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BackgroundThere exist differences in the subjective and objective cognitive functions of patients with depressive disorder， ane there are limited research on influencing factors of such phenomenon currently. ObjectiveTo explore the differences in subjective and objective cognitive function in patients with depressive disorder as well as influencing factors， and to provide references for further understanding of cognitive impairment in patients with depressive disorder. MethodsA total of 77 patients with depressive disorder who received outpatient or inpatient treatment in the Fourth People's Hospital of Chengdu from January 13， 2022 to December 11， 2023 were selected for the study. These patients also met the diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition（DSM-5）. Various tools were employed to assess patients in this study： Montgomery-Asberg Depression Rating Scale （MADRS） for the depressive symptoms， Perceived Deficits Questionnaire for Depression （PDQ-D） and Chinese Version of Brief Neurocognitive Test Battery （C-BCT） for the subjective and objective cognitive function， Sheehan Disability Scale （SDS） for the social function， and Clinical Global Impression-Severity of Illness（CGI-SI） for the severity of patient's condition. Pearson correlation analysis was used to examine the correlation of subjective and objective cognitive function and their differences with age， years of education， MADRS total score， SDS total score， and CGI-SI score. Multiple linear regression was used to explore the influencing factors of the differences between subjective and objective cognitive function. ResultsThere was a statistically significant difference in the total PDQ-D scores and the difference of subjective and objective cognitive function （D value） between depressive patients with and without medication （t=-4.228， -2.392， P<0.05 or 0.01）. There was no statistically significant correlation in subjective and objective cognitive function in patients with depressive disorder （r=-0.148， P>0.05）. Negative correlations can be observed between the PDQ-D total score and age or years of education （r=-0.333， -0.369， P<0.01）. The PDQ-D total score was positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.487， 0.637， 0.434， P<0.01）. D value was negatively correlated with age and years of education （r=-0.411， -0.362， P<0.01）， while positively correlated with MADRS total score， SDS total score and CGI-SI score （r=0.259， 0.468， 0.299， P<0.05 or 0.01）. Age （β=-0.328， P<0.01） and SDS total score （β=0.409， P<0.01） were two predictive factors for D value. ConclusionThe difference between subjective and objective cognitive function among patients with depressive disorder is related to several factors including age， years of education， severity of symptoms and impairment of social function. ［Funded by Surface Project of National Natural Science Foundation of China （number， 62173069）； Technological Innovation 2030-Major Project of "Brain Science and Brain-Like Research" （number， 2022ZD0211700）； Key R&D Support Program and Major Application Demonstration Project of Chengdu Science and Technology Bureau （number， 2022-YF09-00023-SN）］
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ObjectiveThe purpose of this study was to investigate the effects of transcutaneous electrical acupoint stimulation (TEAS) on cognitive function of vascular dementia (VD) rats and its mechanism. MethodsVD rat model was established by modified two-vessel occlusion (2-VO). After modeling, TEAS and electroacupuncture (EA) were used to stimulate Baihui and Zusanli points of rats respectively for 14 d. After treatment, novel object recognition test, Morris water maze test, and Y maze test were used to evaluate the spatial memory and learning ability of rats. Hematoxylin and eosin staining was used to observe the morphology of hippocampal neurons. Transmission electron microscopy was used to observe the ultrastructure of hippocampal mitochondria. Enzyme-linked immunosorbent assay kits were used to detected the levels of SOD, CAT, GSH-Px, MDA and ROS in serum of rats. Western blot was used to detect the expression of PGC-1α, TFAM, HO-1, NQO1 proteins in the hippocampus, Keap1 protein in the cytoplasm and Nrf2, NRF1 proteins in the nucleus. ResultsAfter treatment for 14 d, compared to the model group, the escape latency of VD rats decreased, while the discrimination index, the times of rats crossing the original platform area, the residence time in the original platform quadrant, and the percentage of alternation increased. TEAS can improve the structure of hippocampal neurons and mitochondria of VD rats, showing that neurons were arranged more regularly and distributed more evenly, nuclear membrane and nucleoli were clearer, and mitochondrial swelling were reduced, mitochondrial matrix density were increased, and mitochondrial cristae were more obvious. The levels of SOD, GSH-Px and CAT in serum increased significantly, while the concentration of MDA and ROS decreased. TEAS also up-regulated the expression levels of PGC-1α TFAM, NQO1 and HO-1 proteins in the hippocampus and Nrf2, NRF1 proteins in the nucleus, but down-regulated the Keap1 protein in the cytoplasm. ConclusionTEAS can improve cognition, hippocampal neurons and mitochondrial structure of VD rats, and the effect is better than EA. The mechanism may be the activation of PGC-1α mediated mitochondrial biogenesis and antioxidant stress, which also provides a potential therapeutic technology and experimental basis for the treatment of VD.
