Search

Contains fulltext : 234369.pdf (Publisher’s version ) (Open Access) The literature on repetition priming in Alzheimer's disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing. 19 p.

Working memory and episodic memory are two different processes, although the nature of their interrelationship is debated. As these processes are predominantly studied in isolation, it is unclear whether they crucially rely on different neural substrates. To obtain more insight in this, 81 adults with sub-acute ischemic stroke and 29 elderly controls were assessed on a visual working memory task, followed by a surprise subsequent memory test for the same stimuli. Multivariate, atlas- and track-based lesion-symptom mapping (LSM) analyses were performed to identify anatomical correlates of visual memory. Behavioral results gave moderate evidence for independence between discriminability in working memory and subsequent memory, and strong evidence for a correlation in response bias on the two tasks in stroke patients. LSM analyses suggested there might be independent regions associated with working memory and episodic memory. Lesions in the right arcuate fasciculus were more strongly associated with discriminability in working memory than in subsequent memory, while lesions in the frontal operculum in the right hemisphere were more strongly associated with criterion setting in subsequent memory. These findings support the view that some processes involved in working memory and episodic memory rely on separate mechanisms, while acknowledging that there might also be shared processes. Supplementary Information The online version contains supplementary material available at 10.1007/s00429-021-02281-0.

Contains fulltext : 234323.pdf (Publisher’s version ) (Open Access) Feedback of neuropsychological test results to patients and family members include psychoeducation and implications for daily life. This scoping review aimed to provide an overview of the literature on neuropsychological feedback and to offer clinical recommendations. In accordance with formal scoping review methodology, PubMed, PsycInfo, Web of Science, CINAHL, and Embase databases were searched. Studies were included if they reported on neuropsychological feedback, if full papers were available, and if they included human participants. All languages were included, and no limit was placed on the year of publication. Of the 2,173 records screened, 34 publications met the inclusion criteria. Five additional publications were included after cross-referencing. An update of the search led to the inclusion of two additional papers. Of these 41 publications, 26 were research papers. Neuropsychological feedback is provided for a wide spectrum of diagnoses and usually given in-person and has been related to optimal a positive effect on patient outcomes (e.g. increase the quality of life). Most papers reported on satisfaction and found that satisfaction with an NPA increased when useful feedback was provided. However, information retention was found to be low, but communication aids, such as written information, were found to be helpful in improving retention. The current review demonstrated the benefits of neuropsychological feedback and that this should be part of standard clinical procedures when conducting a neuropsychological assessment. Further research on the benefits of neuropsychological feedback and how to improve information provision would enrich the neuropsychological literature. 22 p.

To determine which factors other than child age play a role in the division and transfer of diabetes care responsibilities between parents and children with type 1 diabetes.Qualitative focus group study.Across four sites in the Netherlands, 18 parents (13 mothers) of children (9-14 years) with type 1 diabetes participated in four focus groups in 2015-2016, as part of the research project 'Whose diabetes is it anyway?'. Qualitative content analysis and the constant comparison method were used to analyse the data.According to parents, the transfer process included both direct and indirect tasks, had different levels (remembering, deciding, performing), was at times a difficult and stressful process, and showed large variation between families. A large number of child, parent and context factors were identified that affected the division and transfer of diabetes care responsibilities according to parents. Both positive and negative consequences of the transfer process were described for parental and child health, behaviour and well-being. Parental final evaluations of the division and transfer of diabetes care responsibilities appeared to be dependent on parenting values.How families divide and transfer diabetes care tasks appeared to be affected by a complex interplay of child, parent and context characteristics, which had an impact on several parent and child domains.Parents struggle with the right timing of transfer, which calls for more support from diabetes nurses. The identified factors can be used as input for integrating a more family-based approach into current age-based guidelines, to improve regular care.目的: 确定除儿童年龄外, 哪些因素可能对父母和患有1型糖尿病的儿童的糖尿病护理责任划分和转移产生影响。 设计: 定性焦点小组研究。 方法: 2015-2016年间, 在荷兰境内四地展开研究, 研究对象为18名患有1型糖尿病的儿童 (9-14岁) 的父母 (13名母亲) , 共分为四个重点小组, 此类研究作为‘谁患有糖尿病’研究项目的一部分。此外, 采用定性含量分析法和持续比较法对数据进行分析。 结果: 父母表示, 转移过程中, 需执行不同难度的直接和间接任务 (记忆、决定、执行) , 部分情况下, 面临较大困难和压力, 并且, 不同家庭的差异较大。经确定, 大量儿童、父母和背景因素可能对糖尿病护理责任的划分和转移造成影响。现已对转移过程对父母和儿童健康、行为和幸福的积极和消极后果进行描述。父母对糖尿病护理责任划分和转移的最终评估取决于其价值观。 结论: 家庭分配和转移糖尿病护理责任的方式似乎与儿童、父母及背景特征的复杂作用相关, 而此类作用对父母和儿童均有一定程度的影响。 影响: 父母忙于确定准确的转移时间, 因此, 糖尿病护士需予以更多支持。可考虑此类已确定的因素, 以便将更多家庭方法整合至现有基于年龄的指南中, 从而改善常规护理。.

Contains fulltext : 227913.pdf (Publisher’s version ) (Open Access) Background: Neuropsychological feedback is an important part of the neuropsychological assessment process. However, patients have difficulties remembering this information. Objective: The aim of this study was to develop a web-based visual tool to improve the understanding of neuropsychological results, information retention, and psychologist-patient communication. Methods: The visual tool was developed and optimized using an iterative three-phase stepwise approach to determine its usability, technology acceptance, and feasibility in a memory clinic population. Feedback from different user perspectives (patients, family members, and psychologists) was obtained in each phase using a multimethod approach (e.g., a multidisciplinary brainstorm session, think-aloud sessions, focus groups). The prototype was subsequently tested in a pilot study. Results: The first phases offered insights that led to optimization of the prototype. On a scale ranging from 0 to 100, psychologists evaluated the usability as high [88.1±7.6,70-87]. During the pilot study, both patients and significant others gave positive feedback, but information retention in patients remained low. All participants thought the benefits of the visual tool included seeing cognitive strengths and weaknesses with a translation to daily life all at one glance and receiving feedback on paper to take home. Important barriers were mentioned by psychologists, such as a limited set of tests included and no integration with hospital systems. Conclusion: Overall, patients, family members, and psychologists reported that a visual display of the cognitive profile with insights into daily life had added value to clinical practice. Feedback from the pilot study was adopted in the tool for future implementation purposes. 14 p.

Sequence learning effects in simple perceptual and motor tasks are largely unaffected by normal aging. However, less is known about sequence learning in more complex cognitive tasks that involve attention and memory processes and how this changes with age. In this study, we examined whether incidental and intentional sequence learning would facilitate hybrid visual and memory search in younger and older adults. Observers performed a hybrid search task, in which they memorized four or 16 target objects and searched for any of those target objects in displays with four or 16 objects. The memorized targets appeared either in a repeating sequential order or in random order. In the first experiment, observers were not told about the sequence before the experiment. Only a subset of younger adults and none of the older adults incidentally learned the sequence. The “learners” acquired explicit knowledge about the sequence and searched faster in the sequence compared to random condition. In the second experiment, observers were told about the sequence before the search task. Both younger and older adults searched faster in sequence blocks than random blocks. Older adults, however, showed this sequence-learning effect only in blocks with smaller target sets. Our findings indicate that explicit sequence knowledge can facilitate hybrid search, as it allows observers to predict the next target and restrict their visual and memory search. In older age, the sequence-learning effect is constrained by load, presumably due to age-related decline in executive functions. Supplementary Information The online version contains supplementary material available at 10.3758/s13421-021-01157-2.

