Cognitive Test Performance Research Articles

Effect of antipsychotic on mismatch negativity amplitude and evoked theta power in drug-naïve patients with schizophrenia

BackgroundRecurrent observations have indicated the presence of deficits in mismatch negativity (MMN) among schizophrenia. There is evidence suggesting a correlation between increased dopaminergic activity and reduced MMN amplitude, but there is no consensus on whether antipsychotic medications can improve MMN deficit in schizophrenia.MethodsWe conducted clinical assessments, cognitive function tests, and EEG data collection and analysis on 31 drug-naïve patients with schizophrenia. Comprehensive evaluation tools such as PANSS and MCCB. MMN amplitude was analyzed by event-related potential (ERP) approaches, evoked theta power was analyzed by event-related spectral perturbation (ERSP) approaches.ResultsOur findings indicate that antipsychotic treatment significantly improved clinical symptoms, as evidenced by reductions in PANSS positive, negative, general symptoms, and total scores (all p < 0.001). Cognitive function improvements were observed in language learning, working memory, and overall MCCB scores (p < 0.05), although other cognitive domains showed no significant changes. However, no significant improvements were noted in MMN amplitude and evoke theta power after four weeks of antipsychotic treatment (p > 0.05).ConclusionThese results suggest that while antipsychotic medications effectively alleviate clinical symptoms, their impact on MMN amplitude and evoke theta power deficit is limited in the short term. Moreover, the amelioration of cognitive impairment in individuals with schizophrenia is not readily discernible, and it cannot be discounted that the enhancement observed in language acquisition and working memory may be attributed to a learning effect. These findings underscore the complexity of the neurobiological mechanisms involved and highlight the need for further research to optimize individualized treatment strategies for schizophrenia.Trial RegistrationChiCTR2000038961, October 10, 2020.

Evaluating Social Determinants of Health-Based Alternatives to Race-Based Cognitive Normative Models.

Race and ethnicity are proxy measures of sociocultural factors that influence cognitive test performance. Our objective was to compare different regression-based cognitive normative models adjusting for demographics and different combinations of easily accessible/commonly used social determinants of health (SDoH) factors, which may help describe cognitive performance variability historically captured by ethnoracial differences. We performed cross-sectional analyses on data from Black and White participants without mild cognitive impairment/dementia in the Atherosclerosis Risk in Communities Study who attended visit 5 in 2011-2013. Participants underwent a battery of 11 cognitive tests (3 domains: memory, executive function, language). We fit 6 separate normative models for each cognitive test, all including age and education, with different combinations of race, the Wide Range of Achievement Test (education quality proxy), and area deprivation index (neighborhood deprivation) associated with current residence. We compared model fits and calculated concordances/discordances between models using z-scores derived from each normative model and a z-score <-1.5 threshold for impairment. Participants (n = 2,392) had a mean age of 74.4 years, 60.4% were female, and 17.1% were of self-reported Black race. The "Full" model with race alongside demographic and SDoH measures consistently outperformed other nested submodels (likelihood ratios ≥ 100) for all domains/tests except Delayed Word Recall. Models with education quality alone ("WRAT") generally outperformed models with neighborhood deprivation ("ADI") or race ("Race") alone for memory and language tests while "Race" models performed better for executive function tests. Adding neighborhood deprivation to education quality ("WRAT + ADI") did not improve models vs using "WRAT" alone. Across all domains/tests, the concordance compared with the "Full" model was lower for "Education" and "ADI" models than for other nested models. Although numbers were small, there was greater discordance among Black (range = 8.2%-23.2%) compared with White (range = 2.2%-3.4%) participants, particularly for Boston Naming Test and executive function tests. Education quality outperformed neighborhood disadvantage as an additional/alternative SDoH measure in normative models and may be useful to collect in cognitive aging studies. While performance varied across cognitive domains and tests, routinely reported SDoH variables (education level, education quality, late-life neighborhood deprivation) did not fully account for observed ethnoracial variability; future work should evaluate SDoH across the lifespan in more ethnoracially diverse populations.

Association between cumulative body mass index exposure and cognitive function among elderly people aged 60 years and older in China

