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Background: Down syndrome (DS) is considered the most frequent cause of early-onset Alzheimer’s disease (AD), and the typical pathophysiological signs are present in almost all individuals with DS by the age of 40. Despite of this evidence, the investigation on the pre-dementia stages in DS is scarce. In the present study we analyzed the complexity of brain oscillatory patterns and neuropsychological performance for the characterization of mild cognitive impairment (MCI) in DS. Materials and methods: Lempel-Ziv complexity (LZC) values from restingstatemagnetoencephalography recordings and the neuropsychological performance in 28 patients with DS [control DS group (CN-DS) (n = 14), MCI group (MCI-DS) (n = 14)] and 14 individuals with typical neurodevelopment (CN-no-DS) were analyzed. Results: Lempel-Ziv complexity was lowest in the frontal region within the MCI-DS group, while the CN-DS group showed reduced values in parietal areas when compared with the CN-no-DS group. Also, the CN-no-DS group exhibited the expected pattern of significant increase of LZC as a function of age, while MCI-DS cases showed a decrease. The combination of reduced LZC values and a divergent trajectory of complexity evolution with age, allowed the discrimination of CN-DS vs. MCI-DS patients with a 92.9% of sensitivity and 85.7% of specificity. Finally, a pattern of mnestic and praxic impairment was significantly associated in MCI-DS cases with the significant reduction of LZC values in frontal and parietal regions (p = 0.01). Conclusion: Brain signal complexity measured with LZC is reduced in DS and its development with age is also disrupted. The combination of both features might assist in the detection of MCI within this population., Ministerio de Economía y Competitividad (Instituto de Salud Carlos III), Jérôme Lejeune Foundation, Ministerio de Ciencia, Innovación y Universidades, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

Background: Autism Spectrum Disorder (ASD) and Attention Deficit Hyperactivity Disorder (ADHD) are two common childhood-onset neurodevelopmental disorders, and about 30–80% of children with ASD meet the diagnostic criteria for ADHD, whereas about 20–50% of children with ADHD meet the diagnostic criteria for ASD. For a full understanding of the functional levels of children with these disorders, neuropsychological and emotion recognition (ER) examinations are important. Studying ASD across countries allows identifying possible different phenotypes of ASD. Evidence of similar neurocognitive profiles and ER ability across countries might strengthen the notion of innate ASD features. Aims: We aimed to compare neuropsychological and ER abilities in Egyptian children with ASD (with and without ADHD), with ADHD, and typically developing children; to assess the effect of comorbid ADHD on neuropsychological and ER abilities in Egyptian children with ASD; and to compare Egyptian and Finnish children with ASD on their neuropsychological and ER abilities. Methods: Using Developmental Neuropsychological Assessment (NEPSY) and the Frankfurt Test and Training of Facial Affect Recognition (FEFA), we evaluated 34 Egyptian children with ASD (17/34 pure ASD; 17/34 comorbid ASD+ADHD), 37 ADHD, and 34 typical development (TD). We also evaluated Finnish children with ASD (Finnish ASD n = 54 with NEPSY; n = 32 with FEFA). Diagnoses were determined with the ICD-10. The Autism Diagnostic Interview and Autism Diagnostic Observation Schedule were used to obtain diagnostic confirmation. Results and Conclusions: Our results suggest that in Egypt, both children with ASD and with comorbid ASD+ADHD have lower neuropsychological and ER abilities in general than children with ADHD. Children with ASD and comorbid ASD+ADHD did not differ significantly on NEPSY and FEFA. However, compared to TD children, ADHD symptoms in children with ASD may worsen planning ability, hand motor coordination, a, Tiivistelmä Tausta: Autismikirjon häiriö (ASD) ja aktiivisuuden ja tarkkaavuuden häiriö (ADHD) ovat kaksi yleistä lapsuusiässä alkavaa neurobiologista kehityshäiriötä. Noin 30–80% lapsista, joilla on ASD, täyttää ADHD:n diagnostiset kriteerit, kun taas noin 20–50% lapsista, joilla on ADHD, täyttää ASD:n diagnostiset kriteerit. Jotta voidaan saavuttaa kattava käsitys lasten toimintakyvystä näissä häiriöissä, on tärkeää saada tutkittua tietoa heidän neuropsykologisesta suoriutumisestaan ja kyvystään tunnistaa tunteita. ASD:n tutkiminen eri maissa antaa mahdollisuuden tunnistaa häiriön mahdolliset erilaiset fenotyypit. Viitteet samanlaisista neurokognitiivisista profiileista ja tunteiden tunnistamiskyvystä eri maissa voisivat vahvistaa kulttuurista riippumattomien ASD-piirteiden käsitettä. Tavoitteet: Tutkimuksen tavoitteena oli arvioida egyptiläislasten, joilla on ASD, ASD+ADHD, ADHD tai tyypillinen kehitys (TD) neuropsykologista suoriutumista ja kykyä tunnistaa tunteita; tutkia samanaikaisen ADHD:n vaikutusta egyptiläisten ASD-lasten neuropsykologiseen suoriutumiseen ja tunteiden tunnistamiskykyyn; ja verrata egyptiläis- ja suomalaislasten, joilla on ASD, neuropsykologista suoriutumista ja tunteiden tunnistamiskykyä. Menetelmät: Arvioimme egyptiläislapsia, joilla oli ASD (n = 34; ASD n=17; ASD+ADHD n=17), ADHD (n = 37) ja tyypillinen kehitys (TD) (n = 34) sekä suomalaislapsia, joilla oli ASD, neuropsykologisella tutkimuksella (NEPSY) ja tunteiden tunnistamistestillä (the Frankfurt Test and Training of Facial Affect Recognition; FEFA) (suomalaiset ASD-lapset: NEPSY n = 54; FEFA n = 32). Diagnoosit määritettiin ICD-10:llä ja diagnostiikan apuna käytettiin autismin diagnostista haastattelua ja autismin diagnostista havainnointimenetelmää. Tulokset ja johtopäätökset: Tuloksemme viittaavat siihen, että Egyptissä sekä lapsilla, joilla on ASD, että lapsilla, joilla on samanaikainen ASD ja ADHD, on heikommat neuropsykologiset taidot ja kyky tunnistaa tunteita kuin lapsilla

