Longitudinal assessment of cancer-related cognitive impairment (CRCI) up to six-months post-chemotherapy with multiple cognitive testing methods in 943 breast cancer (BC) patients and controls.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10014-10014 ◽  
Author(s):  
Michelle Christine Janelsins ◽  
Charles E. Heckler ◽  
Luke Joseph Peppone ◽  
Supriya Gupta Mohile ◽  
Karen Michelle Mustian ◽  
...  
Keyword(s):  
Visual Processing ◽  
Mixed Model ◽  
Word Association ◽  
Cognitive Testing ◽  
Longitudinal Change ◽  
Word Recall ◽  
Significant Group ◽  
Significant Difference ◽  
Group Time

10014 Background: Large nationwide studies are needed to assess CRCI. Methods: NCORPs recruited BC patients and age-matched non-cancer controls. Computerized ((CANTAB Delayed Match to Sample (DMS), Rapid Visual Processing (RVP), Verbal Recognition Memory (VRM)), paper-based ((Controlled Oral Word Association (COWA), and Trail Making Test (TMT)) , and phone-based (category fluency, word recall, backward counting and digits backward) cognitive assessments of memory, attention, and executive function at pre-chemotherapy, post-chemotherapy, and 6 months follow-up (or time-equivalent for controls) were completed. Longitudinal mixed model (LMM)s included group, time, time*group, and adjusted for age, education, reading, anxiety, and depression. Results: 580 BC patients (mean age = 54) and 363 controls (mean age = 53) were assessed. In all LMMs, there was a significant group*time interaction depicting lower scores in patients compared to controls (p < 0.005) except for TMT (p = 0.09). For longitudinal change on the DMS memory test (primary aim), we observed no significant difference between groups from pre- to post-chemotherapy but did observe a significant difference from pre-chemotherapy to follow-up (p = 0.017) where patients significantly declined (p = 0.005) and controls did not change. We observed similar results for RVP. For VRM, there was a significant pre- to post-chemotherapy group difference (p = 0.003). For COWA, patients significantly declined and controls significantly improved reflecting a significant between group difference (p < 0.001) from pre- to post-chemotherapy. For TMT, both groups significantly improved with patients improving less than controls reflected by a significant between group difference (p = 0.04) that remained a trend at follow-up (p = 0.06). On all phone tests, there was a significant between group effect from both pre- to post-chemotherapy and at follow-up with patients doing less well than controls (all p < 0.001). Conclusions: This nationwide study shows CRCI in BC patients persists in multiple cognitive domains up to 6 months post-chemotherapy compared to controls. Clinical trial information: NCT01382082.

scholarly journals Association of parathyroid hormone with 20-year cognitive decline

Neurology ◽  
2017 ◽  
Vol 89 (9) ◽  
pp. 918-926 ◽  
Author(s):  
Samuel M. Kim ◽  
Di Zhao ◽  
Andrea L.C. Schneider ◽  
Sai Krishna Korada ◽  
Pamela L. Lutsey ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Cognitive Function ◽  
Cognitive Decline ◽  
Large Population ◽  
Population Based ◽  
Cognitive Testing ◽  
Word Recall ◽  
Cross Sectional ◽  
Significant Difference

Objective:We hypothesized that elevated parathyroid hormone (PTH) levels will be independently associated with 20-year cognitive decline in a large population-based cohort.Methods:We studied 12,964 middle-aged white and black ARIC participants without a history of prior stroke who, in 1990–1992 (baseline), had serum PTH levels measured and cognitive function testing, with repeat cognitive testing performed at up to 2 follow-up visits. Cognitive testing included the Delayed Word Recall, the Digit Symbol Substitution, and the Word Fluency tests, which were summed as a globalZscore. Using mixed-effects models, we compared the relative decline in individual and global cognitive scores between each of the top 3 quartiles of PTH levels to the reference bottom quartile. We adjusted for demographic variables, education, vascular risk factors, and levels of calcium, phosphate, and vitamin D. We imputed missing covariate and follow-up cognitive data to account for attrition.Results:The mean (SD) age of our cohort was 57 (6) years, 57% were women, and 24% were black. There was no cross-sectional association of elevated PTH with cognitive globalZscore at baseline (p> 0.05). Over a median of 20.7 years, participants in each PTH quartile showed a decline in cognitive function. However, there was no significant difference in cognitive decline between each of the top 3 quartiles and the lowest reference quartile (p> 0.05). In a subset, there was also no association of higher mid-life PTH levels with late-life prevalent adjudicated dementia (p> 0.05).Conclusions:Our work does not support an independent influence of PTH on cognitive decline in this population-based cohort study.

