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Assess the efficiency of a cognitive training program using an artificial intelligence application to optimize cognitive reserve and reduce memory disturbance in patients aged 55 to 75 after Class II-III elective noncardiac surgery. Experimental with random assignment. The study was conducted on 80 patients undergoing surgery at the Teknon Medical Center Hospital in Barcelona, from April 2018 to June 2021. Both groups were evaluated with cognitive tests before surgery and 7 and 30 days after surgery. The experimental group was subjected to cognitive training for 10 days before surgery to improve their cognitive reserve. Significant differences were found between the study groups 30 days after surgery in the three screening tests (Mini-Cog, T@M, and MFE). The intervention group presented with fewer cognitive and memory alterations. Age and pre-existing comorbidities were not correlated with an impact on memory impairment or cognitive function. A cognitive training program based on artificial intelligence, prescribed and monitored by anesthesia nurses has a positive impact on increasing cognitive reserve and reducing memory disturbance in patients aged 55 to 75 undergoing Class II to III elective, noncardiac surgery. This intervention may serve as a prehabilitation strategy in patients with a risk of cognitive dysfunction evaluated by anesthesia nurses for the purpose of preserving their cognitive function and optimizing their recovery. [ABSTRACT FROM AUTHOR]

Abstract Three-terminal (3-T) thyristor random-access memory is explored for a next-generation high-density nanoscale vertical cross-point array. The effects of standby voltages on the device are thoroughly investigated in terms of gate–cathode voltage (V GC,ST) and anode–cathode voltage (V AC,ST) in the standby state for superior data retention characteristics and low-power operation. The device with the optimized V GC,ST of − 0.4 V and V AC,ST of 0.6 V shows the continuous data retention capability without refresh operation with a low standby current of 1.14 pA. In addition, a memory array operation scheme of 3-T TRAM is proposed to address array disturbance issues. The presented array operation scheme can efficiently minimize program, erase and read disturbances on unselected cells by adjusting gate–cathode voltage. The standby voltage turns out to be beneficial to improve retention characteristics: over 10 s. With the proposed memory array operation, 3-T TRAM can provide excellent data retention characteristics and high-density memory configurations comparable with or surpass conventional dynamic random-access memory (DRAM) technology.

Anti-leucine-rich glioma-inactivated 1 (LGI1) encephalitis is a treatable form of limbic encephalitis, marked by frequent focal seizures and cognitive decline (particularly memory disturbance); however, it can be difficult to diagnose in patients with subtle cognitive decline. Ictal pouting, a rare seizure feature, has not yet been reported in anti-LGI1 encephalitis. A 73-year-old man with anti-LGI1 encephalitis presented with subacute onset of frequent ictal pouting without apparent cognitive decline. Steroid treatment alone resolved seizures and improved subtle visual memory. Middle-aged and older patients experiencing subacute-onset frequent focal seizures should be thoroughly evaluated for memory disturbances to determine the need for anti-LGI1 antibody measurement.

Three-terminal (3-T) thyristor random-access memory is explored for a next-generation high-density nanoscale vertical cross-point array. The effects of standby voltages on the device are thoroughly investigated in terms of gate–cathode voltage (VGC,ST) and anode–cathode voltage (VAC,ST) in the standby state for superior data retention characteristics and low-power operation. The device with the optimized VGC,ST of − 0.4 V and VAC,ST of 0.6 V shows the continuous data retention capability without refresh operation with a low standby current of 1.14 pA. In addition, a memory array operation scheme of 3-T TRAM is proposed to address array disturbance issues. The presented array operation scheme can efficiently minimize program, erase and read disturbances on unselected cells by adjusting gate–cathode voltage. The standby voltage turns out to be beneficial to improve retention characteristics: over 10 s. With the proposed memory array operation, 3-T TRAM can provide excellent data retention characteristics and high-density memory configurations comparable with or surpass conventional dynamic random-access memory (DRAM) technology. [ABSTRACT FROM AUTHOR]

