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Background: The present narrative review aims to discuss cognitive-emotional-behavioral symptoms in adults with brain tumors at the time of diagnosis., Methods: The PubMed database was searched considering glioma, pituitary adenoma, and meningioma in adulthood as pathologies, together with cognitive, neuropsychological, or behavioral aspects., Results: Although a significant number of studies describe cognitive impairment after surgery or treatment in adults with brain tumors, only few focus on cognitive-emotional-behavioral symptoms at diagnosis. Furthermore, the importance of an effective communication and its impact on patients' quality of life and compliance with treatment are seldom discussed., Conclusions: Adults with brain tumors have needs in terms of cognitive-emotional-behavioral features that are detectable at the time of diagnosis; more research is needed to identify effective communication protocols in order to allow a higher perceived quality of life in these patients.

Background: Suicide is a health problem among patients diagnosed with schizophrenia. Telehealth technology has become an emerging intervention that may offer opportunities to reach this at-risk group. However, to consider the implementation of telehealth systems in the prevention of suicidal behaviors in patients diagnosed with schizophrenia, a review of the evidence is required. The present aim was to explore the effectiveness of telephone-based suicide prevention programs among patients with schizophrenia and related disorders., Methods: A bibliographic search was carried out in the PubMed, PsycInfo, Scopus and Web of Science electronic databases following PRISMA guidelines. Two reviewers performed the selection, data extraction and methodological quality assessment. A total of 352 articles were retrieved, of which five studies met the eligibility criteria., Results: Globally, an adherence was observed ranging from 78 to 100%. Three studies reported a reduction in suicidal ideation and two studies showed a reduction in the risk of relapse observed in the intervention group compared to a control group., Conclusions: In accordance with the limited data available, the use of a telephone contact approach appears to be feasible and effective in schizophrenia patients with suicidal behaviors. The preliminary evidence also suggests that this system appears to reduce suicidal ideation. Further research is required to design evidence-based future interventions and to determine whether this approach can improve patient outcomes.

The study aimed to assess the impact of clinical symptoms and cognitive impairment on disability in patients with paranoid schizophrenia (PS)., Methods: 108 patients with schizophrenia were included (66 male and 42 female). Their average age was 38.86 ± 10.02 years and the disease duration was 12.80 ± 8.20 years, with mean disease onset of 24 years. Clinical symptoms were assessed with the PANSS, and cognitive performance was measured using a seven-item neurocognitive battery. The disability level of the subjects was assessed using the World Health Organization-Disability Assessment Schedule 2.0 (WHO-DAS 2.0). The relation between the variables studied was assessed using Spearman's rank correlation coefficient ( r s ) at a probability level of p < 0.05., Results: An increase in symptom severity resulted in worsening of the "participation in society" ( r = 0.56, p < 0.01), "life activities-household" ( r = 0.55, p < 0.01), and "getting along with people" ( r = 0.59, p < 0.01) WHO-DAS 2.0 domains. Positive symptoms (13.89 ± 3.48) correlated strongly with "getting along with people" ( r = 0.55, p < 0.01), "life activities-household" ( r = 0.58, p < 0.01), and "participation in society" ( r = 0.62, p < 0.01), and negative symptoms (14.25 ± 4.16) with "participation in society" ( r = 0.53, p < 0.01) and "life activities-household" ( r = 0.48, p < 0.01). Symptoms of disorganization (15.67 ± 4.16) had the highest impact on "life activities-household" ( r = 0.81, p < 0.01), "getting along with people" ( r = 0.56, p < 0.05), and "participation in society" ( r = 0.65, p < 0.01). Episodic memory ( r = -0.28, p < 0.01) was remotely related to comprehension and communication. The information processing speed ( r s = 0.38, p < 0.01), visual memory ( r s = -0.30, p < 0.01), and focused executive functions showed moderate correlations with all domains on the WHO-DAS 2.0 scale ( r s = 0.38, p < 0.01). Attention ( r s = -0.33, p < 0.01) was moderately related to community activities. Semantic ( r s = -0.29, p < 0.01) and literal ( r s = -0.27, p < 0.01) verbal fluency demonstrated weak correlations with "cognition-understanding", "getting along with people", and "participation in society"., Conclusion: Symptoms of disorganization and disturbed executive functions contribute most to disability in patients with schizophrenia through impairment of real-world functioning, especially in social interactions and communication. Severe clinical symptoms (negative and disorganization-related ones) as well as deficits in executive function, verbal memory, and verbal fluency cause the biggest problems in the functional domains of interaction with other people and participation in society.

