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To review the efficacy of add-on yoga therapy in improving symptoms of schizophrenia and quality of life and examine the possible underlying biological mechanisms of yoga in schizophrenia. Quality of life, cognitive symptoms, and negative symptoms have been found to improve with add-on yoga therapy in schizophrenia (pooled mean effect size 0.8, 0.6, and 0.4, respectively). Yoga also seems to have a small effect on improving positive symptoms. Less explored areas include adverse effects of yoga itself as well as its effects on antipsychotic-induced complications. Preliminary findings suggest that the effects of yoga may be mediated by neurohormonal mechanisms and functional changes in brain activity. Add-on yoga therapy is a potential treatment option for improving quality of life, cognitive symptoms, and negative symptoms in schizophrenia. Future studies should explore efficacy in multicentric trials as well as possible neurobiological changes underlying the effects.

COVID-19 is an ongoing pandemic with a devastating impact on public health. Acute neurological symptoms have been reported after a COVID-19 diagnosis, however there is no data available on the long-term neurological symptoms. Using a prospective registry of hospitalized COVID-19 patients, we assessed the neurological assessments (including functional, cognitive and psychiatric assessments) of several hospitalized patients at 3 months. Our main finding is that 71% of the patients still experienced neurological symptoms at 3 months and the most common symptoms being fatigue (42%) and PTSD (29%). 64% of the patients report pain symptoms we well. Cognitive symptoms were found in 12%. Our preliminary findings suggests the importance of investigating long-term and rationalizes the need for further studies investigating the neurologic outcomes after COVID-19.

Throughout our lifespan, new sensory experiences and learning continually shape our neuronal circuits to form new memories. Plasticity at the level of synapses has been recognized and studied for decades, but recent work has revealed an additional form of plasticity - affecting oligodendrocytes and the myelin sheaths they produce - that plays a crucial role in learning and memory. In this Review, we summarize recent work characterizing plasticity in the oligodendrocyte lineage following sensory experience and learning, the physiological and behavioural consequences of manipulating that plasticity, and the evidence for oligodendrocyte and myelin dysfunction in neurodevelopmental disorders with cognitive symptoms. We also discuss the limitations of existing approaches and the conceptual and technical advances that are needed to move forward this rapidly developing field.

Background Treatment-resistance is recognized as a significant dilemma in schizophrenia, which has been reported to involve approximately one-third of patients with schizophrenia. Case presentation This case report described a 12-week treatment course for a 39-year-old Persian man with treatment-refractory schizophrenia, who showed a significant improvement in terms of positive, negative, and cognitive symptoms after taking ursodeoxycholic acid 300 mg capsules twice a day. Also, ursodeoxycholic acid was well tolerated, and he did not exhibit any side effects during treatment, based on interview and physical examination. Conclusion Ursodeoxycholic acid augmentation seems to be an effective treatment strategy for patients with treatment-refractory schizophrenia. However, further investigations in this field need to be carried out through randomized controlled trials.

Olfaction is in addition to touch the most ancient of our senses, developing already in the womb it decays progressively from 65 years of age with a more pronounced impairment associated with dementia. Despite its clinical relevance and testing accessibility, smell remains an overlooked biomarker, which is rarely used by neurologists in the early screening phase. In this perspective article, we outline the reasons underlying the lack of awareness for this sense. In an attempt to put olfaction forward as an early biomarker for pathological brain aging, we draw a comparison with vision and hearing, regarded as more relevant for general health. This perspective article wants to encourage further studies aimed at understanding the mechanisms responsible for the early smell dysfunction in individuals a decade or more before the onset of cognitive symptoms.

This study was conducted to compare the neurocognitive changes in an episode of primary psychosis in a group treated with minocycline and control. In this randomized controlled clinical trial, 40 patients with schizophrenia were randomized into two groups and underwent eight weeks of treatment with either minocycline (100 mg twice per day) or placebo in addition to routine treatment. Patients were evaluated using the Wechsler Adult Intelligence Scale (WAIS), Positive and Negative Syndrome Scale (PANSS), and Wisconsin Card Sorting Test (WCST) at baseline and at weeks 4 and 8. General linear model repeated measures showed a significant effect for time treatment interaction on the scores of WAIS, PANSS, and WCST of patients in the minocycline group (P>0.05). Regardless of the type of intervention, there was a remarkable difference between the mean scores of WAIS, PANSS, and WCST measured on three stages. Minocycline seems to be a safe and effective adjuvant in the management of patients with schizophrenia.

International audience; Donepezil is a potent acetylcholinesterase inhibitor, largely used worldwide to alleviate cognitive symptoms in Alzheimer’s disease (AD). Beyond the widely described neuronal impact of donepezil, it was recently shown that targeting connexins, the proteins involved in astrocyte network organization, potentiates donepezil efficacy profile using behavioral tests in AD rodent models. We herein present data demonstrating the potential of functional ultrasound imaging to monitor cerebral activity changes after pharmacological challenge in mice. As an example, we showed that although administration of donepezil or mefloquine alone at low dose had only very limited effects on the signal compared to the baseline, their combination produced marked hemodynamic effects in the hippocampus, in line with previously published behavioral data demonstrating a synergic interaction between both drugs. Thus, the present study provides new perspectives, (i) through the use of pharmaco-fUS, a new non-clinical imaging modality, to move forward drug discovery in AD and (ii) by the profiling of two drug treatments on brain dynamics, one used in AD: donepezil, and the other in development: donepezil combined with mefloquine (THN201) as a modulator of astrocyte network.

