scholarly journals The Smart Aging Platform for Assessing Early Phases of Cognitive Impairment in Patients With Neurodegenerative Diseases

2021 ◽  
Vol 12 ◽  
Author(s):  
Sara Bottiroli ◽  
Sara Bernini ◽  
Elena Cavallini ◽  
Elena Sinforiani ◽  
Chiara Zucchella ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Neurodegenerative Diseases ◽  
Small Sample Size ◽  
Small Sample ◽  
Single Domain ◽  
Assessment Tools ◽  
Healthy Older Adults ◽  
Familiar Environment ◽  
Neuropsychological Assessments ◽  
Time Distance

Background: Smart Aging is a serious game (SG) platform that generates a 3D virtual reality environment in which users perform a set of screening tasks designed to allow evaluation of global cognition. Each task replicates activities of daily living performed in a familiar environment. The main goal of the present study was to ascertain whether Smart Aging could differentiate between different types and levels of cognitive impairment in patients with neurodegenerative disease.Methods: Ninety-one subjects (mean age = 70.29 ± 7.70 years)—healthy older adults (HCs, n = 23), patients with single-domain amnesic mild cognitive impairment (aMCI, n = 23), patients with single-domain executive Parkinson's disease MCI (PD-MCI, n = 20), and patients with mild Alzheimer's disease (mild AD, n = 25)—were enrolled in the study. All participants underwent cognitive evaluations performed using both traditional neuropsychological assessment tools, including the Mini-Mental State Examination (MMSE), Montreal Overall Cognitive Assessment (MoCA), and the Smart Aging platform. We analyzed global scores on Smart Aging indices (i.e., accuracy, time, distance) as well as the Smart Aging total score, looking for differences between the four groups.Results: The findings revealed significant between-group differences in all the Smart Aging indices: accuracy (p < 0.001), time (p < 0.001), distance (p < 0.001), and total Smart Aging score (p < 0.001). The HCs outperformed the mild AD, aMCI, and PD-MCI patients in terms of accuracy, time, distance, and Smart Aging total score. In addition, the mild AD group was outperformed both by the HCs and by the aMCI and PD-MCI patients on accuracy and distance. No significant differences were found between aMCI and PD-MCI patients. Finally, the Smart Aging scores significantly correlated with the results of the neuropsychological assessments used.Conclusion: These findings, although preliminary due to the small sample size, suggest the validity of Smart Aging as a screening tool for the detection of cognitive impairment in patients with neurodegenerative diseases.

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

2020 ◽  
Vol 50 (13) ◽  
pp. 2113-2127
Author(s):  
Elsa Caballeria ◽  
Clara Oliveras ◽  
Laura Nuño ◽  
Mercedes Balcells-Oliveró ◽  
Antoni Gual ◽  
...  
Keyword(s):  
Systematic Review ◽  
Working Memory ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Small Sample Size ◽  
Small Sample ◽  
Long Term Memory ◽  
Positive Effects ◽  
Jadad Scale ◽  
No Gold Standard

AbstractAlcohol-related cognitive impairment (ARCI) is highly prevalent among patients with alcohol dependence. Although it negatively influences treatment outcome, this condition is underdiagnosed and undertreated. The aim of this systematic review is to investigate the existing evidence regarding both cognitive and pharmacological interventions for ARCI. We systematically reviewed PubMed, Scopus and Science direct databases up to May 2019 and followed the PRISMA guidelines. The quality of the studies was assessed using the Jadad Scale. Twenty-six studies were eligible for inclusion (14 referring to neuropsychological interventions and 12 to pharmacological treatments). Among neuropsychological interventions, computerised treatments, errorless learning and component method showed positive effects on working memory, memory measures and general cognitive function. On the other hand, thiamine, memantine and methylphenidate improved working memory, long-term memory and general cognitive function. Nevertheless, these studies have several limitations, such as small sample size, lack of replication of the results or low specificity of the interventions. Therefore, no gold-standard intervention can yet be recommended for clinical practice, and further research based on promising strategies (e.g. digital interventions, thiamine) is required.

