BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential t...BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.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
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
Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.P...Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.Patients often experience profound psychological and social impacts,such as depression,anxiety,and cognitive impairment,affecting their quality of life.Rapid progression and high mortality necessitate timely intervention.Advances in neurosurgical techniques,including microscopic surgery and neuroendoscopy,offer distinct advantages.Microscopic surgery provides precision and direct visualization,while neuroendoscopy ensures minimally invasive access and reduced tissue trauma.Integrating these methods optimizes treatment efficacy and clinical outcomes.AIM To evaluate the impact of combined microscopic and neuroendoscopic techniques on psychological,cognitive outcomes,and quality of life in patients with ruptured intracranial aneurysms.METHODS The study focused on 189 patients with intracranial aneurysm rupture and hemorrhage from January 2020 to May 2024 as the objects of observation and analysis.They were randomly divided into a control group(treated with simple microscope surgery,n=94)and an observation group(treated with microscope combined with neuroendoscopy,n=95).The treatment effects of the two groups were observed,mainly including depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data.RESULTS Before treatment,the depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data of the two groups of patients at different time points were compared,and there was no statistically significant difference(P>0.05).After microscope combined with neuroendoscopy treatment,the study revealed that the observation group surpassed the control group in alleviating depression and anxiety,accelerating cognitive function recovery,and enhancing quality of life,with these differences being statistically significant(P<0.05).CONCLUSION Surgical treatment combined with microscopy and neuroendoscopy has a significant positive effect on the mental health,cognitive function and overall quality of life of patients with intracranial aneurysm rupture and bleeding,can shorten the operation time and treatment time,and provides a new strategic reference for clinical treatment.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
Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as t...Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.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 Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exerc...Background Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exercise(RE)interventions in older adults with mild cognitive impairment(MCI).Methods This study is a 6-month pilot three-arm randomised controlled trial.Eligible participants(n=108)were recruited and randomised to the AE group,RE group or control(CON)group with a 1:1:1 ratio.Interventions were delivered at home with remote supervision.We evaluated participants’global cognition,memory,executive function,attention,physical activity levels,physical performance and muscle strength of limbs at baseline,3 months(T1)and 6 months(T2)after randomisation.A linear mixed-effects model was adopted for data analyses after controlling for covariates.Tukey’s method was used for adjusting for multiple comparisons.Sensitivity analyses were performed after excluding individuals with low compliance rates.Results 15(13.89%)participants dropped out.The median compliance rates in the AE group and RE group were 67.31%and 93.27%,respectively.After adjusting for covariates,the scores of the Alzheimer’s Disease Assessment Scale-Cognitive subscale in the AE group decreased by 2.04(95%confidence interval(CI)−3.41 to−0.67,t=−2.94,p=0.004)and 1.53(95%CI−2.88 to−0.17,t=−2.22,p=0.028)points more than those in the CON group at T1 and T2,respectively.The effects of AE were still significant at T1(estimate=−1.70,95%CI−3.20 to−0.21,t=−2.69,p=0.021),but lost statistical significance at T2 after adjusting for multiple comparisons.As for executive function,the Stroop time interference in the RE group decreased by 11.76 s(95%CI−21.62 to−1.90,t=−2.81,p=0.015)more than that in the AE group at T2 after Tukey’s adjustment.No other significant effects on cognitive functions were found.Conclusions Both remotely supervised AE and RE programmes are feasible in older adults with MCI.AE has positive effects on global cognition,and RE improves executive function.展开更多
Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design...Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.展开更多
Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxan...Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxanthin monoester(AST-DHA)showed neuroprotection against AD pathology.However,its in-depth mechanism and autophagic responses in AD brains are poorly understood.Herein,SH-SY5Y cells overexpressing the Swedish mutation(K595N/M596L)of APP gene were established to preliminarily evaluate the actions of AST-DHA on reducing Aβ_(1-42)levels and regulating autophagy.In microglial BV2 cells,AST-DHA and free astaxanthin(F-AST)recovered p62 and LC3Ⅱ/Ⅰlevels,and restored autophagy flux by rescuing the late phase of microglial autophagy.Notably,autophagic inhibitor bafilomycin A1 blunted the abilities of AST-DHA to reduce Aβ_(1-42)and fibral Aβ,suggesting that AST-DHA probably promoted Aβclearance in a microglial autophagy-dependent manner.Further studies in APP/PS1 mice verified that dietary AST-DHA and F-AST promoted Aβphagocytosis via microglial autophagy.Significant decreases of Iba1 and p62 were observed around Aβplaque in the hippocampus and cortex using triple fluorescence staining.Furthermore,AST-DHA exhibited superior performance over F-AST in restoring autophagic dysfunction,ameliorating Aβburden and cognitive deficit.Our findings suggest a possible mechanism of AST-DHA in improving AD by which it restores microglial autophagy to facilitate cerebral Aβclearance.It supports the future application of AST-DHA as an autophagic regulator in maintaining brain function.展开更多
BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,eff...BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.展开更多
Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated it...Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.展开更多
BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid ...BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.展开更多
In current memristor-based neuromorphic computing research,several studies face the challenge of realizing only a single function at a time or having isolated functions.This limitation is particularly evident when sim...In current memristor-based neuromorphic computing research,several studies face the challenge of realizing only a single function at a time or having isolated functions.This limitation is particularly evident when simulating biological cognition,as the overall synergy between multiple cognitive functions is difficult to represent.In this work,a high-performance heterojunction memristor is presented at first.The memristor-based neural network and functional circuit are further implemented to realize and integrate multiple cognitive functions.Specifically,the proposed photoelectric memristor has the structure of Ag/ZnO-SnO_(2)/WO_(3-x)/ITO,it exhibits various synaptic behaviors under external modulations,which are characterized by good stability and repeatability.Based on this device,a neural network is built to realize the basic recognition function in biological cognition.The recognition results are translated into different labelled voltage signals and subsequently fed into a memristor-based functional circuit.By leveraging memory characteristics and tunable conductance of the memristor,and controlling the specific circuit functionalities,the input signals are processed to produce different outputs representing various cognitive functions.This methodology allows the realization and integration of recognition,memory,learning,association,relearning,and forgetting into one single system,thereby enabling a more comprehensive and authentic simulation of biological cognition.This work presents a novel memristor and a method for achieving and integrating multiple neuromorphic computing functions within a single system,providing a successful example for achieving complete biological function.展开更多
BACKGROUND Mild cognitive impairment(MCI)is a 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
Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a sign...Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.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
It is well known that appropriate aerobic exercise can effectively alleviate fatty liver and enhance brain function.The concept of multi-organ crosstalk coordinating disease progression has become the current research...It is well known that appropriate aerobic exercise can effectively alleviate fatty liver and enhance brain function.The concept of multi-organ crosstalk coordinating disease progression has become the current research hot topic.However,there remains an urgent need to elucidate its specific mechanisms.This study aimed to explore the impact of a high-fat diet(HFD)on liver health and cognitive function,and to further uncover the regulatory effect of aerobic exercise by liver-specific activating transcription factor 3(Atf3)knockout(ATF3cKO)mice in a“liver-brain”axis mode.The 5-week-old C57BL/6 and