Visuospatial Function Research Articles

Neurocognitive Safety of Endoscopic Colloid Cyst Resection: Paired Pre- and Post-Operative Cognitive Function from an Exploratory Cohort

Objective: Resection of colloid cysts, a rare third ventricle pathology, is accepted clinical practice. Owing to their location proximal to deep gray nuclei and forniceal columns, colloid cysts have been theorized to contribute to cognitive decline. Comprehensive pre- and post-operative cognitive testing, however, has rarely been implemented. Methods: We analyzed formal neuropsychological testing performed in 20 patients undergoing endoscopic cyst resection. Pre- and post-operative performance was compared either for each individual patient or according to aggregated neuropsychological factor scores grouped via expert census. A change in performance was deemed significant if (i) it reached statistical significance and (ii) was greater than 1.5 pre-operative standard deviations. Results: Twenty patients with colloid cysts (average diameter 13.3 ± 1.3 mm) underwent matched pre- and post-operative testing. No patient had a significant change in cognitive performance. Neurocognitive metrics assessing cognitive functions typically subsumed by the temporal (p = 0.35), extratemporal (p = 0.20), occipitoparietal (p = 0.31), or frontal lobes (p = 0.11) did not change post-operatively. Similarly, no differences emerged when factor scores were generated according to composite scores of different neurocognitive domains: attention (p = 0.32), executive function (p = 0.14), language (p = 0.98), and visuospatial function (p = 0.42). Conclusions: Neuropsychological testing allows for the careful monitoring of cognitive status before and after surgery and for the identification of patients who may benefit from pre- and post-operative cognitive rehabilitation. It should also be used as a valuable surgical psychometric marker and adjuvant. No significant cognitive decline was observed in this cohort.

Motor and visuospatial processing profile in a cross-conditions study: A comparison between developmental coordination disorder and nonverbal learning disability.

Neurodevelopmental conditions often exhibit overlapping symptoms, posing challenges for differential diagnosis. Developmental Coordination Disorder (DCD) manifests as fundamental motor impairments, often along with co-occurring visuospatial difficulties. Nonverbal Learning Disorder (NLD) features visuospatial core challenges, with a less consistent characterization of its motor profile. Strikingly, to date no study has directly compared DCD and NLD profiles. The present study aimed to analyze whether DCD and NLD share any characteristics by contrasting their motor and visuospatial performances, comparing them with non-diagnosed (ND) peers. A total of 102 participants (8-16 years; DCD N = 29, NLD N = 29, ND N = 44) completed motor and visuospatial tasks. The groups' performance was compared, and the discriminatory power of the measures administered was analyzed. Our findings support the substantial motor and visuospatial impairments in DCD and NLD, respectively. Regarding diagnostic efficacy, motor and visuospatial tasks effectively differentiated DCD or NLD from ND, with specificities related to each condition. Balance, and to a lesser extent, Spatial Processing revealed significant predictive power in distinguishing between DCD and NLD. Our results revealed cross-disorder similarities and highlighted specific hallmarks, corroborating the need of a comprehensive motor and visuospatial assessment for distinguishing between DCD and NLD.

Expert consensus on neuropsychological assessment for mild cognitive impairment (2025 edition)

Mild cognitive impairment (MCI) is a state of objective cognitive decline that falls between normal aging and dementia, with a high prevalence among the elderly in China. Cognitive impairments in MCI patients involve multiple cognitive domains such as memory, language, attention, executive, visuospatial functions, and social cognition, as well as non-cognitive domains such as neuropsychiatric, mood, sleep, daily living activities, and frailty. The assessment and clinical diagnosis of MCI highly rely on neuropsychological testing. In order to standardize the neuropsychological assessment of MCI, the Dementia and Cognitive Disorders Group of the Chinese Society of Neurology formulated this consensus document. It recommends tools for assessing global cognition, various cognitive domains, and non-cognitive functions suitable for both clinical and research settings. The consensus proposes assessment procedures and precautions based on the experiences of domestic researchers. Based on the latest international and domestic research advancements, using the Delphi method and the GRADE evidence system, 24 recommendations were formulated in 5 aspects of MCI: global cognitive function assessment, various cognitive domains assessment, non-cognitive assessment, the use of neuropsychological scales, and precautions in neuropsychological assessment, aiming to improve the diagnosis and management of MCI in China.

