Trail Making Test A Research Articles

뇌졸중으로 인한 경도인지장애 환자에게 모바일 인지 활동 프로그램이 미치는 영향 : Case Study

Objective : This study aimed to investigate the effects of a mobile cognitive activity program on patients with mild cognitive impairment (MCI) caused by stroke, using a single-case study design. Methods: An case study design was employed in the study: Baseline A Traditional cognitive activity pro gram, Intervention Phase B: Mobile cognitive activity program, Return-to-Baseline A’: Reversion to the traditional program, Three stroke patients with MCI participated in the program for 30 minutes per session, five days per week, over three weeks (October 14–November 1, 2024). Assessments using online MoCA-K and CERAD-K were conducted at the end of each phase. Data were analyzed using SPSS 25.0 for descriptive statistics, including means and standard deviations. Results: The mean MoCA-K score improved from 20.33 (±2.08) during baseline A to 22.33 (±2.51) during intervention B and remained at 22.33 (±2.51) during the return-to-baseline A’. For the CERAD-K Trail Making Test A (TMA), the mean time improved from 129.66 seconds (±69.97) in baseline A to 108.00 seconds (±48.53) in intervention B, and further improved to 100.33 seconds (±38.68) in return-to-baseline A’. Conclusion: The mobile cognitive activity program had positive effects on patients with mild cognitive impairment caused by stroke, particularly in improving cognitive abilities related to language. This study provides foundational data for the application of mobile cognitive activity programs in stroke patients. Future research should further validate its effectiveness, allowing for broader use of such programs in the community.

Gray Matter Reserve Modulates the Association between Glymphatic System Function and Cognition in Patients with Type 2 Diabetes Mellitus

Introduction: The glymphatic system is regarded as a key factor in the pathogenesis of neurodegenerative diseases. Given the heightened risk of cognitive impairment in patients with type 2 diabetes mellitus (T2DM), the possible alterations in the glymphatic system in T2DM patients remain to be explored. Diffusion tensor imaging (DTI) analysis along the perivascular space (ALPS) index can be utilized to model the glymphatic system in humans. Our aim was to explore the relationship between the ALPS index and cognitive function in patients with T2DM and whether this relationship is modulated by gray matter (GM) integrity anchored by the ALPS index. Methods: All participants underwent evaluation using a comprehensive cognitive assessment scale to determine their neurocognitive status. The ALPS index was calculated based on DTI data, and the disparity in ALPS index values between patients with T2DM and healthy controls (HCs) was examined. Furthermore, multiple linear regression analysis was conducted in the T2DM group to identify the GM regions associated with the ALPS index, and the volumes of the GM partitions were extracted. The volume of GM partitions was used as the regulating variable, the ALPS index was used as the independent variable, and cognitive test scores were used as the dependent variable in our analysis. Results: The ALPS index differed significantly between the two groups, and the ALPS index in patients with T2DM was significantly lower than that in HCs. In addition, our analysis revealed a correlation between the ALPS index and GM volume in the insular region, consistent with the observed GM atrophy in the patient cohort. Moreover, a significant negative correlation was observed between the ALPS index in patients and performance on the Trail-Making Test-A (TMT-A), and this relationship was moderated by GM integrity. In patients with more severe GM atrophy, the ALPS index was more strongly correlated with cognitive function. Conclusions: In this study, a decreased ALPS index was found in T2DM patients, indicating impaired glymphatic function in this population. Furthermore, a significant association was detected between the ALPS index and cognitive performance in T2DM patients, and this correlation was influenced by GM integrity. Therefore, the ALPS index has the potential to be used as a biomarker of cognitive impairment in diabetic patients. Further studies are needed to investigate the diagnostic and therapeutic implications of glymphatic dysfunction in T2DM patients with cognitive impairment.

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.

Interleukin-5: an indicator of mild cognitive impairment in patients with type 2 diabetes mellitus - a comprehensive investigation ranging from bioinformatics analysis to clinical research.