ATF3cKO mice were fed with HFD for 32 weeks,and sequentially subjected to aerobic exercise intervention at the 20th week for another 12 consecutive weeks.Meanwhile,C57BL/6 mice were provided with a normal diet as the control group.The functional parameters of liver and brain of all mice were assessed.Cognitive capacity of all mice was assessed by the Morris water maze(MWM).Inflammatory factors in the serum and brain of mice were quantified using enzyme-linked immunosorbent assay(ELISA),and the expression of inflammasomes was detected by immunohistochemistry(IHC).Additionally,the activation of nuclear factor-κB(NF-κB)and phosphoinositide 3-kinase(PI3K)signal pathways was analyzed by Western blotting.In this study,HFD impaired hepatic and brain functions,while aerobic exercise and liver-specific Atf3 knockout suppressed inflammatory factors in the peripheral circulation through hepatoprotective mechanisms,thereby attenuating cerebral inflammation and preserving neurological integrity,as well as mitigating HFD-induced cognitive decline.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
文摘BACKGROUND Cognitive frailty and depression are prevalent among the elderly,significantly impairing physical and cognitive functions,psychological well-being,and quality of life.Effective interventions are essential to mitigate these adverse effects and enhance overall health outcomes in this population.AIM To evaluate the effects of exercise-cognitive dual-task training on frailty,cognitive function,psychological status,and quality of life in elderly patients with cognitive frailty and depression.METHODS A retrospective study was conducted on 130 patients with cognitive frailty and depression admitted between December 2021 and December 2023.Patients were divided into a control group receiving routine intervention and an observation group undergoing exercise-cognitive dual-task training in addition to routine care.Frailty,cognitive function,balance and gait,psychological status,and quality of life were assessed before and after the intervention.RESULTS After the intervention,the frailty score of the observation group was(5.32±0.69),lower than that of the control group(5.71±0.55).The Montreal cognitive assessment basic scale score in the observation group was(24.06±0.99),higher than the control group(23.43±1.40).The performance oriented mobility assessment score in the observation group was(21.81±1.24),higher than the control group(21.15±1.26).The self-efficacy in the observation group was(28.27±2.66),higher than the control group(30.05±2.66).The anxiety score in the hospital anxiety and depression scale(HADS)for the observation group was(5.86±0.68),lower than the control group(6.21±0.64).The depression score in the HADS for the observation group was(5.67±0.75),lower than the control group(6.27±0.92).Additionally,the scores for each dimension of the 36-item short form survey in the observation group were higher than those in the control group,with statistically significant differences(P<0.05).CONCLUSION Exercise-cognitive dual-task training is beneficial for improving frailty,enhancing cognitive function,and improving psychological status and quality of life in elderly patients with cognitive frailty and depression.
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This article explored the application of dexmedetomidine(Dex),a highly selective alpha-2 agonist,in managing postoperative cognitive dysfunction(POCD)in elderly patients undergoing radical colon cancer surgery.Aging is associated with a progressive decline in physiological functions and an increased risk of adverse surgical outcomes,including POCD,which encompasses many neurocognitive disorders that manifest during the perioperative period.The aging population is at a higher risk for POCD,which can lead to prolonged hospital stays,delayed recovery,and increased healthcare costs.Dex has neuroprotective,opioid-sparing,and sympatholytic properties,which reduces the incidence and severity of POCD.Dex was introduced for sedation in patients receiving mechanical ventilation but has since been adopted in anesthesia due to its multifaceted benefits.Its appli-cation extends to sedation,analgesia,maintenance of anesthesia,and controlling delirium.Its neuroprotective and anti-inflammatory effects have been explored in managing POCD.This article discussed the broad range of patient and procedure-related risk factors for POCD.Early identification and intervention are crucial to prevent the progression of POCD,which can have severe physical,psychological,and economic consequences.The article underscored the importance of a mul-tidisciplinary approach in managing POCD,involving the optimization of comor-bidities,depth of anesthesia monitoring,hemodynamic stability,and cerebral oxygenation monitoring.