Background: Physical and cognitive symptoms of multiple sclerosis (MS) correlate with unemployment cross-sectionally. Prospective studies, rarely published, have not accounted for personality traits such as Conscientiousness. Methods: In a 3-year study of 70 people with MS (PwMS) and 25 healthy controls (HCs), we evaluated employment status using online interviews capturing hours worked, negative work events, employee relations, and accommodations. Deteriorating employment status (DES) was defined as reduced employment (full-time to part-time or negative work events). In PwMS, we explored workplace accommodations, disclosure of disease status, and physical/psychological predictors of DES (e.g. Conscientiousness). Results: At follow-up, DES was 0% in HCs and 25.7% in MS, and 62.7% of work-stable PwMS used at least one work accommodation, most frequently, flexible hours. At baseline, DES-PwMS had lower education ( p = 0.009), lower Conscientiousness ( p 2(7) = 30.936, p Conclusion: Accommodations for low Conscientiousness, flexible hours, and physical/cognitive rehabilitation may prevent DES.

The contribution of sleep disturbance to persistent cognitive symptoms following a mild traumatic brain injury (mTBI) remains unclear. Obstructive sleep apnea (OSA) is very common, yet its relationship between risk factors for developing OSA and cognitive performance in those with history of mTBI has not been investigated. The current study examined OSA risk levels and its association with cognitive performance in 391 combat-exposed, post-911 veterans and service members (median age = 37 years) enrolled in the Chronic Effects of Neurotrauma Consortium (CENC) prospective multi-center study. Participants included those with and without mTBI (n = 326 and 65, respectively). When using clinical cut-offs, those with history of mTBI were more likely to be categorized as high risk for OSA (mTBI positive = 65% vs. mTBI negative = 51%). After adjustment for TBI status and demographic variables, increased OSA risk was significantly associated with worse performance on measures of complex processing speed and executive functioning (Wechsler Adult Intelligence Scale Fourth Edition Coding, Trail Making Test, part B) and greater symptom burden (Neurobehavioral Symptom Inventory). Thus, OSA, a modifiable behavioral health factor, likely contributes to cognitive performance following mTBI. Accordingly, OSA serves as a potential point of intervention to improve clinical and cognitive outcomes after injury.

Alzheimer's disease (AD) is the most prevalent neurodegenerative disorder and affects more than 10% of the population aged over 65 worldwide. Despite considerable global efforts, AD patients can only be diagnosed after the onset of symptoms based on neuropsychological tests and neuroimaging. Because the changes in the levels of biomarkers associated with Aβ deposits and tau tangles precede the appearance of the first cognitive symptoms, accurate measurements of AD core biomarkers is critical for identifying asymptomatic AD patients and predicting disease progression. In this regard, significant efforts have been made to develop novel AD biomarker-targeting sensor platforms that have superb sensitivity and high accessibility. This review provides an overview of recent advances in optical and electrical sensing of core AD biomarkers in clinically relevant fluids such as the cerebrospinal fluid and human blood. We have summarized current challenges and future strategies for translating the sensing techniques discovered in the academic laboratories into clinical analytic platforms for early diagnosis of AD.

The animal models of neuropathic pain that faithfully reproduce the symptoms that occur in humans are a fundamental tool for understanding the mechanisms underlying the disease, identifying new targets, and developing effective drugs. So far, the studies aimed at describing the animal models of neuropathic pain have been focused mainly on the sensory symptoms associated with the disease consisting of mechanical allodynia and hyperalgesia, cold allodynia and hyperalgesia, and heat hyperalgesia. However, affective and cognitive comorbidities occur in patients suffering from neuropathic pain, arising in a closely associated and dependent manner on the sensory symptoms. The same occurs in animal models of neuropathic pain in which anxiety- and depressive- like behaviors and cognitive disorders are observable at different time points from the induction of neuropathy. Today there are several tests available that exploit different paradigms in rodents for measuring sensorial, affective, and cognitive behavior. This review will describe those mainly used in the scientific community. The tests mainly used are based on the motor activity of the animals tested, so it is fundamental that it remains unaffected in the model used for inducing neuropathic pain. We hope that this review will be useful to the scientific community to direct the choice towards the best, most suitable, and simplest tests for the study of the sensory, affective, and cognitive symptoms associated with neuropathic pain.

Introduction: Converging evidence from both clinical and experimental studies has shown that Tourette syndrome (TS) is not a unitary condition, but a cluster of multiple phenotypes, which encompass both tics and specific behavioural and cognitive symptoms (mainly attention-deficit and hyperactivity disorder and obsessive-compulsive disorder). Methods: We conducted a narrative review of the recent literature on the cognitive neuropsychiatry of TS. Results: Although clinical research has shown that TS is not associated with cognitive deficits per se, the findings of recent studies have suggested the presence of subtle alterations in specific cognitive functions. A promising line of research on imitative behaviour could provide a common background for the alterations in executive control and social cognition observed in TS. Two different (but not mutually exclusive) neurocognitive theories have recently suggested that TS could originate from altered perception-action binding and social decision-making dysfunction, respectively. Conclusions: Since the presence of behavioural comorbidities influences individualised treatment approaches, it is likely that a more precise characterisation of TS phenotypes, including cognitive aspects, will result in improved levels of care for patients with tic disorders.

