Rey-Osterrieth Complex Figure Research Articles

A new method for detecting unilateral spatial neglect with tracing tasks using the Rey-Osterrieth complex figure: a pilot study.

To explore efficacy of the "Rey-Osterrieth complex figure (ROCF) tracing task" as a new test to detect unilateral spatial neglect (USN). Subjects were 40 healthy control (HC) and 20 right brain-damaged patients with (USN + , n = 10) or without USN (USN - , n = 10). After the ROCF copying task, the tracing task was performed under conditions that did not leave any tracing lines on the sample figure. Evaluation used the conventional 36-point scoring system, laterality index (LI) as the ratio of the left and right structure scores, and the number of overlaps for each of the left and right structures scored. In the tracing task, USN + showed a lower LI than HC. Furthermore, left-sided neglect was sometimes more evident than in the copying task. Regarding the total overlapping score, USN + showed a greater score than HC. The right-sided overlapping scores in USN + and USN - were also greater than that in HC. In the right brain-damaged subjects, clinically meaningful correlations were not found between evaluations in the ROCF tracing task and in conventional USN screening tests. Receiver-operating-characteristic analysis to test the power of detection showed moderate performance for the tracing LI (AUC = 0.76, 95% CI = 0.54-0.97), which was greater than that of other tests. Further, the total overlapping score in the tracing task showed sensitivity 0.9 (highest among the tests performed), specificity 0.5, and AUC 0.68 (95% CI = 0.43-0.92). The ROCF tracing task might be a convenient method to detect USN and to reveal the extent of spatial working memory impairment.

The Benson Complex Figure Test: Normative Data for the Healthy Iranian Population

Purpose: Visual-related abilities such as visual memory and visuo-constructional skills are among the cognitive abilities with fundamental importance for normal cognitive function, and their impairment is manifested in many neurological and psychiatric disorders. The present study aimed to generate normative data for the Benson Complex Figure Test (BCFT), a well-known simplified version of the Rey-Osterrieth Complex Figure Test, in Iran and to assess the effect of demographic variables of age, gender, and education on its various measures.
 Materials and Methods: The present study was conducted in 2017-2018 as part of the Iranian Brain Imaging Database (IBID) project. The study sample consisted of 300 normal individuals in the age range of 20 to 70 years, with an equal number of participants and an equal proportion of genders in each age decade (#60). Independent and dependent variables, respectively, were age (classified by five decades including 20-30-year-olds, 31-40-year-olds, 41-50-year-olds, 51-60-year-olds, and 61-70-year-olds) and performance in the BCFT (defined in terms of 3 scores on a copy, recall, and recognition of the geometric figure and 2 scores on time of copy and recall).
 Results: The correlation matrix among the variables showed that age and education have a significant correlation with most of the BCFT scores, while gender only has a significant correlation with recognition score. Multivariate analysis of variance showed the effect of age, gender, and their interaction on scores, while education did not make a significant difference in the BCFT scores. Also, the t-test showed a significant difference between men and women in recall and recognition, so women and men showed better performance in recall and recognition, respectively.
 Conclusion: In summary, our results suggest that demographic variables of age, gender, and education affect visual memory and visuospatial abilities, and it is essential to generate normative data for research or clinical settings.

Bayesian modelling disentangles language versus executive control disruption in stroke.

Stroke is the leading cause of long-term disability worldwide. Incurred brain damage can disrupt cognition, often with persisting deficits in language and executive capacities. Yet, despite their clinical relevance, the commonalities and differences between language versus executive control impairments remain under-specified. To fill this gap, we tailored a Bayesian hierarchical modelling solution in a largest-of-its-kind cohort (1080 patients with stroke) to deconvolve language and executive control with respect to the stroke topology. Cognitive function was assessed with a rich neuropsychological test battery including global cognitive function (tested with the Mini-Mental State Exam), language (assessed with a picture naming task), executive speech function (tested with verbal fluency tasks), executive control functions (Trail Making Test and Digit Symbol Coding Task), visuospatial functioning (Rey Complex Figure), as well as verbal learning and memory function (Soul Verbal Learning). Bayesian modelling predicted interindividual differences in eight cognitive outcome scores three months after stroke based on specific tissue lesion topologies. A multivariate factor analysis extracted four distinct cognitive factors that distinguish left- and right-hemispheric contributions to ischaemic tissue lesions. These factors were labelled according to the neuropsychological tests that had the strongest factor loadings: One factor delineated language and general cognitive performance and was mainly associated with damage to left-hemispheric brain regions in the frontal and temporal cortex. A factor for executive control summarized mental flexibility, task switching and visual-constructional abilities. This factor was strongly related to right-hemispheric brain damage of posterior regions in the occipital cortex. The interplay of language and executive control was reflected in two distinct factors that were labelled as executive speech functions and verbal memory. Impairments on both factors were mainly linked to left-hemispheric lesions. These findings shed light onto the causal implications of hemispheric specialization for cognition; and make steps towards subgroup-specific treatment protocols after stroke.