文摘Intracranial aneurysms,characterized by focal arterial wall dilation,pose significant neurosurgical challenges due to their potential for rupture and hemorrhage,leading to severe clinical outcomes,including fatality.Patients often experience profound psychological and social impacts,such as depression,anxiety,and cognitive impairment,affecting their quality of life.Rapid progression and high mortality necessitate timely intervention.Advances in neurosurgical techniques,including microscopic surgery and neuroendoscopy,offer distinct advantages.Microscopic surgery provides precision and direct visualization,while neuroendoscopy ensures minimally invasive access and reduced tissue trauma.Integrating these methods optimizes treatment efficacy and clinical outcomes.AIM To evaluate the impact of combined microscopic and neuroendoscopic techniques on psychological,cognitive outcomes,and quality of life in patients with ruptured intracranial aneurysms.METHODS The study focused on 189 patients with intracranial aneurysm rupture and hemorrhage from January 2020 to May 2024 as the objects of observation and analysis.They were randomly divided into a control group(treated with simple microscope surgery,n=94)and an observation group(treated with microscope combined with neuroendoscopy,n=95).The treatment effects of the two groups were observed,mainly including depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data.RESULTS Before treatment,the depression and anxiety scale scores,cognitive function assessment results and quality of life assessment data of the two groups of patients at different time points were compared,and there was no statistically significant difference(P>0.05).After microscope combined with neuroendoscopy treatment,the study revealed that the observation group surpassed the control group in alleviating depression and anxiety,accelerating cognitive function recovery,and enhancing quality of life,with these differences being statistically significant(P<0.05).CONCLUSION Surgical treatment combined with microscopy and neuroendoscopy has a significant positive effect on the mental health,cognitive function and overall quality of life of patients with intracranial aneurysm rupture and bleeding,can shorten the operation time and treatment time,and provides a new strategic reference for clinical treatment.
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 National Natural Science Foundation of China(82172018 and 62333002).
文摘Cognitive enhancement is essential for maintaining the quality of life in healthy individuals and improving the ability of those with mental impairments.In recent years,noninvasive neuromodulation techniques(such as transcranial magnetic stimulation,transcranial direct-current stimulation,and transcranial ultrasound stimulation)have shown significant potential in enhancing cognitive functions[1,2].Existing technologies are limited mainly to superficial cortical regions,with limited efficacy in targeting deep brain areas and inadequate methods for evaluating their modulatory effects.Selecting stimulation parameters(such as locus,depth,and intensity)and assessing the impact of neuromodulation remains incompletely understood.
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funded by the National Natural Science Foundation of China(81871854,72374014)the National Key R&D Program of China(2020YFC2008804)+1 种基金the Shanghai Jiao Tong University Young Talent Cultivation Program in Liberal Arts(2024QN041)the Shanghai Jiao Tong University School of Medicine:Nursing Development Program(SJTUHLXK2024).
文摘Background Evidence on the effects of different exercise interventions on cognitive function is insufficient.Aims To evaluate the feasibility and effects of remotely supervised aerobic exercise(AE)and resistance exercise(RE)interventions in older adults with mild cognitive impairment(MCI).Methods This study is a 6-month pilot three-arm randomised controlled trial.Eligible participants(n=108)were recruited and randomised to the AE group,RE group or control(CON)group with a 1:1:1 ratio.Interventions were delivered at home with remote supervision.We evaluated participants’global cognition,memory,executive function,attention,physical activity levels,physical performance and muscle strength of limbs at baseline,3 months(T1)and 6 months(T2)after randomisation.A linear mixed-effects model was adopted for data analyses after controlling for covariates.Tukey’s method was used for adjusting for multiple comparisons.Sensitivity analyses were performed after excluding individuals with low compliance rates.Results 15(13.89%)participants dropped out.The median compliance rates in the AE group and RE group were 67.31%and 93.27%,respectively.After adjusting for covariates,the scores of the Alzheimer’s Disease Assessment Scale-Cognitive subscale in the AE group decreased by 2.04(95%confidence interval(CI)−3.41 to−0.67,t=−2.94,p=0.004)and 1.53(95%CI−2.88 to−0.17,t=−2.22,p=0.028)points more than those in the CON group at T1 and T2,respectively.The effects of AE were still significant at T1(estimate=−1.70,95%CI−3.20 to−0.21,t=−2.69,p=0.021),but lost statistical significance at T2 after adjusting for multiple comparisons.As for executive function,the Stroop time interference in the RE group decreased by 11.76 s(95%CI−21.62 to−1.90,t=−2.81,p=0.015)more than that in the AE group at T2 after Tukey’s adjustment.No other significant effects on cognitive functions were found.Conclusions Both remotely supervised AE and RE programmes are feasible in older adults with MCI.AE has positive effects on global cognition,and RE improves executive function.
