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Ngan STJ, Cheng CPW, Chan WC, Tsui KHH, Chan SMC, Chan KWS. The modulation effect of cognition on mentalization in late-life depression: a study of gaze perception-a potential screening tool for high-risk group of late-life depression. Front Psychiatry 2024; 15:1199119. [PMID: 38751421 PMCID: PMC11094541 DOI: 10.3389/fpsyt.2024.1199119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 04/12/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Impairment in mentalization is implicated in the development and maintenance of depression. Major depressive disorders showed significant impairment in social cognition and such impairment appears to be positively associated with the severity of depression. Self-referential gaze perception (SRGP), a measurement of mentalization, was predominantly measured in patients with psychosis but rarely examined in late-life depression (LLD). Methods To assess the effect of cognition on the interpretation bias of mentalization, 29 LLD patients and 29 healthy controls were asked to judge if various gaze directions were directed to self in SRGP. Results Patients with better cognition showed less unambiguous-SRGP bias than those with worse cognitive scores; this difference was not found in healthy controls. Global cognition and executive function contributed to the SRGP rate in patients. Conclusion The current study is the first study to explore the relationship between cognition and SRGP in the LLD population. Our study findings suggested that the cognitive function of LLD patients may contribute to the modulation of interpretation bias, which in turn underlie the role of SRGP bias. Greater SRGP bias in patients may reflect social cognition deterioration, impairing the social interaction and functioning of LLD patients. This highlights the need for early intervention and cognitive decline identification to facilitate better prognosis and treatment effectiveness; thus, further studies could navigate the potential of SRGP task as a screening tool for high-risk group of LLD likely to develop dementia.
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Affiliation(s)
- Sze Ting Joanna Ngan
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | | | - Wai Chi Chan
- Department of Psychiatry, Queen Mary Hospital Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kam Hung Harry Tsui
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Sau Man Corine Chan
- Department of Public Health, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kit Wa Sherry Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Timko CA, Schnabel J, Orloff NC. The importance of improving cognitive flexibility in adolescents with anorexia nervosa: The case for cognitive remediation therapy. Int J Eat Disord 2024; 57:1109-1118. [PMID: 38333943 DOI: 10.1002/eat.24164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
OBJECTIVE Inefficiencies in executive functioning (EF), more specifically cognitive flexibility and an overly detailed processing style, are frequently observed in individuals with Anorexia Nervosa (AN) and have been identified as potential targets in treatment. Cognitive Remediation Therapy (CRT) is an adjunctive treatment approach specifically designed to have a positive impact on EF. Mainly evaluated in adults, CRT has been criticized for its perceived ineffectiveness in promoting weight restoration or directly reducing eating disorder symptoms. METHOD We argue that we need to refocus our conceptual framework for using CRT as an adjunctive treatment and specifically explore its potential benefit in adolescents. RESULTS Adolescence is a critical window for EF development during which CRT has the potential to have the most impact. While it may not specifically ameliorate eating disorder symptoms and directly improve weight gain, CRT may mitigate the impact of malnutrition on adolescent brain development, reduce attrition rates in treatment, and improve cognitive flexibility and (indirectly) other maintaining factors, thereby improving global functioning. DISCUSSION More research needs to be done to understand the development of EF in adolescents with AN and how best to employ CRT as an adjunctive treatment to support development and target maintaining factors. The current article broadly reviews findings on executive functioning inefficiencies in adolescents with AN and discusses the purpose and role of CRT in treating AN. Finally, we highlight key critiques of using CRT and pose questions for future research. PUBLIC SIGNIFICANCE Treatments targeting executive functioning in adolescents with AN are limited. We need to better understand how CRT can benefit adolescents in treatment. Increasing treatment options, including adjunctive treatments, is necessary to reduce the long-term impact of AN.
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Affiliation(s)
- C Alix Timko
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Jiana Schnabel
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Psychology and Neuroscience, Temple University, Philadelphia, Pennsylvania, USA
| | - Natalia C Orloff
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Equip Health, Carlsbad, California, USA
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Morais S, d’Almeida OC, Caldeira S, Meneses S, Areias G, Girão V, Bettencourt C, Pereira DJ, Macedo A, Castelo-Branco M. Executive function in schizophrenia and autism in adults shares common components separating high and low performance groups. Front Psychiatry 2024; 15:1381526. [PMID: 38699455 PMCID: PMC11064061 DOI: 10.3389/fpsyt.2024.1381526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/27/2024] [Indexed: 05/05/2024] Open
Abstract
The profile of executive function (EF) in adults with Schizophrenia (SCZ) and autism spectrum disorder (ASD) remains unclear. This study aims to ascertain if distinct EF patterns can be identified between each clinical condition by comparing the neuropsychological profile of adults with SCZ and ASD, for whom the differential diagnosis is still highly challenging. Forty-five individuals (15 SCZ, 15 ASD, 15 controls) matched for age, sex, education level, and handedness underwent intelligence evaluation and neuropsychological testing for working memory, inhibition, planning and set-shifting, and verbal fluency subdomains. Principal component analysis (2D-PCA) using variables representing 4 domains was employed to identify patterns in neuropsychological profiles. The ASD group had lower scores on the Digits Forward subtest compared to the SCZ group (7.2 ± 2.1 vs. 9.3 ± 1.9, p = 0.003; Cohen's d: 1.05). ASD also performed significantly worse on the Stroop Word Test compared to the control group (77.7± 17.9 vs. 98.0 ± 12.7, p = 0.009; Cohen's d: 1.31). No significant differences were observed between ASD and SCZ on other EF measures. The larger contributors for the dimensions in 2D-PCA were the Digits Forward subtest and Stroop Word Test. Still, there was substantial overlap between the clinical groups. This study suggests a high degree of similarity of EF between SCZ and ASD. Through four EF measures, the discrimination of low and high-functioning EF groups spanning both diagnostic categories may help to identify the individuals who could better benefit from cognitive rehabilitation strategies.
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Affiliation(s)
- Sofia Morais
- Psychiatry Department, Coimbra Hospital and University Centre, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Otília C. d’Almeida
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Salomé Caldeira
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Sofia Meneses
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Graça Areias
- Psychology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Vanessa Girão
- Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Catarina Bettencourt
- Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
- Centre for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), Faculty of Psychological and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Daniela Jardim Pereira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Neurorradiology Functional Area, Imaging Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - António Macedo
- Psychiatry Department, Coimbra Hospital and University Centre, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Psychological Medicine, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Castelo-Branco
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
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Pereira DJ, Morais S, Sayal A, Pereira J, Meneses S, Areias G, Direito B, Macedo A, Castelo-Branco M. Neurofeedback training of executive function in autism spectrum disorder: distinct effects on brain activity levels and compensatory connectivity changes. J Neurodev Disord 2024; 16:14. [PMID: 38605323 PMCID: PMC11008042 DOI: 10.1186/s11689-024-09531-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 03/28/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Deficits in executive function (EF) are consistently reported in autism spectrum disorders (ASD). Tailored cognitive training tools, such as neurofeedback, focused on executive function enhancement might have a significant impact on the daily life functioning of individuals with ASD. We report the first real-time fMRI neurofeedback (rt-fMRI NF) study targeting the left dorsolateral prefrontal cortex (DLPFC) in ASD. METHODS Thirteen individuals with autism without intellectual disability and seventeen neurotypical individuals completed a rt-fMRI working memory NF paradigm, consisting of subvocal backward recitation of self-generated numeric sequences. We performed a region-of-interest analysis of the DLPFC, whole-brain comparisons between groups and, DLPFC-based functional connectivity. RESULTS The ASD and control groups were able to modulate DLPFC activity in 84% and 98% of the runs. Activity in the target region was persistently lower in the ASD group, particularly in runs without neurofeedback. Moreover, the ASD group showed lower activity in premotor/motor areas during pre-neurofeedback run than controls, but not in transfer runs, where it was seemingly balanced by higher connectivity between the DLPFC and the motor cortex. Group comparison in the transfer run also showed significant differences in DLPFC-based connectivity between groups, including higher connectivity with areas integrated into the multidemand network (MDN) and the visual cortex. CONCLUSIONS Neurofeedback seems to induce a higher between-group similarity of the whole-brain activity levels (including the target ROI) which might be promoted by changes in connectivity between the DLPFC and both high and low-level areas, including motor, visual and MDN regions.
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Affiliation(s)
- Daniela Jardim Pereira
- Neurorradiology Functional Area, Imaging Department, Coimbra Hospital and University Center, Coimbra, Portugal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sofia Morais
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Psychiatry Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- Siemens Healthineers Portugal, Lisboa, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Sofia Meneses
- Psychology Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Graça Areias
- Psychology Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
- IATV-Instituto do Ambiente, Tecnologia e Vida (IATV), Coimbra, Portugal
| | - António Macedo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Siemens Healthineers Portugal, Lisboa, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal.
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal.
- Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal.
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Bergkamp MI, Jacob MA, Cai M, Claassen JA, Kessels RPC, Esselink R, Tuladhar AM, De Leeuw FE. Long-Term Longitudinal Course of Cognitive and Motor Symptoms in Patients With Cerebral Small Vessel Disease. Neurology 2024; 102:e209148. [PMID: 38382000 DOI: 10.1212/wnl.0000000000209148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/27/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Patients with cerebral small vessel disease (SVD) show a heterogenous clinical course. The aim of the current study was to investigate the longitudinal course of cognitive and motor function in patients who developed parkinsonism, dementia, both, or none. METHODS Participants were from the Radboud University Nijmegen Diffusion Tensor and Magnetic Resonance Cohort study, a prospective cohort of patients with SVD. Parkinsonism and dementia were, respectively, diagnosed according to the UK Parkinson's Disease Society brain bank criteria and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria for major neurocognitive disorder. Linear and generalized linear mixed-effect analyses were used to study the longitudinal course of motor and cognitive tasks. RESULTS After a median follow-up of 12.8 years (interquartile range 10.2-15.3), 132 of 501 (26.3%) participants developed parkinsonism, dementia, or both. Years before diagnosis of these disorders, participants showed distinct clinical trajectories from those who developed none: Participant who developed parkinsonism had an annual percentage of 22% (95% CI 18%-27%) increase in motor part of the Unified Parkinson's Disease Rating Scale score. This was significantly higher than the 16% (95% CI 14%-18%) of controls, mainly because of a steep increase in bradykinesia and posture and gait disturbances. When they developed dementia as well, the increase in Timed Up and Go Test time of 0.73 seconds per year (95% CI 0.58-0.87) was significantly higher than the 0.20 seconds per year increase (95% CI 0.16-0.23) of controls. All groups, including the participants who developed parkinsonism without dementia, showed a faster decline in executive function compared with controls: Annual decline in Z-score was -0.07 (95% CI -0.10 to -0.05), -0.09 (95% CI -0.11 to -0.08), and -0.11 (95% CI -0.14 to -0.08) for participants who developed, respectively, parkinsonism, dementia, and both parkinsonism and dementia. These declines were all significantly faster than the annual decline in Z-score of 0.07 (95% CI -0.10 to -0.05) of controls. DISCUSSION A distinct pattern in deterioration of clinical markers is visible in patients with SVD, years before the diagnosis of parkinsonism and dementia. This knowledge aids early identification of patients with a high risk of developing these disorders.
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Affiliation(s)
- Mayra I Bergkamp
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Mina A Jacob
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Mengfei Cai
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Jurgen A Claassen
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Roy P C Kessels
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Rianne Esselink
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Anil Man Tuladhar
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
| | - Frank-Erik De Leeuw
- From the Departments of Neurology (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), of Medical Psychology (R.P.C.K.), Geriatrics (J.A.C.), and Radboudumc Alzheimer Center (J.A.C., R.P.C.K.), Radboud University Medical Center; Donders Center for Medical Neuroscience (M.I.B., M.A.J., M.C., R.E., A.M.T., F.-E.D.L.), and Donders Institute for Brain (J.A.C., R.P.C.K.), Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands; Department of Neurology (M.C.), Guangdong Neuroscience Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, China; Department of Cardiovascular Sciences (J.A.C.), University of Leicester, United Kingdom; Vincent van Gogh Institute for Psychiatry (R.P.C.K.), Venray, the Netherlands
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Wilens TE, Stone M, Lanni S, Berger A, Wilson RLH, Lydston M, Surman CB. Treating Executive Function in Youth With Attention Deficit Hyperactivity Disorder: A Review of Pharmacological and Non-Pharmacological Interventions. J Atten Disord 2024; 28:751-790. [PMID: 38178649 DOI: 10.1177/10870547231218925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
INTRODUCTION Executive function (EF) deficits are common in youth with ADHD and pose significant functional impairments. The extent and effect of interventions addressing EF in youth with ADHD remain unclear. METHODS We conducted a systematic literature review using PRISMA guidelines. Included studies were randomized controlled trials of interventions to treat EF in youth with ADHD. RESULTS Our search returned 136 studies representing 11,443 study participants. We identified six intervention categories: nonstimulant pharmacological (N = 3,576 participants), neurological (N = 1,935), psychological (N = 2,387), digital (N = 2,416), physiological (N = 680), and combination (N = 366). The bulk of the evidence supported pharmacological interventions as most effective in mitigating EF, followed by psychological and digital interventions. CONCLUSION A breadth of treatments exists for EF in youth with ADHD. Pharmacological, psychotherapeutic, and digital interventions had the most favorable, replicable outcomes. A lack of outcome standardization across studies limited treatment comparison. More data on the persistence of intervention effects are necessary.
