BACKGROUND A growing number of recent studies have explored underlying activity in the brain by measuring electroencephalography(EEG)in people with depression.However,the consistency of findings on EEG microstates in ...BACKGROUND A growing number of recent studies have explored underlying activity in the brain by measuring electroencephalography(EEG)in people with depression.However,the consistency of findings on EEG microstates in patients with depression is poor,and few studies have reported the relationship between EEG microstates,cognitive scales,and depression severity scales.AIM To investigate the EEG microstate characteristics of patients with depression and their association with cognitive functions.METHODS A total of 24 patients diagnosed with depression and 32 healthy controls were included in this study using the Structured Clinical Interview for Disease for The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition.We collected information relating to demographic and clinical characteristics,as well as data from the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS;Chinese version)and EEG.RESULTS Compared with the controls,the duration,occurrence,and contribution of microstate C were significantly higher[depression(DEP):Duration 84.58±24.35,occurrence 3.72±0.56,contribution 30.39±8.59;CON:Duration 72.77±10.23,occurrence 3.41±0.36,contribution 24.46±4.66;Duration F=6.02,P=0.049;Occurrence F=6.19,P=0.049;Contribution F=10.82,P=0.011]while the duration,occurrence,and contribution of microstate D were significantly lower(DEP:Duration 70.00±15.92,occurrence 3.18±0.71,contribution 22.48±8.12;CON:Duration 85.46±10.23,occurrence 3.54±0.41,contribution 28.25±5.85;Duration F=19.18,P<0.001;Occurrence F=5.79,P=0.050;Contribution F=9.41,P=0.013)in patients with depression.A positive correlation was observed between the visuospatial/constructional scores of the RBANS scale and the transition probability of microstate class C to B(r=0.405,P=0.049).CONCLUSION EEG microstate,especially C and D,is a possible biomarker in depression.Patients with depression had a more frequent transition from microstate C to B,which may relate to more negative rumination and visual processing.展开更多
Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function....Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function.Unraveling the factors that lead to this cognitive resilience to AD offers promising prospects for identifying new therapeutic targets.Our hypothesis focuses on the contribution of resilience to changes in excitatory synapses at the structural and molecular levels,which may underlie healthy cognitive performance in aged AD animals.Utilizing the Morris Water Maze test,we selected resilient(asymptomatic)and cognitively impaired aged Tg2576 mice.While the enzyme-linked immunosorbent assay showed similar levels of Aβ42 in both experimental groups,western blot analysis revealed differences in tau pathology in the pre-synaptic supernatant fraction.To further investigate the density of synapses in the hippocampus of 16-18 month-old Tg2576 mice,we employed stereological and electron microscopic methods.Our findings indicated a decrease in the density of excitatory synapses in the stratum radiatum of the hippocampal CA1 in cognitively impaired Tg2576 mice compared with age-matched resilient Tg2576 and non-transgenic controls.Intriguingly,through quantitative immunoelectron microscopy in the hippocampus of impaired and resilient Tg2576 transgenic AD mice,we uncovered differences in the subcellular localization of glutamate receptors.Specifically,the density of GluA1,GluA2/3,and mGlu5 in spines and dendritic shafts of CA1 pyramidal cells in impaired Tg2576 mice was significantly reduced compared with age-matched resilient Tg2576 and non-transgenic controls.Notably,the density of GluA2/3 in resilient Tg2576 mice was significantly increased in spines but not in dendritic shafts compared with impaired Tg2576 and non-transgenic mice.These subcellular findings strongly support the hypothesis that dendritic spine plasticity and synaptic machinery in the hippocampus play crucial roles in the mechanisms of cognitive resilience in Tg2576 mice.展开更多
The dichotomized brain system is a concept that was generalized from the‘dual syndrome hypothesis’to explain the heterogeneity of cognitive impairment,in which anterior and posterior brain systems are independent bu...The dichotomized brain system is a concept that was generalized from the‘dual syndrome hypothesis’to explain the heterogeneity of cognitive impairment,in which anterior and posterior brain systems are independent but partially overlap.The dopaminergic system acts on the anterior brain and is responsible for executive function,working memory,and planning.In contrast,the cholinergic system acts on the posterior brain and is responsible for semantic fluency and visuospatial function.Evidence from dopaminergic/cholinergic imaging or functional neuroimaging has shed significant insight relating to the involvement of the cerebellum in the cognitive process of patients with Parkinson’s disease.Previous research has reported evidence that the cerebellum receives both dopaminergic and cholinergic projections.However,whether these two neurotransmitter systems are associated with cognitive function has yet to be fully elucidated.Furthermore,the precise role of the cerebellum in patients with Parkinson’s disease and cognitive impairment remains unclear.Therefore,in this review,we summarize the cerebellar dopaminergic and cholinergic projections and their relationships with cognition,as reported by previous studies,and investigated the role of the cerebellum in patients with Parkinson’s disease and cognitive impairment,as determined by functional neuroimaging.Our findings will help us to understand the role of the cerebellum in the mechanisms underlying cognitive impairment in Parkinson’s disease.展开更多
Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarmi...Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the world.Brain and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and memory.DM affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal damage.Cognitive decline can further worsen diabetes care as DM is a disease largely self-managed by patients.Therefore,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this context.This evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.展开更多
AIM:To determine the association between distance and near visual acuity(VA)and cognitive function among older adults in Selangor,Malaysia.METHODS:A total of 230 older adults(age≥60y)participated in this study.Habitu...AIM:To determine the association between distance and near visual acuity(VA)and cognitive function among older adults in Selangor,Malaysia.METHODS:A total of 230 older adults(age≥60y)participated in this study.Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart,respectively.Global cognitive function was assessed using the Mini-Mental State Examination(M-MSE)and the Malay language version of the Montreal Cognitive Assessment(M-MoCA).Digit Symbol(DS)subtest was used to measure information processing.RESULTS:No significant association was observed between vision and M-MSE and M-MoCA scores.However,poor distance and near VA were found to be significantly associated with low DS scores[distance VA:β=-0.01,R2=0.1,P=0.02;odds ratio(OR)=2.84,95%confidence interval(CI),1.10-7.33,P=0.03;near VA:β=-0.05,R2=0.08,P=0.00;OR=3.32,95%CI,1.28-8.59,P=0.01].CONCLUSION:Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.展开更多
Objective:To explore whether maternal stress exposure during pregnancy impairs cognitive function and white matter ultrastructure in offspring mice.Methods:The parent rats were divided into two groups:pressure exposur...Objective:To explore whether maternal stress exposure during pregnancy impairs cognitive function and white matter ultrastructure in offspring mice.Methods:The parent rats were divided into two groups:pressure exposure group(group PE)and control group(group C),and the positive date of vaginal smear of female SD rats was day 0 of gestation.Female mice in group PE were exposed to binding pressure(3 times/day)on day 14-20 of gestation for 45 min-1 h/time.Behavioral tests(Morris water maze and Y maze)were performed on 1-month-old offspring mice followed by cardiac perfusion of fixed brain specimens and placement in mixed fixative solution.The total volume of white matter,total length and volume of myelinated nerve fibers and total length and volume of myelin sheath were calculated using modern stereoscopic methods,and the inner and outer diameter and inner and outer circumference of the myelin sheath were analyzed.Results:1)Behavioral tests:compared with the group C,the average latency of the 3th and 4th day in the group PE were significantly prolonged,the percentage of the resting time in the quadrant of the platform and the frequency of acrossing the effective area of platform in the fifth day of space exploration experiment were significantly reduced of Morris water maze test,and visiting distance,duration and numbers in novel arm significantly increased of Y-maze test(P<0.05).2)Compared with group C,the total volume of white matter,total length of myelinated nerve fibers,total volume of myelinated nerve fibers and myelin sheath in the group PE were significantly reduced(P<0.05),the inner diameter and outer diameter of myelin sheath decreased significantly(P<0.05),and the inner perimeter,outer perimeter and inner and outer perimeter differences increased significantly(P<0.05).3)There was a correlation between behavioral test results and white matter ultrastructure measurement results.Conclusions:Maternal stress exposure during pregnancy could impair the cognitive function and white matter and its ultrastructure in the offspring,and there was a correlation between decreased cognitive function and white matter damages.展开更多
