Efectos sobre los procesos cognitivos del entrenamiento basado en doble tarea en personas con enfermedad de Parkinson: una revisión sistemática / Effects on cognitive processes of dual-task training in people with Parkinson’s disease: a systematic review

Introducción: La doble tarea es una intervención no farmacológica en personas con condiciones neurodegenerativas, utilizada en la enfermedad de Parkinson (EP), principalmente para favorecer el desempeño motor. El objetivo de esta revisión es reunir la evidencia actual sobre cómo el entrenamiento de doble tarea afecta a los procesos cognitivos en personas que presenten EP. Material y métodos. Se desarrolló una revisión sistemática, aplicando las directrices de PRISMA, incluyendo artículos obtenidos en las bases de datos de PubMed, Web of Science, Science Direct y Springer Link. La calidad metodológica se evaluó mediante PEDro y ROBINS-I. Resultados: Doce artículos cumplieron con los criterios de inclusión y exclusión: nueve de ellos corresponden a ensayos controlados aleatorizados y los tres restantes fueron estudios no aleatorizados. Se identificaron mejoras en la atención y las funciones ejecutivas, aunque la diversidad en enfoques y duración dificulta llegar a conclusiones definitivas. Conclusiones: Es crucial expandir la investigación, estandarizando los programas de intervención. Del mismo modo, es importante llevar a cabo estudios longitudinales y controlados aleatorizados en muestras representativas que permitan llegar a conclusiones aplicables a otros contextos.(AU)

Introduction: Dual-tasking is a non-pharmacological intervention in people with neurodegenerative conditions, and is used in Parkinson’s disease (PD), primarily to enhance motor performance. The aim of this review is to compile the current evidence on how dual-task training affects cognitive processes in people with PD. Material and methods: A systematic review was undertaken, applying PRISMA guidelines, which included articles obtained from the PubMed, Web of Science, Science Direct and Springer Link databases. Methodological quality was assessed using PEDro and ROBINS-I. Results: Twelve articles met the inclusion and exclusion criteria: nine of them were randomized controlled trials, and the remaining three were non-randomized studies. Improvements in attention and executive functions were identified, although the diversity of approaches and duration means that reaching definitive conclusions is difficult. Conclusions: Increased research and standardized intervention programmes are essential. Longitudinal and randomized controlled studies in representative samples which provide conclusions that are applicable to other contexts are also important.(AU)

Comparing fine motor performance among young children with autism spectrum disorder, intellectual disability, attention-deficit/hyperactivity disorder, and specific developmental disorder of motor function.

Objective: The acquisition of fine motor skills is considered to be a crucial developmental milestone throughout early childhood. This study aimed to investigate the fine motor performance of young children with different disability diagnoses. Methods: We enrolled a sample of 1,897 young children under the age of 6 years who were at risk of developmental delays and were identified by a transdisciplinary team. A series of standardized developmental assessments included the Bayley Scales of Infant Development-Third Edition, Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition, Peabody Developmental Motor Scale-Second Edition, and Movement Assessment Battery for Children-Second Edition were used. Retrospective chart reviews were conducted on all children to identify specific developmental disorders. The number of autism spectrum disorder (ASD), intellectual disability (ID), attention-deficit/hyperactivity disorder (ADHD), comorbidity, motor dysfunction, and unspecified developmental delays (DD) were 363 (19.1%), 223 (11.8%), 234 (12.3%), 285 (15.0%), 128 (6.7%), and 590 (31.1%), respectively. Results: Young children with ID, comorbidity, and motor dysfunction demonstrated significant difficulty in performing manual dexterity and visual motor integration tasks and scored significantly lower in these areas than children with ASD, ADHD, and unspecified DD. In addition, fine motor performance was associated with cognitive ability in children with different disability diagnoses, indicating that young children showed better fine motor performance when they demonstrated better cognitive ability. Conclusion: Our findings support that differences in fine motor performance differ by disability type. Close links between fine motor performance and cognitive ability in children under the age of 6 years were seen in all disability types.

