Severity Of Cognitive Dysfunction Research Articles

The relationship between dehydration and etiologic subtypes of major neurocognitive disorder in older patients.

Studies investigating associations between etiologic subtypes of major neurocognitive disorder (MND) and dehydration frequency are lacking. The aim of this study was to investigate the prevalence and risk factors of dehydration among older adults with and without MND (dementia), and across different etiologic subtypes of MND. This cross-sectional study included adults aged ≥ 65years old from one geriatric outpatient clinic. Dehydration was defined as a calculated [1,86 × (Na + K) + 1,15 × glucose + urea + 14] plasma osmolarity of > 295mOsm/L.Clinical characteristics and measures of comprehensive geriatric assessments of patients with dehydration and normohydration were compared. MND was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition criteria. The underlying etiologic subtypes were determined by specific diagnostic criteria. Of the 1377 patients 72% were female, the mean age was 80 ± 8years, and 575 had dementia. Dehydration was more common in patients with dementia than those without dementia (58% vs. 53%, p = 0.044). The prevelance of dehydration was 57%, 62%, 54%, 57% and 68% in Alzheimer's disease, Parkinson's disease dementia, fronto-temporal dementia, dementia with Lewy bodies, and vascular dementia, respectively (p ≥ 0.05). MND was associated with dehydration (OR 1.26, 95% CI 1.01-1.57; p = 0.037) after adjustment for age and sex. In multivariable analysis, among patients with dementia, hypertension, DM, CKD, and dysphagia were more common while mean Mini-Mental State Examination score was lower in those who had dehydration versus no dehydration in older patients with dementia (p < 0.05). Dehydration is slightly associated with the presence of MND independent of age and sex. However, dehydration is also quite common in older patients without cognitive disorders. Therefore, hydration status should be monitored in older adults irrespective of neurocognitive status. Hypertension, DM, CKD, dysphagia and severity of cognitive dysfunction were associated with dehydration in patients with dementia. The prevalence of dehydration is highest in patients with vascular dementia.

A clinical study on cognitive dysfunction in depressed patients

ABSTRACT Background: Major depression is a commonly occuring, seriously impairing, and often recurrent mental disorder. Depression and cognitive impairement have enormous implications for public health. Cognitive symptoms represent one of the core features of depression and have an impact on many functional outcomes. Different cognitive domains such as attention and concentration, psychomotor speed, executive functioning, and memory have been found to be implicated. Aim: This study aimed at assessing the cognitive domains affected and severity of cognitive dysfunction in first-episode patients of the unipolar depressive episode without psychosis and to assess the correlation of association of severity of cognitive deficit with severity of depression. Materials and Methods: A total of 40 patients with depression diagnosed according to International Classification of Diseases Research Diagnostic Criteria and 40 healthy controls were included. PGI Battery of Brain Dysfunction, Frontal Assessement Battery, and Hamilton Depression Rating scale (HAM–D) were adminstered, and analysis was done using Chi-square test, unpaired t-test, and Pearson’s correlation. Results: The study revealed significant differences in the dysfunction scores between the study and control populations. In the study group, more than 80% of patients had cognitive dysfunction and a positive correlation was found between dysfunction and HAM–D scores. Conclusion: Depression is associated with significant disturbance in cognitive functioning, and the cognitive dysfunction increases with an increase in the severity of depression.

Attitude to the disease and quality of life in elderly patients with mild vascular dementia after the novel coronavirus infection

In order to study the types of attitude towards the disease and quality of life (QoL) in elderly patients with mild vascular dementia (MVD) living in the conditions of the psychoneurological institution Social Service House “Severnoye Izmailovo” in Moscow, there were 2 study groups: the patients with the clinical debut of the novel coronavirus infection (NCVI) of 6 months +/– 1 month with the recovery outcome (n=65; 33 men, 32 women) and those who did not have COVID-19 (hospital control group; n=67; 34 men, 33 women). The mean age of the studied patients was 73.05±3.48 years. The age and sex composition of the two groups was homogeneous (p&gt;0.05). Emotional disorders were investigated using the Cornell Scale for Depression in Dementia (CSDD); cognitive disorders – by means of the Montreal Cognitive Assessment (MoCA); QoL – by the Quality of Life in Alzheimer's Disease scale (QoL-AD): QoL self-assessment (QoL-AD-SR (self-rating)) and proxy QoL rating (QoL-AD-PR (proxy rating)); the type of attitude towards the disease – by the TATD scale (Wasserman L.I. et al., 2005). It was found that COVID-19 aggravates cognitive deficits in patients with MVD (according to MoCA 20.80±0.59 /21.40±0.78 points; p&lt;0.05) in the absence of depression (according to CSDD 1.52±0.50 / 1.52±0.84 points in the group of the patients after NCVI / hospital control group, respectively; p&gt;0.05). In the patients after COVID-19, a correlation was found between the proxy QoL rating and the severity of cognitive dysfunction according to the MoCA (R= – 0.28), while in the hospital control group – between the proxy QoL rating and the severity of depressive manifestations (R= – 0.33). The first group of the patients was characterized by a mixed type of attitude to the disease and intrapsychic maladaptation (the neurasthenic type ranked first at 16.03±8.29 / 9.34±5.03 points), while the second group had a diffuse type of attitude to the disease and interpsychic maladaptation (the sensitive type ranked first at 10.31±5.71 / 14.90±7.62 points by the TATD scale among the elderly patients with MVD who have / have not undergone NCVI; p&lt;0.05). The revealed patterns can contribute to the optimization of personalized models of medical and psychological rehabilitation of elderly patients with MVD living in closed-type care facilities.

