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Context: Racial identity may associate with clinical outcomes following sport-related concussion (SRC). This study compared clinical outcome scores before and after recovery from a SRC between Black or White college athletes. Design: Prospective cohort. Methods: Participants were self-reported White (n = 61, 18.5 [1.1] y of age) and Black (n = 24, 18.3 [1.1] y of age) NCAA Division 1 college athletes. The revised Head Injury Scale (HIS-r), the Immediate Postconcussion and Cognitive Test (ImPACT) battery, and the Sensory Organization Test (SOT) at baseline (T1), upon symptom resolution (T2) following a diagnosed SRC, and upon establishing a new baseline assessment (T3). Race was collected from paper and electronic medical records. The revised Head Injury Scale total symptom severity, ImPACT's Verbal Memory, Visual Memory, Visual Motor Speed (VMS), and Reaction Time, and the SOT Equilibrium Score, were compared between groups at each time point. Multivariate analyses of variance (2 [group] × 3 [time]) were used to compare revised Head Injury Scale, ImPACT, and SOT outcome scores. Post hoc analyses consisted of independent and paired sample t tests. Results: A significant main effect for time (λ = 0.66, F2,82 = 21.55, P <.001, η p 2 =.34) was observed for the SOT. White athletes significantly improved on the Equilibrium Score between all time points (all P <.006). Similarly, Black athletes significantly improved on the Equilibrium Score between T1–T2 and T1–T3 (all P <.001). A significant main effect of time was observed for ImPACT's Verbal Memory, Visual Memory, and VMS outcome scores (all P <.001). VMS improved for White athletes between T1–T2 (P =.02) and T3 (P =.006). Black athletes had improved VMS scores between T1–T3 (P =.015) and T2–T3 (P =.005). A between-group difference was observed for VMS at T2 (P =.004). Conclusions: There was 1 small and not clinically significant difference between groups for the VMS score at T2. Overall, groups performed consistently or improved upon their baseline balance, cognition, and symptom outcome scores at clinically relevant time points following a SRC. [ABSTRACT FROM AUTHOR]

PurposeTraumatic brain injury (TBI) and potentially traumatic events (PTEs) contribute to increased substance use, mental health issues, and cognitive impairments. However, there's not enough research on how TBI and PTEs combined impact mental heath, substance use, and neurocognition.MethodsThis study leverages a subset of The National Consortium on Alcohol and Neurodevelopment in Adolescence (NCANDA) multi-site dataset with 551 adolescents to assess the combined and distinctive impacts of TBI, PTEs, and TBI+PTEs (prior to age 18) on substance use, mental health, and neurocognitive outcomes at age 18.ResultsTBI, PTEs, and TBI+PTEs predicted greater lifetime substance use and past-year alcohol and cannabis use. PTEs predicted greater internalizing symptoms, while TBI+PTEs predicted greater externalizing symptoms. Varying effects on neurocognitive outcomes included PTEs influencing attention accuracy and TBI+PTEs predicting faster speed in emotion tasks. PTEs predicted greater accuracy in abstraction-related tasks. Associations with working memory were not detected.ConclusionThis exploratory study contributes to the growing literature on the complex interplay between TBI, PTEs, and adolescent mental health, substance use, and neurocognition. The developmental implications of trauma via TBIs and/or PTEs during adolescence are considerable and worthy of further investigation.

BACKGROUND: About one-third of older adults aged 65 years and older often have mild cognitive impairment or dementia. Acoustic and psycho-linguistic features derived from conversation may be of great diagnostic value because speech involves verbal memory and cognitive and neuromuscular processes. The relative decline in these processes, however, may not be linear and remains understudied. OBJECTIVE: This study aims to establish associations between cognitive abilities and various attributes of speech and natural language production. To date, the majority of research has been cross-sectional, relying mostly on data from structured interactions and restricted to textual versus acoustic analyses. METHODS: In a sample of 71 older (mean age 83.3, SD 7.0 years) community-dwelling adults who completed qualitative interviews and cognitive testing, we investigated the performance of both acoustic and psycholinguistic features associated with cognitive deficits contemporaneously and at a 1-2 years follow up (mean follow-up time 512.3, SD 84.5 days). RESULTS: Combined acoustic and psycholinguistic features achieved high performance (F1-scores 0.73-0.86) and sensitivity (up to 0.90) in estimating cognitive deficits across multiple domains. Performance remained high when acoustic and psycholinguistic features were used to predict follow-up cognitive performance. The psycholinguistic features that were most successful at classifying high cognitive impairment reflected vocabulary richness, the quantity of speech produced, and the fragmentation of speech, whereas the analogous top-ranked acoustic features reflected breathing and nonverbal vocalizations such as giggles or laughter. CONCLUSIONS: These results suggest that both acoustic and psycholinguistic features extracted from qualitative interviews may be reliable markers of cognitive deficits in late life.

Purpose: Compare tracking groups with cognitive control functions and plasma brain-derived neurotrophic factors concentrations from childhood to adolescence. Methods: This is a prospective study with 3 years of follow-up. At baseline, data from 394 individuals were collected (11.7 y), and data were obtained from 134 adolescents (14.9 y) at the 3-year follow-up. At both time points, anthropometric and maximal oxygen uptake data were collected. Cardiorespiratory fitness (CRF) groups were classified into high or low CRF. At follow-up, cognitive outcomes were collected via the Stroop and Corsi block test; plasma brain-derived neurotrophic factors concentrations were also analyzed. Results: Comparisons demonstrated that maintaining high CRF over 3 years results in shorter reaction time, better inhibitory control, and higher working memory values. Likewise, the group that moved from low to high CRF over 3 years presented better reaction time. Plasma brain-derived neurotrophic factors concentrations were higher for the group that increased its CRF over the 3 years in relation to the low–low group (90.58 pg·mL−1; P =.004). However, after scaling by an allometric approach, differences were only found for reaction time and working memory between high–high and high–low groups. Conclusion: Maintaining high CRF over 3 years was positively related to reaction time and working memory in relation to adolescents that decreased their levels of CRF. [ABSTRACT FROM AUTHOR]

