Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has ...Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.展开更多
Astrocytes,a major class of glial cells,have emerged as crucial regulators of synaptic function,neuronal homeostasis,and cognitive processes(Cabral-Miranda et al.,2024).These star-shaped cells not only provide structu...Astrocytes,a major class of glial cells,have emerged as crucial regulators of synaptic function,neuronal homeostasis,and cognitive processes(Cabral-Miranda et al.,2024).These star-shaped cells not only provide structural and metabolic support to neurons but also actively participate in modulating synaptic transmission,neurovascular coupling,and inflammatory responses in the brain.展开更多
Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In th...Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In this study,we investigated the potential therapeutic effects of MCC950,a selective NOD-like receptor family pyrin domain-containing protein 3 inhibitor,on cerebral small vessel disease pathogenesis and cognitive decline in spontaneously hypertensive rats.Our results showed that chronic administration of MCC950(10 mg/kg)to spontaneously hypertensive rats inhibited NOD-like receptor family pyrin domain-containing protein 3 inflammasome activation,thereby considerably suppressing the production of pyroptosis executive protein gasdermin D and pro-inflammatory factors,including interleukin-1βand-18.A decrease in astrocytic and microglial activation was also observed.We also found that MCC950 significantly inhibited autophagy.More importantly,behavioral assessment indicated that MCC950 administration ameliorated impaired neurocognitive function,which was associated with improvements in neuropathological hallmarks in the cerebral small vessel disease brain,such as blood‒brain barrier breakdown,white matter damage,and endothelial dysfunction.Thus,our findings revealed that the NOD-like receptor family pyrin domain-containing protein 3 inflammasome is a key contributor to the onset or progression of cerebral small vessel disease and suggested the potential of NOD-like receptor family pyrin domain-containing protein 3-based therapy as a potential novel strategy for treating cerebral small vessel disease.展开更多
Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ER...Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.展开更多
This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging i...This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.展开更多
BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patie...BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.展开更多
Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MC...Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MCR syndrome and changes in cognitive and physical functions,to provide a new perspective on preventing dementia.Methods:Participants were selected from the China Health and Retirement Longitudinal Study(CHARLS).Demographic characteristics,health status,and lifestyle variables were assessed in 2011.MCR syndrome was defined as the presence of subjective cognitive complaints and objective slow gait,with preserved activities of daily living and absence of dementia,and assessed in 2011.Cognitive function,including orientation,attention and calculation,episodic memory,and visuospatial ability,was measured from 2011 to 2018.Physical function,including grip strength,balance ability,and repeated chair stand tests,was measured from 2011 to 2015.Generalized estimating equation was employed to analyze the longitudinal associations between MCR syndrome in 2011 and changes in cognitive functions over 7 years and physical functions over 4 years.Results:Among 4,217 participants,475 had MCR syndrome in 2011.Both participants with MCR syndrome and those without exhibited a decline in both cognitive and physical function over 7 years and 4 years of follow-up,except for fluctuations in visuospatial ability.Non-MCR syndrome participants demonstrated significantly better overall cognitive function in 2018 compared to 2011(Group×Time:B=0.44,P=0.035)than those in the MCR syndrome group.However,participants with non-MCR syndrome demonstrated significantly worse visuospatial ability in 2013(Group×time:B=−0.44,P=0.002)and 2018(Group×time:B=−0.34,P=0.016)compared to those in the MCR syndrome group.Non-MCR syndrome participants demonstrated significantly better performance in repeated chair stand tests in 2013(Group×time:B=0.31,P<0.001)and 2015(Group×time:B=0.37,P<0.001)compared to those in the MCR syndrome group in 2011.Conclusions:Older adults with MCR syndrome experience worse overall cognitive and physical function performance,especially in repeated chair stand tests,than individuals without MCR syndrome over 7-year and 4-year follow-up periods.It is suggested that future interventional studies will target both physical and cognitive functions in MCR syndrome individuals,providing insights for the prevention of dementia.展开更多
In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers su...In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers survival in older adults[2].A decline in physical function can also be observed in older adults with increasing age.Grip strength has been shown to be a marker of overall physiological function in older adults.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To i...BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.展开更多
BACKGROUND There is no effective treatment for Alzheimer's disease(AD),and pharmacological treatment of AD in clinical settings is expensive and prolonged,resulting in a huge psychological and economic burden on t...BACKGROUND There is no effective treatment for Alzheimer's disease(AD),and pharmacological treatment of AD in clinical settings is expensive and prolonged,resulting in a huge psychological and economic burden on the patient's family and caregivers and society as a whole,AD is characterized by progressive,worsening cognitive impairment,and there are currently no drugs that can effectively reverse cognitive impairment.However,it is important to intervene early or delay cognitive impairment so that the condition can be delayed and,ultimately,the burden on patients and families can be reduced through maintenance treatment.It may be that non-pharmacological interventions such as cognitive stimulation therapy(CST)can help with cognitive dysfunction.AIM To provide a better treatment plan for AD patients and delay the deterioration of cognitive function,the effect of CST on cognitive function in AD was studied by Meta-analysis.METHODS Comprehensive search the Chinese and English databases were comprehensively searched by computer.Chinese databases:China Biomedical Literature Database(CBM),Wanfang Database,VIP Database,and China Periodicals Full-text Database(CNKI).The collection time limit is from July 21,2010 to July 21,2022 randomized controlled trials literature on the effects of CST on cognitive function in patients with AD.According to the inclusion and exclusion criteria,literature screening,data extraction,and quality evaluation were performed.Standardized mean difference(SMD)and 95%CI were used as evaluation criteria to evaluate the cognitive function of CST in AD patients.Sensitivity analysis and publication bias detection were performed on the results.Publication bias was assessed using funnel plots,and funnel plot symmetry was assessed with Eggr's test.RESULTS CST can not improve Mental State Examination Scale(MMSE)scores in AD patients.Meta-analysis of CST on MMSE scores showed that the heterogeneity was P=0.14,I2=35%.I2=35%<50%,and the Q test P>0.1,choose the random effect model to integrate statistics,get SMD=0.02,95%CI:-0.37,0.42,P>0.05.Meta-analysis of CST on AD Cognitive Functioning Assessment Scale scores showed that the heterogeneity was P=0.13,I2=36%.I2=36%<50 choose a fixed effect model to integrate statistics,get SMD=-0.01,95%CI:-0.40,0.39,P>0.05,the difference is not statistically significant.Meta-analysis of CST on the cognitive function indicators of patients showed that the heterogeneity was P=0.17,I2=31%.I2=31%<50%,the fixed effect model showed SMD=0.01,95%CI:-0.37,0.38,P>0.05,the difference was not statistically significant.CONCLUSION CST may not improve the cognitive function of AD patients,not improve the cognitive function of AD patients,not improve the ability of daily living,and not reduce mental behavior can improve the cognitive function of AD patients.展开更多
BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adh...BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adherence.This study aimed to characterize the prevalence and profile of MCI in AF patients,examine its associations with cardiovascular comorbidities,and assess how these comorbidities influence specific cognitive domains.METHODS This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021.Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment.Associations between comorbidities and MCI were assessed by logistic regression,and cognitive domains were compared using the Mann-Whitney U test.RESULTS Of 4136 AF patients(mean age:64.7±9.4 years,64.7%male),33.5%of patients had MCI.Among the AF patients,31.2%of patients had coronary artery disease,20.1%of patients had heart failure,and 18.1%of patients had hypertension.88.7%of patients had left atrial enlargement,and 11.0%of patients had reduced left ventricular ejection fraction.Independent factors associated with higher MCI prevalence included older age(OR=1.04,95%CI:1.03-1.05,P<0.001),lower education level(OR=1.51,95%CI:1.31-1.73,P<0.001),hypertension(OR=1.28,95%CI:1.07-1.52,P=0.001),heart failure(OR=1.24,95%CI:1.04-1.48,P=0.020),and lower left ventricular ejection fraction(OR=1.43,95%CI:1.04-1.98,P=0.028).A higher CHA_(2)DS_(2)-VASc score(OR=1.27,95%CI:1.22-1.33,P<0.001;≥2 points vs.<2 points),and greater atherosclerotic cardiovascular disease burden(OR=1.45,95%CI:1.02-2.08,P=0.040;2 types vs.0 type)were linked to increased MCI risk.These above factors influenced various cognitive domains.CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity.Patients with multiple comorbidities are at higher risk,highlighting the importance of routine cognitive assessment to support self-management and integrated care.展开更多
BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of...BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms.It remains unclear whether anxiety and depression are caused by stressors or viral infection.AIM To use functional near-infrared spectroscopy(fNIRS)to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms(mainly depression and anxiety),to investigate whether COVID-19 causes these changes by affecting brain function.METHODS A total of 58 subjects,comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited.Then cortical activation during the performance of the verbal fluency test(VFT)and brain connectivity during the resting state(rs)were evaluated by 53-channel fNIRS.For the COVID-19-infected group,Patient Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7)were used to assess the emotional state before fNIRS measures.RESULTS For the rs,compared to the uninfected group,the infected group exhibited lower rs functional connectivity(FC)in the dorsolateral prefrontal cortex(DLPFC),which was correlated with both the PHQ score and GAD score.During the VFT,the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right.Besides,the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group.CONCLUSION There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups,which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms.In addition,the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety,which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety,rather than depression or anxiety alone.Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits,which also provide insights into the future treatment and prognosis of individuals with COVID-19.展开更多
Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated it...Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.展开更多
BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid ...BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.展开更多
Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sect...Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sectional data from seven geographical regions across Chinese mainland.The Changsha version of the Montreal Cognitive Assessment was used to assess cognitive function.A“least absolute shrinkage and selection operator”(LASSO)model,multivariate linear regression analysis,and random forest(RF)model were used.Subgroup analyses were performed to examine the correlation between key TCM constitution types and cognitive function in different population subgroups.Results:A total of 24803 individuals aged 60 and above were included in the study.We selected 18 influential factors using the LASSO model.Higher education,being married,and having insurance were positively correlated with cognitive function in the elderly(all P<0.05).In contrast,poor sleep,vision impairment,hearing impairment,basic activities of daily living disability,instrumental activities of daily living disability,depression,hypertension,coronary heart disease,diabetes,stroke,yang-deficiency constitution(YADC),yin-deficiency constitution(YIDC),qi deficiency constitution(QDC),and blood stasis constitution(BSC)were negatively correlated with cognitive function(all P<0.05).YIDC and BSC affected all dimensions of cognitive function(all P<0.05).YADC mainly affected attention,language,abstraction(verbal analogies),memory,and orientation to time and place dimensions(P<0.001).QDC mainly affected language and abstraction(verbal analogies)dimensions(P<0.05).The negative correlations between BSC,YADC,YIDC,and QDC scores and cognitive function revealed statistically significant dif-ferences across most subgroups.The RF model identified education,BSC,and poor sleep quality as the three most influential factors in our study.Conclusion:BSC,YADC,YIDC,and QDC were associated with cognitive decline in the elderly.Our findings provide new perspectives and significant references for interventions for early-stage cognitive disorders.展开更多
