One step beyond the lab and clinic: "walking the dementia conversation".

Millions of dollars have been lost in dementia research over the last 30 years owing to unsuccessful clinical trials aimed at finding an effective treatment for the condition. Although two promising drugs have been identified, the research effort is insufficient. The dehumanization of patients and the pressure to publish have led to a decline in the quality and usefulness of scientific research. One way to tackle these problems is establishing close contact with those who put their faith in researchers. Fine-tuning the participation of patients with dementia and caregivers in research design and improving their connection and communication with researchers could positively contribute to enhancing the perspectives and designing strategies for scientists in order to generate a new and enriching vision. The Walking the Talk for Dementia event showed that people can still live with dementia despite their condition. Approximately 300 people participated in the all-week "Santiago's Camino" symposium. People living with dementia, caregivers, healthcare professionals, activists, clinicians, and researchers participated in this event. The "Walking the Talk for Dementia" (WTD) event vividly demonstrated a strong commitment to upholding Global Brain Health Institute's (GBHI) core values of Authenticity, Fairness, Openness, Respect, Courage, and Empathy (A FORCE) to advance equity in brain health. These values provide clear guidance for their advocacy initiatives aimed at mitigating the global impact of dementia. Research and development are essential across scientific fields, especially in clinical contexts where involving patients and caregivers is critical. The WTD initiative exemplifies this aspect by bringing together researchers, caregivers, and dementia patients on the Camino de Santiago in Spain.

Multi-modal analysis of infant cry types characterization: Acoustics, body language and brain signals.

BACKGROUND: Infant crying is the first attempt babies use to communicate during their initial months of life. A misunderstanding of the cry message can compromise infant care and future neurodevelopmental process. METHODS: An exploratory study collecting multimodal data (i.e., crying, electroencephalography (EEG), near-infrared spectroscopy (NIRS), facial expressions, and body movements) from 38 healthy full-term newborns was conducted. Cry types were defined based on different conditions (i.e., hunger, sleepiness, fussiness, need to burp, and distress). Statistical analysis, Machine Learning (ML), and Deep Learning (DL) techniques were used to identify relevant features for cry type classification and to evaluate a robust DL algorithm named Acoustic MultiStage Interpreter (AMSI). RESULTS: Significant differences were found across cry types based on acoustics, EEG, NIRS, facial expressions, and body movements. Acoustics and body language were identified as the most relevant ML features to support the cause of crying. The DL AMSI algorithm achieved an accuracy rate of 92%. CONCLUSIONS: This study set a precedent for cry analysis research by highlighting the complexity of newborn cry expression and strengthening the potential use of infant cry analysis as an objective, reliable, accessible, and non-invasive tool for cry interpretation, improving the infant-parent relationship and ensuring family well-being.

Knowledge, Perception, and Attitudes during the COVID-19 Pandemic in the Peruvian Population.

BACKGROUND: Latin American countries have been profoundly affected by COVID-19. Due to the alarming incidence of identified cases, we intended to explore which psychosocial elements may influence poor adherence to the mandatory control measures among the population. OBJECTIVE: We aimed to assess Peruvians' knowledge, attitudes, and vulnerability perception during the coronavirus outbreak. METHOD: We collected data from 225 self-selected participants using a web-based cross-sectional survey. RESULTS: The overall respondents were between 18 and 29 years old (56.8%), female (59.5%), belonged to educated groups, and graduated professionals (69.3%), most of them. Logistic regression showed that Knowledge is highly associated with education (p = 0.031), occupation (p = 0.002), and age (p = 0.016). Our study identified that, although people reported adequate Knowledge by identifying expected symptoms and virus transmission ways in COVID-19 disease. There is a significant perceived susceptibility to contracting the mentioned virus, displaying stigmatized behavior (59.1%) and fear of contracting the virus from others (70.2%). Additionally, it is reported to lack people's confidence in national health authorities regarding sanitary responses (62.7%), preparedness for the disease (76.9%), and the lack of adequate measures to deal with it (51.1%). CONCLUSION: We found that age, education, and occupation modulate Knowledge. At the same time, only age affected Perception and Attitude. Public policies should consider specific guidelines on knowledge translation and risk communication strategies for both containing psychological responses promptly and ensuring compliance with general control measures by the population.

How can cry acoustics associate newborns' distress levels with neurophysiological and behavioral signals?