Low cognitive functioning and depressive symptoms in patients with rheumatoid arthritis and systemic sclerosis: a clinical study

BackgroundRecently, cognitive deficits occurring in rheumatic diseases have attracted scientific attention. Cognitive symptoms in patients with Rheumatoid Arthritis (RA) and Systemic Sclerosis (SSc) have not been thoroughly studied. This study aimed to assess cognitive function and its relationship with depressive symptoms in RA and SSc and compare it to mild neurocognitive disorder due to Alzheimer’s disease (MiND) and to individuals without cognitive impairment.MethodsCognitive function and depressive symptoms were tapped with the Cognitive Telephone Screening Instrument plus (COGTEL+), the Serial Seven Test (SST), the Mini-Mental State Examination (MMSE) and the Geriatric Depression scale-15 (GDS), respectively. Statistical analyses included between groups-, correlation- and regression analyses. Demographic characteristics were considered in the regression models.ResultsThe study included 30 individuals with RA, 24 with SSc, 26 adults without cognitive impairment and 33 individuals with MiND. Lower performance in verbal short-term memory, concentration/attention, verbal fluency and MMSE in patients with RA compared to individuals without cognitive impairment was detected. Of note, performance on verbal fluency, concentration/attention, inductive reasoning and MMSE was lower in RA compared to MiND. Individuals with SSc performed worse in verbal fluency and in MMSE in comparison to adults without cognitive deficits. Verbal fluency deficits in SSc exceeded that in MiND. Performance on MMSE, COGTEL+, prospective memory, working memory, verbal fluency and concentration/attention was related to GDS scores, which did not vary across the groups.ConclusionsPatients with RA and SSc encountered cognitive dysfunction, which partially pertains to depressive symptoms. Of note, the severity of cognitive dysfunction in many cases exceeded that of MiND.

Alpha Rhythm Wavelength of Electroencephalography Signals as a Diagnostic Biomarker for Alzheimer's Disease.

To explore changes in the alpha rhythm wavelength of background electroencephalography in Alzheimer's disease patients with different degrees of dementia in a resting state; examine their correlation with the degree of cognitive impairment; determine whether the alpha rhythm wavelength can distinguish mild Alzheimer's disease patients, moderately severe Alzheimer's disease patients, and healthy controls at the individual level; and identify a cut-off value to differentiate Alzheimer's disease patients from healthy controls. Quantitative electroencephalography signals of 42 patients with mild Alzheimer's disease, 42 patients with moderately severe Alzheimer's disease, and 40 healthy controls during rest state with eyes closed were analyzed using wavelet transform. Electroencephalography signals were decomposed into different scales, and their segments were superimposed according to the same length (wavelength and amplitude) and phase alignment. Phase averaging was performed to obtain average phase waveforms of the desired scales of each lead. The alpha-band wavelengths corresponding to the ninth scale of the background rhythm of different leads were compared between groups. The average wavelength of the alpha rhythm phase of the whole-brain electroencephalography signals in Alzheimer's disease patients was prolonged and positively correlated with the severity of cognitive dysfunction (P < 0.01). The ninth-scale phase average wavelength of each lead had high diagnostic efficacy for Alzheimer's disease, and the diagnostic efficacy of lead P3 (area under the receiver operating characteristic curve = 0.873) was the highest. The average wavelength of the electroencephalography alpha rhythm phase may be used as a quantitative feature for the diagnosis of Alzheimer's disease, and the slowing of the alpha rhythm may be an important neuro-electrophysiological index for disease evaluation.