Our understanding of the neural substrates underlying the cognitive symptoms of schizophrenia remains limited, contributing to a lack of pharmaceuticals effective in treating these deficits. Cognitive impairment is the main source of disability in schizophrenia. Thus, research endeavours involving the identification of therapeutic targets can vastly improve the lives of affected individuals. Compared to previously employed techniques, optogenetics has accelerated such endeavours by allowing for manipulations of neuronal activity to occur with an unprecedented combination of cellular and temporal specificity. Research using this technique has united multiple, once tangentially-related, streams of evidence suggesting dysfunctional fast-spiking parvalbumin (PV) containing interneurons are a common substrate underlying the cognitive aberrations documented in schizophrenia. This review summarizes relevant optogenetic studies and identifies areas for future research, using this emerging technique.

This analysis was undertaken to examine the relationship between different symptoms of major depressive disorder (MDD) and psychosocial functioning from the perspectives of patients and healthcare providers (HCPs) across the different phases of the disease (acute, post-acute, and remission). Data regarding symptoms of MDD and psychosocial functioning, assessed by an adapted version of the Functioning Assessment Short Test (FAST) scale, were elicited via an online survey from 2,008 patients diagnosed with MDD (based on their personal experience of the disease) and 3,138 patients observed by 1,046 HCPs (based on individual patient records). Correlations between patient-reported and HCP-reported MDD symptoms and impairment of psychosocial functioning were assessed by multivariate regression analysis. The population comprised 1,946 patient respondents and 3,042 HCP-reported patients. Patients reported experiencing a wider range of symptoms and greater impairment of functioning than reported by HCPs across all phases of the disease. At the domain level, only cognitive symptoms were found to be significantly associated with functioning during the acute phase from the perspective of patients, while from the HCPs’ perspective both mood and cognitive symptoms significantly impacted functioning in this phase. Significant associations were seen between mood, physical, and cognitive symptom domains and functioning in both cohorts during the post-acute and remission phases. Differences in associations between individual MDD symptoms and functioning were also observed between the two cohorts across all disease phases; in particular, HCPs found that more physical symptoms impacted functioning during remission than did patients. In summary, the results suggest that perceptions of MDD symptoms and the associations between these symptoms and functioning differ significantly between patients and HCPs across all phases of the disease. These findings further highlight the need for improved communication between patients and HCPs in order to set appropriate treatment goals and promote symptomatic and functional recovery in MDD.

Objective: The 5-level EuroQoL (EQ-5D-5L) is a patient-reported outcome measure frequently used in stroke research. However, it does not assess the cognitive problems many patients with stroke experience. The aim of this article is to compare the content validity, internal consistency and discriminative ability of the EQ-5D-5L with and without an additional cognitive domain (EQ-5D-5L+C), administered three months post-stroke. Design: Cross-sectional study. Setting: Six general hospitals in the Netherlands. Subjects: In all, 360 individuals with stroke three months after the event. Interventions: Not applicable. Main measures: The modified Rankin Scale and EQ-5D-5L+C were administered in telephone interviews three months post-stroke. Results: A total of 360 patients with stroke were included. Mean age was 68.8 years (standard deviation (SD) = 11.7), 143 (40%) were female, 334 (93%) had had an ischemic stroke, 165 (46%) had a National Institutes of Health Stroke Scale (NIHSS) score ⩽ 4 at presentation and the Barthel Index was 17.2 (SD = 4) four days post-stroke. Cognitive problems were reported by 199 (55%) patients three months post-stroke. Internal consistencies of the EQ-5D-5L and EQ-5D-5L+C were 0.75 and 0.77, respectively. Adding a cognitive domain resulted in a decrease of the ceiling effect from 22% to 14%. Both EQ-5D-5L and EQ-5D-5L+C showed good discriminative ability, but differences between patients with different modified Rankin Scale scores and with/without reported decrease in health and daily activities were slightly larger with the EQ-5D-5L+C compared to the EQ-5D-5L. Conclusions: The EQ-5D-5L+C, which includes a cognitive domain that is highly significant for stroke patients, showed increased content validity and good discriminative ability, without losing internal consistency.

International audience; Collecting 130 electronic medical records and diagnoses from emergency room stays of eleven patients with confirmed psychogenic nonepileptic seizure (PNES) over a 17-year period (2001-2018), 48 different diagnostic terms were retrieved. This emphasized the need for a consensual terminology encompassing not only PNES but also all functional transient (paroxysmal) events, including episodes of motor or sensory deficits, and cognitive symptoms. Rather than defining what it is not (PNES, stroke mimicks…), it would be more accurate to define what it is: a paroxysmal functional event.

A variety of factors affect the success of music therapy students in practica. Many music therapy students may have invisible illnesses or invisible disabilities (II/ID) that affect their work. II/ID have physical or psychological effects but are not apparent to an observer. Such illnesses may include chronic illnesses, mental illnesses, and developmental disabilities. Although researchers have studied the success of post-secondary students with II/ID and the success of music therapy students without II/ID, there is a lack of research on music therapy students who identify with having II/ID. This researcher used an exploratory online survey to investigate the prevalence of II/ID among music therapy students and how it may affect their success in music therapy practica. Quantitative responses were compiled and analyzed into frequencies and percentages, and open-ended responses were coded and analyzed for patterns and themes. Results indicated that music therapy students with II/ID have various reasons for disclosure or nondisclosure. Some music therapy students with II/ID required accommodations, while many did not. Additionally, the effects of II/ID on music therapy practica students included physical, psychosocial, and cognitive symptoms, which led to various choices for disclosure/nondisclosure and the request/use of individualized accommodations. Music therapy students with II/ID self-reported that making decisions regarding appropriate disclosure and determining their need for accommodations or not allowed them to be more successful in practica.