Cognitive performance in people with HIV (PWH) may be affected by brain injury attributable to the infection itself, by other medical and psychiatric comorbidities (including major depressive disorder; MDD), and by psychosocial factors (e.g., education, food insecurity). We investigated effects of these variables on cognitive performance in a South African cohort of PWH with comorbid MDD and incomplete adherence to antiretroviral therapy (ART). We also examined (a) associations of depression severity with cognitive performance, and (b) whether improvement in depression led to improved cognitive performance. Participants (N = 105) completed baseline neuropsychological, psychiatric, and sociodemographic assessments. Subsequently, 33 were assigned to a cognitive-behavioural therapy for ART adherence and depression (CBT-AD) and 72 to standard-of-care treatment. Eight months post-baseline, 81 (n(CBT-AD) = 29) repeated the assessments. We investigated (a) baseline associations between sociodemographic, medical, and psychiatric variables and cognitive performance, (b) whether, from baseline to follow-up, depression and cognitive performance improved significantly more in CBT-AD participants, and (c) associations between post-intervention improvements in depression and cognitive performance. At baseline, less education (beta = 0.62) and greater food insecurity (beta = -0.20) predicted poorer overall cognitive performance; more severe depression predicted impairment in the attention/working memory domain only (beta = -0.25). From baseline to follow-up, depression decreased significantly more in CBT-AD participants (p = .017). Improvement over time in depression and cognitive performance was not significantly associated except in the attention/working memory domain (p = .026). Overall, factors associated with cognitive performance were unrelated to brain injury. We conclude that clinicians examining PWH presenting with cognitive difficulties must assess depression, and tha

Down syndrome (DS) has been considered a unique model for the investigation of Alzheimer’s disease AD) but intermediate stages in the continuum are poorly defined. Considering this, we investigated the neurophysiological (i.e., magnetoencephalography [MEG]) and neuropsychological patterns of mild cognitive impairment (MCI) and AD in middle-aged adults with DS. The sample was composed of four groups: Control-DS (n ¼ 14, mean age 44.64 3.30 years), MCI-DS (n ¼ 14, 51.64 3.95 years), AD-DS (n ¼ 13, 53.54 6.58 years), and Control-no-DS (healthy controls, n ¼ 14, 45.21 4.39 years). DS individuals were studied with neuropsychological tests and MEG, whereas the Control-no-DS group completed only the MEG session. Our results showed that the AD-DS group exhibited a significantly poorer performance as compared with the Control-DS group in all tests. Furthermore, this effect was crucially evident in AD-DS individuals when compared with the MCI-DS group in verbal and working memory abilities. In the neurophysiological domain, the Control-DS group showed a widespread increase of theta activity when compared with the Control-no-DS group. With disease progression, this increased theta was substituted by an augmented delta, accompanied with a reduction of alpha activity. Such spectral patterndspecifically observed in occipital, posterior temporal, cuneus, and precuneus regionsdcorrelated with the performance in cognitive tests. This is the first MEG study in the field incorporating both neuropsychological and neurophysiological information, and demonstrating that this combination of markers is sensitive enough to characterize different stages along the AD continuum in DS., Fundación Jerome Lejeune, Instituto de Salud Carlos III, Comunidad de Madrid, Ministerio de Economía y Competitividad, Depto. de Medicina Legal, Psiquiatría y Patología, Fac. de Medicina, TRUE, pub