Neuroinflammation constitutes an underlying mechanism for cognitive impairment. Here, we endeavor to scrutinize the potential contribution of interleukin-5 (IL-5) towards mild cognitive impairment (MCI), and to assess its diagnostic value for MCI in patients with type 2 diabetes mellitus (T2DM). RNA-seq was used to explore the potential neuroinflammation factors in the hippocampus of diabetic mice with cognitive decline. Additionally, the promising risk factor was verified in animals. Finally, the association between IL-5 levels and cognitive function and its diagnostic value for MCI were assessed. In animals, up-regulated IL-5 mRNA and protein levels were detected by RNA-seq and (or) verified experiments in the hippocampus of diabetic db/db mice with cognitive decline, compared to those of db/m mice without diabetes. In human, compared to diabetic patients without MCI, those with MCI demonstrate elevated levels of IL-5. It is natively associated with Montreal Cognitive Assessment (MoCA) scores, reflecting global cognitive function, and positively correlated with Trail Making Test A (TMTA) scores, reflecting information processing speed. Furthermore, an elevated level of IL-5 is identified as a risk factor for MCI, and a factor that influences TMTA scores. Finally, it is recommended that the cut-off value for IL-5 in the diagnosis of MCI is 22.98 pg/mL, with a sensitivity of 68.6% and specificity of 72.9%. IL-5 is considered a risk factor for MCI in T2DM patients and is associated with their performance in information processing speed. Moreover, an elevated level of IL-5 is a plausible biomarker for MCI in T2DM patients.

THE EFFECTS OF MULTICOMPONENT EXERCISE ON MILD COGNITIVE IMPAIRMENT IN ELDERLY POPULATION: A RANDOMIZED CONTROL TRIAL

Objective: To determine the effectiveness of multicomponent exercise on mild cognitive impairment in older adults. Materials and Methods: This randomized control trial was conducted at the Department of Rehabilitation at Pakistan Railway General Hospital, Rawalpindi. Fifty-eight older persons with mild cognition impairment were allocated randomly into 2 groups. The participants of the experimental group (n=29) performed multicomponent exercises two times a week for 55-60 minutes. In the control group (n=29), participants performed 20 minutes of treadmill walking thrice a week. Both groups performed these exercises for 6 weeks. Pre and post assessment was carried out at baseline and after 6 weeks of intervention for the following test: Mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), Trail-making test A (TMT-A) and Trail making test-B (TMT-B). Data was analyzed using SPSS 21. Results: The overall mean age of study participants was 62.74±74 years. Within-group analysis for MMSE, MoCA, TMT-A, and TMT-B significantly improved (p <0.05) in the experimental group in comparison to the control group. Between-group analysis showed that all parameters were significantly improved (P <0.05) at post-intervention assessment. Conclusion: Multicomponent exercise training was found to be effective in the elderly with mild cognitive impairment. A combination of exercise can enhance cognitive function, help in the prevention of the decline in cognitive function, and reduce the risk for dementia. Keywords: Mild Cognitive Impairment, Cognition, Trail Making Test, Dementia Trial Registration number: NCT03938051

An Investigation of the Correlation Between Retinal Nerve Fiber Layer Thickness with Blood Biochemical Indices and Cognitive Dysfunction in Patients with Type 2 Diabetes Mellitus.

The study aimed to explore the correlation between retinal nerve fiber layer thickness (RNFLT) with blood biochemical indicators and cognitive dysfunction in patients with type 2 diabetes mellitus (T2DM) and the possible mechanism, thereby providing more theoretical basis for the occurrence and prevention of diabetes related complications. Eighty T2DM patients treated in our hospital from March 2022 to September 2022 were selected as the study subjects, and the clinical data of the patients were retrospectively analyzed. All patients underwent fundus fluorescein angiography (FFA) to analyze the changes in retinal blood vessels. Patients who met the inclusion criteria were divided as the diabetic retinopathy (DR) group (n=46) and simple diabetes group (n=34). The RNFLT, blood biochemical indexes and changes in cognitive functions of the patients were detected. The correlation between RNFLT with blood biochemical indexes and cognitive dysfunction was analyzed. Compared with the simple diabetes group, patients in the DR group had much lower mean, nasal, inferior and superior thicknesses (P<0.01). There existed no significant difference in blood pressure, body mass index (BMI), blood lipids (triglycerides, cholesterol, low-density lipoprotein, high-density lipoprotein) between the two groups (P>0.05). Compared with the simple diabetes group, patients in the DR group had much higher fasting blood glucose (FBG), hemoglobin A1c (HbA1c), fasting insulin (FINS), insulin resistance (HOMA-IR) index, apolipoprotein B (ApoB)/apolipoprotein A1 (ApoA1) (P<0.001). Besides, the DR group had sharply lower scores on the Mini-Mental State Examination (MMSE) scale and higher levels of the Trail Making Test-A (TMT-A) and TMT-B (P<0.001). Spearman correlation analysis confirmed that the mean RNFLT was negatively correlated with the levels of FBG, HbA1c, HOMA-IR index, TMT-A and TMT-B (P<0.05), positively correlated with the score of mini-mental state examination (MMSE) (P<0.05), and was no significant correlation with FINS and ApoB/ApoA1 (P>0.05). DR patients had significantly reduced RNFLT, elevated levels of blood glucose related indicators, and cognitive dysfunction. There existed a correlation between RNFLT and FBG, HbA1c, HOMA-IR index, TMT-A, TMT-B and MMSE.

