Effects of physical activity interventions on cognitive and academic performance in children and adolescents: a novel combination of a systematic review and recommendations from an expert panel.

OBJECTIVE: To summarise the current evidence on the effects of physical activity (PA) interventions on cognitive and academic performance in children, and formulate research priorities and recommendations. DESIGN: Systematic review (following PRISMA guidelines) with a methodological quality assessment and an international expert panel. We based the evaluation of the consistency of the scientific evidence on the findings reported in studies rated as of high methodological quality. DATA SOURCES: PubMed, PsycINFO, Cochrane Central, Web of Science, ERIC, and SPORTDiscus. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: PA-intervention studies in children with at least one cognitive or academic performance assessment. RESULTS: Eleven (19%) of 58 included intervention studies received a high-quality rating for methodological quality: four assessed effects of PA interventions on cognitive performance, six assessed effects on academic performance, and one on both. All high-quality studies contrasted the effects of additional/adapted PA activities with regular curriculum activities. For cognitive performance 10 of 21 (48%) constructs analysed showed statistically significant beneficial intervention effects of PA, while for academic performance, 15 of 25 (60%) analyses found a significant beneficial effect of PA. Across all five studies assessing PA effects on mathematics, beneficial effects were reported in six out of seven (86%) outcomes. Experts put forward 46 research questions. The most pressing research priority cluster concerned the causality of the relationship between PA and cognitive/academic performance. The remaining clusters pertained to PA characteristics, moderators and mechanisms governing the 'PA-performance' relationship and miscellaneous topics. CONCLUSION: There is currently inconclusive evidence for the beneficial effects of PA interventions on cognitive and overall academic performance in children. We conclude that there is strong evidence for beneficial effects of PA on maths performance.The expert panel confirmed that more 'high-quality' research is warranted. By prioritising the most important research questions and formulating recommendations we aim to guide researchers in generating high-quality evidence. Our recommendations focus on adequate control groups and sample size, the use of valid and reliable measurement instruments for physical activity and cognitive performance, measurement of compliance and data analysis. PROSPERO REGISTRATION NUMBER: CRD42017082505.

Children's representations of another person's spatial perspective: Different strategies for different viewpoints?

The current study investigated development and strategy use of spatial perspective taking (i.e., the ability to represent how an object or array of objects looks from other viewpoints) in children between 8 and 12years of age. We examined this ability with a task requiring children to navigate a route through a model city of wooden blocks from a 90° and 180° rotated perspective. We tested two hypotheses. First, we hypothesized that children's perspective-taking skills increase during this age period and that this process is related to a co-occurring increase in working memory capacity. Results indeed showed clear age effects; accuracy and speed of perspective-taking performance were higher in the older age groups. Positive associations between perspective-taking performance and working memory were observed. Second, we hypothesized that children, like adults, use a mental self-rotation strategy during spatial perspective taking. To confirm this hypothesis, children's performance should be better in the 90° condition than in the 180° condition of the task. Overall, the results did show the reversed pattern; children were less accurate, were slower, and committed more egocentric errors in the 90° condition than in the 180° condition. These findings support an alternative scenario in which children employ different strategies for different rotation angles. We propose that children mentally rotated their egocentric reference frame for 90° rotations; for the 180° rotations, they inverted the left-right and front-back axes without rotating their mental position.

Social information influences trust behaviour in adolescents.

Trust plays an integral role in daily interactions within adolescents' social environment. Using a trust game paradigm, this study investigated the modulating influence of social information about three interaction partners on trust behaviour in adolescents aged 12-18 (N = 845). After receiving information about their interaction partners prior to the task, participants were most likely to share with a 'good' partner and rate this partner as most trustworthy. Over the course of the task all interaction partners showed similar levels of trustworthy behaviour, but overall participants continued to trust and view the good partner as more trustworthy than 'bad' and 'neutral' partners throughout the game. However, with age the ability to overcome prior social information and adapt trust behaviour improved: middle and late adolescents showed a larger decrease in trust of the good partner than early adolescents, and late adolescents were more likely to reward trustworthy behaviour from the negative partner.

