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Selingerova I, Holikova K, Chodur T, Hynkova L, Pospisil P, Bulik M, Belanova R, Siffelova K, Kolouskova I, Slavik M, Burkon P, Hrstka R, Jancalek R, Sana J, Slampa P, Kazda T. Challenges with hippocampal MR spectroscopy as a surrogate for pre-radiotherapy assessment of neurocognitive impairment in patients with brain metastasis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024. [PMID: 38623639 DOI: 10.5507/bp.2024.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024] Open
Abstract
AIM Patients with multiple brain metastases (BM) benefit from hippocampal-avoiding whole brain radiotherapy (HA-WBRT), the challenging and less available form of WBRT. This study explores potential of pre-radiotherapy (pre-RT) hippocampal magnetic resonance spectroscopy (MRS) measuring hippocampal neuronal density as an imaging surrogate and predictive tool for assessing neurocognitive functions (NCF). METHODS 43 BM patients underwent pre-RT hippocampal MRS. N-acetyl aspartate (NAA) concentration, a marker for neuronal density (weighted by creatine (Cr) and choline (Cho) concentrations), and neurocognitive function (NCF) tests (HVLT and BVMT) performed by certified psychologists were evaluated. Clinical variables and NAA concentrations were correlated with pre-RT NCFs. RESULTS HVLT and BVMT subtests showed pre-RT deterioration except for BVMT recognition. Significantly better NCFs were observed in women in HVLT subsets. Significantly higher NAA/Cr + Cho was measured in women (median 0.63 vs. 0.55; P=0.048) in the left hippocampus (no difference in the right hippocampus). In men, a positive correlation (0.51, P=0.018) between total brain volume and HVLT-TR, between left hippocampal NAA/Cr + Cho and HVLT-R (0.45, P=0.063), and between right hippocampal NAA/Cr + Cho and BVMT-recognition (0.49, P=0.054) was observed. In women, a borderline significant negative correlation was observed between left hippocampal NAA/Cr + Cho and BVMT-TR (-0.43, P=0.076) and between right NAA/Cr + Cho and HVLT-DR (-0.42, P=0.051). CONCLUSION Borderline statistically significant correlations were observed with speculative interpretation underlying the challenges of hippocampal MRS as a surrogate for neurocognitive impairment. Further studies need to be done to ascertain the opportunities for imaging predictors of benefit from memory sparing radiotherapy.
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Affiliation(s)
- Iveta Selingerova
- Research Center for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Klara Holikova
- Department of Medical Imaging, St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Chodur
- Unit of Clinical Psychology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ludmila Hynkova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Martin Bulik
- Department of Medical Imaging, St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Renata Belanova
- Department of Radiology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Kamila Siffelova
- Unit of Clinical Psychology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Ivana Kolouskova
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Marek Slavik
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Petr Burkon
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Roman Hrstka
- Research Center for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Radim Jancalek
- Department of Neurosurgery, St. Anne's University Hospital Brno, Brno, Czech Republic
- Department of Neurosurgery, St. Anne's University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Jiri Sana
- Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute and Faculty of Medicine, Masaryk University, Brno, Czech Republic
- Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Pavel Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomas Kazda
- Research Center for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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Ranucci L, Brischigiaro L, Mazzotta V, Anguissola M, Menicanti L, Bedogni F, Ranucci M. Neurocognitive function in procedures correcting severe aortic valve stenosis: patterns and determinants. Front Cardiovasc Med 2024; 11:1372792. [PMID: 38682100 PMCID: PMC11055462 DOI: 10.3389/fcvm.2024.1372792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/26/2024] [Indexed: 05/01/2024] Open
Abstract
Background Neurocognitive changes occurring after a surgical aortic valve replacement (SAVR) or transcatheter aortic valve implantation (TAVI) procedure for the correction of severe aortic stenosis (AS) have not been widely addressed and, if addressed, have produced conflicting results. The purpose of this study is to identify the pre-procedural neurocognitive pattern and its determinants in a setting of elderly (>65 years) patients with severe AS undergoing SAVR or TAVI and the changes occurring at a 2-3 month follow-up. Methods This was a prospective cohort study included in the Italian Registry on Outcomes in Aortic Stenosis Treatment in Elderly Patients. Patients were assessed both before and after (2-3 months) the procedure using the Montreal Cognitive Assessment (MoCA) test. Data on periprocedural demographics, clinical factors, and outcome measures were collected. Results Before the procedure, 70% of the patients demonstrated a MoCA score <23 points, which was indicative of cognitive dysfunction. The factors associated with neurocognitive dysfunction were age, functional capacity, chronic heart failure, and hemoglobin levels. After the procedure, there was an overall improvement in the MoCA score of the patients, but 28% of the patients showed a reliable worsening of their condition. The factors associated with MoCA worsening were platelet transfusions and the amount of red blood cell units transfused. Conclusion The correction of severe AS leads to an improvement in neurocognitive function after 2-3 months. This improvement does not differentiate between SAVR and TAVI after matching for pre-procedural factors. The only modifiable factor associated with pre-procedural neurocognitive function is anemia, and anemia correction with red blood cell transfusions is associated with a worsening of neurocognitive function. This leads to the hypothesis that anemia correction before the procedure (with iron and/or erythropoietin) may limit the risk of a post-procedural worsening of neurocognitive function.
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Affiliation(s)
- L. Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - L. Brischigiaro
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - V. Mazzotta
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - M. Anguissola
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
| | - L. Menicanti
- Department of Cardiac Surgery, IRCCS Policlinico San Donato, Milan, Italy
| | - F. Bedogni
- Department of Cardiology, IRCCS Policlinico San Donato, Milan, Italy
| | - M. Ranucci
- Department of Cardiovascular Anesthesia and Intensive Care, IRCCS Policlinico San Donato, Milan, Italy
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Bromberg JEC, Issa S, van der Holt B, van der Meulen M, Dirven L, Minnema MC, Seute T, Durian M, Cull G, van der Poel MWM, Stevens WBC, Zijlstra JM, Brandsma D, Nijland M, Mason KD, Beeker A, Abrahamse-Testroote MCJ, van den Bent MJ, de Jong D, Doorduijn JK. Survival, neurocognitive function, and health-related quality of life outcomes after rituximab-methotrexate, BCNU, teniposide, and prednisolone for primary CNS lymphoma: Final results of the HOVON 105/ALLG NHL 24 study. Neuro Oncol 2024; 26:724-734. [PMID: 38037691 PMCID: PMC10995504 DOI: 10.1093/neuonc/noad224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Studies on the efficacy of rituximab in primary CNS lymphoma (PCNSL) reported conflicting results. Our international randomized phase 3 study showed that the addition of rituximab to high-dose methotrexate, BCNU, teniposide, and prednisolone (MBVP) in PCNSL was not efficacious in the short term. Here we present long-term results after a median follow-up of 82.3 months. METHODS One hundred and ninety-nine eligible newly diagnosed, nonimmunocompromised patients with PCNSL aged 18-70 years with WHO performance status 0-3 was randomized between treatment with MBVP chemotherapy with or without rituximab, followed by high-dose cytarabine consolidation in responding patients, and reduced-dose WBRT in patients aged ≤ 60 years. Event-free survival was the primary endpoint. Overall survival rate, neurocognitive functioning (NCF), and health-related quality of life (HRQoL) were additionally assessed, with the IPCG test battery, EORTC QLQ-C30 and QLQ-BN20 questionnaires, respectively. RESULTS For event-free survival, the hazard ratio was 0.85, 95% CI 0.61-1.18, P = .33. Overall survival rate at 5 years for MBVP and R-MBVP was 49% (39-59) and 53% (43-63) respectively. In total, 64 patients died in the MBVP arm and 55 in the R-MBVP arm, of which 69% were due to PCNSL. At the group level, all domains of NCF and HRQoL improved to a clinically relevant extent after treatment initiation, and remained stable thereafter up to 60 months of follow-up, except for motor speed which deteriorated between 24 and 60 months. Although fatigue improved initially, high levels persisted in the long term. CONCLUSIONS Long-term follow-up confirms the lack of added value of rituximab in addition to MBVP and HD-cytarabine for PCNSL.
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Affiliation(s)
- Jacoline E C Bromberg
- Department of Neuro-Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Samar Issa
- Department of Hematology, Middlemore Hospital, Auckland, New Zealand
| | - Bronno van der Holt
- HOVON Foundation, Rotterdam, The Netherlands
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Monique C Minnema
- Department of Hematology, University Medical Center Utrecht, The Netherlands
| | - Tatjana Seute
- Department of Neurology, University Medical Center, Utrecht, The Netherlands
| | - Marc Durian
- Department of Hematology, ETZ Hospital, Tilburg, The Netherlands
| | - Gavin Cull
- Sir Charles Gairdner Hospital and PathWest Laboratory Medicine, Nedlands, Western Australia, Australia
- Department of Hematology, University of Western Australia, Crawley, Western Australia, Australia
| | - Marjolein W M van der Poel
- Department of Internal Medicine, Division of Hematology, GROW School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Wendy B C Stevens
- Department of Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Josee M Zijlstra
- Department of Hematology, Amsterdam UMC, VUMC, Amsterdam, The Netherlands
| | - Dieta Brandsma
- Department of Neuro-Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marcel Nijland
- Department of Hematology, UMCG, Groningen, The Netherlands
| | - Kylie D Mason
- Department of Hematology, Royal Melbourne Hospital, Melbourne, Australia
| | - Aart Beeker
- Department of Hematology, Spaarne Gasthuis, Haarlem, The Netherlands
| | | | - Martin J van den Bent
- Department of Neuro-Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Daphne de Jong
- Department of Pathology and HOVON Pathology, Facility and Biobank, Amsterdam UMC, VUMC, Amsterdam, The Netherlands
| | - Jeanette K Doorduijn
- Department of Hematology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
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Zheng Y, Yee BJ, Wong K, Grunstein RR, Piper AJ. A comparison of two obesity-related hypoventilation disorders: Impact on sleep, quality of life and neurocognitive outcomes and the effects of positive airway pressure therapy. Sleep Adv 2024; 5:zpae016. [PMID: 38571727 PMCID: PMC10990061 DOI: 10.1093/sleepadvances/zpae016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/29/2023] [Indexed: 04/05/2024]
Abstract
Study Objectives Symptom impact and neurocognitive function have not been previously compared between patients with obesity-associated hypoventilation disorders (obesity hypoventilation syndrome [OHS]) and hypoventilation in the setting of obesity and obstructive airways disease (OHAD). The aim of this study is to compare baseline sleep-related symptoms, health-related quality of life, and neurocognitive function between OHS and OHAD and the impact of PAP therapy on these outcomes. Methods Epworth Sleepiness Scale (ESS), Pittsburgh Sleepiness Quality Index (PSQI), SF36, and various neurocognitive tests, in addition to anthropometric, polysomnography, lung function, and blood gas data from participants with OHS and participants with OHAD, were included in the analysis. These data were originally collected in their respective randomized clinical trials, comparing the efficacy of different PAP modes (bilevel PAP vs. CPAP) in resolving hypercapnia. Between groups (OHS vs OHAD), pre- and post-treatment (with 3 months of positive airway pressure) comparisons were made using linear mixed modeling. Results 45 OHS participants (mean age 51 years old, 33% female, BMI 52 kg/m2, FER 0.81, PaCO2 54 mmHg, AHI 87/h) and 32 OHAD participants (mean age 61years old, 31% female, BMI 43kg/m2, FER 0.60, PaCO2 54 mmHg, AHI 59/h) were included in the analysis. Both OHS and OHAD had similar baseline ESS (14(5.6) vs. 12(5.4)), Global PSQI (10(3.2) vs. 11(4.8)), SF36 and neurocognitive test performances (other than OHAD had lower digit symbol substitution test performance). Treatment with PAP therapy resulted in similar ESS, Global PSQI, and SF36 improvements in both groups. Neurocognitive performance did not significantly improve after PAP therapy in either group. Conclusions The symptom impact between two separate hypoventilation disorders (OHS and OHAD), in terms of sleepiness, sleep quality, quality of life, and cognitive function, were similar. OHS and OHAD had similar treatment responses in these parameters after 3 months of PAP therapy.Nocturnal ventilatory support in OHS.
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Affiliation(s)
- Yizhong Zheng
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
- Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
- Department of Respiratory and Sleep Medicine, St George Hospital, Sydney, NSW 2217, Australia
| | - Brendon J Yee
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
- Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Keith Wong
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
- Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
| | - Ronald R Grunstein
- Sleep and Circadian Research Group, Woolcock Institute of Medical Research, Sydney, NSW 2037, Australia
- Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia
| | - Amanda J Piper
- Central Clinical School, University of Sydney, Sydney, NSW 2050, Australia
- Department of Respiratory and Sleep Medicine, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia
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Won J, Callow DD, Purcell JJ, Smith JC. Hippocampal functional connectivity mediates the association between cardiorespiratory fitness and cognitive function in healthy young adults. J Int Neuropsychol Soc 2024; 30:199-208. [PMID: 37646336 DOI: 10.1017/s1355617723000498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Higher cardiorespiratory fitness (CRF) induces neuroprotective effects in the hippocampus, a key brain region for memory and learning. We investigated the association between CRF and functional connectivity (FC) of the hippocampus in healthy young adults. We also examined the association between hippocampal FC and neurocognitive function. Lastly, we tested whether hippocampal FC mediates the association between 2-Min Walk Test (2MWT) and neurocognitive function. METHODS 913 young adults (28.7 ± 3.7 years) from the Human Connectome Project were included in the analyses. The 2MWT performance result was used as a proxy for cardiovascular endurance. Fluid and crystalized composite neurocognitive scores were used to assess cognition. Resting-state functional MRI data were processed to measure hippocampal FC. Linear regression was used to examine the association between 2MWT, hippocampal FC, and neurocognitive outcomes after controlling for age, sex, years of education, body mass index, systolic blood pressure, and gait speed. RESULTS Better 2MWT performance was associated with greater FC between the anterior hippocampus and right posterior cingulate and left middle temporal gyrus. No associations between 2MWT and posterior hippocampal FC, whole hippocampal FC, and caudate FC (control region) were observed. Greater anterior hippocampal FC was associated with better crystalized cognition scores. Lastly, greater FC between the anterior hippocampus and right posterior cingulate mediated the association between better 2MWT scores and higher crystalized cognition scores. CONCLUSIONS Anterior hippocampal FC may be one underlying neurophysiological mechanism that promotes the association between 2MWT performance and crystalized composite cognitive function in healthy young adults.
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Affiliation(s)
- Junyeon Won
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas, TX, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Daniel D Callow
- Department of Kinesiology, University of Maryland, College Park, MD, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | - Jeremy J Purcell
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
| | - J Carson Smith
- Department of Kinesiology, University of Maryland, College Park, MD, USA
- Program in Neuroscience and Cognitive Science, University of Maryland, College Park, MD, USA
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Bitetti I, Manna MR, Stella R, Varone A. Motor and neurocognitive profiles of children with symptomatic spinal muscular atrophy type 1 with two copies of SMN2 before and after treatment: a longitudinal observational study. Front Neurol 2024; 15:1326528. [PMID: 38450080 PMCID: PMC10915206 DOI: 10.3389/fneur.2024.1326528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/30/2024] [Indexed: 03/08/2024] Open
Abstract
Introduction Spinal muscular atrophy (SMA) is a neurodegenerative disease caused by mutations in the survival motor neuron 1 (SMN1) gene. In clinical studies, gene replacement therapy with onasemnogene abeparvovec (formerly AVXS-101, Zolgensma®, Novartis) was efficacious in improving motor functioning in children with SMA. However, its effects on cognitive and language skills are largely unknown. Methods This longitudinal observational study evaluated changes in motor and neurocognitive functioning over a 1-year period after administration of onasemnogene abeparvovec in 12 symptomatic SMA type 1 patients with two copies of SMN2 aged 1.7-52.6 months at administration. Motor functioning was measured using the Children's Hospital of Philadelphia Infant Test for Neuromuscular Disorders (CHOP-INTEND) while neurocognitive assessment was measured using Griffiths III. Motor milestones and language ability were also assessed at each timepoint. Results and discussion Statistically significant increases in median CHOP-INTEND scores from baseline were observed at 1, 3, 6, and 12 months after onasemnogene abeparvovec administration (all p ≤ 0.005). Most (91.7%) patients were able to roll over or sit independently for >1 min at 12 months. Significant increases in the Griffiths III Foundations of Learning, Language and Communication, Eye and Hand Coordination, and Personal-Social-Emotional subscale scores were observed at 12-months, but not in the Gross Motor subscale. Speech and language abilities progressed in most patients. Overall, most patients showed some improvement in cognitive and communication performance after treatment with onasemnogene abeparvovec in addition to significant improvement in motor functioning and motor milestones. Evaluation of neurocognitive function should be considered when assessing the global functioning of patients with SMA.