Introduction: Even though infant crying is a common phenomenon in humans' early life, it is still a challenge for researchers to properly understand it as a reflection of complex neurophysiological functions. Our study aims to determine the association between neonatal cry acoustics with neurophysiological signals and behavioral features according to different cry distress levels of newborns. Methods: Multimodal data from 25 healthy term newborns were collected simultaneously recording infant cry vocalizations, electroencephalography (EEG), near-infrared spectroscopy (NIRS) and videos of facial expressions and body movements. Statistical analysis was conducted on this dataset to identify correlations among variables during three different infant conditions (i.e., resting, cry, and distress). A Deep Learning (DL) algorithm was used to objectively and automatically evaluate the level of cry distress in infants. Results: We found correlations between most of the features extracted from the signals depending on the infant's arousal state, among them: fundamental frequency (F0), brain activity (delta, theta, and alpha frequency bands), cerebral and body oxygenation, heart rate, facial tension, and body rigidity. Additionally, these associations reinforce that what is occurring at an acoustic level can be characterized by behavioral and neurophysiological patterns. Finally, the DL audio model developed was able to classify the different levels of distress achieving 93% accuracy. Conclusion: Our findings strengthen the potential of crying as a biomarker evidencing the physical, emotional and health status of the infant becoming a crucial tool for caregivers and clinicians.

Impact of respect, equity, and leadership in brain health.

Respect is a feeling of admiration for someone. It forms one of the core values of the Global Brain Health Institute (GBHI), which strives to protect the world's aging populations from threats to brain health. These values guide us as we advocate for reducing the global impact of dementia. By taking a values-based approach to brain health, we can drive global changes for millions of people. Respect fortifies gratitude and embraces diversity. Philosophical discussions of the ideas support the assertion that respect is crucial in everyday conversations and actions as well as in personal, social, political, and moral spheres. No one can become a leader unless they genuinely respect and care about the success of each team member. Diversity, equity, and inclusivity form the fundamental cornerstones of respect. Understanding this core value of respect will ensure altruistic behavior among the leaders that may help mitigate racism, cultural insults, gender discrimination, stigmatization, religious hatred, and, worst of all, poor leadership abilities that have been the disconcerting examples of disrespect in recent years. We present the underlying neurobiology of respect and its impact on equity and leadership.

Impact of COVID-19 Pandemic Lockdown on Migraine Patients in Latin America.

The coronavirus (COVID-19) pandemic, confinement, fear, lifestyle changes, and worldwide health care impacted almost all diseases. Reports from countries outside Latin America revealed differences in migraine patients. In this study, we describe and compare the immediate changes in migraine symptoms associated with COVID-19 quarantine in patients from Argentina, Mexico, and Peru. An online survey was conducted from May to July 2020. The survey was answered by 243 migraine patients, with questions related to sociodemographic data, quarantine conditions, changes in working conditions, physical activity, coffee intake, healthcare access, acute migraine medication use, symptoms of anxiety, depression, and fear of COVID-19. The results show that 48.6% of migraine patients experienced worsened symptoms, 15.6% improved, and 35.8% remained unchanged. Worsening migraine symptoms were associated with staying at home during the lockdown. Intake of analgesics was associated with an increase in migraine symptoms of 18 times relative to those who did not increase their intake. Migraine symptoms improved when the number of sleep hours was increased, and we observed an improvement when patients decreased analgesic intake. The uncertainty about the end of the pandemic, the news, and social media are three items that contributed to the worsening of migraine symptoms in patients in the three investigated countries. Confinement during the first pandemic wave in Latin America harmed migraine patients who stayed home during the lockdown.

Validation and Normative Data on the Verbal Fluency Test in a Peruvian Population Ranging from Pediatric to Elderly Individuals.

In neuropsychological evaluation, verbal fluency is a crucial measure of cognitive function, but this measure requires standardized and normative data for use. The present study aimed to obtain validation and normative data for the verbal fluency task in the Peruvian population, with participants ranging from 6 to 94 years and varying in age, educational level, and sex. We recruited 2602 healthy individuals and used linear regression analysis to determine the effect of age, sex, and educational level. We also evaluated internal consistency between categories and phonological tasks with Cronbach's alpha and Pearson's correlation analysis and calculated test-retest reliability after three months. We found significant effects of age, educational level, and sex on phonological and semantic fluency. Participants with more than 12 years of education had the highest scores overall. Regarding age, middle-aged participants (between 31 and 40 years old) had the highest scores; scores gradually decreased outside of this age range. Regarding sex, men performed better than women. These results will increase the ability of clinicians to precisely determine the degree to which verbal fluency is affected in patients of different ages and educational levels.