Aims In patients with a history of chronic alcohol abuse, neurocognitive disorders (NCD) are not uncommon. The current study aimed to explore the course of cognitive performance, as measured by the Montreal Cognitive Assessment (MoCA), and everyday cognitive functioning, as measured by the Patient Competency Rating Scale (PCRS), in a large group of patients with alcohol use disorder (AUD) admitted to the Center of Excellence for Korsakov and Alcohol-related Cognitive Impairments. Methods A multiple time-series design was used, in which the MoCA was administered at three time points of assessment, and the PCRS was completed by both the patient and a clinician at two time points, all during clinical treatment. Results A total of 524 patients were included, 71 of whom were diagnosed with AUD only, 284 with AUD and mild NCD (ARCI) and 169 with AUD, major NCD and fulfilling criteria for Korsakoff’s syndrome (KS). Conclusions Cognitive performance improved for all three groups during treatment, sustained abstinence and recovery from AUD. A low memory performance on the MoCA without improvement over time was predictive for KS, while improvement on this domain did not differentiate between AUD and ARCI. Changes in overall cognitive performance and orientation in patients with KS were positively related to changes in everyday cognitive functioning., Short Summary Cognitive performance improves during treatment, sustained abstinence and recovery from AUD. Low memory performance without improvement over time predicted KS, while improvement in memory did not differentiate between AUD and ARCI. Changes in overall cognitive performance and orientation in KS patients were positively related to changes in everyday cognitive functioning.

Patients with insomnia frequently use acupuncture as an alternative treatment to pharmacotherapy globally. The aim of this paper is to assess the effect of acupuncture on insomnia. Seven medical databases, including MEDLINE, EMBASE, CENTRAL, CNKI, RISS, NDSL, and OASIS, were used to identify studies published through July 09, 2020. Twenty-four randomized controlled trials (RCTs) were included in this qualitative review comparing acupuncture to either pharmacotherapy or sham-acupuncture therapy. Methodological quality was assessed, using the Cochrane risk of bias (ROB). In the subsequent quantitative meta-analysis of studies comparing acupuncture versus pharmacotherapy, fifteen RCTs demonstrated that acupuncture had a significant effect on patients with insomnia as assessed by the Pittsburgh sleep quality index (PSQI) (RR: –0.74; 95% CI: –1.07 to –0.40; [Formula: see text] ¡0.0001; [Formula: see text] = 89%; [Formula: see text] = 1475). A subgroup analysis showed that there was no significant effect after weeks 1 and 2, but six studies found that acupuncture had a significant effect insomnia at week 3 (RR: –0.97; 95% CI: –1.65 to –0.28; [Formula: see text] = 0.006; [Formula: see text] = 91%; [Formula: see text] = 463) and nine studies demonstrated a significant effect at week 4 (RR: –0.70; 95% CI: –1.15 to –0.25; [Formula: see text] = 0.002; [Formula: see text] = 85%; [Formula: see text] = 594). These results suggest that insomnia patients may experience significant improvement in symptoms after more than three weeks of acupuncture treatment compared to pharmacological treatments.

Background: Cognitive decline remains difficult to predict as structural brain damage cannot fully explain the extensive heterogeneity found between MS patients. Objective: To investigate whether functional brain network organization measured with magnetoencephalography (MEG) predicts cognitive decline in MS patients after 5 years and to explore its value beyond structural pathology. Methods: Resting-state MEG recordings, structural MRI, and neuropsychological assessments were analyzed of 146 MS patients, and 100 patients had a 5-year follow-up neuropsychological assessment. Network properties of the minimum spanning tree (i.e. backbone of the functional brain network) indicating network integration and overload were related to baseline and longitudinal cognition, correcting for structural damage. Results: A more integrated beta band network (i.e. smaller diameter) and a less integrated delta band network (i.e. lower leaf fraction) predicted cognitive decline after 5 years ([Formula: see text]), independent of structural damage. Cross-sectional analyses showed that a less integrated network (e.g. lower tree hierarchy) related to worse cognition, independent of frequency band. Conclusions: The level of functional brain network integration was an independent predictive marker of cognitive decline, in addition to the severity of structural damage. This work thereby indicates the promise of MEG-derived network measures in predicting disease progression in MS.

AbstractThis review investigates the severity and nature of post-stroke working memory deficits with reference to the multi-component model of working memory. We conducted a systematic search in PubMed up to March 2019 with search terms for stroke and memory. Studies on adult stroke patients, that included a control group, and assessed working memory function, were selected. Effect sizes (Hedges’ g) were extracted from 50 studies (in total 3,084 stroke patients) based on the sample size, mean and standard deviation of patients and controls. Performance of stroke patients was compared to healthy controls on low-load (i.e. capacity) and high-load (executively demanding) working memory tasks, grouped by modality (verbal, non-verbal). A separate analysis compared patients in the sub-acute and the chronic stage. Longitudinal studies and effects of lesion location were systematically reviewed. Stroke patients demonstrated significant deficits in working memory with a moderate effect size for both low-load (Hedges’ g = -.58 [-.82 to -.43]) and high-load (Hedges’ g = -.59 [-.73 to -.45]) tasks. The effect sizes were comparable for verbal and non-verbal material. Systematically reviewing the literature showed that working memory deficits remain prominent in the chronic stage of stroke. Lesions in a widespread fronto-parietal network are associated with working memory deficits. Stroke patients show decrements of moderate magnitude in all subsystems of working memory. This review clearly demonstrates the global nature of the impairment in working memory post-stroke.

Contains fulltext : 219554.pdf (Publisher’s version ) (Closed access) Individuals with sequence-space synesthesia (SSS) perceive sequences like months, days and numbers in certain spatial arrangements. Several cognitive benefits have been associated with SSS, such as enhanced mental rotation, more vivid visual imagery and an advantage in spatial processing. The current study aimed to further investigate these cognitive benefits, focusing on spatial navigation skills, to explore if their enhanced sensitivity to spatial relations is reflected in enhanced navigational performance. Synesthetes were distinguished from controls by means of a questionnaire, a consistency test and drawings. A virtual Morris Water Maze (MWM) task with two allocentric and two egocentric navigation conditions was used to assess spatial navigation abilities. For the allocentric tasks, participants had to use object cues to find a hidden platform and for the egocentric tasks, they had to use their own position as a reference. Results showed that synesthetes performed significantly better compared to controls on the allocentric and egocentric tasks that reflected real life situations more accurately. However, this significant result was only found for the time taken to find the platform and not for the length of the path that was taken. In exploratory analyses, no significant relations were found between task performance and the specific features of the manifestation of each individual's synesthesia. Our hypothesis that synesthetes with the ability to mentally rotate their spatial arrangements would perform better on the allocentric task was not confirmed. Results add to the growing body of literature concerning the cognitive benefits of SSS and are consistent with the possibility that enhanced spatial navigation skills emerge from generally enhanced visuospatial abilities in SSS. 15 p.

Contains fulltext : 221796.pdf (Publisher’s version ) (Closed access) MS related fatigue might be related to autonomous nervous system (ANS) dysfunctions or to inflammation related vagal (hyper-) activation. Consequently, influencing ANS status may lead to relieve of fatigue. We used two opposite biofeedback interventions to either increase sympathetic ("self-alert training", SAT) or parasympathetic activation ("progressive muscle relaxation", PMR). We recorded fatigue status of patients before and after a challenging vigilance task, their behavioural performance on this task, their skin conductance response (SCR), and parameters indicating parasympathetic activity concerning heart rate variability (HRV). We repeated these recordings after the biofeedback training sessions. Patients of the SAT group were able to learn to increase their SCR voluntarily. Patients of the PMR group showed increasing parameters indicating parasympathetic modulation of the HRV. The vigilance task increased their feeling of fatigue. However, there was no effect of biofeedback training on either fatigue status or performance on the vigilance task. Our results show that MS patients can learn to change voluntarily their ANS activity using biofeedback instructions based on SCR and this can be used in future studies to test the postulated link between ANS and fatigue. However, in this experimental intervention we were unable to document a relation between ANS activity and fatigue. 17 p.

