Stroop interference in Chinese and English

Dynamic and static changes of amplitude of low-frequency fluctuations in anti‑N‑methyl‑D‑aspartate receptor encephalitis

BACKGROUND

Previous neuroimaging research has examined static local brain activity changes in patients with anti-N-methyl-d-aspartate receptor (anti-NMDAR) encephalitis. However, the dynamic properties of local brain activity in anti-NMDAR encephalitis remain unknown.

METHODS

This study used a combination of the amplitude of low-frequency fluctuation (ALFF) method and a sliding-window dynamic analysis approach to examine the time-varying local brain activity changes in anti-NMDAR encephalitis.

RESULTS

Results showed that patients with anti-NMDAR encephalitis exhibited increased dynamic ALFF (dALFF) variability in the left inferior occipital gyrus compared to healthy controls (HCs), while the patients exhibited decreased sALFF in widespread regions, including the left inferior frontal gyrus, left medial frontal gyrus, bilateral putamen, left medial superior frontal gyrus. dALFF had superior classification performance in distinguishing anti-NMDAR encephalitis patients from HCs over sALFF, but sALFF was correlated with multiple clinical and neuropsychological measures.

CONCLUSIONS

These findings may shed light on anti-NMDAR encephalitis brain dysfunction from the perspective of dynamic local brain activity. sALFF and dALFF analyses provide complementary information, emphasizing the potential usefulness of combining sALFF and dALFF in elucidating the neuropathological mechanisms of autoimmune encephalitis and may ultimately inform future disease diagnosis.

The executive functions among patients with an initial Glasgow coma scale score of 15

Executive functions (EF) were the critical neuropsychological functions linked to long-term adaptation. Given the heterogeneous prognosis trajectories of mild traumatic brain jury (mTBI), the mildest TBI may not always be benign in the chronic stage. The present study explored the long-term EF in patients with chronic complicated mTBI and a Glasgow Coma Scale (GCS) score of 15. Fifty patients with complicated mTBI and GCS scores of 15 and 35 control participants were recruited in this study. Medical records were retrospectively analyzed, and neuropsychological assessments and subjective measures examined the neuropsychological functions. Compared with healthy controls, complicated mTBI patients with a GCS score of 15 performed significantly worse on most EF assessments, including longer reaction time (RT) and poor cognitive flexibility and abstract reasoning performances. Patients also reported more EF problems and lower quality of life (QoL) than healthy controls. Females and those with subdural hematoma (SDH) had significantly longer reaction times (RT) on executive attention tests. This study found that complicated mTBI with a GCS score of 15 had incomplete recovery of EF, even in the chronic stage. We suggest that early neuropsychological assessment and rehabilitation should be arranged for such patients.

Effects of computerized cognitive training on structure‒function coupling and topology of multiple brain networks in people with mild cognitive impairment: a randomized controlled trial

BACKGROUND

People with mild cognitive impairment (MCI) experience a loss of cognitive functions, whose mechanism is characterized by aberrant structure‒function (SC-FC) coupling and topological attributes of multiple networks. This study aimed to reveal the network-level SC-FC coupling and internal topological changes triggered by computerized cognitive training (CCT) to explain the therapeutic effects of this training in individuals with MCI.

METHODS

In this randomized block experiment, we recruited 60 MCI individuals and randomly divided them into an 8-week multidomain CCT group and a health education control group. The neuropsychological outcome measures were the Montreal Cognitive Assessment (MoCA), Chinese Auditory Verbal Learning Test (CAVLT), Chinese Stroop Color-Word Test (SCWT), and Rey-Osterrieth Complex Figure Test (Rey CFT). The brain imaging outcome measures were SC-FC coupling and topological attributes using functional MRI and diffusion tensor imaging methods. We applied linear model analysis to assess the differences in the outcome measures and identify the correspondence between the changes in the brain networks and cognitive functions before and after the CCT.

RESULTS

Fifty participants were included in the analyses after the exclusion of three dropouts and seven participants with low-quality MRI scans. Significant group × time effects were found on the changes in the MoCA, CAVLT, and Rey CFT recall scores. The changes in the SC-FC coupling values of the default mode network (DMN) and somatomotor network (SOM) were higher in the CCT group than in the control group (P(unc.) = 0.033, P(unc.) = 0.019), but opposite effects were found on the coupling values of the visual network (VIS) (P(unc.) = 0.039). Increasing clustering coefficients in the functional DMN and SOM and subtle changes in the nodal degree centrality and nodal efficiency of the right dorsal medial prefrontal cortex, posterior cingulate cortex, left parietal lobe, somatomotor area, and visual cortex were observed in the CCT group (P < 0.05, Bonferroni correction). Significant correspondences were found between global cognitive function and DMN coupling values (P(unc.) = 0.007), between immediate memory and SOM as well as FPC coupling values (P(unc.) = 0.037, P(unc.) = 0.030), between delayed memory and SOM coupling values (P(unc.) = 0.030), and between visual memory and VIS coupling values (P(unc.) = 0.007).

CONCLUSIONS

Eight weeks of CCT effectively improved global cognitive and memory functions; these changes were correlated with increases in SC-FC coupling and changes in the topography of the DMN and SOM in individuals with MCI. The CCT regimen also modulated the clustering coefficient and the capacity for information transformation in functional networks; these effects appeared to underlie the cognitive improvement associated with CCT.

TRIAL REGISTRATION

Chinese Clinical Trial Registry, ChiCTR2000034012. Registered on 21 June 2020.

Lack of functional brain connectivity was associated with poor inhibition in children with attention-deficit/hyperactivity disorder using near-infrared spectroscopy

Objectives

The present study aimed to evaluate the characteristics of functional brain connectivity in the resting state in children with attention deficit hyperactivity disorder (ADHD) and to assess the association between the connectivity and inhibition function using near-infrared spectroscopy (NIRS).

Methods

In total, 34 children aged 6-13 diagnosed with ADHD were recruited from Hangzhou Seventh People's Hospital. In comparison, 37 healthy children were recruited from a local primary school as controls matched by age and sex. We used NIRS to collect information on brain images. The Stroop test assessed inhibition function. We compared the differences in functional brain connectivity in two groups by analyzing the resting-state brain network. Pearson partial correlation analysis was applied to evaluate the correlation between functional brain connectivity and inhibition in all the children.

Results

Compared with the control group, results of NIRS images analysis showed that children with ADHD had significantly low functional brain connectivity in regions of the orbitofrontal cortex, left dorsolateral prefrontal cortex, left pre-motor and supplementary motor cortex, inferior prefrontal gyrus, and right middle temporal gyrus (p = 0.006). Inhibition function of children with ADHD was negatively correlated with functional brain connectivity (p = 0.009), while such correlation was not found in the control group.

Conclusion

The present study demonstrated that children with ADHD had relatively low connectivity in several brain regions measured at the resting state. Our results supported the evidence that lack of functional brain connectivity was associated with impaired inhibition function in children with ADHD.

Early- and late-onset of isolated rapid eye movement sleep behavior disorder: A retrospective cohort study

OBJECTIVE

Age at onset of neurodegenerative disease has significant implications in differentiating disease profiles. We aimed to determine whether age at onset could identify clinical and neurodegenerative profiles in patients with isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) - a prodromal stage of α-synucleinopathies.

METHODS

In this retrospective cohort study, the time of the first episode of dream-enactment behaviors that the patient/bed-partners recalled at the time of the patient's first visit to sleep clinic was collected. The distribution of age at onset was examined and patients were dichotomized into early- and late-onset groups based on the intersection point of underlying two Gaussian distributions of onset age.

RESULTS

A total of 241 patients were included. The intersection of underlying two Gaussian models of onset age was 64.6 years, yielding 168 early- (median onset age: 58.0 years, range: 38.0-64.0) and 73 late-onset patients (median onset age: 70.0 years, range: 65.0-82.0). Among them, 154 of early- and 68 late-onset patients were followed-up. Late-onset patients had milder RBD symptoms, but worse sleep, cognition, olfactory and motor functions, and a higher risk of phenoconversion (adjusted hazard ratio (aHR) = 2.2, 95% confidence interval (CI) = 1.2-3.9), especially to probable dementia with Lewy bodies (DLB) (aHR = 8.9, 95% CI = 3.0-26.2), than early-onset patients.

CONCLUSIONS

Late-onset iRBD was associated with a higher level of neurodegenerative markers and a quicker phenoconversion, especially to probable DLB. Age at onset of iRBD could help identify clinical features and predict prognosis of iRBD.