In current memristor-based neuromorphic computing research,several studies face the challenge of realizing only a single function at a time or having isolated functions.This limitation is particularly evident when sim...In current memristor-based neuromorphic computing research,several studies face the challenge of realizing only a single function at a time or having isolated functions.This limitation is particularly evident when simulating biological cognition,as the overall synergy between multiple cognitive functions is difficult to represent.In this work,a high-performance heterojunction memristor is presented at first.The memristor-based neural network and functional circuit are further implemented to realize and integrate multiple cognitive functions.Specifically,the proposed photoelectric memristor has the structure of Ag/ZnO-SnO_(2)/WO_(3-x)/ITO,it exhibits various synaptic behaviors under external modulations,which are characterized by good stability and repeatability.Based on this device,a neural network is built to realize the basic recognition function in biological cognition.The recognition results are translated into different labelled voltage signals and subsequently fed into a memristor-based functional circuit.By leveraging memory characteristics and tunable conductance of the memristor,and controlling the specific circuit functionalities,the input signals are processed to produce different outputs representing various cognitive functions.This methodology allows the realization and integration of recognition,memory,learning,association,relearning,and forgetting into one single system,thereby enabling a more comprehensive and authentic simulation of biological cognition.This work presents a novel memristor and a method for achieving and integrating multiple neuromorphic computing functions within a single system,providing a successful example for achieving complete biological function.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor ...BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.展开更多
Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods...Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.展开更多
BACKGROUND Sepsis is a life-threatening condition defined by organ dysfunction,triggered by a dysregulated host response to infection.there is limited published literature combining cognitive impairment with topologic...BACKGROUND Sepsis is a life-threatening condition defined by organ dysfunction,triggered by a dysregulated host response to infection.there is limited published literature combining cognitive impairment with topological property alterations in brain networks in sepsis survivors.Therefore,we employed graph theory and Granger causality analysis(GCA)methods to analyze resting-state functional magnetic resonance imaging(rs-fMRI)data,aiming to explore the topological alterations in the brain networks of intensive care unit(ICU)sepsis survivors.Using correlation analysis,the interplay between topological property alterations and cognitive impairment was also investigated.AIM To explore the topological alterations of the brain networks of sepsis survivors and their correlation with cognitive impairment.METHODS Sixteen sepsis survivors and nineteen healthy controls from the community were recruited.Within one month after discharge,neurocognitive tests were administered to assess cognitive performance.Rs-fMRI was acquired and the topological properties of brain networks were measured based on graph theory approaches.GCA was conducted to quantify effective connectivity(EC)between brain regions showing positive topological alterations and other regions in the brain.The correlations between topological properties and cognitive were analyzed.RESULTS Sepsis survivors exhibited significant cognitive impairment.At the global level,sepsis survivors showed lower normalized clustering coefficient(γ)and small-worldness(σ)than healthy controls.At the local level,degree centrality(DC)and nodal efficiency(NE)decreased in the right orbital part of inferior frontal gyrus(ORBinf.R),NE decreased in the left temporal pole of superior temporal gyrus(TPOsup.L)whereas DC and NE increased in the right cerebellum Crus 2(CRBLCrus2.R).Regarding directional connection alterations,EC from left cerebellum 6(CRBL6.L)to ORBinf.R and EC from TPOsup.L to right cerebellum 1(CRBLCrus1.R)decreased,whereas EC from right lingual gyrus(LING.R)to TPOsup.L increased.The implementation of correlation analysis revealed a negative correlation between DC in CRBLCrus2.R and both Mini-mental state examination(r=-0.572,P=0.041)and Montreal cognitive assessment(MoCA)scores(r=-0.629,P=0.021)at the local level.In the CRBLCrus2.R cohort,a negative correlation was identified between NE and MoCA scores,with a statistically significant result of r=-0.633 and P=0.020.CONCLUSION Frontal,temporal and cerebellar topological property alterations are possibly associated with cognitive impairment of ICU sepsis survivors and may serve as biomarkers for early diagnosis.展开更多
Objective:To explore the effect of continuous positive airway pressure(CPAP)therapy on daytime sleepiness and cognitive function in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Met...Objective:To explore the effect of continuous positive airway pressure(CPAP)therapy on daytime sleepiness and cognitive function in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods:From January to December 2024,60 patients with moderate to severe OSAHS were enrolled and randomly divided into an observation group and a control group,with 30 patients in each group.The observation group received CPAP combined with routine intervention,while the control group only received routine intervention,with a course of 3 months for both groups.Results:After 3 months of intervention,the observation group showed significantly better improvements in the frequency and duration of daytime sleepiness as well as all dimensions of cognitive function compared with the control group,and the differences were statistically significant(P<0.05).Conclusion:CPAP therapy can effectively relieve daytime sleepiness in patients with moderate to severe OSAHS,and significantly improve memory,attention and logical thinking ability.The comprehensive intervention effect is superior to simple routine management.展开更多
基金supported by the Beijing Nova Program,Nos.20230484436,Z211100002121038the Chinese Institutes for Medical Research,No.CX23YQ01+1 种基金the NationalNatural Science Foundation of China,Nos.32100925,82027802Beijing-Tianjin-Hebei Basic Research Cooperation Project,No.22JCZXJC00190(all to XJand JL).
文摘Vascular cognitive impairment and dementia is a debilitating neurological disorder caused by chronic cerebral hypoperfusion,for which no effective causative treatments are currently available.Intermittent hypoxia has been shown to enhance cerebral blood flow in mice,but its efficacy in a model of vascular cognitive impairment and dementia remains unclear.In this study,we established a mouse model of vascular cognitive impairment and dementia by bilateral carotid artery stenosis.Intermittent hypoxia was induced before and after this stenosis.We found that intermittent hypoxia increased cerebral blood flow,oxygen saturation,and microcirculation in the prefrontal cortex and hippocampus in the model mice,without causing neurovascular damage.Additionally,intermittent hypoxia significantly improved cognitive function in the mouse model of vascular cognitive impairment and dementia,with perconditioning showing greater efficacy than preconditioning.Improvements in cerebral microcirculation and blood flow were positively correlated with cognitive recovery.Even in a mouse model of vascular cognitive impairment and dementia with comorbidities induced by a high-fat,high-fructose diet,intermittent hypoxic perconditioning demonstrated protective effects on cognitive function.Proteomic analysis indicated that mitochondrial protection is a key mechanism,particularly through upregulating NDUFB8 expression and increasing the activity of mitochondrial complex I.These findings suggest that intermittent hypoxia is a potential non-invasive strategy for the prevention and treatment of vascular cognitive impairment and dementia.
