Repeatable Battery For The Assessment Of Neuropsychological Status Scores Research Articles

Differences in fractional amplitude of low-frequency fluctuations (fALFF) and cognitive function between untreated major depressive disorder and schizophrenia with depressive mood patients

BackgroundDistinguishing untreated major depressive disorder without medication (MDD) from schizophrenia with depressed mood (SZDM) poses a clinical challenge. This study aims to investigate differences in fractional amplitude of low-frequency fluctuations (fALFF) and cognition in untreated MDD and SZDM patients.MethodsThe study included 42 untreated MDD cases, 30 SZDM patients, and 46 healthy controls (HC). Cognitive assessment utilized the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Resting-state functional magnetic resonance imaging (rs-fMRI) scans were conducted, and data were processed using fALFF in slow-4 and slow-5 bands.ResultsSignificant fALFF changes were observed in four brain regions across MDD, SZDM, and HC groups for both slow-4 and slow-5 fALFF. Compared to SZDM, the MDD group showed increased slow-5 fALFF in the right gyrus rectus (RGR). Relative to HC, SZDM exhibited decreased slow-5 fALFF in the left gyrus rectus (LGR) and increased slow-5 fALFF in the right putamen. Changes in slow-5 fALFF in both RGR and LGR were negatively correlated with RBANS scores. No significant correlations were found between remaining fALFF (slow-4 and slow-5 bands) and RBANS scores in MDD or SZDM groups.ConclusionsAlterations in slow-5 fALFF in RGR may serve as potential biomarkers for distinguishing MDD from SZDM, providing preliminary insights into the neural mechanisms of cognitive function in schizophrenia.

Study on the Correlation between Hcy and Hs-CRP Levels and Cognitive Function in Patients with Bipolar Disorder and Borderline Personality Disorder.

This study aims to explore the correlation and clinical significance of homocysteine and high-sensitivity C-reactive protein levels with cognitive function in patients with bipolar disorder (BD) and borderline personality disorder (BPD). Patients with BD admitted to our hospital from January 2022 to December 2022 were chosen retrospectively. BPD patients were categorized into comorbidity groups, while those without BPD were assigned to non-comorbidity groups, each consisting of 60 cases. Enzyme-linked immunosorbent assay (ELISA) was utilized to assess serum levels of homocysteine (Hcy) and high-sensitivity C-reactive protein (hs-CRP) in both patient groups. Clinical symptoms were evaluated by the Hamilton Depression Rating Scale (HAMD) and the Young Mania Rating Scale (YMRS). Cognitive function was evaluated and compared using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Pearson correlation analysis was performed on the correlation between patients' serum Hcy and hs-CRP levels and HAMD, YMRS, and RBANS scores. In the comorbidity group, patients exhibited significantly elevated serum Hcy and hs-CRP levels compared to the non-comorbidity group (p < 0.05). Patients in the comorbidity group displayed higher HAMD and YMRS scores than those in the non-comorbidity group (p < 0.05). Additionally, attention, speech, visual span, immediate memory, and delayed memory in the comorbidity group were notably lower than in the non-comorbidity group (p < 0.05). The speech, visual span, and immediate memory of RBANS in bipolar depressive patients with comorbid BPD were lower than those in bipolar depressive patients without comorbid BPD (p < 0.05), the speech of RBANS in bipolar manic patients with comorbid BPD was lower than those in bipolar manic patients without comorbid BPD (p < 0.05). Pearson correlation analysis showed that the expression of Hcy and hs-CRP in the comorbid group was positively correlated with HAMD and YMRS scores, and negatively correlated with attention, speech, visual span, immediate memory, and delayed memory, and these differences were statistically significant (p < 0.05). High serum Hcy and hs-CRP expression levels may regulate inflammatory responses, aggravating cognitive impairment in patients with BD and BPD. Serum Hcy and hs-CRP expression levels are significantly related to cognitive dysfunction. They are expected to guide the prevention and treatment of BD comorbid BPD patients.