Parental Education as a Factor Correlated to Cognitive Performance in Offspring

Abstract Background The purpose of the study was to investigate the correlation between the results of 4 cognitive tests and years of parental education and to analyze their impact on cognitive performance in mentally healthy subjects. Subjects and Methods The sample consisted of 72 mentally healthy subjects (25 men, 47 women) assessed by 4 cognitive tests – the Trail Making Test A (TMT-A), the Trail Making Test Β (TMT-B), Digit Symbol Test (DST) and Verbal Fluency Test (VFT). Results were analyzed with descriptive statistics, Pearson correlation analysis and the partial correlation method to control the influence of one factor on the correlation between two variables. Results More years of parental education were associated with higher cognitive results. All four tests showed that mother's years of education have stronger positive influence on the cognitive performance of the child than fathers's years of education. For mothers this positive influential correlation have reached statistical significance for two cognitive tests – TMT-A (p &lt; .000) and TMT-B (p &lt; .007) and for DST was dose to reaching statistical significance (p &lt;. 103), while for fathers only TMT-A has showed a statistically significant correlation. These general patterns of tendencies of parental education as a factor correlated to cognitive performance in offspring are retained even after Controlling for subject's age or years of education, which independently have strong correlations with the results of the 4 cognitive tests. Conclusions Mother's years of education affect cognitive functions of the offspring much more than father's years of education.

Serum glial cell line-derived neurotrophic factor: a potential biomarker for white matter alteration in Parkinson's disease with mild cognitive impairment.

Mild cognitive impairment (MCI) is a common non-motor manifestation of Parkinson's disease, commonly referred to as PD-MCI. However, there is a lack of comprehensive data regarding the role of glial cell line-derived neurotrophic factor (GDNF) and cerebral white matter damage in the pathogenesis of PD-MCI. The objective of this study is to investigate the association between alterations in GDNF levels and cerebral white matter damage in individuals diagnosed with PD-MCI, as well as to explore their potential involvement in cognitive progression. Neuropsychological assessments were conducted on 105 patients with Parkinson's disease and 45 healthy volunteers to examine various cognitive domains. An enzyme-linked immunosorbent assay (ELISA) was employed to measure serum levels of GDNF. Additionally, all participants underwent 3.0T magnetic resonance imaging (MRI) to acquire diffusion tensor images (DTI), and a voxel-based analysis (VBA) approach was utilized to compare the fractional anisotropy (FA) values of white matter in the brain. There was a significant correlation between the right corpus callosum, right cingulate gyrus, and the Digit Span Backward Test (DSB-T) as well as the Trail Making Test A (TMT-A), both of which assess attention and working memory functions. The left internal capsule exhibited a significant correlation with the Trail Making Test B (TMT-B) and the Clock Drawing Test (CDT), which evaluate executive function. Additionally, the right cingulate gyrus showed a significant association with scores on the Auditory Verbal Learning Test-HuaShan (AVLT-H), assessing memory function. Abnormal fiber structures that demonstrated significant correlations with serum GDNF levels included the left internal capsule, left corticospinal tract, right corpus callosum, and right cingulate gyrus. The decrease in serum GDNF levels among PD-MCI patients exhibiting impairments in attention and working memory function was significantly correlated with alterations in the corpus callosum (knee) and posterior cingulate gyrus. Furthermore, the reduction of serum GDNF levels in PD-MCI patients with impaired executive function is associated with changes in the internal capsule (forelimb) projection fibers. Additionally, the decline of serum GDNF levels in PD-MCI patients experiencing memory function impairment is related to alterations in the right cingulate gyrus.