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Objective:To explore the association between grip strength and cognitive function in elderly people aged 65 years and over.Methods:Information on grip strength, cognitive function, and lifestyle in the elderly population aged 65 years and over in Wuhan was collected by unified professionally trained investigators.A total of 533 study subjects aged(70.7±5.1)years were grouped by quartile into four grip strength groups of Q1(<18.6 kg), Q2(18.6~24.1 kg), Q3(24.2~31.1 kg), Q4(>31.1 kg).Multiple linear regression and Logistic regression analyses were used to analyze the relationship of grip strength with cognitive function scores and cognitive impairment.Results:The mean grip strength of the 533 subjects was(24.94±9.15)kg.After adjusting for sociodemographic characteristics, lifestyle factors, history of diseases, as compared with grip strength Q1 group, the linear regression coefficients(Beta value)of cognitive scores and 95% confidence intervals(95% CI)showed statistically significantly positive correlation[0.45(-0.36, 1.26)、0.40(-0.52, 1.32)and 1.19(0.07, 2.31), all P<0.05]only between cognitive scores and grip strength Q2、Q3 and Q4 value; and the odds ratio and 95% CI of incidence of cognitive impairment were 0.97(0.43, 2.21)for grip strength Q2, 0.79(0.30, 2.06)for grip strength Q3, and 0.22(0.05, 0.92)for grip strength Q4.Considering grip strength as the continuous variable, the risk of cognitive impairment was decreased by 6% and the cognitive score was increased by 0.07 with per 1kg increase of grip strength. Conclusions:The results of this study suggest that there is a positive correlation between grip strength and cognitive function in the elderly population, and a lower grip strength is related to increased risk of cognitive impairment.More attention should be paid to the grip strength of the elderly in the community.
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Objective To observe the effect of edaravone (ED) on cognition function and expression of Nogo-A in prefrontal cortex neuron of rats with serious intermittent hypoxia.Methods Ninety-six adult male Wistar rats were randomly divided into normal control group, chronic intermittent hypoxia (CIH) model group and ED group, 32 rats in each group. The rat model of CIH was reproduced in a low oxygen box at 08:00-15:00 every day: alternatively, different flow rates of nitrogen and compressed air were given, 120 seconds being one cycle, maintaining the oxygen concentration at 5%-21% in the low oxygen chamber; the normalcontrol group was continuously under the circumstance fulfilled with compressed air. The rat in ED group was given intravenous injection of 3 mg/kg ED in a tail vein at 07:00 daily. After modeling for 7, 14, 21, 28 days, the learning and memory functions of rats were assessed with the Morris water maze test, and the reactive oxygen species (ROS) content in the rat prefrontal lobe tissue was detected; the level of Nogo-A protein expression in the rat prefrontal cortex was examined by immunohistochemical method .Results ① Rat learning results: in CIH model group, with the time prolongation escaping latency period was gradually longer, since 14 days after the modeling, the difference was statistically significant compared with that in normal control group, while the learning time in ED group was obviously shorter than that in the CIH model group (seconds: 14 days was 26.97±3.35 vs. 34.95±3.36, 21 days was 32.78±4.59 vs. 46.72±4.11, 28 days was 41.39±3.84 vs. 57.35±3.72, allP < 0.05). ② Rat memory results: the rats in CIH model group, with the time prolongation crossing the target quadrant time was gradually shorter, since 14 days