A bioenergetic model that links psychopathology and intelligence: Implications for research and clinical practice

Decomposing the structure of human cerebral function in its domains, such as affect regulation or cognition, forms the backbone of psychiatric diagnosis and treatment. Research continues to decipher the domains and hierarchical structure of cerebral function. So far, the findings strongly suggest two higher-order latent factors of general psychopathology (p factor) and general intelligence (g factor). Both general factors are functions of the same organ, covary, share risk factors as well as biomarkers, and benefit from the same treatments. However, to our knowledge, a model that connects both components of cerebral function within a higher-order latent factor and describes its potential biological underpinning is lacking. First, we suggest the general factor of cerebral function (c factor) as the shared variance of the measures of g and p in a bi-factor model. Second, we propose and provide evidence that mitochondrial bioenergetics (MB) is one core biological underpinning of c. Third, we describe how this c factor mito-bioenergetics (CMB) model may transform research and clinical practice by advancing knowledge of treatment effects, risk factors, biomarkers and clinical outcomes. Finally, we present a CMB model-based hypothesis stating that fatigue—as a phenotypical correlate of MB—directly loads on c.

Acute stroke and transient ischaemic attack

The World Health Organization defines a stroke as ‘rapidly developing clinical signs of focal (or global) disturbance of cerebral function, with symptoms lasting 24 hours or longer or leading to death, with no apparent cause other than vascular origin’. If the symptoms last less than 24 hours, typically less than 2 hours, then this is classified as a transient ischaemic attack. ‘Brain attack’ is a term that is increasingly used, as the rapid nature of treatment means the differentiating criterion of symptoms lasting at least 24 hours, is often not met before initiation of treatment.

Cerebral Damage after Stroke: The Role of Neuroplasticity as Key for Recovery

Stroke remains global health care problem that constitutes world’s second-leading perpetrator of mortality and third most pronounced cause of all disabilities. The hallmark of cerebral stroke is the persistent loss of cerebral function consequence of abnormality of the blood supply. The ultimate goal of stroke care is to recover and maximize the cerebral functions lost due to the cerebral damage. Therefore, understanding the mechanism of cerebral damage after stroke is fundamental to comprehension of mechanisms of recovery following stroke, as well as key towards eliminating devastating human disability as a result of stroke. Therapeutic strategies aim to harness and enhance neuroplasticity offers reasonable level of hope towards maximizing recovery from post stroke impairments. This paper therefore, highlighted the mechanism of cerebral damage after stroke as well as elucidates the concept of neuroplasticity as key for recovery following stroke.

Data-driven filtration and segmentation of mesoscale neural dynamics

Recording neuronal group activity across the cortical hemispheres from awake, behaving mice is essential for understanding information flow across cerebral networks. Video recordings of cerebral function comes with challenges, including optical and movement-associated vessel artifacts, and limited references for time series extraction. Here we present a data-driven workflow that isolates artifacts from calcium activity patterns, and segments independent functional units across the cortical surface. Independent Component Analysis utilizes the statistical interdependence of pixel activation to completely unmix signals from background noise, given sufficient spatial and temporal samples. We also utilize isolated signal components to produce segmentations of the cortical surface, unique to each individual’s functional patterning. Time series extraction from these maps maximally represent the underlying signal in a highly compressed format. These improved techniques for data pre-processing, spatial segmentation, and time series extraction result in optimal signals for further analysis.

Lama Hari Rawat Pasien Stroke

Background: Stroke has remained the leading cause of death globally in the last 15 years. Stroke is rapidly developing clinical signs of focal or global disturbance of cerebral function. Hospitalization is a treatment process which including patient to stay at the hospital. Length of stay is influenced by the type of stroke. This study aimed to know classification of stroke and length of stay of stroke patients. Methods: The study was a descriptive study with restrospective design. Data collected from medical record from May until December 2020 in RS PKU Muhammadiyah Yogyakarta. There were 207 patients with stroke. Descriptive data is then processed. Results: The results showed the highest percentage stroke patients male (50,24%), non hemorrhagic stroke (57,49%), length of stay hemorrhagic stroke 8 days. Conclusion: The result of this study may provide nursing research in patients with stroke.

