Visuospatial Domains Research Articles

Towards theoretically understanding how long-term memory semantics can support working memory performance.

Working memory is the system that supports the temporary storage and processing of information. It is generally agreed that working memory is a mental workspace, with a combination of resources operating together to maintain information in mind for potential use in thought and action. Theories typically acknowledge the contributions of long-term memory to this system. One particular aspect of long-term memory, namely semantic long-term memory, can effectively supplement or "boost" working memory performance. This may be a relatively automatic process via the semantic properties of the stimuli or more active via strategy development and implementation. However, the precise mechanisms require greater theoretical understanding. In this review of the literature, we critically discuss theoretical models of working memory and their proposed links with long-term memory. We also explore empirical research that contributes to our understanding of the ways in which semantics can support performance of both verbal and visuospatial working memory tasks, with a view to potential intervention development. This includes the possibility of training people with lower performance (e.g., older adults) to use semantics during working memory tasks. We conclude that semantics may offer an opportunity to maximise working memory performance. However, to realise this potential, more research is needed, particularly in the visuospatial domain.

Electrode Location and Domain-Specific Cognitive Change Following Subthalamic Nucleus Deep Brain Stimulation for Parkinson's Disease.

Deep brain stimulation (DBS) is an effective treatment for Parkinson's disease (PD) motor symptoms. DBS is also associated with postoperative cognitive change in some patients. Previous studies found associations between medial active electrode contacts and overall cognitive decline. Our current aim is to determine the relationship between active electrode contact location and domain-specific cognitive changes. A single-institution retrospective cohort study was conducted in patients with PD who underwent subthalamic nucleus (STN) DBS from August 05, 2010, to February 22, 2021, and received preoperative and postoperative neuropsychological testing. Standardized norm-referenced test z-scores were categorized into attention, executive function, language, verbal memory, and visuospatial domains. SD change scores were averaged to create domain-specific change scores. We identified anterior commissure/posterior commissure coordinates of active electrode contacts in atlas space. We evaluated differences in active electrode contact location between patients with a domain score decrease of at least 1 SD and less than 1 SD. We performed multiple variable linear regression controlling for age, sex, education, time from surgery to postoperative neuropsychological testing (follow-up duration), disease duration, preoperative unified Parkinson's disease rating scale off medication scores, and preoperative memory scores to determine the relationship between active electrode contact location and domain change. A total of 83 patients (male: n = 60, 72.3%) were included with a mean age of 63.6 ± 8.3 years, median disease duration of 9.0 [6.0, 11.5] years, and median follow-up duration of 8.0 [7.0, 11.0] months. More superior active electrode contact location in the left STN (P = .002) and higher preoperative memory scores (P < .0001) were associated with worsening memory. Active electrode contact location was not associated with change in other domains. In patients with PD who underwent STN DBS, we found an association between superior active electrode contacts in the left STN and verbal memory decline. Our study increases understanding of factors associated with cognitive change after DBS and may help inform postoperative programming.

Exploring cognitive functions and brain structure in Hereditary Transthyretin amyloidosis using brain MRI and neuropsychological assessment.

Central nervous system symptoms, such as cognitive dysfunction, have been reported in Hereditary Transthyretin Amyloidosis (ATTRv). However, there is a lack of neuroimaging studies investigating structural alterations in the brain related to cognition in ATTRv amyloidosis. This study aimed to investigate cognition and cortical morphology in a cohort of ATTRv patients. 29 ATTRv patients and 26 healthy controls completed neuropsychological assessment. 21 of these patients underwent 3T brain MRI, and 23 healthy subjects constituted the control group for MRI. Cortical measures of volume, thickness, fractional anisotropy (FA), and mean diffusivity (MD) were obtained for both groups. Correlation analyses between brain and cognitive measurements were performed. Patients displayed worse performance than controls in executive functions, verbal and visual memory, visuospatial domains, and language tests. Our study indicated cortical thinning in ATTRv patients in the temporal, occipital, frontal, and parietal areas. The inferior temporal gyrus correlated with verbal memory. Insula and, pars opercularis correlated with both verbal memory and executive function. Cortical thickness in the inferior temporal gyrus, pars opercularis, and insula were linked to memory and executive function. We observed no correlations between cortical volume measures and cognition. Further investigations are imperative to confirm these findings across different populations.

