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Background: Amnestic mild cognitive impairment (aMCI) is regarded as a transitional state of Alzheimer’s disease, with working memory (WM) impairment. Objective: To investigate the brain activity in aMCI patients during WM tasks with the functional near-infrared spectroscopy (fNIRS) technique, as well as explore the association between brain activity and cognitive function in multiple domains. Methods: This study is a case-control study of 54 aMCI patients and 33 cognitively healthy elderly (NC). All participants underwent neuropsychological assessments. fNIRS was applied to examine the brain activation during the WM task. Multivariable linear regression analysis was applied to evaluate associations between brain activation and cognitive function in multiple domains. Results: Compared to NC subjects, aMCI patients had lower activation in the bilateral prefrontal, parietal, and occipital cortex during the WM task. Additionally, activation in the left prefrontal, bilateral parietal, and occipital cortex during the encoding and maintenance phase was positively associated with memory function. During memory retrieval, higher activity in the left prefrontal, parietal, and occipital cortex were correlated with higher memory scores. Besides, a positive association also formed between attention function and the activation in the left prefrontal, parietal, and occipital cortex during the WM task. Conclusion: These findings demonstrated that reduced activation in the prefrontal, parietal and occipital cortex during WM might reflect the risk of cognitive impairment, especially memory and attention function in aMCI patients. Given the brain activation visualization, fNIRS may be a convenient and alternative tool for screening the risk of Alzheimer’s disease.

Objective It was recently found that structural changes in the substantia nigra (SN) and motor symptoms become more prominent in Parkinson's disease (PD) patients with striatal silent lacunar infarction (SSLI) than in those without SSLI. Hyperhomocysteinemia (HHCY) was an independent risk factor for SSLI in PD patients. In this follow-up study, we investigated the relationship between HHCY and structural changes of the SN in PD patients. Methods A total of 72 untreated early PD patients without SSLI, divided into control and HHCY groups, were enrolled in this study. All participants underwent conventional MRI and diffusion kurtosis imaging (DKI) twice; at baseline and at the 2-year visit. The differences of the following variables between the two groups were analyzed: mean kurtosis (MK) values of the SN, the severity of disease, daily dosage of levodopa, and the variation of these indexes from baseline to 2-year visit. Logistic regression analysis was used to identify the relationship between HHCY and structural changes of the SN in PD patients. Results 1.All variables mentioned above showed significant differences between the two groups. 2. The variation in MK values of the SN were positively correlated with the variation in the severity of disease. 3. HHCY was an independent risk factor for the variation in MK values of the SN in PD patients. Conclusion HHCY is associated with the structural changes of the SN in PD patients. As PD progresses, motor symptoms become aggravated with increased structural changes to the SN, especially in patients with HHCY.

Medical diagnostic robot systems have been paid more and more attention due to its objectivity and accuracy. The diagnosis of mild cognitive impairment (MCI) is considered an effective means to prevent Alzheimer's disease (AD). Doctors diagnose MCI based on various clinical examinations, which are expensive and the diagnosis results rely on the knowledge of doctors. Therefore, it is necessary to develop a robot diagnostic system to eliminate the influence of human factors and obtain a higher accuracy rate. In this paper, we propose a novel Group Feature Domain Adversarial Neural Network (GF-DANN) for amnestic MCI (aMCI) diagnosis, which involves two important modules. A Group Feature Extraction (GFE) module is proposed to reduce individual differences by learning group-level features through adversarial learning. A Dual Branch Domain Adaptation (DBDA) module is carefully designed to reduce the distribution difference between the source and target domain in a domain adaption way. On three types of data set, GF-DANN achieves the best accuracy compared with classic machine learning and deep learning methods. On the DMS data set, GF-DANN has obtained an accuracy rate of 89.47%, and the sensitivity and specificity are 90% and 89%. In addition, by comparing three EEG data collection paradigms, our results demonstrate that the DMS paradigm has the potential to build an aMCI diagnose robot system., This paper has been accepted by 2021 International Conference on Robotics and Automation (ICRA 2021)