文摘Astrocytes,a major class of glial cells,have emerged as crucial regulators of synaptic function,neuronal homeostasis,and cognitive processes(Cabral-Miranda et al.,2024).These star-shaped cells not only provide structural and metabolic support to neurons but also actively participate in modulating synaptic transmission,neurovascular coupling,and inflammatory responses in the brain.
基金supported by the National Natural Science Foundation of China,No.82201626(to CC)the Natural Science Foundation of LiaoningProvince,No.2022-MS-442(to CC)the Dalian Municipal Medical Key Specialty Climbing Project,No.2024ZZ040(to MZ).
文摘Cerebral small vessel disease is a major vascular contributor to cognitive impairment and dementia.However,there remains a lack of effective preventative or therapeutic regimens for cerebral small vessel disease.In this study,we investigated the potential therapeutic effects of MCC950,a selective NOD-like receptor family pyrin domain-containing protein 3 inhibitor,on cerebral small vessel disease pathogenesis and cognitive decline in spontaneously hypertensive rats.Our results showed that chronic administration of MCC950(10 mg/kg)to spontaneously hypertensive rats inhibited NOD-like receptor family pyrin domain-containing protein 3 inflammasome activation,thereby considerably suppressing the production of pyroptosis executive protein gasdermin D and pro-inflammatory factors,including interleukin-1βand-18.A decrease in astrocytic and microglial activation was also observed.We also found that MCC950 significantly inhibited autophagy.More importantly,behavioral assessment indicated that MCC950 administration ameliorated impaired neurocognitive function,which was associated with improvements in neuropathological hallmarks in the cerebral small vessel disease brain,such as blood‒brain barrier breakdown,white matter damage,and endothelial dysfunction.Thus,our findings revealed that the NOD-like receptor family pyrin domain-containing protein 3 inflammasome is a key contributor to the onset or progression of cerebral small vessel disease and suggested the potential of NOD-like receptor family pyrin domain-containing protein 3-based therapy as a potential novel strategy for treating cerebral small vessel disease.
文摘Impairments on body function,activities of daily living(ADL)and cognition are common after stroke.Eccentric resistance training(ERT)may be implemented to improve them.The primary objectives were to evaluate whether ERT improves body function,ADL and cognition after stroke.The secondary objectives were to evaluate whether ERT improves strength,gait,quality of life,and self-perceived health.Seven electronic databases were searched:Cochrane Central Register of Controlled Trials,Cochrane Stroke Group Trials Register,PubMed,Epistemonikos,Embase,SPORTDiscus,and WHO International Clinical Trials Registry Platform.Last search was run in December 2023,including studies since 2012.Selection criteria were studies with stroke participants of both sexes,aged 18 or more,with an intervention based on ERT.Accepted languages were English,Spanish or French.First search was done in pairs.Authors removed duplicate studies and those which did not meet inclusion criteria through title and abstracts.Finally,all authors,independently,screened the final search results and extracted data.Of 68 records identified,15 were eligible and 6 were finally included(with moderate risk of bias),analyzing 159 participants.Body function(4 interventions,n=84),gait(4 interventions,n=115)and strength(3 interventions,n?78)showed significantly better results when ERT was performed.Meta-analysis could not be done because of the few studies and their heterogeneity.This review provided low-moderate quality evidence suggesting that ERT might be effective at improving body function,strength,and gait after stroke.Besides,no harm was documented,and it was well-accepted.
文摘This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.
文摘BACKGROUND Mild cognitive impairment(MCI)has a high risk of progression to Alzheimer’s disease.The disease is often accompanied by sleep disorders,and whether sleep disorders have an effect on brain function in patients with MCI is unclear.AIM To explore the near-infrared brain function characteristics of MCI with sleep disorders.METHODS A total of 120 patients with MCI(MCI group)and 50 healthy subjects(control group)were selected.All subjects underwent the functional near-infrared spec-troscopy test.Collect baseline data,Mini-Mental State Examination,Montreal Cognitive Assessment scale,fatigue severity scale(FSS)score,sleep parameter,and oxyhemoglobin(Oxy-Hb)concentration and peak time of functional near-infrared spectroscopy test during the task period.The relationship between Oxy-RESULTS Compared with the control group,the FSS score of the MCI group was higher(t=11.310),and the scores of Pittsburgh sleep quality index,sleep time,sleep efficiency,nocturnal sleep disturbance,and daytime dysfunction were higher(Z=-10.518,-10.368,-9.035,-10.661,-10.088).Subjective sleep quality and total sleep time scores were lower(Z=-11.592,-9.924).The sleep efficiency of the MCI group was lower,and the awakening frequency,rem sleep latency period,total sleep time,and oxygen desaturation index were higher(t=5.969,5.829,2.887,3.003,5.937).The Oxy-Hb concentration at T0,T1,and T2 in the MCI group was lower(t=14.940,11.280,5.721),and the peak time was higher(t=18.800,13.350,9.827).In MCI patients,the concentration of Oxy-Hb during T0 was negatively correlated with the scores of Pittsburgh sleep quality index,sleep time,total sleep time,and sleep efficiency(r=-0.611,-0.388,-0.563,-0.356).It was positively correlated with sleep efficiency and total sleep time(r=0.754,0.650),and negatively correlated with oxygen desaturation index(r=-0.561)and FSS score(r=-0.526).All comparisons were P<0.05.CONCLUSION Patients with MCI and sleep disorders have lower near-infrared brain function than normal people,which is related to sleep quality.Clinically,a comprehensive assessment of the near-infrared brain function of patients should be carried out to guide targeted treatment and improve curative effect.
