BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration ...BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.展开更多
BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational c...BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.展开更多
This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s ex...This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.展开更多
Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to ex...Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.展开更多
Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that ph...Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that physical exercise is beneficial to cognitive function.The purpose of this meta-analysis was to critically assess the effect of Tai Chi exercise on global cognitive,executive,and memory functions in older adults.Methods:After a thorough electronic search and selection,eight studies were included in this meta-analysis with two cross-sectional and six intervention studies.Nine variables included in this meta-analysis were:mini mental status examination(MMSE),Alzheimer’s disease assessment scale-cognitive subscale(ADAS-cog),trailmaking test part A(TMA),trailmaking test part B(TMB),digit span test forward(DSF),digit span test backward(DSB),visual span test backward(VSB),verbal fluency test(VFT),and word delay recall test(WDR).The effect sizes and forest plots of these nine variables were generated.Results:Four(MMSE,DSB,VSB,and VFT)out of nine variables were significantly improved after Tai Chi exercise with the effect sizes ranged from 0.20 to 0.46(small to medium).MMSE represented global cognitive function,and DSB,VSB,and VFT represented memory function.Conclusion:Tai Chi as a mind-body exercise has the positive effects on global cognitive and memory functions,and more consistent positive effects were found on memory function,especially verbal working memory.展开更多
The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（A...The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.展开更多
Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data ...Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data sources:PubMed,Scopus,Web of Science,PsychInfo,and SPORTDiscus were searched.Eligibility criteria for selecting studies:randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered(Aim 2),as were studies investigating the effects of hypoxia on cognition(Aim 1).Results:In total,18 studies met our inclusionary criteria for the systematic review,and 12 studies were meta-analyzed.Exposure to hypoxia impaired attentional ability(standardized mean difference(SMD)=-0.4),executive function(SMD=-0.18),and memory function(SMD=-0.26),but not information processing(SMD=0.27).Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement(SMD=0.3,95%confidence interval:0.14-0.45,I^2=54%,p<0.001).Various characteristics(e.g.,age,cognitive task type,exercise type,exercise intensity,training type,and hypoxia level)moderated the effects of hypoxia and exercise on cognitive function.Conclusion:Exercise during exposure to hypoxia improves cognitive function.This association appears to be moderated by individual and exercise/hypoxia-related characteristics.展开更多
Background： Attention deficit hyperactivity disorder （ADHD） is a common childhood disorder that affects approximately 11% of children in the United States. Research supports that a single session of exercise benefi...Background： Attention deficit hyperactivity disorder （ADHD） is a common childhood disorder that affects approximately 11% of children in the United States. Research supports that a single session of exercise benefits cognitive performance by children, and a limited number of studies have demonstrated that these effects can also be realized by children with ADHD. The purpose of this study was to examine the effect of acute exercise on cognitive performance by children with and without ADHD. Methods： Children with and without ADHD were asked to perform cognitive tasks on 2 days following treatment conditions that were assigned in a random, counterbalanced order. The treatment conditions consisted of a 30-min control condition on 1 day and a moderate intensity exercise condition on the other day. Results： Exercise significantly benefited performance on all three conditions of the Stroop Task, but did not significantly affect performance on the Tower of London or the Trail Making Test. Conclusion： children with and without ADHD realize benefits in speed of processing and inhibitory control in response to a session of acute exercise, but do not experience benefits in planning or set shifting.展开更多
Purpose: Although exercise and sleep duration habits are associated with cognitive function, their beneficial effects on cognitive function remain unclear. We aimed to examine the effect of sleep duration and daily ph...Purpose: Although exercise and sleep duration habits are associated with cognitive function, their beneficial effects on cognitive function remain unclear. We aimed to examine the effect of sleep duration and daily physical activity on cognitive function, elucidating the neural mechanisms using near-infrared spectroscopy(NIRS).Methods: A total of 23 healthy young adults(age 22.0 ± 2.2 years) participated in this study. Exercise amount was assessed using a uniaxial accelerometer. We evaluated total sleep time(TST) and sleep efficiency by actigraphy. Cognitive function was tested using the N-back task, the Wisconsin Card Sorting Test(WCST), and the Continuous Performance Test—Identical Pairs(CPT-IP), and the cortical oxygenated hemoglobin levels during a word fluency task were measured with NIRS.Results: Exercise amount was significantly correlated with reaction time on 0- and 1-back tasks(r = —0.602, p = 0.002; r = —0.446, p = 0.033,respectively), whereas TST was significantly correlated with % corrects on the 2-back task(r = 0.486, p = 0.019). Multiple regression analysis,including exercise amount, TST, and sleep efficiency, revealed that exercise amount was the most significant factor for reaction time on 0- and 1-back tasks(b = —0.634, p = 0.002; b = —0.454, p = 0.031, respectively), and TST was the most significant factor for % corrects on the 2-back task(b = 0.542, p = 0.014). The parameter measured by WCST and CPT-IP was not significantly correlated with TST or exercise amount. Exercise amount, but not TST, was significantly correlated with the mean area under the NIRS curve in the prefrontal area(r = 0.492, p = 0.017).Conclusion: Exercise amount and TST had differential effects on working memory and cortical activation in the prefrontal area. Daily physical activity and appropriate sleep duration may play an important role in working memory.展开更多
