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
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: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
An enriched environment is used as a behavio ral intervention therapy that applies sensory,motor,and social stimulation,and has been used in basic and clinical research of va rious neurological diseases.In this study,...An enriched environment is used as a behavio ral intervention therapy that applies sensory,motor,and social stimulation,and has been used in basic and clinical research of va rious neurological diseases.In this study,we established mouse models of photothrombotic stroke and,24 hours later,raised them in a standard,enriched,or isolated environment for 4 weeks.Compared with the mice raised in a standard environment,the cognitive function of mice raised in an enriched environment was better and the pathological damage in the hippocampal CA1 region was remarkably alleviated.Furthermore,protein expression levels of tumor necrosis factor receptor-associated factor 6,nuclear factorκB p65,interleukin-6,and tumor necrosis factorα,and the mRNA expression level of tumor necrosis factor receptor-associated factor 6 were greatly lower,while the expression level of miR-146a-5p was higher.Compared with the mice raised in a standard environment,changes in these indices in mice raised in an isolated environment were opposite to mice raised in an enriched environment.These findings suggest that different living environments affect the hippocampal inflammatory response and cognitive function in a mouse model of stro ke.An enriched environment can improve cognitive function following stroke through up-regulation of miR-146a-5p expression and a reduction in the inflammatory response.展开更多
Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Me...Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.展开更多
Objective The influence of cocoa flavanols(CFs)on cognitive functions in human has been investigated in some clinical trials,but the results are inconclusive.We conduct this systematic review and meta-analysis of rand...Objective The influence of cocoa flavanols(CFs)on cognitive functions in human has been investigated in some clinical trials,but the results are inconclusive.We conduct this systematic review and meta-analysis of randomized controlled trials(RCTs)to figure out whether CFs intervention have a positive effect on cognitive functions.Methods A comprehensive literature search of articles published until June 2019 was performed in PubMed,Cochrane Library,Medline,and Web of Science.Weighted mean difference(WMD)and 95%confidence interval(95%CI)were calculated to reflect the size of the combined effect.Random effect models were used for all analyses.Results A total of 9 RCT studies were finally enrolled in this meta-analysis.CFs has no notable effect on Trail Making Test-A(TMT-A)(WMD:-5.75s,95%CI:-16.71-5.21),which reflects the shifting subdomain of executive function and global executive function.CFs has no significant effect on Trail Making Test-B(TMT-B)(WMD:-11.32s,95%CI:-26.14-3.50),which reflects another specific aspect of the shifting subdomain.Gross cognitive changed as measured by mini mental state examination(MMSE)which consists of a series of items covering cognitive functions except for the executive function domain,but significantly associated with composite z score of several subdomains tests of executive function(WSD:0.40s,95%CI:0.29-0.46).Conclusion This study suggests CFs may have a positive effect on cognitive function,especially executive function.However,large scale and high quality RCTs are needed to further confirm/refute this conclusion.展开更多
BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant wo...BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.展开更多
Cognitive function of older adults is influenced by several factors such as age,sex,education,and physical activity so that it can impact the decrease in progressive cognitive function.It is necessary to implement cog...Cognitive function of older adults is influenced by several factors such as age,sex,education,and physical activity so that it can impact the decrease in progressive cognitive function.It is necessary to implement cognitive training in old people’s care to prevent or delay the onset of age-related cognitive decline.Brain gym is a series of simple motion exercises and is an alternative therapy that stimulates the brain.This study aims to evaluate the effect of brain gym as a cognitive training intervention on global cognitive functioning of institutionalized older population.The study is a non-randomized quasi-experimental one using pre-and post-test control group design.The participants of the study were 65 years old or older who had been part of gerontological centers from a local community.They were divided into two groups:control and intervention,each one with 15 people.Mini-Mental State Examination was applied to the sample before and after the cognitive training.The brain gym training consists of bi-weekly group meeting for 12 weeks,lasting 50 min each.The treated group had a significantly better global cognitive function.Recalling(memory),orientation and language skills were the domains with the most significant changes(p<0.05).On the other hand,no significant changes were found in the participants of control groups during post test.Our results suggest that cognitive training based in brain gym improves global cognitive function of institutionalized older people lease type your abstract here.Abstract of a research paper is typically 200 to 400 words in length,and 150 to 300 words for a review paper.Abstract shall be running continuously(not structured)and shall not include reference citations.Abbreviations that appear only once in the abstract should be defined in full.If abbreviations appear more than once,the full definitions should be provided first before they can be used elsewhere.展开更多
BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine u...BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited.Due to specific characteristics of methamphetamine users,the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well.We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIM To investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODS A total of 110 subjects were recruited for an observational,longitudinal study from a German inpatient addiction treatment center:55 patients with methamphetamine dependence and 55 patients with dependence of other substances(“OS group”).Both groups were examined at beginning(baseline)and end of treatment(after 6 mo)with regard to treatment retention,craving,cognitive functioning,psychosocial resources,personality traits,depression,and other psychiatric symptoms.Instruments used were Raven’s IQ test,Mannheimer craving scale,cognitrone cognitive test battery,NEO personality factors inventory,Hamilton depression scale,Becks depression inventory,and a symptom checklist.The statistical methods used were χ^(2)-test,t-test and multiple mixed ANOVAs.RESULTS A total drop-out rate of 40%(methamphetamine-group:36.4%;OS-group:43.6%)was observed without significant differences between groups.At baseline,methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient,fewer years of education,slower working speed,and decreased working accuracy,as well as less cannabinoid and cocaine use.Methamphetamine-group subjects further showed a significantly lower score of conscientiousness,depressive,and psychiatric symptoms than subjects from the OSgroup.In both groups,a reduction of craving and depressive symptoms and an improvement of working speed and working accuracy was noted after treatment.CONCLUSION There are differences between methamphetamine users and users of other drugs,but not with regard to the effectiveness of treatment in this inpatient setting.There are differences in cognitive function and psychopathology between methamphetamine and other drugs users.The existing treatment options seem to be an effective approach in treating methamphetamine dependence.展开更多
BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after bra...BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE: To comparatively observe the intelligence quotient (IQ), latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase (AChE) in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN: Correlation analysis of contrast observation. SETTING: Department of Endocrinology, Affiliated Hospital of Binzhou Medical College. PARTICIPANTS: Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS: ① Evaluation on IQ: The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian (WAIS-RC). WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ (VIQ), performance IQ (PIQ) and full scale IQ (FIQ). FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave: P300 wave was detected with evoked potential instrument (MYTOPRO, Italian), and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid: Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer. ④Correlation analysis: Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed. t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES: ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS: Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups: The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were (97.4±10.4),(92.6±8.4) and (95.2±9.7) scores, respectively; and those of patients with non-diabetes mellitus were (104.7±9.6),(102.5±8.5)and(102.7±8.9) scores, respectively, and P < 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was (370.8±41.8),(371.5±39.1)and (375.1±43.1) ms, respectively, and that of patients with non-diabetes mellitus was (332.1±28.3),(335.7±29.4)and(339.7±27.3) ms, respectively, and P < 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was (8.6±4.1),(8.6±4.0) and(7.7±4.0) μV, respectively and that of patients with non-diabetes mellitus was (11.9±4.1),(11.5±4.4) and (10.9±5.0) μV, respectively , and P < 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was (235.61±50.34)and (17.89±4.46) μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [(205.03±44.15)and (14.63±0.48) μkat /L, respectively], and P < 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave: The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid (r=-0.588 1, P < 0.01), significantly negatively correlated with the latent period at points Fz, C and Pz of P300 wave (r= -0.700 5, -0.689 4, -0.688 5, P < 0.01), and significantly positively correlated with the amplitude at points Fz , Cz and Pz of P300 wave(r= 0.607 4,0.616 1,0.592 0,P < 0.01). CONCLUSION: ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ② Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.展开更多