Association between white matter microstructure, executive functions, and processing speed in older adults: the impact of vascular health.

Cerebral white matter damage is not only a commonly reported consequence of healthy aging, but is also associated with cognitive decline and dementia. The aetiology of this damage is unclear; however, individuals with hypertension have a greater burden of white matter signal abnormalities (WMSA) on MR imaging than those without hypertension. It is therefore possible that elevated blood pressure (BP) impacts white matter tissue structure which in turn has a negative impact on cognition. However, little information exists about whether vascular health indexed by BP mediates the relationship between cognition and white matter tissue structure. We used diffusion tensor imaging to examine the impact of vascular health on regional associations between white matter integrity and cognition in healthy older adults spanning the normotensive to moderate-severe hypertensive BP range (43-87 years; N = 128). We examined how white matter structure was associated with performance on tests of two cognitive domains, executive functioning (EF) and processing speed (PS), and how patterns of regional associations were modified by BP and WMSA. Multiple linear regression and structural equation models demonstrated associations between tissue structure, EF and PS in frontal, temporal, parietal, and occipital white matter regions. Radial diffusivity was more prominently associated with performance than axial diffusivity. BP only minimally influenced the relationship between white matter integrity, EF and PS. However, WMSA volume had a major impact on neurocognitive associations. This suggests that, although BP and WMSA are causally related, these differential metrics of vascular health may act via independent pathways to influence brain structure, EF and PS.

Decreased gray matter diffusivity: a potential early Alzheimer's disease biomarker?

BACKGROUND: Gray matter atrophy, an important biomarker for early Alzheimer's disease, might be due to white matter changes within gray matter. METHODS: Twenty older participants with significant memory decline over a 12-year period (T12) were matched to 20 nondeclining participants. All participants were magnetic resonance imaging scanned at T12. Cortical thickness and diffusion tensor imaging analyses were performed. RESULTS: Lower cortical thickness values were associated with lower diffusion values in frontal and parietal gray matter areas. This association was only present in the memory decline group. The cortical thickness-diffusion tensor imaging correlations showed significant group differences in the posterior cingulate gyrus, precuneus, and superior frontal gyrus. CONCLUSIONS: Decreased gray matter diffusivity in the posterior cingulate/precuneus area might be a disease-specific process and a potential new biomarker for early Alzheimer's disease. Future studies should validate its potential as a biomarker and focus on cellular changes underlying diffusivity changes in gray matter.

Establishing normative data for repeated cognitive assessment: a comparison of different statistical methods.

Serial cognitive assessment is conducted to monitor changes in the cognitive abilities of patients over time. At present, mainly the regression-based change and the ANCOVA approaches are used to establish normative data for serial cognitive assessment. These methods are straightforward, but they have some severe drawbacks. For example, they can only consider the data of two measurement occasions. In this article, we propose three alternative normative methods that are not hampered by these problems-that is, multivariate regression, the standard linear mixed model (LMM), and the linear mixed model combined with multiple imputation (LMM with MI) approaches. The multivariate regression method is primarily useful when a small number of repeated measurements are taken at fixed time points. When the data are more unbalanced, the standard LMM and the LMM with MI methods are more appropriate because they allow for a more adequate modeling of the covariance structure. The standard LMM has the advantage that it is easier to conduct and that it does not require a Monte Carlo component. The LMM with MI, on the other hand, has the advantage that it can flexibly deal with missing responses and missing covariate values at the same time. The different normative methods are illustrated on the basis of the data of a large longitudinal study in which a cognitive test (the Stroop Color Word Test) was administered at four measurement occasions (i.e., at baseline and 3, 6, and 12 years later). The results are discussed and suggestions for future research are provided.

Maturation of task-induced brain activation and long range functional connectivity in adolescence revealed by multivariate pattern classification.