This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with n...This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged -〉 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions： anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only （partial coefficient = 0.453, P = 0.045）, after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.661, P = 0.001） and between the left prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.573, P = 0.004） in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.展开更多
Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-defic...Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-deficit hyperactivity disorder(ADHD),but its efficacy(based on effect size calculations),safety,and stimulation parameters have not been systematically examined.In this systematic review,we aimed to(1)explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients,(2)evaluate the safety of tDCS application,especially in children with ADHD,(3)model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols,and(4)discuss and propose advanced tDCS parameters.Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach,a literature search identified 14 empirical experiments investigating tDCS effects in ADHD.Partial improving effects of tDCS on cognitive deficits(response inhibition,working memory,attention,and cognitive flexibility)or clinical symptoms(e.g.,impulsivity and inattention)are reported in10 studies.No serious adverse effects are reported in 747 sessions of tDCS.The left and right dorsolateral prefrontal cortex are the regions most often targeted,and anodal tDCS the protocol most often applied.An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes.In ADHD children,however,the electrical field induced by 1 mA,which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children,was sufficient to result in significant behavioral change.Overall,tDCS seems to be a promising method for improving ADHD deficits.However,the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes.Cortical regions involved in ADHD pathophysiology,stimulation parameters(e.g.intensity,duration,polarity,and electrode size),and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD.Developmental aspects of tDCS in childhood ADHD should be considered as well.展开更多
Purpose： The purpose of this study was to determine the effects of acute exercise on motor response inhibition using both behavioral and electrophysiological approaches. Methods： The P3 and N1 event-related potenti...Purpose： The purpose of this study was to determine the effects of acute exercise on motor response inhibition using both behavioral and electrophysiological approaches. Methods： The P3 and N1 event-related potential （ERP） components were recorded while performing a stop-signal task in 21 college students following a moderately intense acute exercise bout for 30 min and a sedentary control session that involved reading. Results： Acute exercise induced a shorter stop signal response time （SSRT） as compared to control; however, the go response time （Go RT） remained unchanged. In examining the ERP data, acute exercise increased both P3 amplitude and latency but did not affect the N1 component. Conclusion： Acute exercise has a selective and beneficial effect on cognitive function, specifically affecting the motor response inhibition aspect of executive function. Furthermore, acute exercise predominately impacts later stages of information processing during motor response inhibition, which may lead to an increase in attentional resource allocation and confer the ability to successfully withhold a response to achieve motor response inhibition.展开更多
Using the conflict principle of the Stroop task, “effect of interference in color naming”, the present study proposes to create a computational version of the emotional Stroop task, called TREFACE, for its acronyms ...Using the conflict principle of the Stroop task, “effect of interference in color naming”, the present study proposes to create a computational version of the emotional Stroop task, called TREFACE, for its acronyms in Portuguese “Teste de Reconhecimento de Expressões Faciais com Conflito Emocional” (Facial Expression Recognition Test with Emotional Conflict). In this protocol, four fixed styles of presentation were generated according to the condition: Congruent Word Reading, Incongruent Word Reading, Congruent Recognition of Face Expression and Incongruent Recognition of Face Expression, counterbalanced in terms of each facial expression, word and gender of the photo character. Forty-two healthy volunteers completed the task. Results revealed that a task associated with word reading allows better performance than a task associated with face recognition. It was also identified that in the congruent condition, there is an advantage in terms of the correct responses. Additionally, the data regarding recognition of face expression showed greater difficulty when the image was not congruent with the word. In general, the results suggest that the emotional attribute can compromise the ability to recognize the faces, reaching the functioning of mechanisms such as cognitive control and regulation of emotions. Thus, the TREFACE paradigm can be considered a good assessment tool for monitoring emotional conflict, in addition to presenting itself as a new instrument in Portuguese language for assessing emotional working memory in healthy individuals and, eventually, in different pathologies that affect the functioning of cortical areas related to executive functions.展开更多
文摘BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.
