ABSTRACT
All-solid-state lithium metal batteries (ASSLMBs) have emerged as the most promising next-generation energy storage devices. However, the unsatisfactory ionic conductivity of solid electrolytes at room temperature has impeded the advancement of solid-state batteries. In this work, a multifunctional composite solid electrolyte (CSE) is developed by incorporating boron nitride nanotubes (BNNTs) into polyvinylidene fluoride-hexafluoropropylene (PVDF-HFP). BNNTs, with a high aspect ratio, trigger the dissociation of Li salts, thus generating a greater population of mobile Li+, and establishing long-distance Li+ transport pathways. PVDF-HFP/BNNT exhibits a high ionic conductivity of 8.0 × 10-4 S cm-1 at room temperature and a Li+ transference number of 0.60. Moreover, a Li//Li symmetric cell based on PVDF-HFP/BNNT demonstrates robust cyclic performance for 3400 h at a current density of 0.2 mA cm-2. The ASSLMB formed from the assembly of PVDF-HFP/BNNT with LiFePO4 and Li exhibits a capacity retention of 93.2% after 850 cycles at 0.5C and 25 °C. The high-voltage all-solid-state LiCoO2/Li cell based on PVDF-HFP/BNNT also exhibits excellent cyclic performance, maintaining a capacity retention of 96.4% after 400 cycles at 1C and 25 °C. Furthermore, the introduction of BNNTs is shown to enhance the thermal conductivity and flame retardancy of the CSE.
ABSTRACT
Previous brain imaging studies have identified three brain regions that selectively respond to visual scenes, the parahippocampal place area (PPA), the occipital place area (OPA), and the retrosplenial cortex (RSC). There is growing evidence that these visual scene-sensitive regions process different types of scene information and may have different developmental timelines in supporting scene perception. How these scene-sensitive regions support memory functions during child development is largely unknown. We investigated PPA, OPA and RSC activations associated with episodic memory formation in childhood (5-7 years of age) and young adulthood, using a subsequent scene memory paradigm and a functional localizer for scenes. PPA, OPA, and RSC subsequent memory activation and functional connectivity differed between children and adults. Subsequent memory effects were found in activations of all three scene regions in adults. In children, however, robust subsequent memory effects were only found in the PPA. Functional connectivity during successful encoding was significant among the three regions in adults, but not in children. PPA subsequently memory activations and PPA-RSC subsequent memory functional connectivity correlated with accuracy in adults, but not children. These age-related differences add new evidence linking protracted development of the scene-sensitive regions to the protracted development of episodic memory.
Subject(s)
Brain Mapping , Memory, Episodic , Adult , Child , Humans , Young Adult , Brain Mapping/methods , Child Development , Magnetic Resonance Imaging/methods , Photic Stimulation , Pattern Recognition, Visual/physiologyABSTRACT
Solid polymer electrolytes (SPEs), which are favorable to form intimate interfacial contacts with electrodes, are promising electrolyte of choice for long-cycling lithium metal batteries (LMBs). However, typical SPEs with easily oxidized oxygen-bearing polar groups exhibit narrow electrochemical stability window (ESW), making it impractical to increase specific capacity and energy density of SPE based LMBs with charging cut-off voltage of 4.5 V or higher. Here, we apply a polyfluorinated crosslinker to enhance oxidation resistance of SPEs. The crosslinked network facilitates transmission of the inductive electron-withdrawing effect of polyfluorinated segments. As a result, polyfluorinated crosslinked SPE exhibits a wide ESW, and the Li|SPE|LiNi0.5Co0.2Mn0.3O2 cell with a cutoff voltage of 4.5 V delivers a high discharge specific capacity of ~164.19 mAh g-1 at 0.5 C and capacity retention of ~90% after 200 cycles. This work opens a direction in developing SPEs for long-cycling high-voltage LMBs by using polyfluorinated crosslinking strategy.