Background: Anhedonia and cognitive impairment are core features of major depressive disorder (MDD), and are essential to the treatment and prognosis. Here, we aimed to investigate anhedonia and its cognitive correlates between first episode of depression (FED) and recurrent depression (RD), which was part of the National Survey on Symptomatology of Depression., Methods: In this study, 1400 drug naïve FED patients and 487 on medicine RD patients were included. Differences of anhedonia, cognitive symptoms and other clinical characteristics between groups were compared via Student's t-test, or the chi-square test as appropriate. Partial correlation analysis was used to analyze the correlations between anhedonia and cognitive symptoms after adjusting for potential confounders. A stepwise logistic regression analysis was performed to identify relapse risk factors among symptomatic variables, demographic factors, clinical characteristics and medication use., Results: Compared to FED, RD patients displayed more comprehensive depressive, impaired cognitive and anhedonia symptoms. Cognitive symptoms were significantly related with the anhedonia symptoms with varying aspects. Patients taking emotional stabilizers displayed more abnormal cognitive symptoms, followed by benzodiazepines, and finally SSRIs, SNRIs and TCAs. The effect of drug use on anhedonia is not as extensive as that of cognitive symptoms., Conclusion: Collectively, the results of this investigation advance the knowledge on changes in anhedonia and cognitive symptoms in MDD., Limitations: As this is a cross sectional study, it is difficult to draw any causal conclusions between cognitive impairment and anhedonia in MDD, and to ascertain the worse cognitive performances identified here were induced by current drug use., Competing Interests: Conflict of interest The authors declare that they have no conflicts of interest., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Vortioxetine has demonstrated procognitive effects in patients with major depressive disorder (MDD). We assessed the effectiveness and safety of vortioxetine in a cohort of patients with MDD and comorbid Alzheimer's disease participating in a large post-marketing surveillance study in South Korea., Methods: Subgroup analysis of a 6-month, prospective, multicenter, non-interventional cohort study in outpatients with MDD with a pre-baseline diagnosis of Alzheimer's disease receiving vortioxetine in routine care settings ( n  = 207). Patients were assessed at baseline and after 8 weeks; a subset of patients was also assessed after 24 weeks. Depression severity was assessed using the Montgomery-Åsberg Depression Rating Scale (MADRS) and Clinical Global Impression (CGI) scale, cognitive symptoms using the Perceived Deficits Questionnaire-Depression, Korean version (PDQ-K), and cognitive performance using the Digit Symbol Substitution Test (DSST)., Results: Most patients were receiving a mean daily vortioxetine dose of 5 mg/day (174/190 patients; 91.6%). After 24 weeks of vortioxetine treatment, 71.4% of patients (40/56) had experienced overall clinical improvement (i.e., CGI-Improvement score ≤3) and 51.9% (28/54) had achieved remission from depressive symptoms (i.e., MADRS total score ≤10 points). Respective mean changes in MADRS, PDQ-K, and DSST total scores from baseline to week 24 were -11.5 ( p  < 0.0001), -5.1 ( p  = 0.03), and +3.8 points ( p  = 0.0524). Adverse events were reported by 27 patients (13.0%) and were mostly mild (89.2%)., Conclusion: Patients with MDD and comorbid Alzheimer's disease receiving vortioxetine in routine care settings in South Korea demonstrated clinically meaningful improvements in depressive symptoms, cognitive symptoms, and objective cognitive performance over the 6-month treatment period. Treatment with vortioxetine was well tolerated in this patient cohort, with reported adverse events consistent with the established tolerability profile of vortioxetine., Competing Interests: EC has participated in advisory boards and pharmaceutical industry-sponsored symposia for Pfizer, GSK, Eli Lilly, UCB Pharma, Lundbeck, Novartis Pharma, and Neopharmed Gentili. MA, DOÅ, and MCC are employees of H. Lundbeck A/S. The handling editor AF declared a past co-authorship with the author MCC., (Copyright © 2023 Cumbo, Adair, Åstrom and Christensen.)

BACKGROUND: Cognitive symptoms and other functional limitations associated with multiple sclerosis (MS) have a significant negative impact on employment status. Work accommodations positively impact the ability of a person with MS to obtain and retain employment, however, current understanding of the role of accommodations in the careers of adults with MS is limited. OBJECTIVE: To analyze the percentage of American workers with MS who utilize workplace accommodations as per Title I of the ADA, the types of accommodations most frequently required, and differences in disease variables, job-related factors, and quality of life between workers using and not using work accommodations. METHODS: Data from 746 employed adult members of the National MS Society surveyed about career concerns were analyzed. Descriptive and inferential statistics were used as appropriate to address the research questions. RESULTS: Approximately 25% reported having requested accommodations, and 87.7% reported receiving the requested accommodation. Participants with progressive MS, cognitive impairment, higher number of MS symptoms and greater symptom severity were more likely to use work accommodations. Participants with accommodations reported poorer job match and career optimism than those using no accommodations. CONCLUSION: This large-scale analysis addresses several outstanding questions concerning work accommodations among workers with MS. Cognitive symptoms and disease severity are strongly associated with need for accommodations, however accommodations do not appear to promote job satisfaction or longevity. The accommodation request process and the impact of accommodations on employment retention remain important research foci. [ABSTRACT FROM AUTHOR]