基金Supported by the 2025 Undergraduate Research Project of the Shandong Society for Innovation and Development in Philosophy and Social Sciences,No.Z-DXS25007。
文摘BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.
基金supported by the National Natural Science Foundation of China(CN)(Grant No.32071074).
文摘This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.
基金supported by the STI 2030-Major Projects(2021ZD0200500).
文摘Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.
文摘Background:Cognitive impairment is prevalent among older adults and results in degraded quality of life for older adults.As the population ages,this may cause a huge burden to society.Research has demonstrated that physical exercise is beneficial to cognitive function.The purpose of this meta-analysis was to critically assess the effect of Tai Chi exercise on global cognitive,executive,and memory functions in older adults.Methods:After a thorough electronic search and selection,eight studies were included in this meta-analysis with two cross-sectional and six intervention studies.Nine variables included in this meta-analysis were:mini mental status examination(MMSE),Alzheimer’s disease assessment scale-cognitive subscale(ADAS-cog),trailmaking test part A(TMA),trailmaking test part B(TMB),digit span test forward(DSF),digit span test backward(DSB),visual span test backward(VSB),verbal fluency test(VFT),and word delay recall test(WDR).The effect sizes and forest plots of these nine variables were generated.Results:Four(MMSE,DSB,VSB,and VFT)out of nine variables were significantly improved after Tai Chi exercise with the effect sizes ranged from 0.20 to 0.46(small to medium).MMSE represented global cognitive function,and DSB,VSB,and VFT represented memory function.Conclusion:Tai Chi as a mind-body exercise has the positive effects on global cognitive and memory functions,and more consistent positive effects were found on memory function,especially verbal working memory.
基金supported by a Project of Shanghai Municipal Health and Family Planning Commission (201540114)a Key Specialty Project of Shanghai Municipal Health and Family Planning Commission grant for Child Psychiatry (ZK2015B01)a Research Project of the Shanghai Changning Health and Family Planning Commission grant (20164Y013)
文摘The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.
基金supported by grants from the National Natural Science Foundation of China(Grant#31671150)Guangdong Province Key Project(Grant#2018B030335001).
文摘Objective:This study aimed to examine(1)the independent effects of hypoxia on cognitive function and(2)the effects of exercise on cognition while under hypoxia.Methods:Design:Systematic review with meta-analysis.Data sources:PubMed,Scopus,Web of Science,PsychInfo,and SPORTDiscus were searched.Eligibility criteria for selecting studies:randomized controlled trials and nonrandomized controlled studies that investigated the effects of chronic or acute exercise on cognition under hypoxia were considered(Aim 2),as were studies investigating the effects of hypoxia on cognition(Aim 1).Results:In total,18 studies met our inclusionary criteria for the systematic review,and 12 studies were meta-analyzed.Exposure to hypoxia impaired attentional ability(standardized mean difference(SMD)=-0.4),executive function(SMD=-0.18),and memory function(SMD=-0.26),but not information processing(SMD=0.27).Aggregated results indicated that performing exercise under a hypoxia setting had a significant effect on cognitive improvement(SMD=0.3,95%confidence interval:0.14-0.45,I^2=54%,p<0.001).Various characteristics(e.g.,age,cognitive task type,exercise type,exercise intensity,training type,and hypoxia level)moderated the effects of hypoxia and exercise on cognitive function.Conclusion:Exercise during exposure to hypoxia improves cognitive function.This association appears to be moderated by individual and exercise/hypoxia-related characteristics.
