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BACKGROUND: Current studies have shown that electronic moxibustion can improve memory function in amnestic mild cognitive impairment; however, its mechanism of action needs to be further investigated. The atrophy of hippocampal volume and impairment of functional connectivity are important imaging markers of amnestic mild cognitive impairment. Whether electronic moxibustion can regulate the volume of hippocampal subregion of partients with amnestic mild cognitive impairment is worth studying. OBJECTIVE: To observe the effect of electronic moxibustion on the volume of hippocampal subregions in patients with amnestic mild cognitive impairment. METHODS: Forty patients with amnestic mild cognitive impairment were recruited from April 1, 2018 to January 31, 2019 at the community service centers around the Second Affiliated Hospital of Shenzhen University (Baoan Hospital of Southern Medical University), Shenzhen, China. They were randomly divided into treatment group (n=20) and control group (n=20). The treatment group was treated with electronic moxibustion of regulating the mind and benefiting the intelligence, while the control group was treated with placebo moxibustion. Moxibustion was given at 45 oC, 20 minutes each time, once a day, 5 times a week, for 8 weeks in total. Memory evaluation using Rivermead behavioral memory test and magnetic resonance imaging scanning for detecting the hippocampal subregion volume were performed for each patient before and after treatment, and cognitive function of each patient was assessed using Montreal cognitive assessment and mini-mental state examination. Correlation of hippocampal subregion volumes with scores on each scale was analyzed. RESULTS AND CONCLUSION: After treatment, the volumes of the left parasubiculum and the left hippocampal-amygdala migrating area increased in the treatment group but decreased in the control group, and there was a significant difference between the two groups (P < 0.05). Compared with the pretreatment data, the Rivermead behavioral memory test, Montreal cognitive assessment, and mini-mental state examination scores were significantly higher in the treatment group after treatment (P < 0.05), while there was no significant change in the three scale scores in the control group after treatment (P > 0.05). The three scale scores were higher in the treatment group than in the control group after treatment (P < 0.05). Pearson correlation analysis showed that the changes in the volume of the left parasubiculum was significantly and positively correlated with the Rivermead behavioral memory test scale score in the treatment group (r=0.418, P=0.014). To conclude, electronic moxibustion can improve memory in patients with amnestic mild cognitive impairment, and the mechanism may be the regulation of structural plasticity in hippocampal subregions. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect of bone window closure on moderate to severe traumatic brain injury (TBI) in mice by controlled cortical impact (CCI). Methods A total of 200 healthy male mice were divided into 2 groups for moderate and severe TBI. Fifty were randomly selected from each group for bone window closed, and the remaining 50 were not closed. The intracranial pressure (ICP) was monitored, the water content of brain tissue and the volume of cerebral edema were measured, the degree of neurological impairment was assessed by modified Neurological Severity Score (mNSS), and the spatial learning ability and memory were evaluated by Morris water maze test. Nissl staining assessed the degree of neuronal damage in the cerebral cortex and CA1 region of the hippocampus. Results For ICP, there were differences in ICP between the bone window closed group and the unclosed group in both the moderate and severe TBI (P = 0.007, 0.000). There were also significant differences in ICP at different observation time points after modeling (P = 0.000, 0.000). The ICP on 1 d of the moderate bone window closed group was higher than that in the moderate bone window unclosed group (P = 0.009), 1 d (P = 0.000) and 3 d (P = 0.038) of the severe bone window closed group was higher than that of the severe bone window unclosed group. On 7 d, the ICP in the moderate bone window closed group (P = 0.000, 0.000) and the severe bone window closed group (P = 0.000, 0.008) was lower than that on 1 and 3 d, and the ICP on 3 d was also lower than that on 1 d (P = 0.000, 0.000). The ICP in the moderate bone window unclosed group on 7 d was lower than that on 1 d (P = 0.031). The water content of brain tissue was lower on 1 d (P = 0.028), 3 d (P = 0.023) and 7 d (P = 0.023) in severe bone window closed group than that of severe bone window unclosed group. The volume of brain edema in the bone window closed group was smaller than that in the bone window unclosed group (P = 0.021, 0.037). In the evaluation of the degree of neurological impairment, there were differences in mNSS scores at different observation time points between the bone window closed group and the bone window unclosed group (P = 0.000, 0.001). On 7 d, the mNSS scores of the moderate bone window closed group (P = 0.002), the moderate bone window unclosed group (P = 0.013) and the severe bone window closed group (P = 0.009) were all lower than those on 1 d. The mNSS scores of the severe bone window closed group (P = 0.006) and the severe bone window unclosed group (P = 0.002) were all lower than those of 3 d. Morris water maze test showed that the platform latency of mice in the severe bone window closed group was longer than that in the severe bone window unclosed group (P = 0.045), and the target quadrant residence time was shorter than that in the severe bone window unclosed group (P = 0.025). Nissl staining showed compared with the moderate bone window unclosed group, the density of Nissl bodies in cerebral cortex neurons was decreased, the staining was lighter, and the density of Nissl bodies in cerebral cortex neurons of CA1 region of hippocampus was decreased, the Nissl staining was lighter and the shape was blurred in the moderate bone window closed group. In severe TBI model mice, compared with the bone window unclosed group, the density of Nissl bodies in cerebral cortex and hippocampal CA1 region of the bone window closed group was decreased, the staining was blurred, and more metachromic particles appeared, hippocampal CA1 region body edema, the Nissl staining blurred. Conclusions In moderate TBI model mice, bone window closure increases ICP in the acute stage, but has no significant effect on the degree of cerebral edema, neurological function and cognitive function. In severe TBI model mice, bone window closure can lead to increased ICP and decreased spatial learning ability and memory, but it can reduce the degree of brain edema and improve neurological function. It is suggested that bone window closure should be selected according to the purpose of the study. [ABSTRACT FROM AUTHOR]

Objective To analyze relationship between autonomic nervous function and cognitive function in elderly patients with Parkinson's disease (PD). Methods A total of 130 elderly patients with PD admitted to The Affiliated Brain Hospital of Nanjing Medical University from January 2020 to December 2022 were included. Hoehn-Yahr staging was used to evaluate stage of the disease, Unified Parkinson's Disease Rating Scale III (UPDRS III) was used to evaluate the severity of motor disorders, Scales for Outcomes in Parkinson's Disease - Autonomic (SCOPA - AUT) was used to evaluate autonomic nervous function, Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate cognitive function, Non-Motor Symptoms Scale (NMSS) was used to evaluate the severity of nonmotor symptoms. Results According to whether the patients were accompanied by Alzheimer's disease (AD), they were divided into a group with AD (n = 82) and a group without AD (n = 48). The proportion of Hoehn-Yahr staging 3 to 5 (χ² = 5.689, P = 0.017), UPDRS III score (t = 21.490, P = 0.000), SCOPA-AUT score (t = 21.330, P = 0.000), dysregulation of body temperature (χ² = 8.512, P = 0.004), urinary dysfunction (χ² = 17.270, P = 0.000), gastrointestinal dysfunction (χ² = 24.471, P = 0.000), dysregulation of pupil (χ² = 5.299, P = 0.021), cardiovascular dysfunction (χ² = 15.355, P = 0.000) and NMSS score (t = 32.309, P = 0.000) in the group with AD were higher than those in the group without AD, the MMSE (t = 4.730, P = 0.000) and MoCA (t = 6.840, P = 0.000) total scores and subtype scores (P = 0.000, for all) in the group with AD were lower than those in the group without AD. Correlation analysis showed that the SCOPA-AUT score of PD patients with AD was negatively correlated with MMSE and MoCA total scores and subtype scores (P = 0.000, for all). Conclusions The autonomic dysfunction of elderly PD patients with AD is more serious, and the autonomic nervous function is closely related to cognitive function. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore changes of brain structure in patients with functional movement disorder (FMD) and their correlation with disease severity. Methods Nine patients with FMD (FMD group) as well as 10 gender⁃ and age⁃matched healthy volunteers (control group) were recruited in Ruijin Hospital, Shanghai Jiaotong University School of Medicine, from May to October 2023, and then they underwent MRI. Simplified Functional Movement Disorder Rating Scale (S ⁃FMDRS) was used to assess movement disorder symptoms and severity. Clinical Global Impression ⁃ Severity (CGI ⁃ S) was used to evaluate disease severity. Somatoform Dissociation Questionnaire ⁃ 20 (SDQ ⁃20) was used to assess body dissociation. Chinese version of Maltreatment and Abuse Chronology of Exposure (MACE) was used to assess childhood abuse situation. 36⁃Item Short Form of Health Survey (SF⁃36) was used to assess health status. Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale 17 (HAMD⁃17) were used to evaluate anxiety and depression. Results Compared with the control group, the FMD group exhibited higher scores on SDQ⁃20 (Z = 2.259, P = 0.028) and Chinese version of MACE (t = ⁃ 3.570, P = 0.002) as well as HAMA (t = ⁃ 3.999, P = 0.001), while SF⁃36 scores for vitality (t = 3.091, P = 0.009) and social functioning (t = 2.275, P = 0.046) were lower in the FMD group. Cortical thickness was greater in the FMD group in the right inferior occipital gyrus and sulcus cortex (t = ⁃ 2.924, P = 0.009), right anterior cingulate gyrus and sulcus cortex (t = ⁃ 3.286, P = 0.004), right orbitofrontal cortex (t = ⁃ 2.381, P = 0.029), while thickness in the left subcallosal area (t = 2.492, P = 0.023) and left paracentral lobule gyrus and sulcus (t = 2.139, P = 0.047), as well as volume of the right cerebellar white matter (t = 2.685, P = 0.016), left cerebellar white matter (t = 2.121, P = 0.049), and the middle posterior region of the corpus callosum (t = 2.550, P = 0.021) were smaller than those of the control group. Correlation analysis revealed left cerebellar white matter were positively correlated with disease duration (r = 0.837, P = 0.038), while cortical thickness in the left subcallosal area were negatively correlated with disease duration (r = ⁃ 0.831, P = 0.040). Conclusions There are structural changes in the limbic system, sensorimotor area, visual cortex, and certain white matter regions in the brains of FMD patients, and several regions were correlated with the disease duration.

Objective To investigate the changes of neural function and its correlation with cognitive function and emotion in patients with neuropsychiatric systemic lupus erythematosus (NPSLE). Methods A total of 46 patients with systemic lupus erythematosus (SLE) admitted to The Affiliated Taizhou People's Hospital of Nanjing Medical University from June 2020 to September 2022 were included. The patients were divided into the NPSLE group (n = 26) and the non⁃NPSLE group (n = 20) based on the presenceor absence of neuropsychiatric symptoms. The mean regional homogeneity (mReHo) and mean fractional amplitude of low⁃frequency fluctuation (mfALFF) were calculated by resting⁃state fMRI (rs⁃fMRI). The Mini⁃Mental State Examination (MMSE) was used to evaluate overall cognitive function, the Fatigue Scale for Motor and Cognitive Functions (FSMC) was used to assess both motor and cognitive fatigue, and the Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression mood. Pearson correlation analysis and partial correlation analysis were conducted to explore the correlation of mReHo and mfALFF values in various brain regions with neuropsychologcial tests. Results The MMSE scores in NPSLE group was lower than non⁃NPSLE group (Z = ⁃ 3.934, P = 0.000). Additionally, the FSMC⁃ Motor (t = 2.016, P = 0.050), FSMC⁃Cognition (t = 2.055, P = 0.046), HADS⁃Anxiety (Z = ⁃ 2.424, P = 0.015) and HADS⁃Depression (Z = ⁃ 2.731, P = 0.006) scores in NPSLE group were higher than those in non⁃NPSLE group. The mReHo values of the right dorsolateral superior frontal gyrus, right middle occipital gyrus, right posterior central gyrus, right inferior parietal margin angular gyrus and right inferior temporal gyrus decreased, while mfALFF values of the right middle occipital gyrus and right posterior central gyrus decreased in the NPSLE group (false discovery rate correction; voxel level P < 0.001, cluster P < 0.05). The mReHo and mfALFF in the right postcentral gyrus were both negatively correlated with HADS⁃Depression (r = ⁃ 0.483, P = 0.017; r = ⁃ 0.504, P = 0.012). The mReHo in the right inferior parietal gyrus was negatively correlated with FSMC ⁃Motor (r = ⁃ 0.475, P = 0.019) and FSMC ⁃Cognition (r = ⁃ 0.414, P = 0.044). The mReHo in the right inferior temporal gyrus was negatively correlated with FSMC⁃Cognition (r = ⁃ 0.427, P = 0.037). Conclusions NPSLE patients exhibited abnormal local activity in brain regions, and neural function is closely related to neuropsychological test.

