RESUMEN
Adolescence is a period of increased vulnerability for the development of psychiatric disorders, including schizophrenia. The prefrontal cortex (PFC) undergoes substantial maturation during this period, and PFC dysfunction is central to cognitive impairments in schizophrenia. As a result, impaired adolescent maturation of the PFC has been proposed as a mechanism in the etiology of the disorder and its cognitive symptoms. In adulthood, PFC function is tightly linked to its reciprocal connections with the thalamus, and acutely inhibiting thalamic inputs to the PFC produces impairments in PFC function and cognitive deficits. Here, we propose that thalamic activity is equally important during adolescence because it is required for proper PFC circuit development. Because thalamic abnormalities have been observed early in the progression of schizophrenia, we further postulate that adolescent thalamic dysfunction can have long-lasting consequences for PFC function and cognition in patients with schizophrenia.
Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Esquizofrenia , Adolescente , Adulto , Trastornos del Conocimiento/complicaciones , Disfunción Cognitiva/etiología , Humanos , Corteza Prefrontal , TálamoRESUMEN
Neurophysiological biomarkers of auditory processing show promise predicting outcomes following auditory-based targeted cognitive training (TCT) in schizophrenia, but the viability of the frequency following response (FFR) as a biomarker has yet to be examined, despite its ecological and face validity for auditory-based interventions. FFR is an event-related potential (ERP) that reflects early auditory processing. We predicted that schizophrenia patients would show acute- and longer-term FFR malleability in the context of TCT. Patients were randomized to either TCT (n = 30) or treatment as usual (TAU; n = 22), and electroencephalography was recorded during rapid presentation of an auditory speech stimulus before treatment, after one hour of training, and after 30 h of training. Whereas patients in the TCT group did not show changes in FFR after training, amplitude reductions were observed in the TAU. FFR was positively associated with performance on a measure of single word-in-noise perception in the TCT group, and with a measure of sentence-in-noise perception in both groups. Psychometric reliability analyses of FFR scores indicated high internal consistency but low one-hour and 12-week test-rest reliability. These findings support the dissociation between measures of speech discriminability along the hierarchy of cortical and subcortical early auditory information processing in schizophrenia.
Asunto(s)
Trastornos del Conocimiento , Esquizofrenia , Percepción del Habla , Estimulación Acústica , Percepción Auditiva/fisiología , Biomarcadores , Cognición , Trastornos del Conocimiento/complicaciones , Electroencefalografía , Humanos , Reproducibilidad de los Resultados , Esquizofrenia/complicaciones , Esquizofrenia/terapia , Percepción del Habla/fisiologíaRESUMEN
Metabolic syndrome represents a major risk factor for severe comorbidities such as cardiovascular diseases or diabetes. It is also associated with an increased prevalence of emotional and cognitive alterations that in turn aggravate the disease and related outcomes. Identifying therapeutic strategies able to improve those alterations is therefore a major socioeconomical and public health challenge. We previously reported that both hippocampal inflammatory processes and neuronal plasticity contribute to the development of emotional and cognitive alterations in db/db mice, an experimental model of metabolic syndrome that displays most of the classical features of the syndrome. In that context, nutritional interventions with known impact on those neurobiological processes appear as a promising alternative to limit the development of neurobiological comorbidities of metabolic syndrome. We therefore tested here whether n-3 polyunsaturated fatty acids (n-3 PUFAs) associated with a cocktail of antioxidants can protect against the development of behavioral alterations that accompany the metabolic syndrome. Thus, this study aimed: 1) to evaluate if a diet supplemented with the plant-derived n-3 PUFA α-linolenic acid (ALA) and antioxidants (provided by n-3 PUFAs-rich rapeseed oil fortified with a mix of naturally constituting antioxidant micronutrients, including coenzyme Q10, tocopherol, and the phenolic compound canolol) improved behavioral alterations in db/db mice, and 2) to decipher the biological mechanisms underlying this behavioral effect. Although the supplemented diet did not improve anxiety-like behavior and inflammatory abnormalities, it reversed hippocampus-dependent spatial memory deficits displayed by db/db mice in a water maze task. It concomitantly changed subunit composition of glutamatergic AMPA and NMDA receptors in the hippocampus that has been shown to modulate synaptic function related to spatial memory. These data suggest that changes in local neuronal plasticity may underlie cognitive improvements in db/db mice fed the supplemented diet. The current findings might therefore provide valuable data for introducing new nutritional strategies for the treatment of behavioral complications associated with MetS.