Attention-sensitive signalling by 7- to 20-month-old infants in a comparative perspective.

Attention-sensitive signalling is the pragmatic skill of signallers who adjust the modality of their communicative signals to their recipient's attention state. This study provides the first comprehensive evidence for its onset and development in 7-to 20-month-olds human infants, and underlines its significance for language acquisition and evolutionary history. Mother-infant dyads (N = 30) were studied in naturalistic settings, sampled according to three developmental periods (in months); [7-10], [11-14], and [15-20]. Infant's signals were classified by dominant perceptible sensory modality and proportions compared according to their mother's visual attention, infant-directed speech and tactile contact. Maternal visual attention and infant-directed speech were influential on the onset and steepness of infants' communicative adjustments. The ability to inhibit silent-visual signals towards visually inattentive mothers (unimodal adjustment) predated the ability to deploy audible-or-contact signals in this case (cross-modal adjustment). Maternal scaffolding of infant's early pragmatic skills through her infant-directed speech operates on the facilitation of infant's unimodal adjustment, the preference for oral over gestural signals, and the audio-visual combinations of signals. Additionally, breakdowns in maternal visual attention are associated with increased use of the audible-oral modality/channel. The evolutionary role of the sharing of attentional resources between parents and infants into the emergence of modern language is discussed.

Differences in attentional function between experienced mindfulness meditators and non-meditators.

Introduction: Attentional enhancement has often been identified as the central cognitive mechanism underlying the benefits of mindfulness meditation. However, the extent to which this enhancement is observable in the neural processes underlying long-term meditation is unclear. This current study aimed to examine differences in attentional performance between meditators and controls (non-meditators) using a visual oddball task with concurrent electroencephalography (EEG) recordings. Methods: Thirty-four participants were recruited, including 16 meditators and 18 healthy controls, who were non-meditators. The participants completed a visual oddball task, using visual stimuli, and EEG recording. Results: Self-reports revealed that meditators had higher mindful attention scores than did the control group. The behavioral results showed that the meditators demonstrated faster reaction times than the non-meditators did. Neural findings indicated a higher P2 amplitude in the meditators than in the controls. The meditators demonstrated a significantly higher P3 in the target trials than in the distractor trials, which was not observed in the controls. Additionally, the time-frequency analysis demonstrated that the delta and theta powers in the meditators were significantly higher than those in the controls. Conclusions: The study suggests the meditators exhibited greater attentional performance than the controls did, as revealed by EEG and behavioral measures. This study extends previous research on the effects of mindfulness meditation on attention and adds to our understanding of the effects of long-term mindfulness meditation.

Spatial attention in mental arithmetic: A literature review and meta-analysis.

We review the evidence for the conceptual association between arithmetic and space and quantify the effect size in meta-analyses. We focus on three effects: (a) the operational momentum effect (OME), which has been defined as participants' tendency to overestimate results of addition problems and underestimate results of subtraction problems; (b) the arithmetic cueing effect, in which arithmetic problems serve as spatial cues in target detection or temporal order judgment tasks; and (c) the associations between arithmetic and space observed with eye- and hand-tracking studies. The OME was consistently found in paradigms that provided the participants with numerical response alternatives. The OME shows a large effect size, driven by an underestimation during subtraction while addition was unbiased. In contrast, paradigms in which participants indicated their estimate by transcoding their final estimate to a spatial reference frame revealed no consistent OME. Arithmetic cueing studies show a reliable small to medium effect size, driven by a rightward bias for addition. Finally, eye- and hand-tracking studies point to replicable associations between arithmetic and eye or hand movements. To account for the complexity of the observed pattern, we introduce the Adaptive Pathways in Mental Arithmetic (APiMA) framework. The model accommodates central notions of numerical and arithmetic processing and helps identifying which pathway a given paradigm operates on. It proposes that the divergence between OME and arithmetic cueing studies comes from the predominant use of non-symbolic versus symbolic stimuli, respectively. Overall, our review and findings clearly support an association between arithmetic and spatial processing.