Association between pain intensity and cognitive function in primary headache

Background: Patients suffering from primary headaches such as migraine, tension-type headache, and cluster headache frequently report cognitive problems, particularly with attention and memory. The aim of this study was to see if there was a link between pain intensity and cognitive function in people who had primary headaches. Methods: This cross-sectional study included 69 primary headache patients (37 migraines, 27 tension-type headaches and 5 cluster headaches; age range 18–80 year). Migraine, tension-type headache and cluster headache diagnosis were determined according to the International Classification of Headache Disorders 3rd edition beta version (ICHD-3 beta) diagnostic criteria. All eligible subjects underwent cognitive function examination using Montreal Cognitive Assessment Indonesian version (MoCA-INA), Trail Making test A (TMT-A), Trail Making test B (TMT-B), Trail Making test C (TMT-C), Forward Digit Span and Backward Digit Span. The intensity of pain was assessed using Numeric Rating Scale (NRS). Results: There were 69 primary headache patients included in this study, 52 (75.4%) patients had abnormal MoCA-INA, 52(75.4%) patients had abnormal Forward Digit Span and 48(69.6%) patients had abnormal Backward Digit Span. There was significant correlation between pain intensity and cognitive function in migraine, TTH and cluster headaches patients. The MoCA-INA, Forward Digit Span and Backward Digit Span had negative correlations with pain intensity, whereas TMT A-time, TMT A-error, TMT B-time and TMT B-error had positive correlation. Conclusion: There were significant associations between pain intensity of and cognitive function in primary headaches with p&amp;lt;0.05. It is suggested that the more severe pain intensity, the more impair of cognitive function.

Comparison of olfactory function, cognitive function and serum tumor necrosis factor-α between bipolar and schizophrenic patients in the remission stage

ObjectivesOlfactory function, serum tumor necrosis factor-α (TNF-α) and cognitive function were compared between bipolar disorder (BD) and schizophrenia (SP) patients in the remission stage combined with correlation analysis, with the aim of identifying new indicators for the auxiliary diagnosis of these psychiatric illnesses.MethodsA total of 46 euthymic BD patients, 42 clinically stable SP patients and 42 healthy controls (HC) were included in this study. Olfactory sensitivity (OS) and olfactory identification (OI) were assessed using Sniffin’ Sticks test, and serum TNF-α levels were measured by ELISA. Clinical symptoms were evaluated with the Hamilton Rating Scale for Depression, Young Mania Rating Scale, Hamilton anxiety scale, and the Positive and Negative Syndrome Scale (PANSS). Social function was evaluated with the Global Assessment Function (GAF) scale. Cognitive function was evaluated using the Trail Making Test-A (TMT-A) and Digit Cancellation Test (DCT).ResultsOI and cognitive function scores and serum TNF-α levels were significantly lower in the BD and SP patients compared with the HC participants. There was no significant difference between the BD and SP groups, and there were no significant differences in OS among the three groups. OI score was positively correlated with years of education in both the BD and SP groups. OI score in the SP group was negatively correlated with age and PANSS score, and positively correlated with GAF score. In the BD group, OS was positively correlated with DCT II and DCT III. In the SP group, OS and OI scores were positively correlated with DCT III, and negatively correlated with TMT-A time. Furthermore, there was a positive correlation between TNF-α and DCT II in the BD group. There was no significant linear correlation between olfactory function and TNF-α in the BD or SP group.ConclusionOI may be a trait marker for BD and SP. Some cognitive functions may be correlated not only with TNF-α in BD patients in remission, but also with olfactory function in BD and SP patients in remission.

B - 64 Association of Perceived Stress during the COVID-19 Pandemic on Cognitive Performance in HIV+ Adults.

Stress may impact cognitive ability, and perceived stress may be a modifiable risk factor for cognitive impairment. This study investigates the potential impact of perceived stress levels on cognitive test performance in a NYC cohort of people living with HIV (PLWH), assessed during the COVID-19 pandemic. 124 racially-diverse PLWH participating in a longitudinal cohort completed comprehensive face-to-face neurocognitive test batteries between August 2020 and February 2023 (Mage = 61.22). Self-reported stress was assessed using the Perceived Stress Scale-14, and a median split (value of 18) was used to divide the sample into high and low stress groups. One-way ANOVAs were used to evaluate differences in cognitive performance based on stress grouping. Significant differences between high and low stress groups were found in: Trail Making Test-A (TMT-A), F(1,104) = 3.962,p = 0.049; Trail Making Test-B (TMT-B), F(1,80) = 7.106,p = 0.009; Paced Auditory Serial Addition Test (PASAT), F(1,80) = 7.096,p = 0.009; and Symbol Search (SS), F(1,102) = 5.280,p = 0.024. Participants in the high stress group had lower performance on TMT-A (M = 48.78, SD = 13.47), TMT-B(M = 49.56, SD = 13.92), PASAT (M = 43.07, SD = 12.57), and SS (M = 44.85, SD = 11.76) compared to the low stress group (M = 53.71, SD = 11.87; M = 57, SD = 10.72; M = 50.20, SD = 11.62; M = 49.78, SD = 9.85; respectively). Individuals reporting higher levels of stress during the COVID pandemic had reduced performance on tasks assessing information processing speed, executive functioning, and attention. This suggests that higher perceived stress levels and ambient stressors (such as the pandemic) may influence cognitive functioning.