scholarly journals Functional remediation in bipolar disorder: 1-year follow-up of neurocognitive and functional outcome

2016 ◽  
Vol 208 (1) ◽  
pp. 87-93 ◽  
Author(s):  
C. M. Bonnin ◽  
C. Torrent ◽  
C. Arango ◽  
B. L. Amann ◽  
B. Solé ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Psychosocial Functioning ◽  
Repeated Measures ◽  
Significant Group ◽  
Treatment As Usual ◽  
Time Interaction ◽  
Group Time ◽  
Patient Groups ◽  
Short Test

BackgroundFew randomised clinical trials have examined the efficacy of an intervention aimed at improving psychosocial functioning in bipolar disorder.AimsTo examine changes in psychosocial functioning in a group that has been enrolled in a functional remediation programme 1 year after baseline.MethodThis was a multicentre, randomised, rater-masked clinical trial comparing three patient groups: functional remediation, psychoeducation and treatment as usual over 1-year follow-up. The primary outcome was change in psychosocial functioning measured by means of the Functioning Assessment Short Test (FAST). Group×time effects for overall psychosocial functioning were examined using repeated-measures ANOVA (trial registration NCT01370668).ResultsThere was a significant group×time interaction for overall psychosocial functioning, favouring patients in the functional remediation group (F = 3.071, d.f. = 2, P = 0.049).ConclusionsImprovement in psychosocial functioning is maintained after 1-year follow-up in patients with bipolar disorder receiving functional remediation.

scholarly journals 852. Bridging the Gap in PrEP Provider Training: An Implementation Science Study

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S516-S516
Author(s):  
Aditi Ramakrishnan ◽  
Jessica Sales ◽  
Micah McCumber ◽  
Matthew Psioda ◽  
Leah Powell ◽  
...  
Keyword(s):  
Self Efficacy ◽  
Mixed Model ◽  
Healthcare Providers ◽  
Provider Training ◽  
Southern States ◽  
Significant Difference ◽  
Initiation Step ◽  
Prep Implementation ◽  
Exposure Prophylaxis

Abstract Background Training healthcare providers in a variety of clinical settings to deliver pre-exposure prophylaxis (PrEP) is a key component of the Ending the HIV Epidemic (EHE) initiative. Self-efficacy, the individual’s belief in their ability to carry out the steps of PrEP delivery, is a core part of provider training and necessary for successful PrEP implementation. We characterized self-efficacy among providers from family planning (FP) clinics that do not provide PrEP to inform provider training strategies. Methods We surveyed providers (any clinical staff who could screen, counsel, or prescribe PrEP) from FP clinics in 18 Southern states (Feb-June 2018, N=325 respondents from 224 clinics not providing PrEP) using contraception- and PrEP-specific self-efficacy questions (overall and grouped into PrEP delivery steps: screening, initiation, and follow-up). We compared self-efficacy scores (5-point Likert scale) by prescriber status, between PrEP delivery steps, and used linear mixed models to analyze provider-, clinic-, and county-level covariates associated with overall PrEP self-efficacy. Results Among 325 FP providers, self-efficacy scores were lowest in the PrEP initiation step, higher in follow-up, and highest in screening (p &lt; 0.0001, Table). Mean overall PrEP self-efficacy scores were significantly higher among prescribers compared to non-prescribers (p &lt; 0.0001). However, providers reported lowest self-efficacy regarding insurance navigation for PrEP with no significant difference by prescriber status. The mixed model demonstrated overall PrEP self-efficacy was positively associated with favorable PrEP attitudes among non-prescribers, PrEP knowledge among prescribers, and contraception self-efficacy in both groups, but was not associated with availability of insurance navigation on-site or other covariates (Figure). Provider Self-Efficacy along the PrEP Delivery Model stratified by prescriber status Conclusion FP providers reported low confidence in their ability to perform the steps that comprise PrEP initiation. Provider training focused on elements of PrEP initiation are critical to improve PrEP implementation and EHE initiatives. Alternatively, programs employing referral or telehealth models to support the PrEP initiation step can successfully bridge this gap. Disclosures All Authors: No reported disclosures