BackgroundRecent evidence indicates that disrupted sleep could contribute to the development of Alzheimer’s disease by influencing the production and/or clearance of the amyloid-β protein. We set up a case-control study to investigate the association between long-term work-induced sleep disruption, cognitive function, and brain amyloid-β burden.MethodsNineteen male maritime pilots (aged 48–60 years) with chronic work-related sleep disruption and a sex-, age-, and education-matched control sample (n = 16, aged 50–60 years) with normal sleep completed the study. Primary sleep disorders were ruled out with in-lab polysomnography. Additional sleep measurements were obtained at home using actigraphy, sleep-wake logs, and a single-lead EEG device. Cognitive function was assessed with a neuropsychological test battery, sensitive to early symptomatic Alzheimer’s disease. Brain amyloid-β burden was assessed in maritime pilots using18F-flutemetamol amyloid PET-CT.ResultsMaritime pilots reported significantly worse sleep quality (Pittsburgh Sleep Quality Index (PSQI) = 8.8 ± 2.9) during work weeks, compared to controls (PSQI = 3.2 ± 1.4; 95% CI 0.01 to 2.57;p = 0.049). This was confirmed with actigraphy-based sleep efficiency (86% ± 3.8 vs. 89.3% ± 4.3; 95% CI 0.43 to 6.03;p = 0.03). Home-EEG recordings showed less total sleep time (TST) and deep sleep time (DST) during work weeks compared to rest weeks (TST 318.56 (250.21–352.93) vs. TST 406.17 (340–425.98);p = 0.001; DST 36.75 (32.30–58.58) vs. DST 51.34 (48.37–69.30);p = 0.005)). There were no differences in any of the cognitive domains between the groups. For brain amyloid-β levels, mean global cortical standard uptake value ratios of18F-flutemetamol were all in the normal range (1.009 ± 0.059; 95% CI 0.980 to 1.037), confirmed by visual reads.ConclusionsCapitalizing on the particular work-rest schedule of maritime pilots, this study with a small sample size observed that long-term intermittent sleep disruption had no effects on global brain amyloid-β levels or cognitive function.

Item does not contain fulltext Stephanus Bisius (1724-1790) was a physician of Italian descent and a graduate of the University of Pavia. He was invited to the Polish-Lithuanian Commonwealth in the early 1760s and became head of the Faculty of Medicine at Vilnius University in 1781. In 1772, Bisius had authored the first original study on nervous and mental diseases in the Grand Duchy of Lithuania. In his 35-page booklet, written in Latin and Polish, Bisius characterized mania and melancholy as diseases of the brain, explaining that the organs that feed the human soul are affected, not the soul itself. He introduced the principles of humoralism and solidism to readers, and recognized that autopsies had failed to reveal reliable findings concerning mania or melancholy. Bisius also described the origins of the challenging disorder called plica polonica, a strange condition associated with tufts of matted hair. As a physician during the medical Enlightenment, Bisius criticized metaphysical speculations in medicine and stated that plica was only a result of superstitions. Even though he proposed antiphlogistic treatments for patients with mania and melancholy, he maintained that time and faith in God might help some patients overcome their infirmities. 17 p.

Background Healthy aging is accompanied by a decline in learning ability and memory capacity. One widely-studied method to improve learning outcome is by reducing the occurrence of errors during learning (errorless learning; EL). However, there is also evidence that committing errors during learning (trial-and-error learning; TEL) may benefit memory performance. We argue that these inconsistent findings could be driven by a lack of control over the error frequency in traditional EL and TEL paradigms. Aim This study employed a spatial learning task to study EL and TEL and to determine the impact of error frequency on memory recall in healthy older adults (OA; N = 68) and young adults (YA; N = 60). Method Four groups of participants (YA-EL, YA-TEL, OA-EL, OA-TEL) were instructed to first place and memorize the locations of everyday objects in a chest of drawers presented on a computer screen, and in whom memory recall performance was later tested. In the TEL condition, the amount of errors made before the correct drawer was ‘found’ was predetermined, varying from 0 to 5. During the EL condition, every first attempt was correct (i.e., no errors were made). Results We found better overall performance in YA compared to OA and a beneficial effect of EL in both age groups. However, the amount of errors committed during learning did not influence accuracy of memory recall. Conclusion Our results indicate that elimination of errors during learning can benefit memory performance in both YA and OA compared to TEL.

The current meta-analysis first aimed to quantify the overall effect of physical exercise training on the quality of life (QoL) in healthy older adults. Second, the effects on the social, physical, and psychological QoL were assessed. In total, 16 randomized controlled trials were included. The primary analysis showed a medium effect of physical exercise training on QoL in healthy older adults (standard mean difference [SMD] = 0.38, confidence interval, CI, [0.18, 0.59],p p p p = .17). These findings warrant implementation efforts pertaining to exercise training for older adults to improve the QoL in our aging societies.

Contains fulltext : 219411.pdf (Publisher’s version ) (Open Access) Cognitive training research has revealed support for both the magnification and compensation accounts, respectively predicting larger or smaller training benefits for individuals already having strong cognitive abilities. A recent study in older adults (OAs) revealed evidence for the Compensation-Related Utilization of Neural Circuits Hypothesis, which best fits a magnification account. Only few studies examined working memory (WM) training gains in OAs as a function of initial executive functioning level. Here, we tracked the progress of high and low functioning OAs across WM training sessions. The high functioning OAs continued to improve their performance on the three training tasks. However, for one of the training tasks, the low functioning participants failed to improve performance or terminated participation in the course of training. The results suggest that during cognitive training, evaluation of the individual?s cognitive capacity and performance monitoring are essential to maintain an optimal balance between cognitive resources and task demands. 14 p.

BACKGROUND: Cognitive functions are altered in patients with CKD. However, it is suggested that cognitive functions improve after kidney transplantation, at least partially. A possible cause for this improvement could be the reduction of uremic retention solutes after transplantation. This study assessed the association between the changes in uremic toxin concentration with the changes in cognitive function in patients after kidney transplantation. METHODS: Ten recipients of kidney transplants were compared with 18 controls (nine patients on hemodialysis, and nine patients with CKD stage 4 or 5 [eGFR

Contains fulltext : 219420.pdf (Publisher’s version ) (Closed access) Just a few weeks before his death in 1828, Franz Joseph Gall, the father of what others would later call phrenology, wrote a letter to an unknown person, presumably a fellow physician. The manuscript describes the case of girl, 19 months of age. The girl's skull showed marked deformations consistent with what would be called craniosynostosis or Crouzon('s) syndrome by physicians today. Gall related some clinical features of her case and suggested some treatment options. This case report is particularly interesting because it is almost 200 years old, predates Crouzon's description of the syndrome by 84 years, and shows that Gall was still involved with treating patients, even in his final year. 12 p.

Contains fulltext : 218474.pdf (Publisher’s version ) (Open Access) Alcoholic Korsakoff's syndrome is characterized by severe amnesia, also affecting spatial memory. To date, research on cognitive rehabilitation in these patients is scarce. Aim of the present study is to examine the efficacy of a mnemonic strategy training in patients with Korsakoff's syndrome. A randomized controlled exploratory study was performed. A convenience sample of 14 patients with amnesia due to alcoholic Korsakoff's syndrome was included and randomized into a mnemonic strategy training group (n = 7) and a control group (n = 7). The training group completed a 3-day 45–60 min mnemonic strategy training that focused on specific strategies to encode and retrieve information about specific objects and their locations in virtual rooms, using labeling, verbal reasoning and mental imagery. The control group only received care as usual. Outcome measure was an object-location memory task consisting of novel, untrained object locations administered 1 day before the intervention, as well as 1 day and 1 week after completing the intervention. Patients in the intervention group were able to acquire and use the strategies, but no significant differences were found between the intervention group and the control group, and no significant change in performance was demonstrated compared to baseline 1 day and 1 week after the intervention. To conclude, the mnemonic strategy training in KS patients did not result in a better spatial memory performance 1 day or 1 week after training completion compared to participation in the regular non-cognitive treatment program that focused on occupational therapy, music therapy and exercise. 5 p.

