cognitive outcome
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Author(s):  
Polly Kellner ◽  
Jenny Kwon ◽  
Joan Smith ◽  
Roberta G Pineda

Objective: To 1) define the prevalence of motor, cognitive, and language delays in preterm infants born < 32 weeks estimated gestational age (EGA) and 2) identify the relationship between the timing of discharge from the NICU and neurodevelopmental outcome in early childhood. Study Design: This retrospective study of 176 preterm infants born < 32 weeks EGA and hospitalized in a level IV NICU captured medical factors, including timing of discharge, from the NICU stay. Standardized developmental testing at 1-2 years corrected age was conducted in the newborn follow-up clinic. Results: At 1-2 years corrected age, the sample had an average cognitive composite score of 91.5 ± 17.4, language composite score of 84.5 ± 17.3, and motor composite score of 88.9 ± 18.4. Lower EGA at birth, necrotizing enterocolitis, patent ductus arteriosus, and oxygen requirement for > 28 days were independently associated with higher postmenstrual age (PMA) at NICU discharge. After controlling for known risk factors, higher PMA at discharge was associated with poorer cognitive outcome [p < 0.001, (-0.16, -0.07), β = -0.35], poorer language outcome [p = 0.049 (-0.10, 0.00), β = -0.15] and poorer motor outcome [p < 0.001, (-0.14, -0.05), β = -0.30]. Conclusion: Poorer cognitive, language, and motor outcomes were associated with longer hospitalization, even after controlling for medical risk factors known to be associated with poorer outcome. This provides further evidence for the potential role of the environment that may be impacting the developmental outcomes of infants hospitalized in the NICU.


2022 ◽  
Vol 12 (1) ◽  
pp. 36
Author(s):  
Simone Migliore ◽  
Giulia D’Aurizio ◽  
Eugenia Scaricamazza ◽  
Sabrina Maffi ◽  
Consuelo Ceccarelli ◽  
...  

We focused on Cognitive Reserve (CR) in patients with early Huntington Disease (HD) and investigated whether clinical outcomes might be influenced by lifetime intellectual enrichment over time. CR was evaluated by means of the Cognitive Reserve Index questionnaire (CRIq), an internationally validated scale which includes three sections: education, working activity, and leisure time. The clinical HD variables were quantified at three different time points (baseline-t0, 1 year follow up-t1 and 2 years follow up-t2) as per the Unified Huntington’s Disease Rating Scale (UHDRS), an internationally standardized and validated scale including motor, cognitive, functional and behavioral assays. Our sample consisted of 75 early manifest patients, withclinical stage scored according to the Total Functional Capacity (TFC) scale. Our correlational analysis highlighted a significant inverse association between CRIq leisure time (CRIq_LA) and longitudinal functional impairment (namely, the differential TFC score between t2 and t0 or ΔTFC) (p < 0.05), and the multidimensional progression of HD as measured by the composite UHDRS (cUHDRS, p < 0.01). CRIq_LA was significantly and positively associated with better cognitive performances at all time points (p < 0.05). Our results suggest that higher is the CRIq_LA, milder is the progression of HD in terms of functional, multidimensional and cognitive outcome.


Author(s):  
Ben Gaastra ◽  
Frederick Ewbank ◽  
William Tapper ◽  
Diederik Bulters ◽  
Ian Galea

Nutrients ◽  
2021 ◽  
Vol 14 (1) ◽  
pp. 176
Author(s):  
Myrna J. V. Brandt ◽  
Cora H. Nijboer ◽  
Isabell Nessel ◽  
Tatenda R. Mutshiya ◽  
Adina T. Michael-Titus ◽  
...  