Exosomal miR-let-7c-5p is involved in the cognitive function of type 2 diabetes mellitus patients by interleukin 10: A cross-sectional study.

Interleukin (IL)-10 plays a notable role in the inflammatory-associated mild cognitive impairment (MCI). We aimed to investigate whether IL-10 and its upstream factors exert an impact on MCI in type 2 diabetes mellitus (T2DM) patients. A total of 117 T2DM patients were recruited and divided into Control group and MCI group based on the presence or absence of MCI. Clinical parameters were collected. The Montreal Cognitive Assessment (MoCA) was conducted for global cognitive function. Digit Span Test (DST), Verbal Fluency Test (VFT), and Trail Making Test-B (TMTB) were used to evaluate the executive functions of the diabetic patients. Trail Making Test-A (TMTA) was performed to examine the information processing speed function. Patients' scene memory was examined by Logical Memory Test (LMT). After the baseline data were compared, correlation and regression analyses were performed to explore the relationship amongIL-10, miR-let-7c-5p and cognitive function. Compared to 80 patients in the control group, 37 patients in the MCI group exhibited lower IL-10 in plasma and higher miR-let-7c-5p levels in exosomes from plasma. The IL-10 level was negatively associated with MoCA. Likewise, miR-let-7c-5p levels were negatively correlated with IL-10 levels and MoCA. Elevated miR-let-7c-5p levels and decreased IL-10 levels are risk factors for MCI in T2DM patients. Increased miR-let-7c-5p and downregulated IL-10 may influence VFT and TMTB, respectively, associated with executive function. We demonstrated that IL-10 is correlated to the executive function of T2DM patients. Decreased IL-10 may result from the regulation of miR-let-7c-5p in exosomes.

Differential and correlational tractography as tract-based biomarkers in mild traumatic brain injury: A longitudinal MRI study.

We evaluated the fiber bundles in mild traumatic brain injury (mTBI) patients using differential and correlational tractography in a longitudinal analysis. Diffusion MRI data were acquired in 34 mTBI patients at 7 days (acute stage) and 3 months or longer (chronic stage) after mTBI. Trail Making Test A (TMT-A) and Digital Symbol Substitution Test changes were used to evaluate the cognitive performance. Longitudinal correlational tractography showed decreased anisotropy in the corpus callosum during the chronic mTBI stage. The changes in anisotropy in the corpus callosum were significantly correlated with the changes in TMT-A (false discovery rate [FDR] = 0.000094). Individual longitudinal differential tractography found that anisotropy decreased in the corpus callosum in 30 mTBI patients. Group cross-sectional differential tractography found that anisotropy increased (FDR = 0.02) in white matter in the acute mTBI patients, while no changes occurred in the chronic mTBI patients. Our study confirms the feasibility of using correlational and differential tractography as tract-based monitoring biomarkers to evaluate the disease progress of mTBI, and indicates that normalized quantitative anisotropy could be used as a biomarker to monitor the injury and/or repairs of white matter in individual mTBI patients.

Gait performance and prefrontal cortex activation during single and dual task walking in older adults with different cognitive levels.

