Brain Sparing Effect on Neurodevelopment in Children with Intrauterine Growth Restriction: A Systematic Review

Background: Fetal growth restriction (FGR) is a pregnancy complication. Multiple studies have connected FGR to poor cognitive development, behavior disorders, and academic difficulties during childhood. Brain sparing has traditionally been defined as an adaptive phenomenon in which the brain obtains the blood flow that it needs. However, this adaptive phenomenon might not have a complete protective effect. This publication aims to systematically review the consequences of brain redistribution on neurodevelopment in children who presented with placental intrauterine growth restriction. Methods: We performed a systematic review according to PRISMA guidelines. It included studies on intrauterine growth restriction or small-for-gestational-age (SGA) fetuses, which middle cerebral artery was measured, and neurodevelopment assessed during childhood. PUBMED and EMBASE databases were searched for relevant published studies. Results: Of the 526 studies reviewed, only 12 were included. Brain sparing was associated with poor cognitive function and lower scores in IQ. Cerebral redistribution was related to better executive function and better behavior at 4 years old but not at 12 years old. Conclusions: We can assume that fetal brain sparing could not be a fully protective phenomenon. We could not find clinical differences in behavioral and executive functions because the results were heterogeneous. Some cognitive abilities could be affected in FGR brain sparing fetuses.

Association of the Irregular 3-Dimensional Shape of White Matter Hyperintensities with Cognitive Function

<b><i>Introduction:</i></b> The irregular shapes of white matter hyperintensities (WMHs) are associated with poor cognitive function, diabetes, or lacunes. However, the association between the WMH shape and dementia remains understudied. We investigated the association between the calculated shape index of WMH and the diagnosis of dementia and cognitive function. <b><i>Methods:</i></b> The inverse sphericity index (ISI_WMH) and volume of WMHs (VOL_WMH) were compared among 82 participants with normal cognition, 82 with Alzheimer’s dementia (AD), and 82 with subcortical vascular dementia (SVD). We examined the associations of ISI_WMH and VOL_WMH with the modified Hachinski Ischemic Score (mHIS), diagnosis of AD and SVD, and cognitive test scores, using linear, multinomial, or hierarchical linear regression models. <b><i>Results:</i></b> The mHIS was associated with both ISI_WMH (β = 0.326, <i>p</i> &#x3c; 0.001) and VOL_WMH (β = 0.299, <i>p</i> &#x3c; 0.001). Both ISI_WMH and VOL_WMH were associated with the SVD diagnosis (odds ratio [OR] = 2.685, <i>p</i> = 0.002, ISI_WMH; OR = 2.597, <i>p</i> = 0.005, VOL_WMH), but not with AD. The SVD diagnosis was better explained when the multinomial regression model included both ISI_WMH and VOL_WMH instead of VOL_WMH alone (χ² = 20.768, df = 2, <i>p</i> &#x3c; 0.001). The Trail Making Test-D (TMT-D) scores of the SVD patients were associated with both ISI_WMH (β = 0.308) and VOL_WMH (β = 0.293). <b><i>Conclusion:</i></b> An irregular WMH shape may be associated with the high cerebrovascular component of cognitive impairment and the diagnosis and low cognitive flexibility of SVD, which may improve the prediction of SVD diagnosis when used in combination with WMH volume.

Informant-Reported Discrimination, Dementia, and Cognitive Impairment in Older Brazilians