Perinatal hypoxia-ischemia (HI) is a major cause of neonatal brain injury, leading to long-term neurological impairments. Medical nutrition can be rapidly implemented in the clinic, making it a viable intervention to improve neurodevelopment after injury. The omega-3 (n-3) fatty acids docosahexaenoic acid (DHA, 22:6n-3) and eicosapentaenoic acid (EPA, 20:5n-3), uridine monophosphate (UMP) and choline have previously been shown in rodents to synergistically enhance brain phospholipids, synaptic components and cognitive performance. The objective of this study was to test the efficacy of an experimental diet containing DHA, EPA, UMP, choline, iodide, zinc, and vitamin B12 in a mouse model of perinatal HI. Male and female C57Bl/6 mice received the experimental diet or an isocaloric control diet from birth. Hypoxic ischemic encephalopathy was induced on postnatal day 9 by ligation of the right common carotid artery and systemic hypoxia. To assess the effects of the experimental diet on long-term motor and cognitive outcome, mice were subjected to a behavioral test battery. Lesion size, neuroinflammation, brain fatty acids and phospholipids were analyzed at 15 weeks after HI. The experimental diet reduced lesion size and neuroinflammation specifically in males. In both sexes, brain n-3 fatty acids were increased after receiving the experimental diet. The experimental diet also improved novel object recognition, but no significant effects on motor performance were observed. Current data indicates that early life nutritional supplementation with a combination of DHA, EPA, UMP, choline, iodide, zinc, and vitamin B12 may provide neuroprotection after perinatal HI.


2021 ◽  
Author(s):  
Lukas Roell

Schizophrenia is accompanied by widespread alterations in static functional connectivity associated with symptom severity and cognitive deficits. Improvements in aerobic fitness have been demonstrated to ameliorate symptomatology and cognition in people with schizophrenia, but the intermediary role of macroscale connectivity patterns remains unknown. Therefore, we aim to explore the relation between aerobic fitness and the functional connectome in individuals with schizophrenia. Further, we investigate clinical and cognitive relevance of the identified fitness-connectivity links. 58 patients with schizophrenia were included in the resting-state fMRI analysis. Multilevel Bayesian partial correlations between aerobic fitness and functional connections across the whole brain as well as between static functional connectivity patterns and clinical and cognitive outcome were performed. Preliminary causal inferences were enabled based on a mediation analysis. Static functional connectivity between the subcortical nuclei and the cerebellum as well as between temporal seeds mediated the attenuating impact of aerobic fitness on total symptom severity. Functional connections between cerebellar seeds affected the positive link between aerobic fitness and global cognition, while the functional interplay between central and limbic seeds drove the beneficial relation between aerobic fitness and emotion recognition. The current study provides first insights into the interactions between aerobic fitness, the functional connectome and clinical and cognitive outcome in people with schizophrenia, but results have to be interpreted carefully. Further interventional aerobic exercise studies are needed in order to replicate the current findings and to enable conclusive causal inferences.


Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013207
Author(s):  
Stephanie Abgottspon ◽  
Qendresa Thaqi ◽  
Leonie Steiner ◽  
Nedelina Slavova ◽  
Sebastian Grunt ◽  
...  

Objectives:To investigate the impact of age at pediatric arterial ischemic stroke on long-term cognitive outcome in order to identify patients particularly at risk for the development of cognitive long-term cognitive sequelae.Methods:This cross-sectional study included patients in the chronic phase of stroke (> 2 years after stroke) previously diagnosed with neonatal or childhood arterial ischemic stroke and a control group. Participants with active epilepsy, severe learning difficulties, or behavioral problems hindering the cognitive assessment were excluded. Several cognitive domains, including intelligence, executive functions (working memory, inhibition, and cognitive flexibility), processing speed, memory, letter fluency, and visual-motor skills were assessed with neuropsychological tests. Cognitive long-term outcome was compared across patients after neonatal stroke (stroke between 0 and 28 days of life), early childhood stroke (stroke between 29 days and < 6 years) and late childhood stroke (stroke between ≥ 6 and < 16 years).Results:52 patients after neonatal or childhood arterial ischemic stroke (median age: 15.3 years, IQR = 10.6 – 18.7) and 49 healthy controls (median age: 13.6 years, IQR = 9.8 – 17.2) met the inclusion criteria. Cognitive outcome was significantly worse in the pediatric stroke group compared to the control group. A non-linear effect of age at stroke (irrespective of lesion size and lesion location) was found for cognitive flexibility, processing speed, and verbal learning with early childhood stroke (29 days to < 6 years) showing significantly worse cognitive outcome compared to neonatal or late childhood stroke (p < .05, FDR-corrected).Conclusion:Age at stroke is an important factor for post-stroke recovery and modulates long-term cognitive outcome irrespective of lesion size and lesion location. Children after early childhood stroke are at particular risk for alterations of long-term cognitive functions.


