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1.
IEEE Pulse ; 12(2): 17-21, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33861695

RESUMEN

"I am now eight-and-a-half months into my journey with long COVID … My symptoms include diagnosed post-COVID tachycardia and acute fatigue. I also have chest tightness and breathlessness from time to time; anxiety; muscle aches and pains, especially in the evening; memory loss; and insomnia."-38-year-old female from the U.K.


Asunto(s)
/complicaciones , Pandemias , Adulto , Autoinmunidad , /etiología , /rehabilitación , Disfunción Cognitiva/etiología , Estudios de Cohortes , Fatiga/etiología , Femenino , Interacciones Microbiota-Huesped/inmunología , Interacciones Microbiota-Huesped/fisiología , Humanos , Masculino , Ciudad de Nueva York/epidemiología , Disautonomías Primarias/etiología , Factores de Tiempo
2.
Medicine (Baltimore) ; 100(16): e25633, 2021 Apr 23.
Artículo en Inglés | MEDLINE | ID: mdl-33879740

RESUMEN

ABSTRACT: Our previous study demonstrated that patients with end-stage renal disease had decreased structural and functional brain connectivity, and there was a significant association between brain connectivity and cognitive function. The aim of this study was to evaluate the alterations of structural and functional connectivity using graph theoretical analysis in neurologically asymptomatic patients with relatively early-stage chronic kidney disease (CKD).We enrolled 18 neurologically asymptomatic patients with early CKD and 28 healthy controls. All the subjects underwent diffusion-tension imaging and resting functional magnetic resonance imaging. We calculated structural and functional connectivity based on diffusion-tension imaging and resting functional magnetic resonance imaging using a graph theoretical analysis. Then, we investigated differences of structural and functional connectivity between the CKD patients and the healthy controls.All the measures of structural connectivity were significantly different between the patients with CKD and healthy controls. The global efficiency, local efficiency, mean clustering coefficient, and small-worldness index were decreased, whereas the characteristic path length was increased in the patients with CKD compared with healthy controls. The structural betweenness centrality of the left calcarine and right posterior cingulum was also significantly different from that in healthy participants. However, all the measures of global functional connectivity in patients with CKD were not different from those in healthy controls. In patients with CKD, the functional betweenness centrality of the right insular cortex, right occipital pole, and right thalamus was significantly different from that in healthy participants.There are significant alterations of the global structural connectivity between the patients with CKD and the healthy subjects, whereas the global functional connectivity of the brain network is preserved. We find that the efficiency of the structural brain network is decreased in the patients with CKD.


Asunto(s)
Encéfalo/fisiopatología , Imagen de Difusión Tensora , Imagen por Resonancia Magnética , Vías Nerviosas/fisiopatología , Insuficiencia Renal Crónica/diagnóstico por imagen , Insuficiencia Renal Crónica/fisiopatología , Anciano , Encéfalo/diagnóstico por imagen , Estudios de Casos y Controles , Disfunción Cognitiva/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Vías Nerviosas/diagnóstico por imagen , Insuficiencia Renal Crónica/psicología , Descanso/fisiología
3.
Zh Nevrol Psikhiatr Im S S Korsakova ; 121(3. Vyp. 2): 16-21, 2021.
Artículo en Ruso | MEDLINE | ID: mdl-33908227

RESUMEN

Post-stroke cognitive impairment (PCI) is a common complication of stroke. PCI in most cases is associated with an increased risk of progression to dementia, with a progression rate of 8-15% per year. When post-stroke cognitive impairment reaches dementia, patients lose independence, professional and social maladjustment occurs, which, in turn, significantly worsen the quality of life and reduce the rehabilitation potential. According to many experimental and clinical studies, the inflammatory process has an important role in the development of PCI. Several previous studies have looked at the association between inflammatory markers and PCI, with some results conflicting with specific biomarkers. Based on the results of studies, inflammatory markers such as IL-8, IL-12 and ESR were closely associated with PCI, high ESR values are associated with worse cognitive impairment, especially memory. The relationship was not confirmed between the markers IFN-gamma, TNF-α and PCI. With regard to IL-1ß, IL-6, IL-10, CRP, the results obtained are not unambiguous. Thus, the inflammatory process in the development of PCI has an important role, including a series of complex reactions, the combined effect of which induces neuronal damage and loss of synapses that ultimately leads to cognitive impairment.


