Telerrehabilitación de sujetos con trastornos del neurodesarrollo durante el confinamiento por COVID-19 / Telerehabilitation of Subjects with Neurodevelopmental Disorders During Confinement due to COVID-19

RESUMEN Introducción: Las medidas de distanciamiento social debidas a la pandemia por COVID-19 impidieron que muchos chicos con trastornos del neurodesarrollo pudieran acceder a tratamientos presenciales. La telerrehabilitación creció en este tiempo como una herramienta terapéutica alternativa. El objetivo es analizar la telerrehXbilitación cognitiva en trastornos del neurodesarrollo. Métodos: En este estudio prospectivo, cuasi-experimental (antes-después), se incluyó a 22 pacientes (media de edad, 9,41 arios) con trastornos del neurodesarrollo que realizaron telerrehabilitación con el programa Rehametrics por más de 6 meses. Resultados: Luego de 6 meses de telerrahabilitación, se constató una mejoría estadísticamente significativa con un gran tamaño del efecto en áreas de: atención (sostenida, selectiva y dividida), funciones ejecutivas (memoria de trabajo verbal y visual, categorización, velocidad de procesamiento), habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia) y lenguaje (comprensivo y expresivo). En la Escala de Impedimento Funcional de Weiss mejoraron con significancia estadística todas las áreas (familia, aprendizaje y escuela, autoconcepto, actividades de la vida diaria, actividades de riesgo). Se constata una correlación positiva entre la cantidad de sesiones y la mejoría observada en funciones ejecutivas (memoria de trabajo visual, velocidad de procesamiento), atencionales (atención sostenida, atención dividida) y habilidades visuoespaciales (orientación espacial, integración perceptiva, percepción, simultagnosia). No encontramos significancia estadística entre la estructura familiar y la cantidad de sesiones realizadas. Se observó un alto grado de percepción de mejora y satisfacción en los padres. Conclusiones: La telerrehabilitación puede ser una herramienta alternativa segura que, sin reemplazar la presencialidad, puede lograr mejoras cognitivas y funcionales significativas en niños con trastornos del neurodesarrollo.

ABSTRACT Introduction: Social distancing measures due to the COVID-19 pandemic prevented many children with neurodevelopmental disorders from accessing face-to-face treatments. Tele-rehabilitation grew at this time as an alternative therapeutic tool. In this study we analyzed remote cognitive rehabilitation in neurodevelopmental disorders. Methods: This was a prospective, quasi-experimental (before-after) study that included 22 patients (mean age 9.41 years) with neurodevelopmental disorders who had telerehabilitation for over six months. Results: After six months of telerehabilitation, a statistically significant improvement was found with a large effect size in these areas: attention (sustained, selective and divided), executive functions (verbal and visual working memory, categorization, processing speed), visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia) and language (comprehensive and expressive). On the Weiss Functional Impairment Scale, all areas (family, learning and school, self-concept, activities of daily living, risk activities) improved with statistical significance. We found a positive correlation between the number of sessions and the improvement observed in executive functions (visual working memory, processing speed), attention (sustained attention, divided attention) and visuospatial skills (spatial orientation, perceptual integration, perception, simultanagnosia). We did not find statistical significance between the family structure and the number of sessions carried out. A high degree of perception of improvement and satisfaction was observed in the parents. Conclusions: Telerehabilitation is a safe alternative tool which, although it does not replace face-to-face therapy, can achieve significant cognitive and functional improvements in children with neurodevelopmental disorders.

Relación entre trastorno obsesivo-compulsivo y alteración en funciones ejecutivas / Relationship between obsessive-compulsive disorder and executive function alteration

Resumen Introducción: El trastorno obsesivo-compulsivo (TOC) se caracteriza por obsesiones y compulsiones. Las obsesiones corresponden a ideas o imágenes intrusivas y la compulsión es el acto motor o cognitivo para aplacar la obsesión. Su prevalência mundial es del 3 % y existen diferentes factores que influyen en su aparición, que pueden ser biológicos, psicológicos o ambientales. Por otra parte, las funciones ejecutivas son un conjunto de habilidades que regulan la cognición y el comportamiento, donde este estudio busca describir la relación y afectación de las funciones ejecutivas en personas que padecen TOC. Materiales y métodos: Artículo de revisión narrativa a partir del estado del arte sobre el TOC y las funciones ejecutivas. Resultados: Diversos estudios han reportado la relación clínico-anatómica entre signos y síntomas característicos del TOC y la alteración evidenciada en funciones ejecutivas. Las funciones ejecutivas impactan el funcionamiento en la vida diaria y se encuentran fuertemente relacionadas al TOC, generando limitaciones funcionales en estos pacientes. Para esta afección hay tratamientos como las terapias farmacológica, psicológica y quirúrgica. Discusión: Se encuentra la necesidad de implementar, dentro de su tratamiento, la rehabilitación neuropsicológica para rehabilitar y fortalecer las funciones ejecutivas, buscando que se desarrolle de manera integral y que le permita a la persona desenvolverse de manera óptima en su día a día. Conclusión: Las funciones ejecutivas son un componente fundamental para nuestro funcionamiento y autonomía, es por esto que al estar el TOC directamente relacionado con fallas en estas funciones, se considera un punto importante para tener en cuenta al acompañar y tratar a personas que presentan este trastorno.

