) and its components. Cross-sectional study involving 120 community-dwelling older adults without dementia, but with subjective cognitive complaints (SCC, defined as AD8 ≥ 1). Participants were stratified into three groups to assess CF: SCC-Robust, SCC-Prefrail, and SCC-Frail, and further categorized by individual FFP components. Cognitive performance was assessed by comparing neuropsychological test battery (NTB) Z-scores between CF and non-CF groups with Cohen's d for effect sizes. We performed linear regression to examine the relationships between both groups with NTB scores, Instrumental Activities of Daily Living (IADL), Frenchay Activities Index (FAI), and quality of life scores. NTB scores showed no differences between individuals with CF when classified according to FFP criteria. Individuals with SCC-slow gait speed exhibited reduced processing speed (d = 0.62) and memory (d = 0.61); SCC-fatigue was associated with decreased working memory (d = 0.55). Regression analyses, adjusted for demographic and clinical variables, identified significant associations: slow gait speed with logical memory (-0.42; 95% CI -0.79 to -0.038]) and symbol search (-0.28; 95% CI -0.56 to -0.006]); fatigue with digit span backwards (-0.66; 95% CI -1.19 to -0.14) and color trails 2 (-0.67; 95% CI, -1.15 to -0.20). SCC-slow gait speed and SCC-fatigue were associated with reduced quality of life scores, but not with IADL and FAI scores. Specific frailty components, notably slow gait speed and fatigue, influence cognitive function and quality of life. Our findings provide greater insights into characterizing CF. Further longitudinal studies are required to determine the cognitive and functional trajectories of CF.

Abstract P348: Effects of Different Antihypertensive Regimens on Cognitive Function and Blood Pressure Changes in Elderly Hypertensive Patients: Network Meta-Analysis

Background: Elderly hypertensive patients with cognitive impairment not only exhibit reduced processing speed and executive function but also suffer significant deficits in memory and motor speed, adversely affecting their quality of life. This study employs a network meta-analysis to evaluate the effects of different antihypertensive regimens on cognitive function and blood pressure changes in elderly hypertensive patients. Methods: A comprehensive search was conducted in PubMed, Cochrane Library, Embase, Web of Science, CNKI, Wanfang and VIP databases for randomized controlled trials on different antihypertensive regimens for elderly hypertensive patients. Data analysis and graphing were performed using Review Manager 5.3 and Stata 16.0 software. Results: A total of 16 studies involving 11,694 elderly hypertensive patients and six antihypertensive regimens were included. The network meta-analysis results indicated that elderly hypertensive patients treated with angiotensin II receptor blockers (ARBs) had a greater change in cognitive function scores compared to those receiving usual care (standardized mean difference [SMD] = 0.46, 95% CI [0.23, 0.70]), angiotensin-converting enzyme inhibitors (ACEIs) (SMD = 0.33, 95% CI [0.06, 0.61]), beta-blockers (BBs) (SMD = 0.48, 95% CI [0.17, 0.78]), and diuretics (SMD = 0.32, 95% CI [0.01, 0.63]). Similarly, patients treated with calcium channel blockers (CCBs) showed greater changes in cognitive function scores compared to those receiving usual care (SMD = 0.37, 95% CI [0.04, 0.70]) and BBs (SMD = 0.38, 95% CI [0.02, 0.74]). The SUCRA rankings for changes in cognitive function scores among different antihypertensive regimens were ARB (93.6%), CCB (81.2%), diuretics (47.1%), ACEI (43.4%), usual care (17.9%), and BB (16.8%). Conclusion: The current evidence suggests that, compared to usual care, ACEIs, BBs, CCBs, and diuretics, ARBs might be the optimal regimen for improving cognitive function in elderly hypertensive patients.

Reduced P300 amplitude in children and adolescents with autism is associated with slowed processing speed, executive difficulties, and social-communication problems.