Reduced skeletal muscle mass to visceral fat area ratio is independently associated with reduced cognitive function in type 2 diabetes mellitus

AimSkeletal muscle mass to visceral fat area ratio (SVR) has been recognised as an index of sarcopenic obesity. SVR is associated with type 2 diabetes mellitus (T2DM), metabolic syndrome and arterial stiffness which are known risk factors for cognitive dysfunction. We aimed to investigate association between SVR and cognitive function in patients with T2DM. MethodsThis was a cross-sectional study of 1326 patients with T2DM and mean age 61.3 ± 8.0 years. SVR was assessed based on bioelectrical impedance measurements of muscle mass and visceral fat area (VFA). Cognitive function was assessed using Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Linear regression was used to examine the association between SVR in quartiles and RBANS score, adjusting for demographics, education, presence of depressive symptoms, clinical covariates and medications. ResultsThe lower SVR quartiles were negatively associated with RBANS total score in the unadjusted analysis. The corresponding coefficients for Quartiles 1 and 2 SVR were −3.79 (95 % CI −5.39 to −2.19; p < 0.001) and −1.47 (95 % CI −2.86 to −0.07; p = 0.039) in fully adjusted analysis. The negative association between Quartile 1 SVR and RBANS score was evident in immediate memory, delayed memory, visuo-spatial construction, language and attention domains. Muscle mass and VFA alone had weaker associations with RBANS scores. ConclusionOur study demonstrated, for the first time, an independent association between reduced SVR and lower cognitive function. This is evident in global and multiple cognitive domains. The synergistic effects of reduced muscle mass and visceral obesity may be more pronounced than their independent effects on cognitive function.

Impaired Cognitive Function in Immune-TTP Is Better Predicted By Serum Thrombomodulin Than ADAMTS13 Activity: Results of a Longitudinal Multicenter Pilot Study

Background: High rates of mood disorders and cognitive dysfunction in immune-mediated thrombotic thrombocytopenic purpura (iTTP) survivors have been observed. However, there are no long-term prospective studies to precisely define the proportion of affected patients, rate of progression, and underlying mechanisms. We hypothesized that a large-scale multicenter study is essential to determine the natural history of these complications. Thus, we conducted a multicenter pilot study of iTTP patients in remission to assess feasibility, study design, and explore novel biomarkers. Given ADAMTS13 deficiency during remission is a risk factor for stroke, we also hypothesized that low ADAMTS13 activity predisposes patients to cognitive impairment. Methods: We aimed to enroll 50 participants from 3 USTMA Consortium sites, prospectively including adult iTTP patients (age ≥ 18 years) in clinical remission (ADAMTS13 remission was not required) for at least 90 days. Diagnosis of iTTP relied on ADAMTS13 activity &amp;lt;10% during an acute TMA episode. Over 2 years, participants underwent comprehensive assessments of mental and physical health, cognition, ADAMTS13 activity, and biomarker sample collection every 3 months. Study assessments included: Beck Anxiety Index (BAI), Beck Depression Index-II (BDI), Headache Impact Test (HIT-6), SF-36v2 (health-related quality of life), and CPT-3 (computer-based assessment of reaction-time, attention, and processing speed). Cognition was assessed annually (entry, year 1 and close) using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), with the Montreal Cognitive Assessment (MoCA) substituted the other visits. Results: Between September 2019 and July 2022, we enrolled 38 of 50 planned participants. Of the 38 enrolled, 16 completed the study (42.1%) 11 were lost to follow up because they did not complete the close-out visit (29%), and 11 have not yet completed the study (29%). After excluding lost subjects, we found that 131 of 221 visits were completed (59%). Demographics and burden of mental and physical health impairments are shown (Figure A). At enrollment, 45% (15/33) had at least moderate anxiety on BAI, and 45 % (15/33) had at least moderate depression on BDI. HIT-6 revealed69.7 % (23/33) had clinically significant headaches warranting referral to a specialist (median score 57, IQR 47-63). SF-36 found increased fatigue (median fatigue score of 30, population mean 52.15) and pain (median 57.5, population mean 78.77), as well as impairments in social functioning (median 50, population mean 78.77) and general health (median 35, population mean 56.99). The The CPT-3 test (see table) was highly unacceptable to some participants at all sites. RBANS scores at enrollment detected overall cognitive impairment (median score 18 th %ile) with marked deficiencies in immediate memory (median score 11 th %ile), visuospatial construction (median score 10 th %ile), and milder impairments in language and delayed memory with no evidence of attention deficits. We collected several novel biomarkers and observed a correlation between serum CD141 (thrombomodulin) and overall RBANS scores (Figure B) when compared between participants above and below the median baseline CD141. This association was not seen with ADAMTS13, or the other biomarkers collected (Syndecan-1, Vascular adhesion protein-1, E-selectin). Conclusions: In this pilot study, we found a high attrition rate, likely due to the frequency of study visits and the COVID-19 pandemic. We conclude a larger study is feasible but should account for high attrition, employ less frequent study visits, and avoid unacceptable study assessments to reduce lost subjects. Enrollment findings confirmed previous single-center reports of high prevalence of mental health disorders, reduced physical health, and subtle but measurable cognitive deficits. The CPT-3 test should be excluded from future studies due to poor acceptance. Surprisingly, we found no association between lower ADAMTS13 activity and cognitive impairment but observed a significant link between serum CD141 and cognitive impairment. These findings suggest CD141 is potentially a sensitive biomarker for risk of cognitive impairment during remission and may suggest a novel mechanism. A longer-term study with more subjects will be essential to fully explore the clinical and therapeutic implications of these findings.