scholarly journals Comparison of cerebrospinal fluid biomarkers relevant to neurodegenerative diseases in healthy cynomolgus and rhesus macaque monkeys

2021 ◽  
Author(s):  
Emma L. Robertson ◽  
Susan E. Boehnke ◽  
Natalia M. Lyra e Silva ◽  
Brittney Armitage-Brown ◽  
Andrew Winterborn ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Rhesus Macaque ◽  
Rhesus Macaques ◽  
Small Sample Size ◽  
Small Sample ◽  
Normative Values ◽  
Csf Biomarkers ◽  
List Type ◽  
Neurofilament Light ◽  
Macaque Monkeys

Structured AbstractINTRODUCTIONNon-human primates are important translational models of neurodegenerative disease. We characterized how species, sex, age, and site of sampling affected concentrations of key biomarkers of neurodegeneration.METHODSAmyloid-beta (Aβ40, Aβ42), tau (tTau, pTau), and neurofilament light (NFL) in CSF were measured in 82 laboratory-housed naïve cynomolgus and rhesus macaques of both sexes.RESULTSAβ40, Aβ42, and NFL were significantly higher in rhesus compared with cynomolgus macaques. tTau and NFL were higher in males. pTau was not affected by species or sex. Site of acquisition only affected NFL, with NFL being higher in CSF acquired from lumbar compared with cisterna magna puncture.DISCUSSIONNormative values for key neurodegeneration biomarkers were established for laboratory housed cynomolgus and rhesus macaque monkeys. Differences were observed as a function of species, sex and site of CSF acquisition that should be considered when employing primate models.Research In ContextSystematic review: We reviewed reports characterizing CSF biomarkers of neurodegenerative diseases in non-human primates – an increasingly important model of disease - revealing that studies with laboratory housed macaque monkeys were of small sample size, with a paucity of data about how biomarkers varied as a function of species, sex, age, and site of acquisition.Interpretation: To address this gap, we collected CSF from 82 naïve laboratory housed male and female macaques of two species and measured Aβ40, Aβ42, tTau, pTau, and NFL. In addition to providing normative statistics for concentrations of these biomarkers, we revealed various species and sex differences.Future directions: Establishing normative values of biomarkers is an important step to the efficient development of cynomolgus and rhesus macaques as models of neurodegenerative disorders such as Alzheimer’s disease. Reference values reduce the need for large control groups by which to compare with disease model animals.

scholarly journals What is the evidence for mirtazapine in treating cancer-related symptomatology? A systematic review

2019 ◽  
Vol 28 (4) ◽  
pp. 1597-1606 ◽  
Author(s):  
Guillaume Economos ◽  
Natasha Lovell ◽  
Anna Johnston ◽  
Irene J. Higginson
Keyword(s):  
Systematic Review ◽  
Small Sample Size ◽  
Poor Quality ◽  
Small Sample ◽  
Assessment Tools ◽  
Data Synthesis ◽  
Small Sample Sizes ◽  
Randomised Controlled ◽  
Multiple Symptoms ◽  
The Impact

Abstract Purpose Cancer patients often experience multiple distressing symptoms which are challenging to manage. It would therefore be helpful to find a treatment that alleviates more than one symptom, to avoid polypharmacy: mirtazapine has been used in several studies for this purpose. The objective of this study was to assess the effectiveness and safety of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Methods Systematic review of clinical trials in English or French. Eight databases were searched. Included studies assessed the effectiveness of mirtazapine in alleviating one or more frequently encountered cancer-related symptoms. Comparator and validated assessment tools were required. Studies were independently appraised by two investigators before data synthesis. Results The search yielded 1898 references, from which we identified 12 relevant articles evaluating highly heterogeneous outcomes. These were two randomised-controlled (RCTs), three non-randomised controlled, and seven non-randomised non-controlled trials. In total, 392 participants were included and 185 were in RCTs. No study assessed the effectiveness of mirtazapine in alleviating symptoms at the same time, but some considered more than one symptom. Overall, the data was of poor quality, limited by small sample size and bias. However, mirtazapine showed effectiveness in treating depression, anxiety, sleep disorders, emesis and neuropathic pain. Across all studies, mirtazapine is safe to use, with drowsiness and dizziness the most common side-effects. Conclusion Study design and small sample sizes limit the ability to interpret results. Trials to assess the impact of mirtazapine or other medicines in alleviating multiple symptoms would be valuable.