Towers of Kuwait Arabic Neurocognitive Assessment: A novel executive and visuospatial functions assessment tool added to the CERAD neuropsychological battery-Arabic version (CERAD-ArNB)

Assessment of executive and visuospatial neurocognitive domains is lacking in the Omani population, especially for elderly individuals with low educational levels. Therefore, the Towers of Kuwait-Arabic Neurocognitive Assessment (ToK-ArNA) was developed using similar psychometric features of Tower of London (ToL) test, and the unique architecture of Towers of Kuwait, with the potential to overcome the limitation of ToL color perception difficulties that might be encountered in subjects with hereditary or acquired color vision disorders. We enrolled 120 older Arabic-speaking Omanis from January 2022 to November 2022 and all participants underwent screening to ensure normal cognitive function before performing the ToL and ToK-ArNA tests. Validity, reliability, and non-parametric statistical tests were used for data analysis. A total of 85 participants, 51 men (60%) and 34 women (40%) met the inclusion criteria and completed the testing. Statistical analyses confirmed the validity and reliability of ToK-ArNA compared to ToL, with comparable total Time and Accuracy scores and more preference towered the ToK-ArNA among the participants. Despite the study limitations, these results indicate that the ToK-ArNA is a reliable and applicable executive and visuospatial function assessment tool and further studies are warranted to establish its validity in patients with various neurocognitive disorders

Disease progression in Parkinson's disease patients with mild cognitive impairment: 5-year longitudinal study from the early Parkinson's disease longitudinal Singapore (PALS) cohort.

To investigate motor, non-motor and cognitive progression in early Parkinson's disease (PD) patients with Mild Cognitive Impairment (MCI). PD patients were recruited within 1 year of diagnosis and were classified into PD-MCI group and PD with normal cognition (PD-NC) group. H&Y staging scale, MDS-UPDRS part III were used to assess disease severity and motor progression. Non-motor symptom scale (NMSS) was used to evaluate the NMS progression. Cognitive progression was assessed from 5 cognitive domains. Annual progression changes in the longitudinal outcomes were examined via linear mixed model with random intercept effect. False discovery rate (FDR) method was performed to control for multiple testing comparison and q-value was calculated. We set the threshold of q-values as 0.1. A total of 205 PD patients, including 107 PD-MCI and 98 PD-NC patients were assessed prospectively over a 5-year period. PD-MCI patients, compared to PD-NC group, had a significantly higher progression rate in H&Y score (0.11 vs. 0.06, p=0.03, q=0.08), MDS-UPDRS motor score (3.11 vs. 1.90 p<0.001, q=0.06) and postural instability gait difficulty (PIGD) score (0.40 vs. 0.20, p=0.02, q=0.07). PD-MCI group also exhibited significantly faster deterioration in NMSS perceptual domain (PD-MCI vs. PD-NC: 0.38 vs. -0.04, p=0.01, q=0.06) and cognitive visuospatial domain (PD-MCI vs. PD-NC: 0.13 vs. -0.06, p=0.048, q=0.09) after adjustment for confounders and multiple comparisons. PD-MCI patients had faster decline in motor functions, visuo-perceptual and visuospatial performance. These findings provide a more comprehensive prognosis of PD-MCI, which could be helpful for clinician to manage PD-MCI patients.

Cumulative Effect of Psychosis and Aging on Cognitive Function in Patients Diagnosed With Schizophrenia Spectrum Disorders: A Cognitive Domain Approach.

