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1.
Zhonghua Yi Xue Za Zhi ; 102(2): 125-129, 2022 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-35012301

RESUMO

Objective: To investigate the feasibility of assessing cognitive function of the elderly by serum metabolites of brain-gut axis. Methods: Convenience sampling was used to select 100 and 60 participants from the healthy population cohort and microecological balance cohort of the longevity population in Guangxi, to constitute subset of healthy population and longevity population, respectively. A questionnaire was used to investigate the demographic characteristics of the subjects, 2-5 ml of fasting venous blood was collected from the subjects, and the serum untargeted metabolomics was determined by liquid chromatography tandem mass spectrometry. The biomarkers related to the brain-gut axis were collected through literature retrieval, and the results were intersected with the untargeted metabolites and annotated. Spearman correlation analysis was used to screen serum metabolites of brain-gut axis associated with aging, and multiple linear regression method was used to construct biological age model. The mini mental status examination was used to evaluate the cognitive function of longevity population subsets. The differences of biological age and chronological age of longevity population subsets with different cognitive function were compared. Results: The M (Q1, Q3) of subset of healthy population and longevity population were 64 (38, 72) and 97 (95, 99) years old, respectively, and there were 50 (50.0%) and 44 (73.3%) females, respectively. Nine serum metabolites of brain-gut axis were obtained by initial screening, which were propionic acid, glutamic acid, γ-aminobutyric acid (GABA), lactic acid, 5-hydroxytryptamine (5-HT), tryptophan, trimethylamine oxide, dopamine and canine urea. Spearman correlation analysis showed that glutamic acid and dopamine were positively correlated with aging (r values were 0.208 and 0.524, respectively, all P values<0.05), and tryptophan, 5-HT and GABA were negatively correlated with aging (r values were -0.308, -0.533 and -0.213, respectively, all P values<0.05). The biological age model was constructed as: y=49.81-1.18×10-5× GABA-1.82×10-4×5-HT+1.99×10-3×dopamine+1.65×10-6×glutamic acid -2.04×10-6×tryptophan+2.36×gender, where y was the biological age (years), the items on the right were the intercept item, the relative concentration of each metabolite, and gender (male=1, female=2). The coefficient of determination of model was 0.50 (P<0.001). The M (Q1, Q3) of the chronological age of the subset of longevity population with poor, moderate and good cognitive function were 97 (94, 100), 97 (93, 101) and 96 (94, 101) years old, respectively, and there was no statistical significance in pairwise comparison (all P values>0.05). The M (Q1, Q3) of the biological age of the subjects with better cognitive function was 51 (38, 54) years old, which was lower than that of the subjects with poor cognitive function [57 (47, 61)] (P=0.040). Conclusion: The biological age model can be constructed based on serum metabolites of brain-gut axis and used to evaluate the cognitive function of the elderly.


Assuntos
Metabolômica , Idoso , Idoso de 80 Anos ou mais , Animais , China , Cromatografia Líquida , Cognição , Cães , Feminino , Humanos , Masculino
2.
Am J Clin Hypn ; 64(3): 248-262, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35007479

RESUMO

The aim of the present study is to investigate the effectiveness of Cognitive Developmental Hypnotherapy (CDH) on Differentiation of Self, Meaning in Life and Marital Conflicts in married women. The method is quasi-experimental pretest and posttest with a control group. The statistical population of this study includes married women who came to FUM Counseling and Psychological Services Center to receive psychological services. The sample of this study included 40 married women who were selected by targeted sampling method and randomly assigned to two experimental and control groups. Participants in the pretest and posttest study answered the Differentiation of Self Inventory, the Marital Conflicts questionnaire by Sanaei, and the Meaning in Life questionnaire. The research data were analyzed using ANCOVA and MANCOVA with SPSS-21. The findings showed CDH led to an increase in Differentiation of Self and Meaning in life, and a reduction in Marital Conflicts in women. Accordingly, CDH through using techniques such as induction and empowerment of the Ego is effective in marital conflicts of married women. Therefore, using it as a means to improve the quality of married women's lives is recommended.