BackgroundHIV infection may result in neurocognitive deficits, but the effects of pulmonary tuberculosis (TB+), a common comorbid condition in HIV infection, on cognition in HIV infections are unknown. Accordingly, we examined the effects of TB+, on neurocognitive functioning in HIV-infected (HIV+) Zambian adults.SettingAll participants were drawn from HIV clinics in and around Lusaka, the capital of Zambia.MethodsParticipants were 275 HIV+, of whom 237 were HIV+ and TB-negative (HIV+/TB-), and 38 also had pulmonary TB+ (HIV+/TB+). Controls were 324 HIV- and TB-uninfected (HIV-) healthy controls. All HIV+ participants were prescribed combination antiretroviral treatment (cART). Published, demographically corrected Zambian neuropsychological norms were used to correct for effects of age, education, sex, and urban/rural residence.ResultsNeuropsychological deficits, assessed by global deficit scores, were more prevalent in this order: 14% (46 of 324) of HIV- controls, 34% (80 of 237) of HIV+/TB-, and 55% (21 of 38) of HIV+/TB+ group. Thus, both HIV-infected groups evidenced more impairment than HIV- controls, and the HIV+/TB+ group had a higher rate of neurocognitive impairment than the HIV+/TB- group. HIV+/TB+ patients were more likely to be male, younger, less-educated, and have lower CD4 counts and detectable HIV RNA in blood compared with the HIV+/TB- patients.ConclusionsIn HIV infection, TB may contribute to cognitive impairment, even after controlling for lower CD4 counts and viral load. Thus, systemic inflammation from HIV and TB and more advanced immune deficiency at diagnosis of HIV may contribute to impaired cognition in HIV+/TB+ patients.

Neuroimaging of opiate-dependent individuals indicates both altered brain structure and function. Magnetic resonance-based arterial spin labeling has been used to measure noninvasively cerebral blood flow (i.e. perfusion) in alcohol, tobacco and stimulant dependence; only one arterial spin labeling paper in opiate-dependent individuals demonstrated frontal and parietal perfusion deficits. Additional research on regional brain perfusion in opiate dependence and its relationship to cognition and self-regulation (impulsivity, risk taking and decision making) may inform treatment approaches for opiate-dependent individuals. Continuous arterial spin labeling magnetic resonance imaging at 4 T and neuropsychological measures assessed absolute brain perfusion levels, cognition and self-regulation in 18 cigarette smoking opiate-dependent individuals (sODI) stable on buprenorphine maintenance therapy. The sODI were compared with 20 abstinent smoking alcohol-dependent individuals (a substance-dependent control group), 35 smoking controls and 29 nonsmoking controls. sODI had lower perfusion in several cortical and subcortical regions including regions within the brain reward/executive oversight system compared with smoking alcohol-dependent individuals and nonsmoking controls. Perfusion was increased in anterior cingulate cortex and globus pallidus of sODI. Compared with all other groups, sODI had greater age-related declines in perfusion in most brain reward/executive oversight system and some other regions. In sODI, lower regional perfusion related to greater substance use, higher impulsivity and weaker visuospatial skills. Overall, sODI showed cortical and subcortical hypoperfusion and hyperperfusion. Relating to neuropsychological performance and substance use quantities, the frontal perfusion alterations are clinically relevant and constitute potential targets for pharmacological and cognitive-based therapeutic interventions to improve treatment outcome in opiate dependenc

Neuroimaging of opiate-dependent individuals indicates both altered brain structure and function. Magnetic resonance-based arterial spin labeling has been used to measure noninvasively cerebral blood flow (i.e. perfusion) in alcohol, tobacco and stimulant dependence; only one arterial spin labeling paper in opiate-dependent individuals demonstrated frontal and parietal perfusion deficits. Additional research on regional brain perfusion in opiate dependence and its relationship to cognition and self-regulation (impulsivity, risk taking and decision making) may inform treatment approaches for opiate-dependent individuals. Continuous arterial spin labeling magnetic resonance imaging at 4 T and neuropsychological measures assessed absolute brain perfusion levels, cognition and self-regulation in 18 cigarette smoking opiate-dependent individuals (sODI) stable on buprenorphine maintenance therapy. The sODI were compared with 20 abstinent smoking alcohol-dependent individuals (a substance-dependent control group), 35 smoking controls and 29 nonsmoking controls. sODI had lower perfusion in several cortical and subcortical regions including regions within the brain reward/executive oversight system compared with smoking alcohol-dependent individuals and nonsmoking controls. Perfusion was increased in anterior cingulate cortex and globus pallidus of sODI. Compared with all other groups, sODI had greater age-related declines in perfusion in most brain reward/executive oversight system and some other regions. In sODI, lower regional perfusion related to greater substance use, higher impulsivity and weaker visuospatial skills. Overall, sODI showed cortical and subcortical hypoperfusion and hyperperfusion. Relating to neuropsychological performance and substance use quantities, the frontal perfusion alterations are clinically relevant and constitute potential targets for pharmacological and cognitive-based therapeutic interventions to improve treatment outcome in opiate depe