Growing evidence shows the cognitive function influences the motor performance. The prefrontal cortex (PFC) as a part of the executive locomotor pathway is also important for cognitive function. This study investigated the differences in motor function and brain activity among older adults with different cognitive levels, and examined the significance of cognition on motor functions. Normal control (NC), individuals with mild cognitive impairment (MCI) or mild dementia (MD) were enrolled in this study. All participants received a comprehensive assessment including cognitive function, motor function, PFC activity during walking, and fear of fall. The assessment of cognitive function included general cognition, attention, executive function, memory, and visuo-spatial. The assessment of motor function included timed up and go (TUG) test, single walking (SW), and cognitive dual task walking (CDW). Individuals with MD had worse SW, CDW and TUG performance as compared to individuals with MCI and NC. These gait and balance performance did not differ significantly between MCI and NC. Motor functions all correlated with general cognition, attention, executive function, memory, and visuo-spatial ability. Attention ability measured by trail making test A (TMT-A) was the best predictor for TUG and gait velocity. There were no significant differences in PFC activity among three groups. Nevertheless, the PFC activated more during CDW as compared with SW in individuals with MCI (p = 0.000), which was not demonstrated in the other two groups. MD demonstrated worse motor function as compared to NC and MCI. The greater PFC activity during CDW in MCI may be considered as a compensatory strategy for maintaining the gait performance. Motor function was related to the cognitive function, and the TMT A was the best predictor for the gait related performance in present study among older adults.

Relationship between key continuous glucose monitoring-derived metrics and specific cognitive domains in patients with type 2 diabetes mellitus

BackgroundContinuous glucose monitoring (CGM)-derived time in range (TIR) is closely associated with micro- and macrovascular complications in type 2 diabetes mellitus (T2DM). This study was performed to investigate the relationship between key CGM-derived metrics and specific cognitive domains in patients with T2DM.MethodsOutpatients with T2DM who were otherwise healthy were recruited for this study. A battery of neuropsychological tests was performed to evaluate cognitive function, including memory, executive functioning, visuospatial ability, attention, and language. Participants wore a blinded flash continuous glucose monitoring (FGM) system for 72 h. The key FGM-derived metrics were calculated, including TIR, time below range (TBR), time above range (TAR), glucose coefficient of variation (CV), and mean amplitude of glycemic excursions (MAGE). Furthermore, the glycemia risk index (GRI) was also calculated by the GRI formula. Binary logistic regression was used to assess risk factors for TBR, and we further analysed the associations between neuropsychological test results and key FGM-derived metrics with multiple linear regressions.ResultsA total of 96 outpatients with T2DM were recruited for this study, with 45.8% experiencing hypoglycemia (TBR< 3.9 mmol/L). Spearman analysis results revealed that a higher TBR< 3.9 mmol/L was correlated with worse performance on the Trail Making Test A (TMTA), Clock Drawing Test (CDT), and cued recall scores (P < 0.05). Logistic regression analysis results indicated that the TMTA (OR = 1.010, P = 0.036) and CDT (OR = 0.429, P = 0.016) scores were significant factors influencing the occurrence of TBR< 3.9 mmol/L. Multiple linear regressions further demonstrated that TBR< 3.9 mmol/L (β = -0.214, P = 0.033), TAR> 13.9 mmol/L (β = -0.216, P = 0.030) and TAR10.1–13.9 mmol/L (β = 0.206, P = 0.042) were significantly correlated with cued recall scores after adjusting for confounding factors. However, TIR, GRI, CV and MAGE showed no significant correlation with the results of neuropsychological tests (P > 0.05).ConclusionsA higher TBR< 3.9 mmol/L and TAR> 13.9 mmol/L were associated with worse cognitive functions (memory, visuospatial ability, and executive functioning). Conversely, a higher TAR of 10.1–13.9 mmol/L was associated with better memory performance in memory tasks.

O-DEM: a new cognitive screening in patients with hearing loss

Hearing loss is asignificant risk factor for dementia. To date, cognitive impairment and dementia in patients with hearing impairment (HI) cannot be adequately diagnosed by commonly administered cognitive screening tests due to sensory impairments. Therefore, an adapted screening is needed. The aim of the present study was to develop and evaluate acognitive screening for people with HI. The new cognitive screening, called O‑DEM, entails aword fluency test, the Trail Making TestA (TMT-A), and asubtraction task. First, the O‑DEM was tested in alarge clinical sample (N = 2837) of people without subjective HI. In asecond step, the O‑DEM was evaluated in 213patients with objectively assessed HI and compared with the Hearing-Impaired Montreal Cognitive Assessment (HI-MoCA). The results indicate that the O‑DEM subtests significantly discriminate between participants with no, mild, and moderate to severe cognitive impairment. Based on the mean and standard deviation of the participants without cognitive impairment, atransformation of the raw scores was performed and atotal score with amaximum value of 10 was determined. In the second part of the study, the O‑DEM was shown to be as sensitive as the HI-MoCA in differentiating between people with and without cognitive impairment. Compared to other screenings, the O‑DEM is aquickly administrable screening for the detection of mild and moderate cognitive impairment in people with HI.