Assuntos
Conflito Familiar , Hipnose , Cognição , Feminino , Humanos , Casamento , Inquéritos e Questionários
3.
BMC Anesthesiol ; 22(1): 10, 2022 01 04.
Artigo em Inglês | MEDLINE | ID: mdl-34983402

RESUMO

BACKGROUND: ICU operational conditions may contribute to cognitive overload and negatively impact on clinical decision making. We aimed to develop a quantitative model to investigate the association between the operational conditions and the quantity of medication orders as a measurable indicator of the multidisciplinary care team's cognitive capacity. METHODS: The temporal data of patients at one medical ICU (MICU) of Mayo Clinic in Rochester, MN between February 2016 to March 2018 was used. This dataset includes a total of 4822 unique patients admitted to the MICU and a total of 6240 MICU admissions. Guided by the Systems Engineering Initiative for Patient Safety model, quantifiable measures attainable from electronic medical records were identified and a conceptual framework of distributed cognition in ICU was developed. Univariate piecewise Poisson regression models were built to investigate the relationship between system-level workload indicators, including patient census and patient characteristics (severity of illness, new admission, and mortality risk) and the quantity of medication orders, as the output of the care team's decision making. RESULTS: Comparing the coefficients of different line segments obtained from the regression models using a generalized F-test, we identified that, when the ICU was more than 50% occupied (patient census > 18), the number of medication orders per patient per hour was significantly reduced (average = 0.74; standard deviation (SD) = 0.56 vs. average = 0.65; SD = 0.48; p < 0.001). The reduction was more pronounced (average = 0.81; SD = 0.59 vs. average = 0.63; SD = 0.47; p < 0.001), and the breakpoint shifted to a lower patient census (16 patients) when at a higher presence of severely-ill patients requiring invasive mechanical ventilation during their stay, which might be encountered in an ICU treating patients with COVID-19. CONCLUSIONS: Our model suggests that ICU operational factors, such as admission rates and patient severity of illness may impact the critical care team's cognitive function and result in changes in the production of medication orders. The results of this analysis heighten the importance of increasing situational awareness of the care team to detect and react to changing circumstances in the ICU that may contribute to cognitive overload.


Assuntos
Cognição , Unidades de Terapia Intensiva , Equipe de Assistência ao Paciente , Idoso , COVID-19/terapia , Tomada de Decisões Gerenciais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , SARS-CoV-2 , Carga de Trabalho
4.
BMC Neurol ; 22(1): 13, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996385

RESUMO

BACKGROUND: Parkinson's disease (PD) is associated with enteric nervous system dysfunction and gut microbiota dysbiosis. Short-chain fatty acids (SCFAs), derived from gut microbiota, are supposed to anticipate PD pathogenesis via the pathway of spinal cord and vagal nerve or the circulatory system. However, the serum concentration of SCFAs in PD patients is poorly known. This study aims to investigate the exact level of SCFAs in PD patients and its correlation with Parkinson's symptoms. METHODS: 50 PD patients and 50 healthy controls were recruited, and their demographic and clinical characteristics were collected. The serum concentration of SCFAs was detected using a gas chromatography-mass spectrometer. SCFAs were compared between PD and control groups. The correlation between serum SCFAs and Parkinson's symptoms and the potential effects of medications on the serum SCFAs was analyzed. RESULTS: Serum propionic acid, butyric acid and caproic acid were lower, while heptanoic acid was higher in PD patients than in control subjects. However, only the serum level of propionic acid was correlated with Unified Parkinson's Disease Rating Scale (UPDRs) part III score (R = -0.365, P = 0.009), Mini-mental State Examination (MMSE) score (R = -0.416, P = 0.003), and Hamilton Depression Scale (HAMD) score (R = 0.306, P = 0.03). There was no correlation between other serum SCFAs and motor complications. The use of trihexyphenidyl or tizanidine increased the serum concentration of propionic acid. CONCLUSIONS: Serum SCFAs are altered in PD patients, and the decrease of serum propionic acid level is correlated with motor symptoms, cognitive ability and non-depressed state. Thus, the gut microbial-derived SCFAs potentially affect Parkinson's symptoms through the blood circulation. Propionic acid supplementation might ameliorate motor and non-motor symptoms of PD patients, although clinical trials are needed to test this hypothesis.


Assuntos
Microbioma Gastrointestinal , Doença de Parkinson , Cognição , Ácidos Graxos Voláteis , Humanos , Doença de Parkinson/tratamento farmacológico
5.
BMC Med Educ ; 22(1): 20, 2022 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34996425

RESUMO

BACKGROUND: In order to improve work participation of workers with a chronic disease, it is important for occupational health professionals (OHPs) to focus on those factors that can influence work participation. Cognitions and perceptions, such as recovery expectations and self-efficacy, are examples of these factors that can influence work participation. However, no training program is available for OHPs on how to involve cognitions and perceptions during their practice. Therefore, the aim of this study was to develop a training program for OHPs on how to involve cognitions and perceptions in the occupational health management and work disability assessment of workers with a chronic disease. In addition, to evaluate the OHPs' satisfaction with the training and the feasibility of the training and learned skills. METHODS: The training program was developed using information from previously conducted studies regarding cognitions and perceptions in relation to work participation. Satisfaction with the training by OHPs was evaluated by means of a questionnaire. A smaller group of OHPs were interviewed three to six months after the training to evaluate the feasibility of the training and learned skills. RESULTS: The 4.5-h training program consisted of four parts concerning: 1) cognitions and perceptions associated with work participation, 2) how to obtain information on them, 3) the course of the conversation on these factors, and 4) intervening on these factors. Eight training sessions were conducted with 57 OHPs, of whom 54 evaluated the training. Participants were very satisfied (score 8.5 on a scale from 1 to 10). The eleven interviewed participants were more aware of cognitions and perceptions during consultations and perceived the training to be feasible. However, not all participants had applied the acquired skills in their practice, partially because of a lack of time. CONCLUSIONS: OHPs are very satisfied with the training program and perceive it to be feasible. The training increases awareness of important cognitions and perceptions and may possibly help to increase work participation of workers with a chronic disease.