Asunto(s)
Disfunción Cognitiva , Accidente Cerebrovascular , Biomarcadores , Disfunción Cognitiva/etiología , Humanos , Calidad de Vida , Accidente Cerebrovascular/complicaciones , Factor de Necrosis Tumoral alfa
4.
Artículo en Ruso | MEDLINE | ID: mdl-33834731

RESUMEN

Cognitive impairment (CI) develops not only in structural damage to the central nervous system, but also in encephalopathies of dysmetabolic and deficiency etiology. Recently, special attention is focused on the appearance of CI due to the deficiency of cobalamin (vitamin B12) and folic acid (FA), the change in the level of homocysteine (HC). To detect vitamin B12 deficiency is possible by examining key biomarkers in serum based on a decrease in the levels of vitamin B12 and holotranscobalamin, and levels of methylmalonic acid (MMA) and HC. The article presents an analysis of studies conducted in Norway, Korea, India, and other countries to assess the risks of CI in the presence of reduced levels of vitamin B12 in the elderly, which demonstrated a decrease in brain volume in the elderly (according to MRI data) in combination with altered test parameters that assess cognitive functions. In many studies, female patients with reduced levels of vitamin B12 predominated among the studied patients. Also, some studies have demonstrated the effectiveness of complex CI therapy with the inclusion of vitamin B12 (both for oral and intravenous administration). Oral vitamin B12 therapy at a dose of 1000 µg has been shown to be adequate for the treatment of vitamin B12 deficiency. Also, the administration of vitamin B12 for prophylactic purposes is recommended for patients with subnormal or borderline concentrations of vitamin B12 in the blood serum.


Asunto(s)
Disfunción Cognitiva , Deficiencia de Vitamina B 12 , Anciano , Biomarcadores , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/etiología , Disfunción Cognitiva/prevención & control , Femenino , Ácido Fólico , Humanos , Ácido Metilmalónico , Vitamina B 12 , Deficiencia de Vitamina B 12/complicaciones , Deficiencia de Vitamina B 12/tratamiento farmacológico
5.
Zhongguo Zhen Jiu ; 41(3): 247-51, 2021 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-33798304

RESUMEN

OBJECTIVE: To explore the effect of Bushen Tiaodu Yizhi acupuncture combined with computer-assisted cognitive training on the recovery of cognitive function and activities of daily living in patients with post stroke cognitive impairment. METHODS: A total of 98 patients with post stroke cognitive impairment were randomized into an observation group (50 cases, 6 cases dropped off) and a control group (48 cases, 5 cases dropped off). Both groups were treated with conventional treatment, such as computer-assisted cognitive training. On the basis of the conventional treatment, Bushen Tiaodu Yizhi acupuncture at Taixi (KI 3), Sanyinjiao (SP 6), Shuigou (GV 26), Baihui (GV 20), ect. was given in the observation group. In the control group, acupuncture at acupoints of limbs was given. The treatment was given once a day, 5 times a week for 8 weeks. Before and after treatment, the scores of Montreal cognitive assessment (MoCA) scale, modified Barthel index (MBI) and stroke syndrome of TCM scale were used to evaluate the cognitive function, activities of daily living and syndrome of TCM in the two groups. The latency and amplitude of P300 were detected by electromyographs and evoked response instrument. And the clinical efficacy was evaluated in the two groups. RESULTS: Compared before treatment, the MoCA and MBI scores were increased (P<0.01), and the scores of stroke syndrome of TCM scale were decreased (P<0.01) after treatment in the two groups. After treatment,the MoCA and MBI scores in the observation group were higher than the control group (P<0.01, P<0.05), and the score of stroke syndrome of TCM scale was lower than the control group (P<0.05). Compared before treatment, the latency of P300 was shortened and amplitude was prolonged after treatment in the two groups (P<0.01). After treatment, in the observation group, the latency of P300 was shorter, and amplitude was longer than the control group (P<0.01). The effective rate was 86.4% (38/44) in the observation group, which was higher than 67.4% (29/43) in the control group (P<0.01). CONCLUSION: Bushen Tiaodu Yizhi acupuncture combined with computer-assisted cognitive training could improve the cognitive function of patients with post stroke cognitive impairment.