Computerized cognitive training for problem gambling: A randomized controlled trial (TRAIN-online).

Non-face-to-face interventions offer promise, with cognitive training showing potential butinconsistent efficacy in problem gambling. We conducted a non-face-to-face, parallel, randomized, controlled, single-blinded trial to evaluate training programs in adults with problem gambling (CPGI ≥5). Participants were randomized 1:1 to a web-based cognitive training program targeting inhibition unrelated to addiction cues or a control program on visuo-spatial functioning. Both programs benefited from weekly phone calls to support engagement and transferability to daily life. Amixed community and out-patient sample was recruited at the national-level. The primary outcome was change in CPGI at week 6. Secondary outcomes were change in impulsivity, gambling behavior andquality of lifeat 6 and 14 weeks. 187 participants were screened, with 185 randomized: 93tointervention and 92 to control. No significant differences were found between groups for any outcome. Mean PGSI change at 6 weeks was -2.75, 95% CI [-12.95; 7.44] in the experimental arm versus -2.44, 95% CI [-13.52; 8.64] in controls, p = 0.76. 34% of participants were classed as no longer problem gamblers at week 14. Intervention acceptability was moderate, with 21 participants (22.58%) in the experimental group, and 32 (34.78%) controls never accessing the platform (p = 0.07). Further research is needed to optimize cognitive interventions in problem gambling, to improve engagement and to demonstrate their added value beyond minimal intervention. For a number of problem gamblers, minimal telephone interventions appeared to be sufficient to reduce gambling. Objective account-based gambling data will provide valuable insights into long-term and objective effects.

A systematic review of cognitive telerehabilitation in patients with cognitive dysfunction

IntroductionOne of the possible treatment options for patient with cognitive dysfunction is cognitive telerehabilitation. Previous systematic reviews on cognitive telerehabilitation have focused on specific disease groups and the analysis of intervention methods did not differentiate between traditional face-to-face cognition treatment and usual care. In this systematic review, we aim to analyze randomized controlled trials (RCTs) that compare telerehabilitation with face-to-face treatment or usual care for improving cognitive function in elderly individuals with cognitive dysfunction or patients with acquired brain injury.MethodsWe conducted this systematic review following the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). In this systematic review, we searched 7 electronic databases (PubMed, Cochrane, EMbase, CINAHL, Web of Science, Scopus, KMbase) to identify relevant studies published through December 10, 2024. We conducted a meta-analysis to assess the quality of the studies and synthesize the evidence. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method.ResultsFinally, 16 studies were included in the analysis. For comparing telerehabilitation with face-to-face cognition treatment, the meta-analysis included 2 RCTs for global cognition (immediate outcome), 2 RCTs for attention (immediate outcome), 2 RCTs for visuospatial function (immediate outcome). For comparing telerehabilitation with usual care, the meta-analysis included 7 RCTs for global cognition (immediate outcome), 3 RCTs for global cognition (persistence outcome), 4 RCTs for attention (immediate outcome), 3 RCTs for executive function (immediate outcome), 3 RCTs for working memory (immediate outcome), 3 RCTs for visuospatial function (immediate outcome).DiscussionTelerehabilitation has been shown to be more effective than usual care in improving global cognitive function, and its effectiveness is not inferior to that of traditional face-to-face cognitive treatment. By overcoming the limitations of traditional cognition rehabilitation and providing continuous treatment, telerehabilitation can offer effective treatment in specific situations.