Assuntos
Saúde do Trabalhador , Cognição , Avaliação da Deficiência , Pessoal de Saúde , Humanos , Inquéritos e Questionários
6.
BMC Med Educ ; 22(1): 6, 2022 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-34980099

RESUMO

INTRODUCTION: This study aimed to explore the decision-making processes of raters during objective structured clinical examinations (OSCEs), in particular to explore the tacit assumptions and beliefs of raters as well as rater idiosyncrasies. METHODS: Thinking aloud protocol interviews were used to gather data on the thoughts of examiners during their decision-making, while watching trigger OSCE videos and rating candidates. A purposeful recruiting strategy was taken, with a view to interviewing both examiners with many years of experience (greater than six years) and those with less experience examining at final medical examination level. RESULTS: Thirty-one interviews were conducted in three centres in three different countries. Three themes were identified during data analysis, entitled 'OSCEs are inauthentic', 'looking for glimpses of truth' and 'evolution with experience'. CONCLUSION: Raters perceive that the shortcomings of OSCEs can have unwanted effects on student behaviour. Some examiners, more likely the more experienced group, may deviate from an organisations directions due to perceived shortcomings of the assessment. No method of assessment is without flaw, and it is important to be aware of the limitations and shortcomings of assessment methods on student performance and examiner perception. Further study of assessor and student perception of OSCE performance would be helpful.


Assuntos
Competência Clínica , Avaliação Educacional , Cognição , Humanos , Exame Físico , Gravação de Videoteipe
7.
Handb Clin Neurol ; 184: 473-479, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35034755

RESUMO

Alzheimer's disease (AD) is considered the most harmful form of dementia in the elderly population. At present, there are no effective treatments and this is likely due to the incomplete understanding of the pathophysiology. Recent data indicate that synaptic dysfunction could be a central element of AD pathophysiology. It was found that a synaptic breakdown is an early event that heralds neuronal degeneration. Transcranial magnetic stimulation (TMS) has been recently introduced as a novel approach to identify the early signatures of synaptic dysfunction characterizing AD pathophysiology. In this chapter, we review the new neurophysiologic signatures of AD that have been emphasized by TMS studies. We show how TMS measurement of neuroplasticity identified long-term potentiation (LTP)-like cortical plasticity as a key element of AD synaptic dysfunction. These measurements are useful to increase the accuracy of differential diagnosis, predict disease progression, and anticipate response to therapy. Moreover, enhancing neuroplasticity holds as a promising therapeutic approach to improve cognition in AD. In recent years, studies showed treatments with multiple sessions of rTMS can influence cognition in people with neurodegenerative diseases. In the second part of this chapter, we also consider novel therapeutic approaches based on the clinical use of rTMS.


Assuntos
Doença de Alzheimer , Idoso , Doença de Alzheimer/terapia , Cognição , Humanos , Potenciação de Longa Duração , Plasticidade Neuronal , Estimulação Magnética Transcraniana
8.
Med Sci Monit Basic Res ; 28: e934180, 2022 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-35034949

RESUMO

BACKGROUND Transcranial direct current stimulation (tDCS) is a non-invasive brain modulatory technique that can boost cognitive processes and alter performance in cognitive tasks. The effect of anodal-tDCS on cognitive functions following a single session has been repeatedly reported. However, results are varied, mixed, and confounded by several factors, including differences in tDCS current intensity and sham conditions used. Therefore, we assessed the effect of a single session of anodal-tDCS over the primary motor cortex (M1) on cognitive functions, particularly response inhibitory control and visual recognition memory, in healthy adults. MATERIAL AND METHODS Thirty healthy male subjects participated in a randomized, double-blind, sham-controlled tDCS study (2 mA, for 20 min). In the sham stimulation, subjects received the same intensity (2 mA, for 30 s, ramped up, then ramped down). We assessed the cognitive functions response inhibitory control and visual recognition memory using the stop signal task (SST) and pattern recognition memory (PRM) task before and after the stimulation. RESULTS There was a statistically significant difference in cognitive function as assessed by the stop signal task go trial (SST) (P=0.019) and SST correct response time on go trials (P=0.04) after real stimulation only. There was no significant effect observed in sham condition. CONCLUSIONS The findings suggest that anodal-tDCS applied over M1 improves inhibitory control and visual recognition memory compared to sham stimulation. Thus, application of anodal-tDCS to the M1, as an integral node in inhibitory motor control, might be a promising adjuvant therapeutic intervention for modulation of motor response inhibition.


