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ABSTRACT Objective: To analyze the cognitive development of preterm infants at six and 12 months of corrected age and the associations with perinatal and socioeconomic factors. Methods: Cognitive development of 40 infants (20 preterm and 20 full-term) at six and 12 months of age was evaluated using the Bayley-III scale. Correlations between cognitive outcome and associated factors were assessed using Spearman correlation. Stepwise multiple linear regression analysis with covariance was applied to identify changes on cognitive score between six and 12 months. Results: Bayley-III cognitive score in preterm group was significantly lower than in full-term group at both six and 12 months of age. Birth weight correlated with cognitive performance at six months and head circumference at birth at 12 months, in full-terms infants. The occurrence of necrotizing enterocolitis was inversely associated with cognitive score in preterms at 12 months. An increase in cognitive score was observed between six and 12 months in both groups, but the gain was more pronounced in preterms. Conclusions: These findings suggest some cognitive recovery capacity in the first year despite the restrictions imposed by premature birth and emphasize the importance of early interventions in this population.
RESUMO Objetivo: Avaliar o desenvolvimento cognitivo de crianças pré-termo aos seis e 12 meses de idade corrigida e as associações com fatores perinatais e socioeconômicos. Métodos: O desenvolvimento cognitivo de 40 crianças (20 pré-termo e 20 a termo) foi avaliado aos seis e 12 meses de idade, utilizando a escala Bayley-III. Correlações entre resultados cognitivos e fatores associados foram avaliadas pelo teste de correlação de Spearman. A análise de regressão linear múltipla stepwise com covariância foi aplicada para identificar mudanças na pontuação cognitiva entre seis e 12 meses. Resultados: O escore cognitivo no grupo pré-termo foi significativamente menor que no grupo a termo aos seis e 12 meses. O peso ao nascer foi diretamente associado com o desempenho cognitivo aos seis meses e perímetro cefálico ao nascimento aos 12 meses, nas crianças a termo. A ocorrência de enterocolite necrosante foi inversamente associada ao desempenho cognitivo em pré-termos, aos 12 meses. Verificou-se aumento na pontuação cognitiva entre seis e 12 meses nos dois grupos, porém mais pronunciado no pré-termo. Conclusões: O estudo sugere que crianças pré-termo apresentam alguma capacidade de recuperação cognitiva no primeiro ano, apesar das restrições impostas pelo nascimento prematuro, e enfatizam a importância de acompanhamento dessa população desde os primeiros meses de vida.
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Asymptomatic cerebral artery stenosis (aCAS) is closely associated with cognitive impairment, which can lead to multiple cognitive domain impairments, thereby affecting the behavior and daily life of patients. This article reviews the main involved cognitive domains, injury mechanisms, and treatment in different types of aCAS, with the aim of increasing attention to aCAS, early clinical intervention, and delaying cognitive deterioration.
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Cerebral small vessel disease (CSVD) is a group of pathological, imaging and clinical syndromes involving small cerebral vessels with different causes. The incidence rate of CSVD increases with age and is the most important cause of vascular cognitive impairment. Different diffusion imaging techniques can quantify white matter microstructure damage by revealing the diffusion movement of water molecules in specific brain tissues, explore the basis and biophysical mechanisms of tissue change, and have important value for the mechanism research, early diagnosis, progression risk, and therapeutic evaluation of cognitive impairment related to CSVD. This article reviews the research progress of diffusion magnetic resonance imaging in CSVD related cognitive impairment.