Background: Klotho and neurotrophic factors, including brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), and glial cell line-derived neurotrophic factor (GDNF), have been shown to play a role in cognitive functions. However, these molecules have not been investigated in bipolar disorder simultaneously to assess the interactions among them and their relationships with cognitive functions. This study investigated the relationships among cognitive function, klotho, and neurotrophic factors in patients with bipolar disorder in the remission period. Methods: Male, bipolar disorder (BD) patients (patient group, n = 48) in the remission period and healthy volunteers (control group, n = 48) were included in the study. The Stroop test and Wechsler Memory Scale–Visual Production Subtest were applied, and the serum levels of Klotho, BDNF, GDNF, and NGF were measured with an ELISA reader. Results: The klotho protein levels (0.12 ± 0.15 and 0.17 ± 0.16) and NGF levels (34.36 ± 41.99 and 48.54 ± 41.06) in the patient group were significantly lower than those in the control group (Z = -3.071, p = 0.002 and Z = -2.217, p = 0.027, respectively). In the patient group, there was a positive correlation between the klotho and NGF levels (p = 0.003, rs = 0.413), and a negative correlation was detected between the NGF and GDNF levels (p = 0.013, rs = -0.355). Klotho and NGF were predictors of Weshler 40-min test results (adjusted R2 = 0.467), and Klotho and BDNF were predictors of Stroop test colour word reading time (adjusted R2 = 0.391) with other variables. Conclusion: In BD patients, klotho, BDNF, GDNF and NGF are associated with cognitive functions and exhibit different characteristics from those of the control group. Nevertheless, the differences related to these molecules seem to be associated with a regulatory system rather than merely an increase or decrease in serum levels. [ABSTRACT FROM AUTHOR]

Numerous studies have established the presence of gray matter atrophy and brain activation abnormalities during neurocognitive and social cognitive tasks in schizophrenia. Despite a growing consensus that diseases localize better to distributed brain networks than individual anatomical regions, relatively few studies have examined brain network localization of gray matter atrophy and neurocognitive and social cognitive dysfunction in schizophrenia. To address this gap, we initially identified brain locations of structural and functional abnormalities in schizophrenia from 301 published neuroimaging studies with 8712 individuals with schizophrenia and 9275 healthy control participants. By applying novel functional connectivity network mapping to large-scale resting-state functional magnetic resonance imaging datasets, we mapped these affected brain locations to 3 brain abnormality networks of schizophrenia. The gray matter atrophy network of schizophrenia comprised a broadly distributed set of brain areas predominantly implicating the ventral attention, somatomotor, and default networks. The neurocognitive dysfunction network was also composed of widespread brain areas primarily involving the frontoparietal and default networks. By contrast, the social cognitive dysfunction network consisted of circumscribed brain regions mainly implicating the default, subcortical, and visual networks. Our findings suggest shared and unique brain network substrates of gray matter atrophy and neurocognitive and social cognitive dysfunction in schizophrenia, which may not only refine the understanding of disease neuropathology from a network perspective but may also contribute to more targeted and effective treatments for impairments in different cognitive domains in schizophrenia. [ABSTRACT FROM AUTHOR]

There is well-established evidence of reduced neurocognitive performance in adults and youth with bipolar disorder (BD). However, little is known about the polygenic underpinnings of neurocognition in individuals with BD, particularly in youth. The current study aimed to examine the association between polygenic risk score for BD (BD-PRS) and neurocognition among youth with BD and healthy controls (HC). 129 youth of European ancestry (72 BD, 57 HC), ages 13–20 years, were included. Six neurocognitive tasks within the Cambridge Neuropsychological Test Automated Battery were assessed. General linear models were used to examine the association between BD-PRS and neurocognitive composite scores, controlling for age, sex, IQ, and two genetic principal components. In the overall sample, higher BD-PRS was associated with significantly poorer affective processing (β = −0.25, p = 0.01), decision-making (β = −0.23, p = 0.02), and sustained attention (β = −0.28, p = 0.002). Secondary analyses revealed that higher BD-PRS was associated with significantly poorer sustained attention within the BD group (β = −0.27, p = 0.04), and with significantly poorer affective processing within the HC group (β = −0.29, p = 0.04). Cross-sectional design. Modest sample size may have reduced power to detect smaller effect sizes. The current study found that higher BD-PRS generated based on adult GWAS was associated with poorer neurocognitive performance in youth with BD and HC. Future longitudinal studies incorporating repeated neurocognitive assessments would further inform whether the associations of BD-PRS with neurocognition vary from youth to adulthood, and whether BD-PRS is associated with differential neurodevelopmental trajectories in individuals with and without BD. • Bipolar disorder is highly heritable and polygenic. • Higher bipolar disorder polygenic risk score was associated with poorer neurocognition in youth with and without BD. • Implicated neurocognitive domains included affective processing, decision-making, and sustained attention. [ABSTRACT FROM AUTHOR]

The present study aims to develop and present a proof-of-concept for a stop signal task with effector-specificity and higher complexity. Sixteen participants performed a stop signal task developed for lower extremities using Fitlight System™. The effect of four different delays and two sessions on response time, stop signal reaction time and accuracy was assessed using two-way repeated-measures ANOVA. The reliability of outcomes was assessed using intraclass correlation coefficients. There was a significant main effect of delay on all outcomes and an interaction of delay and session on accuracy. The reliability of outcomes was substantial with dependency on delays. Our preliminary findings suggest the feasibility of stop signal principles within more complex movements and provide an example for the development of further tests in sports context. [ABSTRACT FROM AUTHOR]

• The cortical silent period measured by TMS was prolonged in CHR patients who later converted into schizophrenia. • The cortical silent period was negatively correlated with neurocognitive performances in CHR patients. • Abnormal cortical inhibition might be a potential biomarker for predicting the conversion risk in CHR patients. Cortical inhibition (CI) can be in-vivo measured using transcranial magnetic stimulation (TMS), and patients with schizophrenia had abnormal CI. However, whether the abnormal CI occur early in patients with clinical high risk for psychosis (CHR) or could predict their clinical outcomes remains less known. We measured short-interval cortical inhibition (SICI), cortical silent period (CSP), and intra-cortical facilitation (ICF) over the motor cortex and neurocognitive performances in 55 CHR, 35 first-episode schizophrenia (FES), and 35 healthy controls (HC). We divided CHR patients into CHR converters (CHR-C) and CHR non-converters (CHR-NC) according to their clinical outcomes within the two-year follow-up. CSP was longer in CHR-C (P = 0.033) and FES (P = 0.047) than in HC, while CSP was comparable between CHR-NC and HC. In CHR, CSP was negatively related to their performances in symbol coding and maze tasks. There was no significant between-group difference for either SICI or ICF. Our findings suggested GABA B -mediated CSP was prolonged in CHR, who later converted into schizophrenia, and was associated with poor neurocognitive functions. CSP is prolonged before the onset of psychosis, particularly in CHR-C patients, suggesting that CSP could be a potential biomarker for predicting transition to schizophrenia. [ABSTRACT FROM AUTHOR]

