scholarly journals Personalized Prediction of Postconcussive Working Memory Decline: A Feasibility Study

2021 ◽  
Author(s):  
Yung-Chieh Chen ◽  
Yung- Li Chen ◽  
Duen-Pang Kuo ◽  
Yi-Tien Li ◽  
Yung-Hsiao Chiang ◽  
...  
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Support Vector Machine Classifier ◽  
Prospective Observational Study ◽  
Cognitive Outcomes ◽  
Support Vector ◽  
Memory Decline ◽  
Neuropsychological Measures

Concussion, also known as mild traumatic brain injury (mTBI), commonly causes transient neurocognitive symptoms, but in some cases, it causes cognitive impairment, including working memory (WM) deficit, which can be long-lasting and impede a patient’s return to work. The predictors of long-term cognitive outcomes following mTBI remain unclear because abnormality is often absent in structural imaging findings. The purpose of the study was to determine whether machine learning-based models using functional magnetic resonance imaging (fMRI) biomarkers and demographic or neuropsychological measures at baseline could effectively predict 1-year cognitive outcomes of concussion. We conducted a prospective, observational study of patients with mTBI who were compared with demographically-matched healthy controls enrolled between September 2015 to August 2020. Baseline assessments were collected within the first week of injury, and follow-ups were conducted at 6 weeks, 3 months, 6 months, and 1 year. Potential demographic, neuropsychological, and fMRI features were selected according to the significance of correlation with the estimated changes in WM ability. The support vector machine classifier was trained using these potential features and estimated changes in WM between the predefined time periods. Patients demonstrated significant cognitive recovery at the third month, followed by worsened performance after 6 months, which persisted until 1 year after concussion. Approximately half of the patients experienced prolonged cognitive impairment at 1-year follow up. Satisfactory predictions were achieved for patients whose WM function did not recover at 3 months (accuracy=87.5%), 6 months (accuracy=83.3%), 1 year (accuracy=83.3%), and performed worse at 1-year follow-up compared to baseline assessment (accuracy=83.3%). This study demonstrated the feasibility of personalized prediction for long-term postconcussive WM outcomes based on baseline fMRI and demographic features, opening a new avenue for early rehabilitation intervention in selected individuals with possible poor long-term cognitive outcomes.

scholarly journals Long-Term Cognitive Outcomes in Patients with Autoimmune Encephalitis

2018 ◽  
Vol 45 (5) ◽  
pp. 540-544 ◽  
Author(s):  
Julien Hébert ◽  
Gregory S. Day ◽  
Claude Steriade ◽  
Richard A. Wennberg ◽  
David F. Tang-Wai
Keyword(s):  
Cognitive Impairment ◽  
Status Epilepticus ◽  
Symptom Onset ◽  
Autoimmune Encephalitis ◽  
Cognitive Outcomes ◽  
Delayed Recall ◽  
Improved Outcomes ◽  
Modifiable Factors

AbstractBackground: A need exists to characterise the long-term cognitive outcomes in patients who recovered from autoimmune encephalitis and to identify the modifiable factors associated with improved outcomes. Methods: We retrospectively analysed data from patients diagnosed with autoimmune encephalitis in our outpatient autoimmune encephalitis clinic over a 5-year period, where the Montreal Cognitive Assessment (MoCA) is routinely administered. Results: In total, 21 patients met the inclusion criteria, of whom 52% had persistent cognitive impairment at their latest follow-up (median delay to testing=20 months, range 13-182). Visuospatial and executive abilities, language, attention, and delayed recall were predominantly affected. Patients with status epilepticus at presentation had lower total MoCA scores at their last follow-up (median total score 21, range 15-29) compared with patients without status epilepticus at presentation (median total score 27.5, range 21-30; r2=0.366, p=0.004). Patients who experienced delays of more than 60 days from symptom onset to initiation of treatment (either immunosuppression or tumour removal) were more likely to have a MoCA score compatible with cognitive impairment at their last follow-up (r2=0.253, p=0.0239; z-score=−2.01, p=0.044). Conclusions: Our study suggests that the MoCA may be used to evaluate cognition in recovering patients with autoimmune encephalitis. Delays to treatment shorter than 60 days and absence of status epilepticus at onset were associated with better performance on the MoCA obtained more than 1 year after symptom onset, and may predict better long-term cognitive outcomes.

scholarly journals 332 - Electroconvulsive therapy in older adults with major depression was not associated with cognitive decline during a 15-year follow-up