Neural association between cognitive function and anhedonia in adolescents with melancholic major depressive disorder: A fNIRS study

BackgroundCognitive dysfunction is common among adolescent patients with major depressive disorder (MDD). However, the pattern and magnitude of cognition impairment in patients during melancholic episodes remains unclear. The purpose of this study was to compare the neurocognitive performance and the underlying cerebral blood flow activation of adolescent patients with melancholic and non-melancholic features. MethodsFifty-seven and 44 adolescent patients with MDD with or without melancholic feature (MDD-MEL/nMEL) and 58 healthy controls (HCs) were recruited. We used the repeatable battery for the assessment of neuropsychological status (RBANS) measuring neurocognitive function, and used functional near infrared spectroscopy (fNIRS) monitoring cerebral hemodynamic changes, described by β value. The non-parametric test and post-hoc analysis were conducted in RBANS scores and β values among three groups. Spearman correlation and mediating analysis was performed for RBANS scores, β values, and clinical symptoms in the MDD-MEL group. ResultsThere were no significant difference in RBANS scores between MDD-MEL and MDD-nMEL group. Compared with patients in MDD-nMEL, patients in MDD-MEL have lower β values in eight channels (ch10, ch16, ch20, ch25, ch27, ch37, ch41, ch45). The cognitive function is significantly correlated with anhedonia, and the β values play a partial mediating role between anhedonia and cognitive function. LimitationIt's a cross-sectional study and monitoring longitudinal effects are needed to further elucidate the mechanism. ConclusionThe cognitive function in adolescents with MDD-MEL may not significantly differ from those with MDD-nMEL. However, the anhedonia may influenced the cognitive function by altering the function of medial frontal cortex.

Home-Based Electronic Cognitive Therapy in Patients With Alzheimer Disease: Feasibility Randomized Controlled Trial.

BackgroundCan home-based computerized cognitive training programs be a useful tool to sustain cognition and quality of life in patients with Alzheimer disease (AD)? To date, the progressive nature of the disease has made this question difficult to answer. Computerized platforms provide more accessibility to cognitive trainings; however, the feasibility of long-term, home-based computerized programs for patients with AD dementia remains unclear.ObjectiveWe aimed to investigate the feasibility of a 24-week home-based intervention program using the Constant Therapy app and its preliminary efficacy on cognition in patients with AD. Constant Therapy is a program developed for patients with speech and cognitive deficits. We hypothesized that patients with AD would use Constant Therapy daily over the course of the 24-week period.MethodsData were collected over a 48-week period. We recruited participants aged between 50 and 90 years with a diagnosis of mild cognitive impairment due to AD or mild AD dementia. Participants were randomly assigned to either the Constant Therapy (n=10) or active control (n=9) group. The Constant Therapy group completed a tablet-based training during the first 24 weeks; the second 24 weeks of computerized training were optional. The active control group completed paper-and-pencil games during the first 24 weeks and were invited to complete an optional Constant Therapy training during the second 24 weeks. Every 6 weeks, the participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The participants independently accessed Constant Therapy using an Apple iPad. Our primary feasibility outcomes were the rate of adherence and daily use of Constant Therapy over 24 weeks. Our secondary outcomes were Constant Therapy performance over 24 weeks and change in RBANS scores between the 2 experimental groups.ResultsFeasibility analyses were computed for participants who completed 24 weeks of Constant Therapy. We found that long-term use of the Constant Therapy program was feasible in patients with AD over 24 weeks (adherence 80%; program use 121/168 days, for 32 minutes daily). These participants showed an overall improvement in accuracy and latency (P=.005) in the Constant Therapy scores, as well as specific improvements in visual and auditory memory, attention, and arithmetic tasks. The Constant Therapy group showed improvement in the RBANS coding subtest. No unexpected problems or adverse events were observed.ConclusionsLong-term (eg, 24 weeks) computerized cognitive training using Constant Therapy is feasible in patients with AD in the mild cognitive impairment and mild dementia stages. Patients adhered more to Constant Therapy than to the paper-and-pencil training over 24 weeks and improved their performance over time. These findings support the development of future randomized controlled trials that will investigate the efficacy of Constant Therapy to sustain cognitive function in patients with AD.Trial RegistrationClinicalTrials.gov NCT02521558; https://clinicaltrials.gov/ct2/show/NCT02521558

