Long-Term Neuropsychological Outcomes Following Temporal Lobe Epilepsy Surgery: An Update of the Literature

We present an update of the literature concerning long-term neuropsychological outcomes following surgery for refractory temporal lobe epilepsy (TLE). A thorough search was conducted through the PubMed and Medline electronic databases for studies investigating neuropsychological function in adult patients undergoing resective TLE surgery and followed for a mean/median > five years period. Two independent reviewers screened citations for eligibility and assessed relevant studies for the risk of bias. We found eleven studies fulfilling the above requirements. Cognitive function remained stable through long-term follow up despite immediate post-surgery decline; a negative relation between seizure control and memory impairment has emerged and a possible role of more selective surgery procedures is highlighted.

The negative impact of chronic tobacco smoking on adult neuropsychological function: a cross-sectional study

Background The evidence on the effects of chronic tobacco smoking on neuropsychological functions is conflicting. The literature remains limited by inconsistent accounting for potentially confounding biomedical and psychiatric conditions. This study aimed to assess the neuropsychological functions of adult chronic tobacco smokers in comparison to group-matched non-smokers. Method The study included 73 smokers and 84 group-matched non-smokers. The data was collected during the year 2019. After an initial interview to collect demographics and smoking profile, the subjects undertook neuropsychological assessments that targeted a wide range of cognitive domains. Results The performance of smokers was poorer on almost all neuropsychological domains, namely selective attention (p ≤ .001, p = .044), alternating attention (p = .002) working memory (p ≤ .001), Short-term memory (p = .006 and .003), Long-term memory (p ≤ .001), processing accuracy (p ≤ .001), and executive function (p = .011 and .026). Smokers were intact on processing speed. Smoking accumulation and lower age onset of regular smoking were correlated with lower neuropsychological function. Conclusion Our findings add to the growing body of evidence suggesting that chronic tobacco smoking impacts cognition negatively.

043 Sleep Restriction Affects Memory in Healthy Adults: Preliminary Findings

Introduction Sleep loss has a range of detrimental effects on cognitive ability. However, few studies have examined the impact of sleep restriction on neuropsychological function using an experimental design. The goal of this study was to examine the extent to which maintained insufficient sleep affects cognition in healthy adults compared to habitual adequate sleep. Methods This study used a randomized, crossover, outpatient sleep restriction design. Adults who regularly slept at least 7 h/night, verified by 2 weeks of screening with actigraphy, completed 2 phases of 6 weeks each: habitual sleep (>7 h of sleep/night) or sleep restriction (habitual sleep minus 1.5 h) separated by a 6-week washout period. During the sleep restriction phase, participants were asked to delay their bedtime by 1.5 hours/night while maintaining their habitual wake time. Neuropsychological function was evaluated with the NIH Toolbox Cognition Battery at baseline (week 0) and endpoint (week 6) of each intervention phase. The NIH Toolbox evaluates a range of cognitive abilities, including attention, executive functioning, and working memory. General linear models with post hoc paired t-tests were used to assess demographically-adjusted test scores prior to and following each sleep condition. Results At the time of analyses, 16 participants were enrolled (age 34.5□14.5 years, 9 women), 10 of whom had completed study procedures. An interaction between sleep condition and testing session revealed that individuals performed worse on List Sorting, a working memory test, after sleep restriction but improved slightly after habitual sleep (p<0.001). While not statistically reliable, the pattern of test results was similar on the other tests of processing speed, executive function, and attention. Conclusion In these preliminary results from this randomized experimental study, we demonstrated that sleep restriction has a negative impact while stable habitual adequate sleep has a positive impact on working memory, or the ability to temporarily hold information in mind while executing task demands. This finding contributes to our understanding of the complex interplay between different aspects of sleep quality (i.e., both sleep restriction as well as the maintenance of stable sleep patterns) on cognition and underscores the importance of routine sleep screening as part of medical evaluations. Support (if any):