A (mérsékelten rizikós) koraszülöttség az IQ hátrány ellenére nem akadályozza az olvasási és helyesírási képességek fejlődését

Background and aims: It is well established that the impacts of prematurity are often long-lasting in the various domains of development, however, the published findings concerning the prevalence, severity, and background of disorders are inconsistent. As yet research into the development of abilities contributing to the academic progress in Hungarian preterm children has been scarce. Our study aimed to find out to what extent prematurity impeded the reading and spelling abilities in school age and to contribute some information on the cognitive background of the performances. Methods: Three groups of 7 – 12 year-old children participated in the study. The target group consisted of moderate-risk preterms. For comparison two groups of full-term children were tested: typically developing good readers and dyslexics. To assess the reading and spelling abilities the Hungarian version of the 3DM (Dyslexia Differential Diagnosis) was used. Cognitive abilities were assessed using the Hungarian adaptation of the WISC-IV and the Rey Complex Figure Test. Results: The reading and spelling performances of the full-term good readers and the preterms did not differ and the preterms scored higher than the dyslexics. The cognitive tests did not offer any direct explanation to this, since the preterms lagged behind the full-term good readers in the WISC-IV full-scale IQ as well as in several specific cognitive measures. The CART Decision Tree served to analyse the relationships, allowing to reveal the interactions and the moderation effects. Discussion: The CHC model as a theoretical framework and the CART Decision Tree statistical analysis proved to be fruitful to disentangle the complex interplay of the cognitive background factors. There are various cognitive paths of acquiring the reading and spelling skills, e.g., in case of relatively lower IQs the sufficient levels of memory and processing speed may ensure success.

Association between mammillary body atrophy and memory impairment in retired athletes with a history of repetitive mild traumatic brain injury

Cognitive dysfunction, especially memory impairment, is a typical clinical feature of long-term symptoms caused by repetitive mild traumatic brain injury (rmTBI). The current study aims to investigate the relationship between regional brain atrophy and cognitive impairments in retired athletes with a long history of rmTBI. Overall, 27 retired athletes with a history of rmTBI (18 boxers, 3 kickboxers, 2 wrestlers, and 4 others; rmTBI group) and 23 age/sex-matched healthy participants (control group) were enrolled. MPRAGE on 3 T MRI was acquired and segmented. The TBV and TBV–adjusted regional brain volumes were compared between groups, and the relationship between the neuropsychological test scores and the regional brain volumes were evaluated. Total brain volume (TBV) and regional brain volumes of the mammillary bodies (MBs), hippocampi, amygdalae, thalami, caudate nuclei, and corpus callosum (CC) were estimated using the SPM12 and ITK–SNAP tools. In the rmTBI group, the regional brain volume/TBV ratio (rmTBI vs. control group, Mann–Whitney U test, p < 0.05) underwent partial correlation analysis, adjusting for age and sex, to assess its connection with neuropsychological test results. Compared with the control group, the rmTBI group showed significantly lower the MBs volume/TBV ratio (0.13 ± 0.05 vs. 0.19 ± 0.03 × 10−3, p < 0.001). The MBs volume/TBV ratio correlated with visual memory, as assessed, respectively, by the Rey–Osterrieth Complex Figure test delayed recall (ρ = 0.62, p < 0.001). In conclusion, retired athletes with rmTBI have MB atrophy, potentially contributing to memory impairment linked to the Papez circuit disconnection.