Нейронспецифическая енолаза ликвора как объективный маркер когнитивных нарушений при ВИЧ-ассоциированной энцефалопатии

One of the main causes of cognitive dysfunction in a late stage of HIV infection is HIV-associated encephalopathy. The direct neurotropic impact of HIV creates the pathogenic basis for this clinical syndrome. The purpose — to evaluate the cognitive status and neuron-specific enolase (NSE) level in cerebrospinal fluid (CSF) in HIV-encephalopathy patients. Material and methods. 35 patients were included in the study. They were divided into two groups: 20 patients (9 females and 11 males) with cognitive dysfunction and confirmed diagnosis of HIV/AIDS and 15 patients (6 females and 9 males) were in comparison group. The cognitive status was investigated by mini-mental state examination (MMSE), international HIV-dementia scale (IHDS) and frontal assessment battery (FAB). CSF level of NSE were investigated by ELISA test. Results. Correlation between cognitive dysfunction severity and NSE level in CSF was determined in HIV-encephalopathy patients. Conclusion. NSE level changing in CSF is an objective indicator of clinical severity of HIV-encephalopathy and neurotropic impact of HIV.

USEFULNESS OF REVISED SIMPLIFIED SHORT-TERM COGNITIVE SCREENING TEST (STMT-R) IN ACUTELY ILL GERIATRIC PATIENTS

Abstract Background Dementia can be a major cause of mortality and morbidity in geriatric patients. So, it would be essential to assess their mental state.Aims: We aim to appraise the impact of cognitive dysfunction on the long-term prognosis on STMT-R as a quicker and sensitive cognitive identification in acutely ill geriatric patients. Methods The inclusion criteria were to measure geriatric patients by STMT-R at admission, age≧50yo and being non-critical ill. Between October 2014 and September 2015, 836 were enrolled (52.4% female, mean age: 78.9 years). STMT-R≦4 was considered as cognitive dysfunction. Following the collection of clinical data, survival was subsequently measured for 7-8 years until January 2022. Cox’s proportional hazards regression models were used to evaluate the hazard of death according to the dementia severity, with adjustment for potential covariates. Survival was estimated using Kaplan-Meier method. Results Among enrolled subjects, 144 were unable to complete the test due to severe dementia (ITG). 433 had cognitive dysfunction (STMT-R≦4; CDG) and 259 didn’t have cognitive dysfunction (STMT-R&amp;gt;4; NCDG). The survival curves for death among three groups were significantly decreased in the CDG and ITG compared with the NCDG. The risks for mortality in the ITG and CDG are 3.92 (hazard ratio; 95% confidence interval:2.74-5.61, p&amp;lt; 0.001) and 1.82(1.33-2.51, p&amp;lt; 0.001) compared with the NCDG as reference. Conclusion 1) It was suggested that severity of cognitive dysfunction at admission has independently an impact on survival rate in acutely ill geriatric patients.2) STMT-R may also be useful for the future bedside or remote cognitive assessment.

Characteristic cerebral perfusion pattern in neuronal intranuclear inclusion disease.

Neuronal intranuclear inclusion disease (NIID), which pathogenesis remains largely unclear, is a neurodegenerative disease caused by GGC repeat expansion in NOTCH2NLC gene. As case studies have reported dynamic cortical perfusion changes in NIID, this study aimed to explore the cerebral perfusion pattern in NIID patients. A total of 38 NIID patients and 34 healthy controls (HCs) were recruited, and 2 NIID patients who had had episodic symptoms within 2 months were excluded. Data on demographic characteristics and clinical features were collected. All participants underwent three-dimensional pseudo-continuous arterial spin labeling perfusion magnetic resonance imaging (MRI) scanning. Voxel-based comparisons of cerebral blood flow (CBF) were conducted. NIID patients showed decreased perfusion in the cortex but increased perfusion in the deep brain regions compared with HCs. The regions with significant hypoperfusion were distributed in the bilateral frontal, temporal, parietal, and occipital gyri, with the left frontal gyrus being the most prominent. The regions with significant hyperperfusion included the bilateral basal ganglia, midbrain, pons, para-hippocampal, and parts of the bilateral cerebellum, fusiform, lingual, rectus, orbital, and cingulum anterior gyri, which were adjacent to the midline (all FDR-corrected p <0.05). When comparing the mean CBF value of the whole brain, no significant differences were observed between NIID patients and HCs (28.81 ± 10.1 vs. 27.99 ± 5.68 ml/100 g*min, p = 0.666). Voxel-based analysis showed no significant difference in cerebral perfusion between NIID patients with and without episodic symptoms. The perfusion within the bilateral middle frontal and anterior cingulate gyri showed positive correlations with MMSE and MoCA scores using age, sex, and education as covariates (p <0.005 uncorrected). NIID patients exhibited characteristic cortical hypoperfusion and deep brain hyperperfusion. The perfusion in the bilateral frontal lobe and cingulate gyrus was correlated with the severity of cognitive dysfunction. Cerebral perfusion change may be involved in NIID pathophysiology and serve as a potential indicator for monitoring NIID severity and progression.

