Traumatic brain injury involves complex pathophysiological mechanisms,among which oxidative stress significantly contributes to the occurrence of secondary injury.In this study,we evaluated hypidone hydrochloride(YL-0...Traumatic brain injury involves complex pathophysiological mechanisms,among which oxidative stress significantly contributes to the occurrence of secondary injury.In this study,we evaluated hypidone hydrochloride(YL-0919),a self-developed antidepressant with selective sigma-1 receptor agonist properties,and its associated mechanisms and targets in traumatic brain injury.Behavioral experiments to assess functional deficits were followed by assessment of neuronal damage through histological analyses and examination of blood-brain barrier permeability and brain edema.Next,we investigated the antioxidative effects of YL-0919 by assessing the levels of traditional markers of oxidative stress in vivo in mice and in vitro in HT22 cells.Finally,the targeted action of YL-0919 was verified by employing a sigma-1 receptor antagonist(BD-1047).Our findings demonstrated that YL-0919 markedly improved deficits in motor function and spatial cognition on day 3 post traumatic brain injury,while also decreasing neuronal mortality and reversing blood-brain barrier disruption and brain edema.Furthermore,YL-0919 effectively combated oxidative stress both in vivo and in vitro.The protective effects of YL-0919 were partially inhibited by BD-1047.These results indicated that YL-0919 relieved impairments in motor and spatial cognition by restraining oxidative stress,a neuroprotective effect that was partially reversed by the sigma-1 receptor antagonist BD-1047.YL-0919 may have potential as a new treatment for traumatic brain injury.展开更多
BACKGROUND Ischemic stroke(IS)survivors face an elevated risk of epileptic seizures,and recurrent seizures following the first episode often signal worsening functional outcomes.AIM To investigate risk factors associa...BACKGROUND Ischemic stroke(IS)survivors face an elevated risk of epileptic seizures,and recurrent seizures following the first episode often signal worsening functional outcomes.AIM To investigate risk factors associated with seizure recurrence after a first episode in patients with IS and explore their associations with cognitive function,anxiety,and depression.METHODS A total of 100 patients with IS admitted to Shaanxi Provincial People’s Hospital between January 2017 and January 2024 were enrolled in this study.After a 1-5-year follow-up,patients were categorized into recurrence(n=43)and nonrecurrence(n=57)groups.Their medical records were collected and analyzed using univariate and multivariate analyses to determine potential predictors of seizure recurrence.Variables with statistical significance in the univariate analysis were incorporated into a binary logistic regression model for multivariate analysis.The risk model’s predictive performance was evaluated using the receiver operating characteristic curve.How independent risk factors,identified in multivariate analysis,related to cognitive[Montreal Cognitive Assessment(MoCA)]and emotional[Self-Rating Anxiety Scale(SAS)/Self-Rating Depression Scale(SDS)]outcomes,were assessed.RESULTS Recurrent seizures were significantly associated with age,stroke severity(National Institutes of Health Stroke Scale),late-onset seizures,electroenceph-alogram abnormalities,cortical involvement,hemorrhagic infarction,and extensive cerebral infarctions,with lateonset seizures,cortical involvement,and hemorrhagic infarction serving as independent predictors.The risk model revealed an area under the curve of 0.732,with 88.37%specificity and 42.11%sensitivity.These three were also correlated with lower MoCA scores and higher SAS and SDS scores.CONCLUSION In patients with IS,recurrent seizures after the first episode can be independently predicted by late-onset seizures,cortical involvement,and hemorrhagic cerebral infarction-factors also correlating with cognitive impairment and emotional distress.These findings underscore the need for close clinical monitoring and targeted interventions(e.g.,cognitive rehabilitation and psychological support)to mitigate seizure recurrence in high-risk individuals.展开更多
BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed ...BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed in patients with depression.AIM To investigate the relationship between Hcy,microbiome,and cognition in depressive patients.METHODS We recruited 67 patients with major depressive disorder(MDD)(MDD group)and 94 healthy controls(HCs)individuals(HCs group).Serum Hcy levels were determined using the enzyme circulation method.16s rRNA sequencing was used to classify and identify the fecal bacteria.17 Hamilton depression rating scale and MATRICS consensus cognitive battery were used to evaluate mood states and cognition in patients with MDD. Correlation analysis was performed to explore the correlation between fecal flora,Hcy, and depressive cognitive function.RESULTSElevated serum levels of Hcy were seen in patients with MDD compared to healthy individuals. Patients withMDD indicated significant decreases in cognitive scores (P < 0.001) in six modules: Speed of processing, workingmemory, visual learning, reasoning and problem-solving, social cognition, and total scores. Hcy levels showed anegative correlation with processing speed, social cognition, and total MDD scores (P < 0.05). Hcy was alsosignificantly negatively correlated with Alistipes, Ruminococcae, Tenericides, and Porphyromonas (P < 0.05).CONCLUSIONOur results highlight that Hcy was correlated with cognition and gut microbiome in MDD. This interaction may berelated to the physiological and pathological mechanisms underlying cognitive deficits in depression.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 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 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