after the modeling, the difference was statistically significant compared with that of the normal control group, while the memory time in the ED group was obviously longer than that of the model group (seconds: 14 days was 42.72±3.35 vs. 39.88±3.56, 21 days was 40.48±4.62 vs. 28.72±3.93, 28 days was 31.13±3.46 vs. 22.79±3.24, allP < 0.05). ③ ROS content: with the time prolongation, ROS content was gradually increased in CIH model group, but the ROS content in ED group was significantly lower than that in CIH model group at various time points (MU/L: 7 days was 13.27±0.23 vs. 17.68±0.51, 14 days was 15.51±0.28 vs. 20.41±0.65, 21 days was 20.29±0.44 vs. 23.86±0.35, 28 days was 24.46±0.53 vs. 30.43±0.85, allP < 0.05). ④ Protein expression of Nogo-A: with the time prolongation, the protein expression of Nogo-A was gradually increased in CIH model group, they reached the peak on the 14th day, the expression of Nogo-A [absorbance (A) value] in ED group were significantly lower than that in CIH model group at each time point (×103: 7 days was 4.80±0.70 vs. 5.99±0.62, 14 days was 5.89±0.90 vs. 7.42±0.66, 21 days was 4.92±0.64 vs. 5.90±0.37, 28 days was 3.59±0.59 vs. 4.27±0.40, allP < 0.05).Conclusions The mechanism of ED has a valid therapeutic effect on the cognitive dysfunction induced by serious intermittent hypoxia in rats, ED can remove oxygen free radicals and inhibit the protein expression of Nogo-A in the prefrontal cortex, so ED can alleviate the damage of cognitive function in rats with CIH.
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Objective To investigate the relationship between nutritional risk and cognitive score in pa-tients with acute stroke .Methods From January 2015 to December 2015, 160 inpatients with acute stroke were observed and divided into two groups according to Nutritional Risk Screening 2002 (NRS 2002) scores.All the patients were on natural diets and did not receive enteral or parenteral nutrition support .Cognitive functions were evaluated using the Mini-Mental State Examination ( MMSE) within 24 hours and 6 months after the acute cere-bral artery diseases .Logistic regression analysis was performed to investigate the effects of nutritional risks on the cognition.Results Totally 145 patients entered the final analysis , among whom 72 had nutritional risks and 73 had no nutritional risks .The average ages of patients with nutritional risks were significantly older than those without nutritional risks [ (67.04 ±8.95) years vs.(63.10 ±9.12) years, P=0.027], along with significantly higher incidence of diabetes (75.0%vs.49.3%, P=0.001).The lesion locations showed no statistically signif-icant difference between two groups ( frontal lobe 24.5%vs.17.5%, P=0.670;parietal lobe and occipital lobe 40.8%vs.26.3%, P=0.398;basal ganglia region 51.0%vs.49.1%, P=0.490;brain stem and cerebellum 53.0%vs.42.1%, P=0.777).Compared to the patients without nutritional risks , the MMSE scores of the pa-tients with nutritional risks were lower within 24 hours, but without statistical significance (27.45 ±2.21 vs. 28.09 ±1.27, P=0.209);however, six-month follow-up showed that the MMSE scores were significantly differ-ent between two groups (24.70 ±2.16 vs.27.43 ±2.32, P=0.036).Univariate Logistic regression analysis was used to evaluate factors associated with cognitive impairment (MMSE<27).NRS 2002, ages, diabetes mellitus history, and body mass index entered in the Logistic regression analysis .In all patients, ages and NRS 2002 had a positive correlation with cognitive impairment (P=0.000, OR=1.156;P=0.004, OR=2.341).Conclusion The cognitive function in stroke patients with nutritional risks is worse than in patients without nutritional risks .