Efficacy of twice-daily high-frequency repetitive transcranial magnetic stimulation on associative memory

Objectives

Several studies have examined the effects of repetitive transcranial magnetic stimulation (rTMS) on associative memory (AM) but findings were inconsistent. Here, we aimed to test whether twice-daily rTMS could significantly improve AM.

Methods

In this single-blind, sham-controlled experiment, 40 participants were randomized to receive twice-daily sham or real rTMS sessions for five consecutive days (a total of 16,000 pulses). The stimulation target in left inferior parietal lobule (IPL) exhibiting peak functional connectivity to the left hippocampus was individually defined for each participant. Participants completed both a picture-cued word association task and Stroop test at baseline and 1 day after the final real or sham rTMS session. Effects of twice-daily rTMS on AM and Stroop test performance were compared using two-way repeated measures analysis of variance with main factors Group (real vs. sham) and Time (baseline vs. post-rTMS).

Results

There was a significant Group × Time interaction effect. AM score was significantly enhanced in the twice-daily real group after rTMS, but this difference could not survive the post hoc analysis after multiple comparison correction. Further, AM improvement in the twice-daily real group was not superior to a previously reported once-daily rTMS group receiving 8,000 pulses. Then, we combined the twice- and once-daily real groups, and found a significant Group × Time interaction effect. Post hoc analysis indicated that the AM score was significantly enhanced in the real group after multiple comparisons correction.

Conclusion

Our prospective experiment did not show significant rTMS effect on AM, but this effect may become significant if more participants could be recruited as revealed by our retrospective analysis.

Abnormal Insular Dynamic Functional Connectivity and Its Relation to Social Dysfunctioning in Children With Attention Deficit/Hyperactivity Disorder

Anomalies in large-scale cognitive control networks impacting social attention abilities are hypothesized to be the cause of attention deficit hyperactivity disorder (ADHD). The precise nature of abnormal brain functional connectivity (FC) dynamics including other regions, on the other hand, is unknown. The concept that insular dynamic FC (dFC) among distinct brain regions is dysregulated in children with ADHD was evaluated using Insular subregions, and we studied how these dysregulations lead to social dysfunctioning. Data from 30 children with ADHD and 28 healthy controls (HCs) were evaluated using dynamic resting state functional magnetic resonance imaging (rs-fMRI). We evaluated the dFC within six subdivisions, namely both left and right dorsal anterior insula (dAI), ventral anterior insula (vAI), and posterior insula (PI). Using the insular sub-regions as seeds, we performed group comparison between the two groups. To do so, two sample t-tests were used, followed by post-hoc t-tests. Compared to the HCs, patients with ADHD exhibited decreased dFC values between right dAI and the left middle frontal gyrus, left postcentral gyrus and right of cerebellum crus, respectively. Results also showed a decreased dFC between left dAI and thalamus, left vAI and left precuneus and left PI with temporal pole. From the standpoint of the dynamic functional connectivity of insular subregions, our findings add to the growing body of evidence on brain dysfunction in ADHD. This research adds to our understanding of the neurocognitive mechanisms behind social functioning deficits in ADHD. Future ADHD research could benefit from merging the dFC approach with task-related fMRI and non-invasive brain stimulation, which could aid in the diagnosis and treatment of the disorder.

Tai Chi versus conventional exercise for improving cognitive function in older adults: a pilot randomized controlled trial

Studies have shown that Tai Chi and conventional exercise can modify the brain through distinct mechanisms, resulting in different brain adaptations. Therefore, it is conceivable to speculate that these two exercise modalities may have different effects on improving cognitive function. This study was a parallel group, assessor-blinded, pilot randomized controlled trial comparing the effects of Tai Chi and conventional exercise on improving cognitive function in older persons with mild cognitive impairment (MCI). A total of 34 adults aged ≥ 50 years with MCI were randomized (1:1:1) to the Tai Chi group (TC, n = 10, 3 sessions of 60-min Yang-style Tai Chi training per week for 24 weeks), conventional exercise group (EX: n = 12, 3 sessions of 60-min fitness training per week for 24 weeks), or control group (CON: n = 12, no intervention). Global cognitive function assessed by the Hong Kong version of the Montreal Cognitive Assessment (MoCA-HK) and performance in various cognitive domains were examined at baseline, and 12 and 24 weeks of the intervention. Both exercise groups showed improved global cognitive function as measured by MoCA-HK compared with the control group after 12 and 24 weeks of the intervention, (all P < 0.001). Only TC achieved clinically relevant improvement on global cognitive function at week 12. Both exercise groups achieved clinically relevant improvements at the end of the interventions at week 24. Compared with EX, TC exhibited greater improvements on global cognitive function indicated by MoCA-HK after 12 weeks of the intervention (P < 0.001) and cognitive flexibility indicated by part B/A ratio score of the Trail Making Test throughout the study (all P < 0.05). Both interventions were equally effective in improving the other examined cognitive domains. Further studies are needed to substantiate the superior long-term benefits of Tai Chi on global cognitive function compared with conventional exercise, and dissect the underlying mechanisms of the two exercises on improving cognitive domains and the corresponding brain adaptations. Trial registration: This study was registered at clinicaltrials.gov (Trial registration number: NCT04248400; first registration date: 30/01/2020).

The Effect of Cerebrolysin on Anxiety, Depression, and Cognition in Moderate and Severe Traumatic Brain Injury Patients: A CAPTAIN II Retrospective Trial Analysis

Background and Objectives: Traumatic brain injuries represent an important source of disease burden requiring emergency inpatient care and continuous outpatient tailored rehabilitation. Although most TBIs are mild, patients are still developing post-TBI depression, anxiety, and cognitive impairments. Our secondary retrospective trial analysis aimed to (1) analyze correlations between HADS-Anxiety/HADS-Depression and scales that measure cognitive and motor processes in patients treated with Cerebrolysin compared to the placebo group and (2) compare anxiety and depression scores among the two treatment groups. Materials and Methods: Our secondary retrospective analysis focused on TBI patients with moderate and severe disability divided into two groups: Cerebrolysin (treatment) and saline solution (procedural placebo). We analyzed data from 125 patients. We computed descriptive statistics for nominal and continuous variables. We used Spearman’s correlation to find associations between HADS and other neuropsychological scales and the Mann–Whitney U test to compare HADS-Anxiety and HADS-Depression scores among the two study arms. Results: Our sample consisted of patients with a mean age of 45.3, primarily men, and with a 24 h GCS (Glasgow Coma Scale) mean of 12.67. We obtained statistically significant differences for HADS-Anxiety during the second and third visits for patients treated with Cerebrolysin. Our results show that Cerebrolysin has a large effect size (0.73) on anxiety levels. In addition, there are positive and negative correlations between HADS-Anxiety and Depression subscales and other neuropsychological scales. Conclusions: Our secondary database analysis supports the existing body of evidence on the positive effect of Cerebrolysin on post-TBI mental health status. Future confirmatory trials are necessary to clarify the link between the intervention and measured outcomes.

The Interactive Model of L2 Listening Processing in Chinese Bilinguals: A Multiple Mediation Analysis

Second language (L2) listening is a common challenge for language learners. It remains largely unknown how bilinguals process L2 listening. The literature has suggested an interactive model of L2 listening processing. However, few studies have examined the model from an experimental approach. The current study tried to provide empirical evidence for the interactive model of L2 listening processing in bilinguals by exploring the relationships among English spoken word segmentation (SWS), cognitive inhibition, cognitive flexibility, and L2 listening proficiency. The results showed positive associations among SWS, cognitive inhibition, cognitive flexibility, and L2 listening proficiency. Mediation analysis suggested that SWS might have a positive influence on L2 listening proficiency both directly and indirectly through cognitive inhibition and cognitive flexibility, respectively. These results imply that both bottom-up (reflected at SWS) and top-down (reflected at cognitive inhibition and flexibility) processes are engaged in bilinguals’ L2 listening processing.

Association between abnormal glycolipid level and cognitive dysfunction in drug-naïve patients with bipolar disorder

OBJECTIVES

Cognitive impairment and abnormal glycolipid metabolism are common clinical features of bipolar disorder (BD). The purpose of this study was to investigate the relationship between conventional glycolipid metabolism indicators and cognitive impairment in patients with BD.

