M60. EARLY VERSUS DELAYED PRESCRIPTION OF CLOZAPINE AND THE COGNITIVE PERFORMANCE ON SCHIZOPHRENIA

Abstract Background Patients with schizophrenia display a wide and characteristic array of cognitive deficits. A range of factors has been shown to influence cognition, including cognitive reserve (CR). Amongst antipsychotics only clozapine has shown positive results on cognition to date. Although it is known that delayed initiation of clozapine may be related to poor clinical psychotic response, no previous results have been tested on relation to cognitive improvements. This study aimed to analyze the improvement in cognitive performance after starting clozapine treatment according to the early versus late treatment initiation after diagnosis. Methods 41 patients with schizophrenia were enrolled. All subjects were assessed clinically, neuropsychologically and functionally at baseline and at the 18th week of clozapine treatment. Premorbid IQ was calculated with the vocabulary subtest of the WAIS-III and it was considered a measure of CR. For study purposes, sample was divided into early or late treatment initiation of clozapine (± 3 years after diagnosis). Lineal mixed model analyses were used while confounding from different factors. Results There were no differences between groups in terms of gender, functional, clinical and neuropsychological outcomes at baseline and follow-up. Neither clozapine dose, nor plasma concentration of nor-clozapine, have been found to be different at 18 weeks. Significant difference in age was found (p<0.001). In early initiation clozapine treatment group (n=22), improvements in working memory, attention, executive functions, and processing speed were found. Thus, CR was the only significant factor explaining these improvements in all cognitive domains, except in processing speed that was explained by time. Late onset group (n=19) improved their cognitive performance on working memory and executive functions, both explained by CR (not time or age). Discussion There were no differences between groups at baseline, except for age. Patients who started an early treatment of clozapine improved more cognitive domains at 18-week that those who started it later. In both cases, CR is a key factor in predicting cognitive improvement. Reducing clozapine treatment delay might represent immediate prospective improvements on cognitive domains in comparison with delayed start. Time-wise cognitive monitoring and CR enhancement at early stages of the psychotic illness/treatment may be helpful in order to prevent cognitive impairment.

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The Effect of Curcumin Differs on Individual Cognitive Domains across Different Patient Populations: A Systematic Review and Meta-Analysis

Pharmaceuticals ◽

10.3390/ph14121235 ◽

2021 ◽

Vol 14 (12) ◽

pp. 1235

Author(s):

I-Chen Tsai ◽

Chih-Wei Hsu ◽

Chun-Hung Chang ◽

Ping-Tao Tseng ◽

Ke-Vin Chang

Keyword(s):

Working Memory ◽

Placebo Group ◽

Cognitive Function ◽

Processing Speed ◽

Verbal Memory ◽

Meta Analysis ◽

Visual Learning ◽

Clinical Effectiveness ◽

Cognitive Domains ◽

Significant Difference

Curcumin is a polyphenol with strong antioxidant and anti-inflammatory effects that has been shown to be effective in ameliorating cognitive decline in animal studies. However, its clinical effectiveness is inconclusive, and relevant gastrointestinal adverse events (AEs) have been reported. The aim of this meta-analysis was to summarize the existing evidence from randomized controlled trials (RCTs) of effects of curcumin on overall cognitive function, individual cognitive domains, and gastrointestinal AE. The study includes 8 RCTs and 389 participants. A random-effects model was used for the meta-analysis. Compared with the placebo group, the curcumin group was associated with an improvement in working memory (Hedges’ g = 0.396, 95% confidence interval (CI) = 0.078 to 0.714, p = 0.015) and a borderline benefit in processing speed (Hedges’ g = 0.303, 95% CI = ‒0.013 to 0.619, p = 0.06). In the domains of language, episodic memory/visual learning, verbal memory, cognitive flexibility/problem solving, and overall cognitive function, no significant difference existed for the comparison between the curcumin and placebo groups. The curcumin group had a significantly higher risk of gastrointestinal AEs than the placebo group (odds ratio = 3.019, 95% CI = 1.118 to 8.150, p = 0.029). In the future, the effects of curcumin on working memory, processing speed, and gastrointestinal AE should be further investigated.