Non-equivalence of sub-tasks of the Rey-Osterrieth Complex Figure Test with convolutional neural networks to discriminate mild cognitive impairment

BackgroundThe Rey-Osterrieth Complex Figure Test (RCFT) is a tool to evaluate cognitive function. Despite its usefulness, its scoring criteria are as complicated as its figure, leading to a low reliability. Therefore, this study aimed to determine the feasibility of using the convolutional neural network (CNN) model based on the RCFT as a screening tool for mild cognitive impairment (MCI) and investigate the non-equivalence of sub-tasks of the RCFT.MethodsA total of 354 RCFT images (copy and recall conditions) were obtained from 103 healthy controls (HCs) and 74 patients with amnestic MCI (a-MCI). The CNN model was trained to predict MCI based on the RCFT-copy and RCFT-recall images. To evaluate the CNN model’s performance, accuracy, sensitivity, specificity, and F1-score were measured. To compare discriminative power, the area under the curve (AUC) was calculated by the receiver operating characteristic (ROC) curve analysis.ResultsThe CNN model based on the RCFT-recall was the most accurate in discriminating a-MCI (accuracy: RCFT-copy = 0.846, RCFT-recall = 0.872, MoCA-K = 0.818). Furthermore, the CNN model based on the RCFT could better discriminate MCI than the MoCA-K (AUC: RCFT-copy = 0.851, RCFT-recall = 0.88, MoCA-K = 0.848). The CNN model based on the RCFT-recall was superior to the RCFT-copy.ConclusionThese findings suggest the feasibility of using the CNN model based on the RCFT as a surrogate for a conventional screening tool for a-MCI and demonstrate the superiority of the CNN model based on the RCFT-recall to the RCFT-copy.

Cognitive and psychological characteristics in patients with Cerebral Amyloid Angiopathy: a literature review.

To review the current data on cognitive and psychological characteristics of patients with CAA and on the instruments used for their evaluation. A systematic search was performed in Embase, Scopus and PubMed with terms related to "cerebral amyloid angiopathy", "neuropsychological measures" and "patient-reported outcome measures" from January 2001 to December 2021. Out of 2851 records, 18 articles were selected. The cognitive evaluation was present in all of which, while the psychological one only in five articles. The MMSE (Mini Mental State Examination), TMT (Trail Making Test), fluency test, verbal learning test, digit span, digit symbol and Rey figure tests were the most used cognitive tests, while executive function, memory, processing speed, visuospatial function, attention and language were the most frequent impaired cognitive functions. Depression was the most considered psychological factor usually measured with BDI (Beck Depression Inventory) and GDS (Geriatric Depression Scale). The results of this study might be used in clinical practice as a guide to choose cognitive and psychological instruments and integrate them in the clinical evaluation. The results might also be used in the research field for studies investigating the impact of cognitive and psychological variables on the disease course and for consensus studies aimed at define a standardized evaluation of these aspects.

Is an 8-Week Regimen of Nordic Walking Training Sufficient to Benefit Cognitive Performance in Healthy Older Adults? A Pilot Study.

Nordic walking requires the association of walking and coordination of limbs while orienteering in a natural environment. It has been shown to improve functional capacities more than normal walking. However, its cognitive benefits are less clear. The main hypothesis was that this training improves visuospatial capacities and inhibition functions. A total of 14 healthy older adults were included. The training was performed in three sessions of 75 min a week for 8 weeks. Pre-, intermediate, and post-tests were carried out. Cognitive functions including global cognition (MoCA), executive functions (Color-Word Stroop test), speed of information processing, switching capacities (Trail Making Test A and B), and visuospatial capacities (Rey Complex Figure Copy Task) were assessed. Motor functions including balance control (Unipedal Balance Test), functional mobility (Timed Up and Go), hamstring flexibility (Chair Sit and Reach test), and motor coordination (Four-Square Stepping Test) were evaluated. Physical function, including lower limb strength (Timed Sit-To-Stand) and cardiovascular capacities (Incremental Shuttle Walking Test), was measured. Cardiovascular capacity, strength of lower limbs, and motor coordination were positively affected by training. With respect to cognition, training improved visuospatial capacities, while switching capacities, information processing speed, and executive functions did not improve. A possible explanation is that they needed a longer program duration to show benefits. However, analyses of responders suggested that NW positively affected cognitive functioning in a subset of participants. Eight weeks of NW training produced physical, motor, and cognitive improvements. A longer training duration could be necessary to extend the benefits to executive functions in all participants.

Predicting clinical progression and cognitive decline in patients with relapsing-remitting multiple sclerosis: a 6-year follow-up study.