scholarly journals Temporal Characteristics of Visual Processing in Amblyopia

2021 ◽  
Vol 15 ◽  
Author(s):  
Xia Hu ◽  
Yi Qin ◽  
Xiaoxiao Ying ◽  
Junli Yuan ◽  
Rong Cui ◽  
...  
Keyword(s):  
Temporal Processing ◽  
Visual Processing ◽  
Spatial Vision ◽  
Stimulus Onset ◽  
Orientation Discrimination ◽  
Temporal Window ◽  
Significant Group ◽  
Significant Difference ◽  
Temporal Vision ◽  
Vision Deficits

PurposeAmblyopia affects not only spatial vision but also temporal vision. In this study, we aim to investigate temporal processing deficits in amblyopia.MethodsTwenty amblyopic patients (age: 27.0 ± 5.53 years, 15 males), and 25 normal observers (age: 25.6 ± 4.03 years, 15 males) were recruited in this study. Contrast thresholds in an orientation discrimination task in five target-mask stimulus onset asynchronies (SOA) conditions (16.7 ms, 33.4 ms, 50.0 ms, 83.4 ms, and ∞/no noise) were measured. An elaborated perceptual template model (ePTM) was fit to the behavioral data to derive the temporal profile of visual processing for each participant.ResultsThere were significant threshold differences between the amblyopic and normal eyes [F(1,43) = 10.6, p = 0.002] and a significant group × SOA interaction [F(2.75,118) = 4.98, p = 0.004], suggesting different temporal processing between the two groups. The ePTM fitted the data well (χ2 test, all ps &gt; 0.50). Compared to the normal eye, the amblyopic eye had a lower template gain (p = 0.046), and a temporal window with lower peak and broader width (all ps &lt; 0.05). No significant correlation was found between the observed temporal deficits and visual acuity in amblyopia (ps &gt; 0.50). Similar results were found in the anisometropic amblyopia subgroup. No significant difference was found between the fellow eyes of the monocular amblyopia and the normal eyes.ConclusionAmblyopia is less efficient in processing dynamic visual stimuli. The temporal deficits in amblyopia, represented by a flattened temporal window, are likely independent of spatial vision deficits.

scholarly journals T138. ADOLESCENT ONSET OF PSYCHOSIS IMPACTS SEGREGATION OF CORTICO-SUBCORTICAL NETWORKS DURING DEVELOPMENT

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S283-S283
Author(s):  
Daniel Ilzarbe ◽  
Inmaculada Baeza ◽  
Elena De la Serna ◽  
Mireia Rosa ◽  
Olga Puig-Navarro ◽  
...  
Keyword(s):  
Resting State ◽  
Fixed Effects ◽  
Neurodevelopmental Disorder ◽  
Mixed Effect ◽  
Significant Group ◽  
Time Interaction ◽  
Increased Risk ◽  
Significant Difference ◽  
Over Time