2020 ◽  
Vol 32 (S1) ◽  
pp. 91-91
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Major Depression ◽  
Cognitive Decline ◽  
Electroconvulsive Therapy ◽  
Antidepressant Treatment ◽  
Community Sample ◽  
Control Group

AUTHORS:Kerstin Johansson, Karolina Thömkvist, Ingmar Skoog and Sacuiu SF* (*presenter)OBJECTIVE:To determine the effects of electroconvulsive therapy (ECT) in major depression in relation to the development of dementia during long-term follow-up.METHOD:In an observational clinical prospective study of consecutive patients 70 years and older diagnosed with major depression at baseline 2000-2004 (n=1090), who were free of dementia and received antidepressant treatment, with or without ECT, we sought to determine if cognitive decline (mild cognitive impairment and dementia) during 15 -year follow-up was associated with receiving ECT at baseline. The control group was selected among the participants in the Gothenburg H70 Birth Cohort Studies matched by age group and sex 1:1.RESULTS:Among patients with affective syndromes 7% received ECT. During follow-up, 157 patients were diagnosed with dementia, equal proportions among those who received ECT (14.5%) and those who did not receive ECT (14.5%). The relation between ECT and cognitive decline remained non-significant irrespective antidepressive medication or presence of mild cognitive impairment at baseline.CONCLUSION:Preliminary results indicate that ECT was not associated with the development of cognitive decline in the long-term in a hospital-based cohort of 70+ year-olds. The results remain to verify against controls from a representative community sample.

scholarly journals Working Memory and Cross-Frequency Coupling of Neuronal Oscillations

2021 ◽  
Vol 12 ◽  
Author(s):  
Mohammed Abubaker ◽  
Wiam Al Qasem ◽  
Eugen Kvašňák
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Brain Stimulation ◽  
Large Body ◽  
Cognitive Outcomes ◽  
Essential Component ◽  
Non Invasive ◽  
Transcranial Alternating Current Stimulation ◽  
Frequency Coupling ◽  
Cross Frequency Coupling

Working memory (WM) is the active retention and processing of information over a few seconds and is considered an essential component of cognitive function. The reduced WM capacity is a common feature in many diseases, such as schizophrenia, attention deficit hyperactivity disorder (ADHD), mild cognitive impairment (MCI), and Alzheimer's disease (AD). The theta-gamma neural code is an essential component of memory representations in the multi-item WM. A large body of studies have examined the association between cross-frequency coupling (CFC) across the cerebral cortices and WM performance; electrophysiological data together with the behavioral results showed the associations between CFC and WM performance. The oscillatory entrainment (sensory, non-invasive electrical/magnetic, and invasive electrical) remains the key method to investigate the causal relationship between CFC and WM. The frequency-tuned non-invasive brain stimulation is a promising way to improve WM performance in healthy and non-healthy patients with cognitive impairment. The WM performance is sensitive to the phase and rhythm of externally applied stimulations. CFC-transcranial-alternating current stimulation (CFC-tACS) is a recent approach in neuroscience that could alter cognitive outcomes. The studies that investigated (1) the association between CFC and WM and (2) the brain stimulation protocols that enhanced WM through modulating CFC by the means of the non-invasive brain stimulation techniques have been included in this review. In principle, this review can guide the researchers to identify the most prominent form of CFC associated with WM processing (e.g., theta/gamma phase-amplitude coupling), and to define the previously published studies that manipulate endogenous CFC externally to improve WM. This in turn will pave the path for future studies aimed at investigating the CFC-tACS effect on WM. The CFC-tACS protocols need to be thoroughly studied before they can be considered as therapeutic tools in patients with WM deficits.

scholarly journals Nationwide COVID-19-EII Study: Incidence, Environmental Risk Factors and Long-Term Follow-Up of Patients with Inflammatory Bowel Disease and COVID-19 of the ENEIDA Registry

2022 ◽  
Vol 11 (2) ◽  
pp. 421
Author(s):  
Yamile Zabana ◽  
Ignacio Marín-Jiménez ◽  
Iago Rodríguez-Lago ◽  
Isabel Vera ◽  
María Dolores Martín-Arranz ◽  
...  
Keyword(s):  
Risk Factors ◽  
General Population ◽  
Prospective Observational Study ◽  
Similar Data ◽  
Protection Measures ◽  
Long Term Follow Up ◽  
Immunosuppressed Patients ◽  
Inflammatory Bowel

