Comparing cognition, coping skills and vedic personality of individuals practicing yoga, physical exercise or sedentary lifestyle: a cross-sectional fMRI study.

BACKGROUND: Nature and intensity of physical activity may influence cognition, coping mechanisms and overall personality of an individual. The objective of this cross-sectional study was to compare cognition, coping styles and vedic personality among individuals practicing different lifestyle. METHODS: Thirty-nine healthy young adults of both gender (27.63±4.04 years) were recruited and categorized into three groups; i.e. yoga, physical activity or sedentary lifestyle groups. Participants were assessed on cognition, coping styles and Vedic personality inventory (VPI). Verbal-n-back and Stroop tasks were performed using 3 Tesla MRI scanner. Task Based Connectivity (TBC) analysis was done using CONN toolbox in SPM. RESULTS: There were no significant differences in the cognitive domains across the groups. The planning (p=0.03) and acceptance domain (p=0.03) of the Brief COPE scale showed difference across the groups. Post-hoc analysis revealed that planning and acceptance scores were distinctly higher in the physical activity group, however, there was no difference between physical activity group and yoga practitioners. Similarly, in the VPI, Sattva (p=0.003), Rajas (p=0.05) and Tamas (p=0.01) were different across the groups, and the post hoc analysis showed superiority in Sattva scores in Yoga group, meanwhile, both Rajas and Tamas were higher in the physical activity group. Yoga practitioners preferentially recruited left Superior Frontal Gyrus in relation to the physically active group and precuneus in relation to the sedentary lifestyle group. CONCLUSION: The study revealed that yoga practitioners had a distinct higher sattva guna and preferentially recruited brain areas associated with self-regulation and inhibitory control.

Cognitive impairment in spinocerebellar ataxia type 12.

INTRODUCTION: Cognitive impairment has now been recognised to be present in patients with several of spinocerebellar ataxias (SCAs). Cognitive impairment in patients with spinocerebellar ataxia type 12 has not been evaluated. OBJECTIVE: To evaluate the cognitive impairment in patients diagnosed with spinocerebellar ataxia type 12 (SCA12). METHODS: We conducted a cross sectional study and enrolled 30 (20 male and 10 female) genetically confirmed SCA12 patients and 30 healthy, age, gender and education matched individuals as controls. Cognitive domains were tested using a battery of validated neurocognitive tests. RESULT: Mean age of patients was 51.6 ± 8.0 years and mean disease duration was 5.3 ± 3.0 years. Mean International Cooperative Ataxia Rating Scale (ICARS) score was 29.8 ± 12.5. SCA 12 patients scored significantly lower than controls in executive function and new learning ability. Other tested cognitive domains were also affected but did not reach statistical significance. Age, age at onset, severity of ataxia, disease duration and CAG repeat length did not correlate with cognitive impairment. CONCLUSION: Cognitive impairment is a part of the spectrum of SCA12 and is characterized by dysfunction in executive function and new learning ability even early in the course of disease.

Development and Validation of a Comprehensive Neuropsychological and Language Rehabilitation for Stroke Survivors: A Home-Based Caregiver-Delivered Intervention Program.

CONTEXT: Aphasia is a major disabling condition after a stroke that profoundly affects the quality of life of stroke survivors (SS) and their caregivers. Comprehensive neuropsychological rehabilitation has emerged as a complementary intervention that helps in improving the associated cognitive and psychological deficits and quality of life following a brain injury. A standardized, simple, and easy to administer intervention that can be delivered as a home-based intervention can assist in faster recovery. AIMS: To describe the development, validation, and feasibility of a home-based, caregiver-delivered comprehensive neuropsychological and language rehabilitation for SS. METHODS AND MATERIAL: A culture-specific picture and task-based 8-week training workbook and manual were developed based on extensive review and focused group discussions. This intervention targeted areas of language (comprehension, fluency, and naming) and cognition (working memory, attention and concentration, executive functioning, and response inhibition). It was standardized on 40 healthy controls (HC) and 15 SS. Before recruitment, written informed consent was obtained from each patient, their primary caregiver, and the HCs. RESULTS: All tasks were found to be effective in discriminating the performance of SS from the HC. The performance of the HC with respect to the errors and the time taken for each task was used for the hierarchical arrangement of the tasks. The developed intervention was later validated on 15 SS where they significantly improved in the pre-post assessment of language functioning (P < 0.001), quality of life (P < 0.001), and depression (P < 0.001). CONCLUSIONS: This intervention can be feasible to administer as a home-based intervention and may help to alleviate language and neuropsychological complaints after stroke in low-literate or mixed-cultural populations. Further, large sample size studies are recommended.