Abstract Background Functional connectivity (FC) during the resting-state is reduced in schizophrenia, especially within the Default Mode Network (DMN) (Dong 2018), and between the hippocampus, striatum and ventral tegmental area (VTA), which together conform a Midbrain Network (Gangadin 2019). Cross-sectional studies in adult samples have reported altered FC between dopamine synthesizing centers in midbrain and cortical areas in schizophrenia (Martino 2018). Conceptualizing schizophrenia as a neurodevelopmental disorder, we hypothesize that these changes may take place in early ages, prior to the clinical onset of psychosis. Therefore, we aim to examine FC of the DMN and Midbrain networks longitudinally in adolescents at increased risk of developing psychosis compared with youth with early onset psychosis and healthy volunteers (HV). Methods This longitudinal case-control study encompassed adolescents (12.6–18.9 years old) with psychosis risk syndrome (PRS; n=47), first episode of psychosis (FEP; n=59), and age and sex-matched HV (n=34). Fourteen out of the 30 PRS with follow-up assessment developed psychosis (t-PRS). Resting-state fMRI data was available for 88 subjects at baseline and follow-up [no significant differences in relation to drop-outs]: 10 t-PRS re-scanned at 3–12 months (at transition), and 14 PRS who did not transited (nt-PRS), 35 FEP; and 29 HV re-scanned at 10–36 month follow-up. After exclusion due to poor acquisition or excess movement, the final sample encompassed: 27 FEP, 9 t-PRS, 12 nt-PRS and 28 HV. Individual time series were extracted from Regions of Interest (ROI): for the DMN, the medial Prefrontal Cortex (mPFC), precuneus (PC), and bilateral temporo-parietal junction (Schilbach 2016); and for the Midbrain Network, the associative and limbic striatum, VTA and subiculum (Gangadin 2019). The orthogonal parameters of movement, white matter and cerebrospinal fluid (and their derivatives) and head motion scrubbing regressors were regressed out before performing the correlations. Multivariate mixed-effect models were estimated, including group (4), time and group by time interaction as fixed effects; and time and individual variability as random effects. Results There were no significant differences within-network FC. There was a significant group by time interaction in FC between the two networks (p = .02), driven by VTA-PC (pFDR = .02) and VTA-mPFC (pFDR = .04). Post-hoc analyses showed a significant reduction in FC in nt-PRS over time (psFDR ≤ .03), with FEP and t-PRS showing an opposite pattern (psFDR ≤ .01) in both networks. There was a trend-level reduction in FC over time in HV (ps ≤ .09), which showed significant differences relative to FEP (ps ≤ .04) in the VTA-PC and VTA-mPFC, and with t-PRS in the VTA-PC (p = .02). There was no significant difference between HV and nt-PRS. Cumulative dose of antipsychotics was negatively correlated with FC between mPFC-VTA in FEP at follow-up (r = -.41; p = .04); yet group by time effects survived when used as covariable. Sex, socio-economic status or global intelligence quotient did not exert significant effects. Discussion Our findings suggest that the onset of psychosis during adolescence impacts on the age-normative reduction of FC between the DMN and Midbrain networks, characteristic of the network segregation which takes place during typical brain functional development (Satterthwaite 2013). Antipsychotic medication on cortico-subcortical FC appear to have a reversing effect on these findings, although longitudinal group differences in network connectivity persist despite controlling for this effect. Our data sheds light on the changes in the organization of brain function taking place in the early stages of psychosis, coinciding with a key developmental period.

scholarly journals Efficacy of Fresh Osteochondral Allograft Transplantation in the Knee for Adults 40 Years and Older

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711880544 ◽  
Author(s):  
Devon E. Anderson ◽  
Katlyn S. Robinson ◽  
Jack Wiedrick ◽  
Dennis C. Crawford
Keyword(s):  
Mixed Model ◽  
Young Patients ◽  
Growth Curves ◽  
International Knee Documentation Committee ◽  
Osteochondral Allograft ◽  
Control Group ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Patient Reported