Asunto(s)
Terapia por Acupuntura , Disfunción Cognitiva , Accidente Cerebrovascular , Actividades Cotidianas , Puntos de Acupuntura , Cognición , Disfunción Cognitiva/etiología , Disfunción Cognitiva/terapia , Computadores , Medicamentos Herbarios Chinos , Humanos , Accidente Cerebrovascular/complicaciones , Resultado del Tratamiento
6.
Zhongguo Zhen Jiu ; 41(3): 252-6, 2021 Mar 12.
Artículo en Chino | MEDLINE | ID: mdl-33798305

RESUMEN

OBJECTIVE: To compare the efficacy of interactive scalp acupuncture, scalp acupuncture alone and scalp acupuncture plus cognitive training for cognitive dysfunction after stroke. METHODS: A total of 660 patients with cognitive dysfunction after stroke were randomly divided into an interactive scalp acupuncture group (218 cases, 18 cases dropped off), a scalp acupuncture group (220 cases, 20 cases dropped off) and a scalp acupuncture plus cognitive training group (222 cases, 22 cases dropped off). All the patients were treated with routine medication and exercise rehabilitation training. The interactive scalp acupuncture group was treated with scalp acupuncture on the parietal midline, and contralateral anterior parietal temporal oblique line and posterior parietal temporal oblique line at the same time of cognitive training; the scalp acupuncture group was treated with scalp acupuncture alone, and the scalp acupuncture plus cognitive training group was treated with scalp acupuncture and cognitive training in the morning and afternoon respectively. All the treatments were given once a day, 6 times a week for 8 weeks. Montreal cognitive assessment (MoCA) scale score was used to evaluate the cognitive function before treatment, 4 weeks and 8 weeks into treatment. RESULTS: Compared before treatment, the total score of MoCA was increased after 4-week treatment and 8-week treatment in the three groups (P<0.01), and the score in the interactive scalp acupuncture group was higher than that in the scalp acupuncture group and the scalp acupuncture plus cognitive training group (P<0.05, P<0.01). Compared before treatment, each item score of MoCA was increased after 8-week treatment in the three groups (P<0.01), and the score in the interactive scalp acupuncture group was higher than that in the scalp acupuncture group and the scalp acupuncture plus cognitive training group (P<0.01). Except for the attention, the remaining items scores of MoCA in the scalp acupuncture plus cognitive training group were higher than those in the scalp acupuncture group (P<0.01). CONCLUSION: The interactive scalp acupuncture could significantly improve the cognitive function in patients with cognitive dysfunction after stroke, and the efficacy is superior to scalp acupuncture alone and scalp acupuncture plus cognitive training.


Asunto(s)
Terapia por Acupuntura , Disfunción Cognitiva , Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Puntos de Acupuntura , Disfunción Cognitiva/etiología , Disfunción Cognitiva/terapia , Humanos , Cuero Cabelludo , Accidente Cerebrovascular/complicaciones , Resultado del Tratamiento
7.
Wiad Lek ; 74(2): 257-262, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33813482

RESUMEN

OBJECTIVE: The aim: Our study aimed at evaluating the relationships between sleep disorders (SD), cognitive impairment (CI), anxiety and depression in patients with relapsing-remitting multiple sclerosis (RRMS). PATIENTS AND METHODS: Materials and methods: One hundred and five patients with RRMS (80 females and 25 males) aged from 22 to 67 years (mean age: 41,8±10,7; EDSS:3,5±1,6; disease duration (DD): 10,3±8,5 years) were enrolled into the study. All participants completed questionnaires on sleep (the Pittsburgh Sleep Quality Index /PSQI), cognitive functions (The Montreal Cognitive Assessment /MoCA), anxiety (Hamilton Anxiety Rating Scale /HAM-A), depression (Beck Depression Inventory/ BDI). RESULTS: Results: According to PSQI score the patients were divided into two groups: with (n=42) and without SD (n=63). The patients with SD were older (45,36±1,66 vs 39,41±1,27, p=0.005), had higher EDSS score (3,98±0,26 vs 3,14±0,19, p=0,008), BDI (13,79±1,14 vs 8,96±0,86, p=0,0009) and HAM-A (24,52±1,42 vs 16,56±0,99, p<0,0001) scales compared with patients without SD. The frequency of anxiety (p=0,0034) and depression (p=0,038) was significantly higher in RRMS patients with compared to those without SD. No significant difference was found in gender, DD and MoCA score. In patients with SD significant negative correlation between MoCA and BDI score (r = -0,42, p<0,005) was found. In the group of patients without SD significant negative correlation between MoCA and EDSS (r = -0,27, p=0,03), MoCA and BDI (r = -0,26, p=0,043),) MoCA and HAM-A (r = -0,25, p=0,041) score was detected. CONCLUSION: Conclusions: Insomnia type SD in RRMS patients were associated with older age, higher EDSS score and presence of anxiety and depression.


