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
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
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
An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a cop...An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a copyrighted instrument and may not be used or reproduced in whole or in part,in any form or language,or by any means without the written permission of PAR(www.parinc.com).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 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
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
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
Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness ...Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive declin e in patients withcognitive dysfunction,especially in patients with dementia.Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.展开更多
Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of dai...Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of daily living(A),also known as ABC symptoms.Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis,comprehensive treatment,and prognosis of AD.To guide Chinese clinical practice for optimization of the comprehensive management of AD,in 2018,The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD.Based on a review of the evidence,the consensus summarizes the pathogenesis,pathological changes,clinical manifestations,evaluation,diagnosis,drug and non-drug treatment,and patient care for AD.Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients.The new consensus provides a feasible AD management process for clinicians.展开更多
Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment usi...Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment using DBS. While STN-DBS can significantly improve motor symptoms in PD patients, adverse cognitive effects have also been reported. The specific effects of STN-DBS on cognitive function and the related mechanisms remain unclear. Thus, it is imperative to identify the influence of STN-DBS on cognition and investigate the potential mechanisms to provide a clearer view of the various cognitive sequelae in PD patients. For this review, a literature search was performed using the following inclusion criteria： （1） at least 10 patients followed for a mean of at least 6 months after surgery since the year 2006; （2） pre- and postoperative cognitive data using at least one standardized neuropsychological scale; and （3） adequate reporting of study results using means and standard deviations. Of -170 clinical studies identified, 25 cohort studies （including 15 self-controlled studies, nine intergroup controlled studies, and one multi-center, randomized control experiment） and one meta- analysis were eligible for inclusion. The results suggest that the precise mechanism of the changes in cognitive function after STN-DBS remains obscure, but STN-DBS certainly has effects on cognition. In particular, a progressive decrease in verbal fluency after STN-DBS is consistently reported and although executive function is unchanged in the intermediate stage postoperatively, it tends to decline in the early and later stages. However, these changes do not affect the improvements in quality of life. STN-DBS seems to be safe with respect to cognitive effects in carefully-selected patients during a follow-up period from 6 months to 9 years.展开更多
Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this s...Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this study, we established rat models of middle cerebral artery occlusion/reperfusion.One day after modeling, a group of rats were treated with ELF-EMF(50 Hz, 1 mT) for 2 hours daily on 28 successive days.Our results showed that rats treated with ELF-EMF required shorter swimming distances and latencies in the Morris water maze test than those of untreated rats.The number of times the platform was crossed and the time spent in the target quadrant were greater than those of untreated rats.The number of BrdU~+/NeuN~+ cells, representing newly born neurons, in the hippocampal subgranular zone increased more in the treated than in untreated rats.Up-regulation in the expressions of Notch1, Hes1, and Hes5 proteins, which are the key factors of the Notch signaling pathway, was greatest in the treated rats.These findings suggest that ELF-EMF can enhance hippocampal neurogenesis of rats with cerebral ischemia, possibly by affecting the Notch signaling pathway.The study was approved by the Institutional Ethics Committee of Sichuan University, China(approval No.2019255A) on March 5, 2019.展开更多
[Objective] The research aimed to study the effects of microwave on the chick embryo development and the cognitive function of chickling. [Method] The microwave which was transmitted by the permatron and was 2 450 MHz...[Objective] The research aimed to study the effects of microwave on the chick embryo development and the cognitive function of chickling. [Method] The microwave which was transmitted by the permatron and was 2 450 MHz was used to simulate the microwave radiation source to radiate the hatching eggs until the chickling was hatched out. The disposable passive avoidance learning and RT-PCR were respectively used to detect the influences of microwave on the cognitive function of chickling and the expression amounts of NMDA receptor NR1 and NR2 subunits. [Result] After the microwave radiation,the avoidance rate of exposed group was significantly lower than that in the control group. Especially the avoidance rate of highest radiation intensity group was extremely significantly lower than that in the control group. Meanwhile,the body weights of two groups of chickling in the exposed group increased,and the hatching time in one group increased. Via RT-PCR analysis,the expression amount of NR2 subunit increased on the 10th day and the 15th day. The expression amount of NR1 subunit only decreased on the 15th day. [Conclusion] The microwave had the certain influence on the individual development. By changing the structure composition and function of NMDA receptor in the endbrain,the microwave made the self-regulation ability of chickling decline,which had the certain damage on the cognitive function.展开更多
Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarmi...Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the world.Brain and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and memory.DM affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal damage.Cognitive decline can further worsen diabetes care as DM is a disease largely self-managed by patients.Therefore,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this context.This evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.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
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.