Cognitive impairment occurs from the earliest stages of multiple sclerosis (MS) and progresses over time. The introduction of disease modifying therapies (DMTs) has changed the prognosis for MS patients, offering a potential opportunity for improvement in the cognitive arena as well. 41 patients with relapsing-remitting multiple sclerosis (MS) were recruited to the study. Thirty patients were available for final follow-up and were included in the analysis. Baseline (BL) brain MRI including volumetry and neuropsychological tests were performed. Blood samples were collected at BL and follow-up (FU) and were tested for: vascular endothelial growth factor (VEGF), soluble vascular cell adhesion molecule-1 (sVCAM1), soluble platelet-endothelial CAM-1 (sPECAM1), and soluble intercellular CAM-1 (sICAM-1). Patients were invited for a final neuropsychological follow-up after a median of 6 years. Disease activity (relapses, EDSS increase, new/active brain lesions on MRI) was analysed between BL and FU. The study group deteriorated in the Rey-Osterrieth Complex Figure (ROCF) test (p = 0.001), but improved significantly in three other tests, i.e. semantic fluency test (p = 0.013), California Verbal Learning Test (CVLT, p = 0.016), and Word Comprehension Test (WCT, p < 0.001). EDSS increase correlated negatively with semantic fluency and WCT scores (r = -0.579, p = 0.001 and r = -0.391, p = 0.033, respectively). Improvements in semantic fluency test and WCT correlated positively with baseline deep grey matter, grey matter, and cortical volumes (p < 0.05, r > 0). Higher EDSS on FU correlated significantly negatively with baseline left and right pallidum, right caudate, right putamen, right accumbens, and cortical volume (p < 0.05, r < 0). No significant relationship was found between the number of relapses and EDSS on FU or neuropsychological deteriorations. Improvements in WCT and CVLT correlated positively with baseline sPECAM1 and sVCAM1 results, respectively (r > 0, p < 0.05). Deterioration in ROCF test correlated significantly with higher levels of baseline VEGF and sVCAM1 (p < 0.05). Brain volume is an important predictor of future EDSS and cognitive functions outcome. MS patients have a potential for improving in neuropsychological tests over time. It remains to be established whether this is related to successful disease modification with immunotherapy. Baseline volumetric measures are stronger predictors of cognitive performance than relapse activity, which yet again highlights the importance of atrophy in MS prognosis.

The Effectiveness of Training the Components of Compassion-Focused Therapy on Memory, Anxiety, and Sleep Quality in Patients with Obstructive Sleep Apnea

Background: Obstructive sleep apnea (OSA) is a common and debilitating sleep disorder with both mental and physical complications. Although medical treatments may improve OSA symptoms, they may not affect its mental sequelae. Objectives: The aim of this study was to evaluate the effect of training the components of compassion-focused therapy (CFT) on sleep quality, anxiety, and memory in patients with OSA. Methods: This experimental study was performed on 37 patients (18 to 65 years old) with confirmed OSA diagnosed in the past year with a minimum apnea index score of 5 and no history of medical or psychiatric diseases. The study was conducted between 2022 and 2023. Exclusion criteria were being absent from more than two training sessions, experiencing stressful events, and refusing to continue the study. The intervention group (n = 19) received the training component of CFT in 8 sessions (once a week), while the control group received no psychological intervention. The Pittsburg sleep quality index (PSQI), Rey Auditory-Verbal Learning Test (RAVLT), Rey-Osterrieth complex figure (ROCF), and Beck Anxiety Inventory (BAI), as well as a demographic information questionnaire, were filled out by the participants at the baseline and after the intervention. Results: There was no significant difference between the groups in terms of demographic variables. The training component of CFT was effective in reducing anxiety and improving sleep quality, as well as the auditory-verbal and visual-spatial components of short-term memory in patients with OSA (P &lt; 0.05). Conclusions: The training component of CFT was efficient and beneficial in reducing anxiety and improving immediate memory and sleep quality in patients with OSA.

A cross-sectional study on the effect of altered sleep patterns on working memory among nursing professionals

Background: Sleep is a critical component of existence and vital for the rejuvenation of the body. A minimum of 7 h of sleep is needed for adults for optimal wellness. In the present condition, extended periods of wakefulness are a common occurrence. Such wakefulness can be acute total sleep deprivation or chronic partial sleep restriction. Both forms can negatively impact cognitive abilities. It is prevalent among nursing professionals, who play a vital role in health care, remaining alert during working hours, especially night shifts. Aims and Objectives: This study aims to examine the effects of altered sleep patterns on working memory among nursing personnel working day and night shifts. Materials and Methods: The necessary documents for conducting the study were obtained from the institution and the participants. For this cross-sectional study, 31 nursing staff, age group of 25–40 years, males – six, and females – 25 were chosen according to the selection criteria. They were posted to wards on rotational day and night shifts. Rey–Osterrieth figure copy and recall test (Rey–Osterrieth complex figure test [ROCF]) was used for assessing working memory. The performance was based on a copy score and a recall score. Results: A paired “t” test with one-way repeated within the subject analysis of variance test was applied for analysis. Recall scores of ROCF were significantly less. Copy scores of ROCF were also less but statistically insignificant. Conclusion: The present study showed that the recall scores were significantly less in nursing professionals at the end of the night shift duration indicating poor working memory.

