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Postoperative cognitive dysfunction (POCD) is a major concern, particularly among older adults. This study used social isolation (ISO) and multiomics analyses in aged mice to investigate potential mechanisms underlying POCD development. Aged mice were divided into two groups: ISO and paired housing (PH). Oleamide and the cannabinoid receptor type 2 (CB2R) antagonist AM630 were administered intraperitoneally, while Foxq1 adeno‐associated viral (AAV) vector was injected directly into the hippocampus. Intramedullary tibial surgeries were subsequently performed to establish the POCD models. Behavioral tests comprising the Y‐maze, open field test, and novel object recognition were conducted 2 days after surgery. Hippocampal and serum inflammatory cytokines were assessed. Following surgery, ISO mice demonstrated intensified cognitive impairments and escalated inflammatory markers. Integrative transcriptomic and metabolomic analysis revealed elevated oleamide concentrations in the hippocampus and serum of PH mice, with associative investigations indicating a close relationship between the Foxq1 gene and oleamide levels. While oleamide administration and Foxq1 gene overexpression substantially ameliorated postoperative cognitive performance and systemic inflammation in mice, CB2R antagonist AM630 impeded these enhancements. The Foxq1 gene and oleamide may be crucial in alleviating POCD. While potentially acting through CB2R‐mediated pathways, these factors may modulate neuroinflammation and attenuate proinflammatory cytokine levels within the hippocampus, substantially improving cognitive performance postsurgery. This study lays the groundwork for future research into therapeutic approaches targeting the Foxq1‐oleamide‐CB2R axis, with the ultimate goal of preventing or mitigating POCD. [ABSTRACT FROM AUTHOR]

Wilson's disease (WD) is an autosomal recessive disorder of copper metabolism. The genetic defect in WD affects the ATP7B gene, which encodes the ATP7B transmembrane protein, which is essential for maintaining normal copper homeostasis in the body. It is primarily expressed in the liver and acts by incorporating copper into ceruloplasmin (Cp), the major copper transport protein in the blood. In conditions of excess copper, ATP7B transports it to bile for excretion. Mutations in ATP7B lead to impaired ATP7B function, resulting in copper accumulation in hepatocytes leading to their damage. The toxic "free"—unbound to Cp—copper released from hepatocytes then accumulates in various organs, contributing to their damage and clinical manifestations of WD, including hepatic, neurological, hematological, renal, musculoskeletal, ophthalmological, psychiatric, and other effects. While most clinical manifestations of WD correspond to identifiable organic or cellular damage, the pathophysiology underlying its psychiatric manifestations remains less clearly understood. A search for relevant articles was conducted in PubMed/Medline, Science Direct, Scopus, Willy Online Library, and Google Scholar, combining free text and MeSH terms using a wide range of synonyms and related terms, including "Wilson's disease", "hepatolenticular degeneration", "psychiatric manifestations", "molecular mechanisms", "pathomechanism", and others, as well as their combinations. Psychiatric symptoms of WD include cognitive disorders, personality and behavioral disorders, mood disorders, psychosis, and other mental disorders. They are not strictly related to the location of brain damage, therefore, the question arises whether these symptoms are caused by WD or are simply a coincidence or a reaction to the diagnosis of a genetic disease. Hypotheses regarding the etiology of psychiatric symptoms of WD suggest a variety of molecular mechanisms, including copper-induced CNS toxicity, oxidative stress, mitochondrial dysfunction, mitophagy, cuproptosis, ferroptosis, dysregulation of neurotransmission, deficiencies of neurotrophic factors, or immune dysregulation. New studies on the expression of noncoding RNA in WD are beginning to shed light on potential molecular pathways involved in psychiatric symptomatology. However, current evidence is still insufficient to definitively establish the cause of psychiatric symptoms in WD. It is possible that the etiology of psychiatric symptoms varies among individuals, with multiple biological and psychological mechanisms contributing to them simultaneously. Future studies with larger samples and comprehensive analyses are necessary to elucidate the mechanisms underlying the psychiatric manifestations of WD and to optimize diagnostics and therapeutic approaches. [ABSTRACT FROM AUTHOR]

Background and Objectives Social isolation is commonly experienced by older people and is associated with adverse health outcomes. Little is known about the influence of social isolation on the risk of acute care utilization among people living with mild cognitive impairment (MCI) or dementia. Our objective was to investigate the impact of social isolation on the risk of death, hospitalization, and emergency department (ED) use among people living with MCI or dementia who are followed in our Community Internal Medicine practice at Mayo Clinic, Rochester, Minnesota. Research Design and Methods We included people living with MCI or dementia, 55 years and older, who had a clinic visit between June 1, 2019, and June 30, 2021, and who had completed questions about social connections. The risk of death, hospitalization, and ED use was examined by levels of social connection (socially isolated, moderately isolated, moderately integrated, or socially integrated). Results Of 2,320 people included (1,010 with MCI and 1,310 with dementia), 455 (19.6%) were classified as socially isolated and 591 (25.5%) were moderately isolated. Compared with those who were socially integrated, people who were socially isolated were at higher risk of death, hospitalization, and ED visits (p  < .001). Discussion and Implications Social isolation is associated with an increased risk of acute health care utilization and death in people living with MCI or dementia. Interventions to address social isolation in this population are needed. [ABSTRACT FROM AUTHOR]

The aim of the study. To investigate the peculiarities of changes in hormonal and metabolic markers and their relationships with neurovegetative disorders in patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period). Materials and methods. 71 patients with coronary artery disease were examined: stable angina pectoris II–III FC (age 69.0 (64.0; 76.0) years): 1 group (main) – 31 patients with coronary artery disease after suffering from the COVID-19 coronavirus disease (in the long-COVID period); Group 2 (comparison) – 40 patients with coronary artery disease who did not have a history of COVID-19. 15 practically healthy people were included in the control group. The concentration of vasopressin, ghrelin, and insulin in blood serum was estimated using immunoenzymatic analysis. The HOMA index is calculated according to the generally accepted formula. Statistical data processing was carried out in accordance with modern requirements. Results. Significant changes in hormonal and metabolic markers were found in patients with coronary artery disease in the long-COVID period in comparison with the control group and with patients without a history of COVID-19: an increase in the concentration of vasopressin by 70.23 % and 33.38 %, insulin by 52.16 % and 32.76 %, glucose level by 31.20 % and 20.00 %, HOMA index by 60.00 % and 35.77 %, reduction of active ghrelin level by 45.71 % and 49.20 % (p < 0.05) respectively. The number of patients with insulin resistance in the 1st group was significantly higher compared to the 2nd group (χ2 = 0.516, p < 0.001). Inverse correlations were established between the level of ghrelin and vasopressin (r = -0.33, p < 0.05), insulin (r = -0.25, p < 0.05) and the HOMA index (r = -0.24, p < 0.05); direct correlation between the level of vasopressin and the HOMA index (r = +0.26, p < 0.05). In addition, a wide range of reliable correlations between the level of vasopressin, ghrelin and the degree of anxiety-depressive, cognitive and autonomic disorders were found in patients with coronary artery disease in the long-COVID period. Conclusions. The obtained results confirm common mechanisms between the development of hormonal and metabolic disorders and the occurrence of anxiety-depressive, cognitive disorders, vegetative imbalance against the background of overstrain of functional adaptation processes in patients with coronary heart disease in the long-COVID period.

The aim of the work was to evaluate the pharmacological effects and therapeutic potential of individual compounds and extracts of B. monnieri based on the analysis of data from scientific periodicals regarding chemical composition and biological action. Theoretically significant were the studies of the materials of the scientific-metric database PubMed and Google Scholar over the last five years regarding the chemical composition and biological action of extracts based on B. monnieri and their individual components. The search query was carried out by the Latin name of the plant, with the exception of publications related to botanical research. In separate PubChem searches, names of individual phytocompounds were used to establish structure and distribution in plants. The SuperPred web server was used to predict therapeutic potential. The authors analyzed the chemical composition of the extracts, presented the structural and pharmacological characteristics of bacosides and their aglycones: bacosin and juubogenin, cucurbitacin E, loliolide, betulinic and asiatic acids and the flavonoid oroxindin. The mechanism of action of bacoside on β-amyloid is characterized and illustrated. Using machine learning, the prospects for using the main compounds of bacopa to create drugs were calculated taking into account the ATC classification, their biological effects and alternative plant sources were given. Experimental animal studies of whole aqueous or ethanolic extracts of B. monnieri have been found to support a cognitive enhancement effect. The extract was not toxic to humans. Numerous clinical trials show the effectiveness of the use of extracts in the treatment of anhedonia, depression, Alzheimer's disease, Parkinson's disease, dementia and hyperactivity. An analysis of clinical studies in Ukraine shows that drugs based on B. monnieri can be used in the complex treatment of cognitive impairment associated with dyscirculatory encephalopathy in adults and perinatal CNS damage in children. Considering the amphiphilicity of bacosides and the non-toxicity of extracts, they can be involved in the development of various dosage forms with a wide range of therapeutic applications. Further study of the pharmacological action of B. monnieri and the development of drug technology for solid and liquid dosage forms based on it are promising.