Diverse preclinical studies exploiting the modulation of the GABAergic and/or glutamatergic system in brain via metabotropic receptors suggest their potential therapeutic utility. GS39783 and CDPPB, positive allosteric modulators of GABA B and mGlu 5 receptors, were previously shown to reverse behavioral phenotypes in animal models to mimic selected (predominantly positive) symptoms of schizophrenia. In the present study we investigated the activity of selected GABA B (GS39783 and CGP7930) and mGlu 5 (CDPPB) positive allosteric modulators. We focused mainly on the aspects of their efficacy in the models of negative and cognitive symptoms of schizophrenia. We used modified swim test, social interactions (models of negative symptoms) and novel object recognition (model of cognitive disturbances). The activity of the compounds was also tested in haloperidol-induced catalepsy test. The mutual interaction between GABA B /mGlu 5 ligands was investigated as well. In the second part of the study, DHPG-induced PI hydrolysis in the presence of GABA B receptor antagonist (SKF97541), and SKF97541-induced inhibition of cAMP formation in the presence of DHPG, was performed. Both mGlu 5 and GABA B receptor modulators effectively reversed MK-801-induced deficits in behavioral models of schizophrenia. Moreover, the concomitant administration of sub-effective doses of CDPPB and GS39783 induced a clear antipsychotic-like effect in all the procedures used, except DOI-induced head twitches. The concomitant administration of group I mGlu and GABA B agonists did not displayed any synergistic effects in vitro. Summing up, an activation of both types of receptor may be a promising mechanism for the development of novel antipsychotic drugs, efficacious toward positive, negative and cognitive symptoms. [ABSTRACT FROM AUTHOR]

Objective: Previous transcranial magnetic stimulation (TMS) studies have demonstrated cortical inhibition (CI) abnormalities in patients with schizophrenia. However, the relationship between changes in CI and changes in psychopathology and cognition resulting from antipsychotic treatment is not known. This is an 8 week follow up study which aims to evaluate the relation of the CI with the symptoms and cognitive functions of the patients who are switched to new atypical antipsychotic treatment, and to compare the TMS measurements of patients with those of controls. Method: Thirteen patients and 13 control subjects matched according to age, sex, and educational level were included in the study. Patients were assessed with TMS, Positive and Negative Syndrome Scale (PANSS), and a neurocognitive battery at baseline and at 8 weeks post-treatment, while the control group was evaluated with the neurocognitive battery and TMS at baseline only. CI parameters evaluated by TMS include resting motor threshold, cortical silent period, ipsilateral silent period (ISP), short interval intracortical inhibition (SICI) and intracortical facilitation. Results: Intracortical facilitation (ICF) was weaker and ISP was longer in patients relative to control subjects both at baseline and at the end of the eight weeks. Intracortical facilitation decreased following 8 weeks of antipsychotic treatment, indicating an increase in CI. The decrease in PANSS general psychopathology score was directly correlated with the decrease in ICF. SICI positively correlated with cognitive test performance in both cross-sectional and longitudinal analyses. Conclusion: Our findings suggest that increase in CI is associated with the improvement in the symptoms and the action of the atypical antipsychotics. [ABSTRACT FROM AUTHOR]

The assessment of cognitive symptoms following concussion has evolved over the last several decades as a distinct focus in research and an essential component of clinical decision making and management. The aims of this paper are to (1) identify issues related to assessment of postconcussion cognitive functioning and (2) provide a review of common self-report and performance-based measures, including computerized-based assessments (CBAs), and, more traditional, comprehensive neuropsychological evaluations. We conclude that (1) there has yet to emerge one cognitive-symptom measurement method that can be considered the 'gold standard' for all settings, (2) the usefulness of cognitive symptoms assessment findings in the clinical management decisions rests a great deal on the background of the practitioner, and (3) cognitive-symptom assessment needs to be considered in the context of a broader evaluation of other postconcussion symptoms. [ABSTRACT FROM AUTHOR]