Study objectivesTo investigate the extent to which sleep quality associated with plasma Aβ levels in amnestic mild cognitive impairment (aMCI) elderly.MethodsA total of 172 cognitively normal (NC) elderly and 133 aMCI elderly were included in this study. For the evaluation of sleep quality, the Pittsburgh Sleep Quality Index (PSQI) was used. Levels of plasma Aβ were determined by the sandwich enzyme-linked immunosorbent assay technique. Multivariable linear regression analysis was applied to evaluate associations between sleep quality and plasma Aβ levels after adjusting potential confounders.ResultsCompared to NC subjects, participants with aMCI had a higher global PSQI score (8.72 ± 3.87 vs. 7.10 ± 3.07, p < 0.001). The global PSQI score was positively associated with plasma Aβ42 level in the aMCI group (β = 0.063, 95% CI 0.001–0.125, and p = 0.049) but not in the NC group (p > 0.05). Additionally, a higher global PSQI score was associated with a higher plasma Aβ42/Aβ40 ratio in both NC (β = 0.010, 95% CI 0.003–0.016, and p = 0.003) and aMCI groups (β = 0.012, 95% CI 0.005–0.018, and p < 0.001). The association between global PSQI score and plasma Aβ42/Aβ40 ratio was stronger in individuals with aMCI relative to the NC subjects (β = 0.076 vs. 0.030, p for interaction = 0.023).ConclusionPoor sleep quality was associated with plasma Aβ42 and Aβ42/Aβ40 ratio, with a stronger effect among individuals with aMCI. A better understanding of the role of sleep in plasma Aβ levels in aMCI patients could lead to effective sleep-based intervention against the risk of Alzheimer’s disease.

This study aims to investigate the extent to which sleep duration and efficiency are associated with plasma amyloid-β (Aβ) levels in non-demented older people. This study is a cross-sectional analysis of 305 non-demented older people. Sleep duration and efficiency were assessed used the Pittsburgh Sleep Quality Index. Levels of plasma Aβ were determined by sandwich enzyme-linked immunosorbent assay technique. Associations between sleep variables and plasma Aβ levels were evaluated with multivariable linear regression analysis. Compared to those with sleep duration > 7 h, participants with sleep duration < 6 h had a higher plasma Aβ42 level (β = 0.495, 95% CI 0.077~0.913, p = 0.021) and Aβ42/Aβ40 ratio (β = 0.101, 95% CI 0.058~0.144, p < 0.001). Compared to those with sleep efficiency ≥ 85%, participants with lower sleep efficiency (65~74%

Latent genetic variations of cholesterol metabolism-related genes in late-onset Alzheimer’s disease, especially, as well as in mild cognitive impairment pathogenesis are still to be studied extensively. Thus, we performed the targeted-sequencing of 12 nuclear receptor genes plus APOE which were involved in cholesterol content modulation to screen susceptible genetic variants and focused on a new risk variant ESR1 rs9340803 at 6q25.1 for both late-onset Alzheimer’s disease (OR=3.30[1.84~4.22], p

Walking is one of the major human activities, and walking pattern is unique for each individual. Thus, human gait can be applied in biometric personal authentication. The traditional method for gait recognition is based on one or multiple cameras. With the rapid development of Micro-Electro-Mechanical System (MEMS), small light inertial sensors have been used for human identification so far. In this study, a gait based personal authentication method is proposed using MEMS inertial sensors. They are fixed in the smart shoes, collecting motion signals and transmitting them to the server. Then, gait parameters such as step length, cadence, stance phase, swing phase and the pitch angular are calculated and used as features for personal identification. A probabilistic neural network is proposed as a classification mechanism to uniquely identify different users. Experiments are conducted to validate the proposed method. By using two cross-validation techniques, the overall mean classification rate for 22 persons is up to 85.3 and 85.7% respectively, which demonstrates the effectiveness of the method.

Introduction The socioeconomic costs of Alzheimer's disease (AD) in China and its impact on global economic burden remain uncertain. Methods We collected data from 3098 patients with AD in 81 representative centers across China and estimated AD costs for individual patient and total patients in China in 2015. Based on this data, we re-estimated the worldwide costs of AD. Results The annual socioeconomic cost per patient was US $19,144.36, and total costs were US $167.74 billion in 2015. The annual total costs are predicted to reach US $507.49 billion in 2030 and US $1.89 trillion in 2050. Based on our results, the global estimates of costs for dementia were US $957.56 billion in 2015, and will be US $2.54 trillion in 2030, and US $9.12 trillion in 2050, much more than the predictions by the World Alzheimer Report 2015. Discussion China bears a heavy burden of AD costs, which greatly change the estimates of AD cost worldwide.