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Affiliation(s)
- Ilaria Bitetti
- Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Maria Rosaria Manna
- Neurorehabilitation Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Roberto Stella
- Neurorehabilitation Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Antonio Varone
- Pediatric Neurology, Santobono-Pausilipon Children's Hospital, Naples, Italy
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Domena AM, Rosenblum DJ, Donahue CC, Resch JE. The Influence of Race on Time to Symptom Resolution Following Sport Concussion in Collegiate Athletes. J Sport Rehabil 2024:1-6. [PMID: 38335953 DOI: 10.1123/jsr.2023-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 09/14/2023] [Accepted: 12/20/2023] [Indexed: 02/12/2024]
Abstract
CONTEXT Race has been shown to influence computerized neurocognitive test scores, motor function test scores, and reported symptomology following sport-related concussion (SRC). However, the effect race may have on recovery time following SRC remains unknown. The objective of this study was to determine the influence of race on days until symptom free from SRC in NCAA Division 1 collegiate athletes. DESIGN Prospective cohort study. METHODS Participants were Black (n = 53 [28% female]) and White (n = 150 [43.3% female]) who were on average 19.0 (1.21) and 20.2 (1.3) years of age, respectively. Data were collected from the 2015-2016 to 2020-2021 collegiate sport seasons. Participants were evaluated before and after an SRC at empirically derived time points. The primary outcome measure was time until symptom free (days). Additional outcomes included baseline and postinjury Immediate Postconcussion Assessment and Cognitive Test and Sensory Organization Test (SOT) scores. A Mann-Whitney U test compared days to symptom free between groups. Immediate Postconcussion Assessment and Cognitive Test and SOT outcome scores were analyzed using a 2 (group) × 2 (time) analysis of variance. RESULTS White participants had a longer median recovery time (9 d) to symptom free compared with Black participants (6 d [P = .04]). Statistically significant differences were observed between Black 87.3 (9.84) and White 90.4 (8.30) groups for Immediate Postconcussion Assessment and Cognitive Test's verbal memory composite score (P = .03). Postinjury, White participants scored significantly higher 44.5 (5.63) on visual motor speed compared with Black participants (42.4 (5.90) [P = .02]). Within-group SOT differences between baseline and postinjury testing were observed in both groups (all P < .001). CONCLUSIONS Black collegiate athletes achieved symptom resolution sooner than White athletes. We did not explore underlying sociocultural factors such as socioeconomic status or previous concussion education, which may have influenced our results. Future studies should explore factors that may contextualize these findings.
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Affiliation(s)
- Angelina M Domena
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Daniel J Rosenblum
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
| | - Catherine C Donahue
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, Colorado
- Sports Medicine Center, Children's Hospital of Colorado, Aurora, Colorado
| | - Jacob E Resch
- Department of Kinesiology, University of Virginia, Charlottesville, VA, USA
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Rao S, Cai Y, Zhong Z, Gou T, Wang Y, Liao S, Qiu P, Kuang W. Prevalence, cognitive characteristics, and influencing factors of amnestic mild cognitive impairment among older adults residing in an urban community in Chengdu, China. Front Neurol 2024; 15:1336385. [PMID: 38356893 PMCID: PMC10864602 DOI: 10.3389/fneur.2024.1336385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 01/16/2024] [Indexed: 02/16/2024] Open
Abstract
Objective Dementia is a significant public health concern, and mild cognitive impairment (MCI) serves as a transitional stage between normal aging and dementia. Among the various types of MCI, amnestic MCI (aMCI) has been identified as having a higher likelihood of progressing to Alzheimer's dimension. However, limited research has been conducted on the prevalence of aMCI in China. Therefore, the objective of this study is to investigate the prevalence of aMCI, examine its cognitive characteristics, and identify associated risk factors. Methods In this cross-sectional study, we investigated a sample of 368 older adults aged 60 years and above in the urban communities of Chengdu, China. The participants underwent a battery of neuropsychological assessments, including the Mini-Mental State Examination (MMSE), the Clinical Dementia Rating (CDR), Auditory Verbal Learning Test (AVLT), Wechsler's Logical Memory Task (LMT), Boston Naming Test (BNT) and Trail Making Test Part A (TMT-A). Social information was collected by standard questionnaire. Multiple logistic regression analysis was utilized to screen for the risk and protective factors of aMCI. Results The data analysis included 309 subjects with normal cognitive function and 59 with aMCI, resulting in a prevalence of 16.0% for aMCI. The average age of participants was 69.06 ± 7.30 years, with 56.0% being females. After controlling for age, gender and education, the Spearman partial correlation coefficient between various cognitive assessments and aMCI ranged from -0.52 for the long-term delayed recall scores in AVLT to 0.19 for the time-usage scores in TMT-A. The results indicated that all cognitive domains, except for naming scores (after semantic cue of BNT) and error quantity (in TMT-A), showed statistically significant associations with aMCI. Furthermore, the multiple logistic regression analysis revealed that older age (OR = 1.044, 95%CI: 1.002~1.087), lower educational level, and diabetes (OR = 2.450, 95%CI: 1.246~4.818) were risk factors of aMCI. Conclusion This study found a high prevalence of aMCI among older adults in Chengdu, China. Individuals with aMCI exhibited lower cognitive function in memory, language, and executive domains, with long-term delayed recall showing the strongest association. Clinicians should prioritize individuals with verbal learning and memory difficulties, especially long-term delayed recall, in clinical practice.
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Affiliation(s)
- Shan Rao
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yan Cai
- Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zhujun Zhong
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Tianyuan Gou
- Chengdu Jinxin Mental Diseases Hospital, Chengdu, Sichuan, China
| | - Yangyang Wang
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Shiyi Liao
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Peiyuan Qiu
- Department of Epidemiology and Statistics, West China School of Public Health, Sichuan University, Chengdu, Sichuan, China
| | - Weihong Kuang
- Department of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Pospisil P, Hynkova L, Hnidakova L, Maistryszinova J, Slampa P, Kazda T. Unilateral hippocampal sparing during whole brain radiotherapy for multiple brain metastases: narrative and critical review. Front Oncol 2024; 14:1298605. [PMID: 38327742 PMCID: PMC10847587 DOI: 10.3389/fonc.2024.1298605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
Background The landscape of brain metastases radiotherapy is evolving, with a shift away from whole-brain radiotherapy (WBRT) toward targeted stereotactic approaches aimed at preserving neurocognitive functions and maintaining overall quality of life. For patients with multiple metastases, especially in cases where targeted radiotherapy is no longer feasible due to widespread dissemination, the concept of hippocampal sparing radiotherapy (HA_WBRT) gains prominence. Methods In this narrative review we explore the role of the hippocampi in memory formation and the implications of their postradiotherapy lateral damage. We also consider the potential advantages of selectively sparing one hippocampus during whole-brain radiotherapy (WBRT). Additionally, by systematic evaluation of relevant papers published on PubMed database over last 20 years, we provide a comprehensive overview of the various changes that can occur in the left or right hippocampus as a consequence of radiotherapy. Results While it is important to note that various neurocognitive functions are interconnected throughout the brain, we can discern certain specialized roles of the hippocampi. The left hippocampus appears to play a predominant role in verbal memory, whereas the right hippocampus is associated more with visuospatial memory. Additionally, the anterior part of the hippocampus is more involved in episodic memory and emotional processing, while the posterior part is primarily responsible for spatial memory and pattern separation. Notably, a substantial body of evidence demonstrates a significant correlation between post-radiotherapy changes in the left hippocampus and subsequent cognitive decline in patients. Conclusion In the context of individualized palliative radiotherapy, sparing the unilateral (specifically, the left, which is dominant in most individuals) hippocampus could expand the repertoire of strategies available for adapted WBRT in cases involving multiple brain metastases where stereotactic radiotherapy is not a viable option. Prospective ongoing studies assessing various memory-sparing radiotherapy techniques will define new standard of radiotherapy care of patients with multiple brain metastases.
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Affiliation(s)
- Petr Pospisil
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ludmila Hynkova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Lucie Hnidakova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jana Maistryszinova
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Pavel Slampa
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Tomas Kazda
- Department of Radiation Oncology, Masaryk Memorial Cancer Institute, Brno, Czechia
- Department of Radiation Oncology, Faculty of Medicine, Masaryk University, Brno, Czechia
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Wijaya EA, Solek P, Rachmadi D, Rahayuningsih SE, Tarigan R, Hilmanto D. Effect of Executive Function on Health-Related Quality of Life in Children with Chronic Kidney Disease. Int J Nephrol Renovasc Dis 2024; 17:17-28. [PMID: 38223907 PMCID: PMC10785681 DOI: 10.2147/ijnrd.s428657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 12/21/2023] [Indexed: 01/16/2024] Open
Abstract
Introduction As the highest function in the brain that regulates our daily activity, executive dysfunction might affect someone's health-related quality of life (HRQoL), especially in those with chronic diseases, including chronic kidney disease (CKD). Neurocognitive functions, including intelligence quotient (IQ) and executive function can be affected through various mechanisms in CKD. However, there was still no specific study regarding how IQ and executive function might affect HRQoL in children with CKD. Purpose To assess Executive Function's impact on HRQoL and to find association between treatment modalities and CKD stages with HRQoL in children with CKD. Methods A cross sectional study was conducted at Pediatric Nephrology Clinic at Hasan Sadikin General Hospital, Bandung, Indonesia from September 2022 to April 2023. We included 38 children whose age range were 6-16 years 11 months old with CKD stage III - V. Assessment tools used were: BRIEF questionnaire for executive function; WISC III tool for IQ; PedsQLTM questionnaire generic module for HRQoL. Data was analyzed using SPSS ver. 26.0. Results Total number of samples was 38. Complete examinations were done on 30 patients. Eight other patients did not undergo the IQ test. There was a negative correlation between executive function components scores (GEC, BRI, MI) with HRQoL scores on parents' proxy in all domains. We found no correlation between HRQoL and IQ scores, but we found a correlation between IQ and CKD stage. There was a significant difference in HRQoL from the children's perspective among the three modalities; children who underwent conservative treatment were having the best HRQoL scores. Conclusion Interventions to improve executive function of children with CKD should be done to improve their HRQoL in the future. Early diagnosis and treatment of CKD should be done at the earliest to improve neurocognitive function and HRQoL.
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Affiliation(s)
- Elrika Anastasia Wijaya
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Purboyo Solek
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dedi Rachmadi
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Sri Endah Rahayuningsih
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Rodman Tarigan
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran, Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
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Liu Y, Ouyang Y, You W, Liu W, Cheng Y, Mai X, Shen Z. Physiological roles of human interleukin-17 family. Exp Dermatol 2024; 33:e14964. [PMID: 37905720 DOI: 10.1111/exd.14964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 11/02/2023]
Abstract
Interleukin-17 s (IL-17s) are well-known proinflammatory cytokines, and their antagonists perform excellently in the treatment of inflammatory skin diseases such as psoriasis. However, their physiological functions have not been given sufficient attention by clinicians. IL-17s can protect the host from extracellular pathogens, maintain epithelial integrity, regulate cognitive processes and modulate adipocyte activity through distinct mechanisms. Here, we present a systematic review concerning the physiological functions of IL-17s. Our goal is not to negate the therapeutic effect of IL-17 antagonists, but to ensure their safe use and reasonably explain the possible adverse events that may occur in their application.
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Affiliation(s)
- Yucong Liu
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Ye Ouyang
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Wanchun You
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China
| | - Wenqi Liu
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Yufan Cheng
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Xinming Mai
- Medical School, Shenzhen University, Shenzhen, China
| | - Zhu Shen
- Department of Dermatology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
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12
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Reiche E, Collins K, Genoese F, Walaszek M, Triplett A, Kuenze C, Harkey M, Baez S. Lower Extremity Reaction Time in Individuals With Contact Versus Noncontact Anterior Cruciate Ligament Injuries After Reconstruction. J Athl Train 2024; 59:66-72. [PMID: 37248503 PMCID: PMC10783466 DOI: 10.4085/1062-6050-0428.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
CONTEXT Deficits in perceptual-motor function, like visuomotor reaction time (VMRT), are risk factors for primary and secondary anterior cruciate ligament (ACL) injury. Noncontact ACL injuries have been associated with slower reaction time, but whether this association exists for patients with contact ACL injuries is unknown. Exploring differences in VMRT among individuals with contact versus noncontact ACL injuries may provide a more comprehensive understanding of modifiable risk factors. OBJECTIVE To compare lower extremity VMRT (LEVMRT) in individuals with contact or noncontact ACL injuries after ACL reconstruction (ACLR). DESIGN Cross-sectional study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS A total of 36 participants with primary, unilateral ACLR completed an LEVMRT assessment (contact ACL injury = 20 [56%], noncontact ACL injury = 16 [44%]). MAIN OUTCOME MEASURE(S) The LEVMRT was assessed bilaterally and collected using a series of wireless light discs deactivated by individuals with their feet. The ACLR-active LEVMRT (ie, ACLR limb is deactivating lights) and ACLR-stable LEVMRT were compared using separate analyses of covariance to determine the association with contact or noncontact injury using time since surgery as a covariate. RESULTS After controlling for time since surgery, a difference and large effect size between groups was found for the ACLR-stable LEVMRT (P = .010; η2 = 0.250) but not for the ACLR-active (P = .340; η2 = 0.065) condition. The contact group exhibited slower ACLR-stable LEVMRT (521.7 ± 59.3 milliseconds) than the noncontact group (483.4 ± 83.9 milliseconds). CONCLUSIONS Individuals with contact ACL injury demonstrated a slower LEVMRT while their ACLR limb was stabilizing. The group differences during the ACLR-stable LEVMRT task might indicate deficits in perceptual-motor function when the surgical limb maintains postural control during a reaction time task. After ACLR, individuals with contact injuries may need additional motor learning interventions to enhance perceptual-motor functioning.
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Affiliation(s)
- Elaine Reiche
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
| | | | | | | | - Ashley Triplett
- Department of Kinesiology, Michigan State University, East Lansing
| | | | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing
| | - Shelby Baez
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill
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Zampi JD, Heinrich KP, Bergersen L, Goldstein BH, Batlivala SP, Fuller S, Glatz AC, O'Byrne ML, Marino B, Afton K, Lowery R, Yu S, Goldberg CS. Neurocognitive function and health-related quality of life in adolescents and young adults with CHD with pulmonary valve dysfunction. Cardiol Young 2023:1-8. [PMID: 38031461 DOI: 10.1017/s1047951123003979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Neurocognitive impairment and quality of life are two important long-term challenges for patients with complex CHD. The impact of re-interventions during adolescence and young adulthood on neurocognition and quality of life is not well understood. METHODS In this prospective longitudinal multi-institutional study, patients 13-30 years old with severe CHD referred for surgical or transcatheter pulmonary valve replacement were enrolled. Clinical characteristics were collected, and executive function and quality of life were assessed prior to the planned pulmonary re-intervention. These results were compared to normative data and were compared between treatment strategies. RESULTS Among 68 patients enrolled from 2016 to 2020, a nearly equal proportion were referred for surgical and transcatheter pulmonary valve replacement (53% versus 47%). Tetralogy of Fallot was the most common diagnosis (59%) and pulmonary re-intervention indications included stenosis (25%), insufficiency (40%), and mixed disease (35%). There were no substantial differences between patients referred for surgical and transcatheter therapy. Executive functioning deficits were evident in 19-31% of patients and quality of life was universally lower compared to normative sample data. However, measures of executive function and quality of life did not differ between the surgical and transcatheter patients. CONCLUSION In this patient group, impairments in neurocognitive function and quality of life are common and can be significant. Given similar baseline characteristics, comparing changes in neurocognitive outcomes and quality of life after surgical versus transcatheter pulmonary valve replacement will offer unique insights into how treatment approaches impact these important long-term patient outcomes.