As explained in the first part, the acquisition of firsthand experiences is an essential element of qualitative research for uncovering and enriching study findings. However, individuals with cognitive disorders are often excluded due to various challenges. In these cases, researchers may rely on caregivers or close associates to understand their feelings and views. This approach not only reduces these individuals to mere objects but also presents ethical dilemmas, thereby impacting the depth and richness of study findings (1). Given that the methods of data collection significantly impacts the results of studies (2), it is imperative for qualitative researchers to strive towards directly gathering information from the individuals themselves. Understanding the experiences of people with cognitive impairments is crucial for providing evidence-based services. However, these patients often encounter challenges such as speech difficulties (3), ‘pseudo-reminiscences’ (4-6), mood fluctuations and behavioral problems (7), and other issues. Therefore, researchers should take into consideration certain factors when conducting interviews with these individuals as in-depth interviews aim to gain a deeper understanding of participants' life experiences (8,9). These interviews require specialized skills across various stages, encompassing the development of interview guides, participant recruitment, obtaining consent, conducting effective interviews, data analysis and interpretation, and proficient communication and dissemination of research findings. This section delves into the key aspects of each of these phases. During interviews, it is important to prioritize the well-being of both the researcher and the participant while reflecting on and ensuring the depth and richness of the interview content (6).

One of the most common neurological symptoms is cognitive impairment. Cognitive disorders occur especially often in old age. An analysis of cognitive functions in 58 elderly patients with alcohol dependence formed in middle and old age and complicated by secondary organic mental disorders is presented. The identified neurological signs indicate the absence of severe brain lesions. Data are presented showing that the level of alcohol anosognosia for its individual components, as well as the overall score of cognitive function indicators in elderly patients with alcohol dependence, formed in middle and old age and complicated by secondary organic mental disorders, differs.

Background and Objectives: Defining the exercise habits of individuals with Alzheimer's Disease (AD) may help to determine optimal rehabilitation programs. This study aimed to investigate the physical and psychological parameters associated with exercise barriers in older individuals with AD, with the goal of informing more effective rehabilitation programs. Materials and Methods: A cross-sectional prospective study was conducted with 50 individuals with AD. The individuals were evaluated with the Exercise Benefit/Barriers Scale (EBBS), the Mini-Mental State Examination (MMSE), the Five Times Sit to Stand Test (FTSTS), the Barthel Index (BI), the Tampa Scale for Kinesiophobia (TSK), and the Hospital Anxiety and Depression Scale (HADS). Results: There was a significant positive correlation between age with EBBS-Exercise Barriers (r = 0.308; p = 0.029) and EBBS-Total Score (r = 0.295; p = 0.038). There were significant negative correlations between the time of diagnosis with EBBS-Exercise Benefits (r = −0.569; p = 0.000), EBBS-Exercise Barriers (r = −0.324; p = 0.022), and EBBS-Total Score (r = −0.508; p = 0.000). There was a positive correlation between MMSE and EBBS-Exercise Benefits (r = 0.465; p = 0.001), EBBS-Exercise Barriers (r = 0.471; p = 0.001) and EBBS-Total Score (r = 0.519; p = 0.000). There were significant positive correlations between FTSTS and EBBS-Exercise Barriers (r = 0.340; p = 0.016), and EBBS-Total Score (r = 0.280; p = 0.049). There were positive correlations between BI and EBBS-Exercise Benefits (r = 0.362; p = 0.010), EBBS-Exercise Barriers (r = 0.377; p = 0.007), and EBBS-Total Score (r = 0.405; p = 0.004). Conclusions: Exercise barriers/benefits were associated with cognition and post-diagnosis duration in individuals with AD. Individuals with lower physical function had lower exercise perception. In addition, living with relatives or caregivers led to better exercise benefit scores. [ABSTRACT FROM AUTHOR]

Background and purpose: Idiopathic normal pressure hydrocephalus (iNPH) is a chronic neurological disease resulting in progressive gait and cognitive disorders. We investigated whether the gait phenotype is associated with the severity of cognitive deficits in iNPH. Methods: This retrospective study recruited 88 patients (mean age = 76.18 ± 7.21 years, 42% female). Patients were initially referred for suspicion of iNPH and underwent a comprehensive analysis, including gait analysis and cognitive evaluation. Results: In this cohort (27% normal gait, 25% frontal gait, 16% parkinsonian gait, 27% other gait abnormalities), patients with parkinsonian and frontal gait had the lowest Mini‐Mental State Examination (MMSE) scores and the slowest gait speed. Patients with normal gait had the highest MMSE scores and gait speed. Frontal gait was associated with lower MMSE score, even after adjusting for age, gender, comorbidities, white matter lesions, and education level (β = −0.221 [95% confidence interval (CI) = −3.718 to −0.150], p = 0.034). Normal gait was associated with the best MMSE scores, even after adjusting for the abovementioned variables (β = 0.231 [95% CI = 0.124–3.639], p = 0.036). Conclusions: Gait phenotypes among iNPH patients are linked to global cognition as assessed with MMSE. [ABSTRACT FROM AUTHOR]

Introduction: Neurofibromatosis type 1 (NF type 1) is an autosomal dominant disease with typical clinical manifestations, such as skin lesions, Lisch nodules, optic pathway gliomas, and neurofibromas, caused by the mutation of the NF1 gene. Visual evoked potentials (VEP) present a measure of the electrophysiological response of visual cortex to a visual stimulus. The role of VEP in the pathophysiology of NF type 1 is very complex and requires additional research. The Aim: We examined the differences between NF type 1 patients with normal and altered VEP and analyzed the correlation between the prolongation of P100 latency and disease severity. Materials and Methods: Two groups were formed: a control group and a study group with NF type 1 patients. Based on the control group analysis, a threshold value for a normal VEP finding of 116 ms was obtained, and it was used to divide the study group into subgroups with normal and altered VEP. We proceeded with examining the differences in clinical manifestations of the disease between the subgroups, after which we checked if there is a correlation between the prolongation of the P100 latency and the severity of the clinical picture according to the Riccardi scale. Statistical analysis was performed using the Pearson chi-square test and the Spearman correlation test in the program SPSS 28.0, with levels of statistical significance p = 0.05 and p = 0.001. Results: In the group with the abnormal VEP we found a statistically significant more frequent occurrence of optic tract glioma (p = 0.008), tumors (p = 0.032), epilepsy (p = 0.043), and cognitive disorders (p = 0.028), while the other clinical signs had an equal prevalence in both groups. A moderately strong correlation (rs = 0.665) was observed between the prolongation of P100 latency and the severity of the clinical picture. Conclusion: Our results showed the important role of VEP in the description of clinical phenotypes of NF type 1. The authors of the study propose VEP to be included in the diagnostic algorithms designed for patients with NF type 1. [ABSTRACT FROM AUTHOR]

Over the last several years, a growing body of evidence from anatomical, physiological, and functional neuroimaging studies has increasingly indicated that the cerebellum is actively involved in managing higher order cognitive functions and regulating emotional responses. It has become clear that when children experience congenital or acquired cerebellar lesions, these injuries can lead to a variety of cognitive and emotional disorders, manifesting in different combinations. This underscores the cerebellum's essential role not only throughout developmental stages but particularly in facilitating learning processes, highlighting its critical importance beyond its traditional association with motor control. Furthermore, the intricate neural circuits within the cerebellum are believed to contribute to the fine-tuning of motor actions and coordination but are also increasingly recognized for their involvement in cognitive processes such as attention, language, and problem solving. Recent research has highlighted the importance of cerebellar health and integrity for optimal functioning across various domains of the human experience. [ABSTRACT FROM AUTHOR]