Objectives: To characterize gait disorders in patients with amnestic mild cognitive impairments and determine the association between the performance of the gait function and cognition. Methodology: In this study, we enrolled 38 patients with amnestic mild cognitive impairment (aMCI) and 30 cognitively normal individuals (NC). Neuropsychological assessments included tests of memory, executive function, language, and attention. Using an inertial-sensor-based wearable instrument, we collected the gait data dynamically for at least 1 h/day for 2 weeks. The gait parameters included walking velocity, stride length, stride time, cadence, and stride time variability. Results: The aMCI patients had reduced walking velocity and stride length and increased stride time variability compared with the NCs. Walking velocity was positively correlated with long-term memory (r = 0.256, p = 0.043) and executive function (r = 0.490, p = 0.007). Stride length was positively correlated with long-term memory (r = 0.322, p = 0.036), executive function (r = 0.366, p = 0.024), and attention (r = 0.264, p = 0.048). Stride time variability was negatively correlated with long-term memory (r = −0.206, p = 0.038), executive function (r = −0.430, p = 0.022), and attention (r = −0.247, p = 0.015). Conclusion: This study suggested that cognitive impairment-related gait disorders occur (reduced gait speed, gait length, and gait stability) in daily life walking among the aMCI patients. A sensor-based wearable device for gait measurement may be an alternative and convenient tool for screening cognitive impairment.

Background Obesity is a risk factor for many diseases. However, the potential association between adiposity and cognitive decline in hypertensive patients is inconclusive. We performed a secondary data analysis of the CSPPT (China Stroke Primary Prevention Trial) to examine whether adiposity is correlated with longitudinal cognitive performance in hypertensive adults. Methods and Results The analysis included 16 791 patients in the CSPPT who received at least 2 cognitive assessments by the Mini‐Mental State Examination ( MMSE ) during the follow‐up (median, 4.5 years; interquartile range, 4.2–4.8 years). Outcomes included changes in MMSE scores and cognitive impairment (defined as MMSE score less than education‐specific cutoff point). A marked reduction in MMSE scores at the final (compared with at the 1‐year) follow‐up was apparent in both men (n=4838; mean [ SD ] score, 0.41 [3.62]) and women (n=7190; mean [SD] score, 1.07 [4.61]; both P MMSE decline, even after controlling for demographics and comorbidities (men, β=0.0134 [ SE , 0.0036]; women, β=0.0133 [SE, 0.0034]; both P Conclusions Higher adiposity is independently associated with slower cognitive decline in Chinese hypertensive adults. Clinical Trial Registration URL: http://www.clinicaltrials.gov . Unique identifier: NCT 00794885 CSPPT .

Objective Striatal silent lacunar infarction (SSLI) is associated with structural changes to the substantia nigra (SN), detectable by diffusion kurtosis imaging (DKI). In this follow-up study, we investigated the effects of SSLI on the SN and movement disorders in patients with Parkinson's disease (PD). Methods A total of 60 untreated patients with early-stage PD, divided into control and SSLI groups, were enrolled in this study. All participants underwent conventional MRI and DKI twice; at baseline and after a 1-year period. We analyzed the differences of the following variables between the two groups: mean kurtosis (MK) values of the SN, the severity of disease, daily dosage of levodopa, and the variation of these indexes from baseline to 1-year visit. Logistic regression analysis was used to identify the major risk factors for SSLI in PD patients. Results 1. All variables showed significant differences between the two groups. 2. The variation in MK values of the SN had a positive correlation with the variation in the severity of disease. 3. Hypertension and hyperhomocysteinemia were independent factors for SSLI in patients with PD. Conclusion As PD progresses, movement disorders become more prominent, with increased structural changes to the SN, especially in patients with SSLI. Furthermore, PD patients with hypertension and hyperhomocysteinemia are more likely to have SSLI.