Schizophrenia spectrum disorders are characterized by cognitive decline, which is evident even in the prodromal phase. Aging is a complex gradual procedure that affects, among other organs, the central nervous system, resulting in age-related cognitive decline. The objective of this study is to assess the cognitive function of patients diagnosed with psychotic disorders, in comparison with healthy controls, along the age spectrum. Sixty patients diagnosed with schizophrenia spectrum disorders in remission, 20-59 years old, and 60 healthy controls, matched by age and educational level, from the region of Thessaly in Central Greece, were evaluated, with respect to their cognitive performance, using the Greek version of the Montreal Cognitive Assessment (MoCA). Correlations between age and MoCA total and cognitive domains' scores, as well as statistical analysis of variance (ANOVA) and t-test among age groups, were performed using Statistical Product and Service Solutions (SPSS, version 23; IBM SPSS Statistics for Windows, Armonk, NY). The MoCA score was negatively correlated with age, both in the patients' group (p<0.001) and in the control group (p=0.001).A significant statistical difference in mean MoCA scores between patients and healthy controls was observed, not only in the total sample (p<0.001) but also in all age groups (20-29: p=0.006, 40-49: p=0.024, 50-59: p<0.001), except for age group 30-39 (30-39: p=0.356).Statistically significant differences were also found between patients and healthy controls in the total sample, regarding specific cognitive domains, in the visuospatial and executive function domain (p=0.01), attention domain (p<0.001), language domain (p<0.001), and orientation domain (p<0.005). Interestingly, different deterioration patterns in cognitive domains were observed in each age group. Specifically,in the age group 20-29, statistically significant differences were found between patients and healthy controls in the language domain (p<0.014) and orientation domain (p<0.041). No difference was found in the age group 30-39, while statistically significant differences were found between patients and healthy controls in the age group 40-49 inthe attention domain (p<0.001) and language domain (p<0.001). Finally, in the age group 50-59, such differences were found in the visuospatial and executive function domain (p=0.041), attention domain (p=0.006), and language domain (p=0.001).Statistically significant cognitive decline occurs in a shorter period in the patients' group, suggesting an accelerated cognitive decline in psychotic patients after middle age. Age-related cognitive decline in psychotic patients occurs at an accelerated rate in relation to the control sample, with age-specific cognitive domain decline patterns, due to the cumulative effect of aging and psychosis on cognition. Further, larger, multicenter research should focus on establishing these results and designing relevant procognitive interventions.

Effect of a Cardiovascular Polypill on Poststroke Cognition Among Ghanaians: Secondary Analysis of a Randomized Clinical Trial.

Poststroke cognitive impairment is prevalent worldwide, with no satisfactory preventative therapeutic strategies. We report on the effect of a cardiovascular polypill on cognitive performance among recent stroke survivors. The SMAART (Stroke Minimization through Additive Anti-atherosclerotic Agents in Routine Treatment) trial was a phase II randomized trial primarily assessing the polypill versus usual care for secondary prevention after a recent ischemic stroke. Participants allocated to the experimental arm were provided 2 Polycaps taken orally once a day for 12 months. A capsule of Polycap contained aspirin 100 mg, simvastatin 20 mg, hydrochlorothiazide 12.5 mg, ramipril 5 mg, and atenolol 50 mg. Participants in the usual care arm received standard secondary prevention therapy. We compared slopes of the trajectory of raw scores in the executive, language, memory, and visuospatial cognitive domains and aggregated cognitive scores over 12 months via a linear mixed-effects model. We enrolled 148 eligible participants (n=74 in each arm) and 59 versus 64 participants in the polypill and usual care arms, respectively, at month 12. Compared with the usual care arm, the slopes of cognitive performance over 12 months in the polypill arm were steeper by 2.02 units (95% CI, 0.52-3.53), P=0.009 in executive domain, 1.88 units (95% CI, 0.42-3.34), P=0.012 in language domain, 2.60 (0.03-5.17), P=0.049 in memory domain, 0.55 (-0.80 to 1.91), P=0.42 in the visuospatial domain, and global cognitive performance 6.87 units (95% CI, 1.44-12.30), P=0.013. The cardiovascular polypill is associated with a signal of better cognitive performance over 12 months among stroke survivors. Further definitive trials are warranted. URL: https://www.clinicaltrials.gov; Unique Identifier: NCT03329599.

Disease Progression of Data-Driven Subtypes of Parkinson's Disease: 5-Year Longitudinal Study from the Early Parkinson's Disease Longitudinal Singapore (PALS) Cohort.