Contains fulltext : 226514.pdf (Publisher’s version ) (Closed access) Met de vergrijzing is er een toename in de prevalentie van dementie. Momenteel is er voor dementie geen effectieve medicamenteuze behandeling. Daarom is er behoefte aan niet-medicamenteuze interventies om cognitieve achteruitgang te vertragen. Bij gezonde ouderen kan een combinatie van beweging en cognitieve training mogelijk het cognitief functioneren verbeteren, maar er is nog onvoldoende bewijs of dit ook geldt voor ouderen met dementie. Het doel van deze studie was het effect te onderzoeken van een gecombineerde fysieke en cognitieve training op cognitief functioneren bij ouderen met dementie. Hiertoe werd een beweeggame ingezet: het interactieve fietsen, met als onderzoeksdesign een enkelblind randomised controlled trial (RCT). Mensen ouder dan 60 jaar die waren gediagnosticeerd met milde tot matig-ernstige dementie kwamen in aanmerking voor deelname aan de studie. Na inclusie werden de 115 deelnemers gerandomiseerd naar een van de drie interventiegroepen: een aerobe fietsgroep, een interactieve fietsgroep en een flexibiliteit- en ontspanningsgroep. Alle deelnemers trainden drie keer per week gedurende 12 weken. Voor de start van de trainingen (T0), na zes weken (T1), na 12 weken (T2) en na 24 weken follow-up (FU) werd het cognitief functioneren in kaart gebracht door middel van neuropsychologisch onderzoek. Na 12 weken was er een significante verbetering in snelheid van informatieverwerking in de interactieve fietsgroep en in de aerobe fietsgroep, in vergelijking met de flexibiliteit- en ontspanningsgroep. Deze bevinding is relevant, omdat psychomotorische snelheid een belangrijke voorspeller is voor cognitieve achteruitgang. Er waren geen verschillen tussen de groepen op executief functioneren, episodisch geheugen en werkgeheugen. 8 p.

Changes in brain organization following damage are commonly observed, but they remain poorly understood. These changes are often studied with imaging techniques that overlook the temporal granularity at which language processes occur. By contrast, electrophysiological measures provide excellent temporal resolution. To test the suitability of magnetoencephalography (MEG) to track language‐related neuroplasticity, the present study aimed at establishing the spectro‐temporo‐spatial across‐session consistency of context‐driven picture naming in healthy individuals, using MEG in two test–retest sessions. Spectro‐temporo‐spatial test–retest consistency in a healthy population is a prerequisite for studying neuronal changes in clinical populations over time. For this purpose, 15 healthy speakers were tested with MEG while performing a context‐driven picture‐naming task at two time points. Participants read a sentence missing the final word and named a picture completing the sentence. Sentences were constrained or unconstrained toward the picture, such that participants could either retrieve the picture name through sentence context (constrained sentences), or could only name it after the picture appeared (unconstrained sentences). The context effect (constrained versus unconstrained) in picture‐naming times had a strong effect size and high across‐session consistency. The context MEG results revealed alpha–beta power decreases (10–20 Hz) in the left temporal and inferior parietal lobule that were consistent across both sessions. As robust spectro‐temporo‐spatial findings in a healthy population are required for working toward longitudinal patient studies, we conclude that using context‐driven language production and MEG is a suitable way to examine language‐related neuroplasticity after brain damage., Context‐driven picture naming (naming a picture after a constrained or unconstrained sentence) shows large effect size and high consistency across two test–retest sessions in healthy speakers. Constrained sentence context yielded faster picture naming times and consistent left‐lateralized alpha–beta power decreases (10–20 Hz) relative to unconstrained, even for half session duration. Hence, MEG provides suitable spatio‐spectro‐temporal consistency to track neuroplasticity after brain damage.

Contains fulltext : 217742.pdf (Publisher’s version ) (Closed access) Introduction: This study zoomed into the relation between self-regulation, resilience and quality of life (QOL) within a mixed psychiatric sample of patients with Dual-Diagnosis (DD) or an Autism spectrum disorder (ASD). Method: Patients with DD or ASD participated and healthy control (HC) data were present. The Barkley Deficits in Executive Functioning Scale (BDEFS), Shortened Temperament and Character Inventory and Manchester Short Assessment of Quality of Life were administered. Results: The BDEFS revealed more executive problem reporting by DD or ASD patients than by HC. Both patient groups revealed that, the more problems were reported in executive self-regulation (like self-motivation, problem-solving), the lower QOL was experienced. The resilience aspect of self-directedness (goal-directed, responsible attitude) was positively related to higher QOL and to lesser experience of self-motivational and problem-solving problems. But, the more harm-avoidant, the lesser one was self-directed and the more self-motivational and problem-solving problems were reported. Discussion: Self-regulation and harm-avoidance problems were related to lower QOL in DD and ASD. Self-directedness, executive self-motivation and problem-solving predicted higher QOL. Treatment focus on self-directedness, executive self-regulation and resilience is recommended. 18 p.

Contains fulltext : 216048pub.pdf (Publisher’s version ) (Open Access) While much progress has been made in how brain organization supports language function, the language network's ability to adapt to immediate disturbances by means of reorganization remains unclear. The aim of this study was to examine acute reorganizational changes in brain activity related to conceptual and lexical retrieval in unimpaired language production following transient disruption of the left middle temporal gyrus (MTG). In a randomized single-blind within-subject experiment, we recorded the electroencephalogram from 16 healthy participants during a context-driven picture-naming task. Prior to the task, the left MTG was perturbed with real continuous theta-burst stimulation (cTBS) or sham stimulation. During the task, participants read lead-in sentences creating a constraining (e.g., "The farmer milks the") or nonconstraining context (e.g., "The farmer buys the"). The last word was shown as a picture that participants had to name (e.g., "cow"). Replicating behavioral studies, participants were overall faster in naming pictures following a constraining relative to a nonconstraining context, but this effect did not differ between real and sham cTBS. In contrast, real cTBS increased overall error rates compared to sham cTBS. In line with previous studies, we observed a decrease in alpha-beta (8-24 Hz) oscillatory power for constraining relative to nonconstraining contexts over left temporal- parietal cortex after participants received sham cTBS. However, following real cTBS, this decrease extended toward left prefrontal regions associated with both domain-general and domain-specific control mechanisms. Our findings provide evidence that immediately after perturbing the left MTG, the lexical-semantic network is able to quickly reconfigure, also recruiting domain-general regions. 11 p.

Contains fulltext : 218710.pdf (Publisher’s version ) (Closed access) The aim of this review was to provide an overview of developments, clinical implications and gaps in knowledge regarding the relationship between diabetes and sleep over the past 25 years, with special focus on contributions from the behavioural sciences. Multiple prospective observational and experimental studies have shown a link between suboptimal sleep and impaired glucose tolerance, decreased insulin sensitivity and the development of type 2 diabetes. While prevalence rates of suboptimal sleep vary widely according to definition, assessment and sample, suboptimal subjective sleep quality appears to be a common reality for one-third of people with type 1 diabetes and over half of people with type 2 diabetes. Both physiological and psychosocial factors may impair sleep in these groups. In turn, suboptimal sleep can negatively affect glycaemic outcomes directly or indirectly via suboptimal daytime functioning (energy, mood, cognition) and self-care behaviours. Technological devices supporting diabetes self-care may have both negative and positive effects. Diabetes and its treatment also affect the sleep of significant others. Research on the merits of interventions aimed at improving sleep for people with diabetes is in its infancy. Diabetes and sleep appear to be reciprocally related. Discussion of sleep deserves a central place in regular diabetes care. Multi-day, multi-method studies may shed more light on the complex relationship between sleep and diabetes at an individual level. Intervention studies are warranted to examine the potential of sleep interventions in improving outcomes for people with diabetes. 9 p.