Renal insufficiency is associated with the prognosis of acute ischemic stroke (AIS) and homocysteine (Hcy) levels. This study investigated the association between plasma Hcy levels and renal insufficiency in patients with AIS. A total of 987 patients with AIS who had been treated at the First People’s Hospital of Foshan between 2011 and 2014 were retrospectively studied. Based on their cystatin C (Cys C) levels, the patients were divided into the normal renal function group (Cys C ≤ 1.25 mg/L) or the renal impairment group (Cys C > 1.25 mg/L). Multivariate regression analysis was applied to reveal the association between hyperhomocysteinemia (HHcy) and renal impairment. The renal impairment group showed more advanced age of onset, higher percentage of prior stroke and hypertension, higher baseline National Institute of Health Stroke Scale score, lower high-density lipoprotein cholesterol levels, and higher Hcy levels compared with the normal renal function group. A multivariate analysis revealed a relationship between early renal impairment and Hcy levels: an increase of Hcy by 1 μmol/L was associated with an increase of 12–18% of the risk of renal impairment among patients with AIS and HHcy. Patients with AIS and HHcy had a 2.42–3.51 fold increase of the risk of renal impairment compared with patients with normal Hcy level (P

Background: Dementia is increasingly prevalent due to rapid aging of the population, but under-recognized among people with low education levels. This is partly due to a lack of appropriate and precise normative data, which underestimates cognitive aging in the use of screening tools for dementia. Objective: We aimed to improve the precision of screening for cognitive impairment, by characterizing the patterns of cognitive aging and derived normative data of the Mini-Mental State Examination (MMSE) for illiterate and low-educated populations. Methods: This community-based study included data from 2,280 individuals aged 40 years or older from two rural areas. Multiple linear modeling examined the effect of aging on cognition reflected by the MMSE, stratified by education level and gender. Threshold effect of age on cognition was performed using a smoothing function. Results: The majority of participants (60.4%) were illiterate or had attended only primary school (24.6%). The effect of aging on cognition varied by gender and education. Primary-school educated females and males remained cognitively stable up to 62 and 71 years of age, respectively, with MMSE score declining 0.4 and 0.8 points/year in females and males thereafter. Illiterates females scored 2.3 points lower than illiterate males, and scores for both declined 0.2 points/year. According to these results, normative data stratified by age, education and gender was generated. Conclusion: This study suggests gender and educational differences exist in cognitive aging among adults with limited or no formal education. To improve screening precision for cognitive impairment with the use of MMSE in low-educated population, age, gender, and education level should be considered.

This study sought first to identify individual items of the Mini-Mental State Examination (MMSE) and demographic variables at baseline that predicted the trajectories of cognitive change among patients with mild cognitive impairment (MCI), and second to quantify the risk of cognitive decline in such patients based on their pattern of failure of MMSE items. 187 MCI patients were evaluated serially with the MMSE for up to 3.5 years. Patients who followed a declining cognitive trajectory differed from the stable reference group in their baseline profile of MMSE test performance. Patient age and performance on delayed recall, constructional praxis, attention, and orientation to time and floor predicted future cognitive decline with good accuracy (79.9%) and specificity (86.4%), and moderate sensitivity (67.2%). These results are presented in the form of a simple clinical tool for quantifying risk of future cognitive decline in MCI.

The AD-8 dementia screening questionnaire is a novel tool that allows clinicians to assess changes in cognitive function. This study examined psychometric properties of the test in French-speaking and English-speaking patients, and its impact on diagnostic practice in the geriatric assessment clinics of a university health centre. Data were extracted from the clinical database for all new patients screened for cognitive impairment 15 months before (historic control group) and 15 months after the introduction of the test (AD-8 group and concurrent control group). Analysis of differential item functioning revealed formal equivalence of the French- and English-language items, supporting the validity of the French version. Respondent type significantly influenced the total score on the AD-8. Concurrent validity with other cognitive screening tests was moderately high. Finally, among patients who did not present with pre-existing dementia, a higher proportion of dementia diagnoses was made in those administered the AD-8 relative to the concurrent control group. Implications for clinical use of the AD-8 are discussed.