The ability to adapt to changing circumstances has strong survival value. Individuals with substance use disorders tend to get "stuck" over-responding to drug-reward signals and pursuing drugs despite negative consequences. A lack of flexibility may be tied to impairments in neurocognition, including learning, memory, and executive function. However, results are often mixed, potentially due to heterogeneity in factors such as mental health, personality traits, or prior adversity. This study aimed to identify which factors influence neurocognitive variations within the opioid use disorder (OUD) population. Based on prior literature, we hypothesized that individuals with OUD would show deficits (vs. controls) in one or more neurocognitive domains, and that these cognitive difficulties might be greater in individuals with other known contributors to impaired cognition. This pilot project included 32 individuals receiving medication for OUD and 15 non-substance using controls (NSC). Questionnaires assessed addiction and relapse risk factors, such as impulsiveness, social function, depressive symptoms, and childhood adversity. Neurocognitive performance was measured via the Penn Computerized Neurocognitive Battery (P-CNB), including tasks that probe attention, working memory, episodic memory, cognitive flexibility, and complex cognition, and was compared between the OUD and NSC groups. OUD participants (vs. NSCs) exhibited significantly lower performance on the conditional exclusion task (CET) (Accuracy: 1.11 vs. 2.38, p < 0.001) and the n-Back task (NBT) (F1 Scores: 83% vs. 95%, p < 0.001). Impulsiveness, social function, and depressive symptoms were highly inter-related; however, only higher impulsiveness (r = -.48, p = 0.006) and more social impairment (r = -.47, p = 0.007) significantly correlated with decreased CET (but not n-Back) performance. This pilot study suggests that working memory and cognitive flexibility are impaired in people with OUD and that impulsiveness and social function are key factors in cognitive flexibility impairments in people with OUD. These results may offer insights for larger-scale investigations and potential interventions to reduce relapse risk. [ABSTRACT FROM AUTHOR]

AbstractAs people live longer with HIV, reports of poor sleep and neurocognitive impairments are expected to increase. Poor sleep and neurocognitive impairments commonly occur in people living with HIV (PLWH) and some medications (e.g., anticholinergics) contribute to these problems. The association between sleep and neurocognition among PLWH taking such medications remains unclear. This study examined trend level associations between neurocognitive domains and subjective and objective sleep outcomes. Among 29 PLWH (Mage = 61 years old), the use of anticholinergics and/or antidepressants were examined as a moderator between neurocognition and sleep outcomes. For PLWH taking anticholinergics and/or antidepressants, the associations between insomnia and neurocognitive measures were counter-intuitive, and so were the associations between sleep time and neurocognitive measures. For these adults, objective longer sleep time was associated with poorer verbal learning (immediate, p = .005; delayed recall, p = .002) and visuospatial memory (delayed recall, p = .010). Greater sleep efficiency was associated with better visuospatial memory (immediate, p = .007; delayed recall p = .022). Despite sleep benefits, the use of anticholinergics and/or antidepressants may compromise neurocognitive function in older PLWH. Clinical implications include routine sleep and neurocognitive assessments along with medication monitoring to detect adverse neurocognitive effects of commonly prescribed medications. [ABSTRACT FROM AUTHOR]

The 11+ is a structured warm-up program designed to prevent injuries in soccer players, but has proven efficacy in many populations, settings and sports. It consists of 15 exercises that target the most common injury sites, such as the knee, ankle, and groin. However, the implementation and adherence of the 11+ remain suboptimal, and recent compelling data indicates underlying mechanisms of injury risk related to neural control of movement may not be adequately targeted. Updates to the 11+ considering practical implications of neurocognitive and ecological motor learning may be warranted for coaches and practitioners. We review the evidence on how an updated 11+ may influence the cognitive and perceptual processes involved in motor control and learning, such as attention, anticipation, decision making, and feedback. How the 11+ can be adapted to the ecological constraints and affordances of the football (soccer) environment is also discussed, including the task, the individual, and the context. By considering these factors, the 11+ can be more effective, engaging, and enjoyable for the players, and thus improve its adoption and compliance. The 11+ has the capability to not only a physical warm-up, but also a neurocognitive and ecological preparation for the game. Therefore, the purpose of this manuscript is to describe the conceptual design of a new ecological neurocognitively enriched 11+, that builds on the strong foundation of the original intervention with considerations for the newly discovered potential neural control of movement risk factors. [ABSTRACT FROM AUTHOR]

Brain magnetic resonance imaging (MRI) offers a unique lens to study neuroanatomic support of human neurocognition. A core mystery is the MRI explanation of individual differences in neurocognition and its manifestation in intelligence. The past four decades have seen great advancement in studying this century-long mystery, but the sample size and population-level studies limit the explanation at the individual level. The recent rise of big data and artificial intelligence offers novel opportunities. Yet, data sources, harmonization, study design, and interpretation must be carefully considered. This review aims to summarize past work, discuss rising opportunities and challenges, and facilitate further investigations on artificial intelligence inferring human neurocognition. [ABSTRACT FROM AUTHOR]

Background: Current evidence supports the idea that neurocognitive deficits (NCD) constitute a core dimension of schizophrenia. Studies on longitudinal changes in neurocognition among neuroleptic-naive first-episode schizophrenia (FES) from Africa are uncommon. We aimed to highlight the prevalence of, and changes in NCD among FES on naturalistic treatment follow-up for 8 weeks, and the relationship with psychopathological and psychosocial outcomes. Methods: Consecutive FES and Healthy Control (HC) were recruited. Diagnosis of schizophrenia was based on ICD-10 criteria. The HC (n = 86) consisted of nursing students in the same facility, recruited purposely to match the cases in age and gender. After the baseline assessment, 82 FES were followed up 4-weekly for changes in NCD, psychopathological and psychosocial ratings for a period of 8 weeks, using the 3 alternate forms of the Screen for Cognitive Impairment in Psychiatry (SCIP), the Wisconsin Card Test, the Mini Mental State Examination, as well as the Brief Psychiatric Rating Scale, the WHO Disability Assessment Scale, and the Global Assessment of Functioning scale. The control group was tested only once, and their scores were utilized for comparison with the patients' scores only at week 8. The prevalence of neurocognitive deficits in the two groups was described using percentages and 95% confidence interval. Predictors of cognitive function was determined using multivariate linear regression. Results: The prevalence of any NCD among FES at 8 weeks and HC was 62.9% (95% CI: 51.5%, 74.2%) and 1.2% (95% CI: 0.0%, 6.6%), respectively. With treatment, there was a significant improvement in cognitive function at each interval of follow-up. At week 8, the prevalence of any NCD among patients in remission was 55.1%. Total SCIP scores at week 8 had significant inverse moderate relationship with the dimensions of psychopathology. Conversely, total SCIP score was strongly positively correlated with functioning (rhos= 0.71, p < 0.001) at week 8. At week 8, the baseline predictors of total SCIP score were, duration of untreated psychosis (β = -0.33, p = 0.01, variance = 19.8%), negative symptoms (β = -0.35, p = 0.03, variance = 4.9%) and positive symptoms (β = -0.43, p = 0.01, variance = 4.8%). Conclusion: The high prevalence of NCD when patients were in remission indicates that they are enduring and merit consideration as a domain of psychopathology. [ABSTRACT FROM AUTHOR]