Objective:To observe the effect of aripiprazole and olanzapine on the cognitive function in patients with schizophrenia in order to provide a reference evidence for the clinical medication.Methods:A total of 60 patien...Objective:To observe the effect of aripiprazole and olanzapine on the cognitive function in patients with schizophrenia in order to provide a reference evidence for the clinical medication.Methods:A total of 60 patients with schizophrenia who were admitted in our hospital were included in the study and randomized into the treatment 1 group and treatment 2 group.The patients in the two groups were given aripiprazole and olanzapine,respectively.PANSS,WCST,DS,IGT,and EIRT were used to evaluate the disease condition and cognitive function before and after treatment in the two groups.Results:Comparision of PANSS scores and other various scores before treatment between the two groups was not significantly different(P>0.05);however,PANSS scores and other various scores after treatment were significantly reduced(P<0.05).Comparision of PANSS scores and other various scores after treatment between the two groups was not significantly different(P>0.05).DS,WCST,and IGT scores before treatment between the two groups was comparable(P>0.05),and those scores after treatment were significantly elevated(P<0.05).DS score after treatment in the treatment 2 group was significantly higher than that in the treatment 1 group(P<0.05).Comparison of WCST and IGT scores after treatment between the two groups was not significantly different(P>0.05).The four cognition scores of happiness,fear,anger,and disgust after treatment in the treatment 1 group were significantly elevated(P<0.05),while the cognition of happiness and sadness after treatment in the treatment 2 group was significantly elevated when compared with before treatment(P<0.05).The comparison of various scores before and after treatment between the two groups was not significantly different(P>0.05).Conclusions:Aripiprazole and olanzapine can improve the clinical symptoms and partial cognitive function in patients with schizophrenia,while aripiprazole can make a better effect on the work and memory.展开更多
Exercise has widely been shown to improve cognition, potentially by making individuals more receptive to sensory stimulation or inhibiting irrelevant information. Caffeine, one of the world’s most widely used stimula...Exercise has widely been shown to improve cognition, potentially by making individuals more receptive to sensory stimulation or inhibiting irrelevant information. Caffeine, one of the world’s most widely used stimulants, seems to have similar effects. It seems that both exercise and caffeine improve cognitive function separately, but little research has been done examining their combined effects. The purpose of this study was to examine the impact of caffeine and exercise, independently and combined, on cognitive function. 20 healthy college students completed the study. These participants were low caffeine consumers. Each participant came to the lab 5 times. During the first session, they completed a graded exercise test on a cycle ergometer to determine ventilatory threshold (VT). The following four sessions were test sessions involving supplementation and exercise. During these, each participant engaged in 30 minutes of cycling (at 90% VT) or 30 minutes of quiet reading after consuming either caffeine (at 4 mg/kg body weight) or a placebo. The Contingent Continuous Performance Task (CPT) and Wisconsin Card Sorting Task were used to measure cognitive function and were completed 5 minutes and 20 minutes after exercise or quiet reading. There were no significant differences found for any variables tested, for condition effect, time effect or condition*time interaction, except for a significant time effect on false alarms on the Contingent CPT (p = 0.017). This study may have been limited by multiple variables including the population, executive function measures, caffeine dosage, or exercise prescription. These findings point to the need for future research to understand the changes in cognition from exercise and caffeine in combination. Future research may include looking at exercise at different intensities, different dosages of caffeine, or looking at the long-term cognitive effects.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.
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.
基金financially the National Natural Science Foundation of China,No.82072533the China Postdoctoral Science Foundation,No.2017M621675+1 种基金Huxin Foundation of Jiangsu Key Laboratory of Zoonosis of China,No.HX2003Yangzhou Science and Technology Development Plan Project of China,No.YZ2020201(all to XW)。
文摘An enriched environment is used as a behavio ral intervention therapy that applies sensory,motor,and social stimulation,and has been used in basic and clinical research of va rious neurological diseases.In this study,we established mouse models of photothrombotic stroke and,24 hours later,raised them in a standard,enriched,or isolated environment for 4 weeks.Compared with the mice raised in a standard environment,the cognitive function of mice raised in an enriched environment was better and the pathological damage in the hippocampal CA1 region was remarkably alleviated.Furthermore,protein expression levels of tumor necrosis factor receptor-associated factor 6,nuclear factorκB p65,interleukin-6,and tumor necrosis factorα,and the mRNA expression level of tumor necrosis factor receptor-associated factor 6 were greatly lower,while the expression level of miR-146a-5p was higher.Compared with the mice raised in a standard environment,changes in these indices in mice raised in an isolated environment were opposite to mice raised in an enriched environment.These findings suggest that different living environments affect the hippocampal inflammatory response and cognitive function in a mouse model of stro ke.An enriched environment can improve cognitive function following stroke through up-regulation of miR-146a-5p expression and a reduction in the inflammatory response.
