Visuospatial Executive Function Research Articles

1 Detection of Cognitive Subtypes Within Cognitively Normal Older Adults Using Hierarchical Community Detection

Objective:Identifying individuals at the earliest stages of Alzheimer’s Disease (AD) would enable development and study of interventions prior to onset of symptoms. However, differentiating age-related cognitive changes from subtle pathological changes remains a challenge in the field. Methods that would enable earlier detection of AD in elders with no subjective or objective cognitive concerns (i.e., individuals in the preclinical stage) would be of great interest. Community detection, a metric founded in graph theory, offers an alternative approach for characterizing subtle heterogeneity within aging samples and has the potential to inform cognitive variability in aging.Participants and Methods:Using a hierarchical community detection, we examined whether cognitive subtypes could be identified in 226 cognitively normal older adults (from the Alzheimer’s Disease Neuroimaging Initiative [ADNI] study). Cognitive profiles of each community were characterized first using MANOVAs to examine the relationship between community membership and 12 age-, gender-, and education-corrected neuropsychological variables. Pair-wise comparisons were examined for significant main effects. We then examined whether these subtypes were related to biomarkers (cortical volumes, fluorodeoxyglucose (FDG)-positron emission tomography (PET) hypometabolism) or clinical progression. All p values were corrected for multiple comparisons.Results:Three communities (i.e., cognitive subtypes) were identified within the healthy aging sample. The first and largest community identified (N = 106) was characterized by a relative weakness on a single measure visuospatial executive function. Both the second (N = 76) and third community (N = 44) scored significantly lower on immediate, delayed, and recognition memory relative to the first community. The third community was characterized by a relative weakness in category fluency and speeded visual sequencing as well (p < .000). The three communities did not differ on age, gender, education, race, or ethnicity. Community membership was associated with entorhinal volume (with the second and third communities having significantly smaller entorhinal volumes than the first community), though community membership was not significantly associated with other biomarkers examined. Conversion rate reached trend level significance at 12 month follow up (more converters in the third community).Conclusions:Hierarchical community detection is an alternative method for characterizing neuropsychological variation and it appears sensitive to relatively small differences that may be observed in a normal aging sample. While the sample size was relatively small, this approach shows promise for potentially leading to earlier detection of cognitive decline among individuals classified to be aging normally (e.g., community 3).

Age and Marital Status Predict Mild Cognitive Impairment During Acute Coronary Syndrome Admission: An Observational Study of Acute Coronary Syndrome Inpatients.

Mild cognitive impairment (MCI) has been reported after acute coronary syndrome (ACS), but it is uncertain who is at risk, particularly during inpatient admission. In this study, we aimed to explore the prevalence and cognitive domains affected in MCI during ACS admission and determine factors that identify patients most at risk of MCI. Inpatients with ACS were consecutively recruited from 2 tertiary hospital cardiac wards and screened with the Montreal Cognitive Assessment and the Hopkins Verbal Learning Test. Screening included health literacy (Newest Vital Sign), depressive symptoms (Patient Health Questionnaire-9), and physical activity (Physical Activity Scale for the Elderly). Factors associated with MCI were determined using logistic regression. Participants (n = 81) had a mean (SD) age of 63.5 (10.9) years, and 82.7% were male. In total, MCI was identified in 52.5%, 42.5% with 1 screen and 10% with both. Individually, the Montreal Cognitive Assessment identified MCI in 48.1%, and the Hopkins Verbal Learning Test identified MCI in 13.8%. In Montreal Cognitive Assessment screening, the cognitive domains in which participants most frequently did not achieve the maximum points available were delayed recall (81.5%), visuospatial executive function (48.1%), and attention (30.9%). Accounting for education, depression, physical activity, and ACS diagnosis, the likelihood of an MCI positive screen increased by 11% per year of age (odds ratio, 1.11; 95% confidence interval, 1.04-1.18) and by 3.6 times for those who are unmarried/unpartnered (odds ratio, 3.61; 95% confidence interval, 1.09-11.89). An estimated half of patients with ACS screen positive for MCI during admission, with single and older patients most at risk. Multiple areas of thinking were affected with potential impact on capacity for learning heart disease management.