Selective attention to auditory input is reflected in the brain by an electric amplitude called the P3b amplitude, which is measured using electroencephalography. Previous research has shown that children and adolescents with autism have an attenuated P3b amplitude when they have to attend specific sounds while ignoring other sounds. However, it is unknown whether a reduced P3b amplitude in autistic children and adolescents is associated with their autism features, daily functioning and/or cognitive functions. This study aimed to examine these questions. Therefore, we assessed selective attention to auditory input in 57 children with autism aged 7-14 years and 57 neurotypically developing controls while measuring their brain activity with electroencephalography. Participants further underwent cognitive assessment, and parents reported on autistic traits and daily functioning. As expected, children with autism had lower P3b amplitude compared to their neurotypical peers. Importantly, an attenuated P3b amplitude was associated with more parent-reported social-communication problems and difficulties with daily functioning. Children with autism further had reduced processing speed of visual input, which also was coupled to a lower P3b amplitude. In conclusion, we found attenuated P3b amplitude in children with autism performing an auditory selective attention task, which was related to difficulties with processing visual input and allocating attentional resources critical for social and daily functioning. The results suggest that autistic children are more vulnerable to being disturbed when the environment is filled with conflicting sensory input.

QOL-14. EPILEPTIC SEIZURES, ANTI-SEIZURE MEDICATIONS, AND NEUROCOGNITION IN SURVIVORS OF PEDIATRIC BRAIN TUMORS

Abstract BACKGROUND Younger age at diagnosis and cranial radiation therapy are associated with neurocognitive late complications in survivors of pediatric brain tumors (PBT). Less is known about the association between neurocognition and epileptic seizures, with the latter affecting 27% of 5-year survivors. This study aimed to explore whether epileptic seizures exacerbate neurocognitive late complications beyond treatment and demographic factors. METHODS Fifty-nine survivors of PBT who had experienced at least one epileptic seizure, and a control group of survivors matched on sex, age at diagnosis, and cancer treatment, all diagnosed at Skåne University Hospital, were included in the study. Demographic and clinical variables, along with neurocognitive measures of verbal and non-verbal reasoning, cognitive processing speed, working memory, and cognitive flexibility were collected from medical records. Neuropsychological scores, assessed on average 3.68 years after diagnosis, were transformed into z-scores employing age-adjusted norms (m=0, sd=1). Generalized linear models, controlling for increased intracranial pressure at diagnosis and tumor localization, were used to analyze the association between epileptic seizures, cumulative use of anti-seizure medications (ASM), and neurocognition. RESULTS Experiencing any type of epileptic seizures was associated with reduced processing speed (β = -0.91z, p<0.01) and cognitive flexibility (β =-1.05z, p<0.01). Treatment with one ASM was associated with reduced cognitive processing speed (β =-0.81z, p=0.03), and treatment with two or more ASM was associated with lower scores on measures of non-verbal reasoning (β =-0.81z, p<0.01), working memory (β =-0.77z, p=0.01), processing speed (β=-1.26z, p<0.01), and flexibility (β =-1.54z, p<0.01). CONCLUSIONS Epileptic seizures and treatment with ASM were both associated with neurocognitive late complications. Optimal seizure management presents a potential modifiable factor for reducing cognitive burden in survivors of PBT.

Processing speed and its association with working memory and episodic memory 3-6 months after pediatric mild traumatic brain injury

ABSTRACT Objective Following mild traumatic brain injury (mTBI), children show reduced processing speed (PS). Evidence suggests that slowed PS after TBI is associated with working memory deficits. Our aim was to investigate several forms of PS and to examine its impact on working and episodic memory performance in children after mTBI. Method We included data of 64 children after mTBI and 57 healthy control children aged 8–16 years. PS (Color Naming, Coding, Symbol Search, Alertness) was compared between groups 1 week (T1) and 3–6 months (T2) after the injury; working and episodic memory outcome was compared between groups at T2. Results Alertness at T1 and Color Naming at T1 and T2 were significantly reduced following mTBI compared to controls, although most group differences in PS disappeared when patients with previous impairments and mTBI were excluded. PS was predictive for episodic and working memory performance 3–6 months after injury, whereas group was a significant predictor of working memory. Conclusions Compared to healthy controls, children after mTBI showed reduced performance in verbal PS, which was associated with working memory. In children who are symptomatic after mTBI, diagnostic screening of PS could be helpful in identifying patients that could profit from speed-improving strategies.