Contains fulltext : 219128.pdf (Publisher’s version ) (Open Access) Prospective memory (PM) involves remembering intended actions in the future, such as posting a letter when seeing a post box (event-based PM) or making a phone call at 2:00 pm (time-based PM). Studies on aging and PM have often reported negative age effects in the laboratory, but positive age effects in naturalistic tasks outside the laboratory (the so-called age-PM-paradox). The present study re-examined this pattern of the paradox by studying, for the first time, age differences in time- and event-based PM in lab-based, experimenter-generated naturalistic and self-assigned real-life PM tasks within the same sample of young and older adults. Results showed that differential age effects in and outside the laboratory were qualified by the type of PM cue. While age-related deficits were obtained for laboratory event-based tasks, no age effect was obtained for naturalistic event-based PM. Age benefits in the field were only observed for naturalistic time-based tasks, but not for participants’ own self-assigned time-based tasks. These findings indicate that the age benefits for naturalistic PM tasks may have been overestimated due to the dominant use of experimenter-generated naturalistic time-based PM tasks in previous studies. Therefore, the precise pattern of the age–PM-paradox may need redefining as mostly consisting of negative age effects in lab-based PM tasks and mostly the absence of negative age effects (rather than age benefits) in naturalistic and self-assigned tasks outside the laboratory. 17 p.

Contains fulltext : 236035.pdf (Publisher’s version ) (Open Access) Some patients with Oculopharyngeal Muscular Dystrophy (OPMD) develop frontotemporal dementia (FTD). The prevalence and clinical correlates of behavioural impairment, including FTD, is unknown in OPMD. 24 OPMD patients and their proxies completed a questionnaire concerning behavioural impairment (ALS-FTD-Q). We examined proportions with mild or severe behavioural changes, according to validated cut-off proxy scores. We examined correlations with the Hospital Anxiety and Depression Scale (HADS), the Short Form Health Survey (SF-36), motor symptoms, genotype and disease duration. In this small patient sample, behavioural impairment was present in 29%of OPMD patients; in 17%the severity of symptoms was compatible with bvFTD. Correlations were small to medium. 7 p.

Confabulations refer to the emergence of memories of experiences and events that are incorrect in place and time, or never took place. In alcoholic Korsakoff's syndrome, confabulations have been frequently reported, but seldomly been investigated. Traditional reports on confabulations state that confabulations in KS mainly occur in the post-acute phase of the illness. The aim of the study was to investigate whether confabulations extinguish in KS.An observational rating of confabulation behaviour (the NVCL-R) was completed for 172 KS patients with alcoholic KS. Post-acute and chronic KS patients were compared cross-sectionally in two centres.Provoked and spontaneous confabulations were present in post-acute and chronic patients. Patients residing in a long-term care facility more often presented themselves with spontaneous confabulations than patients in a diagnostic centre.In contrast to the traditional view, confabulations may be present throughout the course of KS, and are possibly more frequently present in patients receiving care in specialised long-term care facilities than in patients who receive less intensive support.Key pointsConfabulations are a central characteristic of Korsakoff's syndromeIn contrast to popular belief, confabulations may be present in acute and chronic Korsakoff's syndromeThe severity of confabulations is related to an unfavourable disease outcome in KSA longitudinal approach would help the confirmation of finding no decline in confabulations over time.

BackgroundClassic theories posit that depression is driven by a negative learning bias. Most studies supporting this proposition used small and selected samples, excluding patients with comorbidities. However, comorbidity between psychiatric disorders occurs in up to 70% of the population. Therefore, the generalizability of the negative bias hypothesis to a naturalistic psychiatric sample as well as the specificity of the bias to depression, remain unclear. In the present study, we tested the negative learning bias hypothesis in a large naturalistic sample of psychiatric patients, including depression, anxiety, addiction, attention-deficit/hyperactivity disorder, and/or autism. First, we assessed whether the negative bias hypothesis of depression generalized to a heterogeneous (and hence more naturalistic) depression sample compared with controls. Second, we assessed whether negative bias extends to other psychiatric disorders. Third, we adopted a dimensional approach, by using symptom severity as a way to assess associations across the sample.MethodsWe administered a probabilistic reversal learning task to 217 patients and 81 healthy controls. According to the negative bias hypothesis, participants with depression should exhibit enhanced learning and flexibility based on punishment v. reward. We combined analyses of traditional measures with more sensitive computational modeling.ResultsIn contrast to previous findings, this sample of depressed patients with psychiatric comorbidities did not show a negative learning bias.ConclusionsThese results speak against the generalizability of the negative learning bias hypothesis to depressed patients with comorbidities. This study highlights the importance of investigating unselected samples of psychiatric patients, which represent the vast majority of the psychiatric population.

Background: Suboptimal performance during neuropsychological assessment renders cognitive test results invalid. However, suboptimal performance has rarely been investigated in multiple sclerosis (MS). Objectives: To investigate potential underlying mechanisms of suboptimal performance in MS. Methods: Performance validity testing, neuropsychological assessments, neuroimaging, and questionnaires were analyzed in 99 MS outpatients with cognitive complaints. Based on performance validity testing patients were classified as valid or invalid performers, and based on neuropsychological test results as cognitively impaired or preserved. Group comparisons and correlational analyses were performed on demographics, patient-reported, and disease-related outcomes. Results: Twenty percent displayed invalid performance. Invalid and valid performers did not differ regarding demographic, patient-reported, and disease-related outcomes. Disease severity of invalid and valid performers with cognitive impairment was comparable, but worse than cognitively preserved valid performers. Lower performance validity scores related to lower cognitive functioning, lower education, being male, and higher disability levels ( p Conclusion: Suboptimal performance frequently occurs in patients with MS and cognitive complaints. In both clinical practice and in cognitive research, suboptimal performance should be considered in the interpretation of cognitive outcomes. Identification of factors that differentiate between suboptimal and optimal performers with cognitive impairment needs further exploration.

Item does not contain fulltext In a recent article of the Journal of Alzheimer's Disease, Hack et al. (2019) argue that linguistic ability rather than multilingualism is a significant predictor of dementia. In their longitudinal study, they investigated 325 religious sisters who were older than 75 years of age. Self-reports were used in order to determine multilingualism. They found that speaking two or three languages did not delay the onset of dementia. However, they did find that individuals speaking four or more languages were less likely to suffer from dementia than those speaking only one language and concluded that having linguistic ability was a more significant predictor of dementia than being multilingual. However, more research is needed in order to identify the characteristics of multilingualism most salient for the risk of dementia. In this commentary, we raise several important methodological and statistical issues that are likely to have affected the findings of Hack et al.'s study. As a result, although their study makes an important contribution to the research field, drawing a conclusion at this time that linguistic ability is more a predictor of dementia than multilingualism would be premature; moreover, their preliminary results cannot be generalized to the general population. 4 p.

Contains fulltext : 236748.pdf (Publisher’s version ) (Open Access) Objectives: The goal of the present study was to identify the role of the medial temporal lobe (MTL) in the detection and later processing of novelty. Methods: Twenty-one epilepsy patients with unilateral MTL resection (10 left-sided; 11 right-sided) and 26 matched healthy controls performed an adapted visual novelty oddball task. In this task two streams of stimuli were presented on the left and right of fixation while the patients’ electroencephalogram was measured. The participants had to respond to infrequent target stimuli, while ignoring frequent standard, and infrequent novel stimuli that were presented to the left or right, appearing either contra- or ipsilateral to the patients’ resections. Results: Novelty detection, as indexed by the N2 ERP component elicited by novels, was reduced by the MTL resections, as evidenced by a smaller N2 for patients than healthy controls. Later processing of novels, as indexed by the novelty P3 ERP component, was reduced for novels presented contra- versus ipsilateral to the resected side. Moreover, at a frontal electrode site, the N2-P3 complex showed reduced novelty processing in patients with MTL resections compared to healthy controls. The ERP differences were specific for the novel stimuli, as target processing, as indexed by the P3b, was unaffected in the patients: No P3b differences were found between targets presented ipsi- or contralaterally to the resected side, nor between patients and healthy controls. Conclusions: The current results suggest that MTL structures play a role in novelty processing. In contrast, target processing was unaffected by MTL resections. 11 p.