BACKGROUND Traditional treatments for major depressive disorder(MDD),including medication and therapy,often fail and have undesirable side effects.Electroconvulsive therapy(ECT)uses electrical currents to induce brief...BACKGROUND Traditional treatments for major depressive disorder(MDD),including medication and therapy,often fail and have undesirable side effects.Electroconvulsive therapy(ECT)uses electrical currents to induce brief seizures in the brain,resulting in rapid and potent antidepressant effects.However,owing to misconceptions and controversies,ECT is not as widely used as it could and often faces stigmatization.AIM To evaluate the efficacy and safety of ECT compared to those of medication and/or therapy in patients with severe MDD.METHODS This prospective cohort study included 220 individuals with severe MDD who were divided into the ECT and non-ECT groups.The patients in the ECT group underwent bilateral ECT three times a wk until they either achieved remission or reached a maximum of 12 sessions.The non-ECT group received medication and/or therapy according to clinical guidelines for MDD.The primary outcome was the variation in the hamilton depression rating scale(HDRS)score from treatment/ECT initiation to week 12.In addition,patients’quality of life,cognitive abilities,and biomarkers were measured throughout the study.RESULTS Although both groups showed significant improvements in their HDRS scores over time,the improvement was more pronounced in the ECT group than in the non-ECT group.Additionally,the ECT group exhibited a more substantial improvement in the quality of life and cognitive function than those of the non-ECT group.Compared with the non-ECT group,the ECT group exhibited evidently lower variations in the brain-derived neurotrophic factor(BDNF)and cytokine interleukin-6(IL-6)levels.The side effects were generally mild and comparable between the two groups.ECT is safer and more potent than medication and/or therapy in mitigating depressive symptoms,enhancing wellbeing,and bolstering cognitive capabilities in individuals with severe MDD.ECT may also affect the levels of BDNF and IL-6,which are indicators of neuroplasticity and inflammation,respectively.CONCLUSION ECT has emerged as a potentially advantageous therapeutic approach for patients with MDD who are unresponsive to alternative treatments.展开更多
BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgentl...BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients.AIM To determine the influence of two surgical treatment modalities on postoperative cognitive function(CF)and delirium in elderly patients with EUHFs.METHODS A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included.Of them,30 patients received conventional treatment(control group;general consultation+fracture type-guided internal fixation),and the other 30 received novel treatment(research group;perioperative multidisciplinary treatment diagnosis and treatment+individualized surgical plan+risk prediction).Information on hip function[Harris hip score(HHS)],perioperative risk of orthopedic surgery[Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM)],CF[Montreal cognitive assessment scale(MoCA)],postoperative delirium[mini-cognitive(Mini-Cog)],adverse events(AEs;internal fixation failure,infection,nonunion,malunion,and postoperative delirium),and clinical indicators[operation time(OT),postoperative hospital length of stay(HLOS),ambulation time,and intraoperative blood loss(IBL)]were collected from both groups for comparative analyses.RESULTS The HHS scores were similar between both groups.The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group,and MoCA and Mini-Cog scores were statistically higher.In addition,the overall postoperative complication rate was significantly lower in the research than in the control group,including reduced OT,postoperative HLOS,ambulation time,and IBL.CONCLUSION The new treatment modality has more clinical advantages over the conventional treatment,such as less IBL,faster functional recovery,more effectively optimized perioperative quality control,improved postoperative CF,mitigated postoperative delirium,and reduced operation-related AEs.展开更多
Background Early screening of cognitive function is critical to dementia treatment and care.However,traditional tests require face-to-face administration and are often limited by implementation costs and biases.Aims T...Background Early screening of cognitive function is critical to dementia treatment and care.However,traditional tests require face-to-face administration and are often limited by implementation costs and biases.Aims This study aimed to assess whether the Thoven Cognitive Self-Assessment(TCSA),a novel,innovative two-step touchscreen-based cognition assessment tool,could identify early cognitive impairment due to dementia in older adults.Methods The TCSA was administered to 61 healthy controls(HCs),46 participants with mild cognitive impairment(MCI)and 44 participants diagnosed with dementia recruited from Shanghai.Two outcome measures were generated from the TCSA test:the TCSA_(primary task)score and the TCSA_(secondary task)score.Results The total average scores in the control group for the TCSA_(primary task)and TCSA_(secondary task)were significantly higher than those in the MCI and dementia groups(TCSA_(primary task):HCs vs MCI group vs dementia group,8.58±1.76 vs 5.40±2.67 vs 2.74±2.11,F=75.40,p<0.001;TCSA_(secondary task):HCs vs MCI group vs dementia group,23.02±3.31 vs 17.95±4.93 vs 11.93±5.50,F=76.46,p<0.001).Moreover,receiver operating characteristic analysis showed that a score below 7.5 for the TCSA_(primary task)and a score below 22.5 for the TCSA_(secondary task)were indicators of MCI.Conclusions The TCSA appears to be efficacious for the detection of cognitive impairment in older adults.It demonstrates the potential for large-scale cognition screening in community service settings.展开更多
BACKGROUND Lacunes are the manifestations of lacunar infarction which can lead many patients to the clinical outcome of disability or dementia.However,the relationship between lacune burden,cognitive function and bloo...BACKGROUND Lacunes are the manifestations of lacunar infarction which can lead many patients to the clinical outcome of disability or dementia.However,the relationship between lacune burden,cognitive function and blood glucose fluctuation in patients with type 2 diabetes mellitus(T2DM)complicated with lacunes is not very clear.AIM To explore the correlation between glucose variability,lacune burden and cognitive function in patients with lacunes complicated with T2DM.METHODS The clinical and imaging data of 144 patients with lacunes combined with T2DM were reviewed retrospectively.72 h continuous glucose monitoring was performed.The Montreal Cognitive Assessment was used to assess cognitive function.The burden of lacunes was evaluated using magnetic resonance imaging performance.Multifactorial logistic regression analysis was used to study the affecting the lacune load and cognitive impairment in patients.To predict the value of patients’cognitive impairment with lacunes complicated with T2DM,a receiver operating characteristic(ROC)curve and a nomogram prediction model were constructed.RESULTS The standard deviation(SD)of the average blood glucose concentration,percentage coefficient of variation(%CV)and time of range(TIR)were significantly different between the low and the high load groups(P<0.05).The SD,%CV and TIR of the cognitive impairment group and non-cognitive impairment group were significantly different(P<0.05).SD(odds ratio(OR):3.558,95%confidence interval(CI):1.268-9.978,P=0.006),and%CV(OR:1.192,95%CI:1.081-1.315,P<0.05)were the risk factors for an increased infarct burden in lacunes patients complicated with T2DM.TIR(OR:0.874,95%CI:0.833-0.928,P<0.05)is a protective factor.In addition,an increased SD(OR:2.506,95%CI:1.008-6.23,P=0.003),%CV(OR:1.163,95%CI:1.065-1.270,P<0.05)were the risk factors for cognitive impairment in patients with lacunes complicated with T2DM,TIR(OR:0.957,95%CI:0.922-0.994,P<0.05)is a protective factor.A nomogram prediction model of the risk of cognitive impairment was established based on SD,%CV and TIR.Decision curve analysis and the internal calibration analysis were used for internal verification and showed that the model was clinical benefit.The area under the ROC curves for predicting cognitive impairment in patients with lacunes complicated with T2DM was drawn were%CV:0.757(95%CI:0.669-0.845,P<0.05),TIR:0.711(95%CI:0.623-0.799,P<0.05).CONCLUSION Blood glucose variability is closely associated with the level of lacune burden and cognitive dysfunction in lacune patients combined with T2DM.%CV,TIR have a certain predictive effect in cognitive impairment in lacune patients.展开更多
Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have ...Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have been reported to be a potential target for controlling epileptic seizures in tempo ral lobe epile psy.However,their role in the cognitive impairment of temporal lobe epilepsy remains unclear.In this study,we found that patients with temporal lobe epile psy with hippocampal sclerosis had a low memory quotient and severe impairment in verbal memory,but had no impairment in nonverbal memory.The cognitive impairment was slightly correlated with reduced medial septum volume and medial septum-hippocampus tra cts measured by diffusion tensor imaging.In a mouse model of chronic temporal lobe epilepsy induced by kainic acid,the number of medial septum choline rgic neurons was reduced and acetylcholine release was reduced in the hippocampus.Furthermore,selective apoptosis of medial septum cholinergic neurons mimicked the cognitive deficits in epileptic mice,and activation of medial septum cholinergic neurons enhanced hippocampal acetylcholine release and restored cognitive function in both kainic acid-and kindling-induced epile psy models.These res ults suggest that activation of medial septum cholinergic neurons reduces cognitive deficits in temporal lobe epilepsy by increasing acetylcholine release via projections to the hippocampus.展开更多
Background Due to the inaccuracy of the traditional geographical distance-based definition of left-behind status,data on the negative effect of left-behind status on cognitive function among older adults are controver...Background Due to the inaccuracy of the traditional geographical distance-based definition of left-behind status,data on the negative effect of left-behind status on cognitive function among older adults are controversial.Aims This study examined the cross-sectional and longitudinal associations of left-behind status with cognitive function in older Chinese adults.The left-behind status definition was based on the frequency of face-to-face parent-child meetings.Methods Data from a nationally representative sample of 8682 older adults(60+years)in 2015(5658 left behind and 3024 non-left behind),of which 6933 completed the follow-up in 2018,were obtained from the China Health and Retirement Longitudinal Study.Left-behind older adults werebroadlydefined as those aged 60+years who had living adult children and saw their children less than once per month.The cognitive function was assessed with a composite cognitive test with higher total scores indicating better cognitive function.Results Left-behind older adults had significantly lower cognitive test scores than non-left-behind older adults in both 2015(11.1(6.0)vs 13.2(5.9),t=15.863,p<0.001)and 2018(10.0(6.6)vs 12.4(6.7),t=14.177,p<0.001).After adjusting for demographic factors,lifestyle factors,chronic medical conditions and the baseline cognitive test score(in the longitudinal analysis only),on average,the cognitive test score of left-behind older adults was 0.628 lower than their non-left-behind counterparts in 2015(t=5.689,p<0.001).This difference in cognitive test scores attenuated to 0.322 but remained significant in 2018(t=2.733,p=0.006).Conclusions Left-behind older Chinese adults have a higher risk of poor cognitive function and cognitive decline than their non-left-behind counterparts.Specific efforts targeting left-behind older adults,such as encouraging adult children to visit their parents more regularly,are warranted to maintain or delay the progression of cognitive decline.展开更多
Background Physical activity(PA)and reductions in sedentary behavior(SED)may mitigate cancer-related cognitive impairment.The purpose of this study was to examine(a)the associations between changes in PA,SED,and cogni...Background Physical activity(PA)and reductions in sedentary behavior(SED)may mitigate cancer-related cognitive impairment.The purpose of this study was to examine(a)the associations between changes in PA,SED,and cognitive function in cancer survivors before and during the coronavirus disease 2019(COVID-19)pandemic;and(b)clinical subgroups that moderate this association.Methods A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020.This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic.Self-reported Questionnaires assessed moderate-to-vigorous PA(MVPA)using the modified Godin Leisure Time Exercise Questionnaire,cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function(FACT-Cog)scale,and SED using the Domain-specific Sitting Time questionnaire.Cancer survivors were classified into no change in behavior,desirable change(i.e.,increase MVPA to meet PA guidelines or decrease SED by≥60 min/day),and undesirable change(i.e.,decrease MVPA to<150 min/week or increase SED by≥60 min/day).Analysis of covariance examined differences in FACT-Cog scores across the activity change categories.Planned contrasts compared differences in FACT-Cog scores between cancer survivors with(a)no meaningful change vs.any change,and(b)a desirable change vs.an undesirable change.Results There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors(n=371;age=48.6±15.3 years(mean±SD)).However,cancer survivors who were diagnosed≥5 years ago(t(160)=–2.15,p=0.03)or who received treatment≥5 years ago(t(102)=–2.23,p=0.03)and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change.Conclusion PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.展开更多
Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer's disease(AD),and some studies suggest a close relationship between cognition and plasticity.However,the clinic...Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer's disease(AD),and some studies suggest a close relationship between cognition and plasticity.However,the clinical benefits of transcranial direct current stimulation(tDCS)in patients still need to be evaluated.Aims This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity.Methods 124 patients with AD were randomly assigned to active tDCS(n=63)or sham tDCS(n=61).The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks(5 days per week,2 days off).The Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive(ADAS-Cog)were used for cognition evaluation at baseline,week 2 and week 6.The cortical plasticity was represented by motor-evoked potential(MEP)measured with an electromyogram.Results The results showed thatmultiplecourses of active tDcS can improve the cognitive functions of patients with AD,especially in the memory domain(word recall,recall of test instructions and word recognition).In addition,the damaged MEP level was enhanced following active treatment.In the active tDCS group,the improvements in ADAS-Cog total and subitem(word recall and word recognition)scores were negatively correlated with the enhancement of MEP.Conclusions Our research indicates for the first time that twice-a-day tDS may improve the cognitive function of patients with AD.This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity,which warrants mechanistic investigations of the relationship between cognition and plasticity in the future.展开更多
Background:Elderly people with depression require special care and attention.However,nostalgia is a complex emotional situation for a person who recalls the missing past.To improve mental health,quality of life,and at...Background:Elderly people with depression require special care and attention.However,nostalgia is a complex emotional situation for a person who recalls the missing past.To improve mental health,quality of life,and attitudes toward aging in institutional care,group nostalgia therapy can be a nursing intermediary for the elderly.This study aimed to analyze the effect of group nostalgia therapy on quality of life cognitive function in elderly patients with depression.Methods:A total of 89 participants were enrolled in this study,which was further categorized into a control(n=40)and a nostalgia therapy group(n=49).A standard questionnaire was used to compare the QoL,MMSE and GDS scores between the control and the nostalgia therapy groups.Results:Neither the nostalgia group nor the control group showed any statistical difference based on the patient characteristics,and both groups had a homogeneous distribution with p<0.05.However,in the intervention with nostalgia therapy,the therapy group showed improvements in almost all four domains of quality of life:physical health,psychological,environmental and social well-being.Moreover,the standard regression residual plot observed that both the post-test scores of MMSE and GDS showed favorable scores with respect to WHO-QoL.Conclusion:The study observed that group nostalgia therapy helps improve the quality of life and cognitive function in elderly patients with depression.The study also concludes that reducing depressive symptoms through nostalgia therapy could improve all four domains of the WHOQoL BREF.展开更多
Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness ...Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive declin e in patients withcognitive dysfunction,especially in patients with dementia.Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.展开更多
Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this s...Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this study, we established rat models of middle cerebral artery occlusion/reperfusion.One day after modeling, a group of rats were treated with ELF-EMF(50 Hz, 1 mT) for 2 hours daily on 28 successive days.Our results showed that rats treated with ELF-EMF required shorter swimming distances and latencies in the Morris water maze test than those of untreated rats.The number of times the platform was crossed and the time spent in the target quadrant were greater than those of untreated rats.The number of BrdU~+/NeuN~+ cells, representing newly born neurons, in the hippocampal subgranular zone increased more in the treated than in untreated rats.Up-regulation in the expressions of Notch1, Hes1, and Hes5 proteins, which are the key factors of the Notch signaling pathway, was greatest in the treated rats.These findings suggest that ELF-EMF can enhance hippocampal neurogenesis of rats with cerebral ischemia, possibly by affecting the Notch signaling pathway.The study was approved by the Institutional Ethics Committee of Sichuan University, China(approval No.2019255A) on March 5, 2019.展开更多
BACKGROUND:Endogenous neural progenitor cells play a beneficial role for cognitive recovery following traumatic brain injury.However,there are few classification-control studies aimed at varying graded brain trauma.OB...BACKGROUND:Endogenous neural progenitor cells play a beneficial role for cognitive recovery following traumatic brain injury.However,there are few classification-control studies aimed at varying graded brain trauma.OBJECTIVE:To observe the effects of adult endogenous neurogenesis on cognitive function repair and regeneration of neural progenitor cells following varying graded traumatic hippocampal injury to determine the significance of endogenous neurogenesis in the repair of brain injury.DESIGN,TIME AND SETTING:A randomized,controlled,animal experiment was performed at the Key Laboratory of Injuries,Variations and Regeneration of Nervous System,Tianjin Medical University General Hospital,from February to October 2009.MATERIALS:Mouse anti-rat 5-bromodeoxyuridine (BrdU) and neuronal nuclei (NeuN) monoclonal antibodies were purchased from Millipore Corporation,USA.METHODS:A total of 45 Wistar rats were randomly assigned to three groups.Mild and severe injury groups were respectively subjected to (182 ± 2) kPa and (284 ± 4) kPa lateral fluid percussion to establish models of brain injury,and the control group was subjected to surgery with no lateral fluid percussion.MAIN OUTCOME MEASURES:Cognitive function was estimated using the Morris water maze.Proliferation,survival,and differentiation of newly generated cells in the injured hippocampus were observed through the use of immunofluorescent staining.RESULTS:At 7 days post-injury,the number of BrdU+ cells in the hippocampal dentate gyrus significantly increased in the mild and severe injury groups compared with the control group (P < 0.01).At 61 days post-injury,the number of BrdU+/NeuN+ cells in the hippocampal dentate gyrus was significantly greater in the mild injury group compared with the severe injury and control groups (P < 0.01).In addition,the control group exhibited the greatest proportion of surviving cells that differentiated into mature neurons compared with the injury groups (P < 0.01).Moreover,at 61 days post-injury,cognitive function in rats with mild injury recovered to normal levels,whereas the severe injury group exhibited cognitive deficits (P < 0.01).CONCLUSION:Traumatic brain injury may be a stimulation factor for proliferation of neural progenitor cells in the adult hippocampus but severe brain trauma does not lead to an increased number of newly generated cells.Endogenous adult neurogenesis repairs neurological functions to an extent.However,recovery of neurological function remains limited following severe traumatic brain injury.展开更多
The many important benefits of physical exercise also encompass maintenance or improvement of cognitive functions. Among the variousmechanisms underlying the association between physical exercise and brain health, rec...The many important benefits of physical exercise also encompass maintenance or improvement of cognitive functions. Among the variousmechanisms underlying the association between physical exercise and brain health, recent evidence attests that neurotrophin receptor signalingmay have an important role, because the activation of this pathway leads to growth and differentiation of new neurons and synapses, supportsaxonal and dendritic growth, fosters synaptic plasticity, and preserves survival of existing neurons. In this review of published evidence, we highlightthat a positive relationship exists between physical exercise and circulating brain-derived neurotrophic factor levels and that the postexercisevariation of this molecule is associated with improvement of neurocognitive functioning. Less clear evidence has instead been published forother neurotrophins, such as nerve growth factor, neurotrophin-3, and neurotrophin-4. Overall, promotion of adequate volumes and intensities ofphysical exercise (i.e., approximately 3 months of moderate-intensity aerobic exercise, with 2—3 sessions/week lasting not less than 30 min)may hence be regarded as an inexpensive and safe strategy for boosting brain-derived neurotrophic factor release, thus preserving or restoringcognitive functions.展开更多
OBJECTIVE Lychee seed,a famous traditional Chinese medicine,recently were reported to improve the learning and memory abilities in mice.However,it is still unclear whether lychee seed saponins(LSS)can improve the cogn...OBJECTIVE Lychee seed,a famous traditional Chinese medicine,recently were reported to improve the learning and memory abilities in mice.However,it is still unclear whether lychee seed saponins(LSS)can improve the cognitive function and associated mechanisms.METHODS In present studies,we established the Alzheimer disease(AD)model by injecting Aβ25-35 into the lateral ventricle of rats.Then the spatial learning and memory abilities of LSS-treated rats were evaluated with the Morris water maze,meanwhile the protein expressions of AKT,GSK3β and Tau in the hippocampal neuron were analyzed by immunohistochemistry and Western blotting.RESULTS The results showed LSS can improve the cognitive functions of AD rats through shortening the escape latency,increasing the number across the platform,platform quadrant dwell time and the percentage of the total distance run platform quadrant.The protein expression of AKT was significantly up-regulated and that of GSK3β and Tau were decreased remarkably in the hippocampal CA1 area.CONCLUSION Our study is the first to show that LSS significantly improve the cognitive function and prevent hippocampal neuronal injury of the rats with AD by activation of the PI3K/AKT/GSK3βsignaling pathway,suggesting LSS may be developed into the nutrient supplement for the treatment of AD.展开更多
基金Supported by Suzhou Key Technologies Program,No.SKY2021063Suzhou Clinical Medical Center for Mood Disorders,No.Szlcyxzx202109+4 种基金Suzhou Clinical Key Disciplines for Geriatric Psychiatry,No.SZXK202116Jiangsu Province Social Development Project,No.BE2020764the Gusu Health Talents Project,No.GSWS2022091the Science and Technology Program of Suzhou,No.SKYD2022039 and No.SKY2023075the Doctoral Scientific Research Foundation of Suzhou Guangji Hospital,No.2023B01.
文摘BACKGROUND A growing number of recent studies have explored underlying activity in the brain by measuring electroencephalography(EEG)in people with depression.However,the consistency of findings on EEG microstates in patients with depression is poor,and few studies have reported the relationship between EEG microstates,cognitive scales,and depression severity scales.AIM To investigate the EEG microstate characteristics of patients with depression and their association with cognitive functions.METHODS A total of 24 patients diagnosed with depression and 32 healthy controls were included in this study using the Structured Clinical Interview for Disease for The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition.We collected information relating to demographic and clinical characteristics,as well as data from the Repeatable Battery for the Assessment of Neuropsychological Status(RBANS;Chinese version)and EEG.RESULTS Compared with the controls,the duration,occurrence,and contribution of microstate C were significantly higher[depression(DEP):Duration 84.58±24.35,occurrence 3.72±0.56,contribution 30.39±8.59;CON:Duration 72.77±10.23,occurrence 3.41±0.36,contribution 24.46±4.66;Duration F=6.02,P=0.049;Occurrence F=6.19,P=0.049;Contribution F=10.82,P=0.011]while the duration,occurrence,and contribution of microstate D were significantly lower(DEP:Duration 70.00±15.92,occurrence 3.18±0.71,contribution 22.48±8.12;CON:Duration 85.46±10.23,occurrence 3.54±0.41,contribution 28.25±5.85;Duration F=19.18,P<0.001;Occurrence F=5.79,P=0.050;Contribution F=9.41,P=0.013)in patients with depression.A positive correlation was observed between the visuospatial/constructional scores of the RBANS scale and the transition probability of microstate class C to B(r=0.405,P=0.049).CONCLUSION EEG microstate,especially C and D,is a possible biomarker in depression.Patients with depression had a more frequent transition from microstate C to B,which may relate to more negative rumination and visual processing.
