Is there an association between non-alcoholic fatty liver disease and cognitive function? A systematic review

Background Non-alcoholic fatty liver disease (NAFLD) is represented as the most common liver disease worldwide. NAFLD is associated with metabolic risk factors underpinned by insulin resistance, inflammation and endothelial dysfunction, leading to extrahepatic changes in central nervous diseases such as cognitive impairment, Alzheimer’s disease and dementia. The aim of the review is to explore the association between NAFLD and cognitive function. Methods Using the PRISMA guidelines, a systematic electronic literature search was conducted in four databases: MEDLINE, PsychINFO, Embase and CINAHL from inception until March 2021. Neuropsychological tests utilised within each study were grouped into relevant cognitive domains including ‘general cognition’, ‘reasoning’, ‘mental speed, attention and psychomotor speed’, ‘memory and learning’, ‘language’, ‘visuospatial perception’ and ‘ideas, abstraction, figural creations and mental flexibility’. Results Eleven observational studies that involved 7978 participants with a mean age of 51 years were included. Those with NAFLD had poor cognitive performance in three cognitive domains, including ‘general cognition’, ‘mental speed, attention and psychomotor speed’, and ‘ideas, abstraction, figural creations and mental flexibility’. Conclusion The observed results from the 11 included studies showed that NAFLD was associated with lower cognitive performance across several domains. However, studies conducted to date are limited to observational designs and are heterogeneous with varying diagnostic tools used to assess cognitive function. Trial registration PROSPERO Registration: CRD42020161640.

Selective Inhibitory Circuit Dysfunction after Chronic Frontal Lobe Contusion

Traumatic brain injury (TBI) is a leading cause of neurologic disability; the most common deficits affect prefrontal cortex-dependent functions such as attention, working memory, social behavior, and mental flexibility. Despite this prevalence, little is known about the pathophysiology that develops in frontal cortical microcircuits after TBI. We investigated if alterations in subtype-specific inhibitory circuits are associated with cognitive inflexibility in a mouse model of frontal lobe contusion that recapitulates aberrant mental flexibility as measured by deficits in rule reversal learning. Using patch clamp recordings and optogenetic stimulation, we identified selective vulnerability in the non-fast spiking, somatostatin-expressing (SOM+) subtype of inhibitory neurons in layer V of the orbitofrontal cortex (OFC) two months after injury. These neurons exhibited reduced intrinsic excitability and a decrease in their synaptic output onto pyramidal neurons. By contrast, fast spiking, parvalbumin-expressing (PV+) interneurons did not show changes in intrinsic excitability or synaptic output. Impairments in SOM+ inhibitory circuit function were also associated with network hyperexcitability. These findings provide evidence for selective disruptions within specific inhibitory microcircuits that may guide the development of novel therapeutics for TBI.

Predicting University Adjustment from Coping-Styles, Self-Esteem, Self-Efficacy, and Personality: Findings from a Survey in a Sample of Italian Students

Starting university life requires that students learn to cope with several personal, academic, and social challenges. A wide array of variables affects how students adjust to university life. This study was aimed to investigate which factors among coping styles, self-esteem, self-efficacy, and personality traits (i.e., diligence, relational availability, mental flexibility, activity, and emotional stability) best predicted the levels of university adjustment in a sample of university freshmen (N = 204, 63% women). Data were collected using self-report instruments. Multiple regressions analyses were conducted to identify the most significant predictors of adjustment to college. Our findings reported that self-efficacy, task-, and emotion-oriented coping were the most significant predictors, together with relational availability and mental flexibility. These findings might improve the growing knowledge concerning university adjustment, supporting main previous research. The observed relationships between university adjustment and the measured variables suggest intriguing considerations about the importance for schools and universities of providing interventions for students that aim to develop and strengthen the investigated personality facets, reducing withdrawal, behavioral and/or mental disengagement, and promoting academic achievement and success.

Cluster profiles of mild traumatic brain injury : neurocognitive and psychological symptoms

Mild traumatic brain injuries (mTBI) comprise roughly 80% of all brain injuries and represent the majority of TBI patients seen in hospitals. mTBI can result in a wide-range of cognitive deficits and patients often develop co-morbid psychological disorders post-injury. The current study identified whether co-morbid psychological diagnoses are associated with specific patterns of cognitive deficits in 232 mTBI patients, aged 17-78 years, by means of cluster analyses. The presence of a co-morbid adjustment disorder was related to deficits in mental flexibility and attention, and the presence of a pain disorder was associated with deficits in abstract reasoning. Also, the presence of multiple co-morbid diagnoses was related to deficits in visual-spatial construction, abstract reasoning, mental flexibility and attention. Demographic variables, such as greater months since injury and fewer years of education, were also linked to deficits in cognitive functioning. This study highlights the influence of psychological diagnoses on cognitive test performance and provides support for the need to address co-morbid diagnoses during rehabilitation.