Short-Latency Afferent Inhibition Correlates with Stage of Disease in Parkinson's Patients.

Sensory-motor decoupling at the cortical level involving cholinergic circuitry has also been reported in Parkinson's Disease (PD). Short-latency afferent inhibition (SAI) is a transcranial magnetic stimulation (TMS) paradigm that has been used previously to probe cortical cholinergic circuits in well-characterised subgroups of patients with PD. In the current study, we compared SAI in a cohort of PD patients at various stages of disease and explored correlations between SAI and various clinical measures of disease severity. The modified Hoehn and Yahr (H&Y) scale was used to stage disease in 22 patients with PD. Motor and cognitive function were assessed using the MDS-UPDRS (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale) part III and MoCA (Montreal Cognitive Assessment) score, respectively. Objective gait assessment was performed using an electronic walkway (GAITRite®). SAI was measured as the average percentage inhibition of test motor-evoked potentials (MEPs) conditioned by electrical stimulation of the contralateral median nerve at the wrist. SAI was significantly reduced in patients with advanced PD (H&Y stage 3) compared to early PD patients (H&Y stage 1) on pairwise comparison. The visuospatial executive function and orientation domains of cognition demonstrated significant negative associations with SAI. Cortical sensory-motor integration is progressively diminished as disease progresses. The observation that a reduction in SAI is associated with a reduction in cognitive function possibly reflects the progressive involvement of cortical cholinergic circuits in PD with increasing motor stage. Future longitudinal studies are necessary to confirm this preliminary result.

Cognitive Functions after Carotid Artery Stenting-1-Year Follow-Up Study.

Background: The revascularization of carotid arteries minimizes the risk of future cerebral stroke and usually improves cognitive functions. The aim of this study was to assess changes in cognitive function and verify the hypothesis assuming an improvement of selected cognitive functions—psychomotor speed, visuospatial episodic memory, executive function and verbal fluency—in patients after carotid artery stenting during a 12-month follow-up. Methods: 47 persons subject to CAS, including 13 symptomatic persons, were examined before and 12 months after a procedure with a psychological test battery (digit symbol test—DS, Rey–Osterrieth complex figure test—ROCF, Wisconsin Card Sorting Test—WCST, letter verbal fluency—LVF). Sociodemographic data and clinical parameters were acquired from an author questionnaire. Results: The one-year follow-up, after the performed CAS procedure, demonstrated a significant improvement of psychomotor speed, visuospatial episodic memory, and executive function. No changes in the area of verbal fluency or decline in any of cognitive functions under analysis were observed. Conclusions: Carotid artery stenting improves cognitive functioning, both in the area of basic and more complex cognitive functions in persons with carotid atherosclerosis.

Cognitive impairment and microvascular function in end-stage renal disease.

ObjectiveHemodialysis patients show an approximately threefold higher prevalence of cognitive impairment compared to the age‐matched general population. Impaired microcirculatory function is one of the assumed causes. Dynamic retinal vessel analysis is a quantitative method for measuring neurovascular coupling and microvascular endothelial function. We hypothesize that cognitive impairment is associated with altered microcirculation of retinal vessels.Methods152 chronic hemodialysis patients underwent cognitive testing using the Montreal Cognitive Assessment. Retinal microcirculation was assessed by Dynamic Retinal Vessel Analysis, which carries out an examination recording retinal vessels' reaction to a flicker light stimulus under standardized conditions.ResultsIn unadjusted as well as in adjusted linear regression analyses a significant association between the visuospatial executive function domain score of the Montreal Cognitive Assessment and the maximum arteriolar dilation as response of retinal arterioles to the flicker light stimulation was obtained.ConclusionThis is the first study determining retinal microvascular function as surrogate for cerebral microvascular function and cognition in hemodialysis patients. The relationship between impairment in executive function and reduced arteriolar reaction to flicker light stimulation supports the involvement of cerebral small vessel disease as contributing factor for the development of cognitive impairment in this patient population and might be a target for noninvasive disease monitoring and therapeutic intervention.

Integration of Virtual Reality into Transcranial Magnetic Stimulation Improves Cognitive Function in Patients with Parkinson's Disease with Cognitive Impairment: A Proof-of-Concept Study.