Longitudinal normative data obtained from a robust elderly sample (i.e., believed to be free from neurodegenerative disease) are sparse. The purpose of the present study was to develop reliable change indices (RCIs) that can assist with interpretation of test score changes relative to a healthy sample of older adults (ages 50+). Participants were 4217 individuals who completed at least three annual evaluations at one of 34 past and present Alzheimer’s Disease Centers throughout the United States. All participants were diagnosed as cognitively normal at every study visit, which ranged from three to nine approximately annual evaluations. One-year RCIs were calculated for 11 neuropsychological variables in the Uniform Data Set by regressing follow-up test scores onto baseline test scores, age, education, visit number, post-baseline assessment interval, race, and sex in a linear mixed effects regression framework. In addition, the cumulative frequency distributions of raw score changes were examined to describe the base rates of test score changes. Baseline test score, age, education, and race were robust predictors of follow-up test scores across most tests. The effects of maturation (aging) were more pronounced on tests related to attention and executive functioning, whereas practice effects were more pronounced on tests of episodic and semantic memory. Interpretation of longitudinal changes on 11 cognitive test variables can be facilitated through the use of reliable change intervals and base rates of score changes in this robust sample of older adults. A Web-based calculator is provided to assist neuropsychologists with interpretation of longitudinal change. (JINS, 2015, 21, 558–567) [ABSTRACT FROM PUBLISHER]

Purpose: Cognitive impairment may occur in 42-50% of cardiac arrest survivors. Hyperbaric oxygen therapy (HBO2) has recently been shown to have neurotherapeutic effects in patients suffering from chronic cognitive impairments (CCI) consequent to stroke and mild traumatic brain injury. The objective of this study was to assess the neurotherapeutic effect of HBO2 in patients suffering from CCI due to cardiac arrest. Methods: Retrospective analysis of patients with CCI caused by cardiac arrest, treated with 60 daily sessions ofHBO2.Evaluation included objective computerized cognitive tests (NeuroTrax), Activity of Daily Living (ADL) and Quality of life questionnaires. The results of these tests were compared with changes in brain activity as assessed by single photon emission computed tomography (SPECT) brain imaging. Results: The study included 11 cases of CCI patients. Patients were treated with HBO2, 0.5-7.5 years (mean 2.6±0.6 years) after the cardiac arrest. HBO2 was found to induce modest, but statistically significant improvement in memory, attention and executive function (mean scores) of 12%, 20% and 24% respectively. The clinical improvements were found to be well correlated with increased brain activity in relevant brain areas as assessed by computerized analysis of the SPECT imaging. Conclusions: Although further research is needed, the results demonstrate the beneficial effects of HBO2 on CCI in patients after cardiac arrest, even months to years after the acute event. [ABSTRACT FROM AUTHOR]

Background: Cognitive difficulties contribute to patients' disability during migraine attacks and have been overlooked in migraine research. Neuropsychological studies performed during attacks have produced inconsistent findings due to design differences and limitations. Objective: Our objective is to document changes in cognitive performance of migraine patients during migraine attacks with a comprehensive battery of cognitive/behavioral tests, while controlling for potential confounders. Method: A prospective two-period, randomized, cross-over study compared within-subject neuropsychological evaluation in two conditions-during a naturally occurring untreated migraine attack and a headache-free period. Results: Thirty-nine patients with episodic migraine (37 females, average 38 years old) were included and 24 completed the study. Participants performed worse during the attack in the majority of cognitive tests, compared to the headachefree status, and significantly so in word reading speed (p=0.013), verbal learning (p=0.01), short-term verbal recall with (p=0.01) and without (p=0.013) semantic cueing and delayed recall with (p=0.003) and without (p=0.05) semantic cues. Differences found were unrelated to age, gender, literacy, condition order, interval between evaluations, anxiety, pain intensity or duration of the attack. Discussion: Cognitive performance decreases during migraine attacks, especially in reading and processing speed, verbal memory and learning, supporting patients' subjective complaints. These findings suggest the existence of a reversible brain dysfunction during attacks of migraine without aura, which can relate specifically to migraine or be a consequence of acute pain processing by the brain. [ABSTRACT FROM AUTHOR]

The article presents the case-control stdy which investigates the school performance as a marker of cognitive impairment prior clinical diagnosis of multiple sclerosis. The study involves evaluating the overall school performance in math and language among patients. Results show the lower school performance for MS patients.

To compare neuropsychological test performance of Veterans with and without mild traumatic brain injury (MTBI), blast exposure, and posttraumatic stress disorder (PTSD) symptoms. We compared the neuropsychological test performance of 49 Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans diagnosed with MTBI resulting from combat blast-exposure to that of 20 blast-exposed OEF/OIF Veterans without history of MTBI, 23 OEF/OIF Veterans with no blast exposure or MTBI history, and 40 matched civilian controls. Comparison of neuropsychological test performance across all four participant groups showed a complex pattern of mixed significant and mostly nonsignificant results, with omnibus tests significant for measures of attention, spatial abilities, and executive function. The most consistent pattern was the absence of significant differences between blast-exposed Veterans with MTBI history and blast-exposed Veterans without MTBI history. When blast-exposed Veteran groups with and without MTBI history were aggregated and compared to non–blast-exposed Veterans, there were significant differences for some measures of learning and memory, spatial abilities, and executive function. However, covariation for severity of PTSD symptoms eliminated all significant omnibus neuropsychological differences between Veteran groups. Our results suggest that, although some mild neurocognitive effects were associated with blast exposure, these neurocognitive effects might be better explained by PTSD symptom severity rather than blast exposure or MTBI history alone. (JINS, 2015, 21, 353–363) [ABSTRACT FROM PUBLISHER]