The detailed trajectory of data-driven subtypes in Parkinson's disease (PD) within Asian cohorts remains undisclosed. To evaluate the motor, non-motor symptom (NMS) progression among the data-driven PD clusters. In this 5-year longitudinal study, NMS scale (NMSS), Hospital Anxiety Depression Scale (HADS), and Epworth sleepiness scale (ESS) were carried out annually to monitor NMS progression. H& Y staging scale, MDS-UPDRS part III motor score, and postural instability gait difficulty (PIGD) score were assessed annually to evaluate disease severity and motor progression. Five cognitive standardized scores were used to assess detailed cognitive progression. Linear mixed model was performed to assess the annual progression rates of the longitudinal outcomes. Two hundred and six early PD patients, consisting of 43 patients in cluster A, 98 patients in cluster B and 65 subjects in cluster C. Cluster A (severe subtype) had significantly faster progression slope in NMSS Domain 3 (mood/apathy) score (p = 0.01), NMSS Domain 4 (perceptual problems) score (p = 0.02), NMSS Domain 7 (urinary) score (p = 0.03), and ESS Total Score (p = 0.04) than the other two clusters. Cluster A also progressed significantly in PIGD score (p = 0.04). For cognitive outcomes, cluster A deteriorated significantly in visuospatial domain (p = 0.002), while cluster C (mild subtype) deteriorated significantly in executive domain (p = 0.04). The severe cluster had significantly faster progression, particularly in mood and perceptual NMS domains, visuospatial cognitive performances, and postural instability gait scores. Our findings will be helpful for clinicians to stratify and pre-emptively manage PD patients by developing intervention strategies to counter the progression of these domains.

Effects of a case management-based intervention on non-motor risk factors for falls in older people with history of falls: a randomised clinical trial.

Falls are directly related to morbidity and mortality of older people. Multifactorial approaches that are individualised and based on fall risk factors are necessary. This study aims to verify the effects of a case management-based intervention on non-motor risk factors for falls in community-dwelling older people with a history of falls. The intervention applied a multidimensional assessment of risk factors for falls, a discussion about the identified risk factors, the preparation of an individualised plan with the participant, and the application, monitoring and review of the plan. There was a significant interaction between groups and assessments only in the visuospatial domain (P = 0.031). After simple main effects analysis, differences between groups and assessments were not significant, although there was a tendency of worse visuospatial performance in the control group in the follow-up assessment (P = 0.099). There were no significant differences between groups or between assessments in other variables. The intervention has the potential to maintain non-motor risk factors for falls in community-dwelling older people with a history of falls. However, more clinical trials are needed to prove its effects.

A Preliminary Analysis of Stress Burden and Cognitive Function and Clinically Adjudicated Cognitive Outcomes in Black American Adults.

The combination of exposure to multiple stressors and psychological distress may contribute to the disproportionate burden of dementia risk among Black Americans. This study estimates the effect of an index of stress and psychological distress (ie, "stress burden") on cognitive function and clinically adjudicated cognitive outcomes among older Black American adults, and examines sleep as a mediator. The sample included 204 Black adults (79% female; mean age = 64 years) from Pittsburgh, PA, USA. Stress burden comprised 3 self-reported stress and distress measures assessed in 2016: discrimination, psychological distress, and posttraumatic stress. Potential mediators included actigraphy-assessed sleep duration and efficiency from 2018. Cognitive battery and clinical adjudication in 2019 assessed cognitive function and clinically adjudicated outcomes. Causal mediation analysis estimated the direct effect between stress burden and cognitive outcomes, and indirect effects through sleep, after adjusting for sociodemographics and hypertension. Higher stress burden had a significant direct effect on lower executive functioning and visuospatial performance. However, there were no significant indirect effects (ie, mediation) by sleep disturbances on any domain of cognitive function assessed. Also, there were no significant direct or indirect effects on clinically adjudicated outcomes. Multiple stressors often co-occur and may contribute to racial disparities in cognitive health. Findings suggest that higher stress burden had negative effects on functioning in executive and visuospatial domains in this community-based sample of older Black American adults. However, there was no evidence of mediation by sleep. Findings highlight the importance of continued work to identify modifiable pathways between stress burden and cognitive health disparities.