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Affiliation(s)
- Timothy E Wilens
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Mira Stone
- Massachusetts General Hospital, Boston, MA, USA
| | | | - Amy Berger
- Massachusetts General Hospital, Boston, MA, USA
| | | | | | - Craig B Surman
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
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Wang J, Li H, Jia J, Shao X, Li Y, Zhou Y, Wang H, Jin L. Progressive Cerebrovascular Reactivity Reduction Occurs in Parkinson's Disease: A Longitudinal Study. Mov Disord 2024; 39:94-104. [PMID: 38013597 DOI: 10.1002/mds.29671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/15/2023] [Accepted: 11/07/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND The change of microvascular function over the course of Parkinson's disease (PD) remains unclear. OBJECTIVE We aimed to ascertain regional cerebrovascular reactivity (CVR) changes in the patients with PD at baseline (V0) and during a 2-year follow-up period (V1). We further investigated whether alterations in CVR were linked to cognitive decline and brain functional connectivity (FC). METHODS We recruited 90 PD patients and 51 matched healthy controls (HCs). PD patients underwent clinical evaluations, neuropsychological assessments, and magnetic resonance (MR) scanning at V0 and V1, whereas HCs completed neuropsychological assessments and MR at baseline. The analysis included evaluating CVR and FC maps derived from resting-state functional magnetic resonance imaging and investigating CVR measurement reproducibility. RESULTS Compared with HCs, CVR reduction in left inferior occipital gyrus and right superior temporal cortex at V0 persisted at V1, with larger clusters. Longitudinal reduction in CVR of the left posterior cingulate cortex correlated with decline in Trail Making Test B performance within PD patients. Reproducibility validation further confirmed these findings. In addition, the results also showed that there was a tendency for FC to be weakened from posterior to anterior with the progression of the disease. CONCLUSIONS Microvascular dysfunction might be involved in disease progression, subsequently weaken brain FC, and partly contribute to executive function deficits in early PD. © 2023 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Jian Wang
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Radiology, Zhongshan Hospital, Fudan University (Xiamen Branch), China
| | - Hongwei Li
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Jia Jia
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Neurology, Shanghai Xuhui Central Hospital, Shanghai, China
| | - Xiali Shao
- Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yuanfang Li
- Department of Neurology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China
| | - Ying Zhou
- Department of Neurology, Zhongshan Hospital, Fudan University (Xiamen Branch), Xiamen, China
| | - He Wang
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- Human Phenome Institute, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Lirong Jin
- Department of Neurology, Zhongshan Hospital, Fudan University, Shanghai, China
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Trapp W, Heid A, Röder S, Wimmer F, Weiß H, Hajak G. "Try to Build This Bunny as Fast as Possible without Using Red or Pink Bricks": How Simple Assembly Tasks Might Aid in Detecting People with Mild Cognitive Impairment and Dementia. Brain Sci 2023; 13:1693. [PMID: 38137141 PMCID: PMC10742155 DOI: 10.3390/brainsci13121693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 11/22/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
(1) Background: Dementia and mild cognitive impairment (MCI) are still underdiagnosed in the general population. Impaired odor identification has been identified as an early marker of MCI and dementia. We aim to investigate whether short tasks, in which simple forms must be assembled from single building blocks based on a template or while considering specific re-strictions, could increase the diagnostic quality of established cognitive screening tests in detecting MCI or dementia. (2) Methods: A brief assembly test, where participants had to assemble simple animal shapes from Lego® Duplo® building blocks, the Frontal Assessment Battery, and the Mini-Mental State Exam (MMSE) were administered to a consecutive series of 197 patients (89 with mild dementia, 62 with mild cognitive impairment, and 46 without cognitive impairment) referred for neuropsychological testing. (3) Results: Both participants with dementia and with MCI performed badly in the assembly tasks. The assembly tasks and the Frontal Assessment Battery were substantially correlated. Complementing MMSE scores with the assembly tasks improved the diagnostic accuracy of individuals with dementia and MCI. (4) Conclusions: People with suspected dementia or MCI may already benefit from simple assembly tasks. Although these tests require little additional time, they can notably increase sensitivity for dementia or MCI.
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Affiliation(s)
- Wolfgang Trapp
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
- Department of Physiological Psychology, Otto-Friedrich University Bamberg, Markusplatz 3, 96045 Bamberg, Germany
| | - Andreas Heid
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
| | - Susanne Röder
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
| | - Franziska Wimmer
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
| | - Helmar Weiß
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
| | - Göran Hajak
- Department of Psychiatry, Sozialstiftung Bamberg, St.-Getreu-Straße 18, 96049 Bamberg, Germany; (A.H.); (S.R.); (F.W.); (H.W.); (G.H.)
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Portley M, Sherer C, Wu T, Farren J, Danielian LE, Scholz SW, Traynor BJ, Ward ME, Haselhuhn T, Snyder A, Kwan JY. Cognitive determinants of decisional capacity in neurodegenerative disorders. Ann Clin Transl Neurol 2023; 10:1816-1823. [PMID: 37545108 PMCID: PMC10578892 DOI: 10.1002/acn3.51871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/08/2023] Open
Abstract
OBJECTIVE Cognitive contributions to decisional capacity are complex and not well understood. Capacity to consent for research has been linked to executive function, but executive function assessment tools are imperfect. In this study, we examine the relationship between decisional capacity and a newly developed executive function composite score and determine whether cognitive performance can predict impaired decisional capacity. METHODS This is a cross sectional study of participants at the National Institutes of Health with frontotemporal dementia-amyotrophic lateral sclerosis spectrum disorders enrolled between 2017 and 2022. A structured interview tool was used to ascertain research decisional capacity. Study participant Uniform Data Set (v3.0) executive function (UDS3-EF) composite score, Clinical Dementia Rating Scale©, and Neuropsychiatric Inventory was determined. RESULTS A decrease in UDS3-EF composite score significantly increased the odds of impaired decisional capacity (OR = 2.92, 95% CI [1.66-5.13], p = 0.0002). Executive function was most impaired in frontotemporal dementia (-2.86, SD = 1.26) and least impaired in amyotrophic lateral sclerosis (-0.52, SD = 1.25) participants. The UDS3-EF composite score was also strongly correlated to the Clinical Dementia Rating Scale©. INTERPRETATION Decisional capacity is intrinsically related to executive function in neurodegenerative disorders, and executive dysfunction may predict a lack of decisional capacity alerting investigators of the need for additional scrutiny during the informed consent process.
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Affiliation(s)
- Makayla Portley
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Carolyn Sherer
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Tianxia Wu
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Jennifer Farren
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMarylandUSA
| | - Laura E. Danielian
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Sonja W. Scholz
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Bryan J. Traynor
- National Institute on AgingNational Institutes of HealthBethesdaMarylandUSA
| | - Michael E. Ward
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Taryn Haselhuhn
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Allison Snyder
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
| | - Justin Y. Kwan
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMarylandUSA
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10
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Royall DR, Palmer RF. The effects of CNS atrophy and ICVD on tests of executive function and functional status are mediated by intelligence. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100184. [PMID: 37811522 PMCID: PMC10550593 DOI: 10.1016/j.cccb.2023.100184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 09/05/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023]
Abstract
Background Impairments in executive function (EF) are often attributed to ischemic cerebrovascular disease (ICVD) and frontal circuit pathology. However, EF can be distinguished from general intelligence and the latter is likely to manifest in "executive" measures. We aimed to distinguish the effects of imaging biomarkers on these constructs. Methods We tested neuroimaging biomarkers as independent predictors of observed 12 month-prospective cognitive performance by a Multiple Indicators Multiple Causes (MIMIC) model in the Alzheimer's Disease Neuroimaging Initiative (ADNI) (N ≅ 1750). Results ICVD was associated with ''Organization" (ORG) and "Planning" (PLAN) domain scores from the test of Every Day Cognition. Left anterior cingulate (LAC) atrophy was independently associated with Trail-Making part B and Animal Naming. The MIMIC model had excellent fit and tests additional latent variables i.e., EF and dEF (a latent δ homolog derived from Spearman's general intelligence factor, g). Only dEF was associated with instrumental activities of daily living (IADL). ICVD and LAC were both associated with observed executive measures through dEF. ICVD was independently associated with those same measures through EF. Conclusions Observed EF is independently determined by multiple factors. The effects of EF-associated MRI biomarkers can be related to disability and dementia only via their effects on g. Because g /δ are unlikely to be located within the frontal lobes, the dementia-specific variance in executive measures may have little to do with either frontal structure or function. Conversely, domain-specific variance in EF may have little to do with either IADL-impairment or dementia.
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Affiliation(s)
- Donald R. Royall
- Department of Psychiatry, the University of Texas Health Science Center, San Antonio, TX, United States of America
- Department of Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
- The Glenn Biggs Institute for Alzheimer's and Neurodegenerative Disease, the University of Texas Health Science Center, San Antonio, TX, United States of America
| | - Raymond F. Palmer
- Department of Family and Community Medicine, the University of Texas Health Science Center, San Antonio, TX, United States of America
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11
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Fu Y, Xu C, Fan H, Yang X, Ou J, Yao L, Wang W. Traumatic brain injury and rTMS-ERPs: Case report and literature review. Open Life Sci 2023; 18:20220677. [PMID: 37724119 PMCID: PMC10505337 DOI: 10.1515/biol-2022-0677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 06/20/2023] [Accepted: 07/18/2023] [Indexed: 09/20/2023] Open
Abstract
Currently, there are no cases of targeted, individualized repeated transcranial magnetic stimulation (rTMS) treatment based on event-related potential (ERPs) results showing the activation of functional brain regions. The identification and treatment of mild cognitive impairment after traumatic brain injury are challenging. rTMS has shown unique advantages in previous studies, with positive effects on noninvasive modulation and neuroplasticity after brain injury. The selection of the rTMS parameters and targets remains controversial. ERPs indicate the cortical activity involved in cognitive processing in patients. Therefore, this study proposes that ERPs can be used as biomarkers of cognitive recovery. The results of this study will guide the development of rTMS protocols for patient treatment. To help clinicians better apply rTMS and ERPs in combination, we conducted a relevant literature review and discussion, detailing the therapeutic mechanisms of the combination of ERPs and rTMS. This will facilitate the precise assessment and personalized treatment of such patients, improve the abnormal processing patterns of patients, and promote their return to life and society.
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Affiliation(s)
- Yutong Fu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Chunyan Xu
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Hong Fan
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Xue Yang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Jibing Ou
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Liqing Yao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
| | - Wenli Wang
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China
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12
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Ogonowski N, Santamaria-Garcia H, Baez S, Lopez A, Laserna A, Garcia-Cifuentes E, Ayala-Ramirez P, Zarante I, Suarez-Obando F, Reyes P, Kauffman M, Cochran N, Schulte M, Sirkis DW, Spina S, Yokoyama JS, Miller BL, Kosik KS, Matallana D, Ibáñez A. Frontotemporal dementia presentation in patients with heterozygous p.H157Y variant of TREM2. J Med Genet 2023; 60:894-904. [PMID: 36813542 PMCID: PMC10447405 DOI: 10.1136/jmg-2022-108627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND The triggering receptor expressed on myeloid cell 2 (TREM2) is a major regulator of neuroinflammatory processes in neurodegeneration. To date, the p.H157Y variant of TREM2 has been reported only in patients with Alzheimer's disease. Here, we report three patients with frontotemporal dementia (FTD) from three unrelated families with heterozygous p.H157Y variant of TREM2: two patients from Colombian families (study 1) and a third Mexican origin case from the USA (study 2). METHODS To determine if the p.H157Y variant might be associated with a specific FTD presentation, we compared in each study the cases with age-matched, sex-matched and education-matched groups-a healthy control group (HC) and a group with FTD with neither TREM2 mutations nor family antecedents (Ng-FTD and Ng-FTD-MND). RESULTS The two Colombian cases presented with early behavioural changes, greater impairments in general cognition and executive function compared with both HC and Ng-FTD groups. These patients also exhibited brain atrophy in areas characteristic of FTD. Furthermore, TREM2 cases showed increased atrophy compared with Ng-FTD in frontal, temporal, parietal, precuneus, basal ganglia, parahippocampal/hippocampal and cerebellar regions. The Mexican case presented with FTD and motor neuron disease (MND), showing grey matter reduction in basal ganglia and thalamus, and extensive TDP-43 type B pathology. CONCLUSION In all TREM2 cases, multiple atrophy peaks overlapped with the maximum peaks of TREM2 gene expression in crucial brain regions including frontal, temporal, thalamic and basal ganglia areas. These results provide the first report of an FTD presentation potentially associated with the p.H157Y variant with exacerbated neurocognitive impairments.
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Affiliation(s)
- Natalia Ogonowski
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Adolfo Ibanez University, Santiago, Chile, Santiago de Chile, Chile
| | - Hernando Santamaria-Garcia
- Global Brain Health Institute (GBHI), University California San Francisco (UCSF), San Francisco, California, USA
- Pontificia Universidad Javeriana. Ph.D Program of Neuroscience, Bogotá, Colombia
- Hospital Universitario San Ignacio. Centro de Memoria y Cognición Intellectus, Bogotá, Colombia
| | | | - Andrea Lopez
- Hospital Universitario de la Fundación Santa Fe de Bogotá, Bogota, Colombia
- Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Andrés Laserna
- Pontificia Universidad Javeriana, Bogota, Colombia
- University of Rochester Medical Center. Department of Anesthesiology and Perioperative Medicine. of Anesthesiology and Perioperative Medicine, Rochester, NY, New York, USA
| | - Elkin Garcia-Cifuentes
- Pontificia Universidad Javeriana, Bogota, Colombia
- Hospital Universitario San Ignacio, Bogotá, Colombia
| | - Paola Ayala-Ramirez
- Human Genomics Institute, Pontificia Universidad Javeriana, Bogota, Colombia
| | | | | | - Pablo Reyes
- Pontificia Universidad Javeriana, Bogota, Colombia
| | - Marcelo Kauffman
- Hospital General de Agudos Jose Maria Ramos Mejia Consultorio y Laboratorio de Neurogenetica, Buenos Aires, Argentina
- Universidad Austral. IIMT-FCB. Conicet, Buenos Aires, Argentina
| | | | | | - Daniel W Sirkis
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- Weil Institute of Neuroscience, University of California, San Francisco, San Francisco, California, USA
| | - Salvatore Spina
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
| | - Jennifer S Yokoyama
- Department of Neurology, University of California, San Francisco, San Francisco, California, USA
- Weil Institute of Neuroscience, University of California, San Francisco, San Francisco, California, USA
| | | | - Kenneth S Kosik
- University of California Santa Barbara, Santa Barbara, California, USA
| | - Diana Matallana
- Pontificia Universidad Javeriana, Bogota, Colombia
- Hospital Universitario Fundación Santa Fe, Bogotá, Colombia
| | - Agustín Ibáñez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Adolfo Ibanez University, Santiago, Chile, Santiago de Chile, Chile
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
- Cognitive Neuroscience Center (CNC), Universidad de San Andres & CONICET, Buenos Aires, Argentina
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13
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Harahap HS, Ferdiana A, Mahardika A, Hunaifi I, Putri SA. Higher education level as a protective factor against executive dysfunction in patients with epilepsy in Mataram, Indonesia. Clin Neurol Neurosurg 2023; 232:107886. [PMID: 37451091 DOI: 10.1016/j.clineuro.2023.107886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 07/03/2023] [Accepted: 07/07/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Since the concept of cognitive reserve is applicable in epilepsy-associated cognitive impairment, the role of cognitive reserve components as a protective factor against epilepsy-associated executive dysfunction needs further investigation. This study aimed at investigating the association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction in Mataram, Indonesia. METHODS This case-control study involved both epilepsy outpatient and healthy participants recruited consecutively in 5 hospitals in Mataram, between October 2021 and September 2022. Data on sociodemographic, cognitive reserve components, and executive function status were collected from both groups, while data on seizure were collected only from epilepsy participants. The association between cognitive reserve components and the frequency of epilepsy-associated executive dysfunction was tested using logistic regression. RESULTS A total of 119 epilepsy patients and 93 healthy participants were recruited. The frequency of epilepsy-associated executive dysfunction was 50.4%. Multivariate logistic regression analysis showed that higher education level was the only cognitive reserve component protective against epilepsy-associated executive dysfunction (odds ratio [OR]: 3.36; 95% confidence interval [CI]: 1.33 - 8.50). CONCLUSION A high frequency of epilepsy-associated executive dysfunction was observed in Mataram. Higher education level was a cognitive reserve component protective against executive dysfunction in these patients.