A-125 Sex Moderates the Positive Effects of Sleep Schedule Consistency on Cognitive Function

Abstract Objective: Negative effects of reduced sleep duration and consistency on cognition are well-known. It is also well-known that both decline with age. While emerging research finds that sex interacts with sleep duration, less is known about whether sex interacts with sleep schedule consistency to predict cognitive performance. We hypothesized that reduced sleep consistency would negatively impact cognitive performance and that women would be less affected by inconsistent sleep based on suggested protective effects of brain organization in sleep-deprived women (Corsi-Carbrera et al., 2003). Methods: Participants (N = 77, 96.3% White) were selected from a parent study of community-dwelling older adults. Inclusion criteria: complete demographic data, Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) index scores, and self-reported sleep data. The sample was majority female and well-educated. Results: RBANS performance and sleep measures were within normal limits (see Table). There was a significant main effect of sleep consistency across all RBANS scores, controlling age, education, and sleep duration. There were significant main effects of sex on Immediate Memory, Attention, and Total score. Interactions between sleep consistency and sex were significant for Immediate Memory, Delayed Memory, and Total score. Conclusions: Sleep consistency is associated with better cognitive performance across domains. Women perform better than men globally and in domains of immediate memory and attention, regardless of consistency. Women who sleep consistently are most likely to exhibit better memory and global cognitive function. Findings extend sleep duration effects on cognitive function to variability and suggest consistency may benefit women more than men.

Repeatable Battery for the Assessment of Neuropsychological Status: Italian Normative Data for Older Adults.

The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), widely used for detecting cognitive impairment in different neuropsychiatric conditions, is increasingly applied for measuring cognitive functioning in older individuals. Available normative data for RBANS Italian version suffer from under-representation of the older ages (>60years) and are not corrected for education. Moreover, normative data are provided only for Indexes and Total scores. We thus administered RBANS Italian version in a larger sample of older adults, taking into account the effect of age, education and gender on all scores. We used a regression-based model to assess the effect of age, education, and gender on RBANS Subtests, Indexes and Total scores in a consecutive series of healthy cognitively normal volunteers aged 60-79years (N = 158). The obtained norms were compared with the Italian original normative data by means of Wilcoxon rank-sum test. Multiple linear regression analyses showed that age and educational level significantly influence performances on most RBANS scores. A free-to-use Excel to calculate subject's percentiles for any single score was developed. When compared with original normative values, our percentiles distribution of Indexes and Total scores did not reveal significant differences (p > .05). The obtained normative data show good concordance with previous norms. The instrument seems not significantly affected by educational level. The possibility to correct for any single score could make RBANS a more precise measure for capturing subtle cognitive deficits in prevention studies.

Cortical auditory evoked potentials, brain signal variability and cognition as biomarkers to detect the presence of chronic tinnitus