基金supported by the National Natural Science Foundation of China(grant number:72304153)the Supporting Project of National Natural Science Foundation of China from Nanjing University of Chinese Medicine,China,(grant number:XPT72304153)the University Philosophy and Social Science Research in Jiangsu Province Jiangsu Province,China(grant number:2023SJYB0318)。
文摘Objectives:This prospective cohort study examined the change trajectories of cognitive and physical functions of individuals with motoric cognitive risk(MCR)syndrome,as well as the longitudinal associations between MCR syndrome and changes in cognitive and physical functions,to provide a new perspective on preventing dementia.Methods:Participants were selected from the China Health and Retirement Longitudinal Study(CHARLS).Demographic characteristics,health status,and lifestyle variables were assessed in 2011.MCR syndrome was defined as the presence of subjective cognitive complaints and objective slow gait,with preserved activities of daily living and absence of dementia,and assessed in 2011.Cognitive function,including orientation,attention and calculation,episodic memory,and visuospatial ability,was measured from 2011 to 2018.Physical function,including grip strength,balance ability,and repeated chair stand tests,was measured from 2011 to 2015.Generalized estimating equation was employed to analyze the longitudinal associations between MCR syndrome in 2011 and changes in cognitive functions over 7 years and physical functions over 4 years.Results:Among 4,217 participants,475 had MCR syndrome in 2011.Both participants with MCR syndrome and those without exhibited a decline in both cognitive and physical function over 7 years and 4 years of follow-up,except for fluctuations in visuospatial ability.Non-MCR syndrome participants demonstrated significantly better overall cognitive function in 2018 compared to 2011(Group×Time:B=0.44,P=0.035)than those in the MCR syndrome group.However,participants with non-MCR syndrome demonstrated significantly worse visuospatial ability in 2013(Group×time:B=−0.44,P=0.002)and 2018(Group×time:B=−0.34,P=0.016)compared to those in the MCR syndrome group.Non-MCR syndrome participants demonstrated significantly better performance in repeated chair stand tests in 2013(Group×time:B=0.31,P<0.001)and 2015(Group×time:B=0.37,P<0.001)compared to those in the MCR syndrome group in 2011.Conclusions:Older adults with MCR syndrome experience worse overall cognitive and physical function performance,especially in repeated chair stand tests,than individuals without MCR syndrome over 7-year and 4-year follow-up periods.It is suggested that future interventional studies will target both physical and cognitive functions in MCR syndrome individuals,providing insights for the prevention of dementia.
基金supported by the Shanghai New Three-year Action Plan for Public Health(Grant No.GWV-10.1-XK16)the US National Institute on Aging(RO1-AGO34479).
文摘In 2019,China had over 13.14 million dementia cases,with incidence rates of(56.47–207.08)/100,000[1].Early cognitive impairment—a key dementia symptom—reduces quality of life,increases care dependence,and lowers survival in older adults[2].A decline in physical function can also be observed in older adults with increasing age.Grip strength has been shown to be a marker of overall physiological function in older adults.
文摘BACKGROUND Mild cognitive impairment(MCI)is a high-risk precursor to Alzheimer’s disease characterized by declining memory or other progressive cognitive functions without compromising daily living abilities.AIM To investigate the efficacy of repetitive transcranial magnetic stimulation(rTMS)in patients with MCI.METHODS This retrospective analysis involved 180 patients with MCI who were admitted to The First Hospital of Shanxi Medical University from January 2021 to June 2023.Participants were allocated into the research(n=98,receiving rTMS)and control groups(n=82,receiving sham stimulation).Memory tests,cognitive function assessments,event-related potential–P300 tests,and electroencephalogram(EEG)examinations were conducted pre-treatment and post-treatment.Further,memory quotient(MQ),cognitive function scores,and EEG grading results were compared,along with adverse reaction incidences.RESULTS Pre-treatment MQ scores,long-term and short-term memory,as well as immediate memory scores,demonstrated no notable differences between the groups.Post-treatment,the research group exhibited significant increases in MQ scores,long-term memory,and short-term memory compared to baseline(P<0.05),with these improvements being statistically superior to those in the control group.However,immediate memory scores exhibited no significant change(P>0.05).Further,the research group demonstrated statistically better post-treatment scores on the Revised Wechsler Memory Scale than the control group.Furthermore,post-treatment P300 latency and amplitude improved significantly in the research group,surpassing the control group.EEG grading in the research group improved,and the incidence of adverse reactions was significantly lower than in the control group.CONCLUSION Patients with MCI receiving rTMS therapy demonstrated improved memory and cognitive functions and EEG grading and exhibited high safety with fewer adverse reactions.
基金Supported by Liaoning Provincial Natural Science Foundation,No.2022-MS-430Shenyang Science and Technology Bureau Project,No.22-321-33-56Shenyang Municipal Health Commission Project,No.2022006.