The present study uses multivariate pattern classification analysis to examine maturation in task-induced brain activation and in functional connectivity during adolescence. The multivariate approach allowed accurate discrimination of adolescent boys of respectively 13, 17 and 21years old based on brain activation during a gonogo task, whereas the univariate statistical analyses showed no or only very few, small age-related clusters. Developmental differences in task activation were spatially distributed throughout the brain, indicating differences in the responsiveness of a wide range of task-related and default mode regions. Moreover, these distributed age-distinctive patterns generalized from a simple gonogo task to a cognitively and motivationally very different gambling task, and vice versa. This suggests that functional brain maturation in adolescence is driven by common processes across cognitive tasks as opposed to task-specific processes. Although we confirmed previous reports of age-related differences in functional connectivity, particularly for long range connections (>60mm), these differences were not specific to brain regions that showed maturation of task-induced responsiveness. Together with the task-independency of brain activation maturation, this result suggests that brain connectivity changes in the course of adolescence affect brain functionality at a basic level. This basic change is manifest in a range of tasks, from the simplest gonogo task to a complex gambling task.

DNA methylation and cognitive functioning in healthy older adults.

Long-term supplementation with folic acid may improve cognitive performance in older individuals. The relationship between folate status and cognitive performance might be mediated by changes in methylation capacity, as methylation reactions are important for normal functioning of the brain. Although aberrant DNA methylation has been implicated in neurodevelopmental disorders, the relationship between DNA methylation status and non-pathological cognitive functioning in human subjects has not yet been investigated. The present study investigated the associations between global DNA methylation and key domains of cognitive functioning in healthy older adults. Global DNA methylation, defined as the percentage of methylated cytosine to total cytosine, was measured in leucocytes by liquid chromatography-MS/MS, in 215 men and women, aged 50-70 years, who participated in the Folic Acid and Carotid Intima-Media Thickness (FACIT) study (clinical trial registration number NCT00110604). Cognitive performance was assessed by means of the Visual Verbal Word Learning Task, the Stroop Colour-Word Interference Test, the Concept Shifting Test, the Letter-Digit Substitution Test and the Verbal Fluency Test. Using hierarchical linear regression analyses adjusted for age, sex, level of education, alcohol consumption, smoking status, physical activity, erythrocyte folate concentration and 5,10-methylenetetrahydrofolate reductase 677 C â†’ T genotype, we found that global DNA methylation was not related to cognitive performance on any of the domains measured. The present study results do not support the hypothesis that global DNA methylation, as measured in leucocytes, might be associated with cognitive functioning in healthy older individuals.

Effects of a comprehensive educational group intervention in older women with cognitive complaints: a randomized controlled trial.

OBJECTIVE: This study presents a new comprehensive educational group intervention that offers psycho-education about cognitive aging and contextual factors (i.e., negative age stereotypes, beliefs, health, and lifestyle), focuses on skills and compensatory behavior, and incorporates group discussion. Its effects were investigated in community-dwelling older women who report normal age-related cognitive complaints. METHODS: A randomized controlled trial with an experimental and waiting-list control condition was carried out in a sample of 50 women aged 60-75 years. As the main problem of these individuals were perceived cognitive deficits without actual cognitive decrements, metacognition served as the primary outcome measure. OBJECTIVE: cognitive functioning and psychological well-being were secondary outcome measures. A double baseline and a follow-up assessment were carried out. RESULTS: Participants in the experimental condition reported significantly fewer negative emotional reactions toward cognitive functioning (U = 164.500, p = 0.004). The reported effect size (δ = -0.473) could be interpreted as large. CONCLUSIONS: This new comprehensive educational group intervention reduces negative emotional reactions toward cognitive functioning, which seems a prerequisite for improved subjective cognitive functioning and well-being. It can potentially contribute the well-being of an important and large group of older adults.

Occupational activity and cognitive aging: a case-control study based on the Maastricht Aging Study.

UNLABELLED: BACKGROUND/STUDY CONTEXT: Occupational activity is associated with cognitive functioning in older age. The mental exercise hypothesis attributes this association to differences in mental exercise at work. METHODS: A case-control design was used to test the mental exercise hypothesis. Primary and secondary school teachers (aged between 25.29 and 79.01 years) and non-teacher controls were matched for level of occupation, educational level, age, and gender. Regression analyses were used to analyze the data. Possible confounders (such as precareer intelligence and depressive status) were taken into account. RESULTS: Teachers had superior verbal fluency and working memory scanning abilities. CONCLUSION: The results are in line with the mental exercise hypothesis.