Association of Early fMRI Connectivity Alterations With Different Cognitive Phenotypes in Patients With Newly Diagnosed Parkinson Disease.

According to the dual syndrome hypothesis, patients with Parkinson disease (PD) with visuospatial deficits are more likely to progress to dementia, compared with patients with a prevalent dysexecutive syndrome. In this study, we aimed to investigate whether early connectivity changes in the dorsolateral prefrontal cortex (DLPFC) and the precuneus (PCun)-which are critical to fronto-executive and visuospatial functions, respectively-can identify distinct cognitive phenotypes in cognitively intact newly diagnosed patients with PD. Newly diagnosed, drug-naïve patients with PD (≤2 years from clinical onset) with normal Montreal Cognitive Assessment (MoCA), were consecutively enrolled from our Movement Disorders Clinics in Italy. Sex-matched and age-matched healthy controls (HCs) were enrolled among nonconsanguineous patients' relatives. Participants underwent 3T-fMRI to investigate resting-state functional connectivity (rs-FC) of DLPFC and PCun with a seed-based approach at baseline (T0). K-means cluster analysis was performed on z scores of rs-FC values of patients with PD to identify clusters of patients sharing common patterns of connectivity. Differences in neurophysiologic, motor, and nonmotor scales among PD clusters were assessed at T0 and after a 3.5-year follow-up (T1). The study included 68 patients with PD (27% women; mean age: 60 ± 9 years; Hoehn & Yahr score: 1.4 ± 0.5; MoCA score: 27.9 ± 1.6) and 31 HCs (39% women; mean age 64.2 ± 9.3 years) at T0. Forty-two patients completed T1 evaluation. Patients displayed reduced rs-FC of both DLPFC and PCun with several cortical and subcortical areas compared with HCs. Cluster 1 was defined by lower values of rs-FC in all investigated regions of interest while clusters 2 and 3, respectively, by higher and intermediate values. Despite none meeting criteria for mild cognitive impairment (MCI) at T0, cluster 1 was older and lower performing in global cognition, fronto-executive, and memory domains, compared with clusters 2 and 3 (all p < 0.031). At T1, a more evident worsening in global cognition, fronto-executive, and visuospatial domains and nonmotor and motor symptoms was observed in clusters 1 and 3 vs cluster 2 (all p < 0.04), with MCI being more frequent in clusters 1 and 3. Early connectivity changes of the DLPFC and the PCun occur in newly diagnosed patients with PD without MCI and can distinguish cognitive phenotypes, as confirmed after a longitudinal clinical observation.

Long-term Cognitive Trajectories in Older Adults After Surgery: A Population-based Cohort Study.

Postoperative cognitive decline (POCD) is a common, but often unrecognized condition after surgery. We evaluate postsurgical cognitive changes in a longitudinal population-based study. The study cohort comprises an age-stratified population-based random sample of individuals aged 65+ years from a small-town region of the United States. We identified as cases those participants who, during annual assessments, self-reported having undergone surgery under general anesthesia during the preceding year. We identified as controls those who reported no surgery for at least 6 consecutive years. The outcome variable changed over time (4y) in annual cognitive test composite scores encompassing the domains of attention/processing speed, executive function, memory, language, and visuospatial functions, which were modeled using Generalized Estimating Equations. A total of 436 participants had the required cognitive data; 179 participants (cases) had undergone surgery, while 257 participants (controls) had not undergone surgery. After adjusting for age, years of education, gender, race, heart failure, irregular heartbeat, and stroke, participants who underwent surgery had a greater decline in executive function, memory, and attention over a 2-year period. Participants who underwent surgery had a significant subsequent decline in cognitive function over the long term.

Factors associated with quality of life in long-COVID syndrome.