Background Few studies have investigated gender difference and associated disability among workers. Comprehensive investigations concerning the occurrence and consequences of depression in workplace are scarce. The study aims to evaluate how workers perceive depression in workplace, as well as to examine depression-related disabilities by gender. Methods This is a cross-sectional web-based survey of 1000 Brazilian workers recruited from Internet sources. Participants answered an online questionnaire about depressive symptoms and related consequences in the workplace. Results Common symptoms attributable to depression were crying, loss of interest, and sadness. Almost one in five (18.9%) participants reported had ever been “labeled” by a health professional as suffering from depression. However, the majority of ever-depressed workers (73.5%) remained working. Performance-related impairments were reported by around 60% of depressed workers who continued working. Over half of them also complained about cognitive symptoms (concentration difficulties, indecisiveness, forgetfulness), with men reporting more cognitive dysfunctions than women. One in three workers had taken off work due to depression (mean 65.7 out-of-role days), with these periods being lengthier for men than women. Limitations Some depressive events might have occurred before working age, since the participants have self-reported the diagnosis of health professionals in past timeframe. The representativeness of recruited workers was reliant upon the availability of Internet service. Conclusions The findings suggest that identification and management of symptoms of depression should be set as a priority in worker׳s health care. General and gender-related strategies to handle depression in the workplace are recommended. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cognitive rest is the recommendation for all patients with acute sports concussion. OBJECTIVE/METHODS: A comprehensive literature search was conducted for the research question "What is the optimal cognitive load for patients with a sports concussion?" RESULTS: Seven studies met the inclusion criteria. The optimal cognitive load for patients after sports concussion is yet to be determined. CONCLUSIONS: Additional controlled trials of cognitive rehabilitation are needed to establish best clinical practice. The authors suggest memory training, cognitive behavioral therapy, and environmental interventions as areas of future research for sports concussion injuries. [ABSTRACT FROM AUTHOR]

Background. An assessment of cognitive functioning is considered to be valuable in differential diagnostics of movement disorders. Several studies showed that Addenbrooke's Cognitive Examination-Revised (ACE-R) is an accurate tool in detecting dementia in Parkinson's and related diseases. It is still quite difficult to distinguish between Dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD). The aim of this study is to investigate the ability of Addenbrooke's Cognitive Examination-Revised to differentiate mild-moderate dementia with Lewy bodies from Parkinson's disease with mild-moderate dementia in Lithuanian-speaking population. Methods. The Lithuanian version of Addenbrooke's Cognitive Examination-Revised (ACE-RLT) was applied individually to 30 patients with mild-moderate dementia with Lewy bodies, 34 patients with Parkinson's disease dementia, and 64 controls, who were matched for age, gender and education. By using ACE-RLT, the following cognitive domains were evaluated: orientation, attention, memory, verbal fluency, language, and visuospatial abilities; the higher score, the better performance. For statistitical analysis, one-way ANOVA, Mann-Whitney U test, and binary logistic regression were done. Results. The statistical analysis yielded no significant difference among three groups of participants in age (p=0.036), years of education (p=0.401), and gender (χ², p=0.048). The ACE-RLT appeared to be good enough in prognosticating dementia (Ex(B)=0.828, χ²=84.171, p=0.000), with 84% of overall correct cases. While comparing two groups with different diseases, DLB patients had lower scores in overall cognitive performance on ACE-R (DLB average score was 58 and PDD average score was 70, p=0.000). The DLB group had lower scores compared to PDD in those particular cognitive domains: orientation (6.8 points for DLB and 8.7 for PDD), attention (5.4<6.7), verbal fluency (3.3<7.2), and visuospatial abilities (7.5< 12.4); for each domain, p=0.000. Conclussions. The ACE-RLT, an accurate tool in prognosticating dementia, showed only mild differences between DLB and PDD. In line with former studies, the only difference between the DLB and PDD cognitive functioning was that DLB had more severe impairments. Whether DLB and PDD is the same entity or not, remains an open question suggesting the need for more research in this field using different tasks for the cognitive evaluation. [ABSTRACT FROM AUTHOR]