Assuntos
Córtex Motor , Estimulação Transcraniana por Corrente Contínua , Adulto , Cognição , Humanos , Masculino , Memória , Tempo de Reação
9.
Nat Commun ; 13(1): 4, 2022 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-35013147

RESUMO

The emergence of distributed patterns of neural activity supporting brain functions and behavior can be understood by study of the brain's low-dimensional topology. Functional neuroimaging demonstrates that brain activity linked to adaptive behavior is constrained to low-dimensional manifolds. In human participants, we tested whether these low-dimensional constraints preserve working memory performance following local neuronal perturbations. We combined multi-session functional magnetic resonance imaging, non-invasive transcranial magnetic stimulation (TMS), and methods translated from the fields of complex systems and computational biology to assess the functional link between changes in local neural activity and the reshaping of task-related low dimensional trajectories of brain activity. We show that specific reconfigurations of low-dimensional trajectories of brain activity sustain effective working memory performance following TMS manipulation of local activity on, but not off, the space traversed by these trajectories. We highlight an association between the multi-scale changes in brain activity underpinning cognitive function.


Assuntos
Mapeamento Encefálico , Encéfalo/fisiologia , Cognição/fisiologia , Adolescente , Adulto , Mapeamento Encefálico/métodos , Feminino , Neuroimagem Funcional/métodos , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Memória de Curto Prazo/fisiologia , Estimulação Magnética Transcraniana/métodos
10.
Korean J Radiol ; 23(1): 89-100, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34983097

RESUMO

OBJECTIVE: To improve the N biomarker in the amyloid/tau/neurodegeneration system by radiomics and study its value for predicting cognitive progression in individuals with mild cognitive impairment (MCI). MATERIALS AND METHODS: A group of 147 healthy controls (HCs) (72 male; mean age ± standard deviation, 73.7 ± 6.3 years), 197 patients with MCI (114 male; 72.2 ± 7.1 years), and 128 patients with Alzheimer's disease (AD) (74 male; 73.7 ± 8.4 years) were included. Optimal A, T, and N biomarkers for discriminating HC and AD were selected using receiver operating characteristic (ROC) curve analysis. A radiomics model containing comprehensive information of the whole cerebral cortex and deep nuclei was established to create a new N biomarker. Cerebrospinal fluid (CSF) biomarkers were evaluated to determine the optimal A or T biomarkers. All MCI patients were followed up until AD conversion or for at least 60 months. The predictive value of A, T, and the radiomics-based N biomarker for cognitive progression of MCI to AD were analyzed using Kaplan-Meier estimates and the log-rank test. RESULTS: The radiomics-based N biomarker showed an ROC curve area of 0.998 for discriminating between AD and HC. CSF Aß42 and p-tau proteins were identified as the optimal A and T biomarkers, respectively. For MCI patients on the Alzheimer's continuum, isolated A+ was an indicator of cognitive stability, while abnormalities of T and N, separately or simultaneously, indicated a high risk of progression. For MCI patients with suspected non-Alzheimer's disease pathophysiology, isolated T+ indicated cognitive stability, while the appearance of the radiomics-based N+ indicated a high risk of progression to AD. CONCLUSION: We proposed a new radiomics-based improved N biomarker that could help identify patients with MCI who are at a higher risk for cognitive progression. In addition, we clarified the value of a single A/T/N biomarker for predicting the cognitive progression of MCI.


Assuntos
Doença de Alzheimer , Disfunção Cognitiva , Idoso , Idoso de 80 Anos ou mais , Doença de Alzheimer/diagnóstico por imagem , Peptídeos beta-Amiloides , Biomarcadores , Cognição , Disfunção Cognitiva/diagnóstico por imagem , Progressão da Doença , Feminino , Seguimentos , Humanos , Masculino , Fragmentos de Peptídeos , Proteínas tau
11.
Zhonghua Yan Ke Za Zhi ; 58(1): 41-45, 2022 Jan 11.
Artigo em Chinês | MEDLINE | ID: mdl-34979792