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 Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus(T2DM);however,the association between hippocampal subregion volu...BACKGROUND Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus(T2DM);however,the association between hippocampal subregion volume changes and cognitive decline in different dimensions remains unclear.AIM To investigate changes in hippocampal subregion volumes in patients with T2DM and their relationship with cognitive function impairment.METHODS Sixty patients with T2DM and 32 healthy controls were recruited.All participants underwent a 3.0 T magnetic resonance scan and a series of clinical assessments.Hippocampal subfield volumes were determined using FreeSurfer 7.4.1.A two-sample t-test was used to evaluate group differences.Partial correlation analysis was performed to assess the relationship between hippocampal subregion volumes and cognitive function.aP<0.05 was considered statistically significant.RESULTS Compared with controls,the volume of right hippocampus-amygdala transition area(t=-3.053,P=0.003)in patients with T2DM was significantly reduced,which was negatively correlated with the required time of the Trail Making Test(TMT)-A(r=-0.331,P=0.028)and TMT-B(r=-0.402,P=0.007)and positively correlated with the scores of Symbol Digit Modalities Test(r=0.381,P=0.011),Auditory Verbal Learning Test(AVLT)-N7(r=0.309,P=0.041),and Digital Span Test(r=0.300,P=0.048).The volume of the right molecular layer(t=-2.998,P=0.004)was also significantly reduced,which was positively associated with the scores of AVLT-N7(r=0.311,P=0.045).In addition,the left hippocampal fissure volume(t=3.617,P=0.002)was significantly increased in patients with T2DM.CONCLUSION Declines in cognitive performance,especially memory and executive function,are linked to changes in the volumes of the right hippocampus-amygdala transition area and right molecular layer in patients with T2DM.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
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: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 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
Cognitive dysfunction often occurs in Alzheimer’s disease,Parkinson’s disease,cerebrovascular disease,or other neurodegenerative diseases,and can significantly impact the life quality of patients and create serious ...Cognitive dysfunction often occurs in Alzheimer’s disease,Parkinson’s disease,cerebrovascular disease,or other neurodegenerative diseases,and can significantly impact the life quality of patients and create serious social,psychological,and economic burdens for individuals and their families.Numerous studies have confirmed that exercise can slow the decline in cognitive function through multiple pathways,in which fibronectin type III domain-containing protein 5(FNDC5)plays an important role.However,the current research on the modulation of FNDC5 by exercise and its ability to improve hippocampal cognitive function lacks a systematic and comprehensive understanding.Therefore,this review focuses on the latest research progress regarding the role of exercise-induced FNDC5 in cognitive function,systematically reviews the positive effects of FNDC5 on cognitive function impairment caused by various factors,and clarifies the specific mechanisms by which exerciseinduced FNDC5 improves cognitive function by inhibiting neuroinflammation and improving hippocampal neurogenesis and hippocampal synaptic plasticity.Based on the existing literature,we also identify the areas that require further research in this field.Overall,this review provides a theoretical basis for exercise-based prevention and improvement of cognitive function impairment.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
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