Abstract Introduction: Obsessive-compulsive disorder (OCD) is characterized by obsessions and compulsions. Obsessions correspond to intrusive ideas or images and compulsion is the motor or cognitive act to appease the obsession. Its worldwide prevalence is 3%. There are different factors that influence its appearance, which can be biological, psychological and environmental. Executive functions are a set of skills that regulate cognition and behavior. The objective is to describe the relationship and impact of executive functions in people who suffer from OCD. Materials and methods: Narrative review article based on the state of the art on obsessive-compulsive disorder and executive functions. Results: Various studies report a clinical-anatomical relationship between characteristic signs and symptoms of OCD and alterations evident in executive functions. Executive functions impact functioning in daily life. These functions are strongly related to OCD, generating functional limitations in these patients. For this condition there are treatments such as pharmacological, psychological and surgical therapy. Discussion: There is a need to implement neuropsychological rehabilitation within its treatment to rehabilitate and strengthen such processes, seeking to develop it comprehensively and allow the person to function optimally in their daily lives. Conclusion: Executive functions are a fundamental component for our functioning and autonomy, which is why, since OCD is directly related to failures in these functions, they are considered an important point to take into account when accompanying and treating people who present this condition. disorder.

Representaciones sociales de la parálisis cerebral en madres de niños que asisten a un centro de neurorrehabilitación en Cali-Colombia / Social representations of cerebral palsy in mothers of children who attend a neurological rehabilitation center in Cali-Colombia / Representações sociais da paralisia cerebral em mães de crianças que frequentam um centro de reabilitação neurológica em Cali-Colômbia

Resumen Objetivo: en Colombia, existe una brecha importante entre la reglamentación relacionada con el reconocimiento de derechos, inclusión y mecanismos para la protección de los niños con discapacidad y la implementación de la norma. En este contexto, el objetivo de este estudio fue explorar las representaciones sociales de la parálisis cerebral en madres de niños con parálisis cerebral. Metodología: se realizó un estudio cualitativo bajo el enfoque estructuralista de las representaciones sociales para caracterizar el contenido y la organización de las representaciones sociales de la parálisis cerebral de madres de niños con parálisis cerebral que consultaron a un centro de neurorrehabilitación en Cali, Colombia entre enero y febrero de 2022. Como técnicas de recolección se utilizaron el listado libre y el cuestionario de pares. Resultados: para las madres la parálisis cerebral es la alteración de movimiento que junto con la dificultad de aprendizaje y comunicación generan gran demanda de atención por parte del cuidador acompañado de sentimientos de resignación ante las secuelas de la lesión en el cerebro y la discriminación social percibida. Conclusiones: las representaciones sociales sobre la parálisis cerebral dejan percibir una visión negativa y poco esperanzadora de recuperación, así como resiliencia por parte de los cuidadores.

Abstract Objective: In Colombia, there is a significant gap between the regulations related to the recognition of rights, inclusion, and mechanisms for the protection of children with disabilities and the implementation of the law. In this context, the aim of this study was to explore the social representations of cerebral palsy in mothers of children with cerebral palsy. Methodology: We collected information from mothers with children with cerebral palsy who consulted a neurorrehabilitation center in Cali, Colombia between January and February 2022 using the free list and the peer questionnaire. Results: For mothers, cerebral palsy is a movement disorder that, together with learning and communication difficulties, generates a great demand for care by the caregiver, accompanied by feelings of resignation in the face of the consequences of the brain injury and perceived social discrimination. Conclusions: The social representations on cerebral palsy reveal a negative and hopeless view of recovery, as well as resilience on the part of caregivers.

Resumo Objetivo: Na Colômbia, existe uma brecha importante entre a regulamentação relacionada ao reconhecimento de direitos, inclusão e mecanismos para a proteção dos meninos com deficiência e a implementação da norma. Neste contexto, o objetivo deste estúdio pode explorar as representações sociais da paralisia cerebral em mães de crianças com paralisia cerebral. Metodologia: Recolha a informação das madres com crianças com paralisia cerebral que consulte um centro de neurorreabilitação em Cali, Colômbia entre enero e febrero de 2022 usando o listado livre e o guia de pares. Resultados: Para as mães a paralisia cerebral é a alteração de movimento que se junta com a dificuldade de aprendizagem e comunicação gera grande demanda de atenção por parte do cuidador acompanhado de sentimentos de resignação antes das seqüelas da lesão no cérebro e na discriminação percepção social. Conclusões: Las representaciones sociales sobre la paralisis cerebral dejan ver una visão negativa y poco esperanzadora de recuperação, así como resiliência de parte de los cuidadores.

