Is there an association between non-alcoholic fatty liver disease and cognitive function? A systematic review

Background Non-alcoholic fatty liver disease (NAFLD) is represented as the most common liver disease worldwide. NAFLD is associated with metabolic risk factors underpinned by insulin resistance, inflammation and endothelial dysfunction, leading to extrahepatic changes in central nervous diseases such as cognitive impairment, Alzheimer’s disease and dementia. The aim of the review is to explore the association between NAFLD and cognitive function. Methods Using the PRISMA guidelines, a systematic electronic literature search was conducted in four databases: MEDLINE, PsychINFO, Embase and CINAHL from inception until March 2021. Neuropsychological tests utilised within each study were grouped into relevant cognitive domains including ‘general cognition’, ‘reasoning’, ‘mental speed, attention and psychomotor speed’, ‘memory and learning’, ‘language’, ‘visuospatial perception’ and ‘ideas, abstraction, figural creations and mental flexibility’. Results Eleven observational studies that involved 7978 participants with a mean age of 51 years were included. Those with NAFLD had poor cognitive performance in three cognitive domains, including ‘general cognition’, ‘mental speed, attention and psychomotor speed’, and ‘ideas, abstraction, figural creations and mental flexibility’. Conclusion The observed results from the 11 included studies showed that NAFLD was associated with lower cognitive performance across several domains. However, studies conducted to date are limited to observational designs and are heterogeneous with varying diagnostic tools used to assess cognitive function. Trial registration PROSPERO Registration: CRD42020161640.

Depression Affects Working Memory Performance: A Functional Near Infrared Spectroscopy (fNIRS) Study*

Depression is a complex disorder that can be caused by psychosocial and biological conditions and it not only effects mood disorders, but also cognitive functions such as memory, decision making, psychomotor speed and attention. As a result of the studies, some findings indicate that depressed individuals perform worse in neuropsychological tests than healthy individuals, while other studies indicate there is no difference between the two groups. According to neuroimaging studies on this subject, functional and anatomical differences were detected at the cortex and subcortical levels in the prefrontal lobe. This study is consisting of two parts, behavioral and neuroimaging using fNIRS. BDI was applied to the participants. The average age of the group with lower BDI score is 23,9±3,04; the average age of the higher group with higher BDI score is 22,2+2,28. A visuospatial 2-back task, which includes 4 different stimulus types with neutral, emotional, verbal, and non-verbal qualities, was applied to the participants. No significant differences were observed between the two groups in behavioral data. However, when fNIRS results were examined, it was found that the group with the high BDI scores showed more activation in the right PFC during the visuospatial 2-back task compared to the group with low BDI scores. Although the fNIRS results are consistent in the literature, behavioral findings support some of the findings in literature, while contradicting others. It is thought that the reason for this may be that participants are young, and the 2-back task is not difficult enough.

Dynamic Correlates of Novice Educational Psychologists’ Vitality as aSupra-professional Competency

