Experimental atopic dermatitis is dependent on the TWEAK/Fn14 signaling pathway

Tumor necrosis factor (TNF)-like weak inducer of apoptosis (TWEAK) acts through its receptor fibroblast growth factor inducible 14 (Fn14), and participates in skin inflammation. Both TWEAK and Fn14 are highly expressed in skin lesions of patients with atopic dermatitis. The purpose of this study was to further explore the effect of Fn14 inhibition on experimental atopic dermatitis. Experimental atopic dermatitis was induced in the wild-type and Fn14 knock-out BALB/c mice. The effect of TWEAK/Fn14 interaction on keratinocytes was studied in an in-vitro model of atopic dermatitis. Fn14 deficiency ameliorates skin lesions in the mice model, accompanied by less infiltration of inflammatory cells and lower local levels of proinflammatory cytokines, including TWEAK, TNF-α and interleukin (IL)-17. Fn14 deficiency also attenuates the up-regulation of TNFR1 in skin lesions of atopic dermatitis. Moreover, topical TWEAK exacerbates skin lesion in the wild-type but not in the Fn14 knock-out mice. In vitro, TWEAK enhances the expressions of IL-17, IL-18 and IFN-γ in keratinocytes under atopic dermatitis-like inflammation. These results suggest that Fn14 deficiency protects mice from experimental atopic dermatitis, involving the attenuation of inflammatory responses and keratinocyte apoptosis. In the context of atopic dermatitis-like inflammation, TWEAK modulates keratinocytes via a TNFR1-mediated pathway.

Giant Zero Bias Anomaly due to Coherent Scattering from Frozen Phonon Disorder in Quantum Point Contacts

We demonstrate an unusual manifestation of coherent scattering for electron waves in mesoscopic quantum point contacts, in which fast electron dynamics allows the phonon system to serve as a quasistatic source of disorder. The low-temperature conductance of these devices exhibits a giant (≫2e^{2}/h) zero bias anomaly (ZBA), the features of which are reproduced in a nonequilibrium model for coherent scattering from the "frozen" phonon disorder. According to this model, the ZBA is understood to result from the in situ electrical manipulation of the phonon disorder, a mechanism that could open up a pathway to the on-demand control of coherent scattering in the solid state.

The Association between FLAIR Vascular Hyperintensity and Stroke Outcome Varies with Time from Onset

BACKGROUND AND PURPOSE

FLAIR vascular hyperintensity has been recognized as a marker of collaterals in ischemic stroke, but the impact on outcome is still controversial. We hypothesized that the association between FLAIR vascular hyperintensity and outcome varies with time.

MATERIALS AND METHODS

We included 459 consecutive patients with middle cerebral artery stroke and divided them into 3 groups by symptom-to-MR imaging time (group 1, ≤7 days; group 2, 8-14 days; group 3, ≥15 days). The FLAIR vascular hyperintensity score, ranging from 0 to 3 points, was based on territory distributions of different MCA segments. The associations between FLAIR vascular hyperintensity and outcome with time were analyzed qualitatively and quantitatively.

RESULTS

No patients underwent MR imaging within 6 hours of onset. The proportion of FLAIR vascular hyperintensity (+) and severe stenosis or occlusion of MCA was not significantly dependent on time. In groups 1 and 2, FLAIR vascular hyperintensity (+) was significantly associated with larger lesions, the prevalence of flow injury, and unfavorable outcome (mRS ≥ 2). There were no such associations in group 3. Multiple logistic regressions demonstrated that FLAIR vascular hyperintensity (+) was an independent risk factor for unfavorable outcome in group 2. Infarction volume tended to increase with the increase of the distal FLAIR vascular hyperintensity score in groups 1 and 2, while declining in group 3.

CONCLUSIONS

FLAIR vascular hyperintensity is associated with unfavorable outcome within 6 hours to 14 days of onset, while the wider distribution of distal FLAIR vascular hyperintensity may be favorable beyond 14 days of onset in MCA infarction. Symptom-to-MR imaging time should be considered when assessing the prognostic value of FLAIR vascular hyperintensity.

Prevalence, Influence Factors and Cognitive Characteristics of Mild Cognitive Impairment in Type 2 Diabetes Mellitus

Background: Type 2 diabetes mellitus (T2DM) is considered as an independent risk factor for mild cognitive impairment (MCI). This study was performed to investigate the prevalence, influencing factors and cognitive characteristics of MCI in elderly patients with T2DM in China.