Objective To investigate the association between retinal nerve fiber layer (RNFL) thickness and cognitive dysfunction in patients with mild ischemic stroke. Methods Total 146 patients with mild ischemic stroke that diagnosed and treated in Chengde Central Hospital in Hebei from January 2020 to December 2021 were included. Optical coherence tomography (OCT) was used to measure the RNFL thickness in each quadrant of both eyes, and Mini -Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate cognitive function. Results In patients with mild ischemic stroke, the RNFL thickness at the superior side of left eye was greater than right eye (t = - 4.589, P = 0.000), and the RNFL thickness at the temporal side of right eye was greater than left eye (t = 3.639, P = 0.000). Correlation analysis showed that the correlation between the RNFL thickness at the superior side of the left eye and the MMSE score (r = 0.385, P = 0.000), the RNFL thickness at the temporal side of the left eye and the National Institutes of Health Stroke Scale (NIHSS) score at admission (r = 0.170, P = 0.020) were positively correlated. The correlation between the RNFL thickness at the inferior side of the left eye and the history of drinking (r = - 0.216, P = 0.011), the RNFL thickness at the temporal side of the right eye and the history of hypertension (r = - 0.194, P = 0.023) were negativley correlated. Conclusions The thinning of RNFL in patients with mild ischemic stroke may have a certain degree of association with cognitive dysfunction. [ABSTRACT FROM AUTHOR]

Objective To investigate the sleep structure and autonomic nervous function of patients with chronic insomnia combined with obstructive sleep apnea (OSA) and analyze their correlation with neuropsychological characteristics. Methods A total of 91 patients with chronic insomnia admitted to Tianjin Medical University General Hospital and Airpot Hospital from September 2019 to June 2021 were included. They were divided into simple chronic insomnia group (insomnia group, n = 46) and chronic insomnia combined with OSA group (comorbidity group, n = 45) according to whether combined with OSA. And 22 volunteers matched in sex, age and education were recruited as the control group. Sleep structure and autonomic nervous function were analyzed by PSM⁃100A sleep breathing monitoring. Subjective sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS) and Insomnia Severity Index (ISI). Meanwhile, neuropsychological tests were performed. Results 1) Sleep structure: total sleep time (TST; P = 0.003, 0.002), sleep efficiency (P = 0.000, 0.019), proportion of rapid eye movement (REM; P = 0.000, 0.015), mean arterial oxygen saturation (SaO2; P = 0.000, 0.000), minimum SaO2 (P = 0.000, 0.019) in the comorbidity group were lower than those in control group and insomnia group; while the wake times (P = 0.028, 0.033) and sleep apnea hypopnea index (AHI; P = 0.000, 0.000) were higher than those in control group and insomnia group. 2) Autonomic nervous function: the low frequency coupling (LFC; P = 0.000, 0.006) and LFC/high frequency coupling (HFC) ratio (P = 0.000, 0.009) in comorbidity group and insomnia group were higher than those in control group, while HFC (P = 0.000, 0.006) and PNN50 (P = 0.000, 0.047) were lower than those in control group. 3) Neuropsychological test: the comorbidity group had a lower Mini⁃Mental State Examination (MMSE) score than the control group (P = 0.000) and insomnia group (P = 0.002), and the insomnia group had a lower MMSE score than the control group (P = 0.008). In terms of memory, Auditory Verbal Learning Test (AVLT)⁃short delayed recall, long delayed recall and recognition score were lower in the comorbidity group than those in the control group (P = 0.004, 0.000, 0.000) and insomnia group (P = 0.017, 0.000, 0.000). The AVLT⁃immediate recall score in comorbidity group was lower than that in control group (P = 0.000), and the AVLT⁃immediate recall, long delayed recall and recognition score in insomnia group was lower than those in control group (P = 0.035, 0.005, 0.020). In terms of visuospatial ability, the correct number of Benton's Judgment of Line Orientation (JLO) was less in comorbidity group than in control group (P = 0.000) and insomnia group (P = 0.000), and the correct number of JLO in insomnia group was less than that in control group (P = 0.017). In terms of attention, the number of correct number of Digit Span Test (DST) backward, DST downback and Symbol Digit Modalities Test (SDMT) in comorbidity group was less than that in control group (P = 0.000, 0.000, 0.000) and insomnia group (P = 0.000, 0.000, 0.003). The correct number of DST backward and SDMT in insomnia group was less than those in control group (P = 0.003, 0.003). In terms of executive function, the correct numbers of Stroop Color⁃Word Test (SCWT)⁃A, SCWT⁃B and SCWT⁃C in the comorbidity group were less than those in the control group (P = 0.000, 0.000, 0.000) and insomnia group (P = 0.004, 0.025, 0.044). The correct numbers of SCWT⁃A, SCWT⁃B and SCWT⁃C in insomnia group were less than those in control group (P = 0.003, 0.007, 0.011). In terms of anxiety and depression, the scores of Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) in the comorbidity group were higher than those in control group (P = 0.000, 0.000) and insomnia group (P = 0.000, 0.000), and the scores of HAMA and HAMD in insomnia group were also higher than those in control group (P = 0.000, 0.000). 4) The correlation of sleep structure and autonomic nervous function with neuropsy hological characteristics: the TST in comorborbity group was positively correlated with the correct number of DST downback (r = 0.325, P = 0.031); the proportion of REM was positively correlated with AVLT⁃immediate recall (r = 0.302, P = 0.047), short delayed recall (r = 0.299, P = 0.049), long delayed recall (r = 0.480, P = 0.001) score, and the correct number of SCWT⁃A (r = 0.311, P = 0.040). AHI was negatively correlated with JLO (r = ⁃ 0.432, P = 0.003), the correct number of DST downback (r = ⁃ 0.370, P = 0.013), SDMT (r = ⁃ 0.449, P = 0.002), and positively correlated with HAMA (r = 0.407, P = 0.006) and HAMD (r = 0.446, P = 0.013) score. The average SaO2 was positively correlated with the correct number of DST (r = 0.397, P = 0.008), and negatively correlated with HAMA (r = ⁃ 0.370, P = 0.013) and HAMD (r = ⁃ 0.351, P = 0.020) score. The minimum SaO2 was positively correlated with the correct number of JLO (r = 0.473, P = 0.001). LFC was positively correlated with HAMA (r = 0.428, P = 0.004) and HAMD (r = 0.337, P = 0.025) score. HFC was negatively correlated with HAMA (r = ⁃ 0.428, P = 0.004) and HAMD (r = ⁃ 0.337, P = 0.025) score. The LFC/HFC ratio was positively correlated with HAMA (r = 0.415, P = 0.005) and HAMD (r = 0.308, P = 0.042) score. Conclusions Patients with chronic insomnia combined with OSA have disturbed sleep structure, autonomic imbalance and cognitive decompensation, and disturbed sleep structure and autonomic nervous function may be potential mechanisms for cognitive decompensation and mood abnormalities.

Objective To analyse the neuropsychological characteristics, sleep structure and HLA ⁃ DQB1 gene distribution of narcolepsy type 1 (NT1) patients. Methods A total of 35 patients with NT1 admitted to Tianjin Medical University General Hospital, from August 2018 to November 2022 were included, all of whom underwent neuropsychological tests, noctural polysomnography (nPSG) monitoring, Multiple Sleep Latency Test (MSLT), narcolepsy evaluation and HLA ⁃ DQB1 gene detection. Results Neuropsychological tests showed the scores of Montreal Cognitive Assessment (MoCA; t = 3.159, P = 0.004) and the correct number of immediate recall of the first (t = 3.028, P = 0.004) and the second (t = 2.054, P = 0.044) of Hopkins Verbal Learning Test⁃Revised (HVLT⁃R) were lower of the NT1 group than those of the control group. Trail Making Test (TMT) ⁃B completion time (t = ⁃ 2.126, P = 0.019), Hamilton Anxiety Scale (HAMA) score (Z = ⁃ 5.109, P = 0.000), Hamilton Depression Scale⁃17 (HAMD⁃17) score (Z = ⁃ 3.204, P = 0.001), Epworth Sleepiness Scale (ESS) socre (t = ⁃ 13.609, P = 0.000) and Pittsburgh Sleep Quality Index (PSQI) score (Z = ⁃ 3.004, P = 0.003) were higher of the NT1 group than those of the control group. nPSG showed the total recording time (Z = ⁃ 4.491, P = 0.000), the proportion of non⁃rapid eye movement (NREM) 3 (Z = ⁃ 2.647, P = 0.008), the proportion of rapid eye movement (REM; t = 2.908, P = 0.005) and periodic limb movements of sleep index (PLMSI; Z = ⁃ 3.501, P = 0.000) were higher of the NT1 group than those of the control group. Sleep efficiency (t = ⁃ 2.489, P = 0.016), sleep latency (Z = ⁃ 4.112, P = 0.000), REM sleep latency (Z = ⁃ 4.318, P = 0.000) and the proportion of NREM2 (t = ⁃ 5.224, P = 0.000) were lower of the NT1 group than those of the control group. The clinical features of NT1 patients were excessive daytime sleepiness (97.14%, 34/35), cataplexy (97.14%, 34/35), other sleep disturbances (88.57%, 31/35), sleep hallucination (82.86%, 29/35), and sleep paralysis (68.57%, 24/35). And 34 cases (97.14%) carried the allele HLA ⁃ DQB1*0602. Conclusions Patients with NT1 have cognitive decline, mood change and sleep structure disorder, and the carrying rate of HLA⁃DQB1*0602 is high.