IntroductionEvaluating neurocognitive functions and diagnosing psychiatric disorders in older adults is challenging due to the complexity of symptoms and individual differences. An innovative approach that combines the accuracy of artificial intelligence (AI) with the depth of neuropsychological assessments is needed.ObjectivesThis paper presents a novel protocol for AI-assisted neurocognitive assessment aimed at addressing the cognitive, emotional, and functional dimensions of older adults with psychiatric disorders. It also explores potential compensatory mechanisms.MethodologyThe proposed protocol incorporates a comprehensive, personalized approach to neurocognitive evaluation. It integrates a series of standardized and validated psychometric tests with individualized interpretation tailored to the patient’s specific conditions. The protocol utilizes AI to enhance diagnostic accuracy by analyzing data from these tests and supplementing observations made by researchers.Anticipated resultsThe AI-assisted protocol offers several advantages, including a thorough and customized evaluation of neurocognitive functions. It employs machine learning algorithms to analyze test results, generating an individualized neurocognitive profile that highlights patterns and trends useful for clinical decision-making. The integration of AI allows for a deeper understanding of the patient’s cognitive and emotional state, as well as potential compensatory strategies.ConclusionsBy integrating AI with neuro-psychological evaluation, this protocol aims to significantly improve the quality of neurocognitive assessments. It provides a more precise and individualized analysis, which has the potential to enhance clinical decision-making and overall patient care for older adults with psychiatric disorders.

Post-COVID syndrome (PCS) is characterized by long-term complications and conditions accompanied by neuroimmunoinflammation, and includes chronic fatigue syndrome (CFS) and cognitive disorders (CD), which are often associated with activation of chronic herpesvirus infections (HVI). Timely detection of symptoms and immunodiagnosis of PCS are a priority and are of undoubted interest. Objective: to clarify the levels of serum proand anti-inflammatory cytokines, alpha and gamma interferons in patients with post-COVID syndrome associated with confirmed activation of chronic herpesvirus infections. Patients (n = 60) aged from 18 to 65 years with complaints of manifestations of PCS associated with HVI were studied — the study group (SG). A survey was conducted using a modified scale-questionnaire to assess the severity of PCS symptoms in points from 0 to 4, real-time PCR of HVI (EBV, HSV1/2, VCH6, VCH8, CMV) in saliva and scrapings from the tonsils, determination of the level of IFNα and IFNγ, pro- (TNFα, IL-18, IL-1β, IL-6, IL-17A, IL-8) and anti-inflammatory (IL-4 and IL-10) cytokines in blood serum. Comparison group (CG) — 60 apparently healthy individuals. SG patients with mixed HVI with EBV dominance noted the most pronounced and persistent clinical manifestations of PCS, among which the leading place was occupied by longterm sensations of CFS and CD. A persistent multisystem inflammatory response was identified, confirmed by elevated levels of IL-6 and IL-17A, which caused severe PCS. In post-COVID period, hyperproduction of IL-1β was detected, which was accompanied by clinical manifestations of persistent neuroimmunoinflammation. At the same time, the identified deficiency of IFNα, IFNγ and dysregulatory disorders in the antiviral defense of the immune system in patients with PCS contributed to the activation of HVI. Data on the imbalance of proand anti-inflammatory cytokines in the SG were obtained, which confirms the presence of a persistent multisystem inflammatory reaction with dominance of persistent neuroimmunoinflammation, which causes severe PCS. An imbalance of the cytokine system with IFNα and IFNγ deficiency, associated with the activation of chronic HVI with EBV dominance in the post-COVID period, contributes to the development of neuroimmunoinflammation, which is accompanied by the leading clinical signs of PCS: CFS and CD.

Elderly and senile people often suffer from cognitive impairment. One of the significant issues that develop as the severity of cognitive impairment increases is dysphagia. The article addresses various causes of dysphagia and ways to manage it. Due to the high prevalence of dysphagia in cognitively reduced patients, selecting therapy for cognitive disorders is often challenging. Since patients with dysphagia have difficulties taking solid dosage forms (DF) – tablets and capsules, alternative DFs are being discussed. In particular, studies of the positive effect on the cognitive status of Cereton and the use of its different DFs are presented, allowing for optimal therapy in various situations. The novel DF of Cereton, an oral solution, is convenient for use in patients with dysphagia.

Summary: Background: Brain stimulation therapy (BST) has significant potential in treating psychiatric, movement, and cognitive disorders. Given the high prevalence of comorbidities among these disorders, we conducted an umbrella review to comprehensively assess the efficacy of BSTs in treating the core symptoms across these three categories of disorders. Methods: We systematically searched for meta-analyses and network meta-analyses of randomized controlled trials with sham controls up to September 25, 2024, from databases including PubMed, PsycINFO, Embase, and the Cochrane Library. Our primary outcome was improvements in core symptoms. We evaluated quality using 11 criteria. We calculated pooled effect estimates for core symptoms based on the largest meta-analyses, then conducted sensitivity and subgroup analyses, and assessed heterogeneity, publication bias, and small-study effects. Finally, we synthesized effect sizes from all meta-analyses to provide a comprehensive overview of BSTs' efficacy. PROSPERO registration: CRD42023439090. Findings: We included 198 articles with 108,377 patients evaluating 14 BSTs across 21 disorders. The largest meta-analysis showed a moderate standardized mean difference (SMD) of 0.56 (95% CI: 0.49, 0.64; I2 = 70%). Subgroup analyses revealed significant SMDs for psychiatric disorders (0.60; 95% CI: 0.49, 0.71; I2 = 66%), movement disorders (0.56; 95% CI: 0.42, 0.69; I2 = 79%), and cognitive disorders (0.46; 95% CI: 0.32, 0.61; I2 = 48%). SMDs were 0.44 (95% CI: 0.23, 0.65; I2 = 70%) for follow-up ≤1 month and 0.69 (95% CI: 0.43, 0.94; I2 = 84%) for follow-up >1 month. Compared to other conditions, BSTs show better therapeutic effects in treating depression, post-traumatic stress disorder, obsessive-compulsive disorder, pain, fibromyalgia, and post-stroke motor recovery. Interpretation: This review explored the potential of BSTs for comorbidities of the three disorders from a disorder-specific perspective, providing a roadmap for their clinical application and future research. Funding: This work was supported by the Anhui Natural Science Foundation (2023AH040086), Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention (SYS2023B08), and the Joint Funds of the National Natural Science Foundation of China (U23A20424).

The aim of the work was to evaluate the pharmacological effects and therapeutic potential of individual compounds and extracts of B. monnieri based on the analysis of data from scientific periodicals regarding chemical composition and biological action. Theoretically significant were the studies of the materials of the scientific- metric database PubMed and Google Scholar over the last five years regarding the chemical composition and biological action of extracts based on B. monnieri and their individual components. The search query was carried out by the Latin name of the plant, with the exception of publications related to botanical research. In separate PubChem searches, names of individual phytocompounds were used to establish structure and distribution in plants. The SuperPred web server was used to predict therapeutic potential. The authors analyzed the chemical composition of the extracts, presented the structural and pharmacological characteristics of bacosides and their aglycones: bacosin and juubogenin, cucurbitacin E, loliolide, betulinic and asiatic acids and the flavonoid oroxindin. The mechanism of action of bacoside on β-amyloid is characterized and illustrated. Using machine learning, the prospects for using the main compounds of bacopa to create drugs were calculated taking into account the ATC classification, their biological effects and alternative plant sources were given. Experimental animal studies of whole aqueous or ethanolic extracts of B. monnieri have been found to support a cognitive enhancement effect. The extract was not toxic to humans. Numerous clinical trials show the effectiveness of the use of extracts in the treatment of anhedonia, depression, Alzheimer's disease, Parkinson's disease, dementia and hyperactivity. An analysis of clinical studies in Ukraine shows that drugs based on B. monnieri can be used in the complex treatment of cognitive impairment associated with dyscirculatory encephalopathy in adults and perinatal CNS damage in children. Considering the amphiphilicity of bacosides and the non-toxicity of extracts, they can be involved in the development of various dosage forms with a wide range of therapeutic applications. Further study of the pharmacological action of B. monnieri and the development of drug technology for solid and liquid dosage forms based on it are promising. [ABSTRACT FROM AUTHOR]