Objective: To analyze the relationship between cumulative body mass index (BMI) and cognitive score or cognitive impairment at different age groups among elderly adults aged≥60 years old. Methods: Participants were recruited from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR). A total of 27 227 participants aged≥60 years old, who completed at least 2 physical examinations between 1992-1994 and 2018-2021, and completed cognitive function tests from 2018 to 2021, were included in the final analysis. Cognitive score was assessed using the Minimum Mental State Examination (MMSE). Cognitive impairment was defined based on education level: illiterate individuals with MMSE≤17, primary school graduates with MMSE≤20, and secondary school graduates with MMSE≤24. Multivariate linear regression or multivariate logistic regression models were used to analyze the association between 10-year weighted cumulative BMI and cognitive score or cognitive impairment in the general population, as well as in specific age groups (including 60-64 years, 65-69 years, 70-74 years, and≥75 years). Restricted cubic spline was adopted to explore the dose-response relationship. Results: The age of enrolled participants was (72.3±5.8) years, and 10 639 (39.1%) were males. The mean MMSE score was (24.9±6.8), and 4 171 (15.4%) participants had cognitive impairment. In the general population, the MMSE score increased and the risk of cognitive impairment decreased with the increase in cumulative BMI when cumulative BMI was280 kg/m2 (β=0.095, 95%CI: 0.060-0.130; OR=0.962, 95%CI: 0.946-0.978). When cumulative BMI≥280 kg/m2, the associations between cumulative BMI level and MMSE score and cognitive impairment risk were not statistically significant (β=-0.105, 95%CI:-0.212-0.001; OR=1.047, 95%CI: 0.992-1.102). Subgroup analysis according to age groups revealed a potential"U-shaped"correlation between cumulative BMI and MMSE score or cognitive impairment risk in participants aged75 years old. For cumulative BMI levels280 kg/m2, the OR and 95%CI for cognitive impairment were 0.983 (0.904-1.069), 0.953 (0.919-0.987), and 0.951 (0.922-0.982) for each 10 kg/m2 increment in cumulative BMI in the 60-64, 65-69, and 70-74 years old groups, respectively. For cumulative BMI≥280 kg/m2, the OR and 95%CI were 1.548 (1.134-2.186), 1.037 (0.938-1.139), and 1.109 (1.014-1.208) in the 60-64, 65-69, and 70-74 age groups. Among those aged≥75 years old, the cumulative BMI level was statistically associated with the increased MMSE score and decreased cognitive impairment (β=0.132, 95%CI: 0.074-0.190; OR=0.961, 95%CI: 0.944-0.979). Conclusions: Overall, when cumulative BMI is280 kg/m2, an increase in cumulative BMI is associated with a reduced risk of cognitive impairment in the general population. However, the association varies among individuals aged75 years old and those≥75 years old when cumulative BMI is≥280 kg/m2. The findings highlight the necessity of personalized weight management strategies for elderly individuals across different age groups.

Long -term multimodal exercise intervention for patients with frontotemporal lobar degeneration: Feasibility and preliminary outcomes

Introduction: After Alzheimer's disease, frontotemporal lobar degeneration (FTLD) is the second most common form of early-onset dementia. Despite the heavy burden of care for FTLD, pharmacological and non-pharmacological treatments with sufficient efficacy remain scarce. This study aimed to evaluate the feasibility of a multimodal exercise program for FTLD and to examine preliminary changes in the clinical outcomes of the program in FTLD. Methods: This single-arm preliminary study was conducted from July 2017 to July 2018 and recruited four male patients with FTLD aged 60–78 years. Patients exercised under the supervision of an exercise instructor once every 2 weeks for 48 weeks. The multimodal exercise program comprised cognitive training, moderate-intensity continuous training, strength training, balance training, and flexibility and relaxation training. Feasibility was measured using dropout and attendance rates. Cognitive, psychological, physical, and behavioral function tests were conducted before and after the intervention. Results: All patients completed the intervention (100%) and attended well (93.6%). Positive changes in scores in the Stroop Color Word Test (cognitive; 5 out of 6 items), Mood Check List-short form 2 (psychological), movement subscales of the Stereotypy Rating Inventory (behavioral), and timed up-and-go (TUG, physical) assessments demonstrated a medium-to-high effect size (open effect size: 0.52–0.97). While there were improvements in some domains, such as recovery self-efficacy and exercise efficacy, the MMSE-J scores showed an overall slight decline, especially in the SD case where a marked decrease was observed. Additionally, three physical function items showed no effect, except for a positive outcome in the TUG test. Functional near-infrared spectroscopy (fNIRS) revealed increased activation in the frontal lobe, indicated by elevated oxygenated hemoglobin levels before and after the exercise intervention. This pattern of activation suggests that the intervention may have stimulated neural activity in the frontal lobe, potentially enhancing cognitive and behavioral functions, including executive function and attention. Conclusion: The long-term multimodal exercise intervention may be feasible and positively change the cognitive, psychological, physical, and behavioral functions in older adults with FTLD. Although the intervention led to improvements in certain areas, there were also declines observed in various functions, which may not necessarily be due to the intervention itself but rather reflect the natural progression of the disease.

