[Executive functions: fMRI of healthy volunteers during Stroop test and the serial count test]

[Identifying the neurostimulation target for treatment of cognitive impairment in aging and early cerebral small vessel disease]

OBJECTIVE

To develop individualized approaches to the use of neuromodulation as a non-pharmacological treatment of cognitive impairment (CI) based on the assessment of compensatory brain reserves in functional MRI (fMRI).

MATERIAL AND METHODS

Twenty-one adults over 45 years of age, representing a continuum from healthy norm to mild cognitive impairment due to aging and early cerebral small vessel disease, were studied. All participants underwent fMRI while performing two executive tasks - a modified Stroop task and selective counting. To assess the ability to compensate for CI in real life, functional activation and connectivity were analyzed using the BRIEF-MoCA score as a covariate, which is the difference in ratings between the Behavior Rating Inventory of Executive Function (BRIEF) and the Montreal Cognitive Assessment Scale (MoCA).

RESULTS

Both fMRI tasks were associated with activation of areas of the frontoparietal control network, as well as supplementary motor area (SMA) and the pre-SMA, the lateral premotor cortex, and the cerebellum. An increase in pre- SMA connectivity was observed during the tasks. The BRIEF-MoCA score correlated firstly with connectivity of the left dorsolateral prefrontal cortex (DLPFC) and secondly with involvement of the occipital cortex during the counting task.

CONCLUSIONS

The developed technique allows identification of the functionally relevant target within the left DLPFC in patients with CI in aging and early cerebral microangiopathy.

[Imaging of brain activity using fMRI in a patient with subjective cognitive decline]

In clinical practice, subjective cognitive decline (SCD) is often difficult to diagnose because it is not detected by standard neuropsychological and cognitive tests.The described clinical case is presented to demonstrate the difficulties of diagnosis and treatment choice in a patient with SCD. fMRI might be considered as an instrumental method to analyze the functional relationship between the activity of brain structures and cerebral circulation in patients with SCD. Patient clinical and neuropsychological data with a detailed description of fMRI with a cognitive paradigm are presented. The article is focused on the early diagnosis of SCD and the prognostic assessment of the transition of SCD to dementia.

Effect of tDCS Over the Right Inferior Parietal Lobule on Mind-Wandering Propensity

Mind-wandering is associated with switching our attention to internally directed thoughts and is by definition an intrinsic, self-generated cognitive function. Interestingly, previous research showed that it may be possible to modulate its propensity externally, with transcranial direct current stimulation (tDCS) targeting different regions in the default mode and executive control networks (ECNs). However, these studies used highly heterogeneous montages (targeting the dorsolateral prefrontal cortex (DLPFC), the right inferior parietal lobule (IPL), or both concurrently), often showed contradicting results, and in many cases failed to replicate. Our study aimed to establish whether tDCS of the default mode network (DMN), via targeting the right IPL alone, could modulate mind-wandering propensity using a within-subjects double-blind, counterbalanced design. Participants completed sustained attention to response task (SART) interspersed with thought-probes to capture their subjective reports of mind-wandering before and after receiving anodal, cathodal, or sham tDCS over the right IPL (with the reference over the left cheek). We found evidence for the lack of an effect of stimulation on subjective reports of mind-wandering (JZS-BF₀₁ = 5.19), as well as on performance on the SART task (errors (JZS-BF₀₁ = 6.79) and reaction time (JZS-BF₀₁ = 5.94). Overall, we failed to replicate previous reports of successful modulations of mind-wandering propensity with tDCS over the IPL, instead of providing evidence in support of the lack of an effect. This and other recent unsuccessful replications call into question whether it is indeed possible to externally modulate spontaneous or self-generated cognitive processes.