基金funded by National Natural Science Foundation of China (grant numbers 82270258,82100260)National Key Research&Development Prog ram of China (grant number 2020YFC2004800)。
文摘Background The relationship between glycated hemoglobin(HbA1c) and cognitive impairment in older adults with coronary heart disease(CHD) remains unclear.Methods The present study used a prospective cohort study design and included 3244 participants aged ≥ 65 years in Beijing,China. The Mini-Mental State Examination(MMSE) and Montreal Cognitive Assessment(MoCA) were used to assess cognitive function. Serum HbA1c was detected at admission. All patients were divided into high HbA1c group(≥ 6.5 mmol/L) and low HbA1c group(< 6.5 mmol/L) based on their HbA1c levels. Logistic regression analyses were used to evaluate the association between HbA1c and cognitive impairment.Results In this study of 3244 participants, 1201(37.0%) patients were in high HbA1c group and 2045(63.0%) patients were in a state of cognitive impairment. Logistic regression analyses demonstrated that HbA1c was an independent risk factor for cognitive impairment regardless of whether the HbA1c was a continuous or categorical variable(OR = 1.27, 95% CI: 1.15–1.40, P < 0.001;OR = 1.79, 95% CI: 1.41–2.26, P ≤ 0.001, respectively). The restricted cubic spline curve exhibited that the relationship between the HbA1c and cognitive impairment was linear(p for non-linear = 0.323, P < 0.001).Conclusion Elevated levels of HbA1c were associated with an increased risk of cognitive impairment in older patients with CHD. These insights could be used to improve the accuracy and sensitivity of cognitive screening in these patient populations.
基金supported by the National Natural Science Foundation of China(32302063)Shandong Provincial Natural Science Foundation(ZR2023QC130)。
文摘Autophagy directly regulates the amyloid beta-peptide(Aβ)clearance,and its dysfunction occurs in the early pathogenesis of Alzheimer's disease(AD).We previously reported that docosahexaenoic acid-acylated astaxanthin monoester(AST-DHA)showed neuroprotection against AD pathology.However,its in-depth mechanism and autophagic responses in AD brains are poorly understood.Herein,SH-SY5Y cells overexpressing the Swedish mutation(K595N/M596L)of APP gene were established to preliminarily evaluate the actions of AST-DHA on reducing Aβ_(1-42)levels and regulating autophagy.In microglial BV2 cells,AST-DHA and free astaxanthin(F-AST)recovered p62 and LC3Ⅱ/Ⅰlevels,and restored autophagy flux by rescuing the late phase of microglial autophagy.Notably,autophagic inhibitor bafilomycin A1 blunted the abilities of AST-DHA to reduce Aβ_(1-42)and fibral Aβ,suggesting that AST-DHA probably promoted Aβclearance in a microglial autophagy-dependent manner.Further studies in APP/PS1 mice verified that dietary AST-DHA and F-AST promoted Aβphagocytosis via microglial autophagy.Significant decreases of Iba1 and p62 were observed around Aβplaque in the hippocampus and cortex using triple fluorescence staining.Furthermore,AST-DHA exhibited superior performance over F-AST in restoring autophagic dysfunction,ameliorating Aβburden and cognitive deficit.Our findings suggest a possible mechanism of AST-DHA in improving AD by which it restores microglial autophagy to facilitate cerebral Aβclearance.It supports the future application of AST-DHA as an autophagic regulator in maintaining brain function.
基金Supported by Fuzhou Science and Technology Plan Project,No.2023-S-028.