Study of the clinical profile of older patients with bipolar disorder in a tertiary care center in the Midwest of Brazil / Estudo do perfil clínico de pacientes idosos com transtorno bipolar em um centro terciário do Centro-Oeste do Brasil

Objective: This study aimed to describe the clinical and psychiatric characteristics of older outpatients with bipolar disorder (BD), including psychiatric history (age of onset of symptoms, length of time with the illness, and number of psychiatric hospitalizations), mood state, and cognitive function. Methods: This was a cross-sectional study where clinical and demographic data were obtained by a psychiatric interview with each patient and family members as well as by a review of medical records. The sample consisted of 20 individuals aged 60 years or older with a diagnosis of BD type I according to the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Descriptive data analysis was performed, with categorical variables expressed as absolute and relative frequencies. Results: No patient had manic or depressive symptoms at the time of the evaluation; 15 (75.0%) had an early onset while 5 (25.0%) had a late onset of the disease. Nine patients (45.0%) showed no cognitive decline whereas 11 (55.0%) showed mild cognitive impairment. Conclusions: This study presents an understudied group of patients with BD. Considering the personal impact and burden on the health system related to this psychiatric condition, it is recommended that further studies be conducted in this area to better evaluate this growing population. (AU)

Effects of physical exercise on cognition and glymphatic system of patients with mild cognitive impairment or Alzheimer's disease ­ study protocol

Objective: To evaluate the impact of a multicomponent physical exercise program on clinical variables associated with the glymphatic clearance system, sleep-awake patterns, and cognitive function in individuals with mild cognitive impairment or mild Alzheimer's disease. Methods: This is a single-center parallel randomized controlled trial involving pre- and post-intervention assessments. The intervention consists of a 12 (±3)-week multicomponent aerobic and resistance physical exercise program of moderate intensity divided into 2 groups: an experimental group (undergoing multicomponent training) and a control group (no intervention). Eligible participants are those diagnosed with probable mild cognitive impairment or mild Alzheimer's disease. Expected results: Anticipated outcomes suggest that the multicomponent training protocol, incorporating both aerobic and resistance physical exercises at a moderate intensity, will yield improvements in glymphatic clearance dynamics, sleep-awake parameters, and performance on cognitive, functional, and behavioral tasks among eligible patients. Relevance: The need to move beyond cognitive clinical testing justifies our trial, which proposes an assessment employing neuroimaging techniques and the analysis of biomarkers present in cerebrospinal fluid in conjunction with clinical tests for physical and cognitive assessment. (AU)

Effect of an acute bout strength training on executive function among college students: a pilot study

Executive functions are built such as reasoning, problem solving and planning. Even mild form of executive dysfunction might hamper everyday activities depending on the work and situation, which requires various cognitive domains. Strength exercises are able to increase the anti-inflammatory balance with an increase in cognition and better physical performance. Aim of the study was to evaluate the acute bout effect of strength training on executive function among college students. 10 participants were divided into control and intervention group for experimental study performed at SPB physiotherapy college. Consent was taken from the participants. Only one session of 30 minutes was performed by intervention group. Intervention group performed 10 repetitions of 12 exercise per set and 2 sets per session. Warm up and cool down was performed by participants. Pre and post measures of trail making test B was recorded as outcome measure for executive function. Trail making test score was significantly improved immediately after strength training with p value <0.05 suggesting improvement in executive function. The study concluded that Strength training has greater immediate impact on executive function among college students

Serum autophagy-related gene 5 level in stroke patients: correlation with CD4+ T cells and cognition impairment during a 3-year follow-up

Abstract Autophagy-related gene (ATG) 5 regulates blood lipids, chronic inflammation, CD4+ T-cell differentiation, and neuronal death and is involved in post-stroke cognitive impairment. This study aimed to explore the correlation of serum ATG5 with CD4+ T cells and cognition impairment in stroke patients. Peripheral blood was collected from 180 stroke patients for serum ATG5 and T helper (Th) 1, Th2, Th17, and regulatory T (Treg) cell detection via enzyme-linked immunosorbent assays and flow cytometry. The Mini-Mental State Examination (MMSE) scale was completed at enrollment, year (Y)1, Y2, and Y3 in stroke patients. Serum ATG5 was also measured in 50 healthy controls (HCs). Serum ATG5 was elevated in stroke patients compared to HCs (P<0.001) and was positively correlated to Th2 cells (P=0.022), Th17 cells (P<0.001), and Th17/Treg ratio (P<0.001) in stroke patients but not correlated with Th1 cells, Th1/Th2 ratio, or Treg cells (all P>0.050). Serum ATG5 (P=0.037), Th1 cells (P=0.022), Th17 cells (P=0.002), and Th17/Treg ratio (P=0.018) were elevated in stroke patients with MMSE score-identified cognition impairment vs those without cognition impairment, whereas Th2 cells, Th1/Th2 ratio, and Treg cells were not different between them (all P>0.050). Importantly, serum ATG5 was negatively linked with MMSE score at enrollment (P=0.004), Y1 (P=0.002), Y2 (P=0.014), and Y3 (P=0.001); moreover, it was positively related to 2-year (P=0.024) and 3-year (P=0.012) MMSE score decline in stroke patients. Serum ATG5 was positively correlated with Th2 and Th17 cells and estimated cognitive function decline in stroke patients.