METHODS

A total of 132 drug-naïve patients with BD and 129 healthy controls (HC) were recruited in the study. Five serum glycolipid metabolism indicators were measured and cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and the Stroop Color-Word Test (Stroop test) for each participant.

RESULTS

The scores of immediate memory, attention, language and delayed memory in BD group were significantly lower than those in HC group (P < 0.05). The triglyceride (TG) level in BD group was higher than that in HC group (P = 0.011), and the total cholesterol and high-density lipoprotein cholesterol (HDL) levels were lower than those in HC group (P = 0.026; P = 0.001). Regression analysis showed that TG level was significantly correlated with RBANS total score (β = 0.245, P = 0.008), attention (β = 0.289, P = 0.03) and delayed memory (β = 0.221, P = 0.023). Fasting blood glucose (FBG) level was significantly correlated with language subscale score (β = -0.187, P = 0.046) in BD.

LIMITATIONS

Cross-sectional design and limited control variables.

CONCLUSIONS

Elevated FBG and TG levels may be associated with cognitive dysfunction in BD patients. Improving glycolipid metabolism in patients with BD may help to improve certain domain-specific cognitive functions.

Impaired neurovascular coupling and cognitive deficits in anti-N-methyl-D-aspartate receptor encephalitis

Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a recently identified autoimmune disorder with heterogeneous neurological, psychiatric, and cognitive manifestations. The NMDAR is a key signaling node for neurovascular coupling, the mechanism by which cerebral blood perfusion is enhanced to meet local metabolic requirements from increased neuronal activity. Therefore, anti-NMDAR encephalitis may disrupt neurovascular coupling and induce cognitive deficits. This study examined neurovascular coupling and cognitive function in anti-NMDAR encephalitis patients to identify prognostic biomarkers, reveal potential pathogenic mechanisms, and provide clues to possible therapeutic strategies. In this study, twenty-three anti-NMDAR encephalitis patients and thirty healthy controls received neuropsychological testing and multimodal magnetic resonance imaging (MRI). Cerebral blood flow (CBF) was calculated from arterial spin labeling, and regional homogeneity (ReHo) was computed from functional MRI. Pearson's correlation coefficients between CBF and ReHo were calculated to obtain neurovascular coupling. At the whole gray matter level, CBF‒ReHo coupling was reduced in patients compared to healthy controls. At the regional level, CBF‒ReHo was significantly lower among patients in the precentral gyrus, frontal gyrus, insula, cuneus, inferior parietal lobe, supramarginal gyrus, angular gyrus, precuneus, temporal gyrus, and temporal pole. Reduced CBF‒ReHo in the left superior medial frontal gyrus of patients was significantly correlated with a deficit in verbal inhibition control, and the reduced CBF‒ReHo in the left insula was significantly correlated with impaired executive function. In conclusion, anti-NMDAR encephalitis is associated with both global and regional disruptions in neurovascular coupling that may in turn lead to deficits in specific cognitive domains.

Dynamic Functional Connectivity Reveals Abnormal Variability in the Amygdala Subregions of Children With Attention-Deficit/Hyperactivity Disorder

Objective: This study investigates whether the dynamic functional connectivity (dFC) of the amygdala subregions is altered in children with attention-deficit/hyperactivity disorder (ADHD).

Methods: The dFC of the amygdala subregions was systematically calculated using a sliding time window method, for 75 children with ADHD and 20 healthy control (HC) children.

Results: Compared with the HC group, the right superficial amygdala exhibited significantly higher dFC with the right prefrontal cortex, the left precuneus, and the left post-central gyrus for children in the ADHD group. The dFC of the amygdala subregions showed a negative association with the cognitive functions of children in the ADHD group.

Conclusion: Functional connectivity of the amygdala subregions is more unstable among children with ADHD. In demonstrating an association between the stability of functional connectivity of the amygdala and cognitive functions, this study may contribute by providing a new direction for investigating the internal mechanism of ADHD.

Do Cross-Language Script Differences Enable Bilinguals to Function Selectively When Speaking in One Language Alone?

The present study examined the role of script in bilingual speech planning by comparing the performance of same and different-script bilinguals. Spanish-English bilinguals (Experiment 1) and Japanese-English bilinguals (Experiment 2) performed a picture-word interference task in which they were asked to name a picture of an object in English, their second language, while ignoring a visual distractor word in Spanish or Japanese, their first language. Results replicated the general pattern seen in previous bilingual picture-word interference studies for the same-script, Spanish-English bilinguals but not for the different-script, Japanese-English bilinguals. Both groups showed translation facilitation, whereas only Spanish-English bilinguals demonstrated semantic interference, phonological facilitation, and phono-translation facilitation. These results suggest that when the script of the language not in use is present in the task, bilinguals appear to exploit the perceptual difference as a language cue to direct lexical access to the intended language earlier in the process of speech planning.

Associative memory improvement after 5 days of magnetic stimulation: A replication experiment with active controls

Associative memory (AM) is an essential function of everyday life, but is often disrupted in many neurological diseases. Recent studies have found that repetitive transcranial magnetic stimulation (rTMS) can effectively enhance AM and have shown its potential in clinical applications. In this study, we aimed to reproduce the 5-day rTMS effect on AM in a Chinese version of a face-cued word recall task. In an open-label experiment, AM scores were significantly improved after active 20-Hz rTMS on individualized inferior parietal lobule (IPL) targets. To exclude the placebo effect, we performed a second experiment and added rTMS of the pre-supplementary motor area (preSMA) as an active control. In this within-subject crossover experiment, participants received active rTMS on IPL and preSMA targets, separated by at least 2 weeks. A Stroop task was included as a control test, which was more likely to be modulated by preSMA stimulations. We found that stimulations on IPL targets significantly improved AM, but this change did not significantly higher than that induced by preSMA stimulations. No significant change in Stroop measures were found in either IPL or preSMA condition. In summary, this study did not support that the 5 days of rTMS on individualized IPL targets could improve AM more than placebo rTMS. Further work is required to improve the rTMS paradigms to enhance the aftereffects in memory.

Cerebrolysin after moderate to severe traumatic brain injury: prospective meta-analysis of the CAPTAIN trial series

INTRODUCTION

This prospective meta-analysis summarizes results from the CAPTAIN trial series, evaluating the effects of Cerebrolysin for moderate-severe traumatic brain injury, as an add-on to usual care.

MATERIALS AND METHODS

The study included two phase IIIb/IV prospective, randomized, double-blind, placebo-controlled clinical trials. Eligible patients with a Glasgow Coma Score (GCS) between 6 and 12 received study medication (50 mL of Cerebrolysin or physiological saline solution per day for ten days, followed by two additional treatment cycles with 10 mL per day for 10 days) in addition to usual care. The meta-analysis comprises the primary ensembles of efficacy criteria for 90, 30, and 10 days after TBI with a priori ordered hypotheses based on multivariate, directional tests.

RESULTS

A total 185 patients underwent meta-analysis (mean admission GCS = 10.3, mean age = 45.3, and mean Baseline Prognostic Risk Score = 2.8). The primary endpoint, a multidimensional ensemble of functional and neuropsychological outcome scales indicated a "small-to-medium" sized effect in favor of Cerebrolysin, statistically significant at Day 30 and at Day 90 (Day 30: MW_combined = 0.60, 95%CI 0.52 to 0.66, p = 0.0156; SMD = 0.31; OR = 1.69; Day 90: MW_combined = 0.60, 95%CI 0.52 to 0.68, p = 0.0146; SMD = 0.34, OR = 1.77). Treatment groups showed comparable safety and tolerability profiles.

DISCUSSION

The meta-analysis of the CAPTAIN trials confirms the safety and efficacy of Cerebrolysin after moderate-severe TBI, opening a new horizon for neurorecovery in this field. Integration of Cerebrolysin into existing guidelines should be considered after careful review of internationally applicable criteria.