Associations of cognitive test performance with self-reported mental health, cognition, and quality of life in adults with functional seizures: A systematic review and meta-analysis

Objective: People with functional seizures (FS) have frequent and disabling cognitive dysfunction and mental health symptoms, with low quality of life. However, interrelationships among these constructs are poorly understood. In this meta-analysis, we examined associations between objective (i.e. performance-based) cognitive testing and self-reported (i) mental health, (ii) cognition, and (iii) quality of life in FS. Method: We searched MEDLINE, Embase, PsycINFO, and Web of Science, with the final search on June 10, 2024. Inclusion criteria were studies documenting relationships between objective cognitive test scores and self-reported (i.e. subjective) mental health, cognition, and/or quality of life in adults with FS. Exclusion criteria were mixed FS/epilepsy samples. A modified Newcastle-Ottawa Scale evaluated risk of bias. This project is registered as CRD42023392385 in PROSPERO. Results: Initially, 4,054 unique reports were identified, with the final sample including 24 articles of 1,173 people with FS. Mean age was 35.9 (SD = 3.9), mean education was 12.6 (SD = 1.3), and proportion of women was 73.9%. Risk of bias was moderate, due in part to inconsistent reporting of confounding demographic variables. Significant relationships were found between global objective cognition and global self-reported mental health (k = 21, Z = −0.23 [0.04], 95% CI = −0.30, −0.16), depression (k = 11, Z = −0.13 [0.05], 95% CI = −0.21, −0.04), cognition (k = 5, Z = −0.16 [0.05], 95% CI = −0.26, −0.06), and quality of life (k = 5, Z = −0.17 [0.05], 95% CI = −0.24, −0.10). Exploratory analyses showed associations between select cognitive and mental health constructs. Conclusions: Objective cognition is reliably associated with self-reported mental health, cognition, and quality of life in people with FS. Scientific and clinical implications are discussed.

No Evidence of Interaction Between FADS2 Genotype and Breastfeeding on Cognitive or Other Traits in the UK Biobank.

Breastfeeding is hypothesised to benefit child health and cognitive functioning by providing long-chain polyunsaturated fatty acids, which are essential for brain development. In 2007, Caspi et al. found evidence in two cohorts for an interaction between genetic variation in the FADS2 gene (a gene involved in fatty acid metabolism) and breastfeeding on IQ. However, subsequent studies have provided mixed evidence for the existence of an interaction. We investigated the relationship between genetic variation in the FADS2 region, breastfeeding, and their interaction in up to 335,650 individuals from the UK Biobank. We tested for the interaction over a range of cognitive functioning tests, as well as educational attainment and other traits thought to be influenced by breastfeeding, including cardiometabolic traits, number of offspring, and atopic allergy. FADS2 alleles associated with an increase in docosahexaenoic acid in blood serum (the C allele of rs174575) were associated with decreased verbal-numerical reasoning ( ) and triglycerides ( ), increased number of offspring ( ), total cholesterol ( ), HDL ( ), and LDL cholesterol ( ). We observed no evidence of an interaction in any of the traits, regardless of the modelling strategy on any cognitive or non-cognitive traits. We postulate that the previous positive findings are likely to be spurious, perhaps due to lack of appropriate control for latent population structure.

Arterial calcification in the heart-brain axis and cognitive performance over time.

While cross-sectional studies suggest a link between arteriosclerosis and cognition, longitudinal research is lacking. We investigated how arteriosclerosis in the heart-brain axis is related to cognitive performance trajectories over time. Within the population-based Rotterdam Study, 2368 participants underwent noncontrast CT to quantify arterial calcification, a hallmark of arteriosclerosis, in five major arteries in the heart-brain axis. Following this scan, participants underwent repeated cognitive testing. The association between baseline calcification and longitudinal cognitive test performance was investigated using mixed models. Higher calcification was associated with worse baseline cognitive performance across domains (e.g., β for global cognition per 10-percentile increase of intracranial carotid artery calcification:-0.01 [95% confidence interval (CI): -0.03, -0.00]). Cognition declined faster across all cognitive tests, specifically for the intracranial carotid artery (p≤0.001). Arterial calcification is associated with accelerated cognitive decline across domains, especially for arteries closer to the brain. This effect may be attributable to hemodynamic changes preceding neurovascular damage. Arterial calcification is related to accelerated cognitive decline. Arterial calcification closer to the brain exerts the most influence on cognitive decline. Vascular damage influences cognitive decline across various domains.

Urinary Metal Levels, Cognitive Test Performance, and Dementia in the Multi-Ethnic Study of Atherosclerosis.