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Affiliation(s)
| | - Astri Ferdiana
- Department of Public Health, Faculty of Medicine, University of Mataram, Indonesia
| | - Agustine Mahardika
- Department of Psychiatry, Faculty of Medicine, University of Mataram, Indonesia
| | - Ilsa Hunaifi
- Department of Neurology, Faculty of Medicine, University of Mataram, Indonesia
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Nascimento MDM, Maduro PA, Rios PMB, Nascimento LDS, Silva CN, Kliegel M, Ihle A. The Effects of 12-Week Dual-Task Physical-Cognitive Training on Gait, Balance, Lower Extremity Muscle Strength, and Cognition in Older Adult Women: A Randomized Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085498. [PMID: 37107780 PMCID: PMC10139030 DOI: 10.3390/ijerph20085498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/04/2023] [Accepted: 04/11/2023] [Indexed: 05/11/2023]
Abstract
This study aims to investigate the effects of dual-task physical-cognitive the training on body balance (BB), gait performance (GP), lower limb muscle strength (LEMS), and cognitive performance (CP) in a group of cognitively normal older adult women (n = 44; 66.20 ± 4.05 years). Of these, 22 were randomly allocated to the dual-task training (DT) group, and 22 participated in the control group (CG). Assessments were performed at baseline, after 12 weeks of intervention, and at the end of 12 weeks of follow-up, using the following instruments: Timed Up & Go (TUG), Timed Up & Go manual (TUGm), Timed Up & Go cognitive (TUGc), Balance Test (TEC), sit-to-stand test (STS), and verbal fluency test (VF). After 12 weeks of DT training, participants showed a significant time × group interaction in all motor assessments (BB, GP, LEMS), as well as in three cognitive tests (VF-grouping, VF-exchange, VF-total). No time-group interaction effect was indicated for the VF-category test. At all evaluation times, CG members maintained constant physical and cognitive performance. We conclude that 12 weeks of physical-cognitive DT training was effective in promoting BB, GP, and LEMS, as well as CP in cognitively normal older adult women, with lasting effects up to 12 weeks after the intervention.
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Affiliation(s)
- Marcelo de Maio Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
- Correspondence: ; Tel.: +55-(87)-21016856
| | - Paula Andreatta Maduro
- University Hospital of the Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Pâmala Morais Bagano Rios
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Lara dos Santos Nascimento
- Department of Physical Education, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Carolina Nascimento Silva
- Department of Psychology, Federal University of Vale do São Francisco, Campus Petrolina 56304-917, Brazil
| | - Matthias Kliegel
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
| | - Andreas Ihle
- Department of Psychology, University of Geneva, 1205 Geneva, Switzerland (A.I.)
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, 1205 Geneva, Switzerland
- Swiss National Centre of Competence in Research LIVES—Overcoming Vulnerability: Life Course Perspectives, 1015 Lausanne, Switzerland
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Chung M, Park YS. Hyperkinetic Rat Model Induced by Optogenetic Parafascicular Nucleus Stimulation. J Korean Neurosurg Soc 2023; 66:121-132. [PMID: 36239081 PMCID: PMC10009241 DOI: 10.3340/jkns.2022.0106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 10/11/2022] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The parafascicular nucleus (PF) plays important roles in controlling the basal ganglia. It is not well known whether the PF affects the development of abnormal involuntary movements (AIMs). This study was aimed to find a role of the PF in development of AIMs using optogenetic methods in an animal model. METHODS Fourteen rats were underwent stereotactic operation, in which they were injected with an adeno-associated virus with channelrhodopsin (AAV2-hSyn-ChR2-mCherry) to the lateral one third of the PF. Behavior test was performed with and without optical stimulation 14 days after the injection of the virus. AIM of rat was examined using AIM score. After the behavior test, rat's brain was carefully extracted and the section was examined using a fluorescence microscope to confirm transfection of the PF. RESULTS Of the 14 rats, seven rats displayed evident involuntary abnormal movements. AIM scores were increased significantly after the stimulation compared to those at baseline. In rats with AIMs, mCherry expression was prominent in the PF, while the rats without AIM lacked with the mCherry expression. CONCLUSION AIMs could be reversibly induced by stimulating the PF through an optogenetic method.
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Affiliation(s)
- Moonyoung Chung
- Department of Neurosurgery, Soonchunhyang University Bucheon Hospital, Soonchunhyang University, Korea
| | - Young Seok Park
- Department of Neurosurgery, Chungbuk National University Hospital, Cheongju, Korea
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Pereira DJ, Sayal A, Pereira J, Morais S, Macedo A, Direito B, Castelo-Branco M. Neurofeedback-dependent influence of the ventral striatum using a working memory paradigm targeting the dorsolateral prefrontal cortex. Front Behav Neurosci 2023; 17:1014223. [PMID: 36844653 PMCID: PMC9947361 DOI: 10.3389/fnbeh.2023.1014223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 01/18/2023] [Indexed: 02/11/2023] Open
Abstract
Executive functions and motivation have been established as key aspects for neurofeedback success. However, task-specific influence of cognitive strategies is scarcely explored. In this study, we test the ability to modulate the dorsolateral prefrontal cortex, a strong candidate for clinical application of neurofeedback in several disorders with dysexecutive syndrome, and investigate how feedback contributes to better performance in a single session. Participants of both neurofeedback (n = 17) and sham-control (n = 10) groups were able to modulate DLPFC in most runs (with or without feedback) while performing a working memory imagery task. However, activity in the target area was higher and more sustained in the active group when receiving feedback. Furthermore, we found increased activity in the nucleus accumbens in the active group, compared with a predominantly negative response along the block in participants receiving sham feedback. Moreover, they acknowledged the non-contingency between imagery and feedback, reflecting the impact on motivation. This study reinforces DLPFC as a robust target for neurofeedback clinical implementations and enhances the critical influence of the ventral striatum, both poised to achieve success in the self-regulation of brain activity.
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Affiliation(s)
- Daniela Jardim Pereira
- Neurorradiology Functional Area, Imaging Department, Coimbra Hospital and University Center, Coimbra, Portugal,Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal,Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Alexandre Sayal
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal,Siemens Healthineers Portugal, Lisboa, Portugal
| | - João Pereira
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal
| | - Sofia Morais
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal,Psychiatry Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - António Macedo
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal,Psychiatry Department, Coimbra Hospital and University Center, Coimbra, Portugal
| | - Bruno Direito
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal,IATV—Instituto do Ambiente, Tecnologia e Vida (IATV), Coimbra, Portugal
| | - Miguel Castelo-Branco
- Coimbra Institute for Biomedical Imaging and Translational Research (CIBIT), University of Coimbra, Coimbra, Portugal,Faculty of Medicine, University of Coimbra, Coimbra, Portugal,Institute of Nuclear Sciences Applied to Health (ICNAS), University of Coimbra, Coimbra, Portugal,*Correspondence: Miguel Castelo-Branco
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Ye X, Peng L, Sun N, He L, Yang X, Zhou Y, Xiong J, Shen Y, Sun R, Liang F. Hotspots and trends in fNIRS disease research: A bibliometric analysis. Front Neurosci 2023; 17:1097002. [PMID: 36937686 PMCID: PMC10017540 DOI: 10.3389/fnins.2023.1097002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/17/2023] [Indexed: 03/06/2023] Open
Abstract
Objective To summarize the general information and hotspots of functional near-infrared spectroscopy (fNIRS)-based clinical disease research over the past 10 years and provide some references for future research. Methods The related literature published between 1 January 2011 and 31 January 2022 was retrieved from the Web of Science core database (WoS). Bibliometric visualization analysis of countries/regions, institutions, authors, journals, keywords and references were conducted by using CiteSpace 6.1.R3. Results A total of 467 articles were included, and the annual number of articles published over nearly a decade showed an upward trend year-by-year. These articles mainly come from 39 countries/regions and 280 institutions. The representative country and institution were the USA and the University of Tubingen. We identified 266 authors, among which Andreas J Fallgatter and Ann-Christine Ehlis were the influential authors. Neuroimage was the most co-cited journal. The major topics in fNIRS disease research included activation, prefrontal cortex, working memory, cortex, and functional magnetic resonance imaging (fMRI). In recent years, the Frontier topics were executive function, functional connectivity, performance, diagnosis, Alzheimer's disease, children, and adolescents. Based on the burst of co-cited references, gait research has received much attention. Conclusion This study conducted a comprehensive, objective, and visual analysis of publications, and revealed the status of relevant studies, hot topics, and trends concerning fNIRS disease research from 2011 to 2022. It is hoped that this work would help researchers to identify new perspectives on potential collaborators, important topics, and research Frontiers.
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Affiliation(s)
- Xiangyin Ye
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Li Peng
- Department of Ultrasound, The First People’s Hospital of Longquanyi District, Chengdu, China
| | - Ning Sun
- Rehabilitation Medicine Center and Institute of Rehabilitation Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Lian He
- Department of Ultrasound, The First People’s Hospital of Longquanyi District, Chengdu, China
| | - Xiuqiong Yang
- Department of Ultrasound, The First People’s Hospital of Longquanyi District, Chengdu, China
| | - Yuanfang Zhou
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jian Xiong
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yuquan Shen
- Department of Rehabilitation Medicine, The First People’s Hospital of Longquanyi District, Chengdu, China
| | - Ruirui Sun
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Ruirui Sun,
| | - Fanrong Liang
- Acupuncture and Tuina School, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Fanrong Liang,
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Santamaría-García H, Ogonowsky N, Baez S, Palacio N, Reyes P, Schulte M, López A, Matallana D, Ibanez A. Neurocognitive patterns across genetic levels in behavioral variant frontotemporal dementia: a multiple single cases study. BMC Neurol 2022; 22:454. [PMID: 36474176 PMCID: PMC9724347 DOI: 10.1186/s12883-022-02954-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/06/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Behavioral variant frontotemporal dementia (bvFTD) has been related to different genetic factors. Identifying multimodal phenotypic heterogeneity triggered by various genetic influences is critical for improving diagnosis, prognosis, and treatments. However, the specific impact of different genetic levels (mutations vs. risk variants vs. sporadic presentations) on clinical and neurocognitive phenotypes is not entirely understood, specially in patites from underrepresented regions such as Colombia. METHODS Here, in a multiple single cases study, we provide systematic comparisons regarding cognitive, neuropsychiatric, brain atrophy, and gene expression-atrophy overlap in a novel cohort of FTD patients (n = 42) from Colombia with different genetic levels, including patients with known genetic influences (G-FTD) such as those with genetic mutations (GR1) in particular genes (MAPT, TARDBP, and TREM2); patients with risk variants (GR2) in genes associated with FTD (tau Haplotypes H1 and H2 and APOE variants including ε2, ε3, ε4); and sporadic FTD patients (S-FTD (GR3)). RESULTS We found that patients from GR1 and GR2 exhibited earlier disease onset, pervasive cognitive impairments (cognitive screening, executive functioning, ToM), and increased brain atrophy (prefrontal areas, cingulated cortices, basal ganglia, and inferior temporal gyrus) than S-FTD patients (GR3). No differences in disease duration were observed across groups. Additionally, significant neuropsychiatric symptoms were observed in the GR1. The GR1 also presented more clinical and neurocognitive compromise than GR2 patients; these groups, however, did not display differences in disease onset or duration. APOE and tau patients showed more neuropsychiatric symptoms and primary atrophy in parietal and temporal cortices than GR1 patients. The gene-atrophy overlap analysis revealed atrophy in regions with specific genetic overexpression in all G-FTD patients. A differential family presentation did not explain the results. CONCLUSIONS Our results support the existence of genetic levels affecting the clinical, neurocognitive, and, to a lesser extent, neuropsychiatric presentation of bvFTD in the present underrepresented sample. These results support tailored assessments characterization based on the parallels of genetic levels and neurocognitive profiles in bvFTD.
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Affiliation(s)
- Hernando Santamaría-García
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Memory and cognition Center, Intellectus, Hospital Universitario San Ignacio, Bogotá, Colombia.
- Department of Neurology, Global Brain Health Institute, University of California San Francisco, San Francisco, CA, USA.
| | - Natalia Ogonowsky
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Sandra Baez
- Faculty of Psychology, Universidad de los Andes, Bogotá, Colombia
| | - Nicole Palacio
- Integrated Program in Neuroscience, McGill University, Montreal, Canada
| | - Pablo Reyes
- PhD program in Neuroscience, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Michael Schulte
- CONICET & Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina
| | - Andrea López
- Pontificia Universidad Javeriana, Bogotá, Colombia
- Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Agustín Ibanez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibanez, Santiago de Chile, Chile.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
- Trinity Collegue of Dublin, Dublin, Irland.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, San Francisco, USA.
- Global Brain Health Insititute, Universidad California San Francisco-Trinity College of Dublin, Dublin, Irland.