Developmental changes between ages 13 and 21 years in the extent and magnitude of the BOLD response during decision making.

Developmental neuroimaging results have suggested a progression in focalization in functional activations from childhood to adulthood. The mechanisms underlying this process are thought to be an age-related decrease in activation extent as well as an increased magnitude in task-related areas. The present study aimed to evaluate these notions while controlling for confounders that may bias towards focalization. We used adolescent subjects in small age ranges. In addition, head motion corrections were incorporated in statistical analyses and regions of interest were identified for each participant separately to overcome inter-individual variability in anatomy and functional organization. Activation patterns of 13-, 17- and 21-year-old males were compared during the decision phase of a challenging and complex gambling paradigm. The BOLD amplitude enhanced with increasing age, modulated by task conditions. First, response amplitude during difficult, endogenous relative to exogenous decisions increased with age. This decision difficulty effect was most pronounced in 21-year-olds, both in areas associated with task execution and default mode areas. Second, deciding to pass as opposed to gamble exerted more effort in inferior frontal and parietal areas only by 13- and 17-year-olds. There was neither an age-related decrease in activation extent, nor any qualitative shifts in activated areas as suggested by the focalization hypothesis. These results suggest that although different age groups throughout adolescence engage similar brain areas during decision making, the response magnitude in these areas increases with age particularly during difficult task conditions, providing that confounding factors are controlled.

Depressive symptoms and risk for dementia: a 9-year follow-up of the Maastricht Aging Study.

OBJECTIVE: Depression relates to vascular disease and is a candidate risk factor for dementia. We assessed the risk associated with depressive symptoms for Alzheimer-type dementia and vascular dementia. METHODS: Depressive symptoms (SCL-90 depression subscale) were assessed in 771 community-dwelling individuals age 55 years and older. Onset of dementia (N = 37) was recorded at serial assessments 3, 6, and 9 years after baseline. RESULTS: Depressive symptom scores predicted all-type dementia (OR = 1.06, 95% CI = 1.01-1.10), and vascular dementia (OR = 1.11; 95% CI = 1.03-1.19), but not Alzheimer-type dementia (OR = 1.04; 95% CI = 0.98-1.09). People scoring in the upper quartile of the SCL-90 depression scale (N = 180) were at increased risk for dementia (OR = 2.06, 95% CI = 1.01-4.22). Results were unchanged after co-varying for baseline mini-mental state exam and presence of vascular disease. CONCLUSION: Depressive symptoms increase the risk for later dementia in community-dwelling older adults.

Atrophy of the parietal lobe in preclinical dementia.

Cortical grey matter atrophy patterns have been reported in healthy ageing and Alzheimer disease (AD), but less consistently in the parietal regions of the brain. We investigated cortical grey matter volume patterns in parietal areas. The grey matter of the somatosensory cortex, superior and inferior parietal lobule was measured in 75 older adults (38 cognitively stable and 37 individuals with cognitive decline after 3 years). Dementia screening 6 years after scanning resulted in nine AD cases from the cognitively stable (n=3) and cognitive decline group (n=6), who were assigned to a third group, the preclinical AD group. When regional differences in cortical volume in the parietal lobe areas were compared between groups, significant differences were found between either the cognitive decline or stable group on the one hand and preclinical AD individuals on the other hand in the inferior parietal lobule. Group membership was best predicted by the grey matter volume of the inferior parietal lobule, compared to the other parietal lobe areas. The parietal lobe was characterised by a differential atrophy pattern based on cognitive status, which is in agreement with the 'last-developed-first-atrophied' principle. Future studies should investigate the surplus value of the inferior parietal lobe as a potential marker for the diagnosis of AD compared to other brain regions, such as the medial temporal lobe and the prefrontal lobe.

Cognitive complaints and neuropsychological functioning in adults with and without attention-deficit hyperactivity disorder referred for multidisciplinary assessment.