RESUMO

Objective: To investigate the cognitive effects of monocular blindness and related influencing factors. Methods: A cross-sectional study was conducted. The patients with monocular blindness (the age of onset <16 years) were enrolled from Beijing Tongren Eye Center, Beijing Tongren Hospital between January 2018 and June 2020. The Montreal cognitive assessment (MoCA) scale was applied to assess seven cognitive domains including visuospatial and executive function, naming, attention, etc. Based on MoCA scores, all the patients were classified into two groups: normal cognitive functions and cognitive impairment. Spearman's correlation was used to perform the single factor analysis of the influencing factors of cognitive functions. Multivariate linear regression analyses were applied to identify the independent influencing risk factors. Results: A total of 45 patients with monocular blindness were enrolled. There were 25 males and 20 females, with age at testing being (27±10) years.The incidence of cognitive impairment in 45 patients was 60.0% (27/45). The abnormal items ranking from a high to low rate were language (95.6%, 43 cases), delayed recall (75.6%, 34 cases), visuospatial and executive function (60.0%, 27 cases), abstract (44.4%, 20 cases), attention (35.6%, 16 cases), naming (20.0%, 9 cases), and orientation (0%). There were statistically significant differences (all P<0.05) in total score (21.9±3.3 vs. 27.4±1.4), visuospatial and executive function (3.2±1.7 vs. 4.6±0.7), naming (2.7±0.6 vs. 2.9±0.2), attention (5.3±1.0 vs. 5.8±0.4), language (1.1±0.8 vs. 1.8±0.8), abstract (1.1±0.8 vs. 1.8±0.5) and delayed recall (2.3±1.3 vs. 4.4±0.8) between two groups of patients with and without cognitive impairment. Spearman's correlation analysis showed visuospatial and executive functions, attention, abstract and MoCA total score were positively correlated with education years (correlation coefficients being 0.355, 0.424, 0.434 and 0.370, respectively; all P<0.05). Multiple linear regression showed that duration of blindness was correlated with naming (ß=-0.325), and years of education correlated with attention (ß=0.472), abstract ability (ß=0.441) and MoCA total score (ß=0.390) (all P<0.05). Conclusions: Monocular blindness may affect language, delayed memory and visuospatial executive functions. The duration of blindness is an independent risk factor, and higher education is a protective factor of the cognitive impairment.


Assuntos
Disfunção Cognitiva , Adolescente , Cegueira , Cognição , Estudos Transversais , Função Executiva , Feminino , Humanos , Masculino
12.
Artigo em Inglês | MEDLINE | ID: mdl-34985774

RESUMO

OBJECTIVES: Delirium frequently arises in older demented and non-demented patients in postoperative, clinical settings. To date, the underlying pathophysiological mechanisms remain poorly understood. Monoamine neurotransmitter alterations have been linked to delirium and cognitive impairment. Our aim was to investigate if this holds true in cognitively normal and impaired patients experiencing delirium following hip surgery. METHODS: Monoamines and metabolites were measured in plasma samples of 181 individuals by means of reversed-phase ultra-high-performance liquid chromatography with electrochemical detection. Delirium and delirium severity were scored with the Confusion Assessment Method and Delirium Rating Scale-Revised-1998. Cognitive function was assessed using the Informant Questionnaire on Cognitive Decline and the Mini-Mental State Examination, multimorbidity with the Charlson Comorbidity Index. RESULTS: Plasma 5-hydroxyindoleacetic acid (5-HIAA), the major metabolite of serotonin (5-HT), was significantly higher in delirious and non-delirious cognitively impaired subjects as compared to control individuals without delirium and cognitive impairment (p < 0.001 and p = 0.007), which remained highly significant after excluding patients taking psychotropic medication (p < 0.0001 and p = 0.003). No significant differences were found for cognitively normal delirious patients, although serotonergic levels were numerically higher compared to control counterparts. CONCLUSIONS: Our findings indicate a general serotonergic disturbance in delirious and non-delirious postoperative patients suffering from cognitive impairment. We observed a similar, but less pronounced difference in delirious patients, which suggests serotonergic disturbances may be further aggravated by the co-occurrence of delirium and cognitive impairment.


Assuntos
Delírio , Idoso , Cognição , Humanos , Ácido Hidroxi-Indolacético
13.
Zhonghua Yi Xue Za Zhi ; 102(1): 73-79, 2022 Jan 04.
Artigo em Chinês | MEDLINE | ID: mdl-34991241