2021 ◽  
pp. 089692052110649
Author(s):  
Emine Fidan Elcioglu

Private sponsorship has become a primary way that refugees access resettlement to Canada. Key in this program are the private Canadians who volunteer their money, time, and labor to sponsor and support refugees. Drawing on 25 interviews, this article examines the insights that these privileged citizens of the global north gain as they help refugees struggling with the marginalizing consequences of neoliberal austerity in their new hostland. While sponsors learn about the challenges facing working-class racialized newcomers (otherwise obscured to sponsors by their racial, class, and citizenship privileges), the program robs sponsors of the time and mental bandwidth to reflect on the structural nature of these challenges. Consequently, sponsors rarely understand refugees’ struggles as public troubles necessitating broader intervention, including modest policy reform. I call this cognitive outcome neoliberal fatigue. I conclude by discussing how this fatigue thwarts social change and reinforces neoliberal capitalism.


2021 ◽  
Vol 12 (12) ◽  
pp. 62-67
Author(s):  
Saugata Chaudhuri ◽  
Suchandra Mukherjee ◽  
Tanmoy Kumar Bose ◽  
Turna Roy Chowdhury

Background: Very low birth weight infants are at increased risk of language, cognition delay and also hearing impairment disorder. Identification is essential for early intervention. Aims and Objectives: To estimate the burden of language, cognition delay and hearing impairment at 24 months of corrected gestation and to test the association of examination at 6 months and 12 months with the language and cognitive outcome of very low birth weight (VLBW) infants at 24 months and to identify the perinatal and neonatal risk factors for atypical outcome. Materials and Methods: It is a prospective cohort study. Consecutive 120 VLBW infants were enrolled in a single centre level III neonatal unit of a teaching hospital. Hearing assessment was done before discharge and 3 monthly. Language and cognitive assessment was done by DASII Scale neu at 6 months and BSIDIII Scale at 12 months and 24 months at neurodevelopmental clinic. Language assessment was further done by REELS-3 Subscale at 24 months. All assessment ages were corrected for prematurity. Results: At 24 months 7.8% infants developed Language delay and 4.7% had cognition delay. Four infants developed cerebral palsy at 24 months. Shock in neonatal period had significant association with suboptimal Hearing, Language and Cognitive outcome at 12 months of corrected gestation. Conclusion: Early anticipation and early identification of abnormal hearing, language and cognitive outcome of VLBW infants can be used as simple and cost-effective measures for preventing long-term morbidity at resource limited countries.


2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 501-501
Author(s):  
Precious Esie ◽  
Jennifer Manly ◽  
Justina Avila-Rieger

Abstract State-level labor market disparities have been linked to health outcomes. The current study examines how labor market disparities may shape different patterns of sex/gender inequalities in cognition across race/ethnicity, place, and time. We leverage cognitive outcome data from multiple cohort and nationally representative longitudinal studies, as well as historical data on labor force participation and occupational status from IPUMS CPS. Multilevel modeling analyses was used to examine heterogeneity in sex/gender inequalities in cognitive trajectories within and between race/ethnicity and U.S. state of birth and determine whether such variability is explained by a state-level labor market opportunity composite. We expect women to demonstrate an advantage over men on cognitive measures. Women’s advantage will be more pronounced in states with a small sex/gender gap in labor market opportunities and less pronounced in states with a large gap. The magnitude of this advantage will be greater for White women compared with Black women.


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