Approximately 10% of patients experience persistent symptoms following COVID-19, known as long-COVID syndrome. This cross-sectional study explored factors of quality of life (QoL) in 53 long-COVID patients. QoL was measured using the World Health Organization-Five Well-Being Index, fatigue with the Fatigue Visual Analogue Scale, and psychological health with the Depression-Anxiety-Stress-21 questionnaire. Six neuropsychological tests assessed information processing speed, verbal memory, visual memory, working memory, attention, language, fluency, recall, and visuospatial function with a composite score calculated by averaging z scores. Patients (76% female, mean age: 54.1 years) were assessed 8.7 months postinfection. Cognitive impairment, present in 49% of the sample, was not associated with QoL. In multiple linear regression, gender, fatigue, and psychological distress accounted for 42% of QoL variance, with fatigue and distress contributing 7% and 11%, respectively. Further studies are needed to determine if fatigue and psychological distress are causally related to QoL in long-COVID and could be treatment targets.

Cognitive Performance of Latino and White Non-Latino Individuals With Parkinson's Disease.

Cognitive impairment is a common nonmotor symptom in Parkinson's disease (PD). Individuals of Latino background are traditionally underrepresented in research on PD. Despite the fact that Latinos comprise 18% of the U.S. population, they commonly make up less than 5% of samples in studies of PD. Emerging evidence suggests that Latino individuals with PD may experience disparities relative to White non-Latinos in terms of having more severe motor symptoms, more severe depressive symptoms, and worse health-related quality of life. The purpose of the present study was to investigate differences in cognitive performance between Latino and White non-Latino individuals with PD and examine correlates of cognitive performance. Data were obtained from the Parkinson's Progression Markers Initiative. Participants included 60 Latino individuals with PD and 1,009 White non-Latino individuals with PD, all of whom were followed annually for up to 5 years. Participants completed neuropsychological tests of attention and working memory, processing speed, visuospatial functioning, verbal fluency, and immediate and delayed memory and recall. Relative to White non-Latino individuals with PD, Latino individuals with PD had significantly lower scores on the global measure of cognitive functioning, a test of processing speed, and tests of working memory and attention. Years of education was the strongest correlate of performance in these three cognitive domains among individuals in the Latino group. These findings provide initial evidence of disparities in cognitive functioning among Latino individuals with PD. Educational disadvantages may be one potential driver of these disparities.

The Role of Inflammation, Oxidative Stress, Neuronal Damage, and Endothelial Dysfunction in the Neuropathology of Cognitive Complications in Diabetes: A Moderation and Mediation Analysis.

Cognitive impairment is increasingly recognized as a complication of diabetes, yet the underlying pathology remains unclear. This study aims to investigate the roles of inflammation, oxidative stress, endothelial dysfunction, and neuronal damage in the neuropathology underlying diabetes related cognitive impairment. This study assessed 183 participants (54 prediabetes, 71 Type 2 diabetes mellitus [T2DM], and 58 controls) for cognitive performance using the Montreal Cognitive Assessment (MoCA). Blood samples were analyzed for interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), malondialdehyde (MDA), VCAM-1/CD106, and neuron-specific enolase (NSE) using ELISA. Mediation and moderator analysis methods were used to examine the roles of these biomarkers in diabetes-related cognitive impairment. After adjusting for age, education, and gender, group comparisons revealed significant cognitive impairment in patients with T2DM, particularly in visuospatial functions, naming, language, and memory performance, compared to the control group. The patients with T2DM and prediabetes exhibited similar performance in cognitive functions, except for language. Significant differences in VCAM-1 and TNF-α levels were observed; however, these biomarkers did not mediate the effect of T2DM and prediabetes on cognitive functions. Nevertheless, VCAM-1 was found to moderate abstraction abilities in T2DM. Prediabetes represents a transitional stage not only for the pathology of diabetes but also for cognitive complications. Although there were correlations between cognitive performance and various cognitive scores, IL-6, MDA, NSE, VCAM-1, and TNF-α did not play a mediator role in the neuropathology of diabetes-related cognitive impairment.