Berberine improves negative symptoms and cognitive function in patients with chronic schizophrenia via anti-inflammatory effect: a randomized clinical trial

BackgroundBased on the neuroinflammation hypothesis in schizophrenia and known anti-inflammatory effects of berberine, the aim of the present study is to investigate the efficacy of berberine in treating negative symptoms and cognitive deficits in adult patients with chronic schizophrenia.MethodsEnrolled participants were randomized to receive berberine or placebo for 3 months. The Scale for the Assessment of Negative Symptoms (SANS), Trail-making Test A (TMT-A), Trail-making Test B (TMT-B), and Hopkins Verbal Learning Test (HVLT) were used to evaluate the negative symptoms and cognitive function at four-time points (baseline, 1st, 2nd, and 3rd month). Serum levels of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were used as inflammatory markers. 106 patients with per-protocol were analyzed, 56 in the experimental (berberine) group and 50 in the control (placebo) group.ResultsFrom baseline to month 3, patients receiving berberine demonstrated a decrease in total scores on clinical scales SANS, TMT-A and TMT-B and showed a serum level reduction of IL-1β, IL-6 and TNF-α comparing with patients in the control group (P < 0.05). There were positive correlations between the change of serum IL-1β level and the change of SANS (r = 0.210, P = 0.039), TMT-A (r = 0.522, P < 0.001), and TMT-B (r = 0.811, P < 0.001); between the change of serum IL-6 level and the change of TMT-A (r = 0.562, P < 0.001), and TMT-B (r = 0.664, P < 0.001); between the change of serum TNF-α level and the change of TMT-B (r = 0.472, P < 0.001) after berberine treatment.ConclusionsBerberine is an anti-inflammatory agent that can potentially mitigate the negative symptoms and cognitive deficits in patients with schizophrenia.

Association Between Neuropsychological Functions and Activities of Daily Living in People with Mild Cognitive Impairment

ABSTRACT Objective The aim of this study was to explore the relationship between performance in neurocognitive variables and daily functioning (basic or b- and instrumental or i-ADL) in people with mild cognitive impairment (MCI). Methods A sample of 157 participants with MCI (73.65 ± 7.58 years) completed a battery of tests for assessing ADL and cognitive functions. t-test, Pearson’s correlation and multiple linear regression (backward stepwise selection) were used for data analyses. Results Significant correlations were found between b- and i-ADL, and several neuropsychological tests (p < .01). Multivariate analysis showed that difficulties in Blessed Rating Scales (BLS) explained 33.2% of the variation in b-ADL and that this variation rises to 42.9% when BLS is associated with Frontal Assessment Battery Flexibility, Trail Making Test A (TMT-A) and BLS Personality. For i-ADL, BLS and Dementia Rating Scale Total (DRS-T) explained 47.7% of the variation and the inclusion in the model of BLS, DRS-IP (Initiation/Perseveration), TMT-A and BLS Personality explained 53.5% of this variation. Executive functions explained 24.8% of the variation in i-ADL. Conclusions Cognitive functions are related to i- and b-ADL in people with MCI. The general indicators and those that assess executive functions and verbal- or visual-spatial memory should be considered to predict i-ADL.

Effect of olanzapine combined with art therapy on self harmony and cognitive function in patients with BD