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Mathematics Skills and Executive Functions Following Preterm Birth: A Longitudinal Study of 5-to 7- Year Old Children

10.31234/osf.io/j42at ◽

2019 ◽

Author(s):

Julia Anna Adrian ◽

Frank Haist ◽

Natacha Akshoomoff

Keyword(s):

Working Memory ◽

Executive Functions ◽

Processing Speed ◽

Spatial Working Memory ◽

Working Memory Capacity ◽

Full Term ◽

Healthy Children ◽

Time Points ◽

Mathematics Skills ◽

Increased Risk

Early mathematics skills are an important predictor of later academic, economic and personal success. Children born preterm, about 10% of the US population, have an increased risk of deficits in mathematics. These deficits may be related to lower levels of executive functions and processing speed. We investigated the development of mathematics skills, working memory, inhibitory control and processing speed of healthy children born very preterm (between 25 and 32 weeks gestational age, n=51) and full-term (n=29). Children were tested annually from ages 5 to 7 years. We found persistent lower overall mathematics skills in the preterm group, driven by differences in more informal skills (e.g. counting) at earlier time points, and by differences in more formal skills (e.g. calculation) at later time points. We did not find significant differences between preterm and full-term born children in spatial working memory capacity or processing speed. However, these cognitive measures were significant predictors of mathematics skills in the preterm but not the full-term group, hinting towards the use of different strategies when solving problems.

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Association of AKAP6 and MIR2113 with cognitive performance in a population based sample of older adults

10.1101/070409 ◽

2016 ◽

Author(s):

Shea J. Andrews ◽

Debjani Das ◽

Kaarin J. Anstey ◽

Simon Easteal

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Function ◽

Episodic Memory ◽

Cognitive Performance ◽

Cognitive Change ◽

European Ancestry ◽

Substantial Contribution ◽

Perceptual Speed ◽

Cognitive Domains

AbstractGenetic factors make a substantial contribution to inter-individual variability in cognitive function. A recent meta-analysis of genome-wide association studies identified two loci, AKAP6 and MIR2113 that are associated with general cognitive function. Here, we extend this previous research by investigating the association of MIR2113 and AKAP6 with baseline and longitudinal nonlinear change across a broad spectrum of cognitive domains in community-based cohort of 1,570 older adults without dementia. Two SNPs, MIR211-rs10457441 and AKAP6-rs17522122 were genotyped in 1,570 non-demented older Australians of European ancestry, who were examined up to 4 times over 12 years. Linear mixed effects models were used to examine the association between AKAP6 and MIR2113 with cognitive performance in episodic memory, working memory, vocabulary, perceptual speed and reaction time at baseline and with linear and quadratic rates of change. AKAP6-rs17522122*T was associated with worse baseline performance in episodic memory, working memory, vocabulary and perceptual speed, but it was not associated with cognitive change in any domain. MIR2113-rs10457441*T was associated with accelerated decline in episodic memory. No other associations with baseline cognitive performance or with linear or quadratic rate or cognitive changes was observed for this SNP. These results confirm the previous finding that, AKAP6 is associated with performance across multiple cognitive domains at baseline but not with cognitive decline, while MIR2113 primarily affects the rate at which memory declines over time.

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Brain Training Game Boosts Executive Functions, Working Memory and Processing Speed in the Young Adults: A Randomized Controlled Trial

PLoS ONE ◽

10.1371/journal.pone.0055518 ◽

2013 ◽

Vol 8 (2) ◽

pp. e55518 ◽

Cited By ~ 96

Author(s):

Rui Nouchi ◽

Yasuyuki Taki ◽

Hikaru Takeuchi ◽

Hiroshi Hashizume ◽

Takayuki Nozawa ◽

...

Keyword(s):

Working Memory ◽

Randomized Controlled Trial ◽

Young Adults ◽

Executive Functions ◽

Processing Speed ◽

Controlled Trial ◽

Brain Training ◽

Randomized Controlled

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The Relation Between Cognitively Measured Executive Functions and Reported Self-Regulated Learning Strategy Use in Adult Online Distance Education

Frontiers in Psychology ◽

10.3389/fpsyg.2021.641972 ◽

2021 ◽

Vol 12 ◽

Author(s):

Celeste Meijs ◽

Hieronymus J. M. Gijselaers ◽

Kate M. Xu ◽

Paul A. Kirschner ◽

Renate H. M. De Groot

Keyword(s):