На наш взгляд, важной надпрофессиональной компетенцией педагога-психолога является жизнеспособность, под которой понимается совокупность способностей и свойств личности, обеспечивающих управление своими личностными, профессиональными и социальными ресурсами для успешной адаптации, самореализации и саморазвития, а также преодоления трудных ситуаций во всех сферах профессиональной и личной жизни. Актуальность исследования определяется отсутствием в психолого-педагогической науке теоретической и эмпирической основ для осуществления индивидуального подхода в развитии жизнеспособности педагогов-психологов на этапе их профессиональной подготовки. Становление жизнеспособности личности детерминируется в том числе психодинамическими особенностями человека, что диктует необходимость учета свойств темперамента при организации процесса ее развития у будущих педагогов-психологов. Цель исследования заключалась в выявлении психодинамических коррелятов жизнеспособности будущих педагогов-психологов. Гипотеза состояла в предположении о том, что показатели жизнеспособности будущих педагогов-психологов связаны с их формально-динамическими свойствами. В исследовании были использованы опросник структуры темперамента, ОСТ-150/STQ (В. М. Русалов), опросник «Жизнеспособность личности» (А. А. Нестерова), опросник «Жизнеспособность взрослого человека» (А. В. Махнач). В статье представлены выявленные эмпирическим путем особенности жизнеспособности и темперамента будущих педагогов-психологов, а также положительные связи между интеллектуальной эргичностью, психомоторной пластичностью и скоростью, коммуникативной скоростью и показателями жизнеспособности, отрицательные корреляции между коммуникативной пластичностью и эмоциональностью с некоторыми показателями жизнеспособности будущих педагогов-психологов. Обращено внимание на необходимость дополнительных исследований потенциала высшего психолого-педагогического образования для развития жизнеспособности студентов, имеющих низкий уровень психомоторной и интеллектуальной активности при высокой коммуникативной пластичности и эмоциональности. The author of the article believes that educational psychologists’ supra-professional competencies include vitality, which is a combination of various abilities that enable one to manage one’s personal, professional and social resources for efficient adaptation, self-fulfilment and self-development as well as to enable one to successfully overcome challenges in professional and personal life. The relevance of the research is accounted for by the fact that psychology and pedagogy lack theoretical and empirical foundation for the individualized development of novice educational psychologists’ vitality during their studies. The development of one’s vitality is determined by one’s psychodynamic peculiarities. Therefore, to develop novice educational psychologists’ vitality, it is necessary to take into consideration their temperament. The aim of the research is to investigate psychodynamic correlates of novice educational psychologists’ vitality. The hypothesis of the research consists in an assumption that novice educational psychologists’ vitality indicators are related with their dynamic correlates. The research uses the Structure of Temperament Questionnaire (V. M. Rusalov), Subjective Vitality Questionnaire (A. A. Nesterva), Adults’ Subjective Vitality Questionnaire (A. V. Makhnach). The article presents empirically discovered peculiarities of novice educational psychologists’ vitality and temperament. It shows a positive correlation between intellectual ergicity, psychomotor speed and plasticity, communicative speed and vitality. It also shows a negative correlation between communicative plasticity and vitality in novice educational psychologists. The author underlines that in order to promote vitality development in students with feeble psychomotor and intellectual activities, but good communicative plasticity and emotionality, it is necessary to further investigate the potential of higher psychological and pedagogical education.

Neuropsychological functioning and cognitive reserve in newly HIV diagnosed antiretroviral-naïve South African adults from peri-urban and informal settlements

Despite lower incidences of HIV-associated dementia due to antiretroviral therapy, neuropsychological impairment (NPI) remains a persistent challenge in sub-Saharan Africa. Improving cognitive reserve (CR) can mitigate NPI, but there are few investigations on neuropsychological (NP) performance, and its association with CR in newly diagnosed ART-naïve HIV-positive individuals to inform early treatment strategies. A comprehensive battery of tests were administered to assess various NP domains (International HIV Dementia Scale [for memory, motor speed, psychomotor speed], Digit Span Test [for attention], Action Fluency Test [for language] and Clock Drawing Test [for executive/visuospatial function]), and CR (using Cognitive Reserve Index Questionnaire) among 211 newly diagnosed ART-naïve HIV-positive participants from two clinics that serve peri-urban and informal settlement communities in KwaZulu-Natal, South Africa. Regression models were fitted to assess the association between NP performance and CR controlling for socioeconomic and clinical factors. Test results revealed high levels of impairment across NP domains: language (96.7%), memory and psychomotor speed (82.5%), concentration (17.5%), executive function (15.2%) and visuo-spatial function (3.3%). Low CR and educational attainment were the only factors consistently associated with poor NP performance based on regression. High levels of impairment were found in certain NP domains in a relatively young group of newly diagnosed ART-naïve HIV-positive individuals. Residents of peri-urban and informal settlements face multitude of complex challenges in South Africa. An early multilevel intervention targeting clinical- (e.g. CR) and structural-level challenges (e.g. access to education) is needed for mitigating HIV-associated NPI and promoting long-term healthy living.

Computer-Delivered Cognitive Training and Transcranial Direct Current Stimulation in Patients With HIV-Associated Neurocognitive Disorder: A Randomized Trial