scholarly journals Screening for Cognitive Impairment After Stroke: Validation of the Chinese Version of the Quick Mild Cognitive Impairment Screen

2021 ◽  
Vol 12 ◽  
Author(s):  
Yangfan Xu ◽  
Lingrong Yi ◽  
Yangyang Lin ◽  
Suiying Peng ◽  
Weiming Wang ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Diagnostic Accuracy ◽  
Sample Size ◽  
Small Sample Size ◽  
Small Sample ◽  
Chinese Version ◽  
Cognitive Screening ◽  
Post Stroke ◽  
Normal Cognition

Background: Screening for post-stroke cognitive impairment (PSCI) is necessary because stroke increases the incidence of and accelerates premorbid cognitive decline. The Quick Mild Cognitive Impairment (Qmci) screen is a short, reliable and accurate cognitive screening instrument but is not yet validated in PSCI. We compared the diagnostic accuracy of a Chinese version of the Qmci screen (Qmci-CN) compared with the widely-used Chinese versions of the Montreal Cognitive Assessment (MoCA-CN) and Mini-Mental State Examination (MMSE-CN).Methods: We recruited 34 patients who had recovered from a stroke in rehabilitation unit clinics in 2 university hospitals in China: 11 with post-stroke dementia (PSD), 15 with post-stroke cognitive impairment no dementia (PSCIND), and 8 with normal cognition (NC). Classification was made based on clinician assessment supported by a neuropsychological battery, independent of the screening test scores. The Qmci-CN, MoCA-CN, and MMSE-CN screens were administered randomly by a trained rater, blind to the diagnosis.Results: The mean age of the sample was 63 ± 13 years and 61.8% were male. The Qmci-CN had statistically similar diagnostic accuracy in differentiating PSD from NC, an area under the curve (AUC) of 0.94 compared to 0.99 for the MoCA-CN (p = 0.237) and 0.99 for the MMSE-CN (p = 0.293). The Qmci-CN (AUC 0.91), MoCA-CN (AUC 0.94), and MMSE-CN (AUC 0.79) also had statistically similar accuracy in separating PSD from PSCIND. The MoCA-CN more accurately distinguished between PSCIND and normal cognition than the Qmci-CN (p = 0.015). Compared to the MoCA-CN, the administration times of the Qmci-CN (329s vs. 611s, respectively, p < 0.0001) and MMSE-CN (280 vs. 611s, respectively, p < 0.0001) were significantly shorter.Conclusion: The Qmci-CN is accurate in identifying PSD and separating PSD from PSCIND in patients post-stroke following rehabilitation and is comparable to the widely-used MoCA-CN, albeit with a significantly shorter administration time. The Qmci-CN had relatively poor accuracy in identifying PSCIND from NC and hence may lack accuracy for certain subgroups. However, given the small sample size, the study is under-powered to show superiority of one instrument over another. Further study is needed to confirm these findings in a larger sample size and in other settings (countries and languages).

scholarly journals Cognition in a multiple system atrophy series of cases from Argentina

2014 ◽  
Vol 72 (10) ◽  
pp. 773-776 ◽  
Author(s):  
Emilia Gatto ◽  
Ignacio Demey ◽  
Ana Sanguinetti ◽  
Virginia Parisi ◽  
José Luis Etcheverry ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Informed Consent ◽  
Episodic Memory ◽  
Multiple System Atrophy ◽  
Small Sample Size ◽  
Small Sample ◽  
Cognitive Domain ◽  
Cognitive Tests ◽  
Cognitive Profiles ◽  
Visuospatial Abilities