Always expect the unexpected: Eye position modulates visual cortex excitability in a stimulus-free environment.

BACKGROUND: Stimuli that potentially require a rapid defensive or avoidance action can appear from the periphery at any time in natural environments. De Wit, Faseyitan, and Coslett (2020) recently reported novel evidence suggestive of a fundamental neural mechanism that allows organisms to effectively deal with such situations. In the absence of any task, motor cortex excitability was found to be greater whenever gaze was directed away from either hand. OBJECTIVE/HYPOTHESIS: If modulation of cortical excitability as a function of gaze location is a fundamental principle of brain organization, then one would expect its operation to be present also outside of motor cortex, such as brain regions involved in perception. METHODS: To test this hypothesis, we applied single-pulse transcranial magnetic stimulation (TMS) to the right lateral occipital lobe while participants directed their eyes to the left, straight ahead, or to the right, and reported the presence or absence of a phosphene. No external stimuli were presented. RESULTS: Cortical excitability as reflected by phosphene threshold was greater with eyes deviated to the right as compared to the left. CONCLUSION: In conjunction with our previous findings of upregulation of motor cortex excitability when gaze and effector are not aligned, this eye position-driven increase in visual cortex excitability presumably serves to facilitate the detection of stimuli and subsequent readiness to act in non-foveated regions of space. The existence of this brain-wide mechanism has clear adaptive value given the unpredictable nature of natural environments in which human beings are situated and have evolved.

Social skill and social withdrawal outcomes in children following pediatric stroke.

Pediatric stroke can result in long-term impairments across attention, functional communication and motor domains. The current paper utilized parent reports of the Behavioral Assessment System for Children 2nd Edition and the Pediatric Stroke Outcome Measure to examine children's social skills and withdrawal behavior within a pediatric stroke population. Using the Canadian Pediatric Stroke Registry at The Hospital for Sick Children, data were analyzed for 312 children with ischemic stroke. Children with ischemic stroke demonstrated elevated parent-reported social skills problems (observed = 20.51%, expected = 14.00%) and clinically elevated social withdrawal (observed = 11.21%, expected = 2.00%). Attentional problems significantly contributed to reduced social skills, F (3,164) = 30.68, p < 0.01, while attentional problems and neurological impairments accounted for increased withdrawal behavior, F (2, 164) = 7.47, p < 0.01. The presence of a motor impairment was associated with higher social withdrawal compared to individuals with no motor impairment diagnosis, t(307.73) = 2.25, p < .025, d = 0.25, 95% CI [0.42, 6.21]. The current study demonstrates that children with stroke who experience motor impairments, attentional problems, reduced functional communication skills, and neurological impairments can experience deficits in their social skills and withdrawal behavior.

Light conditions and the evolution of the visual system in birds.

Despite vision is an essential sense for many animals, the intuitively appealing notion that the visual system has been shaped by environmental light conditions is backed by insufficient evidence. Based on a comprehensive phylogenetic comparative analysis of birds, we investigate if exposure to different light conditions might have triggered evolutionary divergence in the visual system through pressures on light sensitivity, visual acuity, and neural processing capacity. Our analyses suggest that birds that have adopted nocturnal habits evolved eyes with larger corneal diameters and, to a lesser extent, longer axial length than diurnal species. However, we found no evidence that sensing and processing organs were selected together, as observed in diurnal birds. Rather than enlarging the processing centers, we found a tendency among nocturnal species to either reduce or maintain the size of the two main brain centers involved in vision -the optic tectum and the wulst. These results suggest a mosaic pattern of evolution, wherein optimization of the eye optics for efficient light capture in nocturnal species may have compromised visual acuity and central processing capacity.

Clinical trial recommendations using Semantics-Based inductive inference and knowledge graph embeddings.

