Cognition, Statins, and Cholesterol in Elderly Ischemic Stroke Patients: A Neurologist’s Perspective

Background and Objectives: The efficacy of hydroxy methyl glutaryl-coenzyme A reductase inhibitors (statins) in reducing the incidence of cardiovascular events pushed the target LDL-cholesterol (LDL-C) levels lower and lower in successive guidelines despite signals regarding potential cognitive side effects. We evaluated the relationship between cognitive impairment and LDL-C levels in elderly ischemic stroke patients. Materials and Methods: 29 ischemic stroke patients aged 65 and above with LDL-C levels ≤70 mg/dL, classified according to the TOAST criteria, underwent detailed neuropsychological testing comprising the MMSE test, Montreal Cognitive Assessment (MoCA) and Addenbrooke’s Cognitive Evaluation (ACE-III) test. Their performances were compared to those of 29 age-matched ischemic stroke patients with LDL-Cl levels >71 mg/dL. Results: The MMSE test failed to detect significant cognitive differences between the two groups. The MoCA and ACE-III tests detected impairments in visuo-spatial/executive function, attention, and recall/memory in patients with low LDL-C. A stepwise linear regression model of the ACE-III total scores revealed that LDL-cholesterol levels could contribute to 13.8% of the detected cognitive dysfunction, second in importance only to age, which contributed to 38.8% of the detected impairment. Conclusions: Physicians should be cautious when prescribing statins to elderly people. Hydrophilic ones may be preferred in cognitively impaired patients.

Aspects of Cognitive Impairment Associated with Agitated Behaviour during Post-traumatic Amnesia

Objectives: Post-traumatic amnesia (PTA) is a transient period of recovery following traumatic brain injury (TBI) characterised by disorientation, amnesia, and cognitive disturbance. Agitation is common during PTA and presents as a barrier to patient outcome. A relationship between cognitive impairment and agitation has been observed. This prospective study aimed to examine the different aspects of cognition associated with agitation. Methods: The sample comprised 82 participants (75.61% male) admitted to an inpatient rehabilitation hospital in PTA. All patients had sustained moderate to extremely severe brain injury as assessed using the Westmead Post-Traumatic Amnesia Scale (WPTAS) (mean duration = 42.30 days, SD = 35.10). Participants were assessed daily using the Agitated Behaviour Scale and WPTAS as part of routine clinical practice during PTA. The Confusion Assessment Protocol was administered two to three times per week until passed criterion was achieved (mean number assessments = 3.13, SD = 3.76). Multilevel mixed modelling was used to investigate the association between aspects of cognition and agitation using performance on items of mental control, orientation, memory free recall, memory recognition, vigilance, and auditory comprehension. Results: Findings showed that improvement in orientation was significantly associated with lower agitation levels. A nonsignificant trend was observed between improved recognition memory and lower agitation. Conclusions: Current findings suggest that the presence of disorientation in PTA may interfere with a patient’s ability to understand and engage with the environment, which in turn results in agitated behaviours. Interventions aimed at maximizing orientation may serve to minimize agitation during PTA.

Two Faces of a Coin? A Systematic Review of Source Monitoring and Its Relationship with Memory in Autism

The ability to discriminate the origin of stimuli, known as source monitoring, is crucial for self–other distinction and the integration of internally generated and externally generated experiences. Despite its valence, evidence on source monitoring in autism is yet scarce and unclear. We systematically reviewed literature concerning source monitoring in autism and its relationship with other constructs, such as memory type, encoding effects, social cognition, general intelligence, and clinical factors. Source-monitoring performance (operationalized as error or accuracy) was reduced in autistic participants in 9 of the 15 studies that met the inclusion criteria. When explicitly investigated, free-recall memory impairments in autism were shown to influence source monitoring deficits. General intelligence was another important factor linked to source-monitoring performance. Conversely, other memory types or encoding effects were not impaired in autism, and no univocal association could be found with source monitoring. Social cognition and clinical symptoms were rarely assessed in spite of their possible involvement in source monitoring. The heterogeneity of the task design, outcome measures and demographical factors limited study comparability. As a research framework on source monitoring as a construct of primary interest in autism is still lacking, we propose preliminary indications for future investigations based on the collected findings.

Effects of Immersive Media on Emotion and Memory: An Experiment Comparing Article, 360-video, and Virtual Reality

Fields such as immersive journalism and VR-based media consumption are expected to holistically engross users and have a deeper emotional impact as well as internalisation of information. This between-subjects experiment (N = 87) employs a 360-degree video was presented either on mobile VR, on screen, or as a written article consisting of the transcript and video stills. The results suggest that the higher immersiveness has a more prominent effect on the emotional response and higher negative affect to predict lower cued recall memory of the presented content. Age in the range does not seem to influence the strength of the affect change but females might experience a higher change than males. This study suggest caution when creating highly emotional content. The negative emotional experience might impede memory of factual information. These implications are further applicable to other related fields, such as education and simulation trainings.