Cognitive impairment represents one of the most debilitating and most difficult symptom to treat of many psychiatric illnesses. Human neurophysiology studies have suggested that specific pathologies of cortical network activity correlate with cognitive impairment. However, we lack demonstration of causal relationships between specific network activity patterns and cognitive capabilities and treatment modalities that directly target impaired network dynamics of cognition. Transcranial alternating current stimulation (tACS), a novel non-invasive brain stimulation approach, may provide a crucial tool to tackle these challenges. Here, we propose that tACS can be used to elucidate the causal role of cortical synchronization in cognition and, eventually, to enhance pathologically weakened synchrony that may underlie cognitive deficits. To accelerate such development of tACS as a treatment for cognitive deficits, we discuss studies on tACS and cognition performed in healthy participants, according to the Research Domain Criteria of the National Institute of Mental Health. [ABSTRACT FROM AUTHOR]

Background. Currently, it is recognised that movement disorders, such as Parkinson's and related diseases, also have a cognitive component and those diseases can even progress in some patients to dementia. Therefore, a cognitive assessment is useful in evaluating movement disorders. There is a need for having more clinical tools for differential diagnostics between DLB and AD. The Addenbrooke's Cognitive Examination-Revised can meet this need as it is a brief sensitive dementia screening test. The Lithuanian version of ACE-R (ACE-RLT) was shown to be able to detect dementia, but further research is still lacking in establishing the use of the ACE-R for differential diagnostics of AD and DLB. Accordingly, the aim of this study was to investigate the ability of the ACE-R to accurately differentiate mild-moderate Alzheimer's disease from mild-moderate dementia with Lewy bodies. Participants and methods. Seventy three patients with early mild-moderate AD and 30 patients with mild-moderate DLB were evaluated with the ACE-R, the test which consists of the following domains: orientation, attention, memory, verbal fluency, language and visuospatial ability, with maximum total score 100. The results were compared with those obtained in 86 healthy controls. The one-way ANOVA, logistic-regression analysis, ROC analysis and Mann-Whitney U-test were done for statistical analysis. Results. In AD group neither age (p=0.060), nor gender (p=0.466) or education (p=0.206) had an effect on ACE-R scores. In DLB group neither age (p=0.249) nor gender (p=0.615) or education (p=0.360) had an effect on ACE-R scores. In control group both age (p<0.001) and education (p<0.001) had an effect, while gender did not (p=0.438). At 74, the previously recommended cut-off score for clinical use in the detection of dementia, the ACE- RLT showed a sensitivity of 100%, and a specificity of 90.5 % for AD in our study. The Cronbach's alpha for the ACE- RLT was 0.912. AD group was significantly more likely to score below the recommended cut-off scores for memory and language subtests than the DLB group (chi-square; p<0.0001). The DLB group was significantly more likely to score below the recommended cut-off scores for verbal fluency and visuospatial abilities subtests than the AD group (chi square; p<0.0001). Conclusions. The ACE- RLT appears to be a reliable and valid tool for differential diagnostics of DLB and AD in Lithuanian speaking population. The cognitive assessment using ACE- RLT indicated that in DLB verbal fluency and visuospatial abilities were more impaired compared to AD. And in AD memory and language performance were worse than in DLB. [ABSTRACT FROM AUTHOR]

Mental status after acute West Nile virus infection has not been examined objectively. We compared Telephone Interview for Cognitive Status scores of 116 patients with West Nile fever or West Nile neuroinvasive disease. Mental status was poorer and cognitive complaints more frequent with West Nile neuroinvasive disease (p = 0.005).

Postoperative delirium (POD) is an acute organic cerebral disturbance of consciousness and attention in combination with additional cognitive symptoms. It usually develops shortly after surgery and lasts for some hours up to some days. It worsens clinical outcomes, prolongs the hospital stay and leads to negative trajectories of cognitive, emotional and functional outcomes up to month if not years after surgery. There are several known predisposing and precipitating factors. Several of them are influenceable. Offering optimal and safe care for an elderly surgery patient requires a team based approach. Strategies for reducing POD incidence include early detection of risk factors, adaptation of surgical and anaesthesiologic techniques, avoiding certain drugs, optimisation of haemostasis, continuously monitoring of the patient's cognitive status as well as early mobilization and careful management of eventual early signs of POD. If POD is prevented, it's negative trajectories may be likewise anticipated. [ABSTRACT FROM AUTHOR]