Background Cognitive dysfunction in fibromyalgia (FM) encompasses objective cognitive difficulties, as measured in neuropsychological tests, and self-reported cognitive complaints. Although it has been suggested that FM patients display problems in working memory, the data are inconsistent, and the overall working memory status of the patients is unclear. It is also not clear whether the working memory problems are related to cognitive complaints or how the dyscognition is affected by the characteristic clinical symptoms of FM. Methods To clarify these aspects, we explored the neuropsychological performance for different components of working memory and the subjective self-perception of cognitive status in a sample of 38 women with FM. They were compared with a matched group of 32 healthy women. Results Our findings suggested that the FM patients do not differ from healthy controls in their overall working memory functioning. Only a poor performance was found in a single task of visuospatial working memory, mediated by the presence of depressive symptoms, fatigue and pain. The FM patients also displayed a higher level of perception of cognitive difficulties than healthy controls, and this difference was mediated by depression and fatigue. Furthermore, cognitive complaints in FM patients were only associated with a lower verbal WM capacity. Discussion FM patients have a subtle specific impairment in their working memory functioning, as well as elevated concern about their cognitive status. These findings suggest a disconnection between neuropsychological performance and subjective complaints. In FM patients, clinical variables such as pain, fatigue, and depression play an important role in dyscognition, as assessed by both objective and subjective measures, and should be taken into account in future research

The expression of cognitive symptoms associated with HIV varies over time and across individuals. This pattern may reflect transient contextual factors, including the degree of effort exerted by individuals undergoing cognitive testing. The present study examined whether effort corresponds to the expression of persistent HIV-related cognitive impairment among individuals receiving combination antiretroviral therapy (cART). HIV+ individuals (n = 111) averaged 48.2 (14.9) years of age and 13.0 (2.7) years of education and HIV- individuals (n = 92) averaged 34.9 (17.2) years of age and 13.5 (1.9) years of education. Participants completed a neuropsychological battery and a clinically validated measure of effort (Test of Memory Malingering, trial 1). Results revealed that the vast majority of HIV+ (85%) and HIV- (89%) individuals performed above published guidelines for adequate effort. Furthermore, the expression of cognitive impairment in HIV was not related to effort performance. The results were unchanged when examining HIV+ individuals with and without viral suppression. Finally, disability and disability-seeking status, and a proxy measure of apathy did not correspond to effort levels in HIV+ individuals. These findings suggest that variability in the expression of cognitive impairment in the cART era is unlikely to represent overt effort failures or other confounds unrelated to the disease. Persistent cognitive impairment in HIV likely represents historical and/or ongoing disease mechanisms despite otherwise successful treatment.

This study examined the neuropsychological functioning in autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), and comorbid ASD and ADHD (ASD + ADHD), using five domains of the Developmental Neuropsychological Assessment (NEPSY): Attention and Executive Functions, Language, Visuospatial Processing, Sensorimotor Functions, and Memory and Learning. The participants were 6- to 12-year-old Egyptian children with ASD (n = 17), ASD + ADHD (n = 15), ADHD (n = 37), and typical development (TD; n = 29). TD children scored highest on the NEPSY domains, then children with ADHD, followed by children with ASD and ASD + ADHD. Children with ASD or ASD + ADHD performed significantly poorer than TD children on all NEPSY domains. Children with ADHD exhibited significantly poorer performance than TD children on NEPSY domains of Attention and Executive Function, Language, and Memory and Learning. Also, both ASD and ASD + ADHD groups scored significantly lower than ADHD group on all other NEPSY domains except Visuospatial Processing. There were no significant differences between ASD and ASD + ADHD groups on NEPSY. Compared to TD children, our results suggest that ADHD symptoms in children with ASD may worsen the ability to plan, hand motor coordination, and memorizing names. Nevertheless, the presence of ADHD symptoms may mitigate the difficulties that children with ASD exhibit in other neuropsychological areas, such as verbal fluency, hand praxis, finger gnosis, and face memory.

The ε4 polymorphism of the APOE gene confers a substantially increased risk of developing Alzheimer's disease. However, the influence of the ε4 allele on age-related cognitive functioning is more contentious. Previously, we demonstrated relatively little evidence for a role of the ε4 allele on baseline cognitive performance in older adults in the Australian Imaging, Biomarkers and Lifestyle (AIBL) Study of Ageing (Foster et al., 2013). We here investigated whether the APOE ε4 allele influenced cognitive status over time when the AIBL cohort was studied longitudinally over a 3-year period. The AIBL neuropsychological test battery was administered at baseline, after 18 months and again after 36 months. Participants comprised 764 Healthy Controls and 131 Mild Cognitively Impaired individuals enroled in the AIBL Study of Ageing. We compared individuals within each group with and without an ε4 allele. Healthy Controls with an ε4 allele manifested a modest acceleration in cognitive decline over 36 months on measures of verbal episodic memory. By contrast, Mild Cognitively Impaired individuals with an ε4 allele showed increased cognitive decline across a range of cognitive tasks, putatively reflecting early cognitive signs of Alzheimer's disease. Given the long prodromal period that has been noted in late onset Alzheimer's disease, we suggest that these findings are consistent with a prodromal account rather than a phenotypic account of ε4-related cognitive ageing.