We aim to describe the incidence and source of contagion of COVID-19 in patients with IBD, as well as the risk factors for a severe course and long-term sequelae. This is a prospective observational study of IBD and COVID-19 included in the ENEIDA registry (53,682 from 73 centres) between March–July 2020 followed-up for 12 months. Results were compared with data of the general population (National Centre of Epidemiology and Catalonia). A total of 482 patients with COVID-19 were identified. Twenty-eight percent were infected in the work environment, and 48% were infected by intrafamilial transmission, despite having good adherence to lockdown. Thirty-five percent required hospitalization, 7.9% had severe COVID-19 and 3.7% died. Similar data were reported in the general population (hospitalisation 19.5%, ICU 2.1% and mortality 4.6%). Factors related to death and severe COVID-19 were being aged ≥ 60 years (OR 7.1, 95% CI: 1.8–27 and 4.5, 95% CI: 1.3–15.9), while having ≥2 comorbidities increased mortality (OR 3.9, 95% CI: 1.3–11.6). None of the drugs for IBD were related to severe COVID-19. Immunosuppression was definitively stopped in 1% of patients at 12 months. The prognosis of COVID-19 in IBD, even in immunosuppressed patients, is similar to that in the general population. Thus, there is no need for more strict protection measures in IBD.

scholarly journals Cognitive Outcome in Childhood-Onset Epilepsy: A Five-Decade Prospective Cohort Study

2017 ◽  
Vol 23 (4) ◽  
pp. 332-340 ◽  
Author(s):  
Mira Karrasch ◽  
Petri Tiitta ◽  
Bruce Hermann ◽  
Juho Joutsa ◽  
Shlomo Shinnar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Cognitive Impairment ◽  
Population Based ◽  
Cognitive Outcomes ◽  
Cognitive Outcome ◽  
Healthy Controls ◽  
Childhood Onset ◽  
Semantic Function ◽  
Active Epilepsy

AbstractObjectives: Little is known about the very long-term cognitive outcome in patients with childhood-onset epilepsy. The aim of this unique prospective population-based cohort study was to examine cognitive outcomes in aging participants with childhood-onset epilepsy (mean onset age=5.3 years) five decades later (mean age at follow-up=56.5 years).Methods: The sample consisted of 48 participants with childhood-onset epilepsy and 48 age-matched healthy controls aged 48–63 years. Thirty-six epilepsy participants were in remission and 12 continued to have seizures. Cognitive function was examined with 11 neuropsychological tests measuring language and semantic function, episodic memory, and learning, visuomotor function, executive function, and working memory. Results: The risk of cognitive impairment was very high in participants with continuing seizures; odds ratio (OR)=11.7 (95% confidence interval [CI] (2.8, 49.6), p=.0008). They exhibited worse performances across measures of language and semantic function, and visuomotor function compared to participants with remitted epilepsy and healthy controls. In the participants with remitted epilepsy, the risk of cognitive impairment was somewhat elevated, but not statistically significant; OR=2.6 (95% CI [0.9, 7.5], p=.08).Conclusions: Our results showed that the distinction of continued versus discontinued seizures was critical for determining long-term cognitive outcome in childhood-onset epilepsy. Few participants in remission exhibited marked cognitive impairment compared to age-matched peers. However, a subgroup of participants with decades long active epilepsy, continuous seizure activity and anti-epileptic drug (AED) medication, showed clinically significant cognitive impairment and are thus in a more precarious position when entering older age. (JINS, 2017, 23, 332–340)

Benefits of training working memory in amnestic mild cognitive impairment: specific and transfer effects

2012 ◽  
Vol 25 (4) ◽  
pp. 617-626 ◽  
Author(s):  
Barbara Carretti ◽  
Erika Borella ◽  
Silvia Fostinelli ◽  
Michela Zavagnin
Keyword(s):  
Working Memory ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Fluid Intelligence ◽  
Amnestic Mild Cognitive Impairment ◽  
Control Group ◽  
Long Term Memory ◽  
Transfer Effects ◽  
Memory Problems