文摘BACKGROUND There is no effective treatment for Alzheimer's disease(AD),and pharmacological treatment of AD in clinical settings is expensive and prolonged,resulting in a huge psychological and economic burden on the patient's family and caregivers and society as a whole,AD is characterized by progressive,worsening cognitive impairment,and there are currently no drugs that can effectively reverse cognitive impairment.However,it is important to intervene early or delay cognitive impairment so that the condition can be delayed and,ultimately,the burden on patients and families can be reduced through maintenance treatment.It may be that non-pharmacological interventions such as cognitive stimulation therapy(CST)can help with cognitive dysfunction.AIM To provide a better treatment plan for AD patients and delay the deterioration of cognitive function,the effect of CST on cognitive function in AD was studied by Meta-analysis.METHODS Comprehensive search the Chinese and English databases were comprehensively searched by computer.Chinese databases:China Biomedical Literature Database(CBM),Wanfang Database,VIP Database,and China Periodicals Full-text Database(CNKI).The collection time limit is from July 21,2010 to July 21,2022 randomized controlled trials literature on the effects of CST on cognitive function in patients with AD.According to the inclusion and exclusion criteria,literature screening,data extraction,and quality evaluation were performed.Standardized mean difference(SMD)and 95%CI were used as evaluation criteria to evaluate the cognitive function of CST in AD patients.Sensitivity analysis and publication bias detection were performed on the results.Publication bias was assessed using funnel plots,and funnel plot symmetry was assessed with Eggr's test.RESULTS CST can not improve Mental State Examination Scale(MMSE)scores in AD patients.Meta-analysis of CST on MMSE scores showed that the heterogeneity was P=0.14,I2=35%.I2=35%<50%,and the Q test P>0.1,choose the random effect model to integrate statistics,get SMD=0.02,95%CI:-0.37,0.42,P>0.05.Meta-analysis of CST on AD Cognitive Functioning Assessment Scale scores showed that the heterogeneity was P=0.13,I2=36%.I2=36%<50 choose a fixed effect model to integrate statistics,get SMD=-0.01,95%CI:-0.40,0.39,P>0.05,the difference is not statistically significant.Meta-analysis of CST on the cognitive function indicators of patients showed that the heterogeneity was P=0.17,I2=31%.I2=31%<50%,the fixed effect model showed SMD=0.01,95%CI:-0.37,0.38,P>0.05,the difference was not statistically significant.CONCLUSION CST may not improve the cognitive function of AD patients,not improve the cognitive function of AD patients,not improve the ability of daily living,and not reduce mental behavior can improve the cognitive function of AD patients.
基金supported by the National Natural Science Foundation of China(No.82270316)the Beijing Municipal Commission of Science and Technology(Z24-1100007724008).
文摘BACKGROUND Mild cognitive impairment(MCI)is common in atrial fibrillation(AF)patients and may develop earlier in those with multiple cardiovascular comorbidities,potentially impairing self-management and treatment adherence.This study aimed to characterize the prevalence and profile of MCI in AF patients,examine its associations with cardiovascular comorbidities,and assess how these comorbidities influence specific cognitive domains.METHODS This cross-sectional study analyzed data from AF patients who underwent cognitive assessment between 2017 and 2021.Cognitive status was categorized as MCI or non-MCI based on the Montreal Cognitive Assessment.Associations between comorbidities and MCI were assessed by logistic regression,and cognitive domains were compared using the Mann-Whitney U test.RESULTS Of 4136 AF patients(mean age:64.7±9.4 years,64.7%male),33.5%of patients had MCI.Among the AF patients,31.2%of patients had coronary artery disease,20.1%of patients had heart failure,and 18.1%of patients had hypertension.88.7%of patients had left atrial enlargement,and 11.0%of patients had reduced left ventricular ejection fraction.Independent factors associated with higher MCI prevalence included older age(OR=1.04,95%CI:1.03-1.05,P<0.001),lower education level(OR=1.51,95%CI:1.31-1.73,P<0.001),hypertension(OR=1.28,95%CI:1.07-1.52,P=0.001),heart failure(OR=1.24,95%CI:1.04-1.48,P=0.020),and lower left ventricular ejection fraction(OR=1.43,95%CI:1.04-1.98,P=0.028).A higher CHA_(2)DS_(2)-VASc score(OR=1.27,95%CI:1.22-1.33,P<0.001;≥2 points vs.<2 points),and greater atherosclerotic cardiovascular disease burden(OR=1.45,95%CI:1.02-2.08,P=0.040;2 types vs.0 type)were linked to increased MCI risk.These above factors influenced various cognitive domains.CONCLUSIONS MCI is common in AF and closely associated with cardiovascular multimorbidity.Patients with multiple comorbidities are at higher risk,highlighting the importance of routine cognitive assessment to support self-management and integrated care.
基金Supported by Hunan Provincial Scientific Research Plan Project of Traditional Chinese MedicineNational Natural Science Foundation of China,No.82371521Special Tasks for the Construction of Hunan Innovative Province,No.2023SK4002.
文摘BACKGROUND Many patients with coronavirus disease 2019(COVID-19)may experience emotional issues and cognitive impairment.However,it remains unclear whether the brain mediates the impact of COVID-19 on the emergence of psychopathological symptoms.It remains unclear whether anxiety and depression are caused by stressors or viral infection.AIM To use functional near-infrared spectroscopy(fNIRS)to detect cortical hemodynamic changes in patients with COVID-19 and their relationship with mental symptoms(mainly depression and anxiety),to investigate whether COVID-19 causes these changes by affecting brain function.METHODS A total of 58 subjects,comprising 29 patients with first acute COVID-19 infection and 29 healthy controls without COVID-19 infection and without anxiety or depression were recruited.Then cortical activation during the performance of the verbal fluency test(VFT)and brain connectivity during the resting state(rs)were evaluated by 53-channel fNIRS.For the COVID-19-infected group,Patient Health Questionnaire-9(PHQ-9)and General Anxiety Disorder-7(GAD-7)were used to assess the emotional state before fNIRS measures.RESULTS For the rs,compared to the uninfected group,the infected group exhibited lower rs functional connectivity(FC)in the dorsolateral prefrontal cortex(DLPFC),which was correlated with both the PHQ score and GAD score.During the VFT,the infected group exhibited significantly lower cortical activation than the uninfected group in both Broca-left and Broca-right.Besides,the integral value in the DLPFC-L showed a significant negative correlation with the PHQ-9 score during the VFT in the infected group.CONCLUSION There were significant differences in the bilateral Broca area and DLPFC between the COVID-19-infected and uninfected groups,which may be the reason why COVID-19 infection impairs cognitive function and language function and leads to psychiatric symptoms.In addition,the rsFC in patients with COVID-19 was positively correlated with the severity of depression and anxiety,which may be related to the fact that the mental symptoms of patients with COVID-19 are characterized by depression and anxiety,rather than depression or anxiety alone.Our study provides evidence that the psychological and emotional issues caused by COVID-19 are not only due to external social factors but also involve more direct brain neural mechanisms and abnormal neural circuits,which also provide insights into the future treatment and prognosis of individuals with COVID-19.