Diabetes, hemoglobin A1c, and cognitive performance in older adults: is there any impact of frailty? Evidence from the ELSI-Brazil study

Abstract The aim of this study was to evaluate the association between diabetes and cognitive performance in a nationally representative study in Brazil. We also aimed to investigate the interaction between frailty and diabetes on cognitive performance. A cross-sectional analysis of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) baseline data that included adults aged 50 years and older was conducted. Linear regression models were used to study the association between diabetes and cognitive performance. A total of 8,149 participants were included, and a subgroup analysis was performed in 1,768 with hemoglobin A1c data. Diabetes and hemoglobin A1c levels were not associated with cognitive performance. Interaction of hemoglobin A1c levels with frailty status was found on global cognitive z-score (P-value for interaction=0.038). These results suggested an association between higher hemoglobin A1c levels and lower cognitive performance only in non-frail participants. Additionally, undiagnosed diabetes with higher hemoglobin A1c levels was associated with both poor global cognitive (β=-0.36; 95%CI: -0.62; -0.10, P=0.008) and semantic verbal fluency performance (β=-0.47; 95%CI: -0.73; -0.21, P=0.001). In conclusion, higher hemoglobin A1c levels were associated with lower cognitive performance among non-frail participants. Higher hemoglobin A1c levels without a previous diagnosis of diabetes were also related to poor cognitive performance. Future longitudinal analyses of the ELSI-Brazil study will provide further information on the role of frailty in the association of diabetes and glycemic control with cognitive decline.

O impacto da depressão pós-parto no desenvolvimento cognitivo infantil / The impact of postpartum depression on child cognitive development

Objetivo: avaliar as consequências da depressão pós-parto no desenvolvimento cognitivo infantil. Métodos: trata-se de uma revisão narrativa, com caráter analítico quantitativo, realizada por meio da busca de artigos científicos publicados, nas plataformas Google Acadêmico, Scielo e PubMed, sobre a relação entre depressão pós-parto e desenvolvimento infantil. Resultados: foi selecionado um total de 23 artigos entre os três bancos de dados. Os resultados apontam que filhos de mães deprimidas são mais propensos a ter alterações no desenvolvimento cognitivo, social e linguístico do que filhos de mães não deprimidas. Entretanto, deve-se lembrar que essa alteração não acontece exclusivamente pela depressão pós-parto, uma vez que ela pode estar associada a outros fatores de risco, como condições socioeconômicas e apoio marital. Conclusão: a depressão pós-parto como fator isolado afeta o bebê de maneira sutil, mas, diante de diversos fatores ambientais e conduta parental, o efeito nocivo pode ser intensificado, o que pode prejudicar os desempenhos nos testes cognitivos, de atenção e aprendizagem. Desse modo, compreende-se que é importante incentivar um acompanhamento pré-natal que valorize a saúde mental das gestantes, para que qualquer manifestação psicológica negativa seja prontamente identificada e receba o apoio necessário o mais rápido possível.

Objective: to evaluate the consequences of postpartum depression on child cognitive development. Methods: this is a narrative review, with a quantitative analytical character, carried out by searching for scientific articles published on the Google Scholar, Scielo and PubMed platforms on the relationship between postpartum depression and child development. Results: a total of 23 articles were selected from the three databases. The results indicate that children of depressed mothers are more likely to have changes in cognitive, social and linguistic development than children of non-depressed mothers. However, it should be remembered that this change does not occur exclusively due to postpartum depression, as it may be associated with other risk factors, such as socioeconomic conditions and marital support. Conclusion: postpartum depression as an isolated factor affects the baby in a subtle way, but, given several environmental factors and parental behavior, the harmful effect can be intensified, which can harm performance in cognitive, attention and learning tests. Therefore, it is understood that it is important to encourage prenatal care that values the mental health of pregnant women, so that any negative psychological manifestations are promptly identified and receive the necessary support as quickyl as possible.

Ayuno intermitente y restricción calórica como tratamiento coadyuvante en enfermedad de Alzheimer y esclerosis múltiple / Intermittent Fasting and Caloric Restriction as an Adjunctive Treatment in Alzheimer's Disease and Multiple Sclerosis

Las enfermedades de Alzheimer y esclerosis múltiple son neurodegenerativas, con tratamientos complejos y de costos elevados, orientados a disminuir la progresión de la sintomatología. Sin embargo, a causa de la falta de terapias adecuadas y de los posibles efectos adversos ocasionados por tratamientos de primera línea, es necesario implementar mejores abordajes terapéuticos complementarios que no produzcan mayores efectos secundarios y mejoren la sintomatología de dichas patologías. La restricción calórica y el ayuno intermitente han demostrado ser estrategias novedosas y beneficiosas en enfermedades neurodegenerativas, a través de mecanismos inmunitarios, metabólicos y fisiológicos. Con el objetivo de determinar el uso del ayuno intermitente y la restricción calórica como tratamiento coadyuvante en esclerosis múltiple y enfermedad de Alzheimer, se realizó una revisión narrativa de artículos originales en revistas científicas, en idiomas inglés y español, de 2018 a 2022. El uso de la restricción calórica y ayuno intermitente han generado cambios positivos produciendo disminución de estados proinflamatorios, estrés oxidativo y envejecimiento. Se consideran abordajes que modulan la progresión de la enfermedad y mejoran la función cognitiva por vías de señalización de monofosfato de adenosina cinasa, factor de crecimiento similar a la insulina y la enzima sirtuina, generando un efecto neuroprotector.