Asunto(s)
Trastornos del Conocimiento/dietoterapia , Cognición/efectos de los fármacos , Alimentos Fortificados , Síndrome Metabólico/dietoterapia , Micronutrientes/farmacología , Aceite de Brassica napus/química , Aceite de Brassica napus/farmacología , Animales , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/fisiopatología , Modelos Animales de Enfermedad , Masculino , Síndrome Metabólico/complicaciones , Síndrome Metabólico/fisiopatología , RatonesRESUMEN
Kai-Xin-San (KXS), a classical Chinese traditional prescription, was widely applied in the treatment of Alzheimer's disease (AD), while its functional mechanisms still remain unclear. By using systems biology approaches at animal, cellular, and molecular levels, the improvement of KXS on cognitive impairment was achieved by inhibiting abnormal acetylcholinesterase. The function on the nerve skeleton was performed by regulating the Tau phosphorylation pathway. Its antioxidant, anti-inflammatory, and antiapoptotic effects by modulating the aberrant upregulation of ROS, proinflammatory factors, and apoptosis-related proteins in the brain were studied to reveal the synergistic therapeutic efficacy of KXS. Then, formula dismantling in vitro indicated that ginseng was the principal herb, whereas three other herbs served adjuvant roles to achieve the best effect. After that, the in vivo analysis of components into plasma and brain of AD rats showed that 8 of 23 components in blood and 4 of 10 components in brain were from ginseng, respectively, further verifying the principal status of ginseng and the synergistic effects of the formula. Thus, the anti-AD effects of KXS were achieved by multitargets and multichannels. The systems biology approaches presented here provide a novel way in traditional herbal medicine research.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Medicamentos Herbarios Chinos/uso terapéutico , Biología de Sistemas , Enfermedad de Alzheimer/sangre , Enfermedad de Alzheimer/complicaciones , Péptidos beta-Amiloides/metabolismo , Animales , Apoptosis/efectos de los fármacos , Encéfalo/efectos de los fármacos , Encéfalo/patología , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/tratamiento farmacológico , Modelos Animales de Enfermedad , Medicamentos Herbarios Chinos/farmacología , Inflamación/patología , Masculino , Trastornos de la Memoria/complicaciones , Trastornos de la Memoria/tratamiento farmacológico , Estrés Oxidativo/efectos de los fármacos , Células PC12 , Fosforilación/efectos de los fármacos , Ratas , Ratas Sprague-Dawley , Transducción de Señal/efectos de los fármacosRESUMEN
Many stroke survivors experience persisting episodic memory disturbances. Since hippocampal and para-hippocampal areas are usually spared from the infarcted area, alterations of memory processing networks remote from the ischemic brain region might be responsible for the observed clinical symptoms. To pinpoint changes in activity of hippocampal connections and their role in post-stroke cognitive impairment, we induced ischemic stroke by occlusion of the middle cerebral artery (MCAO) in adult rats and analyzed the functional and structural consequences using activity-dependent manganese (Mn2+) enhanced MRI (MEMRI) along with behavioral and histopathological analysis. MCAO caused stroke lesions of variable extent along with sensorimotor and cognitive deficits. Direct hippocampal injury occurred in some rats, but was no prerequisite for cognitive impairment. In healthy rats, injection of Mn2+ into the entorhinal cortex resulted in distribution of the tracer within the hippocampal subfields into the lateral septal nuclei. In MCAO rats, Mn2+ accumulated in the ipsilateral thalamus. Histopathological analysis revealed secondary thalamic degeneration 28 days after stroke. Our findings provide in vivo evidence that remote sensorimotor stroke modifies the activity of hippocampal-thalamic networks. In addition to potentially reversible alterations in signaling of these connections, structural damage of the thalamus likely reinforces dysfunction of hippocampal-thalamic circuitries.