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Objective:To investigate the correlation between paroxysmal slow-wave events (PSWEs) and cerebral small vessel disease (CSVD) and CSVD-related cognitive impairment.Methods:Patients with CSVD visited Weihai Municipal Hospital from March 2021 to April 2022 were included, and sex- and age-matched healthy controls were recruited for cross-sectional analysis. The patients with CSVD were further divided into cognitive impairment group and non-cognitive impairment group. The self-developed Python script was used to detect the PSWE parameters in electroencephalogram records. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to evaluate cognitive function. Multivariate logistic regression analysis was used to determine whether PWSE parameters were the independent related factors of CSVD and CSVD-related cognitive impairment. Multiple linear regression analysis was used to determine the correlation between the PSWE parameters and overall cognitive function (MoCA total score) in patients with CSVD. Results:A total of 76 patients with CSVD (including 41 patients with cognitive impairment and 35 patients without cognitive impairment) and 45 healthy controls were included. Compared with the healthy control group, PWSEs in the F3 (left frontal area) and O1 (left occipital area) regions of the CSVD group occurred more frequently and lasted longer (all P<0.05). Multivariate logistic regression analysis showed that the frequency (odds ratio [ OR] 1.080, 95% confidence interval [ CI] 1.023-1.140; P=0.005) and duration ( OR 1.006, 95% CI 1.001-1.011; P=0.023) of PWSEs in the left frontal area, as well as the frequency ( OR 1.052, 95% CI 1.010-1.095; P=0.014) and duration ( OR 1.003, 95% CI 1.000-1.006; P=0.028) of PWSEs in the left occipital region were the independent related factors for CSVD. The frequency ( OR 1.106, 95% CI 1.033-1.183; P=0.004) and duration ( OR1.010, 95% CI 1.003-1.017; P=0.004) of PWSEs in the left frontal area were the independent risk factors for cognitive impairment in patients with CSVD. Multiple linear regression analysis showed that the frequency ( β= –0.242, P=0.045) and duration ( β= –0.235, P=0.046) of PWSEs in the left frontal region were negatively correlated with the overall cognitive function score in patients with CSVD. Conclusions:The frequency and duration of PSWEs in some brain regions of patients with CSVD increase, and there is an independent correlation between PSWEs and cognitive impairment, suggesting that the damage of blood-brain barrier may participate in the pathogenesis of cognitive impairment in patients with CSVD.
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Obstructive sleep apnea hypopnea syndrome (OSAHS) is a sleep breathing disorder caused by obstruction of the upper airway during sleep from various causes. At present, the diagnosis and treatment of OSAHS are insufficient. OSAHS causes cognitive decline due to excessive oxidative stress and inflammatory response caused by sleep breathing disorder, and its alteration of the brain gray matter area may be related to cognitive dysfunction. This review investigates the correlation between cognitive dysfunction and brain gray matter areas changes in OSAHS, and elucidates the underlying mechanisms, which provide a theoretical basis for early clinical diagnosis and treatment.
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Objective:To investigate the correlation of cognitive dysfunction with intracranial lesions and symptoms of depression and anxiety in patients with neuromyelitis optica spectrum disorders (NMOSD).Methods:Thirty-one NMOSD patients (7/24 males/females) were enrolled in the Department of Neurology of the Sixth Medical Center of the PLA General Hospital from August 2019 to August 2022. The average age was 42±13 years, and the average education level was 12 (9, 12) years. There were 30 healthy controls, 11/19 males/females, with an average age of 47±9 years and an average education of 12 (9, 15) years. The general clinical data and imaging data were collected, and the subjects were assessed on their cognition, anxiety and depression using the assessment scale approved at home and abroad. A cross-sectional study was conducted on them. The t-test or Wilcoxon test was used for inter-group comparison, and Pearson test or Spearman test was used to explore the correlation between the cognition of NMOSD patients and their intracranial lesions, depression and anxiety. Results:Compared with the healthy control group, NMOSD patients had significantly lower scores on MoCA ( Z=-3.10, P=0.002), CRAVLT-N7 ( Z=-5.12, P<0.001), CRAVLT-N8 ( t=-4.40, P<0.001), ROCF-R ( t=-3.10, P<0.01), ROCF-C ( Z=-2.72, P<0.01), PASAT-3 ( Z=-2.71, P<0.01), PASAT-2 ( Z=-3.14, P<0.01), and CWT-A ( Z=-3.10, P<0.01)scales. Frontal lobe lesions were negatively correlated with PASAT-2 ( r=-0.448, P=0.012) scores, temporal lobe lesions were negatively correlated with CRAVLT-N9 ( r=-0.564, P=0.001), and parietal lobe lesions were negatively correlated with MoCA ( r=-0.374, P=0.038), PASAT-3 ( r=-0.426, P=0.017), and PASAT-2 ( r=-0.459, P=0.009) scores; The scores of MoCA ( r=-0.392, P=0.029), CRAVLT-N6 ( r=-0.396, P=0.028), CRAVLT-N7 ( r=-0.415, P=0.020), CRAVLT-N8 ( r=-0.406, P=0.023), PASAT-3 ( r=-0.537, P=0.002) and PASAT-2 ( r=-0.495, P=0.005) scales were negatively correlated with the scores of HAMD assessment, and the scores of PASAT-3 ( r=-0.499, P=0.004) and PASAT-2 ( r=-0.452, P=0.011) were negatively correlated with the scores of HAMA. Conclusions:The cognitive function of patients with NMOSD is significantly reduced, involving multiple cognitive domains. The cognitive function is affected by the distribution of intracranial lesions and the degree of depression and anxiety.
