Predicting clinical progression and cognitive decline in patients with relapsing-remitting multiple sclerosis: a 6-year follow-up study.

INTRODUCTION: Cognitive impairment occurs from the earliest stages of multiple sclerosis (MS) and progresses over time. The introduction of disease modifying therapies (DMTs) has changed the prognosis for MS patients, offering a potential opportunity for improvement in the cognitive arena as well. MATERIAL AND METHODS: 41 patients with relapsing-remitting multiple sclerosis (MS) were recruited to the study. Thirty patients were available for final follow-up and were included in the analysis. Baseline (BL) brain MRI including volumetry and neuropsychological tests were performed. Blood samples were collected at BL and follow-up (FU) and were tested for: vascular endothelial growth factor (VEGF), soluble vascular cell adhesion molecule-1 (sVCAM1), soluble platelet-endothelial CAM-1 (sPECAM1), and soluble intercellular CAM-1 (sICAM-1). Patients were invited for a final neuropsychological follow-up after a median of 6 years. Disease activity (relapses, EDSS increase, new/active brain lesions on MRI) was analysed between BL and FU. RESULTS: The study group deteriorated in the Rey-Osterrieth Complex Figure (ROCF) test (p = 0.001), but improved significantly in three other tests, i.e. semantic fluency test (p = 0.013), California Verbal Learning Test (CVLT, p = 0.016), and Word Comprehension Test (WCT, p < 0.001). EDSS increase correlated negatively with semantic fluency and WCT scores (r = -0.579, p = 0.001 and r = -0.391, p = 0.033, respectively). Improvements in semantic fluency test and WCT correlated positively with baseline deep grey matter, grey matter, and cortical volumes (p < 0.05, r > 0). Higher EDSS on FU correlated significantly negatively with baseline left and right pallidum, right caudate, right putamen, right accumbens, and cortical volume (p < 0.05, r < 0). No significant relationship was found between the number of relapses and EDSS on FU or neuropsychological deteriorations. Improvements in WCT and CVLT correlated positively with baseline sPECAM1 and sVCAM1 results, respectively (r > 0, p < 0.05). Deterioration in ROCF test correlated significantly with higher levels of baseline VEGF and sVCAM1 (p < 0.05). CONCLUSIONS: Brain volume is an important predictor of future EDSS and cognitive functions outcome. MS patients have a potential for improving in neuropsychological tests over time. It remains to be established whether this is related to successful disease modification with immunotherapy. Baseline volumetric measures are stronger predictors of cognitive performance than relapse activity, which yet again highlights the importance of atrophy in MS prognosis.

Time of day and chronotype in the assessment of cognitive functions.

Purpose: Circadian rhythms are synchronized, through the endogenous biological clock, with the 24-hour cycle, and associated with numerous changes in human functioning, both in physical and mental aspects. It is assumed that daily fluctuations in cognitive performance are a consequence of interacting homeostatic and circadian processes regulating an individual's sleep-wake rhythms. A chronotype may be understood as a phenotype of circadian cycles determined by an endogenous biological clock. Despite research findings showing a significant relationship between those factors and cognition, they remain insufficiently considered in the domain of cognitive psychology and neuropsychology. Views: This narrative review aims to describe and highlight the interactions between the time of day, chronotype, and cognitive performance in domains of mental activity variables, receptive functions, memory and learning, expressive functions, and thinking. Conclusions: The results of the research show that time-of-day effects on basic and more complex cognitive functions depend on an individual's chronotype with a dominant effect of synchrony between chronotype and time of cognitive testing, with large differences in circadian cycles between younger and older age groups. It is suggested that chronotype assessment and time of day control should be included as important variables in the diagnosis of cognitive function in both healthy and clinical populations. There is also an emerging need for further investigations to better understand how chronotype and circadian rhythms modulate human brain physiology and cognition.

Validation of the Polish Problematic Tinder Use Scale and Its Relationship with Safe Sex Behaviors.

INTRODUCTION: Online dating is a common phenomenon. The manageability and access of the application allows people to quickly reach many potential partners, which can increase risky sexual behaviors. The Problematic Tinder Use Scale (PTUS) was developed and validated in a Polish population by analyzing the reliability, validity, and factor structure of the responses given by Polish-speaking participants. METHODS: Two samples of adult Tinder users were recruited online. The first study aimed to perform the reliability coefficient Cronbach's, interrater analysis, exploratory, and confirmatory factor analysis. The second sample was recruited to investigate the factor structure by combining it with the Safe Sex Behavior Questionnaire (SSBQ). The sociodemographic data, such as hours of use and number of dates, were also investigated. RESULTS: The Polish participants' responses to the PTUS (sample 1: N = 271, sample 2: N = 162) revealed the one-factor structure of the tool. The reliability of the measurement was α = 0.80. The construct validity was confirmed. The results showed a significant, negative, and weak correlation between the PTUS and SSBQ scores and their subscales: risky sexual behaviors (r = -0.18), condom use (r = -0.22), and avoidance of body fluids (r = -0.17). Moreover, the number of partners met in the real world had a statistically significant, moderate relationship with the PTUS scores. CONCLUSIONS: The PTUS measurement is valid and reliable for the Polish population. The findings highlight the need for harm prevention strategies related to potentially addictive Tinder use, as well as the possible risky sexual behaviors associated with dating app use.