This study conducted at Leamna Pulmonology Hospital investigated the interrelations among cognitive, affective, and respiratory variables within a cohort of 100 patients diagnosed with chronic respiratory conditions, utilizing sophisticated machine learning-based clustering techniques. Spanning from October 2022 to February 2023, hospitalized individuals confirmed to have asthma or COPD underwent extensive evaluations using standardized instruments such as the mMRC scale, the CAT test, and spirometry. Complementary cognitive and affective assessments were performed employing the MMSE, MoCA, and the Hamilton Anxiety and Depression Scale, furnishing a holistic view of patient health statuses. The analysis delineated three distinct clusters: Moderate Cognitive Respiratory, Severe Cognitive Respiratory, and Stable Cognitive Respiratory, each characterized by unique profiles that underscore the necessity for tailored therapeutic strategies. These clusters exhibited significant correlations between the severity of respiratory symptoms and their effects on cognitive and affective conditions. The results highlight the benefits of an integrated treatment approach for COPD and asthma, which is personalized based on the intricate patterns identified through clustering. Such a strategy promises to enhance the management of these diseases, potentially elevating the quality of life and everyday functionality of the patients. These findings advocate for treatment customization according to the specific interplays among cognitive, affective, and respiratory dimensions, presenting substantial prospects for clinical advancement and pioneering new avenues for research in the domain of chronic respiratory disease management. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Current proposed criteria for functional cognitive disorder (FCD) have not been externally validated. We sought to analyse the current perspectives of cognitive specialists in the diagnosis and management of FCD in comparison with neurodegenerative conditions.International experts in cognitive disorders were invited to assess seven illustrative clinical vignettes containing history and bedside characteristics alone. Participants assigned a probable diagnosis and selected the appropriate investigation and treatment. Qualitative, quantitative and inter‐rater agreement analyses were undertaken.Eighteen diagnostic terminologies were assigned by 45 cognitive experts from 12 countries with a median of 13 years of experience, across the seven scenarios. Accurate discrimination between FCD and neurodegeneration was observed, independently of background and years of experience: 100% of the neurodegenerative vignettes were correctly classified and 75%–88% of the FCD diagnoses were attributed to non‐neurodegenerative causes. There was <50% agreement in the terminology used for FCD, in comparison with 87%–92% agreement for neurodegenerative syndromes. Blood tests and neuropsychological evaluation were the leading diagnostic modalities for FCD. Diagnostic communication, psychotherapy and psychiatry referral were the main suggested management strategies in FCD.Our study demonstrates the feasibility of distinguishing between FCD and neurodegeneration based on relevant patient characteristics and history details. These characteristics need further validation and operationalisation. Heterogeneous labelling and framing pose clinical and research challenges reflecting a lack of agreement in the field. Careful consideration of FCD diagnosis is advised, particularly in the presence of comorbidities. This study informs future research on diagnostic tools and evidence‐based interventions. [ABSTRACT FROM AUTHOR]

IntroductionAir pollution is a significant contributor to morbidity and mortality globally and has been linked to an increased risk of dementia. Previous studies within the Betula cohort in Northern Sweden have demonstrated associations between air pollution and dementia, as well as distinctive metabolomic profiles in dementia patients compared to controls. This study aimed to investigate whether air pollution is associated with quantitative changes in metabolite levels within this cohort, and whether future dementia status would modify this association.MethodsBoth short-term and long-term exposure to air pollution were evaluated using high spatial resolution models and measured data. Air pollution from vehicle exhaust and woodsmoke were analyzed separately. Metabolomic profiling was conducted on 321 participants, including 58 serum samples from dementia patients and a control group matched for age, sex, and education level, using nuclear magnetic resonance spectroscopy.ResultsNo statistically significant associations were found between any metabolites and any measures of short-term or long-term exposure to air pollution. However, there were trends potentially suggesting associations between both long-term and short-term exposure to air pollution with lactate and glucose metabolites. Notably, these associations were observed despite the lack of correlation between long-term and short-term air pollution exposure in this cohort. There were also tendencies for associations between air pollution from woodsmoke to be more pronounced in participants that would later develop dementia, suggesting a potential effect depending on urban/rural factors.DiscussionWhile no significant associations were found, the trends observed in the data suggest potential links between air pollution exposure and changes in lactate and glucose metabolites. These findings provide some new insights into the link between air pollution and metabolic markers in a low-exposure setting. However, addressing existing limitations is crucial to improve the robustness and applicability of future research in this area. The pronounced associations in participants who later developed dementia may indicate an influence of urban/rural factors, warranting further investigation.

Background: Cognitive impairment (CI) is present in 25–50% of chronic heart failure (CHF) patients. Doctors who monitor patients with cardiovascular disorders do not have clearly set criteria for their referral to a neurologist in case of suspected CI. Therefore, CHF patients do not receive treatment for CI on time. Aim: To identify significant clinical markers of CI in patients with CHF of ischemic origin. Materials and methods: This cross-sectional cohort study included 134 patients with CHF of ischemic origin (mean age 63.36 ± 10.63 years; men, 76.12%), who were regularly monitored in a municipal polyclinic. All patients were tested for CI with the Montreal Cognitive Assessment Scale (MoCA); basic hemodynamic parameters, lipid profile, brain natriuretic peptide (NT-proBNP) were assessed, and triglyceride-glucose index (TyG) and body mass index (BMI) were calculated. Cardio-ankle vascular index (CAVI) was measured, echocardiography and a 6-minute walk test (SMWТ) were performed and past history of CHF, arterial hypertension (AH) and diabetes mellitus (DM) was collected. Results: CI (MoCA score ≤ 25) was detected in 85 (63.43%) outpatients with CHF of ischemic origin; the group without CI (MoCA score 26) included 49 (36.67%) patients. There were significant correlations between MoCA and CAVI scores (partial correlation coefficient, r = -0.802, p 0.001; adjusted squared multiple correlation coefficient (adj. R2) = 0.881, p 0.001), MoCA and TyG (r = -0.357, p = 0.029; adj. R2 = 0.363, p 0.001), MoCA and SMWТ (r = -0.211, p = 0.037; adj. R2 = 0.696, p 0.001). The multivariate test for significance of planned comparisons between CAVI and MoCA scores (Wilks' lambda) was 0.005 (F = 4.74; p 0.001). Conclusion: CAVI, TyG and SMWТ values are the clinical markers of CI in patients with CHF of ischemic origin. There is a direct association between increased CAVI and the presence of CI, regardless of age, lipid metabolism parameters, structural and functional heart parameters, CHF duration, AH and DM. Identification of these markers could be an indication for an in-depth assessment of CHF patients by a neurologist.

Abstract Background The early detection of dementia depends on efficient methods for the assessment of cognitive capacity. Existing cognitive screening tools are ill-suited to the differentiation of cognitive status, particularly when dealing with early-stage impairment. Methods The study included 8,979 individuals (> 50 years) with unimpaired cognitive functions, mild cognitive impairment (MCI), or dementia. This study sought to determine optimal cutoffs values for the Cognitive Abilities Screening Instrument (CASI) aimed at differentiating between individuals with or without dementia as well as between individuals with or without mild cognitive impairment. Cox proportional hazards models were used to evaluate the value of CASI tasks in predicting conversion from MCI to all-cause dementia, dementia of Alzheimer’s type (DAT), or to vascular dementia (VaD). Results Our optimized cutoff scores achieved high accuracy in differentiating between individuals with or without dementia (AUC = 0.87—0.93) and moderate accuracy in differentiating between CU and MCI individuals (AUC = 0.67 – 0.74). Among individuals without cognitive impairment, scores that were at least 1.5 × the standard deviation below the mean scores on CASI memory tasks were predictive of conversion to dementia within roughly 2 years after the first assessment (all-cause dementia: hazard ratio [HR] = 2.81 – 3.53; DAT: 1.28 – 1.49; VaD: 1.58). Note that the cutoff scores derived in this study were lower than those reported in previous studies. Conclusion Our results in this study underline the importance of establishing optimal cutoff scores for individuals with specific demographic characteristics and establishing profiles by which to guide CASI analysis.