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Perioperative neurocognitive disorders(PND)is a common complication after surgery or anesthesia, especially in elderly patients.The effects and mechanism of body temperature on PND are still controversial.In this paper, the relationship between body temperature and PND and its possible mechanism of action were discussed based on some research results of perioperative body temperature management in elderly patients, aiming at suggesting the significance of body temperature management in preventing PND.
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Objective:To explore the correlation between the expression level of the serum CircRNA_ 0005853 and cognitive impairment in elderly patients with acute cerebral infarction (ACI).Methods:A total of 120 elderly patients with ACI admitted to Haikou Third People′s Hospital from January 2019 to March 2022 were retrospectively selected. According to the Montreal Cognitive Assessment (MoCA) score of the patients 4 weeks after treatment, they were divided into a cognitive impairment free group (MoCA score≥26, 55 cases) and a cognitive impairment group (MoCA score<26, 65 cases). The cognitive impairment group was redivided into mild group (MoCA score 21-25, 16 cases), moderate group (MoCA score 15-20, 38 cases), and severe group (MoCA score<15, 11 cases) based on the severity of cognitive impairment. The serum CircRNA_0005853 expression level of each group was compared. multivariate logistic regression analysis was applied to identify the risk factors for cognitive impairment after ACI. A receiver operating characteristic (ROC) curve was drown to analyze the value of CircRNA_0005835 expression level in predicting cognitive impairment. Using Pearson correlation analysis, the correlation between the expression level serum CircRNA_0005835 and MoCA score in patients with cognitive impairment was analyzed.Results:There were statistically significant differences in age, infarct size, and triglycerides between the cognitive impairment group and the non cognitive impairment group (all P<0.05). The MoCA score of the cognitive impairment group was lower than that of the non cognitive impairment group [(19.62±2.73)points vs (28.10±1.05)points, P<0.001]. The expression level of Serum CircRNA_0005835 in the cognitive impairment group was higher than that of the non cognitive impairment group (2.48±1.02 vs 1.25±0.46, P<0.001), and in the severe group, the expression level of the serum CircRNA_0005835 (2.90±1.26) was higher than that of the moderate group (1.87±0.84) and the mild group (0.92±0.35) ( P<0.001). Multivariate logistic regression analysis shew that age ( OR=1.662, 95% CI: 1.140-2.873), infarct size>3.0 cm 2 ( OR=1.853, 95% CI: 1.317-4.112), and CircRNA_0005835 ( OR=2.217, 95% CI: 1.635-5.540) were risk factors for cognitive impairment after ACI. The area under the curve (AUC) of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The AUC of CircRNA_0005835 expression level predicting cognitive impairment was 0.837(95% CI: 0.779-0.894), with a sensitivity of 80.2% and a specificity of 83.7%. The correlation analysis shew that the expression level of serum CircRNA_0005835 in elderly ACI patients was negatively correlated with MoCA score ( r=-0.773, P<0.001). Conclusions:The increased expression level of serum CircRNA_0005853 is related to the occurrence and development of cognitive dysfunction after elderly ACI, and has certain value in predicting cognitive dysfunction.
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Cerebral microbleed (CMB) is a type of cerebral small vessel disease (CSVD). Recently studies have found that there is a certain relationship between CMB and cognitive impairment. This article mainly reviews the etiology of CMB, the relationship between CMB and cognitive impairment, CMB and cognitive disorders and the possible mechanism of CMB-related cognitive impairment, in order to improve the understanding of cognitive impairment caused by CMB.