Efectividad Del Foto-Test Frente Al Mmse, Para El Cribado Del Deterioro Cognitivo En Población Peruana / Effectiveness Of The Photo-Test Front Of The Mmse, For The Screening Of Cognitive Deterioration In Peruvian Population

Resumen El progresivo incremento de la enfermedad de Alzheimer ha generado el interés en su detección temprana, siendo los test de cribado cognitivo una herramienta útil, sin embargo, se necesita que los mismos estén culturalmente adaptados, sean objetivos y confiables. En el Perú, esta necesidad es mayor ya que el nivel educativo de la población de la tercera edad es mayoritariamente bajo. La presente investigación tiene como objetivo conocer la sensibilidad y especificidad del FOTOTEST frente al MMSE para el cribado/detección de deterioro cognitivo, analizando la relación de estos test cognitivos frente a uno de actividad funcional. Se evaluaron a 107 adultos mayores, con un rango de edad entre 60 y 89 años. Se utilizó la escala de Yesavage para la depresión geriátrica, el cuestionario de actividades funcionales de Pfeffer, MMSE y FOTOTEST. El análisis efectuado a través de la prueba de Pearson, evidencia una correlación significativa positiva entre el MMSE/FOTOTEST (Pearson 0.386, p<0.003), mientras que solo el MMSE mostró una correlación significativa negativa con el PFAQ (Pearson -0.320, p<0.013). Sin embargo, el FOTOTEST no mostró una correlación significativa con el PFAQ (Pearson -0.067, p<0.613). Adicionalmente, se calcula el porcentaje de efectividad y especificidad estimada para el FOTOTEST siendo de 100.00% y 92.68% respectivamente, superior al del MMSE, cuyo porcentaje estimado de efectividad fue de 83.33%, y especificidad 34.14%. Se concluye que el FOTOTEST sería una prueba más útil para la detección del deterioro cognitivo.

Abstract The progressive increase of Alzheimer's disease has generated interest in its early detection with cognitive screening tests being a useful tool, however, they need to be culturally adapted, objective and reliable. In Peru, this need is greater since the educational level of the elderly population is mostly low. The aim of the present study is to know the estimate sensitivity and specificity of FOTOTEST against MMSE for the screening/detection of cognitive impairment, analyzing the relationship of these cognitive tests with one of functional activity. 107 elderly people, aged 60-89 years, were evaluated. The Yesavage scale for geriatric depression was used, the functional activities questionnaire of Pfeffer, MMSE, and FOTOTEST. Pearson's analysis showed a significant positive correlation between MMSE/FOTOTEST (Pearson 0.386, p <0.003), whereas only MMSE showed a significant negative correlation with PFAQ (Pearson -0.320, p <0.013). However, FOTOTEST did not show a significant correlation with PFAQ (Pearson -0.067, p <0.613). In addition, the percentage of effectiveness and specificity estimated for FOTOTEST was 100.00% and 92.68%, respectively, higher than the MMSE, with an estimated percentage of effectiveness being 83.33%, and specificity of 34.14%. We conclude that FOTOTEST would be a more useful test for the detection of cognitive impairment than MMSE

Social cognition and executive function in borderline personality disorder: evidence of altered cognitive processes / La cognición social y las funciones ejecutivas en el trastorno límite de la personalidad: evidencia de procesos cognitivos alterados

Abstract Introduction Social cognition (SC) and executive function (EF) research in borderline personality disorder (BPD) has proven to be controversial and lack of sufficient information about deficit patterns. Objective Assess the contribution of SC and EF in the socio-emotional and cognitive patterns in BPD, as well as investigate the possible relationships between SC, EF, and clinic features in BPD. Method The study evaluated 20 females with BPD in ambulatory hospitalization and 20 healthy women in social cognition ("Reading the mind through the eyes" and the IOWA gambling task) and executive function (with the Wisconsin Card Sorting Test, verbal fluency tasks; digit spam test and numbers-and-letters of the WAIS-III, Trail Making Test Form A and B). Results The results show statistically-significant differences for the tasks evaluated in social cognition, the theory of mind (u: 181, p < .001**), and the IOWA gambling task, score IOWA 4 (p < .004*), and IOWA 5 p < .003*); and executive functioning, for example in the Wisconsin card sorting test, WCST1 were found (p < .003*), WCST2 (p < .004*), WCST3 (p < .018*) or WCST4 (p < .003*). Digit span test and verbal fluency had significant differences compared to controls. Discussion and conclusion The subdomains evaluated would be good endophenotypes as well as specific cognitive processes for research and rehabilitation.