Alzheimer's disease and multiple sclerosis are neurodegenerative disorders with expensive and complex treatments aimed at reducing the progression of symptoms. However, due to the lack of adequate therapies and the possible adverse effects caused by first-line treatments, it's necessary to implement better complementary therapeutic approaches that do not produce major side effects and improve symptoms. Caloric restriction and intermittent fasting have been shown to be novel and beneficial strategies in neurodegenerative diseases, through immune, metabolic, and physiological mechanisms. To determine the use of intermittent fasting and caloric restriction as a new treatment in multiple sclerosis and Alzheimer's disease, a narrative review of original articles in both national and international scientific journals, in English and Spanish languages with no greater obsolescence than five years. The use of caloric restriction and intermittent fasting have generated positive changes, producing a decrease in pro-inflammatory states, oxidative stress, and aging. Approaches that modulate disease progression and improve cognitive function of adenosine monophosphate kinase, insulin-like growth factor, and sirtuin enzyme pathways are considered, generating a neuroprotective effect.

Deterioro funcional y neurocognitivo en pacientes con esquizofrenia deficitaria en Perú y confiabilidad de la estructura bidimensional de la sintomatología negativa / Functional and neurocognitive impairment in deficit schizophrenia patients in Peru and reliability of the bidimensional structure of negative symptomatology

Resumen La mayoría de los estudios sugieren que los pacientes con esquizofrenia deficitaria presentan un deterioro funcional y neurocognitivo más grave en comparación con los pacientes con esquizofrenia no deficitaria. Sin embargo, existen pocos estudios al respecto en América Latina. Examinar las diferencias entre el funcionamiento y el deterioro neurocognitivo en pacientes con y sin esquizofrenia deficitaria; y analizar la validez de la estructura bifactorial de los síntomas negativos en una muestra de pacientes peruanos. Se reclutó a un total de 53 pacientes peruanos con esquizofrenia. Se utilizó la versión en español del Schedule for the Deficit Syndrome (SDS) para diagnosticar el síndrome deficitario, el Functioning Assessment Short Test (FAST) para evaluar el funcionamiento global, y el Screen for Cognitive Impairment in Psychiatry (SCIP) para evaluar el funcionamiento neurocognitivo. La prevalencia de esquizofrenia deficitaria fue del 62,3 %. Los pacientes con esquizofrenia deficitaria presentan un mayor deterioro en la memoria de trabajo (p = 0,003), fluidez verbal (p = 0,002), aprendizaje verbal retardado (p = 0,039) y velocidad de procesamiento (p = 0,004). En cuanto al funcionamiento global, los pacientes con esquizofrenia deficitaria muestran un rendimiento inferior en las dimensiones de autonomía (p = 0,002), laboral (p = 0,001), cognitiva (p = 0,010), finanzas (p = 0,015), relaciones interpersonales (p < 0,001) y tiempo de ocio (p < 0,001). Los pacientes con esquizofrenia deficitaria muestran un mayor deterioro en el funcionamiento global y cognitivo. La replicación de la estructura bidimensional de los síntomas negativos en una muestra peruana contribuye a la hipótesis de la universalidad del modelo de «déficit expresivo¼ y «apatía-abulia¼.

ABSTRACT Many studies suggest that patients with deficit schizophrenia exhibit a more severe functional and neurocognitive impairment than those with non-deficit schizophrenia. However, there are few studies on this topic in Latin America. To examine the differences in functioning and neurocognitive impairment between patients with and without deficit schizophrenia, and to analyze the validity of the bifactorial structure of negative symptoms in a sample of Peruvian patients. A total of 53 Peruvian patients with schizophrenia were recruited. The Spanish version of the Schedule for the Deficit Syndrome (SDS) was used to diagnose the syndrome under study. The Functioning Assessment Short Test (FAST) was employed to assess global functioning, and the Screen for Cognitive Impairment in Psychiatry (SCIP), to evaluate neurocognitive functioning. The prevalence of deficit schizophrenia was 62.3%. Patients with deficit schizophrenia exhibited greater impairment in working memory (p = 0.003), verbal fluency (p = 0.002), delayed verbal learning (p = 0.039), and processing speed (p = 0.004). Regarding global functioning, patients with deficit schizophrenia demonstrated poorer performance in the domains of autonomy (p = 0.002), occupational functioning (p = 0.001), cognitive functioning (p = 0.010), financial functioning (p = 0.015), interpersonal relationships (p < 0.001), and leisure time (p < 0.001). Patients with deficit schizophrenia display greater impairment in global and cognitive functioning. The replication of the bidimensional structure of negative symptoms in a Peruvian sample contributes to the hypothesis of the universality of the "expressive deficit" and "apathy-abulia" model.