Methods: In the cross-sectional study, we performed cluster random sampling of 3,246 people age 60 years and older across the country. All participants were interviewed and screened for T2DM and MCI. A total of 341 subjects were diagnosed of MCI according to the criteria of Petersen, and a total of 256 subjects were diagnosed of T2DM by using the American Diabetes Association criteria Among the 256 T2DM people, 56 were also diagnosed with MCI. Logistic regression analyses were performed to evaluate risk and protective factor for MCI with T2DM. We also assessed their cognitive function by using the Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit span, Associative Learning Test (ALT), Visual Identification Test (VIT), Verbal Fluency (VF), Wechsler Adult Intelligence Scale (WAIS)-III Block Design, WAIS-III picture completion and Auditory Verbal Learning Test (AVLT).

Results: Among the 256 T2DM patients, 56 were diagnosed with MCI, and the prevalence of MCI in T2DM was 21.8%. Multivariate logistic regression analyses showed that depression (p = 0.002, OR = 6.220, 95% CI: 2.005–19.290) was a risk factor for MCI among T2DM patients, while education (p < 0.001, OR = 0.869, 95% CI: 0.805–0.983) was a protective one. All the scores of neuropsychological tests (except for MMSE) in T2DM patients with MCI were lower than those without MCI (p < 0.05), but there was no statistical difference (p > 0.05) in neuropsychological tests between T2DM-MCI group and No-T2DM-MCI group. Linear regression analysis showed that the drug treatment of diabetes was positively correlated (t = 2.263, p = 0.025) with the total score of auditory word tests.

Conclusions: The present study suggests a high prevalence of MCI among Chinese T2DM patients. Depression is a risk factor for MCI, while education is a protective one. T2DM patients with MCI often show comprehensive cognitive impairment, and the drug treatment of diabetes might help to improve cognitive function.

Tests of General Relativity with GW170817

The recent discovery by Advanced LIGO and Advanced Virgo of a gravitational wave signal from a binary neutron star inspiral has enabled tests of general relativity (GR) with this new type of source. This source, for the first time, permits tests of strong-field dynamics of compact binaries in the presence of matter. In this Letter, we place constraints on the dipole radiation and possible deviations from GR in the post-Newtonian coefficients that govern the inspiral regime. Bounds on modified dispersion of gravitational waves are obtained; in combination with information from the observed electromagnetic counterpart we can also constrain effects due to large extra dimensions. Finally, the polarization content of the gravitational wave signal is studied. The results of all tests performed here show good agreement with GR.

Polychromatic emission in a wide energy range from InP-InAs-InP multi-shell nanowires

InP-InAs-InP multi-shell nanowires (NWs) were grown in the wurtzite (WZ) or zincblende (ZB) crystal phase and their photoluminescence (PL) properties were investigated at low temperature (≈6 K) for different measurement geometries. PL emissions from the NWs were carefully studied in a wide energy range from 0.7 to 1.6 eV. The different features observed in the PL spectra for increasing energies are attributed to four distinct emitting domains of these nano-heterostructures: the InAs island (axially grown), the thin InAs capping shell (radially grown), the crystal-phase quantum disks arising from the coexistence of InP ZB and WZ segments in the same NW, and the InP portions of the NW. These results provide a useful frame for the rational implementation of InP-InAs-InP multi-shell NWs containing various quantum confined domains as polychromatic optically active components in nanodevices for quantum information and communication technologies.

Study of brain morphology change in Alzheimer's disease and amnestic mild cognitive impairment compared with normal controls

Background

With an aggravated social ageing level, the number of patients with Alzheimer’s disease (AD) is gradually increasing, and mild cognitive impairment (MCI) is considered to be an early form of Alzheimer’s disease. How to distinguish diseases in the early stage for the purposes of early diagnosis and treatment is an important topic.

Aims

The purpose of our study was to investigate the differences in brain cortical thickness and surface area among elderly patients with AD, elderly patients with amnestic MCI (aMCI) and normal controls (NC).

Methods

20 AD patients, 21 aMCIs and 25 NC were recruited in the study. FreeSurfer software was used to calculate cortical thickness and surface area among groups.

Results

The patients with AD had less cortical thickness both in the left and right hemisphere in 17 of the 36 brain regions examined than the patients with aMCI or NC. The patients with AD also had smaller cerebral surface area both in the left and right hemisphere in 3 of the 36 brain regions examined than the patients with aMCI or NC. Compared with the NC, the patients with aMCI only had slight atrophy in the inferior parietal lobe of the left hemisphere, and no significant difference was found.