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van Dam K, Gielissen M, Reijnders R, van der Poel A, Boon B. Experiences of Persons With Executive Dysfunction in Disability Care Using a Social Robot to Execute Daily Tasks and Increase the Feeling of Independence: Multiple-Case Study. JMIR Rehabil Assist Technol 2022; 9:e41313. [PMID: 36326800 PMCID: PMC9672999 DOI: 10.2196/41313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/06/2022] [Accepted: 10/04/2022] [Indexed: 11/06/2022] Open
Abstract
Background Executive functions are essential for independently navigating nearly all of our daily activities. Executive dysfunction often occurs as a result of a neurodevelopmental disorder. Persons with executive dysfunction experience challenges regarding independent execution of daily tasks. Social robots might support persons with executive dysfunction to execute daily tasks and promote their feeling of independence. Objective This study aimed to study the impact of interacting with social robot Tessa on goal attainment in the execution of daily tasks and perceived independence of persons with executive dysfunction. Methods In this multiple-case study, 18 participant–caregiver couples were followed up while using Tessa in the home environment for 3 months. Goal attainment on independently performing a self-determined goal was measured by the Goal Attainment Scale, and participant–caregiver couples were interviewed about their experience with their interaction with Tessa and how they perceived Tessa’s impact on their independence. Results In total, 11 (61%) participants reached their goal after 6 weeks and maintained their goal after 3 months. During the study period, 2 participant–caregiver couples withdrew because of mismatch with Tessa. Participants set goals in the following domains: execution of household tasks; intake of food, water, or medication; being ready in time for an appointment; going to bed or getting out of bed on time; personal care; and exercise. Participants perceived that Tessa increased the feeling of independence by generating more structure, stimulation, and self-direction. Participant–caregiver couples reported that the auditive information provided by Tessa was more effective in coping with executive dysfunction compared to their initial approaches using visual information, and the use of Tessa had a positive impact on their relationship. Conclusions This study paid ample time and attention to the implementation of a social robot in daily care practice. The encouraging findings support the use of social robot Tessa for the execution of daily tasks and increasing independence of persons with executive dysfunction in disability care.
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Affiliation(s)
| | | | | | | | - Brigitte Boon
- Academy Het Dorp, Arnhem, Netherlands
- Siza, Arnhem, Netherlands
- Tranzo, Tilburg University, Tilburg, Netherlands
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Souissi S, Chamari K, Bellaj T. Assessment of executive functions in school-aged children: A narrative review. Front Psychol 2022; 13:991699. [PMID: 36405195 PMCID: PMC9674032 DOI: 10.3389/fpsyg.2022.991699] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 10/12/2022] [Indexed: 10/10/2023] Open
Abstract
Introduction In the past three decades, there has been increasing interest in assessing children's Executive Functions (EF). However, studies on the conceptualization and operationalization of this construct are incongruent and guidance for clinicians and researchers aiming to assess EF is insufficient due to measurement variability. Aims The purpose of this article was to examine current theories and models of EF in children, identify their assessment instruments, issues, and challenges, and discuss their impact on children's cognitive, behavioral, social and/or emotional development. Methods This narrative review reflected on English and French scholarly articles on EF assessment in children. References were identified through searches of PubMed, Medline, ScienceDirect, Google Scholar, and APA PsychNet throughout the last two decades up to June 2022. Results There are commonalities despite divergence in the definition and operationalization of EF. Assessment of EF requires psychometric tests as well as rating scales that must be integrated and interpreted considering the child's biological makeup, environmental background, and cultural specificities. Conclusion Current EF theories, assessment tools, issues, and challenges were discussed in addition to the impact of their components' dysfunctions on children's development. Further studies should be conducted to develop new measurement methods and technologies to improve the ecological and ethological validity of youth assessment, treatment, and interventions.
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Affiliation(s)
- Sofiane Souissi
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Psychology Laboratory, Faculty of Humanities and Social Sciences of Tunis, Tunis University, Tunis, Tunisia
| | - Karim Chamari
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Department of Biological Sciences, ISSEP Ksar-Said, La Manouba University, Tunis, Tunisia
| | - Tarek Bellaj
- Psychology Program, Department of Social Sciences, College of Arts and Science, Qatar University, Doha, Qatar
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21
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Executive Functions and Foreign Language Learning. Pediatr Rep 2022; 14:450-456. [PMID: 36412660 PMCID: PMC9680333 DOI: 10.3390/pediatric14040053] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 09/15/2022] [Accepted: 10/18/2022] [Indexed: 12/14/2022] Open
Abstract
Executive functions (EFs) serve as an umbrella term to describe a set of higher-order cognitive abilities that include working memory, inhibitory control, cognitive flexibility, planning, reasoning, and problem-solving. Various studies suggest that foreign language learning likely promotes executive functions, but others suggest that executive functions could improve foreign language learning. The aim of this study is to investigate the relationship between executive functions and foreign language learning and how these processes could interact. The sample included 64 children from kindergarten, aged 4-5 years, with no documented neuropsychiatric disorders, and from the middle-high literacy group. They were divided into three groups based on the level of their knowledge of the foreign language. A significant effect of the group on the executive tasks is shown in the comparison of the groups. Children who belonged to a group that had advanced foreign language proficiency had better results in executive tasks. Our results suggest that the higher the level of foreign language proficiency, the higher the performance of the executive tasks. However, we do not know if there is a causal effect between these variables.
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22
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Hamidian S, Pourshahbaz A, Ananloo ES, Dolatshahi B, Ohadi M, Davoudi M. The story of memory and executive functions in obsessive-compulsive disorder: a case-control study. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2022; 44:e20210243. [PMID: 33890432 PMCID: PMC10039720 DOI: 10.47626/2237-6089-2021-0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 04/17/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Neuropsychological findings in obsessive-compulsive disorder (OCD) are mainly clustered around the role of memory and executive functions. However, outcomes vary across different OCD populations. In addition, the extent to which each of these factors can distinguish patients with OCD (PwOCD) from healthy individuals remains uncertain and attracts great attention. The present study aims to investigate the above issues. METHOD This was a cross-sectional study of 182 individuals (90 PwOCD and 92 matched healthy controls). After screening for inclusion and exclusion criteria, the participants were administered neuropsychological tests including, the Wechsler Memory Scale-III (WMS-III), the Wisconsin Card Sorting Test (WCST), and the Stroop Color-Word Test (SCWT). Data were analyzed to test the study hypotheses using comparison of means and regression analysis methods. RESULTS The results showed that PwOCD had poorer performance than the control group in Immediate Memory, General Memory, and Working Memory and also according to response inhibition indexes. The results also showed that General Memory and Reaction Time2 from the SCWT index could be predictive variables for discriminating between PwOCD and controls. CONCLUSION The findings of this study support the prior assumptions that PwOCD would have impaired memory dimensions and response inhibition, but did not support worse set-shifting performance. We also present an initial model for the predictive role of these neuropsychological variables in discriminating OCD from healthy individuals and increasing diagnostic accuracy.
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Affiliation(s)
- Sajedeh Hamidian
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Abbas Pourshahbaz
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Esmaeil Shahsavand Ananloo
- Department of Psychosomatic, Imam Khomeini Hospital Complex, School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
| | - Mina Ohadi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammadreza Davoudi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
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Perez SD, Phillips JS, Norise C, Kinney NG, Vaddi P, Halpin A, Rascovsky K, Irwin DJ, McMillan CT, Xie L, Wisse LE, Yushkevich PA, Kallogjeri D, Grossman M, Cousins KA. Neuropsychological and Neuroanatomical Features of Patients with Behavioral/Dysexecutive Variant Alzheimer’s disease (AD): A Comparison to Behavioral Variant Frontotemporal Dementia and Amnestic AD Groups. J Alzheimers Dis 2022; 89:641-658. [PMID: 35938245 PMCID: PMC10117623 DOI: 10.3233/jad-215728] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: An understudied variant of Alzheimer’s disease (AD), the behavioral/dysexecutive variant of AD (bvAD), is associated with progressive personality, behavior, and/or executive dysfunction and frontal atrophy. Objective: This study characterizes the neuropsychological and neuroanatomical features associated with bvAD by comparing it to behavioral variant frontotemporal dementia (bvFTD), amnestic AD (aAD), and subjects with normal cognition. Methods: Subjects included 16 bvAD, 67 bvFTD, and 18 aAD patients, and 26 healthy controls. Neuropsychological assessment and MRI data were compared between these groups. Results: Compared to bvFTD, bvAD showed more significant visuospatial impairments (Rey Figure copy and recall), more irritability (Neuropsychological Inventory), and equivalent verbal memory (Philadelphia Verbal Learning Test). Compared to aAD, bvAD indicated more executive dysfunction (F-letter fluency) and better visuospatial performance. Neuroimaging analysis found that bvAD showed cortical thinning relative to bvFTD posteriorly in left temporal-occipital regions; bvFTD had cortical thinning relative to bvAD in left inferior frontal cortex. bvAD had cortical thinning relative to aAD in prefrontal and anterior temporal regions. All patient groups had lower volumes than controls in both anterior and posterior hippocampus. However, bvAD patients had higher average volume than aAD patients in posterior hippocampus and higher volume than bvFTD patients in anterior hippocampus after adjustment for age and intracranial volume. Conclusion: Findings demonstrated that underlying pathology mediates disease presentation in bvAD and bvFTD.
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Affiliation(s)
- Sophia Dominguez Perez
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Jeffrey S. Phillips
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Catherine Norise
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Nikolas G. Kinney
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Prerana Vaddi
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Halpin
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Psychology, University of Maine, Orono, ME, USA
| | - Katya Rascovsky
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - David J. Irwin
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Disease Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Corey T. McMillan
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Long Xie
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laura E.M. Wisse
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Diagnostic Radiology, Lund University, Lund, Sweden
| | - Paul A. Yushkevich
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Penn Image Computing and Science Lab & Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Dorina Kallogjeri
- Department of Otolaryngology, Washington University, St. Louis, MO, USA
| | - Murray Grossman
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Katheryn A.Q. Cousins
- Penn Frontotemporal Degeneration Center (FTDC), University of Pennsylvania, Philadelphia, PA, USA
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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24
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Arrotta K, Reyes A, Kaestner E, McDonald CR, Hermann BP, Barr WB, Sarmey N, Sundar S, Kondylis E, Najm I, Bingaman W, Busch RM. Cognitive phenotypes in frontal lobe epilepsy. Epilepsia 2022; 63:1671-1681. [PMID: 35429174 PMCID: PMC9545860 DOI: 10.1111/epi.17260] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Neuropsychological profiles are heterogeneous both across and within epilepsy syndromes, but especially in frontal lobe epilepsy (FLE), which has complex semiology and epileptogenicity. This study aimed to characterize the cognitive heterogeneity within FLE by identifying cognitive phenotypes and determining their demographic and clinical characteristics. METHOD One hundred and six patients (age 16-66; 44% female) with FLE completed comprehensive neuropsychological testing, including measures within five cognitive domains: language, attention, executive function, processing speed, and verbal/visual learning. Patients were categorized into one of four phenotypes based on the number of impaired domains. Patterns of domain impairment and clinical and demographic characteristics were examined across phenotypes. RESULTS Twenty-five percent of patients met criteria for the Generalized Phenotype (impairment in at least four domains), 20% met criteria for the Tri-Domain Phenotype (impairment in three domains), 36% met criteria for the Domain-Specific Phenotype (impairment in one or two domains), and 19% met criteria for the Intact Phenotype (no impairment). Language was the most common domain-specific impairment, followed by attention, executive function, and processing speed. In contrast, learning was the least impacted cognitive domain. The Generalized Phenotype had fewer years of education compared to the Intact Phenotype, but otherwise, there was no differentiation between phenotypes in demographic and clinical variables. However, qualitative analysis suggested that the Generalized and Tri-Domain Phenotypes had a more widespread area of epileptogenicity, whereas the Intact Phenotype most frequently had seizures limited to the lateral frontal region. SIGNIFICANCE This study identified four cognitive phenotypes in FLE that were largely indistinguishable in clinical and demographic features, aside from education and extent of epileptogenic zone. These findings enhance our appreciation of the cognitive heterogeneity within FLE and provide additional support for the development and use of cognitive taxonomies in epilepsy.
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Affiliation(s)
- Kayela Arrotta
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Anny Reyes
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCaliforniaUSA
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Erik Kaestner
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Carrie R. McDonald
- San Diego Joint Doctoral Program in Clinical PsychologySan Diego State University/University of CaliforniaSan DiegoCaliforniaUSA
- Center for Multimodal Imaging and GeneticsUniversity of CaliforniaSan DiegoCaliforniaUSA
- Department of PsychiatryUniversity of CaliforniaSan DiegoCaliforniaUSA
| | - Bruce P. Hermann
- Department of NeurologySchool of Medicine and Public HealthUniversity of WisconsinMadisonWisconsinUSA
| | - William B. Barr
- Department of NeurologyNYU Grossman School of MedicineNew York CityNew YorkUSA
| | - Nehaw Sarmey
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Swetha Sundar
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Efstathios Kondylis
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Imad Najm
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - William Bingaman
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurosurgeryNeurological InstituteCleveland ClinicClevelandOhioUSA
| | - Robyn M. Busch
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOhioUSA
- Department of NeurologyNeurological InstituteCleveland ClinicClevelandOhioUSA
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Rubega M, Formaggio E, Ciringione L, Bertuccelli M, Paramento M, Sparacino G, Vianello A, Masiero S, Del Felice A. Sleep spindles changes in people with previous COVID-19 infection. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2022; 2022:4135-4138. [PMID: 36086492 DOI: 10.1109/embc48229.2022.9871679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Stage 2 sleep spindles are considered useful biomarkers for the integrity of the central nervous system and for cognitive and memory skills. We investigated sleep spindles patterns in subjects after 12 months of their hospitalization in the intensive care unit (ICU) of the Padova Teaching Hospital due to COVID-19 between March and November 2020. Before the nap, participants (13 hospitalized in ICU - ICU; 9 hospitalized who received noninvasive ventilation - nonlCU; 9 age and sex-matched healthy controls - CTRL, i.e., not infected by COVID-19) underwent a cognitive and psychological as-sessment. During the nap, high-density electroencephalography (EEG) recordings were acquired. Slow (i.e., [9]-[12] Hz) and fast (i.e.,]12-16] Hz) spindles were automatically detected. Spindle density and spindle source reconstruction in brain grey matter were extracted. The psychological assessment revealed a statistical difference comparing CTRL and nonlCU in Beck Depression Inventory score and in the Physical Quality of Life index (pvalue = 0.03). The cognitive assessment revealed a trend of worsening results in executive functions in COVID-19 survivors. Slow spindle density significantly decreased comparing CTRL to COVID-19 survivors (pvalue= 0.001). There were statistically significant differences in EEG source-waveforms fast spindle amplitude onset among the three groups, mainly between CTRL and nonlCU. Clinical Relevance- Our results suggest that nonlCU were more susceptible to the hospitalization experience than ICU participants with a slight effect on cognitive tests. This impacted the spindle generation revealing a decreased density of slow spindles and affecting the generators of fast spindles in COVID-19 survivors especially in nonlCU.