The Effect of Autogenic Training in a Form of Audio Recording on Sleep Quality and Physiological Stress Reactions of University Athletes-Pilot Study.

Despite the growing popularity of relaxation training, the effectiveness of an autogenic training (AT) as a method of dealing with sleep problems in group of student athletes is unknown. Therefore, this study aimed to fill this gap. University athletes with decreased sleep quality (selected from 209 participants) were randomly assigned to the experimental (EG, n = 11) and control (CG, n = 11) groups similar in terms of sleep quality, age, gender, type of sport discipline and sport experience. During the 14 days dedicated to performing relaxation training in the form of an audio recording, electronic daily logs and actigraphy were used to monitor the athletes' sleep and daily activity. The EG listened to the recording with suggestions based on AT and CG only to the background music. Pre- and post-measurements of sleep quality by means of the Pittsburg Sleep Quality Index (PSQI) and physiological stress reactions by biofeedback device were performed. In EG and CG, the parameters of sleep and daily activity obtained by actigraphy and daily logs as well as physiological indicators of emotional reactivity did not differ. Sleep quality in PSQI significantly increased after AT usage in EG. AT seems to be an effective method for university athletes in improving subjective sleep quality, but further studies are necessary.

Genetic association study reveals impact of interleukin 10 polymorphisms on cognitive functions in schizophrenia.

AIM: Cognitive deficits are the core factors impacting quality of life among patients diagnosed with schizophrenia. Effective method of treatment for this domain of symptoms remains lacking. Recent evidence suggests the link between impaired cognition and aberrant inflammatory response. Severity of symptoms might be linked to individual genetic predispositions and single-nucleotide polymorphisms (SNPs) in genes encoding interleukins and their receptors. Current genetic association studies include anti-inflammatory interleukins, such as IL10. Functional polymorphisms of IL10 (rs1800871, rs18008729) have been indicated to affect information processing in schizophrenia. MATERIALS AND METHODS: In this study, we analyzed the potential impact of 27 functional SNPs in 8 cytokine genes on cognitive parameters measured by Wisconsin card-sorting test (WCST) in schizophrenia group (n = 150) and healthy controls (n = 152). RESULTS: We found significant associations of two functional polymorphisms of IL10 (rs1800871, rs1800872) and WCST results. Allele A carriers in rs1800871 performed significantly better in Percent of Conceptual Level Responses (CLR%). Allele A carriers in rs1800871 and allele T carriers in rs1800872 obtained better results in Completed Categories (CC). The impact of illness duration was observed, with better performance of recent-onset patients. CONCLUSIONS: Results of this study indicate that genetic variants of inflammatory response are associated with cognitive deficits in schizophrenia. The role of cytokines in schizophrenia need to be investigated in the aspect of pro-/anti-inflammatory imbalance. Altered inflammatory response promote chronic mild inflammation in the brain and aberrant synaptic plasticity.

Internet Use and Problematic Use in Seniors: A Comparative Study in Switzerland and Poland.

Background: Seniors have been only little considered in studies examining problematic internet use and associated health issues, although they may present risk factors that make them particularly vulnerable for the development of problematic internet use. Objectives: (1) To compare Internet use and problematic use among seniors in Switzerland and Poland; (2) To examine the relationships between problematic internet use, impulsivity traits and well-being as previous studies showed that internet can be used to cope with negative emotions or life dissatisfaction. Methods: A cross-sectional survey conducted between June 2016 and April 2017 with 264 older internet users aged above 60 years old recruited in Switzerland (88) and Poland (176) assessing sociodemographic variables, online activities, problematic internet use, impulsivity traits and well-being. Results: The two groups differed in their reported online activities in that Polish participants reported more searching for information and buying, whereas Swiss participants reported significantly greater problematic internet use than Polish participants. Finally, a multiple linear regression analysis performed on the whole sample indicated that lower well-being and being a Swiss participant were both significantly associated with greater problematic internet use, after age, gender, level of education, impulsivity traits have been controlled for. Discussion: Swiss seniors showed a more problematic internet use than Polish participants who focused more in their online activities on utility use of internet. The relationships between problematic internet use and well-being suggest that older adults use internet mainly to cope with negative emotion or life dissatisfaction. Socio-cultural differences that could account for these group differences as well as difference with young adults are discussed.

Effects of virtual reality-based cognitive training in older adults living without and with mild dementia: a pretest-posttest design pilot study.