Asunto(s)
Disfunción Cognitiva , Esclerosis Múltiple Recurrente-Remitente , Esclerosis Múltiple , Trastornos del Sueño-Vigilia , Adulto , Anciano , Disfunción Cognitiva/epidemiología , Disfunción Cognitiva/etiología , Depresión/epidemiología , Depresión/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple Recurrente-Remitente/complicaciones , Escalas de Valoración Psiquiátrica , Trastornos del Sueño-Vigilia/epidemiología , Trastornos del Sueño-Vigilia/etiología
10.
J Comput Assist Tomogr ; 45(2): 285-293, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661150

RESUMEN

PURPOSE: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common familial arteriopathy characterized by recurrent lacunar stroke, migraine, and depression. The mechanism of cognitive dysfunction in CADASIL is still uncertain. The aim of this study was to use tract-based spatial statistics (TBSS) to map voxelwise the spatial distribution of brain microstructural change revealed by DTI-derived indices in patients with CADASIL to further study the underlying neuropsychopathological mechanism of CADASIL. METHOD: Twelve patients with CADASIL and 11 age-, sex-matched healthy controls underwent magnetic resonance imaging at 3 T. Then we evaluated DTI-derived indices (fractional anisotropy [FA], mode of anisotropy [MO], mean diffusivity [MD], axial diffusivity [AD] and radial diffusivity [RD]) of brain white matter (WM) between CADASIL patients and healthy subjects through TBSS. RESULTS: Compared with healthy controls, patients with CADASIL showed extensive decreased FA, MO and increased RD, AD, and MD throughout the entire brain (mainly the WM of the temporal poles, inferior and superior longitudinal fasciculus, inferior fronto-occipital fasciculus, corpus callosum, uncinate fasciculus, internal capsule, external capsule, corona radiata, thalamic radiation, and cingulum). Furthermore, these WM microstructural alterations were significantly correlated with cognitive scores and Scheltens scores. Decreased FA values and MO values were positively correlated with Montreal Cognitive Assessment scores in CADASIL patients. Increased AD, RD, and MD values were significantly negatively correlated with Montreal Cognitive Assessment scores. CONCLUSIONS: Widespread WM abnormalities were clearly shown in CADASIL by using TBSS. Severity of microstructural changes correlates significantly with extension of T2 hyperintensity. Moreover, WM microstructural damage and cognitive impairment were significantly correlated. This study indicated that WM tract damage plays an important role in cognitive impairment in CADASIL.


Asunto(s)
Encéfalo/diagnóstico por imagen , CADASIL/diagnóstico por imagen , Disfunción Cognitiva/diagnóstico por imagen , Imagen de Difusión Tensora , Adulto , Encéfalo/patología , CADASIL/complicaciones , CADASIL/patología , Estudios de Casos y Controles , Disfunción Cognitiva/etiología , Disfunción Cognitiva/patología , Femenino , Humanos , Masculino , Persona de Mediana Edad
11.
J Comput Assist Tomogr ; 45(2): 294-299, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33661154

RESUMEN

OBJECTIVE: To determine whether there is a difference between healthy control group and children with neurofibromatosis type 1 (NF1) in terms of apparent diffusion coefficient (ADC) and fractional anisotropy (FA) values in different regions of the brain associated with neurocognitive functions and to investigate the correlation between diffusion tensor imaging parameters and neurocognitive dysfunctions. METHODS: The study included 28 children with NF1 and 21 controls. Nine distinct areas related to cognitive functions were selected for the analysis. The ADC and FA values were compared. RESULTS: There was a significant difference between NF1 and healthy control in terms of ADC values obtained from all areas. The ADC values at obtained from thalamus and striatum were positively correlated with the full-scale intelligence quotient (IQ), verbal IQ, and performance IQ. CONCLUSIONS: We are speculated that the development of microstructural damage in the thalamostriatal pathway may lead to neurocognitive dysfunction.