Mechanisms of animal learning and memory were traditionally studied without reference to niche-specific functional considerations. More recently, ecological demands have informed such investigations, most notably with...Mechanisms of animal learning and memory were traditionally studied without reference to niche-specific functional considerations. More recently, ecological demands have informed such investigations, most notably with respect to foraging in birds. In parallel, behavioural ecologists, primarily concerned with functional optimization, have begun to consider the role of mechanistic factors, including cognition, to explain apparent deviations from optimal predictions. In the present paper we discuss the application of laboratory-based constructs and paradigms of cognition to the real-world challenges faced by avian foragers. We argue that such applications have been handicapped by what we term the ＇paradigmatic assumption＇ - the assumption that a given laboratory paradigm maps well enough onto a congruent cognitive mechanism （or cognitive ability） to justify confiation of the two. We present evidence against the paradigmatic assumption and suggest that to achieve a profitable integration between function and mechanism, with respect to animal cognition, a new conceptualization of cognitive mechanisms - functional cogni- tion - is required. This new conceptualization should define cognitive mechanisms based on the informational properties of the animal＇s environment and the adaptive challenges faced. Cognitive mechanisms must be examined in settings that mimic the im- portant aspects of the natural environment, using customized tasks designed to probe defined aspects of the mechanisms＇ opera- tion. We suggest that this approach will facilitate investigations of the functional and evolutionary relevance of cognitive mecha- nisms, as well as the patterns of divergence, convergence and specialization of cognitive mechanisms within and between species .展开更多
BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surge...BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.展开更多
BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitiv...BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.展开更多
Patients with mild traumatic brain injury have a diverse clinical presentation,and the underlying pathophysiology remains poorly understood.Magnetic resonance imaging is a non-invasive technique that has been widely u...Patients with mild traumatic brain injury have a diverse clinical presentation,and the underlying pathophysiology remains poorly understood.Magnetic resonance imaging is a non-invasive technique that has been widely utilized to investigate neuro biological markers after mild traumatic brain injury.This approach has emerged as a promising tool for investigating the pathogenesis of mild traumatic brain injury.G raph theory is a quantitative method of analyzing complex networks that has been widely used to study changes in brain structure and function.However,most previous mild traumatic brain injury studies using graph theory have focused on specific populations,with limited exploration of simultaneous abnormalities in structural and functional connectivity.Given that mild traumatic brain injury is the most common type of traumatic brain injury encounte red in clinical practice,further investigation of the patient characteristics and evolution of structural and functional connectivity is critical.In the present study,we explored whether abnormal structural and functional connectivity in the acute phase could serve as indicators of longitudinal changes in imaging data and cognitive function in patients with mild traumatic brain injury.In this longitudinal study,we enrolled 46 patients with mild traumatic brain injury who were assessed within 2 wee ks of injury,as well as 36 healthy controls.Resting-state functional magnetic resonance imaging and diffusion-weighted imaging data were acquired for graph theoretical network analysis.In the acute phase,patients with mild traumatic brain injury demonstrated reduced structural connectivity in the dorsal attention network.More than 3 months of followup data revealed signs of recovery in structural and functional connectivity,as well as cognitive function,in 22 out of the 46 patients.Furthermore,better cognitive function was associated with more efficient networks.Finally,our data indicated that small-worldness in the acute stage could serve as a predictor of longitudinal changes in connectivity in patients with mild traumatic brain injury.These findings highlight the importance of integrating structural and functional connectivity in unde rstanding the occurrence and evolution of mild traumatic brain injury.Additionally,exploratory analysis based on subnetworks could serve a predictive function in the prognosis of patients with mild traumatic brain injury.展开更多
BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels pla...BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels play a crucial role in the psychopathology of SCZ.However,their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.AIM To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.METHODS The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ(SCZ group)and 80 healthy controls(HCs group)at the Huzhou Third Municipal Hospital between August 2021 and September 2023.ELISA was employed to measure the serum levels of interleukin(IL)-1β,IL-4,IL-6,IL-10,and BDNF.The Chinese brief cognitive test(C-BCT)and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.RESULTS Compared to the HC group,the SCZ group exhibited elevated IL-1βand IL-6 levels,decreased BDNF levels,and reduced C-BCT scores(all P<0.001).In SCZ,BDNF was negatively correlated with IL-6(r=-0.324,P<0.05).Information processing speed was negatively correlated with IL-6(r=-0.315,P<0.05)and positively with BDNF(r=0.290,P<0.05);attention,working memory,comprehensive ability,and executive function were negatively correlated with IL-1βand IL-6(all P<0.05)and positively with BDNF(all P<0.05).Multiple regression analysis showed IL-6 influenced C-BCT dimensions(β=-0.218 to-0.327,all P<0.05);attention and executive ability were influenced by IL-1β(β=-0.199 to-0.261,all P<0.05);comprehensive executive ability was influenced by BDNF(β=0.209,P<0.05).CONCLUSION Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.展开更多