Objective To summarize the characteristics of cognitive function and sleep structure in patients with idiopathic rapid eye movement sleep behavior disorder (iRBD) and to explore the correlation between them. Methods Total 73 patients with iRBD who visited Fujian Medical University Union Hospital from August 2018 to August 2021 were included, all of whom underwent neuropsychological tests and polysomnography monitoring. Pearson and partial correlation analyses were used to explore correlation between cognitive function and sleep structure parameters. Results 1) Neuropsychological tests: iRBD patients had lower Mini ⁃ Mental State Examination (MMSE; t = ⁃ 3.703, P = 0.000), Montreal Cognitive Assessment (MoCA; t = ⁃ 4.811, P = 0.000), Verbal Fluency Test (VFT)⁃number of correct words (t = ⁃ 2.171, P = 0.032) than control group. Trail Making Test (TMT)⁃A (t = 2.500, P = 0.014), TMT⁃B (t = 2.430, P = 0.016) and Stroop Color Word Test (SCWT)⁃A (t = 2.507, P = 0.013), SCWT⁃B (t = 15.042, P = 0.000), SCWT⁃ C (t = 27.228, P = 0.000) completion times were longer than control group. 2) Polysomnography monitoring: total sleep time (t = 2.699, P = 0.008), sleep efficiency (Z = ⁃ 2.103, P = 0.035), number of sleep stage transitions (t = 3.965, P = 0.000), proportion of non⁃rapid eye movement sleep stage 1 (N1 stage) to total sleep time (t = 2.887, P = 0.005), periodic limb movement of sleep index (PLMSI; t = ⁃ 2.917, P = 0.004), periodic limb movement⁃related arousal index (Z = ⁃ 2.291, P = 0.022), and total arousal index (Z = ⁃ 2.609, P = 0.009) were higher than those in control group, and the time of wakefulness after sleep was less than those in control group (t = ⁃ 2.230, P = 0.027). 3) Correlation between cognitive function and sleep structure parameters: MoCA score was negatively correlated with the percentage of N1 stage (r = ⁃ 0.184, P = 0.035), and positively correlated with the percentage of N2 stage (r = 0.173, P = 0.049); SCWT⁃B completion time was negatively correlated with the number of awakenings (r = ⁃ 0.186, P = 0.033); SCWT⁃C completion time was positively correlated with the number of sleep phase transitions (r = 0.212, P = 0.015) and the percentage of N1 stage (r = 0.181, P = 0.039); VFT⁃number of correct words was negatively correlated with the periodic limb movement of wake index (PLMWI; r = ⁃ 0.216, P = 0.018); the number of correct China⁃Rey Auditory Verbal Learning Test (C⁃RAVLT) immediate recall was positively correlated with the rapid eye movement (REM) sleep latency (r = 0.183, P = 0.045); the number of correct C⁃RAVLT delay recall was negatively correlated with the PLMWI (r = ⁃ 0.196, P = 0.032) and PLMSI (r = ⁃ 0.180, P = 0.049); the Clock Drawing Test was positively correlated with sleep latency (r = 0.192, P = 0.035) and REM sleep latency (r = 0.199, P = 0.029), and negatively correlated with the percentage of REM sleep (r = ⁃ 0.189, P = 0.038). The Beck Depression Inventory (BDI) score was positively correlated with total sleep time (r = 0.347, P = 0.000), sleep efficiency (r = 0.319, P = 0.000) and the percentage of REM sleep (r = 0.204, P = 0.026), and negatively correlated with the time of wakefulness after sleep (r = ⁃ 0.280, P = 0.002) and the percentage of N1 stage (r = ⁃ 0.299, P = 0.001). Conclusions Patients with iRBD have cognitive dysfunction mainly manifested by decreased attention, executive function and language function, and sleep structural disorders may affect the cognitive function of such patients.

Objective To explore the relationship between depression and cognitive function in patients with mild cognitive impairment (MCI). Methods Total 106 patients with MCI were selected from December 2020 to December 2021, including 53 patients with depression based on Geriatric Depression Scale (GDS). Total 106 normal cognitive function people who received physical examination at the same time were selected, also including 53 with depression. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate overall cognitive function, Rey⁃Osterrieth Complex Figure Test (ROCFT) and Clock Drawing Test (CDT) were used to evaluate visual spatial ability, Logical Memory Test (LMT) and Auditory Verbal Learning Test (AVLT) were used to evaluate memory, Stroop Colour⁃Word Test (SCWT) and Trail Making Test (TMT) were used to evaluate attention and executive function, Verbal Fluency Test (VFT) and Boston Naming Test (BNT) were used to evaluate verbal fluency and naming ability, and Activities of Daily Living Scale (ADL) were used to evaluate activities of daily living. Results There were statistically significant differences in cognitive function of multiple dimensions among 4 groups (P

OBJECTIVE: Post-stroke cognitive impairment (PSCI) is mainly manifested as impairment of attention, orientation, memory and visuospatial functions. Repetitive transcranial magnetic stimulation can stimulate brain nerve cells, change the action potential of nerve cells, and improve brain cognitive functions such as speech, memory, attention, and executive ability. This study systematically evaluated the efficacy of repetitive transcranial magnetic stimulation in improving cognitive impairment in stroke patients. METHODS: Randomized controlled trials addressing repetitive transcranial magnetic stimulation for cognitive impairment in stroke patients were searched from CNKI, VIP database, PubMed, Cochrane Library, EBSCO, Web of Science and other electronic databases. The retrieval time was from the database inception to December 2021. Montreal Cognitive Assessment Scale, Mini-Mental State Examination, P300 event-related potential (latency, amplitude), and modified Barthel index were used as outcome indicators. The risk assessment of the screened literatures was carried out according to the Cochrane tool described in the Cochrane Handbook for Systematic Reviews of Interventions. RevMan5.4 software was used for Meta-analysis. RESULTS: A total of 16 randomized controlled trials with 847 patients were included. Meta-analysis results showed that Montreal Cognitive Assessment Scale [mean difference (MD)=3.40, 95% confidence interval (CI): 2.57-4.24, P < 0.000 1), Mini-Mental State Examination (MD=2.22, 95% CI: 0.78-3.65, P=0.002), auditory event-related potential P300 latency (MD=-27.11, 95% CI: -35.56 to -18.66, P < 0.000 1) and P300 amplitude (MD=1.91, 95% CI: 1.06-2.76, P < 0.000 1), and modified Barthel index score (MD=6.98, 95% CI: 3.41-10.56, P=0.000 1) were better in the experimental group than the control group. Subgroup analysis showed that low-frequency (≤ 1 Hz) repetitive transcranial magnetic stimulation had a slightly lower effect than high-frequency (> 1 Hz) repetitive transcranial magnetic stimulation in improving cognitive function of stroke patients, but there was no significant difference between them. CONCLUSION: Current evidence suggests that both high- and low-frequency repetitive transcranial magnetic stimulation therapies can effectively improve the cognitive function and daily living ability of stroke patients. Limited by the number and quality of included studies, the above conclusions need to be verified by more high-quality studies. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Cancer Biotherapy is the property of Editorial Office of Chinese Journal of Cancer Biotherapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI. [ABSTRACT FROM AUTHOR]

Objective To evaluate the correlation between bispectral index (BIS) and the prognosis of patients with spontaneous intracerebral hemorrhage (sICH). Methods Sixty - four patients with sICH admitted to intensive care unit after surgery in Tianjin Huanhu Hospital from March 2019 to May 2022 were enrolled. Glasgow Coma Scale (GCS), quick Sequential Organ Failure Assessment (qSOFA), Acute Physiology and Chronic Health Evaluation II (APACHEII) and intracranial pressure (ICP) monitoring were used to evaluate the severity of disease. The incidence of postoperative artificial airway establishment, invasive mechanical ventilation, intracranial infection and pulmonary infection were recorded. At the same time, continuous BIS monitoring was performed. The Glasgow Outcome Scale (GOS) and modified Rankin Scale (mRS) were used to evaluate the prognosis, and the length of hospital stay was recorded. Results According to the first BIS value, the patients were divided into a high BIS group (BIS value ≥ 60, n = 30) and low BIS group (BIS value < 60, n = 34). In the high BIS group, GCS score (t = 9.597, P = 0.000), the proportion of artificial airway establishment (χ² = 12.818, P = 0.000) and invasive mechanical ventilation (χ² = 4.099, P = 0.043), and GOS score (t = 13.964, P = 0.000) were higher than those in the low BIS group, while qSOFA score (t = - 2.033, P = 0.000), APACHEII score (t = - 7.426, P = 0.000), ICP value (t = - 6.643, P = 0.000) and mRS score (t = 4.099, P = 0.000) were lower than those in the low BIS group. Correlation analysis showed that BIS value was positively correlated with GCS score (r = 0.704, P = 0.000) and GOS score (r = 0.633, P = 0.000), and was negatively correlated with ICP value (r = - 0.668, P = 0.000), qSOFA score (r = - 0.282, P = 0.025), APACHEII score (r = - 0.646, P = 0.000) and mRS score (r = - 0.508, P = 0.000) for patients with sICH after surgery. Conclusions BIS monitoring has good application value in evaluating the prognosis of patients with sICH after surgery. [ABSTRACT FROM AUTHOR]

Objective To explore the intertemporal decision⁃making disorder in patients with Parkinson's disease (PD). Methods From January 2020 to August 2021, a total of 36 patients with PD (PD group) who diagnosed and treated in The Second People's Hospital of Hefei and The Second Affiliated Hospital of Soochow University were selected, and 39 healthy controls (control group) with matched gender age and eudcation were recruited. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Mini⁃Mental State Examination (MMSE), Verbal Fluency Test (VFT), Digit Span Test (DST), and Stroop Color⁃Word Test (SCWT) were used to evaluate the neuropsychological characteristics, the delay⁃discount rate K value in the intertemporal decision⁃making paradigm were used to evaluate the intertemporal decision⁃making ability. Results Compared with control group, the PD group had a decrease in MMSE score (Z=⁃4.536, P=0.000), correct number of VFT (Z=⁃4.555, P=0.000), correct repetition of DST⁃forwards (Z=⁃4.696, P=0.000) and DST⁃backwards (Z=⁃3.261, P=0.001), while had an increase in HAMA score (Z=⁃5.153, P=0.000), HAMD score (Z=⁃5.637, P=0.000), Stroop C-A (Z=⁃7.105, P=0.000) and K value (Z=⁃3.209, P=0.004). Correlation analysis showed that there was no correlation between K value and MMSE score, correct number of VFT, Stroop C-A, and correct repetition of DST⁃forwards and DST⁃backwards in PD patients (P＞0.05, for all). Conclusions Patients with PD have symptoms of intertemporal decision⁃making disorder. They can't reasonably balance the value of delayed reward, prefer immediate reward, and have more impulsive decision⁃making behavior.

Objective To evaluate the improvement of superficial temporal artery⁃middle cerebral artery (STA⁃MCA) bypass combined with encephalo⁃myo⁃synangiosis (EMS) on cognitive function in patients with moyamoya disease (MMD). Methods Total 37 patients with MMD treated with STA⁃MCA+EMS in Tianjin Medical University General Hospital from July 2017 to June 2020 were reviewed. Mini⁃Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT), Trail Making Test⁃A (TMT⁃A), Trail Making Test⁃B (TMT⁃B), Verbal Fluency Test (VFT) and Rey⁃Osterrieth Complex Figure Test (ROCFT) were used to evaluate overall cognitive function, memory, attention, executive function, language function and visuospatial function in all patients one week before surgery and 6 months after surgery. Results Compared with one week before surgery, the MMSE score [24 (23, 26) score vs. 25.00 (23.50, 27.00) score; Z=⁃4.201, P=0.000] and ROCFT score [28 (23, 30) score vs. 31.00 (28.50, 32.00) score; Z=⁃3.968, P=0.004] increased, while the TMT⁃A test [69.00 (56.00, 87.50) s vs. 42 (37, 48) s; Z=⁃5.144, P=0.002] and TMT⁃B test [177 (168, 190) s vs. 138 (133, 144) s; Z=⁃5.309, P=0.001] decreased at 6 months after surgery. There was no statistic difference of AVLT⁃1R (Z=⁃1.595, P=0.113), AVLT⁃5R (Z=⁃1.573, P=0.121) and VFT (Z=⁃1.616, P=0.124) before and after surgery. Conclusions STA⁃MCA+EMS can improve the overall cognitive function, attention, executive function and visuospatial ability of patients with MMD, but has no significant effect on short⁃term memory, long⁃term memory and language function, and can improve cognitive function and the quality of life.