文摘Objective: To compare the effects of total intravenous anesthesia and static aspiration combined general anesthesia on postoperative cognitive function and psychological state of elderly esophageal cancer patients. Methods: From July 2020 to April 2021, 180 elderly patients who underwent radical esophageal cancer surgery in our hospital were randomly divided into 90 cases in the control group and 90 in the observation group. The control group used static aspiration compound general anesthesia, and the patients in the observation group used intravenous anesthesia to compare the cognitive function and psychological state of the two groups of patients. Results: There was no statistical difference in the cognitive function score of patients in the observation group 30 minutes before anesthesia, 1 h and 24 hours after anesthesia compared with that in the control group, P > 0.05;there was no statistical difference between the Hamilton Anxiety Scale (HAMA) scores 30 minutes before and 24 hours after anesthesia in the observation group compared with the control group, P > 0.05;the cognitive function score of patients in the observation group of 4 h after surgery and 12 h after operation was significantly higher than that of the control group;the HAMA scores of patients in the observation group of 1 h, 4 h and 12 h after surgery were significantly lower than that of the control group, P Conclusion: The application of total intravenous anesthesia in elderly patients with esophageal cancer surgery can reduce the impact of anesthesia on their cognitive function and psychological state, which is worth popularizing and applying in clinical practice.
文摘Objective The influence of cocoa flavanols(CFs)on cognitive functions in human has been investigated in some clinical trials,but the results are inconclusive.We conduct this systematic review and meta-analysis of randomized controlled trials(RCTs)to figure out whether CFs intervention have a positive effect on cognitive functions.Methods A comprehensive literature search of articles published until June 2019 was performed in PubMed,Cochrane Library,Medline,and Web of Science.Weighted mean difference(WMD)and 95%confidence interval(95%CI)were calculated to reflect the size of the combined effect.Random effect models were used for all analyses.Results A total of 9 RCT studies were finally enrolled in this meta-analysis.CFs has no notable effect on Trail Making Test-A(TMT-A)(WMD:-5.75s,95%CI:-16.71-5.21),which reflects the shifting subdomain of executive function and global executive function.CFs has no significant effect on Trail Making Test-B(TMT-B)(WMD:-11.32s,95%CI:-26.14-3.50),which reflects another specific aspect of the shifting subdomain.Gross cognitive changed as measured by mini mental state examination(MMSE)which consists of a series of items covering cognitive functions except for the executive function domain,but significantly associated with composite z score of several subdomains tests of executive function(WSD:0.40s,95%CI:0.29-0.46).Conclusion This study suggests CFs may have a positive effect on cognitive function,especially executive function.However,large scale and high quality RCTs are needed to further confirm/refute this conclusion.
文摘BACKGROUND Dipeptidyl peptidase-4(DPP4)is associated with cognitive dysfunction in patients with type 2 diabetes.AIM To assess a possible relationship between serum DPP4 and cognitive function in perinatal pregnant women with gestational diabetes mellitus(GDM).METHODS The study subjects were divided into three groups:GDM group(n=81),healthy pregnant(HP)group(n=85),and control group(n=51).The Montreal Cognitive Assessment(MoCA)was used to assess the cognitive status of each group.Venous blood samples were collected to measure blood lipids,glycated hemoglobin,and glucose levels.For each participant,a 3-mL blood sample was collected and centrifuged,and the serum was collected.Blood samples were stored at-80℃,and DPP4,interleukin-6(IL-6),and 8-iso-prostaglandin F2α(8-iso-PGF2α),and brain-derived neurotrophic factor(BDNF)were detected using ELISA.RESULTS The MoCA scores in the GDM and HP groups were significantly different from those in the control group in terms of visuospatial/executive function and attention(P<0.05);however,the scores were not significantly different between the GDM and HP groups(P>0.05).In terms of language,the GDM group had significantly different scores from those in the other two groups(P<0.05).In terms of memory,a significant difference was found between the HP and control groups(P<0.05),as well as between the GDM and HP groups.The levels of DPP4,IL-6,and 8-iso-PGF2αin the GDM group were significantly higher than those in the HP and control groups(P<0.05);however,the differences between these levels in the HP and control groups were not significant(P>0.05).The level of BDNF in the GDM group was significantly lower than that in the HP and control groups(P<0.05),although the difference in this level between the HP and control groups was not significant(P>0.05).CONCLUSION Cognitive dysfunction in perinatal pregnant women with GDM mainly manifested as memory loss,which might be associated with elevated DPP4 levels.