지역사회 노인의 연하기능과 인지기능간의 상관관계

Objective : The purpose of this study is to evaluate the prevalence and characteristics of dysphagia among community-dwelling older adults and to investigate the correlation between swallowing function and cognitive function. Methods : The study was conducted over eight weeks, from June 1 to July 30, 2024, targeting 108 elderly individuals aged 65 years or older who attended A, B, C, and D Senior Welfare Centers located in W Metropolitan City. Descriptive statistics were derived from the collected data using SPSS 23.0 for Windows. Pearson correlation analysis was performed to examine the relationship between swallowing function and cognitive function in this population. Results : Using the EAT-10 assessment, the prevalence and characteristics of dysphagia among community-dwelling elderly people were identified. The number of individuals reporting dysphagia-related difficulties was as follows: K1 (16), K2 (31), K3 (36), K4 (36), K5 (74), K6 (13), K7 (31), K8 (33), K9 (24), and K10 (25). Among the six cognitive function domains, the orientation (OR) domain showed a positive correlation with K5, while the domains of attention, visuospatial function, executive function, memory, and language showed negative correlations with the K-EAT-10 items. Conclusion : The EAT-10 assessment confirmed a significant prevalence of dysphagia among community-dwelling elderly individuals. Many participants experienced issues such as weight loss, avoidance of eating out, and difficulty swallowing due to dysphagia. Analysis revealed that the severity of dysphagia was negatively correlated with various cognitive functions, including attention, visuospatial function, executive function, memory, and language.

Rapid Cognitive Deterioration in Progressive Supranuclear Palsy: A 1-Year Follow-Up Study.

Nowadays, cognitive impairment has been characterized as one of the most vital clinical symptoms in progressive supranuclear palsy (PSP). Based on a relatively large cohort, we aimed to show the cognitive deterioration in different PSP subtypes during 1-year follow-up and investigate potential contributors for disease prognosis. One hundred seventeen patients from Progressive Supranuclear Palsy Neuroimage Initiative (PSPNI) cohort underwent neuropsychological tests and 1-year follow-up, with 73 diagnosed as PSP-Richardson syndrome (PSP-RS) and 44 as PSP-non-RS. Patients were divided into normal cognition (PSP-NC), mild cognitive impairment (PSP-MCI), and PSP-dementia. Cognitive impairment and progression rates were compared between PSP-RS and PSP-non-RS, and determinants for MCI conversion to dementia were calculated by multiple cox regression. At baseline, 30.8% of PSP patients were diagnosed as dementia, 53.0% as MCI, and only 16.2% as NC. Compared to PSP-non-RS, PSP-RS suffered more from motor symptoms and cognitive impairment. During follow-up, PSP-RS also exhibited faster disease progression in Mini-Mental State Examination and visuospatial function, with cognitive deterioration in attention and executive function, but retained in language and memory subdomains. Twenty-seven of 62 PSP-MCI patients converted to dementia during follow-up, with the diagnosis of RS subtype as the most significant contributor to conversion (hazard ration = 2.993, 95% confidence interval = 1.451, 5.232, P = 0.009). Patients with PSP-RS showed more severe cognitive impairment and faster decline longitudinally than patients with PSP-non-RS. Additionally, the diagnosis of RS subtype appears to be the most contributed factor for MCI conversion to dementia within just 1-year follow-up period.

Effect of Intranasal Insulin on Cognitive Function in Diabetic Patients

A clear association between diabetes and cognitive impairment has been demonstrated in past studies, increasing the incidence of neurodegenerative diseases and accelerating the onset of Alzheimer's disease (AD) and other types of dementia. Many hypothesized mechanisms of diabetes leading to cognitive impairment exist, and the mechanism of insulin resistance has been demonstrated. Transnasal administration of insulin improves recall of spatial memory in healthy subjects in addition to verbal working memory, visuospatial working memory, delayed memory, and cognitive performance in cognitively impaired patients. No safety concerns have been identified in retrospective studies of intranasal insulin. This review aims to assess the potential of intranasal insulin as a treatment for cognitive impairment related to diabetes.