OBJECTIVE: Designing a new clinical trial entails many decisions, such as defining a cohort and setting the study objectives to name a few, and therefore can benefit from recommendations based on exhaustive mining of past clinical trial records. This study proposes an approach based on knowledge graph embeddings and semantics-driven inductive inference for generating such recommendations. METHOD: The proposed recommendation methodology is based on neural embeddings trained on first-of-its-kind knowledge graph constructed from clinical trials data. The methodology includes design of a knowledge graph for clinical trial data, evaluation of various knowledge graph embedding techniques for it, application of a novel inductive inference method using these embeddings, and generation of recommendations for clinical trial design. The study uses freely available data from clinicaltrials.gov and related sources. RESULTS: The proposed approach for recommendations obtained relevance scores ranging from 70% to 83%. These scores were determined by evaluating the text similarity of recommended elements to actual elements used in clinical trials that are in progress. Furthermore, the most pertinent recommendations were consistently located towards the top of the list, indicating the effectiveness of our method. CONCLUSION: Our study suggests that inductive inference using node semantics is a viable approach for generating recommendations using graphs neural embeddings, and that there is a potential for improvement in training graph embeddings using node semantics.

Visuospatial cueing differences as a function of autistic traits.

Atypical orienting of visuospatial attention in autistic individuals or individuals with a high level of autistic-like traits (ALTs) has been well documented and viewed as a core feature underlying the development of autism. However, there has been limited testing of three alternative theoretical positions advanced to explain atypical orienting - difficulty in disengagement, cue indifference, and delay in orienting. Moreover, research commonly has not separated facilitation (reaction time difference between neutral and valid cues) and cost effects (reaction time difference between invalid and neutral cues) in orienting tasks. We addressed these limitations in two experiments that compared groups selected for Low- and High-ALT levels on exogenous and endogenous versions of the Posner cueing paradigm. Experiment 1 showed that High-ALT participants exhibited a significantly reduced cost effect compared to Low-ALT participants in the endogenous cueing task, although the overall orienting effect remained small. In Experiment 2, we increased task difficulty of the endogenous task to augment cueing effects. Results were comparable to Experiment 1 regarding the finding of a reduced cost effect for High-ALT participants on the endogenous cueing task and additionally demonstrated a reduced facilitation effect in High-ALT participants on the same task. No ALT group differences were observed on an exogenous cueing task included in Experiment 2. These findings suggest atypical orienting in High-ALT individuals may be attributable to general cue indifference, which implicates differences in top-down attentional processes between Low- and High-ALT individuals. We discuss how indifference to endogenous cues may contribute to social cognitive differences in autism.

A comparative study on dietary diversity and gut microbial diversity in children with autism spectrum disorder, attention-deficit hyperactivity disorder, their neurotypical siblings, and non-related neurotypical volunteers: a cross-sectional study.

BACKGROUND: Previous research has shown a significant link between gut microbiota in children with autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). However, much remains unknown because of the heterogeneity of disorders and the potential confounders such as dietary patterns and control group variations. METHODS: Children aged 6-12 years who had been clinically diagnosed with ASD and/or ADHD, their unaffected neurotypical siblings, and non-related neurotypical volunteers were recruited cross-sectionally. The ASD diagnosis was confirmed using the Autism Diagnostic Observation Schedule-2 (ADOS-2) in all patients, including those with ADHD. Standardized DNA extraction and sequencing methods were used to compare gut microbial alpha-diversity among the groups. Dietary diversity was calculated from a standardized dietary questionnaire form. We compared the difference in gut microbiome between patients with ASD and/or ADHD with neurotypical siblings and non-related neurotypical controls. RESULTS: Ninety-eight subjects were included in the study (18 with ASD, 19 with ADHD, 20 with both ASD and ADHD, 13 neurotypical siblings, and 28 non-related neurotypical controls). The alpha-diversity indices, such as Chao 1 and Shannon index, showed a significant difference between the groups in a Linear mixed-effect model (F(4, 93) = 4.539, p = .02), (F(4, 93) = 3.185, p = .017), respectively. In a post-hoc pairwise comparison, patients with ASD had lower alpha-diversity compared with non-related controls after Bonferroni correction. Dietary diversity shown in Shannon index did not differ among the groups (F(4, 84) = 1.494, p = .211). CONCLUSIONS: Our study indicates disorder-specific microbiome differences in patients with ASD. In future research on gut microbiota in neurodevelopmental disorders, it is necessary to consider the impact of ASD and ADHD co-occurrence, and strictly control for background information such as diet, to elucidate the gut-microbiota interaction in ASD and ADHD for exploring the potential of therapeutic interventions.