基金The Gerontological Centers from Hidalgo State in Mexico are acknowledged for their support in the development of this research.
文摘Cognitive function of older adults is influenced by several factors such as age,sex,education,and physical activity so that it can impact the decrease in progressive cognitive function.It is necessary to implement cognitive training in old people’s care to prevent or delay the onset of age-related cognitive decline.Brain gym is a series of simple motion exercises and is an alternative therapy that stimulates the brain.This study aims to evaluate the effect of brain gym as a cognitive training intervention on global cognitive functioning of institutionalized older population.The study is a non-randomized quasi-experimental one using pre-and post-test control group design.The participants of the study were 65 years old or older who had been part of gerontological centers from a local community.They were divided into two groups:control and intervention,each one with 15 people.Mini-Mental State Examination was applied to the sample before and after the cognitive training.The brain gym training consists of bi-weekly group meeting for 12 weeks,lasting 50 min each.The treated group had a significantly better global cognitive function.Recalling(memory),orientation and language skills were the domains with the most significant changes(p<0.05).On the other hand,no significant changes were found in the participants of control groups during post test.Our results suggest that cognitive training based in brain gym improves global cognitive function of institutionalized older people lease type your abstract here.Abstract of a research paper is typically 200 to 400 words in length,and 150 to 300 words for a review paper.Abstract shall be running continuously(not structured)and shall not include reference citations.Abbreviations that appear only once in the abstract should be defined in full.If abbreviations appear more than once,the full definitions should be provided first before they can be used elsewhere.
基金the German Federal Ministry of Health(partially).
文摘BACKGROUND The rising number of people using methamphetamine leads to an increasing need for treatment options for this patient group.Evidence-based research on the efficacy of treatment programs for methamphetamine users is limited.Due to specific characteristics of methamphetamine users,the question arises whether established treatment methods for individuals using other substances can be effective for the treatment of methamphetamine dependence as well.We hypothesize that there are significant differences between the two groups that may affect the effectiveness of treatment and worsen the prognosis of treatment outcomes for methamphetamine users compared to consumers of other substances.AIM To investigate potential differences in cognitive functioning and psychopathology between methamphetamine users and other substance users and possible correlations with treatment outcomes.METHODS A total of 110 subjects were recruited for an observational,longitudinal study from a German inpatient addiction treatment center:55 patients with methamphetamine dependence and 55 patients with dependence of other substances(“OS group”).Both groups were examined at beginning(baseline)and end of treatment(after 6 mo)with regard to treatment retention,craving,cognitive functioning,psychosocial resources,personality traits,depression,and other psychiatric symptoms.Instruments used were Raven’s IQ test,Mannheimer craving scale,cognitrone cognitive test battery,NEO personality factors inventory,Hamilton depression scale,Becks depression inventory,and a symptom checklist.The statistical methods used were χ^(2)-test,t-test and multiple mixed ANOVAs.RESULTS A total drop-out rate of 40%(methamphetamine-group:36.4%;OS-group:43.6%)was observed without significant differences between groups.At baseline,methamphetamine-group subjects significantly differed from OS-group individuals in terms of a lower intelligence quotient,fewer years of education,slower working speed,and decreased working accuracy,as well as less cannabinoid and cocaine use.Methamphetamine-group subjects further showed a significantly lower score of conscientiousness,depressive,and psychiatric symptoms than subjects from the OSgroup.In both groups,a reduction of craving and depressive symptoms and an improvement of working speed and working accuracy was noted after treatment.CONCLUSION There are differences between methamphetamine users and users of other drugs,but not with regard to the effectiveness of treatment in this inpatient setting.There are differences in cognitive function and psychopathology between methamphetamine and other drugs users.The existing treatment options seem to be an effective approach in treating methamphetamine dependence.