ABSTRACT
Large-scale brain networks undergo functional reorganization over the course of the lifespan, with concurrent implications for cognition. Characterizing network connectivity during a task may provide complementary insight into cognitive development and aging, to that provided by resting-state. We assessed network background connectivity, which refers to connectivity that remains after task effects have been regressed out, during a visual memory-encoding task in a lifespan sample. More specifically we assessed the within- and between-network background connectivity of the default mode, salience, and frontoparietal networks. Within-network background connectivity of salience and frontoparietal networks differed between age groups, with late-life adults showing lower connectivity. We did not find an effect of age group in default mode network background connectivity, contrary to previous findings using resting-state. However, default mode between-network background connectivity with salience and frontoparietal networks was greater in mid-life and late-life adults than in younger age groups. Overall, our findings in a lifespan sample are in line with previous observations of age-related network de-differentiation. However, the lack of age effect in default mode network background connectivity suggests that background connectivity indeed represents a complementary measure to resting-state connectivity, providing a differential glance of network connectivity during a particular state.
ABSTRACT
All solid-state lithium batteries (SSLBs) are poised to have higher energy density and better safety than current liquid-based Li-ion batteries, but a central requirement is effective ionic conduction pathways throughout the entire cell. Here we develop a catholyte based on an emerging class of porous materials, porous organic cages (POCs). A key feature of these Li+ conducting POCs is their solution-processibility. They can be dissolved in a cathode slurry, which allows the fabrication of solid-state cathodes using the conventional slurry coating method. These Li+ conducting cages recrystallize and grow on the surface of the cathode particles during the coating process and are therefore dispersed uniformly in the slurry-coated cathodes to form a highly effective ion-conducting network. This catholyte is shown to be compatible with cathode active materials such as LiFePO4, LiCoO2 and LiNi0.5Co0.2Mn0.3O2, and results in SSLBs with decent electrochemical performance at room temperature.
ABSTRACT
Understanding complex human brain functions is critically informed by studying such functions during development. Here, we addressed a major gap in models of human memory by leveraging rare direct electrophysiological recordings from children and adolescents. Specifically, memory relies on interactions between the medial temporal lobe (MTL) and prefrontal cortex (PFC), and the maturation of these interactions is posited to play a key role in supporting memory development. To understand the nature of MTL-PFC interactions, we examined subdural recordings from MTL and PFC in 21 neurosurgical patients aged 5.9-20.5 years as they performed an established scene memory task. We determined signatures of memory formation by comparing the study of subsequently recognized to forgotten scenes in single trials. Results establish that MTL and PFC interact via two distinct theta mechanisms, an â¼3-Hz oscillation that supports amplitude coupling and slows down with age and an â¼7-Hz oscillation that supports phase coupling and speeds up with age. Slow and fast theta interactions immediately preceding scene onset further explained age-related differences in recognition performance. Last, with additional diffusion imaging data, we linked both functional mechanisms to the structural maturation of the cingulum tract. Our findings establish system-level dynamics of memory formation and suggest that MTL and PFC interact via increasingly dissociable mechanisms as memory improves across development.
Subject(s)
Prefrontal Cortex , Temporal Lobe , Adolescent , Child , Humans , Magnetic Resonance Imaging , Nerve Net/physiology , Prefrontal Cortex/physiology , Recognition, Psychology , Temporal Lobe/physiology , Theta Rhythm/physiologyABSTRACT
Functional MRI (fMRI) is a key tool for investigating neural underpinnings of cognitive development. Yet, in recent years, the reliability of fMRI effects has come into question and with it, the feasibility of using task-based fMRI to identify developmental changes related to cognition. Here, we investigated the reliability of task-based fMRI activations with a widely used subsequent memory paradigm using two developmental samples: a cross-sectional sample (n = 85, age 8-25 years) and a test-retest sample (n = 24, one-month follow up, age 8-20 years). In the large cross-sectional sample, we found good to excellent group-level reliability when assessing activation patterns related to the encoding task and subsequent memory effects. In the test-retest sample, while group-level reliability was excellent, the consistency of activation patterns within individuals was low, particularly for subsequent memory effects. We observed consistent activation patterns in frontal, parietal, and occipital cortices, but comparatively lower test-retest reliability in subcortical regions and the hippocampus. Together, these findings highlight the limitations of interpreting task-based fMRI effects and the importance of incorporating reliability analyses in developmental studies. Leveraging larger and densely collected longitudinal data may help contribute to increased reproducibility and the accumulation of knowledge in developmental sciences.