Background: Virtually all patients with heart failure experience multiple symptoms simultaneously, yet clinicians and researchers usually consider symptoms in isolation. Recognizing and responding early to escalating symptoms is essential to preventing hospitalizations in heart failure, yet patients have considerable difficulty recognizing symptoms. Identification of symptom clusters could improve symptom recognition, but cultural differences may be present that must be considered. Objectives: To identify and compare symptom clusters in heart failure patients from the United States, Europe and Asia. Design: Cross-sectional, observational study. Settings: In- and out-patient settings in three regions of the world: Asia (i.e., China and Taiwan); Europe (i.e., the Netherlands and Sweden); and the United States. Participants: A total of 720 patients with confirmed heart failure. Propensity scoring using New York Heart Association Classification was used to match participants from each of the three regions. Methods: Symptoms were identified using the Minnesota Living with Heart Failure Questionnaire. To identify symptom clusters we used cluster analysis with the hierarchical cluster agglomerative approach. We used the Euclidean distance to measure the similarity of variables. Proximity between groups of variables was measured using Ward's method. The resulting clusters were displayed with dendrograms, which show the proximity of variables to each other on the basis of semi-partial R-squared scores. Results: There was a core group of symptoms that formed two comparable clusters across the countries. Dyspnea, difficulty in walking or climbing, fatigue/increased need to rest, and fatigue/low energy were grouped into a cluster, which was labeled as a physical capacity symptom cluster. Worrying, feeling depressed, and cognitive problems were grouped into a cluster, which was labeled as an emotional/cognitive symptom cluster. The symptoms of edema and trouble sleeping were variable among the countries and fell into different clusters. Conclusion: Despite the diversity in cultures studied, we found that symptoms clustered similarly among the cultural groups. Identification of similar symptoms clusters among patients with heart failure may improve symptom recognition in both patients and healthcare providers. [ABSTRACT FROM AUTHOR]

The cognitive role of the cerebellum is critically tied to its distributed connections throughout the brain. Accumulating evidence from anatomical, structural and functional imaging, and lesion studies advocate a cognitive network involving indirect connections between the cerebellum and non-motor areas in the prefrontal cortex. Cerebellar stimulation dynamically influences activity in several regions of the frontal cortex and effectively improves cognition in schizophrenia. In this manuscript, we summarize current literature on the cingulocerebellar circuit and we introduce a method to interrogate this circuit combining opotogenetics, neuropharmacology, and electrophysiology in awakebehaving animals while minimizing incidental stimulation of neighboring cerebellar nuclei. We propose the novel hypothesis that optogenetic cerebellar stimulation can restore aberrant frontal activity and rescue impaired cognition in schizophrenia. We focus on how a known cognitive region in the frontal cortex, the anterior cingulate, is influenced by the cerebellum. This circuit is of particular interest because it has been confirmed using tracing studies, neuroimaging reveals its role in cognitive tasks, it is conserved from rodents to humans, and diseases such as schizophrenia and autism appear in its aberrancy. Novel tract tracing results presented here provide support for how these two areas communicate. The primary pathway involves a disynaptic connection between the cerebellar dentate nuclei (DN) and the anterior cingulate cortex. Secondarily, the pathway from cerebellar fastigial nuclei (FN) to the ventral tegmental area, which supplies dopamine to the prefrontal cortex, may play a role as schizophrenia characteristically involves dopamine deficiencies. We hope that the hypothesis described here will inspire new therapeutic strategies targeting currently untreatable cognitive impairments in schizophrenia. [ABSTRACT FROM AUTHOR]

Approximately 50% of persons with multiple sclerosis experience cognitive impairment, which adversely affects daily functioning. Although patients report that fatigue contributes to cognitive difficulties, previous empirical studies do not show a clear association. This study assessed coping style as a moderator of the relationship between fatigue and cognition in a 3-year longitudinal sample. Scores on the Fatigue Impact Scale and the Coping Orientation to Problems Experienced (COPE) at baseline were modeled to predict later performance on a composite of cognitive tests to investigate the hypothesis that coping would have a significant moderating effect on fatigue in predicting cognitive performance. Findings partially supported hypotheses by showing that avoidant coping moderated the relationship between fatigue and cognitive performance. Patients who experienced relatively high fatigue performed better on cognitive tests if they used less avoidant coping. Those who reported lower fatigue had relatively good cognitive performance regardless of their coping style. This study provides evidence that coping style is associated with the ability to deal with stress, like fatigue, and their interaction can impact functional outcomes of disease. These results could benefit understanding of prognosis and improve treatment for patients with MS. (JINS, 2014, 20, 1–5.) [ABSTRACT FROM PUBLISHER]