BACKGROUND: We studied whether increased systolic blood pressure (SBP), as determined by auscultatory SBP, ambulatory SBP, and the number of cardiovascular health risk indicators, are associated with neurocognition in adolescents. METHODS: This cross-sectional study included 365 adolescents (mean age, 15.5 years) from 6 academic medical centers in the United States. The sample was 59.5% male, 52.6% White, with 23.9% of the caregivers having less than or equal to a high school degree. Primary exposures included the following: auscultatory SBP, ambulatory SBP, and the number of cardiovascular risk factors. Neurocognitive outcomes comprised nonverbal IQ, attention, and parent ratings of executive functions. RESULTS: After examining the models for the effects of targeted covariates (eg, maternal education), higher auscultatory SBP was associated with lower nonverbal IQ (β=−1.39; P <0.001) and verbal attention (β=−2.39; P <0.05); higher ambulatory 24 hours. SBP (β=−21.39; P <0.05) and wake SBP (β=−21.62; P <0.05) were related to verbal attention; and all 3 ambulatory blood pressure measures were related to sustained attention accounting for small to medium amounts of variance (adjusted R2=0.08–0.09). Higher ambulatory blood pressure sleep SBP also was significantly associated with parent ratings of behavior regulation (β=12.61; P <0.05). These associations remained stable after a sensitivity analysis removed cases with hypertension. Number of cardiovascular risk factors performed similarly, with more risk factors being associated with lower nonverbal IQ (β=−1.35; P <0.01), verbal attention (β=−1.23; P <0.01), and all parent ratings of executive functions. CONCLUSIONS: Elevated SBP, even below the hypertension range, and general cardiovascular health are associated with neurocognitive outcomes in adolescents. How these findings might guide clinical care is worthy of additional study. [ABSTRACT FROM AUTHOR]

Prospective associations between preadolescent neurocognitive structure and onset of substance use in adolescence have not been examined. This study investigated associations between cognitive structure among youth aged 9 – 10 years and the likelihood of experimentation with tobacco and alcohol by ages 13–14 years. A principal component (PC) analysis of nine neurocognitive assessments was used to identify the cognitive structure of unrelated adolescent brain cognitive development study participants (n = 9,655). We modeled associations between neurocognitive PCs and odds of tobacco or alcohol use by ages 13–14 years using generalized linear mixed models with a logit link and random intercept for recruitment sites. Demographics, family conflict, neighborhood safety, and externalizing and internalizing behavior were considered covariates. Four neurocognitive PCs were identified and labeled general ability, executive function, learning and memory, and mental rotation. Mental rotation [odds ratio [OR] = 0.88, p - value =.013] was associated with lower odds of youth tobacco use; the association was stronger among female youth. General ability [OR = 1.20, p - value <.0001] among both males and females, and learning and memory [OR = 1.11, p -value =.024] among females, were associated with increased odds of youth alcohol use. Among youth, higher neurocognitive performance was protective for tobacco use but increased the likelihood of alcohol use. Potential sex differences were identified. The role of cognition in processing the social contexts surrounding tobacco and alcohol use in the United States may contribute to the formation of disparate youth expectancies for tobacco and alcohol use. [ABSTRACT FROM AUTHOR]

Purposeful heading, in which players may use their heads to advance the ball in play, is a unique part of soccer. Clinical outcome measures used to aid in the diagnosis of a concussion have long been a cornerstone of the contemporary measurements associated with the short- and long-term effects of monitoring repetitive head impacts (RHI) and soccer heading exposure. The effects of RHI in the youth population are still unknown, therefore, the purpose of this study was to examine if heading exposure is predictive of changes in self-reported symptoms, neurocognitive functioning, gait, and balance in female youth soccer players over the course of one soccer season. Small improvements in neurocognitive functioning and gait and slight deficits in balance were observed from pre- to post-season. All changes were not clinically relevant and likely due to a practice effect. The low heading exposure in our cohort of youth soccer players was likely not enough to elicit any changes in clinical measures. In general, our clinical outcomes did not change after a season of soccer play and change scores were not predicted by heading exposure. [ABSTRACT FROM AUTHOR]

Background: Cognitive impairment is frequently observed in bipolar disorder (BD). Previous findings indicated that predominant polarity could have an effect on cognitive deficits. This study aimed to examine the association between predominant polarity and cognitive impairments in BD. Materials and methods: Euthymic BD patients with manic (MPP, n = 31), depressive (DPP, n = 25), undetermined predominant polarity (UPP, n = 28), and healthy controls (HC, n = 27) participated in the study. A battery of neurocognitive and social cognitive tests was implemented. Neurocognitive domains were identified via principal component analysis. Results: The MPP group performed worse in the Controlled Oral Word Association Test (COWAT), Reading the Mind in the Eyes Test (RMET), and Hinting Test (HT) compared to the DPP group and reasoning/problem-solving skills compared to the UPP group. Both MPP and UPP groups showed impairments in processing speed compared to HC. Among patient groups, there was no significant difference in working memory, attention, processing speed, verbal, and visual domain scores. The MPP group had poorer scores compared to controls in most of the social cognitive and neurocognitive domains in the study, while the overall cognitive impairment in the DPP group was relatively milder. Conclusions: Although our sample size was relatively small, the MPP group yielded more severe cognitive impairment in verbal fluency and social cognition tests compared to DPP. Patients with MPP are particularly vulnerable to cognitive impairment, making them a priority for cognitive enhancement interventions. Future studies should focus on the outcomes of cognitive and pharmacological interventions in these polarity subgroups. [ABSTRACT FROM AUTHOR]