Progress on neuropsychological status of the children with short stature / 国际儿科学杂志

The etiology of short stature is multifaceted and influenced by various potential factors including genetics，nutrition，endocrine and psychology. Research has shown that psychological factors can contribute to growth disorders，impacting the behavioral，emotional，and neuropsychological well-being of children with short stature. These growth disorders may lead to language problems，social disorders，etc. Additionally，physical limitations and environmental barriers can pose practical challenges in the daily lives of children with short stature，potentially leading to a decrease in their health-related quality of life（HrQoL）. Moreover，growth disorders can increase parental care burden，further impacting their HrQoL. This article offers a literature review on the challenges faced by children with short stature and the neuropsychological implications of various types of short stature.

Gut microbiota and their metabolites and the outcome of ischemic stroke / 国际脑血管病杂志

An increasing number of studies have shown that gut microbiota and their metabolites play an important role in the occurrence, development, and outcome of ischemic stroke. This article reviews the associations of gut microbiota and their metabolites with the outcome of ischemic stroke, in order to provide new ideas for the prevention and treatment strategies of ischemic stroke.

Lipoprotein-associated phospholipase A 2 and cognitive impairment in patients with cerebral small vessel disease / 国际脑血管病杂志

In recent years, the incidence of cerebral small vessel disease (CSVD) has been increasing with the aging of the population, and the cognitive impairment caused by it has brought huge burden to patients and their families. As a novel inflammatory biomarker, lipoprotein-associated phospholipase A 2 (Lp-PLA 2) directly participates in the pathogenesis of cognitive impairment in patients with CSVD by regulating circulatory vascular injury and neuroinflammation, and is expected to become a predictive indicator and therapeutic target for CSVD.

Effects of warm acupuncture on post-stroke cognitive impairment based on the theory of intestinal flora / 国际中医中药杂志

Objective:To observe the effects of warm acupuncture on post-stroke cognitive impairment (PSCI) based on the theory of intestinal flora.Methods:A randomized controlled trial was conducted. 60 patients with PSCI in the Department of Acupuncture and Neurology of the First Affiliated Hospital of Xinjiang Medical University from October 2020 to June 2022 were selected as the observation objects, and were divided into 2 groups by random number table, with 30 cases in each group. On the basis of cognitive rehabilitation training, the treatment group was given warm acupuncture treatment, and the control group was given routine acupuncture treatment. 2 groups were treated for 4 weeks as 1 course, and a total of 4 courses were treated. Montreal cognitive assessment (MoCA) was used to assess patients' cognitive function before and after treatment, and mini-mental state examination (MMSE) was used to assess patients' intelligence level. The numbers of bifidobacteria and lactic acid bacteria in fecal samples were calculated, and plasma gamma-aminobutyric acid (GABA) levels were detected by ELISA to evaluate the clinical efficacy.Results:During the study, 1 case was lost in each of the two groups, and finally 29 cases were included in the curative effect statistics. The total effective rate was 79.3% (23/29) in the treatment group and 65.5% (19/29) in the control group, with statistical significance ( χ2=43.39， P<0.05). After treatment, MoCA score [(24.23±1.36) vs. (21.26±1.30), t=3.12] and MMSE score [(25.35±1.24) vs. (21.52±1.22), t=3.25] in the treatment group were higher than those in the control group ( P<0.05); Bifidobacterium [(9.20±1.25) LgCFU/g vs. (7.23±1.21) LgCFU/g, t=2.98], Lactic acid bacteria [(8.24±1.12) LgCFU/g vs. (6.25±1.22) LgCFU/g, t=2.92], and the level of GABA [(283.80±83.54) mmol/L vs. (264.76±61.38) mmol/L, t=10.54] were higher than those in the control group ( P<0.05 or P<0.01). Conclusion:Warm acupuncture and moxibustion can effectively regulate the number of intestinal beneficial bacteria in PSCI patients, increase the level of GABA, promote brain tissue repair and improve cognitive function.

Effects and Mechanisms of Xueshuantong on the Cognitive Function and Abnormal Neural Excitability in Mice with Alzheimer's Disease / 昆明医科大学学报