Background: Schizophrenia is a serious mental illness that affects more than 21 million people worldwide. Both genetics and the environment play a role in its etiology and pathogenesis. Symptoms of schizophrenia are mainly categorized into positive, negative, and cognitive. One major approach to identify and understand these diverse symptoms in humans has been to study behavioral phenotypes in a range of animal models of schizophrenia. Objective: We aimed to provide a comprehensive review of the behavioral tasks commonly used for measuring schizophrenia-like behaviors in rodents together with an update of the recent study findings. Methods: Articles describing phenotypes of schizophrenia-like behaviors in various animal models were collected through a literature search in Google Scholar, PubMed, Web of Science, and Scopus, with a focus on advances over the last 10 years. Results: Numerous studies have used a range of animal models and behavioral paradigms of schizophrenia to develop antipsychotic drugs for improved therapeutics. In establishing animal models of schizophrenia, the candidate models were evaluated for schizophrenia-like behaviors using several behavioral tasks for positive, negative, and cognitive symptoms designed to verify human symptoms of schizophrenia. Such validated animal models were provided as rapid preclinical avenues for drug testing and mechanistic studies. Conclusion: Based on the most recent advances in the field, it is apparent that a myriad of behavior tests are needed to confirm and evaluate the congruency of animal models with the numerous behaviors and clinical signs exhibited by patients with schizophrenia.

Schizophrenia is a chronic debilitating psychiatric disorder characterized by positive, negative, and cognitive symptoms. Several studies have consistently demonstrated that negative and cognitive symptoms are important predictors of outcome. However, the efficacy of available antipsychotics, both first-generation and second-generation, in the treatment of negative and cognitive symptoms is modest at best, and the degree of improvement is not clinically meaningful. Yoga, a traditional mind-body therapy from India, has been examined as complementary to antipsychotics for the treatment of schizophrenia. Several open-label and randomized controlled trials have reported the efficacy of yoga as a treatment for cognitive and negative symptoms of schizophrenia. The results of these studies in schizophrenia demonstrate improvement in negative symptoms, cognitive symptoms including social cognition, postural stability, socio-occupational functioning, and quality of life. Although the current reports are promising, there is a need for more evidence. Large-scale, multicentric trials with standard methodology are required in the future.

Cognitive symptoms are characteristic for neurodegenerative disease: there are dominating in the Alzheimer’s, but secondary in Parkinson’s disease (PD). However, in PD motor symptoms (MS) are dominating and their characteristic helps neurologist to recognize the disease. There are a large number of data mining publications that analyzed MS in PD. Present study is related to the question if development of cognitive symptoms is related to motor symptoms or if they are two independent processes? We have responded to this problem with help of IGrC (intelligent granular computing) approach. We have put together eye movement, neurological and neuropsychological tests. Our study was dedicated to 47 Parkinson’s disease patients in two sessions: S#1 - without medications (MedOFF) and S#2 after taking medications (MedON). There were two groups of patients: Gr1 (23 patients) less advanced and Gr2 more advanced PD. We have measured Gr1 in three visits every 6 months: Gr1VIS1, Gr1VIS2, Gr1VIS3. Gr2 (24 patients) has only one visit (no visit number). With rough set theory (RST) that belongs to IGrC we have found from Gr2 three different sets of rules: a) general rules (GRUL) determined by all attributes; b) motor related rules (MRUL) – motor attributes; c) cognitive rules (CRUL) determined by cognitive attributes. By applying these different sets of rules to different Gr1 visits we have found different set of symptoms developments. With GRUL we have found for Gr1VIS1 accuracy = 0.682, for Gr1VIS2 acc. = 0.857, for Gr1VIS3 acc. = 0.875. With MRUL we have found for Gr1VIS1 acc. = 0.80, for Gr1VIS2 acc. = 0.933, for Gr1VIS3 acc. = 1.0. With CRUL we have found for Gr1VIS1 acc. = 0.50, for Gr1VIS2 acc. = 0.60, for Gr1VIS3 acc. = 0.636. Cognitive changes are independent from the motor symptoms development.

Background Primary aim of this study was to compare cognitive performance of patients with chronic Q fever or Q fever fatigue syndrome (QFS) to matched controls from the general population, while taking performance validity into account. Second, we investigated whether objective cognitive performance was related to subjective cognitive complaints or psychological wellbeing. Methods Cognitive functioning was assessed with a neuropsychological test battery measuring the domains of processing speed, episodic memory, working memory and executive functioning. Tests for performance validity and premorbid intelligence were also included. Validated questionnaires were administered to assess self-reported fatigue, depressive symptoms and cognitive complaints. Results In total, 30 patients with chronic Q fever, 32 with QFS and 35 controls were included. A high percentage of chronic Q fever patients showed poor performance validity (38%) compared to controls (14%, p = 0.066). After exclusion of participants showing poor performance validity, no significant differences between patients and controls were found in the cognitive domains. QFS patients reported a high level of cognitive complaints compared to controls (41.2 vs 30.4, p = 0.023). Cognitive complaints were not significantly related to cognitive performance in any of the domains for this patient group. Conclusions The high level of self-reported cognitive complaints in QFS patients does not indicate cognitive impairment. A large proportion of the chronic Q fever patients showed suboptimal mental effort during neuropsychological assessment. More research into the underlying explanations is needed. Our findings stress the importance of assessing cognitive functioning by neuropsychological examination including performance validity, rather than only measuring subjective cognitive complaints.