基金supported by the National Natural Science Foundation of China,Nos.82204360(to HM)and 82270411(to GW)National Science and Technology Innovation 2030 Major Program,No.2021ZD0200900(to YL)。
文摘Traumatic brain injury involves complex pathophysiological mechanisms,among which oxidative stress significantly contributes to the occurrence of secondary injury.In this study,we evaluated hypidone hydrochloride(YL-0919),a self-developed antidepressant with selective sigma-1 receptor agonist properties,and its associated mechanisms and targets in traumatic brain injury.Behavioral experiments to assess functional deficits were followed by assessment of neuronal damage through histological analyses and examination of blood-brain barrier permeability and brain edema.Next,we investigated the antioxidative effects of YL-0919 by assessing the levels of traditional markers of oxidative stress in vivo in mice and in vitro in HT22 cells.Finally,the targeted action of YL-0919 was verified by employing a sigma-1 receptor antagonist(BD-1047).Our findings demonstrated that YL-0919 markedly improved deficits in motor function and spatial cognition on day 3 post traumatic brain injury,while also decreasing neuronal mortality and reversing blood-brain barrier disruption and brain edema.Furthermore,YL-0919 effectively combated oxidative stress both in vivo and in vitro.The protective effects of YL-0919 were partially inhibited by BD-1047.These results indicated that YL-0919 relieved impairments in motor and spatial cognition by restraining oxidative stress,a neuroprotective effect that was partially reversed by the sigma-1 receptor antagonist BD-1047.YL-0919 may have potential as a new treatment for traumatic brain injury.
文摘BACKGROUND Ischemic stroke(IS)survivors face an elevated risk of epileptic seizures,and recurrent seizures following the first episode often signal worsening functional outcomes.AIM To investigate risk factors associated with seizure recurrence after a first episode in patients with IS and explore their associations with cognitive function,anxiety,and depression.METHODS A total of 100 patients with IS admitted to Shaanxi Provincial People’s Hospital between January 2017 and January 2024 were enrolled in this study.After a 1-5-year follow-up,patients were categorized into recurrence(n=43)and nonrecurrence(n=57)groups.Their medical records were collected and analyzed using univariate and multivariate analyses to determine potential predictors of seizure recurrence.Variables with statistical significance in the univariate analysis were incorporated into a binary logistic regression model for multivariate analysis.The risk model’s predictive performance was evaluated using the receiver operating characteristic curve.How independent risk factors,identified in multivariate analysis,related to cognitive[Montreal Cognitive Assessment(MoCA)]and emotional[Self-Rating Anxiety Scale(SAS)/Self-Rating Depression Scale(SDS)]outcomes,were assessed.RESULTS Recurrent seizures were significantly associated with age,stroke severity(National Institutes of Health Stroke Scale),late-onset seizures,electroenceph-alogram abnormalities,cortical involvement,hemorrhagic infarction,and extensive cerebral infarctions,with lateonset seizures,cortical involvement,and hemorrhagic infarction serving as independent predictors.The risk model revealed an area under the curve of 0.732,with 88.37%specificity and 42.11%sensitivity.These three were also correlated with lower MoCA scores and higher SAS and SDS scores.CONCLUSION In patients with IS,recurrent seizures after the first episode can be independently predicted by late-onset seizures,cortical involvement,and hemorrhagic cerebral infarction-factors also correlating with cognitive impairment and emotional distress.These findings underscore the need for close clinical monitoring and targeted interventions(e.g.,cognitive rehabilitation and psychological support)to mitigate seizure recurrence in high-risk individuals.
基金Supported by the Wuxi Municipal Health Commission Youth Fund Project,No.Q202268Wuxi Scientific and technological breakthrough of“Light of the Taihu Lake”(Basic Research),No.K20221039+4 种基金Jiangsu Shuangchuang Doctoral Program,No.JSSCBS20221991Beijing Municipal Administration of Hospital Incubating Program,No.PX2023070 and No.PX2024072Capital’s Funds for Health Improvement and Research,No.SF2024-4-2134Beijing Hospitals Authority Youth Program,No.QML20232003the Top Talent Support Program for young and middle-aged people of Wuxi Health Committee,No.HB2023089.