Subject(s)
Cognition , Magnetic Resonance Imaging , Adolescent , Adult , Brain/physiology , Brain Mapping , Child , Cross-Sectional Studies , Hippocampus , Humans , Reproducibility of Results , Young AdultABSTRACT
The hippocampus (Hc) is composed of cytoarchitectonically distinct subfields: dentate gyrus (DG), cornu ammonis sectors 1-3 (CA1-3), and subiculum. Limited evidence suggests differential maturation rates across the Hc subfields. While longitudinal studies are essential in demonstrating differential development of Hc subfields, a prerequisite for interpreting meaningful longitudinal effects is establishing test-retest consistency of Hc subfield volumes measured in vivo over time. Here, we examined test-retest consistency of Hc subfield volumes measured from structural MR images in two independent developmental samples. Sample One (n = 28, ages 7-20 years, M = 12.64, SD = 3.35) and Sample Two (n = 28, ages 7-17 years, M = 11.72, SD = 2.88) underwent MRI twice with a 1-month and a 2-year delay, respectively. High-resolution PD-TSE-T2 -weighted MR images (0.4 × 0.4 × 2 mm3 ) were collected and manually traced using a longitudinal manual demarcation protocol. In both samples, we found excellent consistency of Hc subfield volumes between the two visits, assessed by two-way mixed intraclass correlation (ICC (3) single measures ≥ 0.87), and no difference between children and adolescents. The results further indicated that discrepancies between repeated measures were not related to Hc subfield volumes, or visit number. In addition to high consistency, with the applied longitudinal protocol, we detected significant variability in Hc subfield volume changes over the 2-year delay, implying high sensitivity of the method in detecting individual differences. Establishing unbiased, high longitudinal consistency of Hc subfield volume measurements optimizes statistical power of a hypothesis test and reduces standard error of the estimate, together improving external validity of the measures in constructing theoretical models of memory development.
Subject(s)
Adolescent Development/physiology , Child Development/physiology , Hippocampus/diagnostic imaging , Hippocampus/growth & development , Magnetic Resonance Imaging/standards , Magnetic Resonance Imaging/trends , Adolescent , Child , Female , Humans , Longitudinal Studies , Male , Random Allocation , Reproducibility of Results , Young AdultABSTRACT
Negative subsequent memory effects in functional MRI studies of memory formation have been linked to individual differences in memory performance, yet the effect of age on this association is currently unclear. To provide insight into the brain systems related to memory across the lifespan, we examined functional neuroimaging data acquired during episodic memory formation and behavioral performance from a memory recognition task in a sample of 109 participants, including three developmental age groups (8-12, 13-17, 18-25â¯year-olds) and one additional group of older adults (55-85â¯year-olds). Young adults showed the highest memory performance and strongest negative subsequent memory effects, while older adults showed reduced negative subsequent memory effects relative to young adults. Across the sample, negative subsequent memory effects were associated with better memory performance, and there was a significant interaction between negative subsequent memory effects and memory performance by age group. Posthoc analyses revealed that this moderation effect was driven by a stronger association between negative subsequent memory effects and memory performance in young adults than children, and that neither children nor older adults showed a significant association. These findings suggest that negative subsequent memory effects may differentially support memory performance across a lifespan trajectory characterized by developmental maturation and support further investigation of this effect in aging.