Asunto(s)
Hipocampo/patología , Red Nerviosa/patología , Corteza Sensoriomotora/patología , Accidente Cerebrovascular/patología , Tálamo/patología , Animales , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/patología , Gliosis/complicaciones , Gliosis/patología , Infarto de la Arteria Cerebral Media/patología , Imagen por Resonancia Magnética , Manganeso/química , Modelos Neurológicos , Ratas Sprague-Dawley , Procesamiento de Señales Asistido por Computador , Accidente Cerebrovascular/complicacionesRESUMEN
INTRODUCTION: People with dementia may be particularly susceptible to medication-related problems for various reasons. They include progressive cognitive decline, high sensitivity to the effect of medications on cognition and memory, and increased likelihood of comorbidities. AREAS COVERED: This paper aimed to review current literature on the frequency and the types of medication-related problems, and their contribution to hospital admission in people with dementia. Literature searches were conducted using key search terms of dementia and medication-related problems. Studies investigating any medication-related problems in people with dementia or cognitive impairment were included. EXPERT OPINION: Previous research showed a high prevalence of medication-related problems in people with dementia. However, no single category of medication-related problems was reported consistently as the most frequent type across studies. The available studies also showed that medication-related hospitalization was common among people with dementia. These findings underline the need for effective medication management services to reduce the risk of these problems in people with dementia and cognitive impairment. Further work is required to characterize medication-related problems comprehensively in this vulnerable patient group across settings of care. Future research should take a holistic approach in the identification of medication-related problems.
Asunto(s)
Trastornos del Conocimiento/fisiopatología , Demencia/fisiopatología , Efectos Colaterales y Reacciones Adversas Relacionados con Medicamentos/epidemiología , Trastornos del Conocimiento/complicaciones , Demencia/complicaciones , Hospitalización/estadística & datos numéricos , Humanos , Administración del Tratamiento Farmacológico/organización & administración , Prevalencia , RiesgoRESUMEN
Extracts from Huperzia serrata (HS) function as a cholinesterase inhibitor and a glutamic acid receptor antagonist. We tested a supplement containing HS extracts, curcumin, and others in dementia patients and individuals with mild cognitive impairment (MCI) in an open label study. Most patients with Alzheimer's disease, dementia with Lewy bodies, and MCI individuals exhibited improvements in cognitive functions, as assessed by the Alzheimer's Disease Assessment Scale-cognitive subscale Japanese version. The scores were significantly improved at 6-12 weeks compared with baseline scores (pâ=â0.007) and at 22-28 weeks (pâ=â0.004). Thus, this supplement may be administered to dementia patients as well as MCI individuals.
Asunto(s)
Alcaloides/uso terapéutico , Trastornos del Conocimiento/dietoterapia , Curcumina/uso terapéutico , Demencia Vascular/dietoterapia , Suplementos Dietéticos , Sesquiterpenos/uso terapéutico , Anciano , Anciano de 80 o más Años , Biosimilares Farmacéuticos , Trastornos del Conocimiento/complicaciones , Demencia Vascular/complicaciones , Femenino , Humanos , Masculino , Pruebas Neuropsicológicas , Escalas de Valoración Psiquiátrica , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Fracturas Osteoporóticas/complicaciones , Fracturas Osteoporóticas , Pelvis/lesiones , Pelvis , Staphylococcus aureus Resistente a Meticilina , Repertorio de Barthel , Trastornos del Conocimiento/complicaciones , Vancomicina/uso terapéutico , Administración Intravenosa , Tomografía Computarizada de EmisiónRESUMEN
BACKGROUND: Melatonin plays a major role in maintaining circadian rhythm. Changes in melatonin metabolism might lead to circadian rhythm disturbances which are often observed in delirious patients. AIM: To assess if high morning plasma melatonin concentrations were associated with delirium. METHODS: Consecutive hip fracture patients aged ≥65 years were included. Delirium was assessed daily with the Confusion Assessment METHOD: Blood samples were collected at 11.00am on weekdays during first week of hospitalization. Melatonin was analyzed by liquid chromatography-tandem mass spectrometry. RESULTS: We analyzed 389 samples of 144 participants [mean age 84.0, 70 experienced delirium]. A Generalized Estimating Equations (GEE) model with outcome melatonin level in highest tertile ( >3.36 pg/ml) and covariates delirium group (i.e. never, before, during, post delirium), cognitive impairment, age, sex and anesthesia type, was constructed. Highest melatonin levels were associated with postoperative samples (Odds Ratio(OR) 2.11 compared to preoperative samples; 95% Confidence Interval(CI) 1.17-3.82, p=0.01) and higher age (OR 1.05 per year; CI 1.01-1.11, p=0.03), but not with delirium group(p=0.35). CONCLUSION: Undergoing surgery and aging in general may induce changes in melatonin metabolism. Future research should focus on daily multiple melatonin measurements to determine whether melatonin supplementation might be beneficial for delirium treatment or prevention.