Cognitive function status and its correlation with blood pressure control in patients with hypertension in China

Objective: To investigate the global cognitive function and the function of specific cognitive domains in hypertensive patients at high risk of cardiovascular disease in China, and to explore the impact of cognition function on blood pressure control. Methods: This is a cross-sectional survey. Data were obtained from the ESPRIT study. Patients with a history of hypertension who participated in the ESPRIT study from September 2019 to July 2020 were selected. Mini-mental state examination (MMSE) was used to evaluate patients' overall cognition and the function of each cognitive domain. According to the total MMSE score, patients were divided into the cognitive-intact group (MMSE total score=30 points), cognitive-declined group (MMSE total score<30 points, but did not reach the dementia screening threshold) and cognitive-impaired group (MMSE total score reached the dementia screening threshold). A multivariable logistic regression model was used to explore the effects of cognitive function and MMSE score on blood pressure control. The years of education were removed from the adjustment variables for sensitivity analysis. The interaction effect modeling of stratified variables and exposed variables was used for hierarchical analysis. Results: A total of 10 834 patients with hypertension at high risk of cardiovascular disease were enrolled, aged 65 (60, 69) years and 4 476 (41.3%) patients were female. There were 989 patients in cognitive-intact group, 8 676 patients in cognitive-declined group and 1 169 patients in cognitive-impaired group. The MMSE score of all included patients was (25.6±3.8) points. In the overall study population, 10.8% (1 169/10 834) of hypertensive patients had cognitive impairment, with an MMSE total score of (18.6±4.1) points. The cognitive domains with obvious impairment were recall memory (-80%), visuospatial function (-64%), attention and computation (-60%); 80.1% (8 676/10 834) of hypertensive patients did not meet the criteria for cognitive dysfunction, but had cognitive decline, and the cognitive domains with significant impairment were recall memory (-51%) and visuospatial structure (-23%). Multivariate logistic regression analysis showed that cognitive dysfunction (OR=0.88, 95%CI: 0.72-1.08, P=0.212) and cognitive decline (OR=0.96, 95%CI: 0.83-1.12,P=0.629) was not correlated with blood pressure control. MMSE total score and scores in each cognitive domain were not correlated with blood pressure control (P>0.05). Sensitivity analysis showed that cognitive function was not related to blood pressure control (all P>0.05). Stratified analysis according to different frequency of medication showed that cognitive function and MMSE score were not correlated with blood pressure control (P>0.05). Conclusion: One in ten hypertensive patients who were at high risk of cardiovascular disease have comorbid cognitive impairment. In patients with high risk of cardiovascular disease, the most affected cognitive domains were recall memory, visuospatial function, attention and calculation. Part of hypertensive patients have not reached the level of cognitive dysfunction, but have begun to show cognitive decline. Cognitive function is not an independent influencing factor on blood pressure control.

Application of Navigated Transcranial Magnetic Stimulation (nTMS) to Study the Visual-Spatial Network and Prevent Neglect in Brain Tumour Surgery.