Working Memory ◽

Executive Functions ◽

Processing Speed ◽

Self Regulation ◽

Cognitive Strategy ◽

Strategy Use ◽

Cognitive Tests ◽

Online Distance Education ◽

Self Regulated Learning ◽

Online Distance

While executive functions (EFs) and self-regulated learning (SRL) strategy use have been found to be related in several populations, this relationship has not been studied in adult online distance education (ODE). This is surprising as self-regulation, and thus using such strategies, is very important here. In this setting, we studied the relation between basic executive functions (i.e., working memory and shifting, measured with cognitive tests) and reported SRL-strategy use (i.e., management of time and effort, complex and simple cognitive strategy use, contacts with others, and academic thinking) within a correlational design with 889 adult online distance students. In this study, we performed regression analyses and took age and processing speed into consideration, as processing speed and EFs decrease with age, whereas self-regulation is reported to increase with age. Cognitively measured working memory was not related to reported SRL-strategy use in adult ODE students. Thus, even though the SRL-components within the strategies seem to elicit working memory, reported SRL-strategy use is not related to the functioning of this basic EF (measured with cognitive tests). This means that if SRL-strategy use needs to be increased in adult ODE students, training of working memory might not be an effective manner for achieving that goal. Better shifting and processing speed were related to less reported SRL-strategy use, which might suggest that SRL-strategies might be used to compensate for lower shifting (in academic thinking) and lower processing speed (in simple cognitive strategy use and contacts with others). With increasing age, the number of contacts with peers or teachers decreases. This latter finding might be of relevance during the pandemic since contacts with others is importance during lockdown.

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Abstract P317: Cognitive Impairment in Coronary Artery Disease Patients: Do Exercise Tolerance and Cerebral Oxygenation During Exercise Matter?

Circulation ◽

10.1161/circ.125.suppl_10.ap317 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Vincent Gremeaux ◽

Joffrey Drigny ◽

Mathieu Gayda ◽

Martin Juneau ◽

Louis Bherer ◽

...

Keyword(s):

Cardiac Output ◽

Executive Functions ◽

Cognitive Performance ◽

Exercise Tolerance ◽

Maximal Exercise ◽

Digit Span ◽

Output Measurement ◽

Stable Coronary Heart Disease ◽

Significant Difference ◽

Nirs Signal

Introduction: Cardiovascular diseases have been associated with impaired cognitive performances, especially in functions. In contrast, it is clearly established that regular physical activity maintained throughout life protects against age-related cognitive decline. Purpose: to assess maximal oxygen uptake (VO2max), cardiac output, and cerebral hemodynamic changes, assessed by Near-Infrared Spectroscopy (NIRS), during a graded maximal exercise tests, and cognitive performance at rest in patients with stable coronary heart disease (CHD) and healthy matched adults. Methods: Ten stable CHD patients (67.1±10.5 years) and 9 age-matched controls (62.2± 11.4 years) were included in this pilot study. Measurements included: body composition (bioelectrical impedance), complete blood analysis in a fasting state, cognitive performance using validated neuropsychological tests, graded maximal exercise testing on ergocycle with gas exchange analysis, non-invasive cardiac output measurement (cardiac bioimpedance) and NIRS signals measurement at the left prefrontal brain level (oxyhaemoglobin: O2Hb, deoxyhaemoglobin: HHb ; total haemoglobin: THb, and differential haemoglogin: Hbdiff). Results: Several cognitive performance items were lower in the CHD group, especially regarding executive functions (Backward digit span score, p<0.05; trail making test B, p=0.05; Stroop test (inhibition/flexibility), p<0.05). There was no difference between CHD and controls in VO2 max (29.7±8.5 Vs 32±6.3 ml/kg/min) and maximal cardiac output (15.5±3.9 Vs 17±2.6 l/min), whereas cardiac output and cardiac index at the ventilatory threshold were lower in CHD (5.75±1 Vs 7.06±0.6 l/min/m2, p<0.05, and 11.2±2.2 Vs 14.1±2.8 l/min, p<0.01, respectively). There was a significant difference in the kinetics of NIRS signal with higher amplitude for CHD patients vs. controls for O2Hb (p<0.01); THb (p<0.05) and Hbdiff (p<0.05). Significant higher amplitude were also found for O2Hb, THb, Hbdiff (p<0.0001) in younger (62 years) participants. HHb (p<0.0001) and Hbdiff (p<0.01) amplitude was higher for fit (≥120% theoretical VO2max) vs. less fit (<120%) participants. Discussion: Compared to age-matched controls, our sample of stable fit CHD patients had a comparable maximal exercise tolerance and cardiac output, with higher NIRS cerebral signals amplitude for O2Hb, THb and Hbdiff. This latter parameter thus does not seem to influence cognitive performance at rest, that was lower in CHD patients, especially in executive functions. However, an important inter-individual variability of cerebral NIRS signal amplitude was observed, with age and fitness appearing as major contributors. We plan to recruit a larger sample of subjects to assess more clearly relationships between exercise, tolerance hemodynamic parameters and cognitive performance.