Asunto(s)
Disfunción Cognitiva/diagnóstico por imagen , Cuerpo Estriado/diagnóstico por imagen , Imagen de Difusión Tensora , Neurofibromatosis 1/diagnóstico por imagen , Tálamo/diagnóstico por imagen , Adolescente , Estudios de Casos y Controles , Niño , Disfunción Cognitiva/etiología , Disfunción Cognitiva/fisiopatología , Cuerpo Estriado/fisiopatología , Femenino , Humanos , Masculino , Neurofibromatosis 1/complicaciones , Neurofibromatosis 1/fisiopatología , Tálamo/fisiopatología
12.
Life Sci ; 273: 119310, 2021 May 15.
Artículo en Inglés | MEDLINE | ID: mdl-33667517

RESUMEN

AIMS: Alzheimer's disease (AD) is a leading health problem in which increased amyloid ß (Aß) accumulation may occur due to abnormal Aß precursor protein processing by ß-secretase 1 (BACE1) enzyme. Lately, neuro-inflammation was recognized as a significant contributor to its pathogenesis. Although the causes of AD are not yet well understood, much evidence has suggested that dyslipidemia has harmful effects on cognitive function and is inextricably involved in AD pathogenesis. Cholesterol is a vital molecule involved in neuronal development. Alteration in neuronal cholesterol levels affects Aß metabolism and results in neurodegeneration. Proprotein-convertase-subtilisin/kexin type-9 (PCSK9) was found to decrease neuronal cholesterol uptake by degradation of LDL-receptor related protein 1 (LRP-1) responsible for neuronal cholesterol uptake. Accordingly, this study was designed to evaluate the effect of PCSK9-inhibition by alirocumab (Aliro) in high-fat-cholesterol-diet (HFCD)-induced-AD-like condition. MAIN METHODS: Wistar Rats were divided into six groups; control; HFCD; HFCD and Memantine; HFCD and Aliro (4, 8 and 16 mg/kg/week) to test for ability of Aliro to modulate cognitive impairment, amyloidosis, brain cholesterol homeostasis and neuro-inflammation in HFCD-induced-AD-like condition. KEY FINDINGS: Our results demonstrated an association between PCSK9 inhibition by Aliro and amelioration of cognitive deficit, cholesterol hemostasis and reduction of neuro-inflammation. Aliro was able to alleviate hippocampal LRP-1expression levels and reduce brain cholesterol, hippocampal BACE1, Aß42, high-mobility-group-box-1 protein, receptor for advanced-glycation-end-products and toll like receptor-4 with subsequent decrease of different inflammatory mediators as nuclear-factor-kappa-B (NF-κB), tumor-necrosis-factor-alpha (TNF-α), interleukin-1beta (IL-1ß) and IL-6. SIGNIFICANCE: PCSK9-inhibition may represent a new therapeutic target in AD especially for HFCD-induced-AD-like condition.


Asunto(s)
Amiloidosis/tratamiento farmacológico , Anticuerpos Monoclonales Humanizados/farmacología , Colesterol/toxicidad , Disfunción Cognitiva/tratamiento farmacológico , Dieta Alta en Grasa/efectos adversos , Memantina/farmacología , Proproteína Convertasa 9/antagonistas & inhibidores , Amiloidosis/etiología , Amiloidosis/metabolismo , Amiloidosis/patología , Animales , Disfunción Cognitiva/etiología , Disfunción Cognitiva/metabolismo , Disfunción Cognitiva/patología , Antagonistas de Aminoácidos Excitadores/farmacología , Ácido Glutámico/metabolismo , Proteína HMGB1/genética , Proteína HMGB1/metabolismo , Hipocampo/efectos de los fármacos , Hipocampo/metabolismo , Hipocampo/patología , Masculino , Ratas , Ratas Wistar , Receptor para Productos Finales de Glicación Avanzada/genética , Receptor para Productos Finales de Glicación Avanzada/metabolismo , Receptor Toll-Like 4/genética , Receptor Toll-Like 4/metabolismo
13.
BMJ Case Rep ; 14(3)2021 Mar 02.
Artículo en Inglés | MEDLINE | ID: mdl-33653852

RESUMEN

The COVID-19 pandemic has dealt a devastating blow to healthcare systems globally. Approximately 3.2% of patients infected with COVID-19 require invasive ventilation during the course of the illness. Within this population, 25% of patients are affected with neurological manifestations. Among those who are affected by severe neurological manifestations, some may have acute cerebrovascular complications (5%), impaired consciousness (15%) or exhibit skeletal muscle hypokinesis (20%). The cause of the severe cognitive impairment and hypokinesis is unknown at this time. Potential causes include COVID-19 viral encephalopathy, toxic metabolic encephalopathy, post-intensive care unit syndrome and cerebrovascular pathology. We present a case of a 60 year old patient who sustained a prolonged hospitalization with COVID-19, had a cerebrovascular event and developed a persistent unexplained encephalopathy along with a hypokinetic state. He was treated successfully with modafinil and carbidopa/levodopa showing clinical improvement within 3-7 days and ultimately was able to successfully discharge home.