文摘BACKGROUND Schizophrenia is commonly associated with comorbid depression,which exacerbates cognitive impairments and negatively impacts quality of life.Despite the high prevalence and burden of these comorbidities,effective treatment options,particularly for cognitive dysfunction,remain limited.AIM To evaluate the efficacy of computerized cognitive behavioral therapy(CCBT)with sertraline vs sertraline monotherapy in improving depressive symptoms,cognitive function,and quality of life in schizophrenia and depressive episodes.METHODS In this single-center,randomized controlled trial,68 adults[mean age(SD)=36.5(10.0),57.4%male]with schizophrenia and depressive symptoms were randomly assigned to receive either CCBT with sertraline or sertraline monotherapy during a 4-week hospitalization.The CCBT intervention involved 45-60-minute sessions twice weekly for four weeks.Outcomes included comparisons of depressive symptoms(Calgary depression scale for schizophrenia),cognitive function[MATRICS consensus cognitive battery(MCCB)],and quality of life(36-item short form survey)between the groups.RESULTS The experimental group showed greater improvements in depressive symptoms at 4,8,and 12 weeks compared to the controls,with the most notable difference at 12 weeks[mean difference(MD)=-1.7;P<0.001;Cohen’s d=0.9].Cognitive function improved across all MCCB domains in the experimental group,with higher processing speed scores(MD=4.1;P=0.043;Cohen’s d=0.5)and social cognition scores(MD=4.9;P=0.006;Cohen’s d=0.7)than in the control group.Quality of life,particularly in mental health,was significantly better in the experimental group.CONCLUSION CCBT with sertraline was more effective than sertraline monotherapy for patients with schizophrenia and depressive episodes,supporting its use as an adjunctive therapy.
基金supported by a grant from Chung Shan Medical University(Grant No.:CSMUINT-109-06).
文摘Background:Cognitive stimulation therapy(CST)is a non-pharmacological intervention designed to improve cognitive function and emotional well-being in individuals with dementia.However,limited studies have evaluated its efficacy in Chinese-speaking populations.This study aimed to assess the effects of a 12-week cognitive stimulation interventiononcognitive functionanddepression inolder adultswithmilddementia.Methods:This quasiexperimental study employed a repeated measures design with a non-randomized experimental and control group.Participants(N=40)65 years and older with mild dementia(clinical dementia rating(CDR)=0.5–1)were recruited from a regional hospital and dementia care center in Taiwan.The experimental group(n=20)received a structured CST intervention for 12 weeks(two sessions per week,120 min per session),while the control group(n=20)received routine care.Cognitive function was assessed using the Saint Louis University Mental Status(SLUMS)exam,and depression was measured using the Chinese version of the Cornell Scale for Depression in Dementia(CSDD-C).Data were collected at baseline,4,8,and 12 weeks and analyzed using repeatedmeasures ANOVA and generalized estimating equation(GEE)modeling.Results:The experimental group showed significant improvements in cognitive function compared to the control group(SLUMS score:baseline 16.1±4.8 to 12th week 19.3±5.0,p<0.001).Depression levels decreased significantly in the experimental group but not in the control group(p<0.05).The GEE analysis showed that the improvement in cognitive function was positively associated with education level and duration,but declined with increasing age.Similarly,depression was lower in participants with higher educational levels and inmen.Conclusions:The findings support the efficacy of CST in improving cognitive function and reducing depression in older adults with mild dementia.The results highlight the importance of the duration of the intervention and individual cognitive reserve in modulating treatment outcomes.