Mild traumatic brain injury (mTBI) is one of the major health problems facing military service members returning from deployments. White matter axonal damage, as measured by neuroimaging techniques like Diffusion Weighted Imaging (DWI), is one of the hypothesized mechanisms contributing to the cognitive and affective sequalae of mTBI. Presently, many of the findings in the literature examining the association between DWI and neuropsychological outcome are contradictory, possibly due to differences in stage of recovery at the time of assessment. This study will address this problem by collecting measures of white matter integrity and concomitant neuropsychological status at five time points in the first year following an mTBI. During the first year, study preparations, including ethical approval, hiring and training of new staff, purchasing of equipment and materials, and validation of neuroimaging protocols, were completed ahead of schedule. During the past year, we have collected usable data from a total of 29 participants. These data have been cleaned and preliminary analyses suggest that we are able to identify meaningful trends in the data, although the sample is still far too small to make valid conclusions. Notably, the PI and laboratory have transferred to a new institution as of 1 JUL 2014. Thus, all further research activities are currently suspended awaiting transfer of funding to the new institution., The original document contains color images.

To assess recovery of cognitive effects, we investigated neuropsychological performance after 1 month of monitored abstinence in teens with histories of heavy episodic drinking, protracted marijuana use, or concomitant use of alcohol and marijuana. Adolescents (ages 16-18 years) with histories of heavy episodic drinking (HED; n=24), marijuana use (MJ; n=20), both heavy alcohol and marijuana use (HED+MJ; n=29), and socio-demographically similar control teens (CON; n=55) completed a neuropsychological battery following 4 weeks of monitored abstinence. Groups were similar on 5th grade standardized test scores, suggesting comparable academic functioning before onset of substance use. Relative to CON, HED showed poorer cognitive flexibility (p=.006), verbal recall (p=.024), semantic clustering (p=.011), and reading skills (p=.018). MJ performed worse than CON on inhibition task accuracy (p=.015), cued verbal memory (p=.031), and psychomotor speed (p=.027). Similar to HED youth, HED+MJ showed differences relative to CON on cognitive flexibility (p=.024) and verbal recall (p=.049). As with MJ teens, HED+MJ showed poorer task accuracy (p=.020). Unique to the HED+MJ group was poorer working memory (p=.012) relative to CON. For all substance using participants, worse performance across domains correlated with more lifetime use of alcohol and of marijuana, more withdrawal symptoms from alcohol, and earlier age of onset of marijuana use (ps<.05). Heavy alcohol use, marijuana use, and concomitant use of both substances during adolescence appear to be associated with decrements in cognitive functioning, and each substance (or combination of substances) may be linked to poorer performance in specific cognitive domains.

To assess recovery of cognitive effects, we investigated neuropsychological performance after 1 month of monitored abstinence in teens with histories of heavy episodic drinking, protracted marijuana use, or concomitant use of alcohol and marijuana. Adolescents (ages 16-18 years) with histories of heavy episodic drinking (HED; n=24), marijuana use (MJ; n=20), both heavy alcohol and marijuana use (HED+MJ; n=29), and socio-demographically similar control teens (CON; n=55) completed a neuropsychological battery following 4 weeks of monitored abstinence. Groups were similar on 5th grade standardized test scores, suggesting comparable academic functioning before onset of substance use. Relative to CON, HED showed poorer cognitive flexibility (p=.006), verbal recall (p=.024), semantic clustering (p=.011), and reading skills (p=.018). MJ performed worse than CON on inhibition task accuracy (p=.015), cued verbal memory (p=.031), and psychomotor speed (p=.027). Similar to HED youth, HED+MJ showed differences relative to CON on cognitive flexibility (p=.024) and verbal recall (p=.049). As with MJ teens, HED+MJ showed poorer task accuracy (p=.020). Unique to the HED+MJ group was poorer working memory (p=.012) relative to CON. For all substance using participants, worse performance across domains correlated with more lifetime use of alcohol and of marijuana, more withdrawal symptoms from alcohol, and earlier age of onset of marijuana use (ps<.05). Heavy alcohol use, marijuana use, and concomitant use of both substances during adolescence appear to be associated with decrements in cognitive functioning, and each substance (or combination of substances) may be linked to poorer performance in specific cognitive domains.