RESUMO

Objective: To clarify the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on cognitive function in cerebral ischemic rats, and to explore its underlying mechanism by RNA sequencing. Methods: Thirty male Sprague-Dawley (SD) rats underwent transient middle cerebral artery occlusion (tMCAO). According to the Bederson score, 10 rats with a score of 1-3 were excluded, and the remaining 20 rats were then randomly divided into the tMCAO group (n=10) and the rTMS group (n=10). Meanwhile, 10 rats with sham operation were assigned to the sham group (n=10). Rats in the rTMS group received 20 Hz rTMS from day 7 to day 28 after surgery. From day 28 to day 33 after the operation, Morris water maze test was performed to detect the cognitive function of rats in each group. The cortical tissues around the infarcts from the rTMS tMCAO groups were taken for RNA sequencing analysis, with 3 rats in each group. Results: The escape latency of rats in the rTMS group[ (53±4)s] and the group [(51±5)s] were significantly shorter than that of the tMCAO group[ (58±4)s, P<0.05)]. The times that the rats crossed the original platform in 60 seconds in the rTMS group[2.5 (1.5-3.0)] and sham group[3.0 (1.5-3.0)] were more than that of the tMCAO group [1.0(0.5-1.5)] (P<0.05). RNA sequencing detected 16 significantly differentially expressed genes, including 9 up-regulated genes and 7 down-regulated genes. GO analysis showed that the functions of up-regulated genes were mainly concentrated in the processes of chemical homeostasis and cell metal ion homeostasis. While the functions of down-regulated genes mainly enriched in the inflammatory response. Conclusion: Twenty Hz rTMS can improve the cognitive function of rats with cerebral infarction, and its underlying mechanism may be related to maintaining chemical and metal ion homeostasis and regulating the polarization of microglia to reduce neuroinflammation.


Assuntos
Estimulação Magnética Transcraniana , Animais , Cognição , Masculino , Ratos , Ratos Sprague-Dawley , Análise de Sequência de RNA
14.
J Theor Biol ; 533: 110933, 2022 01 21.
Artigo em Inglês | MEDLINE | ID: mdl-34655616

RESUMO

Mechanisms for social learning have rightly been the focus of much work in cultural evolution. But mechanisms for teaching-mechanisms that determine what information is available for learners to learn in the first place-are equally important to cultural evolution, especially in the case of humans. Here, we propose a simple model of teaching in the context of skill transmission. Our model derives the evolutionary cost and benefit of teaching by explicitly representing cognitive aspects of skill transmission as a dual-inheritance process. We then show that teaching cannot evolve when its direct cost is too high. We also show that there is an "explain-exploit" trade-off inherent to teaching: when payoffs from sharing information are not constant, there can be an indirect cost to teaching. This gives rise to an opportunity cost that goes beyond any direct cost that it may also entail. Finally, we show that evolution limits the strength of teaching provided that the direct cost of teaching is an increasing function of teaching effort. We then discuss how these factors might explain why teaching mechanisms are self-limiting, suggesting that such mechanisms may nevertheless play an important role in the evolution of cumulative culture in humans.


Assuntos
Evolução Cultural , Aprendizado Social , Evolução Biológica , Cognição , Humanos , Aprendizagem , Ensino
15.
Acta Neurol Scand ; 145(1): 111-118, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34658033

RESUMO

OBJECTIVES: Deep brain stimulation of the anterior thalamic nucleus (ANT-DBS) reduces seizure frequency in patients with refractory epilepsy. There are, however, few studies on treatment-related changes in cognitive functions. The main objective of this study was to investigate cognitive changes in patients receiving ANT-DBS. We also explored whether possible effects were related to stimulation duration and whether change in seizure frequency was associated with cognitive changes. MATERIALS AND METHODS: Bilateral ANT electrodes were implanted in 18 patients with refractory epilepsy, aged 18-52 years. Immediately after implantation, patients were randomized to stimulation ON (n = 8) or OFF (n = 10) for the first 6 months (blinded phase). During the following 6-month open phase, both groups received stimulation. Neuropsychological assessments were conducted before implantation (T1), at the end of the blinded period (T2), and 1 year after implantation (T3). RESULTS: Groupwise comparisons across the three time points revealed changes in performance in two of 22 cognitive test scores: motor speed and sustained attention. We found no significant group differences in cognitive change from T1 to T2. Patients reported fewer symptoms of executive dysfunction after 12 months of stimulation. Patients showing significant improvement in seizure frequency had better performance in a measure of verbal learning. CONCLUSION: Our results indicate that ANT-DBS has very limited effects on cognitive functioning, as measured by formal tests after 6- or 12-month stimulation. ANT-DBS may have a positive influence on executive function. Our findings provide limited support for an association between change in seizure frequency and cognitive functioning.