Objective: HIV infection is associated with impaired cognition, and as individuals grow older, they may also experience age-related changes in mental abilities. Previous studies have shown that computer-based cognitive training (CCT) and transcranial direct current stimulation (tDCS) may be useful in improving cognition in older persons. This study evaluated the acceptability of CCT and tDCS to older adults with HIV-associated neurocognitive disorder, and assessed their impact on reaction time, attention, and psychomotor speed.Methods: In a single-blind randomized study, 46 individuals with HIV-associated mild neurocognitive disorder completed neuropsychological assessments and six 20-min training sessions to which they had been randomly assigned to one of the following conditions: (1) CCT with active tDCS; (2) CCT with sham tDCS, or (3) watching educational videos with sham tDCS. Immediately after training and again 1 month later, participants completed follow-up assessments. Outcomes were evaluated via repeated measures mixed effects models.Results: Participant ratings of the intervention were positive. Effects on reaction time were not significant, but measures of attention and psychomotor speed suggested positive effects of the intervention.Conclusion: Both CCT and tDCS were highly acceptable to older persons with HIV infection. CCT and tDCS may improve cognitive in affected individuals.Clinical Trial Registration: [www.ClinicalTrials.gov], identifier [NCT03440840].

Neurocognitive Assessment of Adults with Sickle Cell Disease: A Descriptive Study

Introduction: Sickle cell disease (SCD) causes devastating complications that can affect any organ in the body. Particularly, SCD can present with neurological complications of overt strokes, silent infarcts and cognitive impairment. As patients are living longer with SCD, cognitive functioning is an important aspect of their disease as deficits can impact education, employment, or adherence to medications. Most of the studies assessing cognitive impairment in this population have been in children with limited data on adults. This study explored the results of cognitive testing in adult patients with SCD when compared to normative data. This study also sought to determine any association between psychological factors (baseline anxiety and depression) as well as biological factors (i.e. hemoglobin levels). Methods: This was a cross-sectional study conducted at the Sickle Cell Center of Southern Louisiana in New Orleans.The study included adults with a diagnosis of sickle cell disease regardless of subtype who were over the age of 18. Patients were excluded if they were not able to physically complete the tasks. Executive function, memory, psychomotor speed, and memory were assessed using the following tasks from standardized pencil-and-paper cognitive tasks from the Cambridge Neuropsychological Automated Battery (CANTAB) test: Stocking of Cambridge (SOC),Delayed Matching to Sample (DMS), Paired Associates Learning (PAL), Motor Screening Task (MOT), Intra-Extra Dimensional Set Shift (IED), Spatial Working Memory (SWM). The Hospital Anxiety and Depression Subscale (HADS) clinical assessment tool was used to screen for anxiety and depression at the time of testing. A HADS score >8 denotes significant anxiety or depression. Results: A total of 22 patients (59% females, mean age 29.6±2.1 years) were included in this study. Attention and psychomotor speed were relatively preserved cognitive domains with 59.1% of patients scoring greater than 75 thpercentile relative to normative mean. Conversely, executive functioning often appeared impaired with 72.7% and 77.3% of patients scoring below 25 thpercentile in outcome measures of IED and SWM, respectively. Similarly, a significant percentage of patients scored below 25 thpercentile in outcome measures of visual memory, PAL and DMS, 63.6% and 45.4%, respectively. Fifteen participants (68%) screened positive for anxiety while two screened positive for depression. Patients with anxiety tended to perform worse on most cognitive tasks, although the differences in scores did not reach statistical significance. Additional analyses of association of biologic factors and neurocognitive functioning are currently underway. Discussion and Conclusion: Our results support that adults with sickle cell disease often suffer from cognitive deficits, which was expected based on pediatric studies demonstrating cognitive impairment in children with SCD. Interestingly, we observed a predominance of poor executive function over changes in attention and psychomotor speed in this study. This is in contrast with what providers familiar with "mini mental assessment" for dementia may expect. Typical dementia patients develop attention and memory changes before executive function is affected. Therefore, it is possible that cognitive impairment in SCD may go by unnoticed without proper testing. Additionally, in this cohort, anxiety was frequent and tended to associate with worse performance. Since this is a cross-sectional study, it is unclear whether cognition is progressively impaired over the years. Prospective studies are required to help determine whether and how fast progression occurs and what risk factors are implicated in the development and progression of cognitive impairment. Such deficits have been demonstrated to be associated with difficulties around employment and adherence to medication, which ultimately jeopardizes long term outcomes. Overall, we recommend neurocognitive and psychological evaluations as part of the routine care for adult SCD patients since abnormal findings seem common and may not be obvious without adequate testing for different domains. Treatment of anxiety disorder and cognitive rehabilitation may prove helpful to improve cognition in SCD patients. Disclosures Fertrin: Sanofi Genzyme: Consultancy, Membership on an entity's Board of Directors or advisory committees; Agios Pharmaceuticals: Consultancy, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau. Kruse-Jarres: Genentech/Roche: Speakers Bureau; Pfizer: Consultancy; CSL Behring: Consultancy; CRISPR: Consultancy; Biomarin: Consultancy; Genentech: Consultancy, Research Funding.