Background: Osteochondral allograft (OCA) transplantation has become a standard therapy for cartilage restoration in young patients. Purpose: To determine the efficacy of fresh OCA transplantation for focal cartilage lesions in patients aged ≥40 years compared with a group of patients aged ≤39 years. Study Design: Cohort study; Level of evidence, 3. Methods: A database was used to identify patients who underwent fresh OCA transplantation in the knee in a single-surgeon practice over a 10-year period and who completed baseline patient-reported outcome (PRO) questionnaires, including the International Knee Documentation Committee (IKDC); Knee injury and Osteoarthritis Outcome Score (KOOS) subscales of Pain, Symptoms, Activities of Daily Living, Quality of Life (QOL), and Sports & Recreation; and Veterans RAND 12-Item Health Survey (VR-12). Patients who completed the same PRO measures at a minimum 12-month follow-up were categorized into 2 groups based on age at surgery and were observed longitudinally. Mixed-model regression was used to predict longitudinal growth curves for each PRO score while controlling for confounding patient and surgical variables. Results: The study group consisted of 38 patients with a mean age of 52.32 years (range, 40-69 years) and mean final follow-up of 44.47 ± 24.32 months. The control group consisted of 42 patients with a mean age of 27.19 years (range, 15-39 years) and mean final follow-up of 33.75 ± 19.53 months. A statistically significant improvement from baseline to final follow-up was seen for the IKDC score and all 5 KOOS subscores in both the study and the control groups ( P < .01 in 10 of 12 comparisons and P < .05 for the other 2 comparisons). Maximum improvements were seen in the KOOS QOL and Sports & Recreation subscores for both groups. There was no statistically significant difference between groups in the change from baseline to final follow-up or in differences at any time point in model-based longitudinal projections for any PRO score through 5 years. Conclusion: There was a significant improvement of outcomes for both groups, with no statistically significant difference between groups over longitudinal follow-up. The efficacy of fresh OCA transplantation in adults aged ≥40 years with a focal chondral lesion and without osteoarthritis is similar to that of younger adults, and benefits are greatest for the KOOS QOL and Sports & Recreation subscales, which reflect functional outcomes.

Investigating the Functions of Self-Talk: The Effects of Motivational Self-Talk on Self-Efficacy and Performance in Young Tennis Players

2008 ◽  
Vol 22 (4) ◽  
pp. 458-471 ◽  
Author(s):  
Antonis Hatzigeorgiadis ◽  
Nikos Zourbanos ◽  
Christos Goltsios ◽  
Yannis Theodorakis
Keyword(s):  
Self Efficacy ◽  
Mixed Model ◽  
Control Group ◽  
Significant Group ◽  
Tennis Players ◽  
Self Talk ◽  
And Performance ◽  
Viable Mechanism ◽  
Experimental Group

The purpose of the current study was to examine the effects of motivational self-talk on self-efficacy and performance. Participants were 46 young tennis players (mean age 13.26, SD 1.96 years). The experiment was completed in five sessions. In the first session, participants performed a forehand drive task. Subsequently, they were divided into an experimental and a control group. Both groups followed the same training protocol for three sessions, with the experimental group practicing self-talk. In the final session, participants repeated the forehand drive task, with participants in the experimental group using motivational self-talk. Mixed model ANOVAs revealed significant group by time interactions for self-efficacy (p < .05) and performance (p < .01). Follow-up comparisons showed that self-efficacy and performance of the experimental group increased significantly (p < .01), whereas self-efficacy and performance of the control group had no significant changes. Furthermore, correlation analysis showed that increases in self-efficacy were positively related to increases in performance (p < .05). The results of the study suggest that increases in self-efficacy may be a viable mechanism explaining the facilitating effects of self-talk on performance.

scholarly journals A - 27 The Clinical Utilization of SWAY and mBESS for Post-Trauma and Follow-up Concussion Evaluations

2021 ◽  
Vol 36 (4) ◽  
pp. 667-667
Author(s):  
Sohoni R ◽  
Gorres K ◽  
Sibol M ◽  
Yousif M ◽  
LoGalbo A
Keyword(s):  
Reaction Time ◽  
Assessment Tool ◽  
Postural Sway ◽  
Cognitive Testing ◽  
Sports Concussion ◽  
Clinical Utilization ◽  
Paired Samples ◽  
Significant Difference ◽  
Before And After