Gate-Tunable Positive and Negative Photoconductance in Near-Infrared Organic Heterostructures for In-Sensor Computing.

The rapid growth of sensor data in the artificial intelligence often causes significant reductions in processing speed and power efficiency. Addressing this challenge, in-sensor computing is introduced as an advanced sensor architecture that simultaneously senses, memorizes, and processes images at the sensor level. However, this is rarely reported for organic semiconductors that possess inherent flexibility and tunable bandgap. Herein, an organic heterostructure that exhibits a robust photoresponse to near-infrared (NIR) light is introduced, making it ideal for in-sensor computing applications. This heterostructure, consisting of partially overlapping p-type and n-type organic thin films, is compatible with conventional photolithography techniques, allowing for high integration density of up to 520 devices cm-2 with a 5µm channel length. Importantly, by modulating gate voltage, both positive and negative photoresponses to NIR light (1050nm) are attained, which establishes a linear correlation between responsivity and gate voltage and consequently enables real-time matrix multiplication within the sensor. As a result, this organic heterostructure facilitates efficient and precise NIR in-sensor computing, including image processing and nondestructive reading and classification, achieving a recognition accuracy of 97.06%. This work serves as a foundation for the development of reconfigurable and multifunctional NIR neuromorphic vision systems.

Associations Between Midlife Anticholinergic Medication Use and Subsequent Cognitive Decline: A British Birth Cohort Study.

Anticholinergic medication use is associated with cognitive decline and incident dementia. Our study, a prospective birthcohortanalysis, aimed to determine if repeated exposure to anticholinergic medicationswas associated with greater decline, and whether decline was reversed with medication reduction. From the Medical Research Council (MRC) National Survey of Health and Development, a British birth cohort with all participants born in a single week of March 1946, we quantified anticholinergic exposure between ages 53 and 69 years using the Anticholinergic Cognitive Burden Scale (ACBS). We used multinomial regression to estimate associations with global cognition, quantified bythe Addenbrooke's Cognitive Examination, 3rd Edition (ACE-III). Longitudinal associations between ACBS and cognitive test results (Verbal memory quantifiedby theWord Learning Test [WLT], and processing speed quantified by theTimed Letter Search Task [TLST]) at three time points (age 53, 60-64 and 69) were assessed using mixed and fixed effects linear regression models. Analyses were adjusted for sex, childhood cognition, education, chronic disease count and severity, and mental health symptoms. Anticholinergic exposure was associated cross-sectionally with lower ACE-III scores at age 69, with the greatest effects in those with high exposure at ages 60-64 (mean difference - 2.34, 95% confidence interval [CI] - 3.51 to - 1.17). Longitudinally, both mild-moderate and high ACBS scores were linked to lower WLT scores, again with high exposure showing larger effects (mean difference with contemporaneous exposure - 0.90, 95% CI - 1.63 to - 0.17; mean difference with lagged exposure - 1.53, 95% CI - 2.43 to - 0.64). Associations remained in fixed effects models (mean difference with contemporaneous exposure -1.78, 95% CI -2.85 to - 0.71; mean difference with lagged exposure - 2.23, 95% CI - 3.33 to - 1.13). Associations with TLST were noted only in isolated contemporaneous exposure (mean difference - 13.14, 95% CI - 19.04 to - 7.23; p<0.01). Anticholinergic exposure throughout mid and later life was associated with lower cognitive function. Reduced processing speed was associated only with contemporaneous anticholinergic medication use, and not historical use. Associations with lower verbal recall were evident with both historical and contemporaneous use of anticholinergic medication, and associations with historical use persisted in individuals even when their anticholinergic medication use decreased over the course of the study.