ABSTRACT
Processing of low-level visual information shows robust developmental gains through childhood and adolescence. However, it is unknown whether low-level visual processing in the occipital cortex supports age-related gains in memory for complex visual stimuli. Here, we examined occipital alpha activity during visual scene encoding in 24 children and adolescents, aged 6.2-20.5 years, who performed a subsequent memory task while undergoing electrocorticographic recording. Scenes were classified as high- or low-complexity by the number of unique object categories depicted. We found that recognition of high-complexity, but not low-complexity, scenes increased with age. Age was associated with decreased alpha power and increased instantaneous alpha frequency during the encoding of subsequently recognized high- compared to low-complexity scenes. Critically, decreased alpha power predicted improved recognition of high-complexity scenes in adolescents. These findings demonstrate how the functional maturation of the occipital cortex supports the development of memory for complex visual scenes.
Subject(s)
Brain Mapping , Pattern Recognition, Visual , Adolescent , Brain , Child , Humans , Magnetic Resonance Imaging , Occipital Lobe/diagnostic imaging , Photic StimulationABSTRACT
Neuroimaging evidence suggests that the development of the hippocampus, a brain structure critical for memory function, contributes to the improvements of episodic memory between middle childhood to adulthood. However, investigations on age differences in hippocampal activation and functional connectivity and their contributions to the development of memory have yielded mixed results. Given the known structural and functional heterogeneity along the long axis of the hippocampus, we investigated age differences in the activation and functional connectivity in hippocampal subregions with a cross-sectional sample of 96 participants ages 8-25 years. We found that anterior and posterior hippocampus supported memory formation, and there was overall stability in memory-related hippocampal activation with age. Without taking account of memory outcome, direct contrast between subregions showed higher functional connectivity of anterior, compared to the posterior hippocampus, with regions in the inferior frontal and lateral temporal lobes, and higher functional connectivity of posterior, compared to the anterior hippocampus, with regions in the medial and superior frontal, inferior parietal, and occipital lobes. A direct contrast between the memory-related connectivity patterns of anterior and posterior hippocampus identified a region in the medial frontal cortex, with which anterior and posterior hippocampus was differentially functionally connected. Finally, we identified age differences in memory-related differential hippocampal functional connectivity with several frontal and visual/sensory cortices, underscoring the importance of examining age differences in the patterns of hippocampal connectivity. Moreover, the specific patterns of differential anterior and posterior functional connectivity indicate an increase in the functional specialization along the long axis of the hippocampus and a dynamic shift in hippocampal connectivity patterns that supports memory development.
ABSTRACT
Recent advances in human cognitive neuroscience show great promise in extending our understanding of the neural basis of memory development. We briefly review the current state of knowledge, highlighting that most work has focused on describing the neural correlates of memory in cross-sectional studies. We then delineate three examples of the application of innovative methods in addressing questions that go beyond description, towards a mechanistic understanding of memory development. First, structural brain imaging and the harmonization of measurements across laboratories may uncover ways in which the maturation of the brain constrains the development of specific aspects of memory. Second, longitudinal designs and sophisticated modeling of the data may identify age-driven changes and the factors that determine individual developmental trajectories. Third, recording memory-related activity directly from the developing brain presents an unprecedented opportunity to examine how distinct brain structures support memory in real time. Finally, the growing prevalence of data sharing offers additional means to tackle questions that demand large-scale datasets, ambitious designs, and access to rare samples. We propose that the use of such innovative methods will move our understanding of memory development from a focus on describing trends to explaining the causal factors that shape behavior.