A recent study has shown that striatal silent infarction may occur secondary to the degeneration of dopaminergic neurons in the substantia nigra (SN) of mice. However, it is uncertain whether this phenomenon occurs in patients with early-stage Parkinson's disease (PD) and can be detected by diffusion kurtosis imaging (DKI). A total of 72 untreated patients with early-stage PD underwent conventional MRI and DKI. Participants were divided into control and striatal silent lacunar infarction (SSLI) groups. The differences in mean kurtosis (MK) values of the SN, Hoehn-Yahr (H-Y) staging, and Unified Parkinson's Disease Rating Scale (UPDRS) III score between groups, were analyzed. Linear regression analysis was used to correlate age, SSLI count, silent lacunar infarction count in other brain areas and age-related white matter change score with MK values of the SN. Spearman correlation coefficient analysis was used to correlate MK values of the SN and SSLI count with H-Y staging and UPDRS III score. There was no significant difference in the severity of disease between two groups; however, MK values of the SN with SSLI present were significantly higher than in SN without SSLI. In addition, SSLI count had linear correlation with MK values of the SN, which had positive correlation with H-Y-staging and UPDRS III score. SSLI is associated with structural changes to the SN in patients with early-stage PD, detectable by DKI, and may aggravate their motor impairments.

Current evidence shows that apolipoprotein E (APOE), apolipoprotein CI (APOC1) and low density lipoprotein receptor-related protein (LRP) variations are related to late-onset Alzheimer's disease. However, it remains unclear if genetic polymorphisms in these genes are associated with cognitive decline in late-onset Alzheimer's disease patients. We performed a 30-month longitudinal cohort study to investigate the relationship between Alzheimer's disease and APOE, APOC1, and LRP. In this study, 78 Chinese Han patients with late-onset Alzheimer's disease were recruited form Guangxi Zhuang Autonomous Region in China. APOE, APOC1, and LRP genotyping was performed using polymerase chain reaction-restriction fragment length polymorphisms. The Mini-Mental State Examination and Clinical Dementia Rating Scale were used to assess patients' cognitive function. After a 30-month follow-up period, we found a significant reduction in Mini-Mental State Examination total score, a higher proportion of patients fulfilling cognitive impairment progression criteria, and a higher proportion of APOC1 H2 carriers in APOE e4 carriers compared with non-carriers. In addition, the APOE e4 allele frequency was significantly higher in the cognitive impairment progression group compared with the non-cognitive impairment progression group. In conclusion, APOE e4 plays an important role in augmenting cognitive decline, and APOC1 H2 may act synergistically with APOE e4 in increasing the risk of cognitive decline in Chinese patients with late-onset Alzheimer's disease.

Background Previous association studies examining the relationship between the APOC1 polymorphism and susceptibility to Alzheimer’s disease (AD) have shown conflicting results, and it is not clear if an APOC1 variant acts as a genetic risk factor in AD etiology across multiple populations. Methods To confirm the risk association between APOC1 and AD, we designed a case-control study and also performed a meta-analysis of previously published studies. Results Seventy-nine patients with AD and one hundred fifty-six unrelated controls were included in case-control study. No association was found between the variation of APOC1 and AD in stage 1 of our study. However, our meta-analysis pooled a total of 2092 AD patients and 2685 controls. The APOC1 rs11568822 polymorphism was associated with increased AD risk in Caucasians, Asians and Caribbean Hispanics, but not in African Americans. APOE e4 carriers harboring the APOC1 insertion allele, were more prevalent in AD patients than controls (χ2 = 119.46, OR = 2.79, 95% CI = 2.31–3.36, P

Introduction. Repetitive transcranial magnetic stimulation (rTMS) is a promising technique for promoting rehabilitation of arm function after stroke. The feasibility and impact of rTMS as an adjunct to traditional task-oriented training to improve arm function have not yet been demonstrated.Objective. Evaluate the feasibility of a randomized controlled trial aimed at determining the efficacy of rTMS as an adjunct to task-oriented therapy in facilitating restoration of arm function after stroke.Methods. Stratified block-randomized controlled trial set in the general community. Eleven stroke persons with mild to severe arm deficits were recruited and randomized to receive 8 sessions ofreal-rTMS orsham-rTMS followed by ninety minutes of arm tasks designed to improve function.Results. Medium to large, statistically significant effect sizes (0.49 to 1.63) were observed in both groups on several measures of arm function at the postintervention evaluation. Three out of four subjects in thereal-TMS condition showed increased levels of corticomotor excitability after the first stimulation session.Conclusions. Preliminary evidence suggests that an rTMS protocol potent enough to induce transient increases in cortical excitability of the lesioned hemisphere is feasible but did not show promising results as an adjunct to task-specific training. This trial is registration with Clinical Trials.govNCT00850408.