Objective To explore the possible effects and the underlying molecular mechanisms of xueshuantong[The main active component is panax notoginseng(PNS)]on the cognitive function and neural excitability of mice with Alzheimer's disease(AD).Methods The APP/PS1 mice were used as an animal model for AD research,at the stage when amyloid protein was not detected in mice(2 months of age).Mice in the xueshuantong group(APP/PS1+PNS)were administered by gavage once a day at a dose of 60 mg/kg for six months(for 8 months of age).The mice of the control group were given 0.9%sodium chloride(APP/PS1+Vehicle)intragastric treatment of the same volume,while the wild-type mice of the same age were given 0.9%sodium chloride intragastric treatment as the normal control group(WT+Vehicle)(15 mice in each group,n=15).After six months,the cognitive function of the mice was evaluated by the Novel Object Recognition(NOR)task and Morris Water Maze(MWM)test.The activity of BACE1,the distribution and expression of Nav1.1α,as well as the expression and enzymatic hydrolysis of Navβ2(Navβ2 full-length and Navβ2-CTF fragments)in cortex and hippocampus were detected by EEG,Western blot and cell surface biotinylation assay,respectively.Results The NOR task showed that compared with the mice in the APP/PS1+Vehicle group,the Discrimination index(DI)of mice in the APP/PS1 group was significantly increased after xueshuantong administration(P<0.05).The MWM test found that,the escape latency of the mice in the xueshuantong group was shortened followed six months in gastric administration(P<0.05),while the stay time in the target quadrant and the number of platforms significantly increased(P<0.05)after the removal of the platform.The results of EEG recording showed that xueshuantong reduced the frequency of spike-wave discharges in APP/PS1 mice(P<0.05).Furthermore,xueshuantong significantly reduced the expression of BACE1(P<0.05).In the APP+PNS group,the expression of Navβ2 full-length was increased(P<0.05),as well as corrected the abnormal distribution of Nav1.1α inside and outside of neurons(P<0.05).Conclusion Treatment with xueshuantong can significantly improve the learning and memory ability and correct the abnormal excitability of the brain in AD model mice.The mechanism may be related to the inhibition of BACE1 activity,the reduction of APP/PS1-induced excessive enzyme digestion of Navβ2,the correction of the abnormal expression and distribution of Nav1.1α in cortical and hippocampal neurons,as well as the subsequent regulation of neuronal excitability.

A study on the cognitive and experience evaluation of "136" leading clinical patients in Shanxi province on the smart ward based on the technology acceptance model / 中国实用护理杂志

Objective:To explore the cognition and use experience of residents based on technical acceptance model, and provide decision-making information and reference for the promotion and optimization construction of the smart ward.Methods:Based on the technical acceptance model, the research team made cognitive and experience evaluation questionnaire of hospitalization patients of the smart wards and evaluated its reliability. By adopting cross-sectional research methods, 368 patients who were hospitalized in the smart wards of the 10 leading clinical specialty in"136" Xingyi Project in Shanxi Province were selected as research objects from January to April 2022. The cognitive and experience evaluation questionnaire of hospitalization patients of the smart wards were used to conduct investigations and research.Results:Among 368 patients, male 148 cases, female 220 cases, aged 18 to 70 years old. The overall Cronbach α coefficient of the questionnaire was 0.887, which had a good degree of reliability. In the cognition and experience evaluation of the smart wards, the five dimensions of perception of usefulness, perception of ease of use, perception safety, attitude and willingness to use were (4.76 ± 0.38),(4.75 ± 0.46), (4.75 ± 0.46), (4.72 ± 0.19), (4.73 ± 0.55), (4.77 ± 0.27) points respectively, the proportion of "very agreed" was 80.16% (295/368); the overall satisfaction of the smart wards scored (4.76 ± 0.35) points, the proportion of "very satisfied" was 79.35% (292/368). Conclusions:The application of the smart ward in the nursing work of inpatients will help optimize the patients′ medical service experience and improve the satisfaction of hospitalization.

A study of the rehabilitation effects of a multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly on patients with cognitive impairment after first-episode stroke / 中国实用护理杂志

Objective:To explore the rehabilitation effect of multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly on patients with cognitive impairment after first-episode stroke, and to provide reference for rehabilitation nursing of cognitive impairment after stroke.Methods:The quasi-experiment research scheme was adopted and convenience sampling method was used to select participants with first-episode stroke cognitive impairment hospitalized in the General Hospital of Tianjin Medical University Airport Site. The 50 patients admitted from January to June 2022 were selected as the control group, and 50 patients admitted from July to December 2022 were selected as the intervention group. The control group received routine rehabilitation nursing and health education, and the intervention group received the Finnish model of prevention of cognitive impairment in the elderly on patients before discharge on the basis of the control group. The Mini-Mental State Examination (MMSE) and Health Education Compliance Assessment Scale for Stroke Patients were used to evaluate the changes of overall cognitive function and rehabilitation compliance before intervention, 3 and 6 months after intervention.Results:The final control group included 49 cases, including 35 males and 14 females, aged (64.67 ± 7.47) years old; the intervention group included 50 cases, 32 males and 18 females, aged (66.68 ± 8.75) years old. Before intervention, there were no significant differences in overall cognitive function and compliance of rehabilitation score ( P>0.05). At 3 and 6 months after intervention, the overall cognitive function score, the total score on compliance of rehabilitation, dimension scores of diet compliance, exercise rehabilitation compliance and health behavior compliance of the intervention group were (26.36±2.36) , (125.96 ± 13.80) , (23.30 ± 5.26) , (27.72 ± 4.46) , (43.66 ± 6.80) and (27.26 ± 3.71) , (152.44 ± 9.06) , (30.12 ± 6.42) , (33.32 ± 3.02) , (52.36 ± 4.70) , respectively. They were higher than the control group (24.04 ± 4.50) , (116.67 ± 10.26) , (19.31 ± 3.95) , (25.29 ± 3.45) , (40.59 ± 4.33) and (24.27 ± 4.33) , (138.92 ± 16.71) , (24.20 ± 4.48) , (30.00 ± 5.53) , (47.65 ± 8.03) , and the differences had statistical significance ( t values were -5.31- -2.67, all P<0.05). According to the variance analysis of repeated measurement, intergroup and time factor, the interaction between groups and time had significant impact on general cognitive function score, the total score of rehabilitation compliance, the dimension scores of diet, exercise rehabilitation and health behavior compliance ( Fgroup values were 8.33-18.08, Ftime values were 135.71-944.69, Finteraction values were 5.46-27.30, all P<0.05) . Time factor had significant impact on patient medication adherence score ( Ftime=206.23, P<0.05) . Conclusions:Multi-factor intervention based on the Finnish model of prevention of cognitive impairment in the elderly can improve the overall cognitive function and rehabilitation compliance of patients with cognitive impairment after first-episode stroke.