Subject(s)
Brain/growth & development , Hippocampus/growth & development , Magnetic Resonance Imaging/methods , Memory/physiology , Prefrontal Cortex/growth & development , Female , Humans , MaleABSTRACT
M-Nb-O compounds are advanced anode materials for lithium-ion batteries (LIBs) due to their high specific capacities, safe operating potentials, and high cycling stability. Nevertheless, the found M-Nb-O anode materials are very limited. Here, Mg2Nb34O87 is developed as a new M-Nb-O material. Mg2Nb34O87 porous microspheres (Mg2Nb34O87-P) with primary-particle sizes of 30-100 nm are fabricated based on a solvothermal method. Mg2Nb34O87 has an open 3 × 4 × ∞ Wadsley-Roth shear structure and a large unit-cell volume, leading to its largest Li+ diffusion coefficients among all the developed M-Nb-O anode materials. In situ X-ray diffraction analyses reveal its high structural stability and intercalating characteristic. These architectural, conductivity, and structural advantages in Mg2Nb34O87-P lead to its most significant intercalation pseudocapacitive contribution (87.7% at 1.1 mV s-1) among the existing M-Nb-O anode materials and prominent rate capability (high reversible capacities of 338 mAh g-1 at 0.1C and 230 mAh g-1 at 10C). Additionally, this new material exhibits a safe operating potential (â¼1.68 V), an ultrahigh initial Coulombic efficiency (94.8%), and an outstanding cycling stability (only 6.9% capacity loss at 10C over 500 cycles). All of these evidences indicate that Mg2Nb34O87-P is an ideal anode material for high-energy, safe, fast-charging, and stable LIBs.
ABSTRACT
Memory functioning undergoes dynamic changes between childhood and adulthood. Spontaneous use of elaborative strategies, which can enhance the recall of information, expands with age and contributes to age-associated improvement in memory functioning. Findings from lesion and neuroimaging studies suggest that the ability to use elaborative strategies is dependent upon intact functioning of the prefrontal cortex (PFC), particularly the dorsolateral PFC region. Because the PFC undergoes protracted maturation, we examined whether age difference in the structure of the PFC is correlated with age-associated increase in strategy use. Here, we investigated the relationship between PFC volume and spontaneous strategy use in a sample of 120 participants aged 5-25 years. We assessed semantic clustering during recall with a standardized word-list recall task (California Verbal Learning Task children's version, CVLT-C) and computed PFC regional volumes from participants' structural brain images. We observed an age-associated increase in the use of semantic clustering and an age-associated decrease in volumes of the PFC. Further, we found that smaller PFC volume was linked to increased use of semantic clustering. Importantly, the volume of the right dorsolateral PFC partially explained the relation between age and the use of semantic clustering. These findings suggest that PFC maturation supports the development of strategy use and lends further support for the notion that brain-behavior relations change across development.
Subject(s)
Association , Human Development/physiology , Mental Recall/physiology , Neuroimaging/methods , Prefrontal Cortex/anatomy & histology , Prefrontal Cortex/growth & development , Semantics , Verbal Learning/physiology , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Prefrontal Cortex/diagnostic imaging , Young AdultABSTRACT
We address the puzzle of "unity in diversity" in human languages by advocating the (minimal) common denominator for the diverse expressions of transitivity across human languages, consistent with the view that early in language evolution there was a modest beginning for syntax and that this beginning provided the foundation for the further elaboration of syntactic complexity. This study reports the results of a functional MRI experiment investigating differential patterns of brain activation during processing of sentences with minimal versus fuller syntactic structures. These structural layers have been postulated to represent different stages in the evolution of syntax, potentially engaging different brain networks. We focused on the Serbian "middles," analyzed as lacking the transitivity (vP) layer, contrasted with matched transitives, containing the transitivity layer. Our main hypothesis was that transitives will produce more activation in the syntactic (Broca's-Basal Ganglia) brain network, in comparison to more rudimentary middles. The participants (n = 14) were healthy adults (Mean age = 33.36; SD = 12.23), native speakers of Serbo-Croatian. The task consisted of reading a series of sentences (middles and transitives; n = 64) presented in blocks of 8, while being engaged in a detection of repetition task. We found that the processing of transitives, compared to middles, was associated with an increase in activation in the basal ganglia bilaterally. Although we did not find an effect in Broca's area, transitives, compared to middles, evoked greater activation in the precentral gyrus (BA 6), proposed to be part of the "Broca's complex." Our results add to the previous findings that Broca's area is not the sole center for syntactic processing, but rather is part of a larger circuit that involves subcortical structures. We discuss our results in the context of the recent findings concerning the gene-brain-language pathway involving mutations in FOXP2 that likely contributed to the enhancement of the frontal-striatal brain network, facilitating human capacity for complex syntax.