The impact of Human Immunodeficiency Virus (HIV) on neurocognition in Africa is a pressing public health issue, with profound implications for both individual well-being and healthcare systems across the continent. This narrative review aims to elucidate the intricate relationship between HIV infection and neurocognitive function, particularly focusing on HIV-associated neurocognitive disorders (HAND), the effects of antiretroviral therapy (ART), and neuropathological changes. Evidence from Africa emphasizes the variability in the prevalence of neurocognitive impairment among people living with HIV. For instance, a meta-analysis showed that Central and South Africa had the highest pooled prevalence of neurocognitive impairment (NCI) (49.33%), followed by East Africa (45.04%) and West Africa (42.40%). These differences may reflect varying ART coverage, healthcare infrastructure, and the prevalence of co-infections like tuberculosis highlighting the importance of region-specific interventions and support services tailored to local contexts. Furthermore, challenges such as late diagnosis, methodological variations, treatment non-adherence, and limited access to specialized care exacerbate the burden of neurocognitive impairment in this setting. Addressing the complex intersection of HIV and neurocognition in Africa requires a multifaceted approach involving various stakeholders, including healthcare providers, policymakers, researchers, and community organizations. Enhancing awareness, education, and capacity- building initiatives can improve early detection and management of neurocognitive disorders among individuals living with HIV. Moreover, investment in infrastructure and resources for neurocognitive care, including diagnostic tools and rehabilitation services, is essential to meet the growing needs of this population. Additionally, promoting research collaboration and knowledge exchange is important for advancing our understanding of HIV-related neurocognitive impairment and developing evidence-based interventions. By fostering partnerships between academia, healthcare institutions, and governmental agencies, we can facilitate the translation of research findings into policy and practice, ultimately improving outcomes and quality of life for individuals affected by HAND in Africa. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Methods Results Discussion and Conclusions The 22q11.2 deletion syndrome (22q11.2DS) entails intellectual disabilities and higher risk of psychotic disorders. Neurocognitive deficits predict real‐life functioning of schizophrenic patients. We investigated real‐life functioning in 22q11.2DS, aiming at defining how neurocognitive profile and psychopathological variables impact on psychotic patients' social functioning.We recruited 63 patients with schizophrenia (SCZ, N = 63), 44 with 22q11.2DS (DEL, N = 44) and 19 with 22q11.2DS and psychosis (DEL–SCZ, N = 19), all matched for age, sex and neurocognitive profile; we administered the Positive and Negative Syndrome Scale (PANSS), the Brief Negative Symptom Scale (BNSS), the Specific Levels of Functioning (SLoF) scale and the Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). We implemented descriptive analyses, MANCOVA and linear regression statistics.The DEL–SCZ and the SCZ groups showed similar levels in Interpersonal Relationships (p = 0.093) and Social Acceptability subscales (p = 0.283). The DEL group scored higher on the Interpersonal Relationships subscale compared with the SCZ group (p = 0.001). The groups scored similarly on the other SLoF subscales. Both BNSS total score (beta = −0.343; p = 0.004) and BNSS asociality (beta = −0.487; p = 0.038) significantly predicted the Interpersonal Relationships variable in the groups with psychosis (SCZ and DEL–SCZ).Individuals with 22q11.2DS display a similar real‐life functioning to patients with chronic schizophrenia. Social functioning impairments are typical of psychosis regardless of the genetic condition and highly predicted by negative symptoms like asociality. The 22q11.2DS represents a reliable biological model to study vulnerability to psychosis and its consequences on patients' real‐life and social functioning. [ABSTRACT FROM AUTHOR]

Can brain structure predict human intelligence? T1-weighted structural brain magnetic resonance images (sMRI) have been correlated with intelligence. However, the population-level association does not fully account for individual variability in intelligence. To address this, studies have emerged recently to predict individual subject's intelligence or neurocognitive scores. However, they are mostly on predicting fluid intelligence (the ability to solve new problems). Studies are lacking to predict crystallized intelligence (the ability to accumulate knowledge) or general intelligence (fluid and crystallized intelligence combined). This study tests whether deep learning of sMRI can predict an individual subject's verbal, comprehensive, and full-scale intelligence quotients (VIQ, PIQ, and FSIQ), which reflect fluid and crystallized intelligence. We performed a comprehensive set of 432 experiments, using different input image channels, six deep learning models, and two outcome settings, in 850 healthy and autistic subjects 6–64 years of age. Our findings indicate a statistically significant potential of T1-weighted sMRI in predicting intelligence, with a Pearson correlation exceeding 0.21 (p < 0.001). Interestingly, we observed that an increase in the complexity of deep learning models does not necessarily translate to higher accuracy in intelligence prediction. The interpretations of our 2D and 3D CNNs, based on GradCAM, align well with the Parieto-Frontal Integration Theory (P-FIT), reinforcing the theory's suggestion that human intelligence is a result of interactions among various brain regions, including the occipital, temporal, parietal, and frontal lobes. These promising results invite further studies and open new questions in the field. [ABSTRACT FROM AUTHOR]

Different people listening to the same story may converge upon a largely shared interpretation while still developing idiosyncratic experiences atop that shared foundation. What linguistic properties support this individualized experience of natural language? Here, we investigate how the "concrete--abstract" axis--the extent to which a word is grounded in sensory experience--relates to within- and across-subject variability in the neural representations of language. Leveraging a dataset of human participants of both sexes who each listened to four auditory stories while undergoing functional magnetic resonance imaging, we demonstrate that neural representations of "concreteness" are both reliable across stories and relatively unique to individuals, while neural representations of "abstractness" are variable both within individuals and across the population. Using natural language processing tools, we show that concrete words exhibit similar neural representations despite spanning larger distances within a high-dimensional semantic space, which potentially reflects an underlying representational signature of sensory experience--namely, imageability-- shared by concrete words but absent from abstract words. Our findings situate the concrete--abstract axis as a core dimension that supports both shared and individualized representations of natural language. [ABSTRACT FROM AUTHOR]

Background: Siblings of individuals with neurodevelopmental conditions (NDCs) are a minority population at higher genetic and environmental risk of poorer neurocognitive and psychosocial outcomes compared to siblings of individuals without NDCs. Method: Measured over a 15-month interval between 2021 and 2022, the present prospective follow-up study is the first Bayesian examination of the unique relationships between self-reported modifiable individual-level risk, resilience, and neuropsychiatric variables amongst siblings of persons with (n = 134) and without (n = 143) NDCs (mean age 22.42, range 9–38 years, 75.81% female, 79.78% White Caucasian). Results: The NDC group maintained elevated rates of self-reported mental health diagnoses at follow-up (effect size δ −0.57), with greater risk and fewer resilience variables than controls (δ ranging 0.50–1.07). The NDC group demonstrated group-level worsening of depression (δ −0.32). At the participant level, NDC siblings had statistically reliable declines in executive functioning and self-regulation (anxiety, empathy, attention, cognitive reappraisal) compared to the controls. Baseline self-reported sleep difficulties strongly predicted both depression and anxiety at follow-up for NDC siblings. Life events had minimal impact on mental health outcomes. Implications: Findings suggest the clinical utility of interventions for NDC siblings could be improved with a multi-modal approach, and monitoring and targeting changes in transdiagnostic risk factors contributing to poorer mental health. [ABSTRACT FROM AUTHOR]