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Objective:To investigate the effect of fascial iliaca compartment block (FICB) continuous analgesia in the early stage after admission on early postoperative cognitive and motor function in elderly patients with hip fractures.Methods:A total of 80 elderly patients with hip fractures admitted toThe First Affiliated Hospital of Tsinghua University from June 2018 to June 2020 were selected and randomly divided into the control group and the observation group, with 40 cases in each group. The control group adopted the routine postoperative analgesia regimen, while the observation group adopted FICB analgesia immediately after admission to the hospital until before the operation. Postoperative analgesia pattern was consistent with that of the control group, and both groups were given postoperative analgesia for 48 h. The scores of visual analogue scale (VAS), mini mental state assessment scale (MMSE), Harris hip score (Harris) and surgical indexes, stress indexes and incidence of adverse reactions were compared between the two groups.Results:The levels of postoperative blood glucose, cortisol, angiotensin Ⅱin the observation group were lower than those in the control group: (5.21 ± 1.03) mmol/L vs. (7.03 ± 1.06) mmol/L, (643.08 ± 77.28) nmol/L vs. (747.96 ± 82.80) nmol/L, (41.03 ± 5.22) ng/L vs. (57.15 ± 8.16) ng/L, there were statistically differences ( P<0.05). The dosage of sufentanil in the observation group was lower than that in the control group: (27.48 ± 3.25) mg vs. (58.54 ± 4.86) mg, there was statistically difference ( P<0.05). The scores of VAS score at 12 h before surgery, 12 h and 48 h after surgery in the observation group were lower than those in the control group, and the scores of MMSE score were higher than those in the control group, there were statistically differences ( P<0.05). After the surgery, the Harris scores in the observation group was higher than that in the control group: (76.09 ± 6.11) scores vs. (65.62 ± 6.13) scores, there was statistically difference ( P<0.05). The incidence rate of postoperative cognitive dysfunction (POCD) in the observation group was lower than that in the control group: 2.5%(1/40) vs. 15.0%(6/40), there was statistically difference ( χ2 = 3.91, P<0.05). Conclusions:FICB continuou sanalgesic in the early stage after admission of elderly patients with hip fracture is satisfactory, which can effectively relieve postoperative pain, while the stress response is relatively mild, the recovery of postoperative cognitive function and hip function is good.
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Introdução: A redução do tempo de sono, abaixo das necessidades básicas individuais, denominada privação do sono (PS) é alvo de pesquisas que buscam entender seus efeitos no organismo humano. Estudos em indivíduos que experienciam a PS regularmente demonstraram consequências negativas da prática na saúde humana. Objetivo: A fim de aprofundar o entendimento sobre o tema, esta revisão integrativa de literatura tem o objetivo de elucidar os impactos da PS na cognição, no humor e no desenvolvimento de transtornos neurodegenerativos. Métodos: Por meio da leitura de artigos, selecionados pelo método PRISMA, e da síntese de seus resultados. Resultados: Após análise, foram selecionados 18 artigos, que discutiam sobre o desenvolvimento de doenças neurodegenerativas. Como resultado, observou-se predominância, nos artigos, de impactos negativos da PS sobre o tema estudado, com pequena minoria demonstrando resultados inconclusivos ou sem impacto/impacto significativo, e sem relatos de impactos positivos. Nota-se prejuízos da PS no desenvolvimento de doenças neurodegenerativas, com alta relação à Doença de Alzheimer e relatos sobre Doença de Parkinson, Doença de Huntington e Esclerose Múltipla. Conclusão: Portanto, constata-se como a PS pode exercer impactos negativos no ser humano, notadamente para o desenvolvimento de transtornos neurodegenerativos.
Introduction: The reduction of sleep time, below individual basic needs, called sleep deprivation (SD), is the subject of research that seeks to understand its effects on the human body. Studies in individuals who experience SD regularly have shown negative consequences of this practice on human health. Objective: In order to deepen the understanding of the subject, this integrative literature review aims to elucidate the impacts of SD on the development of neurodegenerative disorders. Methods: Through the reading of articles, selected by the PRISMA method, and the synthesis of their results. After analysis, 18 articles were selected, in which was discussed the development of neurodegenerative. Results: As a result, there was a predominance, in the articles, of negative impacts of SD on the studied aspect, with a small minority demonstrating inconclusive results or results without impact or significant impact, and without any reports of positive impacts. It is noticeable that SD results in damages in the development of neurodegenerative diseases, with great association with Alzheimer's Disease and one report associating SD and Parkinson's Disease, Huntington's Disease and Multiple Sclerosis. Conclusion: Therefore, it is clear how SD can have negative impacts on humans, notably for the development of neurodegenerative disorders.