Objective To summarize the clinical and imaging features of patients with posterior cortical atrophy (PCA). Methods and Results Five patients with PCA admitted in West China Hospital, Sichuan University from April to June 2021 were included. All of them showed spatial perception disorder, simultaneous agnosia, miscalculation, agraphia, structural apraxia, environmental agnosia. Apraxia of dressing and agnosia of left and right were found in 3 cases. One case had facial agnosia, visual ataxia and object perception disorder. Cerebrospinal fluid (CSF) biomarker determination: amyloid β-protein 42 (Aβ42) decreased in 3 cases, the ratio of Aβ42/amyloid β-protein 40 (Aβ40) decreased significantly in 2 cases, the content of total tau protein (t-tau) increased in all 5 cases, phosphorylated tau 181 protein (p-tau181) increased in 3 cases. Neuropsychological tests showed that: 1) Five patients all had different degrees of cognitive dysfunction and impairment of activities of daily living, as well as impairment of visuospatial ability, visual memory and attention. 2) Three cases had anxiety and depression, language and executive function were impaired in 3 cases, and verbal memory was impaired in 2 cases. Head MRI examination all indicated different degrees of parieto-occipital-temporal cortical atrophy. Hypometabolism in posterior regions involving parietal and temporal cortex was observed in one case with 18F-FDG PET. Three cases completed the visual field examination, including 5 cases of binocular vision loss, one case of complete visual field defect, 2 cases of partial visual field defect. Except one case lost to follow-up, other 4 cases were followed up for 20-22 months. Two cases of cognitive function, visuospatical ability decline, of which one case could not take care of themselves most of the life. Cognitive function and visuospatial ability improved in one case. There was no significant change in cognitive function and visuospatial ability in one case. Conclusions PCA should be considered in patients with relatively early-onset of agnosia, visual field defect and visuospatial impairment. Comprehensive neuropsychological tests related to visual function, brain MRI, 18F-FDG PET and CSF biomarkers would be helpful for accurate diagnosis. [ABSTRACT FROM AUTHOR]

Objective To analyze the correlations between plasma orexin-A and clinical manifestations of dementia with Lewy bodies (DLB). Methods A total of 51 patients with DLB from Beijing Tiantan hospital, Capital Medical University, and 46 sex, age and education matched controls were conducted from January 2019 to December 2021. Overall cognitive function was assessed by Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), dementia severity was assessed by Clinical Dementia Rating Scale (CDR), activities of daily living was assessed by Activities of Daily Living Scale (ADL), depression severity was assessed by Hamilton Depression Rating Scale 17 (HAMD-17), neuropsychiatric symptoms was assessed by Neuropsychiatric Inventory (NPI), and plasma orexin-A level was measured. The univariate and multivariate Logistic regression analyses were used to screen influencing factors for DLB. Pearson and partial correlation analyses were used to explore the correlation between plasma orexin-A and core clinical features of DLB. Multivariate linear stepwise regression analysis was used to analyze the linear correlation between plasma orexin-A level and neuropsychological tests. Results The scores of MMSE (Z = -8.387, P = 0.000) and MoCA (Z = -8.479, P = 0.000) in DLB group were significantly lower than those in control group, while the scores of CDR (Z = -9.072, P = 0.000), ADL (Z = -8.692, P = 0.000), HAMD-17 (Z = -7.568, P = 0.000), NPI (Z = -8.270, P = 0.000) and plasma orexin-A level (Z = -2.688, P = 0.007) were significantly higher than those in control group. Plasma orexin-A level in DLB patients with fluctuating cognition (Z = -2.172, P = 0.030) and with Parkinsonism (Z = -1.981, P = 0.048) were lower than those without these symptoms, respectively. Logistic regression analysis showed drinking history was a potentially independent protective factor for DLB (OR = 0.278, 95%CI: 0.095-0.808; P = 0.019), while increased plasma orexin-A level was an independent risk factor for DLB (OR = 6.878, 95%CI: 1.241-38.137; P = 0.027). Correlation analysis showed that plasma orexin-A level was negatively correlated with the occurrence of Parkinsonism in patients with DLB (r = -0.322, P = 0.043). Multivariate linear stepwise regression analysis showed no statistically significant relationship between the plasma orexin-A level and the scores of neuropsychological tests (P > 0.05, for all). Conclusions The plasma orexin-A level in patients with DLB were higher than controls, and the elevated plasma orexin-A level could significantly increase the risk of DLB, while reduce the incidence of Parkinsonism. Dysfunction of orexin-A system might be a potential mechanism for the occurrence of DLB. [ABSTRACT FROM AUTHOR]

Objective To report clinical phenotype and gene mutation characteristics of one case of early-onset Alzheimer's disease (EOAD) associated with PSEN2 V214L mutation and conduct a pedigree analysis. Methods and Results A 63-year-old male proband with no family history of dementia, onset at 58 years old, had memory loss as the first manifestation and progressive aggravation of symptoms. Neuropsychological tests showed a score of 1 on Mini-Mental State Examination (MMSE), 0 on Montreal Cognitive Assessment (MoCA), 71 on Activities of Daily Living Scale (ADL), and 3 on Hachinski Ischemic Score (HIS). Head MRI revealed extensive cortical atrophy, with prominent atrophy of bilateral hippocampal, multiple hyperintensity in deep white matter (Fazekas grade 2). Exons of high-throughput sequencing of dementia-related genes showed that both the proband and his sister had heterozygous missense mutations in exon 8 of PSEN2 gene c.640G > T (p.V214L) and heterozygous splicing mutations in exon 28 of SORL1 gene c.3815-4A > C. The proband was finally diagnosed with EOAD associated with PSEN2 V214L mutation, and the proband's sister was considered as an absolute risk group for Alzheimer's disease (AD). Conclusions The PSEN2 V214L mutation probably causes EOAD. Further investigations should be conducted to evaluate the effects on the production of amyloid β-protein 40 and 42 (Aβ40 and Aβ42), then verify its pathogenicity. [ABSTRACT FROM AUTHOR]

Subjective cognitive decline (SCD) refers to the preclinical stage of Alzheimer's disease (AD) in which patients have the chief complaint of cognitive decline but no objective manifestations. It is considered to be an earlier stage of mild cognitive impairment (MCI) than the preclinical stage of AD, and the risk of progression to AD is higher. At present, there is a limited understanding of SCD in China. This paper reviews the concept of SCD, the status quo of epidemiological research, research framework, related risk factors, its relationship with AD, as well as the progress of neuropsychological tests and imaging research, so as to provide the possibility for the early clinical diagnosis and treatment of AD. [ABSTRACT FROM AUTHOR]

Objective To explore the relationship between depression and cognitive function in patients with mild cognitive impairment (MCI). Methods Total 106 patients with MCI were selected from December 2020 to December 2021, including 53 patients with depression based on Geriatric Depression Scale (GDS). Total 106 normal cognitive function people who received physical examination at the same time were selected, also including 53 with depression. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate overall cognitive function, Rey-Osterrieth Complex Figure Test (ROCFT) and Clock Drawing Test (CDT) were used to evaluate visual spatial ability, Logical Memory Test (LMT) and Auditory Verbal Learning Test (AVLT) were used to evaluate memory, Stroop Colour-Word Test (SCWT) and Trail Making Test (TMT) were used to evaluate attention and executive function, Verbal Fluency Test (VFT) and Boston Naming Test (BNT) were used to evaluate verbal fluency and naming ability, and Activities of Daily Living Scale (ADL) were used to evaluate activities of daily living. Results There were statistically significant differences in cognitive function of multiple dimensions among 4 groups (P < 0.05, for all). The MMSE and MoCA scores of the MCI group with depression were lower than those of the control group (P = 0.000, for all), the depression group (P = 0.000, for all) and the MCI group without depression (P = 0.000, for all). The ROCFT-imitation, recall, and CDT scores in the MCI group with depression were lower than those in the control group (P = 0.000, for all), the depression group (P = 0.000, for all), and the MCI group without depression (P = 0.000, for all). The LMT-immediate and delayed recall scores of the MCI group were lower than those of the control group (P = 0.000, 0.000, 0.002, 0.001) and the depression group (P = 0.000, 0.000, 0.040, 0.043). The LMT-delayed recall scores of the MCI group with depression were lower than those of the MCI group without depression (P = 0.030). The AVLT-immediate recall, short delayed recall, long delayed recall, and recognition scores in the MCI group with depression were lower than those in the control group (P = 0.000, for all), the depression group (P = 0.000, for all), and the MCI group without depression (P = 0.009, 0.003, 0.017, 0.001). The time of SCWT-A, SCWT-B and SCWT-C, TMT-A, and TMT-B in the MCI group with depression was longer than that in the control group (P = 0.001, 0.000, 0.000, 0.000, 0.000), the depression group (P = 0.008, 0.001, 0.001, 0.001, 0.001), and the MCI group without depression (P = 0.001, 0.000, 0.000, 0.000, 0.004). The correct number of SCWT-A, SCWT-B and SCWT-C was less than that in the control group (P = 0.003, 0.008, 0.001), and the depression group (P = 0.016, 0.031, 0.002). The correct number of SCWT-A and SCWT-C was lower than that of the MCI group without depressive (P = 0.003, 0.008). The correct number of VFT-animals and vegetables, BNT in the MCI group with depression was lower than that in the control group (P = 0.000, for all), the depression group (P = 0.016, 0.003, 0.000), and the MCI group without depression (P = 0.010, 0.005, 0.000). The ADL score of the MCI group with depression was higher than that of the control group (P = 0.000), the depression group (P = 0.001), and the MCI group without depression (P = 0.000), while the ADL score of the depression group was higher than that of the control group (P =0.014) and the MCI group without depression (P = 0.001). The GDS scores of the control group and the MCI group without depressive were lower than those of the depressive group (P = 0.000, for all) and the MCI group with depression (P = 0.000, for all). Correlation analysis showed that GDS scores were correlated with MMSE (r = -0.300, P = 0.000), MoCA (r = -0.357, P = 0.000), ROCFT-copy (r = -0.192, P = 0.006) and recall (r = -0.142, P = 0.044), CDT (r = -0.171, P = 0.015), LMT-immediate recall (r = -0.213, P = 0.002), delayed recall (r = -0.193, P = 0.005), AVLT-immediate recall (r = -0.159, P = 0.021), short delay recall (r = -0.161, P = 0.020) and long delay recall (r = -0.137, P = 0.047), correct number of SCWT-A (r = -0.156, P = 0.025), VFT-animals (r = -0.271, P = 0.000) and vegetables (r = -0.145, P = 0.038), BNT (r = -0.194, P = 0.005) were negatively correlated; compared with the completion time of SCWT-A (r = 0.162, P = 0.020), SCWT-B (r = 0.189, P = 0.007), SCWT-C (r = 0.184, P = 0.009) and TMT-A (r = 0.189, P = 0.006), and ADL score (r = 0.367, P = 0.000) were positively correlated. Conclusions MCI patients with depression have more extensive and severe cognitive deficits, and their psycho-mental states should be paid more attention. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the characteristics of temporal lobe epilepsy (TLE) executive function and its correlation with neuropsychological tests. Methods A total of 25 patients with TLE [including 8 patients with left TLE (LTLE) and 17 patients with right TLE (RTLE)] and 15 healthy controls with matched sex, age and education level admitted to Tianjin Medical University General Hospital and China Resources & WISCO General Hospital from June 2017 to December 2018 were enrolled. Neuropsychological tests [including Mini-Mental State Examination (MMSE), Hamilton Anxiety Rating Scale (HAMA), Beck Depression Inventory (BDI)] and executive function tests [including digital working memory, verbal working memory, Stroop Color-Word Test (SCWT), Trail Making Test-A and B (TMT-A and TMT-B), and Verbal Fluency Test (VFT)] were performed. Pearson correlation analysis and partial correlation analysis were used to explore the correlation between executive function and various factors, and multiple linear stepwise regression analysis was used to verify the linear quantitative relationship between executive function and various factors. Results MMSE score (P = 0.003), digital working memory score (P = 0.000), verbal working memory score (P = 0.000), color response time (P = 0.001), word response time (P = 0.001), color word response time (P = 0.001), TMT-A time (P = 0.010), TMT-B time (P = 0.009) and the number of VFT (P = 0.000) of LTLE group, RTLE group and control group were significantly different. MMSE score (P = 0.013, 0.029), digital working memory score (P = 0.000, 0.000), verbal working memory score (P = 0.000, 0.000) and the number of VFT (P = 0.000, 0.000) in LTLE group and RTLE group were lower than those in control group. Color response time (P = 0.047, 0.000), word response time (P = 0.002, 0.006) and color word response time (P = 0.024, 0.001) were longer than those in control group, but TMT-A time (P = 0.004) and TMT-B time (P = 0.002) in RTLE group were longer than those in control group. There were no significant differences in executive function scores between LTLE group and RTLE group (P > 0.05, for all). Correlation analysis showed that digital working memory score, color response time, vocabulary response time and attention transfer time were positively correlated with MMSE score, HAMA score, BDI score, age, education level, seizure frequency, type of antiepileptic drugs (P < 0.05 or P < 0.01). TMT-A time and TMT-B time were positively correlated with MMSE score, HAMA score, age, education level, seizure frequency, type of anti-epileptic drugs (P < 0.05 or P < 0.01). There was a positive correlation between color word response time and word fluency with HAMA score, age and education level (P < 0.05 or P < 0.01). Multiple linear stepwise regression analysis showed that there was a linear regression relationship between digital working memory score and seizure frequency (standardized partial regression coefficient = 0.998, P = 0.001) and type of antiepileptic drugs (standardized partial regression coefficient = -1.634, P = 0.006). There was a linear regression relationship between verbal working memory score and HAMA score (standardized partial regression coefficient = -0.089, P = 0.035), a linear regression relationship between color response time and education level (standardized partial regression coefficient = -0.097, P = 0.002), a linear regression relationship between vocabulary response time (standardized partial regression coefficient = -0.121, P = 0.004), color word response time (standardized partial regression coefficient = -0.243, P = 0.002), TMT-A time (standardized partial regression coefficient = -5.984, P = 0.002), TMT-B time (standardized partial regression coefficient = -17.376, P = 0.000), attention transfer time (standardized partial regression coefficient = -12.413, P = 0.000) and MMSE score had linear regression relationship. Vocabulary fluency and age (standardized partial regression coefficient = 0.327, P = 0.032), education level (standardized partial regression coefficient = 1.976, P = 0.001), HAMA score (standardized partial regression coefficient = -0.431, P = 0.008) had a linear regression relationship. Conclusions Executive function (working memory, inhibitory control and cognitive flexibility) was impaired in patients with TLE, but there was no significant difference in executive function between RTLE and LTLE. The older the age and the lower the education level, the more severe the overall cognitive dysfunction, the more significant decline in executive function.