ABSTRACT
The present fMRI study tested predictions of the evolution-of-syntax framework which analyzes certain structures as remnants ("fossils") of a non-hierarchical (non-recursive) proto-syntactic stage in the evolution of language (Progovac, 2015, 2016). We hypothesized that processing of these structures, in comparison to more modern hierarchical structures, will show less activation in the brain regions that are part of the syntactic network, including Broca's area (BA 44 and 45) and the basal ganglia, i.e., the network bolstered in the line of descent of humans through genetic mutations that contributed to present-day dense neuronal connectivity among these regions. Fourteen healthy native English-speaking adults viewed written stimuli consisting of: (1) full sentences (FullS; e.g., The case is closed); (2) Small Clauses (SC; e.g., Case closed); (3) Complex hierarchical compounds (e.g., joy-killer); and (4) Simple flat compounds (e.g., kill-joy). SC (compared to FullS) resulted in reduced activation in the left BA 44 and right basal ganglia. Simple (relative to complex) compounds resulted in increased activation in the inferior temporal gyrus and the fusiform gyrus (BA 37/19), areas implicated in visual and semantic processing. We discuss our findings in the context of current theories regarding the co-evolution of language and the brain.
ABSTRACT
The development of the brain, particularly the protracted maturation of the prefrontal cortex (PFC), supports the development of episodic memory. Yet how different regions of the PFC functionally mature to support age-related increases in memory performance remains unclear. We investigated the PFC contribution to subsequent memory (SM) of encoded visual scenes in children, adolescents, and young adults (n = 83). We identified distinct patterns of PFC activations supporting SM: regions in the lateral PFC showed positive SM effects, whereas regions in the superior and medial PFC showed negative SM effects. Both positive and negative SM effects increased with age. The magnitude of negative SM effects in the superior PFC partially mediated the age-related increase in memory. Functional connectivity between lateral PFC and regions in the medial temporal lobe (MTL) increased with age during successful memory formation. In contrast, functional connectivity between the superior PFC and regions in the MTL decreased with age, suggesting an age-related increase in the anti-correlation between these regions. These findings highlight the differential involvement of regions within the PFC supporting memory formation.
Subject(s)
Memory, Episodic , Neural Pathways/growth & development , Neural Pathways/physiology , Prefrontal Cortex/growth & development , Prefrontal Cortex/physiology , Adolescent , Aging/physiology , Child , Female , Humans , Male , Young AdultABSTRACT
Subjective memory complaints, the perceived decline in cognitive abilities in the absence of clinical deficits, may precede Alzheimer's disease. Individuals with subjective memory complaints show differential brain activation during memory encoding; however, whether such differences contribute to successful memory formation remains unclear. Here, we investigated how subsequent memory effects, activation which is greater for hits than misses during an encoding task, differed between healthy older adults aged 50 to 85 years with (n = 23) and without (n = 41) memory complaints. Older adults with memory complaints, compared to those without, showed lower subsequent memory effects in the occipital lobe, superior parietal lobe, and posterior cingulate cortex. In addition, older adults with more memory complaints showed a more negative subsequent memory effects in areas of the default mode network, including the posterior cingulate cortex, precuneus, and ventromedial prefrontal cortex. Our findings suggest that for successful memory formation, older adults with subjective memory complaints rely on distinct neural mechanisms which may reflect an overall decreased task-directed attention.