In contrast to regular statistics which focuses on the typical part of the data and use metrics to describe that part (usually the mean or variance), there is a branch of statistics which focuses on the extreme and thus rare events. The use of extreme value statistics allows us to fit models on this part of the data and like ,,regular" statistics, enables us to calculate estimates and predictions, but in this case for extreme values. These methods are frequently used in fields like meteorology and finance where the extreme events has large impact despite their rarity. Because of this rarity, however, only a small fraction of the data can be used so much higher sample size is required for such analysis – thus fields with a large amount of historical data have an advantage.This factor limited the use of extreme value statistics in biomedical field where available technology and costs are strong limitations at measuring most of the biomarkers until recently.Blood glucose level is one of the exceptions nowadays, as with recent advancements it can be monitored for relatively long time and with high frequency for a patient. Additionally, extreme values of blood glucose levels (both high and low) are associated with – chronic or acute – complications of diabetes.This paper aims to demonstrate that the use of extreme value statistics could be a possible way to characterize blood glucose curves. In addition to providing a metric for the state of the patient, it allows the comparison of the performance of artificial pancreas models.Peak over threshold method was used to model extreme values of a simulated dataset containing 1440 measurements of 99 patients with 250 mg/dl as threshold. Probabilities for exceeding the clinically relevant levels of 270 mg/dl (cognitive symptoms expected) and 600 mg/dl (diabetic hyperosmolar syndrome) were calculated and were 23.9% and 8.0 • 10−6% respectively in the region above the threshold (250 mg/dl). Through these estimates it is possible to compare different controllers.

Schizophrenia is one of the most disabling mental disorders with a large burden of disease. Treatment options for positive, negative and cognitive symptoms of schizophrenia are limited, and a third of the patients with schizophrenia respond insufficiently to antipsychotic medications. Over the past decades, researchers have explored new treatment modalities, including neuromodulation with repetitive Transcranial Magnetic Stimulation (rTMS). The available evidence indicates that rTMS can decrease positive and negative symptoms of schizophrenia and may have procognitive effects, although effects may be modest and transient. More research is needed to investigate moderators of effect in order to optimise treatment parameters and thereby establish more durable and clinically relevant effects.

Background: Subjective cognitive decline (SCD) is associated with an increased risk of Alzheimer’s disease (AD). However, patients reporting SCD to their general practitioner are not always referred to a memory clinic. Objective: To investigate whether prior history of medical help-seeking is associated with AD biomarker abnormality, worse cognitive performance, and/or depressive symptoms in SCD. Methods: We compared levels of cerebrospinal fluid (CSF) Aβ1 - 42, cognitive performance, and depressive symptoms (15-item Geriatric Depression Scale, GDS-15) between healthy controls (n = 88), SCD with a history of medical help seeking (SCD-HS, n = 67), and SCD non help-seekers (SCD-NHS, n = 44). Cases with evidence of amyloid plaques (CSF Aβ1 - 42 ≤708 ng/l) and symptoms of depression (GDS-15≥6) were determined in both SCD groups. Results: The SCD-HS group had lower CSF Aβ1 - 42 (p p n = 12, 18%) and amyloid plaques (n = 18, 27%) compared to SCD-NHS (n = 1, 2% and n = 7, 16%, respectively). None of the SCD-HS cases and only one SCD-NHS case had concurrent symptoms of depression and amyloid plaques. The SCD-HS cases showed equal word list learning and memory performance regardless of amyloid status or symptoms of depression. Conclusion: Medical help-seeking in SCD is associated with an increased risk of AD pathology or symptoms of depression. However, subtle memory deficits are seen in SCD help-seekers, also without amyloid plaques or symptoms of depression.

Cognitive symptoms of Parkinson's disease (PD) have been long underestimated, but are some of the most disabling non-motor features of the disease. In order to establish signs that allow for earlier detection of cognitive decline in PD, the concept of `subjective cognitive decline´ (SCD) has gained a growing interest. SCD refers to patients who report a decline in subjective cognitive capacities, while their results on neuropsychological tests are within the normal performance range, indicating adequate cognitive functions. The aim of this review was to evaluate the concept of SCD in PD and give an overview of the current research. A systematic literature search in PubMed was performed to identify articles published before December 2020. We included 18 studies with a total of n = 2,654 patients. While there is currently no consensus on research or clinical criteria for SCD in PD, this review presents the accumulated evidence for SCD in PD patients and supports the importance of early identification of cognitive deficits, due to the relatively high prevalence for SCD in PD and the added risk of future cognitive impairment it entails. The publications included in this review indicate that SCD may be part of the PD spectrum but further research is needed. Expanding research on SCD in PD will allow for earlier detection of cognitive impairment and may be considered for a preventive intervention.

Objectives The purpose of the study was to explore the impact of perceived cognitive problems on daily life in men with fibromyalgia. Method The data were collected through life-story interviews of eight men with fibromyalgia. Narrative analysis was conducted to create model narratives that comprise the content and storylines across the data. Results Three model narratives are presented in the findings to describe the scope and severity of the cognitive problems. The participants’ experiences of cognitive problems varied from occasional concentration problems to severe and complex difficulties in memory, problem solving and verbal fluency. The impact of these problems on daily life was substantial and overshadowed the participants’ domestic life, social relations and work performance. In some cases, maintaining a role in working life was perceived as challenging. Discussion These patients are usually examined and treated in primary health care settings and the assessment tools and interventions should be applicable in these settings. More research is needed to develop effective interventions that address not only memory but also individual’s ability to solve complex problems and to work under pressure as well as the level of verbal fluency, which all are relevant issues in terms of work ability in contemporary society.