Long-term cognitive performance and its relation to anti-inflammatory therapy in a cohort of survivors of severe COVID-19

Background and objectivesLong-term cognitive performance data in former critically ill COVID-19 patients are sparse. Current evidence suggests that cognitive decline is related to neuroinflammation, which might be attenuated by COVID-19 related anti-inflammatory therapies. The objective of this prospective cohort study was to study long term cognitive outcomes following severe COVID-19 and the relation to anti-inflammatory therapies. MethodsProspective observational cohort of patients that survived an intensive care unit (ICU) admission due to severe COVID-19. Six months after hospital discharge, we extensively assessed both objective cognitive functioning and subjective cognitive complaints. Furthermore, patients were stratified in cohorts according to their anti-inflammatory treatment (i.e. no immunomodulatory therapy, dexamethasone, or both dexamethasone and interleukin-6 receptor antagonist tocilizumab). Results96 patients were included (March 2020–June 2021, median [IQR] age 61 [55–69] years). 91% received invasive mechanical ventilation, and mean ± SD severity-of-disease APACHE–II–score at admission was 15.8 ± 4.1. After 6.5 ± 1.3 months, 27% of patients scored cognitively impaired. Patients that did or did not develop cognitive impairments were similar in ICU-admission parameters, clinical course and delirium incidence. Patients with subjective cognitive complaints (20%) were more likely women (61% vs 26%), and had a shorter ICU stay (median [IQR] 8 [5–15] vs 18 [9–31], p = 0.002). Objective cognitive dysfunction did not correlate with subjective cognitive dysfunction. 27% of the participants received dexamethasone during intensive care admission, 44% received additional tocilizumab and 29% received neither. Overall occurrence and severity of cognitive dysfunction were not affected by anti-inflammatory therapy, although patients treated with both dexamethasone and tocilizumab had worse executive functioning scores (Trail Making Test interference) than patients without anti-inflammatory treatment (T-score 40.3 ± 13.5 vs 49.1 ± 9.3, p = 0.007). DiscussionA relevant proportion of critically ill COVID-19 patients shows deficits in long-term cognitive functioning. Apart from more pronounced executive dysfunction, overall, anti-inflammatory therapy appeared not to affect long-term cognitive performance. Our findings provide insight in long-term cognitive outcomes in patients who survived COVID-19, that may facilitate health-care providers counseling patients and their caregivers.

Cognitive Task Performance and Subjective Cognitive Symptoms in Individuals With Chronic Fatigue Syndrome or Fibromyalgia: A Cross-Sectional Analysis of the Lifelines Cohort Study.

This study examined cognitive task performance and self-reported cognitive functioning in individuals with chronic fatigue syndrome (CFS) and fibromyalgia (FM) in a population-based sample and investigated the role of mood and anxiety disorders as well as severity of the physical symptoms. This study was performed in 79,966 participants (mean [standard deviation] age = 52.9 [12.6] years, 59.2% women) from the Lifelines general population. Symptoms consistent with the diagnostic criteria for CFS and FM were assessed using questionnaires. Two comparison groups were used: participants with self-reported medical disorders with well-defined pathophysiology (i.e., multiple sclerosis and rheumatic arthritis) and controls without these diseases. Objective task performance was based on the computerized CogState cognitive battery and subjective cognitive symptoms using the concentration subscale of the Checklist Individual Strength. Cognitive task performance was poorer in individuals with CFS versus controls without disease and controls with a medical disorder, although the severity of cognitive dysfunction was mild. Participants meeting the criteria for CFS ( n = 2461) or FM ( n = 4295) reported more subjective cognitive symptoms compared with controls without a medical disorder ( d = 1.53, 95% confidence interval [CI] = 1.49-1.57 for CFS; d = 1.25, 95% CI = 1.22-1.29 for FM) and participants with a medical disease ( d = 0.62, 95% CI = 0.46-0.79 for CFS; d = 0.75, 95% CI = 0.70-0.80 for FM). These differences remained essentially the same when excluding participants with comorbid mood or anxiety disorders or adjusting for physical symptom severity. Subjective cognitive symptoms and, to a lesser extent, suboptimal cognitive task performance are more prevalent in individuals with CFS or FM compared with controls without these conditions.