We examined relationships between neurocognition and immune activation in Ugandan adolescents with perinatally acquired HIV (PHIV). Eighty-nine adolescents in Kampala, Uganda (32 virally suppressed [<400 copies/mL] PHIV and 57 sociodemographically matched HIV-negative controls), completed a tabletbased neurocognitive test battery. Control-derived z-scores for 12 individual tests and a global/overall z-score were calculated. We measured plasma (soluble CD14 and CD163), monocyte (proportions of monocyte subsets), and T-cell (expression of CD38 and HLA-DR on CD4+ and CD8+) activation and gut markers. Spearman rank correlations and median regressions examined associations between test performance and immune activation. The median [IQR] age was 15 [13-16] years, and 40% were girls. The median time on antiretroviral therapy was 10 years [7-11] for PHIV; 87% had viral load <50 copies/mL. Compared with controls, global z-scores were lower among PHIV (P0.05) and significantly worse on tests of executive functioning and delayed recall (P's ≤ 0.05). Overall, monocyte activation significantly correlated with worse test performance on global z-score (r = 0.21, P=0.04), attention, processing speed, and motor speed (r = 0.2-0.3, P≤0.01). T-cell activation was significantly correlated with worse performance on tests of learning, executive functioning, and working memory (r=0.2-0.4, P≤ 0.04). In PHIV, after adjusting for age, sex, and antiretroviral therapy duration, activated CD4 T cells remained associated with worse memory (B-0.3, 95% CI: -0.55 to 0.07, P 0.01). PHIV with virologic suppression on antiretroviral therapy shows evidence of worse neurocognitive test performance compared with controls. Monocyte and T-cell activation is correlated with worse neurocognition in Ugandan youth with and without HIV, which has not been previously investigated in this setting. [ABSTRACT FROM AUTHOR]

Background: Only 55% of anterior cruciate ligament-reconstructed (ACLR) athletes return to competitive sports. This brings into question the usefulness of current return to sport (RTS) criteria. High cognitive demand of sport environment clarifies the value of incorporating neurocognitive tests when making decisions regarding the time of RTS. This preliminary study aimed to compare the neurocognitive functions between healthy controls and ACLR male athletes who passed or failed RTS criteria. Methods: A total of 45 male football players, including 15 ACLR who passed RTS criteria, 15 ACLR who did not pass, and 15 healthy controls participated in this cross-sectional study. The Cambridge Neuropsychological Test Automated Battery was used to measure a battery of neurocognitive tasks, including speed of response, sustained attention, working memory, cognitive flexibility, and response inhibition. Results: The results revealed that compared with both the ACLR-passed and healthy groups, the ACLR-failed group showed greater values of 5-choice movement time (P =.02, P =.01, respectively) but lower values of stop signal reaction time (P =.03, P =.001, respectively) and proportion of successful stops variables (P =.02). In addition, compared with the healthy group, both the ACLR-failed and ACLR-passed groups indicated greater values in between errors (P <.001, P =.008, respectively) and reaction latency variables (P =.002, P =.01, respectively) but lower values of A′ (P <.001, P =.007, respectively), probability of hit (P <.001, P =.03, respectively), and percent correct trials variables (P =.006, P =.02, respectively). Conclusions: Our findings indicated deficits in neurocognitive functions in ACLR male athletes. In addition, poor performance in sustained attention, working memory, and cognitive flexibility measures observed in the ACLR-passed group highlighted the necessity for using a multimodal approach via implementation of neurocognitive measures in conjunction with the functional and muscular assessments when making RTS decisions. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The study explored associations between the accuracy of post assessment judgements of cognitive performance with global self-assessments of psychosocial functioning compared to evaluations generated by observers in schizophrenia and bipolar disorder. METHODS: An abbreviated cognitive assessment based on the MATRICS Consensus Cognitive Battery was administered to 122 individuals with schizophrenia and 113 with bipolar disorder. They provided self-estimates of their performance after each subtest. In addition, self-reports on cognition, social cognition, and everyday functioning were collected and compared to observer ratings. RESULTS: Both groups overestimated their cognitive function, but in bipolar disorder, there was 30% shared variance between task performance and self-rated task performance (vs. 5% in schizophrenia). Significant correlations were found between self-reported everyday outcomes and both actual and self-assessed performance. In schizophrenia, immediate judgements were only related to self-rated functioning, not to observer rated functioning. In bipolar disorder, impairments in self-assessment of performance correlated with observer ratings of cognitive ability, which was not observed in schizophrenia. CONCLUSIONS: While both groups showed correlations between cognitive performance and introspective accuracy, individuals with bipolar disorder showed higher accuracy in assessing their cognitive performance and other outcomes. Notably, impairments in introspective accuracy were associated with observer-rated functioning exclusively in bipolar disorder.

Abstract Background Neurocognitive disorders frequently occur in patients with cyanotic congenital heart disease (CCHD) because of the hemodynamic abnormalities induced by preoperative cardiac structural changes. We aimed to evaluate subcortical nuclei volume changes and cognition in postoperative tetralogy of Fallot (TOF) children, and analyze their relationship with preoperative cardiac structural changes. Methods This case-control study involved thirty-six children with repaired TOF and twenty-nine healthy controls (HCs). We utilized three-dimensional (3D) T1-weighted high-resolution structural images alongside the Wechsler Preschool and Primary Scale of Intelligence-Fourth Edition (WPPSI-IV) to evaluate the cognitive differences between the TOF and HC group. Results We observed notable differences in subcortical nuclei volume between the TOF and HC group, specifically in the left amygdala nucleus (LAM, TOF: 1292.60 ± 155.57; HC: 1436.27 ± 140.62, p

Abstract The pathophysiology of amnestic Mild Cognitive Impairment (aMCI) is largely unknown, although some papers found signs of immune activation. To assess the cytokine network in aMCI after excluding patients with major depression (MDD) and to examine the immune profiles of quantitative aMCI (qMCI) and distress symptoms of old age (DSOA) scores. A case-control study was conducted on 61 Thai aMCI participants and 60 healthy old adults (both without MDD). The Bio-Plex Pro human cytokine 27-plex test kit was used to assay cytokines/chemokines/growth factors in fasting plasma samples. aMCI is characterized by a significant immunosuppression, and reductions in T helper 1 (Th)1 and T cell growth profiles, the immune-inflammatory responses system, interleukin (IL)1β, IL6, IL7, IL12p70, IL13, GM-CSF, and MCP-1. These 7 cytokines/chemokines exhibit neuroprotective effects at physiologic concentrations. In multivariate analyses, three neurotoxic chemokines, CCL11, CCL5, and CXCL8, emerged as significant predictors of aMCI. Logistic regression showed that aMCI was best predicted by combining IL7, IL1β, MCP-1, years of education (all inversely associated) and CCL5 (positively associated). We found that 38.2% of the variance in the qMCI score was explained by IL7, IL1β, MCP-1, IL13, years of education (inversely associated) and CCL5 (positively associated). The DSOA was not associated with any immune data. An imbalance between lowered levels of neuroprotective cytokines and chemokines, and relative increases in neurotoxic chemokines are key factors in aMCI. Future MCI research should always control for the confounding effects of affective symptoms.