Assuntos
Núcleos Anteriores do Tálamo , Estimulação Encefálica Profunda , Epilepsia Resistente a Medicamentos , Cognição , Epilepsia Resistente a Medicamentos/terapia , Humanos , Convulsões
16.
Lancet Neurol ; 21(1): 31-41, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34942135

RESUMO

BACKGROUND: Down syndrome is a chromosomal disorder with considerable neurodevelopmental impact and neurodegenerative morbidity. In a pilot trial in young adults with Down syndrome, memantine (a drug approved for Alzheimer's disease) showed a significant effect on a secondary measure of episodic memory. We aimed to test whether memantine would improve episodic memory in adolescents and young adults with Down syndrome. METHODS: We did a randomised, double-blind, placebo-controlled phase 2 trial with a parallel design, stratified by age and sex. Participants (aged 15-32 years) with either trisomy 21 or complete unbalanced translocation of chromosome 21 and in general good health were recruited from the community at one site in Brazil and another in the USA. Participants were randomly assigned (1:1) to receive either memantine (20 mg/day orally) or placebo for 16 weeks. Computer-generated randomisation tables for both sites (allocating a placebo or drug label to each member of a unique pair of participants) were centrally produced by an independent statistician and were shared only with investigational pharmacists at participating sites until unblinding of the study. Participants and investigators were masked to treatment assignments. Neuropsychological assessments were done at baseline (T1) and week 16 (T2). The primary outcome measure was change from baseline to week 16 in the California Verbal Learning Test-second edition short-form (CVLT-II-sf) total free recall score, assessed in the per-protocol population (ie, participants who completed 16 weeks of treatment and had neuropsychological assessments at T1 and T2). Linear mixed effect models were fit to data from the per-protocol population. Safety and tolerability were monitored and analysed in all participants who started treatment. Steady-state concentrations in plasma of memantine were measured at the end of the trial. This study is registered at ClinicalTrials.gov, number NCT02304302. FINDINGS: From May 13, 2015, to July 22, 2020, 185 participants with Down syndrome were assessed for eligibility and 160 (86%) were randomly assigned either memantine (n=81) or placebo (n=79). All participants received their allocated treatment. Linear mixed effect models were fit to data from 149 (81%) participants, 73 in the memantine group and 76 in the placebo group, after 11 people (eight in the memantine group and three in the placebo group) discontinued due to COVID-19 restrictions, illness of their caregiver, adverse events, or low compliance. The primary outcome measure did not differ between groups (CVLT-II-sf total free recall score, change from baseline 0·34 points [95% CI -0·98 to 1·67], p=0·61). Memantine was well tolerated, with infrequent mild-to-moderate adverse events, the most common being viral upper respiratory infection (nine [11%] participants in the memantine group and 12 [15%] in the placebo group) and transient dizziness (eight [10%] in the memantine group and six [8%] in the placebo group). No serious adverse events were observed. Amounts of memantine in plasma were substantially lower than those considered therapeutic for Alzheimer's disease. INTERPRETATION: Memantine was well tolerated, but cognition-enhancing effects were not recorded with a 20 mg/day dose in adolescents and young adults with Down syndrome. Exploratory analyses point to a need for future work. FUNDING: Alana Foundation. TRANSLATION: For the Portuguese translation of the abstract see Supplementary Materials section.


Assuntos
Síndrome de Down/tratamento farmacológico , Memantina/uso terapêutico , Adolescente , Cognição/efeitos dos fármacos , Método Duplo-Cego , Síndrome de Down/psicologia , Feminino , Humanos , Masculino , Memantina/administração & dosagem , Memantina/farmacologia , Resultado do Tratamento , Adulto Jovem
17.
Res Dev Disabil ; 121: 104155, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34968870

RESUMO

BACKGROUND & AIMS: SCT is characterized by sluggishness, daydreaming, lethargy/ apathy, slowed behavior/thinking, and mental confusion. For a long time these symptoms were thought to be a part of ADHD but then studies revealed that SCT is a different phenomenon in some cultures. In this study. we aimed to examine the validity and reliability of Barkley's Adult SCT Ratings Scale, and to determine if SCT is an independent factor from ADHD in Turkish adults like in other cultures. METHODS: 274 Medical School students/trainees enrolled the study (Age: 18-35, 70.4 % female). Data was collected via an online survey including SCT and ADHD rating scales. RESULTS: Exploratory factor analysis demonstrated that the scale consisted of two factors: Daydreaming and Sluggishness.The model demonstrated a good-fit (χ2 = 43.642, p = 0.001; χ2/df = 2.425, GFI = 0.962,RMSEA = 0.072). As expected, there were positive and significant associations between SCT total, Daydreaming, Sluggishness, and ADHD-Inattention scores (r = 0.645, 0.664, 0.382; respectively), but all SCT items loaded within SCT factors and distinquished from ADHD factors. Cronbach's alpha values were: 0.87 for SCT-total, 0.87 for Daydreaming; 0.79 for Sluggishness. CONCLUSION & IMPLICATIONS: Our study provides a valid and reliable SCT screening tool for Turkish adults and increases our confidence in the transcultural generalizability of SCT.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade , Adolescente , Adulto , Transtorno do Deficit de Atenção com Hiperatividade/diagnóstico , Cognição , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos Testes
18.
Anesth Analg ; 134(1): 69-81, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-34908547