The present study aims to gain insight into the clinical presentation (viz., self-reported complaints and neuropsychological functioning) of adults referred for an attention-deficit hyperactivity disorder (ADHD) diagnosis. The investigation evaluated group differences between an ADHD and a non-ADHD sample (n = 30 and n = 42, respectively), all of which had been clinically referred for multidisciplinary assessment of ADHD. Forty-two percent of all referred patients were diagnosed with adult ADHD. Adults with ADHD made significantly more errors on a verbal learning task than the non-ADHD control group, which could indicate an impairment of the self-monitoring function in adult ADHD. The ADHD group reported more problems than the control group in the domains of executive functioning but not in the domains of attention and hyperactivity. More attention should be paid to executive complaints and functioning (present and past) when referring adults suspected of ADHD for multidisciplinary assessment. Also, characteristics that are thought to be striking symptoms of adult ADHD, such as problems with concentration and hyperactive behavior, are in fact not distinctive symptoms of ADHD at all.

Lateral preferences and their assessment in school-aged children.

A behaviour-based lateral preference instrument (the Lateral Preferences Questionnaire; LPQ; Van Strien, 1992, 2001) was administered to a large sample of school-aged children. The aims of the present study were twofold: (i) to evaluate the factor structure and the psychometric properties of the LPQ, and (ii) to evaluate the effects of age, gender, and mean level of parental education on lateral preferences and lateral consistency. Two factor models had an excellent fit with the data. In the first model the LPQ items were considered to be indicators of four different lateral preference factors (the hand, foot, eye, and ear preference factors). In the second model the LPQ items were considered to be indicators of four lateral preference factors, which were in turn expected to load on a single underlying general lateral preference factor. The psychometric properties of the derived hand and eye preference scales of the LPQ were good to excellent, and the psychometric properties of the foot and ear preference scales were acceptable. Lateral preferences and lateral consistency were not affected by age, gender, or mean level of parental education.

On Neuroeducation: Why and How to Improve Neuroscientific Literacy in Educational Professionals.

New findings from the neurosciences receive much interest for use in the applied field of education. For the past 15 years, neuroeducation and the application of neuroscience knowledge were seen to have promise, but there is presently some lack of progress. The present paper states that this is due to several factors. Neuromyths are still prevalent, and there is a confusion of tongues between the many neurodisciplines and the domains of behavioral and educational sciences. Second, a focus upon cognitive neuroimaging research has yielded findings that are scientifically relevant, but cannot be used for direct application in the classroom. A third factor pertains to the emphasis which has been on didactics and teaching, whereas the promise of neuroeducation for the teacher may lie more on pedagogical inspiration and support. This article states that the most important knowledge and insights have to do with the notion of brain plasticity; the vision that development is driven by an interaction between a person's biology and the social system. This helps individuals to select and process information, and to adapt to the personal environment. The paper describes how brain maturation and neuropsychological development extend through the important period of adolescence and emergent adulthood. Over this long period, there is a major development of the Executive Functions (EFs) that are essential for both cognitive learning, social behavior and emotional processing and, eventually, personal growth. The paper describes the basic neuroscience knowledge and insights - or "neuroscientific literacy" - that the educational professional should have to understand and appreciate the above-described themes. The authors formulate a proposal for four themes of neuroscience content "that every teacher should know." These four themes are based on the Neuroscience Core Concepts formulated by the Society for Neuroscience. The authors emphasize that integrating neuroscientific knowledge and insights in the field of education should not be a one-way street; attempts directed at improving neuroscientific literacy are a transdisciplinary undertaking. Teacher trainers, experts from the neuroscience fields but also behavioral scientists from applied fields (notable applied neuropsychologists) should all contribute to for the educational innovations needed.

Migraine does not affect cognitive decline: results from the Maastricht aging study.

OBJECTIVE: To investigate the effects of migraine and related pharmacotherapy on cognitive performance and cognitive change over time in a longitudinal population-based study. METHODS: Migraineurs (n = 99) and healthy controls (n = 1724) participating in the Maastricht Aging Study were cognitively tested at baseline and after 6 years. Scores on Mini Mental State Examination, immediate and delayed recall tests, and tests for simple and complex speed were compared for both groups. Generalized Estimating Equations analyses were performed to test the longitudinal effects of migraines on cognition. Effects of migraine medication use were also tested. RESULTS: Migraine headaches were found to have no effect on any of the cognitive measures. Medication use also had no effect on all cognitive measures. CONCLUSIONS: No evidence was found that migraine headaches or migraine-related medication use are risk or protective factors for cognitive dysfunction or cognitive deterioration over time.