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Objective To investigate the risk factors for early postoperative cognitive function in the patients with peritoneal surface malignancies after cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy(CRS-HIPEC).Methods Fifty-one patients(21 men and 30 women), ranged from 25 to 65 years,42-80 kg,ASA Ⅰ-Ⅲ,undergoing CRS-HIPEC under combined intrave-nous-inhalational anesthesia,were studied.Patients were assigned into postoperative cognitive dys-function (POCD)group or non-POCD group according to their performances of visual verbal learning test,concept shifting task,letter-digit coding test and stroop color-word test 1 day before operation and 7 days after operation.Years of education,medical history,duration of operation,intraoperative blood loss,frequency of cardiovascular events,amount of fluid infused per hour and VAS scores were recorded.Venous blood samples were taken at five time points:before surgery(T0 ),30 minutes after the beginning of the procedure(T1 ),30 minutes after the beginning of HIPEC(T2 ),at the end of the surgery(T3 )and 24 hours after the surgery(T4 ),to determine the concentration of serum amyloid A (SAA).pH,PaCO 2, Hb,blood glucose were recorded at T0-T2.Then the data was statistically analyzed.Results According to the diagnostic criteria,twenty patients developed POCD 20 (39.2%). There were significant differences between POCD and non-POCD groups on age,gender, pre-operative complications and the origin of tumor(P <0.05).The concentration of SAA increased from T2 and reached the peak at T4 ,and SAA concentration for patients in POCD group was higher than that for patients in non-POCD group(P <0.05).Compared with non-POCD group,the levels of blood glucose were significantly increased in POCD group at T2 (P <0.05).Conclusion CRS-HIPEC resul-ted in exaggerated and prolonged inflammatory response.Advanced age,female,diabetes,hyperten-sion,peritoneal carcinomatosis from ovarian cancer and endometrial cancer are associated with early POCD in the patients undergoing CRS-HIPEC.
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Objective To investigate the differences of the working memory tasks' performance between the patients with no neurological syphilis disease and the health controls (HC).Methods 2-back test of N-back task paradigm were applied to measure the performances of working memory.A total of 30 patients with syphilis disease were compared with 35 gender-,age-,years of education-matched healthy persons,then compared the accurate rate and reaction time on the tasks between the two groups.Results Participants with anxiety or depression had to be excluded.The results showed that patients impaired on working memory task.The accurate rate and reaction time of the working memory of the patients was worse than that of the healthy persons ((65.31 ± 8.78) ％ vs (71.00 ±9.64)％ ;(1521.14 ±290.57)ms vs (1296.08 ±253.20)ms respectively) (t=-2.472,P=0.016;t=3.337,P =0.001 respectively).The study indicated the reaction time of the working memory for the patients was negative correlation to the age of final diagnosis (r =-0.362,P =0.049).Conclusion The patients with no neurological syphilis disease show impairment on working memory.This probably because treponema pallidum injures the central nervous system.
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Objective To investigate the effect of dexmedetomidine on cognitive dysfunction after offpump coronary artery bypass grafting in patients.Methods Fifty-eight ASA physical status Ⅱt or Ⅲ patients,aged 51-63 yr,weighing 52-83 kg,undergoing off-pump coronary artery bypass grafting,were randomly divided into 2 groups (n =29 each):control group (group C) and dexmedetomidine group (group D).Anesthesia was induced with midazolam,etomidate,sufentanil and pipecuronium.The patients were thracheal intubated and mechanically ventilated.Anesthesia was maintained with propofol,sufentanil,isoflurane and pipecuronium.A loading dose of dexmedetomidine 1 μg/kg was infused over 15 min after tracheal intubation,followed by dexmedetomidine infusion at 0.5 μg· kg-1 · h-1 until the end of operation in group D,while the equal volume of normal saline was infused in group C.Cognitive function was assessed by Mini-Mental State Examination (MMSE) at 24 h before operation and 24,48 and 72 h after operation.The development of postoperative cognitive dysfunction was recorded within 72 h after operation.The consumption of sufentanil and extubation time after extubation was recorded.Results Compared with group C,MMSE scores at 24 and 48 h after operation were significantly increased and the incidence of postoperative cognitive dysfunction within 72 h after operation was decreased (P ＜ 0.05),and no significant change was found in the consumption of sufentanil and extubation time in group C (P ＞ 0.05).Conclusion Dexmedetomidine can decrease the development of postoperative cognitive dysfunction after off-pump coronary artery bypass grafting in patients.
