Association of Essential Tremor With Dementia and Affective Disorders: A Meta-Analysis.

Background: The dementia and affective disorders are common non-motor features in patients with essential tremor (ET). However, the relationship of ET with cognitive impairments and affective disorders remains controversial. This meta-analysis aimed to analyze the association of ET with dementia and affective disorders. Methods: Original studies published from January 1999 to October 2019 were systematically searched from the database of Medline (OvidSP), EMBASE (OvidSP), and the Cochrane Central Register of Controlled Trials. Pooled standard mean difference (SMD, random effect model), odds ratios (ORs), relative risk (RR), and 95% CI were calculated. Results: Compared with the Non-ET group, patients with ET had significantly lower Mini-Mental State Examination (MMSE) score (SMD, -1.16; 95% CI, -1.75 to -0.58; p = 0.0001) and had significantly higher depressive and anxiety symptoms scale score (SMD, 0.55; 95% CI, 0.22-0.87; p = 0.0009). The OR for dementia and affective disorders in individuals with ET compared with individuals without ET was 2.49 (95% CI, 2.17-2.85, p < 0.00001). While there was no significant difference in Montreal Cognitive Assessment (MoCA) score between ET and Non-ET groups (SMD, -0.52; 95% CI, -0.16 to 0.13; p = 0.23), there was a significant difference in the risk of mortality between ET and Non-ET groups (RR = 4.69, 95% CI, 2.18-10.07). Conclusion: The non-motor symptoms should not be neglected among patients with ET. However, the causal relationship between ET and dementia, depression, and anxiety is unclear.

Validity of the MemTrax Memory Test Compared to the Montreal Cognitive Assessment in the Detection of Mild Cognitive Impairment and Dementia due to Alzheimer's Disease in a Chinese Cohort.

BACKGROUND: A valid, reliable, accessible, engaging, and affordable digital cognitive screen instrument for clinical use is in urgent demand. OBJECTIVE: To assess the clinical utility of the MemTrax memory test for early detection of cognitive impairment in a Chinese cohort. METHODS: The 2.5-minute MemTrax and the Montreal Cognitive Assessment (MoCA) were performed by 50 clinically diagnosed cognitively normal (CON), 50 mild cognitive impairment due to AD (MCI-AD), and 50 Alzheimer's disease (AD) volunteer participants. The percentage of correct responses (MTx-% C), the mean response time (MTx-RT), and the composite scores (MTx-Cp) of MemTrax and the MoCA scores were comparatively analyzed and receiver operating characteristic (ROC) curves generated. RESULTS: Multivariate linear regression analyses indicated MTx-% C, MTx-Cp, and the MoCA score were significantly lower in MCI-AD versus CON and in AD versus MCI-AD groups (all with p≤0.001). For the differentiation of MCI-AD from CON, an optimized MTx-% C cutoff of 81% had 72% sensitivity and 84% specificity with an area under the curve (AUC) of 0.839, whereas the MoCA score of 23 had 54% sensitivity and 86% specificity with an AUC of 0.740. For the differentiation of AD from MCI-AD, MTx-Cp of 43.0 had 70% sensitivity and 82% specificity with an AUC of 0.799, whereas the MoCA score of 20 had 84% sensitivity and 62% specificity with an AUC of 0.767. CONCLUSION: MemTrax can effectively detect both clinically diagnosed MCI and AD with better accuracy as compared to the MoCA based on AUCs in a Chinese cohort.

MicroRNA-93 regulates the neurological function, cerebral edema and neuronal apoptosis of rats with intracerebral hemorrhage through TLR4/NF-κB signaling pathway.

In recent years, many studies have unraveled the impact of microRNAs (miRNAs) in intracerebral hemorrhage (ICH). This study aims to explore the role of miR-93 in modulating neurological function, cerebral edema and neuronal apoptosis of rats with ICH by regulating TLR4/NF-κB signaling pathway. ICH models were constructed using Ⅶ collagenase method. The successfully modeled rats were injected with miR-93 antagomir, TLR4/NF-κB signaling pathway activator or inhibitor together with their controls. The expression of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-1ß (IL-1ß) and vascular endothelial growth factor (VEGF) was measured using enzyme-linked immunosorbent assay (ELISA). The expression of human aquaporin 4 (AQP-4), Caspase-3, Bax, Bcl-2 and TLR4/NF-κB signaling pathway-related proteins was also measured. MiR-93, TLR4 and NF-κB were all highly expressed in ICH, reduced miR-93 and inhibited TLR4/NF-κB signaling pathway could improve neurological function and suppress inflammation in ICH rats. Moreover, down-regulated miR-93 and suppressed TLR4/NF-κB signaling pathway were able to attenuate cerebral edema and abate pathological lesion. We have also found in this research that miR-93 knockdown as well as inhibited TLR4/NF-κB signaling pathway could relieve neuronal apoptosis in ICH rats. This study suggests that reduced miR-93 alleviates the neurological function and cerebral edema as well as repressed neuronal apoptosis of ICH rats via the inhibited activation of TLR4/NF-κB signaling pathway.