Correlation Between Amygdala Nuclei Volumes and Memory in Cognitively Normal Adults Carrying the ApoE ε3/ε3 Allele

The amygdala is known to be related to cognitive function. In this study, we used an automated approach to segment the amygdala into nine nuclei and evaluated amygdala and nuclei volumetric changes across the adult lifespan in subjects carrying the apolipoprotein E (ApoE) ε3/ε3 allele, and we related those changes to memory function alteration. We found that except the left medial nucleus (Me), whose volume decreased in the old group compared with the middle-early group, all other nuclei volumes presented a significant decline in the old group compared with the young group. Left accessory basal nucleus (AB) and left cortico-amygdaloid transition area (CAT) volumes were also diminished in the middle-late group. In addition, immediate memory recall is impaired by the process of aging, whereas delayed recall and delayed recognition memory functions were not significantly changed. We found significant positive correlations between immediate recall scores and volumes of the bilateral basal nucleus (Ba), AB, anterior amygdaloid area (AAA), CAT, whole amygdala, left lateral nucleus (La), left paralaminar nucleus (PL), and right cortical nucleus (Co). The results suggest that immediate recall memory decline might be associated with volumetric reduction of the amygdala and its nuclei, and the left AB and left CAT might be considered as potential imaging biomarkers of memory decline in aging.

Camouflaging in Developmental Language Disorder: The views of speech and language therapists and parents

Background: Camouflaging has been the subject of research in conditions which affect communication skills and social functioning such as autism, and has been shown to have negative impacts on mental health outcomes. However, camouflaging has received no systematic study in Developmental Language Disorder (DLD). Aims: This study aimed to explore the topic of camouflaging in DLD, drawing on the experience and expertise of both speech and language therapists and parents of children with DLD. We aimed to capture the nature and appearance of camouflaging in this population, and its potential impact on the children. Methods & procedures: Using a qualitative descriptive design, we interviewed 6 speech and language therapists and 6 parents of children with DLD. We applied inductive thematic analysis to the interview transcripts. Outcomes & Results: We organised our findings into three broad areas: who camouflages and why, the many strategies for camouflaging, and the impacts of camouflaging. It was clear that camouflaging could take a range of forms, although there we identified 8 common presentations. Participants felt that camouflaging delayed recognition of children’s language needs, and had implications for interventions and support. There were also negative impacts on children’s levels of exhaustion, mental health and self-esteem, their personality and friendships, and how staff and those around them perceived children and young people with DLD. Conclusions & Implications: Our study provides a first look at the topic of camouflaging in DLD. Wesuggest how camouflaging could be taken into account when working with children and young people with DLD, especially when involving other colleagues such as teachers or assistants, who may not see the language needs underneath the camouflaging. Further research that characterises camouflaging DLD could lead to the development of tools that help mitigate against the under-detection of children’s language needs.

A Possible Role for Arterial Duplex and Hand Acceleration Time in Diagnosing and Managing Shock

Shock represents a state when arterial perfusion is inadequate to supply the needs of cellular respiration, leading to anerobic metabolism, acidosis, and cell death. Although typically described in terms of blood pressure and heart rate, these measures can both lead to delayed recognition of shock and under appreciation of the severity of end-organ malperfusion. Recently, there has been increased interest in monitoring peripheral perfusion both to detect early shock and monitor the response to treatment. However, current methods are variable and, in some cases, require specialized equipment. We present a case in which duplex ultrasound assessment of peripheral palmar acceleration time identified a post-hemorrhagic shock state before it was clinically apparent. Bedside arterial duplex and hand acceleration time may provide a simple tool to assess the degree of shock and response to intervention.

Ola Skanks: Delayed Recognition of a Dance Artist Ahead of Her Time

This essay chronicles my research relationship with choreographer, teacher, educator, and activist Ola Skanks. Canadian-born and of West Indian (St. Lucia and Barbados) descent, Skanks was a groundbreaking dance and fashion design artist who combined modern, Western art forms with traditional dances of the Africa diaspora. I share excerpts from my work to date, including my archival exhibition, It’s About Time: Dancing Black in Canada 1900–1970, to provide context for the circumstances that Black people danced in, socially and/or as performers. This is followed by a selection of photos from Skanks’s archival collection that illustrate the scope of her creative and community contributions. In conclusion, I offer a transcription of a speech I gave when Skanks was inducted into the Dance Collection Danse’s 2018 Encore! Dance Hall of Fame, alongside some of Canada’s most well-known dance artists and community builders. I detail some of the highlights of my meetings with her and also the profundity of the delayed recognition of a woman so far ahead of her time.