Asunto(s)
Encefalopatías , Carbidopa/administración & dosificación , Hipocinesia , Levodopa/administración & dosificación , Modafinilo/administración & dosificación , Rehabilitación/métodos , /aislamiento & purificación , Coagulación Sanguínea , Encefalopatías/fisiopatología , Encefalopatías/virología , /complicaciones , /terapia , Estimulantes del Sistema Nervioso Central/administración & dosificación , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/etiología , Cuidados Críticos/métodos , Combinación de Medicamentos , Humanos , Hipocinesia/diagnóstico , Hipocinesia/etiología , Hipocinesia/terapia , /etiología , /terapia , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana Edad , Respiración Artificial/métodos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento , Desconexión del Ventilador/métodos
14.
Artículo en Ruso | MEDLINE | ID: mdl-33728846

RESUMEN

OBJECTIVE: A special place among cognitive disorders in patients with cardiovascular diseases is given to postoperative cognitive dysfunction (POCD). The study aimed at investigating the patterns of beta-2 activity associated with postoperative cognitive dysfunction (POCD) in patients after coronary artery bypass grafting (CABG). MATERIAL AND METHODS: The study included 60 patients who underwent neuropsychological testing 3-5 days before surgery and on the 7-10th day of CABG. A multichannel electroencephalogram of resting state with eyes closed in 62 standard leads was recorded. Statistical processing of the results was carried out using Statistica 10 (StatSoft Inc, USA) and the developed method of data clustering with a minimax criterion, a software implementation of the binary clipping and branching algorithm was used to find optimal solutions. RESULTS: Patients with POCD had higher pre- and postoperative high-frequency beta-2 rhythm power (20-30 Hz) compared with patients without cognitive impairment. The regression model demonstrated that POCD was associated with high values of preoperative beta-2 activity in the right frontal cortex and with low values in the left parietal areas after CABG. The clustering of beta-2 rhythm power before and after CABG revealed that the best cognitive status corresponded to a stable affiliation of patients with the selected clusters. CONCLUSION: The specific POCD correlates were established in patients after CABG. Low cognitive status was characterized by the preoperative beta-2 power increase in the right frontal areas and postoperative decrease in the left parietal cortex. The developed method for classifying patients according to the level of pre- and postoperative beta-2 rhythm power has a good discriminant ability. Stable patient affiliation with the selected clusters was associated with a higher level of cognitive status.


Asunto(s)
Trastornos del Conocimiento , Disfunción Cognitiva , Cognición , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Disfunción Cognitiva/etiología , Puente de Arteria Coronaria , Humanos , Incidencia , Pruebas Neuropsicológicas , Complicaciones Posoperatorias/epidemiología
15.
Artículo en Ruso | MEDLINE | ID: mdl-33728849

RESUMEN

OBJECTIVE: To study the severity of disorders of executive functions in children with dyslexia and to assess the effectiveness of treatment of this pathology with cortexin. MATERIAL AND METHODS: The main study group included 60 children, aged 8-11 years, with a specific reading disorder (F.81.0). Reading skills were assessed using methods of T.A. Fotekova, T.V. Akhutina. Diagnostic examination included neurological examination with dyspraxia test, electroencephalography with visual and quantitative analysis. To objectify the severity of memory impairments, the «Working memory¼ technique was used. Attention and impulsivity disorders were quantified using SNAP-IY and the Test of Variables of Attention (TOVA). The control group consisted of 60 children of the same age without symptoms of dyslexia. Cortexin was used to treat 30 patients from the study group, 30 patients received encephabol. A control study to analyze the effectiveness of the therapy was carried out one month after the end of therapy. RESULTS AND CONCLUSION: Children with dyslexia are characterized by a higher level of inattention and impulsivity, as well as significantly lower indicators of working memory compared to children from the control group. The decrease in attention and working memory as well as an increased level of impulsivity are manifestations of impaired executive functions in children with dyslexia. The results of the control study after treatment showed a significant increase in reading skills in both groups. In addition, there was an improvement in indicators of attention and working memory. However, the effectiveness of treatment with cortexin was slightly higher compared to encephabol (improvement was noted in 73.3% and 60.0%of patients, respectively). According to a comparative analysis of EEG results, after a course of treatment with cortexin, children with dyslexia have significant neurophysiological changes that indicate the activation of the brain regulatory systems.