The purpose of the present work was to investigate whether children with non-lesional temporal lobe epilepsy (TLE) have deficits in neuropsychological performance and whether the possible deficits can be investigated using functional magnetic resonance imaging (fMRI). In this population-based study, 21 children aged 8–15 with non-lesional TLE and a normal intelligence quotient were evaluated and compared with 21 healthy, age- and gender-matched controls. Neuropsychological assessments, clinical examinations, electroencephalography (EEG) and structural and functional MRI were performed on all the subjects. Three fMRI methods were used: resting-state regional homogeneity, resting-state functional connectivity and task-induced blood oxygenation level-dependent activation. The patients with non-lesional TLE showed good neuropsychological performance on average, although the girls were found to have significant problems in several neuropsychological tests. The deficits were not restricted to elements of performance involving the classical temporal lobe memory system but were also found in tests requiring frontal and parietal lobe functioning. Early onset of epilepsy and duration of epilepsy had significant negative effects on neuropsychological performance. All the fMRI methods detected significant functional differences between the TLE patients and the healthy controls, not only in the temporal lobes but also in broad networks extending to the frontal, parietal and thalamic areas. These differences seemed to differ markedly in location between the TLE patients depending on the interictal EEG findings. Neuropsychological performance results were supported by the fMRI findings, implying that TLE should be regarded as a widespread disruption of the brain networks and not just malfunction of a single region in the brain within these networks. This needs to be taken into consideration when evaluating learning abilities among TLE patients even at an early stage in ep, Tiivistelmä Tutkimuksen tarkoituksena oli selvittää onko lapsilla, jotka sairastavat tuntemattomasta syystä aiheutuvaa ohimolohkoepilepsiaa, neuropsykologisia ongelmia ja aiheuttavatko mahdolliset ongelmat aivojen toiminnallisessa magneettikuvauksessa nähtäviä muutoksia. Tähän väestöpohjaiseen tutkimukseen otettiin 21 tuntemattomasta syystä ohimolohkoepilepsiaa sairastavaa normaaliälyistä 8–15-vuotiaista lasta ja verrattiin heitä 21 terveeseen, ikä- ja sukupuolivakioituun kontrollihenkilöön. Kaikille tutkimukseen osallistuneille tehtiin neuropsykologinen tutkimus, kliininen tutkimus, aivosähkökäyrä sekä rakenteellinen ja toiminnallinen aivojen magneettikuvaus. Toiminnallisessa magneettikuvauksessa käytettiin veren happipitoisuudesta riippuvaista (engl. blood oxygenation level-dependent) kontrastia kuvantamaan levossa aivojen paikallista homogeniteettia (engl. regional homogeneity) ja toiminnallista kytkennällisyyttä (engl. functional connectivity) sekä kognitiivisten tehtävien herättämiä aktivaatio-vasteita. Tuntemattomasta syystä ohimolohkoepilepsiaa sairastavien lasten neuropsykologinen suoriutuminen oli keskimäärin hyvää, vaikkakin tytöillä oli nähtävillä tilastollisesti merkitseviä ongelmia useissa eri testeissä. Ongelmat eivät rajoittuneet pelkästään klassisiin ohimolohkoalueen muistitoimintoihin, vaan niitä havaittiin myös otsa- ja päälakilohkojen toimintoja edellyttävissä testeissä. Varhainen sairastumisikä ja epilepsian kesto heikensivät suoriutumista tilastollisesti merkitsevästi osatesteissä, joissa tarvittiin näönvaraisen hahmottamisen taitoja, psykomotorista nopeutta ja työmuistia. Ohimolohkoepilepsiaa sairastavien ja terveiden kontrollien aivoissa löydettiin toiminnallisia eroja kaikilla toiminnallisen magneettikuvauksen menetelmillä. Eroja ei todettu ainoastaan ohimolohkoissa, vaan niitä löytyi myös otsa- ja päälakilohkoon sekä tyvitumakealueelle ylettyvissä laaja-alaisissa hermoverkostoissa. Epilepsiapotilailla erojen paikantuminen riippui kohtaustenv

Background: Albumin serves a range of physiological functions that are vital to overall brain and cognitive health. Indeed, associations between cognitive performance and albumin have been demonstrated in individuals with chronic liver or kidney disease and in patients with a high urinary excretion of albumin. However, an association of plasma albumin with cognitive performance has not been reported in otherwise healthy participants with clinically acceptable plasma albumin concentrations. Method: This study utilized a wide-ranging neuropsychological test battery to investigate the relationship between cognitive performance and plasma albumin homeostasis in 222 healthy participants (143 females) between the ages of 43 and 84 years (mean 65 years). Results: Albumin both with and without the covariates of age, sex and acute-phase proteins was positively associated with enhanced performance on a range of neuropsychological domains including perceptual speed, Stroop and verbal ability. Albumin manifested generally positive but less robust associations with secondary and primary memory. Conclusion: The results indicate that there is a positive association between albumin and cognitive performance in physiologically healthy participants free of chronic renal or liver disease.

Individuals who carry the apolipoprotein E ε4 polymorphism have an increased risk of late-onset Alzheimer's disease. However, because possession of the ε4 allele confers an increased risk for the diagnosis of dementia, it has proven problematic in older individuals to dissociate the influence of ε4 on cognitive capacity per se as distinct from its influence on clinical diagnostic status. We report a statistical approach that attempts to partial out the influence of diagnostic group membership (Alzheimer's disease, mild cognitive impairment, healthy control) from the influence of apolipoprotein ε4 genetic status on cognitive functioning. The cognitive phenotype hypothesis predicts that ε4-positive individuals will show cognitive deficits (relative to matched ε4-negative individuals) independent of the development of Alzheimer's disease. By contrast, the prodromal/preclinical Alzheimer's disease hypothesis proposes that the effect of apolipoprotein E status on cognitive performance is a function of the increased risk of dementia in individuals with the ε4 allele. We evaluated these hypotheses in the Australian Imaging, Biomarkers and Lifestyle cohort (n = 1112). We first determined whether previously reported findings concerning ε4 status and age-related neuropsychological performance could be explained by the inadvertent recruitment of people with mild cognitive impairment into the healthy control group. We then tested each diagnostic group in isolation to identify any neuropsychological patterns that may be attributed to the ε4 allele. Finally, as interactions between the ε4 allele and age have previously been reported in cognitive functioning within healthy elderly populations, we attempted to determine whether the inclusion of mild cognitively impaired individuals in the sample may drive this relationship. An extensive battery of standardized, well-validated neuropsychological tasks was administered to a final sample of 764 healthy control subjects, 131 individual