Introducción: La reducción del tiempo de sueño, abajo de las necesidades básicas individuales, denominada privación de sueño (PS), es objeto de investigación, que busca comprender sus efectos en el organismo humano. Los estudios en individuos que experimentan PS regularmente han mostrado consecuencias negativas de esta práctica en la salud humana. Objetivo: Con el fin de profundizar en la comprensión del tema, esta revisión integrativa de la literatura tiene como objetivo dilucidar los impactos de PS en el desarrollo de trastornos neurodegenerativos. Metodología: Através de la lectura de artículos, seleccionados por el método PRISMA, y la síntesis de sus resultados. Después del análisis, se seleccionaron 18 artículos, que discutieron el desarrollo de trastornos neurodegenerativos. Resultados: Como resultado, fue observado un predominio, en los artículos, de impactos negativos de la DS sobre lo aspecto estudiado, con una pequeña minoría demostrando resultados no concluyentes o resultados sin impacto o impacto significativo, y sin informes de impactos positivos. Es notorio que la PS resulta en daños en el desarrollo de enfermedades neurodegenerativas, con gran asociación con la Enfermedad de Alzheimer y un reporte asociando SD y Enfermedad de Parkinson, Enfermedad de Huntington y Esclerosis Múltiple. Conclusión: Por lo tanto, está claro cómo el PS puede tener impactos negativos en los seres humanos, en particular para trastornos neurodegenerativos.
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Background: SNORE (Sleep deprivation among Night shift health staff On Rotation-Evaluation) study is conceptualized to study the effects of sleep deprivation on healthcare professionals working night shifts on rotation. Materials and Methods: A comparative cross-sectional study is devised including health-care profes-sionals working night shifts on rotation at a tertiary level health-care facility, using a semi-structured questionnaire which can test sleep deprivation, cognitive ability, and quality of life. The process is to ap-proach 309 probable study participants based on stratified random sampling, after exclusion of health-care professionals with other factors which may interfere with sleep deprivation testing. Discussion: The study protocol was set in such a way as to randomly include participants from all cadres of healthcare providers as per population proportion. By measuring the effects on cognitive effect and quality of life necessary steps can be taken to provide better quality of life and to decrease cognitive im-pairment, especially among health care professionals working night shifts.
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Abstract Background: Among the various pathologies that affect the elderly, Heart Failure (HF) stands out. Recently, an attempt has been made to verify the existence of cognitive impairment associated with HF. Objectives: To compare the cognitive performance of elderly people with heart failure with that of age-matched individuals without this pathology. Check the existence of marked impairment in some cognitive functions in the clinical group. Methods: The sample consisted of 78 elderly people, whose inclusion criterion was the presence of HF and no HF (control group); age over 60 years, both sexes, and any level of education. The control group consisted of 37 individuals (with a median age of 68 years - Interquartile range of 12) and the HF group, with 41 individuals (with a median age of 67 years - Interquartile range of 11). The subjects were matched in terms of education level, with a predominance of elderly people with 0 to 4 years of education (65.9% in the Clinical Group and 59.5% in the Control Group). Eleven neuropsychological tests covering cognitive functions were used: attention, language, memory, mood, and executive function. Statistical analysis was performed using SPSS software, version 23, with a significance level of 5%. The Chi-square test and the Mann-Whitney test were applied. Results: The results showed significant differences between the groups, mainly in executive functions, which include the ability to plan, switch, and recall previously stored information. Conclusion: Our study showed differences between the cognitive performance of elderly people with HF and elderly people without HF. The main alteration was found in the so-called executive functions, attention, and memory.