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Affiliation(s)
- Jeffrey D Zampi
- Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | | | - Lisa Bergersen
- Division of Pediatric Cardiology, Boston Children's Hospital, Boston, MA, USA
| | - Bryan H Goldstein
- UPMC Children's Hospital of Pittsburgh and Department of Pediatrics, Heart Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Stephanie Fuller
- Division of Cardiac Surgery, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Andrew C Glatz
- Division of Pediatric Cardiology, St. Louis Children's and Washington University Heart Center, St. Louis, MO, USA
| | - Michael L O'Byrne
- Division of Pediatric Cardiology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Bradley Marino
- Department of Pediatrics, Division of Pediatric Cardiology, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Katherine Afton
- Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Ray Lowery
- Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Sunkyung Yu
- Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
| | - Caren S Goldberg
- Department of Pediatrics, University of Michigan Congenital Heart Center, Ann Arbor, MI, USA
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Keihani A, Mayeli A, Ferrarelli F. Circadian Rhythm Changes in Healthy Aging and Mild Cognitive Impairment. Adv Biol (Weinh) 2023; 7:e2200237. [PMID: 36403250 PMCID: PMC10199146 DOI: 10.1002/adbi.202200237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Disruptions in circadian rhythms can occur in healthy aging; however, these changes are more severe and pervasive in individuals with age-related and neurodegenerative diseases, such as dementia. Circadian rhythm alterations are also present in preclinical stages of dementia, for example, in patients with mild cognitive impairments (MCI); thus, providing a unique window of opportunity for early intervention in neurodegenerative disorders. Nonetheless, there is a lack of studies examining the association between relevant changes in circadian rhythms and their relationship with cognitive dysfunctions in MCI individuals. In this review, circadian system alterations occurring in MCI patients are examined compared to healthy aging individuals while also considering their association with MCI neurocognitive alterations. The main findings are that abnormal circadian changes in rest-activity, core body temperature, melatonin, and cortisol rhythms appear in the MCI stage and that these circadian rhythm disruptions are associated with some of the neurocognitive deficits observed in MCI patients. In addition, preliminary evidence indicates that interventions aimed at restoring regular circadian rhythms may prevent or halt the progress of neurodegenerative diseases and mitigate their related cognitive impairments. Future longitudinal studies with repeated follow-up assessments are needed to establish the translational potential of these findings in clinical practice.
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Affiliation(s)
- Ahmadreza Keihani
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
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Zheng Y, You L, Feng B, Tang M, Na F. Cranial radiation therapy with hippocampus avoidance in lung cancer treatment: systematic review and meta-analysis. Front Oncol 2023; 13:1268754. [PMID: 37936606 PMCID: PMC10626474 DOI: 10.3389/fonc.2023.1268754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023] Open
Abstract
Background The role of cranial radiation therapy with hippocampus avoidance (HA-CRT) in neurocognitive function (NCF), brain metastasis (BM), and overall survival (OS) in lung cancer remains unclear. Methods A meta-analysis was conducted to evaluate the impact of HA-CRT in lung cancer. Data from studies on hippocampal-avoidance prophylactic cranial irradiation (HA-PCI) and whole brain radiotherapy (HA-WBRT) were pooled. Results A total of 14 studies, including 5 randomized controlled trials, were included. The focus of NCF was mainly via the Hopkins Verbal Learning Test-Revised or the Free and Cued Selective Reminding Test. At 6 months post-radiotherapy, the pooled proportion of participants with decline in the performance of total recall, delayed recall, and discrimination in neurocognitive tests were 0.22 (95% CI 0.15, 0.29), 0.20 (95% CI 0.13, 0.27), and 0.14 (95% CI 0.05, 0.24) respectively. After 12 months, the proportion were 0.16 (95% CI 0.08, 0.23), 0.10 (95% CI 0.04, 0.16), and 0.04 (95% CI 0, 0.09) respectively. For HA zone relapse, the RR of HA-CRT versus CRT was 2.72 (95% CI 0.53, 13.87), and for 2-year BM, it was 1.20 (95% CI 0.82, 1.75). Regarding HA-PCI in SCLC, the 1-year BM rate was 0.12 (95% CI 0.07, 0.17), and the 2-year BM rate was 0.20 (95% CI 0.16, 0.25). For HA-WBRT in NSCLC with BM, the 2-year intracranial progression rate was 0.38 (95% CI 0.13, 0.62). There was no significant difference in OS between HA-CRT and CRT. Conclusions HA-CRT appears to be safe in lung cancer, but it may not outperform conventional CRT. Larger RCTs comparing HA-CRT and CRT are warranted. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022360890, identifier CRD42022360890.
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Affiliation(s)
- Yue Zheng
- Division of Thoracic Tumor Multimodality Treatment and Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Liting You
- Department of Laboratory Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Baijie Feng
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Min Tang
- Division of Thoracic Tumor Multimodality Treatment and Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Feifei Na
- Division of Thoracic Tumor Multimodality Treatment and Department of Radiation Oncology, Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Shibata S, Takemura M, Miyakawa S. Kinematics, Kinetics and Muscle Activity Analysis during Single-leg Drop-jump Landing Followed by an Unanticipated Task: Focusing on Differences in Neurocognitive Function. Int J Sports Phys Ther 2023; 18:1085-1093. [PMID: 37795316 PMCID: PMC10547070 DOI: 10.26603/001c.86124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 07/19/2023] [Indexed: 10/06/2023] Open
Abstract
Background Lower neurocognitive function is a risk factor for anterior cruciate ligament (ACL) injury. However, the mechanism by which lower neurocognitive function increases the risk of ACL injury remains unclear. Purpose To clarify the effect of differences in neurocognitive function on landing mechanics during a single-leg drop-jump landing motion followed by an unanticipated task. Study Design Cross-sectional study. Methods Fifteen collegiate female athletes were recruited (20.1 ± 1.3 years, 166.6 ± 7.3 cm, 60.6 ± 6.9 kg) and were divided into two groups (the high-performance (HP) group and the lower-performance (LP) group) using the median Symbol Digit Modalities Test (SDMT) score. Three-dimensional motion analysis was employed for the analysis during the experimental task of a single-leg drop-jump followed by an unanticipated landing task from a 30-cm high box. Joint angular changes of the trunk, pelvis, hip, and knee were calculated within the interval from initial contact (IC) to 40ms. Knee and hip moments were calculated as the maximum values within the interval from IC to 40ms. Surface electromyography data from key muscles were analyzed 50ms before and after IC. Independent t-tests were used to compare the effects of different neurocognitive function on the measurement items. Statistical significance was set at p < 0.05. Results The SDMT score was significantly higher in HP group (HP: 77.9 ± 5.5; LP: 66.0 ± 3.4; p < 0.001). The LP group had a significantly greater trunk rotation angular change to the stance leg side (HP: 0.4 ± 0.8; LP: 1.2 ± 0.4; p = 0.020). There were no significant differences between the two groups in terms of joint moments, and muscle activities. Conclusion Differences in neurocognitive function by SDMT were found to be related to differences in motor strategies of the trunk in the horizontal plane. Although trunk motion in the sagittal and frontal planes during single-leg drop-jump landing increases the ACL injury risk by affecting knee joint motion, the effect of trunk motion in the horizontal plane remains unclear. Level of Evidence 3© The Authors.
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Bitetti I, Manna MR, Stella R, Varone A. Sequential treatment with nusinersen, Zolgensma ® and risdiplam in a paediatric patient with spinal muscular atrophytype 1: a case report. Acta Myol 2023; 42:82-85. [PMID: 38090542 PMCID: PMC10712653 DOI: 10.36185/2532-1900-356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 09/04/2023] [Indexed: 12/18/2023]
Abstract
Spinal muscular atrophy (SMA) is an autosomal recessive neuromuscular disorder that causes muscle atrophy and weakness. While no specific therapies existed until a few years ago, several effective disease-modifying treatments have become available in recent years. However, there are currently no recommendations on the management of therapy sequencing involving these new treatments. A 4-months-old girl with SMA type 1 and two copies of SMN2 was started on treatment with nusinersen resulting in significant improvement in her motor and respiratory function. However, after six doses, treatment was changed to Zolgensma® due to caregiver's decision. In the months following the administration, the patient showed significant clinical improvement in motor performance. After 12 months, the child started therapy with risdiplam in another country. One year after the start of therapy with risdiplam further improvements in both motor and bulbar functions were highlighted. This case report raises a question: is a multiple consecutive theraphy more effective than monotherapy in SMA treatment? These results suggest the need to further explore the potential efficacy of a multidrug treatment.
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Affiliation(s)
- Ilaria Bitetti
- Pediatric Neurology, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Maria Rosaria Manna
- Rehabilitation Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Roberto Stella
- Rehabilitation Unit, Santobono-Pausilipon Children’s Hospital, Naples, Italy
| | - Antonio Varone
- Pediatric Neurology, Santobono-Pausilipon Children’s Hospital, Naples, Italy
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Akins JD, Brothers RM. Unlocking the complications of chronic concussion in rugby players: A traumatic tale of cerebral injury. Exp Physiol 2023; 108:1106-1107. [PMID: 37551823 PMCID: PMC10988438 DOI: 10.1113/ep091352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/09/2023]
Affiliation(s)
- John D. Akins
- Institute for Exercise and Environmental Medicine at Texas Health Presbyterian Hospital DallasDallasTXUSA
- The University of Texas Southwestern Medical CenterDallasTXUSA
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Tomić Mahečić T, Malojčić B, Tonković D, Mažar M, Baronica R, Juren Meaški S, Crkvenac Gregorek A, Meier J, Dünser MW. Near-Infrared Spectroscopy-Guided, Individualized Arterial Blood Pressure Management for Carotid Endarterectomy under General Anesthesia: A Randomized, Controlled Trial. J Clin Med 2023; 12:4885. [PMID: 37568287 PMCID: PMC10420278 DOI: 10.3390/jcm12154885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Revised: 07/13/2023] [Accepted: 07/19/2023] [Indexed: 08/13/2023] Open
Abstract
Background: Differences in blood pressure can influence the risk of brain ischemia, perioperative complications, and postoperative neurocognitive function in patients undergoing carotid endarterectomy (CEA). Methods: In this single-center trial, patients scheduled for CEA under general anesthesia were randomized into an intervention group receiving near-infrared spectroscopy (NIRS)-guided blood pressure management during carotid cross-clamping and a control group receiving standard care. The primary endpoint was postoperative neurocognitive function assessed before surgery, on postoperative days 1 and 7, and eight weeks after surgery. Perioperative complications and cerebral autoregulatory capacity were secondary endpoints. Results: Systolic blood pressure (p < 0.001) and norepinephrine doses (89 (54-122) vs. 147 (116-242) µg; p < 0.001) during carotid cross-clamping were lower in the intervention group. No group differences in postoperative neurocognitive function were observed. The rate of perioperative complications was lower in the intervention group than in the control group (3.3 vs. 26.7%, p = 0.03). The breath-holding index did not differ between groups. Conclusions: Postoperative neurocognitive function was comparable between CEA patients undergoing general anesthesia in whom arterial blood pressure during carotid cross-clamping was guided using NIRS and subjects receiving standard care. NIRS-guided, individualized arterial blood pressure management resulted in less vasopressor exposition and a lower rate of perioperative complications.
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Affiliation(s)
- Tina Tomić Mahečić
- Department of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Branko Malojčić
- Department of Neurology, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Dinko Tonković
- Department of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Mirabel Mažar
- Department of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Robert Baronica
- Department of Anesthesiology and Intensive Care Medicine, Clinical Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | | | | | - Jens Meier
- Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University, 4040 Linz, Austria
| | - Martin W. Dünser
- Department of Anesthesiology and Intensive Care Medicine, Kepler University Hospital and Johannes Kepler University, 4040 Linz, Austria
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Chang JL, Goldberg AN, Alt JA, Alzoubaidi M, Ashbrook L, Auckley D, Ayappa I, Bakhtiar H, Barrera JE, Bartley BL, Billings ME, Boon MS, Bosschieter P, Braverman I, Brodie K, Cabrera-Muffly C, Caesar R, Cahali MB, Cai Y, Cao M, Capasso R, Caples SM, Chahine LM, Chang CP, Chang KW, Chaudhary N, Cheong CSJ, Chowdhuri S, Cistulli PA, Claman D, Collen J, Coughlin KC, Creamer J, Davis EM, Dupuy-McCauley KL, Durr ML, Dutt M, Ali ME, Elkassabany NM, Epstein LJ, Fiala JA, Freedman N, Gill K, Boyd Gillespie M, Golisch L, Gooneratne N, Gottlieb DJ, Green KK, Gulati A, Gurubhagavatula I, Hayward N, Hoff PT, Hoffmann OM, Holfinger SJ, Hsia J, Huntley C, Huoh KC, Huyett P, Inala S, Ishman SL, Jella TK, Jobanputra AM, Johnson AP, Junna MR, Kado JT, Kaffenberger TM, Kapur VK, Kezirian EJ, Khan M, Kirsch DB, Kominsky A, Kryger M, Krystal AD, Kushida CA, Kuzniar TJ, Lam DJ, Lettieri CJ, Lim DC, Lin HC, Liu SY, MacKay SG, Magalang UJ, Malhotra A, Mansukhani MP, Maurer JT, May AM, Mitchell RB, Mokhlesi B, Mullins AE, Nada EM, Naik S, Nokes B, Olson MD, Pack AI, Pang EB, Pang KP, Patil SP, Van de Perck E, Piccirillo JF, Pien GW, Piper AJ, Plawecki A, Quigg M, Ravesloot MJ, Redline S, Rotenberg BW, Ryden A, Sarmiento KF, Sbeih F, Schell AE, Schmickl CN, Schotland HM, Schwab RJ, Seo J, Shah N, Shelgikar AV, Shochat I, Soose RJ, Steele TO, Stephens E, Stepnowsky C, Strohl KP, Sutherland K, Suurna MV, Thaler E, Thapa S, Vanderveken OM, de Vries N, Weaver EM, Weir ID, Wolfe LF, Tucker Woodson B, Won CH, Xu J, Yalamanchi P, Yaremchuk K, Yeghiazarians Y, Yu JL, Zeidler M, Rosen IM. International Consensus Statement on Obstructive Sleep Apnea. Int Forum Allergy Rhinol 2023; 13:1061-1482. [PMID: 36068685 PMCID: PMC10359192 DOI: 10.1002/alr.23079] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 08/12/2022] [Accepted: 08/18/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evaluation and interpretation of the literature on obstructive sleep apnea (OSA) allows for consolidation and determination of the key factors important for clinical management of the adult OSA patient. Toward this goal, an international collaborative of multidisciplinary experts in sleep apnea evaluation and treatment have produced the International Consensus statement on Obstructive Sleep Apnea (ICS:OSA). METHODS Using previously defined methodology, focal topics in OSA were assigned as literature review (LR), evidence-based review (EBR), or evidence-based review with recommendations (EBR-R) formats. Each topic incorporated the available and relevant evidence which was summarized and graded on study quality. Each topic and section underwent iterative review and the ICS:OSA was created and reviewed by all authors for consensus. RESULTS The ICS:OSA addresses OSA syndrome definitions, pathophysiology, epidemiology, risk factors for disease, screening methods, diagnostic testing types, multiple treatment modalities, and effects of OSA treatment on multiple OSA-associated comorbidities. Specific focus on outcomes with positive airway pressure (PAP) and surgical treatments were evaluated. CONCLUSION This review of the literature consolidates the available knowledge and identifies the limitations of the current evidence on OSA. This effort aims to create a resource for OSA evidence-based practice and identify future research needs. Knowledge gaps and research opportunities include improving the metrics of OSA disease, determining the optimal OSA screening paradigms, developing strategies for PAP adherence and longitudinal care, enhancing selection of PAP alternatives and surgery, understanding health risk outcomes, and translating evidence into individualized approaches to therapy.