Traumatic brain injury (TBI) in adolescents and adults can result in cognitive, emotional, behavioral and neurological deficits that can persist more than a year after an injury. The current preliminary study used 3D magnetic resonance spectroscopic imaging (MRSI) and comprehensive neuropsychological assessment to determine if prolonged cerebral metabolic and cognitive alterations occur in individuals with persistent neurocognitive deficits following a mild TBI (mTBI). The current study evaluated the potential interactions between cerebral metabolism and neuropsychological performance, coping style, mood, and perceived quality of life in mTBI subjects with chronic post-concussive symptoms. The mTBI subjects performed worse than controls on neuropsychological measures, endorsed poorer mood and reported significantly poorer perceived quality of life than healthy controls. Additionally, cerebral metabolic differences were found between groups as well as significant interactions between neuropsychological performance and cerebral metabolism. The current findings may potentially guide future research to more eagerly strive to understand possible ways to alter cerebral metabolism, possibly through medication, diet, or other behavioural changes.

Traumatic brain injury (TBI) in adolescents and adults can result in cognitive, emotional, behavioral and neurological deficits that can persist more than a year after an injury. The current preliminary study used 3D magnetic resonance spectroscopic imaging (MRSI) and comprehensive neuropsychological assessment to determine if prolonged cerebral metabolic and cognitive alterations occur in individuals with persistent neurocognitive deficits following a mild TBI (mTBI). The current study evaluated the potential interactions between cerebral metabolism and neuropsychological performance, coping style, mood, and perceived quality of life in mTBI subjects with chronic post-concussive symptoms. The mTBI subjects performed worse than controls on neuropsychological measures, endorsed poorer mood and reported significantly poorer perceived quality of life than healthy controls. Additionally, cerebral metabolic differences were found between groups as well as significant interactions between neuropsychological performance and cerebral metabolism. The current findings may potentially guide future research to more eagerly strive to understand possible ways to alter cerebral metabolism, possibly through medication, diet, or other behavioural changes.

The increased survival of patients with low grade gliomas generated increased interest in the neurotoxic effects associated with treatment, especially radiotherapy. Currently, the radiotherapy is associated with visual memory failures in this population. On the contrary, some authors postulate that radiotherapy, as well as other treatments, helps control the disease and preserves the neuropsychological performance. However, methodological limitations of these studies and the difficulty in monitoring these patients could be causing this divergence in the results found in this research field. Therefore, we note the need for studies that use radiation therapy treatment techniques current, which increase safety and reduce neurological side effects, and apply appropriate questionnaires with a sensitivity to the neurotoxic effects of adjuvant treatments., El aumento en las tasas de supervivencia de los pacientes con gliomas de bajo grado está suscitando un elevado interés en los efectos neurotóxicos asociados a los tratamientos, en especial a la radioterapia. En la actualidad, se señala la presencia de alteraciones principalmente en memoria visual asociada a dicha técnica de tratamiento, aunque existen datos contrarios que postulan que la radioterapia, al igual que otros tratamientos, favorece el control de la enfermedad y preserva el rendimiento neuropsicológico de esta población. No obstante, las limitaciones metodológicas de estos estudios y la dificultad en el seguimiento de estos pacientes podrían estar provocando esta divergencia en los resultados hallados en este campo de investigación. Por ello, se reitera la necesidad de realizar estudios que utilicen las técnicas de tratamiento de radioterapia actuales,que aumentan la seguridad y disminuyen los efectos secundarios neurológicos, así como que apliquen cuestionarios con una adecuada sensibilidad a los efectos neurotóxicos de los tratamientos adyuvantes.

The increased survival of patients with low grade gliomas generated increased interest in the neurotoxic effects associated with treatment, especially radiotherapy. Currently, the radiotherapy is associated with visual memory failures in this population. On the contrary, some authors postulate that radiotherapy, as well as other treatments, helps control the disease and preserves the neuropsychological performance. However, methodological limitations of these studies and the difficulty in monitoring these patients could be causing this divergence in the results found in this research field. Therefore, we note the need for studies that use radiation therapy treatment techniques current, which increase safety and reduce neurological side effects, and apply appropriate questionnaires with a sensitivity to the neurotoxic effects of adjuvant treatments., El aumento en las tasas de supervivencia de los pacientes con gliomas de bajo grado está suscitando un elevado interés en los efectos neurotóxicos asociados a los tratamientos, en especial a la radioterapia. En la actualidad, se señala la presencia de alteraciones principalmente en memoria visual asociada a dicha técnica de tratamiento, aunque existen datos contrarios que postulan que la radioterapia, al igual que otros tratamientos, favorece el control de la enfermedad y preserva el rendimiento neuropsicológico de esta población. No obstante, las limitaciones metodológicas de estos estudios y la dificultad en el seguimiento de estos pacientes podrían estar provocando esta divergencia en los resultados hallados en este campo de investigación. Por ello, se reitera la necesidad de realizar estudios que utilicen las técnicas de tratamiento de radioterapia actuales,que aumentan la seguridad y disminuyen los efectos secundarios neurológicos, así como que apliquen cuestionarios con una adecuada sensibilidad a los efectos neurotóxicos de los tratamientos adyuvantes.