基金supported by grant PID2021-125875OB-I00 funded by MCIN/AEI/10.13039/501100011033 and by"ERDF A way of making Europe"(to RL)supported by a grant from Junta de Comunidades de Castilla-La Mancha (SBPLY/21/180501/000064)+3 种基金Universidad de Castilla-La Mancha (2023-GRIN-34187)(to RL).Grant PID201 9-104921RB-I00/MCI/AEI/10.13039/501100011033 (to AGO)the Foundation for Applied Medical Research,the University of Navarra (Pamplona,Spain)for financial supporthe Asociación de Amigos of the University of Navarra for the grant (to SB)Margarita Salas fellowship from Ministerio de Universidades and Universidad de Castilla-La Mancha (to AMB)
文摘Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function.Unraveling the factors that lead to this cognitive resilience to AD offers promising prospects for identifying new therapeutic targets.Our hypothesis focuses on the contribution of resilience to changes in excitatory synapses at the structural and molecular levels,which may underlie healthy cognitive performance in aged AD animals.Utilizing the Morris Water Maze test,we selected resilient(asymptomatic)and cognitively impaired aged Tg2576 mice.While the enzyme-linked immunosorbent assay showed similar levels of Aβ42 in both experimental groups,western blot analysis revealed differences in tau pathology in the pre-synaptic supernatant fraction.To further investigate the density of synapses in the hippocampus of 16-18 month-old Tg2576 mice,we employed stereological and electron microscopic methods.Our findings indicated a decrease in the density of excitatory synapses in the stratum radiatum of the hippocampal CA1 in cognitively impaired Tg2576 mice compared with age-matched resilient Tg2576 and non-transgenic controls.Intriguingly,through quantitative immunoelectron microscopy in the hippocampus of impaired and resilient Tg2576 transgenic AD mice,we uncovered differences in the subcellular localization of glutamate receptors.Specifically,the density of GluA1,GluA2/3,and mGlu5 in spines and dendritic shafts of CA1 pyramidal cells in impaired Tg2576 mice was significantly reduced compared with age-matched resilient Tg2576 and non-transgenic controls.Notably,the density of GluA2/3 in resilient Tg2576 mice was significantly increased in spines but not in dendritic shafts compared with impaired Tg2576 and non-transgenic mice.These subcellular findings strongly support the hypothesis that dendritic spine plasticity and synaptic machinery in the hippocampus play crucial roles in the mechanisms of cognitive resilience in Tg2576 mice.
基金supported by the National Natural Science Foundation of China,No.82071419Key Research and Development Program of Guangzhou,No.202206010086+1 种基金High-level Hospital Construction Project,No.DFJH201907Supporting Research Funds for Outstanding Young Medical Talents in Guangdong Province,No.KJ012019442(all to YZ)。
文摘The dichotomized brain system is a concept that was generalized from the‘dual syndrome hypothesis’to explain the heterogeneity of cognitive impairment,in which anterior and posterior brain systems are independent but partially overlap.The dopaminergic system acts on the anterior brain and is responsible for executive function,working memory,and planning.In contrast,the cholinergic system acts on the posterior brain and is responsible for semantic fluency and visuospatial function.Evidence from dopaminergic/cholinergic imaging or functional neuroimaging has shed significant insight relating to the involvement of the cerebellum in the cognitive process of patients with Parkinson’s disease.Previous research has reported evidence that the cerebellum receives both dopaminergic and cholinergic projections.However,whether these two neurotransmitter systems are associated with cognitive function has yet to be fully elucidated.Furthermore,the precise role of the cerebellum in patients with Parkinson’s disease and cognitive impairment remains unclear.Therefore,in this review,we summarize the cerebellar dopaminergic and cholinergic projections and their relationships with cognition,as reported by previous studies,and investigated the role of the cerebellum in patients with Parkinson’s disease and cognitive impairment,as determined by functional neuroimaging.Our findings will help us to understand the role of the cerebellum in the mechanisms underlying cognitive impairment in Parkinson’s disease.
文摘Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the world.Brain and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and memory.DM affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal damage.Cognitive decline can further worsen diabetes care as DM is a disease largely self-managed by patients.Therefore,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this context.This evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.
基金Supported by the Ministry of Higher Education Malaysia Long-Term Research Grant Scheme(LRGS/BU/2012/UKM-UKM/K/01)Cabaran Perdana Grant Scheme(DCP-2017-002/1)。
文摘AIM:To determine the association between distance and near visual acuity(VA)and cognitive function among older adults in Selangor,Malaysia.METHODS:A total of 230 older adults(age≥60y)participated in this study.Habitual distance and near VA were measured using the Early Treatment Diabetic Retinopathy Study Chart and Lighthouse Near Visual Acuity Chart,respectively.Global cognitive function was assessed using the Mini-Mental State Examination(M-MSE)and the Malay language version of the Montreal Cognitive Assessment(M-MoCA).Digit Symbol(DS)subtest was used to measure information processing.RESULTS:No significant association was observed between vision and M-MSE and M-MoCA scores.However,poor distance and near VA were found to be significantly associated with low DS scores[distance VA:β=-0.01,R2=0.1,P=0.02;odds ratio(OR)=2.84,95%confidence interval(CI),1.10-7.33,P=0.03;near VA:β=-0.05,R2=0.08,P=0.00;OR=3.32,95%CI,1.28-8.59,P=0.01].CONCLUSION:Poor vision is associated with a decline in information processing in older adults and substantiates the importance of preserving good vision in maintaining cognitive function.
基金Shaanxi Province natural science basic research program (No.2023-JC-QN-0961)。
文摘Objective:To explore whether maternal stress exposure during pregnancy impairs cognitive function and white matter ultrastructure in offspring mice.Methods:The parent rats were divided into two groups:pressure exposure group(group PE)and control group(group C),and the positive date of vaginal smear of female SD rats was day 0 of gestation.Female mice in group PE were exposed to binding pressure(3 times/day)on day 14-20 of gestation for 45 min-1 h/time.Behavioral tests(Morris water maze and Y maze)were performed on 1-month-old offspring mice followed by cardiac perfusion of fixed brain specimens and placement in mixed fixative solution.The total volume of white matter,total length and volume of myelinated nerve fibers and total length and volume of myelin sheath were calculated using modern stereoscopic methods,and the inner and outer diameter and inner and outer circumference of the myelin sheath were analyzed.Results:1)Behavioral tests:compared with the group C,the average latency of the 3th and 4th day in the group PE were significantly prolonged,the percentage of the resting time in the quadrant of the platform and the frequency of acrossing the effective area of platform in the fifth day of space exploration experiment were significantly reduced of Morris water maze test,and visiting distance,duration and numbers in novel arm significantly increased of Y-maze test(P<0.05).2)Compared with group C,the total volume of white matter,total length of myelinated nerve fibers,total volume of myelinated nerve fibers and myelin sheath in the group PE were significantly reduced(P<0.05),the inner diameter and outer diameter of myelin sheath decreased significantly(P<0.05),and the inner perimeter,outer perimeter and inner and outer perimeter differences increased significantly(P<0.05).3)There was a correlation between behavioral test results and white matter ultrastructure measurement results.Conclusions:Maternal stress exposure during pregnancy could impair the cognitive function and white matter and its ultrastructure in the offspring,and there was a correlation between decreased cognitive function and white matter damages.