Research progress of RNA m6A methylation in post-stroke cognitive impairment / 天津医药

Post-stroke cognitive impairment(PSCI)is mainly manifested as learning and memory disorders.Highly enriched RNA m6A methylation modification in mammalian brain is involved in glial cell-mediated neuroinflammation.Given that neuroinflammation is the main mechanism for neural damage and spatial and memory impairment of PSCI,it is speculated that RNA m6A methylation modification can regulate the inflammatory response of glial cells after stroke to improve PSCI.This review summarizes and analyzes the role of RNA m6A methylation modification in the development of PSCI and analyzes its detailed mechanism of regulating glial cell-mediated inflammation,which will provide reference for researchers in this field.

Correlations between brain function and olfactory function in patients with cerebral small vessel disease and Parkinson's disease based on resting-state functional magnetic resonance imaging / 中国组织工程研究

BACKGROUND:Olfactory dysfunction is an early biological marker of various diseases.However,the neuroimaging mechanism by which olfactory dysfunction occurs following cerebral small vessel disease is unclear. OBJECTIVE:To explore the different neuroimaging mechanisms of olfactory function regulation in patients with cerebral small vessel disease and Parkinson's disease,and explore the potential application value of olfactory function assessment in patients with cerebral small vessel disease. METHODS:Neuropsychological and olfactory tests,high-resolution structural magnetic resonance and resting-state functional magnetic resonance data were collected in 80 patients with cerebral small vessel disease,44 healthy controls and 29 patients with Parkinson's disease.DPABI,SPM12 and SPSS were used to analyze and compare the amplitude of low frequency fluctuation,regional homogeneity and functional connectivity values between the cerebral small vessel disease,control and Parkinson's disease groups.Correlations between the significantly altered resting-state functional magnetic resonance imaging measures and olfactory and cognitive scores were evaluated. RESULTS AND CONCLUSION:Compared with the control group,low-frequency fluctuation amplitude of the right dorsolateral superior frontal gyrus and the regional homogeneity of the left wedge leaf were significantly reduced in the cerebral small vessel disease and Parkinson's disease groups.The right dorsolateral superior frontal gyrus and the left cuneiform lobe are the seed points.Compared with the Parkinson's disease group,the functional connectivity values of the right anterior cunei,inferior temporal gyrus,anterior central gyrus and dorsolateral superior frontal gyrus,left posterior central gyrus and inferior temporal gyrus were significantly enhanced in the control and cerebral small vessel disease groups.The left cuneiform lobe was the seed point.Compared with the control group,the functional connectivity of the left lingual gyrus was significantly weakened in the cerebral small vessel disease and Parkinson's disease groups.The functional connectivity values of the left middle temporal gyrus and the right posterior central gyrus were enhanced in the control group compared with the cerebral small vessel disease and Parkinson's disease group,and that was enhanced in the cerebral small vessel disease group compared with the Parkinson's disease group.Correlation analysis showed that the olfactory score and cognitive score were positively correlated in the cerebral small vessel disease group,and the regional homogeneity of the left wedge lobe was negatively correlated with the Montreal Cognitive Assessment Scale score,while the functional connectivity of left wedge lobe-left middle temporal gyrus in the Parkinson's disease group was positively correlated with the olfactory recognition score,and the functional connectivity values of the left wedge lobe-left posterior central gyrus and left wedge lobe-left lingual gyrus were positively correlated with the olfactory identification score and the total olfactory score,respectively.The regulation of olfactory function in patients with cerebral small vessel disease has a different neuroimaging mechanism from that of olfactory dysfunction in patients with Parkinson's disease.The olfactory function of patients with cerebral small vessel disease is related to cognitive function.It is speculated that the olfactory function following cerebral small vessel disease is a secondary change of brain dysfunction,while olfactory dysfunction following Parkinson's disease is directly caused by abnormal function of olfactory-related brain areas.Olfactory function assessment in patients with cerebral small vessel disease has potential application in predicting cognitive function.