Emerging evidence has indicated the positive effects of repetitive transcranial magnetic stimulation (rTMS) on patients with Parkinson's disease (PD) for the treatment of mild cognitive impairment (MCI). Investigating whether combining virtual reality (VR) training with rTMS can further enhance cognitive improvement induced by rTMS treatment. We randomly assigned 40 patients with PD and MCI into three groups, namely the rTMS-VR group (n = 13), rTMS group (n = 11), and sham rTMS group (n = 16). rTMS was administered as 10 consecutive sessions of intermittent theta burst stimulation (iTBS) over the left dorsolateral prefrontal cortex. In the rTMS-VR group, VR training was administered immediately after each rTMS session. Cognitive function was measured using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Montreal Cognitive Assessment (MoCA) at baseline, immediately after intervention, and at 3-month follow-up. Compared with the rTMS group, the rTMS-VR group exhibited significantly more improvements in total and delayed memory scores of the RBANS and the visuospatial/executive function score of the MoCA after intervention (p = 0.000∼0.046) and the delayed memory score of the RBANS at 3-month follow-up (p = 0.028). The integrated rTMS-VR protocol achieved a superior outcome in global cognitive function, more effectively enhancing working memory and visuospatial executive function than did the rTMS protocol alone. The combination of VR and rTMS can be an effective regimen for improving the cognitive function of patients with PD.

Analysis of the cognitive effects of monocular blindness and related influencing factors

Objective: To investigate the cognitive effects of monocular blindness and related influencing factors. Methods: A cross-sectional study was conducted. The patients with monocular blindness (the age of onset <16 years) were enrolled from Beijing Tongren Eye Center, Beijing Tongren Hospital between January 2018 and June 2020. The Montreal cognitive assessment (MoCA) scale was applied to assess seven cognitive domains including visuospatial and executive function, naming, attention, etc. Based on MoCA scores, all the patients were classified into two groups: normal cognitive functions and cognitive impairment. Spearman's correlation was used to perform the single factor analysis of the influencing factors of cognitive functions. Multivariate linear regression analyses were applied to identify the independent influencing risk factors. Results: A total of 45 patients with monocular blindness were enrolled. There were 25 males and 20 females, with age at testing being (27±10) years.The incidence of cognitive impairment in 45 patients was 60.0% (27/45). The abnormal items ranking from a high to low rate were language (95.6%, 43 cases), delayed recall (75.6%, 34 cases), visuospatial and executive function (60.0%, 27 cases), abstract (44.4%, 20 cases), attention (35.6%, 16 cases), naming (20.0%, 9 cases), and orientation (0%). There were statistically significant differences (all P<0.05) in total score (21.9±3.3 vs. 27.4±1.4), visuospatial and executive function (3.2±1.7 vs. 4.6±0.7), naming (2.7±0.6 vs. 2.9±0.2), attention (5.3±1.0 vs. 5.8±0.4), language (1.1±0.8 vs. 1.8±0.8), abstract (1.1±0.8 vs. 1.8±0.5) and delayed recall (2.3±1.3 vs. 4.4±0.8) between two groups of patients with and without cognitive impairment. Spearman's correlation analysis showed visuospatial and executive functions, attention, abstract and MoCA total score were positively correlated with education years (correlation coefficients being 0.355, 0.424, 0.434 and 0.370, respectively; all P<0.05). Multiple linear regression showed that duration of blindness was correlated with naming (β=-0.325), and years of education correlated with attention (β=0.472), abstract ability (β=0.441) and MoCA total score (β=0.390) (all P<0.05). Conclusions: Monocular blindness may affect language, delayed memory and visuospatial executive functions. The duration of blindness is an independent risk factor, and higher education is a protective factor of the cognitive impairment.

Dual-Task Training Program for Older Adults: Blending Gait, Visuomotor and Cognitive Training.