The interplay between polygenic score for tumor necrosis factor-α, brain structural connectivity, and processing speed in major depression

Reduced processing speed is a core deficit in major depressive disorder (MDD) and has been linked to altered structural brain network connectivity. Ample evidence highlights the involvement of genetic-immunological processes in MDD and specific depressive symptoms. Here, we extended these findings by examining associations between polygenic scores for tumor necrosis factor-α blood levels (TNF-α PGS), structural brain connectivity, and processing speed in a large sample of MDD patients. Processing speed performance of n = 284 acutely depressed, n = 177 partially and n = 198 fully remitted patients, and n = 743 healthy controls (HC) was estimated based on five neuropsychological tests. Network-based statistic was used to identify a brain network associated with processing speed. We employed general linear models to examine the association between TNF-α PGS and processing speed. We investigated whether network connectivity mediates the association between TNF-α PGS and processing speed. We identified a structural network positively associated with processing speed in the whole sample. We observed a significant negative association between TNF-α PGS and processing speed in acutely depressed patients, whereas no association was found in remitted patients and HC. The mediation analysis revealed that brain connectivity partially mediated the association between TNF-α PGS and processing speed in acute MDD. The present study provides evidence that TNF-α PGS is associated with decreased processing speed exclusively in patients with acute depression. This association was partially mediated by structural brain connectivity. Using multimodal data, the current findings advance our understanding of cognitive dysfunction in MDD and highlight the involvement of genetic-immunological processes in its pathomechanisms.

Cognitive impairment in children and adolescents living with perinatal HIV disease in the ART era: a meta-analysis

Despite improved survival and overall health outcomes from modern antiretroviral therapy (ART), children and adolescents living with HIV are facing pervasive impairments in neurodevelopment including cognitive impairment, but there remains a lack of consensus on the cognitive domains that are affected in those children and adolescents. The objective of this meta-analysis was to evaluate the impact of perinatal HIV-infection on executive function, working memory, and speed of information processing in the ART era. The PubMed database was searched for studies published between 1997 and 2024, plus additional search with the ScienceDirect, bioRxiv, and medRxiv databases. A meta-analysis was conducted on thirty-five studies published between 2012 and 2023 that encompassed a total of 4066 perinatally-infected HIV patients, 2349 HIV-exposed uninfected (HEU) controls, and 2466 HIV-unexposed, uninfected (HUU) controls. Performance scores on executive function, working memory, and processing speed were pooled using random-effects meta-analysis. Compared to HEU and HUU controls, perinatally HIV-infected children and adolescents presented with significant impairments in processing speed (Hedges g=-0.64, p<0.00001), working memory (Hedges g=-0.69, p<0.00001), and to a lesser degree, executive function (Hedges g=-0.35, p=0.02). Meta-regression analysis suggested that the effect estimate of processing speed impairment negatively correlated with Gross National Income (GNI) per capita of the study countries (CALHIV vs HUU, p=0.0016; CALHIV vs HEU, p=0.0019), even though HIV-infected cases were compared to sociodemographically matched HUU controls from the same countries. Sub-group meta-analyses with participants from high-income or low-/middle-income countries provided further evidence suggesting that the performance gap between HIV-infected cases and HUU/HEU controls may be larger in low-/middle-income countries than high-income countries. In the ART era, cognitive impairment (especially reduced processing speed and working memory) persists in children and adolescents living with HIV. These impairments may be more pronounced among those children and adolescents living with HIV in low-income countries, suggesting that there may be global health inequities in treatment outcomes with perinatal HIV-infection. However, meta-analysis and meta-regression analysis have their limitations, which calls for future collaborative multi-country international studies to directly investigate this important topic. Nevertheless, there is an unmet need to assure equity in timely assessments and interventions to optimize neurocognitive development and outcomes among children and adolescents with perinatal HIV globally. This research was supported in part by NIH R01MH108466, NIH R56NS124422, and NIH R01NS124422.