基金supported by a grant from Chung Shan Medical University(Grant No.:CSMUINT-109-06).
文摘Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.
文摘BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
基金supported by the National Key R&D Program of China(2020YFC2003102).
文摘Objective:To identify key factors influencing cognitive function in the elderly,including traditional Chinese medicine(TCM)constitutional classification,and to rank their relative importance.Methods:We used cross-sectional data from seven geographical regions across Chinese mainland.The Changsha version of the Montreal Cognitive Assessment was used to assess cognitive function.A“least absolute shrinkage and selection operator”(LASSO)model,multivariate linear regression analysis,and random forest(RF)model were used.Subgroup analyses were performed to examine the correlation between key TCM constitution types and cognitive function in different population subgroups.Results:A total of 24803 individuals aged 60 and above were included in the study.We selected 18 influential factors using the LASSO model.Higher education,being married,and having insurance were positively correlated with cognitive function in the elderly(all P<0.05).In contrast,poor sleep,vision impairment,hearing impairment,basic activities of daily living disability,instrumental activities of daily living disability,depression,hypertension,coronary heart disease,diabetes,stroke,yang-deficiency constitution(YADC),yin-deficiency constitution(YIDC),qi deficiency constitution(QDC),and blood stasis constitution(BSC)were negatively correlated with cognitive function(all P<0.05).YIDC and BSC affected all dimensions of cognitive function(all P<0.05).YADC mainly affected attention,language,abstraction(verbal analogies),memory,and orientation to time and place dimensions(P<0.001).QDC mainly affected language and abstraction(verbal analogies)dimensions(P<0.05).The negative correlations between BSC,YADC,YIDC,and QDC scores and cognitive function revealed statistically significant dif-ferences across most subgroups.The RF model identified education,BSC,and poor sleep quality as the three most influential factors in our study.Conclusion:BSC,YADC,YIDC,and QDC were associated with cognitive decline in the elderly.Our findings provide new perspectives and significant references for interventions for early-stage cognitive disorders.
基金supported in part by the Shandong Provincial Natural Science Foundation of China under Grant ZR2023ZD03 and ZR2024QF183in part by the Taishan Scholars Project Special Funds under Grant tsqn202312035.
文摘In current memristor-based neuromorphic computing research,several studies face the challenge of realizing only a single function at a time or having isolated functions.This limitation is particularly evident when simulating biological cognition,as the overall synergy between multiple cognitive functions is difficult to represent.In this work,a high-performance heterojunction memristor is presented at first.The memristor-based neural network and functional circuit are further implemented to realize and integrate multiple cognitive functions.Specifically,the proposed photoelectric memristor has the structure of Ag/ZnO-SnO_(2)/WO_(3-x)/ITO,it exhibits various synaptic behaviors under external modulations,which are characterized by good stability and repeatability.Based on this device,a neural network is built to realize the basic recognition function in biological cognition.The recognition results are translated into different labelled voltage signals and subsequently fed into a memristor-based functional circuit.By leveraging memory characteristics and tunable conductance of the memristor,and controlling the specific circuit functionalities,the input signals are processed to produce different outputs representing various cognitive functions.This methodology allows the realization and integration of recognition,memory,learning,association,relearning,and forgetting into one single system,thereby enabling a more comprehensive and authentic simulation of biological cognition.This work presents a novel memristor and a method for achieving and integrating multiple neuromorphic computing functions within a single system,providing a successful example for achieving complete biological function.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Plan Project,No.2023ZL460Zhejiang Province Traditional Chinese Medicine Modernization Special Project,No.2021ZX011。
文摘BACKGROUND Mild cognitive impairment(MCI)is a transitional state between normal aging and Alzheimer's disease(AD),characterized by subtle cognitive decline.Amnestic MCI(aMCI),in particular,is a critical precursor often progressing to AD.There is growing interest in understanding the neuroanatomical correlates of aMCI,especially the role of gray matter volume(GMV)in cognitive and motor function decline.This study hypothesized that aMCI patients will exhibit reduced GMV,particularly in brain regions associated with cognition and motor control,impacting both cognitive performance and motor abilities.AIM To investigate the association of GMV with cognitive and motor functions in aMCI.METHODS In this cross-sectional study conducted from March 2022 to March 2024,45 aMCI patients and 45 normal controls from our Department of Geratology were enrolled.Voxel-based morphometry was used to compare GMV between groups.Correlation of differential GMV with cognitive scores and gait parameters was assessed via partial correlation analysis.Linear regression was used to assess associations between whole-brain GMV and gait measures.RESULTS GMV of aMCI region of interest(ROI)1 and ROI2 was negatively correlated with Activities of Daily Living(ADL)score.GMV of ROI6 was positively correlated with the total scores of Mini-Mental State Examination and Cambridge Cognitive Examination-Chinese Version(CAMCOG-C)and negatively correlated with ADL score.In the partial correlation analysis of cognitive and motor function parameters,age,gender,educational level,height,and weight were controlled,and the results showed that CAMCOG-C was negatively correlated with Dual Task of Time Up and Go Test(TUG)duration in the aMCI group.The volume of the left occipital gray matter in the aMCI group was negatively correlated with TUG.GMV of the bilateral frontal gyrus,right orbitofrontal gyrus,right occipital cleft,right supraoccipital gyrus,and left anterior central gyrus was positively correlated with walking speed.CONCLUSION GMV reduction in aMCI correlates with impaired cognition and motor function,emphasizing key roles for prefrontal,occipital,and central regions in gait disorders.