Metals are established neurotoxicants, but evidence of their association with cognitive performance at low chronic exposure levels is limited. To investigate the association of urinary metal levels, individually and as a mixture, with cognitive tests and dementia diagnosis, including effect modification by apolipoprotein ε4 allele (APOE4). The multicenter prospective cohort Multi-Ethnic Study of Atherosclerosis (MESA) was started from July 2000 to August 2002, with follow-up through 2018. A total of 6303 MESA participants were included. Data analysis was performed from October 12, 2023, to June 13, 2024. Urine samples were collected at baseline (2000-2002), and arsenic, cadmium, cobalt, copper, lead, manganese, tungsten, uranium, and zinc levels were measured in 2020-2022. Digit Symbol Coding (DSC) (n = 3819) (possible score range, 0-133), Cognitive Abilities Screening Instrument (CASI) (n = 3918) (possible score range, 0-100), and Digit Span (DS) (n = 4176) (possible score range, 0-30) cognitive tests were administered in 2010-2012; higher scores of each test indicate increasing levels of positive response. A total of 6303 participants were followed up for dementia diagnosis through 2018. The median age at baseline was 60 (IQR, 53-70) years, and 3303 participants (52.4%) were female. The median cognitive scores were 51 (IQR, 38-64) for DSC, 90 (IQR, 84-95) for CASI, and 15 (IQR, 12-18) for DS. There were 559 cases of dementia through the follow-up period. Inverse associations with DSC were identified: mean differences in z scores per IQR increase in metal levels were -0.03 (95% CI, -0.07 to 0.00) for arsenic, -0.05 (95% CI, -0.09 to -0.004) for cobalt, -0.05 (95% CI, -0.07 to -0.02) for copper, -0.04 (95% CI, -0.08 to -0.001) for uranium, and -0.03 (95% CI, -0.06 to -0.01) for zinc. Among 1058 APOE4 carriers, manganese was also inversely associated with DSC. The joint mean difference of DSC comparing percentile 95th with the 25th of the 9-metal mixture was -0.30 (95% CI, -0.47 to -0.14) for APOE4 carriers and -0.10 (95% CI, -0.19 to -0.01) for noncarriers. Arsenic, cadmium, cobalt, copper, tungsten, uranium, and zinc were individually associated with dementia, with hazard ratios per IQR of metal ranging from 1.15 (95% CI, 1.03-1.29) for tungsten to 1.46 (95% CI, 1.06-2.02) for uranium. The joint hazard ratio of dementia comparing percentiles 95th with the 25th of the 9-metal mixture was 1.71 (95% CI, 1.24-3.89), with no significant difference by APOE4 status. In this study, participants with higher concentrations of metals in their urine, compared with those with lower concentrations, had worse performance on cognitive tests and greater likelihood of developing dementia. The findings of this multicenter multiethnic cohort study might inform screening and potential interventions for prevention of dementia based on individuals' metal exposure levels and genetic profiles.

Psychosocial factors account for a proportion of the difference in cognitive performance between persons with and without HIV.

To investigate whether psychosocial factors account for a proportion of the difference in cognitive performance between persons with and without HIV. Cross-sectional study of 273 participants (178 persons with HIV) from a low income area of Cape Town, South Africa. Participants completed comprehensive cognitive testing (7 domains) and 12 psychosocial measures (5 current: income, occupation, assets, accommodation, depressive symptoms, 7 from childhood: assets, quality of education, exposure to childhood trauma and violence, primary caregiver occupation and highest level of education), as well as demographic measures standard in cognition studies (age, sex, years of education). We investigated the HIV association with global cognitive performance after adjustment for standard demographic variables, exploratory psychosocial variables, and balancing characteristics of those with and without HIV using propensity score modelling. Persons with HIV had significantly lower scores than persons without HIV in 8/12 psychosocial variables. Of these, 7/12 significantly predicted global T-score. In unadjusted regression, HIV status was associated with a reduction in global T-score of 3.72 units. Adjustment for standard variables, reduced the effect of HIV on global T score by 26.9% to 2.72, additional adjustment for psychosocial variables reduced by 40.3% to 2.22, and adjustment for propensity scores by 42.7% to 2.13. Persons with HIV in this setting have lower psychosocial indices, both current and in childhood, which are associated with lower cognitive test performance as an adult. This is incompletely mitigated by adjustments for standard demographic variables which risks overestimation of cognitive impairment on a population level.

A Detailed study on Effects of Mentha spp. Oil on Human Health

This study investigates the effects of Mentha spp. . essential oil on various aspects of human health, focusing on its antimicrobial, anti-inflammatory, and cognitive-enhancing properties. We conducted a series of in vitro and in vivo experiments to evaluate the efficacy of Mentha spp. . oil against common pathogens, its potential to reduce inflammation markers, and its impact on cognitive function. Our results demonstrate significant antimicrobial activity against Escherichia coli and Staphylococcus aureus, with minimum inhibitory concentrations (MICs) ranging from 0.5 to 2.0 μg/mL. In vivo studies revealed a reduction in inflammatory markers, including C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), by 30% and 25%, respectively, in subjects treated with Mentha spp. . oil. Cognitive function tests showed improvements in memory recall and attention span by 15% and 12%, respectively, in the treatment group compared to the control. These findings suggest that Mentha spp. . oil has potential applications in promoting human health through its antimicrobial, anti-inflammatory, and cognitive-enhancing properties. Keywords: Mentha spp. ., essential oil, antimicrobial, anti-inflammatory, cognitive function, human health.

