Search

Background/aim: Hypertension is an important risk factor for cognitive impairment. This study explored whether elderly patients with stage I hypertension (HPs) and normotensive patients (NPs) showed differences in the recovery of postoperative attention network function according to the attentional network test (ANT) performance. Materials and methods: Of 110 patients screened, 25 HPs and 25 NPs completed this study. The Mini-Mental State Examination (MMSE) was applied to all participants before the operation and the ANT (on days 2 and 7) after the operation. All participants completed 1 day preoperatively and the ANT on postoperative days (PODs) 2 and 7. Results: Compared with NPs, HPs had significantly lower alerting network effect scores and more difficulty resolving conflict on POD 7. However, no significant difference was observed between the groups on POD 2. Orienting network performance was similar between the groups at all time points. Significant differences in alerting and executive control network performances were observed between PODs 2 and 7 in each group. Conclusion: HPs showed selective cognitive impairment at different time points following elective hip or knee arthroplasty. Compared with NPs, during the first postoperative week, HPs were more likely to experience delayed recovery of alerting and executive control network function, but not orienting network function. [ABSTRACT FROM AUTHOR]

• PSEN1 G417S mutation was firstly identified in a Chinese pedigree and classified as pathogenic. • Early-onset parkinsonism is relatively rare in Alzheimer's disease. • Our findings provided the clinical evidence of cerebrovascular factors in the pathogenesis of AD. Presenilin 1 (PSEN1) mutations are a major cause of familial Alzheimer's disease. The pathogenic variant, PSEN1 p.G417S, has been reported to be associated with spastic paraparesis and cotton wool plaques in Japan. Here, we report a 3 generation Chinese pedigree that included 10 patients presenting with early-onset and rapid progression of parkinsonism with cognitive impairment in their third or fourth decade of life. Three additional living patients developed different degrees of cognitive impairment, without movement disorders. Magnetic resonance imaging of the brain showed white matter hyperintensities, multiple microbleeds, and enlarged perivascular spaces. Whole exome sequencing analysis of the proband detected the mutation, p.G417S, in PSEN1 , which was completely co-segregated with the disease phenotype within the family by Sanger sequencing. 3D protein structures predicted that the mutation might influence contact with the lipid membrane and the interaction with beta-catenin. Our study provides insights into the heterogeneity in clinical presentation and imaging associated with mutations in PSEN1. [ABSTRACT FROM AUTHOR]