Background: Nonconvulsive status epilepticus (NCSE) is induced by common neurosurgical conditions, for example, trauma, stroke, tumors, and surgical interventions in the brain. The aggressiveness of the treatment for NCSE depends on its neurological prognosis. Aphasic status epilepticus (ASE) is a subtype of focal NCSE without consciousness impairment. The impact of ASE on neurological prognosis is poorly documented. We describe a case of postoperative ASE resulting in verbal and memory deficits. Case Description: A 54-year-old, right-handed man with focal impaired awareness seizures underwent partial resection for a left temporal lobe tumor. No neurological deficits were observed immediately after surgery. Three days later, however, a focal to bilateral tonic-clonic seizure (FBTCS) occurred, followed by aphasia. Electroencephalography revealed 1.5 Hz left-sided periodic discharges. He was diagnosed with ASE. Multiple anti-seizure drugs were ineffective for the resolution of the patient's verbal disturbance. Nine days after the FBTCS, deep sedation with intravenous anesthetics was performed and the ASE stopped. Thereafter, his symptoms gradually improved. However, the prolonged ASE resulted in verbal and memory deficits. Automated hippocampal volumetry revealed an approximate decrease of 20% on the diseased side on magnetic resonance imaging 3 months after surgery. Conclusion: Prolonged ASE can induce verbal and memory deficits. Early intervention with intravenous anesthetics is required to obtain a favorable neurological prognosis. [ABSTRACT FROM AUTHOR]

The diagnosis of leptomeningeal metastases is sometimes difficult when the cytology of cerebrospinal fluid is negative. We report a rare case of leptomeningeal metastases that required differentiation from paraneoplastic limbic encephalitis. A 67-year-old man with extensive-stage small cell lung cancer was admitted for a sudden decrease in the level of consciousness. He suffered memory disturbances that began the day before admission. Diffusion-weighted and fluid-attenuated inversion recovery images of brain magnetic resonance imaging (MRI) showed bilateral symmetric areas of hyperintensity in the hippocampus, amygdala, insular cortex, and medial temporal lobe; contrast enhancement was positive. Cytology of the cerebrospinal fluid (CSF) was negative. Anti-N-methyl-d-aspartate receptor antibody and herpes simplex virus DNA were not detected in the CSF. Paraneoplastic Limbic encephalitis was suspected due to his symptoms and brain MRI scan. The patient developed generalized seizures after admission. High-dose methylprednisolone and intravenous immune globulin were administered, but his condition did not improve. Uncontrollable seizures persisted and he died in the hospital at day 13. Autopsy revealed leptomeningeal metastasis and invasion of cancer cells into the limbic system. Contrast-enhanced MRI should be performed even if limbic encephalitis is suspected, and leptomeningeal metastases should be suspected if the lesions are enhanced.

Peroxisome is an intracellular organelle that functions in essential metabolic pathways including β-oxidation of very-long-chain fatty acids and biosynthesis of plasmalogens. Peroxisome biogenesis disorders (PBDs) manifest severe dysfunction in multiple organs including central nervous system (CNS), whilst the pathogenic mechanisms are largely unknown. We recently reported that peroxisome-deficient neural cells secrete an increased level of brain-derived neurotrophic factor (BDNF), resulting in the cerebellar malformation. Peroxisomal functions in adulthood brain have been little investigated. To induce the peroxisome deficiency in adulthood brain, we here established tamoxifen-inducible conditional Pex2-knockout mouse. Peroxisome deficiency in the conditional Pex2-knockout adult mouse brain induces the upregulated expression of BDNF and its inactive receptor TrkB-T1 in hippocampus, which notably results in memory disturbance. Our results suggest that peroxisome deficiency gives rise to the dysfunction of hippocampal circuit via the impaired BDNF signaling.

Background: Subcallosal artery infarction injures the fornix and anterior corpus callosum and sometimes causes Korsakoff’s amnesia. We hypothesized that Korsakoff’s amnesia might be caused by fornix dysfunction rather than anterior corpus callosum dysfunction in subcallosal artery infarction. Methods: A systematic review approach was applied to search PubMed and Google Scholar for articles to compare patients who had both bilateral fornix and corpus callosum infarction due to subcallosal artery territory ischemia (vascular event group; V group) with patients who had undergone anterior corpus callosotomy (callosotomy group; C group). Results: The V group comprised 10 patients (mean age, 63 years; median, 69 years; standard deviation (SD), 14.5 years; 5 males, 5 females). The C group comprised 6 patients (mean age, 23.7 years; median, 20 years; SD, 7.3 years; 3 males, 3 females). Six of 10 patients (60%) with subcallosal artery infarction exhibited Korsakoff’s amnesia. One patient showed neither confabulation nor amnesia. Conversely, no amnesia episodes were seen in any patients from the C group (p = 0.034). Conclusion: Fornix injury, rather than anterior corpus callosum injury, might be the major cause of Korsakoff’s amnesia in patients with subcallosal artery infarction.