Cognitive Function Tests: Application of MMSE and MoCA in Various Clinical Settings- a Brief Overview

Introduction: Cognitive impairment can emerge as part of aging or from conditions affecting brain function, such as stroke, brain tumors, delirium, and neurodegenerative diseases. Effective cognitive assessment in clinical practice requires brief, reliable tests that evaluate specific cognitive domains. The MMSE (Mini-Mental State Examination) and MoCA (Montreal Cognitive Assessment) are among the most frequently used tools for these evaluations, each offering unique insights. Purpose of Research: This study aims to compare the effectiveness of MMSE and MoCA in diagnosing cognitive impairment and determining their suitability in various clinical settings and patient profiles. Materials and Methods: The analysis includes 61 articles from databases such as PubMed and Scopus, identified using keywords: Neuropsychological Tests, Cognitive Function Tests, MMSE and MoCA. Basic Results: The results indicate that MMSE, while effective for initial dementia screening, is less sensitive to mild cognitive impairment and influenced by education and age. MoCA offers higher sensitivity for MCI and early Alzheimer's stages, making it valuable as a complementary tool to MMSE. Conclusions: Combining MMSE and MoCA assessments can enhance diagnostic accuracy across diverse clinical contexts. Each tool’s unique strengths contribute to a more comprehensive cognitive assessment approach, optimizing diagnostic strategies for specific patient needs.

Subtle signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with reduced cognitive function: results from the Hamburg City Health Study.

Atrial fibrillation is associated with cognitive dysfunction. Atrial cardiomyopathy has been correlated with both entities. We aimed to characterize the association of echocardiographic parameters of atrial cardiomyopathy with cognitive function and cerebral changes. Participants of the population-based Hamburg City Health Study underwent in-depth transthoracic echocardiography and cognitive function testing, the Animal Naming Test (ANT), the Trail Making Test A (TMT-A) and B (TMT-B), 10-word learning test and cerebral magnetic resonance imaging. After excluding individuals with stroke or depression, data from 7852 individuals were available. In multi-variable-adjusted regression analyses, the E/e'-ratio was associated with the level of impairment in the ANT (-0.19 per one standard deviation [SD] increase, 95% confidence interval [CI] -0.36-[-0.01]) and the TMT-A (0.01 per one SD increase, 95% CI 0.003-0.020). Left atrial global peak strain was associated with positive performance in the TMT-A and B (-0.01 per one SD increase [95% CI -0.02-(-0.002)] and -0.02 per one SD increase [95% CI -0.03-(-0.01)], respectively) and the immediate recall of the 10-word learning test (0.11 per one SD increase, 95% CI 0.02-0.20). The E/e'-ratio was positively associated with the total and periventricular white matter hyperintensity load in age- and sex-adjusted regression analyses though statistical significance was lost after multi-variable adjustment. Subclinical echocardiographic signs of atrial cardiomyopathy and left ventricular diastolic dysfunction are associated with impaired performance in cognitive tests in the population. Our data provide evidence of the clinically important cardio-cerebral axis, relating cardiac dysfunction with cognitive performance.

A Network Analysis of Depression and Cognitive Impairments in Fibromyalgia: A Secondary Analysis Study.

Fibromyalgia is a chronic condition often accompanied by cognitive impairments, such as difficulties with sustained attention, and emotional disturbances, particularly depression and anxiety. Understanding how these emotional and cognitive factors interact is crucial to improving treatment for fibromyalgia patients. This study aimed to investigate the network structure of these interactions, focusing on the relationship between depression, anxiety, and cognitive performance. A total of one hundred ten participants diagnosed with fibromyalgia completed self-reported assessments of depression and anxiety, alongside cognitive performance tests. Key measures included Continuous Performance Tasks (CPT) for impulsivity and sustained attention, the Stroop Interference Index (StI), Stroop Color Naming (StC), and Stroop Word Reading (StW). Network analysis was conducted to estimate the relationships between emotional and cognitive variables and assess their centrality within the network. Errors in CPT emerged as the most significant indicators of the relationship between depression and cognitive performance, with high centrality values observed for the Stroop tasks (StI, StC, and StW). Additionally, Trait Anxiety (A_T) and Beck Depression Inventory (BDI) measures showed high centrality, underscoring the critical role of emotional states in the network of cognitive and emotional variables. The centrality values for cognitive flexibility, processing speed, and inhibitory control were found to be 0.85, 0.78, and 0.72, respectively. This study highlights the strong association between depression symptoms and deficits in cognitive domains, emphasizing the need for integrated care approaches that address both cognitive and emotional health. Multidisciplinary treatment programs, including cognitive rehabilitation and psychological support, could improve patient outcomes by targeting the most influential variables in the cognitive-emotional network.