Androgen treatment effects on neurocognition in female-to-male transgender adolescents.

It has been hypothesized that cognitive and memory-related brain function in transgender during cross-sex hormonal treatment might be activated towards that of the subjective gender. However, research on this topic has produced inconsistent results, and to the best of our knowledge no studies have investigated neurocognitive changes in androgen-treated female-to-male (FM) transgender adolescents. A total of 15 FM transgender adolescents (14-17 years) underwent neuropsychological testing in order to examine the effects of androgen on visuo-spacial abilities, verbal memory language, processing speed and executive functions. We used a longitudinal design in which 10 participants were tested twice, before and after receiving 12 months of testosterone treatment. This group was also compared with 5 FM transgender adolescents off-androgen treatment. Participants tested before and after 12 months of androgen treatment improved significantly on processing speed in a visuo-spatial (Rey-Osterrieth complex figure test) and in a visuo-oral task (Stroop), their performance on a verbal memory task (TAVEC) and on interference (Stroop) and they exhibited lower impulsivity control (CARAS-R). On-androgen treatment adolescents exhibited worse cognitive impulsivity control than off-androgen treatment adolescents. The results indicate that androgen has an influence on immediate verbal memory, cognitive interference, impulsivity control and processing speed.

The multidomain intervention trial for prevention of dementia among older adults with type 2 diabetes: a multi‐center, randomized, 18‐month controlled trial

AbstractBackgroundThe aim of the Japan‐Multidomain Intervention Trial for Prevention of Dementia in Older Adults with Diabetes (J‐MIND‐Diabetes) was to examine the efficacy of multi‐domain intervention in prevention of cognitive decline in older adults with type 2 diabetes and mild cognitive impairment (MCI).MethodThe J‐MIND‐Diabetes is an 18‐month, multi‐centered, randomized controlled trial. Outpatients with type 2 diabetes aged 70‐85 years with MCI were recruited and randomized into multi‐domain intervention (management of metabolic and vascular risk factors, physical exercise, nutritional guidance, and promotion of social participation) and control groups (general instructions on dementia prevention) at a 1:1 allocation ratio using the stratified permuted‐block randomization methods. The primary outcome was a change from baseline to 18‐month follow‐up in a global composite score combining several neuropsychological tests, which include the MoCA‐J, the MMSE, the Rey‐Osterrieth Complex Figure Test (ROCFT), delayed recall test of a 10‐word list, the Digit Span, the Trail Making Test, the Digit Symbol Substitution Test, and the Letter Word Fluency Test.ResultBetween March 13, 2019, and May 8, 2020, 361 patients were screened and 154 were randomly assigned to the multi‐domain intervention group (n = 81) or control group (n = 73). 110 (71%) participants completed the trial. The full analysis set included 136 patients. In the primary efficacy analysis, there was no significant differences in the change of composite score from baseline to 18‐month follow‐up between the intervention group and the control group (mean difference 0.066 [95% CI ‐0.089 to 0.222]). In the analysis for each neuropsychological test, scores of immediate and delayed recall tests of the ROCFT in the intervention group significantly improved by a mean of 1.627 points and 1.793 points, respectively. The mean difference in the change of score of delayed recall test of the ROCFT between intervention group and control group was significant (mean difference 1.803 [95% CI 0.169 to 3.436]). In subgroup analyses, intervention effect on composite score was significant among patients with moderate to severe white matter hyperintensities (mean difference 0.351 [95% CI 0.088 to 0.614]).ConclusionThe multi‐domain intervention could improve memory function in older adults with type 2 diabetes and MCI.