基金the Grants from Department of Education of Shandong Province, No.J02K11
文摘BACKGROUND: At present, central cholinergic neuron system is regarded the most major structural basis of cognitive function. Changes in structure of cholinergic neuron system of brain and receptor expression after brain injury can cause cognitive impairment. OBJECTIVE: To comparatively observe the intelligence quotient (IQ), latent period and wave amplitude of P300 event-related potential and the difference of activity of acetylcholinesterase (AChE) in blood and cerebrospinal fluid between patients with type 2 diabetes mellitus and with non-diabetes mellitus, and analyze the correlation of IQ of cognitive impairment patients with diabetes mellitus with AChE activity, latent period and wave amplitude of P300 event-related potential in cerebrospinal fluid. DESIGN: Correlation analysis of contrast observation. SETTING: Department of Endocrinology, Affiliated Hospital of Binzhou Medical College. PARTICIPANTS: Totally 32 patients with type 2 diabetes mellitus who received the treatment in the Department of Endocrinology, Affiliated Hospital of Binzhou Medical College between April 2004 and April 2005 were recruited, serving as diabetes mellitus group. They, including 19 male and 13 female, aged 49 to 73 years, with disease course of 4 to 11 years, all met the diagnostic criteria of diabetes mellitus revised by World Health Organization in 1999. Another 30 patients with non-diabetes mellitus who homeochronously underwent lumbar anesthesia in the Department of Surgery and Department of Gynecology were recruited, serving as non-diabetes mellitus group. The 30 patients included 18 male and 12 female, and their age ranged from 46 to 71 years. Informed consents of detected items were obtained from the involved patients. METHODS: ① Evaluation on IQ: The IQ of involved subjects was evaluated with Chinese Version of the Wechsler Adult Intelligence Scale revised by Gong Yao-xian (WAIS-RC). WAIS-RC included 6 verbal subscales and 5 performance subscales. The test scores of the 11 subscales integrated into the scores of the whole scale, and the scores on the WAIS-RC included verbal IQ (VIQ), performance IQ (PIQ) and full scale IQ (FIQ). FIQ ≤79 scores indicated low IQ and FIQ≤69 indicated intelligence impairment. ② Detection of P300 wave: P300 wave was detected with evoked potential instrument (MYTOPRO, Italian), and data of latent period and amplitude of P300 event-related potential were automatically shown by computer. ③ Detection of AChE activity in blood and cerebrospinal fluid: Activity of AChE of blood and cerebrospinal fluid was measured with biochemical methods by using CORNING-560 autoanalyzer. ④Correlation analysis: Correlation of FIQ with AChE of cerebrospinal fluid and P300 wave of patients with type 2 diabetes mellitus was analyzed. t test was used in intergroup comparison and linear correlation analysis for relevant treatment. MAIN OUTCOME MEASURES: ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups. ② Analysis on the correlation of FIQ of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave. RESULTS: Thirty-two patients with diabetes mellitus and 30 non-diabetes mellitus participated in the result analysis. ① Comparison of IQ, latent period and wave amplitude of P300 wave as well as the activity of AChE between two groups: The scores of VIP, PIQ and FIQ of patients with type 2 diabetes mellitus were (97.4±10.4),(92.6±8.4) and (95.2±9.7) scores, respectively; and those of patients with non-diabetes mellitus were (104.7±9.6),(102.5±8.5)and(102.7±8.9) scores, respectively, and P < 0.05-0.01 was set in intergroup comparison. The latent period of P300 wave at points Fz , Cz and Pz of patients with type 2 diabetes mellitus was (370.8±41.8),(371.5±39.1)and (375.1±43.1) ms, respectively, and that of patients with non-diabetes mellitus was (332.1±28.3),(335.7±29.4)and(339.7±27.3) ms, respectively, and P < 0.01 was set in intergroup comparison; Wave amplitude of P300 of patients with type 2 diabetes mellitus was (8.6±4.1),(8.6±4.0) and(7.7±4.0) μV, respectively and that of patients with non-diabetes mellitus was (11.9±4.1),(11.5±4.4) and (10.9±5.0) μV, respectively , and P < 0.05-0.01 was set in intergroup comparison; The level of AChE in blood and cerebrospinal fluid of patients with type 2 diabetes mellitus was (235.61±50.34)and (17.89±4.46) μkat/L, respectively, which was significantly higher than that of patients with non-diabetes mellitus [(205.03±44.15)and (14.63±0.48) μkat /L, respectively], and P < 0.05-0.01 was set in the intergroup comparison. ② Correlation of FIQ value of patients with type 2 diabetes mellitus with AChE of cerebrospinal fluid and P300 wave: The value of FIQ was significantly negatively correlated with the AChE activity of cerebrospinal fluid (r=-0.588 1, P < 0.01), significantly negatively correlated with the latent period at points Fz, C and Pz of P300 wave (r= -0.700 5, -0.689 4, -0.688 5, P < 0.01), and significantly positively correlated with the amplitude at points Fz , Cz and Pz of P300 wave(r= 0.607 4,0.616 1,0.592 0,P < 0.01). CONCLUSION: ① Cognitive impairment of patients with type 2 diabetes mellitus might be related to the increase of activity of AChE in cerebrospinal fluid. ② Combined application of examination of P300 wave and evaluation of IQ is more useful in deciding the state of cognitive function of patients with type 2 diabetes mellitus.