Prevalence and risk factors associated with memory disturbance and dementia were determined in acute ischemic stroke (AIS) patients in hospitals before discharge, three and six months after stroke. A prospective cohort study was conducted during January-December 2017 with 401 AIS patients admitted to Srinagarind Hospital, Khon Kaen Hospital and Chum Phae Hospital, Khon Kaen, Thailand. The demographics and clinical characteristics, previous illness and past medical history, and laboratory test results of the patients were collected from the medical records, while depression screening, NIH stroke scale (NIHSS) scoring and mini mental state examination (MMSE) were performed using particular medical record forms. The prevalence of memory disturbance and dementia was 56.6, 41.6 and 38.2% before discharge, three and six months after stroke, respectively. Based on logistic regression analysis, age, education and stroke severity were the risk factors associated with the studied disorders before discharge and three months after stroke. Meanwhile, age and education were the risk factors for six months after stroke. Our findings suggested that the prevalence of memory disturbance and dementia remained high at all study periods.

Prevalence and risk factors associated with memory disturbance and dementia were determined in acute ischemic stroke (AIS) patients in hospitals before discharge, three and six months after stroke. A prospective cohort study was conducted during January-December 2017 with 401 AIS patients admitted to Srinagarind Hospital, Khon Kaen Hospital and Chum Phae Hospital, Khon Kaen, Thailand. The demographics and clinical characteristics, previous illness and past medical history, and laboratory test results of the patients were collected from the medical records, while depression screening, NIH stroke scale (NIHSS) scoring and mini mental state examination (MMSE) were performed using particular medical record forms. The prevalence of memory disturbance and dementia was 56.6, 41.6 and 38.2% before discharge, three and six months after stroke, respectively. Based on logistic regression analysis, age, education and stroke severity were the risk factors associated with the studied disorders before discharge and three months after stroke. Meanwhile, age and education were the risk factors for six months after stroke. Our findings suggested that the prevalence of memory disturbance and dementia remained high at all study periods. [ABSTRACT FROM AUTHOR]

A Japanese woman showed slowly progressive memory disturbance since the age of 85 years. Later, disorientation gradually appeared. Head computed tomography revealed severe hippocampal atrophy, particularly in the posterior portion, and lateral ventricular dilatation, particularly in the inferior horn at the age of 99 years. The amygdala was relatively preserved from atrophy, and atrophy of the frontal lobe was relatively mild for her age. Apolipoprotein E gene analysis showed the ε3 homozygous phenotype. The woman died at the age of 101 years, and her clinical diagnosis was mild Alzheimer's disease. No apparent behavioural and psychological symptoms of dementia were observed during the disease course. Autopsy revealed severe hippocampal atrophy with numerous neurofibrillary tangles and ghost tangles, particularly in the hippocampal region, but senile plaques were rarely observed in the brain. The pathological findings were compatible with senile dementia of the neurofibrillary tangle type, whereas other neurodegenerative disorders were not recognized. The clinicopathologic findings of the present case are considered significant for the clinical diagnosis and pathogenesis of senile dementia of the neurofibrillary tangle type. [ABSTRACT FROM AUTHOR]

Objective: To clarify memory, the iconic memory was quantitatively studied with Necker's cube for memory disturbances. Design: A case-control study. Materials and Methods: One hundred and two patients complaining of memory disturbance and 30 volunteers participated in this study. After observing a sample picture of Necker's cube for less than 30 sec, the picture was covered with a sheet of blank paper, the subjects were asked to draw the sample picture from memory. Then after covering the drawn picture, the sample picture was uncovered, and they were asked to copy the sample picture under observation. The revised Hasegawa's Dementia Scale was done. The drawn pictures were quantitatively assessed by scoring main characteristic parts of the pictures in appropriate position. Results: The scores showed significant multiple coefficience of correlations and Pearson's correlations between the drawn pictures and the revised Hasegawa's Dementia Scale. Conclusion: A test for the iconic memory was quickly assessed quantitatively with Necker's cube, the test might provide us some diagnostic help for memory disturbance. [ABSTRACT FROM AUTHOR]