Severity of HIV-associated neurocogtitive disordes and performance at the Rey-Osterrieth Complex figure

Severity of HIV-associated neurocogtitive disordes and performance at the Rey-Osterrieth Complex figure

Exploring the relationship between MRI changes and cognitive/neuropsychiatric complaints in a cohort of long COVID‐19 patients: A cross‐sectional and longitudinal study

AbstractBackgroundPost‐acute Covid‐19 syndrome (PACS) frequently refers to cognitive complaints. It is not yet clear whether there is an association between cognitive symptoms with brain changes or neuropsychiatric symptoms. Our aims are 1) to study cross‐sectional and longitudinal MRI brain measures in a cohort of PACS and 2) their association with cognitive performance and mood disturbances.MethodWe performed a prospective single‐center study with 3T‐T1w MRI of 49 PACS patients at a cross‐sectional level. These participants had confirmed SARS‐CoV2 infection, ≥ 8 weeks after symptoms onset and cognitive complaints. All participants completed a comprehensive neuropsychological battery (NPS) and questionnaires assessing depression, anxiety, and subjective cognitive complaints (SCD). We obtained global MRI measures (e.g; gray and white matter volumes and mean cortical thickness) with FreeSurfer. We measured correlations of global MRI measures with SCD, memory and executive function outcomes, anxiety, and depression. All analyses were corrected for multiple comparisons. 44 PACS subjects had a 6‐month follow‐up MRI: in these, we performed longitudinal analyses with Generalized Linear Mixed‐Effects Models to study changes between visits in global MRI measures.ResultDemographics are shown in Table 1. We did not find any correlation between clinical outcomes (SCD, anxiety, depression) and MRI findings. Visual memory (Rey figure’s recall) and cognitive interference inhibition and processing speed ((Stroop’s color‐word condition) were positively correlated with global gray and white matter volume measures (Figure 1). We did not identify changes in global MRI measures at 6 months in PACS participants.ConclusionIn PACS, worse visual memory and executive function, but not other clinical outcomes, were associated with lower global structural MRI indexes. We did not observe global longitudinal changes in MRI.

P71: Predicting amyloid-ß deposition status in amnestic mild cognitive impairment using neuropsychological profiles.

Objective:Previous studies investigating neuropsychological profiles of cognitive impairment people have found a learning curve can be a useful indicator of AD diagnosis or progression. However, the data on the relationship between amyloid β (Aβ) deposition status and the learning curve in amnestic mild cognitive impairment (aMCI) are limited. In this study, we investigate the role of the learning curve in predicting Aβ deposition status in patients with aMCI.Methods:This is a cross-sectional study of 67 aMCI patients (N = 67; 33 aMCI with amyloid positive (Aβ-PET (+)), and 34 aMCI with amyloid negative (Aβ-PET (-))). All participants underwent Seoul Neuropsychological Screening Battery for a comprehensive neuropsychological test battery and brain MRI. To determine Aβ deposition status, each participant underwent amyloid PET scans using 18F-florbetaben. The learning curve was obtained using immediate recall of Seoul Verbal Learning Test-learning curve (SVLT- learning curve). The association of cognitive test scores and dichotomized Aβ deposition status was examined using logistic regression models in patients with aMCI. Receiver operating characteristic (ROC) curves were used to examine the predictive ability of cognitive test to detect Aβ deposition status in aMCI.Results:Logistic regression models showed that SVLT-learning curve and Rey Complex Figure Test- delayed recall (RCFT-delayed recall) scores were significantly associated with Aβ deposition status. In ROC analysis to assess the predictive power, SVLT-learning curve (area under the curve (AUC) = 0.734, P = 0.001) and RCFT-delayed recall (AUC = 0.739, P = 0.001) independently discriminated Aβ-PET (+) and Aβ-PET (-). The combination of these clinical markers (SVLT-learning curve and RCFT-delayed recall) improved the predictive accuracy of Aβ-PET (+) (AUC = 0.833, P &lt; 0.001).Conclusions:Our findings of association of Aβ deposition status with SVLT-learning curve and RCFT- delayed recall suggest that these cognitive tests could be a useful screening tool for Aβ deposition status among aMCI patients in resource-limited clinics.