文摘Objective:To explore the effect of cognitive intervention combined with aerobic limb rehabilitation exercise on neurological and limb functions in hemiplegic patients with hypertensive intracerebral hemorrhage.Methods:A prospective study was conducted with eighty-six hemiplegic patients with hypertensive intracerebral hemorrhage admitted to Taikang Xianlin Drum Tower Hospital from October 2021 to October 2023.The patients were randomly divided into a study group(43 cases)and a control group(43 cases).After 6 months of intervention,neurological function,motor and limb function,psychological state,and quality of life scores were compared between the two groups to assess the effects of the intervention.Results:After the intervention,neurological function indexes in the study group,including S100B protein,myelin basic protein and National Institutes of Health Stroke Scale score,were significantly lower than those in the control group(all P<0.05).In contrast,brain-derived neurotrophic factor and Mini-Mental State Examination scores were significantly higher in the study group(all P<0.05).Additionally,motor function,Barthel score,Fugl-Meyer score,and muscle strength(grades V and IV)were significantly higher in the study group compared to the control group(all P<0.05).Psychological resilience,including scores for toughness,optimism,and strength,as well as the total resilience score,were significantly higher in the study group(all P<0.05).Moreover,the Generic Quality of Life Inventory score was also significantly higher in the study group(P<0.05).Conclusion:Cognitive intervention combined with aerobic limb rehabilitation exercises can alleviate neurological damage in hemiplegic patients with hypertensive intracerebral hemorrhage,enhance muscle strength,promote limb and motor function recovery,and improve psychological state and quality of life.
基金Supported by National Natural Science Foundation of China,No.82372182,No.82172131,and No.U23A20421Training Project of the Leading Expert Team:"Jiyang Medical Elites",No.RC2023-004.
文摘BACKGROUND Sepsis is a life-threatening condition defined by organ dysfunction,triggered by a dysregulated host response to infection.there is limited published literature combining cognitive impairment with topological property alterations in brain networks in sepsis survivors.Therefore,we employed graph theory and Granger causality analysis(GCA)methods to analyze resting-state functional magnetic resonance imaging(rs-fMRI)data,aiming to explore the topological alterations in the brain networks of intensive care unit(ICU)sepsis survivors.Using correlation analysis,the interplay between topological property alterations and cognitive impairment was also investigated.AIM To explore the topological alterations of the brain networks of sepsis survivors and their correlation with cognitive impairment.METHODS Sixteen sepsis survivors and nineteen healthy controls from the community were recruited.Within one month after discharge,neurocognitive tests were administered to assess cognitive performance.Rs-fMRI was acquired and the topological properties of brain networks were measured based on graph theory approaches.GCA was conducted to quantify effective connectivity(EC)between brain regions showing positive topological alterations and other regions in the brain.The correlations between topological properties and cognitive were analyzed.RESULTS Sepsis survivors exhibited significant cognitive impairment.At the global level,sepsis survivors showed lower normalized clustering coefficient(γ)and small-worldness(σ)than healthy controls.At the local level,degree centrality(DC)and nodal efficiency(NE)decreased in the right orbital part of inferior frontal gyrus(ORBinf.R),NE decreased in the left temporal pole of superior temporal gyrus(TPOsup.L)whereas DC and NE increased in the right cerebellum Crus 2(CRBLCrus2.R).Regarding directional connection alterations,EC from left cerebellum 6(CRBL6.L)to ORBinf.R and EC from TPOsup.L to right cerebellum 1(CRBLCrus1.R)decreased,whereas EC from right lingual gyrus(LING.R)to TPOsup.L increased.The implementation of correlation analysis revealed a negative correlation between DC in CRBLCrus2.R and both Mini-mental state examination(r=-0.572,P=0.041)and Montreal cognitive assessment(MoCA)scores(r=-0.629,P=0.021)at the local level.In the CRBLCrus2.R cohort,a negative correlation was identified between NE and MoCA scores,with a statistically significant result of r=-0.633 and P=0.020.CONCLUSION Frontal,temporal and cerebellar topological property alterations are possibly associated with cognitive impairment of ICU sepsis survivors and may serve as biomarkers for early diagnosis.
文摘Objective:To explore the effect of continuous positive airway pressure(CPAP)therapy on daytime sleepiness and cognitive function in patients with moderate to severe obstructive sleep apnea-hypopnea syndrome(OSAHS).Methods:From January to December 2024,60 patients with moderate to severe OSAHS were enrolled and randomly divided into an observation group and a control group,with 30 patients in each group.The observation group received CPAP combined with routine intervention,while the control group only received routine intervention,with a course of 3 months for both groups.Results:After 3 months of intervention,the observation group showed significantly better improvements in the frequency and duration of daytime sleepiness as well as all dimensions of cognitive function compared with the control group,and the differences were statistically significant(P<0.05).Conclusion:CPAP therapy can effectively relieve daytime sleepiness in patients with moderate to severe OSAHS,and significantly improve memory,attention and logical thinking ability.The comprehensive intervention effect is superior to simple routine management.
