Executive Functions are Independently Associated with Cognitive Dispersion in HIV Disease.

OBJECTIVE: People with HIV (PWH) can demonstrate elevated cognitive intraindividual variability (IIV-dispersion) that is associated with everyday functioning problems. Higher IIV-dispersion is theorized to reflect lapses in executive aspects of cognitive control, but few studies have directly evaluated this possibility. METHOD: 72 PWH completed the Cogstate and clinical measures of executive functions, psychomotor speed, and episodic memory. IIV-dispersion was calculated with the coefficient of variation (CoV) from six age-adjusted Cogstate subtest scores. RESULTS: Multiple regression showed that the three domain-level cognitive predictors explained 8% of the variance in Cogstate CoV (p = .03). Within this model, poorer executive functions were moderately associated with higher Cogstate CoV (p = .01), but the psychomotor and episodic memory domains were not (ps > .05). CONCLUSIONS: Findings align with cognitive theory in demonstrating IIV-dispersion is uniquely associated with independent measures of executive functions among PWH. Future experimental and mechanistic studies are needed to determine the precise executive aspects of IIV-dispersion.

Mindfulness in severe and persistent mental illness: a systematic review.

OBJECTIVE: This systematic review summarises the current state of research on mindfulness in SPMI, given the pressing need to provide alternative, scalable and cost-effective treatment modalities for patients with severe and persistent mental illness (SPMI). METHODS: Articles included mindfulness-based interventions for SPMI. Excluded articles included qualitative studies, acceptance and compassion therapies, case reports and reviews. Studies were identified by searching the databases Medline, Embase and PsycINFO. RESULTS: Six randomised controlled trials, seven prospective studies and one retrospective study were identified. Clinical improvements were observed on psychotic symptoms, and on improvements of depression symptoms, cognition, mindfulness, psycho-social and vocational factors. CONCLUSIONS: Findings suggest that mindfulness is feasible for individuals with SPMI, and displays potential benefits in outcomes aside from psychotic symptoms. The effects of mindfulness in psychotic symptoms needs further investigation in larger definitive studies using methodological rigor and thorough assessments of other psychiatric populations who are also representative of SPMI.

RGMa inhibition with human monoclonal antibodies promotes regeneration, plasticity and repair, and attenuates neuropathic pain after spinal cord injury.

Traumatic spinal cord injury (SCI) causes a cascade of degenerative events including cell death, axonal damage, and the upregulation of inhibitory molecules which prevent regeneration and limit recovery. Repulsive guidance molecule A (RGMa) is a potent neurite growth inhibitor in the central nervous system, exerting its repulsive activity by binding the Neogenin receptor. Here, we show for the first time that inhibitory RGMa is markedly upregulated in multiple cell types after clinically relevant impact-compression SCI in rats, and importantly, also in the injured human spinal cord. To neutralize inhibitory RGMa, clinically relevant human monoclonal antibodies were systemically administered after acute SCI, and were detected in serum, cerebrospinal fluid, and in the injured tissue. Rats treated with RGMa blocking antibodies showed significantly improved recovery of motor function and gait. Furthermore, RGMa blocking antibodies promoted neuronal survival, and enhanced the plasticity of descending serotonergic pathways and corticospinal tract axonal regeneration. RGMa antibody also attenuated neuropathic pain responses, which was associated with fewer activated microglia and reduced CGRP expression in the dorsal horn caudal to the lesion. These results show the therapeutic potential of the first human RGMa antibody for SCI and uncovers a new role for the RGMa/Neogenin pathway on neuropathic pain.