One of the cognitive symptoms observed in schizophrenia is decreased flexibility in several tasks, including reversal learning. Reversal learning has previously been tested in rats following maternal immune activation (MIA), a risk factor for schizophrenia, with varying results. Whereas some previous studies have shown that MIA rats are slower to learn a reversal, others have reported more rapid learning compared with controls. Several of these latter studies have, however, used a T-maze task with aversive, negative reinforcement as a motivating factor. Because most human studies use positive reinforcement in reversal tasks, here we tested whether reinforcement valence might be a critical factor. We ran male MIA and control rats in a T-maze reversal procedure that was very similar to previous studies except that positive, appetitive reinforcement was used for motivation. The results showed that MIA animals performed similarly to controls during training, but in contrast to the previous, aversively motivated T-maze studies, slower reversal learning was observed. These results show that MIA animals are impaired in reversal learning under conditions of positive reinforcement, consistent with the effects observed in individuals with schizophrenia. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Recent work has suggested that anxiety restricts working memory capacity, which may underlie a wide range of cognitive symptoms in anxiety. However, previous literature on the anxiety-visual working memory association yielded mixed results, with some studies demonstrating an anxiety-related increase in visual working memory capacity. In an attempt to gain a more thorough understanding of the relationship between anxiety and visual working memory maintenance function, the current study examined the influence of trait anxiety on visual working memory capacity and resolution for negative, positive, and neutral faces in a large unselected sample, by conducting two different experiments. Experiment 1 used a change-detection task to estimate visual working memory capacity, while Experiment 2 used a modified time-delay estimation task to measure memory precision. Hierarchical linear modeling was used to analyze the relationship between trait anxiety, emotional valence, and visual working memory. Results showed that trait anxiety was associated with decreased visual working memory capacity for faces in a valence-independent manner, whereas anxiety-related change in visual working memory resolution was not significant. This pattern of results was discussed in light of the theories of anxiety and visual working memory.

This study examined the moderator role of gender in the relationship between negative affect and eating psychopathology as well as gender differences in these variables. A community sample of 285 students (61.8% females), aged 13–25, was recruited in middle and high schools and universities. They filled instruments that assess negative affect and eating disordered symptoms (restraint, eating concern, shape concern, weight concern, and global scale). Females scored higher both in all subscales and the global scale of eating psychopathology. The restraint subscale was the only subscale showing non-significant differences between females and males. Controlling for BMI, moderation analyses revealed that gender moderated the relationship between negative affect and eating psychopathology, except for restraint behavior. To deal with negative affect, females engage in more cognitive symptoms associated with disordered eating than males, but both endorse equally in eating restraint. These findings suggest that interventions focused on emotion regulation could help to reduce eating disordered symptoms among females and males. Level V, cross-sectional descriptive study.

Cognitive assessment tools measure cognitive impairment and complement biomarkers to link cognitive symptoms with pathophysiological processes underlying dementia. However, language and cultural differences in multilingual populations can influence the interpretation of cognitive assessment tools when applied in cross-cultural and multinational studies. Areas covered: This article examines the influence of culture and language on the interpretation of the Mini-Mental State Examination, Montreal Cognitive Assessment, and Alzheimer's Disease Assessment Scale-cognitive subscale, which are more commonly used worldwide. It discusses how this impacted multinational studies. Lastly, it presents language-neutral tools such as the Visual Cognitive Assessment Test, which do not require translation when applied in multilingual populations. Expert commentary: Linguistic and cultural variation within tools due to translation and differences in administration introduce method bias and differential item functioning, which influence the interpretation of cognitive scores in multinational studies. The ultimate goal is to have a tool that accurately measures cognitive impairment, yet with minimal influence from linguistic, cultural, educational, and demographic differences, through concerted international efforts to harmonize the development and validation of tools. While recently developed visual-based language-neutral tools show promise in the early detection of cognitive impairment, further validation will be required for these tools to be applied internationally.

Resumen Tanto la demencia como la depresion son frecuentes y condicionan un grave impacto en el paciente y su entorno. Ante la sospecha de deterioro cognitivo, es necesario: confirmar el diagnostico de demencia (afectacion de una o mas funciones superiores con repercusion en el funcionamiento global), realizar un adecuado diagnostico diferencial, clasificar y estadificar la demencia y valorar los sintomas no cognitivos. Se debe considerar la presencia de enfermedades cronicas, el deterioro funcional, el consumo elevado de farmacos o los problemas del entorno sociofamiliar concomitantes. Se recomienda el tratamiento con inhibidores de la acetil-colinesterasa y/o memantina cuando esten indicados, junto con terapias no farmacologicas. En la depresion del mayor es mas comun la irritabilidad, la ansiedad y los sintomas cognitivos. Se asocia a comorbilidad y/o deterioro cognitivo. La relacion entre depresion y enfermedad medica es bidireccional: problemas medicos como el dolor cronico predisponen a la depresion, y la depresion esta asociada con peor un pronostico para otras enfermedades. El tratamiento de la depresion en los ancianos es tan eficaz como en el resto de la poblacion, y es fundamental su deteccion y correcto diagnostico. Dementia and depression are both common and have a major impact on the patient and their environment. If cognitive impairment is suspected, it is necessary to confirm the diagnosis of dementia (impairment of one or more cognitive higher functions affecting overall functioning), to make an appropriate differential diagnosis, to classify and stage the dementia, and to assess non-cognitive symptoms. The presence of chronic disease, functional impairment, high drug consumption and concomitant social and family problems should be considered. Treatment is recommended with acetylcholinesterase and/or memantine when indicated, along with non-pharmacological therapies. Irritability, anxiety and cognitive symptoms are more common in depressed elderly patients. The relationship between depression and medical disease is two-way: medical problems such as chronic pain predispose to depression, and depression is associated with a poorer prognosis for other diseases. Treatment of depression in the elderly is as effective as in the rest of the population, and its detection and correct diagnosis is essential.