BackgroundBipolar disorder (BD) is a mental disorder accompanied by mania and depression. Patient’s mood is sometimes high and sometimes low, and its presentation is complex and irregular. Olanzapine is a commonly used antipsychotic drug, which can improve the condition of patients with BD. However, simple drug treatment cannot achieve the desired effect. In recent years, the means of art intervention in psychological diseases has attracted much attention by enabling the patient’s body and mind in a relaxed and comfortable state through artistic activities. Therefore, it can improve the patient’s cognitive function and promote the patient’s self-harmony. Therefore, this experiment used olanzapine combined with art therapy to treat patients with BD, and observed the improvement of self-harmony and cognitive function of the patients.Subjects and Methods56 patients with BD admitted to our hospital from September 2021 to April 2022 were randomly selected and divided into experimental group (28 cases) and control group (28 cases). The patients in the control group were treated with olanzapine and basic drugs. The experimental group added the activity of appreciating famous paintings on this basis, aiming to improve the patients’ cognitive and memory abilities. After 2 months of the experiment, the self-harmonious psychological state of the patients was analyzed by observing the Self Consistency and Congruence Scale (SCCS) scores of the two groups of patients; The cognitive function of patients was analyzed by Wisconsin Card Sorting Test (WCST), Wechsler Adult Intelligence Scale (WAIS-RC), and Trail Making Test-A (TMT-A).ResultsTable 1 shows the changes of SCCS scores of the two groups of patients before and after the intervention. After the intervention, the total scores, and scores of each factor of the experimental group decreased significantly, and the scores of self-disharmony factors were significantly lower than those of the control group. For the improvement of cognitive function of the two groups of patients before and after the intervention, the scale score results showed that the WCST index values and TMT-A index values of the experimental group were significantly reduced after the intervention; All indicators of WAIS-RC increased significantly. The test results of the three types of scales in the experimental group were better than those in the control group.Table 1.Comparison of SCCS scores between the two groups before and after intervention ($ \overline{x}\pm s $)FactorGroupBefore interventionAfter interventionSelf-flexibilityExperimental group49.54±8.6545.22±7.98Control group46.97±6.7245.31±7.43Self-stereotypeExperimental group23.22±4.6518.21±3.72Control group23.43±3.6520.21±3.65Self-disharmonyExperimental group48.21±9.6542.24±9.98Control group48.97±9.7347.81±11.65Total scoreExperimental group94.27±12.7587.21±13.65Control group96.07±13.0394.50±14.21ConclusionsThis experiment intervened patients with BD through olanzapine combined with art therapy. The results show that olanzapine combined with art therapy can effectively improve the cognitive function of patients with BD and promote their self-harmony, which is conducive to improving the prognosis of patients.AcknowledgementsThe research is supported by: National social science fund project “Research on the Protection and Inheritance of Yao’s’ Ancient Legal Drum ‘Traditional Skills” (No. 21BMZ037).

Application of Immersive Virtual-Reality-Based Puzzle Games in Elderly Patients with Post-Stroke Cognitive Impairment: A Pilot Study.

The society is aging in China, and the cognitive level of elderly post-stroke patients gradually declines. Face-to-face cognitive functional training is no longer sufficient. Immersive virtual reality (IVR) is a promising rehabilitation training device. In this study, we developed an IVR-based puzzle game to explore its effectiveness, feasibility, and safety in elderly stroke patients with cognitive dysfunction. A total of 30 patients with mild post-stroke cognitive impairment after stroke were randomly assigned to a control or IVR group. Patients in both groups received routine rehabilitation therapy. Patients in the control group received traditional cognitive training, and those in the IVR group received IVR-based puzzle game therapy. Before and after treatment, Montreal cognitive assessment (MOCA), trail-making test-A (TMT-A), digit symbol substitution test (DSST), digital span test (DST), verbal fluency test (VFT), and modified Barthel index (MBI) were evaluated in both groups. In addition, the IVR group was administered a self-report questionnaire to obtain feedback on user experience. There was no significant difference in the baseline data between the two groups. After six weeks of treatment, the cognitive assessment scores were improved in both groups. Moreover, the IVR group showed more improvements than the control group in the DSST (Z = 2.203, p = 0.028 &lt; 0.05, η2 = 0.16); MOCA (T = 1.186, p = 0.246 &gt; 0.05, d = 0.44), TMT-A (T = 1.791, p = 0.084 &gt; 0.05, d = 0.65), MBI (T = 0.783, p = 0.44 &gt; 0.05, d = 0.28), FDST (Z = 0.78, p = 0.435 &gt; 0.05, η2 = 0.02), BDST (Z = 0.347, p = 0.728 &gt; 0.05, η2 = 0.004), and VFT(Z = 1.087, p = 0.277 &gt; 0.05, η2 = 0.039) did not significantly improve. The significant difference in DSST represents an improvement in executive function and visual-spatial cognitive characteristics. The other assessment scores did not show such features. Therefore, we did not observe significant differences through this measure. According to the results of the self-report questionnaire, most of the patients were satisfied with the equipment stability and training content. Several individuals reported mild adverse reactions. This pilot study suggests that IVR-based puzzle games are a promising approach to improve post-stroke cognitive function, especially executive cognitive function, and visual-spatial attention in older adults.