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Affiliation(s)
- Jolie L. Chang
- University of California, San Francisco, California, USA
| | | | | | | | - Liza Ashbrook
- University of California, San Francisco, California, USA
| | | | - Indu Ayappa
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | - Maurits S. Boon
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Pien Bosschieter
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | - Itzhak Braverman
- Hillel Yaffe Medical Center, Hadera Technion, Faculty of Medicine, Hadera, Israel
| | - Kara Brodie
- University of California, San Francisco, California, USA
| | | | - Ray Caesar
- Stone Oak Orthodontics, San Antonio, Texas, USA
| | | | - Yi Cai
- University of California, San Francisco, California, USA
| | | | | | | | | | | | | | | | | | - Susmita Chowdhuri
- Wayne State University and John D. Dingell VA Medical Center, Detroit, Michigan, USA
| | - Peter A. Cistulli
- Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - David Claman
- University of California, San Francisco, California, USA
| | - Jacob Collen
- Uniformed Services University, Bethesda, Maryland, USA
| | | | | | - Eric M. Davis
- University of Virginia, Charlottesville, Virginia, USA
| | | | | | - Mohan Dutt
- University of Michigan, Ann Arbor, Michigan, USA
| | - Mazen El Ali
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | | | | | | | - Kirat Gill
- Stanford University, Palo Alto, California, USA
| | | | - Lea Golisch
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | | | | | - Arushi Gulati
- University of California, San Francisco, California, USA
| | | | | | - Paul T. Hoff
- University of Michigan, Ann Arbor, Michigan, USA
| | - Oliver M.G. Hoffmann
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | | | - Jennifer Hsia
- University of Minnesota, Minneapolis, Minnesota, USA
| | - Colin Huntley
- Sidney Kimmel Medical Center at Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | | | | | - Sanjana Inala
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | | | | | | | | | | | | | - Meena Khan
- Ohio State University, Columbus, Ohio, USA
| | | | - Alan Kominsky
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | - Meir Kryger
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Derek J. Lam
- Oregon Health and Science University, Portland, Oregon, USA
| | | | | | | | | | | | | | - Atul Malhotra
- University of California, San Diego, California, USA
| | | | - Joachim T. Maurer
- University Hospital Mannheim, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - Anna M. May
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Ron B. Mitchell
- University of Texas, Southwestern and Children’s Medical Center Dallas, Texas, USA
| | | | | | | | | | - Brandon Nokes
- University of California, San Diego, California, USA
| | | | - Allan I. Pack
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | | | | | | | | | | | | | | | - Mark Quigg
- University of Virginia, Charlottesville, Virginia, USA
| | | | - Susan Redline
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Armand Ryden
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, California, USA
| | | | - Firas Sbeih
- Cleveland Clinic Head and Neck Institute, Cleveland, Ohio, USA
| | | | | | | | | | - Jiyeon Seo
- University of California, Los Angeles, California, USA
| | - Neomi Shah
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Ryan J. Soose
- University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | | | - Erika Stephens
- University of California, San Francisco, California, USA
| | | | | | | | | | - Erica Thaler
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Sritika Thapa
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | - Nico de Vries
- Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands
| | | | - Ian D. Weir
- Yale School of Medicine, New Haven, Connecticut, USA
| | | | | | | | - Josie Xu
- University of Toronto, Ontario, Canada
| | | | | | | | | | | | - Ilene M. Rosen
- University of Pennsylvania, Philadelphia, Pennsylvania, USA
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21
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Fraley CE, Neiman JS, Feddersen CR, James C, Jones TG, Mikkelsen M, Nuss R, Schlenz AM, Winters AC, Green AL, Compas BE. Identifying patterns of neurocognitive dysfunction through direct comparison of children with leukemia, central nervous system tumors, and sickle cell disease. Pediatr Blood Cancer 2023; 70:e30299. [PMID: 37036272 PMCID: PMC10546486 DOI: 10.1002/pbc.30299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 02/06/2023] [Accepted: 02/23/2023] [Indexed: 04/11/2023]
Abstract
PURPOSE To quantify and compare the magnitude and type of neurocognitive dysfunction in at-risk children with central nervous system (CNS) tumors, acute lymphoblastic leukemia (ALL), and sickle cell disease (SCD) using a common instrument and metric to directly compare these groups with each other. METHODS Fifty-three participants between the ages of 7 and 12 years (n = 27 ALL, n = 11 CNS tumor, n = 15 SCD) were enrolled and assessed using the NIH Toolbox Cognition Battery (NIHTCB). Participants with ALL or CNS tumor were 0-18 months posttherapy, while participants with SCD possessed the SS or Sβ0 genotype, took hydroxyurea, and had no known history of stroke. RESULTS Independent sample t-tests showed that participants with ALL and CNS tumor experienced greatest deficits in processing speed (ALL d = -0.96; CNS tumor d = -1.2) and inhibitory control and attention (ALL d = -0.53; CNS tumor d = -0.97) when compared with NIHTCB normative data. Participants with SCD experienced deficits in cognitive flexibility only (d = -0.53). Episodic memory was relatively spared in all groups (d = -0.03 to -0.32). There were no significant differences in function when groups were compared directly with each other by analysis of variance. CONCLUSIONS Use of a common metric to quantify the magnitude and type of neurocognitive dysfunction across at-risk groups of participants by disease shows that participants perform below age-expected norms in multiple domains and experience dysfunction differently than one another. This approach highlights patterns of dysfunction that can inform disease- and domain-specific interventions.
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Affiliation(s)
- Claire E Fraley
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Jamie S Neiman
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Charlotte R Feddersen
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Claire James
- Department of Biology, Carleton College, Northfield, Minnesota, USA
| | - Taylor G Jones
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Margit Mikkelsen
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Rachelle Nuss
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Alyssa M Schlenz
- Developmental Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Amanda C Winters
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Adam L Green
- Center for Cancer and Blood Disorders, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Bruce E Compas
- Department of Psychology and Human Development, Vanderbilt University, Nashville, Tennessee, USA
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22
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Zhang Z, Fan L, Yuan L, Li Z, Ouyang L, Ma X, Yang Z, Lv J, Chen S, Chen X, He Y. The month of walking alone and BDNF level differ between drug-naive first-episode schizophrenia patients and healthy controls. Front Mol Neurosci 2023; 16:1177524. [PMID: 37234686 PMCID: PMC10206054 DOI: 10.3389/fnmol.2023.1177524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Introduction Schizophrenia is a neurodevelopmental disorder, characterized by impairment in reasoning, affectivity, and social relationships. Previous studies have shown delayed motor development and Brain-Derived Neurotrophic Factor (BDNF) level change in individuals with schizophrenia. We researched the month of walking alone (MWA) and BDNF level between drug-naive first-episode schizophrenia patients (FEP) and healthy control (HC), as well as how they behave in neurocognitive function and severity of symptoms. Predictors of schizophrenia were further explored too. Methods We researched the MWA and BDNF levels between FEP and HCs in the Second Xiangya Hospital of Central South University from August 2017 to January 2020, as well as how they behave in neurocognitive function and the severity of symptoms. A binary logistic regression analysis was used to examine the risk factors affecting the onset and treatment outcome of schizophrenia. Results We find that FEP showed a walking delay and lower BDNF levels compared to HCs, which were associated with cognitive impairment and severity of symptoms. According to the difference and correlation analysis results, and combined with the appropriate application conditions for binary logistic regression, Wechsler Intelligence Scale Picture completion, Hopkins Verbal Learning Test-Revised, and Trail Making Test: part A were added to the binary logistic regression analysis to distinguish FEP and HCs. Conclusion Our study has shown delayed motor development and changes in BDNF levels in schizophrenia, extending insight into the early identification of patients with schizophrenia versus healthy populations.
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Affiliation(s)
- Zhenmei Zhang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lejia Fan
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Liu Yuan
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zongchang Li
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Lijun Ouyang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaoqian Ma
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Zihao Yang
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jingyan Lv
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Shuting Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Xiaogang Chen
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Institute of Mental Health, Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Ying He
- National Clinical Research Center for Mental Disorders, Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Psychiatry and Mental Health, China National Technology Institute on Mental Disorders, Institute of Mental Health, Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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23
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Okwuegbuna OK, Kaur H, Iudicello J, Bush WS, Bharti A, Umlauf A, Ellis RJ, Franklin DR, Heaton RK, McCutchan JA, Kallianpur AR, Letendre SL. Anemia and Erythrocyte Indices Are Associated With Neurocognitive Performance Across Multiple Ability Domains in Adults With HIV. J Acquir Immune Defic Syndr 2023; 92:414-421. [PMID: 36580636 PMCID: PMC10006328 DOI: 10.1097/qai.0000000000003155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 12/19/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Anemia is linked to neurocognitive impairment (NCI) in people with HIV (PWH), but its impact within specific ability domains, and in diverse populations with HIV, is uncertain. METHODS Participants included 1339 PWH enrolled in observational HIV cohort studies with a mean of 3 comprehensive neurocognitive assessments over 30 months. Global and domain-specific neurocognitive function were assessed by the global deficit score and domain deficit score (GDS and DDS, respectively) or as GDS-defined or DDS-defined NCI (GDS ≥ 0.5, DDS > 0.5). Time-dependent associations of anemia or red-cell indices with neurocognitive function were evaluated by multivariable regression. RESULTS The mean age at entry was 43.6 years (85% male, 23.9% Hispanic, 16.7% African ancestry by self-report, and 69.8% virally suppressed). Anemia occurred at entry in 297 (22.2%) and developed subsequently in another 129 (9.6%). Anemia (present in 26.8% of cognitively impaired PWH at entry) and lower hemoglobin were associated with higher (worse) GDS values; the association for anemia persisted after multivariable adjustment and in virally suppressed persons ( P < 0.0001). Anemia was also associated with reduced processing speed, motor function, learning, delayed recall, working memory (all P < 0.01), executive function ( P = 0.021), and verbal fluency ( P = 0.035), and these findings persisted in longitudinal analyses (adjusted P < 0.01 for all domains, except verbal fluency). Higher mean corpuscular volume and mean corpuscular hemoglobin were associated with less impairment in learning and recall (all P < 0.05). CONCLUSIONS Anemia in diverse and virally suppressed PWH associates with reduced neurocognitive performance in multiple domains, cross-sectionally and over time. The impact of identifying and treating anemia to prevent or slow neurocognitive decline in PWH should be prospectively evaluated.
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Affiliation(s)
| | - Harpreet Kaur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic
| | | | - William S. Bush
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
| | - Ajay Bharti
- Department of Medicine, University of California, San Diego, CA
| | - Anya Umlauf
- Department of Psychiatry, University of California, San Diego, CA
| | - Ronald J. Ellis
- Department of Neuroscience, University of California, San Diego, CA
- Department of Psychiatry, University of California, San Diego, CA
| | | | - Robert K. Heaton
- Department of Psychiatry, University of California, San Diego, CA
| | | | - Asha R. Kallianpur
- Department of Genomic Medicine, Lerner Research Institute, Cleveland Clinic
- Department of Population and Quantitative Health Sciences, Case Western Reserve University School of Medicine, Cleveland, OH
- Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Scott L. Letendre
- Department of Medicine, University of California, San Diego, CA
- Department of Psychiatry, University of California, San Diego, CA
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Zhang X, Yang X, Shi Z, Xu R, Tan J, Yang J, Huang X, Huang X, Zheng W. A Systematic Review of Intermittent Theta Burst Stimulation for Neurocognitive Dysfunction in Older Adults with Schizophrenia. J Pers Med 2023; 13:jpm13030485. [PMID: 36983667 PMCID: PMC10057590 DOI: 10.3390/jpm13030485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/01/2023] [Accepted: 03/06/2023] [Indexed: 03/30/2023] Open
Abstract
OBJECTIVE Neurocognitive dysfunction is thought to be one of the core clinical features of schizophrenia, and older adults with schizophrenia exhibited greater overall cognitive deficits than younger adults. The aim of this systematic review was to examine the neurocognitive effects of intermittent theta burst stimulation (iTBS) as an adjunctive treatment for older adults suffering from schizophrenia. METHODS Randomized double-blinded controlled trials (RCTs) investigating the neurocognitive effects of adjunctive active iTBS versus sham iTBS in older adults with schizophrenia were systematically identified by independent investigators searching Chinese and English databases. RESULTS Two double-blinded RCTs (n = 132) compared the neurocognitive effects of adjunctive active iTBS (n = 66) versus sham iTBS (n = 66) in patients that fulfilled the inclusion criteria of this systematic review and were analyzed. One RCT found significant superiority of active iTBS over sham iTBS in improving neurocognitive performance in older adults with schizophrenia. In the other RCT, the findings on the neurocognitive effects of iTBS as measured by three different measurement tools were inconsistent. The dropout rate was reported in the two RCTs, ranging from 3.8% (3/80) to 7.7% (4/52). CONCLUSION There is preliminary evidence that adjunctive iTBS may have some beneficial effects in the treatment of neurocognitive function in older patients with schizophrenia. Future RCTs with larger sample sizes focusing on the neurocognitive effects of adjunctive iTBS in older adults with schizophrenia are warranted to verify these findings.
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Affiliation(s)
- Xinyang Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
- Laboratory of Laser Sports Medicine, School of Sports Science, South China Normal University, Guangzhou 510260, China
| | - Xinhu Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Zhanming Shi
- Chongqing Jiangbei Mental Health Center, Chongqing 400000, China
| | - Rui Xu
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Jianqiang Tan
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Jianwen Yang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Xiong Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Xingbing Huang
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
| | - Wei Zheng
- The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou 510260, China
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25
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Herber E, Aeschbacher S, Coslovsky M, Schwendinger F, Hennings E, Gasser A, Di Valentino M, Rigamonti E, Reichlin T, Rodondi N, Netzer S, Beer JH, Stauber A, Müller A, Ammann P, Sinnecker T, Duering M, Wuerfel J, Conen D, Kühne M, Osswald S, Bonati LH. Physical activity and brain health in patients with atrial fibrillation. Eur J Neurol 2023; 30:567-577. [PMID: 36478335 DOI: 10.1111/ene.15660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/25/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE Vascular brain lesions, such as ischemic infarcts, are common among patients with atrial fibrillation (AF) and are associated with impaired cognitive function. The role of physical activity (PA) in the prevalence of brain lesions and cognition in AF has not been investigated. METHODS Patients from the multicenter Swiss-AF cohort study were included in this cross-sectional analysis. We assessed regular exercise (RE; at least once weekly) and minutes of weekly PA using a validated questionnaire. We studied associations with ischemic infarcts, white matter hyperintensities, cerebral microbleeds, and brain volume on brain magnetic resonance imaging and with global cognition measured with a cognitive construct (CoCo) score. RESULTS Among 1490 participants (mean age = 72 ± 9 years), 730 (49%) engaged in RE. In adjusted regression analyses, RE was associated with a lower prevalence of ischemic infarcts (odds ratio [OR] = 0.78, 95% confidence interval [CI] = 0.63-0.98, p = 0.03) and of moderate to severe white matter hyperintensities (OR = 0.78, 95% CI = 0.62-0.99, p = 0.04), higher brain volume (β-coefficient = 10.73, 95% CI = 2.37-19.09, p = 0.01), and higher CoCo score (β-coefficient = 0.08, 95% CI = 0.03-0.12, p < 0.001). Increasing weekly PA was associated with higher brain volume (β-coefficient = 1.40, 95% CI = 0.65-2.15, p < 0.001). CONCLUSIONS In AF patients, RE was associated with a lower prevalence of ischemic infarcts and of moderate to severe white matter disease, with larger brain volume, and with better cognitive performance. Prospective studies are needed to investigate whether these associations are causal. Until then, our findings suggest that patients with AF should be encouraged to remain physically active.