基金ebei Province 2018 Medical Science Research Key Discipline Programs,No.20180214.
文摘BACKGROUND Traditional treatments for major depressive disorder(MDD),including medication and therapy,often fail and have undesirable side effects.Electroconvulsive therapy(ECT)uses electrical currents to induce brief seizures in the brain,resulting in rapid and potent antidepressant effects.However,owing to misconceptions and controversies,ECT is not as widely used as it could and often faces stigmatization.AIM To evaluate the efficacy and safety of ECT compared to those of medication and/or therapy in patients with severe MDD.METHODS This prospective cohort study included 220 individuals with severe MDD who were divided into the ECT and non-ECT groups.The patients in the ECT group underwent bilateral ECT three times a wk until they either achieved remission or reached a maximum of 12 sessions.The non-ECT group received medication and/or therapy according to clinical guidelines for MDD.The primary outcome was the variation in the hamilton depression rating scale(HDRS)score from treatment/ECT initiation to week 12.In addition,patients’quality of life,cognitive abilities,and biomarkers were measured throughout the study.RESULTS Although both groups showed significant improvements in their HDRS scores over time,the improvement was more pronounced in the ECT group than in the non-ECT group.Additionally,the ECT group exhibited a more substantial improvement in the quality of life and cognitive function than those of the non-ECT group.Compared with the non-ECT group,the ECT group exhibited evidently lower variations in the brain-derived neurotrophic factor(BDNF)and cytokine interleukin-6(IL-6)levels.The side effects were generally mild and comparable between the two groups.ECT is safer and more potent than medication and/or therapy in mitigating depressive symptoms,enhancing wellbeing,and bolstering cognitive capabilities in individuals with severe MDD.ECT may also affect the levels of BDNF and IL-6,which are indicators of neuroplasticity and inflammation,respectively.CONCLUSION ECT has emerged as a potentially advantageous therapeutic approach for patients with MDD who are unresponsive to alternative treatments.
基金Supported by the Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX211Medical Research Project of Wanzhou District(Joint Project of Health Commission and Science and Technology Bureau),No.wzstc-kw2020023.
文摘BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients.AIM To determine the influence of two surgical treatment modalities on postoperative cognitive function(CF)and delirium in elderly patients with EUHFs.METHODS A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included.Of them,30 patients received conventional treatment(control group;general consultation+fracture type-guided internal fixation),and the other 30 received novel treatment(research group;perioperative multidisciplinary treatment diagnosis and treatment+individualized surgical plan+risk prediction).Information on hip function[Harris hip score(HHS)],perioperative risk of orthopedic surgery[Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM)],CF[Montreal cognitive assessment scale(MoCA)],postoperative delirium[mini-cognitive(Mini-Cog)],adverse events(AEs;internal fixation failure,infection,nonunion,malunion,and postoperative delirium),and clinical indicators[operation time(OT),postoperative hospital length of stay(HLOS),ambulation time,and intraoperative blood loss(IBL)]were collected from both groups for comparative analyses.RESULTS The HHS scores were similar between both groups.The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group,and MoCA and Mini-Cog scores were statistically higher.In addition,the overall postoperative complication rate was significantly lower in the research than in the control group,including reduced OT,postoperative HLOS,ambulation time,and IBL.CONCLUSION The new treatment modality has more clinical advantages over the conventional treatment,such as less IBL,faster functional recovery,more effectively optimized perioperative quality control,improved postoperative CF,mitigated postoperative delirium,and reduced operation-related AEs.
基金This study was funded by Key R&D Program of China(Grant number:2017YFC1310500)Shanghai Municipal Health Commission project(Grant number:202040500)Shanghai public health projects(Grant number:GWV-9.2)。
文摘Background Early screening of cognitive function is critical to dementia treatment and care.However,traditional tests require face-to-face administration and are often limited by implementation costs and biases.Aims This study aimed to assess whether the Thoven Cognitive Self-Assessment(TCSA),a novel,innovative two-step touchscreen-based cognition assessment tool,could identify early cognitive impairment due to dementia in older adults.Methods The TCSA was administered to 61 healthy controls(HCs),46 participants with mild cognitive impairment(MCI)and 44 participants diagnosed with dementia recruited from Shanghai.Two outcome measures were generated from the TCSA test:the TCSA_(primary task)score and the TCSA_(secondary task)score.Results The total average scores in the control group for the TCSA_(primary task)and TCSA_(secondary task)were significantly higher than those in the MCI and dementia groups(TCSA_(primary task):HCs vs MCI group vs dementia group,8.58±1.76 vs 5.40±2.67 vs 2.74±2.11,F=75.40,p<0.001;TCSA_(secondary task):HCs vs MCI group vs dementia group,23.02±3.31 vs 17.95±4.93 vs 11.93±5.50,F=76.46,p<0.001).Moreover,receiver operating characteristic analysis showed that a score below 7.5 for the TCSA_(primary task)and a score below 22.5 for the TCSA_(secondary task)were indicators of MCI.Conclusions The TCSA appears to be efficacious for the detection of cognitive impairment in older adults.It demonstrates the potential for large-scale cognition screening in community service settings.
基金Supported by the Medical Technology and Science Research Project in Henan Province,ChinaNo.SBGJ202102177。
文摘BACKGROUND Lacunes are the manifestations of lacunar infarction which can lead many patients to the clinical outcome of disability or dementia.However,the relationship between lacune burden,cognitive function and blood glucose fluctuation in patients with type 2 diabetes mellitus(T2DM)complicated with lacunes is not very clear.AIM To explore the correlation between glucose variability,lacune burden and cognitive function in patients with lacunes complicated with T2DM.METHODS The clinical and imaging data of 144 patients with lacunes combined with T2DM were reviewed retrospectively.72 h continuous glucose monitoring was performed.The Montreal Cognitive Assessment was used to assess cognitive function.The burden of lacunes was evaluated using magnetic resonance imaging performance.Multifactorial logistic regression analysis was used to study the affecting the lacune load and cognitive impairment in patients.To predict the value of patients’cognitive impairment with lacunes complicated with T2DM,a receiver operating characteristic(ROC)curve and a nomogram prediction model were constructed.RESULTS The standard deviation(SD)of the average blood glucose concentration,percentage coefficient of variation(%CV)and time of range(TIR)were significantly different between the low and the high load groups(P<0.05).The SD,%CV and TIR of the cognitive impairment group and non-cognitive impairment group were significantly different(P<0.05).SD(odds ratio(OR):3.558,95%confidence interval(CI):1.268-9.978,P=0.006),and%CV(OR:1.192,95%CI:1.081-1.315,P<0.05)were the risk factors for an increased infarct burden in lacunes patients complicated with T2DM.TIR(OR:0.874,95%CI:0.833-0.928,P<0.05)is a protective factor.In addition,an increased SD(OR:2.506,95%CI:1.008-6.23,P=0.003),%CV(OR:1.163,95%CI:1.065-1.270,P<0.05)were the risk factors for cognitive impairment in patients with lacunes complicated with T2DM,TIR(OR:0.957,95%CI:0.922-0.994,P<0.05)is a protective factor.A nomogram prediction model of the risk of cognitive impairment was established based on SD,%CV and TIR.Decision curve analysis and the internal calibration analysis were used for internal verification and showed that the model was clinical benefit.The area under the ROC curves for predicting cognitive impairment in patients with lacunes complicated with T2DM was drawn were%CV:0.757(95%CI:0.669-0.845,P<0.05),TIR:0.711(95%CI:0.623-0.799,P<0.05).CONCLUSION Blood glucose variability is closely associated with the level of lacune burden and cognitive dysfunction in lacune patients combined with T2DM.%CV,TIR have a certain predictive effect in cognitive impairment in lacune patients.