OBJECTIVE: Modern technologies are increasingly used in the development of cognitive interventions for older adults. Research into possible applications of virtual reality in such interventions has begun only recently. The aim of present study was to evaluate the effects of 8 sessions of VR-based cognitive training using the GRADYS game in healthy older adults (n = 72; aged 60-88) and older adults living with mild dementia (n = 27; aged 60-89). RESULTS: Older adults with mild dementia demonstrated worse baseline cognitive performance than participants without dementia. Both groups showed progress in training, which was greater in healthy older adults. There were also significant differences in cognitive functioning before and after the training. However, positive changes were revealed almost exclusively in the group of older adults without dementia. Based on the findings, we can recommend the GRADYS game for cognitive enhancement and as a possible counter-measure for cognitive decline experienced in normal cognitive ageing. Our results provide also support for the usefulness of VR technology in cognitive interventions in older adults. The use of the GRADYS game in persons living with dementia, however, would require several of the hardware and software modifications. Trial registration ISRCTN17613444, date of registration: 10.09.2019. Retrospectively registered.

Comparison of Retinal Microvasculature in Patients With Alzheimer's Disease and Primary Open-Angle Glaucoma by Optical Coherence Tomography Angiography.

Purpose: Comparison of retinal microvasculature within the macula and the optic nerve head in the eyes of patients with Alzheimer's disease (AD), primary open-angle glaucoma (POAG), and in a healthy control (HC) group, using optical coherence tomography angiography (OCTA). Methods: In this cross-sectional study, 27 patients with AD, 27 with POAG, and 27 healthy controls were enrolled. The Mini-Mental State Examination test was used to assess cognitive function. Ophthalmic examination included OCTA, which was used for the imaging of vascular flow within the layer of radial peripapillary capillaries (RPCs), and also in the superficial vascular plexus (SVP) and deep vascular plexus (DVP) of the retina. Results: In the AD group, the density of vessels in DVP was significantly reduced and the foveal avascular zone was increased when compared to POAG and HC groups (P < 0.001). Patients with POAG had a significantly reduced vessel density in RPCs and SVP as compared to AD and HC groups (P < 0.001). The average thickness of peripapillary retinal nerve fiber layer was correlated with the vessel density in SVP in patients with POAG (Pearson's r = 0.66; P = 0.0002) and was significantly lower in POAG and AD groups than in the HC group (P < 0.001). Conclusions: AD and POAG are neurodegenerative diseases associated with apoptosis of nerve cells and impairment of microvasculature. Despite the fact that in both diseases there are abnormalities of the entire retinal vascular system, significant microcirculatory impairment in POAG patients affects superficial vessels, whereas in AD patients it affects vessels located in the deeper retinal layers.

Nonverbal communication of trauma patients in a state of minimal consciousness.

INTRODUCTION: In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. OBJECTIVE: The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. MATERIAL AND METHODS: 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. RESULTS: Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6-8 points) and Stage III (GCS=9-12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. CONCLUSIONS: It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.

Peripapillary Retinal Nerve Fiber Layer Thickness in Patients with Alzheimer's Disease: A Comparison of Eyes of Patients with Alzheimer's Disease, Primary Open-Angle Glaucoma, and Preperimetric Glaucoma and Healthy Controls.

BACKGROUND The aim of this study was to assess and compare peripapillary retinal nerve fiber layer (RNFL) thickness in patients with Alzheimer's disease (AD), primary open-angle glaucoma (POAG), preperimetric glaucoma (PPG), and healthy controls with the use of Spectral Domain Optical Coherence Tomography (SD-OCT). MATERIAL AND METHODS Thirty patients with AD, 30 patients with POAG, 30 patients with PPG, and 30 healthy controls were enrolled in this cross-sectional study. Only 1 randomly selected eye of each patient was analyzed. Every subject underwent a thorough ophthalmological examination and OCT of the optic disc. The peripapillary RNFL thickness in each of the 6 sectors and globally was analyzed. RESULTS The RNFL was thinnest in patients with POAG. The mean RNFL thickness value was 60.97±12.97 µm and it was significantly lower than in healthy controls (106.30±8.95 µm), patients with PPG (93.20±12.04 µm), and AD patients (95.73±13.52 µm). Mean RNFL thickness in patients with AD was significantly lower when compared to healthy controls, and was higher compared to eyes with POAG, while there were no significant differences compared to patients with PPG. CONCLUSIONS Neuronal damage in the central nervous system (CNS) also affects to retinal axons. A major problem is to distinguish the cause for a moderate decrease in the RNFL thickness. This is particularly true for patients with glaucoma who have not been diagnosed with changes in the visual field. It is not possible to distinguish the cause of a mild decrease in the RNFL thickness based on the SD-OCT. This may result in misdiagnosis of glaucoma, unnecessary use of anti-glaucoma eye drops, and a delayed diagnosis of AD.