BackgroundThe symptoms of major depression (MD) are clinically diverse. Do they form coherent factors that might clarify the underlying nature of this important psychiatric syndrome?MethodSymptoms at lifetime worst depressive episode were assessed at structured psychiatric interview in 6008 women of Han Chinese descent, age ⩾30 years with recurrent DSM-IV MD. Exploratory factor analysis (EFA) and confirmatoryfactor analysis (CFA) were performed in Mplus in random split-half samples.ResultsThe preliminary EFA results were consistently supported by the findings from CFA. Analyses of the nine DSM-IV MD symptomatic A criteria revealed two factors loading on: (i) general depressive symptoms; and (ii) guilt/suicidal ideation. Examining 14 disaggregated DSM-IV criteria revealed three factors reflecting: (i) weight/appetite disturbance; (ii) general depressive symptoms; and (iii) sleep disturbance. Using all symptoms (n = 27), we identified five factors that reflected: (i) weight/appetite symptoms; (ii) general retarded depressive symptoms; (iii) atypical vegetative symptoms; (iv) suicidality/hopelessness; and (v) symptoms of agitation and anxiety.ConclusionsMD is a clinically complex syndrome with several underlying correlated symptom dimensions. In addition to a general depressive symptom factor, a complete picture must include factors reflecting typical/atypical vegetative symptoms, cognitive symptoms (hopelessness/suicidal ideation), and an agitated symptom factor characterized by anxiety, guilt, helplessness and irritability. Prior cross-cultural studies, factor analyses of MD in Western populations and empirical findings in this sample showing risk factor profiles similar to those seen in Western populations suggest that our results are likely to be broadly representative of the human depressive syndrome. [ABSTRACT FROM PUBLISHER]

Introduction. AD and VD are preceded by a preclinical stage. Small but tangible cognitive impairments sometimes occur many years before the onset and diagnosis of dementia. The ongoing degenerative process can be conductive to behavioural and psychological symptoms. Aim. The aim of the study was to investigate the rates of neurobehavioral symptoms in the preclinical stages of AD and VD. Methods: Two hundred and ninety one residents of nursery homes were included in the study. Participants of the study did not display symptoms of dementia in accordance with DSMIV criteria and obtained at least 24 points on the MMSE scale and were on the first or second level of the Global Deterioration Scale. Participants were screened for behavioural and psychological symptoms with the NPI - NH scale, while their cognitive functioning was evaluated by means of the ADAS-cog. Participants of the study were evaluated with the MMSE scale annually. Participants who obtained less than 24 points on the MMSE scale were evaluated by a senior psychiatrist. Diagnosis of dementia was done on the basis of DSM criteria. Alzheimer's Disease was diagnosed on the basis of NINCDS-ADRDA criteria and vascular dementia on the NINDS-AIREN criteria. The study was carried out over a period of seven consecutive years. Results. A hundred and fifty people were included in the final analysis - in 111 of them were found not to be afflicted with dementia, 25 were found to have AD and in 14 VD was diagnosed. The control group differed from the AD and VD group with respect to the initial level of cognitive impairment (ADAS-cog) and the intensity of behavioural and psychological symptoms (NPI--NH scale). Particular items of the NPI -NH scale differentiated the two groups to a different degree. In people with AD the greatest differences were observed with respect to agitation/aggression, mood swings, irritability/emotional liability and the rates of anxiety. People with VD, similarly to people with AD, significantly differed from the control group with respect to mood disorders and irritability/emotional liability, as well as disinhibition and anxiety. People with VD were found not have high rates of agitation/aggression. In the AD group, the shorter the period between the evaluation with the NPI-NH scale and the diagnosis of AD was the greater the rates of agitation/aggression, anxiety, and elevated mood/euphoria were. Conclusion. Inpreclinical stages of both AD and VD behavioural and psychological symptoms occur very frequently. The closer the diagnosis of dementia is the greater the possibility of behavioural and psychological symptoms occurring, especially in AD. [ABSTRACT FROM AUTHOR]

Corticobasal degeneration is a pathologic entity. Presenting clinical phenotypes include corticobasal syndrome (CBS), frontal behavioral spatial syndrome, aphasia, progressive supranuclear palsy-like syndrome (PSPS), and a predominantly cognitive phenotype often mistaken for Alzheimer's disease (AD). Treatment of CBD is symptomatic, particularly given recently negative neuroprotective studies. Given the relentless progression in CBD, all interested patients should be offered the opportunity to enroll in clinical neuroprotective trials as they arise. For symptomatic therapy, treatment options are necessarily based on evidence from other disorders given the lack of studies in CBD. In patients with CBS and PSPS, parkinsonism is treated with levodopa/carbidopa. This generally has modest and transient benefits at best and often results in no improvement. Botulinum toxin injections are the treatment of choice for limb dystonia. Clonazepam and levetiracetam are commonly used for myoclonus. Physical therapy is an important part of motor treatment, particularly for fall prevention strategies and assist device assessment. Whether medications such as cholinesterase inhibitors or memantine have any role in CBD is unclear given the various responses described in related phenotypes and diseases. Treating the behavioral symptoms associated with CBD is critical in an attempt to treat symptoms for which we have good pharmacologic interventions and to hopefully improve quality of life. General supportive care is important, including assessing for sores related to dystonia or immobility, monitoring dysphagia, and identifying needs for support services. Finally, as with other relentlessly progressive neurodegenerative diseases, it is critical to provide family and caregiver support and to assess for when palliative care services will serve the patient best. [ABSTRACT FROM AUTHOR]