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Makmee P, Wongupparaj P. Virtual Reality-based Cognitive Intervention for Enhancing Executive Functions in Community-dwelling Older Adults. INTERVENCION PSICOSOCIAL 2022; 31:133-144. [PMID: 37361011 PMCID: PMC10268555 DOI: 10.5093/pi2022a10] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 04/22/2022] [Indexed: 06/28/2023]
Abstract
With the rapid growth of the older population globally, it is anticipated that age-related cognitive decline in the prodromal phase and more severe pathological decline will increase. Moreover, currently, no effective treatment options for the disease exist. Thus, early and timely prevention actions are promising and prior strategies to preserve cognitive functions by preventing symptomatology from increasing the age-related deterioration of the functions in healthy older adults. This study aims to develop the virtual reality-based cognitive intervention for enhancing executive functions (EFs) and examine the EFs after training with the virtual reality-based cognitive intervention in community-dwelling older adults. Following inclusion/exclusion criteria, 60 community-dwelling older adults aged 60-69 years were involved in the study and randomly divided into passive control and experimental groups. Eight 60 min virtual reality-based cognitive intervention sessions were held twice a week and lasted for 1 month. The EFs (i.e., inhibition, updating, and shifting) of the participants were assessed by using standardized computerized tasks, i.e., Go/NoGo, forward and backward digit span, and Berg's card sorting tasks. Additionally, a repeated-measure ANCOVA and effect sizes were applied to investigate the effects of the developed intervention. The virtual reality-based intervention significantly improved the EFs of older adults in the experimental group. Specifically, the magnitudes of enhancement were observed for inhibitory as indexed by the response time, F(1) = 6.95, p < .05, ηp2 = .11, updating as represented by the memory span, F(1) = 12.09, p < .01, ηp2 = .18, and the response time, F(1) = 4.46, p = .04, ηp2 = .07, and shifting abilities as indexed by the percentage of correct responses, F(1) = 5.30, p = .03, ηp2 = .09, respectively. The results indicated that the simultaneous combined cognitive-motor control as embedded in the virtual-based intervention is safe and effective in enhancing EFs in older adults without cognitive impairment. Nevertheless, further studies are required to investigate the benefits of these enhancements to motor functions and emotional aspects relating to daily living and the well-being of older populations in communities.
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Affiliation(s)
- Pattrawadee Makmee
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
| | - Peera Wongupparaj
- Burapha UniversityCollege of Research Methodology and Cognitive ScienceCognitive Science and Innovation Research UnitThailandCognitive Science and Innovation Research Unit, College of Research Methodology and Cognitive Science, Burapha University, Thailand
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Bellartz E, Pertz M, Jungilligens J, Kleffner I, Wellmer J, Schlegel U, Thoma P, Popkirov S. Point-of-Care Testing Using a Neuropsychology Pocketcard Set: A Preliminary Validation Study. Brain Sci 2022; 12:brainsci12060694. [PMID: 35741580 PMCID: PMC9221077 DOI: 10.3390/brainsci12060694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/21/2022] [Accepted: 05/25/2022] [Indexed: 02/05/2023] Open
Abstract
Neurocognitive screening instruments usually require printed sheets and additional accessories, and can be unsuitable for low-threshold use during ward rounds or emergency workup, especially in patients with motor impairments. Here, we test the utility of a newly developed neuropsychology pocketcard set for point-of-care testing. For aphasia and neglect assessment, modified versions of the Language Screening Test and the Bells Test were validated on 63 and 60 acute stroke unit patients, respectively, against expert clinical evaluation and the original pen-and-paper Bells Test. The pocketcard aphasia test achieved an excellent area under the curve (AUC) of 0.94 (95% CI: 0.88−1, p < 0.001). Using an optimal cut-off of ≥2 mistakes, sensitivity was 91% and specificity was 81%. The pocketcard Bells Task, measured against the clinical neglect diagnosis, achieved higher sensitivity (89%) and specificity (88%) than the original paper-based instrument (78% and 75%, respectively). Separately, executive function tests (modified versions of the Trail Making Test [TMT] A and B, custom Stroop color naming task, vigilance ‘A’ Montreal Cognitive Assessment item) were validated on 44 inpatients with epilepsy against the EpiTrack® test battery. Pocketcard TMT performance was significantly correlated with the original EpiTrack® versions (A: r = 0.64, p < 0.001; B: r = 0.75, p < 0.001). AUCs for the custom Stroop task, TMT A and TMT B for discriminating between normal and pathological EpiTrack® scores were acceptable, excellent and outstanding, respectively. Quick point-of-care testing using a pocketcard set is feasible and yields diagnostically valid information.
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Affiliation(s)
- Emily Bellartz
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
- Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, 44801 Bochum, Germany;
| | - Milena Pertz
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Johannes Jungilligens
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Ilka Kleffner
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Jörg Wellmer
- Ruhr-Epileptology, Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany;
| | - Uwe Schlegel
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
| | - Patrizia Thoma
- Neuropsychological Therapy Centre (NTC)/Clinical Neuropsychology, Faculty of Psychology, Ruhr University Bochum, 44801 Bochum, Germany;
| | - Stoyan Popkirov
- Department of Neurology, University Hospital Knappschaftskrankenhaus Bochum, Ruhr University Bochum, 44892 Bochum, Germany; (E.B.); (M.P.); (J.J.); (I.K.); (U.S.)
- Correspondence:
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28
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Ortiz GG, Huerta M, González-Usigli HA, Torres-Sánchez ED, Delgado-Lara DLC, Pacheco-Moisés FP, Mireles-Ramírez MA, Torres-Mendoza BMG, Moreno-Cih RI, Velázquez-Brizuela IE. Cognitive disorder and dementia in type 2 diabetes mellitus. World J Diabetes 2022; 13:319-337. [PMID: 35582669 PMCID: PMC9052006 DOI: 10.4239/wjd.v13.i4.319] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/14/2021] [Accepted: 03/17/2022] [Indexed: 02/06/2023] Open
Abstract
Insulin, a key pleiotropic hormone, regulates metabolism through several signaling pathways in target tissues including skeletal muscle, liver, and brain. In the brain, insulin modulates learning and memory, and impaired insulin signaling is associated with metabolic dysregulation and neurodegenerative diseases. At the receptor level, in aging and Alzheimer’s disease (AD) models, the amount of insulin receptors and their functions are decreased. Clinical and animal model studies suggest that memory improvements are due to changes in insulin levels. Furthermore, diabetes mellitus (DM) and insulin resistance are associated with age-related cognitive decline, increased levels of β-amyloid peptide, phosphorylation of tau protein; oxidative stress, pro-inflammatory cytokine production, and dyslipidemia. Recent evidence shows that deleting brain insulin receptors leads to mild obesity and insulin resistance without influencing brain size and apoptosis development. Conversely, deleting insulin-like growth factor 1 receptor (IGF-1R) affects brain size and development, and contributes to behavior changes. Insulin is synthesized locally in the brain and is released from the neurons. Here, we reviewed proposed pathophysiological hypotheses to explain increased risk of dementia in the presence of DM. Regardless of the exact sequence of events leading to neurodegeneration, there is strong evidence that mitochondrial dysfunction plays a key role in AD and DM. A triple transgenic mouse model of AD showed mitochondrial dysfunction, oxidative stress, and loss of synaptic integrity. These alterations are comparable to those induced in wild-type mice treated with sucrose, which is consistent with the proposal that mitochondrial alterations are associated with DM and contribute to AD development. Alterations in insulin/IGF-1 signaling in DM could lead to mitochondrial dysfunction and low antioxidant capacity of the cell. Thus, insulin/IGF-1 signaling is important for increased neural processing and systemic metabolism, and could be a specific target for therapeutic strategies to decrease alterations associated with age-related cognitive decline.
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Affiliation(s)
- Genaro G Ortiz
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Department of Neurology, Movement Disorders Clinic, Sub-Specialty Medical Unit, National Western Medical Center, Mexican Social Security Institute (IMSS), Guadalajara 44340, Jalisco, Mexico
| | - Miguel Huerta
- University Biomedical Research Center, University of Colima, Colima 28040, Mexico
| | - Héctor A González-Usigli
- Department of Neurology, Movement Disorders Clinic, Sub-Specialty Medical Unit, National Western Medical Center, Mexican Social Security Institute (IMSS), Guadalajara 44340, Jalisco, Mexico
| | - Erandis D Torres-Sánchez
- Department of Medical and Life Sciences, University Center of ‘La Ciénega’, University of Guadalajara, Ocotlán 47810, Jalisco, Mexico
| | - Daniela LC Delgado-Lara
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Fermín P Pacheco-Moisés
- Department of Chemistry, University Center of Exact Sciences and Engineering, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Mario A Mireles-Ramírez
- Department of Neurology, Movement Disorders Clinic, Sub-Specialty Medical Unit, National Western Medical Center, Mexican Social Security Institute (IMSS), Guadalajara 44340, Jalisco, Mexico
| | - Blanca MG Torres-Mendoza
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
- Division of Neurosciences, Western Biomedical Research Center, Mexican Social Security Institute (IMSS), Guadalajara 44340, Jalisco, Mexico
| | - Roxana I Moreno-Cih
- Gerontology Postgraduate Program, Public Health Department, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Irma E Velázquez-Brizuela
- Department of Philosophical and Methodological Disciplines, University Health Sciences Center, University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
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Ferrucci R, Mameli F, Ruggiero F, Reitano M, Miccoli M, Gemignani A, Conversano C, Dini M, Zago S, Piacentini S, Poletti B, Priori A, Orrù G. Alternate fluency in Parkinson’s disease: A machine learning analysis. PLoS One 2022; 17:e0265803. [PMID: 35320291 PMCID: PMC8942276 DOI: 10.1371/journal.pone.0265803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/08/2022] [Indexed: 11/18/2022] Open
Abstract
Objective
The aim of the present study was to investigate whether patients with Parkinson’s Disease (PD) had changes in their level of performance in extra-dimensional shifting by implementing a novel analysis method, utilizing the new alternate phonemic/semantic fluency test.
Method
We used machine learning (ML) in order to develop high accuracy classification between PD patients with high and low scores in the alternate fluency test.
Results
The models developed resulted to be accurate in such classification in a range between 80% and 90%. The predictor which demonstrated maximum efficiency in classifying the participants as low or high performers was the semantic fluency test. The optimal cut-off of a decision rule based on this test yielded an accuracy of 86.96%. Following the removal of the semantic fluency test from the system, the parameter which best contributed to the classification was the phonemic fluency test. The best cut-offs were identified and the decision rule yielded an overall accuracy of 80.43%. Lastly, in order to evaluate the classification accuracy based on the shifting index, the best cut-offs based on an optimal single rule yielded an overall accuracy of 83.69%.
Conclusion
We found that ML analysis of semantic and phonemic verbal fluency may be used to identify simple rules with high accuracy and good out of sample generalization, allowing the detection of executive deficits in patients with PD.
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Affiliation(s)
- Roberta Ferrucci
- Department of Health Sciences, Aldo Ravelli Research Center, University of Milan, Milan, Italy
- ASST-Santi Paolo e Carlo Hospital, Milan, Italy
- IRCCS Ca’ Granda Foundation, Policlinico of Milan, Milan, Italy
- * E-mail:
| | | | | | | | - Mario Miccoli
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Angelo Gemignani
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Ciro Conversano
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
| | - Michelangelo Dini
- Department of Health Sciences, Aldo Ravelli Research Center, University of Milan, Milan, Italy
| | - Stefano Zago
- IRCCS Ca’ Granda Foundation, Policlinico of Milan, Milan, Italy
| | | | | | - Alberto Priori
- Department of Health Sciences, Aldo Ravelli Research Center, University of Milan, Milan, Italy
- ASST-Santi Paolo e Carlo Hospital, Milan, Italy
| | - Graziella Orrù
- Department of Surgical, Medical, Molecular & Critical Area Pathology, University of Pisa, Pisa, Italy
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30
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Kim H, Fraser S. Neural correlates of dual-task walking in people with central neurological disorders: a systematic review. J Neurol 2022; 269:2378-2402. [PMID: 34989867 DOI: 10.1007/s00415-021-10944-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND People with central neurological disorders experience difficulties with dual-task walking due to disease-related impairments. The objective of this review was to provide a comprehensive examination of the neural correlates (structural/functional brain changes) of dual-task walking in people with Parkinson's disease (PD), multiple sclerosis (MS), stroke, and Alzheimer's disease (AD). METHODS A systematic review of the literature was conducted, following PRISMA guidelines, on Medline, Embase, and Scopus. Included studies examined the relationship between structural and functional brain imaging and dual-task walking performance in people with PD, MS, stroke, and AD. Articles that met the inclusion criteria had baseline characteristics, study design, and behavioral and brain outcomes extracted. Twenty-three studies were included in this review. RESULTS Most structural imaging studies (75%) found an association between decreased brain integrity and poor dual-task performance. Specific brain regions that showed this association include the striatum regions and hippocampus in PD and supplementary motor area in MS. Functional imaging studies reported an association between increased prefrontal activity and maintained (compensatory recruitment) or decreased dual-task walking performance in PD and stroke. A subset (n = 2) of the stroke papers found no significant correlations. Increased supplementary motor area activity was associated with decreased performance in MS and stroke. No studies on AD were identified. CONCLUSION In people with PD, MS, and stroke, several neural correlates of dual-task walking have been identified, however, the direction of the association between neural and performance outcomes varied across the studies. The type of cognitive task used and presentation modality (e.g., visual) may have contributed to these mixed findings.