Abstract Introduction Cognitive impairments present challenges for patients, impacting memory, attention, and problem-solving abilities. Virtual reality (VR) offers innovative ways to enhance cognitive function and well-being. This study explores the effects of VR-based training programs and games on improving cognitive disorders. Methods PubMed, Scopus, and Web of Science were systematically searched until May 20, 2023. Two researchers selected and extracted data based on inclusion and exclusion criteria, resolving disagreements through consultation with two other authors. Inclusion criteria required studies of individuals with any cognitive disorder engaged in at least one VR-based training session, reporting cognitive impairment data via scales like the MMSE. Only English-published RCTs were considered, while exclusion criteria included materials not primarily focused on the intersection of VR and cognitive disorders. The risk of bias in the included studies was assessed using the MMAT tool. Publication bias was assessed using funnel plots and Egger’s test. The collected data were utilized to calculate the standardized mean differences (Hedges’s g) between the treatment and control groups. The heterogeneity variance was estimated using the Q test and I2 statistic. The analysis was conducted using Stata version 17.0. Results Ten studies were included in the analysis out of a total of 3,157 retrieved articles. VR had a statistically significant improvement in cognitive impairments among patients (Hedges’s g = 0.42, 95% CI: 0.15, 0.68; p_value = 0.05). games (Hedges’s g = 0.61, 95% CI: 0.30, 0.39; p_value = 0.20) had a more significant impact on cognitive impairment improvement compared to cognitive training programs (Hedges’s g = 0.29, 95% CI: -0.11, 0.69; p_value = 0.24). The type of VR intervention was a significant moderator of the heterogeneity between studies. Conclusion VR-based interventions have demonstrated promise in enhancing cognitive function and addressing cognitive impairment, highlighting their potential as valuable tools in improving care for individuals with cognitive disorders. The findings underscore the relevance of incorporating virtual reality into therapeutic approaches for cognitive disorders.

(R, S)- and (S)-ketamine have made significant progress in the treatment of treatment-resistant depression (TRD) and have become a research focus in recent years. However, they both have risks of psychomimetic effects, dissociative effects, and abuse liability, which limit their clinical use. Recent preclinical and clinical studies have shown that (R)-ketamine has a more efficient and lasting antidepressant effect with fewer side effects compared to (R, S)- and (S)-ketamine. However, a recent small-sample randomized controlled trial found that although (R)-ketamine has a lower incidence of adverse reactions in adult TRD treatment, its antidepressant efficacy is not superior to the placebo group, indicating its antidepressant advantage still needs further verification and clarification. Moreover, an increasing body of research suggests that (R)- ketamine might also have significant applications in the prevention and treatment of medical fields or diseases such as cognitive disorders, perioperative anesthesia, ischemic stroke, Parkinson's disease, multiple sclerosis, osteoporosis, substance use disorders, inflammatory diseases, COVID-19, and organophosphate poisoning. This article briefly reviews the mechanism of action and research on antidepressants related to (R)-ketamine, fully revealing its application potential and development prospects, and providing some references and assistance for subsequent expanded research. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) occurs as a result of direct mechanical action on the brain and causes degeneration and cell death in the central nervous system. Cell transplantation has proven itself not only as an experimental method for studying structural and functional relationships, development, neuroplasticity, and regeneration in the adult central nervous system but has also recently shown optimistic results in restoring functions after traumatic brain injury. Unfortunately, TBI leads to the death of a large number of brain parenchyma, therefore, one of the promising approaches used in regenerative medicine is the use of three-dimensional biocompatible scaffolds capable of supporting the growth and integration of nerve cells at the site of injury. The biocompatibility of a biodegradable scaffold, which acts as a carrier of transplanted cells and replaces the matrix of nervous tissue during neuro transplantation, was studied on the model of experimental open brain injury in mice. The 3D biodegradable scaffold was created using micro stereolithographic techniques by combining bacterial cellulose and hyaluronic acid. In an experiment on the parameters of cognitive behavior of mice (a study of longterm conditioned reflexes and short-term memory during recognition of a new object), visualization of the integrity of brain tissue using high-field MRI (9.4 T), it was shown that transplantation of a 3D scaffold based on bacterial cellulose during reconstructive therapy of a brain tissue defect reduces cognitive deficit after injury, restores the integrity of brain tissue 5 months after injury. [ABSTRACT FROM AUTHOR]

Efficient assistive speech technology is essential for persons with cognitive disorders to improve their standard of life. Various kinds of cognitive disorders affect the speech articulation. Disordered Speech Recognition (DSR) can be used for rehabilitation and gain much importance as the disordered speakers population keeps increasing in recent years. The speech utterance is commonly represented in the form of spectrogram. Since the spectrograms are noisy and incomplete, the corresponding spectrograms need to be enhanced. We propose an approach that explores Denoising Convolutional Autoencoder (DCAE) to enhance the spectrograms of disordered speech utterances which are then utilized to train CNN to recognize the disordered words. Evaluation of proposed approach is carried out using the 20 words (acoustically similar word classes) dataset and 50 words dataset of Impaired speech corpus in Tamil and 100 common words dataset of UA-Speech database. Significantly better performance is achieved by proposed approach than HMM, DNN-HMM, LFMMI and CNN without enhancement. The spectrogram enhancement using DCAE helps to obtain better discrimination among overlapping disordered word classes and achieves a maximum Word Recognition Accuracy. [ABSTRACT FROM AUTHOR]

(1) Background: Primary Familial Brain Calcification (PFBC) is a neurodegenerative disease characterized by bilateral calcifications of the basal ganglia and other intracranial areas. Many patients experience symptoms of motor dysfunction and cognitive disorders. The aim of this study was to investigate the association between the amount and location of intracranial calcifications with these symptoms. (2) Methods: Patients with suspected PFBC referred to our outpatient clinic underwent a clinical work-up. Intracranial calcifications were visualized on Computed Tomography (CT), and a Total Calcification Score (TCS) was constructed. Logistic and linear regression models were performed. (3) Results: Fifty patients with PFBC were included in this study (median age 64.0 years, 50% women). Of the forty-one symptomatic patients (82.0%), 78.8% showed motor dysfunction, and 70.7% showed cognitive disorders. In multivariate analysis, the TCS was associated with bradykinesia/hypokinesia (OR 1.07, 95%-CI 1.02–1.12, p < 0.01), gait ataxia (OR 1.06, 95%-CI 1.00–1.12, p = 0.04), increased fall risk (OR 1.04, 95%-CI 1.00–1.08, p = 0.03), and attention/processing speed disorders (OR 1.06, 95%-CI 1.01–1.12, p = 0.02). Calcifications of the lentiform nucleus and subcortical white matter were associated with motor and cognitive disorders. (4) Conclusions: cognitive and motor symptoms are common among patients with PFBC, and there is an association between intracranial calcifications and these symptoms. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is considered a continuum, progressing from preclinical disease to mild cognitive impairment (MCI) as an early stage, before reaching clinically apparent dementia. Although it is difficult to assess the potential impairments in performance of patients with MCI due to AD, this condition should be diagnosed as early as possible so that, by means of early interventions, patients can maintain their quality of life longer. Healthcare systems should support primary care physicians in their effort to identify patients with MCI due to AD and refer patients to memory clinics and specialists who can provide a reliable diagnosis and initiate appropriate disease management. This review discusses the benefits of earlier AD diagnosis, along with potential challenges and future directions. Healthcare systems need to support primary care physicians to identify patients with MCI due to AD to refer to specialists who can start managing the disease. Read our review on earlier diagnosis of AD. [ABSTRACT FROM AUTHOR]

IntroductionNeurofibromatosis type 1 (NF type 1) is an autosomal dominant disease with typical clinical manifestations, such as skin lesions, Lisch nodules, optic pathway gliomas, and neurofibromas, caused by the mutation of the NF1 gene. Visual evoked potentials (VEP) present a measure of the electrophysiological response of visual cortex to a visual stimulus. The role of VEP in the pathophysiology of NF type 1 is very complex and requires additional research.The AimWe examined the differences between NF type 1 patients with normal and altered VEP and analyzed the correlation between the prolongation of P100 latency and disease severity.Materials and methodsTwo groups were formed: a control group and a study group with NF type 1 patients. Based on the control group analysis, a threshold value for a normal VEP finding of 116 ms was obtained, and it was used to divide the study group into subgroups with normal and altered VEP. We proceeded with examining the differences in clinical manifestations of the disease between the subgroups, after which we checked if there is a correlation between the prolongation of the P100 latency and the severity of the clinical picture according to the Riccardi scale. Statistical analysis was performed using the Pearson chi-square test and the Spearman correlation test in the program SPSS 28.0, with levels of statistical significance p = 0.05 and p = 0.001.ResultsIn the group with the abnormal VEP we found a statistically significant more frequent occurrence of optic tract glioma (p = 0.008), tumors (p = 0.032), epilepsy (p = 0.043), and cognitive disorders (p = 0.028), while the other clinical signs had an equal prevalence in both groups. A moderately strong correlation (rs = 0.665) was observed between the prolongation of P100 latency and the severity of the clinical picture.ConclusionOur results showed the important role of VEP in the description of clinical phenotypes of NF type 1. The authors of the study propose VEP to be included in the diagnostic algorithms designed for patients with NF type 1.