Resumen Introducción La investigación sobre cognición social (SC) y funciones ejecutivas (EF) en el trastorno límite de la personalidad (TLP) ha arrojado datos controvertidos e insuficientes sobre los patrones de déficit. Objetivo Evaluar la contribución de SC y EF en los patrones cognitivos en el TLP, así como investigar las posibles relaciones entre SC, EF y las características clínicas del TLP. Método El estudio evaluó 20 mujeres con TLP en hospitalización ambulatoria y 20 mujeres sanas en cognición social ("Leer la mente a través de los ojos" y la tarea de apuestas IOWA) y función ejecutiva (con la Prueba de clasificación de tarjetas de Wisconsin, tareas de fluidez verbal; y números y letras del WAIS-III, formulario de prueba de Trail Making A y B). Resultados Se evidencian diferencias estadísticamente significativas en cognición social, la teoría de la mente (p < .001**) y la tarea de apuestas IOWA, puntúan IOWA 4 (p < .004 *) e IOWA 5 (p < .003*) y en funciones ejecutivas; por ejemplo, en la prueba de clasificación de tarjetas de Wisconsin, se encontraron WCST1 (p < .003*), WCST2 (p < .004*), WCST3 (p < .018*) o WCST4 (p < .003*). Además, la prueba de amplitud de dígitos o la fluidez verbal tuvieron diferencias significativas en comparación con los controles. Discusión y conclusión Los subdominios evaluados serían buenos endofenotipos, así como también procesos cognitivos específicos para investigación y rehabilitación.

Insulin-like growth factor type 1 and its relation with neuropsychiatric disorders. / Factor de crecimiento insulínico tipo 1 y su relación con trastornos neuropsiquiátricos.

The study of different neurotrophic factors, including insulin-like growth factor-1 (IGF-1), has become relevant in recent years because of its role in brain activity and its potential therapeutic applications. This article reviews IGF-1 in relation to neuropsychiatric disorders such as autism, anxiety, depression, post-traumatic stress disorder and Alzheimer's disease. An exhaustive search of different original articles, clinical, experimental, and review studies was carried out in MEDLINE/PubMed and ScienceDirect databases, selecting 80 high-impact post-2000 publications. It is concluded that despite the many functions of IGF-1 in the developing nervous system as well as in the adult brain that have been studied, especially with animal models, their role in the human brain with neuropsychiatric disorders is not completely understood, yielding contradictory data in highly prevalent disorders such as mood disorders. However, greater implications are encountered with neurodegenerative disorders. In addition, its high potential as a therapeutic resource in difficult-to-approach neuropsychiatric disorders, such as autism and Alzheimer's disease, is pointed out, but more research is needed at both basic and clinical levels, to fully understand its relevance in these disorders.

El estudio de distintos factores neurotróficos, entre ellos, el factor de crecimiento insulínico tipo 1, ha alcanzado relevancia en los últimos años por su rol en la actividad cerebral y sus potenciales aplicaciones terapéuticas. En el presente artículo se realiza una revisión del factor de crecimiento insulínico tipo 1 vinculado a trastornos neuropsiquiátricos como el autismo, la ansiedad, depresión, trastorno de estrés post traumático y la enfermedad de Alzheimer. Esto nos permitirá conocer su relación e importancia en dichos trastornos, en distintas etapas del desarrollo. Se realizó una búsqueda exhaustiva de distintos artículos originales, estudios clínicos, experimentales y de revisión, en las bases de datos de MEDLINE/PubMed y ScienceDirect, seleccionando 80 publicaciones de alto impacto posteriores al año 2000. Se concluye que a pesar de las muchas funciones del factor de crecimiento insulínico tipo 1 que han sido estudiadas en el sistema nervioso en desarrollo, así como en el cerebro adulto y especialmente con modelos animales, no se comprende completamente su papel en el cerebro humano con trastornos neuropsiquiátricos. Los datos son contradictorios en lo referente a trastornos altamente prevalentes, como los que afectan al estado del ánimo. Sin embargo, se encuentran mayores implicancias en los trastornos neurodegenerativos. Adicionalmente se señala su alto potencial como recurso terapéutico en trastornos neuropsiquiátricos de difícil abordaje, como el autismo y la enfermedad de Alzheimer. No obstante ello, es necesario efectuar una mayor investigación, tanto a nivel básico y clínico aplicado, para entender completamente su relevancia en estos trastornos.