文摘Background： Attention deficit hyperactivity disorder （ADHD） is a common childhood disorder that affects approximately 11% of children in the United States. Research supports that a single session of exercise benefits cognitive performance by children, and a limited number of studies have demonstrated that these effects can also be realized by children with ADHD. The purpose of this study was to examine the effect of acute exercise on cognitive performance by children with and without ADHD. Methods： Children with and without ADHD were asked to perform cognitive tasks on 2 days following treatment conditions that were assigned in a random, counterbalanced order. The treatment conditions consisted of a 30-min control condition on 1 day and a moderate intensity exercise condition on the other day. Results： Exercise significantly benefited performance on all three conditions of the Stroop Task, but did not significantly affect performance on the Tower of London or the Trail Making Test. Conclusion： children with and without ADHD realize benefits in speed of processing and inhibitory control in response to a session of acute exercise, but do not experience benefits in planning or set shifting.
基金supported by the Japan Society for the Promotion of Science, KAKENHI (25282210,15H05935)by Grants-in-Aid from the Comprehensive Research on Disability Health and Welfare+3 种基金the Ministry of Health,Labor and Welfare of Japanthe Academic Frontier Project for Private UniversitiesComparative Cognitive Science InstitutesMeijo University
文摘Purpose: Although exercise and sleep duration habits are associated with cognitive function, their beneficial effects on cognitive function remain unclear. We aimed to examine the effect of sleep duration and daily physical activity on cognitive function, elucidating the neural mechanisms using near-infrared spectroscopy(NIRS).Methods: A total of 23 healthy young adults(age 22.0 ± 2.2 years) participated in this study. Exercise amount was assessed using a uniaxial accelerometer. We evaluated total sleep time(TST) and sleep efficiency by actigraphy. Cognitive function was tested using the N-back task, the Wisconsin Card Sorting Test(WCST), and the Continuous Performance Test—Identical Pairs(CPT-IP), and the cortical oxygenated hemoglobin levels during a word fluency task were measured with NIRS.Results: Exercise amount was significantly correlated with reaction time on 0- and 1-back tasks(r = —0.602, p = 0.002; r = —0.446, p = 0.033,respectively), whereas TST was significantly correlated with % corrects on the 2-back task(r = 0.486, p = 0.019). Multiple regression analysis,including exercise amount, TST, and sleep efficiency, revealed that exercise amount was the most significant factor for reaction time on 0- and 1-back tasks(b = —0.634, p = 0.002; b = —0.454, p = 0.031, respectively), and TST was the most significant factor for % corrects on the 2-back task(b = 0.542, p = 0.014). The parameter measured by WCST and CPT-IP was not significantly correlated with TST or exercise amount. Exercise amount, but not TST, was significantly correlated with the mean area under the NIRS curve in the prefrontal area(r = 0.492, p = 0.017).Conclusion: Exercise amount and TST had differential effects on working memory and cortical activation in the prefrontal area. Daily physical activity and appropriate sleep duration may play an important role in working memory.
基金supported by the Research Grants Council of the Hong Kong SAR,No. 452906
文摘This study aimed to investigate the association between atrophy in the prefrontal cortex with executive function and verbal fluency in elderly male and female patients poststroke. Thirty elderly female patients with non-aphasic ischemic stroke aged -〉 60 years and 30 age-matched non-aphasic male patients with ischemic stroke were recruited. Automatic magnetic resonance imaging segmentation was used to assess the volume of the whole prefrontal cortex, along with its subdivisions： anterior cingulate cortex, orbitofrontal cortex and dorsolateral prefrontal cortex. The Semantic Verbal Fluency Test was administered at 3 and 15 months poststroke. At 3 months poststroke, left dorsolateral prefrontal cortex volume was significantly correlated with Verbal Fluency Test score in female patients only （partial coefficient = 0.453, P = 0.045）, after controlling for age, education, diabetes, neurological deficit, white matter lesions volume, as well as the location and volume of infarcts. At 15 months poststroke, there remained a significant association between the left dorsolateral prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.661, P = 0.001） and between the left prefrontal cortex volume and Verbal Fluency Test （partial coefficient = 0.573, P = 0.004） in female patients after the same adjustments. These findings indicate that atrophy of the left dorsolateral prefrontal cortex contributes to the impairment of verbal fluency in elderly female patients with stroke. Sex differences may be present in the neuropsychological mechanisms of verbal fluency impairment in patients with stroke.
基金This review was supported by the Department of Psychology and Neurosciences,Leibniz-Institut fiir Arbeitsforschung Ministry of Science,Research and Technology,Deputy of Scholarship and Students Affairs,Iran(95000171)the German Ministry of Research and Education(German Center for Brain Stimulation grant number 01EE1403C).