Objective: Navigated transcranial magnetic stimulation (nTMS) has seldom been used to study visuospatial (VS) circuits so far. Our work studied (I) VS functions in neurosurgical oncological patients by using repetitive nTMS (rnTMS), (II) the possible subcortical circuits underneath, and (III) the correspondence between nTMS and direct cortical stimulation (DCS) during awake procedures. Methods: We designed a monocentric prospective study, adopting a protocol to use rnTMS for preoperative planning, including VS functions for lesions potentially involving the VS network, including neurosurgical awake and asleep procedures. nTMS-based-DTI tractography allowed the visualization of subcortical circuits. Statistical analyses on nTMS/DCS points were performed. Clinical results were collected pre- and postoperatively. Results: Finally, 27 patients with primitive intra-axial brain lesions were enrolled between April 2023 and March 2024. Specific tests and an experimental integrated VS test (VISA) were used. The clinical evaluation (at 5 ± 7, 30 ± 10, 90 ± 10 days after surgery) documented 33% of patients with neglect in the left hemisphere four days after surgery and, during the 3-month follow-up, preservation of visuospatial function/clinical recovery (90.62% in MMSE, 98.86% in the bell test, 80% in the clock test, and 98% in the OCS test). The surgical strategy was modulated according to the nTMS map. Subcortical bundles were traced to identify those most involved in these functions: SFLII > SLFII > SLFI. A comparison of the nTMS and DCS points in awake surgery (n = 10 patients) documented a sensitivity (Se) of 12%, a specificity (Sp) of 91.21%, a positive predictive value (PPV) of 42%, a negative predictive value (NPV) of 66%, and an accuracy of ~63.7%. Conclusions: Based on our preliminary results, nTMS is advantageous for studying cognitive functions, minimising neurological impairment. Further analyses are needed to validate our data.

Greater baseline cortical atrophy in the dorsal attention network predicts faster clinical decline in Posterior Cortical Atrophy

BackgroundPosterior Cortical Atrophy (PCA) is a clinical syndrome characterized by progressive visuospatial and visuoperceptual impairment. As the neurodegenerative disease progresses, patients lose independent functioning due to the worsening of initial symptoms and development of symptoms in other cognitive domains. The timeline of clinical progression is variable across patients, and the field currently lacks robust methods for prognostication. Here, evaluated the utility of MRI-based cortical atrophy as a predictor of longitudinal clinical decline in a sample of PCA patients.MethodsPCA patients were recruited through the Massachusetts General Hospital Frontotemporal Disorders Unit PCA Program. All patients had cortical thickness estimates from baseline MRI scans, which were used to predict longitudinal change in clinical impairment assessed by the CDR Sum-of-Boxes (CDR-SB) score. Multivariable linear regression was used to estimate the magnitude of cortical atrophy in PCA patients relative to a group of amyloid-negative cognitively unimpaired participants. Linear mixed-effects models were used to test hypotheses about the utility of baseline cortical atrophy for predicting longitudinal clinical decline.ResultsData acquired from 34 PCA patients (mean age = 65.41 ± 7.90, 71% females) and 24 controls (mean age = 67.34 ± 4.93, 50% females) were analyzed. 62% of the PCA patients were classified as having mild cognitive impairment (CDR 0.5) at baseline, with the rest having mild dementia (CDR 1). Each patient had at least one clinical follow-up, with the mean duration of 2.78 ± 1.62 years. Relative to controls, PCA patients showed prominent baseline atrophy in the posterior cortical regions, with the largest effect size observed in the visual network of the cerebral cortex. Cortical atrophy localized to the dorsal attention network, which supports higher-order visuospatial function, selectively predicted the rate of subsequent clinical decline.ConclusionsThese results demonstrate the utility of a snapshot measure of cortical atrophy of the dorsal attention network for predicting the rate of subsequent clinical decline in PCA. If replicated, this topographically-specific MRI-based biomarker could be useful as a clinical prognostication tool that facilitates personalized care planning.

Visuospatial dysfunction predicts dementia-first phenoconversion in isolated REM sleep behaviour disorder

ObjectiveWhile isolated rapid eye movement sleep behaviour disorder (iRBD) is known as a prodrome of α-synucleinopathies, the prediction for its future phenoconversion to parkinsonism-first or dementia-first subtype remains a challenge....