THE OUTCOME OF COGNITIVE THERAPY IN PATIENTS WITH FIRST-EVER STROKE AND RECURRENT STROKE

Background: Vascular dementia (VaD) is the second most prevalent type of dementia that impacts elderly adults, succeeding Alzheimer's disease. In contrast to Alzheimer's disease, Vascular Dementia (VaD) presents a wide range of cognitive changes, which are greatly influenced by the specific neural regions that are impacted by vascular pathology. The incidence of dementia in adults with a prior history of stroke is 30%, demonstrating a frequency that is 3-5 times more than those without any discernible stroke-related impairments. In addition, the intensity or frequency of strokes may contribute to a decrease in cognitive reserve in persons with vascular dementia. Case Report: We presented two cases of VaD. The first case was a 62-year-old man with a history of ischemic stroke without sequelae a year before the complaints of frequent forgetfulness and cognitive impairment. Neuropsychological examination showed neurocognitive disturbances in orientation, attention, memory, and visuospatial domain with impaired daily activities function. The MRI result showed senile brain atrophy with chronic infarction on the right temporoparietooccipital lobe, left side mesencephalon, right side pons accompanied by cortical laminar necrosis on the right frontal lobe and left temporoparietal lobe. The second case was a 79-year-old man with history of recurrent ischemic stroke (three times since 2021-2022) with sequelae of left hemiparesis and complaints of frequent forgetfulness and cognitive impairment in the last 1 year. Neuropsychological examination showed neurocognitive disturbances in orientation, attention, and visuospatial domain with impaired daily activities function. The MRI result showed subacute multiple lacunar infarctions in right insular cortex, right frontotemporal lobe cortex, right corona radiata, with multiple chronic infarcts on the right frontotemporoparietal lobe, right corona radiata, right internal genu capsule, right lateral periventricular anterior horn, pons, right left cerebellum, also senile brain atrophy. Both patients were diagnosed as VaD and given donepezil 1x10mg and memantine 1x5mg to treat the cognitive impairment. Both cases showed improvements after 6 months of therapy with MMSE from 17 to 28, MoCA-INA from 12 to 22 and MMSE from 19 to 23, MoCA-INA from 14 to 21 respectively. Discussion: The probability of acquiring vascular dementia (VaD) was strongly associated with the incidence and frequency of strokes. The prevalence of newly developed dementia after the initial stroke is approximately 10%, which increases to 30% with recurrent strokes. The likelihood of experiencing cognitive impairment and dementia after a stroke is primarily determined by the specific attributes of the stroke. While pharmacological therapy largely focuses on cognitive impairment, other factors, such as the stroke's characteristics, might contribute to neuronal and molecular abnormalities that result in cognitive loss. Two instances were shown, both demonstrating enhancements, with the initial instance, involving primary strokes, exhibiting a superior outcome compared to the subsequent instance with recurring strokes. A more profound or recurring stroke has the potential to reduce cognitive reserve, hence potentially heightening vulnerability to neurodegenerative disorders, either directly or by means of modifications in social contacts or lifestyle, which can subsequently affect cognitive performance. Conclusion: Recurrent stroke plays a role in reducing cognitive reserve and increasing the risk of dementia. Patients with VaD have shorter life expectancy, thus the severity of VaD is best managed by providing optimum acute stroke care and recurrent stroke prevention.

Relationship between hemoglobin and specific cognitive domain among older adults using network analysis

Objectives Hemoglobin (Hgb) is associated with cognitive function, with low and high levels of Hgb leading to impaired cerebral oxygenation and perfusion. Yet, current studies focused on understanding the association between Hgb and cognitive function without consideration for each cognitive domain. Thus, this study aims to identify and visualize potentially interactive associations between Hgb and specific cognitive domains among older adults. Method This is a secondary data analysis using Wave II data from the National Social Life, Health, and Aging Project (NSHAP) and included 1022 older adults aged between 65 and 85 years. The network structure of three different models was estimated to understand the association between specific cognitive domains and Hgb in a mixed graphical model using the R-package ‘mgm’. Model 1 did not adjust for any covariates, Model 2 adjusted for age and gender, and Model 3 adjusted for all covariates. Results Among all cognitive domains, the visuospatial (edge weight = 0.06–0.10) and memory domains (0.04–0.07) were associated with Hgb in all three models Though not present in Model 3, the attention domain was associated with Hgb in Model 1 and Model 2 (0.08–0.11). In addition, the predictability of Hgb was the highest (8.1%) in Model 3. Conclusion Findings from this study suggest that cognition should be considered as a multidimensional construct, and its specific cognitive domain should be carefully assessed and managed in relation to Hgb among older adults.