Cognitive dysfunction may occur in 17-40% of patients with multiple system atrophy (MSA). It has been suggested a milder cognitive impairment in cerebellar (MSA-C) than in parkinsonian variant (MSA-P). However, differences in cognitive profiles remain under discussion. Objective To evaluate cognitive features in a series of patients with “probable MSA” from Argentina. Method After informed consent was obtained, an extensive cognitive tests battery was administered. Nine patients (6 MSA-P and 3 MSA-C) composed the sample. Results Depression was detected in 43% of patients. Seven patients showed at least one cognitive domain impairment. Temporospatial orientation, visuospatial abilities, executive and attentional functions, episodic memory and language were compromised in MSA-P, while MSA-C dysfunction was restricted to attentional and executive domains. Conclusion Despite the small sample size, our findings could suggest a more widespread cognitive impairment in MSA-P than MSA-C.

scholarly journals Low Vitamin D and Its Association with Cognitive Impairment and Dementia

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Sadia Sultan ◽  
Uzma Taimuri ◽  
Shatha Abdulrzzaq Basnan ◽  
Waad Khalid Ai-Orabi ◽  
Afaf Awadallah ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Vitamin D ◽  
Cognitive Impairment ◽  
Behavioral Problems ◽  
Small Sample Size ◽  
Vitamin D Supplementation ◽  
Small Sample ◽  
Vitamin D Levels ◽  
Prevention And Treatment

Vitamin D is a neurosteroid hormone that regulates neurotransmitters and neurotrophins. It has anti-inflammatory, antioxidant, and neuroprotective properties. It increases neurotrophic factors such as nerve growth factor which further promotes brain health. Moreover, it is also helpful in the prevention of amyloid accumulation and promotes amyloid clearance. Emerging evidence suggests its role in the reduction of Alzheimer’s disease hallmarks such as amyloid-beta and phosphorylated tau. Many preclinical studies have supported the hypothesis that vitamin D leads to attentional, behavioral problems and cognitive impairment. Cross-sectional studies have consistently found that vitamin D levels are significantly low in individuals with Alzheimer’s disease and cognitive impairment compared to healthy adults. Longitudinal studies and meta-analysis have also exhibited an association of low vitamin D with cognitive impairment and Alzheimer’s disease. Despite such evidence, the causal association cannot be sufficiently answered. In contrast to observational studies, findings from interventional studies have produced mixed results on the role of vitamin D supplementation in the prevention and treatment of cognitive impairment and dementia. The biggest issue of the existing RCTs is their small sample size, lack of consensus over the dose, and age of initiation of vitamin D supplements to prevent cognitive impairment. Therefore, there is a need for large double-blind randomized control trials to assess the benefits of vitamin D supplementation in the prevention and treatment of cognitive impairment.

A-75 Effects of Rivastigmine on Neurocognitive Deficits in Patients with Parkinson’s Disease

2021 ◽  
Vol 36 (6) ◽  
pp. 1117-1117
Author(s):  
Carrie Roper ◽  
Rainer Coelln ◽  
Lisa Shulman ◽  
Kristen Mordecai
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Executive Functioning ◽  
Cognitive Deficits ◽  
Small Sample Size ◽  
Randomized Study ◽  
Small Sample ◽  
Neurocognitive Deficits ◽  
Open Label