Attentional deficits in fibromyalgia: an ERP study with the oddball dual task and emotional stroop task

The present study investigated the neural correlates of attentional deficits in fibromyalgia through an Oddball Dual Task and an Emotional Stroop Task, both performed during EEG recordings. Thirty female participants were recruited, being divided into two groups: a group of patients with fibromyalgia (FM, n = 15, Mage = 51.87, SDage = 7.12) and a healthy control group (HC, n = 15, Mage = 46.13, SDage = 8.41). In the Emotional Stroop Task, the behavioural results showed that patients with FM had less hits and longer times reactions than healthy controls. These results were consistent with those obtained with our Event-related Potential (ERP) methodology, which evidenced that patients with FM had higher frontal latencies in the P200 time-window compared to healthy controls. Regarding the Oddball Dual Task, we found that patients with FM had lower P300 amplitudes than healthy participants. Moreover, we found that rare stimuli elicited higher P300 amplitudes than frequent stimuli for healthy controls, but this comparison was non-significant for patients with FM. Taken together, our results suggest that fibromyalgia may be associated to a reduced processing speed, along to reduced neural resources to process stimuli, mainly in distinguishing relevant (rare) and irrelevant (frequent) stimuli according to the goals of the task. Altogether, our results seem to support the hypothesis of generalized attentional deficits in FM.

Pericardial Effusion Detection on Post-Mortem Computed Tomography Images Using Convolutional Neural Networks.

Pericardial effusion can be a sign of significant underlying diease and, in some cases, may lead to death. Post-mortem computed tomography (PMCT) is a well-established tool to assist death investigation processes in the forensic setting. In practice, the scarcity of well-trained radiologists is a challenge in processing raw whole-body PMCT images for pericardial effusion detection. In this work, we propose a Pericardial Effusion Automatic Detection (PEAD) framework to automatically process raw whole-body PMCT images to filter out the irrelevant images with heart organ absent and focus on pericardial effusion detection. In PEAD, the standard convolutional neural network architectures of VGG and ResNet are carefully modified to fit the specific characteristics of PMCT images. The experimental results prove the effectiveness of the proposed framework and modified models. The modified VGG and ResNet models achieved superior detection accuracy than the standard architecture with reduced processing speed.

Cognitive impairment in post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) is a common mental health disorder, with an incidence of up to 12.5% among primary care patients. Most often, PTSD is detected in combat veterans, victims of terrorist attacks and terror, but it can also be a consequence of traumatic brain injury and medical interventions. Impaired cognitive functioning is a key feature of PTSD, including attention deficits and reduced processing speed, executive dysfunction, and impairments in verbal learning and memory. Cognitive impairments in PTSD are significantly persistent and are largely similar in nature to neuropsychological impairments in neurodegenerative pathology. Possible pathogenetic mechanisms underlying PTSD are the development of neuroinflammation, oxidative stress and decreased production of neurotrophic factors. One of the promising areas of treatment is the use of Cerebrolysin, which has powerful neurotrophic and anti-inflammatory activity.

Proton Therapy Mediates Dose Reductions to Brain Structures Associated With Cognition in Children With Medulloblastoma