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Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Atención , Envejecimiento , Función Ejecutiva , Disfunción Cognitiva , Insuficiencia Cardíaca , Memoria , Ansiedad , Estudios Transversales , Depresión , Enfermedades del Sistema Nervioso , NeuropsicologíaRESUMEN
Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized by motor deficits. In recent years, cognitive impairment in ALS has been widely concerned, and the concept of ALS-frontotemporal dementia spectrum has been commonly recognized and well-established. With the development of neuropsychology, neuroimaging, neurophysiology, neuropathology and neurogenetics, advances have been made in the diagnosis and pathophysiological mechanism of cognitive impairment in ALS. The most recent advances of cognitive impairment in ALS were reviewed.
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Near-infrared spectroscopy (NIRS) is a new optical imaging technique, which can indirectly reflect the auto-regulation of cerebral blood perfusion and the brain activation by monitoring blood oxygen saturation. This technique has been widely used in neurocritical care in recent years. The basic principle of NIRS and its application in cognitive impairment were reviewed, and the comparison of this technique and functional magnetic resonance imaging which has been commonly used in brain activation assessment was discussed. In the future, NIRS is expected to be more widely used in the field of cognitive impairment assessment.
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Objective:To evaluate the effects of different temperature management strategies on blood-brain barrier (BBB) and postoperative cognitive dysfunction (POCD) in the patients undergoing spinal fixation surgery.Methods:Ninety-six patients, aged 44-78 yr, weighing 45-104 kg, of American Society of Anesthesiology physical status Ⅰ-Ⅲ, undergoing spinal fixation surgery with combined intravenous-inhalational anesthesia, were divided into 3 groups ( n=32 each) by the simple randomization: warming blood transfusion and infusion group (group WBI), active warming group (group AW) and active warming plus selective brain cooling group (group SBC). In WBI group, the fluid for intraoperative intravenous infusion was warmed to 37 ℃ using a medical blood transfusion-infusion warmer.In AW group, warming was maintained using the fluid warming combined with the body surface warming blanket until the end of operation, and the target temperature of the warming blanket was set at 38 ℃.In SBC group, the warming protocol were similar to those previously described in AW group, and selective brain cooling was performed through an electronic ice cap with a set temperature of 4 ℃.Blood samples were collected from the median cubital vein at the end of operation, brain microvascular endothelial cells were isolated and identified by immunomagnetic bead, and the target cells were counted with a fluorescence microscope.The concentration of C-reactive protein in peripheral blood was measured by rate nephelometry on the first day after operation.The extubation time, length of post-anesthesia care unit (PACU) stay, total length of hospital stay, thermal comfortableness score, shivering in PACU, agitation and postoperative fever were recorded.The postoperative recovery was assessed using the 40-item Quality-of-Recovery scale on 7th day after surgery. Results:Compared with WBI group, the incidence of POCD and shivering in PACU, extubation time, length of PACU stay, and serum C-reactive protein concentrations were significantly decreased, and thermal comfortableness score and 40-item Quality-of Recovery scale score were increased in AW group and SBC group ( P<0.05). Compared with AW group, the count of brain microvascular endothelial cells was significantly decreased in SBC group ( P<0.05). Conclusions:Active warming produces no damage to the structure of BBB, and can reduce the development of POCD; active warming combined with selective brain cooling can improve the structural integrity of BBB, but it cannot reduce the development of POCD in the patients undergoing spinal fixation surgery.