Serum neurofilament light reflects cognitive dysfunctions in children with obstructive sleep apnea

BackgroundIn children, obstructive sleep apnea (OSA) can cause cognitive dysfunctions. Amyloid-beta and tau are elevated in OSA. Neurofilament light (NfL) is a marker of neuro-axonal damage, but there are no reports of NfL for OSA. The objective was to investigate the serum levels of NfL and tau in children with or without OSA and explore their relationship with cognitive dysfunctions caused by OSA.MethodsThis retrospective case–control study included children diagnosed with adenoid tonsil hypertrophy from July 2017 to September 2019 at the Second Affiliated Hospital of Xi’an Jiaotong University. Correlations between cognitive scores and tau and NfL were examined.ResultsFifty-six OSA and 49 non-OSA children were included. The serum NfL levels were higher in the OSA group (31.68 (27.29–36.07) pg/ml) than in the non-OSA group (19.13 (17.32–20.95) pg/ml) (P < 0.001). Moreover, NfL was correlated with the course of the disease, apnea–hypopnea index (AHI), obstructive apnea index (OAI), obstructive apnea–hypopnea index (OAHI), average oxygen saturation (SaO2), respiratory arousal index (RAI), and cognitive dysfunctions evaluated by the Chinese Wechsler Intelligence Scale for Children (C-WISC) (all P < 0.05). The area under the receiver operating characteristics curve (AUC) of NfL was 0.816 (95%CI: 0.736–0.897). Multiple regression analysis revealed that NfL was significantly associated with verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ) and full-scale intelligence quotient (FIQ) (P < 0.001, respectively).ConclusionsSerum NfL levels are associated with the severity of cognitive dysfunctions in children diagnosed with adenoid tonsil hypertrophy and might be a candidate noninvasive, objective marker to identify cognitive dysfunctions in children with OSA.

Prevalence and severity of cognitive dysfunction in patients referred for transcatheter aortic valve implantation (TAVI): clinical and cognitive impact at 1year.

We estimated the proportion and severity of cognitive disorders in an unselected population of patients referred for transcatheter aortic valve implantation (TAVI). Second, we describe clinical and cognitive outcomes at 1year. Eligible patients were aged ≥ 70years, with symptomatic aortic stenosis and an indication for TAVI. The Montreal Cognitive Assessment (MoCA) was used to assess cognitive dysfunction (CD), defined as no CD if score ≥ 26, mild CD if 18-25; moderate CD if 10-18, and severe CD if < 10. We assessed survival and in-hospital complications at 6months and 1year. Between June 2019 and October 2020, 105 patients were included; 21 (20%) did not undergo TAVI, and thus, 84 were analyzed; median age 85years, 53.6% females, median EuroScore 11.5%. Median MoCA score was 22 (19-25); CD was excluded in 18 (21%), mild in 50 (59.5%), moderate in 15 (19%) and severe in 1. Mean MoCA score at follow-up was 21.9(± 4.69) and did not differ significantly from baseline (21.79 (± 4.61), p = 0.73). There was no difference in success rate, in-hospital complications, or death across CD categories. The clinical course of patients with mild or moderate CD is not different at 1year after TAVI compared to those without cognitive dysfunction.

Visuospatial alpha and gamma oscillations scale with the severity of cognitive dysfunction in patients on the Alzheimer\u2019s disease spectrum

BackgroundEntrainment of neural oscillations in occipital cortices by external rhythmic visual stimuli has been proposed as a novel therapy for patients with Alzheimer’s disease (AD). Despite this increased interest in visual neural oscillations in AD, little is known regarding their role in AD-related cognitive impairment and in particular during visuospatial processing.MethodsWe used source-imaged magnetoencephalography (MEG) and an established visuospatial processing task to elicit multi-spectral neuronal responses in 35 biomarker-confirmed patients on the AD spectrum and 20 biomarker-negative older adults. Neuronal oscillatory responses were imaged to the level of the cortex, and group classifications and neurocognitive relationships were modeled using logistic and linear regression, respectively.ResultsVisuospatial neuronal oscillations in the theta, alpha, and gamma ranges significantly predicted the classification of patients on the AD spectrum. Importantly, the direction of these effects differed by response frequency, such that patients on the AD spectrum exhibited weaker alpha-frequency responses in lateral occipital regions, and stronger gamma-frequency responses in the primary visual cortex, as compared to biomarker-negative older adults. In addition, alpha and gamma, but not theta, oscillations robustly predicted cognitive status (i.e., MoCA and MMSE scores), such that patients with neural responses that deviated more from those of healthy older adults exhibited poorer cognitive performance.ConclusionsWe find that the multi-spectral neural dynamics supporting visuospatial processing differentiate patients on the AD spectrum from cognitively normal, biomarker-negative older adults. Oscillations in the alpha and gamma bands also relate to cognitive status in ways that are informative for emerging clinical interventions.

