DEVELOPMENT OF THE BRAZILIAN MINI-ADDENBROOKE’S COGNITIVE EXAMINATION (MINI-ACE BR)

Background: Age is the most important risk factor for development of dementia and the recommendation is that the elderly be cognitively tested in order to detect impairment in the initial phase for adequate treatment. The demand for the care of these elderly people is great, drawing attention to the need for rapid tests, with good accuracy and simple application to identify cognitive impairment. Objective: To develop the M-ACE Brazilian version using data from ACE-R deriving sub-items that could better predict the diagnosis of cognitive impairment. Methods: The M-ACE BR was developed using Mokken scaling analysis in 352 participants (cognitively normal = 232, cognitive impairment no dementia (CIND) = 82 and dementia = 38) and validated in an independent sample of 117 participants (cognitively normal = 25, CIND = 88 and dementia = 4). Results: The M-ACE BR has nine items (spatial orientation, anterograde memory, retrograde memory, delayed recall, recognition, verbal fluency letter “P”, repetition of four words, naming 10 items and comprehension) with a max. score of 51 points and average duration time of seven minutes. The cutoff score ≤43/51 for CIND had a sensitivity of 59.09% and a specificity of 80%. For a screening test in which sensitivity is prioritized for further investigation, we suggest using a cutoff of ≤47 (sensitivity 85.23% and specificity 24%), maintaining a good positive predictive value (79.8%) Conclusion: The M-ACE BR is a brief and adequate instrument for detecting cognitive impairment in elderly Brazilians.

Survival of the salient: Emotion rescues otherwise forgettable memories via neural reactivation and post-encoding hippocampal connectivity

Emotion’s selective effects on memory go beyond the simple enhancement of threatening or rewarding stimuli. They can also rescue otherwise forgettable memories that share overlapping features. Here, we use functional magnetic resonance imaging (fMRI) to examine the brain mechanisms that support this retrograde memory enhancement. In a two-phase incidental encoding paradigm, participants first view images of neutral tools and animals. During Phase 1, these images are intermixed with neutral scenes, which provides a unique ‘context tag’ for this specific phase of encoding. A few minutes later, during Phase 2, new pictures from one category are paired with a mild shock (fear-conditioned stimulus; CS+), while pictures from the other category are not shocked. fMRI analyses reveal that, across participants, retroactive memory benefits for Phase 1 CS+ items are associated with greater phasic reinstatement of the prior mental context during Phase 2 CS+ items. We also see that greater VTA/SN activation during Phase 2 CS+ items relates to this retroactive memory enhancement, suggesting that emotion promotes both the encoding and ongoing consolidation of overlapping representations. Additionally, we find that emotional experience-dependent changes in post-encoding hippocampal functional coupling with CS+ category-selective cortex relate to the magnitude of the retroactive memory effect. These hippocampal connectivity patterns also mediate the relationship between dopaminergic emotional encoding effects and across-participant variability in the retroactive memory benefit. Collectively, our findings suggest that an interplay between online and offline brain mechanisms may enable emotion to preserve seemingly mundane memories that become significant in the future.

Transient global amnesia associated with migraine triggered by anxiety under the effects of the coronavirus (COVID-19) pandemic: A case report

Transient global amnesia (TGA) is a clinical syndrome featured with the sudden onset of primarily short-term loss of anterograde as well as a milder decline of retrograde memory. The etiology is still unclear. Various risk factors relate with TGA and it is thought the vulnerability of CA1 neurons to metabolic stress plays an important role in the pathophysiological cascade. During the quarantine period of the coronavirus (COVID-19) pandemic, a 53-year-old Asian woman with 30 years of migraine history presented the emergency department for the first time to evaluate a sudden onset confusion and forgetfulness with repetitive questioning during migraine attack. Neurologic examination showed preserved orientations for time and person and no abnormalities in motor, speech, sensory, coordination, or cranial nerves. No focal Neurologic finding. Her memory gradually improved and restored to normal baseline over the course of a 24-hour in-patient stay. However, are trograde memory gap still existed a month after the TGA attack. The pathogenesis of TGA is unknown and many risk factors are associated with it, but among them migraine is considered a major risk factor, particularly in female patients aged 40-60 years. The anxiety stressor is a significant trigger for TGA. The pathophysiology argues that the vulnerability of CA1 neurons to metabolic stress plays an important role in TGA.

Checkpoint inhibitor develops histological autoimmune pancreatitis like type 1 diabetes. A case report

Transient global amnesia (TGA) is a clinical syndrome featured with the sudden onset of primarily short-term loss of anterograde as well as a milder decline of retrograde memory. The etiology is still unclear. Various risk factors relate with TGA and it is thought the vulnerability of CA1 neurons to metabolic stress plays an important role in the pathophysiological cascade. During the quarantine period of the coronavirus (COVID-19) pandemic, a 53-year-old Asian woman with 30 years of migraine history presented the emergency department for the first time to evaluate a sudden onset confusion and forgetfulness with repetitive questioning during migraine attack. Neurologic examination showed preserved orientations for time and person and no abnormalities in motor, speech, sensory, coordination, or cranial nerves. No focal Neurologic finding. Her memory gradually improved and restored to normal baseline over the course of a 24-hour in-patient stay. However, are trograde memory gap still existed a month after the TGA attack. The pathogenesis of TGA is unknown and many risk factors are associated with it, but among them migraine is considered a major risk factor, particularly in female patients aged 40-60 years. The anxiety stressor is a significant trigger for TGA. The pathophysiology argues that the vulnerability of CA1 neurons to metabolic stress plays an important role in TGA.

L’évaluation de la mémoire rétrograde dans la population Québécoise âgée: Le PUB-40 et le PUB-12

ABSTRACTMemory assessment represents an important part of the clinical neuropsychologist’s duties in a geriatric context. In fact, in Canada, about one-third of seniors report memory complaints, with different causes. Based on the underlying etiology, different components of memory may be affected in older adults. Nonautobiographical retrograde memory (public or semantic) is an important aspect of memory to assess; nevertheless, there is currently no reliable and standardized clinical tool to evaluate this aspect of memory in the elderly Quebecer population. The aims of this research were therefore: (1) to develop a protocol specifically aimed at assessing non-autobiographical retrograde memory in this population, the PUB-40; (2) to obtain reference data among 105 healthy subjects; and (3) to develop a short version based on the items which discriminated a group of 20 patients with amnestic Mild cognitive impairment (aMCI) from older healthy subjects.