Initial expressed emotion during neuropsychological assessment: investigating motivational dimensions of approach and avoidance

ABSTRACT Objective Prior work indicates that discrete emotions are linked to performance across multiple domains of cognitive function and thus have the potential to impact cognitive profiles in neuropsychological assessment. However, reported presence and magnitude of the relationships between emotion and cognitive test performance are inconsistent. Variable findings in this regard could be due to failure to consider motivations associated with expressed emotion. To better understand the potential impact of expressed emotion on neuropsychological test performance, it may be beneficial to consider approach and avoidance motivation during assessment. Method The current cross-sectional study examined associations between cognitive performance and digitally phenotyped facial expressions of discrete emotions on dimensions of approach (i.e. joy, sadness, anger) and avoidance (i.e. fear, disgust) in the context of virtual neuropsychological assessment in 104 adults (ages 55–90). Results Initial facial expressions categorized as anger and joy predicted later reduced cognitive performance in aspects of memory and executive function within the virtual session, respectively. Test performance was associated neither with sadness nor with avoidance emotions (i.e. disgust or fear). Conclusions Results of the current study did not strongly align with approach/avoidance explanations for links between emotion and cognitive performance; however, results might support an arousal-based explanation, as joy and anger are both high arousal emotions. Additional investigation is needed to understand the intersection of emotion motivation and physiological arousal in the context of neuropsychological assessment.

Single and joint exposure of Pb, Cd, Hg, Se, Cu, and Zn were associated with cognitive function of older adults

Background: Impaired cognitive function following exposure to heavy metals has emerged as a significant global health concern. Nevertheless, the impact of combined exposure to multiple heavy metals on cognitive impairment remains unclear. Objective: This study aimed to explore the association between multiple heavy metals exposure and cognitive function to provide theoretical evidence to guide prevention strategies. Methods: The blood levels of lead (Pb), cadmium (Cd), mercury (Hg), selenium (Se), copper (Cu) and zinc (Zn) and the results of the cognitive function tests were extracted from 811 elderly Americans who completed the NHANES between 2011 and 2014. Quantile regression (QR), restricted cubic splines (RCS), and Bayesian kernel machine regression (BKMR) were used to explore the individual and joint association between heavy metals exposure and performance in 4 standardized cognitive tests; Item Response Theory (IRT), Delayed Recall Test (DRT), Animal Fluency Test (AFT) and Digit Symbol Substitution Test (DSST). Results: A negative association was noted between Cd levels and IRT (p = 0.048, 95%CI: -2.7, -0.1). Se concentrations ranging between 2.197 µg/L (95%CI: 0.004, 0.15) to 2.29 µg/L (95%CI: 2.56, 7.64) (log10Se) was postively associated with DSST (p = 0.001 ). Cu was negatively associated with DSST (p = 0.049, 95%CI: -37.75, -0.09), while Zn was positively associated with IRT (p = 0.022, 95%CI: 0.55, 11.73). Exposure to the 6 heavy metals combined showed a positive linear association with IRT, DRT, and a negative linear association with DSST. An interaction between Cd and the other heavy metals (excepted for Pb). Conclusion: Exposure to Pb, Cd, Hg, Se, Cu, and Zn was associated with cognitive function. Joint exposure to the 6 heavy metals showed a positive linear association with IRT, DRT, contrarily, a negative linear association with DSST.

Iron deficiency anemia and its association with cognitive function among adolescents in the Ashanti Region - Ghana

BackgroundIron deficiency anemia (IDA) remains a global health concern, and has been associated with cognitive decline. However, very few studies have explored the association between IDA and cognitive function among Ghanaians. We assessed the association between IDA and cognitive function among adolescents in the Ashanti region, Ghana.MethodsThis cross-sectional study involved 250 adolescents from Kumasi, Ghana. Sociodemographic and dietary data were obtained using a well-structured questionnaire. Blood samples were drawn for estimation of ferritin and complete blood count. The Test of Non-verbal Intelligence (TONI-4) was used to assess cognitive function. Binary logistic regression was used to determine the predictors of cognitive function.ResultsThe prevalence of IDA was 30.4%, which was higher among adolescents with poor cognitive performance test scores (CPTS) (71%). Being female [aOR = 0.32, 95% CI (0.10–0.99), p = 0.0480)], father having junior high education [aOR = 0.08, 95% CI (0.02–0.45), p = 0.0040)], being in a category B school [aOR = 0.26, 95% CI (0.09–0.81), p = 0.0200)] and C [aOR = 0.08, 95% CI (0.02–0.40), p = 0.0020)] and non-fruit consumption [aOR = 0.18, 95% CI (0.06–0.52), p = 0.0010)], were significantly associated with lower likelihood of having very good cognitive function. Moreover, ferritin (r = 0.451, p < 0.001) and hemoglobin (r = 0.402, p < 0.001) demonstrated a moderate positive correlation with CPTS.ConclusionThe prevalence of IDA is high in our study population and was linked with poor cognitive function. Adolescents with IDA had low cognitive performance test scores. High levels of hemoglobin and ferritin showed a moderate correlation with higher cognitive performance. These findings suggest that adolescents’ cognitive function may be moderately influenced by IDA, highlighting the potential impact of iron status on cognitive outcomes.