The Effects of a Novel Non-catechol Dopamine Partial Agonist on Working Memory in the Aged Rhesus Monkey

Aged-related declines in cognition, especially working memory and executive function, begin in middle-age and these abilities are known to be mediated by the prefrontal cortex (PFC) and more specifically the dopamine (DA) system within the PFC. In both humans and monkeys, there is significant evidence that the PFC is the first cortical region to change with age and the PFC appears to be particularly vulnerable to age-related loss of dopamine (DA). Therefore, the DA system is a strong candidate for therapeutic intervention to slow or reverse age related declines in cognition. In the present study, we administered a novel selective, potent, non-catechol DA D1 R agonist PF-6294 (Pfizer, Inc.) to aged female rhesus monkeys and assessed their performance on two benchmark tasks of working memory – the Delayed Non-match to Sample Task (DNMS) and Delayed Recognition Span Task (DRST). The DNMS task was administered first with the standard 10 s delay and then with 5 min delays, with and without distractors. The DRST was administered each day with four trials with unique sequences and one trial of a repeated sequence to assess evidence learning and retention. Overall, there was no significant effect of drug on performance on any aspect of the DNMS task. In contrast, we demonstrated that a middle range dose of PF-6294 significantly increased memory span on the DRST on the first and last days of testing and by the last day of testing the increased memory span was driven by the performance on the repeated trials.

Effects of emotional study context on immediate and delayed recognition memory: Evidence from event-related potentials

Whilst research has largely focused on the recognition of emotional items, emotion may be a more subtle part of our surroundings and conveyed by context rather than by items. Using ERPs, we investigated which effects an arousing context during encoding may have for item-context binding and subsequent familiarity-based and recollection-based item-memory. It has been suggested that arousal could facilitate item-context bindings and by this enhance the contribution of recollection to subsequent memory judgements. Alternatively, arousal could shift attention onto central features of a scene and by this foster unitisation during encoding. This could boost the contribution of familiarity to remembering. Participants learnt neutral objects paired with ecologically highly valid emotional faces whose names later served as neutral cues during an immediate and delayed test phase. Participants identified objects faster when they had originally been studied together with emotional context faces. Items with both neutral and emotional context elicited an early frontal ERP old/new difference (200-400 ms). Neither the neurophysiological correlate for familiarity nor recollection were specific to emotionality. For the ERP correlate of recollection, we found an interaction between stimulus type and day, suggesting that this measure decreased to a larger extend on Day 2 compared with Day 1. However, we did not find direct evidence for delayed forgetting of items encoded in emotional contexts at Day 2. Emotion at encoding might make retrieval of items with emotional context more readily accessible, but we found no significant evidence that emotional context either facilitated familiarity-based or recollection-based item-memory after a delay of 24 h.

The Potential of Invasive and Non-Invasive Vagus Nerve Stimulation To Improve Verbal Memory Performance in Epilepsy Patients

Introduction: It has been demonstrated that acute vagus nerve stimulation (VNS) improves word recognition memory in epilepsy patients. Transcutaneous auricular vagus nerve stimulation (taVNS) has gained interest as a non-invasive alternative to improve cognition. In this prospective randomized cross-over study, we investigated the effect of both invasive VNS and taVNS on verbal memory performance in 15 drug-resistant epilepsy patients. Methods All patients conducted a word recognition memory paradigm in 3 conditions: VNS ON, VNS OFF and taVNS. For each condition, patients memorized 21 highlighted words from text paragraphs. Afterwards, the intervention was delivered for 30 s. Immediate recall and delayed recognition scores were obtained for each condition. This memory paradigm was repeated after 6 weeks of VNS therapy in 2 conditions: VNS ON and VNS OFF. Results Acute VNS and taVNS did not improve verbal memory performance. Immediate recall and delayed recognition scores were significantly improved after 6 weeks of VNS treatment irrespective of the acute intervention. Conclusion The previously described positive effects of invasive VNS on verbal memory performance could not be replicated with invasive VNS and taVNS. An improved verbal memory performance was seen after 6 weeks of VNS treatment, suggesting that longer and more repetitive stimulation of the vagal pathway is required to modulate verbal memory performance.

Cosmetic Filler Blindness: Recovery After Repeated Hyaluronidase Injections

Background The rise of cosmetic injectables has seen new clinical scenarios related to complications. The scenario of hyaluronic acid (HA) aesthetic interventional induced visual loss (AIIVL) has become more recognized. While this complication is rare, there can be delayed recognition and treatment, with limited opportunity to evaluate potential treatments and establish best practice guidelines. Objectives We report a case of documented visual recovery with extra-orbital and intra-orbital hyaluronidase. Central retinal artery occlusion (CRAO) is an ischemic event requiring urgent intervention. We hope to assist protocols being developed for HA AIIVL. Methods Following loss of vision, 675 international units (IU) of hyaluronidase was given immediately to the injection site and extra-orbital area. Within four hours, 3,000 IU intra-orbital and 1,500 IU extra-orbital hyaluronidase was given in the Emergency Department (ED). Results Visual loss in a 38-year-old female, following ipsilateral glabella and nasal injection of 0.15 ml of hyaluronic acid filler Juvéderm Voluma via the nasal tip, was documented at no perception of light (NPL) with afferent pupil defect (APD), CRAO, fundoscopy showing a cherry red spot. This was associated with cerebral irritation and Magnetic Resonance Imaging (MRI) ischemia. Hyaluronidase was injected as described above. The following day, visual acuity (VA) in the affected eye recovered to 6/18 with a relative superior visual field scotoma. VA improved to 6/6 at one month. Conclusions We believe immediate injection, followed by high dose intra-orbital and extra-orbital injection of hyaluronidase, had a positive effect in this case. Recovery of vision was remarkable, from NPL to 6/6, documented at a tertiary referral eye hospital.