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ObjectiveTo investigate the relationship between 10 cGy whole brain radiation and cognitive dystunction.MethodsThirty-two male Sprague-Dawley rats at age one month were randomized into irradiation and sham exposed groups.Behavioral and histopathological tests were performed 3 months after irradiation in the order of open field,Morris water maze,passive avoidance,and histopathological test.Comparison between the two groups was conducted using independent samples t-test.ResultsIn the place navigation test of Morris water maze,irradiation group showed significantly longer latency than sham exposed group on day 3 and 4 ( t =2.91 and 2.65,all P ＜ 0.05 ).In the total latency of the place navigation,irradiation group also presented longer latency comparing with sham exposed group ( t =2.63,P ＜ 0.05 ).In the spatial probe test of Morris water maze,the open field test and the passive avoidance test showed no significant difference between the two groups ( t =0.92,0.59,0.83,all P ＞ 0.05 ).The histopathological examination had no significant difference either.ConclusionWhole brain radiation of 10 cGy could partly injury the cognitive function of the rat.
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Objective To investigate the cognitive, intelligent and cranial MRI status of 4 patients with myotonic dystrophy type 1 (DM1). Methods A pedigree of 4 patients,admitted to our hospital from September 2011 to December 2011 and diagnosed as having DM1, were chosen in our study; Chinese edition tests of Wechsler adult intelligence scale and Wechsler memory scale were used to test the intelligence of these patients; Montreal cognitive assessment (MoCA) and Neurobehavioral cognitive status examination (NCSE) were applied to evaluate the patients' cognitive function.All of the 4 patients received a cranial MRI scan. Results Except for 1 patient,the other 3 patients had low intelligent quotient (IQ) and memory quotient (MQ),and their verbal IQs were all lower than performance IQs.Three patients showed impaired visual space/executive skills,calculation,memory,and conceptual thinking abilities; 1 patient showed impaired sentence repetition and verbal fluency on MoCA,though his final scores were within normal range. Three patients had brain atrophy to some extent on MRI scan,prominently in the frontal lobe and temporal lobe; white matter lesions and thickened skull were founded in all 4 patients. Conclusion Multiple cognition disorders and brain involvements can be found in DM1 patients and deserve further investigation.
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@#Objective To investigate the correlation between levels of glycohemoglobin and cognitive function in elderly patients with type 2 diabetes. Methods Cognition function of 40 elderly patients with type 2 diabetes was assessed by Wechsler Memory Scale (WMS), Trail Marking Test and Wisconsin Card Sorting Test (WCST) and was compared with 40 healthy controls matched for age, gender, education level and profession. Meanwhile, the correlation between cognition function and levels of glycohemoglobin was analyzed by regression analysis.Results The scores of Wechsler Memory Scale in the patients were lower than that in normal controls (P＜0.01，P＜0.05). The patients needed much more time to complete the Trail Marking Test (P＜0.001). The scores of Wisconsin Card Sorting Test were significantly different between two groups (P＜0.01，P＜0.05). The regression analysis showed that there was an obvious correlation between serum level of glycohemoglobin and cognition functions in patients with type 2 diabetes(r=-0.38, -0.43, -0.48, -0.46, 0.41, P＜0.05). Conclusion Cognition function decreases and significantly correlates with the level of glycohemoglobin in the elderly patients with type 2 diabetes.
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Objective To study the impairnlent of cognitive function and the change of P300 event-related potential(ERP)parameters in the patients with tumor in frontal lobe so as to investigate the role of the front lobe in cognitive function and the P300 production. Methods P300 examination and neuropsychological tests for cognition,including Stroop Test,Symbol Digit Modalities Test,and Verbal Fluency Test,et al,were performed in 31 patients with tumor in front lobe(left 15 and right 16)and 30 healthy controls. Results Compared with healthy controls, in the patients with front lobe tumor,cognitive function was degraded(P＜0.05),the latency of N3,P3 of P300 was significantly longer,and the amplitude of P3 was significantly lower(P＜0.05).Funhermore,the patients with tumor in right front lobe had signmcantly lower scores in cognitive tests compared with healthy controls (P＜0.05), but the ones with tumor in left front lobe were demonstrated obviously impaired only in Verbal Fluency Test(P＜0.05).Compared with healthy controls, the patients with tumor in eimer right or left flront lobe, the latency of N3,P3 of P300 was significantly longer,the amplitude of P3 was significantly lower(P＜0.05),while in the comparison of two sides, there was no statistically significantly difference in P300 (P＞0.05).Conclusions The cognitive function is obviously impaired in the patients with tumor in frontal lobe,and the impainnent is more serious in the ones with right frontal lobe tumor. Frontal lobe may be related to the generation and transmission of P300,and it is not significantly different in between left and right frontal lobes.