Development of the subjective cognitive function decline scale for middle-aged Koreans

Objectives This study developed the Subjective Cognitive Function Decline Scale for Middle-aged South Koreans (SCFD-K), addressing the need for early detection of potential mild cognitive impairment. This study fills a gap in the existing research, which mainly targeted older demographics or generalized cultural differences. Method We conducted focus group interviews (FGIs) among 36 participants and with nine experts to answer basic questions related to cognitive decline, after which we developed a draft scale using the Delphi with another 15 experts. To examine the reliability and validity of the scale, an online survey of 2,000 people was conducted. Results An exploratory factor analysis identified four distinct factors, which are language, visuospatial function, personality/emotion, and memory, with a total of 20 items (Cumulative variance ratio = 57.76), and a confirmatory factor analysis validated the four-factor structure with a good model fit (CFI = 0.932, TLI = 0.921, RMSEA = 0.057, and SRMR = 0.042) and acceptable internal consistency (Cronbach’s α = 0.735–0.907). Conclusion This analysis established the SCFD-K as a reliable and valid tool for assessing cognitive decline among middle-aged South Koreans. The findings have key cultural implications and inform proactive interventions and shaping future healthcare strategies in South Korea.

Postural imbalance without visual input is associated with specific neuropsychological deficits in older adults - results from the LIFE-adult study.

Modifiable risk factors play an important role in preventing dementia and reducing its progression. Regular physical activity already in midlife, which relies on intact multisensory balance control, can help to decrease the risk of dementia. However, our understanding of the relationship between postural balance and cognitive functions remains limited. The objective of our study was to investigate the association of postural balance during different sensory conditions with specific cognitive domains in older adults. Participants were from the population-based prospective "Leipzig Research Center for Civilization Diseases" (LIFE-Adult) cohort in Leipzig, Germany. Executive, memory and processing speed functions were tested by the Consortium to Establish a Registry for Alzheimer's disease (CERAD) plus battery. Assessment of visuospatial abilities was based on the short form of the Judgment of Line Orientation Test (JLO). Postural sway was recorded on a force plate with eyes open and closed. Romberg's ratios were calculated for sway path and sway area as a proxy for balance without visual control and tested in generalized linear regression models with the summary scores of executive function, memory, processing speed and visuospatial function as dependent variables. All models were adjusted for sex, age, ApoE status, socioeconomic status, anamnestic stroke, and diabetes. In total, we analyzed 460 participants with a mean age of 68.6 years, range 60 to 80, 47.6% female. A higher Romberg's ratio for sway area was a significant indicator for impaired visuospatial abilities as measured by the dichotomized JLO (Odds Ratio = 1.42, 95% confidence interval 1.07 to 1.88). Romberg's ratios were not significantly associated with executive functions, procedural speed or memory functions. It may be worthwhile to examine in the future whether inclusion of balance testing enhances the value of screening programs for cognitive impairment. Inversely, it may be appropriate to apply routine cognitive tests when balance problems are detected in older patients.

Impact of Neglect on the Relationship Between Upper Limb Motor Function and Upper Limb Performance in the (Hyper)acute Poststroke Phase.

Visuospatial neglect (VSN) is a negative, strong, and independent predictor of poor outcome after stroke, and is associated with poorer upper limb (UL) motor recovery in terms of function or capacity (ie, in standardized, lab-based testing). Although the main aim of stroke rehabilitation is to re-establish optimal functioning in daily life, the impact of VSN on UL performance (ie, in unstructured, everyday environments) is largely unknown. In this proof of principle study, the impact of VSN on the strength of the association between UL motor function (Jamar Hand Dynamometer) and UL performance (Upper Limb Lucerne ICF-based Multidisciplinary Observation Scale) was investigated in 65 (hyper)acute first-ever stroke patients. In a moderator analysis, the interaction term was negative and significant, showing that VSN suppresses the use of UL motor function in daily life (ie, performance). This finding suggests that, when considering UL performance in the (hyper)acute phase after stroke, interventions aimed to reduce deficits in both UL motor function and visuospatial function should already be started in the acute stroke unit setting.