Objective To explore the intertemporal decision - making disorder in patients with Parkinson's disease (PD). Methods From January 2020 to August 2021, a total of 36 patients with PD (PD group) who diagnosed and treated in The Second People's Hospital of Hefei and The Second Affiliated Hospital of Soochow University were selected, and 39 healthy controls (control group) with matched gender, age and eudcation were recruited. Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Mini-Mental State Examination (MMSE), Verbal Fluency Test (VFT), Digit Span Test (DST), and Stroop Color-Word Test (SCWT) were used to evaluate the neuropsychological characteristics, the delay-discount rate K value in the intertemporal decision - making paradigm were used to evaluate the intertemporal decision-making ability. Results Compared with control group, the PD group had a decrease in MMSE score (Z = -4.536, P = 0.000), correct number of VFT (Z = -4.555, P = 0.000), correct repetition of DST-forwards (Z = -4.696, P = 0.000) and DST-backwards (Z = -3.261, P = 0.001), while had an increase in HAMA score (Z = - 5.153, P = 0.000), HAMD score (Z = - 5.637, P = 0.000), Stroop C-A (Z = - 7.105, P = 0.000) and K value (Z = - 3.209, P = 0.004). Correlation analysis showed that there was no correlation between K value and MMSE score, correct number of VFT, Stroop C -- A, and correct repetition of DST-forwards and DST - backwards in PD patients (P > 0.05, for all). Conclusions Patients with PD have symptoms of intertemporal decision-making disorder. They can't reasonably balance the value of delayed reward, prefer immediate reward, and have more impulsive decision-making behavior. [ABSTRACT FROM AUTHOR]

Objective To investigate the prevalence of mild cognitive impairment (MCI) among the elderly in rural communities in Hangzhou, Zhejiang, and to explore the screening accuracy of Screening Scale for Mild Cognitive Impairment (sMCI) in the elderly with low education. Methods From April 2010 to September 2010, 360 elderly people in Sijiqing street, Jianggan district (now Shangcheng district), Hangzhou, Zhejiang were recruited. Dementia and MCI were judged by Mini⁃Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), sMCI and Clinical Dementia Rating Scale (CDR). Draw receiver operating characteristic (ROC) curve and calculate the area under the curve (AUC), and compare the accuracy of sMCI, MoCA and CDR scores in screening MCI. Results Finally, 171 cases completed all investigations. 1) 55 cases (32.16%) were diagnosed as MCI, including 25 cases (14.62%) of amnestic MCI (aMCI) and 30 cases of non⁃aMCI, 11 cases (6.43%) of dementia, 10 cases (5.85%) of depression, 4 cases (2.34%) of anxiety disorder, one case (0.58%) of bipolar disorder, one case (0.58%) of schizophrenia and one case (0.58%) of mental retardation. Among 154 patients with cognitive impairment, 25 cases (16.23%) were screened for dementia by MMSE, 8 cases (5.19%) were screened for dementia by CDR, and 11 cases (7.14%) were clinically confirmed; 138 cases (89.61%) of MCI were screened by MoCA, 117 cases (75.97%) by sMCI, 70 cases (45.45%) by CDR, and 55 cases (32.16%) were clinically confirmed. 2) Taking clinical diagnosis as reference standard, the ROC curve showed CDR score had the highest accuracy in screening MCI, and the AUC was 0.90 ± 0.03 (95%CI: 0.844-0.957, P=0.000); the AUC of MoCA score was 0.53 ± 0.05 (95%CI: 0.430-0.621, P=0.603); when the cut⁃off value of sMCI score was 23, the AUC was 1.00 ± 0.00 (95%CI: 1.000-1.000, P=0.000). The cut⁃off value of subjects with education level of 0-3 years was adjusted to 22, and the AUC was 0.67 ± 0.05 (95%CI: 0.578-0.756, P=0.001). 3) According to education level, they were divided into 0-3 years group (113 cases) and 4-6 years group (47 cases). Taking CDR score as the reference standard, ROC curve showed the AUC of MoCA score in screening MCI in 4-6 years group was 0.49 ± 0.17 (95%CI: 0.157-0.824, P=0.955), the cut⁃off value of sMCI score was 23, the AUC of sMCI score was 0.50 ± 0.17 (95%CI: 0.161-0.839, P=1.000); the AUC of MoCA score in the 0-3 years group was 0.51 ± 0.06 (95%CI: 0.402-0.617, P=0.858), and the cut⁃off value of sMCI score was adjusted to 22, and the AUC was 0.64 ± 0.05 (95%CI: 0.535-0.744, P=0.011). Conclusions It is more common for the elderly in the rural communities with low education to have MCI, the accuracy of sMCI in screening MCI is higher than MoCA, and the cut⁃off value is 23 (education level 4-6 years) and 22 (education level 0-3 years), which is worthy of clinical application.

Objective To explore age⁃related changes in cognitive function and establish a complete set of neuropsychological scales suitable for Chinese people. Methods From April 2018 to December 2020, a cross⁃sectional study and age stratified sampling method were used to recruit 496 healthy subjects in Hefei, Anhui and surrounding township communities, and grouped them according to age (each 10 years old as a group). A set of neuropsychological tests jointly established by the University of Hong Kong and Anhui Medical University (Battery for HKU⁃AHMU) was used to assess cognitive function. The complete set of scales covered attention and executive functions [including Digital Span Test (DST), Balloons Tests (BT), Digital Vigilance Test (DVT), Symbol Digit Modalities Test (SDMT), Color Trail Test (CTT) and Stroop Color⁃Word Test (SCWT)], memory function [including Chinese Rey Auditory⁃Verbal Learning Test (C⁃RAVLT) and Ruff Light Trail Learning Test (RULIT)], visuospatical ability [including Hooper Visual Organization Test (HVOT) and Judgment of Line Orientation Test (JLOT)], frontal fluency [including Verbal Fluency Test (VFT) and Figure Fluency Test (FFT)] having 4 dimensions. Results Among groups, the score of DST⁃forward (H=134.423, P=0.000) and backward (H=178.474, P=0.000); the reaction times of BT⁃A (H=155.433, P=0.000) and BT⁃B (H=64.204, P=0.000); the reaction time (H=224.078, P=0.000) and errors number (H=92.227, P=0.000) of DVT; the score of SDMT writing (H=229.057, P=0.000) and oral (H=226.566, P=0.000); the reaction times of CTT⁃A (H=184.292, P=0.000) and CTT⁃B (H=194.624, P=0.000), the errors number of CTT⁃B (H=20.699, P=0.001); the reaction times of SCWT⁃spot (H=74.683, P=0.000), SCWT⁃word (H=116.839, P=0.000) and SCWT⁃color word (H=84.786, P=0.000), the errors number of SCWT⁃word (H=5.555, P=0.000) and SCWT⁃color word (H=12.188, P=0.000); the score of C⁃RAVLT⁃immediate recall (F=58.765, P=0.000), delayed recall (H=160.660, P=0.000) and recognitions (H=96.833, P=0.000); the number of RULIT⁃immediate recalls correct (H=104.902, P=0.000) and incorrect (H=86.966, P=0.000), the number of delayed recalls correct (H=115.839, P=0.000) and incorrect (H=124.834, P=0.000); the score of HVOT (F=12.186, P=0.000) and JLOT (H=48.597, P=0.000); the score of VFT⁃vegetable and fruit (H=32.565, P=0.000) and VFT⁃animal vocabulary (H=55.000, P=0.000); the score of FFT (F=64.207, P=0.000) were significantly different. The four cognitive domains of attention and executive functions, memory function, visuospatial ability, and frontal fluency decreases with age, especially in people over 40 years of age. Conclusions The neuropsychological tests adopted in the Battery for HKU⁃AHMU are applicable to the mainland population and shows age⁃related declines in cognitive function with increasing age.