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537 Insomnia Symptoms and Subsequent Cognitive Performance in Older Adults: Are Depressive Symptoms and Vascular Disease Mediators?

SLEEP ◽

10.1093/sleep/zsab072.535 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A212-A212

Author(s):

Afsara Zaheed ◽

Adam Spira ◽

Ronald Chervin ◽

Laura Zahodne

Keyword(s):

Executive Function ◽

Depressive Symptoms ◽

Episodic Memory ◽

Cognitive Performance ◽

Processing Speed ◽

Vascular Diseases ◽

Cognitive Domains ◽

Falling Asleep ◽

Function Language ◽

Insomnia Symptoms

Abstract Introduction Alzheimer’s disease and related dementias (ADRD) are growing public health concerns, and poor sleep may represent a modifiable risk factor. However, there is limited research on insomnia as a predictor of subsequent performance in different cognitive domains and mechanisms that might underlie domain-specific associations. The current study examined: (1) which insomnia symptoms predicted performance across five cognitive domains 14 years later, and (2) whether depressive symptoms and/or vascular diseases mediated these associations. Methods Participants included 2,496 adults aged 51+ in the Health and Retirement Study. Insomnia symptoms in 2002 (i.e., “baseline”) were quantified by four self-reported items on frequency of trouble falling asleep, nighttime awakenings, early awakenings, and feeling rested upon awakening. Cognition was assessed in 2016 as part of the Harmonized Cognitive Assessment Protocol and operationalized with five factor scores corresponding to episodic memory, executive function, language, visuoconstruction, and processing speed. Multiple regressions examined associations between baseline insomnia symptoms and subsequent cognitive performance, controlling for sociodemographics and baseline global cognitive performance. Mediation models tested whether associations were explained by self-reported depressive symptoms and/or vascular diseases (i.e., hypertension, heart disease, diabetes, and/or stroke) in 2014, controlling for baseline values. Results Only trouble falling asleep in 2002 was associated with cognition in 2016. Specifically, more frequent trouble falling asleep predicted poorer episodic memory, executive function, language and processing speed performance, but not visuoconstruction. These associations were mediated by depressive symptoms and vascular diseases in 2014 for all domains except episodic memory; only depressive symptoms mediated the association involving memory. After accounting for these mediators, direct effects of trouble falling asleep remained for episodic memory, executive function and language, but not processing speed. Conclusion Difficulty with sleep initiation may be more consequential for later-life cognition than other insomnia symptoms. Depressive symptoms and vascular diseases may partially drive these associations. We speculate that sleep-onset insomnia could mean less total sleep, immune dysfunction, or endocrine effects that worsen mood, vascular health, and cognition. Remaining associations indicate that additional research is needed to characterize other mechanisms through which sleep initiation problems could contribute to later impairments in frontal and temporal cognitive systems, which are implicated early in ADRD. Support (if any):

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Passive heat acclimation does not modulate processing speed and executive functions during cognitive tasks performed at fixed levels of thermal strain

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2021-0243 ◽

2021 ◽

Author(s):

Hadiatou Barry ◽

Philippe Gendron ◽

Christine Gagnon ◽

Louis Bherer ◽

Daniel Gagnon

Keyword(s):

Reaction Time ◽

Executive Functions ◽

Cognitive Performance ◽

Core Temperature ◽

Processing Speed ◽

Heat Exposure ◽

Thermal Strain ◽

Heat Acclimation ◽

Cognitive Tasks ◽

Time Control

Purpose: This study evaluated if passive controlled hyperthermia heat acclimation (HA) modulates cognitive performance during passive heat stress. Methods: Eight healthy adults (25 ± 4 years) underwent 7 consecutive days of hot water immersion (core temperature ≥38.6°C) and a 7-day time-control period. On days 1 and 7 of HA, participants performed a digital Stroop test at baseline, when core temperature reached 38.6°C, and after 60 minutes at a core temperature ≥38.6°C to evaluate reaction time during tasks targeting processing speed (reading and counting) and executive functions (inhibition and switching). On days 1 and 7 of the time-control intervention, participants performed the Stroop test with equivalent amounts of time separating each task as for HA. Results: During day 1 of HA, reaction time was quicker during the reading (-44 ms [-71, -17], P<0.01) and counting (-39 ms [-76, -2], P=0.04) tasks when rectal temperature reached 38.6°C, but after a further 60 minutes of heat exposure, reaction time only remained quicker during the reading task (-56 ms [-83, -29], P<0.01). Changes in reaction time during heat exposure were unaffected by subsequent HA (interaction, all P≥0.09). Conclusion: Seven days of HA does not modulate processing speed and executive functions during passive heat exposure. Novelty: - Whether heat acclimation (HA) to improve cognitive performance during heat exposure remains understudied. - We tested the hypothesis that HA modulates reaction time during cognitive tasks performed at matched levels of thermal strain. - Despite classical signs of HA, reaction time during heat exposure was unaffected by HA.