Abstract Objective SWAY is a mobile software system using an accelerometer designed to measure postural sway and reaction time in the context of concussion. This study examined the efficacy of SWAY in detecting changes in balance and reaction time before and after concussion. Methods College athletes (N = 30, 10 females) underwent baseline, post-trauma, and follow-up evaluations following a concussion including SWAY, mBESS, Sports Concussion Assessment Tool 5th Edition (SCAT-5), and Immediate Post Concussion Assessment and Cognitive Testing (ImPACT). Results Paired-samples t-tests revealed a decline in SWAY balance from baseline (M = 82.65, SD = 14.48) to post-trauma (M = 74.61, SD = 17.41), t(29) = 2.99, p = 0.006, but no significant difference was observed in reaction time (M = 5.07, SD = 13.61), t(29) = 2.04, p = 0.050. Meanwhile, balance improved at follow-up (M = 78.93, SD = 15.32), and was no longer discrepant from baseline (M = 81.97, SD = 14.51), t(21) = 1.03, p = 0.316. Similarly, there was a significant decline in mBESS scores from baseline (M = 2.88, SD = 3.62) to post-trauma (M = 5.68, SD = 5.32), t(24) = −3.51, p = 0.002, followed by a return to baseline at follow up (M = 4.22, SD = 4.95), t(22) = −1.60, p = 0.124. Conclusions Although challenges were apparent in obtaining an optimal baseline, current results appear to support the clinical utility of SWAY for assessing balance in the context of concussion evaluations. Further research appears warranted to support SWAY as a method of diagnosing concussion and monitoring return to baseline.

scholarly journals Are depressive symptoms in mild cognitive impairment predictive of conversion to dementia?

2016 ◽  
Vol 28 (6) ◽  
pp. 921-928 ◽  
Author(s):  
Ellen De Roeck ◽  
Ingrid Ponjaert-Kristoffersen ◽  
Marc Bosmans ◽  
Peter Paul De Deyn ◽  
Sebastiaan Engelborghs ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Mild Cognitive Impairment ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
Cued Recall ◽  
Cognitive Testing ◽  
Cognitive Measures ◽  
Significant Difference

ABSTRACTBackground:Depressive symptoms are common in amnestic mild cognitive impairment (aMCI). The association between depressive symptoms and conversion to dementia is not yet clear. This longitudinal study was conducted to ascertain whether depressive symptoms in aMCI patients are predictive of conversion to dementia.Methods:35 aMCI patients participated in this study. All participants underwent cognitive testing and were administered the geriatric depression scale (GDS) to determine the presence of depressive symptoms. A score equaling or higher than 11 on the GDS was taken as the cut-off point for presence of significant depressive symptoms. Conversion to dementia was assessed at follow-up visits after 1.5, 4, and 10 years.Results:31.4% of the patients reported depressive symptoms at baseline. None of the cognitive measures revealed a significant difference at baseline between patients with and without depressive symptoms. After 1.5, 4, and 10 years respectively 6, 14, and 23 patients had converted to dementia. Although the GDS scores at baseline did not predict conversion to dementia, the cognitive measures and more specifically a verbal cued recall task (the memory impairment scale-plus) was a good predictor for conversion.Conclusions:Based on this dataset, the presence of depressive symptoms in aMCI patients is not predictive of conversion to dementia.

Effectiveness of a Mindfulness-Based Retreat on Distress and Well-Being in Bereaved Parents

2020 ◽  
Vol 30 (7) ◽  
pp. 770-782
Author(s):  
Kara Thieleman ◽  
Joanne Cacciatore
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Intervention Group ◽  
Well Being ◽  
Group Differences ◽  
Significant Group ◽  
Self Compassion ◽  
Bereaved Parents ◽  
Quasi Experimental

Purpose: This study evaluated the effectiveness of a grief-focused mindfulness-based retreat on psychological distress (trauma, anxiety, and depression) and well-being (mindfulness and self-compassion) in bereaved parents. Method: A quasi-experimental design with two nonequivalent groups (intervention, comparison) and three observations was used. Results: Mixed-model repeated-measures analysis of variance showed significant reductions in distress at posttest in the intervention group, with significant group differences on four of the seven scales. While reductions were maintained at follow-up, group differences were only significant for one trauma subscale. The intervention group showed significant increases in two of the four mindfulness facets (describe and act with awareness) and self-compassion at posttest, although group differences were not significant and gains were not maintained at follow-up. A third mindfulness facet, nonjudge, increased significantly at follow-up, with significant group differences. Discussion: This approach shows promise for reducing some areas of distress and improving the nonjudging mindfulness facet in bereaved parents.

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