Objective To investigate the spatial pattern of the activation of the prefrontal and bilateral temporal cortex in first⁃episode depressive disorder patients during Verbal Fluency Test (VFT). Methods Forty first⁃episode patients who met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM⁃5) depressive disorder and 14 normal controls were both measured of spatial pattern in the prefrontal and bilateral temporal cortex by functional near⁃infrared spectroscopy (fNIRS) during VFT, at the same time, the number of words produced during VFT was recorded. The severity of depressive symptoms was assessed by Zung's Self⁃Rating Depression Scale (SDS). The spatial pattern of brain activation during VFT was compared between 2 groups, and the correlation between the oxyhemoglobin (HbO2) integral value of prefrontal or bilateral temporal lobes and SDS score were explored by Pearson correlation analysis in depressive disorder group. Results SDS score of the depressive disorder patients was higher than that of control group (68.38 ± 12.91 vs. 35.98 ± 6.83; t=11.832, P=0.000). Compared with the control group, the scores of prefrontal and bilateral temporal lobes in depression group were significantly lower during VFT [(35.25 ± 41.74) mmol•mm vs. (149.91 ± 54.88) mmol•mm, t=⁃8.140, P=0.000; (84.05 ± 59.23) mmol•mm vs. (211.01 ± 81.27) mmol•mm, t=⁃6.250, P=0.000]. There was no significant difference in the number of words between 2 groups (11.27 ± 4.35 vs. 11.92 ± 5.55; t=⁃0.450, P=0.665). There was a negative correlation between the HbO 2 integral value of bilateral temporal lobes and SDS score in patients with depressive disorder (r=⁃0.330, P=0.039), and there was no significant correlation between the HbO2 integral value of prefrontal lobe and SDS score (r=⁃0.210, P=0.184). Conclusions During the VFT, the decrease of prefrontal and bilateal temporal lobes activation and the bilateral temporal lobes HbO2 integral value is negatively correlated with the degree of depression.

Vascular cognitive impairment (VCI) is a category of syndromes from vascular mild cognitive impairment (VaMCI) to vascular dementia (VaD). It is manifested as impairment of memory, executive function, language and visuospatial ability, which has a serious impact on society, family and individual quality of life. Neuropsychological evaluation is an important basis for the current diagnosis of VCI, observation of curative effect and evaluation of disease outcome. This article reviews the research progress of VCI neuropsychological evaluation from the perspective of VCI neuropsychological characteristics and commonly used evaluation tools.

Objective To study the characteristics of cognitive and neuropsychiatric behavioral features of Alzheimer's disease (AD) with white matter lesion (WML). Methods A total of 58 cases of AD patients were reruited from January 2010 to December 2020. The Mini⁃Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to evaluate the degree of cognitive impairments. Activities of Daily Living Scale (ADL) was used to evaluate the abilities of daily living. Neuropsychiatric Inventory (NPI) was used to evaluate behavioral and psychological symptoms. The Hamilton Depression Rating Scale 21⁃Items (HAMD⁃21) was used to evaluate the mental or emotional state. Clinical Dementia Rating Scale (CDR) was used to evaluate the dementia severity. The Fazekas scale was utilized to assess the severity of periventricular white matter hyperintensities (PWMH) and deep white matter hyperintensities (DWMH). Results 1) The distribution frequency of hypertension (χ2=4.665, P=0.031), NPI score (Z=1.987, P=0.047), CDR score (Z=2.069, P=0.039), MMSE score (t=2.927, P=0.005) and MoCA score (t=3.394, P=0.001) in WML group were significantly different than those in non⁃WML group. Among which, attention and calculation ability (Z=2.234, P=0.025), recall ability (Z=2.792, P=0.005), naming ability (Z=2.382, P=0.017), retelling ability (Z=2.685, P=0.007) were lower than those in non⁃WML group. The incidence of delusion (Fisher's exact probability: P=0.046), depression/dysthymia (χ2=4.376, P=0.036), apathy/indifference (χ2=4.063, P=0.044) in WML group were significantly higher than those in non⁃WML group. 2) The distribution frequency of hypertension (χ2=11.195, P=0.001), low⁃density lipoprotein cholesterol (LDL⁃C; t=2.573, P=0.013), ADL score (Z=3.269, P=0.001), NPI score (Z=3.439, P=0.001) and CDR score (t=2.740, P=0.006) in moderate to severe WML group were higher than those in mild WML group. MMSE score (t=3.686, P=0.001) and MoCA score (t=5.225, P=0.000) were lower than those in without or mild WML group. 3) Homocysteine (Hcy; F=6.291, P=0.003), distribution frequency of hypertension (χ2=10.716, P=0.005), distribution frequency of WML (χ2=8.100, P=0.017), total Fazekas scores (H=13.658, P=0.001), Fazekas score of PWMH (H=6.540, P=0.038) and Fazekas score of DWMH (H=21.550, P=0.000) were statistically significant. While distribution frequency of hypertension (χ2=6.702, P=0.010; Fisher's exact probability: P=0.006), Hcy (P=0.039, 0.001), Fazekas total scores (Z=2.898, P=0.004; Z=3.223, P=0.001) and Fazekas score of DWMH (Z=2.807, P=0.005; Z=4.144, P=0.000) in severe dementia group were higher than those in moderate and mild dementia group, and only the distribution frequency of WML was higher than that in mild dementia group (Fisher's exact probability: P=0.008), Fazekas score of PWMH was higher than that in moderate dementia group (Z=2.567, P=0.010), and Fazekas score of DWMH in moderate dementia group was higher than that in mild dementia group (Z=2.950, P=0.003). 4) The total Fazekas scores (Z=3.284, P=0.001) and DWMH scores (Z=4.083, P=0.000) in AD patients with hypertension were significantly higher than those in AD patients without hypertension. Conclusions The degree of WML was closely related to cognitive function and neuropsychiatric behavioral symptoms of AD patients, which can be used as an observation index for the development of AD. Therefore, we should pay attention to early screening and prevention of WML related risk factors.

Objective To investigate the autonomic nervous dysfunction in patients with Alzheimer's disease (AD) and its relationship with cognitive function. Methods A total of 160 AD patients were enrolled in Shanghai Jinshan Zhongren Aged Care Hospital from July 2020 to June 2021. Min⁃Mental State Examination (MMSE), Montreal Cognitive Assessment⁃Basic (MoCA⁃B) and Scale for Outcomes in Parkinson's Disease⁃Autonomic (SCOPA⁃AUT) were used to assess the cognitive and autonomic nervous function of AD patients, and the occurrence of orthostatic hypotension (OH) in AD were evaluated with the lying and standing blood pressure testing. Spearman rank correlation analysis was used to analyze the correlation between autonomic nervous function and cognitive function. Results Compared with the mild AD group, the scores of MMSE, MoCA⁃B and their subitems were lower (P=0.000, for all), and SCOPA⁃AUT score (P=0.000) and its subitem of digestive system (P=0.000), urinary system (P=0.000) and body temperature (P=0.001) were increased in the severe AD group. The incidence of OH was 32.22% (29/90). Spearman rank correlation analysis showed that the SCOPA⁃AUT sore (rs=⁃2.980, P=0.000; rs=⁃3.580, P=0.000) and its subitem of digestive system (rs=⁃2.730, P=0.000; rs=⁃3.160, P=0.000), urinary system (rs=⁃3.000, P=0.000; rs=⁃3.240, P=0.000) and body temperature (rs=⁃0.244, P=0.005; rs=⁃3.270, P=0.000) were negatively correlated with MMSE and MoCA⁃B scores. Conclusions The autonomic nervous dysfunction and its subitem of digestive system, urinary system and body temperature were significant correlated with the cognitive impairment in AD patients. However, there is a lower incidence of OH in AD.

Objective To describe the cognitive and olfactory function profiles of frontotemporal lobar degeneration (FTLD). Methods A total of 52 FTLD patients admitted to Tianjin Huanhu Hospital from July 2014 to April 2017 were enrolled. Cognitive function was assessed by the Mini⁃Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and neuropsychiatric behavior was assessed by Neuropsychiatric Inventory (NPI). Quantitative olfactory function was assessed by T&T olfactory meter and olfactory fMRI, and changes in glucose metabolism in brain tissues were assessed by 18F⁃fluoro⁃2⁃deoxy⁃D⁃glucose (18F⁃PDG) PET. Results The cognitive dysfunction of 52 patients was mainly manifested as executive dysfunction (71.15%, 37/52), disinhibition (59.62%, 31/52), indifference (44.23%, 23/52), lack of empathy (40.38%, 21/52), memory loss (32.69%, 17/52), hyperstomia (25%, 13/52) and language disorder (3.85%, 2/52). MMSE score was 18 (4, 20), MoCA score was 11 (3, 15), and visuospatial and executive function, attention, language function, abstraction, delayed recall, and orientation were all lower than normal reference values. NPI score was 24 (7, 39), and the main manifestations were apathetic, irritable, excited, and high/euphoric. According to the T&T olfactory meter recognition domain, one case (3.45%) had normal sense of smell, 12 cases (41.38%) had mild hyposmia, 9 cases (31.03%) had moderate hyposmia, 5 cases (17.24%) had severe hyposmia, and 2 cases (6.90%) had anosmia. Olfactory fMRI showed that patients developed adaptation to odor when olfactory stimulation with gas concentration was successively from low to high (0.10%, 0.33%, 1.00%). 18F⁃FDG PET showed symmetric (2 cases) or asymmetric (4 cases) predominance of the frontal and/or temporal lobes. Conclusions In FTLD patients, executive dysfunction and neuropsychiatric behavior abnormalities were more common, while memory impairment appeared later. Abnormal olfactory function may also occur, but olfactory adaptation still exists. Neuropsychological test combined with 18F⁃FDG PET is helpful for early diagnosis and differential diagnosis.

Cognitive impairment has become one of the most important diseases threatening the health of the elderly population. How to identify and evaluate it early is the key to the early diagnosis and treatment for this kind of disease. This review compares the cognitive assessment scales commonly used at home and abroad so as to provide a reference for researchers to choose a suitable scale. It also introduces the recent progress of cognitive impairment screening scales in China in order to develop a cognitive impairment screening scale for Chinese population.

Objective To evaluate the improvement of superficial temporal artery -middle cerebral artery (STA-MCA) bypass combined with encephalo-myo-synangiosis (EMS) on cognitive function in patients with moyamoya disease (MMD). Methods Total 37 patients with MMD treated with STA-MCA + EMS in Tianjin Medical University General Hospital from July 2017 to June 2020 were reviewed. Mini - Mental State Examination (MMSE), Auditory Verbal Learning Test (AVLT), Trail Making Test - A (TMT - A), Trail Making Test-B (TMT-B), Verbal Fluency Test (VFT) and Rey-Osterrieth Complex Figure Test (ROCFT) were used to evaluate overall cognitive function, memory, attention, executive function, language function and visuospatial function in all patients one week before surgery and 6 months after surgery. Results Compared with one week before surgery, the MMSE score [24 (23, 26) score vs. 25.00 (23.50, 27.00) score; Z = - 4.201, P = 0.000] and ROCFT score [28 (23, 30) score vs. 31.00 (28.50, 32.00) score; Z = - 3.968, P = 0.004] increased, while the TMT-A test [69.00 (56.00, 87.50) s vs. 42 (37, 48) s; Z = - 5.144, P = 0.002] and TMT - B test [177 (168, 190) s vs. 138 (133, 144) s; Z = - 5.309, P = 0.001] decreased at 6 months after surgery. There was no statistic difference of AVLT-1R (Z = - 1.595, P = 0.113), AVLT-5R (Z = - 1.573, P = 0.121) and VFT (Z = - 1.616, P = 0.124) before and after surgery. Conclusions STA -MCA + EMS can improve the overall cognitive function, attention, executive function and visuospatial ability of patients with MMD, but has no significant effect on short-term memory, long-term memory and language function, and can improve cognitive function and the quality of life. [ABSTRACT FROM AUTHOR]

Vascular cognitive impairment (VCI) refers to cognitive impairment primarily mainly caused by cerebrovascular pathologies and their risk factors. It is the second leading cause of cognitive impairment in individuals aged 60 and above in China. Currently, there are no specific treatments for VCI, but early identification and prevention can help reduce the risk of onset and improve patients' prognosis. To raise awareness and attention among clinicians towards VCI and provide guidance for its standardized management, the Chinese Stroke Association Vascular Cognitive Impairment Subcommittee updated and revised the clinical classification, diagnostic procedures, neuropsychological evaluation criteria and imaging evaluation criteria and etc.on the basis of the Guidelines for the Diagnosis and Treatment of Vascular Cognitive Impairment in China (2019). Through systematic literature reviews, including meta-analysis, systematic review, randomized controlled trials, retrospective studies, clinical case-control studies, etc, evidence and recommendation levels were formulated according to the evaluation and evaluation criteria of recommendation classification, and a total of 8 recommendations were formed on the etiology, clinical classification, clinical manifestations, diagnostic criteria, prevention and treatment of VCI. A standardized diagnostic process for VCI suitable for the clinical practice in China was proposed, aiming at providing guidance for the standardized diagnosis and accurate treatment of VCI.