Background: Self-reported discrimination is a source of psychosocial stress that has been previously associated with poor cognitive function in older African Americans without dementia. Objective: Here, we examine the association of discrimination with dementia and cognitive impairment in racially diverse older Brazilians. Methods: We included 899 participants 65 years or older (34.3% Black) from the Pathology, Alzheimer’s and Related Dementias Study (PARDoS), a community-based study of aging and dementia. A structured interview with informants of the deceased was conducted. The interview included the Clinical Dementia Rating (CDR) Scale for the diagnosis of dementia and cognitive impairment proximate to death and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a second measure of cognitive impairment. Informant-reported discrimination was assessed using modified items from the Major and Everyday Discrimination Scales. Results: Discrimination was reported by informants of 182 (20.2%) decedents and was more likely reported by informants of Blacks than Whites (25.3% versus 17.6%, p = 0.006). Using the CDR, a higher level of informant-reported discrimination was associated with higher odds of dementia (OR: 1.24, 95% CI 1.08 –1.42, p = 0.002) and cognitive impairment (OR: 1.21, 95% CI: 1.06 –1.39, p = 0.004). Similar results were observed using the IQCODE (estimate: 0.07, SE: 0.02, p = 0.003). The effects were independent of race, sex, education, socioeconomic status, major depression, neuroticism, or comorbidities. Conclusion: Higher level of informant-reported discrimination was associated with higher odds of dementia and cognitive impairment in racially diverse older Brazilians.

Late Menarche, Not Reproductive Period, Is Associated with Poor Cognitive Function in Postmenopausal Women in Taiwan

Female sex hormones such as estrogen and progesterone play an important role in the regulation of a woman’s body, including cognition and neurogenesis. However, the effects of age at menarche and reproductive period on cognitive function are still controversial. The aim of this study was to investigate the relationships between age at menarche and reproductive period with cognitive impairment. Data were obtained from the Taiwan Biobank. Cognitive function was assessed using the Mini Mental State Examination (MMSE) and its five subdomains. Multivariable linear regression analysis revealed that an old age at menarche (per one year; coefficient β, −0.189; p = 0.020) was significantly associated with a low total MMSE score, whereas reproductive period (p = 0.733) was not significantly associated with total MMSE score. Furthermore, an old age at menarche was significantly associated with low MMSE G2 (registration) (per one year; coefficient β, −0.022; p = 0.035) and G5 (language, construction and obey) scores (per one year; coefficient β, −0.054; p = 0.047). However, age at menarche was not significantly associated with MMSE G1 (orientation), G3 (attention and calculation) and G4 (recall) scores. In addition, reproductive period was not significantly associated with any MMSE subscores. Late menarche was associated with poor cognitive function, including low total MMSE score and low MMSE G2 and G5 scores. However, reproductive period was not associated with cognitive function in postmenopausal women.

Cognitive Consequences of Social Isolation During COVID-19: side effects and treatments

Objective: During the COVID-19 pandemic, quarantine and staying at home is advised. The social relationship between people has become deficient, and human social isolation (SI) has become the consequence of this situation. It was shown that SI has made changes in hippocampal neuroplasticity, which will lead to poor cognitive function and behavioral abnormalities. There is a connection between SI, learning, and memory impairments. In addition, anxiety-like behavior and increased aggressive mood in long-term isolation have been revealed during the COVID-19 outbreak. Methods: Term searches was done in Google Scholar, Scopus, ScienceDirect, Web of Science and PubMed databases as well as hand searching in key resource journals from 1979–2020. Results: Studies have shown that some drug administrations may positively affect or even prevent social isolation consequences in animal models. These drug treatments have included opioid drugs, anti-depressants, Antioxidants, and herbal medications. In addition to drug interventions, there are non-drug treatments that include an enriched environment, regular exercise, and music. Conclusion: This manuscript aims to review improved cognitive impairments induced by SI during COVID-19.