Cognitive Sex Differences: Evidence from Indian Young Adults

In the present study, we examined the effect of sex on cognitive abilities among young adults. Our total sample was comprised of 64 participants (33 females). Males and females were matched with respect to age and years of education. Each participant underwent a detailed neuropsychological assessment, including assessment of attention, executive functions, fluency, verbal and visuospatial memory. Results revealed that females exhibited superior performance in verbal domain such as learning, immediate memory, and fruit fluency. Additionally, a noteworthy trend was observed indicating females’ enhanced performance on verbal delayed recall, animal and vegetable fluency. Contrastingly, no discernible gender-based effects were identified in relation to executive functions, working memory, or visuospatial ability. It is pertinent to note that our findings did not conclusively support male superiority in the visuospatial or verbal domains. In conclusion, the present study provides valuable insights into sex-related differences in cognitive abilities among young adults. Nonetheless, further investigations employing larger sample sizes across diverse age groups are imperative to validate and extend these findings.

A Pilot Study to Improve Cognitive Performance and Pupil Responses in Mild Cognitive Impaired Patients Using Gaze-Controlled Gaming.

Mild cognitive impairment (MCI) may progress to severe forms of dementia, so therapy is needed to maintain cognitive abilities. The neural circuitry for oculomotor control is closely linked to that which controls cognitive behavior. In this study, we tested whether training the oculomotor system with gaze-controlled video games could improve cognitive behavior in MCI patients. Patients played a simple game for 2-3 weeks while a control group played the same game using a mouse. Cognitive improvement was assessed using the MoCA screening test and CANTAB. We also measured eye pupil and vergence responses in an oddball paradigm. The results showed an increased score on the MoCA test specifically for the visuospatial domain and on the Rapid Visual Information Processing test of the CANTAB battery. Pupil responses also increased to target stimuli. Patients in the control group did not show significant improvements. This pilot study provides evidence for the potential cognitive benefits of gaze-controlled gaming in MCI patients.

EEG oscillatory evidence for the temporal dynamics of divergent and convergent thinking in the verbal knowledge domain

This study investigates neural mechanisms of divergent and convergent thinking in the verbal knowledge domain while taking into account activation related to working memory (WM). Divergent thinking was assessed using the Alternate Uses Task (AUT) and convergent thinking using the Compound Remote Associates task (RAT). We analyzed upper alpha band (10–12 Hz) oscillatory activity, in which we accounted for the temporal dynamics of both thinking processes by investigating three different time points during each trial for both tasks. We subtracted WM-related oscillatory activity measured by a serial recall task within the same knowledge domain and by using highly similar stimulus material as in both divergent and convergent thinking tasks. Our results show a strong upper alpha synchronization during divergent relative to convergent thinking, most pronounced at fronto-parietal electrodes. Moreover, we observed highest synchronization towards the middle (in contrast to the beginning and end) of each trial during both thinking processes. The results of the present study extend previous findings in the visuo-spatial knowledge domain, using a highly similar analytical approach to investigate divergent and convergent thinking. Together, these findings provide theoretical implications on how divergent and convergent thinking interact beyond WM across different knowledge domains by emphasizing their complex interplay.

Reduced Cortical Thickness Correlates of Cognitive Dysfunction in Post-COVID-19 Condition: Insights from a Long-Term Follow-up.

There is a paucity of data on long-term neuroimaging findings from individuals who have developed the post-coronavirus 2019 (COVID-19) condition. Only 2 studies have investigated the correlations between cognitive assessment results and structural MR imaging in this population. This study aimed to elucidate the long-term cognitive outcomes of participants with the post-COVID-19 condition and to correlate these cognitive findings with structural MR imaging data in the post-COVID-19 condition. A cohort of 53 participants with the post-COVID-19 condition underwent 3T brain MR imaging with T1 and FLAIR sequences obtained a median of 1.8 years after Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection. A comprehensive neuropsychological battery was used to assess several cognitive domains in the same individuals. Correlations between cognitive domains and whole-brain voxel-based morphometry were performed. Different ROIs from FreeSurfer were used to perform the same correlations with other neuroimaging features. According to the Frascati criteria, more than one-half of the participants had deficits in the attentional (55%, n = 29) and executive (59%, n = 31) domains, while 40% (n = 21) had impairment in the memory domain. Only 1 participant (1.89%) showed problems in the visuospatial and visuoconstructive domains. We observed that reduced cortical thickness in the left parahippocampal region (t(48) = 2.28, P = .03) and the right caudal-middle-frontal region (t(48) = 2.20, P = .03) was positively correlated with the memory domain. Our findings suggest that cognitive impairment in individuals with the post-COVID-19 condition is associated with long-term alterations in the structure of the brain. These macrostructural changes may provide insight into the nature of cognitive symptoms.

