Cognition and Cerebrovascular Reactivity in Midlife Women With History of Preeclampsia and Placental Evidence of Maternal Vascular Malperfusion

Background: Preeclampsia is emerging as a sex-specific risk factor for cerebral small vessel disease (SVD) and dementia, but the reason is unknown. We assessed the relationship of maternal vascular malperfusion (MVM), a marker of placental SVD, with cognition and cerebral SVD in women with and without preeclampsia. We hypothesized women with both preeclampsia and MVM would perform worst on information processing speed and executive function.Methods: Women (n = 45; mean 10.5 years post-delivery; mean age: 41 years; 42.2% Black) were classified as preeclampsia-/MVM-, preeclampsia+/MVM-, or preeclampsia+/MVM+. Information processing speed, executive function, and memory were assessed. In a pilot sub-study of cerebrovascular reactivity (CVR; n = 22), cerebral blood flow during room-air breathing and breath-hold induced hypercapnia were obtained via arterial spin labeling MRI. Non-parametric tests and regression models were used to test associations.Results: Between-group cognitive differences were significant for information processing speed (p = 0.02); preeclampsia+/MVM+ had the lowest scores. Cerebral blood flow increased from room-air to breath-hold, globally and in all regions in the three groups, except the preeclampsia+/MVM+ parietal region (p = 0.12). Lower parietal CVR (less change from room-air breathing to breath-holding) was correlated with poorer information processing speed (partial ρ = 0.63, p = 0.005) and executive function (ρ = 0.50, p = 0.03) independent of preeclampsia/MVM status.Conclusion: Compared to women without preeclampsia and MVM, midlife women with both preeclampsia and MVM have worse information processing speed and may have blunted parietal CVR, an area important for information processing speed and executive function. MVM in women with preeclampsia is a promising sex-specific indicator of cerebrovascular integrity in midlife.

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Cerebral small-vessel disease and decline in information processing speed, executive function and memory

Brain ◽

10.1093/brain/awh553 ◽

2005 ◽

Vol 128 (9) ◽

pp. 2034-2041 ◽

Cited By ~ 420

Author(s):

Niels D. Prins ◽

Ewoud J. van Dijk ◽

Tom den Heijer ◽

Sarah E. Vermeer ◽

Jellemer Jolles ◽

...

Keyword(s):

Information Processing ◽

Executive Function ◽

Processing Speed ◽

Small Vessel Disease ◽

Cerebral Small Vessel Disease ◽

Small Vessel ◽

Information Processing Speed ◽

Vessel Disease

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Cerebrovascular reactivity assessment with O2-CO2 exchange ratio under brief breath hold challenge

10.1101/843425 ◽

2019 ◽

Author(s):

Suk Tak Chan ◽

Karleyton C. Evans ◽

Tian Yue Song ◽

Juliett Selb ◽

Andre van der Kouwe ◽

...

Keyword(s):