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@#ObjectiveTo observe effects of early rehabilitation and hyperbaric oxygen treatments on stroke patients.Methods80 patients were randomly divided into rehabilitation group (40 cases) and control group (40 cases). Patients in rehabilitation group were treated with rehabilitation and hyperbaric oxygen treatments; patients in control group were treated only with hyperbaric oxygen treatment. The activities of daily living (ADL) were assessed by modified Barthel index (MBI), and the cognition function was measured by mimi-mental state examination (MMSE).ResultsAfter treatment the scores of MMSE and MBI of two groups increased (P<0.05) and scores of rehabilitation group were higher than that of control group (P<0.05); the process of scores in rehabibilitation group were obviously superior to that in control group (P<0.001).ConclusionEarly rehabilitation and hyperbaric oxygen treatments can obviously improve cognition function and ADL of stroke patients.
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Objective To investigate the changes and their relationship between cognitive function and event-related potentials(ERP)in patients with carotid atherosclerosis.Methods 65 patients with varying degrees of carotid atherosclerosis were carried out Mini-Mental State Examination(MMSE)and Frederick ERP P300 investigation and correlation analysis was done,compared with the control group.Results Compared with the control group,account ability,short-term memory and graphics portrayed score decreased in mild and moderate carotid atherosclerosis group(all P
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Objective To investigate the changes of non-linear dynamics properties of EEG under different mental tasks,and the application of non-linear dynamic analysis for cognitive function research. Methods EEG was recorded in 30 healthy university students under four states: eyes closed,eyes open,mental arithmetic with eyes closed and graphic reasoning test with eyes open.Correlation dimension (D 2) and point-wise correlation dimension (PD 2) were calculated for all subjects.We also performed a surrogate data test in 5 randomized selected subjects. Results In all states tested,the results argued for the presence of non-linearity and fractal D 2 and PD 2.D 2 and PD 2 increased significantly during mental tasks as compared to the rest states (D 2 of above four states was 3.93,4.47,4.33 and 4.98 respectively).The results showed that values of D 2 and PD 2 fluctuated with time,which suggests an intermittent activation of the brain areas participated in the task.With non-linear dynamic analysis,there might be a working circuit from bilateral temporal lobes to the left frontal lobe and parental lobe under mental arithmetic task.Conclusions Through dynamic analysis based on D 2 and PD 2 topographic maps,we can see clearly the distribution of D 2 and PD 2 in the brain,the sequence and the degree of activation of the regions involved in the cognitive task under mental tasks.Dynamic and short-time non-linear analysis methods are more appropriate for the study of mental functions.Non-linear dynamic analysis might help us understand the working mechanism of brain during mental activities.
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0.05 ). MMSE, HDS scores of patients and the concentration of AVP could be obviously elevated (P
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Objective To explore the relevance among the cognition function,the autonomic nerve function,and the serum level of monoamine neurotransmitter in the patients with post-stroke depression(PSD).Methods The event-related potentials(ERP),the sympathetic skin response(SSR),and the serum levels of monoamine neurotransmitter were taken in the 33 cases with PSD(PSD group)and 30 normal collators(NC group),the mean of each target was tested by Pearson multiple correlation analysis.Results Comparing with the NC group,the PSD group demonstrated that the latency phase had been prolonged and the wave amplitude reduced significantly(all P
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Objective To study the change of P 300 in patients with acute puffer poisoning.Methods With medicid-03E brain evoked potential instrument of Neuronic Company. the latency and the amplitude of P 300 evoked by visual (image) and audio stimulation were measured in 21 patients with acute puffer poisoning, these patients were compared with 30 normal subjects and compared with the P 300 during different condition of poisoning.Results The latency of P 300 evoked by visual (image) and audio stimulation in patient group was significantly prolonged as compared with the control group (P