Objective: Physical and cognitive impairments are common with aging and often coexist. Changes in the level of physical and mental activity are prognostic for adverse health events and falls. Dual-task (DT) training programs that can improve mobility and cognition simultaneously can bring significant improvements in rehabilitation. The objective of this mixed methods exploratory RCT was to provide evidence for the feasibility and therapeutic value of a novel game-assisted DT exercise program in older adults. Methods: Twenty-two community dwelling participants, between the ages of 70-85 were randomized to either dual-task treadmill walking (DT-TR) or dual-task recumbent bicycle (DT-RC). Both groups viewed a standard LED computer monitor and performed a range of cognitive game tasks while walking or cycling; made possible with the use of a "hands-free", miniature, inertial-based computer mouse. Participants performed their respective 1-h DT exercise program twice a week, for 12weeks at a community fitness centre. Semi-structured interviews and qualitative analysis was conducted to evaluate the participant's experiences with the exercise program. Quantitative analysis included measures of standing balance, gait function (spatiotemporal gait variable), visuomotor and executive cognitive function, tested under single and DT walking conditions. Results: Compliance was 100% for all 22 participants. Four themes captured the range of participant's experiences and opinions: 1) reasons for participation, 2) difficulties with using the technologies, 3) engagement with the computer games, and 4) positive effects of the program. Both groups showed significant improvements in standing balance performance, visuomotor and visuospatial executive function. However, significant improvement in dual task gait function was observed only in the DT-TR group. Medium to large effect sizes were observed for most balance, spatiotemporal gait variables, and cognitive performance measure. Conclusion: With only minor difficulties with the technology being reported, the findings demonstrate feasible trial procedures and acceptable DT oriented training with a high compliance rate and positive outcomes. These findings support further research and development, and will direct the next phase of a full-scale RCT.

Differential Age Trajectories of White Matter Changes Between Sexes Correlate with Cognitive Performances.

Background: Aging is accompanied by a gradual deterioration in multiple cognitive abilities and brain structures. Both cognitive function and white matter (WM) structure are found to be associated with neurodegeneration diseases and correlated with sex during aging. However, it is still unclear whether the brain structural change could be attributable to sex, and how sex would affect cognitive performances during aging. Materials and Methods: Diffusion magnetic resonance imaging (MRI) scans were performed on 1127 healthy participants (age range: 21-89) at a single site. The age trajectories of the WM tract microstructure were delineated to estimate the turning age and changing rate between sexes. The canonical correlation analysis and moderated mediation analysis were used to examine the relationship between sex-linked WM tracts and cognitive performances. Results: The axon intactness and demyelination of sex-linked tracts during aging were multifaceted. Sex-linked tracts in females peak around 5 years later than those in males but change significantly faster after the turning age. Projection and association tracts (e.g., corticospinal tracts and parahippocampal cingulum) contributed to a significant decrease in visuospatial functions (VS) and executive functions (E). We discovered that there is a stronger indirect effect of sex-linked tracts on cognitive functions in females than in males. Conclusion: Our findings suggest that the vulnerable projection and association tracts in females may induce negative impacts on integrating multiple functions, which results in a faster decrease in VS and E. Impact statement By recruiting a healthy population for diffusion magnetic resonance imaging (MRI) scan, we demonstrated that the age-related changes of white matter (WM) integrity were manipulated by sex. Sex-linked tracts in females reached the turning age 5 years later, but change faster than those in males after the turning age. The most significant sex effect was found in projection and association tracts. Our results indicated that sex affected both WM microstructure and cognitive functions and was further involved in the mediation of the age-WM-cognition relationship. The vulnerability of projection and association tracts in females may induce negative impacts on visuospatial and executive functions.

Efficacy of Multidomain Intervention Against Physio-cognitive Decline Syndrome: A Cluster-randomized Trial

BackgroundsTo investigate the efficacy of a community group-based intervention among community-dwelling older adults with physio-cognitive decline syndrome (PCDS). MethodsA prospective cluster randomized controlled trial included 733 community-dwelling older adults with adjusted Montreal Cognitive Assessment (MoCA adj) scores >18 from 40 community-based sites across Taiwan. PCDS was defined as the concomitant presence of physical declines, i.e., slowness and/or weakness plus dysfunction in any cognitive domain. The multidomain intervention integrated physical exercise, cognitive training, nutritional advices and health education lessons. Conventional health education in control group entailed periodic telephone calls to offer participants health education and advice. The primary outcome was the mean differences of MoCA adj total scores and all domains of MoCA adj between baseline and 6- and 12-month follow-up in each group of PCDS, cognitive dysfunction, mobility-type frailty and normal functioning, and the secondary outcomes included the changes of frailty score, handgrip strength, gait speed and physical activity. Intervention effects were analysed using a generalized linear mixed model. ResultsOverall, 18.9% of the study sample had PCDS. Multidomain intervention for 12 months significantly improved cognitive performance in people with PCDS, and those with cognitive dysfunction only. An early benefit on visuo-spatial executive function was seen in older adults with mobility-type frailty. Intervention also improved frailty scores among participants with mobility-type frailty, handgrip strength for participants with PCDS, and gait speed in the normal group. ConclusionsPCDS is a potentially reversible condition that may prevent subsequent disability and dementia, which deserves further investigation to confirm the long-term effects.