Conclusion

AD, as well as aMCI (to a lesser extent), is associated with reduced cortical thickness and surface area in a few brain regions associated with cognitive impairment. These results suggest that cortical thickness and surface area could be used for early detection of AD.

A comparison between high-intensity focused ultrasound and surgical treatment for the management of abdominal wall endometriosis

OBJECTIVE

The aim of this study was to compare the therapeutic outcomes of high-intensity focused ultrasound (HIFU) and surgical treatment for abdominal wall endometriosis.

DESIGN

A retrospective study.

SETTING

Gynaecological department of a teaching hospital in China.

POPULATION

Patients with abdominal wall endometriosis.

METHODS

Among the 51 patients, 23 patients were treated with ultrasound-guided HIFU and 28 patients with surgery. Pain relief and the size change of the nodule after each management were evaluated 1, 3, 6 and 12 months after treatment, respectively. The hospital stay and blood loss were also compared.

MAIN OUTCOME MEASURES

Difference between HIFU and surgical treatment for abdominal wall endometriosis.

RESULTS

No statistically significant differences were observed between the two groups in the pain relief in 1, 3, 6 and 12 months after treatment, respectively. The hospital stay was clearly shorter in the HIFU group than in the surgery group. Change in nodules was more remarkable in the group treated with surgery; no palpable nodules existed in most patients in the surgery group. HIFU had more advantages over surgery, such as no blood loss, no new scar, no anaesthesia and lower pain score immediately after treatment.

CONCLUSIONS

Based on our results, it appears that either HIFU or surgery is safe and effective in treating patients with AWE in short-term. Compared with surgery, HIFU treatment for AWE has the advantages of shorter hospital stay, no blood loss, no new scar, no anaesthesia and a lower immediate pain score.

TWEETABLE ABSTRACT

Either HIFU or surgical treatment is safe and effective in treating patients with AWE. HIFU has the advantages of a less invasive procedure and shorter hospital stay.

Biomarkers for the diagnosis of Alzheimer's disease, dementia Lewy body, frontotemporal dementia and vascular dementia

Background

Dementia is a chronic brain disorder classified by four distinct diseases that impact cognition and mental degeneration. Each subgroup exhibits similar brain deficiencies and mutations. This review will focus on four dementia subgroups: Alzheimer’s disease, vascular dementia, frontotemporal dementia and dementia Lewy body.

Aim

The aim of this systematic review is to create a concise overview of unique similarities within dementia used to locate and identify new biomarker methods in diagnosing dementia.

Methods

123 300 articles published after 2010 were identified from PubMed, JSTOR, WorldCat Online Computer Library and PALNI (Private Academic Library Network of Indiana) using the following search items (in title or abstract): ‘Neurodegenerative Diseases’ OR ‘Biomarkers’ OR ‘Alzheimer’s Disease’ OR ‘Frontal Temporal Lobe Dementia’ OR ‘Vascular Dementia’ OR ‘Dementia Lewy Body’ OR ‘Cerebral Spinal Fluid’ OR ‘Mental Cognitive Impairment’. 47 studies were included in the qualitative synthesis.

Results

Evidence suggested neuroimaging with amyloid positron emission tomography (PET) scanning and newly found PET tracers to be more effective in diagnosing Alzheimer’s and amnesiac mental cognitive impairment than carbon-11 Pittsburgh compound-B radioisotope tracer. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia and neurodegenerative diseases.

Conclusion

Vast improvements in neuroimaging techniques have led to newly discovered biomarkers and diagnostics. Neuroimaging with amyloid PET scanning surpasses what had been considered the dominant method of neuroimaging and MRI. Newly created methods to make PET scans more accurate and practical in clinical settings signify a major shift in diagnosing dementia pathology. Continued research and studies must be conducted to improve current findings and streamline methods to further subcategorise neurodegenerative disorders and diagnosis.