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Affiliation(s)
- Hyejun Kim
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Ottawa, ON, K1N 6N5, Canada
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, 25 University Private, Ottawa, ON, K1N 7K4, Canada.
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31
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Miranda-Olivos R, Testa G, Lucas I, Sánchez I, Sánchez-González J, Granero R, Jiménez-Murcia S, Fernández-Aranda F. Clinical factors predicting impaired executive functions in eating disorders: The role of illness duration. J Psychiatr Res 2021; 144:87-95. [PMID: 34601380 DOI: 10.1016/j.jpsychires.2021.09.042] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 09/08/2021] [Accepted: 09/22/2021] [Indexed: 01/30/2023]
Abstract
Poor performance in executive functions is observed in individuals with eating disorders (EDs). These impairments have usually been associated with the presence of comorbid psychopathology or with higher severity of EDs. However, few studies have explored the interaction between illness duration and deficits in executive functions. The present study investigates the association between ED duration and performance in decision-making, inhibitory control, and cognitive flexibility in the anorexia nervosa restrictive subtype (AN-R), bulimic/purging subtype (AN-BP), and binge spectrum disorders (BSDs) (namely, bulimia nervosa and binge eating disorder) among 116 women with EDs compared with 123 women healthy controls (HCs). Using cumulative survival analysis, we estimated the risk of deficits related to illness duration. Predictors of executive dysfunctions were assessed by regression analysis, including as potential predictors illness duration, severity of general psychopathology, and ED symptomatology. Results showed poor decision-making and cognitive flexibility in participants with EDs compared with HCs. ED duration was associated with poor inhibitory control in the AN-BP group and poor cognitive flexibility in the BSD group. The illness duration increased the risk of presenting early deficits in executive function. In decision-making and inhibitory control, the AN-R group showed the earliest deficits, whereas in cognitive flexibility it was the BSD group. ED duration predicted impaired cognitive flexibility in the BSD group and impaired inhibitory control in the AN-BP group, whereas the severity of general psychopathological symptoms was a predictor of impaired cognitive flexibility in individuals with AN-R. These results highlight the relevance of illness duration in executive dysfunctions in EDs.
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Affiliation(s)
- Romina Miranda-Olivos
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Giulia Testa
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Ignacio Lucas
- Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Isabel Sánchez
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain
| | - Jessica Sánchez-González
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Departament de Psicobiologia i Metodologia de les Ciències de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Jiménez-Murcia
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiopatología Obesidad y Nutrición (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain; Department of Psychiatry, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Spain; Psychiatry and Mental Health Group, Neuroscience Program, Institut d'Investigació Biomèdica de Bellvitge - IDIBELL, L'Hospitalet de Llobregat, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Liu S, Wang X, Ma J, Wang K, Wang Z, Li J, Chen J, Zhan H, Wu W. Effect of Low-Frequency Repetitive Transcranial Magnetic Stimulation on Executive Function and Its Neural Mechanism: An Event-Related Potential Study. Front Neurosci 2021; 15:701560. [PMID: 34776839 PMCID: PMC8580383 DOI: 10.3389/fnins.2021.701560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 09/29/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: Executive function refers to the conscious control of thinking and behavior in psychological process. Executive dysfunction widely exists in a variety of neuropsychiatric diseases, and is closely related to the decline of daily living ability and function. This study intends to explore the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on executive function and its neural mechanism by using event-related potential (ERP), so as to provide basis for further study on the relationship between cerebral cortex and executive function. Methods: Task switching paradigm was used to study the cognitive flexibility in executive function. Thirty-one healthy subjects were randomly assigned to receive rTMS stimulations (1 Hz rTMS or sham rTMS) to the left dorsolateral prefrontal cortex (DLPFC) twice. The switching task and the electroencephalography EEG recordings were performed before (pre-rTMS/pre-sham rTMS) and immediately after the end of the rTMS application (post-rTMS/post-sham rTMS). Results: The analysis of RTs showed that the main effects of switching and time were statistically significant. Further analysis revealed that the RT of rTMS stimulation was longer than sham rTMS at post-stimulation. ERP analysis showed that there was a significant switching effect in frontal and central scalp location, and the P2 amplitude in switch trials was greater than that in non-switch trials. At post-stimulation, the N2 amplitude of rTMS is more negative than that of sham rTMS at non-switch trials, whereas no such difference was found at switch trials. The P3 amplitude and LPC amplitude are significantly reduced by rTMS at post-stimulation. Conclusion: Low-frequency rTMS of the left DLPFC can cause decline of cognitive flexibility in executive function, resulting in the change of N2 amplitude and the decrease of P3 and LPC components during task switching, which is of positive significance for the evaluation and treatment of executive function.
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Affiliation(s)
- Sishi Liu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, China
| | - Xianglong Wang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, China
| | - Junqin Ma
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Kangling Wang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Zhengtao Wang
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jie Li
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Jiali Chen
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China
| | - Hongrui Zhan
- Department of Rehabilitation, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Wen Wu
- Department of Rehabilitation, Zhujiang Hospital, Southern Medical University, Guangzhou, China.,Rehabilitation Medical School, Southern Medical University, Guangzhou, China
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Li P, Zhao SW, Wu XS, Zhang YJ, Song L, Wu L, Liu XF, Fu YF, Wu D, Wu WJ, Zhang YH, Yin H, Cui LB, Guo F. The Association Between Lentiform Nucleus Function and Cognitive Impairments in Schizophrenia. Front Hum Neurosci 2021; 15:777043. [PMID: 34744673 PMCID: PMC8566813 DOI: 10.3389/fnhum.2021.777043] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 09/29/2021] [Indexed: 01/10/2023] Open
Abstract
Introduction: Cognitive decline is the core schizophrenia symptom, which is now well accepted. Holding a role in various aspects of cognition, lentiform nucleus (putamen and globus pallidus) dysfunction contributes to the psychopathology of this disease. However, the effects of lentiform nucleus function on cognitive impairments in schizophrenia are yet to be investigated. Objectives: We aim to detect the fractional amplitude of low-frequency fluctuation (fALFF) alterations in patients with schizophrenia, and examine how their behavior correlates in relation to the cognitive impairments of the patients. Methods: All participants underwent magnetic resonance imaging (MRI) and cognitive assessment (digit span and digit symbol coding tests). Screening of brain regions with significant changes in fALFF values was based on analysis of the whole brain. The data were analyzed between Jun 2020 and Mar 2021. There were no interventions beyond the routine therapy determined by their clinicians on the basis of standard clinical practice. Results: There were 136 patients (75 men and 61 women, 24.1 ± 7.4 years old) and 146 healthy controls (82 men and 64 women, 24.2 ± 5.2 years old) involved in the experiments seriatim. Patients with schizophrenia exhibited decreased raw scores in cognitive tests (p < 0.001) and increased fALFF in the bilateral lentiform nuclei (left: 67 voxels; x = −24, y = −6, z = 3; peak t-value = 6.90; right: 16 voxels; x = 18, y = 0, z = 3; peak t-value = 6.36). The fALFF values in the bilateral lentiform nuclei were positively correlated with digit span-backward test scores (left: r = 0.193, p = 0.027; right: r = 0.190, p = 0.030), and the right lentiform nucleus was positively correlated with digit symbol coding scores (r = 0.209, p = 0.016). Conclusion: This study demonstrates that cognitive impairments in schizophrenia are associated with lentiform nucleus function as revealed by MRI, involving working memory and processing speed.
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Affiliation(s)
- Ping Li
- Medical Imaging Department 1, Xi'an Mental Health Center, Xi'an, China
| | - Shu-Wan Zhao
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xu-Sha Wu
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ya-Juan Zhang
- Department of Clinical Psychology, School of Medical Psychology, The Fourth Military Medical University, Xi'an, China
| | - Lei Song
- Department of Clinical Psychology, School of Medical Psychology, The Fourth Military Medical University, Xi'an, China
| | - Lin Wu
- Department of Clinical Psychology, School of Medical Psychology, The Fourth Military Medical University, Xi'an, China
| | - Xiao-Fan Liu
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Yu-Fei Fu
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Di Wu
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Wen-Jun Wu
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ya-Hong Zhang
- Department of Psychiatry, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Hong Yin
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Long-Biao Cui
- Department of Clinical Psychology, School of Medical Psychology, The Fourth Military Medical University, Xi'an, China.,Department of Radiology, The Second Medical Center, Chinese PLA General Hospital, Beijing, China
| | - Fan Guo
- Department of Radiology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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Kitai K, Odagiri M, Yamauchi R, Kodama T. Evaluation of Intervention Effectiveness of Sensory Compensatory Training with Tactile Discrimination Feedback on Sensorimotor Dysfunction of the Hand after Stroke. Brain Sci 2021; 11:brainsci11101314. [PMID: 34679379 PMCID: PMC8534145 DOI: 10.3390/brainsci11101314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/22/2021] [Accepted: 09/30/2021] [Indexed: 12/04/2022] Open
Abstract
We investigated the intervention effect of training using a feedback-type tactile discrimination system on sensorimotor dysfunction of the hand after a stroke. A human male subject with sensorimotor dysfunction in his left hand after a stroke was asked to perform peg manipulation practice, a building block stacking task, and a material identification task for 10 min each for six weeks. During the activities, a tactile discrimination feedback system was used. The system is a device that detects the vibration information generated when touching an object with a hand and that feeds back the captured information in real time as vibration information. After the intervention, in addition to the reorganization of the sensorimotor areas, the deep sensation, sense of agency, numbness, amount of use, and quality of the left-hand movement improved. Our results suggest that training with the use of a feedback system could be a new form of rehabilitation for sensorimotor dysfunction of the hand.
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Affiliation(s)
- Ken Kitai
- Department of Rehabilitation, Maizuru Red Cross Hospital, Kyoto 624-0906, Japan;
| | - Masashi Odagiri
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (M.O.); (R.Y.)
| | - Ryosuke Yamauchi
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (M.O.); (R.Y.)
| | - Takayuki Kodama
- Department of Physical Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto 607-8175, Japan; (M.O.); (R.Y.)
- Correspondence: ; Tel.: +81-075-574-4312
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Snyder A, Gruber-Baldini AL, Rainer von Coelln F, Savitt JM, Reich SG, Armstrong MJ, Shulman LM. Comparison of Mini-Mental State Examination and Montreal Cognitive Assessment Ratings Across Levels of Parkinson's Disease Severity. JOURNAL OF PARKINSONS DISEASE 2021; 11:1995-2003. [PMID: 34366371 DOI: 10.3233/jpd-212705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Cognitive impairment (CI) is common in Parkinson's disease (PD) and an important cause of disability. Screening facilitates early detection of CI and has implications for management. Preclinical disability is when patients have functional limitations but maintain independence through compensatory measures. OBJECTIVE The objective of this study was to investigate the relationship between scores on the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) with levels of PD severity and disability. METHODS PD patients (n = 2,234) in a large observational study were stratified by disease severity, based on Total Unified Parkinson's Disease Rating Scale (Total UPDRS) and Hoehn and Yahr (HY) stage. Using MMSE (n = 1,184) or MoCA (n = 1,050) and basic (ADL) and instrumental activities of daily living (IADL) scales for disability, linear regression analysis examined associations between cognitive status and disability. RESULTS Cognition and disability were highly correlated, with the strongest correlation between IADL and MoCA. Only 16.0% of mean MMSE scores were below threshold for CI (28) and only in advanced PD (Total UPDRS 60+, HY≥3). MoCA scores fell below CI threshold (26) in 66.2% of the sample and earlier in disease (Total UPDRS 30+, HY≥2), corresponding with impairments in ADLs. CONCLUSION In a large clinical dataset, a small fraction of MMSE scores fell below cutoff for CI, reinforcing that MMSE is an insensitive screening tool in PD. MoCA scores indicated CI earlier in disease and coincided with disability. This study shows that MoCA, but not MMSE is sensitive to the emergence of early cognitive impairment in PD and correlates with the concomitant onset of disability.
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Affiliation(s)
- Allison Snyder
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Ann L Gruber-Baldini
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - F Rainer von Coelln
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Joseph M Savitt
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Stephen G Reich
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Melissa J Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Lisa M Shulman
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
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Executive Functions and Attention in Childhood Epilepsies: A Neuropsychological Hallmark of Dysfunction? J Int Neuropsychol Soc 2021; 27:673-685. [PMID: 33183389 DOI: 10.1017/s1355617720001125] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time. METHODS Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6-16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models. RESULTS We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies. CONCLUSIONS This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.
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Bluett B, Pantelyat AY, Litvan I, Ali F, Apetauerova D, Bega D, Bloom L, Bower J, Boxer AL, Dale ML, Dhall R, Duquette A, Fernandez HH, Fleisher JE, Grossman M, Howell M, Kerwin DR, Leegwater-Kim J, Lepage C, Ljubenkov PA, Mancini M, McFarland NR, Moretti P, Myrick E, Patel P, Plummer LS, Rodriguez-Porcel F, Rojas J, Sidiropoulos C, Sklerov M, Sokol LL, Tuite PJ, VandeVrede L, Wilhelm J, Wills AMA, Xie T, Golbe LI. Best Practices in the Clinical Management of Progressive Supranuclear Palsy and Corticobasal Syndrome: A Consensus Statement of the CurePSP Centers of Care. Front Neurol 2021; 12:694872. [PMID: 34276544 PMCID: PMC8284317 DOI: 10.3389/fneur.2021.694872] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/10/2021] [Indexed: 11/16/2022] Open
Abstract
Progressive supranuclear palsy (PSP) and corticobasal syndrome (CBS; the most common phenotype of corticobasal degeneration) are tauopathies with a relentless course, usually starting in the mid-60s and leading to death after an average of 7 years. There is as yet no specific or disease-modifying treatment. Clinical deficits in PSP are numerous, involve the entire neuraxis, and present as several discrete phenotypes. They center on rigidity, bradykinesia, postural instability, gait freezing, supranuclear ocular motor impairment, dysarthria, dysphagia, incontinence, sleep disorders, frontal cognitive dysfunction, and a variety of behavioral changes. CBS presents with prominent and usually asymmetric dystonia, apraxia, myoclonus, pyramidal signs, and cortical sensory loss. The symptoms and deficits of PSP and CBS are amenable to a variety of treatment strategies but most physicians, including many neurologists, are reluctant to care for patients with these conditions because of unfamiliarity with their multiplicity of interacting symptoms and deficits. CurePSP, the organization devoted to support, research, and education for PSP and CBS, created its CurePSP Centers of Care network in North America in 2017 to improve patient access to clinical expertise and develop collaborations. The directors of the 25 centers have created this consensus document outlining best practices in the management of PSP and CBS. They formed a writing committee for each of 12 sub-topics. A 4-member Steering Committee collated and edited the contributions. The result was returned to the entire cohort of authors for further comments, which were considered for incorporation by the Steering Committee. The authors hope that this publication will serve as a convenient guide for all clinicians caring for patients with PSP and CBS and that it will improve care for patients with these devastating but manageable disorders.