Epidermoid cysts are benign, slow-growing tumors. They account for 0.2-1.8% of all intracranial tumors and rarely appear as intraparenchymal masses. The most prevalent symptom in people of middle age is an insidious-onset headache., Case Presentation: We present a 20-year-old college student who presented with memory disturbances. The imaging revealed a left thalamic mass. The tumor was excised and diagnosed histopathologically as an epidermoid cyst., Clinical Discussion: Epidermoid cysts resemble epidermal skin cells in histology. The lesion of the thalamus involving the ventrolateral and anterior regions is involved with memory and language. Of note, to our knowledge, no cases of memory issues associated with thalamic epidermoid cysts have been reported in the literature., Conclusion: The ideal treatment is cystic component removal with complete capsule excision. Sometimes, in cases of incomplete excision, radiotherapy can be another option., Competing Interests: None of the authors has any relevant financial or nonfinancial relationships to disclose, as defined above., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Transient global amnesia (TGA) is a syndrome characterized by anterograde amnesia with otherwise intact cognitive function, resolving within 24 h of onset, occurring in the absence of neurological changes. Recurrent episodes remain rare. We report an interesting case of recurrent episodes of TGA in a 63-year-old woman presenting with altered mental status. She had no memory of antecedent events and demonstrated repetitive questioning but retained awareness of self. Physical examination and laboratory diagnostics were unremarkable. Brain magnetic resonance imaging revealed scattered foci of increased FLAIR signal within the bilateral periventricular and subcortical white matter. She was notably diagnosed with TGA a few months prior when she had presented with similar symptoms. During the current hospitalization, she remained alert and fully oriented, with resolution of perseveration. This case emphasizes the recognition of TGA as an important neurological diagnosis, uniquely describes not only the recurrence, but the short interval between recurrent episodes., Competing Interests: Conflict of interest None of the authors have any conflicts of interest., (© 2022 Greater Baltimore Medical Center.)

Background: Some studies have demonstrated high cognitive deficits in patients with post-traumatic stress disorder (PTSD). Considering the limited available information about this issue, we decided to assess the cognitive deficits and memory disturbances in these patients. Materials and Methods: The present study is a case control research conducted on 50 patients with post-traumatic stress disorder who were admitted to Ibn-e-Sina psychiatric hospital in Mashhad, in north-eastern part of Iran in 2008. The control group included 50 people of first degree relatives of these patients who met the inclusion criteria of the study. Case and control groups were selected by simple sampling method; and for all of them, a questionnaire of demographic information, Wechsler memory scale, and mini mental status examination (MMSE) were completed. The gathered data were analyzed using SPSS 14th edition by chi square, t-test, and analyze of variance. Results: The mean score of Wechsler memory scale in patients with PTSD (80.78±18.39) was significantly higher than control group (67.92±7.38) (p=0.001). The mean score of MMSE was significantly lower in patients with PTSD compared to control group (p=0.001). The determined disability level assessed by Iranian veterans' organization and also comorbidity of other psychiatric disorders with PTSD did not have a significant relationship with cognitive deficits, but the duration of PTSD and age of patients were significantly related to the level of cognitive deficits. Conclusion: Cognitive deficits and memory disturbances are higher in patients with PTSD than general population. [ABSTRACT FROM AUTHOR]

Posttraumatic amnesia is a common symptom after traumatic brain injury (TBI), and it may be related to hippocampal dysfunction. However, the mechanisms underlying the secondary or delayed cell death in the hippocampus after TBI have been poorly understood. In this article, we review the clinical and experimental evidence of hippocampal damage after TBI. Recent data suggesting that TBI may be both an inflammatory and/or a neurodegenerative disease are also presented. Further investigations are, therefore, necessary to better understand hippocampal damage and delineate the best practice strategies needed to improve the patient outcomes after TBI. [Copyright &y& Elsevier]

Abstract: In the early process of long-term memory formation, cyclic AMP response element-binding protein (CREB), a transcription factor on which multiple signal transduction pathways converge, has been implicated. We examined whether the age difference in the performance of contextual fear conditioning (CFC) is associated with a change in activation of CREB in the hippocampus which is an important neural structure for long-term memory. The activation of CREB in the hippocampus in young (15 weeks old) and old (120 weeks old) male rats was determined immunohistochemically with an antibody that specifically recognizes the phosphorylated form of CREB (pCREB). Young rats exhibited better performance than old rats with respect to the freezing time in CFC. Phosphorylation of CREB as revealed by the ratio of the pCREB-immunoreactive cell number to the CREB-immunoreactive cell number was increased in the CA1 region, but not in other hippocampal regions following training for CFC. The close relationship between behavioral performance and CREB phosphorylation in the CA1 region suggests that hippocampal CREB is involved in age-related decline of learning and memory. [Copyright &y& Elsevier]

Background: Subcallosal artery infarction injures the fornix and anterior corpus callosum and sometimes causes Korsakoff's amnesia. We hypothesized that Korsakoff's amnesia might be caused by fornix dysfunction rather than anterior corpus callosum dysfunction in subcallosal artery infarction. Methods: A systematic review approach was applied to search PubMed and Google Scholar for articles to compare patients who had both bilateral fornix and corpus callosum infarction due to subcallosal artery territory ischemia (vascular event group; V group) with patients who had undergone anterior corpus callosotomy (callosotomy group; C group). Results: The V group comprised 10 patients (mean age, 63 years; median, 69 years; standard deviation (SD), 14.5 years; 5 males, 5 females). The C group comprised 6 patients (mean age, 23.7 years; median, 20 years; SD, 7.3 years; 3 males, 3 females). Six of 10 patients (60%) with subcallosal artery infarction exhibited Korsakoff's amnesia. One patient showed neither confabulation nor amnesia. Conversely, no amnesia episodes were seen in any patients from the C group (p = 0.034). Conclusion: Fornix injury, rather than anterior corpus callosum injury, might be the major cause of Korsakoff's amnesia in patients with subcallosal artery infarction. [ABSTRACT FROM AUTHOR]