Contains fulltext : 232781.pdf (Publisher’s version ) (Open Access) Damage to the ventromedial PFC (VMPFC) can cause maladaptive social behavior, but the cognitive processes underlying these behavioral changes are still uncertain. Here, we tested whether patients with acquired VMPFC lesions show altered approach–avoidance tendencies to emotional facial expressions. Thirteen patients with focal VMPFC lesions and 31 age- and gender-matched healthy controls performed an implicit approach–avoidance task in which they either pushed or pulled a joystick depending on stimulus color. Whereas controls avoided angry faces, VMPFC patients displayed an incongruent response pattern characterized by both increased approach and reduced avoidance of angry facial expressions. The approach bias was stronger in patients with higher self-reported impulsivity and disinhibition and in those with larger lesions. We further used linear ballistic accumulator modeling to investigate latent parameters underlying approach-avoidance decisions. Controls displayed negative drift rates when approaching angry faces, whereas VMPFC lesions abolished this pattern. In addition, VMPFC patients had weaker response drifts than controls during avoidance. Finally, patients showed reduced drift rate variability and shorter nondecision times, indicating impulsive and rigid decision-making. Our findings thus suggest that VMPFC damage alters the pace of evidence accumulation in response to social signals, eliminating a default, protective avoidant bias and facilitating a dysfunctional approach behavior. 13 p.

Objective. Large structural brain changes, such as chronic stroke lesions, alter the current pathways throughout the patients’ head and therefore have to be taken into account when performing transcranial direct current stimulation simulations. Approach. We implement, test and distribute the first MATLAB pipeline that automatically generates realistic and individualized volume conduction head models of chronic stroke patients, by combining the already existing software SimNIBS, for the mesh generation, and lesion identification with neighborhood data analysis, for the lesion identification. To highlight the impact of our pipeline, we investigated the sensitivity of the electric field distribution to the lesion location and lesion conductivity in 16 stroke patients’ datasets. Main results. Our pipeline automatically generates 1 mm-resolution tetrahedral meshes including the lesion compartment in less than three hours. Moreover, for large lesions, we found a high sensitivity of the electric field distribution to the lesion conductivity value and location. Significance. This work facilitates optimizing electrode configurations with the goal to obtain more focal brain stimulations of the target volumes in rehabilitation for chronic stroke patients.

Contains fulltext : 234164.pdf (Publisher’s version ) (Open Access) Apathy is a fundamental neuropsychiatric symptom of Korsakoff's syndrome (KS) and has also been reported in patients with alcohol use disorder with no (AUD) or less severe cognitive impairments (ARCI). However, research on the nature of apathy is limited in these groups. Aim of this study was to examine the multidimensional nature of apathy in patients with KS, ARCI and AUD. Moreover, we examined differences between apathy ratings by patients and their professional caregivers, and related apathy to everyday functioning and overall cognition. Twenty-five patients with KS, 25 patients with ARCI and 23 patients with AUD participated in this study. Apathy was measured using the apathy motivation index (AMI), which distinguishes behavioral, emotional and social apathy. Both patients and professional caregivers reported social apathy as the most prominent symptom, compared to behavioral and emotional apathy. Apathy ratings did not differ across the three patient groups. Discrepancies between patient and caregiver ratings were observed in patients with KS and ARCI, with more severe apathy reported by caregivers. Caregiver-reported behavioral and social, but not emotional, apathy was related to everyday functioning. These results show that apathy is present in a substantial proportion of patients with alcohol addiction with or without cognitive impairments. 12 p.

Contains fulltext : 209848.pdf (Publisher’s version ) (Open Access) Involvement of the cerebellum to non-motor related aspects of behavior is becoming increasingly clear. The aim of this study was to investigate the role of the cerebellum in reactive and proactive behavioral control and interference. In a double-blind controlled within-subject design, 26 healthy volunteers underwent real and sham cerebellar transcranial direct current stimulation (tDCS) while performing a go/no-go task and a delay discounting task. Results showed that the number of go/no-go commission errors was significantly lower during real as compared with sham cerebellar tDCS. No effects of tDCS were observed on delay discounting. Our findings provide further behavioral support for the involvement of the cerebellum in fast neural processes associated with response inhibition. 6 p.

Contains fulltext : 219022.pdf (Publisher’s version ) (Open Access) Studies of context effects in speech production have shown that semantic feature overlap produces interference in naming of categorically related objects. In neuroimaging studies, this semantic interference effect is consistently associated with involvement of left superior and middle temporal gyri. However, at least part of this effect has recently been shown to be attributable to visual form similarity, as categorically related objects typically share visual features. This fMRI study examined interference produced by visual form overlap in the absence of a category relation in a picture–word interference paradigm. Both visually similar and visually dissimilar distractors led to increased BOLD responses in the left inferior frontal gyrus compared with the congruent condition. Naming pictures in context with a distractor word denoting an object visually similar in form slowed RTs compared with unrelated words and was associated with reduced activity in the left posterior middle temporal gyrus. This area is reliably observed in lexical level processing during language production tasks. No significant differential activity was observed in areas typically engaged by early perceptual or conceptual feature level processing or in areas proposed to be engaged by postlexical language processes, suggesting that visual form interference does not arise from uncertainty or confusion during perceptual or conceptual identification or after lexical processing. We conclude that visual form interference has a lexical locus, consistent with the predictions of competitive lexical selection models. 9 p.

Item does not contain fulltext Uit recente studies blijkt dat bij epilepsiechirurgie vanwege frontaalkwabepilepsie (FE) en temporaalkwabepilepsie (TE) de cognitieve gevolgen pre- en postoperatief deels overeenstemmen. De vraag is in hoeverre FE- en TE-patiënten kunnen worden gedifferentieerd op basis van hun verbale geheugen- en executieve functies. Om dit na te gaan, zijn in een retrospectieve analyse de pre- en postoperatieve neuropsychologische data met betrekking tot het verbale geheugen en de executieve functies geanalyseerd bij een steekproef van 303 patiënten (FE: n = 109 vs. TE: n = 194). De resultaten laten zien dat FE-patiënten preoperatief significant slechter presteerden dan TE-patiënten wat betreft het executief functioneren; er was echter geen significant verschil tussen de verbale geheugenprestaties van beide groepen. Ook was er geen verschil in postoperatief verloop. Rekening houdend met de lateralisatie van het epileptisch focus werd echter gevonden dat patiënten met een epileptisch focus in de taaldominante hemisfeer preoperatief significant lagere verbale geheugenprestaties hadden en postoperatief sterker achteruitgingen dan patiënten met een epileptisch focus in de niet-taaldominante hemisfeer. Wij concluderen dat de lateralisatie van het epileptisch focus van groter belang is dan de lokalisatie van het epileptisch focus voor het verklaren van de pre- en postoperatieve verbale geheugentekorten. Onderzoek van de executieve functies lijkt diagnostische waarde te hebben voor het differentiëren tussen FE- en TE-patiënten. 10 p.

Item does not contain fulltext Intelligentietests zijn wereldwijd de meest gebruikte psychologische tests voor het meten van cognitief functioneren bij mensen. Ze worden in vele werkvelden van de psychologische praktijk ingezet, zoals de geestelijke gezondheidszorg, de neuro- en revalidatiepraktijk, het onderwijs en de werving- en selectiepsychologie. De Wechsler-intelligentieschalen kennen een lange traditie. In dit artikel wordt ingegaan op de geschiedenis van de WISC (de intelligentieschaal voor kinderen en jeugdigen). De verschillen tussen de opeenvolgende versies komen aan de orde. Met name wordt ingegaan op de teststructuur van de WISC-V en waarin deze verschilt van de voorgaande versie. 9 p.