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Affiliation(s)
- Brent Bluett
- Neurology, Pacific Central Coast Health Center, Dignity Health, San Luis Obispo, CA, United States
- Neurology, Stanford University, Stanford, CA, United States
| | - Alexander Y. Pantelyat
- Neurology, The Johns Hopkins Hospital, Johns Hopkins Medicine, Baltimore, MD, United States
| | - Irene Litvan
- Neurology, University of California, San Diego, San Diego, CA, United States
| | - Farwa Ali
- Neurology, Mayo Clinic, Rochester, MN, United States
| | - Diana Apetauerova
- Neurology, Lahey Hospital and Medical Center, Burlington, MA, United States
| | - Danny Bega
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Lisa Bloom
- Neurology, Surgery, University of Chicago, Chicago, IL, United States
| | - James Bower
- Neurology, Mayo Clinic, Rochester, MN, United States
| | - Adam L. Boxer
- Neurology, University of California, San Francisco, San Francisco, CA, United States
| | - Marian L. Dale
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Rohit Dhall
- Neurology, University of Arkansas for Medical Sciences, Little Rock, AK, United States
| | - Antoine Duquette
- Service de Neurologie, Département de Médecine, Unité de Troubles du Mouvement André-Barbeau, Centre Hospitalier de l'Université de Service de Neurologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | - Hubert H. Fernandez
- Center for Neurological Restoration, Neurological Institute, Cleveland Clinic, Cleveland, OH, United States
| | - Jori E. Fleisher
- Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, United States
| | - Murray Grossman
- Neurology, University of Pennsylvania, Philadelphia, PA, United States
| | - Michael Howell
- Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Diana R. Kerwin
- Geriatrics, Presbyterian Hospital of Dallas, Dallas, TX, United States
| | | | - Christiane Lepage
- Service de Neurologie, Département de Médecine, Unité de Troubles du Mouvement André-Barbeau, Centre Hospitalier de l'Université de Service de Neurologie, Centre Hospitalier de l'Université de Montréal (CHUM), Montreal, QC, Canada
| | | | - Martina Mancini
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Nikolaus R. McFarland
- Neurology, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Paolo Moretti
- Neurology, The University of Utah, Salt Lake City, UT, United States
| | - Erica Myrick
- Neurological Sciences, Rush Medical College, Rush University, Chicago, IL, United States
| | - Pritika Patel
- Neurology, Lahey Hospital and Medical Center, Burlington, MA, United States
| | - Laura S. Plummer
- Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | | | - Julio Rojas
- Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Miriam Sklerov
- Neurology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Leonard L. Sokol
- Ken and Ruth Davee Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Paul J. Tuite
- Neurology, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Lawren VandeVrede
- Neurology, School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jennifer Wilhelm
- Neurology, Oregon Health and Science University, Portland, OR, United States
| | - Anne-Marie A. Wills
- Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Tao Xie
- Neurology, Surgery, University of Chicago, Chicago, IL, United States
| | - Lawrence I. Golbe
- Neurology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, United States
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Staffaroni AM, Asken BM, Casaletto KB, Fonseca C, You M, Rosen HJ, Boxer AL, Elahi FM, Kornak J, Mungas D, Kramer JH. Development and validation of the Uniform Data Set (v3.0) executive function composite score (UDS3-EF). Alzheimers Dement 2021; 17:574-583. [PMID: 33215852 PMCID: PMC8044003 DOI: 10.1002/alz.12214] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/28/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Cognitive composite scores offer a means of precisely measuring executive functioning (EF). METHODS We developed the Uniform Data Set v3.0 EF composite score (UDS3-EF) in 3507 controls from the National Alzheimer's Coordinating Center dataset using item-response theory and applied nonlinear and linear demographic adjustments. The UDS3-EF was validated with other neuropsychological tests and brain magnetic resonance imaging from independent research cohorts using linear models. RESULTS Final model fit was good-to-excellent: comparative fit index = 0.99; root mean squared error of approximation = 0.057. UDS3-EF scores differed across validation cohorts (controls > mild cognitive impairment > Alzheimer's disease-dementia ≈ behavioral variant frontotemporal dementia; P < 0.001). The UDS3-EF correlated most strongly with other EF tests (βs = 0.50 to 0.85, Ps < 0.001) and more with frontal, parietal, and temporal lobe gray matter volumes (βs = 0.18 to 0.33, Ps ≤ 0.004) than occipital gray matter (β = 0.12, P = 0.04). The total sample needed to detect a 40% reduction in UDS3-EF change (n = 286) was ≈40% of the next best measure (F-words; n = 714). CONCLUSIONS The UDS3-EF is well suited to quantify EF in research and clinical trials and offers psychometric and practical advantages over its component tests.
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Affiliation(s)
- Adam M. Staffaroni
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Breton M. Asken
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Kaitlin B. Casaletto
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Corrina Fonseca
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Michelle You
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Howard J. Rosen
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Adam L. Boxer
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Fanny M. Elahi
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - John Kornak
- Department of Epidemiology and BiostatisticsMemory and Aging CenterUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
| | - Dan Mungas
- Department of NeurologyUniversity of CaliforniaDavisDavisCaliforniaUSA
| | - Joel H. Kramer
- Department of NeurologyMemory and Aging CenterWeill Institute for NeurosciencesUniversity of California at San Francisco (UCSF)San FranciscoCaliforniaUSA
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Chen Y, Wang J, Cui C, Su Y, Jing D, Wu L, Liang P, Liang Z. Evaluating the association between brain atrophy, hypometabolism, and cognitive decline in Alzheimer's disease: a PET/MRI study. Aging (Albany NY) 2021; 13:7228-7246. [PMID: 33640881 PMCID: PMC7993730 DOI: 10.18632/aging.202580] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/14/2021] [Indexed: 11/25/2022]
Abstract
Glucose metabolism reduction and brain volume losses are widely reported in Alzheimer’s disease (AD). Considering that neuroimaging changes in the hippocampus and default mode network (DMN) are promising important candidate biomarkers and have been included in the research criteria for the diagnosis of AD, it is hypothesized that atrophy and metabolic changes of the abovementioned regions could be evaluated concurrently to fully explore the neural mechanisms underlying cognitive impairment in AD. Twenty-three AD patients and Twenty-four age-, sex- and education level-matched normal controls underwent a clinical interview, a detailed neuropsychological assessment and a simultaneous 18F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET)/high-resolution T1-weighted magnetic resonance imaging (MRI) scan on a hybrid GE SIGNA PET/MR scanner. Brain volume and glucose metabolism were examined in patients and controls to reveal group differences. Multiple linear regression models were employed to explore the relationship between multiple imaging features and cognitive performance in AD. The AD group had significantly reduced volume in the hippocampus and DMN regions (P < 0.001) relative to that of normal controls determined by using ROI analysis. Compared to normal controls, significantly decreased metabolism in the DMN (P < 0.001) was also found in AD patients, which still survived after controlling for gray matter atrophy (P < 0.001). These findings from ROI analysis were further confirmed by whole-brain confirmatory analysis (P < 0.001, FWE-corrected). Finally, multiple linear regression results showed that impairment of multiple cognitive tasks was significantly correlated with the combination of DMN hypometabolism and atrophy in the hippocampus and DMN regions. This study demonstrated that combining functional and structural features can better explain the cognitive decline of AD patients than unimodal FDG or brain volume changes alone. These findings may have important implications for understanding the neural mechanisms of cognitive decline in AD.
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Affiliation(s)
- Yifan Chen
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Junkai Wang
- Department of Psychology, Tsinghua University, Beijing, China.,School of Psychology, Capital Normal University, Beijing, China.,Beijing Key Laboratory of Learning and Cognition, Beijing, China
| | - Chunlei Cui
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yusheng Su
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Donglai Jing
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - LiYong Wu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Peipeng Liang
- School of Psychology, Capital Normal University, Beijing, China.,Beijing Key Laboratory of Learning and Cognition, Beijing, China
| | - Zhigang Liang
- Department of Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China
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EpiTrack is a feasible tool for assessing attention and executive functions in patients with refractory epilepsy. Epilepsy Behav 2021; 115:107691. [PMID: 33360402 DOI: 10.1016/j.yebeh.2020.107691] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The purpose of this cross-sectional retrospective study was to utilize EpiTrack to assess cognitive performance within the domain of attention and executive functions in patients with refractory epilepsy in consideration for treatment interventions either with antiepileptic drug (AED) changes and/or neuromodulation therapies. We also aimed to identify the relevant clinical and treatment factors possibly affecting EpiTrack performance. METHODS The patient group consisted of 95 consecutive refractory epilepsy patients who were evaluated with EpiTrack. Based on their EpiTrack performance, the patients could be categorized as cognitively unimpaired, mildly, or severely impaired. The patients were also divided into three groups based on the planned treatment modification: AED group (n = 38) with only AED treatment, vagal nerve stimulation (VNS) group (n = 40) and deep-brain stimulation (DBS) group (n = 17). However, the effect of planned interventions was not the subject of this study. We retrospectively reviewed the medical records for detailed clinical characterization. RESULTS EpiTrack performance was severely impaired in 48 (50.5%), mildly impaired in 22 (23.2%) and unimpaired in 25 (26.3%) of the patients. The DBS group had significantly lower EpiTrack scores (mean (SD) and median, 25.5 (4.81) and 27.0, respectively) compared to the AED group (28.6 (6.2) and 30.0, respectively, p = 0.049). Sixty-three (66.3%) of the whole study population had more than 2 AEDs. When comparing EpiTrack scores between patient groups based on the number of AEDs administered, there was a trend toward better performance in EpiTrack with 2 AEDs as compared to 3-4 AEDs. CONCLUSIONS Deficits in attention and executive functions were frequent among patients with refractory epilepsy. Deficits were evident in all three treatment groups being most severe in the DBS group reflecting the patient selection. Furthermore, the effect of AED burden on executive functions was remarkable since two thirds of the patients had more than two AEDs and the deficits were more prominent among those with a higher AED burden. These results highlight the benefits of a feasible screening tool such as EpiTrack for assessing attention and executive functions when optimizing the treatment effects of neurostimulation therapies on cognition, and when evaluating the impacts of the AED burden.
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Rockhold MN, Krueger AM, de Water E, Lindgren CW, Sandness KE, Eckerle JK, Schumacher MJ, Fink BA, Boys CJ, Carlson SM, Fuglestad AJ, Mattson SN, Jones KL, Riley EP, Wozniak JR. Executive and Social Functioning Across Development in Children and Adolescents With Prenatal Alcohol Exposure. Alcohol Clin Exp Res 2021; 45:457-469. [PMID: 33349933 DOI: 10.1111/acer.14538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 12/14/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Prenatal alcohol exposure (PAE) is linked to a variety of neurodevelopmental challenges, including social functioning (SF) and executive functioning (EF) deficits. These deficits present differently across developmental stages from preschool age to adolescence. METHODS The post hoc analyses described here were conducted on data from 83 preschool-age children with PAE (early childhood group; ages 2.5 to 5.0) and 95 adolescents (49 with PAE, 46 controls; ages 8 to 16). Each child completed EF tasks as part of several prior studies. Parents completed social and communication inventories about their child's abilities. Thirty-three participants from the early childhood group returned for a 4-year follow-up and completed both SF and EF measures. RESULTS Both the early childhood and adolescent groups with PAE showed deficits in SF and EF. There was a relationship between SF and EF within the adolescent PAE group that was not present in the adolescent control group or the early childhood PAE group. However, at the 4-year follow-up (Mage = 8.45), participants originally in the early childhood PAE group also demonstrated this relationship. CONCLUSIONS These findings support previous research on EF/SF deficits in adolescents with PAE while also addressing a gap in the literature concerning early childhood research on this topic. Additionally, these findings suggest that the relationship between EF and SF deficits may strengthen throughout development. This line of research highlights potential sensitive periods for SF and EF training in children with PAE and suggests that fetal alcohol spectrum disorders programs consider targeting EF training as a component of social skill interventions.
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Coronado C, Wade NE, Aguinaldo LD, Mejia MH, Jacobus J. Neurocognitive Correlates of Adolescent Cannabis Use: An Overview of Neural Activation Patterns in Task-Based Functional MRI Studies. JOURNAL OF PEDIATRIC NEUROPSYCHOLOGY 2021; 6:1-13. [PMID: 33425663 DOI: 10.1007/s40817-020-00076-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Adolescence is dynamic and comprises physiological, psychological, and neurocognitive changes. Notably, many developmentally associated neurobiological changes (e.g., synaptic pruning, myelination) coincide with peak substances use prevalence rates, particularly for cannabis use. Cannabis remains the most commonly used illicit drug among adolescents with 23.9% reporting cannabis use in the last year (Johnston et al., 2019). Adolescents who engage in cannabis use often show poorer neurocognitive performance and alterations in structural and functional brain development as compared to their non-using peers (Jacobus & Tapert, 2014). Over the past several decades, the cognitive domains most consistently associated with cannabis use among adolescents are learning and memory and several facets of executive functioning (e.g., inhibitory control, decision-making). Functional magnetic resonance imaging (fMRI) is a non-invasive method for probing the neural substrates underlying possible cannabis-related changes in cognition. This brief review aims to synthesize recent findings on the relationship between adolescent (≤25 years old) cannabis use and neural response during task-based functional magnetic resonance imaging (fMRI). Findings thus far suggest aberrant, often hyperactive, response to task-based stimuli in youth cannabis users. When considering the future directions of fMRI research with cannabis-using youth, review of existing studies also highlights the need for more prospective research with diverse samples.