Abstract Objective Cognitive impairments are commonly seen in Parkinson’s disease (PD). However, identification and tracking of cognitive deficits are not always part of treatment plans. Cholinergic treatment with rivastigmine has demonstrated beneficial effects on cognition and gait stability in PD-dementia, but less evidence exists in PD-mild cognitive impairment. We investigated the cognitive effects of rivastigmine treatment in a 3-month open-label pilot study. Method 31 participants with PD and mild–moderate cognitive impairment (24 male; mean age = 71.7; mean years-of-education = 17.2; mean Montreal Cognitive Assessment (MoCA) score = 21.7) completed pre-testing in a single-site, non-randomized study at the University of Maryland Parkinson’s Disease and Movement Disorders Center. A subset of 12 patients returned for follow-up after 12 weeks of rivastigmine treatment. A physical examination, the MoCA, and a computerized cognitive measure (NeuroTrax) were completed at each session. It was hypothesized that rivastigmine would benefit cognition, particularly executive functioning. Results Rivastigmine benefited global cognitive functioning as measured by both the MoCA (t(10) = −2.5, p < 0.05; M(Time 1) = 22.6(2.2), M(Time 2) = 24.9(3.9)) and NeuroTrax (t(11) = −3.0, p < 0.05; M(Time 1) = 88.7(13.6), M(Time 2) = 95.5(11.6)), though no domain-specific changes were evident. Relationships among the two measures were also examined. Moderate correlations were found between MoCA total scores and NeuroTrax measures including Global Cognitive Scale (r = 0.40, p < 0.05), Visuospatial Functioning (r = 0.39, p < 0.05), Executive Functioning (r = 0.50, p < 0.005), and Motor Response (speed/planning; r = 0.51, p < 0.005). Conclusions Although small sample size and practice effects must be considered, results suggest potential global cognitive benefit of rivastigmine for patients with PD experiencing mild–moderate cognitive deficits. Treatment planning for all PD patients should include periodic cognitive screenings and consideration of treatment options.

scholarly journals Quantitation of circulating GDF-11 and β2-MG in aged patients with age-related impairment in cognitive function

2017 ◽  
Vol 131 (15) ◽  
pp. 1895-1904 ◽  
Author(s):  
Rungong Yang ◽  
Shuhong Fu ◽  
Liang Zhao ◽  
Bei Zhen ◽  
Ling Ye ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Function ◽  
Small Sample Size ◽  
Small Sample ◽  
Advanced Age ◽  
Ageing Process ◽  
Aged Patients ◽  
Healthy Elderly ◽  
Age Related ◽  
Significant Difference

Growth differentiation factor 11 (GDF-11) has been implicated in reverse effects of ageing on the central nervous system of humans. β2-microglobulin (β2-MG) has been reported to negatively regulate cognition. However, there is a lot of controversy about the role of GDF-11 and β2-MG in ageing and cognitive regulation. To examine the involvement of GDF-11 and β2-MG in the ageing process and cognitive dysfunction, a total of 51 healthy subjects and 41 elderly patients with different degrees of age-related cognitive impairment participated in the study. We measured plasma GDF-11 and β2-MG levels using ELISA and immunoturbidimetry, respectively. The results were statistically analyzed to evaluate the associations between levels of GDF-11 and β2-MG, and ageing and cognitive impairments. Circulating GDF-11 levels did not decline with age or correlate with ageing in healthy Chinese males. We did not detect differences in circulating GDF-11 levels amongst the healthy advanced age and four cognitive impairment groups. β2-MG levels increased with age, but there was no significant difference between healthy elderly males and advanced age males. Increased levels of β2-MG were observed in the dementia group compared with the healthy advanced age group. Our results suggest that circulating GDF-11 may not exert a protective effect during the ageing process or on cognitive function, and β2-MG may play a role in ageing and cognitive impairment. However, it is possible that the relatively small sample size in the present study affected the quality of the statistical analysis, and future studies are needed to further validate our findings.

scholarly journals Targeted Nutritional Intervention for Patients with Mild Cognitive Impairment: The Cognitive impAiRmEnt Study (CARES) Trial 1

2020 ◽  
Vol 10 (2) ◽  
pp. 43 ◽  
Author(s):  
Rebecca Power ◽  
John Nolan ◽  
Alfonso Prado-Cabrero ◽  
Robert Coen ◽  
Warren Roche ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Vitamin E ◽  
Episodic Memory ◽  
Cognitive Performance ◽  
Synergistic Effects ◽  
Small Sample Size ◽  
Nutritional Intervention ◽  
Small Sample ◽  
Global Cognition