Constraining the p-Mode-g-Mode Tidal Instability with GW170817

We analyze the impact of a proposed tidal instability coupling p modes and g modes within neutron stars on GW170817. This nonresonant instability transfers energy from the orbit of the binary to internal modes of the stars, accelerating the gravitational-wave driven inspiral. We model the impact of this instability on the phasing of the gravitational wave signal using three parameters per star: an overall amplitude, a saturation frequency, and a spectral index. Incorporating these additional parameters, we compute the Bayes factor (lnB_{!pg}^{pg}) comparing our p-g model to a standard one. We find that the observed signal is consistent with waveform models that neglect p-g effects, with lnB_{!pg}^{pg}=0.03_{-0.58}^{+0.70} (maximum a posteriori and 90% credible region). By injecting simulated signals that do not include p-g effects and recovering them with the p-g model, we show that there is a ≃50% probability of obtaining similar lnB_{!pg}^{pg} even when p-g effects are absent. We find that the p-g amplitude for 1.4  M_{⊙} neutron stars is constrained to less than a few tenths of the theoretical maximum, with maxima a posteriori near one-tenth this maximum and p-g saturation frequency ∼70  Hz. This suggests that there are less than a few hundred excited modes, assuming they all saturate by wave breaking. For comparison, theoretical upper bounds suggest ≲10^{3} modes saturate by wave breaking. Thus, the measured constraints only rule out extreme values of the p-g parameters. They also imply that the instability dissipates ≲10^{51}  erg over the entire inspiral, i.e., less than a few percent of the energy radiated as gravitational waves.

The Association Between Eating Green Vegetables Every Day And Mild Cognitive Impairment: A Community-Based Cross-Sectional Study In Shanghai

BACKGROUND

Emerging evidence has suggested that green vegetables may prevent cognitive decline.

METHODS

We examined the cross-sectional association between green vegetables intake and mild cognitive impairment (MCI) using data from 525 participants aged 55 years and above from the China Longitudinal Aging Study (CLAS) in Shanghai.

RESULTS

Compared with participants who did not eat green vegetables every day, those who had consumed green vegetables every day had a significantly lower risk of mild cognitive impairment (MCI) (OR = 0.218, 95% CI, 0.116-0.411, p < 0.001), and this association was independent of age, education, having hobbies, surfing the Internet, sleep time per night (youth), long-term residency and consumption of specific red food, such as meat, bread, bean curd, and ginger.

CONCLUSION

In summary, using community-based data in Shanghai, we found out that subjects who eat green vegetables every day have significantly lower odds of MCI than those who do not eat every day. Based on current evidence, we propose that eating green vegetables every day might be a potential preventive measure to slow cognitive decline and neurodegeneration in the elderly.

Short-term adverse effects of the apolipoprotein E ε4 allele over language function and executive function in healthy older adults

Background: The 4 allele of the apolipoprotein E (APOE) gene is known as a risk factor for cognitive impairment. How APOE ε polymorphism affects the language and executive functions of healthy aging subjects remains less clear. Purpose: In this follow-up study, the relationship between APOE status and cognitive performance across various cognitive domains in healthy individuals (without dementia or mild cognitive impairment (MCI)) over 60 years old was investigated. Patients and methods: Based on multiplex amplification refractory mutation system polymerase chain reaction (PCR), 228 subjects (n=228; mean age: 70.59±8.07 years old; male %=40.8%) were divided into three groups, e2 (ε2/ε2 and ε2/ε3, n=35), e3 (ε3/ε3, n=152), and e4 (ε2/ε4, ε3/ε4, and ε4/ε4, n=41). Results: There was no statistical difference (p>0.05) in the general demographic data and neuropsychological tests among the three groups on the baseline; however, e4 group showed a greater drop rate (p<0.05) versus non-carriers on verbal fluency (e2: -0.043±0.221; e3: -0.081±0.239; e4: 0.069±0.329) and Webster picture completion (e2: 0.055±0.281; e3: 0.083±0.428; e4: 0.438±1.280) over the subsequent one year. Conclusion: The findings suggest that possession of the APOE ε4 allele predicted a higher decline on tasks of language function and executive function in healthy elderly. And further research is required to determine whether strengthening the training of language function and executive function will delay the occurrence of cognitive impairment.

Associations Between the Apolipoprotein E ε4 Allele and Reduced Serum Levels of High Density Lipoprotein a Cognitively Normal Aging Han Chinese Population

Background: Previous studies have confirmed that APOE genotype is associated with lipid metabolism, but related studies are inconsistent. Therefore, we conducted this cross-sectional study to explore the associations between apolipoprotein E (APOE) genotypes and serum levels of fasting blood sugar, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein in a cognitively normal aging Han Chinese population. Methods: One hundred sixty-nine community elders with normal cognitive function were included in the study. Based on multiplex amplification refractory mutation system polymerase chain reaction (PCR), these subjects were divided into three groups: (1) E2/2 or E2/3 (APOE E2); (2) E3/3 (APOE E3); and (3) E2/4, E3/4, or E4/4 (APOE E4). Correlations of serum levels of fasting blood sugar, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein with APOE genotypes were assessed. Results: The results of Mann-Whitney analysis showed that the concentration of high density lipoprotein (HDL) in APOE E2 and E3 groups was higher than that in E4 groups (p < 0.05). Logistic regression analysis also suggested that a lower level of high density lipoprotein was associated with the E4 allele (adjusted odds ratio 0.164, 95% confidence interval 0.031~ 0.876, P = 0.034). Conclusion: APOE E4 is associated with decreased serum high density lipoprotein concentration in healthy elderly. However, the above conclusions need to be further verified.