We explored the possible augmenting effect of traumatic brain injury (TBI) history on HIV (human immunodeficiency virus) associated neurocognitive complications. HIV-infected participants with self-reported history of definite TBI were compared to HIV patients without TBI history. Groups were equated for relevant demographic and HIV-associated characteristics. The TBI group evidenced significantly greater deficits in executive functioning and working memory. N-acetylaspartate, a putative marker of neuronal integrity, was significantly lower in the frontal gray matter and basal ganglia brain regions of the TBI group. Together, these results suggest an additional brain impact of TBI over that from HIV alone. One clinical implication is that HIV patients with TBI history may need to be monitored more closely for increased risk of HIV-associated neurocognitive disorder signs or symptoms.

We explored the possible augmenting effect of traumatic brain injury (TBI) history on HIV (human immunodeficiency virus) associated neurocognitive complications. HIV-infected participants with self-reported history of definite TBI were compared to HIV patients without TBI history. Groups were equated for relevant demographic and HIV-associated characteristics. The TBI group evidenced significantly greater deficits in executive functioning and working memory. N-acetylaspartate, a putative marker of neuronal integrity, was significantly lower in the frontal gray matter and basal ganglia brain regions of the TBI group. Together, these results suggest an additional brain impact of TBI over that from HIV alone. One clinical implication is that HIV patients with TBI history may need to be monitored more closely for increased risk of HIV-associated neurocognitive disorder signs or symptoms.

In childhood onset growth hormone deficiency (GHD) a reduction in cardiac left ventricular mass (LVMi) and impairment of cardiac systolic function, as well as in glomerular filtration rate (GFR) has been shown. In study I, we showed that a low dose of GH treatment for 10 months resulted in increased LVMi and kidney size. No significant improvement in cardiac systolic function or GFR, except for a normalisation in GFR in 3 patients, was recorded. Hypopituitary patients receiving conventional hormone treatment, but without GH replacement, have an increased mortality from cardiovascular disease and a reduced insulin sensitivity. Hypothalamic-pituitary hormone insufficiencies are well known consequences of cranial radiotherapy (CRT) and CRT has previously been part of treatment regimens in childhood acute lymphoblastic leukemia (ALL) to prevent central nervous system relapses. A decline in intellectual function has been shown 4-8.5 years after treatment with18-24 Gy of CRT in childhood ALL patients, but information on longer follow-up is missing. In study II, we aimed to investigate cardiovascular risk factors in former ALL patients, and in study III to evaluated insulin sensitivity before and after 12 months of GH treatment. In study IV, we evaluated neuropsychological performance and self-rated mental well-being. All comparisons were made with matched population controls. Further, the impact of 12 months of GH treatment on neuropsychological test scores was evaluated. We have shown that, at a median 17 years after treatment with CRT and chemotherapy, the former ALL had an increase in cardiovascular risk factors, including dyslipidemia, increased fibrinogen levels, insulin resistance, increase in fat mass and decrease in lean mass, and a marked reduction in cardiac dimensions and performance. We suggested that GH deficiency (GHD), induced by CRT is a primary cause, because 91% of the former ALL patients were GHD, and strong correlations between stimulated GH secretion

In childhood onset growth hormone deficiency (GHD) a reduction in cardiac left ventricular mass (LVMi) and impairment of cardiac systolic function, as well as in glomerular filtration rate (GFR) has been shown. In study I, we showed that a low dose of GH treatment for 10 months resulted in increased LVMi and kidney size. No significant improvement in cardiac systolic function or GFR, except for a normalisation in GFR in 3 patients, was recorded. Hypopituitary patients receiving conventional hormone treatment, but without GH replacement, have an increased mortality from cardiovascular disease and a reduced insulin sensitivity. Hypothalamic-pituitary hormone insufficiencies are well known consequences of cranial radiotherapy (CRT) and CRT has previously been part of treatment regimens in childhood acute lymphoblastic leukemia (ALL) to prevent central nervous system relapses. A decline in intellectual function has been shown 4-8.5 years after treatment with18-24 Gy of CRT in childhood ALL patients, but information on longer follow-up is missing. In study II, we aimed to investigate cardiovascular risk factors in former ALL patients, and in study III to evaluated insulin sensitivity before and after 12 months of GH treatment. In study IV, we evaluated neuropsychological performance and self-rated mental well-being. All comparisons were made with matched population controls. Further, the impact of 12 months of GH treatment on neuropsychological test scores was evaluated. We have shown that, at a median 17 years after treatment with CRT and chemotherapy, the former ALL had an increase in cardiovascular risk factors, including dyslipidemia, increased fibrinogen levels, insulin resistance, increase in fat mass and decrease in lean mass, and a marked reduction in cardiac dimensions and performance. We suggested that GH deficiency (GHD), induced by CRT is a primary cause, because 91% of the former ALL patients were GHD, and strong correlations between stimulated GH secretion