Purpose Early cognitive symptoms such as word-finding difficulty (WFD) in daily conversation are common in Parkinson's disease (PD), but studies have been limited by a lack of feasible, quantitative measures. Linguistic analysis, focused on pauses in speech, may yield markers of impairment of cognition and communication in PD. The objective of this study was to evaluate the relationship of linguistic markers in semistructured speech to WFD symptoms and cognitive function in PD. Method Speech recordings of description of the Cookie Theft picture in 53 patients with PD without dementia and 23 elderly controls were analyzed with Praat software. Montreal Cognitive Assessment (MoCA; Nasreddine et al., 2005), category naming fluency, and confrontation naming tests were administered. Questionnaires rating WFD symptoms and cognitive instrumental activities of daily living were completed. We determined the relationships between (a) pause length and location, (b) MoCA score, and (c) WFD symptoms, using Pearson's correlations and multivariate regression models. Results Compared with controls, patients with PD had more pauses within utterances as well as fewer words per minute and a lower percentage of well-formed sentences. Pauses within utterances differed significantly between PD–mild cognitive impairment and normal cognition ( p < .001). Words per minute and percentage of well-formed sentences were predictive of MoCA in multivariate regression models. Pauses before verbs were associated with patient-reported severity of WFD symptoms ( p = .006). Conclusions Linguistic markers including pauses within utterances distinguish patients with PD with mild cognitive symptoms from elderly controls. These markers are associated with global cognitive function before the onset of dementia. Pauses before verbs and grammatical markers may index early cognitive symptoms such as WFD that may interfere with functional communication. Supplemental Material https://doi.org/10.23641/asha.6615401

Background/Aims: Individuals with Parkinson's disease, besides the motor and cognitive symptoms may even present deficits in the motor learning. A recent therapeutic approach involves virtual reality that offers elements that can minimize the difficulties in the learning process. Recently, the therapeutic potential of Nintendo Wii® gaming device for rehabilitation of patients with Parkinson's disease has been showing positive results, but studies related to the use of the Kinect for XboxTM are still scarce. The present study aimed to investigate the effects of motor and cognitive demands of six Kinect for Xbox 360TM games on the learning of patients with Parkinson's disease, comparing it with healthy individuals. Methods: A total of 19 adults, 8 with idiopathic Parkinson's disease and 11 healthy adults participated in a program which included 10 training sessions and had their scores registered three times. Findings: The results showed that in four of those games, patients with Parkinson's disease showed an ability to improve and keep their performance, but not in the other two games, similar to healthy adults. Conclusions: It was concluded that motor and cognitive abilities affected by Parkinson's disease may be improved with the use of virtual training proposed in this study. Some of the games and gaming devices features can influence the learning process, even in healthy adults.

Background Alzheimer's disease (AD) is a complex neurodegenerative disorder characterized by the progressive loss of neurons, which typically leads to severe impairments in cognitive functions including memory and learning. Key pathological features of this disease include the deposition of highly insoluble amyloid β peptides and the formation of neurofibrillary tangles (NFTs) in the brain. Mounting evidence also implicates sustained glial-mediated inflammation as a major contributor of the neurodegenerative processes and cognitive deficits observed in AD. Methods This paper provides an overview of findings from both human and animal studies investigating the role of microglia and astrocytes in AD, and discusses potential avenues for therapeutic intervention. Results Glial-mediated inflammation is a 'double-edged sword', performing both detrimental and beneficial functions in AD. Despite tremendous effort in elucidating the molecular and cellular mechanisms underlying AD pathology, to date, there is no treatment that could prevent or cure this disease. Current treatments are only useful in slowing down the progression of AD and helping patients manage some of their behavioral and cognitive symptoms. Conclusion A better understanding of the role of microglia and astrocytes in the regulation of AD pathology is needed as this could pave the way for new therapeutic strategies.

Purpose The aims of this study are to investigate the course of work functioning, health status, and work-related factors among cancer patients during 18 months after return to work (RTW) and to examine the associations between these variables and work functioning over time. Methods Data were used from the 18-month longitudinal “Work Life after Cancer” (WOLICA) cohort, among 384 cancer patients who resumed work. Linear mixed models were performed to examine the different courses during 18-month follow-up. Linear regression analyses with generalized estimating equations (GEE) were used to examine the associations and interactions. Results Cancer patients reported an increase of work functioning and a decrease of fatigue and depressive symptoms in the first 12 months, followed by a stable course between 12 and 18 months. Cognitive symptoms were stable during the first 18 months. Working hours increased and social support decreased during the first 6 months; both remained stable between 6 and 18 months. Fatigue, depressive, and cognitive symptoms were negatively associated with work functioning over time; working hours and supervisor social support were positively associated. Conclusions Interventions to improve cancer patients’ work functioning over time might be promising if they are aimed at reducing fatigue, depressive symptoms, cognitive symptoms, and encouraging supervisor social support. Implications for Cancer Survivors It is important to monitor cancer patients not only in the period directly after RTW but up to 18 months after RTW, allowing for timely interventions when needed.