Flunitrazepam’s (FNZ) effect on sleep and memory 1 mg and 2 mg was investigated in 6 healthy volunteers (mean age 21.5 ± 0.8 years) by polysomnography (PSG) and memory testing. A PSG was recorded on each study night. Memory testing was done before sleep (40 min after taking FNZ or placebo), and after waking (560 min after medication). Rapid eye movement (REM) latency was found to be prolonged on the FNZ 2 mg night (FNZ2N) compared to the baseline night (BN). Percentage of stage 2 sleep was increased in the FNZ2N as compared to BN, while REM percentage on both FNZ nights did not significantly differ from BN. The number of total REM and REM density were decreased in the FNZ2N compared to BN. Memory testing showed significant differences between before sleep and after waking on the FNZ2N. There was a significant correlation between the degree of impairment on memory testing and the rate of reduced REM density, but there was no significant correlation between degree of impairment on memory testing and the rate of increased non-REM sleep on the FNZ2N. The results of this study suggest that impairments in memory result from the dose of FNZ, and that there is a possibility of a relationship between memory disturbance and REM sleep suppression caused by this benzodiazepine. [ABSTRACT FROM AUTHOR]

2• Currently, no study that provide clear link of evidence between dementia and COVID-19. 2• Dementia was associated with composite poor outcome from COVID-19 infections. 2• Extra care should be provided to dementia patients to minimize risk of COVID-19 infection. The number of positive and death cases from coronavirus disease 2019 (COVID-19) is still increasing until now. One of the most prone individuals, even in normal situations is patients with dementia. Currently, no study provides clear evidence regarding the link between dementia and COVID-19. This study aims to analyze the relationship between dementia and poor outcomes of COVID-19 infection. We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until October 25th, 2020. All articles published on COVID-19 and dementia were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies. Statistical analysis was done using Review Manager 5.4 software. A total of 24 studies with 46,391 dementia patients were included in this meta-analysis. This meta-analysis showed that dementia was associated with composite poor outcome [RR 2.67 (95% CI 2.06 – 3.47), p < 0.00001, I 2 = 99%, random-effect modeling] and its subgroup which comprised of risk of COVID-19 infection [RR 2.76 (95% CI 1.43 – 5.33), p = 0.003, I 2 = 99%, random-effect modeling], severe COVID-19 [RR 2.63 (95% CI 1.41 – 4.90), p = 0.002, I 2 = 89%, random-effect modeling], and mortality from COVID-19 infection [RR 2.62 (95% CI 2.04 – 3.36), p < 0.00001, I 2 = 96%, random-effect modeling]. Extra care and close monitoring should then be provided to patients with dementia to minimize the risk of infections, preventing the development of severe and mortality outcomes. [ABSTRACT FROM AUTHOR]

The diagnosis of leptomeningeal metastases is sometimes difficult when the cytology of cerebrospinal fluid is negative. We report a rare case of leptomeningeal metastases that required differentiation from paraneoplastic limbic encephalitis. A 67-year-old man with extensive-stage small cell lung cancer was admitted for a sudden decrease in the level of consciousness. He suffered memory disturbances that began the day before admission. Diffusion-weighted and fluid-attenuated inversion recovery images of brain magnetic resonance imaging (MRI) showed bilateral symmetric areas of hyperintensity in the hippocampus, amygdala, insular cortex, and medial temporal lobe; contrast enhancement was positive. Cytology of the cerebrospinal fluid (CSF) was negative. Anti- N -methyl- d -aspartate receptor antibody and herpes simplex virus DNA were not detected in the CSF. Paraneoplastic Limbic encephalitis was suspected due to his symptoms and brain MRI scan. The patient developed generalized seizures after admission. High-dose methylprednisolone and intravenous immune globulin were administered, but his condition did not improve. Uncontrollable seizures persisted and he died in the hospital at day 13. Autopsy revealed leptomeningeal metastasis and invasion of cancer cells into the limbic system. Contrast-enhanced MRI should be performed even if limbic encephalitis is suspected, and leptomeningeal metastases should be suspected if the lesions are enhanced. [ABSTRACT FROM AUTHOR]