Blood-Derived Plasma Protein Biomarkers for Alzheimer's Disease in Han Chinese

It is well known that Alzheimer's disease (AD) is one of the most common progressive neurodegenerative diseases; it begins gradually, and therefore no effective medicine is administered in the beginning. Thus, early diagnosis and prevention of AD are crucial. The present study focused on comparing the plasma protein changes between patients with AD and their healthy counterparts, aiming to explore a specific protein panel as a potential biomarker for AD patients in Han Chinese. Hence, we recruited and collected plasma samples from 98 AD patients and 101 elderly healthy controls from Wuxi and Shanghai Mental Health Centers. Using a Luminex assay, we investigated the expression levels of fifty plasma proteins in these samples. Thirty-two out of 50 proteins were found to be significantly different between AD patients and healthy controls (P < 0.05). Furthermore, an eight-protein panel that included brain-derived neurotrophic factor (BDNF), angiotensinogen (AGT), insulin-like growth factor binding protein 2 (IGFBP-2), osteopontin (OPN), cathepsin D, serum amyloid P component (SAP), complement C4, and prealbumin (transthyretin, TTR) showed the highest determinative score for AD and healthy controls (all P = 0.00). In conclusion, these findings suggest that a combination of eight plasma proteins can serve as a promising diagnostic biomarker for AD with high sensitivity and specificity in Han Chinese populations; the eight plasma proteins were proven important for AD diagnosis by further cross-validation studies within the AD cohort.

Search for Subsolar-Mass Ultracompact Binaries in Advanced LIGO's First Observing Run

We present the first Advanced LIGO and Advanced Virgo search for ultracompact binary systems with component masses between 0.2  M_{⊙}-1.0  M_{⊙} using data taken between September 12, 2015 and January 19, 2016. We find no viable gravitational wave candidates. Our null result constrains the coalescence rate of monochromatic (delta function) distributions of nonspinning (0.2  M_{⊙}, 0.2  M_{⊙}) ultracompact binaries to be less than 1.0×10^{6}  Gpc^{-3}  yr^{-1} and the coalescence rate of a similar distribution of (1.0  M_{⊙}, 1.0  M_{⊙}) ultracompact binaries to be less than 1.9×10^{4}  Gpc^{-3}  yr^{-1} (at 90% confidence). Neither black holes nor neutron stars are expected to form below ∼1  M_{⊙} through conventional stellar evolution, though it has been proposed that similarly low mass black holes could be formed primordially through density fluctuations in the early Universe and contribute to the dark matter density. The interpretation of our constraints in the primordial black hole dark matter paradigm is highly model dependent; however, under a particular primordial black hole binary formation scenario we constrain monochromatic primordial black hole populations of 0.2  M_{⊙} to be less than 33% of the total dark matter density and monochromatic populations of 1.0  M_{⊙} to be less than 5% of the dark matter density. The latter strengthens the presently placed bounds from microlensing surveys of massive compact halo objects (MACHOs) provided by the MACHO and EROS Collaborations.

[Comparative study between two bleeding grading systems of primary immune thrombocytopenia]

目的

前瞻性评价中华医学会血液学分会在《成人原发免疫性血小板减少症诊断与治疗中国专家共识（2016年版）》中推荐的原发免疫性血小板减少症（ITP）出血评分量表（2016版ITP出血评分量表）的临床应用价值。

方法

采用2016版ITP出血评分量表和ITP特异性出血评价工具（ITP-BAT）对88例ITP患者进行出血评分，分析血小板计数、性别、疾病分期与2016版ITP出血评分量表评分的关系和两种出血评分系统的一致性。在47例新诊断ITP患者大剂量地塞米松治疗前及治疗后1、2周分别进行2016版ITP出血评分量表评分及血小板计数检查，评估2016版ITP出血评分量表的反应度。