Abstract Background Adults with schizophrenia experience a range of neurocognitive problems that affect their daily functioning. Evidence for the efficacy of cognitive remediation in schizophrenia has been established, but its implementation in under-resourced community-based settings is less well-studied. In recent years, interventions have also focused on the strategy-learning approach in favor of drill-and-practice. Moreover, there is an increasing recognition to address social cognition and negative symptoms alongside neurocognition. This study attempts to carry out cognitive remediation in a community mental health setting. The Neuropsychological and Educational Approach to Remediation (NEAR) is used as the cognitive remediation intervention. Neurocognitive and social cognitive games will be introduced during the computer-assisted cognitive exercises sessions. In addition, the instructional technique will foster the use of metacognition and cognitive strategies. Moreover, metamotivation training will be the focus of some bridging sessions to enhance motivation to engage in goal-directed learning behaviors. The aims of the study are to 1) investigate the effects of cognitive remediation on neurocognition, social cognition and functional outcomes of participants with schizophrenia/schizoaffective disorders in community mental health settings; and 2) explore the mediators for change (eg: metamotivation, metacognition and negative symptoms) in cognitive performance and functional outcomes. Methods This randomized controlled trial will be conducted in three Singapore Anglican Community Services (SACS) centers, where standard psychiatric rehabilitation is delivered. Participants who are randomized to the experimental arm will receive cognitive remediation and psychiatric rehabilitation, while those randomized to the control arm will receive standard psychiatric rehabilitation only. Cognitive remediation is carried out three times a week for 12 weeks. It consists of computer-assisted cognitive exercises, as well as bridging groups to aid transfer of learning to daily living. Baseline, post-intervention and eight-week follow-up measurements will be collected. Group by time differences in cognitive performance, negative symptoms, metamotivation, metacognition, functioning and recovery will be analyzed across the three time points. Mediators for improvement in cognitive performance and functioning will also be explored. Discussion Findings of this research will add to the body of knowledge about the key therapeutic ingredients within a strategy-based cognitive remediation program and improve its implementation within under-resourced community settings. Trial registration This study has been registered with ClinicalTrials.gov (ID: NCT06286202). Date of registration: 29 February 2024. Date of last update: 21 May 2024.

Abstract Purpose This study proposed and evaluated a theoretical model for exploring the relationships between neurocognition, self-defeatist beliefs, experiential negative symptoms, and social functioning in individuals with chronic schizophrenia. Method The study recruited 229 individuals given a diagnosis of schizophrenia and schizoaffective disorders from outpatient clinics and the day ward of a mental health hospital. After informed consent was obtained, the participants underwent assessments using the backward digit span, the digit symbol, and measures of self-defeatist beliefs, experiential negative symptoms, and social functioning. A structural equation model was applied to assess the fitness of the hypothesized model, with indices such as the goodness-of-fit index, comparative fit index, root mean square error of approximation, and standardized root mean square residual being used for model evaluation. Results The hypothesized model had an adequate fit. The study findings indicated that neurocognition might indirectly influence self-defeatist beliefs through its effect on experiential negative symptoms. Contrary to expectations, the study did not observe a direct influence of neurocognition, self-defeatist beliefs, or negative symptoms on social functioning. The revised model revealed the role of experiential negative symptoms in mediating the association between neurocognition and social functioning. However, self-defeatist beliefs did not significantly affect social functioning. Discussion Before modifying negative thoughts, enhancement of self-awareness ability can help improve negative symptoms and thereby improve the performance of social functions. Future research should develop a hierarchical program of negative symptoms, from cognition rehabilitation to enhancement of self-awareness, and end with modifying maladaptive beliefs.

Objective: People with bipolar disorder (BD) often show inaccurate subjective ratings of their objective cognitive function. However, it is unclear what information individuals use to formulate their subjective ratings. This study evaluated whether people with BD are likely using information about their crystallized cognitive abilities (which involve an accumulated store of verbal knowledge and skills and are typically preserved in BD) or their fluid cognitive abilities (which involve the capacity for new learning and information processing in novel situations and are typically impaired in BD) to formulate their subjective cognitive ratings. Method: Eighty participants diagnosed with BD and 55 control volunteers were administered cognitive tests assessing crystallized and fluid cognitive abilities. Subjective cognitive functioning was assessed with the Cognitive Failures Questionnaire (CFQ), daily functioning was rated using the Multidimensional Scale of Independent Functioning (MSIF) and the Global Assessment of Functioning Scale (GAF), and quality of life was assessed with the Quality of Life in Bipolar Disorder scale (QoL.BD). Results: The BD group exhibited considerably elevated subjective cognitive complaints relative to controls. Among participants with BD, CFQ scores were associated with fluid cognitive abilities including measures of memory and executive function, but not to crystallized abilities. After controlling for objective cognition and depression, higher cognitive complaints predicted poorer psychosocial outcomes. Conclusions: Cognitive self-reports in BD may represent a metacognitive difficulty whereby cognitive self-appraisals are distorted by a person's focus on their cognitive weaknesses rather than strengths. Moreover, negative cognitive self-assessments are associated with poorer daily functioning and diminished quality of life. [ABSTRACT FROM AUTHOR]

Clinical high risk of psychosis (CHR-P) population has become an attractive area of interest in preventing transitions to psychosis. The consequences of developing a psychotic disorder may be worse in cases of early onset. Thus, childhood and adolescence represent a critical developmental window, where opportunities to gain social and adaptive abilities depend on the individuals' neurocognitive performance. There have been previous syntheses of the evidence regarding neurocognitive functioning in CHR-P individuals and its longitudinal changes. However, there has been less focus on children and adolescents at CHR-P. A multistep literature search was performed from database inception until July 15th, 2022. PRIMSA/MOOSE compliant systematic review and PROSPERO protocol were used to identify studies reporting on longitudinal changes in neurocognitive functioning in children and adolescents (mean age of sample ≤ 18 years) at CHR-P and matched healthy control (HC) group. A systematic review of identified studies was then undertaken. Three articles were included, resulting in a total sample size of 151 CHR-P patients [mean (SD) age, 16.48 (2.41) years; 32.45% female] and 64 HC individuals [mean (SD) age, 16.79 (2.38) years; 42.18% female]. CHR-P individuals had worse outcomes in verbal learning, sustained attention and executive functioning domains compared to HC. Individuals taking antidepressants had better outcomes in verbal learning in contrast with those taking antipsychotics. In children and adolescents, neurocognition may be already impaired before the psychosis onset, and remains stable during the transition to psychosis. Further study should be performed to obtain more robust evidence. [ABSTRACT FROM AUTHOR]