Cytokine Profile in Plasma Extracellular Vesicles of Parkinson's Disease and the Association with Cognitive Function.

Plasma extracellular vesicles (EVs) containing various molecules, including cytokines, can reflect the intracellular condition and participate in cell-to-cell signaling, thus emerging as biomarkers for Parkinson’s disease (PD). Inflammation may be a crucial risk factor for PD development and progression. The present study investigated the role of plasma EV cytokines as the biomarkers of PD. This cross-sectional study recruited 113 patients with PD, with mild to moderate stage disease, and 48 controls. Plasma EVs were isolated, and the levels of cytokines, including pro-interleukin (IL)-1β, IL-6, IL-10, tumor necrosis factor (TNF)-α, and transforming growth factor (TGF)-β1, were evaluated. Patients with PD had significantly increased plasma EV pro-IL-1β and TNF-α levels compared with controls after adjustment for age and sex. Despite the lack of a significant association between plasma EV cytokines and motor symptom severity in patients with PD, cognitive dysfunction severity, assessed using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment, was significantly associated with plasma EV pro-IL-1β, IL-6, IL-10, and TNF-α levels. This association was PD specific and not found in controls. Furthermore, patients with PD cognitive deficit (MMSE < 26) exhibited a distinguished EV cytokine profile compared to those without cognitive deficit. The findings support the concept of inflammatory pathogenesis in the development and progression of PD and indicate that plasma EV cytokines may serve as PD biomarkers in future.

Detection and Prediction of Mild Cognitive Impairment in Alzheimer's Disease Mice.

Background:The recent failure of clinical trials to treat Alzheimer’s disease (AD) indicates that the current approach of modifying disease is either wrong or is too late to be efficient. Mild cognitive impairment (MCI) denotes the phase between the preclinical phase and clinical overt dementia. AD mouse models that overexpress human amyloid-β (Aβ) are used to study disease pathogenesis and to conduct drug development/testing. However, there is no direct correlation between the Aβ deposition, the age of onset, and the severity of cognitive dysfunction.Objective:To detect and predict MCI when Aβ plaques start to appear in the hippocampus of an AD mouse.Methods:We trained wild-type and AD mice in a Morris water maze (WM) task with different inter-trial intervals (ITI) at 3 months of age and assessed their WM performance. Additionally, we used a classification algorithm to predict the genotype (APPtg versus wild-type) of an individual mouse from their respective WM data.Results:MCI can be empirically detected using a short-ITI protocol. We show that the ITI modulates the spatial learning of AD mice without affecting the formation of spatial memory. Finally, a simple classification algorithm such as logistic regression on WM data can give an accurate prediction of the cognitive dysfunction of a specific mouse.Conclusion:MCI can be detected as well as predicted simultaneously with the onset of Aβ deposition in the hippocampus in AD mouse model. The mild cognitive impairment prediction can be used for assessing the efficacy of a treatment.

Когнітивна дисфункція у пацієнтів з артеріальною гіпертензією залежно від рівня загального холестеролу

SummaryObjective. Arterial hypertension (AH) is one of the most important risk factors forthe development of chronic vascular brain damage, significant symptoms of which arecognitive disorders.The aim of the research was to study the characteristics of the clinical picture,extracranial haemodynamics, indices of higher brain functions in patients with AH,depending on total cholesterol (TC) plasma level.Materials and methods. Were examined 157 patients (119 males, 38 females) whowere allocated into 3 groups according to the plasma level TC: the first group (n=48)included patients with the mean TC level (7.3±0.7) mmol/L; the second (n=58) group ofpatients with the TC level (5.8±0.8) mmol/L; the third (n=51) – with the TC level(4.7±0.5) mmol/L.Results. It was found that, with an increase in plasma TC level from the desiredlevel to a higher one, patients with AH develop the signs of chronic cerebral ischemia.The daily blood pressure profile is disturbed due to the insufficient degree of nightlydecline. The elastotonic characteristics of the vascular wall of the extracranial arterieschanges with the increase of the asymmetry of blood flow, which is accompanied withneurasthenic disorders of the anxious-depressive type as well as a significant decreasein cognitive functions.Conclusions. The severity of cognitive dysfunction must be taken into account whenconducting preventive measures and assessing the prognosis in patients with AH andconcomitant hypercholesterolemia.