Influence of the GABA Receptor Subunit Gene Polymorphism and Childhood Sexual Abuse on Processing Speed in Major Depression and Suicide Attempt

Background: Suicide is moderately heritable and also more common in those who report childhood abuse. Previously, it was found that allele A of GABRG2 (GABA A receptor subunit gamma2) polymorphism rs211034 was protective in a suicide attempt (SA). Hence, it was proposed that rs211034 may interact with childhood trauma to influence cognitive deficits related to SA or depression risk. Genetic variants may predict the benefits of certain cognitive treatments. Methods: A total of 52 individuals who had attempted suicide, 59 individuals with major depressive disorder (MDD) or bipolar depression who had not previously attempted suicide, and 90 healthy volunteers were subjected to the modified Suicide Stroop task and were clinically assessed using the Childhood Trauma Questionnaire (CTQ) and Hamilton Depression Scale-24 items (HAMD-24). rs211034 was genotyped using Sanger sequencing. Results: After correcting for covariates, depressed participants displayed longer reaction times for all emotional conditions, including suicide-related words, compared with healthy controls. Depressed suicide attempters displayed longer reaction times for negative words than depressed non-attempters. Depressed non-attempters displayed higher interference scores for negative words compared with healthy controls. There was an interaction between rs211034 risk allele and the effects of reported childhood sexual abuse (CSA) on reaction time for all emotional words and suicide-related words. Carriers of the rs211034 risk allele A exhibited shorter reaction times, but the protective effects of this allele were eliminated in those exposed to reported CSA. Conclusion: Only limited results were found regarding effects of a past suicide attempt on response times to emotional and suicide-related words, but there was an overall effect of major depression on slower response time. Protective genetic effects of the rs211034 A allele on this slowing were eliminated in those with a history of sexual abuse during childhood. Further research is needed to better characterize the mechanisms underlying the effects of childhood trauma on these genetic effects.

Prediction of Neurocognitive Outcome after Moderate-Severe Traumatic Brain Injury Using Serum Neuron-Specific Enolase and S100 biomarkers

Seric biomarkers have been tested in a large number of studies on traumatic brain injuries (TBI) patients in order to predict severity, especially related to the short-term outcome. However, TBI patients have a high risk of developing long-term complications such as physical disability, cognitive impairment, psychiatric pathology, epilepsy, and others. The aim of this study was to assess the correlation between protein biomarkers S100 and neuron-specific enolase (NSE) and neurocognitive status at 10- and 90-days post-injury. Both biomarkers were tested in the first 4h and after 72h post-injury in 62 patients with moderate-severe TBI. The patients were evaluated by a series of neurocognitive tests: Early Rehabilitation Barthel Index (ERBI), Glasgow Outcome Scale-Extended (GOSE), The Mini-Mental State Examination (MMSE), Processing Speed Index (PSI), and Stroop Test, at 10 and 90 days post-injury and supplementary by the Hospital Anxiety and Depression Scale at 90 days. For evaluating the whole neurocognitive status instead of every scale separately, we used Structural Equation Modeling (SEM), while for anxiety and depressive symptoms, we used multiple regression analyses. SEM showed that NSE values at 4 hours were significant predictors of the cognitive status at 10 (p=0.034) and 90 days (p= 0.023). Also, there were found significant correlations between NSE at 4h and the anxiety level. This study demonstrated a significant correlation between NSE at 4h and short and medium-term neuropsychological outcomes, which recommends using this biomarker for selecting patients with a higher risk of cognitive dysfunction.

The Effect of Cerebrolysin on the Predictive Value of Baseline Prognostic Risk Score in Moderate and Severe Traumatic Brain Injury

Cognitive dysfunction is a significant complaint among patients after moderate to severe traumatic brain injury (TBI), with devastating consequences on functional recovery and quality of life. Prognostic models allow a better assessment and management of neurotrauma patients.

The aim of the study was to demonstrate the predictive value of the Baseline Prognostic Risk Score (BPRS) in moderate to severe TBI, in a sample of patients treated with neurotrophic factors.

Eighty patients with moderate-severe TBI from the CAPTAIN II study were included in secondary data analysis. Patients received active treatment with Cerebrolysin, 50 mL per day for ten days, followed by two treatment cycles with 10 mL per day for ten days. BPRS was determined on admission; the age was recorded, and patients were evaluated using the following neurocognitive tests: Mini-Mental State Essay (MMSE), Wechsler Adult Intelligence Scale-Third Edition Processing Speed Index (WAIS-III PSI) and Stroop Colour Word Test-Victoria Version at 10, 30 and 90 days. Hierarchical regression analysis was performed to investigate the unique predictive value of BPRS on cognitive evolution, independent of age. BPRS independently predicted scores on the WAIS-III PSI DSCales and the Word subscale of the Stroop Colour Word Test at 90 days. Age was a significant predictor for all the investigated scales at 10, 30, and 90 days.

This study demonstrates the predictive value of a validated prognostic model (BPRS) for medium-term neurocognitive outcomes in a sample of moderate-severe traumatic brain injury treated with neurotrophic factors.

Meta-Analysis Reveals a Bilingual Advantage That Is Dependent on Task and Age

Debate continues on whether a bilingual advantage exists with respect to executive functioning. This report synthesized the results of 170 studies to test whether the bilingual advantage is dependent on the task used to assess executive functioning and the age of the participants. The results of the meta-analyses indicated that the bilingual advantage was both task- and age-specific. Bilinguals were significantly faster than monolinguals (Hedges' g values ranged from 0.23 to 0.34), and significantly more accurate than monolinguals (Hedges' g values ranged between 0.18 and 0.49) on four out of seven tasks. Also, an effect of age was found whereby the bilingual advantage was larger for studies comprising samples aged 50-years and over (Hedges' g = 0.49), compared to those undertaken with participants aged between 18 and 29 years (Hedges' g = 0.12). The extent to which the bilingual advantage might be due to publication bias was assessed using multiple methods. These were Egger's Test of Asymmetry, Duval and Tweedie's Trim and Fill, Classic Fail-Safe N, and PET-PEESE. Publication bias was only found when using Egger's Test of Asymmetry and PET-PEESE method, but not when using the other methods. This review indicates that if bilingualism does enhance executive functioning, the effects are modulated by task and age. This may arise because using multiple languages has a highly specific effect on executive functioning which is only observable in older, relative to younger, adults. The finding that publication bias was not uniformly detected across the different methods raises questions about the impact that unpublished (or undetected) studies have on meta-analyses of this literature.

Multi-Session Anodal Prefrontal Transcranial Direct Current Stimulation does not Improve Executive Functions among Older Adults

OBJECTIVE

Findings from single-session online studies highlighted the potential of using anodal prefrontal transcranial direct current stimulation (tDCS) to enhance executive functions (EF) in the context of aging. However, tDCS must be executed as a multi-session offline intervention to ascertain its viability in this context. Relatedly, findings from multi-session studies remained inconclusive. To this end, we examined the effects of multi-session anodal prefrontal tDCS on EF in an intervention.

METHOD

The intervention consisted of 15 sessions; in each, healthy older participants (Agemean = 66.7) received either 15 min of 1.5 mA tDCS (Ncompleted = 35) or sham stimulation (Ncompleted = 33) while performing EF training tasks. EF measures were assessed at baseline, post-intervention, and 1-month follow-up. Hierarchical linear models were used to examine the effect of tDCS on EF outcomes.

RESULTS

Both groups of participants did not differ significantly in side effect ratings and attendance. There were no significant tDCS-associated gains in any EF outcomes in the intervention.

CONCLUSIONS

Multi-session prefrontal tDCS did not lead to any significant gains in EF in the current intervention. More research is needed to optimize the use of tDCS before it can be effectively used to enhance EF among older adults.

Different aspects of cognitive function in adult patients with moyamoya disease and its clinical subtypes

Objective

Although a few reports suggested that cognitive function impairment could be found in adult patients with moyamoya disease (MMD), there were still many aspects that are unclear. The aim of our study was to assess the cognitive function of adult patients with MMD and its clinical subtypes.

Methods

49 patients with MMD and 23 healthy controls were asked to take cognitive function tests. Cognitive function tests included IQ, prospective memory (PM), immediate memory (IM), verbal fluency (VF), visual breadth, attention, retrospective memory (RM), Stroop test, Wisconsin Card Sorting Test, Trail-Making Test Part A (TMT-A) and Continuous Performance Test (CPT). Independent t-analysis, one-way analysis of variance and Pearson correlation were used to seek for differences between subgroups and the correlation between cognitive variables.

Results

Compared with healthy controls, adult patients with MMD had a comprehensive cognitive impairment, including IQ, PM, VF, attention, RM, Stroop, CPT and TMT-A, with more serious impairment in PM and attention. PM and RM were separated, indicating that they were independent of each other. Pattern of attention was significantly different from healthy controls. Female patients were better than male patients, where significant differences in PM, IM, Stroop and WCST could be found. The haemorrhagic patients exhibited poorer in the dimension of PM and RM than the ischaemic. The headache subtype exhibited poorer than healthy controls. PM, RM, attention and executive function were moderately correlated with each other.