Memory impairment in Amyloidβ-status Alzheimer's disease is associated with a reduction in CA1 and dentate gyrus volume: In vivo MRI at 7T

IntroductionIn Alzheimer's disease (AD), early diagnosis facilitates treatment options and leads to beneficial outcomes for patients, their carers and the healthcare system. The neuropsychological battery of the Uniform Data Set (UDSNB3.0) assesses cognition in ageing and dementia, by measuring scores across different cognitive domains such as attention, memory, processing speed, executive function and language. However, its neuroanatomical correlates have not been investigated using 7 Tesla MRI (7T MRI). MethodsWe used 7T MRI to investigate the correlations between hippocampal subfield volumes and the UDSNB3.0 in 24 individuals with Amyloidβ-status AD and 18 age-matched controls, with respective age ranges of 60 (42–76) and 62 (52–79) years. AD participants with a Medial Temporal Atrophy scale of higher than 2 on 3T MRI were excluded from the study. ResultsA significant difference in the entire hippocampal volume was observed in the AD group compared to healthy controls (HC), primarily influenced by CA1, the largest hippocampal subfield. Notably, no significant difference in whole brain volume between the groups implied that hippocampal volume loss was not merely reflective of overall brain atrophy. UDSNB3.0 cognitive scores showed significant differences between AD and HC, particularly in Memory, Language, and Visuospatial domains. The volume of the Dentate Gyrus (DG) showed a significant association with the Memory and Executive domain scores in AD patients as assessed by the UDSNB3.0.. The data also suggested a non-significant trend for CA1 volume associated with UDSNB3.0 Memory, Executive, and Language domain scores in AD. In a reassessment focusing on hippocampal subfields and MoCA memory subdomains in AD, associations were observed between the DG and Cued, Uncued, and Recognition Memory subscores, whereas CA1 and Tail showed associations only with Cued memory. DiscussionThis study reveals differences in the hippocampal volumes measured using 7T MRI, between individuals with early symptomatic AD compared with healthy controls. This highlights the potential of 7T MRI as a valuable tool for early AD diagnosis and the real-time monitoring of AD progression and treatment efficacy. ClinicalTrials.govID NCT04992975 (Clinicaltrial.gov 2023)

The visual familiarity effect on attentional working memory maintenance.

Attentional refreshing has been described as an attention-based, domain-general maintenance mechanism in working memory. It is thought to operate via focusing executive attention on information held in working memory, protecting it from temporal decay and interference. Although attentional refreshing has attracted a lot of research, its functioning is still debated. At least one conception of refreshing supposes that it relies on semantic long-term memory representations to reconstruct working memory traces. Although investigations in the verbal domain found evidence against this hypothesis, a different pattern could emerge in visuospatial working memory in which absence of refreshing evidence has been observed for stimuli with minimal associated long-term knowledge. In a series of four experiments, the current study investigated the hypothesis of an involvement of semantic long-term representations in the functioning of attentional refreshing in the visuospatial domain. Both cognitive and memory load effects have been proposed as indexes of attentional refreshing. Therefore, we investigated the interaction between the effects of visual familiarity (a long-term memory effect) and cognitive load on recall performance (Experiments 1A and 1B), as well as the interaction between the effects of visual familiarity and memory load on the response times in a concurrent processing task (Experiments 2A and 2B). Results were consistent across experiments and go against the hypothesis of the involvement of semantic long-term memory in the functioning of attentional refreshing in visuospatial working memory. As such, this study corroborates the results found in the verbal domain. Implications for attentional refreshing and working memory are discussed.