The current limited understanding of tinnitus neurophysiology is one of the major obstacles in developing effective treatments for chronic tinnitus. As such, there is an urgent need for knowledge on underlying neural and/or neurobehavioral correlates that might function as potential biomarkers for tinnitus. We aimed to develop a model for the detection of tinnitus cases based on such potential biomarkers. In a first step, data from twenty patients suffering from chronic tinnitus, but no concurrent hearing loss or psychological complaints, were compared to data from twenty matched controls. Cortical auditory evoked potentials (CAEP) were elicited using a standard oddball paradigm. Source estimation and brain signal variability were analyzed to investigate putative differences between tinnitus patients and controls. Other examinations included standard audiometry, speech understanding in quiet and noisy conditions, and cognitive testing using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The P300 component, a response to unexpected but relevant stimuli, was significantly reduced in the tinnitus group. Source estimation revealed that the response of tinnitus patients was characterized by a decreased activity in temporal cortex, parahippocampus and insula. Brain signal variability on fine time scales was significantly higher in the tinnitus group, suggesting that tinnitus patients rely more strongly on local information processing. Furthermore, tinnitus was associated with a decreased cognitive performance, especially on tasks measuring delayed memory. In a second step, a logistic regression model was constructed based on CAEP activity, brain signal variability and RBANS scores. This model performed significantly above chance level when detecting tinnitus cases in an unseen dataset (accuracy of 75%, area under the ROC curve of 0.86). The successful classification between tinnitus cases and controls demonstrates the potential value of the proposed combination of biomarkers. Moreover, the identified associations between tinnitus, auditory evoked activity and cognitive performance point towards a significant contribution of top-down information processing in the perception of tinnitus.

Gender Differences of Schizophrenia Patients With and Without Depressive Symptoms in Clinical Characteristics.

Objectives: To investigate the differences in psychotic symptoms and cognitive function in schizophrenics with and without depression and to compare gender differences in the correlation between depressive symptoms and clinical characteristics in those patients.Methods: A total of 190 schizophrenia patients and 200 healthy controls were recruited in the study. We used the Positive and Negative Symptom Scale (PANSS), the Calgary Depression Scale for Schizophrenia (CDSS) and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) to evaluate the psychiatric symptoms, depressive symptoms and cognitive function, respectively. Patients with CDSS score ≥7 were divided into depression group, and CDSS < 7 was viewed as without depression.Results: Patients with schizophrenia had lower total scores of RBANS and five subscale (immediate memory, visual span, verbal function, attention, and delayed memory) scores compared to healthy controls. In the case group, patients who concomitant with depression had higher PANSS scores (Ps < 0.001) and lower RBANS (Ps < 0.05) scores than those without depression. After gender stratification, PANSS total scores and subscale scores were significantly different between schizophrenics with and without depressive symptoms in both male and female groups (Ps < 0.001). For cognitive function, there were significant differences in RBANS total score and subscale scores except attention between female patients with and without schizophrenia but not in male schizophrenia patients. Furthermore, the correlation analysis showed that the total CDSS score was positively correlated with PANSS score (P < 0.001) and RBANS score in male and female groups (male: P = 0.010, female: P = 0.001).Conclusion: Our findings provided evidence supporting the gender differences in psychiatric symptoms and cognitive function between schizophrenia patients with and without depressive symptoms.

Identifying obstructive sleep apnea in geriatric outpatients with neuropsychological testing

AbstractBackgroundObstructive sleep apnea (OSA) is common in geriatric patients and has been associated with neurocognitive disorders such as Alzheimer’s disease and other dementias. Dexter and Ebert (2019) reported a unique pattern of lower scores for immediate memory relative to delayed memory was observed in patients with OSA on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The aim of the current investigation was to examine the frequency of confirmed OSA diagnosis in persons with snoring and immediate memory scores less than delayed memory scores in ambulatory geriatric patients referred for memory assessment.MethodPatients were initially assessed for memory complaints at the University of Wisconsin‐Madison Geriatric Memory Assessment Clinic (2016 ‐2020). All patients completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS, Randolph, 1998, 2012) as part of a multidisciplinary evaluation. Patients were referred for a sleep evaluation if sleep disordered breathing was reported and the score difference was noted with immediate memory being less than delayed memory on RBANS. Sleep evaluations consisted of either home sleep testing or polysomnography, based on clinical indication. Board‐certified sleep medicine physicians interpreted all sleep studies, and graded the severity of OSA as mild, moderate, or severe.ResultResults are depicted in Table 1. There were 251 patients referred for sleep evaluation (mean age 75.5 years). Of these, 158 patients completed sleep testing (93 males; 65 females), of which 127 (80.4%) were ultimately diagnosed with OSA. Among sleep study completers, 72 (57%) had moderate or worse sleep apnea. The proportion of cases with moderate or worse sleep apnea was similar for male (59%) and female (53%) completers.ConclusionThis retrospective investigation involved geriatric memory clinic patients with RBANS scores that were lower in immediate memory compared to delayed memory and evidence of snoring that resulted in a referral for a sleep study. The finding of OSA in 80% of the patients evaluated, and the comparable results of male and female patients suggests that all patients who snore and have this unique RBANS profile should be assessed for OSA.