Features of the cognitive component of chronic pain in young people with vertebral dorsalgia

Objective: to identify the presence and characteristics of the cognitive component of pain in young patients suffering from chronic dorsalgia. Material and methods: 97 patients with chronic vertebral pain syndromes of the cervicobrachial (50 patients) and lumbosacral localization (47 patients) and 20 healthy individuals in the control group. Pain assessment was carried out using Visual Analogue Scale, MMSE, Luria’s tests. It was shown, that the examined patients had cognitive impairment in the form of decrease in the concentration of attention and difficulties in the mental activity, more pronounced in patients with pain syndromes of the cervicobrachial localization. The severity of cognitive dysfunction is more associated with the severity of the muscle-tonic syndrome than with the intensity of pain. Cognitive impairment in patients with chronic back pain depends on the degree of muscle tonic syndrome pain intensity. Keywords: cognitive impairment, chronic back pain

A soluble truncated tau species related to cognitive dysfunction is elevated in the brain of cognitively impaired human individuals

Neurofibrillary tangles are a pathological hallmark of Alzheimer’s disease, and their levels correlate with the severity of cognitive dysfunction in humans. However, experimental evidence suggests that soluble tau species cause cognitive deficits and memory impairment. Our recent study suggests that caspase-2 (Casp2)-catalyzed tau cleavage at aspartate 314 mediates synaptic dysfunction and memory impairment in mouse and cellular models of neurodegenerative disorders. Δtau314, the C-terminally-truncated cleavage products, are soluble and present in human brain. In addition, levels of Δtau314 proteins are elevated in the brain of the cognitively impaired individuals compared to the cognitively normal individuals, indicating a possible role for Δtau314 proteins in cognitive deterioration. Here we show that (1) Δtau314 proteins are present in the inferior temporal gyrus of human brains; (2) Δtau314 proteins are generated from all six tau splicing isoforms, (3) levels of both Casp2 and Δtau314 proteins are elevated in cognitively impaired individuals compared to cognitively normal individuals, and (4) levels of Δtau314 proteins show a modest predictive value for dementia. These findings advance our understanding of the characteristics of Δtau314 proteins and their relevance to cognitive dysfunction and shed light on the contribution of Casp2-mediated Δtau314 production to cognitive deterioration.

Prophylaxis of cerebro-vascular complications while performance of aorto-coronary shunting in conditions of artificial blood circulation

Objective. To estimate the efficacy of application of vasodilator nitroglycerine on background of high volumic speed of perfusion for prophylaxis of the cerebral vessels microembolism while performance of the aorto-coronary shunting (ACSH) operations in conditions of artificial blood circulation. Маterials and methods. The investigation was conducted in 72 patients, suffering the ischemic heart disease, to whom aorto-coronary shunting operation was accomplished in conditions of artificial blood circulation in the Odessa Regional Clinical Hospital. Median age of the patients have constituted (67.3 ± 5.2) yrs old, median body mass index - (27.4 ± 5.2) kg/m2, average duration of the operation - (269.4 ± 7.8) min, including the artificial blood circulation stage - (145 ± 4.5) min. General statistical sampling of the patients examined was randomized in accordance to the comparison group (n=34) and the investigated (n=38) group. For prophylaxis of the air microembolism in patients of the comparison group before the artificial blood circulation apparatus switching on during 9 - 10 min nitroglycerine was infused in the dose 8 - 10 mcg/kg × min on background of high (120 - 130% from the calculated one) volumic speed of perfusion with support of median index of arterial pressure on the level 50 - 60 mm Hg. Іntraoperative monitoring of cerebral blood flow was done, using transtemporal access in accordance to standard procedure. Cognitive status of the patients was estimated with the help of verbal and nonverbal tests (day before and on the fifth postoperative day). Results. The investigation accomplished have revealed, that in all the patient the ACSH operation in conditions of artificial blood circulation was accompanied by microembolism in the system of cerebral blood flow of the discrete character. Іntraoperative creation in cerebral blood flow of more than 750 microemboli causes occurrence of a clinically significant lowering of the brain cognitive functions in early postoperative period. Application of nitroglycerine as a kind of peripheral vasodilator in the dose 8 - 10 mcg/kg × min on background of high (120 - 130% of the calculated) volumic speed of perfusion have caused the reduction of the cognitive dysfunction severity by 15 - 20%.