文摘BACKGROUND Patients who undergo cardiac surgery often face postoperative pain and potential cognitive issues.Multimodal analgesia may address these problems.We hypothesized that multimodal analgesia can reduce opioid use and improve cognitive recovery.AIM To investigate the effects of multimodal analgesia on postoperative opioid consumption and cognitive recovery in patients who underwent cardiac surgery.METHODS A prospective,randomized controlled trial at General Hospital from January 2020 to April 2023 recruited a total of 150 adult patients who underwent elective cardiac surgery.The patients were randomly divided into two groups.Group A had patient-controlled intravenous analgesia with sufentanil and flurbiprofen axil.Group B had flurbiprofen axil and paravertebral nerve block.Data were analyzed with appropriate statistical methods.RESULTS Group B had lower postoperative patient-controlled intravenous analgesia drug consumption(2.21 mL/hour vs 4.26 mL/hour,P<0.001),shorter extubation time(2.32 hours vs 3.81 hours,P<0.001),and intensive care unit stay(15.32 h vs 28.63 h,P<0.001).Visual Analogue Scale pain scores were lower in group B(P<0.001).Group B had fewer postoperative complications(no respiratory depression vs 37.9%in group A,P<0.05),a lower postoperative cognitive dysfunction incidence(16.0%vs 28.0%,P<0.05),and higher Barthel Index scores(P<0.05).CONCLUSION Multimodal analgesia with paravertebral nerve block and flurbiprofen axil reduces opioid use and improves cognitive outcomes in patients who underwent cardiac surgery.
基金supported 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.
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 Heilongjiang Provincial Health Commission Scientific Research Project,No.20230404040027the Scientific Technology Project of Qiqihar City,No.CSFGG-2025030.
文摘Mild cognitive impairment(MCI),which is a high-risk transitional phase leading to Alzheimer’s disease,is characterized by mild memory deficits and specific cognitive dysfunctions.Without effective intervention,a significant proportion of patients with MCI progress to dementia.However,current pharmacological treatments are characterized by side effects and poor patient compliance.Therefore,it is necessary to develop effective,noninvasive alternative treatments.Repetitive transcranial magnetic stimulation(rTMS)is becoming a widely studied noninvasive treatment for central nervous system disease.The therapeutic effects of rTMS on patients with MCI and its underlying mechanism are noteworthy issues.Recently,a growing number of studies have shown that meningeal lymphatic vessel damage may be related to cognitive dysfunction.Whether the improvement of the meningeal lymphatic system is an important mechanism through which rTMS improves the clinical manifestations of MCI is worthy of further study.
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 the National Natural Science Foundation of China(32471186 and 31771318)the 14th Five-Year-Plan Advantageous and Characteristic Disciplines(Groups)of Colleges and Universities in Hubei Province for Exercise and Brain Science+1 种基金as well as the Leading Talent Program and Innovative Start-up Foundation from Wuhan Sports University to Ning Chensupported by the Hubei Natural Science Foundation(2022CFB929)and China Postdoctoral Science Foundation(2023M732727)to Tong Wu.
文摘It is well known that appropriate aerobic exercise can effectively alleviate fatty liver and enhance brain function.The concept of multi-organ crosstalk coordinating disease progression has become the current research hot topic.However,there remains an urgent need to elucidate its specific mechanisms.This study aimed to explore the impact of a high-fat diet(HFD)on liver health and cognitive function,and to further uncover the regulatory effect of aerobic exercise by liver-specific activating transcription factor 3(Atf3)knockout(ATF3cKO)mice in a“liver-brain”axis mode.The 5-week-old C57BL/6 and ATF3cKO mice were fed with HFD for 32 weeks,and sequentially subjected to aerobic exercise intervention at the 20th week for another 12 consecutive weeks.Meanwhile,C57BL/6 mice were provided with a normal diet as the control group.The functional parameters of liver and brain of all mice were assessed.Cognitive capacity of all mice was assessed by the Morris water maze(MWM).Inflammatory factors in the serum and brain of mice were quantified using enzyme-linked immunosorbent assay(ELISA),and the expression of inflammasomes was detected by immunohistochemistry(IHC).Additionally,the activation of nuclear factor-κB(NF-κB)and phosphoinositide 3-kinase(PI3K)signal pathways was analyzed by Western blotting.In this study,HFD impaired hepatic and brain functions,while aerobic exercise and liver-specific Atf3 knockout suppressed inflammatory factors in the peripheral circulation through hepatoprotective mechanisms,thereby attenuating cerebral inflammation and preserving neurological integrity,as well as mitigating HFD-induced cognitive decline.
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.