Memory markers in preclinical Alzheimer’s disease

AbstractBackgroundEpisodic memory impairment is a widely known core clinical symptom of Alzheimer’s disease (AD). However, it is still uncertain if it is possible to detect meaningful signs or changes in memory in the preclinical stage of AD due to their within‐normal‐range performance. In the current study, we investigated both verbal and visuospatial memory as markers to track the disease progression in the preclinical AD.MethodWe selected cognitively normal (CN) participants from the Gwangju Alzheimer’s Disease and Related Dementia Cohort in Korea. We included a group of CN individuals who showed a significant amyloid‐beta (aß) deposition, defined by amyloid PET, at baseline and completed at least two follow‐up evaluations. In the final analysis, we included 130 individuals in the preclinical stage of AD. Episodic memory measures were delayed recall scores from the Rey Complex Figure Test (RCFT_delayed) and Seoul Verbal Learning test (SVLT_delayed). We performed logistic regression analysis with stepwise selection to examine associations between memory tests and progression.ResultThe mean follow‐up month was 36.21. Twenty‐one (16.2%) participants were converted to MCI (n = 19) or AD dementia (n = 2), while the rest stayed as CN. When both RCFT_delayed and SVLT_delayed at baseline were entered in the logistic regression model, only the RCFT_delayed was significantly associated with the progression (OR = 0.288; 95% CI, 0.138‐0.602; p = 0.001). When change scores were added to the model, RCFT_delayed at baseline (OR = 0.223; 95% CI, 0.101‐0.496; p &lt; 0.001), RCFT_delayed change score (OR = 0.470; 95% CI, 0.258‐0.857; p = 0.014), and SVLT_delayed change score (OR = 0.523; 95% CI, 0.290‐0.942; p = 0.031), were significant.ConclusionOur results suggest that visuospatial, not verbal, memory measures may play an important role in sensitively detecting the relevant sign of future progression in asymptomatic individuals. In terms of verbal memory, the longitudinal decline was associated with progression. Our study suggests that the inclusion of a visuospatial memory test and repeated evaluation can help to detect the earliest decline in the preclinical stages of AD.

Cognitive reserve in figural and verbal memory in healthy older adults – preliminary results

AbstractBackgroundCognitive reserve plays an important role in individual trajectories of age‐related memory decline, with education and semantic fluency representing cognitive reserve proxies (CRPs). Higher CR may attenuate well‐known effects of ageing on the brain, such as decreases in grey matter volume (GMV). We hypothesised that the known associations between age‐related GMV and cognition would be (differentially) attenuated by CRPs.MethodWe analysed 3‐Tesla T1‐weighted Multi‐Echo MPRAGE and cognitive data (Verbal Learning and Memory Test (VLMT), Rey Complex Figure Test (RCFT), and Regensburg Verbal Fluency Test (RWT)) from 51 cognitively normal adults (73.2±7.62 years, 31 male) in our new cohort established within the CRC1436 (https://sfb1436.de/). MRI data were pre‐processed and analysed using CAT12. We performed a whole‐brain linear regression to first assess age‐related reductions in GMV (covariates: sex, total intracranial volume (TIV), education), extracting mean betas for significant regions of interest (ROIs). We investigated the relationship between GMV in age‐vulnerable regions and memory using linear regressions in R (covariates: age, sex, TIV), and assessed CRPs as moderators on this relationship. Finally, we tested whether CRPs explained variance in memory performance over and above that of GMV and age. We accounted for multiple testing via Benjamini‐Hochberg‐correction.ResultWhole brain analyses identified bilateral hippocampal GMV as negatively associated with age (Fig.1). Linear regression analyses yielded a significant positive association between bilateral hippocampal GMV and figural memory (Fig.2). However, we observed no significant moderation by CRPs on this relationship. Finally, we observed weak evidence for cognitive reserve when adjusting for GMV and age, with higher variance explained by CRPs (Table 1). Semantic fluency positively predicted a figural memory composite when adjusting for right (p = 0.006) as well as left hippocampal GMV (p = 0.014). Education positively predicted verbal memory when adjusting for right (p&lt;0.001) as well as left hippocampal GMV (p&lt;0.001).ConclusionConsistent with operational definitions, our results provide weak evidence for semantic fluency and for education as CRPs in figural and verbal memory, respectively. However, our findings are preliminary, given the future addition of more participants. Nevertheless, these results provide important first insights into cognitive reserve in this developing cohort.