Delphine Saragoussi,1 Michael Cronquist Christensen,2 Lene Hammer-Helmich,3 Benoît Rive,4 Maëlys Touya,5 Josep Maria Haro6 1Real-World Evidence and Epidemiology, Lundbeck SAS, Issy-les-Moulineaux, France; 2Medical Affairs Vortioxetine, H. Lundbeck A/S, Valby, Denmark; 3Real-World Evidence and Epidemiology, H. Lundbeck A/S, Valby, Denmark; 4Global Analytics, Lundbeck SAS, Issy-les-Moulineaux, France; 5Health Economics and Outcomes Research, Lundbeck, Deerfield, IL, USA; 6Research and Teaching Unit, Parc Sanitari Sant Joan de Deu, CIBERSAM, University of Barcelona, Sant Boi de Llobregat, Barcelona, Spain Background: Major depressive disorder (MDD) is associated with significant impairments in health-related quality of life (HRQoL) and everyday functioning. This cohort study investigated the long-term development of HRQoL in patients with MDD and its association with patient characteristics, including depressive symptom severity and cognitive symptoms.Methods: The Prospective Epidemiological Research on Functioning Outcomes Related to Major depressive disorder (PERFORM) study was a longitudinal cohort study conducted in 1,159 outpatients aged 18–65 years with MDD in France, Germany, Spain, Sweden, and the UK. The patients were either initiating antidepressant monotherapy or undergoing their first switch of antidepressant. HRQoL was assessed using the Medical Outcomes Study Short-Form 12-item Health Survey (SF-12) up to month 12 and the EuroQol Five Dimensions questionnaire up to month 24 (UK only). Depressive symptom severity was assessed up to month 24 by the patient-reported Patient Health Questionnaire and cognitive symptoms by the Perceived Deficit Questionnaire. Multivariate analyses were performed to identify patient characteristics associated with HRQoL.Results: Mental HRQoL was severely impaired at baseline versus normative data (mean [SD] SF-12 mental component summary [MCS], 26.5 [9.2]); mean (SD) physical component summary (PCS) total score was 45.2 (12.1). SF-12 MCS improved over 12 months of follow-up (38.7 [11.6] at month 12), while SF-12 PCS remained stable (45.3 [11.1]). At each assessment time point, there was a clear pattern of lower SF-12 MCS and PCS total score in patients experiencing greater cognitive problems. The mean EuroQol Five Dimensions questionnaire utility index score generally decreased (i.e., worsened) with increasing severity of cognitive and depressive symptoms at all time points up to 24 months. Multivariate analyses identified both depression severity and cognitive symptoms as strongly and significantly associated with poor HRQoL.Conclusion: These findings highlight the importance of recognizing and managing residual symptoms in patients with MDD, including the cognitive symptoms, to restore long-term psychosocial functioning. Keywords: major depressive disorder, health-related quality of life, depression, cognitive symptoms&nbsp

Background: Episodic memory loss is one of the most common cognitive symptoms in patients with multiple sclerosis (MS), but the pathophysiology of this symptom remains unclear. Both the hippocampus and thalamus have been implicated in episodic memory and show regional atrophy in patients with MS. Objective: In this work, we used functional magnetic resonance imaging (fMRI) during a verbal episodic memory task, lesion load, and volumetric measures of the hippocampus and thalamus to assess the relative contributions to verbal and visual–spatial episodic memory. Methods: Functional activation, lesion load, and volumetric measures from 32 patients with MS and 16 healthy controls were used in a predictive analysis of episodic memory function. Results: After adjusting for disease duration, immediate recall performance on a visual–spatial episodic memory task was significantly predicted by hippocampal volume ( p Conclusion: Our results suggest that functional activation may be useful as a predictive measure of episodic memory loss in patients with MS.

Dementia is a leading cause of death and disability in Australia. This research evaluated dementia knowledge and educational needs among the Australian health workforce. An online version of the validated Dementia Knowledge Assessment Scale (DKAS) was administered with a random sample of 234 health professionals across eight Australian states. Respondents provided additional self-report data concerning dementia experiences, educational needs, and demographic information. Dementia knowledge deficiencies were identified concerning risk factors, prevalent typologies of the condition, and cognitive symptoms. Prior university education and dementia-specific training were predictive of significantly higher knowledge scores. Self-reported dementia education needs included nonpharmaceutical interventions for the behavioral and psychological symptoms and best-evidence care provision. Knowledge deficiencies among health workers suggest patients with dementia may not be receiving consistent, best-evidence care in Australia. The research findings will support the development of a targeted online dementia education intervention that aims to improve health worker knowledge and patient care.

Psychiatric and neurologic disorders are often characterized by both neuroinflammation and cognitive dysfunction. To date, however, the relationship between neuroinflammation and cognitive dysfunction remains understudied in humans. Preclinical research indicates that experimental induction of neuroinflammation reliably impairs memory processes. In this paradigm development study, we translated those robust preclinical findings to humans using positron emission tomography (PET) imaging with [(11)C]PBR28, a marker of microglia, and lipopolysaccharide (LPS), a potent neuroimmune stimulus. In a sample of 18 healthy adults, we confirmed our previous findings that LPS administration increased whole-brain [(11)C]PBR28 availability by 3150%, demonstrating a robust neuroimmune response (Cohen’s ds>1.6). We now show that LPS specifically impaired verbal learning and recall, hippocampal memory processes, by 11% and 22%, respectively (Cohen’s ds>0.9), but did not alter attention, motor, or executive processes. The LPS-induced increase in [(11)C]PBR28 binding was correlated with significantly greater decrements in verbal learning performance in the hippocampus (r=−0.52, p=.028), putamen (r=−0.50, p=.04), and thalamus (r=−0.55, p=.02). This experimental paradigm may be useful in investigating mechanistic relationships between neuroinflammatory signaling and cognitive dysfunction in psychiatric and neurologic disorders. It may also provide a direct approach to evaluate medications designed to rescue cognitive deficits associated with neuroinflammatory dysfunction.