Background: Emerging evidence suggests proton radiotherapy may offer cognitive sparing advantages over photon radiotherapy, yet dosimetry has not been compared previously. The purpose of this study is to examine dosimetric correlates of cognitive outcomes in children with medulloblastoma treated with proton vs. photon radiotherapy.Methods: In this retrospective, bi-institutional study, dosimetric and cognitive data from 75 patients (39 photon and 36 proton) were analyzed. Doses to brain structures were compared between treatment modalities. Linear mixed effects models were used to create models of global IQ and cognitive domain scores.Results: The mean dose and dose to 40% of the brain (D40) were 2.7 and 4.1 Gy less among proton-treated patients as compared to photon-treated patients (p = 0.03 and 0.007, respectively). Mean doses to the left and right hippocampi were 11.2 Gy lower among proton-treated patients (p < 0.001 for both). Mean doses to the left and right temporal lobes were 6.9 and 7.1 Gy lower with proton treatment, respectively (p < 0.001 for both). Models of cognition found statistically significant associations between higher mean brain dose and reduced verbal comprehension, increased right temporal lobe D40 with reduced perceptual reasoning, and greater left temporal mean dose with reduced working memory. Higher brain D40 was associated with reduced processing speed and global IQ scores.Conclusions: Proton therapy reduces doses to normal brain structures as compared with photon treatment. This leads to reduced cognitive decline post-RT across multiple intellectual endpoints. Proton therapy should be offered to children receiving radiation for medulloblastoma.-Proton therapy for medulloblastoma delivers less dose to brain structures.-Less dose to brain structures leads to cognitive gain.-Children with medulloblastoma should be offered proton therapy.

B - 105 Long COVID: a Pediatric Neuropsychological Case Study.

A neuropsychological case review of Long COVID. Long COVID remains to be a controversial topic in terms of cognitive residuals from contracting the virus. This child was referred due to acute cognitive changes post-COVID-19 contraction. Active COVID-19 infection was generally unremarkable. Patient did not require hospitalization or medication intervention. This patient is a 14-year-old, Caucasian, right-handed male. A psychiatrist referred the patient due to emotional (anxiety and oppositionality), cognitive (attention, reduced processing, memory, "brain fog,"), and physical (disrupted sleep, fatigue) changes post-infection. The diagnostic question was to rule out ADHD and oppositionality prior to obtaining MRI results. MRI of the brain, 30days post-infection, revealed multiple subcortical white matter lesions, located in the cerebral hemispheres near the grey-white matter junction, particularly in the frontal and parietal lobes. Patient was administered the Meyers Neuropsychological Battery (MNB). Findings were consistent with diffuse neuropsychological deficits, that is, reduced processing speed, impaired attention, and below average immediate and delayed memory (spatial > verbal). Psychological findings were consistent with an ongoing anxiety disorder. Initial diagnostic impression of ADHD and oppositional defiance was ruled-out. MNB analysis revealed a pattern of findings consistent with diffuse neuropsychological deficits relating to an inflammatory condition such as Long COVID. Memory, attention, and processing speed were below the cut-off, a finding in agreement with previous research showing impaired results, especially for memory. Because memory, as well as fatigue, seems to be affected by COVID-19, future research should explore possible interactions with cognition and fatigue following COVID-19.

B - 09 Neuropsychological Impacts and Cognitive Effects of Pediatric Leukemia Treatment.

The current study seeks to investigate the neuropsychological and cognitive late effects of pediatric Acute Lymphoblastic Leukemia (ALL) treatment. A search for peer-reviewed articles was conducted. Google Scholar was searched using keywords including neuropsychology, neuro-cognitive, neuropsychological effects, neuropsychological battery, neuropsychological impacts, cognitive effects, cognitive impacts, pediatric, pediatric leukemia, acute lymphoblastic leukemia treatment, bone marrow transplant, whole brain radiation, whole-body radiation, chemotherapy, cranial radiotherapy, health psychology, and neuropsychological testing. Articles were included if they discussed neuropsychology and ALL. Articles with non-human subjects and case studies were excluded from the study. Fifty-nine studies were included in the study. Treatments for ALL result in impairments in working memory, reduced processing speed, attention deficits, executive functioning deficits, visual-spatial and visuomotor weakness, fine motor weakness, deficits in delayed memory, an initial decline in performance IQ, and a delayed decline in verbal abilities such as attention and reading. The initial decline in performance abilities following a late decline in verbal abilities seen in patients who have undergone CRT may be due to structural changes in the white and gray matter following CRT treatment. Healthcare providers should attend to patients' cognitive complaints, particularly as they pertain to patients' ability to adhere to treatment recommendations and subsequently to their ability to resume attending school or social roles. As patient and parent complaints of cognitive compromise are associated with psychological distress and functional decline, cognitive complaints could justify further in-depth neuropsychological assessment to mobilize comprehensive supportive care or rehabilitative services.