Abstract 120: Artesunate Reduces the Severity of Post-Resuscitation Myocardial and Cerebral Dysfunction

Introduction: Artesunate (ART) possesses anti-inflammatory activity, which can mitigate the systemic inflammatory response in poor outcomes of cardiac arrest (CA). We investigated the effects of ART on myocardial and cerebral function, duration of survival, and inflammation in a rat model of CA and cardiopulmonary resuscitation (CPR). Hypothesis: ART reduces the severity of post resuscitation myocardial and cerebral dysfunction by alleviating inflammation in a rat model of CA and CPR. Methods: 30 male Sprague-Dawley rats weighing between 450g-550g were randomized into 3 groups: Sham (S), Control (C), and Artesunate (A). C and A were divided into subgroups: survival and non-survival (n=6). Ventricular fibrillation (VF) was induced and untreated for 6 min. A 4J defibrillation was attempted after 8 min of CPR. Phosphate buffer (1ml/kg, pH 7.9-8.1) or ART (2.4mg/kg), was administered at return of spontaneous circulation (ROSC). Myocardial function was measured at baseline and every hour for 4h post ROSC. Plasma levels of IL-6, TNF-α and cTnI were detected at baseline and 4h after ROSC. Survival animals were observed for an additional 72h. Neurologic deficit scores were recorded daily. Results: ART reduced the severity of post-resuscitation myocardial dysfunction compared to C. It attenuated IL-6, TNF-α and cTnI plasma levels 4h after ROSC (p<0.05) (Fig. 1). Post-resuscitation cerebral function and survival rate also improved significantly (p<0.05) (Fig. 2). Conclusion: ART reduces the severity of post-resuscitation myocardial and cerebral dysfunction, improves survival rate and attenuates inflammation in a rat of model of CA and CPR.

Effects of electroencephalography and regional cerebral oxygen saturation monitoring on perioperative neurocognitive disorders: a systematic review and meta-analysis

Background Perioperative neurocognitive disorders (PND) is a common postoperative complication including postoperative delirium (POD), postoperative cognitive decline (POCD) or delayed neurocognitive recovery. It is still controversial whether the use of intraoperative cerebral function monitoring can decrease the incidence of PND. The purpose of this study was to evaluate the effects of different cerebral function monitoring (electroencephalography (EEG) and regional cerebral oxygen saturation (rSO2) monitoring) on PND based on the data from randomized controlled trials (RCTs). Methods The electronic databases of Ovid MEDLINE, PubMed, EMBASE, Cochrane Library database were systematically searched using the indicated keywords from their inception to April 2020. The odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were employed to analyze the data. Heterogeneity across analyzed studies was assessed with chi-square test and I2 test. Results Twenty two RCTs with 6356 patients were included in the final analysis. Data from 12 studies including 4976 patients were analyzed to assess the association between the EEG-guided anesthesia and PND. The results showed that EEG-guided anesthesia could reduce the incidence of POD in patients undergoing non-cardiac surgery (OR: 0.73; 95% CI: 0.57–0.95; P = 0.02), but had no effect on patients undergoing cardiac surgery (OR: 0.44; 95% CI: 0.05–3.54; P = 0.44). The use of intraoperative EEG monitoring reduced the incidence of POCD up to 3 months after the surgery (OR: 0.69; 95% CI: 0.49–0.96; P = 0.03), but the incidence of early POCD remained unaffected (OR: 0.61; 95% CI: 0.35–1.07; P = 0.09). The remaining 10 studies compared the effect of rSO2 monitoring to routine care in a total of 1380 participants on the incidence of PND. The results indicated that intraoperative monitoring of rSO2 could reduce the incidence of POCD (OR 0.53, 95% CI 0.39–0.73; P < 0.0001), whereas no significant difference was found regarding the incidence of POD (OR: 0.74; 95% CI: 0.48–1.14; P = 0.17). Conclusions The findings in the present study indicated that intraoperative use of EEG or/and rSO2 monitor could decrease the risk of PND. Trial registration PROSPREO registration number: CRD42019130512.