Objective To study the correlation between the time from rapid eye movement sleep behavior disorder (RBD) to disease onset and the clinical characteristics of Parkinson's disease (PD). Methods A total of 123 PD patients were recruited from Tianjin Huanhu Hospital between September 2019 and December 2021. All participants were divided into the group with RBD (41 cases) and the group without RBD (82 cases) according to the probable RBD criteria. Hoehn-Yahr staging was used to evaluate PD grade. Unified Parkinson's Disease Rating Scale III (UPDRS III) was used to evaluate the motor function of PD. Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD), Parkinson's Disease Sleep Scale (PDSS), and Non - Motor Symptom Scale (NMSS) were used to evaluate cognitive function, anxiety, depression, sleep and total non-motor symptoms. The life quality of patients was evaluated by 39-Item Parkinson's Disease Questionnaire (PDQ-39). Spearman rank correlation analysis was used to explore the correlation between the time from RBD to disease onset and clinical characteristics in PD. Results UPDRSIII (t = - 2.703, P = 0.008) and NMSS (t = - 2.176, P = 0.032) scores of PD with RBD group were higher than those of the PD without RBD group. The time from the RBD to the onset of PD was positively correlated with NMSS score (rs = 0.547, P = 0.001). Conclusions The motor and non-motor symptoms in PD patients with RBD are more severe than those of patients without RBD. Early onset of RBD in prodromal period may indicates more severe non-motor symptoms in future. [ABSTRACT FROM AUTHOR]

Objective To explore the risk factors of pain in de novo Parkinson's disease (PD) patients. Methods A total of 129 de novo PD patients collected from The Affiliated Brain Hospital of Nanjing Medical University from October 2018 to September 2021 were included. According to the Item-17 of the Unified Parkinson's Disease Rating Scale II (UPDRS II-17th), patients were classified as PD patients without pain (UPDRS II-17th was 0, n = 88) and PD patients with pain (UPDRS II-17th ≥ 2, n = 41). Mini-Mental State Examination (MMSE) and corrected Montreal Cognitive Assessment (corrected MoCA) were used to assess cognitive function. Meanwhile, Hamilton Depression Rating Scale-24 Items (HAMD-24) was used to assess the depression status and the UPDRS III was used to assess the motor function. The modified version of Hoehn-Yahr staging was used to assess disease severity. The related risk factors of pain in PD patients were analyzed by univariate and multivariate forward Logistic regression. Results The incidence of pain in PD patients was 31.78% (41/129). Compared with PD without pain group, PD with pain group had lower scores in MMSE (Z = - 2.389, P = 0.017) and corrected MoCA (Z = - 2.166, P = 0.030), but higher scores in HAMD-24 (Z = - 4.024, P = 0.000), UPDRS III (Z = - 3.639, P = 0.000) and Hoehn-Yahr staging grading (Z = - 2.232, P = 0.026). Further analysis of the differences between 2 groups in 7 domains of HAMD-24 showed PD with pain group had higher scores of the anxiety/somatization (Z = - 3.707, P = 0.000), mental disorder (Z = - 2.519, P = 0.012), retardation symptom (Z = - 2.048, P = 0.041), sleep disturbances (Z = - 3.484, P = 0.000) and despair symptom (Z = - 3.069, P = 0.002) than PD without pain group. Logistic regression analysis showed long duration (OR = 1.354, 95%CI: 1.013-1.809; P = 0.041), high HAMD-24 score (OR = 1.095, 95%CI: 1.033-1.162; P = 0.002) and high UPDRS III score (OR = 1.040, 95%CI: 1.001- 1.082; P = 0.046) were risk factors of pain in PD patients. Conclusions Pain in PD has a high incidence in de novo PD patients. Long duration, a depressed state and severe motor symptoms are main risk factors for the development of pain in PD patients. [ABSTRACT FROM AUTHOR]

Objective · To explore the effect of psychomotor therapy on negative symptoms and cognitive function of patients with stable schizophrenia. Methods · A random number table was used to divide 64 stable schizophrenia patients from Shanghai No.1 Civil Mental Health Center into a study group and a control group. The control group was given routine treatment, nursing and daily rehabilitation, and the study group increased psychomotor therapy on this basis. Both groups were intervened for 10 weeks, and the patients in the two groups were evaluated by the Positive and Negative Symptom Scale (PANSS), Mini Mental State Examination (MMSE), and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after the intervention. Results · Thirty patients in the study group and the control group completed the observation. The repeated-measures analysis of variance (ANOVA) showed that after 10 weeks of intervention, the score of PANSS negative symptom subscale and PANSS total score were lower than those of the control group (all P=0.000), while the scores of MMSE and RBANS were higher than those of the control group (P=0.008, P=0.000). After 10 weeks, the negative symptom subscale score and PANSS total score of the study group were lower than those before the study (all P=0.000), while the MMSE and RBANS scores were higher than those before the study (all P=0.000). Conclusion · Psychomotor therapy can improve the negative symptoms and cognitive function of patients with stable schizophrenia. [ABSTRACT FROM AUTHOR]

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Objective To explore the relationship between alteration of cerebral blood flow (CBF) and cognitive impairment in patients with white matter hyperintensity (WMH). Methods Eighty patients with WMH and 37 controls matching sex, age and education were enrolled. Patients with WMH were divided into mild WMH group (n = 33, Fazekas score 1-2) and moderate-severe WMH group (n = 47, Fazekas score 3-6). Montreal Cognitive Assessment (MoCA), Chinese Auditory Verbal Learning Test (CAVLT), Symbol Digit Modalities Test (SDMT), Color Trail Test (CTT) and Boston Naming Test (BNT) were respectively used to assess overall cognitive function, memory, attention, executive function and language. The 3D-pseudo-continuous arterial spin labeling (3D-pCASL) was used to assess CBF. The relationship between CBF and cognitive function was estimated by Pearson correlation and partial correlation analyses. Results 1) MoCA (F = 3.433, P = 0.036), CAVLT-study (F = 4.123, P = 0.019), CAVLT-immediate (F = 7.929, P = 0.001), CAVLT-delay (F = 6.738, P = 0.002), CAVLT- recognition (F = 5.762, P = 0.004), SDMT (F = 5.136, P = 0.008), CTT-A (F = 7.155, P = 0.001) and BNT (F = 4.329, P = 0.032) were statistically significant among 3 groups. The moderate-severe WMH group was less than control group in MoCA (t = 2.525, P = 0.013), CAVLT- study (t = 2.683, P = 0.009), CAVLT- immediate (t = 3.593, P = 0.004), CAVLT- delay (t = 3.497, P = 0.001), CAVLT-recognition (t = 3.264, P = 0.002), SDMT (t = 3.170, P = 0.002), BNT (t = 2.584, P = 0.011) as well as less than the mild WMH group in CAVLT-study (t = 2.025, P = 0.046), CAVLT- immediate (t = 3.033, P = 0.003), CAVLT-delay (t = 2.458, P = 0.016) and CAVLT-recognition (t = 2.181, P = 0.032), while more than control group in CTT-A (t =-3.668, P = 0.000). The mild WMH group was more than control group in CTT-A (t =-2.697, P = 0.008). 2) The CBF of right putamen, left putamen and right median cingulate were statistically significant among 3 groups [Gaussian random field (GRF) corrected, cluster P < 0.05, voxel P < 0.001]. Compared to control group and the mild WMH group, the CBF of the right putamen (t = 5.039, P = 0.000; t = 3.672, P = 0.000), the left putamen (t = 5.808, P = 0.000; t = 2.665, P = 0.009) and right median cingulate (t = 5.038, P = 0.000; t = 3.319, P = 0.001) were more in the moderate - severe WMH group. Compared to the control group, the CBF of the right median cingulate was higher in the mild WMH group (t = 1.476, P = 0.006). 3) The correlation analysis showed that in the mild WMH group, the CBF of the right putamen was positively correlated with SDMT (r = 0.478, P = 0.028), and negatively correlated with CTT-A (r =-0.483, P = 0.026), the CBF of left putamen was positively correlated with MoCA (r = 0.451, P = 0.040), and negatively correlated with CTT-A (r =-0.502, P = 0.020), the CBF of right median cingulate was positively correlated with MoCA (r = 0.446, P = 0.043); in the moderate-severe WMH group, the CBF of the right putamen was positively correlated with CAVLT-recognition (r = 0.343, P = 0.043). Conclusions The alteration of CBF in the brain may be a possible neuropathological mechanism of WMH and relate to cognitive impairment in WMH. [ABSTRACT FROM AUTHOR]

Objective To investigate characteristics of cognitive impairment in patients with ischemic deep white matter lesions (DWMLs) and the correlation of cognitive impairment with changes in cortical functionality in different brain regions. Methods We analyzed the data of 38 hospitalized patients or outpatients with mild ischemic DWMLs in our department, including 18 with cognitive impairment and 20 with normal cognitive function. Eighteen patients without DWMLs matched for age, gender and education level served as the control group. The cognitive function of the participants was assessed with neuropsychological tests, and resting-state functional magnetic resonance imaging (fMRI) was performed to detect the cortical regions with functional abnormalities based on the fractional amplitude of low frequency fluctuation (fALFF). Results We found that the patients with DWMLs had significant impairment of executive, attention, memory and visuospatial functions (P < 0.05), and deterioration of executive function and attention function could occur in early stage of cognitive impairment. The fALFFs of the bilateral middle frontal gyrus, bilateral cuneiform lobe, left anterior cuneiform lobe, left anterior cingulate gyrus, bilateral middle temporal gyrus, and left medial occipitotemporal gyrus were markedly reduced, while those of the left hippocampus-amygdaloid nucleus, left superior parietal gyrus, and left cerebellum vermis were obviously increased in patients with both DWMLs and cognitive impairment as compared with the control group (P < 0.05). In patients with DWMLs but normal cognitive function, the fALFFs of the bilateral middle frontal gyrus, left anterior cingulate gyrus, and bilateral middle temporal gyrus were also significantly decreased in comparison with the control group (P < 0.05), but no brain regions with increased fALFF were detected in these patients. Pearson correlation analysis suggested a significant correlation between these abnormalities in the brain regions and cognitive impairment in the patients with DWMLs. Conclusion DWMLs can induce impairment of the executive, attention, memory and visuospatial functions, and deteriorated executive and attention functions can be the initial symptoms of cognitive impairment caused by DWMLs. Resting-state fMRI can detect functional deterioration in multiple brain regions, which was significantly correlated with cognitive impairment in patients with ischemic DWMLs. Impaired cortical function may be one of the causes of cognitive impairment induced by ischemic DWMLs.