Associations between attention-deficit hyperactivity disorder genetic liability and ICD-10 medical conditions in adults: utilizing electronic health records in a Phenome-Wide Association Study.

BACKGROUND: Attention-deficit hyperactivity disorder (ADHD) is often comorbid with other medical conditions in adult patients. However, ADHD is extremely underdiagnosed in adults and little is known about the medical comorbidities in undiagnosed adult individuals with high ADHD liability. In this study we investigated associations between ADHD genetic liability and electronic health record (EHR)-based ICD-10 diagnoses across all diagnostic categories, in individuals without ADHD diagnosis history. METHODS: We used data from the Estonian Biobank cohort (N = 111 261) and generated polygenic risk scores (PRS) for ADHD (PRSADHD) based on the ADHD genome-wide association study. We performed a phenome-wide association study (PheWAS) to test for associations between standardized PRSADHD and 1515 EHR-based ICD-10 diagnoses in the full and sex-stratified sample. We compared the observed significant ICD-10 associations to associations with (1) ADHD diagnosis and (2) questionnaire-based high ADHD risk analyses. RESULTS: After Bonferroni correction (p = 3.3 × 10-5) we identified 80 medical conditions associated with PRSADHD. The strongest evidence was seen with chronic obstructive pulmonary disease (OR 1.15, CI 1.11-1.18), obesity (OR 1.13, CI 1.11-1.15), and type 2 diabetes (OR 1.11, CI 1.09-1.14). Sex-stratified analysis generally showed similar associations in males and females. Out of all identified associations, 40% and 78% were also observed using ADHD diagnosis or questionnaire-based ADHD, respectively, as the predictor. CONCLUSIONS: Overall our findings indicate that ADHD genetic liability is associated with an increased risk of a substantial number of medical conditions in undiagnosed individuals. These results highlight the need for timely detection and improved management of ADHD symptoms in adults.

Attention and executive function impairments in obstructive sleep apnea are associated with decreased sleep spindles.

INTRODUCTION: Sleep spindles play a key role in sleep-mediated cognitive processes. Cognitive functions are well-known to be affected in obstructive sleep apnea (OSA). Here, we analyzed attention and executive functions in patients with OSA and investigated the relationship between sleep spindles and cognitive abilities. METHODS: Sixty patients with OSA (18-65 years, 19 females and 41 males) and a control group (n = 41) including age-and sex-matched healthy individuals were consecutively and prospectively enrolled. All participants had a full-night polysomnography, and sleep spindles were analyzed using a semi-automated program. For the evaluation of short-term memory, attention and executive functions, Stroop test, forward and backward digit span tests were applied to all participants upon awakening following polysomnography. RESULTS: Scores of forward and backward digit span and Stroop tests were worse in OSA patients in compared to those in controls. Mean density of sleep spindles was decreased in OSA patients than those in controls (p = 0.044). A positive correlation was found between fast sleep spindle frequency and forward digit span (r = 2.222; p = 0.038) and backward digit span test scores (r = 2,157; p = 0.042) in OSA patients. In patients with moderate to severe OSA, sleep spindle density was positively correlated with forward (r = 2.323, p = 0.029) and backward (r = 2.500, p = 0.016) DSTs, and the duration of sleep spindles had positive correlation with backward DST (r = 2.452, p = 0.010). CONCLUSION: Our findings demonstrated that the disturbances in sleep spindle characteristics in OSA are associated with the cognitive impairments in attention, short-term memory, and executive functions, especially in patients with moderate to severe OSA.