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Affiliation(s)
- Elena Herber
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
- Clinical Trial Unit Basel, Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Fabian Schwendinger
- Division of Sports and Exercise Medicine, Department of Sport, Exercise, and Health, University Basel, Basel, Switzerland
| | - Elisa Hennings
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andreas Gasser
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Elia Rigamonti
- Department of Internal Medicine, Cantonal Hospital Authority, Lugano, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Rodondi
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Seraina Netzer
- Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Primary Health Care, University of Bern, Bern, Switzerland
| | - Juerg H Beer
- Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zurich, Zurich, Switzerland
| | - Annina Stauber
- Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland
| | - Andreas Müller
- Department of Cardiology, Triemli Hospital Zurich, Zurich, Switzerland
| | - Peter Ammann
- Department of Cardiology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | - Tim Sinnecker
- Medical Image Analysis Center and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Marco Duering
- Medical Image Analysis Center and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Jens Wuerfel
- Medical Image Analysis Center and Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Radiology, University Hospital Magdeburg, Magdeburg, Germany
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, Canada
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, University of Basel, Basel, Switzerland
- Cardiology Division, Department of Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Leo H Bonati
- Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
- Research Department, Reha Rheinfelden, Rheinfelden, Switzerland
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26
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Tomoto T, Verma A, Kostroske K, Tarumi T, Patel NR, Pasha EP, Riley J, Tinajero CD, Hynan LS, Rodrigue KM, Kennedy KM, Park DC, Zhang R. One-year aerobic exercise increases cerebral blood flow in cognitively normal older adults. J Cereb Blood Flow Metab 2023; 43:404-418. [PMID: 36250505 PMCID: PMC9941859 DOI: 10.1177/0271678x221133861] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/04/2022] [Accepted: 09/04/2022] [Indexed: 02/16/2023]
Abstract
The impact of aerobic exercise training (AET) on cerebral blood flow (CBF) regulation remains inconclusive. This study investigated the effects of one-year progressive, moderate-to-vigorous AET on CBF, central arterial stiffness, and cognitive performance in cognitively normal older adults. Seventy-three older adults were randomly assigned to AET or stretching-and-toning (SAT, active control) intervention. CBF was measured with 2D duplex ultrasonography. Central arterial stiffness, measured by carotid β-stiffness index, was assessed with the ultrasonography and applanation tonometry. Cerebrovascular resistance (CVR) was calculated as mean arterial pressure divided by CBF. A cognitive battery was administered with a focus on memory and executive function. Cardiorespiratory fitness was measured by peak oxygen consumption (V ˙ O2peak). One-year AET increased V ˙ O2peak and CBF and decreased CVR and carotid β-stiffness index. In the AET group, improved V ˙ O2peak was correlated with increased CBF (r = 0.621, p = 0.001) and decreased CVR (r = -0.412, p = 0.037) and carotid β-stiffness index (r = -0.478, p = 0.011). Further, increased Woodcock-Johnson recall score was associated with decreased CVR (r = -0.483, p = 0.012) and carotid β-stiffness index (r = -0.498, p = 0.008) in AET group (not in SAT group). In conclusion, one-year progressive, moderate-to-vigorous aerobic exercise training increased CBF and decreased carotid arterial stiffness and CVR which were associated with improved memory function in cognitively normal older adults.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National
Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki,
Japan
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Aryan Verma
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Kayla Kostroske
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National
Institute of Advanced Industrial Science and Technology, Tsukuba, Ibaraki,
Japan
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Graduate School of Comprehensive Human Sciences, University of
Tsukuba, Tsukuba, Ibaraki, Japan
| | - Neena R Patel
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Evan P Pasha
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
| | - Jonathan Riley
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Cynthia D Tinajero
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Linda S Hynan
- Department of Psychiatry, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Department of Population and Data Sciences, University of Texas
Southwestern Medical Center, Dallas, Texas, USA
| | - Karen M Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Kristen M Kennedy
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Denise C Park
- Center for Vital Longevity, School of Behavioral and Brain
Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health
Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern
Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas
Southwestern Medical Center, Dallas, Texas, USA
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27
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Zwimpfer L, Aeschbacher S, Krisai P, Coslovsky M, Springer A, Paladini RE, Girod M, Hufschmid J, Knecht S, Badertscher P, Beer JH, Bonati LH, Zuern CS, Roten L, Reichlin T, Sticherling C, Conen D, Osswald S, Kühne M. Neurocognitive function in patients with atrial fibrillation undergoing pulmonary vein isolation. Front Cardiovasc Med 2022; 9:1000799. [PMID: 36505379 PMCID: PMC9732530 DOI: 10.3389/fcvm.2022.1000799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 11/11/2022] [Indexed: 11/27/2022] Open
Abstract
Background Atrial fibrillation (AF) is associated with cognitive dysfunction. However, neurocognitive function in AF patients undergoing pulmonary vein isolation (PVI) has not been well studied. The aim of this analysis is to compare neurocognitive function in patients who did or did not undergo PVI. Materials and methods We used data from the Swiss Atrial Fibrillation Cohort study (Swiss-AF), a prospective, observational, multicenter study in Switzerland. Patients with documented AF were enrolled and data of 1,576 patients without history of PVI and with complete information on PVI status and neurocognitive function were used. Information on PVI was collected at baseline and during 1 year of follow-up. Neurocognitive testing was performed at baseline and after 1 year of follow-up, using the Montreal Cognitive Assessment (MoCA), trail making test (TMT) A and B, digit symbol substitution test (DSST) and semantic fluency test (SFT). To investigate the association of PVI with neurocognitive function, we use propensity score matching (1:3) and inverse probability of treatment weighting (IPTW). Results The mean age of this population was 74 ± 8 years, 27.1% were women. Overall, 88 (5.5%) patients underwent PVI during 1 year of follow-up. Using ITPW (n = 1576), PVI was weakly associated with the MoCA score after adjusting for time since PVI, baseline MoCA score and other covariates (β (95%CI) 1.19 (0.05; 2.32), p = 0.04). In the propensity matched comparison (n = 352), there was no significant association between PVI and the MoCA score (β (95%CI) 1.04 (-0.19; 2.28), p = 0.1). There were no significant associations between PVI and cognitive function when using the TMT A and B, DSST or SFT independent of the method used. Conclusion In this population of AF patients, there was no consistent evidence of an association between PVI and neurocognitive function. Clinical trial registration [https://clinicaltrials.gov/], identifier [NCT02105844].
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Affiliation(s)
- Leon Zwimpfer
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Philipp Krisai
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Michael Coslovsky
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland,Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Anne Springer
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Rebecca E. Paladini
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Marc Girod
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Janik Hufschmid
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Sven Knecht
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Patrick Badertscher
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Jürg H. Beer
- Department of Medicine, Cantonal Hospital of Baden and Molecular Cardiology, University Hospital of Zürich, Zürich, Switzerland
| | - Leo H. Bonati
- Department of Clinical Research, University Hospital Basel, Basel, Switzerland,Reha Rheinfelden, Department of Neurology, University Hospital Basel, University of Basel, Basel, Switzerland,Department of Neurology and Stroke Center, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Christine S. Zuern
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Laurent Roten
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Tobias Reichlin
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christian Sticherling
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - David Conen
- Population Health Research Institute, McMaster University, Hamilton, ON, Canada
| | - Stefan Osswald
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Michael Kühne
- Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland,Cardiology Division, University Hospital Basel, Basel, Switzerland,*Correspondence: Michael Kühne,
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Binari LA, Kiehl AL, Jackson JC, Feurer ID, Rega SA, Altuhaifi TM, Yankyera RP, Reed M, Sika M, Van J, Collar EM, Forbes RC, Concepcion BP. Neurocognitive Function Changes Following Kidney Transplant: A Prospective Study. Kidney Med 2022; 4:100560. [PMID: 36507052 PMCID: PMC9732409 DOI: 10.1016/j.xkme.2022.100560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Rationale & Objective Patients with advanced kidney disease are at risk for cognitive impairment, which may persist after kidney transplantation. We sought to understand changes in neurocognitive function domains utilizing comprehensive cognitive assessments. Study Design Prospective cohort study. Setting & Population Single-center study of patients undergoing kidney transplantation. Exposure Kidney transplantation. Outcomes Changes in neurocognitive function as measured by the Repeatable Battery for Assessment of Neuropsychological Status (RBANS) and the Trail Making Test Parts A and B (TRAIL A and B) before transplantation (baseline) and compared to 3 months and 12 months posttransplant. Analytical Approach Wilcoxon signed-rank and linear mixed effect models were utilized to assess changes in neurocognitive scores at 3 months and 12 months compared to baseline. Results Thirty-two patients were included with a mean age of 45 years, 47% female, 85% White, and 62% with at least some college education. Hypertension and diabetes were etiologies of kidney disease in 31% and 25% of patients, respectively. Baseline RBANS and TRAIL A and B scores averaged 84.7 ± 14, 40.4 ± 9.9, and 41 ± 11.5, respectively. Although there were posttransplant improvements in immediate and delayed memory at 3 months, these were not sustained at 12 months. There were no significant differences from baseline at 3 months and 12 months in RBANS index scores for language, visuospatial/constructional abilities, and attention. Compared to baseline, TRAIL A scores were not significantly different at 3 months but were significantly improved at 12 months, whereas TRAIL B scores improved significantly at both 3 months and 12 months. Limitations Single-center design and small sample size. Conclusions Utilizing comprehensive cognitive assessments, we found improvements in attention and executive function in the first posttransplant year as measured by TRAIL A and B. However, there was no significant change in global cognition as measured by RBANS. These findings identify cognitive domains for potential intervention in the posttransplant population.
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Affiliation(s)
- Laura A. Binari
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Amy L. Kiehl
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN
- Veteran’s Affairs Tennessee Valley Geriatric Research Education and Clinical Center (GRECC), Nashville, TN
| | - James C. Jackson
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN
- Veteran’s Affairs Tennessee Valley Geriatric Research Education and Clinical Center (GRECC), Nashville, TN
| | - Irene D. Feurer
- Department of Surgery, Department of Biostatistics, Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, TN
| | - Scott A. Rega
- Vanderbilt Transplant Center, Vanderbilt University Medical Center, Nashville, TN
| | - Tareq M. Altuhaifi
- Nephrology Clinical Trials Center, Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Rita P. Yankyera
- Nephrology Clinical Trials Center, Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Malia Reed
- Nephrology Clinical Trials Center, Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Mohammed Sika
- Nephrology Clinical Trials Center, Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Julie Van
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN
- Department of Psychology, Neuroscience Center, Brigham Young University, Provo, UT
| | - Erin M. Collar
- Division of Allergy, Pulmonary, and Critical Care Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Critical Illness, Brain Dysfunction and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN
- Veteran’s Affairs Tennessee Valley Geriatric Research Education and Clinical Center (GRECC), Nashville, TN
| | - Rachel C. Forbes
- Division of Kidney and Pancreas Transplantation, Department of Surgery, Vanderbilt University Medical Center, Nashville, TN
| | - Beatrice P. Concepcion
- Division of Nephrology and Hypertension, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Address for Correspondence: Beatrice P. Concepcion, MD, MS, 1313 21st Avenue S, Oxford House 912F, Nashville, TN 37232.
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Tarumi T, Patel NR, Tomoto T, Pasha E, Khan AM, Kostroske K, Riley J, Tinajero CD, Wang C, Hynan LS, Rodrigue KM, Kennedy KM, Park DC, Zhang R. Aerobic exercise training and neurocognitive function in cognitively normal older adults: A one-year randomized controlled trial. J Intern Med 2022; 292:788-803. [PMID: 35713933 PMCID: PMC9588521 DOI: 10.1111/joim.13534] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Current evidence is inconsistent on the benefits of aerobic exercise training for preventing or attenuating age-related cognitive decline in older adults. OBJECTIVE To investigate the effects of a 1-year progressive, moderate-to-high intensity aerobic exercise intervention on cognitive function, brain volume, and cortical thickness in sedentary but otherwise healthy older adults. METHODS We randomized 73 older adults to a 1-year aerobic exercise or stretching-and-toning (active control) program. The primary outcome was a cognitive composite score calculated from eight neuropsychological tests encompassing inductive reasoning, long-term and working memory, executive function, and processing speed. Secondary outcomes were brain volume and cortical thickness assessed by MRI, and cardiorespiratory fitness measured by peak oxygen uptake (VO2 ). RESULTS One-year aerobic exercise increased peak VO2 by ∼10% (p < 0.001) while it did not change with stretching (p = 0.241). Cognitive composite scores increased in both the aerobic and stretching groups (p < 0.001 for time effect), although no group difference was observed. Total brain volume (p < 0.001) and mean cortical thickness (p = 0.001) decreased in both groups over time, while the reduction in hippocampal volume was smaller in the stretching group compared with the aerobic group (p = 0.040 for interaction). Across all participants, improvement in peak VO2 was positively correlated with increases in cognitive composite score (r = 0.282, p = 0.042) and regional cortical thickness at the inferior parietal lobe (p = 0.016). CONCLUSIONS One-year aerobic exercise and stretching interventions improved cognitive performance but did not prevent age-related brain volume loss in sedentary healthy older adults. Cardiorespiratory fitness gain was positively correlated with cognitive performance and regional cortical thickness.
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Affiliation(s)
- Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
- Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Japan
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Neena R. Patel
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Evan Pasha
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ayaz M. Khan
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Diagnostic Imaging, St. Jude Children Research Hospital, Memphis, TN, USA
| | - Kayla Kostroske
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Jonathan Riley
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Cynthia D. Tinajero
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Ciwen Wang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
| | - Linda S. Hynan
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Karen M. Rodrigue
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Kristen M. Kennedy
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Denise C. Park
- Center for Vital Longevity, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas, USA
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas, USA
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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30
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Wijaya EA, Solek P, Hakim DDL, Rossanti R, Widiasta A, Hilmanto D. Factors Affecting Neurocognitive Function in Children with Chronic Kidney Disease: A Systematic Review. Int J Nephrol Renovasc Dis 2022; 15:277-288. [PMID: 36329897 PMCID: PMC9624145 DOI: 10.2147/ijnrd.s375242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/05/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose In children, chronic kidney disease (CKD) has been known to affect neurocognitive function which can impair the quality of life. This study aims to determine the factors and treatment modalities which might affect neurocognitive function in pediatric population with CKD. Patients and Methods A systematic review was done using 3 electronic databases: PubMed, ScienceDirect, SpringerLink, and carried out based on PRISMA guidelines. Our review included articles published in the last 10 years (2011–2021) in English, on children aged 0–18 years with CKD. Factors affecting the children’s neurocognitive function were assessed. Results Eight articles were included in this study. Three articles reported that parent’s education, especially maternal education affect the neurocognitive function of children with CKD. In relation with modalities, in general, children with CKD who had kidney transplant had a better neurocognitive outcome. A longer duration of hemodialysis (HD) was associated with poorer neurocognitive outcomes. Other factors that can affect the neurocognitive function included depression, a history of abnormal births, seizures, and hypertension. Conclusion In children, CKD might cause neurocognitive function disorders through various complex and interconnected mechanisms. Further studies are needed to determine the mechanism and prevention of neurocognitive disorders, as well as the best choice of therapeutic modality to improve both kidney function and neurocognitive function in children with CKD.
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Affiliation(s)
- Elrika A Wijaya
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Purboyo Solek
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dzulfikar D L Hakim
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Rini Rossanti
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Ahmedz Widiasta
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia
| | - Dany Hilmanto
- Department of Child Health, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung, West Java, Indonesia,Correspondence: Dany Hilmanto, Tel +628122266879, Email
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31
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Thompson EC, Muhammad JN, Adimora AA, Chandran A, Cohen MH, Crockett KB, Goparaju L, Henderson E, Kempf MC, Konkle-Parker D, Kwait J, Mimiaga M, Ofotokun I, Rubin L, Sharma A, Teplin LA, Vance DE, Weiser SD, Weiss DJ, Wilson TE, Turan JM, Turan B. Internalized HIV-Related Stigma and Neurocognitive Functioning Among Women Living with HIV. AIDS Patient Care STDS 2022; 36:336-342. [PMID: 36099481 PMCID: PMC9810353 DOI: 10.1089/apc.2022.0041] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The prevalence of HIV-associated neurocognitive impairment persists despite highly effective antiretroviral therapy (ART). In this study we explore the role of internalized stigma, acceptance of negative societal characterizations, and perceptions about people living with HIV (PLWH) on neurocognitive functioning (executive function, learning, memory, attention/working memory, psychomotor speed, fluency, motor skills) in a national cohort of women living with HIV (WLWH) in the United States. We utilized observational data from a multicenter study of WLWH who are mostly African American living in low-resource settings. Neurocognitive function was measured using an eight-test battery. A multiple linear regression model was constructed to investigate the relationship between internalized stigma and overall neurocognitive functioning (mean of all neurocognitive domain standardized T-scores), adjusting for age, education, race, previous neuropsychological battery scores, illicit drug use, viral load, and years on ART. Our analysis revealed that internalized HIV-related stigma is significantly associated with worse performance on individual domain tests and overall neurocognitive performance (B = 0.27, t = 2.50, p = 0.01). This suggests HIV-related internalized stigma may be negatively associated with neurocognitive functioning for WLWH. This finding highlights a specific psychosocial factor associated with poor neurocognitive function that may be targeted to better promote the health of PLWH. Future research on the longitudinal relationship between these variables and the effects of other stigma dimensions on poor neurocognitive function would provide further insights into the pathways explaining the relationship between internalized stigma and neurocognition.