Abnormal Gray Matter Volume and Functional Connectivity in Parkinson's Disease with Rapid Eye Movement Sleep Behavior Disorder.

Objective Rapid eye movement (REM) sleep behavior disorder (RBD) is a common symptom in Parkinson's disease (PD), and patients with PD-RBD tend to have an increased risk of cognitive decline and have the tendency to be akinetic/rigidity predominant. At the same time, the mechanisms of RBD in patients with PD remain unclear. Therefore, this study aimed to detect the structural and functional differences in patients with PD-RBD and PD without RBD (PD-nRBD). Methods Twenty-four polysomnography-confirmed patients with PD-RBD, 26 patients with PD-nRBD, and 26 healthy controls were enrolled. Structural and functional patterns were analyzed based on voxel-based morphometry and seed-based functional connectivity (FC). Correlations between altered gray matter volume (GMV)/FC values and cognitive scores and motor impairment scores in PD subgroups were assessed. Results Compared with patients with PD-nRBD, patients with PD-RBD showed relatively high GMV in the cerebellar vermis IV/V and low GMV in the right superior occipital gyrus (SOG). For the FC, patients with PD-RBD displayed lower FC between the right SOG and the posterior regions (left fusiform gyrus, left calcarine sulcus, and left superior parietal gyrus) compared with the patients with PD-nRBD. The GMV values in the right SOG were negatively correlated with the Unified PD Rating Scale-III scores in patients with PD-RBD but positively correlated with delayed memory scores. The GMV values in the cerebellar vermis IV/V were positively correlated with the tonic chin EMG density scores. There were positive correlations between the FC values in the right SOG-left superior parietal gyrus and MoCA and visuospatial skills/executive function scores and in the right SOG-left calcarine sulcus and delayed memory scores. Conclusion Higher GMV in the cerebellum may be linked with the abnormal motor behaviors during REM sleep in patients with PD-RBD, and lower GMV and FC in the posterior regions may indicate that PD-RBD correspond to more serious neurodegeneration, especially the visuospatial–executive function impairment and delayed memory impairment. These findings provided new insights to learn more about the complicated characteristics in patients with PD-RBD.

A new and short protocol to achieve the early diagnosis of mild cognitive impairment.

The mild cognitive impairment (MCI) is a neurocognitive disorder which involves cognitive impairments beyond those expected for the age and education of the subject but are not significant enough to interfere with instrumental activities of daily living. The identification of individuals with MCI is particularly important for those who might benefit from new therapies. The aim of this work is to propose a comprehensive neuropsychological protocol to achieve early diagnosis of MCI. A neuropsychological battery was created and administered to a sample of patients with MCI (n = 25) and healthy matched controls (n = 25). Although memory decline is often the first sign preceding the appearance of MCI, significant differences in visuospatial tasks, naming abilities, and executive function can be demonstrated as well between MCI and controls. A proper selection of cognitive measures within those included in the already-available neuropsychological batteries may provide a thorough assessment of MCI and allow its timely diagnosis.