Conclusions

Adult patients with MMD had a wide range of cognitive impairment with more serious impairment in memory and attention. Differences in cognitive function existed between the different subtypes of adult MMD.

Efficacy and safety of cerebrolysin in neurorecovery after moderate-severe traumatic brain injury: results from the CAPTAIN II trial

INTRODUCTION

The objective of this trial was to evaluate the efficacy and safety of Cerebrolysin in treating patients after moderate to severe traumatic brain injury (TBI) as an adjunct to standard care protocols. The trial was designed to investigate the clinical effects of Cerebrolysin in the acute (neuroprotective) stage and during early and long-term recovery as part of a neurorestorative strategy.

MATERIALS AND METHODS

The study was a phase IIIb/IV single-center, prospective, randomized, double-blind, placebo-controlled clinical trial. Eligible patients with a Glasgow Coma Score (GCS) between 7 and 12 received study medication (50 ml of Cerebrolysin or physiological saline solution per day for 10 days, followed by two additional treatment cycles with 10 ml per day for 10 days) in addition to standard care. We tested ensembles of efficacy criteria for 90, 30, and 10 days after TBI with a priori ordered hypotheses using a multivariate, directional test, to reflect the global status of patients after TBI.

RESULTS

The study enrolled 142 patients, of which 139 underwent formal analysis (mean age = 47.4, mean admission GCS = 10.4, and mean Baseline Prognostic Risk Score = 2.6). The primary endpoint, a multidimensional ensemble of 13 outcome scales, indicated a "small-to-medium"-sized effect in favor of Cerebrolysin, statistically significant at day 90 (MW_combined = 0.59, 95% CI 0.52 to 0.66, P = 0.0119). Safety and tolerability observations were comparable between treatment groups.

CONCLUSION

Our trial confirms previous beneficial effects of the multimodal, biological agent Cerebrolysin for overall outcome after moderate to severe TBI, as measured by a multidimensional approach. Study findings must be appraised and aggregated in conjunction with existing literature, as to improve the overall level of insight regarding therapeutic options for TBI patients. The widely used pharmacologic intervention may benefit from a large-scale observational study to map its use and to establish comparative effectiveness in real-world clinical settings.

Dual-Task Exercise Reduces Cognitive-Motor Interference in Walking and Falls After Stroke

Background and Purpose- Functional community ambulation requires the ability to perform mobility and cognitive task simultaneously (dual-tasking). This single-blinded randomized controlled study aimed to examine the effects of dual-task exercise in chronic stroke patients. Methods- Eighty-four chronic stroke patients (24 women; age, 61.2±6.4 years; time since stroke onset, 75.3±64.9 months) with mild to moderate motor impairment (Chedoke-McMaster leg motor score: median, 5; interquartile range, 4-6) were randomly allocated to the dual-task balance/mobility training group, single-task balance/mobility group, or upper-limb exercise (control) group. Each group exercised for three 60-minute sessions per week for 8 weeks. The dual-task interference effect was measured for the time to completion of 3 mobility tests (forward walking, timed-up-and-go, and obstacle crossing) and for the correct response rate during serial-3-subtractions and verbal fluency task. Secondary outcomes included the Activities-specific Balance Confidence Scale, Frenchay Activities Index, and Stroke-specific Quality of Life Scale. The above outcomes were measured at baseline, immediately after, and 8 weeks after training. Fall incidence was recorded for a 6-month period posttraining. Results- Only the dual-task group exhibited reduced dual-task interference in walking time posttraining (forward walking combined with verbal fluency [9.5%, P=0.014], forward walking with serial-3-subtractions [9.6%, P=0.035], and the timed-up-and-go with verbal fluency [16.8%, P=0.001]). The improvements in dual-task walking were largely maintained at the 8-week follow-up. The dual-task cognitive performance showed no significant changes. The dual-task program reduced the risk of falls and injurious falls by 25.0% (95% CI, 3.1%-46.9%; P=0.037) and 22.2% (95% CI, 4.0%-38.4%; P=0.023), respectively, during the 6-month follow-up period compared with controls. There was no significant effect on other secondary outcomes ( P>0.05). Conclusions- The dual-task program was effective in improving dual-task mobility, reducing falls and fall-related injuries in ambulatory chronic stroke patients with intact cognition. It had no significant effect on activity participation or quality of life. Clinical trial registration- URL: https://www.clinicaltrials.gov . Unique identifier: NCT02270398.

Safety and efficacy of Cerebrolysin in acute brain injury and neurorecovery: CAPTAIN I-a randomized, placebo-controlled, double-blind, Asian-Pacific trial

OBJECTIVE

To evaluate the safety and efficacy of Cerebrolysin as an add-on therapy to local standard treatment protocol in patients after moderate-to-severe traumatic brain injury.

METHODS

The patients received the study medication in addition to standard care (50 mL of Cerebrolysin or physiological saline solution daily for 10 days, followed by two additional treatment cycles with 10 mL daily for 10 days) in a prospective, randomized, double-blind, placebo-controlled, parallel-group, multi-centre phase IIIb/IV trial. The primary endpoint was a multidimensional ensemble of 14 outcome scales pooled to be analyzed by means of the multivariate, correlation-sensitive Wei-Lachin procedure.

RESULTS

In 46 enrolled TBI patients (Cerebrolysin 22, placebo 24), three single outcomes showed stand-alone statistically significant superiority of Cerebrolysin [Stroop Word/Dots Interference (p = 0.0415, Mann-Whitney(MW) = 0.6816, 95% CI 0.51-0.86); Color Trails Tests 1 and 2 (p = 0.0223/0.0170, MW = 0.72/0.73, 95% CI 0.53-0.90/0.54-0.91), both effect sizes lying above the benchmark for "large" superiority (MW > 0.71)]. While for the primary multivariate ensemble, statistical significance was just missed in the intention-to-treat population (p_Wei-Lachin < 0.1, MW_combined = 0.63, 95% CI 0.48-0.77, derived standardized mean difference (SMD) 0.45, 95% CI -0.07 to 1.04, derived OR 2.1, 95% CI 0.89-5.95), the per-protocol analysis showed a statistical significant superiority of Cerebrolysin (p_Wei-Lachin = 0.0240, MW_combined = 0.69, 95% CI 0.53 to 0.85, derived SMD 0.69, 95% CI 0.09 to 1.47, derived OR 3.2, 95% CI 1.16 to 12.8), with effect sizes of six single outcomes lying above the benchmark for "large" superiority. Safety aspects were comparable to placebo.

CONCLUSION

Our trial suggests beneficial effects of Cerebrolysin on outcome after TBI. Results should be confirmed by a larger RCT with a comparable multidimensional approach.

Individuals in the prediabetes stage exhibit reduced hippocampal tail volume and executive dysfunction

INTRODUCTION

High glucose levels are associated with cognitive impairment and total hippocampal volume reductions. However, the effects of the blood glucose level on hippocampal subfield volumes remain unclear, especially in the prediabetes stage.

METHODS

Sixty participants were enrolled in this cross-sectional study and were divided into the nondiabetes, prediabetes, and diabetes groups according to their medical history and A1c level. A full battery of neuropsychological tests was used to assess the global cognition, executive function, attention, verbal fluency, working memory, immediate memory, and delayed memory. FreeSurfer 6.0 was used for the hippocampus parcellation. Hippocampal subfield volumes were adjusted by intracranial volume. Analyses of covariance, multiple linear regression, and partial correlation analysis were used to explore the relationship between A1c level, cognitive function, and hippocampal subfields volume, in which age, sex, education years, body mass index, history of hypertension, level of cholesterol, and the presence of ApoE4-positive status were adjusted.

RESULTS

Significant differences in the total left hippocampal volume (p = 0.046) and left hippocampal tail volume (p = 0.014) were noted among three groups. Significant correlation was identified between the A1c level and the volume of left hippocampal tail (r = -0.334, p = 0.009) after adjusting all the covariants. Increased A1c level was significantly associated with executive dysfunction, as assessed by trail making test B (R = 0.503, p = 0.0016) and Stroop test C (R = 0.506, p = 0.001).

CONCLUSIONS

Our results support that the left hippocampal tail volume may be served as an early marker of diabetes-related brain damage, associated with executive dysfunction. Clinicians should pay closer attention to adults in the prediabetes stage to prevent later cognitive impairment.