NVAM-Net: deep learning networks for reconstructing high-quality fiber orientation distributions.

PURPOSE: Diffusion magnetic resonance imaging (dMRI) is a widely used non-invasive method for investigating brain anatomical structures. Conventional techniques for estimating fiber orientation distribution (FOD) from dMRI data often neglect voxel-level spatial relationships, leading to ambiguous associations between target voxels and their neighbors, which, in turn, adversely impacts FOD accuracy. This study aims to address this issue by introducing a novel neural network, the neighboring voxel attention mechanism network (NVAM-Net), designed to reconstruct high-quality FOD images. METHODS: The NVAM-Net leverages a Transformer architecture and incorporates two innovative attention mechanisms: voxel attention and surface attention. These mechanisms are specifically designed to capture overlooked features among neighboring voxels. The processed features are subsequently passed through two fully connected layers, further enhancing FOD estimation accuracy by separately estimating spherical harmonics (SH) coefficients of varying orders. RESULTS: The experimental findings, based on the Human Connectome Project (HCP) dataset, reveal that the reconstructed super-resolution FOD images achieve results comparable to those obtained through more advanced dMRI acquisition protocols. These results underscore the NVAM-Net's robust performance in reconstructing multi-shell multi-tissue constrained spherical deconvolution (MSMT-CSD). CONCLUSION: In summary, this research underscores the NVAM-Net's advantages and practical feasibility in reconstructing high-quality FOD images. It provides a reliable reference point for clinical applications in the field of diffusion magnetic resonance imaging.

Total sleep deprivation effects on the attentional blink.

The Attentional Blink (AB) is a phenomenon that reflects difficulty in detecting or identifying the second of two successive targets (T1 and T2) that are presented in rapid succession, between 200-500ms apart. The AB involves indicators of attentional and temporal integration mechanisms related to the early stages of visual processing. The aim of this study was to identify the effects of 24-h of sleep deprivation (total sleep deprivation, TSD) on the attentional and temporal integration mechanisms of the AB. Twenty-two undergraduate students were recorded during five successive days, in these three conditions: baseline (two days), TSD (one day), and recovery (two days). Each day, at around 12:00 h, participants responded to a Rapid Serial Visual Presentation task (RSVP) that presented two targets separated by random intervals from 100 to 1000ms. The attentional mechanisms were assessed by the AB presence, the AB magnitude, and the AB interval, while the temporal integration mechanisms were evaluated by lag-1 sparing and order reversal responses. TSD negatively affected the attentional mechanisms, which is expressed by an overall reduction in performance, an extended AB interval, and a reduced AB magnitude. TSD also negatively affected the temporal integration mechanisms, manifested by an absence of lag-1 sparing and an increase in order reversals. These results suggest that people are still able to respond to two successive stimuli after 24 h without sleep. However, it becomes more difficult to respond to both stimuli because the attentional and temporal integration mechanisms of the AB are impaired.

Cortico-striatal action control inherent of opponent cognitive-motivational styles.