Blood Flow ◽

Cerebral Blood Flow ◽

Partial Pressure ◽

Cerebral Arteries ◽

Blood Oxygenation ◽

Cerebrovascular Reactivity ◽

Breath Holding ◽

Breath Hold ◽

Bold Signal ◽

Signal Changes

AbstractHypercapnia during breath holding is believed to be the dominant driver behind the modulation of cerebral blood flow (CBF). Here we showed that the cerebrovascular responses to brief breath hold epochs were coupled not only with increased partial pressure of carbon dioxide (PCO2), but also with a decrease in partial pressure of oxygen (PO2). We used transcranial Doppler ultrasound to evaluate the CBF changes during breath holding by measuring the cerebral blood flow velocity (CBFv) in the middle cerebral arteries, a pair of cerebral arteries that supply most parts of the brain. The regional CBF changes during breath hold epochs were mapped with blood oxygenation level dependent (BOLD) signal changes as surrogate of CBF changes using functional magnetic resonance imaging (fMRI) technique. Given the interdependence of the dynamic changes between PCO2 and PO2, we found that the breath-by-breath O2-CO2 exchange ratio (bER), namely the ratio of changes in PO2 (ΔPO2) to changes in PCO2 (ΔPCO2) between end inspiration and end expiration, was superior to either ΔPO2 or ΔPCO2 alone in coupling with the changes of CBFv and BOLD signals under breath hold challenge. The regional cerebrovascular reactivity (CVR) results derived by regressing BOLD signal changes on bER under breath hold challenge resembled those derived by regressing BOLD signal changes on end-tidal partial pressure of CO2 (PETCO2) under exogenous CO2 challenge. Our findings provide a novel insight on the potential of using bER to better quantify CVR changes under breath hold challenge, although the physiological mechanisms of cerebrovascular changes underlying breath hold and exogenous CO2 challenges are potentially different.

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Associations of the Lifestyle for Brain Health Index With Structural Brain Changes and Cognition: Results From the Maastricht Study

Neurology ◽

10.1212/wnl.0000000000012572 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012572

Author(s):

Irene S Heger ◽

Kay Deckers ◽

Miranda T Schram ◽

Coen DA Stehouwer ◽

Pieter C Dagnelie ◽

...

Keyword(s):

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

White Matter ◽

Processing Speed ◽

Grey Matter ◽

White Matter Hyperintensities ◽

Information Processing Speed ◽

Brain Health ◽

Dementia Risk

Background and Objectives:Observational research has shown that a substantial proportion of all dementia cases worldwide is attributable to modifiable risk factors. Dementia risk scores might be useful to identify high-risk individuals and monitor treatment adherence. The objective of this study was to investigate whether a dementia risk score, the LIfestyle for BRAin health (LIBRA) index, is associated with MRI markers and cognitive functioning/impairment in the general population.Methods:Cross-sectional data was used from the observational population-based cohort of The Maastricht Study.. The weighted compound score of LIBRA (including twelve dementia risk and protective factors, e.g. hypertension, physical inactivity) was calculated, with higher scores indicating higher dementia risk. Standardized volumes of white matter, grey matter, CSF (as proxy for general brain atrophy), white matter hyperintensities, and presence of cerebral small vessel disease were derived from 3T MRI. Cognitive functioning was tested in three domains: memory, information processing speed, and executive function and attention. Values ≤1.5 SD below the average were defined as cognitive impairment. Multiple regression analyses and structural equation modelling were used, adjusted for age, sex, education, intracranial volume and type-2 diabetes.Results:Participants (n=4,164; mean age 59y; 49.7% men) with higher LIBRA scores (mean=1.19, range=-2.7 to +9.2), denoting higher dementia risk, had higher volumes of white matter hyperintensities (β=0.051, p=.002), and lower scores on information processing speed (β=-0.067, p=.001) and executive function and attention (β=-0.065, p=.004). Only in men, associations between LIBRA and volumes of grey matter (β=-0.093, p<.001), CSF (β=0.104, p<.001) and memory (β=-0.054, p=.026) were found. White matter hyperintensities and CSF volume partly mediated the association between LIBRA and cognition.Discussion:Higher health- and lifestyle-based dementia risk is associated with markers of general brain atrophy, cerebrovascular pathology and worse cognition, suggesting that LIBRA meaningfully summarizes individual lifestyle-related brain health. Improving LIBRA factors on an individual level might improve population brain health. Sex differences in lifestyle-related pathology and cognition need to be further explored.Classification of Evidence:This study provides Class II evidence that higher LIBRA scores are significantly associated with lower scores on some cognitive domains and a higher risk of cognitive impairment.