基金National Natural Science Foundation of China,Nos.82003 729 (to Ying W),82022071 (to YiW)Natural Science Foundation of Shandong Province of China,No.ZR2020QH357 (to Ying W)Public Welfare Technology Research Program of Zhejiang Province,No.LGF20H09001 1 (to JF)。
文摘Cognitive impairment is the most common complication in patients with temporal lobe epilepsy with hippocampal scle rosis.There is no effective treatment for cognitive impairment.Medial septum cholinergic neurons have been reported to be a potential target for controlling epileptic seizures in tempo ral lobe epile psy.However,their role in the cognitive impairment of temporal lobe epilepsy remains unclear.In this study,we found that patients with temporal lobe epile psy with hippocampal sclerosis had a low memory quotient and severe impairment in verbal memory,but had no impairment in nonverbal memory.The cognitive impairment was slightly correlated with reduced medial septum volume and medial septum-hippocampus tra cts measured by diffusion tensor imaging.In a mouse model of chronic temporal lobe epilepsy induced by kainic acid,the number of medial septum choline rgic neurons was reduced and acetylcholine release was reduced in the hippocampus.Furthermore,selective apoptosis of medial septum cholinergic neurons mimicked the cognitive deficits in epileptic mice,and activation of medial septum cholinergic neurons enhanced hippocampal acetylcholine release and restored cognitive function in both kainic acid-and kindling-induced epile psy models.These res ults suggest that activation of medial septum cholinergic neurons reduces cognitive deficits in temporal lobe epilepsy by increasing acetylcholine release via projections to the hippocampus.
基金supported by National Natural Science Foundation of China(grant number 71774060)2015 Irma and Paul Milstein Program for Senior Health Awards from the Milstein Medical Asian American Partnership Foundation+1 种基金the Young Top Talent Program in Public Health from Health Commission of Hubei Province(principal investigator:BLZ)Wuhan Health and Family Planning Commission(grant numbers WX17Q30,WG16A02 and WG14C24).
文摘Background Due to the inaccuracy of the traditional geographical distance-based definition of left-behind status,data on the negative effect of left-behind status on cognitive function among older adults are controversial.Aims This study examined the cross-sectional and longitudinal associations of left-behind status with cognitive function in older Chinese adults.The left-behind status definition was based on the frequency of face-to-face parent-child meetings.Methods Data from a nationally representative sample of 8682 older adults(60+years)in 2015(5658 left behind and 3024 non-left behind),of which 6933 completed the follow-up in 2018,were obtained from the China Health and Retirement Longitudinal Study.Left-behind older adults werebroadlydefined as those aged 60+years who had living adult children and saw their children less than once per month.The cognitive function was assessed with a composite cognitive test with higher total scores indicating better cognitive function.Results Left-behind older adults had significantly lower cognitive test scores than non-left-behind older adults in both 2015(11.1(6.0)vs 13.2(5.9),t=15.863,p<0.001)and 2018(10.0(6.6)vs 12.4(6.7),t=14.177,p<0.001).After adjusting for demographic factors,lifestyle factors,chronic medical conditions and the baseline cognitive test score(in the longitudinal analysis only),on average,the cognitive test score of left-behind older adults was 0.628 lower than their non-left-behind counterparts in 2015(t=5.689,p<0.001).This difference in cognitive test scores attenuated to 0.322 but remained significant in 2018(t=2.733,p=0.006).Conclusions Left-behind older Chinese adults have a higher risk of poor cognitive function and cognitive decline than their non-left-behind counterparts.Specific efforts targeting left-behind older adults,such as encouraging adult children to visit their parents more regularly,are warranted to maintain or delay the progression of cognitive decline.
基金supported by the University of Toronto COVID-19 Student Engagement Award
文摘Background Physical activity(PA)and reductions in sedentary behavior(SED)may mitigate cancer-related cognitive impairment.The purpose of this study was to examine(a)the associations between changes in PA,SED,and cognitive function in cancer survivors before and during the coronavirus disease 2019(COVID-19)pandemic;and(b)clinical subgroups that moderate this association.Methods A cross-sectional survey was administered online to adult cancer survivors globally between July and November of 2020.This was a secondary analysis of a cross-sectional survey examining changes in self-reported PA and quality of life in cancer survivors before and during the COVID-19 pandemic.Self-reported Questionnaires assessed moderate-to-vigorous PA(MVPA)using the modified Godin Leisure Time Exercise Questionnaire,cognitive function using the Functional Assessment of Cancer Therapy-Cognitive Function(FACT-Cog)scale,and SED using the Domain-specific Sitting Time questionnaire.Cancer survivors were classified into no change in behavior,desirable change(i.e.,increase MVPA to meet PA guidelines or decrease SED by≥60 min/day),and undesirable change(i.e.,decrease MVPA to<150 min/week or increase SED by≥60 min/day).Analysis of covariance examined differences in FACT-Cog scores across the activity change categories.Planned contrasts compared differences in FACT-Cog scores between cancer survivors with(a)no meaningful change vs.any change,and(b)a desirable change vs.an undesirable change.Results There were no significant differences in FACT-Cog scores across activity-change categories in the full sample of cancer survivors(n=371;age=48.6±15.3 years(mean±SD)).However,cancer survivors who were diagnosed≥5 years ago(t(160)=–2.15,p=0.03)or who received treatment≥5 years ago(t(102)=–2.23,p=0.03)and who had a desirable change in activity reported better perceived cognitive abilities than those who had an undesirable change.Conclusion PA promotion efforts should consider reducing SED in addition to maintaining MVPA in long-term cancer survivors to mitigate cancer-related cognitive impairment during the COVID-19 pandemic.
基金supported by the Zhejiang Provincial Health Commission(2020KY285,2020KY286)Ningbo Public Welfare Projects(2021S179,2021S180),Basic Public Welfare Project of Zhejiang Province(LQ21H170001)+5 种基金Ningbo Medical Science and Technology Project(2018A04,2018A54,2019Y65)Major Fund Project of Ningbo Science and Technology Bureau(2019B10034)Ningbo Top Medical and Health Research Program(2022030410)Taizhou Science and Technology Plan Project(20ywb85)Lishui science and technology plan project(2021ZDYF18)Lishui Science and Technology Plan Project(2023GYX56).
文摘Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer's disease(AD),and some studies suggest a close relationship between cognition and plasticity.However,the clinical benefits of transcranial direct current stimulation(tDCS)in patients still need to be evaluated.Aims This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity.Methods 124 patients with AD were randomly assigned to active tDCS(n=63)or sham tDCS(n=61).The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks(5 days per week,2 days off).The Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-Cognitive(ADAS-Cog)were used for cognition evaluation at baseline,week 2 and week 6.The cortical plasticity was represented by motor-evoked potential(MEP)measured with an electromyogram.Results The results showed thatmultiplecourses of active tDcS can improve the cognitive functions of patients with AD,especially in the memory domain(word recall,recall of test instructions and word recognition).In addition,the damaged MEP level was enhanced following active treatment.In the active tDCS group,the improvements in ADAS-Cog total and subitem(word recall and word recognition)scores were negatively correlated with the enhancement of MEP.Conclusions Our research indicates for the first time that twice-a-day tDS may improve the cognitive function of patients with AD.This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity,which warrants mechanistic investigations of the relationship between cognition and plasticity in the future.