Associations of dietary intake and supplement use with post-therapy cognitive recovery in breast cancer survivors

PURPOSE

Cognitive impairment induced by cancer therapy is common and can be long lasting after completion of therapy. Little is known on factors that influence recovery from the impairment. We evaluated the associations of dietary intake and supplement use with post-therapy cognitive recovery in a large cohort of breast cancer survivors.

METHODS

This study included 1047 breast cancer patients aged 20-75 who were recruited to the Shanghai Breast Cancer Survival Study between 2002 and 2006 at approximately 6.5 months post-cancer diagnosis. Two cognitive assessments covering immediate memory, delayed memory, verbal fluency, and attention, were conducted at 18 and 36 months post-diagnosis. We used food frequency questionnaire to collect information on their dietary intake and supplement use between 18 and 36 months post-diagnosis. Linear regression models were used to examine the associations of dietary intake and supplement use with mean cognitive scores at 36 months post-diagnosis and with differences in cognitive scores between 18 and 36 months post-diagnosis.

RESULTS

Higher vegetable, fruit and fish intake, supplementation with vitamin B and vitamin E, and tea drinking were associated with higher cognitive scores, while alcohol drinking was associated with lower cognitive scores at 36 months post-diagnosis. Vegetable intake was positively associated with improvement in verbal fluency, while tea drinking and fish oil supplementation were associated with greater improvements in delayed memory between 18 and 36 months post-diagnosis.

CONCLUSIONS

Our results indicate that higher vegetable intake, tea drinking, and fish oil supplementation may help post-therapy cognitive recovery for cancer patients.

Meditation-induced neuroplastic changes of the prefrontal network are associated with reduced valence perception in older people

Background:

Neuroplastic underpinnings of meditation-induced changes in affective processing are largely unclear.

Methods:

We included healthy older participants in an active-controlled experiment. They were involved a meditation training or a control relaxation training of eight weeks. Associations between behavioral and neural morphometric changes induced by the training were examined.

Results:

The meditation group demonstrated a change in valence perception indexed by more neutral valence ratings of positive and negative affective images. These behavioral changes were associated with synchronous structural enlargements in a prefrontal network involving the ventromedial prefrontal cortex and the inferior frontal sulcus. In addition, these neuroplastic effects were modulated by the enlargement in the inferior frontal junction. In contrast, these prefrontal enlargements were absent in the active control group, which completed a relaxation training. Supported by a path analysis, we propose a model that describes how meditation may induce a series of prefrontal neuroplastic changes related to valence perception. These brain areas showing meditation-induced structural enlargements are reduced in older people with affective dysregulations.

Conclusion:

We demonstrated that a prefrontal network was enlarged after eight weeks of meditation training. Our findings yield translational insights in the endeavor to promote healthy aging by means of meditation.

The relationship of individual social activity and cognitive function of community Chinese elderly: a cross-sectional study

BACKGROUND

The prevention of cognitive impairment is a crucial public health issue, and leisure activities have been studied as the strategy of the cognitive preservation. The aim of the study was to explore the possible relationship between social activity and cognitive function among community-dwelling Chinese elderly in two big cities of Southern China.

PARTICIPANTS AND METHODS

Altogether, 557 nondemented older adults aged 60 years and older (73.4±6.5 years) were recruited in the social centers in Hong Kong and Guangzhou. A leisure activity questionnaire was used to measure the social activity participation. Cognitive function was examined using a neuropsychological battery. The association between social activity and cognitive function was analyzed using the multiple linear regression analysis.

RESULTS

Social activities had a weak relationship with cognitive performance when measured in terms of overall participation. Attending an interest class had significant association with the Cantonese version of Mini Mental State Examination, the word list learning test, the delayed recall test, and the trail making test. Religious activity showed significant association with the word list learning test and the digit vigilance test. Singing had significant association with the Category Verbal Fluency Test (CVFT) and the trail making test.

CONCLUSION

Some individual social activity items may be associated with better cognitive function among the community Chinese elderly independently of other factors.

Lexical processing of Chinese sub-character components: Semantic activation of phonetic radicals as revealed by the Stroop effect

Most Chinese characters are compounds consisting of a semantic radical indicating semantic category and a phonetic radical cuing the pronunciation of the character. Controversy surrounds whether radicals also go through the same lexical processing as characters and, critically, whether phonetic radicals involve semantic activation since they can also be characters when standing alone. Here we examined these issues using the Stroop task whereby participants responded to the ink color of the character. The key finding was that Stroop effects were found when the character itself had a meaning unrelated to color, but contained a color name phonetic radical (e.g., “guess”, with the phonetic radical “cyan”, on the right) or had a meaning associated with color (e.g., “pity”, with the phonetic radical “blood” on the right which has a meaning related to “red”). Such Stroop effects from the phonetic radical within a character unrelated to color support that Chinese character recognition involves decomposition of characters into their constituent radicals; with each of their meanings including phonetic radicals activated independently, even though it would inevitably interfere with that of the whole character. Compared with the morphological decomposition in English whereby the semantics of the morphemes are not necessarily activated, the unavoidable semantic activation of phonetic radicals represents a unique feature in Chinese character processing.

Electrophysiological Study on Cognitive Function in Systemic Lupus Erythematosus Patients With Previous Neuropsychiatric Involvement

This study aimed to evaluate P300 as an electrophysiological marker of cognitive function in patients with systemic lupus erythematosus (SLE) who had previous neuropsychiatric (NPSLE) involvement and were diagnosed to have cognitive impairment by standard neuropsychological tests. Event-related potentials (ERPs) were assessed by the auditory and visual oddball paradigms. Amplitude and latency of P300 at the frontal (Fz), central (Cz), and parietal (Pz) regions were determined and compared with controls. P300 detection was performed in NPSLE patients with pre-diagnosed cognitive impairment (n = 9), matched SLE patients without previous NPSLE (non-NPSLE) (n = 9), and healthy controls (n = 15). Auditory oddball task did not show any P300 abnormality between groups. Visual oddball task revealed reduced amplitude of P300 over Fz ( P = .002) and Cz ( P = .009) electrodes in NPSLE patients compared with healthy controls and among those who had predominant memory deficit ( P = .01 at Fz). Abnormal P300 was also observed in non-NPSLE patients at Fz and Cz. Using visual oddball paradigm, abnormal P300 was found in NPSLE patients over frontal and parietal regions compared with normal controls but was not discriminative from possible subclinical disease in non-NPSLE patients. In conclusion, visual oddball paradigm was a more sensitive electrophysiological marker than auditory oddball paradigm for cognitive impairment in NPSLE patients.

The Integrity of the Corpus Callosum Mitigates the Impact of Blood Pressure on the Ventral Attention Network and Information Processing Speed in Healthy Adults

Hypertension is a risk factor for cognitive impairment in older age. However, evidence of the neural basis of the relationship between the deterioration of cognitive function and elevated blood pressure is sparse. Based on previous research, we speculate that variations in brain connectivity are closely related to elevated blood pressure even before the onset of clinical conditions and apparent cognitive decline in individuals over 60 years of age. Forty cognitively healthy adults were recruited. Each received a blood pressure test before and after the cognitive assessment in various domains. Diffusion tensor imaging (DTI) and resting-state functional magnetic resonance imaging (rsfMRI) data were collected. Our findings confirm that elevated blood pressure is associated with brain connectivity variations in cognitively healthy individuals. The integrity of the splenium of the corpus callosum is closely related to individual differences in systolic blood pressure. In particular, elevated systolic blood pressure is related to resting-state ventral attention network (VAN) and information processing speed. Serial mediation analyses have further revealed that lower integrity of the splenium statistically predicts elevated systolic blood pressure, which in turn predicts weakened functional connectivity (FC) within the VAN and eventually poorer processing speed. The current study sheds light on how neural correlates are involved in the impact of elevated blood pressure on cognitive functioning.

A longitudinal study of the effect of short-term meditation training on functional network organization of the aging brain

The beneficial effects of meditation on preserving age-related changes in cognitive functioning are well established. Yet, the neural underpinnings of these positive effects have not been fully unveiled. This study employed a prospective longitudinal design, and graph-based analysis, to study how an eight-week meditation training vs. relaxation training shaped network configuration at global, intermediate, and local levels using graph theory in the elderly. At the intermediate level, meditation training lead to decreased intra-connectivity in the default mode network (DMN), salience network (SAN) and somatomotor network (SMN) modules post training. Also, there was decreased connectivity strength between the DMN and other modules. At a local level, meditation training lowered nodal strength in the left posterior cingulate gryus, bilateral paracentral lobule, and middle cingulate gyrus. According to previous literature, the direction of these changes is consistent with a movement towards a more self-detached viewpoint, as well as more efficient processing. Furthermore, our findings highlight the importance of considering brain network changes across organizational levels, as well as the pace at which these changes may occur. Overall, this study provides further support for short-term meditation as a potentially beneficial method of mental training for the elderly that warrants further investigation.