Acute Inositol-Stabilized Arginine Silicate Improves Cognitive Outcomes in Healthy Adults.

Inositol-stabilized arginine silicate (ASI) is an ergogenic aid that upregulates nitric oxide. Acute ASI supplementation improves working memory and processing speed in young adults but there is a lack of data examining other cognitive tasks. Therefore, the purpose of this study was to examine acute ASI effects on young healthy adults by assessing multiple cognitive domains. Nineteen young adults (20.9 ± 3.2 years) completed this randomized, double-blind, crossover study consuming ASI (1.5 g ASI + 12 g dextrose) and placebo (12 g dextrose). The participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and two digital cognitive assessments before consuming the supplement and then completed the same battery of tests 60 min post-supplementation. Repeated measures ANOVA demonstrated that ASI consumption significantly improved total RBANS and immediate memory scores compared to the placebo (p < 0.05). However, no significant differences were displayed between trials for other cognitive domains (p > 0.05). Acute ASI ingestion increased overall RBANS scores and immediate memory scores in young adults. More research is needed to examine the acute effects of ASI on other domains of cognition, in older populations, and its long-term effects on cognition.

Abstract 8931: The Role of Preoperative Hypertension on Neurocognitive Decline After Cardiac Surgery

Introduction: Up to 80% of patients experience postoperative neurocognitive decline (pNCD) after cardiac surgery with cardiopulmonary bypass. Objective: We sought to identify the role of pre-op blood pressure (BP) control in pNCD and describe potential contributing mechanisms. Methods: Eligible patients undergoing cardiac surgery with the use of CPB were administered the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) preoperatively and at post-op day 4. We examined 31 patients in this pilot study, of whom 13 experienced pNCD. The highest systolic BP measured within 3 months (maxBP), and the average BP (aBP) taken at clinic visits within 1 year of surgery were used as metrics for BP. T-tests, chi-squared tests, and regression analyses were used. Blood samples were collected 6 hours preoperatively and at postop day 4 to assess cytokine levels (TNFa, C3a, CRP, IL-6) and mRNA expression using Applied Biosystems™ Clariom™ D Pico Assay. Results: Patients who maintained an aBP of ≥130mmHg had greater RBANS deficit than their counterparts (n=19, n=12 respectively; p&lt;0.005). There was also a linear relationship between aBP and RBANS score deficit (F&lt;0.04, adjusted R=11%). These relationships persisted within the younger half patients (n=16, p&lt;0.01) vs. older (n=15, p=0.16). Of patients with stage 2 hypertension or above (≥140mmHg, N=12) 67% experienced pNCD vs. 26% (p=0.02). Within hypertensive patients postoperatively, C3a was upregulated in patients who experienced pNCD (p&lt;0.04). Upon genomic analysis, macrophage markers were uniquely upregulated preoperatively, and genes involved in heme biosynthesis, glutathione synthesis, IL-10 inflammatory attenuation, and oxidative stress attenuation were downregulated postoperatively among patients who maintained an aBP of ≥130mmHg. Conclusions: BP control prior to surgery may play a role in pNCD. Genomic analysis explains a mechanism: upregulated immune response markers preoperatively and a weaker attenuation of oxidative stress and inflammation postoperatively. These effects are more robust among younger patients. The stage of preoperative hypertension may also influence the frequency of pNCD.

Cross-sectional associations of housework with cognitive, physical and sensorimotor functions in younger and older community-dwelling adults: the Yishun Study

ObjectivesRegular moderate-to-vigorous intensity recreational physical activity (PA) improves physical and cognitive functions. However, the age-associated relationships between non-recreational PA and functional ability remain less explored. We examined the associations between...

Impaired interaural correlation processing in people with schizophrenia.