The role of cognition for identifying unsafe young drivers

Young drivers (individuals between the ages of 15 and 25 years) engage in unsafe driving more than any other age group, accounting for a large portion of youth mortality rates both in Australia and worldwide. Recent research has found a link between cognitive factors such as memory, attention and executive functions and driving performance in younger drivers. The aim of the current study was to explore the unique contribution made by specific cognitive domains to unsafe youth driving, with the intention of using cognitive measures to help identify unsafe drivers. Participants comprised 95 (72% female) undergraduate students aged between 18 and 24 years. Participants completed a demographic questionnaire, a battery of cognitive tests shown to be related to driving performance in older age groups and two simulated drives. Driving performance measures included speeding (percentage of time over the limit, and average speed greater than 10 km/h over the limit), collisions and lane keeping measured via the Standard Deviation of Lane Position (SDLP). Results revealed that visuospatial ability (the visual object space and perception battery) predicted unsafe time spend speeding, whilst visuospatial executive function (Rey Complex Figure Organisation) and psychomotor skills with dominant hand (Grooved Pegboard) were found to predict average speed over the limit. The results returned on those measures, however, did not permit the clinical utility of the measures that would enable categorisation of safe and unsafe drivers above an 80% criterion of clinical significance. Recommendations for future studies are considered in light of limitations with the study such as the dichotomisation and choice of the driving performance measures, the choice of the cognitive tests and the sample of participants. These results provide a starting point for further investigation into the feasibility of cognitive testing for younger drivers.

Level of play and coach-rated game intelligence are related to performance on design fluency in elite soccer players

Executive brain functions are innate mechanisms for regulating behavior. While the impact of suboptimal executive functions has been characterized in patients, their contribution to individual success has not been elucidated. We set out to understand how executive functions relate to successful human behavior by examining their relation to game intelligence in sport - the ability to read a game and quickly adapt the behavior. In elite soccer players (n = 51), those playing in national teams (national team players) significantly outperformed those only playing at premier league level (premier league players) in Design Fluency (DF), a complex visuo-spatial executive function test that includes measures of creativity and cognitive flexibility. Their result showed a moderate correlation with coach rated game intelligence, remained also when correcting for low level cognitive capacity and was most evident when considering cognitive flexibility. DF capacity also correlated with number of assists made during the season but not with number of made goals during the same period, linking the fast planning of several steps in DF to fast planning of several steps in the soccer game. Altogether, our data suggests that DF capacity relates to success in soccer both on a subjective and on an objective level.

33 Cognitive Domain Associations with Balance Performance in Community – Dwelling Older People with Cognitive Impairment

Abstract Aims Investigate the relationship between global cognition and cognitive domain function and balance performance in a large sample of older people with cognitive impairment. Methods Three hundred and nine community-dwelling older people (mean age=82 years; 47% female) with cognitive impairment were recruited for the iFOCIS fall prevention randomised controlled trial. Baseline assessments completed before randomisation were used for analyses and included the Addenbrooke’s Cognitive Examination-III (ACE-III; global cognitive function) and its individual cognitive domains (attention; memory; verbal fluency; language; visuospatial ability) and executive function, further examined using the Frontal Assessment Battery (FAB). Balance performance was derived by averaging postural sway on floor and foam, maximal balance range (reverse z-score) and co-ordinated stability z-scores. With balance performance as the dependent variable, global cognition and each cognitive domain were entered into multivariate linear regression models. Results Mean (± standard deviation) ACE-III and FAB scores were 62.8±19.2 and 11.4±4.6 respectively. In linear regression analyses adjusted for covariates, global cognitive function and each cognitive domain were significantly associated with balance performance. Executive function (verbal fluency; β=-.248, p&amp;lt;0.001, adjusted R2=0.376) and visuospatial ability (β=-.250, p&amp;lt;0.001, adjusted R2=0.381) had the strongest and memory the weakest (β=-.119, p=0.018, adjusted R2=0.334) association with balance. Visuospatial ability remained significantly associated with balance performance when adjusted for attention, memory, language, verbal fluency and the FAB. Executive function (verbal fluency) remained significantly associated with balance when adjusted for attention, memory, language and visuospatial ability. Conversely, attention, memory, and language did not withstand adjustment for visuospatial ability or executive function. Conclusions Poorer global cognition and performance in each cognitive domain were associated with poorer balance performance in this large sample of community-dwelling older people with cognitive impairment. Visuospatial ability and executive function were independently associated with balance, highlighting the role higher-level cognitive processes and spatial perception and processing play in postural control.