Subject(s)
Aging/psychology , Brain/physiology , Memory Disorders/psychology , Memory/physiology , Aged , Aged, 80 and over , Alzheimer Disease/psychology , Brain/diagnostic imaging , Female , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
BACKGROUND: Previous research suggests that testosterone (T) plays a key role in shaping competitive and aggressive behavior in humans, possibly by modulating threat-related neural circuitry. However, this research has been limited by the use of T augmentation that fails to account for baseline differences and has been conducted exclusively in women. Thus, the extent to which normal physiologic concentrations of T affect threat-related brain function in men remains unknown. METHODS: In the current study, we use a novel two-step pharmacologic challenge protocol to overcome these limitations and to evaluate causal modulation of threat- and aggression-related neural circuits by T in healthy young men (n = 16). First, we controlled for baseline differences in T through administration of a gonadotropin releasing hormone antagonist. Once a common baseline was established across participants, we then administered T to within the normal physiologic range. During this second step of the protocol we acquired functional neuroimaging data to examine the impact of T augmentation on neural circuitry supporting threat and aggression. RESULTS: Gonadotropin releasing hormone antagonism successfully reduced circulating concentrations of T and brought subjects to a common baseline. Administration of T rapidly increased circulating T concentrations and was associated with heightened reactivity of the amygdala, hypothalamus, and periaqueductal grey to angry facial expressions. CONCLUSIONS: These findings provide novel causal evidence that T rapidly potentiates the response of neural circuits mediating threat processing and aggressive behavior in men.
Subject(s)
Aggression/physiology , Brain/physiology , Facial Expression , Testosterone/metabolism , Visual Perception/physiology , Adolescent , Adult , Aggression/drug effects , Blood Chemical Analysis , Brain/drug effects , Cross-Over Studies , Double-Blind Method , Gonadotropin-Releasing Hormone/antagonists & inhibitors , Gonadotropin-Releasing Hormone/metabolism , Hormone Antagonists/administration & dosage , Humans , Magnetic Resonance Imaging , Male , Neuropsychological Tests , Oxygen/blood , Photic Stimulation , Signal Processing, Computer-Assisted , Testosterone/administration & dosage , Visual Perception/drug effects , Young AdultABSTRACT
BACKGROUND: Patients with strabismus experience visual dysfunction, self-image disorders, low self-esteem, and social and emotional barriers, which adversely influence their health-related quality of life (HRQoL). Currently no strabismus-specific questionnaire is available in China to identify patients' quality of life and to evaluate the effectiveness of strabismus treatment. The aims of the present study were to validate the Chinese-language version of the Adult Strabismus Quality of Life Questionnaire (AS-20) and to evaluate the impacts of strabismus on the quality of life among Chinese strabismus patients. METHODS: Two hundred and fifty-five Chinese adults with strabismus, one hundred visually normal adults and one hundred patients with other eye diseases completed the Chinese version of AS-20. Psychometric properties of the Chinese AS-20 were examined by Cronbach's α coefficient, test-retest and split-half reliability, and construct and criterion-related validity. Independent-samples t test and one-way ANOVA analyses were conducted to explore the impact of demographic factors and clinical characteristics on HRQoL in Chinese strabismic adults. RESULTS: The final AS-20 in Chinese (AS-C) included 18 items and two subscales: psychosocial (12 items) and function (6 items). The Cronbach's α was 0.908 for overall scale, with 0.913 and 0.808 for 'psychosocial' and 'function' subscales respectively, indicating high internal consistency reliability. The mean of the overall AS-C score among strabismus patients was 62.80 ± 18.94, significantly lower than that in visually normal adults (t = -18.693, P < 0.001), and in patients with other eye diseases (t = -5.512, P < 0.001). CONCLUSIONS: The AS-C is a culturally appropriate tool to evaluate the HRQoL in Chinese strabismus adults. The psychosocial health well-being and overall quality of life in strabismic patients should receive greater emphasis.