Turning on cue or stopping at a red light requires the detection of such cues to select action sequences, or suppress action, in accordance with cue-associated action rules. Cortico-striatal projections are an essential part of the brain's attention-motor interface. Here, we used glutamate-sensing microelectrode arrays to measure glutamate transients in the dorsomedial striatum (DMS) of male and female rats walking a treadmill and executing cued turns and stops. Prelimbic-DMS projections were chemogenetically inhibited to determine their behavioral necessity and the cortico-striatal origin of cue-evoked glutamate transients. Furthermore, we investigated rats exhibiting preferably goal-directed (goal trackers, GTs) versus cue-driven attention (sign trackers, STs), to determine the impact of such cognitive-motivational biases on cortico-striatal control. GTs executed more cued turns, and initiated such turns more slowly, than STs. During turns, but not missed turns or cued stops, cue-evoked glutamate concentrations were higher in GTs than in STs. In conjunction with turn cue-evoked glutamate spike levels, the presence of a single spike rendered GTs to be almost twice as likely to turn than STs. In contrast, multiple glutamate spikes predicted STs to be robustly more likely to turn than GTs. In GTs, inhibition of prelimbic-DMS projections attenuated turn rates and turn cue-evoked glutamate peaks and increased the number of spikes. These findings suggest that turn cue-evoked glutamate release dynamics in GTs are tightly controlled by cortico-striatal neuronal activity. In contrast, in STs, glutamate release from DMS glutamatergic terminals is regulated by other striatal circuitry, preferably mediating cued suppression of action and reward tracking.

Psychometric properties of the Chinese version of the Quick Delay Questionnaire (C-QDQ) and ecological characteristics of reward-delay impulsivity of adults with ADHD.

BACKGROUND: The Quick Delay Questionnaire (QDQ) is a short questionnaire designed to assess delay-related difficulties in adults. This study aimed to examine the reliability and validity of the Chinese version of the QDQ (C-QDQ) in Chinese adults, and explore the ecological characteristics of delay-related impulsivity in Chinese adults with attention-deficit/hyperactivity disorder (ADHD). METHODS: Data was collected from 302 adults, including ADHD (n = 209) and healthy controls (HCs) (n = 93). All participants completed the C-QDQ. The convergent validity, internal consistency, retest reliability and confirmatory factor analysis (CFA) of the C-QDQ were analyzed. The correlations between C-QDQ and two laboratory measures of delay-related difficulties and Barratt Impulsiveness Scale-11 (BIS-11), the comparison of C-QDQ scores between ADHD subgroups and HCs were also analyzed. RESULTS: The Cronbach's α of C-QDQ was between 0.83 and 0.89. The intraclass correlation coefficient of C-QDQ was between 0.80 and 0.83. The results of CFA of C-QDQ favoured the original two-factor model (delay aversion and delay discounting). Significant positive associations were found between C-QDQ scores and BIS-11 total score and performance on the laboratory measure of delay-related difficulties. Participants with ADHD had higher C-QDQ scores than HCs, and female ADHD reported higher scores on delay discounting subscale than male. ADHD-combined type (ADHD-C) reported higher scores on delay aversion subscale than ADHD-inattention type (ADHD-I). CONCLUSION: The C-QDQ is a valid and reliable tool to measure delay-related responses that appears to have clinical utility. It can present the delay-related impulsivity of patients with ADHD. Compared to HCs, the level of reward-delay impulsivity was higher in ADHD.

Associations between breakfast skipping and outcomes in neuropsychiatric disorders, cognitive performance, and frailty: a Mendelian randomization study.