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Affiliation(s)
- Clarisa Coronado
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Natasha E Wade
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Laika D Aguinaldo
- Department of Psychiatry, University of California, San Diego, California, USA
| | | | - Joanna Jacobus
- Department of Psychiatry, University of California, San Diego, California, USA
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Manrique-Niño J, Díaz-Forero A, Velez-van Meerbeke A, Ramírez-Guerrero S, Florez-Esparza G, Talero-Gutiérrez C. Executive function in down syndrome children in Bogotá, Colombia. Heliyon 2020; 6:e05585. [PMID: 33294710 PMCID: PMC7701347 DOI: 10.1016/j.heliyon.2020.e05585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 06/01/2020] [Accepted: 11/19/2020] [Indexed: 12/17/2022] Open
Abstract
The study aim was to characterize executive function in 114 children with Down syndrome from a reference institution in Bogotá, Colombia. Children were screened with the Battelle Developmental Inventory to establish their developmental age. Eighty children with an equivalent mental age of 2–5.11 years were allocated to groups of 20 according to their mental age. Parents and teachers then completed the Behavior Rating Inventory of Executive Function-Preschool Version. We found a high variability and a low correlation between parent and teacher ratings. In general, children showed a specific profile characterized by weakness in the domains of working memory, shifting, planning, and organization, and strengths in the emotional control domain. These findings indicate a characteristic pattern of executive function in children with Down syndrome. This profile could form the basis for the planning of clinical assessment programs.
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Affiliation(s)
- Julián Manrique-Niño
- Neuroscience Research Group Neuros, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
| | - Andrés Díaz-Forero
- Neuroscience Research Seedbed SemineURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
| | - Alberto Velez-van Meerbeke
- Neuroscience Research Group Neuros, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
| | - Sofía Ramírez-Guerrero
- Neuroscience Research Seedbed SemineURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
| | - Gabriela Florez-Esparza
- Neuroscience Research Seedbed SemineURos, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
| | - Claudia Talero-Gutiérrez
- Neuroscience Research Group Neuros, Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá D.C., Colombia
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Alwan F, Mahdi D, Tayabali S, Cipolotti L, Lakey G, Hyare H, Scully M. Cerebral MRI findings predict the risk of cognitive impairment in thrombotic thrombocytopenic purpura. Br J Haematol 2020; 191:868-874. [DOI: 10.1111/bjh.17126] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Ferras Alwan
- Department of Haematology University College London Hospital London UK
| | - Dina Mahdi
- Department of Haematology University College London Hospital London UK
| | - Sarrah Tayabali
- Department of Haematology University College London Hospital London UK
| | - Lisa Cipolotti
- Department of Neuropsychology National Hospital for Neurology and Neurosurgery UCLH NHS Trust London UK
| | - Grace Lakey
- Department of Neuropsychology National Hospital for Neurology and Neurosurgery UCLH NHS Trust London UK
| | - Harpreet Hyare
- Department of Radiology University College London Hospital London UK
| | - Marie Scully
- Department of Haematology University College London Hospital London UK
- Cardiometabolic Programme‐NIHR UCLH/UCL BRC London UK
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45
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VandeVrede L, Ljubenkov PA, Rojas JC, Welch AE, Boxer AL. Four-Repeat Tauopathies: Current Management and Future Treatments. Neurotherapeutics 2020; 17:1563-1581. [PMID: 32676851 PMCID: PMC7851277 DOI: 10.1007/s13311-020-00888-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Four-repeat tauopathies are a neurodegenerative disease characterized by brain parenchymal accumulation of a specific isoform of the protein tau, which gives rise to a wide breadth of clinical syndromes encompassing diverse symptomatology, with the most common syndromes being progressive supranuclear palsy-Richardson's and corticobasal syndrome. Despite the lack of effective disease-modifying therapies, targeted treatment of symptoms can improve quality of life for patients with 4-repeat tauopathies. However, managing these symptoms can be a daunting task, even for those familiar with the diseases, as they span motor, sensory, cognitive, affective, autonomic, and behavioral domains. This review describes current approaches to symptomatic management of common clinical symptoms in 4-repeat tauopathies with a focus on practical patient management, including pharmacologic and nonpharmacologic strategies, and concludes with a discussion of the history and future of disease-modifying therapeutics and clinical trials in this population.
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Affiliation(s)
- Lawren VandeVrede
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA.
| | - Peter A Ljubenkov
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Julio C Rojas
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Ariane E Welch
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
| | - Adam L Boxer
- Memory and Aging Center, Department of Neurology, University of California San Francisco, San Francisco, California, USA
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Wang T, Bai S, Wang W, Chen Z, Chen J, Liang Z, Qi X, Shen H, Xie P. Diterpene Ginkgolides Exert an Antidepressant Effect Through the NT3-TrkA and Ras-MAPK Pathways. DRUG DESIGN DEVELOPMENT AND THERAPY 2020; 14:1279-1294. [PMID: 32308365 PMCID: PMC7132272 DOI: 10.2147/dddt.s229145] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 03/16/2020] [Indexed: 12/13/2022]
Abstract
Background Depression is a highly prevalent mental illness that severely impacts the quality of life of affected individuals. Our recent studies demonstrated that diterpene ginkgolides (DG) have antidepressant effects in mice. However, the underlying molecular mechanisms remained much unclear. Methods In this study, we assessed the antidepressant effects of chronic DG therapy in rats by evaluating depression-related behaviors, we also examined potential side effects using biochemical indicators. Furthermore, we performed an in-depth molecular network analysis of gene–protein–metabolite interactions on the basis of metabolomics. Results Chronic DG treatment significantly ameliorated the depressive-like behavioral phenotype. Furthermore, the neurotrophin signaling-related NT3-TrkA and Ras-MAPK pathways may play an important role in the antidepressant effect of DG in the hippocampus. Conclusion These findings provide novel insight into the mechanisms underlying the antidepressant action of DG, and should help advance the development of new therapeutic strategies for depression.
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Affiliation(s)
- Ting Wang
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China
| | - Shunjie Bai
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China
| | - Wei Wang
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Zhi Chen
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China
| | - Jianjun Chen
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China
| | - Zihong Liang
- Department of Neurology, The Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, People's Republic of China
| | - Xunzhong Qi
- NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Hailan Shen
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Peng Xie
- Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,NHC Key Laboratory of Diagnosis and Treatment on Brain Functional Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Chongqing Key Laboratory of Neurobiology, Chongqing, People's Republic of China.,Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.,Department of Neurology, The Inner Mongolia Autonomous Region People's Hospital, Hohhot, Inner Mongolia, People's Republic of China.,Chongqing Key Laboratory of Cerebrovascular Disease Research, Chongqing, People's Republic of China
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47
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Alterations in intra- and internetwork functional connectivity associated with levetiracetam treatment in temporal lobe epilepsy. Neurol Sci 2020; 41:2165-2174. [PMID: 32152874 DOI: 10.1007/s10072-020-04322-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 02/29/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Levetiracetam (LEV) is an antiepileptic drug with a novel pharmacological mechanism. Advances in functional magnetic resonance imaging (fMRI) enable researchers to explore the cognitive effects of antiepileptic drugs on the living brain. This study aimed to explore how the functional connectivity patterns of the cognitive networks changed in association with LEV treatment. METHODS Patients with temporal lobe epilepsy (TLE), including both users and nonusers of LEV, were included in this study along with healthy controls. Core cognitive networks were extracted using an independent component analysis approach. Functional connectivity patterns within and between networks were investigated. The relationships between functional connectivity patterns and clinical characteristics were also examined. RESULTS The patterns of intranetwork connectivity in the default mode network (DMN), left executive control network (lECN), and dorsal attention network (DAN) differed among the three groups. The internetwork interactions did not show intergroup differences once corrected for multiple comparisons. No correlation between functional connectivity and clinical characteristics was found in patients with TLE. CONCLUSIONS Changes in intranetwork connectivity are a key effect of LEV administration. SIGNIFICANCE Alterations in intranetwork connectivity patterns may underlie the cognitive effects of LEV administration; this finding improves our understanding of the neural mechanisms of LEV therapy.
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48
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Vriend C, Wagenmakers MJ, van den Heuvel OA, van der Werf YD. Resting-state network topology and planning ability in healthy adults. Brain Struct Funct 2020; 225:365-374. [PMID: 31865409 PMCID: PMC6957556 DOI: 10.1007/s00429-019-02004-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 12/06/2019] [Indexed: 12/29/2022]
Abstract
Functional magnetic resonance imaging (fMRI) studies have been used extensively to investigate the brain areas that are recruited during the Tower of London (ToL) task. Nevertheless, little research has been devoted to study the neural correlates of the ToL task using a network approach. Here we investigated the association between functional connectivity and network topology during resting-state fMRI and ToL task performance, that was performed outside the scanner. Sixty-two (62) healthy subjects (21-74 years) underwent eyes-closed rsfMRI and performed the task on a laptop. We studied global (whole-brain) and within subnetwork resting-state topology as well as functional connectivity between subnetworks, with a focus on the default-mode, fronto-parietal and dorsal and ventral attention networks. Efficiency and clustering coefficient were calculated to measure network integration and segregation, respectively, at both the global and subnetwork level. Our main finding was that higher global efficiency was associated with slower performance (β = 0.22, Pbca = 0.04) and this association seemed mainly driven by inter-individual differences in default-mode network connectivity. The reported results were independent of age, sex, education-level and motion. Although this finding is contrary to earlier findings on general cognition, we tentatively hypothesize that the reported association may indicate that individuals with a more integrated brain during the resting-state are less able to further increase network efficiency when transitioning from a rest to task state, leading to slower responses. This study also adds to a growing body of literature supporting a central role for the default-mode network in individual differences in cognitive performance.
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Affiliation(s)
- Chris Vriend
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands.
- Department of Anatomy and Neuroscience, Amsterdam UMC, Location VUmc, p/a sec. ANW O|2, BT, PO Box 7007, 1007 MB, Amsterdam, The Netherlands.
| | - Margot J Wagenmakers
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Odile A van den Heuvel
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
| | - Ysbrand D van der Werf
- Department of Anatomy and Neurosciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, De Boelelaan 1117, Amsterdam, The Netherlands
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49
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Han YL, Dai ZP, Ridwan MC, Lin PH, Zhou HL, Wang HF, Yao ZJ, Lu Q. Connectivity of the Frontal Cortical Oscillatory Dynamics Underlying Inhibitory Control During a Go/No-Go Task as a Predictive Biomarker in Major Depression. Front Psychiatry 2020; 11:707. [PMID: 32848905 PMCID: PMC7416643 DOI: 10.3389/fpsyt.2020.00707] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 07/06/2020] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is characterized by core functional deficits in cognitive inhibition, which is crucial for emotion regulation. To assess the response to ruminative and negative mood states, it was hypothesized that MDD patients have prolonged disparities in the oscillatory dynamics of the frontal cortical regions across the life course of the disease. METHOD A "go/no-go" response inhibition paradigm was tested in 31 MDD patients and 19 age-matched healthy controls after magnetoencephalography (MEG) scanning. The use of minimum norm estimates (MNE) examined the changes of inhibitory control network which included the right inferior frontal gyrus (rIFG), pre-supplementary motor area (preSMA), and left primary motor cortex (lM1). The power spectrum (PS) within each node and the functional connectivity (FC) between nodes were compared between two groups. Furthermore, Pearson correlation was calculated to estimate the relationship between altered FC and clinical features. RESULT PS was significantly reduced in left motor and preSMA of MDD patients in both beta (13-30 Hz) and low gamma (30-50 Hz) bands. Compared to the HC group, the MDD group demonstrated higher connectivity between lM1 and preSMA in the beta band (t = 3.214, p = 0.002, FDR corrected) and showed reduced connectivity between preSMA and rIFG in the low gamma band (t = -2.612, p = 0.012, FDR corrected). The FC between lM1 and preSMA in the beta band was positively correlated with illness duration (r = 0.475, p = 0.005, FDR corrected), while the FC between preSMA and rIFG in the low gamma band was negatively correlated with illness duration (r = -0.509, p = 0.002, FDR corrected) and retardation factor scores (r = -0.288, p = 0.022, uncorrected). CONCLUSION In this study, a clinical neurophysiological signature of cognitive inhibition leading to sustained negative affect as well as functional non-recovery in MDD patients is highlighted. Duration of illness (DI) plays a key role in negative emotional processing, heighten rumination, impulsivity, and disinhibition.
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Affiliation(s)
- Ying-Lin Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Zhong-Peng Dai
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing, China
| | - Mohammad Chattun Ridwan
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Pin-Hua Lin
- Medical School of Nanjing University, Nanjing Brain Hospital, Nanjing, China
| | - Hong-Liang Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Hao-Fei Wang
- Department of Psychology, Jiangsu Province Hospital Affiliated to Nanjing Medical University , Nanjing, China
| | - Zhi-Jian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.,School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Medical School of Nanjing University, Nanjing Brain Hospital, Nanjing, China
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing, China.,Key Laboratory of Child Development and Learning Science, Ministry of Education, Southeast University, Nanjing, China
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50
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Tsoy E, Possin KL, Thompson N, Patel K, Garrigues SK, Maravilla I, Erlhoff SJ, Ritchie CS. Self-Administered Cognitive Testing by Older Adults At-Risk for Cognitive Decline. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2020; 7:283-287. [PMID: 32920631 DOI: 10.14283/jpad.2020.25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Self-administered computerized cognitive testing could effectively monitor older individuals at-risk for cognitive decline at home. In this study, we tested the feasibility and reliability of 3 tablet-based executive functioning measures and an executive composite score in a sample of 30 older adults (age 80±6) with high multimorbidity. The tests were examiner-administered at baseline and then self-administered by the participants at home across 2 subsequent days. Eight of the participants reported no prior experience with touchscreen technology. Twenty-seven participants completed both self-administered assessments, and 28 completed at least one. Cronbach's alpha (individual tests: .87-.89, composite: .93) and correlations between examiner-administered and self-administered performances (individual tests: .72-.91, composite: .93) were high. The participants who had never used a smartphone or a tablet computer showed comparable consistency. Remote self-administered tablet-based testing in older adults at-risk for cognitive decline is feasible and reliable, even among participants without prior technology experience.
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Affiliation(s)
- E Tsoy
- Elena Tsoy, PhD, Memory and Aging Center, Department of Neurology, University of California San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, California, USA, 94158, Tel: 415-514-7477, E-mail:
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