Is set-shifting and central coherence in anorexia nervosa influenced by body mass index, anxiety or depression? A systematic review

Background Anorexia nervosa (AN) is a severe eating disorder, recognized by a relentless pursuit for thinness and extreme low body weight. The disorder is often accompanied by comorbid disorders such as anxiety and depression, and altered neuropsychological function in terms of poor set-shifting and reduced central coherence. The aim of this review was to evaluate whether neuropsychological impairments in AN are influenced by body mass index, anxiety or depression. Method A systematic review approach was used, following the PRISMA guidelines for systematic reviews. Literature was identified via searches in PubMed, PsychInfo and Embase database, by using the search words [anorexia nervosa] AND [central coherence], and [anorexia nervosa] AND [set-shifting]. Studies were included if they were written in English, peer-reviewed, included individuals with AN, included tests measuring set-shifting and/or central coherence, investigated associations between set-shifting/central coherence with anxiety and/or depression and/or BMI. Risk of bias was assessed by using a critical appraisal checklist from the Joanna Briggs Institute. Results were summarized in a narrative synthesis. Results Although results are heterogeneous, the majority of studies report that neither body mass index (BMI), anxiety or depression is associated with altered central coherence and set-shifting in individuals with AN. Conclusions Findings indicate that BMI, depression and anxiety does not influence neuropsychological function in AN, suggesting that it could be a characteristic of the disorder. A complete understanding of predisposing, precipitating and maintaining factors in AN needs to be addressed in future research. This could contribute to the development of better and more targeted treatment strategies.

The long‐term outcome of neuropsychological function is favorable in patients with non‐malignancy related anti-GABABR encephalitis: a case series

Background Anti-GABABR encephalitis is a rare type of autoimmune encephalitis, which often presents with memory impairments, behavioral changes and seizures. This case series describes the neuropsychological function recovery pattern in five adult patients with anti-GABABR encephalitis. Case presentation We recruited five patients with clinically confirmed anti-GABABR encephalitis without any accompanying malignancy. Comprehensive neuropsychological evaluation was conducted on each patient. All the five patients were evaluated in the chronic phase. Five age and gender matched healthy adults were recruited as control group. Our study demonstrated that the neuropsychological function of the patients with anti-GABABR encephalitis was no different with respect to the control group during the chronic phase (more than 6 months after onset). Moreover, one patients with neuropsychological evaluation at acute (within 2 months after onset of symptoms), post-acute (2 to 6 months after onset) and chronic phases respectively, presented neuropsychological function recovered as early as in the post-acute phase and only showed cognition impairment in the acute phase. Conclusions The results of this retrospective study indicate a favorable long-term neuropsychological function outcome in adult patients with anti-GABABR encephalitis, despite severe memory deficits occurring during the acute phase. These findings improve our understanding related to the prognosis of neuropsychological function in anti-GABABR encephalitis.

Systematic Changes in Gait Pursuant to Choir Participation for Caregivers and Persons With Dementia

Choir interventions confer psychological benefits for persons with dementia (PwD) and their caregivers. However, less is known about whether physiological function also exhibits improvements pursuant to such social-cognitive interventions. The present study, based upon a subsample of the Voices in Motion (ViM) project, explored whether participation in an intergenerational choir results in systematic improvements in gait velocity (indexed using a GAITRite computerized walkway) for both informal caregivers (n=14; 71.4% female) and PwD (n=14; 64.3% female). Longitudinal burst data from the first of three cohorts spanning 4 assessments over 3.5 months was analysed using multilevel modeling. Whereas caregivers exhibited significant improvements (p<.05) in gait velocity, PwD showed no improvement. Ongoing analyses are exploring additional cohorts, and whether improvements in gait dynamically covary with reductions in comorbidities (e.g., neuropsychological function, caregiver burden, depressive affect). These results underscore the potential of choir for facilitating both psychosocial and physiological function for caregivers and PwD.