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Neuropsychological Alterations in Narcolepsy with Cataplexy and the Expression of Cognitive Deficits

Journal of the International Neuropsychological Society ◽

10.1017/s1355617719001334 ◽

2019 ◽

Vol 26 (6) ◽

pp. 587-595

Author(s):

Pablo Medrano-Martinez ◽

Rosa Peraita-Adrados

Keyword(s):

Information Processing ◽

Executive Function ◽

Negative Correlation ◽

Cognitive Deficits ◽

Processing Speed ◽

Disease Duration ◽

Control Group ◽

Depression Symptoms ◽

Information Processing Speed ◽

Significant Difference

AbstractObjectives:The objective of our study was to assess attention processes and executive function in patients with narcolepsy with cataplexy (NT1). To do so, we compared the results with those of a control group from the general population using an extensive neuropsychological test battery.Methods:We studied 28 patients with NT1 and 28 healthy control participants matched for age, gender, and educational level. They all completed questionnaires on sleepiness, anxiety, and depression symptoms. In addition, they underwent neuropsychological tests. The ability to maintain attention was assessed using three computer tasks with different levels of complexity.Results:Patients had significantly more daytime sleepiness than controls. A significant negative correlation between depression and disease duration was found in NT1 patients. The results of the anxiety questionnaire correlated with the presence of sleep paralysis. There were significant differences in information processing speed subtasks. Patients made significantly more omissions and generally reacted slower and more variably than controls in computerized tasks. As for executive function, patients performed worse in phonologic fluency tasks than controls. However, when the influence of processing speed on fluency tasks was statistically controlled, part of this significant difference disappeared.Conclusions:Our results indicate that the negative correlation between depression and disease duration probably reflects progressive adaptation to the functional burden of the disease. Information processing speed plays a fundamental role in the expression of cognitive deficits. We emphasized the need to control the influence of processing speed and sustained attention in the neuropsychological assessment of NT1 patients.

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A comparison of cognitive performances between neuromyelitis optica spectrum disorder and multiple sclerosis patients in Indian context

The Egyptian Journal of Neurology Psychiatry and Neurosurgery ◽

10.1186/s41983-021-00351-y ◽

2021 ◽

Vol 57 (1) ◽

Author(s):

Swati Kumar ◽

Goutam Gangopadhyay ◽

Atanu Biswas ◽

Souvik Dubey ◽

Alak Pandit ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Neuromyelitis Optica ◽

Processing Speed ◽

Verbal Fluency ◽

Spectrum Disorder ◽

Neuromyelitis Optica Spectrum Disorder ◽

Information Processing Speed

Abstract Background To compare the frequency and pattern of cognitive impairment in neuromyelitis optica spectrum disorder (NMOSD) and multiple sclerosis (MS) patients. Results Twenty NMOSD and forty MS patients were included. Clinical and detailed neuropsychological assessment was done using frontal assessment battery and Kolkata cognitive battery supplemented with additional standard tests for different domains of cognitive functions. Domain wise tests were performed and compared. 15/20 (75%) NMOSD and 32/40 (80%) MS patients had cognitive impairment (p = 0.65). Executive function, verbal fluency, information processing speed, visuo-constructional ability, attention, complex calculation, and memory were more commonly involved in NMOSD in decreasing order. Compared to MS, the pattern was similar except that verbal fluency was more impaired in NMOSD. Expanded Disability Status scale (EDSS) correlated with cognitive involvement in NMOSD (p = 0.02) as against MS. Conclusions Executive function, verbal fluencies, and information processing speed were more affected compared to visual and verbal memory in NMOSD patients. The pattern of cognitive performance was similar in the MS group, even though clinical and radiological characteristics and pathophysiology is different, suggesting similar brain involvement.