Objective: To quantify cerebral cortical and deep gray matter atrophy in patients with multiple sclerosis (MS) and explore its correlation with impairment in domains of cognitive function. Methods: Twenty patients with MS and 16 healthy controls (HC) matched for age, sex, and education level were included. Using FreeSurfer software, based on 3D-MRI technology, the differences in cortical thickness and deep gray matter volume between the two groups were comparatively analyzed. A neuropsychological scale that included six domains of cognitive function was scored on both study groups to analyze the correlation between cortical thickness and volume of deep gray matter in MS patients with impairment in cognitive function domains. Results: Impairment in domains of cognitive function: cognitive impairment was present in 60% MS patients in this study, mainly manifesting as impairment of verbal memory, verbal fluency, visuospatial memory, and information processing speed function (all P <0.05). Of these, the majority had impaired visuospatial memory function (55.0%), and the least number of patients had impaired information processing speed (15.0%). Changes in cortical thickness: compared with the HC group, the MS group showed that cortical atrophy was mainly concentrated in the frontoparietal region, including significant thinning of cortical thickness in the left inferior parietal gyrus, right superior frontal gyrus, and the right superior parietal gyrus (all P <0.05). Among them, atrophy of the left inferior parietal gyrus was significantly positively correlated with the impairment of verbal memory, verbal fluency, and information processing speed (all P <0.05). There was a significant positive correlation between the right superior frontal gyrus atrophy and verbal memory, verbal fluency, and visuospatial memory impairment (all P <0.05). Changes in deep gray matter volume: compared with the HC group, deep gray matter volume in the MS group decreased significantly in the bilateral thalamus, bilateral putamen, bilateral pallidum (all P <0.01), and right nucleus accumbens ( P <0.05). Among them, left thalamus atrophy was significantly positively correlated with visuospatial memory impairment ( r =0.45, P =0.046), and left putamen atrophy was both significantly positively correlated with visuospatial memory ( r =0.45, P =0.047) and information processing speed impairment ( r =0.50, P =0.026). Conclusions: Early structural brain changes in MS are dominated by gray matter atrophy. Deep gray matter is more prominent than cortical atrophy.

Copyright of Chinese Journal of Contemporary Pediatrics is the property of Xiangya Medical Periodical Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the feasibility of picture naming training in improving naming ability of patients with semantic dementia (SD). Methods A total of 14 cases of semantic dementia whose the first symptom was semantic memory impairment were given picture naming training 30 min/time, twice a day, for 5 d from October 2018 to December 2020 at Xuanwu Hospital, Capital Medical University. One day before and one day after the end of training, Picture Naming Test and Boston Naming Test (BNT) were used to evaluate the naming ability. Results After training, Picture Naming Test score (65.79 ± 34.54 vs. 49.79 ± 30.85; t = -3.297, P = 0.001) and BNT score [6.50 (4.75, 14.00) vs. 5.00 (3.00, 11.50); Z = -2.007, P = 0.045] were higher than before training. Conclusions Picture naming training can effectively improve the naming ability of patients with semantic dementia. [ABSTRACT FROM AUTHOR]

Objective To observe the application of fMRI in detecting the default mode network (DMN) of patients with carotid artery stenosis and cognitive impairment. In the combination with neuropsychological scores, to explore the relationship between DMN and cognitive function under hypoperfusion. Methods A sample of 32 individuals, who went to Beijing Tiantan Hospital affiliated to Capital Medical University for treatment since June 2017 to December 2018, have been selected for this research. Among them 16 patients were confirmed by DSA with severe stenosis (stenosis rate ≥ 70%) of unilateral internal carotid artery (ICA); while the other 16 were healthy people as normal controls. The neuropsychological tests [Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA)] and blood oxygen level-dependent functional MRI (BOLD-fMRI) were performed to all the individuals. Furthermore, the function imaging was performed to develop a brain network model and to compare the differences of functional connectivity (FC) between 2 groups. Results The MoCA score in ICA stenosis group was lower than that in normal control group [(21.19 ± 4.00) score vs. (27.94 ± 2.00) score; t = 2.609, P = 0.048], indicating there was cognitive impairment in some degree in ICA stenosis. The significant FC in ICA stenosis group and normal control group were widely distributed between the frontal lobe and the occipital lobe, within the hemisphere and between both hemispheres. The FC of ICA stenosis group was significantly weaker than that of normal control group. The functional reduction between both hemispheres was indicated in the regions including the right frontal lobe, left parietal lobe and left temporal lobe, the lower margin of right parietal lobe and left amygdala. In the hemisphere, the FC was weaken between the frontal and prefrontal lobes. A specific enhancement in the function of the local brain region was also shown in ICA stenosis group. Conclusions Regarding the patients with carotid artery stenosis and cognitive impairment, the DMN has changed. The enhancement or attenuation of the FC within the hemisphere and between both hemispheres were reflected on fMRI. This may be related to the local functional changes under long-term hypoperfusion. DOI:10.3969/j.issn.1672-6731.2019.10.006

Objective To explore effect of internal carotid artery (ICA) stenting on mild cognitive impairment (MCI) of patients with asymptomatic ICA stenosis. Methods Fifty-four patients with severe ICA stenosis (stenosis rate ≥ 70%) from October 2016 to September 2018 were studied. Cognitive function was examined in 54 patients with asymptomatic ICA stenosis 24 h before operation and 1 month, 3 months, 6 months after operation. Cognitive function was assessed with the Mini-Mental State Examination (MMSE), Trail Making Test (TMT) and Stroop Color-Word Test (SCWT). Results There were statistical differences in MMSE (P = 0.000), time of TMT-A and TMT-B (P = 0.000, 0.000), time of SCWT-A, SCWT-B and SCWT-C (P = 0.000, 0.036, 0.000), and correct number of SCWT-A (P = 0.005) before and after ICA stenting. MMSE, time of TMT-A, TMT-B and SCWT-A at 3 and 6 months after stenting were shorter than before and one month after stenting (P < 0.05, for all), while time of SCWT-C was shorter than before stenting (P < 0.05, for all). Time of SCWT-B at 6 months after stenting was shorter than before stenting (P < 0.05, for all). Correct number of SCWT-A at 6 months after stenting was higher than before and 3 months after stenting (P < 0.05, for all), which at 3 monthes after stenting was lower than one month after stenting (P < 0.05, for all). Conclusions ICA stenting can help to improve the MCI patients with asymptomatic ICA stenosis. DOI:10.3969/j.issn.1672-6731.2019.10.007

Objective To discuss the cognitive function and the clinical characteristics of hereditary cerebral small vessel disease (cSVD). Methods Clinical data,imaging and neuropsychological score of 8 patients with monogenic hereditary cSVD were included from January 2015 to January 2018. The cognitive characteristics of the patients were analyzed during the first diagnosis,follow-up for 6-month and 12-month. Results Among 8 patients, 6 patients met the diagnostic criteria of cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy (CADASIL) and 2 patients met the diagnostic criteria of cerebral autosomal recessive arteriopathy with subcortical infarct and leukoencephalopathy (CARASIL). The main manifestations of CADASIL patients were acute cerebral infarction (2 cases), dizziness and headache (1 case) and cognitive impairment (3 cases), and CARASIL patients showed dizziness (1 case) or cognitive impairment (1 case) during the first diagnosis. Head MRI showed subcortical white matter lesions in different parts and degrees. Three patients had decreased activity of daily living and four patients had different degrees of neuropsychiatric and behavioral disorders, one case might have anxiety and mild depression. All patients had different degrees of neuropsychiatric and behavioral disorders at 6-month follow-up. Patients with CADASIL suffered from impairment of delayed recall, visuospatial and executive function, abstract ability, language, attention and computational ability, as well as neuropsychiatric behavior disorders such as irritability, emotional apathy, agitation and abnormal motor behavior. Patients with CARASIL suffered from impairment of executive function, orientation (time, place) and short term memory. In addition to irritability, apathy, agitation and abnormal motor behavior, there were delusions, depression and sleep disorders. Conclusions The progress and changes of cognitive function in patients with CARASIL and CADASIL have different characteristics, and there are differences among individuals.

The process approach,a set of analytical methods used in neuropsychology,quantifies the word-list learning tests and conventional analytical methods and fully reflects the memory profile of the subject.Therefore,it is widely used in the memory assessment of patients with Alzheimer's disease(AD)and mild cognitive impairment(MCI).The common indices of process approach,such as learning slope,semantic clustering,serial position effects,discriminability,and response bias,are key components of memory assessment.This article reviews the application of common indices of process approach in memory assessment of AD and MCI patients and discusses the shortcomings and future research directions of process approach.

Objective: The intellectualized versions of the Montreal Cognitive Assessment Scale (MoCA) and the Mini-mental State Examination (MMSE) (i-MoCA/i-MMSE) were developed. The validity of this system was evaluated in a clinical sample through comparing with the manual-based assessments. Methods: A total of 88 patients [aged (66.82±11.37) years, 30 males and 58 females] were enrolled in the outpatient clinic of Xuanwu Hospital of Capital Medical University with complaints of cognitive decline, from February to October 2023. All participants completed manual-based and intellectualized assessments in a randomized order, with an interval of 2 weeks to control for the practice effect. The reliability of the intellectualized version of assessments was evaluated based on the manual-based version using the Concordance correlation coefficient ( CCC ). The difference between the intellectualized and the manual-based assessments was tested by the Repeated ANCOVA with demographic information controlled. The accuracy of evaluation of the i-MoCA and i-MMSE was analyzed by the Receiver Operating Characteristic (ROC) analysis. Results: High concordance was observed between the intellectualized version and the manual-based assessments ( CCC MoCA = 0.87, CCC MMSE =0.83). Controlling for basic demographic information, there was no significant difference in the scores of the intellectualized version and the manual-based assessments (all P> 0.05). The accuracy of i-MoCA in screening patients with cognitive impairment was 94.3% (sensitivity=94.6%, specificity=78.1%), while the accuracy of i-MMSE in screening patients with cognitive impairment was 94.9% (sensitivity=94.9%, specificity=77.6%). In addition, the majority of subdomains measured by the cognitive assessments exhibited high consistency across the intellectualized the manual-based versions ( CCC MoCA = 0.32-0.78; CCC MMSE =0.54-0.79). Conclusion: Both the i-MoCA and i-MMSE showed high consistency and diagnostic accuracy with the manual-based versions in terms of overall cognitive function and subdomains.

Objective To explore the effect of comprehensive intervention in the labor- deli very-recovery (LDR) room on neonatal jaundice index and physical and mental development. Methods 92 full-term newborns born in Zhenjiang Maternity and Child Health Hospital from January 2019 to December 2019 were selected as the research objects. According to the type of delivery room, they were divided into an observation group and a control group, each with 46 cases. The observation group was given LDR room comprehensive care, and the control group was given routine delivery room care. Jaundice index and physical and mental development of newborns before and after intervention were compared between two groups. Results Before intervention, there was no statistically significant difference in jaundice index between the two groups (P > 0.05). On the 3rd and 7th day after the intervention, the jaundice index of the two groups were significantly lower than before the intervention (ail P < 0. 05), and the improvement degree of the observation group was significantly higher than that of the control group (P < 0. 05). Before the intervention, there was no statistically significant difference in head circumference, body length, body mass, intelligence (MDI) and Psychomotor Development! Index (PDI) scores between the two groups ( all P > 0. 05). Three months after the intervention, the head circumference, body length, body weight, MDI score and PDI score of the two groups were significantly higher than those before the intervention (all P < 0. 05), and the improvement degree of the observation group was significantly higher than that of the control group ( all P <0. 05 ). Conclusion The comprehensive intervention of LDR room can improve the symptoms of jaundice and play a positive role in the physical and mental development of newborns with jaundice. [ABSTRACT FROM AUTHOR]