Development of neuropsychological evaluation screening tool: An education-free cognitive screening instrument.

BACKGROUND: Due to the paucity of quick, cognitive screening tools available in India that are independent of cultural and educational influences, a 6-item paper and pencil test, covering areas of memory, executive functioning, attention, and visuospatial ability domains - the Neuropsychological Evaluation Screening Tool (NEST) was developed. AIM AND METHOD: NEST was administered to 84 healthy controls to analyze, revise, and review items. In the second phase, 408 patients, above 16 years of age, with their educational level ranging from being illiterate to having greater than 25 years of education, with various neurological and psychiatric conditions were independently administered NEST, Hindi Mental State Examination (HMSE), and a detailed cognitive evaluation using PGI Memory Scale (PGIMS). RESULTS: Using receiver operating characteristics analysis for 341 patients, ≥3 was identified as the optimum cut-off for NEST. NEST could correctly classify 87.9% of the patients with an impaired vs. an intact cognition. The diagnostic characteristics of NEST with PGIMS were sensitivity (95% CI): 94.78% (91.1, 97.3); specificity (95% CI): 60.31% (51.3, 68.7); positive predictive value (95% CI): 80.74% (78.1, 93.0); and negative predictive value (95% CI): 86.81% (75.6, 85.3). NEST had an 82.5% agreement (95% CI: 78.1, 86.2) with PGIMS. On the other hand, the diagnostic characteristics of HMSE with PGIMS were sensitivity (95% CI): 73.79% (67.5, 79.3); specificity (95% CI): 82.44% (74.8, 88.5); positive predictive value (95% CI): 88.02% (82.5, 92.2); and negative predictive value (95% CI): 64.3% (56.5, 71.5). HMSE had a 76.95% (95% CI: 72.2, 81.1) agreement with PGIMS. CONCLUSIONS: NEST has better sensitivity compared to HMSE for detecting cognitive impairment when compared to a detailed evaluation at all educational levels.

Translation and Adaptation of Stroke Aphasia Depression Questionnaire-10 to Hindi.

BACKGROUND: Depression is one of the most researched emotional responses after stroke and shows that the emotional impact of aphasia can have a marked negative impact on recovery, response to rehabilitation, and psychosocial adjustment. There is an evident dearth of validated instruments to assess depression in people with aphasia including Hindi, the national language of the country. AIMS: The aim of this study was to translate and adapt the original English version of widely used hospital version of Stroke Aphasia Depression Questionnaire (SADQ-10) to Hindi. SUBJECTS AND METHODS: English version of SADQ-10 was translated and adapted for the use in Hindi-speaking population in concordance to the WHO guidelines. STATISTICAL ANALYSIS USED: The intraclass correlation coefficient (ICC) analysis of the data was performed using SPSS, version 16, to compute the test-retest reliability. RESULTS: The Hindi version of SADQ-10 yielded an overall high test-retest reliability (ICC = 0.91) as well as internal consistency (α = 0.98), which in turn were comparable to the original instrument in English. CONCLUSIONS: SADQ10-Hindi may assist the identification of depressed mood in patients with speech and language impairment in an Indian population as well. It is an easy to administer and quick test which can be used by health-care professionals in a hospital- or community-based settings.

Moyamoya Disease: a ray of hope from a psychosocial perspective.

Moyamoya disease (MMD) is a rare blood vessel disorder occurring in people from Japan and other Asian countries, but people in other countries also have been diagnosed with MMD. Impaired neuropsychological functioning is a common sequelae of MMD in children as well as adults. We report a male, diagnosed as MMD at 8 years who was referred for neuropsychological evaluation (NPE) at 12 year, revealed impaired intellectual functioning with moderate retardation on social adaptive functioning. After 2 years of follow up, post psychosocial intervention, the patient showed remarkably upward trend in his social adaptive functioning, with shift in his intellectual functioning by 21 I.Q. Points thereby brining him to mild category of mental retardation. Therefore, this rare case shows improved neuropsychological functioning, highlighting importance of interplay between nature and nurture roles. Hence, NPE is sensitive in comparing and drawing inferences for neuropsychological rehabilitation and pharmacological management for such patients.