Background: The field of geriatric medicine has identified a need for an evaluative tool that can rapidly quantify global cognitive ability and accurately monitor change over time in patients with a wide range of impairments. We hypothesized that the development of an adaptive test approach to cognitive measurement would help to meet that need. This study aimed to provide evidence for the interpretability of scores obtained from a novel, adaptive approach to cognitive assessment, called the Geriatric Rapid Adaptive Cognitive Estimate (GRACE) method.Methods: An adaptive method for cognitive assessment was developed using data from 185 patients referred for geriatric cognitive assessment, and pilot tested in an additional 137 patients. Correlations between test scores and between rank orders of patients were computed to examine the reliability and validity of cognitive ability scores obtained by (1) administering test questions out of their usual order, (2) administering only a subset of questions, and (3) administering questions adaptively using simplified selection rules based on the most difficult question passed.Results: Cognitive ability scores obtained with the GRACE method correlated highly with the Montreal Cognitive Assessment (MoCA) scores (r = 0.93) and ranked patients similarly in order of ability (r > 0.87). A simplified adaptive testing algorithm for pencil-and-paper assessment demonstrated moderately high correlations with scores obtained from administering the full set of MMSE and MoCA items as well as the MoCA items alone.Conclusions: Scores from the GRACE method can be obtained easily in 5–10 minutes, reducing test burden. The resulting numeric score quantifies cognitive ability, allowing clinicians to compare patients and monitor change in global cognition over time. The adaptive nature of this method allows for evaluation of persons across a broader range of cognitive ability levels than currently available tests.

Background: The Montreal Cognitive Assessment (MoCA) can be used to quantify cognitive ability in older persons undergoing screening for cognitive impairment. Although highly sensitive in detecting mild cognitive impairment, its measurement precision is weakest among persons with milder forms of impairment. We sought to overcome this limitation by integrating information from the Mini-Mental State Examination (MMSE) into the calculation of cognitive ability.Methods: Data from 185 geriatric outpatients screened for cognitive impairment with the MoCA and the MMSE were Rasch analyzed to evaluate the extent to which the MMSE items improved measurement precision in the upper ability ranges of the population.Results: Adding information from the MMSE resulted in a 13.8% (13.3–14.3%) reduction in measurement error, with significant improvements in all quartiles of patient ability. The addition of three-word repetition and recall, copy pentagons, repeat sentence, and write sentence improved measurement of cognition in the upper levels of ability.Conclusions: The algorithm presented here maximizes the yield of available clinical data while improving measurement of cognitive ability, which is particularly important for tracking changes over time in patients with milder levels of impairment.

Background: Mild cognitive impairment (MCI) represents a state of high risk for dementia but is heterogeneous in its course. To date, the trajectories reflecting distinct developmental courses of cognition among patients with MCI have not been well defined. Aim: To identify the developmental trajectory of groups with distinct cognitive change patterns among a cohort of MCI patients. Methods: 187 MCI patients from 2 geriatric outpatient clinics were evaluated serially with the Mini-Mental State Examination (MMSE) for up to 3.5 years. Group-based trajectory analysis was applied to identify distinct trajectories. Estimates of decline for each group were compared with the mean rate of decline obtained from mixed modeling of the entire sample. Results: 5 trajectories were identified and labeled based on their baseline MMSE score and course: (1) 29/stable (6.5%); (2) 27/stable (53.9%); (3) 25/slow decline (23.8%); (4) 24/slow decline (11.6%); (5) 25/rapid decline (4.2%). Annual rate of change in the MMSE score for these 5 groups was 0.09, –0.43, –1.23, –1.84, and –4.6 points, respectively. None corresponded to the mean rate of –0.82 points estimated for the group as a whole. A majority of MCI patients (60.4%) follow stable cognitive trajectories over time. Within the 3 groups with declining trajectories, cognitive decline occurs slowly in a vast majority of MCI patients (98.5%). Conclusions: Results provide direct evidence for the heterogeneous course of cognitive decline that has been suggested by the variable prognosis for patients with MCI.