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Affiliation(s)
- Emma C. Thompson
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Josh N. Muhammad
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adoara A. Adimora
- School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Aruna Chandran
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Mardge H. Cohen
- Chicago Women's Interagency HIV Study, Chicago, Illinois, USA
| | - Kaylee B. Crockett
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lakshmi Goparaju
- School of Medicine, Georgetown University, Washington, District of Columbia, USA
| | - Emmett Henderson
- School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Mirjam-Colette Kempf
- School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Deborah Konkle-Parker
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Jennafer Kwait
- Whitman-Walker Institute, Washington, District of Columbia, USA
| | - Matthew Mimiaga
- School of Public Health, University of California Los Angeles, Los Angeles, California, USA
| | - Igho Ofotokun
- School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Leah Rubin
- School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Anjala Sharma
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Linda A. Teplin
- School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - David E. Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Sheri D. Weiser
- Department of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Deborah J. Weiss
- Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Tracey E. Wilson
- School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, New York, USA
| | - Janet M. Turan
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Bulent Turan
- Department of Psychology, Koc University, Istanbul, Turkey
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32
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Phillips JL, Van Geel A, Burhunduli P, Vasudev D, Batten LA, Norris S, Talbot J, Ortiz A, Owoeye O, Blier P. Assessment of Objective and Subjective Cognitive Function in Patients With Treatment-Resistant Depression Undergoing Repeated Ketamine Infusions. Int J Neuropsychopharmacol 2022; 25:992-1002. [PMID: 35931041 PMCID: PMC9743964 DOI: 10.1093/ijnp/pyac045] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 06/20/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Subanesthetic ketamine infusions can elicit rapid and sustained antidepressant effects, yet the potential cognitive impact of ketamine has not been thoroughly examined. This study measured changes in objective and subjective cognitive function following repeated ketamine treatment. METHODS Thirty-eight patients with treatment-resistant depression were administered cognitive assessments before and after undergoing 7 i.v. ketamine infusions (0.5 mg/kg over 40 minutes) within a clinical trial examining the efficacy of single and repeated administrations. Depression severity and perceived concentration were evaluated with the Montgomery-Åsberg Depression Rating Scale (MADRS) and the Quick Inventory of Depressive Symptoms Self-Report. RESULTS Twenty-three participants (60.5%) responded after repeated infusions (≥50% decrease in MADRS total scores). We measured significant improvements in several cognitive domains, including attention, working memory, verbal, and visuospatial memory (effect sizes ranging from Cohen d = 0.37-0.79). Cognitive changes were attributed to reduction in depressive symptoms except for improvement in verbal memory, which remained significant after adjustment for change in MADRS total score (P = .029, η p2 = 0.13). Only responders reported improvement in subjective cognitive function with repeated ketamine administration (MADRS item 6, P < .001, d = 2.00; Quick Inventory of Depressive Symptoms Self-Report item 10, P < .001, d = 1.36). CONCLUSION A short course of repeated ketamine infusions did not impair neurocognitive function in patients with treatment-resistant depression. Further research is required to understand the potential mediating role of response and remission on improved cognitive function accompanying ketamine treatment as well as to examine longer-term safety outcomes. ClinicalTrials.gov identifier NCT01945047.
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Affiliation(s)
- Jennifer L Phillips
- Correspondence: Jennifer L. Phillips, PhD, University of Ottawa Institute of Mental Health Research at The Royal, 1145 Carling Avenue, Ottawa, Ontario, K1Z7K4, Canada ()
| | - Amanda Van Geel
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Patricia Burhunduli
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dominique Vasudev
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Lisa A Batten
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada
| | - Sandhaya Norris
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Jeanne Talbot
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Abigail Ortiz
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada,Centre for Addiction and Mental Health, Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Olabisi Owoeye
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Pierre Blier
- University of Ottawa Institute of Mental Health Research at The Royal, Ottawa, Ontario, Canada,Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada,Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada,Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada
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Sandalic D, Tran Y, Craig A, Arora M, Pozzato I, Simpson G, Gopinath B, Kaur J, Shetty S, Weber G, Benad L, Middleton JW. The Need for a Specialized Neurocognitive Screen and Consistent Cognitive Impairment Criteria in Spinal Cord Injury: Analysis of the Suitability of the Neuropsychiatry Unit Cognitive Assessment Tool. J Clin Med 2022; 11:jcm11123344. [PMID: 35743411 PMCID: PMC9225056 DOI: 10.3390/jcm11123344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/01/2022] [Accepted: 06/07/2022] [Indexed: 02/04/2023] Open
Abstract
The assessment of mild cognitive impairment (MCI) following spinal cord injury (SCI) is vital. However, there are no neurocognitive screens which have been developed specifically to meet the unique requirements for SCI, nor are there consistent MCI criteria applied to determine the rates of MCI. The aim of this study was to determine the suitability of a neurocognitive screen for assessing MCI in adults with SCI. A total of 127 participants were recruited. Socio-demographic and injury related variables were assessed. All participants completed the screen. Descriptive statistics are provided for total/domain screen scores and all items, and the screen’s ability to distinguish MCI was examined. Congeneric confirmatory factor analyses (CFA) were employed to investigate structural validity. The screen total score was sensitive to differences in neurocognitive capacity, as well as for time since the injury occurred (p < 0.01). The MCI rate ranged between 17−36%. CFA revealed attention and visuoconstruction domains had an adequate model fit and executive function had poor fit, while CFA models for memory and language did not fit the data (did not converge), hence could not be determined. While the screen differentiated between those with MCI and those without, and MCI as a function of time since injury, limitations of its suitability for assessing MCI after SCI exist, demonstrating the need for a specialized neurocognitive screen for adults with SCI.
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Affiliation(s)
- Danielle Sandalic
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- SCI Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (J.K.); (L.B.)
| | - Yvonne Tran
- Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia; (Y.T.); (B.G.)
| | - Ashley Craig
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- Correspondence:
| | - Mohit Arora
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Ilaria Pozzato
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Grahame Simpson
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
| | - Bamini Gopinath
- Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2113, Australia; (Y.T.); (B.G.)
| | - Jasbeer Kaur
- SCI Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (J.K.); (L.B.)
| | - Sachin Shetty
- SCI Unit, Prince of Wales Hospital, Randwick, NSW 2031, Australia;
| | - Gerard Weber
- SCI Unit, Royal Rehab, Ryde, NSW 2112, Australia;
| | - Lisa Benad
- SCI Unit, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (J.K.); (L.B.)
| | - James W. Middleton
- John Walsh Centre Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, St Leonards, NSW 2065, Australia; (D.S.); (M.A.); (I.P.); (G.S.); (J.W.M.)
- Faculty of Medicine and Health, Sydney Medical School, The University of Sydney, Sydney, NSW 2006, Australia
- Spinal Outreach Service, Royal Rehab, Ryde, NSW 2112, Australia
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Yao L, Aoyama S, Ouchi A, Yamamoto Y, Sora I. Retention and impairment of neurocognitive functions in mild cognitive impairment and Alzheimer's disease with a comprehensive neuropsychological test. Neuropsychopharmacol Rep 2022; 42:174-182. [PMID: 35246952 PMCID: PMC9216360 DOI: 10.1002/npr2.12243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/29/2022] [Accepted: 02/08/2022] [Indexed: 01/10/2023] Open
Abstract
AIM MATRICS Consensus Cognitive Battery was developed by the National Institute of Mental Health to establish acceptance criteria for measuring cognitive changes in schizophrenia and can be used to assess cognitive functions in other psychiatric disorders. We used a Japanese version of MATRICS Consensus Cognitive Battery to explore the changes in multiple cognitive functions in patients with mild cognitive impairment and mild Alzheimer's disease. METHODS We administered the Japanese version of MATRICS Consensus Cognitive Battery to 11 patients with mild cognitive impairment (MCI), 11 patients with Alzheimer's disease, and 27 healthy controls. All Japanese versions of MATRICS Consensus Cognitive Battery domain scores were converted to t-scores using sample means and standard deviations and were compared for significant performance differences among healthy control, MCI, and mild Alzheimer's disease groups. RESULTS Compared with healthy controls, patients with MCI and mild Alzheimer's disease demonstrated the same degree of impairment to processing speed, verbal learning, and visual learning. Reasoning and problem-solving showed significant impairments only in mild Alzheimer's disease. Verbal and visual abilities in working memory showed different performances in the MCI and mild Alzheimer's disease groups, with the Alzheimer's disease group demonstrating significantly more deficits in these domains. No significant difference was found among the groups in attention/vigilance and social cognition. CONCLUSIONS The Japanese version of MATRICS Consensus Cognitive Battery can be used to elucidate the characteristics of cognitive dysfunction of normal aging, MCI, and mild dementia in clinical practice.
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Affiliation(s)
- Lu Yao
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Shinsuke Aoyama
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Atushi Ouchi
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
| | - Yasuji Yamamoto
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
- Department of Biosignal PathophysiologyKobe University Graduate School of MedicineKobeJapan
| | - Ichiro Sora
- Department of PsychiatryKobe University Graduate School of MedicineKobeJapan
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35
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Yi Y, Huang Y, Chen Q, Yang H, Li H, Feng Y, Feng S, Zhou S, Li Z, Wu F. Violence, neurocognitive function and clinical correlates in patients with schizophrenia. Front Psychiatry 2022; 13:1087372. [PMID: 36741559 PMCID: PMC9893505 DOI: 10.3389/fpsyt.2022.1087372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Schizophrenia patients with violent behavior are a severe public health concern, but the correlates of this violent behavior are unknown. Additionally, the relationship between neurocognitive function and violent behavior in Chinese patients with schizophrenia has not yet been investigated. METHODS A total of 337 schizophrenia inpatients were recruited. The Positive and Negative Syndrome Scale (PANSS) was used to assess psychopathological symptoms. Neurocognitive functioning was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS The percentage of violent behavior was 10.4% in patients with schizophrenia. Patients with violent behavior had higher PANSS-positive, excited, and total subscale scores than patients who did not show violent behavior. Patients with violent behavior also had lower RBANS language, semantic fluency, and total subscale scores. Gender (OR = 0.066∼0.819, p = 0.023), illness duration (OR = 0.876∼0.971, p = 0.002), smoking (OR = 1.127∼2.950, p = 0.014), the PANSS positive subscale (OR = 1.050∼1.197, p = 0.001), and the RBANS language subscale (OR = 0.927∼0.987, p = 0.005) significantly contributed to the development of violent behavior in schizophrenia patients. CONCLUSION Our findings revealed that cognitive and clinical assessments should be considered in comprehensive assessments of future risks of violence in schizophrenia patients.
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Affiliation(s)
- Yun Yi
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Yuanyuan Huang
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Qiang Chen
- Department of Psychiatry, The Brain Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Hanlun Yang
- School of Pharmaceutical Sciences (Shenzhen), Sun Yat-sen University, Shenzhen, China
| | - Hehua Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yangdong Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shixuan Feng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Sumiao Zhou
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China
| | - Fengchun Wu
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.,Guangdong Engineering Technology Research Center for Translational Medicine of Mental Disorders, Guangzhou, China.,Department of Biomedical Engineering, Guangzhou Medical University, Guangzhou, China
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Abstract
BACKGROUND Prospective memory is a critical neurocognitive capacity that refers to the ability to execute delayed intentions. To date, few studies have investigated the effects of acute alcohol consumption on prospective memory, and important questions remain about the mechanisms that might underpin acute alcohol-induced prospective memory impairment. AIMS The current study sought to clarify the nature and magnitude of prospective memory difficulties following acute alcohol consumption and to test the degree to which any problems with prospective remembering might be a secondary consequence of broader cognitive impairment. This study also investigated whether there were potential sex differences. METHODS In all, 124 healthy adult social drinkers were assigned to either the alcohol (n = 61) or placebo (n = 63) condition. Participants were administered a dose of 0.6 g/kg alcohol or a matched placebo drink and then asked to complete a measure of prospective memory. A broader neurocognitive test battery was also administered. RESULTS Relative to the placebo condition, acute alcohol intoxication led to significant impairment on all prospective memory tasks, with effects mostly large in magnitude. These difficulties could not be explained by broader problems in retrospective memory, executive function or episodic future thinking. In addition, females recorded a higher blood alcohol concentration than males; however, no sex differences in prospective memory performance were identified following acute alcohol use. CONCLUSION The results show that acutely, even a moderate dose of alcohol substantially impairs prospective memory function. These findings have potentially important implications for understanding many of the maladaptive behaviours associated with acute alcohol consumption.
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Affiliation(s)
- Morgan Elliott
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Gill Terrett
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - H Valerie Curran
- Clinical Psychopharmacology Unit, University College London, London, UK
| | - Natalie De Bono
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Peter G Rendell
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Julie D Henry
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
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Abstract
The purpose of this study was to compare visuomotor reaction time (VMRT) in collegiate athletes based on ankle sprain history. Participants included athletes with ankle sprain history (n = 18) and athletes with no ankle sprain history (n = 33). Participants completed an upper-extremity VMRT task which was comprised of eight wireless light-emitting diode sensors. The difference between reaction time (sec) and the number of "Hits" and "Misses" were compared between groups. The ankle sprain history group had significantly slower VMRT compared to the no ankle sprain history group with moderate effect sizes. However, there was no difference in the number of "Hits" or "Misses" between groups, despite observing moderate effect sizes. This result suggests that VMRT may be a potential target for prevention and rehabilitation strategies in individuals with ankle sprains. However, further research is needed to better understand the role of VMRT on the risk of ankle sprains.
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Affiliation(s)
- Kyeongtak Song
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Johanna M Hoch
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Carolina Quintana
- Department of Kinesiology, California State University Fresno, Fresno, CA, USA
| | - Nicholas R Heebner
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA
| | - Matthew C Hoch
- Sports Medicine Research Institute, Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY, USA
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38
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Groves SJ, Douglas KM, Milanovic M, Bowie CR, Porter RJ. Systematic review of the effects of evidence-based psychotherapies on neurocognitive functioning in mood disorders. Aust N Z J Psychiatry 2021; 55:944-957. [PMID: 34278831 DOI: 10.1177/00048674211031479] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Neurocognitive impairment is considered a core feature of mood disorders. Research has shown that neurocognitive impairment often persists beyond mood symptom resolution and can have significant deleterious effects on interpersonal relationships, academic achievement, occupational functioning and independent living. As such, neurocognitive impairment has become an important target for intervention. In this systematic review, we aimed to examine the extant literature to ascertain whether current standard evidence-based psychotherapies can improve neurocognitive functioning in mood disorders. METHOD Studies examining changes in neurocognitive functioning following evidence-based psychotherapy were identified using MEDLINE, PsycINFO and Web of Science databases. Given the heterogeneity of study procedures, treatment protocols and patient samples, a narrative rather than meta-analytic review technique was employed. RESULTS Nineteen studies (21 articles) met inclusion criteria. There was preliminary evidence of improved executive functioning following evidence-based psychotherapy for Major Depressive Disorder and Bipolar Disorder. There was also some signal of reduced negative biases in emotional information processing following psychotherapy in depression. Due to methodological variability across studies however, it was difficult to draw clear conclusions. CONCLUSION Findings from the current review suggest that evidence-based psychotherapies may influence some aspects of neurocognitive functioning in mood disorders. This continues to be an ongoing area of importance and warrants further research.