The Impact of Iron Deficiency Anemia on Cerebrovascular Physiology, Brain Structure, and Cognitive Function in Otherwise Healthy Women

Introduction: Moderate iron deficiency anemia(IDA), defined as a hemoglobin below 11 g/dl, occurs in 1.5% of the United States population and is overrepresented in minority populations. IDA is known to cause permanent structural and function damage in children, but IDA's cognitive and neurovascular phenotype in adults is poorly characterized. We performed brain MRI and cognitive testing in 34 otherwise healthy women with IDA to determine whether oxygen delivery and metabolism are preserved as well as the association of IDA with brain volumes and cognitive function. Methods: We recruited potential blood donors from four hospital-based donor centers, Children's Hospital Los Angeles, University of California Los Angeles, Cedar's Sinai, and City of Hope, whose point-of-care hemoglobin values were less than 10.5 g/dl. We also recruited individuals from the community using social media advertisements, with anemia documented by screening hemoglobin assessment. All participants were free from inflammatory, infectious, or malignant diseases that may impact blood counts and iron metabolism. IDA was confirmed by laboratory assessment of CBC, reticulocyte count, iron indices, methyl malonic acid, hemoglobin electrophoresis, homocysteine, and high-sensitivity C-reactive protein. Patients underwent a four-hour neurocognitive assessment consisting of subsets from the Weschler Abbreviated Scale of Intelligence (WASI-II), the California Verbal Learning Test (CVLT), the Rey Complex Figure Test (RCFT), and the NIH Cognitive Toolkit. MRI was performed on a 3T Philips Achieva using a 32-element head coil. Anatomic imaging consisted of 3D T1, 3D T2, 3D T2*/QSM, and 2D multishell diffusion imaging. Phase contrast and arterial spin labeling measured total and regional brain blood flow, respectively. Cerebral venous oximetry was performed using T2 relaxation under spin tagging. Results: The study population demonstrated a classic IDA phenotype characterized by low ferritin and transferrin saturation, high iron binding capacity, decreased MCV and MCHC, and hypochromic microcytosis on blood smear (not shown). Neurocognitive function was impaired across multiple domains for women having hemoglobin values less than 10.0 g/dl (Figure 1, left), with Cohen's D values ranging from 0.7 - 1.5. Cerebral blood flow (CBF) rose slightly as oxygen content declined (Figure 1, right), but much less than predicted based on historical controls 1,2 leading to impaired brain oxygen delivery. Oxygen extraction fraction was independent of hemoglobin concentration, thus cerebral metabolic rate was also decreased. Grey matter volume was smaller in the right temporal lobe and correlated with 2/3 of the abnormal cognitive indices (in Figure 1, left). White matter volume was decreased in the right cingulate gyrus, corpus callosum, and cerebellum, correlating with the remaining abnormal cognitive indices. Discussion: Our study demonstrates that iron deficiency has serious effects on cognitive performance; individuals with hemoglobin less than 10.0 g/dl scored more than one standard deviation below their peers with milder anemia. Poor cognitive performance was correlated with demonstrable brain shrinkage whose reversibility is unknown. The failure of the brain to upregulate CBF in response to IDA was striking because most patients with chronic anemia preserve cerebral oxygen delivery through compensatory hyperemia 1,2. While both anemia and iron deficiency can impair brain function on their own, it is likely that iron deficiency is the primary contributor to the cognitive and neurovascular effects. We will test this hypothesis in subsequent work by reexamining women with IDA shortly after intravenous iron administration, thus creating a window where the iron deficiency has been corrected but the anemia persists(NCT05929729). We will also determine whether the cerebrovascular, anatomic, and functional deficits are reversible with iron repletion.

Benefits of vagus nerve stimulation on psychomotor functions in patients with severe drug-resistant epilepsy

PurposePatients with severe drug-resistant epilepsy (DRE) experience psychomotor disorders. Our study aimed to assess the psychomotor outcomes after vagus nerve stimulation (VNS) in this population. MethodsWe prospectively evaluated psychomotor function in 17 adult patients with severe DRE who were referred for VNS. Psychomotor functions were examined, in the preoperative period and at 18 months post-surgery, by a psychomotor therapist using a full set of the following specific tests: the Rey–Osterrieth complex figure (ROCF) test, the Zazzo's cancelation task (ZCT), the Piaget-Head test and the paired images test. ResultsAt 18 months post-VNS surgery, the Piaget-head scores increased by 3 points (p = 0.008) compared to baseline. Performances were also improved for ROCF test both in copy (+2.4 points, p = 0.001) and recall (+2.0 points, p = 0.008) tasks and for the paired images test (accuracy index: +28.6 %, p = 0.03). Regarding the ZCT findings, the efficiency index increased in both single (+16 %, p = 0.005) and dual (+17.1 %, p < 0.001) tasks. QoL improved in 88.2 % of patients. ConclusionsPatients with severe DRE treated with VNS experienced improved performance in terms of global psychomotor functions. Perceptual organization, visuospatial memory, laterality awareness, sustained attention, concentration, visual scanning, and inhibition were significantly improved.