Inspiratory loading in awake humans is associated with electroencephalographic signs of supplementary motor area (SMA) activation. To provide evidence for a functional connection between SMA and the diaphragm representation in the primary motor cortex (M1DIA), we tested the hypothesis that modulating SMA activity using repetitive transcranial magnetic stimulation (rTMS) would alter M1DIA excitability. Amplitude and latency of diaphragm motor evoked potentials (MEPDIA), evoked through single pulse M1DIA stimulation, before and up to 16 min after SMA stimulation, were taken as indicators of M1DIA excitability. MEPs from the first dorsal interosseous muscle (FDI, MEPFDI) served as a control. Four SMA conditioning sessions were performed in random order at 1-wk intervals. Two aimed at increasing SMA activity (5 and 10 Hz, both at 110% of FDI active motor threshold; referred to as 5Hz and 10Hz, respectively), and two aimed at decreasing it (1 Hz either at 110% of FDI active or resting motor threshold, referred to as aMT or rMT, respectively). The 5Hz protocol increased MEPDIA and MEPFDI amplitudes with a maximum 11–16 min poststimulation ( P = 0.04 and P = 0.02, respectively). The 10Hz protocol increased MEPFDI amplitude with a similar time course ( P = 0.03) but did not increase MEPDIA amplitude ( P = 0.32). Both aMT and rMT failed to decrease MEPDIA or MEPFDI amplitudes ( P = 0.23 and P = 0.90, respectively, for diaphragm and P = 0.48 and P = 0.14 for FDI). MEPDIA and MEPFDI latencies were unaffected by rTMS. These results demonstrate that 5-Hz rTMS over the SMA can increase the excitability of M1DIA. These observations are consistent with the hypothesis of a functional connection between SMA and M1DIA.

Objective: To evaluate the psychometric properties of the Montreal Cognitive Assessment as a quantitative measure of cognitive ability. Data analyzed: A total of 222 cases extracted from a clinical database (57-91 years) of patients screened for cognitive impairment in outpatient geriatric assessment clinics. Data collected: Demographic information and individual item responses to Montreal Cognitive Assessment. Results: Comparison of the data with a unidimensional Rasch model indicated that the total score obtained by summing across all items yields a reliable (0.75) quantitative estimate of global cognitive ability. All items fit the model and together spanned a range of difficulty from -3.75 to +2.88 logits. Items were assessed for differential item functioning across such patient characteristics as age, education, and language spoken. We provide a table for converting Montreal Cognitive Assessment total scores onto a linearly scaled score, with guidelines for interpreting changes in Montreal Cognitive Assessment score in terms of their statistical significance. Conclusions: The Montreal Cognitive Assessment can provide a reliable and valid quantitative estimate of cognitive ability in a geriatric cognitive disorders clinic setting.