Asunto(s)
Delirio/sangre , Fracturas de Cadera/sangre , Fracturas de Cadera/cirugía , Melatonina/sangre , Anciano , Anciano de 80 o más Años , Cromatografía Liquida , Ritmo Circadiano , Trastornos del Conocimiento/complicaciones , Delirio/complicaciones , Femenino , Fracturas de Cadera/complicaciones , Humanos , Masculino , Oportunidad Relativa , Procedimientos Ortopédicos , Sueño , Espectrometría de Masas en TándemRESUMEN
BACKGROUND: Non-verbal auditory impairment is increasingly recognised in the primary progressive aphasias (PPAs) but its relationship to speech processing and brain substrates has not been defined. Here we addressed these issues in patients representing the non-fluent variant (nfvPPA) and semantic variant (svPPA) syndromes of PPA. METHODS: We studied 19 patients with PPA in relation to 19 healthy older individuals. We manipulated three key auditory parameters-temporal regularity, phonemic spectral structure and prosodic predictability (an index of fundamental information content, or entropy)-in sequences of spoken syllables. The ability of participants to process these parameters was assessed using two-alternative, forced-choice tasks and neuroanatomical associations of task performance were assessed using voxel-based morphometry of patients' brain magnetic resonance images. RESULTS: Relative to healthy controls, both the nfvPPA and svPPA groups had impaired processing of phonemic spectral structure and signal predictability while the nfvPPA group additionally had impaired processing of temporal regularity in speech signals. Task performance correlated with standard disease severity and neurolinguistic measures. Across the patient cohort, performance on the temporal regularity task was associated with grey matter in the left supplementary motor area and right caudate, performance on the phoneme processing task was associated with grey matter in the left supramarginal gyrus, and performance on the prosodic predictability task was associated with grey matter in the right putamen. CONCLUSIONS: Our findings suggest that PPA syndromes may be underpinned by more generic deficits of auditory signal analysis, with a distributed cortico-subcortical neuraoanatomical substrate extending beyond the canonical language network. This has implications for syndrome classification and biomarker development.
Asunto(s)
Afasia Progresiva Primaria , Encéfalo/patología , Trastornos del Conocimiento/complicaciones , Habla , Estimulación Acústica , Anciano , Anciano de 80 o más Años , Afasia Progresiva Primaria/complicaciones , Afasia Progresiva Primaria/diagnóstico por imagen , Afasia Progresiva Primaria/patología , Afasia Progresiva Primaria/psicología , Encéfalo/diagnóstico por imagen , Estudios de Cohortes , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Escala del Estado Mental , Persona de Mediana Edad , PsicoacústicaRESUMEN
Introducción. El objetivo del estudio es identificar los atributos físicos del síndrome de temor a caerse (STAC) en mayores con caídas previas. Metodología. Estudio observacional analítico sobre 183 sujetos mayores de 64 años que hayan sufrido al menos una caída en el último año, captados desde la consulta de geriatría del Complejo Hospitalario Universitario de Albacete. De ellos, 140 cumplían criterios de STAC, y los otros 43 no (grupo control). Como covariables se recogieron datos sociodemográficos, antropométricos, de comorbilidad y fármacos, situación funcional, función física, fragilidad, estado cognitivo y afectivo. Se determinó la masa muscular mediante bioimpedanciometría (BIA) y densitometría (DXA), la fuerza prensora mediante dinamómetro digital de JAMAR, la fuerza extensora (1RM) de miembros inferiores, la potencia muscular de miembros inferiores mediante el instrumento T-Force, la variabilidad de la marcha con el instrumento Gait-Rite, las alteraciones posturales mediante posturografía. Se analizará si el STAC se asocia con alteraciones físicas ajustado por las covariables de estudio. Resultados. Edad media 78,4 años, 147 mujeres. En 182 participantes se pudo realizar posturografía, en 146 se pudo determinar potencia muscular de piernas, en 117 se realizó DXA y en 165, BIA. El STAC se asoció a sexo femenino, estado de fragilidad, ánimo deprimido, riesgo social, fuerza y potencia muscular, función física, número de fármacos e hipotensión ortostática en la muestra global, pero al ajustar por sexo, solo la fragilidad, el ánimo deprimido y el consumo de fármacos se asociaron al STAC. Conclusiones. Se presenta el razonamiento, el diseño y la metodología del estudio FISTAC (AU)