Recently, there has been increasing attention on the impact of acupuncture on the dysregulated neural circuits in different disease. This has led to new understandings of how acupuncture works. This review presents a comprehensive analysis of research that have examined the impact of acupuncture on abnormal neural circuits associated with pain, anxiety, Parkinson’s disease, addiction disorders, cognitive problems, and gastrointestinal disorders. These studies have shown that acupuncture’s therapeutic effects are mediated by specific brain areas and neurons involved in neural circuit mechanisms, emphasising its wide-ranging influence. The positive impacts of acupuncture can be ascribed to its ability to modify the functioning of neurocircuits in various physiological conditions. Nevertheless, contemporary studies on acupuncture neural circuits frequently overlook the comprehensive circuit mechanism including the periphery, central nervous system, and target organ. Additionally, the scope of diseases studied is restricted. Future study should focus on broadening the range of diseases studied and exploring the neural circuit mechanisms of these diseases in depth in order to enhance our understanding of acupuncture’s neurobiological impacts.

BackgroundTo examine longitudinal neurocognitive decline among Latino, non-Latino Black, and non-Latino White people with HIV (PWH) and factors that may explain ethnic/racial disparities in neurocognitive decline.MethodsFour hundred ninety nine PWH (13.8% Latino, 42.7% Black, 43.5% White; baseline age: M = 43.5) from the CNS HIV Anti-Retroviral Therapy Effects Research (CHARTER) study completed neurocognitive, neuromedical, and laboratory assessments every 6-12 months with up to 5 years of follow-up. Longitudinal neurocognitive change was determined via published regression-based norms. Survival analyses investigated the relationship between ethnicity/race and neurocognitive change, and baseline and time-dependent variables that may explain ethnic/racial disparities in neurocognitive decline, including socio-demographic, HIV-disease, medical, psychiatric, and substance use characteristics.ResultsIn Cox proportional hazard models, hazard ratios for neurocognitive decline were increased for Latino compared with White PWH (HR = 2.25, 95% CI = 1.35 to 3.73, P = 0.002), and Latino compared with Black PWH (HR = 1.86, 95% CI = 1.14 to 3.04, P = 0.013), with no significant differences between Black and White PWH (P = 0.40). Comorbidities, including cardiometabolic factors and more severe neurocognitive comorbidity classification, accounted for 33.6% of the excess hazard for Latino compared with White PWH, decreasing the hazard ratio associated with Latino ethnicity (HR = 1.83, 95% CI = 1.06 to 3.16, P = 0.03), but did not fully account for elevated risk of decline.ConclusionsLatino PWH may be at higher risk of early neurocognitive decline compared with Black and White PWH. Comorbidities accounted for some, but not all, of this increased risk among Latino PWH. Future research examining institutional, sociocultural, and biomedical factors, including structural discrimination and age-related biomarkers, may further explain the observed disparities.

Background: Diagnosis of neuropsychiatric systemic lupus erythematosus (NPSLE) is challenging due to nonspecific biomarkers. High serum levels of neurofilament protein light subunit (NFL), high mobility group box 1 (HMGB1), Matrix metalloproteinase-9 (MMP-9) and have been reported in several autoimmune diseases. The aim of this study was to examine whether their plasma levels could serve as a diagnostic or prognostic biomarker for NPSLE. Methods: There were 90 SLE patients enrolled in this cross-sectional study (87.8% women and 12.2% men with a mean age of 41.67±11.05 years). We assessed the mental status of patients, also we measured the Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) and Systemic Lupus International Collaborating Clinics/ACR (SLICC/ ACR) Damage Index or SDI scores. Serum levels of NFL, HMGB1, MMP9, and ds-DNA were investigated to find a role in the pathophysiology of NPSLE. Results: Among the 90 patients with SLE, 63 (70%) met the criteria of NPSLE syndrome. Our results have shown a notable difference concerning SEDIAC-2k score, SDI score, PANS, MoCA, and Beck anxiety depression, between the two groups (p < 0.05). Although serum level of all measured serum biomarkers (NFL, MMP-9, HMGB1, dsDNA) were higher in patients with NPSLE, the difference was not statistically significant. Interestingly, our results showed that the serum level of NFL was correlated with the serum level of HMGB-1 and MMP-9. (r: 0.411, P=0.003). Conclusion: Serum level of NFL, HMGB-1 and MMP-9 may be used to detect abnormal mental status in patients with SLE.

According to a global report, 47 million people are currently living with dementia, and due to the aging population, its prevalence is expected to triple by 2050. In the future, Iran is expected to experience a significant increase in the elderly population. Currently, in Iran, the prevalence of dementia among individuals over 60 years old is 7.9%. Therefore, this group represents a significant population that warrants further research (1). The best understanding and explanation of human experiences come from first-hand sources, specifically from people who have experienced those phenomena. Therefore, reliable research sources place great emphasis on including the voices of these individuals (2). Qualitative research out for its collaborative, inclusive, and flexible structure, enabling the exploration of complex issues, including mixed or ambiguous attitudes (2). It can reveal the profound experiences and core values of people with cognitive impairment that may not emerge in quantitative studies. Additionally, qualitative research excels in vividly portraying these experiences and values (3). Throughout history, people with cognitive impairments have been marginalized from engagement in health and social research, resulting in their voices being inadequately represented in such studies. (2, 4). Instead, their perspectives have been channeled through their legal representatives or guardians, a practice that often entails constraints. These limitations include the inability to accurately predict the patient's decision-making process, the amount and manner of information provided, and the weight of decision-making responsibility placed on them (5). Furthermore, excluding these individuals from the research process can dehumanize them and perpetuate negative stereotypes about people with cognitive disorders. This also contributes to power imbalances (2). Therefore, it is crucial to develop strategies that ensure the safe participation of these individuals in research endeavors. Through these efforts, we can improve our understanding of policy and measures aimed at promoting health and well-being (6).

Aim of the research: interdisciplinary description of functioning of lexical connections in a patient with spinocerebellar ataxia (SCAtype1). There is little research on lexical networks in patients with neurodegenerative diseases. Procedure: the subject was asked to give associations to 63 stimulilexemes. Tools used in the study: the Experimental lexical network of the Polish language, a digital recorder, an Olympus 650 DM. The Experimental lexical network was developed by Izabela Gatkowska (2017). It was created as a result of the study concerning the associations of 900 healthy Polish speaking adults. Utterances of the subject were recorded, transcribed and compared with standard data. Results: the reactions of the subject were different from the associations presented in the Experimental lexical network. The most common verbal reactions were: creating definitions of stimuli word meanings or making comment on them. Associations created by the subject were based on paradigmatic or syntagmatic relations. The authors explain how the specific verbal behaviour of the subject is related to the cognitive and language dysfunctions caused by the cerebellar damages. The results showed that language processing should not be regarded as separate from other cognitive functions. Verbal reactions of the subject are slightly similar to aphasic symptoms, but mostly they are related to cerebellar damage and executive disorders. The results obtained proved the validity of the connection between linguistic and psychological methods and tools in studies which concern the language behaviour of patients with neurodegenerative diseases.