基金funded by Longyan Science and Technology Innovation Joint Fund Health Project(2021LYF17053).
文摘Background:Elderly people with depression require special care and attention.However,nostalgia is a complex emotional situation for a person who recalls the missing past.To improve mental health,quality of life,and attitudes toward aging in institutional care,group nostalgia therapy can be a nursing intermediary for the elderly.This study aimed to analyze the effect of group nostalgia therapy on quality of life cognitive function in elderly patients with depression.Methods:A total of 89 participants were enrolled in this study,which was further categorized into a control(n=40)and a nostalgia therapy group(n=49).A standard questionnaire was used to compare the QoL,MMSE and GDS scores between the control and the nostalgia therapy groups.Results:Neither the nostalgia group nor the control group showed any statistical difference based on the patient characteristics,and both groups had a homogeneous distribution with p<0.05.However,in the intervention with nostalgia therapy,the therapy group showed improvements in almost all four domains of quality of life:physical health,psychological,environmental and social well-being.Moreover,the standard regression residual plot observed that both the post-test scores of MMSE and GDS showed favorable scores with respect to WHO-QoL.Conclusion:The study observed that group nostalgia therapy helps improve the quality of life and cognitive function in elderly patients with depression.The study also concludes that reducing depressive symptoms through nostalgia therapy could improve all four domains of the WHOQoL BREF.
基金financial support from the National Natural Science Foundation of Chinafunded by the National Natural Science Foundation of China(81871854)。
文摘Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive declin e in patients withcognitive dysfunction,especially in patients with dementia.Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.
基金supported by the National Natural Science Foundation of China,No.81201513 (to QG)。
文摘Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this study, we established rat models of middle cerebral artery occlusion/reperfusion.One day after modeling, a group of rats were treated with ELF-EMF(50 Hz, 1 mT) for 2 hours daily on 28 successive days.Our results showed that rats treated with ELF-EMF required shorter swimming distances and latencies in the Morris water maze test than those of untreated rats.The number of times the platform was crossed and the time spent in the target quadrant were greater than those of untreated rats.The number of BrdU~+/NeuN~+ cells, representing newly born neurons, in the hippocampal subgranular zone increased more in the treated than in untreated rats.Up-regulation in the expressions of Notch1, Hes1, and Hes5 proteins, which are the key factors of the Notch signaling pathway, was greatest in the treated rats.These findings suggest that ELF-EMF can enhance hippocampal neurogenesis of rats with cerebral ischemia, possibly by affecting the Notch signaling pathway.The study was approved by the Institutional Ethics Committee of Sichuan University, China(approval No.2019255A) on March 5, 2019.
基金the National Natural Science Foundation of China,No. 30973090the Natural Science Foundation of Tianjin,No.09JCZDJC17200
文摘BACKGROUND:Endogenous neural progenitor cells play a beneficial role for cognitive recovery following traumatic brain injury.However,there are few classification-control studies aimed at varying graded brain trauma.OBJECTIVE:To observe the effects of adult endogenous neurogenesis on cognitive function repair and regeneration of neural progenitor cells following varying graded traumatic hippocampal injury to determine the significance of endogenous neurogenesis in the repair of brain injury.DESIGN,TIME AND SETTING:A randomized,controlled,animal experiment was performed at the Key Laboratory of Injuries,Variations and Regeneration of Nervous System,Tianjin Medical University General Hospital,from February to October 2009.MATERIALS:Mouse anti-rat 5-bromodeoxyuridine (BrdU) and neuronal nuclei (NeuN) monoclonal antibodies were purchased from Millipore Corporation,USA.METHODS:A total of 45 Wistar rats were randomly assigned to three groups.Mild and severe injury groups were respectively subjected to (182 ± 2) kPa and (284 ± 4) kPa lateral fluid percussion to establish models of brain injury,and the control group was subjected to surgery with no lateral fluid percussion.MAIN OUTCOME MEASURES:Cognitive function was estimated using the Morris water maze.Proliferation,survival,and differentiation of newly generated cells in the injured hippocampus were observed through the use of immunofluorescent staining.RESULTS:At 7 days post-injury,the number of BrdU+ cells in the hippocampal dentate gyrus significantly increased in the mild and severe injury groups compared with the control group (P < 0.01).At 61 days post-injury,the number of BrdU+/NeuN+ cells in the hippocampal dentate gyrus was significantly greater in the mild injury group compared with the severe injury and control groups (P < 0.01).In addition,the control group exhibited the greatest proportion of surviving cells that differentiated into mature neurons compared with the injury groups (P < 0.01).Moreover,at 61 days post-injury,cognitive function in rats with mild injury recovered to normal levels,whereas the severe injury group exhibited cognitive deficits (P < 0.01).CONCLUSION:Traumatic brain injury may be a stimulation factor for proliferation of neural progenitor cells in the adult hippocampus but severe brain trauma does not lead to an increased number of newly generated cells.Endogenous adult neurogenesis repairs neurological functions to an extent.However,recovery of neurological function remains limited following severe traumatic brain injury.
基金supported by a postdoctoral contract granted by Subprograma Atraccio de Talent-Contractes Postdoctorals de la Universitat de Valencia
文摘The many important benefits of physical exercise also encompass maintenance or improvement of cognitive functions. Among the variousmechanisms underlying the association between physical exercise and brain health, recent evidence attests that neurotrophin receptor signalingmay have an important role, because the activation of this pathway leads to growth and differentiation of new neurons and synapses, supportsaxonal and dendritic growth, fosters synaptic plasticity, and preserves survival of existing neurons. In this review of published evidence, we highlightthat a positive relationship exists between physical exercise and circulating brain-derived neurotrophic factor levels and that the postexercisevariation of this molecule is associated with improvement of neurocognitive functioning. Less clear evidence has instead been published forother neurotrophins, such as nerve growth factor, neurotrophin-3, and neurotrophin-4. Overall, promotion of adequate volumes and intensities ofphysical exercise (i.e., approximately 3 months of moderate-intensity aerobic exercise, with 2—3 sessions/week lasting not less than 30 min)may hence be regarded as an inexpensive and safe strategy for boosting brain-derived neurotrophic factor release, thus preserving or restoringcognitive functions.
基金supported by Science and Technology Planning Project of Sichuan Province(2008SZ0050,14JC0798)Educational Commission of Sichuan Province(10ZA035,15ZA0155)+1 种基金Science and Technology Program of Luzhou(2015-S-43,2016LZXNYD-T03)Key Development Program of Southwest Medical University(2010ZD-010)
文摘OBJECTIVE Lychee seed,a famous traditional Chinese medicine,recently were reported to improve the learning and memory abilities in mice.However,it is still unclear whether lychee seed saponins(LSS)can improve the cognitive function and associated mechanisms.METHODS In present studies,we established the Alzheimer disease(AD)model by injecting Aβ25-35 into the lateral ventricle of rats.Then the spatial learning and memory abilities of LSS-treated rats were evaluated with the Morris water maze,meanwhile the protein expressions of AKT,GSK3β and Tau in the hippocampal neuron were analyzed by immunohistochemistry and Western blotting.RESULTS The results showed LSS can improve the cognitive functions of AD rats through shortening the escape latency,increasing the number across the platform,platform quadrant dwell time and the percentage of the total distance run platform quadrant.The protein expression of AKT was significantly up-regulated and that of GSK3β and Tau were decreased remarkably in the hippocampal CA1 area.CONCLUSION Our study is the first to show that LSS significantly improve the cognitive function and prevent hippocampal neuronal injury of the rats with AD by activation of the PI3K/AKT/GSK3βsignaling pathway,suggesting LSS may be developed into the nutrient supplement for the treatment of AD.