Cognitive dysfunction in post-COVID-19 condition: Mechanisms, management, and rehabilitation.

The long-term effects of COVID-19 on cognitive function have become an area of increasing concern. This paper provides an overview of characteristics, risk factors, possible mechanisms, and management strategies for cognitive dysfunction in post-COVID-19 condition (PCC). Prolonged cognitive dysfunction is one of the most common impairments in PCC, affecting between 17% and 28% of the individuals more than 12 weeks after the infection and persisting in some cases for several years. Cognitive dysfunctions can be manifested as a wide range of symptoms including memory impairment, attention deficit, executive dysfunction, and reduced processing speed. Risk factors for developing PCC, with or without cognitive impairments, include advanced age, preexisting medical conditions, and the severity of acute illness. The underlying mechanisms remain unclear, but proposed contributors include neuroinflammation, hypoxia, vascular damage, and latent virus reactivation not excluding the possibility of direct viral invasion of the central nervous system, illustrating complex viral pathology. As the individual variation of the cognitive impairments is large, a neuropsychological examination and a person-centered multidimensional approach are required. According to the World Health Organization, limited evidence on COVID-19-related cognitive impairments necessitates implementing rehabilitation interventions from established practices of similar conditions. Psychoeducation and compensatory skills training are recommended. Assistive products and environmental modifications adapted to individual needs might be helpful. In specific attention- and working memory dysfunctions, cognitive training-carefully monitored for intensity-might be effective for people who do not suffer from post-exertional malaise. Further research is crucial for evidence-based interventions specific to COVID-19-related cognitive impairments.

Endoscopic image classification algorithm based on Poolformer.

Image desmoking is a significant aspect of endoscopic image processing, effectively mitigating visual field obstructions without the need for additional surgical interventions. However, current smoke removal techniques tend to apply comprehensive video enhancement to all frames, encompassing both smoke-free and smoke-affected images, which not only escalates computational costs but also introduces potential noise during the enhancement of smoke-free images. In response to this challenge, this paper introduces an approach for classifying images that contain surgical smoke within endoscopic scenes. This classification method provides crucial target frame information for enhancing surgical smoke removal, improving the scientific robustness, and enhancing the real-time processing capabilities of image-based smoke removal method. The proposed endoscopic smoke image classification algorithm based on the improved Poolformer model, augments the model's capacity for endoscopic image feature extraction. This enhancement is achieved by transforming the Token Mixer within the encoder into a multi-branch structure akin to ConvNeXt, a pure convolutional neural network. Moreover, the conversion to a single-path topology during the prediction phase elevates processing speed. Experiments use the endoscopic dataset sourced from the Hamlyn Centre Laparoscopic/Endoscopic Video Dataset, augmented by Blender software rendering. The dataset comprises 3,800 training images and 1,200 test images, distributed in a 4:1 ratio of smoke-free to smoke-containing images. The outcomes affirm the superior performance of this paper's approach across multiple parameters. Comparative assessments against existing models, such as mobilenet_v3, efficientnet_b7, and ViT-B/16, substantiate that the proposed method excels in accuracy, sensitivity, and inference speed. Notably, when contrasted with the Poolformer_s12 network, the proposed method achieves a 2.3% enhancement in accuracy, an 8.2% boost in sensitivity, while incurring a mere 6.4 frames per second reduction in processing speed, maintaining 87 frames per second. The results authenticate the improved performance of the refined Poolformer model in endoscopic smoke image classification tasks. This advancement presents a lightweight yet effective solution for the automatic detection of smoke-containing images in endoscopy. This approach strikes a balance between the accuracy and real-time processing requirements of endoscopic image analysis, offering valuable insights for targeted desmoking process.