Objective: Almost all diseases of the nervous system are related to neuroinflammation, oxidative stress, neuronal death, glia activation, and increased pro-inflammatory cytokines. Cognitive disorders are one of the common complications of nervous system diseases. The role of some plant compounds in reducing or preventing cognitive disorders has been determined. Silibinin is a plant bioflavonoid and exhibits various effects on cognitive functions. This article discusses the different mechanisms of the effect of silibinin on cognitive disorders in experimental studies.Materials and Methods: Databases, including ISI, , Google Scholar, Scopus, Medline and PubMed, were investigated from 2000 to 2021, using related keywords to find required articles.Results: Silibinin can improve cognitive disorders by different pathways such as reducing neuroinflammation and oxidative stress, activation of reactive oxygen species- Brain-derived neurotrophic factor- Tropomyosin receptor kinase B (ROS–BDNF–TrkB) pathway in the hippocampus, an increase of dendritic spines in the brain, inhibition of hyperphosphorylation of tau protein and increasing the expression of insulin receptor (IR) and insulin-like growth factor receptor 1 (IGF-1R), inhibiting inflammatory responses and oxidative stress in the hippocampus and amygdala, and decrease of Homovanillic acid/Dopamine (HVA/DA) ratio and 3,4-Dihydroxyphenylacetic acid + Homovanillic acid/Dopamine (DOPAC+ HVA/DA) ratio in the prefrontal cortex and 5-hydroxyindoleacetic acid/5-hydroxytryptamine (5-HIAA/5-HT) ratio in the hippocampus.Conclusion: These results suggest that silibinin can be considered a therapeutic agent for the symptom reduction of cognitive disorders, and it acts by affecting various mechanisms such as inflammation, programmed cell death, and oxidative stress.

Factors that influence the risk of neurocognitive decline and Alzheimer's disease (AD) may provide insight into therapies for both disease treatment and prevention. Although age is the most striking risk factor for AD, it is notable that the prevalence of AD is higher in women, representing two-thirds of cases. To explore potential underlying biological underpinnings of this observation, the intent of this article is to explore the interplay between cognitive aging and sex hormones, the cholinergic system, and novel hypotheses related to the essential nutrient choline. Mechanistic evidence points toward estrogen's neuroprotective effects being strongly dependent on its interactions with the cholinergic system, a modulator of attentional functioning, learning, and memory. Estrogen has been shown to attenuate anticholinergic-induced impairments in verbal memory and normalize patterns of frontal and occipital cortex activation, resulting in a more "young adult" phenotype. However, similar to estrogen replacement's effect in cardiovascular diseases, its putative protective effects may be restricted to early postmenopausal women only, a finding supportive of the "critical window hypothesis." Estrogen's impact on the cholinergic system may act both locally in the brain but also through peripheral tissues. Estrogen is critical for inducing endogenous choline synthesis via the phosphatidylethanolamine N-methyltransferase (PEMT) gene-mediated pathway of phosphatidylcholine (PC) synthesis. PEMT is dramatically induced in response to estrogen, producing not only a PC molecule and source of choline for the brain but also a key source of the long-chain ω-3 fatty acid, DHA. Herein, we highlight novel hypotheses related to hormone replacement therapy and nutrient metabolism aimed at directing future preclinical and clinical investigation.

This study evaluated stakeholders' perspectives regarding participation in two hypothetical neuromodulation trials focused on individuals with Alzheimer's disease and related disorders (ADRDs). Stakeholders (i.e., individuals at risk for ADRDs [n = 56], individuals with experience as a caregiver for someone with a cognitive disorder [n = 60], and comparison respondents [n = 124]) were recruited via MTurk. Primary outcomes were willingness to enroll (or enroll one's loved one), feeling lucky to have the opportunity to enroll, and feeling obligated to enroll in two protocols (transcranial magnetic stimulation, TMS; deep brain stimulation, DBS). Relative to the Comparison group, the At Risk group endorsed higher levels of "feeling lucky" regarding both research protocols, and higher willingness to participate in the TMS protocol. These findings provide tentative reassurance regarding the nature of decision making regarding neurotechnology-based research on ADRDs. Further work is needed to evaluate the full range of potential influences on research participation.

Background and Objectives: Defining the exercise habits of individuals with Alzheimer’s Disease (AD) may help to determine optimal rehabilitation programs. This study aimed to investigate the physical and psychological parameters associated with exercise barriers in older individuals with AD, with the goal of informing more effective rehabilitation programs. Materials and Methods: A cross-sectional prospective study was conducted with 50 individuals with AD. The individuals were evaluated with the Exercise Benefit/Barriers Scale (EBBS), the Mini-Mental State Examination (MMSE), the Five Times Sit to Stand Test (FTSTS), the Barthel Index (BI), the Tampa Scale for Kinesiophobia (TSK), and the Hospital Anxiety and Depression Scale (HADS). Results: There was a significant positive correlation between age with EBBS-Exercise Barriers (r = 0.308; p = 0.029) and EBBS-Total Score (r = 0.295; p = 0.038). There were significant negative correlations between the time of diagnosis with EBBS-Exercise Benefits (r = −0.569; p = 0.000), EBBS-Exercise Barriers (r = −0.324; p = 0.022), and EBBS-Total Score (r = −0.508; p = 0.000). There was a positive correlation between MMSE and EBBS-Exercise Benefits (r = 0.465; p = 0.001), EBBS-Exercise Barriers (r = 0.471; p = 0.001) and EBBS-Total Score (r = 0.519; p = 0.000). There were significant positive correlations between FTSTS and EBBS-Exercise Barriers (r = 0.340; p = 0.016), and EBBS-Total Score (r = 0.280; p = 0.049). There were positive correlations between BI and EBBS-Exercise Benefits (r = 0.362; p = 0.010), EBBS-Exercise Barriers (r = 0.377; p = 0.007), and EBBS-Total Score (r = 0.405; p = 0.004). Conclusions: Exercise barriers/benefits were associated with cognition and post-diagnosis duration in individuals with AD. Individuals with lower physical function had lower exercise perception. In addition, living with relatives or caregivers led to better exercise benefit scores.

Over the last several years, a growing body of evidence from anatomical, physiological, and functional neuroimaging studies has increasingly indicated that the cerebellum is actively involved in managing higher order cognitive functions and regulating emotional responses. It has become clear that when children experience congenital or acquired cerebellar lesions, these injuries can lead to a variety of cognitive and emotional disorders, manifesting in different combinations. This underscores the cerebellum’s essential role not only throughout developmental stages but particularly in facilitating learning processes, highlighting its critical importance beyond its traditional association with motor control. Furthermore, the intricate neural circuits within the cerebellum are believed to contribute to the fine-tuning of motor actions and coordination but are also increasingly recognized for their involvement in cognitive processes such as attention, language, and problem solving. Recent research has highlighted the importance of cerebellar health and integrity for optimal functioning across various domains of the human experience.

Aim: to study the relationship between neurotransmitter support and the degree of cognitive and psycho-emotional impairments in patients in the post-coronavirus period depending on the presence of overall obesity. Materials and methods. 44 patients aged 19 to 76 years (17 women and 27 men) with a history of moderate-to-severe COVID-19 were examined. 2 groups were allocated depending on body mass index (BMI): Group 1 – 20 non-obese patients (BMI

Background. Many COVID-19 survivors suffer from post-COVID syndrome, which significantly worsens the quality of life. Its presentation is quite diverse, with cognitive disorders being of particular importance. Liver injury due to the direct virus action and the treatment of the new coronavirus infection can persist for a long time during the recovery period and lead to hyperammonemia, which can cause cognitive disorders, including minimal hepatic encephalopathy. Aim. To study cognitive disorders in post-COVID syndrome and the possibility of their treatment with L-ornithine-L-aspartate. Materials and methods. The study included 30 students from 18 to 24 years old who had COVID-19 and decreased attention, memory impairment, and other cognitive disorders inherent in hepatic encephalopathy of latent (grade 0) or mild (grade 1) severity, without pronounced impairment of intelligence, memory, speech, and learning ability. Hyperammonemia, elevated alanine aminotransferase, aspartate aminotransferase, and -glutamyl transpeptidase, signs of hepatic encephalopathy according to psychometric tests, were reported in young people. All patients in the study were treated with L-ornithine-L-aspartate to correct the ammonia blood level and improve signs of hepatic encephalopathy and the general condition. Results and conclusion. An improvement in the objective findings, liver enzymes, a decrease in ammonia level, and an improvement in testing results for changes in cognitive functions were reported.