Detection of transient changes in interaural correlation is based on the temporal precision of the central representations of acoustic signals. Whether schizophrenia impairs the temporal precision in the interaural correlation process is not clear. In both participants with schizophrenia and matched healthy-control participants, this study examined the detection of a break in interaural correlation (BIC, a change in interaural correlation from 1 to 0 and back to 1), including the longest interaural delay at which a BIC was just audible, representing the temporal extent of the primitive auditory memory (PAM). Moreover, BIC-induced electroencephalograms (EEGs) and the relationships between the early binaural psychoacoustic processing and higher cognitive functions, which were assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), were examined. The results showed that compared to healthy controls, participants with schizophrenia exhibited poorer BIC detection, PAM and RBANS score. Both the BIC-detection accuracy and the PAM extent were correlated with the RBANS score. Moreover, participants with schizophrenia showed weaker BIC-induced N1-P2 amplitude which was correlated with both theta-band power and inter-trial phase coherence. These results suggested that schizophrenia impairs the temporal precision of the central representations of acoustic signals, affecting both interaural correlation processing and higher-order cognitions.

Association between cognitive impairment and apolipoprotein A1 or apolipoprotein B levels is regulated by apolipoprotein E variant rs429358 in patients with chronic schizophrenia.

ApoE gene polymorphism may be involved in the change in blood lipid profile and cognitive impairment of the general population. However, few studies explored the effects of ApoE gene polymorphism on blood lipid levels and cognition in schizophrenia. The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was employed to evaluate the cognition and the SNPStats was used to investigate the association of ApoE rs429358 with schizophrenia. The models of analysis of covariance and multivariate analysis were conducted to investigate the effect of ApoE rs429358 on cognition in schizophrenia. Altogether, 637 patients with schizophrenia and 467 healthy controls were recruited in this study. The findings in the case group found that both the ApoA1 and ApoB levels were predictors for RBANS total score (p < 0.001 vs. p = 0.011), immediate memory (p < 0.001 vs. p = 0.019), language (p < 0.001 vs. p = 0.013), attention (p < 0.001 vs. p < 0.001), except ApoA1 level only was a predictor for visuospatial/constructional (p = 0.014) and delayed memory (p < 0.001). When the association was examined in different ApoE rs429358 genotype subgroups, the association between ApoA1 level and RBANS scores (except for the language score) or between ApoB level and RBANS scores (except for the attention score) was regulated by ApoE rs429358. Our results suggest that patients with schizophrenia have broad cognitive impairment compared with healthy controls. For patients with schizophrenia, both ApoA1 and ApoB levels were positively associated with cognition. There was a significant association between ApoA1 or ApoB levels and cognition in schizophrenia, which was regulated by the ApoE rs429358.

Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study.

PurposeEvidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction.Patients and MethodsAt two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS).ResultsWe included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores.ConclusionGenerally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.

Cognitive indices correlate with [18F]GTP1 tau PET signal and white matter hyperintensities in prodromal‐to‐mild Alzheimer's disease: Baseline data from the Tauriel Study

AbstractBackgroundIn prior cross‐sectional studies using [18F]GTP1 or other tau PET tracers across a spectrum of Alzheimer’s disease (AD) severity, tau PET signal has independently correlated with cognition, even after adjustments for β‐amyloid (Aβ) load and atrophy. However, it remains uncertain how robust these correlations are in more homogeneous patient populations (e.g., clinical trial participants) and after adjustment for MRI white‐matter hyperintensities (WMH). We sought to address this question by examining baseline data from the Phase 2 Tauriel study (NCT03289143), which is investigating the safety and efficacy of semorinemab (an anti‐tau antibody) in prodromal‐to‐mild AD.MethodWe analyzed data from a subset of Tauriel participants who underwent baseline [18F]GTP1 tau PET imaging and met criteria for probable AD dementia (n=244) or mild cognitive impairment (MCI; n=137), with MMSE of 20‐30, global Clinical Dementia Rating (CDR) of 0.5 or 1, significant Aβ pathology (PET or CSF), and significant episodic memory impairment on the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). Other screening/baseline assessments included the 13‐item version of the Alzheimer’s Disease Assessment Scale‐Cognitive Subscale (ADAS‐Cog13) and MRI (WMH scored with Fazekas scale). Relationships between cognitive indices, whole cortical gray (WCG) [18F]GTP1 SUVR, WMH, and age were assessed using Pearson correlations and multiple linear regression.ResultUnivariate analyses revealed significant correlations between all cognitive indices [MMSE, CDR Sum of Boxes, ADAS‐Cog13, and RBANS] and [18F]GTP1 SUVR across the whole cortical gray (WCG; p’s&lt;0.001). Significant univariate correlations were also seen between WMH and ADAS‐Cog13 scores (p=0.035) and between age and RBANS scores (p&lt;0.001). Multivariate linear regression analyses that included all three factors consistently identified both WCG [18F]GTP1 SUVR and WMH as independent predictors of cognitive performance across all indices (p’s&lt;0.05), with a much larger proportion of variance attributable to WCG [18F]GTP1 SUVR.ConclusionAmongst participants with prodromal‐to‐mild AD enrolled in the Tauriel study, [18F]GTP1 tau PET signal was more strongly associated with baseline cognitive performance than the extent of WMH. These data suggest that even in AD participants with co‐morbid cerebral microvascular ischemic disease, therapeutic interventions targeting tau have the potential to ameliorate subsequent cognitive decline.