文摘BACKGROUND Cognitive impairment is one of the common clinical manifestations of depression,causing negative distress to patients.Elevated homocysteine(Hcy)concentrations and gut microbiome dysfunction may be observed in patients with depression.AIM To investigate the relationship between Hcy,microbiome,and cognition in depressive patients.METHODS We recruited 67 patients with major depressive disorder(MDD)(MDD group)and 94 healthy controls(HCs)individuals(HCs group).Serum Hcy levels were determined using the enzyme circulation method.16s rRNA sequencing was used to classify and identify the fecal bacteria.17 Hamilton depression rating scale and MATRICS consensus cognitive battery were used to evaluate mood states and cognition in patients with MDD. Correlation analysis was performed to explore the correlation between fecal flora,Hcy, and depressive cognitive function.RESULTSElevated serum levels of Hcy were seen in patients with MDD compared to healthy individuals. Patients withMDD indicated significant decreases in cognitive scores (P < 0.001) in six modules: Speed of processing, workingmemory, visual learning, reasoning and problem-solving, social cognition, and total scores. Hcy levels showed anegative correlation with processing speed, social cognition, and total MDD scores (P < 0.05). Hcy was alsosignificantly negatively correlated with Alistipes, Ruminococcae, Tenericides, and Porphyromonas (P < 0.05).CONCLUSIONOur results highlight that Hcy was correlated with cognition and gut microbiome in MDD. This interaction may berelated to the physiological and pathological mechanisms underlying cognitive deficits in depression.
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.
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 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 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.
基金Supported by the Bethune Charitable Foundation,No.Z04JKM2022E035the Liyang City's 2023 Annual research and development Plan Follows Nanjing Project,No.LC2024001.
文摘BACKGROUND Increasing evidence has shown that hippocampal damage serves as a marker of early cognitive decline in patients with type 2 diabetes mellitus(T2DM);however,the association between hippocampal subregion volume changes and cognitive decline in different dimensions remains unclear.AIM To investigate changes in hippocampal subregion volumes in patients with T2DM and their relationship with cognitive function impairment.METHODS Sixty patients with T2DM and 32 healthy controls were recruited.All participants underwent a 3.0 T magnetic resonance scan and a series of clinical assessments.Hippocampal subfield volumes were determined using FreeSurfer 7.4.1.A two-sample t-test was used to evaluate group differences.Partial correlation analysis was performed to assess the relationship between hippocampal subregion volumes and cognitive function.aP<0.05 was considered statistically significant.RESULTS Compared with controls,the volume of right hippocampus-amygdala transition area(t=-3.053,P=0.003)in patients with T2DM was significantly reduced,which was negatively correlated with the required time of the Trail Making Test(TMT)-A(r=-0.331,P=0.028)and TMT-B(r=-0.402,P=0.007)and positively correlated with the scores of Symbol Digit Modalities Test(r=0.381,P=0.011),Auditory Verbal Learning Test(AVLT)-N7(r=0.309,P=0.041),and Digital Span Test(r=0.300,P=0.048).The volume of the right molecular layer(t=-2.998,P=0.004)was also significantly reduced,which was positively associated with the scores of AVLT-N7(r=0.311,P=0.045).In addition,the left hippocampal fissure volume(t=3.617,P=0.002)was significantly increased in patients with T2DM.CONCLUSION Declines in cognitive performance,especially memory and executive function,are linked to changes in the volumes of the right hippocampus-amygdala transition area and right molecular layer in patients with T2DM.
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 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 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 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 the Beijing Natural Science Foundation(No.7222115)the Central University Basic Scientific Research Business Fee Project(No.2023073),China.
文摘Cognitive dysfunction often occurs in Alzheimer’s disease,Parkinson’s disease,cerebrovascular disease,or other neurodegenerative diseases,and can significantly impact the life quality of patients and create serious social,psychological,and economic burdens for individuals and their families.Numerous studies have confirmed that exercise can slow the decline in cognitive function through multiple pathways,in which fibronectin type III domain-containing protein 5(FNDC5)plays an important role.However,the current research on the modulation of FNDC5 by exercise and its ability to improve hippocampal cognitive function lacks a systematic and comprehensive understanding.Therefore,this review focuses on the latest research progress regarding the role of exercise-induced FNDC5 in cognitive function,systematically reviews the positive effects of FNDC5 on cognitive function impairment caused by various factors,and clarifies the specific mechanisms by which exerciseinduced FNDC5 improves cognitive function by inhibiting neuroinflammation and improving hippocampal neurogenesis and hippocampal synaptic plasticity.Based on the existing literature,we also identify the areas that require further research in this field.Overall,this review provides a theoretical basis for exercise-based prevention and improvement of cognitive function impairment.