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Affiliation(s)
- Samantha J Groves
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | - Katie M Douglas
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
| | | | | | - Richard J Porter
- Department of Psychological Medicine, University of Otago, Christchurch, New Zealand
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Fisher FL, Zamanipoor Najafabadi AH, van der Meer PB, Boele FW, Peerdeman SM, Peul WC, Taphoorn MJB, Dirven L, van Furth WR. Long-term health-related quality of life and neurocognitive functioning after treatment in skull base meningioma patients. J Neurosurg 2021; 136:1077-1089. [PMID: 34598137 DOI: 10.3171/2021.4.jns203891] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 04/01/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patients with skull base meningioma (SBM) often require complex surgery around critical neurovascular structures, placing them at high risk of poor health-related quality of life (HRQOL) and possibly neurocognitive dysfunction. As the survival of meningioma patients is near normal, long-term neurocognitive and HRQOL outcomes are important to evaluate, including evaluation of the impact of specific tumor location and treatment modalities on these outcomes. METHODS In this multicenter cross-sectional study including patients 5 years or more after their last tumor intervention, Short-Form Health Survey (SF-36) and European Organisation for Research and Treatment of Cancer (EORTC) QLQ-BN20 questionnaires were used to assess generic and disease-specific HRQOL. Neurocognitive functioning was assessed with standardized neuropsychological assessment. SBM patient assessments were compared with those of 1) informal caregivers of SBM patients who served as controls and 2) convexity meningioma patients. In addition, the authors compared anterior/middle SBM patients with posterior SBM patients and anterior/middle and posterior SBM patients separately with controls. Multivariable and propensity score regression analyses were performed to correct for possible confounders. RESULTS Patients with SBM (n = 89) with a median follow-up of 9 years after the last intervention did not significantly differ from controls (n = 65) or convexity meningioma patients (n = 84) on generic HRQOL assessment. Statistically significantly but not clinically relevantly better disease-specific HRQOL was found for SBM patients compared with convexity meningioma patients. Anterior/middle SBM patients (n = 62) had significantly and clinically relevantly better HRQOL in SF-36 and EORTC QLQ-BN20 scores than posterior SBM patients (n = 27): physical role functioning (corrected difference 17.1, 95% CI 0.2-34.0), motor dysfunction (-10.1, 95% CI -17.5 to -2.7), communication deficit (-14.2, 95% CI -22.7 to -5.6), and weakness in both legs (-10.1, 95% CI -18.8 to -1.5). SBM patients whose primary treatment was radiotherapy had lower HRQOL scores compared with SBM patients who underwent surgery on two domains: bodily pain (-33.0, 95% CI -55.2 to -10.9) and vitality (-18.9. 95% CI -33.7 to -4.1). Tumor location and treatment modality did not result in significant differences in neurocognitive functioning, although 44% of SBM patients had deficits in at least one domain. CONCLUSIONS In the long term, SBM patients do not experience significantly more sequelae in HRQOL and neurocognitive functioning than do controls or patients with convexity meningioma. Patients with posterior SBM had poorer HRQOL than anterior/middle SBM patients, and primary treatment with radiotherapy was associated with worse HRQOL. Neurocognitive functioning was not affected by tumor location or treatment modality.
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Affiliation(s)
- Fleur L Fisher
- 1Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center and Haga Teaching Hospitals, Leiden and The Hague
| | - Amir H Zamanipoor Najafabadi
- 1Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center and Haga Teaching Hospitals, Leiden and The Hague.,2Department of Neurology, Leiden University Medical Center, Leiden; The Netherlands
| | - Pim B van der Meer
- 2Department of Neurology, Leiden University Medical Center, Leiden; The Netherlands
| | - Florien W Boele
- 3Leeds Institute of Medical Research at St. James's, St. James's University Hospital, Leeds.,4Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Saskia M Peerdeman
- 5Department of Neurosurgery, Amsterdam University Medical Centers, location VUmc, Amsterdam; and
| | - Wilco C Peul
- 1Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center and Haga Teaching Hospitals, Leiden and The Hague
| | - Martin J B Taphoorn
- 2Department of Neurology, Leiden University Medical Center, Leiden; The Netherlands.,6Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Linda Dirven
- 2Department of Neurology, Leiden University Medical Center, Leiden; The Netherlands.,6Department of Neurology, Haaglanden Medical Center, The Hague, The Netherlands
| | - Wouter R van Furth
- 1Department of Neurosurgery, University Neurosurgical Center Holland, Leiden University Medical Center and Haaglanden Medical Center and Haga Teaching Hospitals, Leiden and The Hague
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40
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Yang H, Liu Y, Yang C, Lin X. The effect of systemic antidepressant treatments in early stage on neurocognitive function of euthymic bipolar patients initiated with a depressive onset: An observational, cross-sectional, single-blind study protocol. Brain Behav 2021; 11:e2360. [PMID: 34520638 PMCID: PMC8553326 DOI: 10.1002/brb3.2360] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/28/2021] [Accepted: 08/31/2021] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Patients with bipolar disorder (BD) have a wide range of neurocognitive dysfunction even in euthymic state, leading to impaired psychosocial function and reduced quality of life. However, the understanding on risk factors related to neurocognitive impairment in such group of people is limited. In view of significantly delayed diagnosis of BD and common use of antidepressants prior to the BD diagnosis, the study aims to clarify whether systemic antidepressant use in early stage, defined as from the initial depressive episode to the diagnosis of BD, could impact neurocognitive function of euthymic bipolar patients. METHODS It is an observational, cross-sectional, single-blind trial, making a comparison in neurocognitive function between euthymic bipolar patients who had a depressive episode as initial onset and being with and without systemic antidepressant treatments in early stage (n = 62 and 62, respectively); secondary outcomes include the impact of systemic antidepressant use on global function, quality of life, sleep quality, positive and negative affect, and peripheral level of neuron-specific enolase. DISCUSSION The study will provide a comprehensive and in-depth understanding on the effect of systemic antidepressant treatments in early stage in such group of patients. It is expected to better guide the related prevention and treatment work of BD management. TRIAL REGISTRATION The study was registered on Clinicaltrials.gov with protocol ID (TJAH2020-18) and clinicaltrials.gov ID (NCT04564573).
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Affiliation(s)
- Huizeng Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Yuanyuan Liu
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Chenghao Yang
- Tianjin Mental Health Center, Tianjin Anding Hospital, Tianjin, China
| | - Xiaoling Lin
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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41
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Wang B, Fu S, Huang Y, Liu L, Liang Y, An W, Fan Y, Zhao Y. The Effect of Hippocampal Avoidance Whole Brain Radiotherapy on the Preservation of Long-Term Neurocognitive Function in Non-Small Cell Lung Cancer Patients With Brain Metastasis. Technol Cancer Res Treat 2021; 20:15330338211034269. [PMID: 34396867 PMCID: PMC8371724 DOI: 10.1177/15330338211034269] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Whole-brain radiotherapy (WBRT) is the mainstay of therapy in treating cancer
patients with brain metastases, but unfortunately, it might also lead to decline
in neurocognitive function. This study aims to investigate the preservation of
long-term neurocognitive function in patients after hippocampal avoidance
whole-brain radiotherapy (HA-WBRT). Retrospectively, 47 patients diagnosed with
brain metastases of non-small cell lung cancer (NSCLC) between 2015-01-01 and
2017-12-31 at the Department of Oncology, XXX Hospital were selected and divided
into 2 groups. Group A (n = 27) received HA-WBRT, whereas group B (n = 20)
received WBRT. Neurocognitive function was analyzed at baseline and at 3, 6, 9,
12 and 24 months after radiotherapy, using Mine-Mental State Examination (MMSE)
scales and Montreal Cognitive Assessment (MoCA) scales. The OS, PFS and tumor
recurrence sites were also analyzed. When evaluated at 12 and 24 months after
radiotherapy, the cognitive function scores of the hippocampal avoidance group
were significantly higher than those of the non-hippocampal avoidance group
(P < 0.001). In terms of patient survival, there was no
significant difference in OS (P = 0.2) and PFS (P = 0.18)
between these 2 groups. Fourteen patients in group A and 12 patients in group B
had brain tumor recurrence after radiation, only one patient in group A occurred
within 5 mm from the edge of the hippocampus (P > 0.05). In
conclusion, HA-WBRT might have a protective effect on long-term neurocognitive
function and did not affect patient survival.
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Affiliation(s)
- Buhai Wang
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Shiwei Fu
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Yuxiang Huang
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Liqin Liu
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Yichen Liang
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Wenxian An
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Yaqin Fan
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
| | - Yisa Zhao
- Department of Oncology, Jiangsu Subei People's Hospital, Yangzhou, Jiangsu Province, China
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Wefel JS, Armstrong TS, Pugh SL, Gilbert MR, Wendland MM, Brachman DG, Roof KS, Brown PD, Crocker IR, Robins HI, Hunter G, Won M, Mehta MP. Neurocognitive, symptom, and health-related quality of life outcomes of a randomized trial of bevacizumab for newly diagnosed glioblastoma (NRG/RTOG 0825). Neuro Oncol 2021; 23:1125-1138. [PMID: 33515019 DOI: 10.1093/neuonc/noab011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Results of NRG Oncology RTOG 0825 reported adding bevacizumab to standard chemoradiation did not significantly improve survival endpoints and resulted in greater decline in neurocognitive function (NCF) and patient-reported outcomes (PRO) over time in bevacizumab-treated patients. The present report provides additional results of patient-centered outcomes over time and their prognostic association with survival endpoints. METHODS NCF tests, MD Anderson Symptom Inventory - Brain Tumor Module (MDASI-BT), and European Organization for Research and Treatment of Cancer (EORTC) quality of life (QOL) questionnaire with brain cancer module (QLQ-C30/BN20) were completed in a subset of progression-free patients at baseline and longitudinally. The prognostic value of baseline and early changes in NCF and PROs and differences between treatments from baseline to follow-up assessments were evaluated. RESULTS A total of 508 randomized patients participated. Baseline/early changes in NCF and PROs were prognostic for OS and PFS. No between-arm differences in time to deterioration were found. At week 6, patients treated with bevacizumab evidenced greater improvement on NCF tests of executive function and the MDASI-BT Cognitive Function scale, but simultaneously reported greater decline on the EORTC Cognitive Function Scale. At later time points (weeks 22, 34, and 46), patients treated with bevacizumab had greater worsening on NCF tests as well as PRO measures of cognitive, communication, social function, motor symptoms, general symptoms, and interference. CONCLUSION The collection of patient-centered clinical outcome assessments in this phase III trial revealed greater deterioration in NCF, symptoms, and QOL in patients treated with bevacizumab. Baseline and early change in NCF and PROs were prognostic for survival endpoints.
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Affiliation(s)
- Jeffrey S Wefel
- Department of Neuro-Oncology and Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Terri S Armstrong
- Neuro-Oncology Branch, University of Texas Health Science Center, Houston, Texas, USA
| | - Stephanie L Pugh
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Merideth M Wendland
- Radiation Oncology, USON-Willamette Valley Cancer Institute, Eugene, Oregon, USA
| | - David G Brachman
- Department of Radiation Oncology, Arizona Oncology Services Foundation, Phoenix, Arizona, USA
| | - Kevin S Roof
- Department of Radiation Oncology, Southeast Cancer Control Consortium, CCOP, Winston-Salem, North Carolina, USA
| | - Paul D Brown
- Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Ian R Crocker
- Department of Radiation Oncology, Emory University, Atlanta, Georgia, USA
| | - H Ian Robins
- Departments of Medicine and Human Oncology, University of Wisconsin Hospital, Madison, Wisconsin, USA
| | - Grant Hunter
- Department of Radiation Oncology, Intermountain Medical Center, Murray, Utah, USA
| | - Minhee Won
- NRG Oncology Statistics and Data Management Center, Philadelphia, Pennsylvania, USA
| | - Minesh P Mehta
- Department of Radiation Oncology, University of Maryland, Baltimore, Maryland, USA
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Wen X, Xu X, Luo X, Yin J, Liang C, Zhu J, Nong X, Zhu X, Ning F, Gu S, Xiong S, Fu J, Zhu D, Dai Z, Lv D, Lin Z, Lin J, Li Y, Ma G, Wang Y. Nucks1 gene polymorphism rs823114 is associated with the positive symptoms and neurocognitive function of patients with schizophrenia in parts of southern China. Psychiatr Genet 2021; 31:119-125. [PMID: 34030174 PMCID: PMC8265546 DOI: 10.1097/ypg.0000000000000285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 04/23/2021] [Indexed: 01/14/2023]
Abstract
Nuclear casein kinase and cyclin-dependent kinase substrate 1 (nucks1) are considered a potential susceptibility gene for certain neurological diseases, such as Parkinson's disease (PD). In our study, we genotyped three single nucleotide polymorphisms (SNPs) (rs4951261, rs823114 and rs951366) of the nucks1 gene in 774 schizophrenic patients and 819 healthy controls using the improved multiplex ligation detection reaction (imLDR) technique. Furthermore, we also studied the relationship between the above SNPs and the clinical psychiatric symptoms and neurocognitive function of the patients. Genotype distributions and allele frequencies of these SNPs showed no significant differences and were found between patients and healthy controls. However, in an analysis of the positive symptom score of rs823114 among male patients, we found that the score of the A/A genotype was lower than that of the G/A+G/G genotypes (P = 0.001, P(corr) = 0.003]. Additionally, we also found that among the female patients, G allele carriers with rs823114 had lower semantic fluency scores than subjects with the A/A genotype (P = 0.010, P(corr) = 0.030]. Our data show for the first time that rs823114 polymorphism of nucks1 may affect positive symptoms and neurocognitive function in patients with schizophrenia in parts of southern China.
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Affiliation(s)
- Xia Wen
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
- Maternal and Children’s Health Research Institute, Shunde Women and Children’s Hospital, Guangdong Medical University, Foshan
| | - Xusan Xu
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
- Maternal and Children’s Health Research Institute, Shunde Women and Children’s Hospital, Guangdong Medical University, Foshan
| | - Xudong Luo
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Jinwen Yin
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Chunmei Liang
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | | | | | - Xiudeng Zhu
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | - Fan Ning
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | - Shanshan Gu
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | - Susu Xiong
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Jiawu Fu
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | - Dongjian Zhu
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Zhun Dai
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Dong Lv
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Zhixiong Lin
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - Juda Lin
- Department of Psychiatry, Affiliated Hospital of Guangdong Medical University, Zhanjiang
| | - You Li
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
| | - Guoda Ma
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjian
- Maternal and Children’s Health Research Institute, Shunde Women and Children’s Hospital, Guangdong Medical University, Foshan
| | - Yajun Wang
- Medical Genetics Laboratory, Shunde Women and Children’s Hospital, Guangdong Medical University, Foshan, China
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Weusthof K, Lüttich P, Regnery S, König L, Bernhardt D, Witt O, Herfarth K, Unterberg A, Jungk C, Farnia B, Combs SE, Debus J, Rieken S, Harrabi S, Adeberg S. Neurocognitive Outcomes in Pediatric Patients Following Brain Irradiation. Cancers (Basel) 2021; 13:cancers13143538. [PMID: 34298751 PMCID: PMC8307409 DOI: 10.3390/cancers13143538] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/18/2021] [Accepted: 06/26/2021] [Indexed: 11/16/2022] Open
Abstract
Advanced radiation techniques can reduce the severity of neurocognitive sequelae in young brain tumor patients. In the present analysis, we sought to compare neurocognitive outcomes after proton irradiation with patients who underwent photon radiotherapy (RT) and surgery. Neurocognitive outcomes were evaluated in 103 pediatric brain tumor patients (proton RT n = 26, photon RT n = 30, surgery n = 47) before and after treatment. Comparison of neurocognitive outcomes following different treatment modalities were analyzed over four years after treatment completion. Longitudinal analyses included 42 months of follow-up after proton RT and 55 months after photon RT and surgery. Neurocognitive assessment included standardized tests examining seven domains. A comparison of neurocognitive outcomes after RT (proton and photon with >90% additional surgery) and surgery showed no significant differences in any neurocognitive domain. Neurocognitive functioning tests after proton RT failed to identify alterations compared to baseline testing. Long-term follow up over four years after photon RT showed a decrease in non-verbal intelligence (-9.6%; p = 0.01) and visuospatial construction (-14.9%; p = 0.02). After surgery, there was a decline in non-verbal intelligence (-10.7%; p = 0.01) and processing speed (14.9%; p = 0.002). Differences in neurocognitive outcomes between RT and surgical cohorts in direct intermodal comparison at long-term follow-up were not identified in our study, suggesting that modern radiation therapy does not affect cognition as much as in the past. There were no alterations in long-term neurocognitive abilities after proton RT, whereas decline of processing speed, non-verbal intelligence, and visuospatial abilities were observed after both photon RT and surgery. Domains dependent on intact white matter structures appear particularly vulnerable to brain tumor treatment irrespective of treatment approach.