Cluster profiles of mild traumatic brain injury : neurocognitive and psychological symptoms

Mild traumatic brain injuries (mTBI) comprise roughly 80% of all brain injuries and represent the majority of TBI patients seen in hospitals. mTBI can result in a wide-range of cognitive deficits and patients often develop co-morbid psychological disorders post-injury. The current study identified whether co-morbid psychological diagnoses are associated with specific patterns of cognitive deficits in 232 mTBI patients, aged 17-78 years, by means of cluster analyses. The presence of a co-morbid adjustment disorder was related to deficits in mental flexibility and attention, and the presence of a pain disorder was associated with deficits in abstract reasoning. Also, the presence of multiple co-morbid diagnoses was related to deficits in visual-spatial construction, abstract reasoning, mental flexibility and attention. Demographic variables, such as greater months since injury and fewer years of education, were also linked to deficits in cognitive functioning. This study highlights the influence of psychological diagnoses on cognitive test performance and provides support for the need to address co-morbid diagnoses during rehabilitation.

Courage Under Fire

This chapter highlights the fateful moment of the Gaokao itself, investigating the important role of attitude and composure in examination success. It shows how head teachers personify an educational contradiction, both helping children to overcome their deficits in cultural capital and encouraging them to take individual responsibility for their examination results. It also considers the relationship between knowledge and attitude, elaborating how the capriciousness of attitude is accounted for. The chapter cites Gaokao observers that commonly remark how top students can choke on the exam, whereas dark horses can tap into their latent potential to surge from behind. It elaborates how the Gaokao assesses the diligent accumulation of knowledge and the less tangible aspects of character, particularly testing the ability of students to maintain composure and mental flexibility in the face of high pressure.

Effects of therapeutic instrumental music performance and motor imagery on chronic post-stroke cognition and affect: A randomized controlled trial

BACKGROUND: The burden of post-stroke cognitive impairment, as well as affective disorders, remains persistently high. With improved stroke survival rates and increasing life expectancy, there is a need for effective interventions to facilitate remediation of neurocognitive impairments and post-stroke mood disorders. OBJECTIVE: To investigate the effects of Therapeutic Instrumental Music Performance (TIMP) training with and without Motor Imagery on cognitive functioning and affective responding in chronic post-stroke individuals. METHODS: Thirty chronic post-stroke, community-dwelling participants were randomized to one of three experimental arms: (1) 45 minutes of active TIMP, (2) 30 minutes of active TIMP followed by 15 minutes of metronome-cued motor imagery (TIMP+cMI), (3) 30 minutes of active TIMP followed by 15 minutes of motor imagery without cues (TIMP+MI). Training took place three times a week for three weeks, using a selection of acoustic and electronic instruments. Assessments, administered at two baselines and post-training, included the Trail Making Test (TMT) - Part B to assess mental flexibility, the Digit Span Test (DST) to determine short-term memory capacity, the Multiple Affect Adjective Checklist - Revised (MAACL-R) to ascertain current affective state, and the General Self-Efficacy Scale (GSE) to assess perceived self-efficacy. The Self-Assessment Maniqin (SAM) was also administered prior to and following each training session. RESULTS: Thirty participants completed the protocol, ten per arm [14 women; mean age = 55.9; mean time post-stroke = 66.9 months]. There were no statistically significant differences between pooled group baseline measures. The TIMP+MI group showed a statistically significant decrease in time from pre-test 2 to post-test on the TMT. The TIMP group showed a significant increase on MAACL sensation seeking scores, as well as on the Valence and Dominance portions of the SAM; TIMP+cMI showed respective increases and decreases in positive and negative affect on the MAACL, and increases on the Valence, Dominance, and Arousal portions of the SAM. No statistically significant association between cognitive and affective measures was obtained. CONCLUSIONS: The mental flexibility aspect of executive functioning appears to be enhanced by therapeutic instrumental music training in conjunction with motor imagery, possibly due to multisensory integration and consolidation of representations through motor imagery rehearsal following active practice. Active training using musical instruments appears to have a positive impact on affective responding; however, these changes occurred independently of improvements to cognition.