RESULTS OF THE ADNI-DEPRESSION STUDY: Session 323

Results Of The ADNI-Depression Study. Overview: Late life depression (LLD) is one of the most common mental health disorders with which older patients are afflicted. LLD is complicated by the common co-occurrence of cognitive impairment (CI). Estimates suggest as many as 50-60% of older depressed patients may have mild cognitive deficits however the mechanisms contributing to CI are unclear. The ADNI-Depression (ADNI-D) Study is a 5-year two-site (University of California San Francisco and the University of Pittsburgh) NIMH sponsored study of late life depression. The study aims to characterize cognitive functioning patients with LLD and clarify neurobiological mechanisms contributing to cognitive impairment and accelerated cognitive decline in this patient population. The ADNI -D study partners with the Alzheimer's Disease Network Initiative (ADNI) and utilizes its core labs for data management, brain imaging, and biomarker assessments. The ADNI D study has been designed to focus on evaluating the impact of reduced cerebral blood flow, cortical atrophy, white matter disease, and amyloid deposition on cognitive impairment in LLD. The study is longitudinal; after an initial assessment subject are followed for 2 ½ years. ADNI-D is committed to rapid data sharing of the ADNI-D data. This session will present initial data from the ADNI-Depression Study baseline evaluation and will be organized into 4 topic areas. ADNI-D Methodology and Sample Characteristics (Nelson) The ADNI D sample is a well characterized sample of older adults with depression. The ADNI D methodology facilitates comparisons of this cohort of LLD participants with the larger ADNI study of non-depressed older adults with normal cognition, Mild Cognitive Impairment (MCI), and dementia in order to clarify neurobiological mechanisms contributing to cognitive impairment and accelerated cognitive decline. This session will be focused on describing the ADNI-D methodology for participant enrollment and data collection and to report ADNI D sample (n=121) characteristics for depression severity, lifetime history of depression and depression treatment, and functional impairment. Specifically, participant enrollment criteria and methods for the assessment of depression severity and lifetime history of depression and depression treatments will be summarized. Additionally, standardized methodology for collection of neuroimaging data, biomarkers, and data management will be presented. Cognitive Functioning in the ADNI Depression cohort (Morin). The clarification of types and severity of cognitive dysfunction in LLD remains a significant area of research. This session will focus on identifying the cognitive impairment rates of participants with LLD in the ADNI-D study at baseline, highlighting methodological considerations for matching subjects to ADNI participants on basis of cognitive functioning for biomarker analyses, and to assess the relationship of subjective cognitive complaints and ApoE status with objective measures cognitive performance. Association of Cortical Atrophy, White Matter Lesions, and Amyloid Accumulation with Cognition in Late Life Depression (Mackin) Cognitive impairment (CI) in LLD is often characterized by deficits of executive functioning (EF), memory, and language and LLD has been strongly linked to accelerated rates of cognitive decline in older adults. However, the causes of CI in LLD are not clear, in part due to limitations of previous work which have lacked comparisons to well characterized non-depressed older adults with CI caused by neurodegenerative diseases that are often concurrent with LLD, such as the early stages of Alzheimer's disease (AD) and cerebrovascular disease (CVD). The ADNI-D study will facilitate clarification of neurobiological mechanisms contributing to CI in LLD. This session will be focused on evaluating the impact of reduced cerebral blood flow (hypoperfusion), cortical atrophy, and amyloid deposition on CI in LLD in the context of previously documented relationships between CI and subcortical white matter abnormalities and genetic risk factors. Functional Network Level Pathophysiologic Abnormalities Associated with Late Life Depression (Tosun) Cognitive impairment, particularly in the domains of information processing speed, executive functioning, and memory, in LLD is consistent with neurobiological conceptualizations of LLD as being heavily mediated by extended neural networks comprised of the orbitofrontal, medial prefrontal, and cingulate cortices, and anatomical connections with the temporal and parietal lobes, and basal ganglia. By disturbing the normal function and dynamics of different brain networks, the pathophysiological mechanisms of LLD may generate different specific clinical symptoms. Therefore we examine the extent to which multimodal neuroimaging techniques can identify biomarkers reflecting key pathophysiologic processes in LLD and whether such biomarkers may act as predictors, moderators, and mediators of depressive symptoms. This might facilitate development of personalized treatments based on a better understanding of the pathophysiological mechanisms of late life depression.