Enhancement of the Cognitive Abilities in Visually Impaired Children Following a Yoga Based Intervention

Background: Perception and cognition in individuals are directly linked to the sensory organs. Yogic practices and meditation are known to calm the mind and enhance the cognitive abilities in an individual. Objective: In visually impaired children, academic performance is affected by their loss of vision. The present study is a pilot study to understand the improvement in verbal recall memory of children with visual impairment following the practice of a yogic module. Methods: The study was a pre-post single arm study of 113 children from a blind school in Surat who underwent a seven hour yoga and pranayama-based workshop. The intervention included three ancient techniques, viz. pranayama (breathing techniques), super brain yoga and yoga nidra (supine relaxation). Assessment of the verbal memory was done using Rey Auditory Verbal Learning Test (RAVLT). Subjects were tested for verbal memory recall before and after the intervention. Results: Results indicated a significant improvement in the retention and recall memory of the participants post intervention (p value <0.001). Both genders demonstrated an equivalent performance after the intervention. Conclusion: The results indicate that such holistic techniques play a positive role in improving the academic performance of visually impaired children.

Hippocampal Volume and Amyloid PET Status Three Years After Ischemic Stroke: A Pilot Study

Hippocampal atrophy is seen in many neurodegenerative disorders and may be a cardinal feature of vascular neurodegeneration. We examined hippocampal volume (HV) in a group of ischemic stroke survivors with amyloid 18F-NAV4694 PET imaging three years after stroke. We compared HV between the amyloid-positive (n = 4) and amyloid-negative (n = 29) groups, and associations with co-morbidities using Charlson Comorbidity Indices and multi-way ANOVA. Amyloid status was not associated with verbal or visual delayed free recall memory indices or cognitive impairment. We found no association between amyloid status and HV in this group of ischemic stroke survivors.

Age affects pigeon memory capacity, but not representation of serial order, during a locomotor sequential-learning task

Aging affects individuals of every species, with sometimes detrimental effects on memory and cognition. The simultaneous-chaining task, a sequential-learning task, requires subjects to select items in a predetermined sequence, putting demands on memory and cognitive processing capacity. It is thus a useful tool to investigate age-related differences in these domains. Pigeons of three age groups (young, adult and aged) completed a locomotor adaptation of the task, learning a list of four items. Training began presenting only the first item; additional items were added, one at a time, once previous items were reliably selected in their correct order. Although memory capacity declined noticeably with age, not all aged pigeons showed impairments compared to younger pigeons, suggesting that inter-individual variability emerged with age. During a subsequent free-recall memory test, when all trained items were presented alongside novel distractor items, most pigeons did not reproduce the trained sequence in the absence of reinforcement. During a further forced-choice test, when pigeons were given a choice between only two of the trained items, all three age groups showed evidence of an understanding of the ordinal relationship between items by choosing the earlier item, indicating that complex cognitive processing, unlike memory capacity, remained unaffected by age.

CHILDREN’S HOPE SYMBOLIZED BY JACK FROST’S MOTIVATION TO BE A TRUE GUARDIAN IN PETER RAMSEY’S FILM RISE OF THE GUARDIANS

This thesis entitled Children’s Hope Symbolized by Jack Frost’s Motivation to be A True Guardian in Peter Ramsey’s Film “Rise of The Guardians” has set a goal at finding semiotic elements of sign of motivation to become the true guardian experienced by Jack Frost as the main character described in film. In conducting the research, descriptive qualitative used to find semiotic aspect to find semiotic aspect of Children Hope’s Symbolized by Jack Frost Motivation to be A True Guardian. The approaches that are used by the researcher are divided into two to analyze the data. They are structural approach and semiotic approach. The researcher used a structural approach to analyze structural elements such as plot, main character traits of the main character, conflict experienced by the main character, and setting described in this story. Semiotic approach used to describe signs that consist of icon, index, symbol to analyze appearance of signs that reflect main character motivation to become a true guardian. This research shows the plot of Peter Ramsey’s film Rise of the Guardians consist of exposition, rising actions, climax, falling action, and resolution. The main character of Peter Ramsey’s film Rise of the Guardians is Jack Frost. Jack described has 6 traits such as Self-Doubt, Mischievous, Hesitant, Caring, Persistent, Generous. In this film, the main character Jack Frost has experienced internal and external conflict. The setting in film is divided into setting of place and setting of time. The Setting of the place is Frozen Pond Town. North Pole, Jamie’s House. Tooth Palace, Warren, Pitch Lair. The setting of times is 300 years after Jack’s revival, Snow day, Day/Noon, Evening, Night. Last is about signs that appear at Peter Ramsey’s film Rise of the Guardians classified into Icon, index, symbol. The icons that show in the film are Jack’s staff, The Globe of Belief, Jack’s Gold Box, Nesting Doll, Oath Book/Guardians oath, Sandy’s sand and Pitch sand. The Index shows in film are Jack's first thing to remember after revival, freezing something, Good dream becoming Bad dream (Nightmare), North advice, Jack’s sister voice, fixing staff, Denying and Accepting oath. The symbol shows in film are Frozen Pond, G shaped Jack’s staff, Recall memory, Man in the moonlight. Symbol Recall memory becomes the result of Jack being motivated to become a true Guardian that has correlation with analysis, structural aspects, and other semiotics aspects.