Contains fulltext : 203443.pdf (Publisher’s version ) (Open Access) Introduction and Aims: Cognitive impairments in substance use disorder predict treatment outcome and are assumed to differ between substances. They often go undetected, thus the current study focuses on the prevalence of and differences in cognitive functioning across substances by means of a cognitive screen at the early stage of addiction treatment. Design and Methods: The Montreal Cognitive Assessment was administered to outpatients seeking treatment for substance use disorder. Patient characteristics (age, years of regular use, polysubstance use, severity of dependence/abuse, depression, anxiety and stress) were also taken into account. Results: A total of 656 patients were included (n = 391 used alcohol, n = 123 used cannabis, n = 100 used stimulants and n = 26 used opioids). The prevalence of cognitive impairments was 31%. Patients using alcohol had a lower total- and memory domain score than those using cannabis. Patients using opioids scored lower on visuospatial abilities than those using cannabis or stimulants. Younger patients scored higher than older patients. No effect was found for the other investigated characteristics. Discussion and Conclusions: Given the high prevalence of cognitive impairments, standard screening at an early stage of treatment is important to determine the course of treatment and maximise treatment outcome. Caution is needed in interpreting results about opioids due to an underrepresentation of this patient group, and more research is needed on the effect of age on Montreal Cognitive Assessment performance. 8 p.

ObjectiveTo investigate whether longer-term antibiotic treatment improves cognitive performance in patients with persistent symptoms attributed to Lyme borreliosis.MethodsData were collected during the Persistent Lyme Empiric Antibiotic Study Europe (PLEASE) trial, a randomized, placebo-controlled study. Study participants passed performance-validity testing (measure for detecting suboptimal effort) and had persistent symptoms attributed to Lyme borreliosis. All patients received a 2-week open-label regimen of intravenous ceftriaxone before the 12-week blinded oral regimen (doxycycline, clarithromycin/hydroxychloroquine, or placebo). Cognitive performance was assessed at baseline and after 14, 26, and 40 weeks with neuropsychological tests covering the cognitive domains of episodic memory, attention/working memory, verbal fluency, speed of information processing, and executive function.ResultsBaseline characteristics of patients enrolled (n = 239) were comparable in all treatment groups. After 14 weeks, performance on none of the cognitive domains differed significantly between the treatment arms (p = 0.49–0.82). At follow-up, no additional treatment effect (p = 0.35–0.98) or difference between groups (p = 0.37–0.93) was found at any time point. Patients performed significantly better in several cognitive domains at weeks 14, 26, and 40 compared to baseline, but this was not specific to a treatment group.ConclusionsA 2-week treatment with ceftriaxone followed by a 12-week regimen of doxycycline or clarithromycin/hydroxychloroquine did not lead to better cognitive performance compared to a 2-week regimen of ceftriaxone in patients with Lyme disease–attributed persistent symptoms.ClinicalTrials.gov identifierNCT01207739.Classification of evidenceThis study provides Class II evidence that longer-term antibiotics in patients with borreliosis-attributed persistent symptoms does not increase cognitive performance compared to shorter-term antibiotics.

Item does not contain fulltext Background: It is uncertain whether self- and proxy-reported cognitive decline in older adults reflect an actual objective cognitive dysfunction in the clinical sense, and if these are predictive for developing dementia. Objective: The aim of the present study is to investigate the cross-sectional and longitudinal relation between subjective cognitive decline and objective cognitive performance, depressive symptoms, and to determine the predictive value for development of dementia. Methods: We included 405 patients without dementia at first visit from the Maastricht memory clinic participating in a longitudinal cohort study. Subjective cognitive decline was measured using a self- and proxy-report questionnaire. All patients underwent a standardized neuropsychological assessment. Follow-up assessments were performed yearly for three consecutive years, and once after five years. Results: Subjective cognitive decline was associated with lower cognitive performance and more depressive symptoms. When comparing self- (n = 342, 84% ) and proxy-reported decline (n = 110, 27% ), it was shown that proxy reports were associated with a more widespread pattern of lower cognitive performance. In participants without cognitive impairment proxy-reported decline was not associated with depressive symptoms. In contrast, self-reported decline was associated with a stable course of depressive symptoms at follow-up. Proxy-reported cognitive decline (HR = 1.76, 95% CI = 1.12- 2.78), and mutual complaints (HR = 1.73, CI:1.09- 2.76) predicted incident dementia while self-reported decline did not reach statistical significance (HR = 1.26, 95% CI = 0.65- 2.43). Conclusion: Proxy-reported cognitive decline was consistently associated with lower cognitive performance and conversion to dementia over 5 years. Self-reported cognitive decline in patients without cognitive impairment might indicate underlying depressive symptoms and thus deserve clinical attention as well. 15 p.

Research into strategies that can combat episodic memory decline in healthy older adults has gained widespread attention over the years. Evidence suggests that a short period of rest immediately after learning can enhance memory consolidation, as compared to engaging in cognitive tasks. However, a recent study in younger adults has shown that post-encoding engagement in a working memory task leads to the same degree of memory consolidation as from post-encoding rest. Here, we tested whether this finding can be extended to older adults. Using a delayed recognition test, we compared the memory consolidation of word–picture pairs learned prior to 9 min of rest or a 2-Back working memory task, and examined its relationship with executive functioning and mindwandering propensity. Our results show that (1) similar to younger adults, memory for the word–picture associations did not differ when encoding was followed by post-encoding rest or 2-Back task and (2) older adults with higher mindwandering propensity retained more word–picture associations encoded prior to rest relative to those encoded prior to the 2-Back task, whereas participants with lower mindwandering propensity had better memory performance for the pairs encoded prior to the 2-Back task. Overall, our results indicate that the degree of episodic memory consolidation during both active and passive post-encoding periods depends on individual mindwandering tendency. Electronic supplementary material The online version of this article (10.1007/s40520-019-01251-1) contains supplementary material, which is available to authorized users.

Item does not contain fulltext Using EEG recordings of patients with endometriosis-related chronic pelvic pain, we have examined the effective connectivity within the cortical pain-related network during rest and during pain-related imagery. During rest, an altered connectivity was hypothesized between cortical somatosensory pain areas and regions involved in emotional and cognitive modulation of pain. During pain-related imagery, alterations in prefrontal-temporal connectivity were expected. The effective connectivity was estimated using the Directed Transfer Function method. Differences between endometriosis patients and controls were found in the beta band (14-25Hz). During rest, endometriosis was associated with an increased connectivity from the left dorsolateral prefrontal cortex to the left somatosensory cortex and also from the left somatosensory cortex to the orbitofrontal cortex and the right temporal cortex. These results might be related to sustained activation of the somatosensory pain system caused by the ongoing pain. During pain-related imagery, endometriosis patients showed an increased connectivity from the left dorsolateral prefrontal cortex to the right temporal cortex. This finding might point to impaired emotional regulation when processing pain-related stimuli, or it might be related to altered memorization of pain experiences. Results of this study open up new directions in chronic pain research aimed at exploring the beta band connectivity alterations. Perspective This study examined the pain system's dynamics in endometriosis patients with chronic pelvic pain during resting-state and pain-related mental imagery. The results could contribute to the development of new therapies using guided mental imagery. 13 p.

Contains fulltext : 200858.pdf (Publisher’s version ) (Open Access) Subjectively perceived confidence is critically involved in distinguishing recollection from familiarity in episodic memory retrieval. However, the extent to which recollection and familiarity share similar electrophysiological processes associated with subjectively perceived memory confidence remains an open question. In addition, the role of memory encoding in subjectively perceived confidence during retrieval has not yet been investigated. To address these issues, an EEG study was performed in thirty healthy volunteers. During a memory task, participants encoded a subset of words while rating the words on pleasantness. Memory recognition and subjectively perceived confidence concerning these 'old' and additional 'new' words was tested. Results showed that during retrieval, correctly classifying an old item with high subjectively perceived confidence was associated with a parietal ERP and parietal theta power, while frontal theta activity was related to high-confident novelty processing. During the memory encoding phase, a parietal ERP and frontal theta oscillations were related to subsequent subjectively perceived memory confidence. Our findings provide the first evidence that subjectively perceived memory confidence is associated with distinct electrophysiological correlates during both memory encoding and retrieval. 8 p.