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 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.
文摘Mechanisms of animal learning and memory were traditionally studied without reference to niche-specific functional considerations. More recently, ecological demands have informed such investigations, most notably with respect to foraging in birds. In parallel, behavioural ecologists, primarily concerned with functional optimization, have begun to consider the role of mechanistic factors, including cognition, to explain apparent deviations from optimal predictions. In the present paper we discuss the application of laboratory-based constructs and paradigms of cognition to the real-world challenges faced by avian foragers. We argue that such applications have been handicapped by what we term the ＇paradigmatic assumption＇ - the assumption that a given laboratory paradigm maps well enough onto a congruent cognitive mechanism （or cognitive ability） to justify confiation of the two. We present evidence against the paradigmatic assumption and suggest that to achieve a profitable integration between function and mechanism, with respect to animal cognition, a new conceptualization of cognitive mechanisms - functional cogni- tion - is required. This new conceptualization should define cognitive mechanisms based on the informational properties of the animal＇s environment and the adaptive challenges faced. Cognitive mechanisms must be examined in settings that mimic the im- portant aspects of the natural environment, using customized tasks designed to probe defined aspects of the mechanisms＇ opera- tion. We suggest that this approach will facilitate investigations of the functional and evolutionary relevance of cognitive mecha- nisms, as well as the patterns of divergence, convergence and specialization of cognitive mechanisms within and between species .
文摘BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.
文摘BACKGROUND Propofol and sevoflurane are commonly used anesthetic agents for maintenance anesthesia during radical resection of gastric cancer.However,there is a debate concerning their differential effects on cognitive function,anxiety,and depression in patients undergoing this procedure.AIM To compare the effects of propofol and sevoflurane anesthesia on postoperative cognitive function,anxiety,depression,and organ function in patients undergoing radical resection of gastric cancer.METHODS A total of 80 patients were involved in this research.The subjects were divided into two groups:Propofol group and sevoflurane group.The evaluation scale for cognitive function was the Loewenstein occupational therapy cognitive assessment(LOTCA),and anxiety and depression were assessed with the aid of the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Hemodynamic indicators,oxidative stress levels,and pulmonary function were also measured.RESULTS The LOTCA score at 1 d after surgery was significantly lower in the propofol group than in the sevoflurane group.Additionally,the SAS and SDS scores of the sevoflurane group were significantly lower than those of the propofol group.The sevoflurane group showed greater stability in heart rate as well as the mean arterial pressure compared to the propofol group.Moreover,the sevoflurane group displayed better pulmonary function and less lung injury than the propofol group.CONCLUSION Both propofol and sevoflurane could be utilized as maintenance anesthesia during radical resection of gastric cancer.Propofol anesthesia has a minimal effect on patients'pulmonary function,consequently enhancing their postoperative recovery.Sevoflurane anesthesia causes less impairment on patients'cognitive function and mitigates negative emotions,leading to an improved postoperative mental state.Therefore,the selection of anesthetic agents should be based on the individual patient's specific circumstances.