Severe Sepsis During Treatment for Childhood Leukemia and Sequelae Among Adult Survivors

Children undergoing treatment for leukemia are at increased risk of severe sepsis, a dysregulated immune response to infection leading to acute organ dysfunction. As cancer survivors, they face a high burden of long-term adverse effects. The association between sepsis during anticancer therapy and long-term organ dysfunction in adult survivors of childhood cancer has not been examined. To determine whether severe sepsis during therapy for leukemia in childhood is associated with subsequent chronic health conditions in adult survivors. This cohort study included 644 adult survivors of childhood leukemia who were diagnosed between January 1, 1985, and July 19, 2010, and participated in the St Jude Lifetime Cohort Study. Participants were excluded if they received hematopoietic cell transplant or had relapsed leukemia. Data collection ended June 30, 2017. Data were analyzed from July 1, 2020, to January 5, 2024. Severe sepsis episodes, defined according to consensus criteria as septic shock, acute respiratory distress syndrome, or multiorgan dysfunction associated with infection occurring during anticancer therapy, were abstracted by medical record review for all participants. Common Terminology Criteria for Adverse Events-defined chronic health condition outcomes were independently abstracted. Associations between sepsis and cumulative incidence of chronic health conditions (eg, cardiovascular, pulmonary, kidney, neurological, and neurocognitive outcomes) were compared by adjusted hazard ratios from Cox proportional hazards logistic regression. Inverse propensity score weighting was used to adjust for potential confounders, including age, year of diagnosis, and leukemia type. The study sample consisted of 644 adult survivors of pediatric leukemia (329 women [51.1%] and 315 men [48.9%]; including 56 with a history of acute myeloid leukemia and 585 with a history of acute lymphoblastic leukemia) who were most recently evaluated at a median age of 24.7 (IQR, 21.2-28.3) years at a median time after leukemia diagnosis of 17.3 (IQR, 13.7-21.9) years. Severe sepsis during treatment of acute childhood leukemia occurred in 46 participants (7.1%). Participants who experienced severe sepsis during treatment were more likely to develop moderate to severe neurocognitive impairment (29 of 46 [63.0%] vs 310 of 598 [51.8%]; adjusted hazard ratio, 1.86 [95% CI, 1.61-2.16]; P < .001) significantly affecting attention, executive function, memory and visuospatial domains. Sepsis was not associated with long-term risk of cardiovascular, pulmonary, kidney, or neurological chronic health conditions. In this cohort study of long-term outcomes in survivors of pediatric leukemia, severe sepsis during anticancer therapy for leukemia was associated with a selectively increased risk for development of serious neurocognitive sequelae. Efforts to reduce the effects of anticancer therapy on long-term function and quality of life in survivors might include prevention of severe sepsis during therapy and early detection or amelioration of neurocognitive deficits in survivors of sepsis.

The association between motor and non-motor symptoms in essential tremor patients being evaluated for deep brain stimulation surgery

BackgroundNon-motor symptoms, including depression and cognitive impairment, are common in essential tremor (ET), but associations between these symptoms and tremor are poorly understood. MethodsA retrospective, single-institution, cohort study evaluated 140 patients with ET undergoing evaluation for deep brain stimulation (DBS) surgery. The Fahn-Tolosa-Marin (FTM) or Washington Heights-Inwood Genetic Study of ET (WHIGET) scale was used to grade tremor. Tremor scores were divided into quartiles. Patients underwent clinical neuropsychological evaluations that included a comprehensive cognitive test battery and Beck Depression Inventory-II (BDI-II). Subgroup analysis was performed with groups who met criteria for depression (BDI-II > 14) or overall cognitive impairment (<9th percentile on at least two dissimilar cognitive tests). Independent samples t-tests were used for continuous variables and chi square tests for categorical variables. Univariable and multivariable regressions were used to determine relationships between tremor and non-motor scores. ResultsTremor quartile was correlated with language domain performance (p = 0.044) but not depression scores. FTM score was associated with BDI-II (β = 0.940, p = 0.010), language (β = −0.936, p = 0.012), and visuospatial domain (β = −0.836, p = 0.025) scores, such that worse tremor was associated with more depression and worse language and visuospatial function. WHIGET score was not associated with any neuropsychological scores on multivariable regression. ConclusionFTM score was associated with language, visuospatial, and mood symptoms, suggesting a relationship between the severity of these symptom types. Different tremor scores capture different motor symptoms and relationships with nonmotor symptoms.