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Objective:To investigate the efficacy of MR radiomics in predicting the transformation of amnesic mild cognitive impairment (aMCI) into Alzheimer′s disease (AD).Methods:The clinical and imaging data of 30 patients with aMCI diagnosed in the First Hospital of Shanxi Medical University from December 2018 to December 2020 and 190 aMCI cases from public databases were retrospectively analyzed. The study population included 120 males and 110 females, aging from 50 to 80 years old. Thirty-nine cases progressed to AD, and 181 cases did not progress to AD. They were randomly divided into a training set (154 cases) and a validation set (66 cases) with a ratio of 7∶3. The edges of the bilateral hippocampus were manually delineated layer by layer on the transverse, coronal, sagittal images of T 1WI three-dimensional magnetization preparatory gradient echo sequence to obtain a three-dimensional labeled image, and then the radiomics features of the left hippocampus, right hippocampus, and combined bilateral hippocampus were extracted and screened, respectively. Finally, a radiomics label was constructed. Receiver operating characteristic (ROC) curves were used to evaluate the performance of each radiomics signature. The optimal radiomics label was selected to calculate the radiomics score (Rad-score), and constructed a radiomics (R) nomogram. According to the Rad-score threshold of the optimal radiomics signature, high-risk and low-risk groups for aMCI converting to AD were distinguished, and Kaplan-Meier survival curves were drawn to predict conversion to AD in aMCI patients. The clinical features affecting the progression of aMCI patients were determined by univariate logistic regression analysis, the nomogram of clinical features (C) was established, and finally the nomogram of radiomics & clinical features (R+C) was established. The efficacy of R nomogram, C nomogram, and R+C nomogram in predicting the progression of AD in aMCI patients at 3 years and 5 years was evaluated by C index. The decision curve was drawn to determine the application value of R nomogram, C nomogram and R+C nomogram in the clinical diagnosis. Results:The ROC curve showed that the right hippocampal radiomics signature had the best performance in predicting the conversion of aMCI to AD (the area under the curve was 0.989 for the training set and 0.897 for the validation set). Taking the Rad-score=21.374 of the right hippocampus radiomics label as the threshold, there were 70 cases in the high-risk group and 84 cases in the low-risk group in the training set, and 34 cases in the high-risk group and 32 cases in the low-risk group in the validation set. The mean time for conversion to AD in aMCI patients in the low-risk and high-risk groups predicted by the right hippocampal radiomics label in the training set was 42.5 and 25.0 months, and 41.3 and 22.4 months in the validation set, respectively. Both the nomogram and the decision curve indicated that the R+C nomogram showed greater benefit in predicting the conversion of aMCI to AD than the R nomogram and the C nomogram.Conclusions:The right hippocampal radiomics signature has good performance in predicting whether aMCI patients will progress to AD. The right hippocampal radiomics signature combined with the nomogram of clinical features can be used to predict the progression to AD in aMCI patients, which may help clinicians make decisions.
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Objective:To discuss the effect of acupuncture on learning and memory ability and the expression of neuroglobin (Ngb) of the hippocampus of vascular cognitive impaired (VCI) rats.Methods:VCI rats model was established by repeated ligation of the carotid arteries of the two sides to induce ischemia-reperfusion injury. The successful modeled rats were divided into acupuncture group and a model group according to the random number table method, with 12 rats in each group, and 12 rats were selected as the normal group. The rats in the acupuncture group received acupuncture at "Baihui", "Fengfu" and "Yongquan", 10 times as a course of treatment, a total of 3 courses, and stop acupuncture treatment for 2 days during the courses of treatment. Neurobehavioral scores were measured on the 3rd day after the intervention. Morris water maze was conducted to detect the learning and memory ability of the rats in each group, and Western blot was used to detect the expression of Ngb in the hippocampus of the rats.Results:Compared with the model group, the behavioral score of the acupuncture group decreased after intervention ( P<0.05), the escape latency was significantly shortened ( P<0.05), the number of crossing platforms was increased ( P<0.05), and the hippocampal Ngb (1.18±0.06 vs.0.98±0.04) was significantly increased ( P<0.05). Conclusion:Acupuncture at "Baihui", "Fengfu" and "Yongquan" could promote the expression of Ngb in the hippocampus of rats and improve the learning and memory ability of VCI rats.
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Microglia are the main innate immune cells in the central nervous system, which play a variety of roles in the development of the central nervous system and the occurrence of diseases. Recent studies have found that microglia play an important role in the occurrence and development of vascular cognitive impairment (VCI), which can lead to cognitive decline by activating neuroinflammation, oxidative stress, and destroying the blood-brain barrier. This article reviews the role of microglia in the pathophysiology of VCI, aiming to provide a new basis for targeting microglia to treat VCI.
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Cerebral small vessel disease (CSVD) refers to a series of clinical, imaging and pathological syndromes of cerebral arterioles, capillaries, venules, as well as perivascular brain parenchyma caused by various etiologies, and is one of the important causes of vascular cognitive impairment and dementia. The onset of CSVD is insidious, and the early diagnosis mainly depends on imaging examination. This article reviews the effects of different imaging markers of CSVD on cognitive function and their pathophysiological mechanism.