基金supported by the National Natural Science Foundation of China,Nos.81671671(to JL),61971451(to JL),U22A2034(to XK),62177047(to XK)the National Defense Science and Technology Collaborative Innovation Major Project of Central South University,No.2021gfcx05(to JL)+6 种基金Clinical Research Cen terfor Medical Imaging of Hunan Province,No.2020SK4001(to JL)Key Emergency Project of Pneumonia Epidemic of Novel Coronavirus Infection of Hu nan Province,No.2020SK3006(to JL)Innovative Special Construction Foundation of Hunan Province,No.2019SK2131(to JL)the Science and Technology lnnovation Program of Hunan Province,Nos.2021RC4016(to JL),2021SK53503(to ML)Scientific Research Program of Hunan Commission of Health,No.202209044797(to JL)Central South University Research Program of Advanced Interdisciplinary Studies,No.2023Q YJC020(to XK)the Natural Science Foundation of Hunan Province,No.2022JJ30814(to ML)。
文摘Patients with mild traumatic brain injury have a diverse clinical presentation,and the underlying pathophysiology remains poorly understood.Magnetic resonance imaging is a non-invasive technique that has been widely utilized to investigate neuro biological markers after mild traumatic brain injury.This approach has emerged as a promising tool for investigating the pathogenesis of mild traumatic brain injury.G raph theory is a quantitative method of analyzing complex networks that has been widely used to study changes in brain structure and function.However,most previous mild traumatic brain injury studies using graph theory have focused on specific populations,with limited exploration of simultaneous abnormalities in structural and functional connectivity.Given that mild traumatic brain injury is the most common type of traumatic brain injury encounte red in clinical practice,further investigation of the patient characteristics and evolution of structural and functional connectivity is critical.In the present study,we explored whether abnormal structural and functional connectivity in the acute phase could serve as indicators of longitudinal changes in imaging data and cognitive function in patients with mild traumatic brain injury.In this longitudinal study,we enrolled 46 patients with mild traumatic brain injury who were assessed within 2 wee ks of injury,as well as 36 healthy controls.Resting-state functional magnetic resonance imaging and diffusion-weighted imaging data were acquired for graph theoretical network analysis.In the acute phase,patients with mild traumatic brain injury demonstrated reduced structural connectivity in the dorsal attention network.More than 3 months of followup data revealed signs of recovery in structural and functional connectivity,as well as cognitive function,in 22 out of the 46 patients.Furthermore,better cognitive function was associated with more efficient networks.Finally,our data indicated that small-worldness in the acute stage could serve as a predictor of longitudinal changes in connectivity in patients with mild traumatic brain injury.These findings highlight the importance of integrating structural and functional connectivity in unde rstanding the occurrence and evolution of mild traumatic brain injury.Additionally,exploratory analysis based on subnetworks could serve a predictive function in the prognosis of patients with mild traumatic brain injury.
基金Supported by Huzhou Public Welfare Research Project Social Development Category,No.2021GYB09,No.2021GY38,No.2019GY26 and No.2019GZB02.
文摘BACKGROUND The pathogenesis of cognitive impairment in schizophrenia(SCZ)remains unclear.Accumulating studies showed that inflammatory-immune dysregulation and altered brain derived neurotrophic factor(BDNF)levels play a crucial role in the psychopathology of SCZ.However,their association with cognitive dysfunction in first-episode SCZ patients has not been thoroughly investigated.AIM To explore the interaction effects between cognitive function and inflammatory cytokines and BDNF in first-episode SCZ.METHODS The current study is a cross-sectional case-control investigation that recruited 84 patients with first-episode SCZ(SCZ group)and 80 healthy controls(HCs group)at the Huzhou Third Municipal Hospital between August 2021 and September 2023.ELISA was employed to measure the serum levels of interleukin(IL)-1β,IL-4,IL-6,IL-10,and BDNF.The Chinese brief cognitive test(C-BCT)and the positive and negative syndrome scales were measured the severity of cognitive impairment and psychiatric symptoms.RESULTS Compared to the HC group,the SCZ group exhibited elevated IL-1βand IL-6 levels,decreased BDNF levels,and reduced C-BCT scores(all P<0.001).In SCZ,BDNF was negatively correlated with IL-6(r=-0.324,P<0.05).Information processing speed was negatively correlated with IL-6(r=-0.315,P<0.05)and positively with BDNF(r=0.290,P<0.05);attention,working memory,comprehensive ability,and executive function were negatively correlated with IL-1βand IL-6(all P<0.05)and positively with BDNF(all P<0.05).Multiple regression analysis showed IL-6 influenced C-BCT dimensions(β=-0.218 to-0.327,all P<0.05);attention and executive ability were influenced by IL-1β(β=-0.199 to-0.261,all P<0.05);comprehensive executive ability was influenced by BDNF(β=0.209,P<0.05).CONCLUSION Our findings suggested that interrelationships between immune dysfunction and neurotrophic deficiency might underlie the pathological mechanisms of cognitive impairments in first-episode SCZ patients.