Introduction. The aim of this study was to identify the physical determining factors of the Fear of Falling Syndrome (FoF) in older adults with a history of falls. Methods. An observational study was conducted on 183 subjects older than 64 years with a fall in the previous year, with data collected from the geriatrics outpatient clinic of the Complejo Hospitalario Universitario from Albacete, Spain. Sociodemographic and anthropometric data, as well as comorbidity, drugs usually taken, functional status, physical function, frailty, cognitive and affective status were collected. Muscle mass was measured using bioimpedancy meter (BIA), and densitometry (DXA), strength with digital hand-held JAMAR dynamometer and with a Leg-press machine, muscle potency with a T-Force instrument, gait variability with the Gait-Rite instrument, and postural stability with the Neurocom Balance Master posturograph were also determined. An analysis was performed to determine if the FoF is associated with physical impairments adjusted for the study covariates. Results. The study included 140 subjects with FoF, and 43 without it. The mean age was 78.4 years, and 147 were women. Posturography could be measured in 182 participants, DXA in 117, BIA in 165, and muscle potency in 146. FoF was associated with female sex, frailty, depressed mood, social risk, muscle strength and power, physical function, number of drugs used, and orthostatic hypotension in the overall sample. After adjusting for sex, only frailty, depressed mood, and number of drugs remained associated. Conclusions. Rationale, design, and methods of the FISTAC study are presented (AU)
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Anciano de 80 o más Años , Miedo/psicología , Trastornos Fóbicos/epidemiología , Trastornos Fóbicos/psicología , Sarcopenia/complicaciones , Sarcopenia/psicología , Síncope/psicología , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/psicología , Actividad Motora/fisiología , Antropometría , Comorbilidad , Envejecimiento Cognitivo/psicología , Densitometría/métodos , Repertorio de BarthelRESUMEN
Abstract Introduction: The difficulty the elderly experience in understanding speech may be related to several factors including cognitive and perceptual performance. Objective: To evaluate the influence of cognitive performance, depressive symptoms, and education on speech perception in noise of elderly hearing aids users. Methods: The sample consisted of 25 elderly hearing aids users in bilateral adaptation, both sexes, mean age 69.7 years. Subjects underwent cognitive assessment using the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-cognitive and depressive symptoms evaluation using the Geriatric Depression Scale. The assessment of speech perception in noise (S/N ratio) was performed in free field using the Portuguese Sentence List test. Statistical analysis included the Spearman correlation calculation and multiple linear regression model, with 95% confidence level and 0.05 significance level. Results: In the study of speech perception in noise (S/N ratio), there was statistically significant correlation between education scores (p = 0.018), as well as with the Mini-Mental State Examination (p = 0.002), Alzheimer's Disease Assessment Scale-cognitive (p = 0.003), and Geriatric Depression Scale (p = 0.022) scores. We found that for a one-unit increase in Alzheimer's Disease Assessment Scale-cognitive score, the S/N ratio increased on average 0.15 dB, and for an increase of one year in education, the S/N ratio decreased on average 0.40 dB. Conclusion: Level of education, cognitive performance, and depressive symptoms influence the speech perception in noise of elderly hearing aids users. The better the cognitive level and the higher the education, the better is the elderly communicative performance in noise.
Resumo Introdução: A dificuldade na compreensão de fala dos idosos pode estar relacionada a vários fatores, como o desempenho cognitivo e perceptual. Objetivo: Avaliar a influência do desempenho cognitivo, sintomas depressivos e escolaridade no reconhecimento de fala no ruído de idosos usuários de próteses auditivas. Método: A amostra constituiu-se de 25 idosos usuários de próteses auditivas em adaptação bilateral, de ambos os sexos e média de 69,7 anos. Os indivíduos foram submetidos à avaliação cognitiva por meio do miniexame do estado mental (MEEM) e a escala de avaliação da doença de Alzheimer-cognitiva (ADAS-Cog) e avaliação de sintomatologia depressiva por meio da escala de depressão geriátrica (EDG). Já a pesquisa do reconhecimento de fala no ruído (relação S/R) foi feita, em campo livre, por meio do teste lista de sentenças no português (LSP). A análise estatística incluiu o cálculo de correlação de Spearman e modelo de regressão linear múltiplo, foram adotados coeficiente de confiança de 95% e nível de significância de 0,05. Resultados: No estudo do reconhecimento de sentenças no ruído (relação S/R) houve correlação, com significância estatística, entre a escolaridade (p = 0,018); assim como com os escores dos testes MEEM (p = 0,002), o Adas-Cog (p = 0,003) e o EDG (p = 0,022). Observou-se que, para um aumento de uma unidade no escore do Adas-Cog, a relação S/R aumenta, em média, 0,15 dB e para um aumento de um ano na escolaridade, a relação S/R diminui, em média, 0,40 dB. Conclusão: O nível de escolaridade, o desempenho cognitivo e sintomas depressivos influenciam o reconhecimento de fala no ruído de idosos usuários de prótese auditiva. Quanto melhor o nível cognitivo e maior a escolaridade, melhor é o desempenho comunicativo do idoso no ruído.
Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Percepción del Habla/fisiología , Audífonos , Pérdida Auditiva/rehabilitación , Ruido , Estimulación Acústica , Evaluación Geriátrica , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/diagnóstico , Depresión/complicaciones , Depresión/diagnóstico , Escolaridad , Pérdida Auditiva/fisiopatologíaRESUMEN
Schizophrenia is associated with cognitive deficits that reflect impaired cortical information processing. Mismatch negativity (MMN) indexes pre-attentive information processing dysfunction at the level of primary auditory cortex. This study investigates mechanisms underlying MMN impairments in schizophrenia using event-related potential, event-related spectral decomposition (ERSP) and resting state functional connectivity (rsfcMRI) approaches. For this study, MMN data to frequency, intensity and duration-deviants were analyzed from 69 schizophrenia patients and 38 healthy controls. rsfcMRI was obtained from a subsample of 38 patients and 23 controls. As expected, schizophrenia patients showed highly significant, large effect size (P=0.0004, d=1.0) deficits in MMN generation across deviant types. In ERSP analyses, responses to deviants occurred primarily the theta (4-7 Hz) frequency range consistent with distributed corticocortical processing, whereas responses to standards occurred primarily in alpha (8-12 Hz) range consistent with known frequencies of thalamocortical activation. Independent deficits in schizophrenia were observed in both the theta response to deviants (P=0.021) and the alpha-response to standards (P=0.003). At the single-trial level, differential patterns of response were observed for frequency vs duration/intensity deviants, along with At the network level, MMN deficits engaged canonical somatomotor, ventral attention and default networks, with a differential pattern of engagement across deviant types (P<0.0001). Findings indicate that deficits in thalamocortical, as well as corticocortical, connectivity contribute to auditory dysfunction in schizophrenia. In addition, differences in ERSP and rsfcMRI profiles across deviant types suggest potential differential engagement of underlying generator mechanisms.
Asunto(s)
Electroencefalografía/métodos , Potenciales Evocados Auditivos/fisiología , Esquizofrenia/fisiopatología , Estimulación Acústica/métodos , Adulto , Atención/fisiología , Corteza Auditiva/metabolismo , Corteza Auditiva/fisiopatología , Percepción Auditiva/fisiología , Estudios de Casos y Controles , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/fisiopatología , Femenino , Humanos , Masculino , Potenciales de la Membrana/fisiología , Persona de Mediana Edad , Esquizofrenia/complicacionesRESUMEN
Alzheimer's disease (AD) is the most common cause of dementia; however, available treatments have had limited success. Therefore AD patients are in tremendous need of new pharmacological approaches that may delay or slow the progression of the disease. In addition to the classical neuropathological features, immunological and inflammatory processes are also involved in AD pathogenesis. Naturally occurring compounds, such as Mangifera indica Linn (MGF) extracts have previously been shown to significantly reduce peripheral inflammatory processes. In order to explore the role of MGF in AD central pathology, we have orally treated APP/PS1 mice for 22 weeks. While MGF did not affect amyloid pathology, tau hyperphosphorylation was significantly reduced in the cortex and hippocampus. Also, inflammatory processes, measured by microglia and astrocyte burdens, were diminished in MGF-treated mice. Moreover, neuronal morphological alterations, such as abnormal neurite curvature and dystrophies, highly increased in APP/PS1 mice, were significantly ameliorated by long-term MGF treatment. Reduction of all these pathological features were accompanied by compelling improvements of episodic and spatial memory in APP/PS1 mice treated with MGF. Altogether our data suggest that MGF may provide a useful tool to target different aspects of AD pathology and could lead to more effective future therapeutic or preventive strategies.
Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Enfermedad de Alzheimer/patología , Péptidos beta-Amiloides/metabolismo , Trastornos del Conocimiento/tratamiento farmacológico , Trastornos del Conocimiento/patología , Extractos Vegetales/uso terapéutico , Presenilina-1/metabolismo , Xantonas/uso terapéutico , Enfermedad de Alzheimer/complicaciones , Amiloide/metabolismo , Animales , Trastornos del Conocimiento/complicaciones , Inflamación/complicaciones , Inflamación/tratamiento farmacológico , Inflamación/patología , Mangifera , Ratones , Neuritas/efectos de los fármacos , Neuritas/metabolismo , Neuritas/patología , Extractos Vegetales/farmacología , Xantonas/farmacología , Proteínas tau/metabolismoRESUMEN
INTRODUCTION: The difficulty the elderly experience in understanding speech may be related to several factors including cognitive and perceptual performance. OBJECTIVE: To evaluate the influence of cognitive performance, depressive symptoms, and education on speech perception in noise of elderly hearing aids users. METHODS: The sample consisted of 25 elderly hearing aids users in bilateral adaptation, both sexes, mean age 69.7 years. Subjects underwent cognitive assessment using the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale-cognitive and depressive symptoms evaluation using the Geriatric Depression Scale. The assessment of speech perception in noise (S/N ratio) was performed in free field using the Portuguese Sentence List test. Statistical analysis included the Spearman correlation calculation and multiple linear regression model, with 95% confidence level and 0.05 significance level. RESULTS: In the study of speech perception in noise (S/N ratio), there was statistically significant correlation between education scores (p=0.018), as well as with the Mini-Mental State Examination (p=0.002), Alzheimer's Disease Assessment Scale-cognitive (p=0.003), and Geriatric Depression Scale (p=0.022) scores. We found that for a one-unit increase in Alzheimer's Disease Assessment Scale-cognitive score, the S/N ratio increased on average 0.15dB, and for an increase of one year in education, the S/N ratio decreased on average 0.40dB. CONCLUSION: Level of education, cognitive performance, and depressive symptoms influence the speech perception in noise of elderly hearing aids users. The better the cognitive level and the higher the education, the better is the elderly communicative performance in noise.
Asunto(s)
Audífonos , Pérdida Auditiva/rehabilitación , Ruido , Percepción del Habla/fisiología , Estimulación Acústica , Anciano , Anciano de 80 o más Años , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/diagnóstico , Depresión/complicaciones , Depresión/diagnóstico , Escolaridad , Femenino , Evaluación Geriátrica , Pérdida Auditiva/fisiopatología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Medical conditions and medications may be associated with motor vehicle collisions (MVCs), which pose a major public health problem worldwide. Further epidemiological assessment is necessary for certain diseases and medications. Moreover, since disease aetiology and patterns of medication use may differ among ethnicities and healthcare systems, a population-specific approach is necessary. The present epidemiological study is designed to assess the medical conditions and medications associated with the risk of fatal MVCs among at-fault drivers in the Korean population. METHOD AND DESIGN: A retrospective cohort will be constructed for individuals who died in MVCs between 2005 and 2014 in the Korean Traffic Accident Analysis System database, which is linked to the Korean National Health Insurance database between 2002 and 2014. In order to compare medical conditions and medication use among drivers who died in a fatal MVC with the general population, standardised prevalence ratios will be calculated. In the culpability study, we will identify conditions and drugs associated with MVCs, comparing drivers with higher levels of responsibility to those with lower levels of responsibility. In the case-crossover study, the transient effects of medical conditions and medications will be examined using a conditional logistic regression model that adjusts for confounders. DISCUSSION: The results of this study will help to characterise the associations of diseases and medications with fatal MVCs in an Asian population, with the goal of informing regulatory and clinical decision-making regarding patients with the relevant conditions and the establishment of strategies for improving traffic safety.