基金Science and technology research and development program of Hebei province(No.1221068D).
文摘Objective:To observe the effect of aripiprazole and olanzapine on the cognitive function in patients with schizophrenia in order to provide a reference evidence for the clinical medication.Methods:A total of 60 patients with schizophrenia who were admitted in our hospital were included in the study and randomized into the treatment 1 group and treatment 2 group.The patients in the two groups were given aripiprazole and olanzapine,respectively.PANSS,WCST,DS,IGT,and EIRT were used to evaluate the disease condition and cognitive function before and after treatment in the two groups.Results:Comparision of PANSS scores and other various scores before treatment between the two groups was not significantly different(P>0.05);however,PANSS scores and other various scores after treatment were significantly reduced(P<0.05).Comparision of PANSS scores and other various scores after treatment between the two groups was not significantly different(P>0.05).DS,WCST,and IGT scores before treatment between the two groups was comparable(P>0.05),and those scores after treatment were significantly elevated(P<0.05).DS score after treatment in the treatment 2 group was significantly higher than that in the treatment 1 group(P<0.05).Comparison of WCST and IGT scores after treatment between the two groups was not significantly different(P>0.05).The four cognition scores of happiness,fear,anger,and disgust after treatment in the treatment 1 group were significantly elevated(P<0.05),while the cognition of happiness and sadness after treatment in the treatment 2 group was significantly elevated when compared with before treatment(P<0.05).The comparison of various scores before and after treatment between the two groups was not significantly different(P>0.05).Conclusions:Aripiprazole and olanzapine can improve the clinical symptoms and partial cognitive function in patients with schizophrenia,while aripiprazole can make a better effect on the work and memory.
文摘Exercise has widely been shown to improve cognition, potentially by making individuals more receptive to sensory stimulation or inhibiting irrelevant information. Caffeine, one of the world’s most widely used stimulants, seems to have similar effects. It seems that both exercise and caffeine improve cognitive function separately, but little research has been done examining their combined effects. The purpose of this study was to examine the impact of caffeine and exercise, independently and combined, on cognitive function. 20 healthy college students completed the study. These participants were low caffeine consumers. Each participant came to the lab 5 times. During the first session, they completed a graded exercise test on a cycle ergometer to determine ventilatory threshold (VT). The following four sessions were test sessions involving supplementation and exercise. During these, each participant engaged in 30 minutes of cycling (at 90% VT) or 30 minutes of quiet reading after consuming either caffeine (at 4 mg/kg body weight) or a placebo. The Contingent Continuous Performance Task (CPT) and Wisconsin Card Sorting Task were used to measure cognitive function and were completed 5 minutes and 20 minutes after exercise or quiet reading. There were no significant differences found for any variables tested, for condition effect, time effect or condition*time interaction, except for a significant time effect on false alarms on the Contingent CPT (p = 0.017). This study may have been limited by multiple variables including the population, executive function measures, caffeine dosage, or exercise prescription. These findings point to the need for future research to understand the changes in cognition from exercise and caffeine in combination. Future research may include looking at exercise at different intensities, different dosages of caffeine, or looking at the long-term cognitive effects.