Multiple sclerosis (SM) is an autoimmune, demyelinating disease of the central nervous system. The disease affects patients of all ages, with a higher incidence in women. The etiopathogenesis of SM is not fully understood — it is believed that autoreactive lymphocytes play a key role in the development of the disease, although genetic predisposition and environmental factors also play a role. Diagnosis is based on the McDonald criteria, and the disease has different clinical presentations. Treatment is based on immunomodulation, aims to control the disease, and prevent recurrence. Frequent symptoms of the disease are motor, sensory, and cognitive disorders. Cognitive impairment, which is common in multiple sclerosis patients, has numerous consequences in everyday life (mental, social, economic) that significantly reduce the quality of life. Psycho-cognitive dysfunction, which can occur at any stage of the disease, is associated with changes in the central nervous system. Prevention of these disorders includes the early application of treatment methods that modify the natural course of the disease and the implication of pro-health behaviors, such as quitting smoking, proper diet and physical exercise. Pharmacological treatment shows limited effectiveness. Rehabilitation involving the use of compensatory strategies, remedial methods aimed at brain neuroplasticity and cognitive training shaping new functional networks of the brain is important. The aim of this work is to present the problem of cognitive and emotional disorders in the course of multiple sclerosis, with particular emphasis on endo- and exogenous conditions, together with modern methods of their treatment and prevention. (JNNN 2023;12(3):140–146)

Abstract Background The levels of synaptic markers synaptosomal-associated protein 25 (SNAP-25) and neurogranin (Ng) have been shown to increase early in the cerebrospinal fluid (CSF) of patients with Creutzfeldt-Jakob disease (CJD) and to have prognostic potential. However, no validation studies assessed these biomarkers' diagnostic and prognostic value in a large clinical setting cohort of rapidly progressive dementia. Methods In this retrospective study, using commercially available immunoassays, we measured the levels of SNAP-25, Ng, 14–3-3, total-tau (t-tau), neurofilament light chain (NfL), and phospho-tau181 (p-tau) in CSF samples from consecutive patients with CJD (n = 220) or non-prion rapidly progressive dementia (np-RPD) (n = 213). We evaluated and compared the diagnostic accuracy of each CSF biomarker and biomarker combination by receiver operating characteristics curve (ROC) analyses, studied SNAP-25 and Ng CSF concentrations distribution across CJD subtypes, and estimated their association with survival using multivariable Cox regression analyses. Results CSF SNAP-25 and Ng levels were higher in CJD than in np-RPD (SNAP-25: 582, 95% CI 240–1250 vs. 115, 95% CI 78–157 pg/ml, p

Background. According to epidemiological studies, the prevalence of subclinical hypothyroidism is about 6 % and it depends on age, gender, region of residence and, at the same time, significantly exceeds the frequency of primary hypothyroidism. Within one year, 5 % of cases of subclinical hypothyroidism turn into the manifested form. Delayed diagnosis of the disease increases the risk of serious complications. It is still controversial whether subclinical hypothyroidism affects blood pressure because of conflicting results in published studies. Thus, the aim of this study was to assess the effects of levothyroxine replacement therapy in patients with subclinical hypothyroidism and hypertension on lipid metabolism, functional state of the endothelium and cognition. Materials and methods. Thirty-one patients with subclinical hypothyroidism and stage 2 hypertension participa­ted in the study, among them 12 (38.71 %) men and 19 (61.29 %) women. The average age of participants was 63.19 ± 1.93 years. The study examined lipid profile, functional state of the endothelium, and cognitive functions based on the results of the Montreal Cognitive Assessment before and after 3 months of additional administration of the levothyroxine replacement thera­py at a dose 25–50 µg daily. Results. The lipid analysis revealed a significant decrease in total cholesterol for 10.08 % (5.54 ± 0.17 mmol/L against 6.23 ± 0.25 mmol/L, Р

Introduction: The Clock Drawing Test (CDT) is a highly effective screening tool for assessing cognitive function. It complements the Mental State Examination (MSE) in the early detection of various types of dementia and the evaluation of cognitive functions. Documenting the specific type of error in clock drawing significantly enhances the clinical evaluation of dementia patients in an economical manner. The CDT can effectively detect errors in execution and visuospatial functions associated with different types of dementia, including Alzheimer’s Disease (AD), Vascular Dementia (VD), and Frontotemporal Dementia (FTD). Additionally, it allows for a comparative analysis of the CDT with the severity of dementia assessed by the Bengal Mental Status Examination (BMSE) Scale. Aim: Present study aims to determine the ability of the CDT to scriminate these three disorders AD, VD, and FTD by analysing patterns of error in clock drawing. Materials and Methods: This cross-sectional observational study was conducted at the Department of Neuromedicine, Memory Clinic, Medical College, Kolkata, West Bengal, India, from March 2019 to February 2020. The diagnosis of dementia was made based on the Diagnostic and Statistical Manual of Mental Disorders- Fifth Edition (DSM-V) criteria for AD and VD, and the Rascovsky Criteria for FTD. A total of 80 patients were included in the study, with 40 in the AD group, 30 in the VD group, and 10 in the FTD group, considering 80% power and a 5% probability of error. Dementia severity was assessed using the BMSE [Annexure-III]. The subjects were provided with an 8.5×11-inch blank sheet of paper and a pencil, and were asked to draw a clock, including all the numbers, and set the hands to 10 minutes past 11. They were also requested to copy a clock as accurately as possible from a model. The resulting drawings were then analysed quantitatively by revised scale score and qualitatively using Rouleau’s qualitative analysis of clock drawing. Numerical variables were compared between groups using the Analysis of Variance (ANOVA) test and the Wilcoxon test, depending on the distribution’s normalcy. All analyses were two-tailed, and p

One of the important complications related to surgery and anesthesia is cognitive disorders, it is necessary to think about such complications before the surgery and anesthesia and put the necessary preparations on the agenda. Lack of accuracy and lack of awareness of the factors that cause these problems can be the main cause of these problems. The purpose of this review article is to examine the causes and factors that cause cognitive problems around surgery so that by providing solutions, they can be prevented from spreading and appearing after surgery. In this study, various appropriate articles related to the topic were used, which were published between 1990 and 2022 in the field of causes of cognitive problems and prevention strategies. References for this review article are from Google Scholar, PubMed, and Science Direct were obtained. The authors used keywords including cognitive problems, psychological problems during anesthesia, after anesthesia, and surgery in these sites. In this study, the things that should be considered in anesthesia and surgery to prevent the occurrence of cognitive problems were investigated. These include: the use of neuroprotectants, psychoactive drugs, anticholinergic system, anesthesia depth, pediatrics and occurrence of problems, circadian and sleep disorders, patient privacy, blood sugar, patient's spiritual rituals, hemoglobin, electrolytes, blood pressure, capnography and oxygenation, patient position and posture, emboli, drug interactions, cardiac function, platelet activity, stress and pain, hypothermia and hyperthermia, delay in discharge, ileus and antibiotics. [ABSTRACT FROM AUTHOR]

Diabetes mellitus is a chronic metabolic disease, the prevalence of which is constantly increasing worldwide. It is often burdened by disabling comorbidities that reduce the quality and expectancy of life of the affected individuals. The traditional complications of diabetes are generally described as macrovascular complications (e.g., coronary heart disease, peripheral arterial disease, and stroke), and microvascular complications (e.g., diabetic kidney disease, retinopathy, and neuropathy). Recently, due to advances in diabetes management and the increased life expectancy of diabetic patients, a strong correlation between diabetes and other pathological conditions (such as liver diseases, cancer, neurodegenerative diseases, cognitive impairments, and sleep disorders) has emerged. Therefore, these comorbidities have been proposed as emerging complications of diabetes. P66Shc is a redox protein that plays a role in oxidative stress, apoptosis, glucose metabolism, and cellular aging. It can be regulated by various stressful stimuli typical of the diabetic milieu and is involved in various types of organ and tissue damage under diabetic conditions. Although its role in the pathogenesis of diabetes remains controversial, there is strong evidence regarding the involvement of p66Shc in the traditional complications of diabetes. In this review, we will summarize the evidence supporting the role of p66Shc in the pathogenesis of diabetes and its complications, focusing for the first time on the emerging complications of diabetes. [ABSTRACT FROM AUTHOR]