Asunto(s)
Accidentes de Tránsito/estadística & datos numéricos , Conducción de Automóvil , Trastornos del Conocimiento/complicaciones , Responsabilidad Legal , Medicamentos bajo Prescripción/efectos adversos , Tiempo de Reacción/efectos de los fármacos , Trastornos de la Visión/complicaciones , Prevención de Accidentes , Accidentes de Tránsito/legislación & jurisprudencia , Accidentes de Tránsito/mortalidad , Adulto , Anciano , Pueblo Asiatico , Conducción de Automóvil/legislación & jurisprudencia , Trastornos del Conocimiento/fisiopatología , Estudios Cruzados , Femenino , Humanos , Concesión de Licencias , Masculino , Persona de Mediana Edad , Programas Nacionales de Salud , Prevalencia , República de Corea/epidemiología , Estudios Retrospectivos , Responsabilidad Social , Trastornos de la Visión/fisiopatologíaRESUMEN
At present, we have no reliable means of recovering cognitive impairment in Alzheimer's disease (AD) patients. We hypothesized that homocysteic acid (HA) in the blood might represent one such pathogen that could be excreted into the urine. Since DHA is known to reduce circulating levels of homocysteine, and since exercise attenuates this effect, it follows that supplementation of the diet with DHA, along with increased levels of physical activity, may help to reduce cognitive impairment in AD patients. Our hypothesis was proven to be correct because memory problems in 3xTg- AD mice (a model for AD in which animals develop amyloid pathology), and in a mouse model of familial AD, were recovered following treatment with an anti-HA antibody and not by amyloid treatment. Interestingly, 3xTg-AD mice with amyloid pathology showed increased levels of HA level. This could perhaps be explained by the fact that amyloid precursor protein and/or presenilin increases calcium influx, which could then increase levels of superoxide and consequently increase levels of HA from homocysteine or methionine. Our hypothesis is also partially supported by an open clinical trial of certain dietary supplements that has shown impressive results. Also there are other treatments hypothesis which would be possible for the effective therapies, such as ribonucleoprotein therapy, a ß-secretase inhibitor treatment and the metabolic enhancement treatment.
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Enfermedad de Alzheimer/complicaciones , Anticuerpos/uso terapéutico , Trastornos del Conocimiento/tratamiento farmacológico , Homocisteína/análogos & derivados , Enfermedad de Alzheimer/sangre , Animales , Trastornos del Conocimiento/sangre , Trastornos del Conocimiento/complicaciones , Modelos Animales de Enfermedad , Homocisteína/sangre , Homocisteína/inmunología , RatonesRESUMEN
Mindfulness is theorised to improve attention regulation and other cognitive processes. This systematic review examines whether 8-week standardised and manualised mindfulness training programs such as Mindfulness Based Cognitive Therapy (MBCT) and Mindfulness Based Stress Reduction (MBSR) enhances attention, memory and executive function abilities measured by objective neuropsychological tests. Seven databases were searched resulting in 18 studies meeting inclusion criteria for review. Overall studies did not support attention or executive function improvements. We found preliminary evidence for improvements in working memory and autobiographical memory as well as cognitive flexibility and meta-awareness. Short-term mindfulness meditation training did not enhance theorised attentional pathways. Results call into question the theoretical underpinnings of mindfulness, further highlighting the need for a comprehensive theoretical framework.
Asunto(s)
Trastornos del Conocimiento/terapia , Atención Plena/métodos , Estrés Psicológico/terapia , Atención , Trastornos del Conocimiento/complicaciones , Trastornos del Conocimiento/psicología , Terapia Cognitivo-Conductual/métodos , Bases de Datos Factuales , Función Ejecutiva , Humanos , Memoria a Corto Plazo , Metacognición , Pruebas Neuropsicológicas , Estrés Psicológico/complicaciones , Estrés Psicológico/psicología , Resultado del TratamientoRESUMEN
This study was conducted to evaluate the effects of polysaccharides extracted from Pleurotus ostreatus (POP) on d-galactose and AlCl3-induced cognitive impairments. A behavioral test suggested that POP significantly decreased escape latency and increased crossing parameters of platform quadrant in a Morris water maze test. Furthermore, POP decreased error numbers and increased passive avoidance latency in a step-down test. Biochemical examinations revealed that POP significantly elevated superoxide dismutase, glutathione peroxidase, and catalase activities; and reduced malondialdehyde levels and acetylcholinesterase activity. Moreover, POP could decrease amyloid ß peptide formation and tau phosphorylation by elevating the expression of protein phosphatase 2A as well as by reducing the expression of amyloid precursor protein (APP), ß-site APP clearing enzyme1, and glycogen synthase kinase 3beta. These findings provide scientific evidence to support the exploitation of POP as a safe and effective drug to prevent and treat Alzheimer's disease.