Unleashing the power of golden berry leaves to counteract cyclophosphamide's toll with antioxidant, anti-inflammatory, anti-apoptotic, and neurotransmitter boosting effects

Ethnopharmacological relevanceGolden berries (Physalis peruviana) are esteemed for their healing properties and widespread use in traditional medicine, particularly for their neuroprotective benefits. Aim of the studyThis work aims to evaluate the neuroprotective effect of golden berry total leaf extract cultivated in Egypt (TLE) against cyclophosphamide (CP)-induced neurotoxicity and to identify the chemical composition of different organs of P. peruviana from both Egypt and USA. Material and methodsMetabolite profiling of TLE was conducted using ultra-high-performance liquid chromatography combined with quadrupole time-of-flight tandem mass spectrometry (UHPLC-QTOF-MS/MS). In the animal model experiment, CP (100 mg/kg, i.p.) was administered once weekly for four weeks to induce neurocognitive dysfunction. Concurrently, TLE (500 mg/kg, orally) was administered twice weekly throughout the four weeks to evaluate its effectiveness in alleviating CP-induced neuronal deficits. Behavioral assessments, Morris water maze and passive avoidance tests, were conducted, followed by, histological evaluations of brain tissue samples. Additionally, biochemical analyses were performed on hippocampal tissue samples, examining the following markers, acetylcholinesterase activity (AChE), malondialdehyde (MDA), nitric oxide (NO), superoxide dismutase (SOD), reduced glutathione (GSH), catalase (CAT) activity, nuclear factor kappa B (p-NF-κB p65) (Ser536), Interleukin 1β (IL-1β), Interleukin 6 (IL-6), tumor necrosis factor-α (TNF-α), B-cell lymphoma 2 (Bcl-2), and Bax (Bcl-2-associated X) levels. ResultsTLE significantly preserved hippocampal neurons and improved cognitive performance in behavioral tests. TLE achieved these beneficial effects by suppressing AChE activity, diminishing the oxidative stress and restoring redox balance via inhibiting p-NFκB/IL-1β,/TNFα/IL-6 cascades. Leaf extract revealed the highest total phenolic content (TPC) (2.7 ± 6.41 mg GAE/g extract) and total flavonoid content (TFC) (0.37 ± 1.19 mg QE/g) and the strongest antioxidant effects in Ferric Reducing Antioxidant Power (FRAP) and 2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) (ABTS) assays with IC50 values of 21.13 ± 1.48 and 18.19 ± 1.29 μg/mL, respectively. UHPLC–QTOF-MS/MS analysis resulted in the tentative identification of 20 metabolites including phenolic acids, flavonoids, hydroxycinnamic acid amides, and alkyl resorcinols. ConclusionsFindings verify for the first time the neuroprotective potential of golden berry leaf, currently discarded as agricultural waste, and highlight its multifaceted mechanism of neuroprotection in CP-induced neurotoxicity, suggesting its suitability as a promising therapeutic agent for neurotoxicity management.

A diffusion tensor imaging-based multidimensional study of brain structural changes after long-term high-altitude exposure and their relationships with cognitive function.

Brain structure changes after long-term adaptation to the high-altitude environment; however, related studies are few, results are in consistent, and long-term effects on cognitive function and pathophysiological mechanisms are unclear. Therefore, diffusion tensor imaging (DTI) was used to investigate the damage to white matter fiber tracts and correlations between brain structural abnormalities and cognitive function. Forty healthy Han people living on the high-altitude and 40 healthy Han people living on the plains were enrolled in this study and underwent magnetic resonance imaging, emotional state assessment, and cognitive function tests. The sex, age, education level, and social status of the two groups were not different. The tract-based spatial statistics (TBSS) method was used to analyze the DTI parameters of the white matter fiber tracts of the two groups. Moreover, the partial correlation method (age and sex as covariates) was used to analyze the correlations between the intergroup differences in the DTI parameters and a series of clinical indicators of emotional state and cognitive function. Two-sample t tests, Mann-Whitney U test, generalized linear model, or chi-square tests were used for statistical analysis. Compared with those individuals in the plain group, the scores on the PSQI, SDS, SAS, PHQ-9, and GAD-7 of individuals in the high-altitude group were higher, while the scores on the DST-Backwards, MoCA, and MMSE in the high-altitude group were lower. The fractional anisotropy (FA) value of the body of the corpus callosum in the high-altitude group was lower than that in the plain group. The FA value of the body of the corpus callosum in the plain group was negatively correlated with the Logical Memory, while no significant correlation was found in the high-altitude group. This study revealed that long-term exposure to a high-altitude environment could lead to a series of changes in sleep, emotion, and cognitive function and irreversible damage to the white matter microstructure of the body of the corpus callosum, which is the related brain region responsible for logical memory. The absence of logical memory impairment in the healthy Han Chinese population living on the high-altitude in this study may be due to the existence of adaptive compensation after long-term high-altitude exposure.