Asunto(s)
Disfunción Cognitiva , Dislexia , Atención , Niño , Disfunción Cognitiva/diagnóstico , Disfunción Cognitiva/tratamiento farmacológico , Disfunción Cognitiva/etiología , Dislexia/diagnóstico , Función Ejecutiva , Humanos , Memoria a Corto Plazo
16.
Medicine (Baltimore) ; 100(11): e24833, 2021 Mar 19.
Artículo en Inglés | MEDLINE | ID: mdl-33725953

RESUMEN

ABSTRACT: To assess the prevalence and factors associated with mild cognitive impairment (MCI) in patients suffering from psoriatic arthritis (PsA).A cross-sectional evaluation was conducted in consecutive PsA patients. Sociodemographic data and the clinimetric variables related to PsA and psoriasis were collected for each patient. MCI was assessed through the Montreal Cognitive Assessment (MoCA). The cognitive performance of PsA patients was compared to healthy subjects using one-way analysis of variance (ANOVA). The correlations among variables were studied by the Spearman rank correlation coefficient. A multivariate logistic regression analysis was carried out to establish the predictors of MCI.The study involved 96 PsA patients and 48 healthy subjects. MCI (defined as a MoCA score < 26/30) was detected in 47 (48.9%) PsA patients. Compared to healthy subjects, the MoCA score resulted significantly lower in PsA patients (P = .015). The main differences involved the denomination and language domains. MoCA was negatively correlated with age (r = -0.354; P < .0001), HAQ-DI (r = -0.227; P = .026), and fatigue (r = -0.222; P = .029), and positively correlated with psoriasis duration (r = 0.316; P = .001) and DLQI (r = 0.226; P = .008).The multivariate logistic regression analysis revealed the duration of psoriasis (P = .0005), age (P = .0038), PASI (P = .0050), and HAQ-DI (P = .0193) as predictors of the MoCA score.MCI is present in a significant proportion of PsA patients, and is mainly determined by age, cutaneous variables, and disability.


Asunto(s)
Artritis Psoriásica/psicología , Disfunción Cognitiva/epidemiología , Índice de Severidad de la Enfermedad , Adulto , Factores de Edad , Análisis de Varianza , Disfunción Cognitiva/etiología , Estudios Transversales , Evaluación de la Discapacidad , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Prevalencia , Calidad de Vida , Factores de Riesgo , Estadísticas no Paramétricas
17.
Am J Occup Ther ; 75(2): 7502345020p1-7502345020p7, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33657357

RESUMEN

IMPORTANCE: Psychometrically sound instruments are needed to evaluate executive functioning in the population of people with cancer. OBJECTIVE: To develop and evaluate the reliability and validity of the Executive Function Performance Test-Enhanced (EFPT-E) in women after being treated for breast cancer. DESIGN: Cross-sectional. SETTING: University research laboratory. PARTICIPANTS: Women treated for breast cancer who had cognitive impairment (n = 12) and community control participants (n = 13). OUTCOMES AND MEASURES: Evaluators (n = 8) independently scored a recorded administration of the EFPT-E to evaluate interrater reliability. An assessment battery, including the EFPT-E, was administered to evaluate the EFPT-E's known-groups validity and concurrent validity. RESULTS: Excellent interrater reliability was observed for the EFPT-E total score and each subtask score (intraclass correlation coefficient = .90-.98). Moderate effect sizes were noted for the EFPT-E total score (Cohen's d = 0.5) and the total number of cues (d = 0.4) between the breast cancer group and the control group, with the breast cancer group demonstrating poorer performance. A limited correlation was found between the EFPT-E and the other cognitive measures. CONCLUSIONS AND RELEVANCE: The results support the EFPT-E's interrater reliability and warrant continued investigation to further establish its reliability and validity. WHAT THIS ARTICLE ADDS: Assessments are needed to quantify the impact of cognitive processes within functional tasks. The EFPT-E has been developed to assess the functional impact of mild cognitive impairment; initial testing with women with cancer showed excellent agreement between raters and promising results for validity.