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.
文摘An unauthorised version of the Chinese MMSE was used in this article by the authors without permission from the copyright owner,PAR.Necessary permission has now been retrospectively obtained from PAR.The MMSE is a copyrighted instrument and may not be used or reproduced in whole or in part,in any form or language,or by any means without the written permission of PAR(www.parinc.com).
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 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.
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.
基金financial support from the National Natural Science Foundation of Chinafunded by the National Natural Science Foundation of China(81871854)。
文摘Background:Exercise is a promising nonpharmacological therapy for cognitive dysfunction,but it is unclear which type of exercise is most effective.The objective of this study was to compare and rank the effectiveness of various exercise interventions on cognitive function in patients with mild cognitive impairment(MCI)or dementia and to examine the effects of exercise on the symptoms relevant to cognitive impairment.Methods:We searched PubMed,Web of Science,Embase,Cochrane Central Register of Controlled Trials,SPORTDiscus,and PsycInfo through September 2019 and included randomized controlled trials that examined the effectiveness of exercise interventions in patients with MCI or dementia.Primary outcomes included global cognition,executive cognition,and memory cognition.Secondary outcomes included activities of daily living,neuropsychiatric symptoms,and quality of life.Pairwise analyses and network meta-analyses were performed using a random effects model.Results:A total of 73 articles from 71 trials with 5606 participants were included.All types of exercise were effective in increasing or maintaining global cognition,and resistance exercise had the highest probability of being the most effective intervention in slowing the decrease in global cognition(standard mean difference(SMD)=1.05,95%confidence interval(95%CI):0.56-1.54),executive function(SMD=0.85,95%CI:0.21-1.49),and memory function(SMD=0.32,95%CI:0.01-0.63)in patients with cognitive dysfunction.Subgroup analyses for patients with MCI revealed different effects,and multicomponent exercise was most likely to be the optimal exercise therapy for preventing the decline of global cognition(SMD=0.99,95%CI:0.44-1.54)and executive function(SMD=0.72,95%CI:0.06-1.38).However,only resistance exercise showed significant effects on memory function for patients with MCI(SMD=0.35,95%CI:0.01-0.69).Exercise interventions also showed various effects on the secondary outcomes.Conclusion:Resistance exercise has the highest probability of being the optimal exercise type for slowing cognitive declin e in patients withcognitive dysfunction,especially in patients with dementia.Multicomponent exercise tends to be most effective in protecting global cognition and executive function in patients with MCI.
文摘Alzheimer's disease(AD)is the most common cognitive disorder in the elderly.Its main clinical manifestations are cognitive decline(C),behavioral and psychological symptoms(B),and a decline in the activities of daily living(A),also known as ABC symptoms.Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis,comprehensive treatment,and prognosis of AD.To guide Chinese clinical practice for optimization of the comprehensive management of AD,in 2018,The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD.Based on a review of the evidence,the consensus summarizes the pathogenesis,pathological changes,clinical manifestations,evaluation,diagnosis,drug and non-drug treatment,and patient care for AD.Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients.The new consensus provides a feasible AD management process for clinicians.
基金supported by National Natural Science Foundation of China(81071065)
文摘Deep brain stimulation （DBS） is an effective technique for treating Parkinson＇s disease （PD） in the middle and advanced stages. The subthalamic nucleus （STN） is the most common target for clinical treatment using DBS. While STN-DBS can significantly improve motor symptoms in PD patients, adverse cognitive effects have also been reported. The specific effects of STN-DBS on cognitive function and the related mechanisms remain unclear. Thus, it is imperative to identify the influence of STN-DBS on cognition and investigate the potential mechanisms to provide a clearer view of the various cognitive sequelae in PD patients. For this review, a literature search was performed using the following inclusion criteria： （1） at least 10 patients followed for a mean of at least 6 months after surgery since the year 2006; （2） pre- and postoperative cognitive data using at least one standardized neuropsychological scale; and （3） adequate reporting of study results using means and standard deviations. Of -170 clinical studies identified, 25 cohort studies （including 15 self-controlled studies, nine intergroup controlled studies, and one multi-center, randomized control experiment） and one meta- analysis were eligible for inclusion. The results suggest that the precise mechanism of the changes in cognitive function after STN-DBS remains obscure, but STN-DBS certainly has effects on cognition. In particular, a progressive decrease in verbal fluency after STN-DBS is consistently reported and although executive function is unchanged in the intermediate stage postoperatively, it tends to decline in the early and later stages. However, these changes do not affect the improvements in quality of life. STN-DBS seems to be safe with respect to cognitive effects in carefully-selected patients during a follow-up period from 6 months to 9 years.