The characteristics of neurocognitive function in farmers exposed to chronic pesticides at Banjar Tengah Kelod, Kerambitan, Tabanan, Bali, Indonesia

Purpose: This study aims to evaluate the characteristics of neurocognitive function in farmers exposed to chronic pesticides.Material and Methods: This study uses a descriptive cross-sectional design with total sampling methods. The study was conducted from 1st January 2019 until 31st January 2019 located in Banjar Tengah Kelod, Kerambitan sub-district, Tabanan district, Bali, Indonesia.Results: A total of 60 samples, consisted of 36 samples (60%) were women and 24 samples (40%) were men were obtained. The median age of the study sample was 55 year-old. Most of the samples who experienced neurocognitive impairment used organophosphate pesticides (60%), followed by organochlorine (20%), carbamate (13.3%), and pyrethroid (6.7%). Organophosphate users experienced neurocognitive impairment in both memory domain (mean score of 1.5 what scoring was used?) and visuospatial executive functions (mean score of 1, what scoring system?). The mean memory function score in the organochlorine user group was the highest compared to other groups of pesticide users while the average score of visuospatial function was 1. The samples of the study using carbamate pesticides had the same average score in both domains of neurocognitive function. The mean score of memory function in pyrethroid user was 2.5 and the average score of executive visuospatial function was 1.Conclusion: Chronic exposure to the four types of pesticides provided a picture of neurocognitive function impairment, including memory, visuospatial and executive functions. This result did not show clinical significance. The addition of sample size and analytic method studies should be considered for further research.

Multi-modal latent factor exploration of atrophy, cognitive and tau heterogeneity in Alzheimer’s disease

Individuals with Alzheimer’s disease (AD) dementia exhibit significant heterogeneity across clinical symptoms, atrophy patterns, and spatial distribution of Tau deposition. Most previous studies of AD heterogeneity have focused on atypical clinical subtypes, defined subtypes with a single modality, or restricted their analyses to a priori brain regions and cognitive tests. Here, we considered a data-driven hierarchical Bayesian model to identify latent factors from atrophy patterns and cognitive deficits simultaneously, thus exploiting the rich dimensionality within each modality. Unlike most previous studies, our model allows each factor to be expressed to varying degrees within an individual, in order to reflect potential multiple co-existing pathologies.By applying our model to ADNI-GO/2 AD dementia participants, we found three atrophy-cognitive factors. The first factor was associated with medial temporal lobe atrophy, episodic memory deficits and disorientation to time/place (“MTL-Memory”). The second factor was associated with lateral temporal atrophy and language deficits (“Lateral Temporal-Language”). The third factor was associated with atrophy in posterior bilateral cortex, and visuospatial executive function deficits (“Posterior Cortical-Executive”). While the MTL-Memory and Posterior Cortical-Executive factors were discussed in previous literature, the Lateral Temporal-Language factor is novel and emerged only by considering atrophy and cognition jointly. Several analyses were performed to ensure generalizability, replicability and stability of the estimated factors. First, the factors generalized to new participants within a 10-fold cross-validation of ADNI-GO/2 AD dementia participants. Second, the factors were replicated in an independent ADNI-1 AD dementia cohort. Third, factor loadings of ADNI-GO/2 AD dementia participants were longitudinally stable, suggesting that these factors capture heterogeneity across patients, rather than longitudinal disease progression. Fourth, the model outperformed canonical correlation analysis at capturing associations between atrophy patterns and cognitive deficits.To explore the influence of the factors early in the disease process, factor loadings were estimated in ADNI-GO/2 mild cognitively impaired (MCI) participants. Although the associations between the atrophy patterns and cognitive profiles were weak in MCI compared to AD, we found that factor loadings were associated with inter-individual regional variation in Tau uptake. Taken together, these results suggest that distinct atrophy-cognitive patterns exist in typical Alzheimer’s disease, and are associated with distinct patterns of Tau depositions before clinical dementia emerges.