BACKGROUND: Prior studies have identified a correlation between breakfast skipping and a heightened risk of mental health issues. This investigation aimed to employ a Two-Sample Mendelian Randomization (MR) approach to explore the potential causal links between breakfast skipping and various psychiatric, neurological disorders, cognitive performance, and frailty. METHODS: Utilizing data from genome-wide association studies within European demographics, this research scrutinized the association between breakfast habits and several neuropsychiatric conditions and physical health outcomes, including Alzheimer's disease (AD), Attention Deficit Hyperactivity Disorder (ADHD), Bipolar Disorder (BD), Major Depressive Disorder (MDD), Narcolepsy, Insomnia, cognitive performance, and frailty. In this MR analysis, the Inverse Variance Weighted (IVW) method was primarily utilized for evaluation. Outcomes were reported as Odds Ratios (OR) and regression coefficients (ß), and underwent validation through False Discovery Rate (FDR) corrections, thereby offering a rigorous evaluation of the effects of breakfast habits on both mental and physical health dimensions. RESULTS: Findings demonstrate a significant causal link between skipping breakfast and an increased risk of ADHD (OR = 2.74, 95%CI: 1.54-4.88, PFDR = 0.003) and MDD (OR = 1.7, 95%CI: 1.22-2.37, PFDR = 0.005). Conversely, no substantial causal associations were identified between breakfast skipping and AD, BD, narcolepsy, or insomnia (PFDR > 0.05). Moreover, a notable causal relationship was established between skipping breakfast and a reduction in cognitive performance (ß = -0.16, 95%CI: -0.29-0.04, PFDR = 0.024) and an increase in frailty (ß = 0.29, 95%CI: 0.12-0.45, PFDR = 0.003). CONCLUSION: The MR analysis reveals that skipping breakfast is associated with an increased risk of ADHD, MDD, decreased cognitive performance, and greater frailty, while showing no associations were found with AD, BD, narcolepsy, or insomnia. These findings warrant further investigation into the underlying mechanisms and emphasize the importance of regular breakfast consumption for mental and physical well-being.

Martial Arts as a Tool for Enhancing Attention and Executive Function: Implications for Cognitive Behavioral Therapy - A Literature Review.

With a focus on its implications for cognitive behavioral therapy (CBT), this review study seeks to investigate the possible advantages of martial arts training on attention and executive function. Common cognitive impairments seen in a variety of psychiatric diseases, such as depression and attention deficit hyperactivity disorder, include difficulties in attention and executive function. Training in martial arts, which is known for its demanding physical and mental requirements, has drawn interest as a potential intervention for improving cognitive function. An overview of the most recent research on how martial arts training affects focus and executive function is given in this publication. The results demonstrate the potential of martial arts as a strategy for enhancing executive function and attention-related cognitive functions. The article also explores the implications of adding martial arts instruction to CBT therapies, arguing that doing so might be a beneficial supplementary strategy to improve treatment outcomes. With information on the possible advantages of martial arts training for attention and executive function, this review paper adds to the expanding corpus of research on non-pharmacological therapies for cognitive enhancement.

Usformer: A small network for left atrium segmentation of 3D LGE MRI.

Left atrial (LA) fibrosis plays a vital role as a mediator in the progression of atrial fibrillation. 3D late gadolinium-enhancement (LGE) MRI has been proven effective in identifying LA fibrosis. Image analysis of 3D LA LGE involves manual segmentation of the LA wall, which is both lengthy and challenging. Automated segmentation poses challenges owing to the diverse intensities in data from various vendors, the limited contrast between LA and surrounding tissues, and the intricate anatomical structures of the LA. Current approaches relying on 3D networks are computationally intensive since 3D LGE MRIs and the networks are large. Regarding this issue, most researchers came up with two-stage methods: initially identifying the LA center using a scaled-down version of the MRIs and subsequently cropping the full-resolution MRIs around the LA center for final segmentation. We propose a lightweight transformer-based 3D architecture, Usformer, designed to precisely segment LA volume in a single stage, eliminating error propagation associated with suboptimal two-stage training. The transposed attention facilitates capturing the global context in large 3D volumes without significant computation requirements. Usformer outperforms the state-of-the-art supervised learning methods in terms of accuracy and speed. First, with the smallest Hausdorff Distance (HD) and Average Symmetric Surface Distance (ASSD), it achieved a dice score of 93.1% and 92.0% in the 2018 Atrial Segmentation Challenge and our local institutional dataset, respectively. Second, the number of parameters and computation complexity are largely reduced by 2.8x and 3.8x, respectively. Moreover, Usformer does not require a large dataset. When only 16 labeled MRI scans are used for training, Usformer achieves a 92.1% dice score in the challenge dataset. The proposed Usformer delineates the boundaries of the LA wall relatively accurately, which may assist in the clinical translation of LA LGE for planning catheter ablation of atrial fibrillation.