基金supported by the National Natural Science Foundation of China,No.81201513 (to QG)。
文摘Extremely low frequency electromagnetic fields(ELF-EMF) can improve the learning and memory impairment of rats with Alzheimer's disease, however, its effect on cerebral ischemia remains poorly understood.In this study, we established rat models of middle cerebral artery occlusion/reperfusion.One day after modeling, a group of rats were treated with ELF-EMF(50 Hz, 1 mT) for 2 hours daily on 28 successive days.Our results showed that rats treated with ELF-EMF required shorter swimming distances and latencies in the Morris water maze test than those of untreated rats.The number of times the platform was crossed and the time spent in the target quadrant were greater than those of untreated rats.The number of BrdU~+/NeuN~+ cells, representing newly born neurons, in the hippocampal subgranular zone increased more in the treated than in untreated rats.Up-regulation in the expressions of Notch1, Hes1, and Hes5 proteins, which are the key factors of the Notch signaling pathway, was greatest in the treated rats.These findings suggest that ELF-EMF can enhance hippocampal neurogenesis of rats with cerebral ischemia, possibly by affecting the Notch signaling pathway.The study was approved by the Institutional Ethics Committee of Sichuan University, China(approval No.2019255A) on March 5, 2019.
基金Supported by Suzhou City Science and Technology Bureau Item(YJS0904)~~
文摘[Objective] The research aimed to study the effects of microwave on the chick embryo development and the cognitive function of chickling. [Method] The microwave which was transmitted by the permatron and was 2 450 MHz was used to simulate the microwave radiation source to radiate the hatching eggs until the chickling was hatched out. The disposable passive avoidance learning and RT-PCR were respectively used to detect the influences of microwave on the cognitive function of chickling and the expression amounts of NMDA receptor NR1 and NR2 subunits. [Result] After the microwave radiation,the avoidance rate of exposed group was significantly lower than that in the control group. Especially the avoidance rate of highest radiation intensity group was extremely significantly lower than that in the control group. Meanwhile,the body weights of two groups of chickling in the exposed group increased,and the hatching time in one group increased. Via RT-PCR analysis,the expression amount of NR2 subunit increased on the 10th day and the 15th day. The expression amount of NR1 subunit only decreased on the 15th day. [Conclusion] The microwave had the certain influence on the individual development. By changing the structure composition and function of NMDA receptor in the endbrain,the microwave made the self-regulation ability of chickling decline,which had the certain damage on the cognitive function.
文摘Several epidemiological studies have clearly identified diabetes mellitus(DM)as a major risk factor for cognitive dysfunction,and it is going to be a major public health issue in the coming years because of the alarming rise in diabetes prevalence across the world.Brain and neural tissues predominantly depend on glucose as energy substrate and hence,any alterations in carbohydrate metabolism can directly impact on cerebral functional output including cognition,executive capacity,and memory.DM affects neuronal function and mental capacity in several ways,some of which include hypoperfusion of the brain tissues from cerebrovascular disease,diabetes-related alterations of glucose transporters causing abnormalities in neuronal glucose uptake and metabolism,local hyper-and hypometabolism of brain areas from insulin resistance,and recurrent hypoglycemic episodes inherent to pharmacotherapy of diabetes resulting in neuronal damage.Cognitive decline can further worsen diabetes care as DM is a disease largely self-managed by patients.Therefore,it is crucial to understand the pathobiology of cognitive dysfunction in relation to DM and its management for optimal long-term care plan for patients.A thorough appraisal of normal metabolic characteristics of the brain,how alterations in neural metabolism affects cognition,the diagnostic algorithm for patients with diabetes and dementia,and the management and prognosis of patients when they have this dangerous combination of illnesses is imperative in this context.This evidence-based narrative with the backup of latest clinical trial reviews elaborates the current understanding on diabetes and cognitive function to empower physicians to manage their patients in day-to-day clinical practice.
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.