Autism - A Comprehensive Array of Prominent Signs and Symptoms

Background: Autism Spectrum Disorder (ASD) is a multifaceted neurodevelopmental condition characterized by multiple psychological and physiological impairments in young children. According to the recent reports 1 out of every 58 newly born children is suffering from autism. The aetiology of disorder is complex and poorly understood, hindering the adaptation of targeted and effective therapies. There are no well-established diagnostic biomarkers for autism, hence the analysis of symptoms by the pediatricians play a critical role in the early intervention. Methods: In the present report we have emphasized on 24 behavioral, psychological and clinical symptoms of autism. Results: Impaired social interaction, restrictive and narrow interests, anxiety, depression; aggressive, repetitive, rigid and self-injurious behavior, lack of consistency, short attention span, fear, shyness and phobias, hypersensitivity and rapid mood alterations, high level of food and toy selectivity; inability to establish friendships or follow the instructions; fascination by round spinning objects and eating non-food materials are common psychological characteristics of autism. Speech or hearing impairments, poor cognitive function, gastrointestinal problems, weak immunity, disturbed sleep and circadian rhythms, weak motor neuromuscular interaction, lower level of serotonin and neurotransmitters, headache and body pain include common physiological symptoms. Conclusion: A variable qualitative and quantitative impact of these wide range of symptoms is perceived in each autistic individual making him/her distinct, incomparable and exceptional. Selection and application of highly personalized medical and psychological therapies are therefore recommended for the management and treatment of autism.

Evaluating Additional Aspects of Muscle Function with a Digital Handgrip Dynamometer and Accelerometer for Cognitive Functioning in Older Adults: A Pilot Study

Handgrip dynamometers are used to assess handgrip strength (HGS), and low HGS is linked to poor cognitive function. Although HGS is a reliable measure of muscle function, it is only measuring maximal grip force. Other aspects of muscle function such as force control, fatigability, and steadiness are unaccounted for in current HGS protocols. This pilot study sought to determine the role of maximal HGS, submaximal HGS force control, HGS fatigability, and HGS neuromuscular steadiness on cognitive function in older adults. Our findings indicate that these additional HGS measurements could factor into detecting poorer cognitive functioning, while also evolving HGS protocols.

Transcranial Doppler for Early Prediction of Cognitive Impairment after Aneurysmal Subarachnoid Hemorrhage and the Associated Clinical Biomarkers

Background and Aim. Cognitive impairment after aneurysmal subarachnoid hemorrhage (aSAH) stays under investigation. This study is aimed at predicting the cognitive impairment by transcranial Doppler (TCD) and detecting the associated clinical biomarkers of impaired cognition after aSAH after 3 months from the onset. Methods. Prospective study included 40 cases with acute aSAH. Initial evaluation by Glasgow Coma Scale (GCS) and the severity of aSAH was detected by both the clinical Hunt and Hess and radiological Fisher’s grading scales. TCD was done for all patients five times within 10 days measuring the mean flow velocities (MFVs) of cerebral arteries. At the 3-month follow-up, patients were classified into two groups according to Montreal Cognitive Assessment (MoCA) scale: the first group was 31 cases (77.5%) with intact cognitive functions and the other group was 9 cases (22.5%) with impaired cognition. Results. Patients with impaired cognitive functions showed significantly lower mean GCS ( p = 0.03 ), significantly higher mean Hunt and Hess scale grades ( p = 0.04 ), significantly higher mean diabetes mellitus (DM) ( p = 0.03 ), significantly higher mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) ( p = 0.02 and p = 0.005 , respectively), and significantly higher MFVs measured within the first 10 days. The patients with cognitive impairment were accompanied by a higher incidence of hydrocephalus ( p = 0.01 ) and a higher incidence of delayed cerebral ischemia (DCI) ( p < 0.001 ). Logistic regression analysis detected that MFV ≥ 86 cm / s in the middle cerebral artery (MCA), MFV ≥ 68 cm / s in the anterior cerebral artery (ACA), and MFV ≥ 45 cm / s in the posterior cerebral artery (PCA) were significantly associated with increased risk of cognitive impairment. Conclusion. Cognitive impairment after the 3-month follow-up phase in aSAH patients was 22.5%. Acute hydrocephalus and DCI are highly associated with poor cognitive function in aSAH. Increased MFV is a strong predictor for poor cognitive function in aSAH. This trial is registered with NCT04329208.