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Targeted Cognitive Game Training Enhances Cognitive Performance in Multiple Sclerosis Patients Treated With Interferon Beta 1-a

10.21203/rs.3.rs-725383/v1 ◽

2021 ◽

Author(s):

Shay Menascu ◽

Roy Aloni ◽

Mark Dolev ◽

David Magalashvili ◽

Keren Gutman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Cognitive Performance ◽

Processing Speed ◽

Interferon Beta ◽

Training Group ◽

Information Processing Speed

Abstract BackgroundPrevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of short-term computerized game training on cognitive performance in MS patients with mild cognitive impairment.MethodsWe enrolled in this prospective study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform byHappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores.ResultsIn both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group.ConclusionsOur findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

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Targeted cognitive game training enhances cognitive performance in multiple sclerosis patients treated with interferon beta 1-a

Journal of NeuroEngineering and Rehabilitation ◽

10.1186/s12984-021-00968-3 ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

Shay Menascu ◽

Roy Aloni ◽

Mark Dolev ◽

David Magalashvili ◽

Keren Gutman ◽

...

Keyword(s):

Multiple Sclerosis ◽

Cognitive Impairment ◽

Information Processing ◽

Executive Function ◽

Mild Cognitive Impairment ◽

Cognitive Performance ◽

Processing Speed ◽

Interferon Beta ◽

Training Group ◽

Information Processing Speed

Abstract Background Prevention of cognitive decline in Multiple Sclerosis (MS) is of major importance. We explored the effect of a 6 months computerized game training program on cognitive performance in MS patients with mild cognitive impairment. Methods This was a single-center, randomized prospective study. We enrolled in this study 100 eligible MS patients treated with Interferon-beta-1a (Rebif). All had mild cognitive impairment in either executive function or information processing speed. Patients were randomized 1:1 to either use the cognitive games platform by HappyNeuron (HN) or receive no intervention. Executive function and information processing speed scores were measured at 3 and 6 months from baseline to evaluate the effect of game training on cognitive scores. Results In both executive function and information processing speed, the game Training group showed significant improvement after 3 and 6 months. The Non-Training group showed mild deterioration in both domains at 3 months, and further deterioration that became significant at 6 months in executive function. Furthermore, at 6 months, the percent of patients in the Training group that improved or remained stable in both cognitive domains was significantly higher compared to the Non-Training group. Conclusions Our findings suggest that cognitive game training has a beneficial effect on cognitive performance in MS patients suffering from mild cognitive impairment. While further evaluation is required to assess the longevity of that effect, we nonetheless recommend to MS patients to be engaged in cognitive gaming practice as part of a holistic approach to treating their condition.

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Correlation Of Functional Disorders In Cerebral Blood Flow With Cognitive Style Of Freshmen Students

Russian Open Medical Journal ◽

10.15275/rusomj.2021.0308 ◽

2021 ◽

Vol 10 (3) ◽

Author(s):

Elena S. Olenko ◽

Ekaterina V. Fomina ◽

Anna I. Kodochigova ◽

Anton R. Kiselev ◽

Vyacheslav F. Kirichuk

Keyword(s):

Blood Flow ◽

Information Processing ◽

Cognitive Style ◽

Processing Speed ◽

Blood Velocity ◽

Cerebral Vessels ◽

Arterial Blood Flow ◽

Information Processing Speed ◽

Venous Outflow ◽

Freshmen Students

In 97 healthy male freshmen students, we studied the parameters of arterial blood flow intensity (index of vascular resistance RI, amplitude-frequency index AFI), venous outflow (venous outflow index VOI), and tone and elasticity of cerebral vessels (diastolic index DIA, dicrotic index DIC, maximum blood velocity of fast filling in the artery Vmax, average blood velocity of slow filling in the artery Vav). Separately, we assessed the effectiveness of such mental operations as classification and analysis and studied the cognitive styles. In 35.9% of male freshmen, we revealed the functional dystonia of cerebral vessels with a pronounced inter-lacunar redistribution of blood flow to the region of internal carotid arteries. Their cognitive style had low rigidity, flexible control, strong cognitive automation, and low information processing speed. The cognitive style in freshmen without dystonic disorders was characterized by a balance of rigidity and flexibility of thinking, with a medium information processing speed.

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