ABSTRACTBackground:A growing number of studies are attempting to understand how effective cognitive interventions may be for patients with amnestic mild cognitive impairment (aMCI), particularly in relation to their memory problems.Methods:The present study aimed to explore the benefits of a working memory (WM) training program in aMCI patients. Patients (N= 20) were randomly assigned to two training programs: the experimental group practiced with a verbal WM task, while the active control group conducted educational activities on memory.Results:Results showed that the aMCI patients completing the WM training obtained specific gains in the task trained with some transfer effects on other WM measures (visuospatial WM) and on processes involved in or related to WM, e.g. fluid intelligence (the Cattell test) and long-term memory. This was not the case for the aMCI control group, who experienced only a very limited improvement.Conclusion:This pilot study suggests that WM training could be a valuable method for improving cognitive performance in aMCI patients, possibly delaying the onset of Alzheimer's disease.

scholarly journals Automatic Detection of Atrial Fibrillation and Other Arrhythmias in ECG Recordings Acquired by a Smartphone Device

Electronics ◽  
2018 ◽  
Vol 7 (9) ◽  
pp. 199 ◽  
Author(s):  
Lucia Billeci ◽  
Magda Costi ◽  
David Lombardi ◽  
Franco Chiarugi ◽  
Maurizio Varanini
Keyword(s):  
Atrial Fibrillation ◽  
Support Vector Machine Classifier ◽  
Least Square ◽  
Support Vector ◽  
Personal Health ◽  
Cardiac Complications ◽  
Linear Discriminant ◽  
Novel Approach ◽  
Health Monitoring Systems

Atrial fibrillation (AF) is the most common cardiac disease and is associated with other cardiac complications. Few attempts have been made for discriminating AF from other arrhythmias and noise. The aim of this study is to present a novel approach for such a classification in short ECG recordings acquired using a smartphone device. The implemented algorithm was tested on the Physionet Computing in Cardiology Challenge 2017 Database and, for the purpose of comparison, on the MIT-BH AF database. After feature extraction, the stepwise linear discriminant analysis for feature selection was used. The Least Square Support Vector Machine classifier was trained and cross-validated on the available dataset of the Challenge 2017. The best performance was obtained with a total of 30 features. The algorithm produced the following performance: F1 Normal rhythm = 0.92; F1 AF rhythm: 0.82; F1 Other rhythm = 0.75; Global F1 = 0.83, obtaining the third best result in the follow-up phase of the Physionet Challenge. On the MIT-BH ADF database the algorithm gave the following performance: F1 Normal rhythm = 0.98; F1 AF rhythm: 0.99; Global F1 = 0.98. Since the algorithm reliably detect AF and other rhythms in smartphone ECG recordings, it could be applied for personal health monitoring systems.

scholarly journals Long-term Safety and Dosing of OnabotulinumtoxinA: A Prospective, Observational Study

2019 ◽  
Vol 46 (6) ◽  
pp. 742-752 ◽  
Author(s):  
Theodore Wein ◽  
Mandar Jog ◽  
Meetu Bhogal ◽  
Sonja Dhani ◽  
Robert Miller ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Observational Study ◽  
Therapeutic Indication ◽  
Prospective Observational Study ◽  
Muscular Weakness ◽  
Canadian Study ◽  
Safety Population ◽  
Risk Balance

ABSTRACT:Background:Although therapeutic treatments are intended to help alleviate symptoms associated with disease, safety must be carefully considered and monitored to confirm continued positive benefit/risk balance. The objective of MOBILITY was to study the long-term safety of onabotulinumtoxinA for treatment of various therapeutic indications.Methods:A prospective, multicenter, observational, Phase IV Canadian study in patients treated with onabotulinumtoxinA for a therapeutic indication. Dosing was determined by the participating physician. Adverse events (AEs) were recorded throughout the study.Results:Patients (n= 1372) with adult focal spasticity, blepharospasm, cerebral palsy, cervical dystonia, hemifacial spasm, hyperhidrosis, or “other” diagnoses were enrolled into the safety cohort. Eighty-three patients (6%) reported 209 AEs; 44 AEs in 24 patients (2%) were considered treatment-related AEs. Seventy-two serious AEs were reported by 38 patients (3%); 10 serious AEs in 5 patients (0.4%) were considered treatment related. Most commonly reported treatment-related AEs were muscular weakness (n= 7/44) and dysphagia (n= 6/44).Conclusions:In patients with follow-up for up to six treatments with onabotulinumtoxinA, treatment-related AEs were reported in <2% of the safety population over the course of nearly 5 years. Our findings from MOBILITY provide further evidence that onabotulinumtoxinA treatment is safe for long-term use across a variety of therapeutic indications.

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