Asunto(s)
Disfunción Cognitiva , Neoplasias , Disfunción Cognitiva/etiología , Estudios Transversales , Función Ejecutiva , Femenino , Humanos , Reproducibilidad de los Resultados
18.
Arq Neuropsiquiatr ; 79(2): 133-138, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33759980

RESUMEN

INTRODUCTION: People with epilepsy frequently complain of poor memory. OBJECTIVE: To assess the occurrence of memory complaints in older adults with epilepsy (OAE) and whether it is associated with clinical variables, objective cognitive performance, and quality of life (QoL). METHODS: The Memory Complaint Questionnaire (MAC-Q) was related to objective cognitive performance, the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), the Quality of Life in Epilepsy Inventory (QOLIE-31), and the clinical characteristics of 83 OAE. RESULTS: OAE showed worse cognitive performance and higher MAC-Q scores when compared to a similar control group (n=40). Impairment in multiple cognitive domains occurred in 34 (41%) OAE and was associated with older age and lower educational level. Memory complaints (MAC-Q≥25) were reported by 45 (54.2%) OAE and associated with older age, lower educational level, onset at ≥60 years, higher NDDI-E scores, lower QOLIE-31 scores, and impairment in multiple cognitive domains. CONCLUSIONS: OAE presented worse cognitive performance and greater memory complaints. Episode onset at ≥60 years of age was associated with complaints, but not with objective cognitive deficit. We found an association between subjective and objective cognitive performance, with aspects of epilepsy and worse QoL scores.


Asunto(s)
Disfunción Cognitiva , Epilepsia , Anciano , Disfunción Cognitiva/etiología , Epilepsia/complicaciones , Humanos , Memoria , Trastornos de la Memoria/etiología , Pruebas Neuropsicológicas , Calidad de Vida
20.
Neurology ; 96(15): e1966-e1974, 2021 04 13.
Artículo en Inglés | MEDLINE | ID: mdl-33632803

RESUMEN

OBJECTIVE: To investigate the associations between general cognitive impairment and domain-specific cognitive impairment with depression and anxiety at 6 months poststroke. METHODS: Participants were patients with confirmed acute stroke from the OCS-Care Study who were recruited on stroke wards in a multisite study and followed up at a 6-month poststroke assessment. Depression and anxiety symptoms were assessed by the Hospital Anxiety and Depression Scale subscales, with scores greater than 7 indicating possible mood disorders. General cognitive impairment at follow-up was assessed using the Montreal Cognitive Assessment (MoCA); stroke-specific cognitive domain impairments were assessed using the Oxford Cognitive Screen (OCS). Linear regression was used to examine the associations between cognition and depression/anxiety symptoms at 6 months, controlling for acute stroke severity and activities of daily living impairment, age, sex, education, and co-occurring poststroke depression/anxiety. RESULTS: A total of 437 participants (mean age, 69.28 years [SD 12.17], 226 male [51.72%]) were included in analyses. Six-month poststroke depression (n = 115, 26%) was associated with 6-month impairment on the MoCA (ß = 0.96, standard error [SE] 0.31, p = 0.006) and all individual domains assessed by the OCS: spatial attention (ß = 0.67, SE 0.33, p = 0.041), executive function (ß = 1.37, SE 0.47, p = 0.004), language processing (ß = 0.87, SE 0.38, p = 0.028), memory (ß = 0.76, SE 0.37, p = 0.040), number processing (ß = 1.13, SE 0.40, p = 0.005), and praxis (ß = 1.16, SE 0.49, p = 0.028). Poststroke anxiety (n = 133, 30%) was associated with impairment on the MoCA (ß = 1.47, SE 0.42, p = 0.001) and spatial attention (ß = 1.25, SE 0.45, p = 0.006); these associations did not remain significant after controlling for co-occurring poststroke depression. CONCLUSION: Domain-general and domain-specific poststroke cognitive impairment was found to be highly related to depressive symptomatology but not anxiety symptomatology.


Asunto(s)
Ansiedad/psicología , Disfunción Cognitiva/etiología , Depresión/psicología , Accidente Cerebrovascular/psicología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Accidente Cerebrovascular/complicaciones
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