Contains fulltext : 205930.pdf (Publisher’s version ) (Open Access) Objective: Although alcoholic Korsakoff patients show profound cognitive impairments (including amnesia), intellectual function has typically been assumed to be preserved. Based on more recent models on intelligence, however, it can be hypothesized that although preserved verbal or crystallized abilities may be expected in Korsakoff patients, fluid reasoning may be significantly reduced. Aim of this study was to gain insight in intelligence profiles of patients with alcohol-related cognitive disorders with and without Korsakoff's syndrome (KS). Method: Test performance on the Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV) and the National Adult Reading Test (NART) was assessed in 34 patients diagnosed with KS, 40 patients with chronic alcohol-related cognitive disorder without Korsakoff's syndrome (ALC), and 47 non-alcoholic psychiatric controls (non-ALC). Results: Analysis revealed significant lower WAIS-IV Full-Scale IQ scores compared to the estimated premorbid NART-IQ in both groups with alcohol-related cognitive disorders (KS and ALC). With respect to the index scores, KS patients performed worse than non-ALC patients on the Perceptual Reasoning and Processing Speed Indices. Performance on the Verbal Comprehension and Working Memory Indices did not differ between groups. Conclusion: Not all aspects of intelligence are preserved in Korsakoff's syndrome and implications of assessment of intellectual function in patients with alcohol-use disorder are discussed. 7 p.

Contains fulltext : 207798pos.pdf (Author’s version postprint ) (Open Access) Background: High-intensity aerobic exercise might attenuate the symptoms of Parkinson's disease, but high-quality evidence is scarce. Moreover, long-term adherence remains challenging. We aimed to evaluate the effectiveness of aerobic exercise-gamified and delivered at home, to promote adherence-on relieving motor symptoms in patients with Parkinson's disease with mild disease severity who were on common treatment regimes. Methods: In this single-centre, double-blind, randomised controlled trial (Park-in-Shape), we recruited sedentary patients with Parkinson's disease from the outpatient clinic at Radboudumc, Nijmegen, Netherlands. Patients were made aware of the study either by their treating neurologist or via information in the waiting room. Patients could also contact the study team via social media. We included patients aged 30-75 years with a Hoehn and Yahr stage of 2 or lower, who were on stable dopaminergic medication. Patients were randomly assigned (in a 1:1 ratio) to either aerobic exercise done on a stationary home-trainer (aerobic intervention group) or stretching (active control group) by means of a web-based system with minimisation for sex and medication status (treated or untreated) and permuted blocks of varying sizes of more than two (unknown to study personnel). Patients were only aware of the content of their assigned programme. Assessors were unaware of group assignments. Both interventions were home based, requiring 30-45 min training three times per week for 6 months. Both groups received a motivational app and remote supervision. Home trainers were enhanced with virtual reality software and real-life videos providing a so-called exergaming experience (ie, exercise enhanced by gamified elements). The primary outcome was the between-group difference in the Movement Disorders Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) motor section at 6 months, tested during the off state (>/=12 h after last dopaminergic medication). The analysis was done on an intention-to-treat basis in patients who completed the follow-up assessment, regardless of whether they completed the assigned intervention. Patients reported adverse events directly to their coach and also after the 6-month visit retrospectively. A between-group difference of 3.5 points or more was deemed a-priori clinically relevant. The study is concluded and registered with the Dutch Trial Registry, NTR4743. Findings: Between Feb 2, 2015, and Oct 27, 2017, 139 patients were assessed for eligibility in person, of whom 130 were randomly assigned to either the aerobic intervention group (n=65) or the active control group (n=65). Data from 125 (96%) patients were available for the primary analysis; five patients were lost to follow-up (four in the intervention group; one in the control group). 20 patients (ten in each group) did not complete their assigned programme. The off-state MDS-UPDRS motor score revealed a between-group difference of 4.2 points (95% CI 1.6-6.9, p=0.0020) in favour of aerobic exercise (mean 1.3 points [SE 1.8] in the intervention group and 5.6 points [SE 1.9] for the control group). 11 patients had potentially related adverse events (seven [11%] in the intervention group, four [6%] in the control group) and seven had unrelated serious adverse events (three in the intervention group [vestibilar disorder, vasovagal collapse, knee injury during gardening that required surgery; 6%], four in the control group [supraventricular tachycardia, hip fracture, fall related injury, severe dyskinesias after suprathreshold dose levodopa in a patient with deep brain stimulation; 7%]). Interpretation: Aerobic exercise can be done at home by patients with Parkinson's disease with mild disease severity and it attenuates off-state motor signs. Future studies should establish long-term effectiveness and possible disease-modifying effects. Funding: Netherlands Organization for Health Research and Development. 11 p.

Introduction Recent studies have shown that neuroimaging markers of cerebral small vessel disease can also regress over time. We investigated the cognitive consequences of regression of small vessel disease markers. Patients and methods Two hundred and seventy-six participants of the RUNDMC study underwent neuroimaging and cognitive assessments at three time-points over 8.7 years. We semi-automatically assessed white matter hyperintensities volumes and manually rated lacunes and microbleeds. We analysed differences in cognitive decline and accompanying brain atrophy between participants with regression, progression and stable small vessel disease by analysis of variance. Results Fifty-six participants (20.3%) showed regression of small vessel disease markers: 31 (11.2%) white matter hyperintensities regression, 10 (3.6%) vanishing lacunes and 27 (9.8%) vanishing microbleeds. Participants with regression showed a decline in overall cognition, memory, psychomotor speed and executive function similar to stable small vessel disease. Participants with small vessel disease progression showed more cognitive decline compared with stable small vessel disease (p Discussion Regression of small vessel disease markers was associated with similar cognitive decline compared to stable small vessel disease and did not accompany brain atrophy, suggesting that small vessel disease regression follows a relatively benign clinical course. Future studies are required to validate these findings and to assess the role of vascular risk factor control on small vessel disease regression and possible recovery of clinical symptoms. Conclusion Our findings of comparable cognitive decline between participants with regression and stable small vessel disease might suggest that small vessel disease regression has a relative benign cognitive outcome.

Contains fulltext : 195401.pdf (Author’s version postprint ) (Open Access) We know how age affects the brain during lab-based tasks, but what about situations truer to everyday life, such as watching movies? We measured fMRI activity while participants (N=577) from the Cambridge Centre for Ageing and Neuroscience (www.cam-can.com) watched a movie. Watching the same movie induces significant inter-subject synchronization of brain activity across participants. These cross-subject correlations suggest that viewers are processing incoming information in a similar (or shared) way. We show that with advancing age, synchrony is preserved in some areas, including the language network, but decreased in others, including the medial prefrontal cortex, medial temporal lobe and fronto-parietal network. Synchrony declines were driven by more idiosyncratic responding in older adults and were associated with regionally-distinct temporal profiles and functional connectivity patterns, as well as declines in white matter integrity. These findings suggest that areas involved in language processing remain intact with age, while regions involved in attentional control and memory may show age-related declines, even in situations similar to daily life. 15 p.

Contains fulltext : 234476.pdf (Publisher’s version ) (Closed access) Black, Indigenous, and People of Color (BIPOC) currently constitute 40% of the US population and will become the majority by 2045. Current mental health systems have not sufficiently accounted for disparities, inequities, and social determinants impacting BIPOC lives. We outline several advances that could improve mental health disparities research. Research on BIPOC requires mental health assessment accurately capturing multiple facets of one's identity, taking into account the complexities of multifaceted historical oppression. Assessing (personality) psychopathology in a dimensional and hierarchical manner could provide greater insight into mental health disparities between diverse identity individuals. We encourage studying moderators that are protective assets for BIPOC - such as resiliency and community factors - as opposed to deficit-dominant, category-based, and majority-dominant assessments. 16 p.