NCOG-13. TUMOR-RELATED MOLECULAR DETERMINANTS OF NEUROCOGNITIVE DEFICITS IN PATIENTS WITH DIFFUSE GLIOMA

BACKGROUND Cognitive impairment is a common and debilitating symptom in patients with diffuse glioma and is the result of multiple factors. We hypothesized that molecular tumor characteristics influence neurocognitive functioning (NCF), and we aimed to identify tumor-related markers of NCF in diffuse glioma patients. METHODS We examined the relation between cognitive performance (executive function, memory and psychomotor speed) and intratumoral expression level of molecular markers, in treatment-naive patients with diffuse glioma. We performed a single-center study in a prospectively collected cohort, through a two-step design: (1) differential expression and gene set enrichment analysis (GSEA) to identify candidate oncogenetic markers for cognitive impairment in a hypothesis-free manner. Nineteen molecular markers of interest were derived from this set of genes as well as from prior knowledge; (2) correlation of cognitive performance (executive function, memory and psychomotor speed) to intratumoral expression level of these nineteen molecular markers, measured with immunohistochemistry. RESULTS After correcting for tumor volume and location, we found significant associations, between expression level of CD3 and IDH on the one hand with psychomotor speed on the other; between IDH, ATRX, BDNF, CSNK2B, EAAT1, GAT-3, SRF and memory performance; and between IDH, P-STAT5b, CSNK2B and executive functioning. P-STAT5b, CD163, CD3 and SEMA3 were independently associated after further correction for histopathological grade. CONCLUSION Several molecular characteristics of gliomas are independent determinants of patients’ cognitive functioning. This suggests that besides tumor volume, location and histological grade, variations in glioma biology influence cognitive performance through mechanisms that include perturbation of neuronal communication. These results pave the way towards targeted cognition improving therapies in neuro-oncology.

Processing speed and clinical features of schizophrenia: comparison between men and women

Evidence about differences in processing speed (PS) performance between men and women with schizophrenia is inconclusive. Moreover, PS deconstruction into its subcomponents has not been compared among sexes. The aim of this study was to compare PS and its subcomponents (i.e., response processing – RP; accuracy – AC; and psychomotor speed - PmS) performance between men and women with schizophrenia and to explore its associations with clinical variables. Fiftysix patients (36 men, 20 women) were recruited. The PS domain tasks from the MATRICS Consensus Cognitive Battery were used. Women outperformed men in RP and AC but were slower in PmS. For men, correlations were found between functionality, RP and AC; age of onset was associated with AC; in women, illness duration and symptomatology correlated with AC. Sex-related differences regarding PS performance in schizophrenia resemble those observed in healthy individuals. Remediation strategies should consider sex differences in PS for more accurate interventions.

UCancellation: A New Mobile Measure of Selective Attention

Measuring selective attention in a speeded task can provide valuable insight into the current concentration ability of an individual, and can inform neuropsychological assessment of attention in aging, traumatic brain injury, and in various psychiatric disorders. There are few tools to measure selective attention that are freely available, psychometrically validated and can be used flexibly both for in-person and remote assessment. To address this gap, we developed a self-administrable, mobile-based test of selective attention, psychomotor speed, and inhibitory control called ‘UCancellation’ (University of California Cancellation) with two stimulus sets: Letters and Pictures. UCancellation takes less than 7 minutes to complete, is automatically scored, allows for multiple testing sessions, and is compatible with a variety of IOS and Android devices. Here we report the results of a study that examined 1-week retest reliability and convergent validity of UCancellation in a sample of 104 college students. UCancellation Letters and Pictures showed adequate retest reliability (r=.71-.83, p<0.01) and internal consistency (ɑ=.73-.91). It also showed convergent validity with another widely used cancellation task, D2 Test of Attention (r =.43-.59, p<0.01), and predicted performance on a cognitive control composite (r = .34-.41, p<0.05). These results suggest that UCancellation is a valid test of selective attention and inhibitory control, which warrants further data collection to establish norms.