Omega-3 fatty acids (ω-3FAs), carotenoids, and vitamin E are important constituents of a healthy diet. While they are present in brain tissue, studies have shown that these key nutrients are depleted in individuals with mild cognitive impairment (MCI) in comparison to cognitively healthy individuals. Therefore, it is likely that these individuals will benefit from targeted nutritional intervention, given that poor nutrition is one of the many modifiable risk factors for MCI. Evidence to date suggests that these nutritional compounds can work independently to optimize the neurocognitive environment, primarily due to their antioxidant and anti-inflammatory properties. To date, however, no interventional studies have examined the potential synergistic effects of a combination of ω-3FAs, carotenoids and vitamin E on the cognitive function of patients with MCI. Individuals with clinically confirmed MCI consumed an ω-3FA plus carotenoid plus vitamin E formulation or placebo for 12 months. Cognitive performance was determined from tasks that assessed global cognition and episodic memory. Ω-3FAs, carotenoids, and vitamin E were measured in blood. Carotenoid concentrations were also measured in tissue (skin and retina). Individuals consuming the active intervention (n = 6; median [IQR] age 73.5 [69.5–80.5] years; 50% female) exhibited statistically significant improvements (p < 0.05, for all) in tissue carotenoid concentrations, and carotenoid and ω-3FA concentrations in blood. Trends in improvements in episodic memory and global cognition were also observed in this group. In contrast, the placebo group (n = 7; median [IQR] 72 (69.5–75.5) years; 89% female) remained unchanged or worsened for all measurements (p > 0.05). Despite a small sample size, this exploratory study is the first of its kind to identify trends in improved cognitive performance in individuals with MCI following supplementation with ω-3FAs, carotenoids, and vitamin E.

scholarly journals Ocular Motor Abnormalities in Anti-IgLON5 Disease

2021 ◽  
Vol 12 ◽  
Author(s):  
Stefan Macher ◽  
Ivan Milenkovic ◽  
Tobias Zrzavy ◽  
Romana Höftberger ◽  
Stefan Seidel ◽  
...  
Keyword(s):  
Neurodegenerative Diseases ◽  
Small Sample Size ◽  
Sampling Rate ◽  
Vestibular Function ◽  
Small Sample ◽  
Ocular Motor ◽  
Therapeutic Implications ◽  
Saccade Velocity ◽  
Motor Abnormalities ◽  
Oculomotor Function

ObjectiveAnti-IgLON5 disease forms an interface between neuroinflammation and neurodegeneration and includes clinical phenotypes that are often similar to those of neurodegenerative diseases. An early diagnosis of patients with anti-IgLON5 disease and differentiation from neurodegenerative diseases is necessary and may have therapeutic implications.MethodsIn our small sample size study we investigated oculomotor function as a differentiating factor between anti-IgLON5 disease and neurodegenerative disorders. We examined ocular motor and vestibular function in four patients suffering from anti-IgLON5 disease using video-oculography (VOG) and a computer-controlled rotational chair system (sampling rate 60 Hz) and compared the data with those from ten age-matched patients suffering from progressive supranuclear palsy (PSP) and healthy controls (CON).ResultsPatients suffering from anti-IgLON5 disease differed from PSP most strikingly in terms of saccade velocity and accuracy, the presence of square wave jerks (SWJ) (anti-IgLON5 0/4 vs. PSP 9/10) and the clinical finding of supranuclear gaze palsy (anti-IgLON5 1/4). The presence of nystagmus, analysis of smooth pursuit eye movements, VOR and VOR suppression was reliable to differentiate between the two disease entities. Clear differences in all parameters, although not always significant, were found between all patients and CON.DiscussionWe conclude that the use of VOG as a tool for clinical neurophysiological assessment can be helpful in differentiating between patients with PSP and patients with anti-IgLON5 disease. VOG could have particular value in patients with suspected PSP and lack of typical Parkinson’s characteristics. future trials are indispensable to assess the potential of oculomotor function as a biomarker in anti-IgLON5 disease.

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