Aging, obesity, and post-therapy cognitive recovery in breast cancer survivors

Therapy-induced cognitive impairment is prevalent and long-lasting in cancer survivors, but factors affecting post-therapy cognitive recovery are unclear. We conducted this study to evaluate the associations of age, body mass index (BMI), waist-to-hip ratio (WHR), and physical activity (PA) with post-therapy cognitive changes in a population-based breast cancer (BC) survivor cohort. We collected information on PA, weight, height, waist and hip circumferences of 1286 BC survivors aged 20-75. We assessed their cognitive functions, including immediate memory, delayed memory, verbal fluency, and attention, at 18 and 36 months after cancer diagnosis. Linear regression models were used to examine the associations of age, BMI, WHR and PA with mean changes in cognitive scores from 18- to 36-month follow-up interview. We found that the post-therapy cognitive changes differed by age and obesity status. Verbal fluency and attention improved in younger patients aged <60 and non-abdominally obese patients, but deteriorated in older patients aged ≥60 (i.e. verbal fluency and attention) and abdominally obese patients (i.e. verbal fluency). Memory improved in all patients, with a smaller improvement in obese patients compared with normal-weight patients. No significant association was found between PA and post-therapy cognitive change. Due to the novelty of our findings and the limitations of our study, further research, including intervention trials, is warranted to confirm the causal relationship between obesity and cognitive impairments.

Relation between serum leptin levels, lipid profiles and neurocognitive deficits in Chinese OSAHS patients

OBJECTIVE

The aim of this study was to compare serum leptin, apolipoprotein A1 (ApoA1), apolipoprotein J (ApoJ) and apolipoprotein H (ApoH) levels in males with obstructive sleep apnea and hypopnea syndrome (OSAHS) to those in healthy control subjects and to examine the possible relation between neurocognitive performance and these factors/serum markers in the subjects.

METHODS

In this observational, cross-sectional study, a full-night polysomnography and sensitive neuropsychological assessment were performed on 50 newly diagnosed Chinese male patients and 30 healthy subjects. Fasting blood samples were used to measure leptin and ApoA1, ApoH and ApoJ levels using ELISA.

RESULTS

Compared with normal control subjects, OSAHS patients have significantly lower levels of ApoA1 and higher levels of leptin, ApoH and ApoJ. After adjustment for age, years of education, body mass index (BMI) and apnea-hypopnea index, leptin and ApoA1 were associated with global cognitive function, and leptin level was positively correlated with inhibition reaction time. ApoJ was negatively correlated with visual reproduction and logical memory performance. Multiple regression analysis shows that from age, BMI, education year, biomarker levels and the parameters of PSG, only the variables of leptin and education year added to the prediction of the Montreal cognitive assessment score in a statistically significant way.

CONCLUSIONS

Abnormal expression of leptin and apolipoproteins and poor performance on neuropsychological tests were observed in patients with OSAHS. There is also an association between serum leptin, ApoA1, and ApoJ levels and cognitive performance in the patients.

Facial emotion perception impairments in schizophrenia patients with comorbid antisocial personality disorder

Impairment in facial emotion perception is believed to be associated with aggression. Schizophrenia patients with antisocial features are more impaired in facial emotion perception than their counterparts without these features. However, previous studies did not define the comorbidity of antisocial personality disorder (ASPD) using stringent criteria. We recruited 30 participants with dual diagnoses of ASPD and schizophrenia, 30 participants with schizophrenia and 30 controls. We employed the Facial Emotional Recognition paradigm to measure facial emotion perception, and administered a battery of neurocognitive tests. The Life History of Aggression scale was used. ANOVAs and ANCOVAs were conducted to examine group differences in facial emotion perception, and control for the effect of other neurocognitive dysfunctions on facial emotion perception. Correlational analyses were conducted to examine the association between facial emotion perception and aggression. Patients with dual diagnoses performed worst in facial emotion perception among the three groups. The group differences in facial emotion perception remained significant, even after other neurocognitive impairments were controlled for. Severity of aggression was correlated with impairment in perceiving negative-valenced facial emotions in patients with dual diagnoses. Our findings support the presence of facial emotion perception impairment and its association with aggression in schizophrenia patients with comorbid ASPD.

Different aspects of dysexecutive syndrome in patients with moyamoya disease and its clinical subtypes

OBJECTIVE Dysexecutive syndrome is common in patients with moyamoya disease (MMD), a chronic cerebrovascular disease that is characterized by stenosis of the bilateral internal carotid arteries and progressive collateral revascularization, and MMD can be classified as ischemic or hemorrhagic according to the disease presentation and history. In this study, the authors aimed to determine which aspects of executive function are impaired in patients with MMD, in addition to the specific dysexecutive functions present among its clinical subtypes and the mechanisms underlying dysexecutive function in these patients. METHODS The authors administered 5 typical executive function tests (the Stroop test, the Hayling Sentence Completion Test [HSCT], the verbal fluency [VF] test, the N-back test, and the Sustained Attention to Response Task [SART]) to 49 patients with MMD and 47 IQ-, age-, education-, and social status-matched healthy controls. The dysexecutive questionnaire (DEX) was also used to assess participants' subjective feelings about their executive function. A total of 39 of the patients were evaluated by CT perfusion (CTP) before the assessments were performed, and the correlations among the performances of the patients on the above tests with the parameters of cerebral blood volume, cerebral blood flow (CBF), mean transit time (MTT), and time-to-peak (TTP) in the frontal lobes of these patients were also analyzed. RESULTS Many aspects of executive function in the patients with MMD were significantly poorer than those in the healthy controls, and the patients performed particularly poorer on the VF test, HSCT, N-back test, and SART. The patients with hemorrhagic MMD exhibited worse executive inhibition, executive processing, and semantic inhibition compared with those with ischemic MMD, but the latter group presented a worse working memory and poorer sustained attention. There were no significant differences in the DEX scores between the patients with MMD and healthy controls. The other findings were as follows: CBF was significantly positively correlated with the number correct on part B of the HSCT (r = 0.481, p = 0.01) and accuracy on the 0-back task of the N-back (r = 0.346, p = 0.031); MTT was significantly positively correlated with accuracy on the 2-back task of the N-back (r = 0.349, p = 0.034) and factor 5 of the DEX (r = 0.359, p = 0.032); and TTP was significantly positively correlated with the number correct on part B of the HSCT (r = 0.402, p = 0.034) and the 1-back reaction time of the N-back (r = 0.356, p = 0.026). CONCLUSIONS The patients with MMD exhibited impairments in semantic inhibition, executive processing, working memory, and sustained attention, but they were not aware of these deficits. Moreover, differences in dysexecutive function existed between the different subtypes of MMD. Hypoperfusion of the frontal lobe may be related to working memory and semantic inhibition impairments in patients with MMD.

Systemic lupus erythematosus patients with past neuropsychiatric involvement are associated with worse cognitive impairment: a longitudinal study

Longitudinal studies on cognitive impairment in patients with past history of neuropsychiatric lupus (NPSLE) are scant. In this study, NPSLE patients and matched disease and healthy controls were examined with a full battery of neuropsychological tests that covered eight cognitive domains at two time-points 12 months apart. Confounders, including depressive and anxiety symptoms, were measured by the Hospital Anxiety and Depression Scale. Eighteen NPSLE, 18 patients with systemic lupus erythematosus (SLE) who had no previous cerebral involvement (non-NPSLE) and 16 healthy subjects were recruited. NPSLE patients consistently reported more cognitive and anxiety symptoms than non-NPSLE patients over both time-points. NPSLE patients had significantly worse memory, simple and complex attention compared to non-NPSLE patients, among which memory remained significantly impaired after adjustment for confounders. NPSLE patients demonstrated a trend of higher raw scores of some neurocognitive tests upon re-evaluation over 12 months, but NPSLE patients did not demonstrate any practice effect. In conclusion, NPSLE patients had significantly worse and persistently impaired memory and learning deficits compared to non-NPSLE patients over the 12-month re-assessment period.