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A-114 Neurocognitive Correlates of Persistent Post-Concussion Syndrome in Youth

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.132 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1163-1164

Author(s):

Christopher Anzalone ◽

Rachel M Bridges ◽

Jessica C Luedke ◽

Scott L Decker

Keyword(s):

Working Memory ◽

Cognitive Processing ◽

Processing Speed ◽

Cognitive Abilities ◽

Cognitive Testing ◽

Control Group ◽

Cognitive Domains ◽

Post Concussion Syndrome ◽

Patients Experience ◽

Future Work

Abstract Objective In the U.S., youths account for most annual mild traumatic brain injury (mTBI) cases. Often mTBI patients experience impairing symptoms that affect several domains of functioning, typically these symptoms remit within a month though many patients will experience impairing symptoms that persist for greater than three months. Due to the current difficulties in diagnosing this condition in a standardized way, the current study aims to clarify the cognitive profiles of persistent post-concussion syndrome (PPCS) in youth patients. Method 30 youths between the ages of 8 and 18 years participated. 15 youths with mTBI symptoms for greater than three months were recruited from a mTBI treatment clinic. An additional 15 youths without a mTBI history were recruited as a control group. All participants underwent cognitive testing using the standard Woodcock-Johnson Tests of Cognitive Abilities battery. Logistic regression analyses explored the importance of cognitive processing speed and working memory for identifying youth patients with PPCS. Further exploratory analyses were conducted to clarify additional cognitive domains that may be impacted by PPCS. Results Findings suggest processing speed and working memory abilities alone are not adequate for identifying patients with PPCS and measures of processing speed, fluid reasoning, working memory, and long-term retrieval may be important to consider when differentially diagnosing PPCS. Conclusions More research is needed to appropriately identify and validate diagnostic practices for PPCS in youth. Our findings provide a basis for future work and suggests neuropsychological batteries that include measures for these four cognitive domains may be valuable for identifying PPCS in youth patients.

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Heterogeneity of late-life depression: relationship with cognitive functioning

International Psychogeriatrics ◽

10.1017/s1041610214000155 ◽

2014 ◽

Vol 26 (6) ◽

pp. 953-963 ◽

Cited By ~ 29

Author(s):

Nicole C. M. Korten ◽

Brenda W. J. H. Penninx ◽

Rob M. Kok ◽

Max L. Stek ◽

Richard C. Oude Voshaar ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Functioning ◽

Psychotropic Medication ◽

Processing Speed ◽

Depressive Episode ◽

Late Life ◽

Late Life Depression ◽

Symptom Dimensions ◽

Cognitive Domains

ABSTRACTBackground:Late-life depression is a heterogeneous disorder, whereby cognitive impairments are often observed. This study examines which clinical characteristics and symptom dimensions of late-life depression are especially impacting on specific cognitive domains.Methods:Cross-sectional data of 378 depressed and 132 non-depressed older adults between 60–93 years, from the Netherlands Study of Depression in Older adults (NESDO) were used. Depressed older adults were recruited from both inpatient and outpatient mental healthcare institutes and general practices, and diagnosed according to DSM-IV-TR criteria. Multivariable associations were examined with depression characteristics (severity, onset, comorbidity, psychotropic medication) and symptom dimensions as independent variables and cognitive domains (episodic memory, processing speed, interference control, working memory) as dependent variables.Results:Late-life depression was associated with poorer cognitive functioning. Within depressed participants, higher severity of psychopathology and having a first depressive episode was associated with poorer cognitive functioning. The use of tricyclic antidepressants, serotonergic and noradrenergic working antidepressants, and benzodiazepines was associated with worse cognitive functioning. Higher scores on the mood dimension were associated with poorer working memory and processing speed, whereas higher scores on a motivational and apathy dimension were associated with poorer episodic memory and processing speed.Conclusions:Heterogeneity in late-life depression may lead to differences in cognitive functioning. Higher severity and having a first depressive episode was associated with worse cognitive performance. Additionally, different domains of cognitive functioning were associated with specific symptom dimensions. Our findings on the use of psychotropic medication suggest that close monitoring on cognitive side effects is needed.

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