文摘Transcranial direct current stimulation(tDCS)is a promising method for altering cortical excitability with clinical implications.It has been increasingly used in neurodevelopmental disorders,especially attention-deficit hyperactivity disorder(ADHD),but its efficacy(based on effect size calculations),safety,and stimulation parameters have not been systematically examined.In this systematic review,we aimed to(1)explore the effectiveness of tDCS on the clinical symptoms and neuropsychological deficits of ADHD patients,(2)evaluate the safety of tDCS application,especially in children with ADHD,(3)model the electrical field intensity in the target regions based on the commonly-applied and effective versus less-effective protocols,and(4)discuss and propose advanced tDCS parameters.Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach,a literature search identified 14 empirical experiments investigating tDCS effects in ADHD.Partial improving effects of tDCS on cognitive deficits(response inhibition,working memory,attention,and cognitive flexibility)or clinical symptoms(e.g.,impulsivity and inattention)are reported in10 studies.No serious adverse effects are reported in 747 sessions of tDCS.The left and right dorsolateral prefrontal cortex are the regions most often targeted,and anodal tDCS the protocol most often applied.An intensity of 2 mA induced stronger electrical fields than 1 mA in adults with ADHD and was associated with significant behavioral changes.In ADHD children,however,the electrical field induced by 1 mA,which is likely larger than the electrical field induced by 1 mA in adults due to the smaller head size of children,was sufficient to result in significant behavioral change.Overall,tDCS seems to be a promising method for improving ADHD deficits.However,the clinical utility of tDCS in ADHD cannot yet be concluded and requires further systematic investigation in larger sample sizes.Cortical regions involved in ADHD pathophysiology,stimulation parameters(e.g.intensity,duration,polarity,and electrode size),and types of symptom/deficit are potential determinants of tDCS efficacy in ADHD.Developmental aspects of tDCS in childhood ADHD should be considered as well.
基金supported in part by grants from the Ministry of Science and Technology to Yu-Kai Chang (NSC 102-2410-H-179-014-MY3)
文摘Purpose： The purpose of this study was to determine the effects of acute exercise on motor response inhibition using both behavioral and electrophysiological approaches. Methods： The P3 and N1 event-related potential （ERP） components were recorded while performing a stop-signal task in 21 college students following a moderately intense acute exercise bout for 30 min and a sedentary control session that involved reading. Results： Acute exercise induced a shorter stop signal response time （SSRT） as compared to control; however, the go response time （Go RT） remained unchanged. In examining the ERP data, acute exercise increased both P3 amplitude and latency but did not affect the N1 component. Conclusion： Acute exercise has a selective and beneficial effect on cognitive function, specifically affecting the motor response inhibition aspect of executive function. Furthermore, acute exercise predominately impacts later stages of information processing during motor response inhibition, which may lead to an increase in attentional resource allocation and confer the ability to successfully withhold a response to achieve motor response inhibition.
文摘Using the conflict principle of the Stroop task, “effect of interference in color naming”, the present study proposes to create a computational version of the emotional Stroop task, called TREFACE, for its acronyms in Portuguese “Teste de Reconhecimento de Expressões Faciais com Conflito Emocional” (Facial Expression Recognition Test with Emotional Conflict). In this protocol, four fixed styles of presentation were generated according to the condition: Congruent Word Reading, Incongruent Word Reading, Congruent Recognition of Face Expression and Incongruent Recognition of Face Expression, counterbalanced in terms of each facial expression, word and gender of the photo character. Forty-two healthy volunteers completed the task. Results revealed that a task associated with word reading allows better performance than a task associated with face recognition. It was also identified that in the congruent condition, there is an advantage in terms of the correct responses. Additionally, the data regarding recognition of face expression showed greater difficulty when the image was not congruent with the word. In general, the results suggest that the emotional attribute can compromise the ability to recognize the faces, reaching the functioning of mechanisms such as cognitive control and regulation of emotions. Thus, the TREFACE paradigm can be considered a good assessment tool for monitoring emotional conflict, in addition to presenting itself as a new instrument in Portuguese language for assessing emotional working memory in healthy individuals and, eventually, in different pathologies that affect the functioning of cortical areas related to executive functions.