A time-saving and facilitating approach for segmentation of anatomically defined cortical regions: MRI volumetry.

In this study, we present an accurate, reliable, robust, and time-efficient technique for a semi-automatic segmentation of neuroanatomically defined cortical structures in Magnetic Resonance Imaging (MRI) scans. It involves manual drawing of the border of a region of interest (ROI), supported by three-dimensional (3D) visualization techniques (rendering), and a subsequent automatic tracing of the gray matter voxels inside the ROI by means of an automatic tissue classifier. The approach has been evaluated on a set of MRI scans of 75 participants selected from the Maastricht Aging Study (MAAS) and applied to cortical brain structures for both the left and right hemispheres, viz., the inferior prefrontal cortex (PFC); the orbital PFC; the dorsolateral PFC; the anterior cingulate cortex; and the posterior cingulate cortex. The use of a 3D surface-rendered brain can be rotated in any direction was invaluable in identifying anatomical landmarks on the basis of gyral and sulcal topography. This resulted in a high accuracy (anatomical correctness) and reliability: the intra-rater intra-class correlation coefficient (ICC) was between 0.96 and 0.99. Furthermore, the obtained time savings were substantial, i.e., up to a factor of 7.5 compared with fully manual segmentations.

The neurovegetative complaints questionnaire in the Maastricht aging study: Psychometric properties and normative data.

OBJECTIVES: Neurovegetative and somatic symptoms (such as headaches, heart palpitations and dizziness) have a high prevalence. These symptoms are often indicative for 'masked depression' or 'depression without sadness', especially in older adults. At present, no instrument exists which enables the assessment of these symptoms. This study presents a questionnaire which assesses neurovegetative and somatic complaints, as well as reactive emotional complaints: the 'Neurovegetative Complaints Questionnaire' (NCQ). METHODS: The factor structure, internal consistency and validity of the NCQ were evaluated in a very large sample of 1105 healthy subjects aged 24-81 years from the Maastricht Aging Study. The effects of age, sex and educational level on the NCQ measures were established to provide demographically corrected normative data. RESULTS: Two constructs underlay the responses to the NCQ items, i.e. the neurovegetative/somatic and reactive/emotional complaints factors (eigenvalues were 4.63 and 1.65, respectively, 33.0% of the variance was explained, Pearson's r between both factors equalled 0.448). Internal consistency of both scales was acceptable (i.e. Cronbach's alpha = 0.74 and 0.71, respectively) and convergent validity was sufficient (Pearson's r = |0.387 - 0.499|). Females and older participants were characterised by more neurovegetative/somatic and reactive/emotional complaints compared to males and younger people. Demographically corrected regression-based norms were provided for use in research and clinical settings. CONCLUSIONS: The NCQ is a psychometrically sound questionnaire that is specifically aimed at assessing neurovegetative/somatic and reactive/emotional complaints, symptoms that often are indicative for a 'masked depression'.

Environmental effects in the performance of daily tasks in healthy adults.

OBJECTIVE: We examined the effect of switching from a familiar to an unfamiliar setting on household task performance in healthy adults. We also examined the influence of the cognitive functions abstract reasoning and memory on the ability to adapt to different environments. METHOD: Thirty healthy adults were observed in two different settings while they performed two daily tasks. We evaluated process skill abilities in task performance, time needed to perform each task, memory functioning, and abstract reasoning. RESULTS: Performance of both tasks required significantly more time in the unfamiliar kitchen. Scores on process skill abilities were significantly lower in the unfamiliar kitchen. We found no associations between environmental effects and abstract reasoning or memory. CONCLUSION: We found environmental effects on task performance in healthy adults. These findings have important implications for rehabilitation practice. Addressing facilitation of transfer of training effects to familiar environments is of great importance to rehabilitation programs.