The nature of prospective memory deficit in patients with obsessive-compulsive disorder

We comprehensively examined prospective memory (PM) performance in patients with obsessive-compulsive disorder (OCD), and explored the cognitive and psychopathological correlates of PM in this clinical population. Fifty-eight OCD patients and 58 healthy controls were assessed with computer-based PM tasks and related neurocognitive functions, and the participants also reported frequency of PM failures and compulsive behaviours in daily life. OCD patients had intact activity-based PM performance but had lower accuracy in time-based PM and longer reaction time to event-based PM cues compared to healthy controls. Among the neurocognitive functions, both the WCST (perseverative error) and the letter number span correlated with time-based PM. OCD patients reported similar number of PM failures in daily life as controls, which correlated with their intact event-based PM performance, suggesting a generally good insight into their PM functions. Neither clinician-assessed nor self-reported OCD symptoms correlated with PM performance. This study indicates that PM impairment tends to vary with the PM cue types in OCD patients. In addition, certain executive functions (i.e., mental shifting and updating) may contribute to time-based PM impairment in patients with OCD.

Physical activity and cognitive function of community Chinese elderly in Hong Kong (HK) and Guangzhou (GZ)

BACKGROUND

Some studies demonstrated that physical activity may have beneficial effect on cognitive function. The objective of the study was to estimate the association between physical activity and cognitive function in community-dwelling elderly Chinese in Hong Kong (HK) and Guangzhou (GZ).

METHODS

In the neighborhood of HK and GZ, a convenience sample of 557 (260 in HK and 297 in GZ) older persons without dementia aged over 60 years (73.4 ± 6.5) was recruited. Physical activity was measured using a checklist. Information on physical activity participation, cognitive function, and other variables were collected. Multivariate linear regression analyses were performed to evaluate the association between physical activity and cognitive function.

RESULTS

Total number of physical activities showed significant association with the delayed recall test (p 0.05) CONCLUSION: Physical activity may not be associated with better cognitive function among elderly Chinese independently of other factors.

Cerebrolysin Asian Pacific trial in acute brain injury and neurorecovery: design and methods

Traumatic brain injury (TBI) is one of the leading causes of injury-related death. In the United States alone, an estimated 1.7 million people sustain a TBI each year, and approximately 5.3 million people live with a TBI-related disability. The direct medical costs and indirect costs such as lost productivity of TBIs totaled an estimated $76.5 billion in the U.S. in the year 2000. Improving the limited treatment options for this condition remains challenging. However, recent reports from interdisciplinary working groups (consisting primarily of neurologists, neurosurgeons, neuropsychologists, and biostatisticians) have stated that to improve TBI treatment, important methodological lessons from the past must be taken into account in future clinical research. An evaluation of the neuroprotection intervention studies conducted over the last 30 years has indicated that a limited understanding of the underlying biological concepts and methodological design flaws are the major reasons for the failure of pharmacological agents to demonstrate efficacy. Cerebrolysin is a parenterally-administered neuro-peptide preparation that acts in a manner similar to endogenous neurotrophic factors. Cerebrolysin has a favorable adverse effect profile, and several meta-analyses have suggested that Cerebrolysin is beneficial as a dementia treatment. CAPTAIN is a randomized, double-blind, placebo-controlled, multi-center, multinational trial of the effects of Cerebrolysin on neuroprotection and neurorecovery after TBI using a multidimensional ensemble of outcome scales. The CAPTAIN trial will be the first TBI trial with a 'true' multidimensional approach based on full outcome scales, while avoiding prior weaknesses, such as loss of information through "dichotomization," or unrealistic assumptions such as "normal distribution."

Long-term cognitive function change among breast cancer survivors

Cognitive decline is a common health problem among breast cancer patients and understanding trajectories of cognitive change following among breast cancer survivors is an important public health goal. We conducted a longitudinal study to investigate the cognitive function changes from 18 month to 3 years after breast cancer diagnosis among participants of the Shanghai Breast cancer survivor study, a population-based cohort study of breast cancer survivors. In our study, we completed cognitive function evaluation for 1,300 breast cancer survivors at the 18th month's survey and 1,059 at 36th month's survey, respectively, using a battery of cognitive function measurements. We found the scores in attention and executive function, immediate memory and delayed memory significantly improved from 18 to 36 months after breast cancer diagnosis. The improvements appeared in breast cancer survivors receiving treatments (i.e., surgery, radiotherapy, tamoxifen, or chemotherapy combined with or without tamoxifen), but not in those who received neither chemotherapy nor tamoxifen treatment. The results indicate that cognitive functions, particularly immediate verbal episodic memory, and delayed memory significantly improved among breast cancer survivors from 18 to 36 months after cancer diagnosis. In general, comorbidity was inversely associated with the improvements.

Cognitive impairment in native Chinese with spinocerebellar ataxia type 3

BACKGROUND

Previous studies have shown cognitive impairment in patients with spinocerebellar ataxia type 3 (SCA3). However, there is a lack of data on Chinese patients with SCA3.

METHOD

We investigated 22 native Chinese with SCA3 and 18 controls matched for age, education as well as mental status. Cognitive assessments were carefully carried out to measure verbal fluency, memory, attention, executive function, visuospatial and visuoconstructive functions.

RESULTS

The most common impairments of cognition in native Chinese with SCA3 were disruption of phonemic verbal fluency and frontal executive dysfunction. Deficits in semantic fluency were detected in about 31.8% patients. Impaired visuospatial function and verbal memory were also found in native Chinese with SCA3. The degree of ataxia, CAG repeat length and education were found to correlate with cognitive performance. Multivariate binary logistic regression suggested that an oculomotor disorder and depression are predictors of cognitive impairment.

CONCLUSION

Native Chinese with SCA3 had cognitive impairment of frontal executive function, temporal and parietal functions. An oculomotor disorder might be an index of cognitive dysfunction.

Aerobic exercise interacts with neurotrophic factors to predict cognitive functioning in adolescents

Recent findings have suggested that aerobic exercise may have a positive effect on brain functioning, in addition to its well-recognized beneficial effects on human physiology. This study confirmed the cognitive effects of aerobic exercise on the human brain. It also examined the relationships between exercise and the serum levels of neurotrophic factors (BDNF, IGI-1, and VEGF). A total of 91 healthy teens who exercised regularly participated in this study. A between-group design was adopted to compare cognitive functioning subserved by the frontal and temporal brain regions and the serum levels of neurotrophic factors between 45 regular exercisers and 46 matched controls. The exercisers performed significantly better than the controls on the frontal and temporal functioning parameters measured. This beneficial cognitive effect was region-specific because no such positive cognitive effect on task-tapping occipital functioning was observed. With respect to the serum levels of the neurotrophic factors, a negative correlation between neurotrophic factors (BDNF and VEGF) with frontal and medial-temporal lobe function was revealed. Furthermore, the levels of BDNF and VEGF interacted with exercise status in predicting frontal and temporal lobe function. This is the first report of the interaction effects of exercise and neurotrophic factors on cognitive functioning. Herein, we report preliminary evidence of the beneficial effects of regular aerobic exercise in improving cognitive functions in teens. These beneficial effects are region-specific and are associated with the serum levels of neurotrophic factors. Our findings lay the path for future studies looking at ways to translate these beneficial effects to therapeutic strategies for adolescents.

Prospective memory impairment and its implications for community living skills in bipolar disorder

OBJECTIVE

Prospective memory (PM) refers to the ability to undertake intended actions in the future. The functional significance of PM in bipolar disorder (BD) has not yet been investigated. This study examined PM impairment and its role in community living skills in clinically stable individuals with BD.

METHODS

Seventy-six individuals with BD and 44 healthy individuals were assessed with the Chinese version of the Cambridge Prospective Memory Test. Socio-demographic characteristics, retrospective memory (RM; the ability to recall or recognize past information), and intelligence were also measured in all participants. The clinical condition and community living skills of patients with BD were rated independently with standardized instruments.

RESULTS

Patients with BD showed PM impairment and their PM total scores independently predicted the level of community living skills in regression analyses. In follow-up analyses, the contribution was found to be accounted for by the time-based PM scores.

CONCLUSIONS

Given the expanding body of research on the utility of PM in predicting functioning, these findings further support the role of PM in community living skills in individuals with BD. The results suggest that PM training might be an integral part of clinical rehabilitation devised for individuals with BD.