Background Cardiovascular disease (CVD) and neuroinflammation are thought to exacerbate neurocognitive dysfunction in treated people with human immunodeficiency virus (PWH). Here, we longitudinally measured brain glucose metabolism as a measure of neuronal integrity in treated PWH using [18F]Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in correlation with atherosclerotic cardiovascular disease (ASCVD) scores, cerebrospinal fluid (CSF) neuroinflammatory markers, neurocognitive outcomes, and other clinical and laboratory variables (CLVs). Methods Well-controlled PWH (n = 36) underwent baseline and follow-up FDG PET/CT obtained 3.5 years apart on average. Longitudinal changes in whole brain and regional relative FDG uptake, brain volumes, CLVs, CSF cytokines, and neuropsychological measures were measured. A variable selection model identified baseline variables related to future brain metabolic changes while multivariable models explored neuropsychological implications of brain metabolism and volumetrics. Results High ASCVD scores predicted future decreased thalamic uptake (slope = −0.0068, P =.027) and decreasing thalamic uptake correlated with worsening cognition (slope = 15.80, P =.020). Despite longitudinal greater than expected gray matter loss, whole brain FDG uptake did not change over the follow-up period. Most CSF cytokines decreased longitudinally but were not predictive of FDG changes. Conclusions We found that high ASCVD scores in a group of treated PWH were related to thalamic hypometabolism, which in turn correlated with neurocognitive decline. Our findings support the contribution of CVD to neurocognitive dysfunction. More proactive CVD management may have a role in mitigating progression of cognitive impairment. Lack of change in global brain glucose metabolism despite documented accelerated gray matter volume loss over the same period suggests that FDG PET might underestimate neuronal injury in PWH compared to structural magnetic resonance imaging. [ABSTRACT FROM AUTHOR]

Introduction: Early Exercise Intolerance (EEI) is associated with delayed recovery and longer time to Return To Play (RTP), but this has not been established. Participants; (n = 52, male n = 30) UK university-aged rugby-union student-athletes. Methods: Student-athletes completed baseline screening (July–October 2021 and 2022). The test battery was repeated within 48 h, 4, 8 and 14 days after a Sports-Related Concussion (SRC) with the Buffalo Concussion Bike or Treadmill Test to set sub-symptom heart rate threshold. Student-athletes then completed a controlled early exercise protocol in-between reassessment (days 3, 5–7 and 9–13). Those with EEI were compared to those with early-exercise tolerance. Outcome measures: Post-Concussion Symptom Scale, Immediate Post-Concussion and Cognitive Test, Vestibular-Ocular Motor Screening Tool and the Revised Perceived Academic Impact Tool. Results: EEI was seen throughout the initial 14-days post-SRC (23.8%, 22.4%, 25.5%. 25.0%). EEI was associated with a slower reaction time within 48 h (−0.01 (−0.030–0.043) Vs 0.06 (0.033–0.24), p = 0.004) and greater VOMS scores within 48 h; (0.00 (0.00–4.00) Vs 5.50 (2.75–9.00), p = 0.016) and 4 days (0.00 (0.00–2.00) Vs 5.00 (0.00–6.00), p = 0.044). RTP was 12.5 days longer in those with EEI at 14-days post-SRC. Conclusion: EEI is prevalent following an SRC in university-aged student-athletes and was associated with delayed recovery and RTP. [ABSTRACT FROM AUTHOR]

Functional magnetic resonance imaging (fMRI) studies have demonstrated that HIV-infection affects the fronto-striatal network. It has not been examined what impact efavirenz (EFV), an antiretroviral drug notorious for its neurocognitive effects, has on the reward system: a key subcomponent involved in depressive and apathy symptoms. Therefore, this study aims to investigate the effect of EFV on reward processing using a monetary incentive delay (MID) task. In this multicenter randomized controlled trial, asymptomatic adult participants stable on emtricitabine/tenofovirdisoproxil fumarate (FTC/TDF)/EFV were randomly assigned in a 2:1 ratio to switch to FTC/TDF/rilpivirine (RPV) (n = 30) or continue taking FTC/TDF/EFV (n = 13). At baseline and 12 weeks after therapy switch, both groups performed an MID task. Behavior and functional brain activity related to reward anticipation and reward outcome were assessed with blood-oxygen-level-dependent fMRI. Both groups were matched for age, education level, and time since HIV diagnosis and on EFV. At the behavioral level, both groups had faster response times and better response accuracy during rewarding versus nonrewarding trials, with no improvement resulting from switching FTC/TDF/EFV to FTC/TDF/RPV. No significant change in activation related to reward anticipation in the ventral striatum was found after switching therapy. Both groups had significantly higher activation levels over time, consistent with a potential learning effect. Similar activity related to reward outcome in the orbitofrontal cortex was found. Discontinuing FTC/TDF/EFV was not found to improve activity related to reward anticipation in asymptomatic people living with HIV, with similar cortical functioning during reward outcome processing. It is therefore likely that EFV does not affect motivational control. Further research is needed to determine whether EFV affects motivational control in HIV populations with different characteristics. [ABSTRACT FROM AUTHOR]

The pathophysiology of amnestic Mild Cognitive Impairment (aMCI) is largely unknown, although some papers found signs of immune activation. To assess the cytokine network in aMCI after excluding patients with major depression (MDD) and to examine the immune profiles of quantitative aMCI (qMCI) and distress symptoms of old age (DSOA) scores. A case-control study was conducted on 61 Thai aMCI participants and 60 healthy old adults (both without MDD). The Bio-Plex Pro human cytokine 27-plex test kit was used to assay cytokines/chemokines/growth factors in fasting plasma samples. aMCI is characterized by a significant immunosuppression, and reductions in T helper 1 (Th)1 and T cell growth profiles, the immune-inflammatory responses system, interleukin (IL)1β, IL6, IL7, IL12p70, IL13, GM-CSF, and MCP-1. These 7 cytokines/chemokines exhibit neuroprotective effects at physiologic concentrations. In multivariate analyses, three neurotoxic chemokines, CCL11, CCL5, and CXCL8, emerged as significant predictors of aMCI. Logistic regression showed that aMCI was best predicted by combining IL7, IL1β, MCP-1, years of education (all inversely associated) and CCL5 (positively associated). We found that 38.2% of the variance in the qMCI score was explained by IL7, IL1β, MCP-1, IL13, years of education (inversely associated) and CCL5 (positively associated). The DSOA was not associated with any immune data. An imbalance between lowered levels of neuroprotective cytokines and chemokines, and relative increases in neurotoxic chemokines are key factors in aMCI. Future MCI research should always control for the confounding effects of affective symptoms. [ABSTRACT FROM AUTHOR]