Serum C-Reactive Protein in Patients with Deficit Schizophrenia and the Relationship with Cognitive Function.

BackgroundSerum levels of C-reactive protein (CRP) were measured in patients with deficit schizophrenia (DS) to confirm the association between CRP level and cognitive performance and to determine whether CRP was a new biological indicator with the potential clinical applications in DS patients.MethodsThree independent samples [41 DS and 50 non-deficit schizophrenia (NDS) and 30 sex- and age-matched healthy controls (HCs)] were recruited in our study. Serum CRP levels were measured by immunofluorescence. The Positive and Negative Syndrome Scale (PANSS) and alternative forms of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) were also assessed. And the relationships between serum CRP levels and both PANSS and RBANS scores were finally analyzed.ResultsThe results of serum CRP level were showed significantly different among the three groups and increased from the HCs to NDS patients to DS patients. There were also significant differences in the cognitive subdomain analyses among the three groups. Serum CRP levels were found positively correlated with total and negative PANSS scores, and showed negatively correlated with overall cognitive test scores in the DS samples.ConclusionSerum C-reactive protein levels and their association with cognitive performance were different between deficit schizophrenia and non-deficit schizophrenia samples, and higher serum CRP level was associated with worse cognitive performance in the DS patients. The results indicated that CRP could be a potential biomarker, and DS could be a distinct subset of schizophrenia.

Effect of 1 Year of Qigong Exercise on Cognitive Function Among Older Chinese Adults at Risk of Cognitive Decline: A Cluster Randomized Controlled Trial.

Background: The rapidly aging Chinese population is showing an increase in age-related illnesses, including mild cognitive impairment and Alzheimer disease. The best types of physical activity for the improvement of cognition remain unknown. This study aimed to compare the effectiveness of a tailored qigong exercise with that of stretching exercise in the maintenance of cognitive abilities in Chinese elders at risk of cognitive decline. Methods: Seventy-four community-dwelling adults aged ≥60 years were screened for eligibility. Using a randomized control group design, participants with scores ≥19 on the Chinese version of the Montreal Cognitive Assessment-Basic (MoCA) were allocated to a 1-year qigong intervention (n = 33) and a stretching control exercise group (n = 33). The primary outcome was the MoCA score, as a measure of global cognitive function, and secondary outcomes were globe cognition and five domain scores on the Chinese version of the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The MoCA and RBANS were administered at baseline and 1 year after intervention to assess the effect of the exercises on cognitive decline. Results: Twenty-five of 33 (75.8%) participants in the qigong group and 26 of 33 (78.8%) participants in the control group completed the 1-year exercise programs. A bivariate test revealed strong correlation between MoCA and RBANS total scores after the intervention (r = 0.517, p < 0.01). Generalized estimating equations revealed a lower risk of progression of cognitive decline at 1 year in the qigong group than in the control group (odds ratio, 0.314; 95% confidence interval, 0.103–0.961; p = 0.04). Two-way repeated-measures ANOVA followed by post hoc t tests with Bonferroni corrections indicated that MoCA and RBANS scores were significantly higher in the qigong group than in the control group (MoCA and RBANS global cognition, memory, visuospatial/constructional ability, and language, all p < 0.01), with the exception of RBANS attention score (p > 0.05). Conclusions: One year of qigong practice was significantly superior to stretching exercise not only for the prevention of cognitive decline progression, but also for the improvement of several cognitive functions, among older Chinese adults at risk of cognitive decline.