Abstract 4136180: Sex Differences in Cognition Related to Cerebral Small Vessel Disease Associated with Younger Age ofHypertension Diagnosis

Background: There are sex differences in the effect of age at onset (AO) of hypertension onbrain structural changes later in life. This may differentially affect long-term cognition through cerebral smallvessel disease (CSVD) in females and males. However, whether and how the association between age ofhypertension diagnosis contributes to sex differences in cognitive decline related to CVSD later in life remainsunclear. Objective: Our objective was to examine sex differences in cognition in relation to brain structural changesexacerbated by CSVD caused by younger AO of hypertension. Methods: We used data from the UK Biobank to select participants with a known age of hypertensiondiagnosis who also had neuropsychological test scores for cognitive functions affected by CSVD i.e., memoryand executive function (n= 6095). We stratified data by sex and AO at baseline (2006-2010). Controlparticipants who did not have hypertension were chosen at random using propensity score matching. Principalcomponents analysis (PCA) was used to reduce the number of CSVD related cognitive function tests(measured at 2014 follow-up). We selected participants &gt;65 years of age at the time of cognitive function teststo determine cognitive function later in life. This was followed by a sex disaggregated regression analysis totest for the effect of AO on cognitive functions identified from the PCA in females and males. Results: Our main outcomes were cognitive function tests in the domains of memory (working and visual-spatial) and executive function/processing speed. When compared to normotensive controls, cognitiveoutcomes differed by sex and age of hypertension diagnosis. Whereas females diagnosed at middle age (45-54 years) had worse outcomes in the working memory domain compared to controls, males diagnosed at olderage (&gt;65 years) had worse outcomes compared to controls. Only females diagnosed with hypertension ateither younger age (&lt; 35 years) or older age (&gt;65 years) had worse outcomes in the executive visualdeclarative memory domain. We did not see any differences in the processing speed/executive functiondomain in either males or females. Conclusions: This study demonstrates distinctive characteristics of CSVD-related cognitive decline in malesand females based on the age of hypertension onset. Therefore, CSVD is a critical pathophysiologicalmechanism for sex differences in cognitive decline and may aid in identification of novel sex-specific therapy.

NCOG-09. ASSOCIATIONS OF COGNITIVE FUNCTION WITH BRAIN STRUCTURE, COMT GENOTYPE, AND PSYCHOLOGICAL FACTORS IN MELANOMA PATIENTS PRIOR TO ADJUVANT IMMUNE CHECKPOINT INHIBITOR THERAPY

Abstract BACKGROUND Cancer-related cognitive impairment (CRCI) presents a significant concern in cancer patients. Yet, limited research addresses its prevalence and potential underlying risk factors in melanoma patients, including neurobiological, genetic, and psychological factors. METHODS We assessed cognitive functioning, cognitive complaints, brain gray matter (GM) properties, COMT genotype, and psychological factors (fatigue, anxiety, depression, insomnia severity, sleep difficulties, quality of life) in malignant melanoma patients (MMPs) before treatment with immune checkpoint inhibitors (ICIs) and compared with matched healthy controls (HCs). A total of 47 MMPs and 53 HCs were enrolled. Between-group differences were tested, and statistical associations between cognitive function and brain GM properties, COMT polymorphisms, and psychological factors were explored. RESULTS MMPs exhibited significantly lower levels of cognitive functioning compared with HCs across multiple cognitive tests (all p’s&amp;lt;.05), with a high prevalence of clinically significant CRCI (68.1% VS 26.4%). Analysis of GM properties revealed volumetric differences in the left cuneus between MMPs and HCs with MMPs having smaller volume compared to HCs. In MMPs but not in HCs, statistically significant associations were found between WAIS-IV Coding and right precentral cortical thickness, TMT-A and left inferior parietal cortical thickness, and BVMT-R Delayed Recall and right postcentral GM volume (all p’s&amp;lt;.01). COMT polymorphisms were associated with self-reported cognitive complaints but not with objective cognitive performance. Compared with HCs, MMPs reported higher levels of fatigue, anxiety, insomnia severity, and sleep difficulties, and lower levels of quality of life (all p’s ≤.009). Additionally, self-reported cognitive complaints in MMPs were associated with different cognitive test performances (all p’s&amp;lt;.05), fatigue (p&amp;lt;.001) and anxiety (p&amp;lt;.045). CONCLUSIONS These findings underscore the importance of comprehensive cognitive and psychological assessments in MMPs referred for adjuvant ICI therapy. Understanding the complex array of symptoms including CRCI in this population can inform tailored interventions to improve quality of life and treatment outcomes.