Cognitive deficits have only limited influence on health-related quality of life in amyotrophic lateral sclerosis

Objective To explore the association between cognitive deficits and health-related quality of life in amyotrophic lateral sclerosis (ALS). Methods The revised ALS Functional Rating Scale (ALSFRS-R for physical impairment), the ALS Assessment Questionnaire (ALSAQ-40 for health-related quality of life) and the Edinburgh Cognitive and Behavioral ALS Screen (ECAS for cognition) were assessed in 125 patients with ALS. Correlations between ALSAQ-40 domains and ECAS functions were tested using Spearman correlation. Linear regression was used to evaluate the relationship between dysphagia, depression, hopelessness, pain (all derived from corresponding items from the ALSFRS-R or ALSAQ-40), ALSFRS-R, ECAS and the ALSAQ-40. Results Verbal fluency, language and executive function were disturbed in 69 (55%), 54 (43%) and 41 (33%) patients, respectively. In the ALS non-specific domains the memory and visuospatial function were impaired in 44 (35%) and 12 (10%) patients. In the non-demented group the five ECAS functions did not correlate with the ALSAQ-40 subdomains. The ALSFRS-R score, hopelessness, pain, and depression explained 65% of the ALSAQ-40 SI variance; the ECAS total score did not significantly predict ALSAQ-40 summary index. The ECAS visuospatial, executive function and fluency significantly predicted emotional well-being (adjusted R 2 = 0.08). When the model was controlled for depression, hopelessness and pain none of the ECAS functions (visuospatial, executive function and fluency) were significant predictors of emotional well-being. Conclusion Deficits in visuospatial function, executive function and fluency constrain the ability to manage activities of daily living and this might cause decline in well-being.

Visuospatial Executive Functions are Improved by Brief Brain Training in Young Rugby Players - Evidence of Far Transfer Test Effects: A Pilot Study

Brain training apps are becoming increasingly popular for at home use and as an adjunct to more traditional therapies. There is uncertainty about whether the effects of brain training transfer to real-world cognition, or performance on other cognitive assessment tests, or is specific only to the brain training app. Executive functions (EF’s) are higher-order cognitive processes important for activities of everyday living and autonomous goal-directed behaviour [1]. EF’s are associated with frontal brain networks that are susceptible to injury after head trauma and concussion so it is important to know whether these functions can be trained after a short training period (transfer effects beyond gains on app play), to general cognitive ability but findings so far have been mixed. The present study investigated efficacy of brief computerised brain training to in producing far-transfer effects to performance on standardised clinical tests of cognition in young rugby players with mixed concussion history, over a 4-week period. Athletes cognitive ability was assessed at baseline and after the training period on standardised tests to establish whether there were transfer effects. The putative relationship between concussion frequency and severity on baseline cognitive performance was also investigated. Results showed effective transfer effects from initial training to selective visuospatial executive functions. There was also a decline over the training period in non-verbal strategy initiation, although ability remained at average levels. Players showed no cognitive deficits at baseline, but correlational analyses and MR results indicated that concussion frequency, not severity, was a significant predictor of some visuospatial executive function scores at baseline. These preliminary findings hold promise for full scale studies investigating efficacy of brief brain training and association between sport-related concussion and cognition.

Central auditory processing findings in a group of cognitively impaired individuals

Introduction: Prevalence of central auditory processing disorders (CAPD) increases with age. Central auditory dysfunction is also more prevalent in older people with mild memory impairment compared with cognitively normal older people. These findings suggest that CAPD could be a marker of subtle cognitive dysfunction. A logical question is whether tests of CAPD have a potential role in evaluation of possible cognitive decline in elderly people with hearing complaints. This question has direct clinical relevance because tests for CAPD are widely available, easy to administer in a short time.Methods: Fifty-one patient having cognitive impairment (diagnosed according Diagnostic and Statistical Manual of Mental disorders, fifth edition 2013 (DSM-V) comprise the study group. The control group includes twenty age and gender matched individuals. A detailed neuropsychological assessment of both groups with tests from various cognitive domains (Visuospatial functions, executive function, short-term memory and verbal episodic memory). Behavioural central auditory tests included the Arabic versions of speech in noise test (SPIN) and/or synthetic sentence identification (SSI) test according to education of patient, the dichotic digits test (DDT), The auditory fusion test (AFT) and auditory memory tests.Results: There was a statistically significant difference between both groups in the behavioural central auditory tests.Conclusions: The relation of some measures of auditory processing to deficits in cognitive function might enable the early identification of cognitive decline with such measures in the older population. Aging can contribute to changes in central auditory processing (CAP) in the elderly especially in Speech understanding in background noise, Dichotic listening and Temporal Processing.