RESUMO

BACKGROUND: The perioperative inflammatory response may be implicated in adverse outcomes including neurocognitive dysfunction and cancer recurrence after oncological surgery. The immunomodulatory role of anesthetic agents has been demonstrated in vitro; however, its clinical relevance is unclear. The purpose of this meta-analysis was to compare propofol and sevoflurane with respect to biomarkers of perioperative inflammation. The secondary aim was to correlate markers of inflammation with clinical measures of perioperative cognition. METHODS: Databases were searched for randomized controlled trials examining perioperative inflammation after general anesthesia using propofol compared to sevoflurane. Inflammatory biomarkers investigated were interleukin (IL)-6, IL-10, tissue necrosis factor alpha (TNF-α), and C-reactive protein (CRP). The secondary outcome was incidence of perioperative neurocognitive disorders. Meta-analysis with metaregression was performed to determine the difference between propofol and sevoflurane. RESULTS: Twenty-three studies were included with 1611 participants. Studies varied by surgery type, duration, and participant age. There was an increase in the mean inflammatory biomarker levels following surgery, with meta-analysis revealing no difference in effect between propofol and sevoflurane. Heterogeneity between studies was high, with surgery type, duration, and patient age contributing to the variance across studies. Only 5 studies examined postoperative cognitive outcomes; thus, a meta-analysis could not be performed. Nonetheless, of these 5 studies, 4 reported a reduced incidence of cognitive decline associated with propofol use. CONCLUSIONS: Surgery induces an inflammatory response; however, the inflammatory response did not differ as a function of anesthetic technique. This absence of an effect suggests that patient and surgical variables may have a far more significant impact on the postoperative inflammatory responses than anesthetic technique. The majority of studies assessing perioperative cognition in older patients reported a benefit associated with the use of propofol; however, larger trials using homogenous outcomes are needed to demonstrate such an effect.


Assuntos
Biomarcadores/sangue , Propofol/uso terapêutico , Sevoflurano/uso terapêutico , Anestesia Geral , Anestésicos , Anestésicos Inalatórios/efeitos adversos , Anestésicos Intravenosos/efeitos adversos , Proteína C-Reativa/biossíntese , Cognição , Humanos , Inflamação , Interleucina-10/sangue , Interleucina-6/sangue , Período Perioperatório , Propofol/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sevoflurano/efeitos adversos , Fator de Necrose Tumoral alfa/sangue
19.
Methods Mol Biol ; 2343: 71-91, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34473316

RESUMO

Life expectancy in sub-Saharan African women is increasing, and by the late 2020s an estimated 76% of postmenopausal women globally will be living in developing countries. Menopause transition has been associated with cognitive decline in a wide range of studies, but data on cognition and reproductive aging are lacking in sub-Saharan African women. Approximately 72 million people in the region are expected to suffer from dementias and neurocognitive decline by 2050. Studies show that compromised cognitive health in low-income countries has significant implications for adult quality of life and socioeconomic development. There is now an urgent need to further examine risk factors for cognitive decline in these aging women and to understand the ability of public health programs to diagnose and treat cognitive dysfunction. This review examines studies assessing cognition and aging in sub-Saharan African adults, while addressing the significant research gaps. It examines data on the association of the menopause transition with cognitive function and describes how validated tools should be available to assess both menopausal stage and symptoms. Culturally appropriate and validated neurocognitive measures are required to better understand the relationship of reproductive aging with cognition. Longitudinal population-based studies are needed to assess the effect of lifestyle interventions, such as diet and exercise, on cognitive health in sub-Saharan African populations, with an emphasis on women as they transition into menopause.


Assuntos
Envelhecimento , Transtornos Cognitivos , Cognição , Qualidade de Vida , África ao Sul do Saara/epidemiologia , Transtornos Cognitivos/epidemiologia , Feminino , Humanos , Menopausa
20.
Zhonghua Yi Xue Yi Chuan Xue Za Zhi ; 39(1): 103-107, 2022 Jan 10.
Artigo em Chinês | MEDLINE | ID: mdl-34964979

RESUMO

Autism spectrum disorder (ASD) is a set of neurodevelopmental disorders. Patients usually exhibit certain degree of social interaction impairment in accompany with impairment in language development as well as repetitive behaviors or interests. In recent years, ASD-related variants, genes, functional pathways, and expression patterns in the brain have been discovered, along with advance in sequencing techniques. This article reviews various aspects of genetic research in association with ASD.


Assuntos
Transtorno do Espectro Autista , Transtornos do Neurodesenvolvimento , Transtorno do Espectro Autista/genética , Cognição , Pesquisa em Genética , Humanos
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