Introduction : En presence de charges inspiratoires mecaniques (charges a seuil ou charges resistives), une hypoventilation tend a se developper chez l’humain endormi ou anesthesie. A l’eveil au contraire, ce type de charge fait l’objet d’une compensation, avec maintien voire baisse moderee de la PetCO2. Il a ete demontre que cette compensation etait associee a une activite electroencephalographique (EEG) premotrice (potentiels premoteurs -PPM-, connus pour avoir leur source dans l’aire motrice supplementaire -AMS-). Or il existe des projections de l’AMS sur les motoneurones phreniques. Pour tester l’hypothese d’une modulation par la SMA des circuits phreniques centraux, nous avons etudie la latence et l’amplitude de potentiels evoques moteurs (PEM) du diaphragme (Di) et du premier inter-osseux dorsal (PID), avant et apres un conditionnement de l’ASM par stimulation transcrânienne magnetique repetitive (rSMT). Methodes : Apres accord du comite d’ethique, les sites optimaux de stimulation de Di, PID et ASM ont ete identifies chez 10 volontaires sains, et stockes dans un systeme de neuronavigation. Quatre sessions de conditionnement de l’ASM ont ensuite ete realisees a une semaine d’intervalle (ordre tire au sort). Deux sessions avaient pour objectif l’induction d’une potentiation : 1) POT5 (10 trains de 10 secondes de rSMT a 5 Hz et 110 % du seuil moteur actif du PID ; 2) POT10 (10 trains de 5 secondes de rSMT a 10 Hz, a la meme intensite. Les deux autres sessions avaient pour objectif l’induction d’une inhibition : 1) INHa : rSMT a 1 Hz pendant 20 minutes a 110 % du seuil moteur actif du PID ; 2) INHr : rSMT a 1 Hz pendant 20 minutes a 110 % du seuil moteur passif du PID. Resultats : POT5 entrainait une augmentation de l’amplitude des PEMpod et PEMdia (en % de la valeur de base) maximale entre 11 et 16 minutes apres la stimulation (+130,7 ± 56,8 %, p = 0,0396, et +69,1 ± 101,2 %, p = 0,0169, respectivement). POT10 entrainait une augmentation de l’amplitude des PEMpid avec la meme dynamique temporelle (+105 ± 215,7 %, p = 0,0327), mais pas d’augmentation de l’amplitude des PEMdia (p = 0,3189). INHa et INHr n’avaient pas d’effet inhibiteur significatif ni sur PEMdia ni sur PEMpid. Les latences des PEM n’etaient jamais modifiees par la rSMT. Conclusions : Le conditionnement de l’aire motrice supplementaire par une stimulation magnetique transcrânienne repetitive a 5 Hz facilite la reponse du diaphragme et du premier interosseux dorsal a la stimulation magnetique transcrânienne. Il convient de noter que l’absence d’effet du protocole INHr elimine l’hypothese d’une diffusion du champ magnetique sur l’aire motrice primaire. Ces observations sont concordantes avec un role facilitateur des projections phreniques de l’aire motrice supplementaire, en particulier lors de la compensation de charges inspiratoires chez les humains eveilles. Ils soulignent aussi la vraisemblance de l’hypothese d’une implication du cortex cerebral dans la commande ventilatoire liee a l’eveil ("wakefulness drive to breathe"). Avec le soutien de la Chancellerie de l’Universite de Paris (Legs Poix) et du Ministere des Affaires Etrangeres (Bourse Lavoisier).

Table of contents 01 The eco-toxicological effects of cadmium stress on five ornamental plants Zhouli Liu, Wei Chen, Xingyuan He, Shuai Yu, Weihang Ding 02 Study on the formation and release mechanisms of hydrogen sulfide in Longtan coal mine Jianjun Liu, Yuliang Wu, Kaixiang Fan 03 Coral bleaching in the North Reef of China’s Xisha Islands in 2014 Yuanchao Li, Xinqing Zheng, Shiquan Chen, Haiqun Xie 04 Soil chemical characteristics in a Cunninghamia lanceolata stand suffering from ice-snow damage Jie Li, Zhuomin Wang, Li Xue 05 Diversity of understory vegetation was under a Cunninghamia lanceolata stand suffering from ice-snow damage Zhiyang Lie, Weilong Huang, Tongtong Zhou, Li Xue 06 The effect of water, nitrogen and harvesting time on yield and biomass allocation of Helianthus tuberosus L. Kai Gao, Tiexia Zhu 07 The vertical variation of microbial communities in the sediment of sea cucumber pond Weiteng Mao, Pei Yu, Xinfang Lv, Yunchun Li 08 Indicating significances of alpine plant functional groups to environmental change Peixi Su, Rui Shi 09 Research on the daily CH4 fluxes of soil in summer mangrove community at Yingluogang of Guangxi, China Yong Jiang, Xingbin Chen, Shichu liang 10 Beach protection structures in middle and lower reaches of Yangtze River Junfeng Xu 11 Social responsibility management of large dam project with owner as core: an empirical case in China Jiwei Zhu, Zhao Zhai, Linan Zhou, Yun Le, Li Cao 12 The ecological function value assessment analysis of urban waterfront Jiwei Zhu, Ping Lu, Zhiqian Huang, Bei Zhou 13 Mechanism of diurnal osmotic potential changes and adjustment of three Caragana species in different habitats of the Inner Mongolia Plateau Zhirong Zheng, Shihai Lv, Chaoyang Feng 14 Biodiversity of phytoplankton and environmental influences analysis of Longfeng Wetland, China Nan Song, Yan Liu, Xinxin Lu, Yawen Fan 15 The effect of human activities on culturable soil microbes from Yaoquan Mountain in Wudalianchi, China Jianfei Guan, Jihua Wang, Xueping Zhang