结果

出血评分和患者血小板计数呈负相关（r=−0.515，P<0.001），不同性别、疾病分期患者2016版ITP出血评分量表评分差异无统计学意义（F=4.255，P=0.382；F=5.251，P=0.753）。ITP出血评分量表与ITP-BAT具有很好的一致性。47例ITP患者大剂量地塞米松治疗前后出血评分比较差异具有统计学意义（z=−5.612，P<0.001），治疗后未达到完全反应的患者治疗前后出血评分比较差异具有统计学意义（z=−3.969，P<0.001）。两名医师背靠背评分完全相同的比例为94.4%（k=0.918）。应用2016版ITP出血评分量表进行评分耗时短于ITP-BAT评分系统[3（2~6）min对7（4~13）min，z=−8.213，P<0.001]。

结论

2016版ITP出血评分量表在临床应用中具有很好的反应度及评价一致性，与ITP-BAT评分系统具有很好的一致性，且采集信息耗时短，可作为病情判断、风险评估及疗效评价的有效工具。

GW170817: Measurements of Neutron Star Radii and Equation of State

On 17 August 2017, the LIGO and Virgo observatories made the first direct detection of gravitational waves from the coalescence of a neutron star binary system. The detection of this gravitational-wave signal, GW170817, offers a novel opportunity to directly probe the properties of matter at the extreme conditions found in the interior of these stars. The initial, minimal-assumption analysis of the LIGO and Virgo data placed constraints on the tidal effects of the coalescing bodies, which were then translated to constraints on neutron star radii. Here, we expand upon previous analyses by working under the hypothesis that both bodies were neutron stars that are described by the same equation of state and have spins within the range observed in Galactic binary neutron stars. Our analysis employs two methods: the use of equation-of-state-insensitive relations between various macroscopic properties of the neutron stars and the use of an efficient parametrization of the defining function p(ρ) of the equation of state itself. From the LIGO and Virgo data alone and the first method, we measure the two neutron star radii as R_{1}=10.8_{-1.7}^{+2.0}  km for the heavier star and R_{2}=10.7_{-1.5}^{+2.1}  km for the lighter star at the 90% credible level. If we additionally require that the equation of state supports neutron stars with masses larger than 1.97  M_{⊙} as required from electromagnetic observations and employ the equation-of-state parametrization, we further constrain R_{1}=11.9_{-1.4}^{+1.4}  km and R_{2}=11.9_{-1.4}^{+1.4}  km at the 90% credible level. Finally, we obtain constraints on p(ρ) at supranuclear densities, with pressure at twice nuclear saturation density measured at 3.5_{-1.7}^{+2.7}×10^{34}  dyn cm^{-2} at the 90% level.

Shanghai cognitive intervention of mild cognitive impairment for delaying progress with longitudinal evaluation-a prospective, randomized controlled study (SIMPLE): rationale, design, and methodology

Background

Mild cognitive impairment is an early stage of Alzheimer’s disease. Increasing evidence has indicated that cognitive training could improve cognitive abilities of MCI patients in multiple cognitive domains, making it a promising therapeutic approach for MCI. However, the effect of long-time training has not been widely explored. It is also necessary to evaluate the extent how it could reduce the convertion rate from MCI to AD.

Methods/design

The SIMPLE study is a multicenter, randomized, single-blind prospective clinical trial assessing the effects of computerized cognitive training on different cognitive domains in MCI patients. It is carried out in 7 centers in China. The study population includes patients aged 50–85, and they are randomly allocated to the training or control group. The primary outcome is to compare the conversion rate of MCI within 36-month follow-up. Structural and functional MRI will be used to interpret the effect of cognitive training. The cognitive training comprises a variety of games related with cognitive domains such as attention, memory, visualspatial ability and executive function. We cautiously set 50% reduction in the rate of conversion as estimated effect. With 80–90% statistical power and 12% as the overall probability of conversion within the study period, 600–800 patients are finally required in the study. The first patent has been recruited in April 2017.

Discussion

Previous studies suggested the benefit of cognitive training for MCI, but neither long-time nor Chinese culture were investigated. The SIMPLE designs and utilizes an improved computerized cognitive training approach and assesses its effects on MCI progress. In addition, neural activities explaining the effects on cognition function changes will be revealed, which could in turn to imply more useful therapeutic approaches.

Trial registration

ClinicalTrials.gov Identifier: NCT03119051.

Electronic supplementary material

The online version of this article (10.1186/s12883-018-1100-x) contains supplementary material, which is available to authorized users.