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Affiliation(s)
- Katharina Weusthof
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
| | - Peggy Lüttich
- Section of Pediatric Brain Tumors, Department of Pediatric Oncology, Hematology and Immunology, University Medical Center for Children and Adolescents, 69120 Heidelberg, Germany; (P.L.); (O.W.)
| | - Sebastian Regnery
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
| | - Laila König
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), 69120 Heidelberg, Germany
| | - Denise Bernhardt
- Department of Radiation Oncology, Technische Universität München, 81675 München, Germany; (D.B.); (S.E.C.)
- Department of Radiation Sciences (DRS), Institut für Innovative Radiotherapie (iRT), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Olaf Witt
- Section of Pediatric Brain Tumors, Department of Pediatric Oncology, Hematology and Immunology, University Medical Center for Children and Adolescents, 69120 Heidelberg, Germany; (P.L.); (O.W.)
- Translational Program, Hopp Children’s Cancer Center at NCT Heidelberg (KiTZ), 69120 Heidelberg, Germany
| | - Klaus Herfarth
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Heidelberg, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Andreas Unterberg
- Department of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; (A.U.); (C.J.)
| | - Christine Jungk
- Department of Neurosurgery, Heidelberg University Hospital, 69120 Heidelberg, Germany; (A.U.); (C.J.)
| | - Benjamin Farnia
- Department of Radiation Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL 33136, USA;
| | - Stephanie E. Combs
- Department of Radiation Oncology, Technische Universität München, 81675 München, Germany; (D.B.); (S.E.C.)
- Department of Radiation Sciences (DRS), Institut für Innovative Radiotherapie (iRT), Helmholtz Zentrum München, 85764 Neuherberg, Germany
| | - Jürgen Debus
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Heidelberg, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Stefan Rieken
- Department of Radiation Oncology, University Hospital Goettingen, 37075 Goettingen, Germany;
| | - Semi Harrabi
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Heidelberg, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Sebastian Adeberg
- Department of Radiation Oncology, Heidelberg University Hospital, 69120 Heidelberg, Germany; (K.W.); (S.R.); (L.K.); (K.H.); (J.D.); (S.H.)
- Department of Radiation Oncology, Heidelberg Institute of Radiation Oncology (HIRO), 69120 Heidelberg, Germany
- National Center for Tumor Diseases (NCT), 69120 Heidelberg, Germany
- Department of Radiation Oncology, Heidelberg Ion-Beam Therapy Center (HIT), 69120 Heidelberg, Germany
- Clinical Cooperation Unit Radiation Oncology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- German Cancer Consortium (DKTK), Partner Site Heidelberg, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Correspondence: ; Tel.: +49-6221-56-8201
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45
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Mutoh T, Yamamoto S, Moriya T. Post-Event Application of Neurotropin Protects against Ischemic Insult toward Better Outcomes in a Murine Model of Subarachnoid Hemorrhage. Biomedicines 2021; 9:biomedicines9060664. [PMID: 34200698 PMCID: PMC8227975 DOI: 10.3390/biomedicines9060664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/01/2021] [Accepted: 06/08/2021] [Indexed: 12/03/2022] Open
Abstract
Early brain injury (EBI) is closely linked to the development of delayed cerebral ischemia and poor outcomes after aneurysmal subarachnoid hemorrhage (SAH). This study aimed to evaluate the neuroprotective effect of neurotropin on EBI in a murine model of SAH. Twenty-four C57BL/6N mice were treated with intraperitoneal injections of either saline or 2.4 units of neurotropin at 1 h after SAH induction and for 3 days consecutively. SAH was created by an endovascular perforation method. In addition to the assessment of cerebral infarction and survival rate, motor and neurocognitive functions were also measured after SAH. Compared to the saline control group, the neurotropin group showed better recovery from locomotive and neurological declines after SAH. The neurotropin group also showed lower rates of post-SAH acute cerebral infarction and better memory and route-learning scores (p < 0.05). Meanwhile, there was no significant between-group differences in the overall mortality, hemodynamic parameters, or body weights. In conclusion, post-event treatment with neurotropin could be protective against EBI, lowering the incidence of ischemia and improving some motor and neurocognitive functions after SAH.
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Affiliation(s)
- Tatsushi Mutoh
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Aoba-ku, Sendai 980-8575, Japan;
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
- Correspondence:
| | - Shuzo Yamamoto
- Department of Geriatric Medicine and Neuroimaging, Tohoku University Hospital, Aoba-ku, Sendai 980-8575, Japan;
- Department of Aging Research and Geriatric Medicine, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai 980-8575, Japan
| | - Takahiro Moriya
- Department of Pharmacology, School of Pharmaceutical Sciences, Ohu University, Koriyama, Fukushima 963-8611, Japan;
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Griggs S, Hickman RL, Strohl KP, Redeker NS, Crawford SL, Grey M. Sleep-wake characteristics, daytime sleepiness, and glycemia in young adults with type 1 diabetes. J Clin Sleep Med 2021; 17:1865-1874. [PMID: 33949941 DOI: 10.5664/jcsm.9402] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The purpose of this study was to describe objective sleep-wake characteristics and glycemia over 7 - 14 days in young adults with type 1 diabetes (T1D). Additionally, person level associations among objective sleep-wake characteristics (total sleep time, sleep variability, and sleep fragmentation index), daytime sleepiness, and glycemia (glycemic control and glucose variability) were examined. METHODS In this cross-sectional study, objective sleep-wake characteristics were measured via actigraphy and glucose variability via continuous glucose monitoring (CGM) over 6-14 days. At baseline, participants completed a psychomotor vigilance test (PVT), Trail Making Test, and questionnaires on daytime sleepiness, sleep quality, and sleep disturbance including sleep diaries. RESULTS Forty-six participants (mean age 22.3 ± 3.2 years) wore a wrist actigraph and CGM concurrently for 6-14 days. Greater sleep variability was directly associated with greater glucose variability (mean of daily differences) (r = 0.33, p = .036). Higher daytime sleepiness was directly associated with greater glucose variability (mean of daily differences) (r = 0.50, p = .001). The association between sleep variability and glucose variability (mean of daily differences) was no longer significant when accounting for daytime sleepiness and controlling for T1D duration (p > .05). A higher sleep fragmentation index was associated with greater glucose variability (B = 1.27, p = .010, pr2 = .40) after controlling for T1D duration and accounting for higher daytime sleepiness. CONCLUSIONS Sleep-wake variability, sleep fragmentation, daytime sleepiness, and the associations with glycemia are new dimensions to consider in young adults with T1D. Sleep habits in this population may explain higher glucose variability and optimizing sleep may improve overall diabetes management.
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Affiliation(s)
- Stephanie Griggs
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Ronald L Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH
| | - Kingman P Strohl
- School of Medicine, Case Western Reserve University, Cleveland, OH
| | - Nancy S Redeker
- School of Nursing and School of Medicine, Yale University, West Haven, Connecticut
| | - Sybil L Crawford
- Graduate School of Nursing, University of Massachusetts Medical School, Worcester, MA
| | - Margaret Grey
- School of Nursing and School of Medicine, Yale University, West Haven, Connecticut
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47
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Iijima M, Liu W, Panetta JC, Hudson MM, Pui CH, Srivastava DK, Krull KR, Inaba H. Association between obesity and neurocognitive function in survivors of childhood acute lymphoblastic leukemia treated only with chemotherapy. Cancer 2021; 127:3202-3213. [PMID: 33914910 DOI: 10.1002/cncr.33624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Neurocognitive impairment and obesity are common adverse sequelae in survivors of childhood acute lymphoblastic leukemia (ALL); however, the association has not been investigated. METHODS Neurocognitive function was evaluated once in survivors of ALL who were at least 8 years old and 5 years from their diagnosis. In a cross-sectional analysis, the associations with the body mass index (BMI) category and Z score were examined. A longitudinal analysis used the overweight/obesity area under the curve (AUC), which was determined via the trapezoidal rule by a sum of the integrals defined by the BMI Z score at each time point and the time intervals of the BMI measurement. RESULTS For 210 survivors, the median BMI Z score at diagnosis was 0.17, which increased to 0.54 at the end of induction and to 0.74 at the neurocognitive assessment. In the cross-sectional analysis, overweight/obese survivors scored significantly lower than others on the measures of executive function (cognitive flexibility, planning, verbal fluency, working memory, and spatial construction; all P < .05), attention (attention span and risk taking; all P < .05), and processing speed (visual motor coordination, visual speed, and motor speed; all P < .05). In the longitudinal analysis, when the treatment period was subdivided into 4 time periods (induction, consolidation, early maintenance, and late maintenance), a greater overweight/obesity AUC during induction therapy was associated with worse cognitive flexibility (P = .01) and slower motor speed (P = .02), which persisted throughout the treatment. CONCLUSIONS Overweight/obesity was significantly associated with neurocognitive impairment during long-term follow-up, and this association started early in treatment for ALL. Novel early interventions to provide cognitive training and prevent weight gain are required for patients at risk.
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Affiliation(s)
- Mayuko Iijima
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychiatry and Behavioral Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Wei Liu
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - John C Panetta
- Department of Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Deo Kumar Srivastava
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Hiroto Inaba
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
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48
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Almahariq MF, Quinn TJ, Arden JD, Roskos PT, Wilson GD, Marples B, Grills IS, Chen PY, Krauss DJ, Chinnaiyan P, Dilworth JT. Pulsed radiation therapy for the treatment of newly diagnosed glioblastoma. Neuro Oncol 2021; 23:447-456. [PMID: 32658268 DOI: 10.1093/neuonc/noaa165] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pulsed radiation therapy (PRT) has shown effective tumor control and superior normal-tissue sparing ability compared with standard radiotherapy (SRT) in preclinical models and retrospective clinical series. This is the first prospective trial to investigate PRT in the treatment of patients with newly diagnosed glioblastoma (GBM). METHODS This is a single-arm, prospective study. Patients with newly diagnosed GBM underwent surgery, followed by 60 Gy of PRT with concurrent temozolomide (TMZ). Each day, a 2-Gy fraction was divided into ten 0.2-Gy pulses, separated by 3-minute intervals. Patients received maintenance TMZ. Neurocognitive function (NCF) and quality of life (QoL) were monitored for 2 years using the Hopkins Verbal Learning Test‒Revised and the European Organisation for Research and Treatment of Cancer QLQ-C30 QoL questionnaire. Change in NCF was evaluated based on a minimal clinically important difference (MCID) threshold of 0.5 standard deviation. RESULTS Twenty patients were enrolled with a median follow-up of 21 months. Median age was 60 years. Forty percent underwent subtotal resection, and 60% underwent gross total resection. One patient had an isocitrate dehydrogenase (IDH)-mutated tumor. Median progression-free survival (PFS) and overall survival (OS) were 10.7 and 20.9 months, respectively. In a post-hoc comparison, median OS for the prospective cohort was longer, compared with a matched cohort receiving SRT (20.9 vs 14 mo, P = 0.042). There was no decline in QoL, and changes in NCF scores did not meet the threshold of an MCID. CONCLUSIONS Treatment of newly diagnosed GBM with PRT is feasible and produces promising effectiveness while maintaining neurocognitive function and QoL. Validation of our results in a larger prospective trial warrants consideration.
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Affiliation(s)
| | - Thomas J Quinn
- Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan
| | - Jessica D Arden
- Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan
| | - P T Roskos
- Neuropsychology Services, Department of Physical Medicine and Rehabilitation, Beaumont Health, Dearborn, Michigan
| | - George D Wilson
- Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester, Rochester, New York
| | - Inga S Grills
- Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| | - Peter Y Chen
- Department of Radiation Oncology, Beaumont Health, Royal Oak, Michigan
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| | - Daniel J Krauss
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| | - Prakash Chinnaiyan
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
| | - Joshua T Dilworth
- Oakland University William Beaumont School of Medicine, Auburn Hills, Michigan
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49
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Chin WC, Liu FY, Huang YS, Hsiao IT, Wang CH, Chen YC. Different positron emission tomography findings in schizophrenia and narcolepsy type 1 in adolescents and young adults: a preliminary study. J Clin Sleep Med 2021; 17:739-748. [PMID: 33226331 DOI: 10.5664/jcsm.9032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES The association between schizophrenia and narcolepsy has been controversial. We conducted a prospective case control study of schizophrenia and comorbid narcolepsy type 1 in adolescents compared with patients with either diagnosis alone and healthy controls using 18F-fluorodeoxy glucose positron emission tomography, sleep studies, and neurocognitive tests. METHODS We included 11 patients (9-20 years old) with schizophrenia and comorbid narcolepsy type 1, 11 with narcolepsy type 1, 11 with schizophrenia, and 11 controls. All groups were matched for age and sex. Participants were required to submit to clinical interviews for sleep and psychiatric disorders, sleep questionnaires, continuous performance test, Wisconsin card sorting test, sleep studies including polysomnography, multiple sleep latency test and actigraphy, and positron emission tomography studies. All data were analyzed to compare the differences between the 4 groups. RESULTS The positron emission tomography results demonstrated significant differences in the dual diagnoses group compared with the 3 other groups. Compared with the controls, the dual diagnoses group had a significant presence of hypometabolism in the right mid-frontal, right orbital inferior frontal, and right posterior cingulum and a significant presence of hypermetabolism in the left amygdala, bilateral striatum, bilateral substantia nigra, bilateral basal ganglia, and bilateral thalamus. Continuous performance tests and Wisconsin card sorting tests showed that the dual diagnoses group had the worst performance. CONCLUSIONS Patients with schizophrenia and comorbid narcolepsy type 1 had different positron emission tomography findings than those with either schizophrenia or narcolepsy type 1 alone. They also had more neurocognitive impairments and required additional interventions.
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Affiliation(s)
- Wei-Chih Chin
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Feng-Yuan Liu
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Yu-Shu Huang
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ing-Tsung Hsiao
- Department of Medical Imaging and Radiological Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan.,Department of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Chih-Huan Wang
- Department of Psychology, Zhejiang Normal University, Zhejiang, China
| | - Ying-Chun Chen
- Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
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50
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Doskas T, Vavougios GD, Karampetsou P, Kormas C, Synadinakis E, Stavrogianni K, Sionidou P, Serdari A, Vorvolakos T, Iliopoulos I, Vadikolias Κ. Neurocognitive impairment and social cognition in multiple sclerosis. Int J Neurosci 2021; 132:1229-1244. [PMID: 33527857 DOI: 10.1080/00207454.2021.1879066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE/AIM OF THE STUDY The impairment of neurocognitive functions occurs in all subtypes of multiple sclerosis, even from the earliest stages of the disease. Commonly reported manifestations of cognitive impairment include deficits in attention, conceptual reasoning, processing efficiency, information processing speed, memory (episodic and working), verbal fluency (language), and executive functions. Multiple sclerosis patients also suffer from social cognition impairment, which affects their social functioning. The objective of the current paper is to assess the effect of neurocognitive impairment and its potential correlation with social cognition performance and impairment in multiple sclerosis patients. MATERIALS AND METHODS An overview of the available-to-date literature on neurocognitive impairment and social cognition performance in multiple sclerosis patients by disease subtype was performed. RESULTS It is not clear if social cognition impairment occurs independently or secondarily to neurocognitive impairment. There are associations of variable strengths between neurocognitive and social cognition deficits and their neural basis is increasingly investigated. CONCLUSIONS The prompt detection of neurocognitive predictors of social cognition impairment that may be applicable to all multiple sclerosis subtypes and intervention are crucial to prevent further neural and social cognition decline in multiple sclerosis patients.
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Affiliation(s)
- Triantafyllos Doskas
- Department of Neurology, Athens Naval Hospital, Athens, Greece.,Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | | | | | | | | | | | | | - Aspasia Serdari
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Theofanis Vorvolakos
- Department of Psychiatry, University Hospital of Alexandroupolis, Alexandroupolis, Greece
| | - Ioannis Iliopoulos
- Department of Neurology, University Hospital of Alexandroupolis, Alexandroupolis, Greece
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