Cognitive and psychopathological outcomes in acute disseminated encephalomyelitis.

Individuals with acute disseminated encephalomyelitis (ADEM) can experience persistent cognitive deficits and psychopathology, which significantly interferes with daily functioning and quality of life. Here, we review the current literature to characterise the cognitive and psychological sequelae, suggest avenues for further research and discuss the implications for clinical practice. Research on this topic is largely limited to the paediatric population with a few case studies in the adult population. The current evidence demonstrates persistent cognitive deficits in attention and information processing speed, as well as elevated symptoms of depression and anxiety. Results are mixed for executive functions and memory, while language and visuospatial functions are relatively undisturbed. There is emerging evidence to suggest that individuals-particularly children-with ADEM experience persistent cognitive deficits and suffer from elevated symptoms of depression and anxiety. Comprehensive neuropsychological assessments are recommended to guide intervention and monitor progress. Further research is required to clarify our understanding of the cognitive and psychological outcomes following ADEM and the factors that influence them.

Cognitive and psychopathological features of neuromyelitis optica spectrum disorder and myelin oligodendrocyte glycoprotein antibody-associated disease: A narrative review.

Clinicians are becoming increasingly aware of the cognitive and psychopathological consequences of neurological diseases, which were once thought to manifest with motor and sensory impairments only. The cognitive profile of multiple sclerosis, in particular, is now well-characterised. Similar efforts are being made to better characterise the cognitive profile of other central nervous system inflammatory demyelinating autoimmune disorders. This review discusses the current understanding of the cognitive and psychological features of neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD). Detailed analysis of the cognitive sequelae of the above conditions can not only assist with understanding disease pathogenesis but also can guide appropriate management of the symptoms and consequently, improve the quality of life and long-term outcomes for these patients. This narrative review will also identify research gaps and provide recommendations for future directions in the field.

Cognition following chimeric antigen receptor T-cell therapy: A systematic review.

BACKGROUND: This systematic review aimed to characterise the cognitive outcomes of patients who received chimeric antigen receptor T-cell therapy. METHODS: A systematic search of the literature was performed using PubMed, PsycINFO, SCOPUS, EMBASE, Medline, and CINAHL (February 2023). Risk of bias was assessed using the JBI Checklist for Case Reports and the Risk of Bias Assessment Tool for Non-randomised Studies. RESULTS: Twenty-two studies met inclusion criteria with a total of 1104 participants. There was considerable methodological heterogeneity with differing study designs (e.g., cohort studies, clinical trials, case studies, a qualitative interview, and a focus group), measures of cognition (e.g., self-report, neuropsychological measures, clinician assessed/neurological examinations), and longest follow-up time points (i.e., five days to five years). DISCUSSION: Results of the studies were heterogenous with studies demonstrating stable, improved, or reduced cognition across differing time points. Overall, cognitive symptoms are common particularly in the acute stage (<2 weeks) post-infusion. Most deficits that arise in the acute stage resolve within one to two weeks, however, there is a subset of patients who continue to experience and self-report persistent deficits in the subacute and chronic stages. Future studies are needed to comprehensively analyse cognition using a combination of self-report and psychometric measures following chimeric antigen receptor T-cell therapy in the acute, subacute, and chronic settings.

Sensitivity of Video-Based Pulse Arrival Time to Dynamic Blood Pressure Changes.

Estimating blood pressure (BP) from pulse arrival time (PAT) by image-based (skin video) photoplethysmography (iPPG) is of increasing interest due to the non-contact method advantage (over cuff-based methods) and potential for BP measurement to be built into portable devices such as mobile phones. The relationship between pulse transit time extracted from iPPG has been investigated during stable BP. The sensitivity of beat-to-beat iPPG-PAT to dynamic changes in BP has not been explored. This study investigated the correlation between iPPG-PAT and diastolic BP (DBP) during 1-minute seated rest and 3-minute isometric handgrip exercise. 15 healthy participants (9 female, 34±13 years) were recruited. Video was recorded from subjects' faces at 30 frames per second using a standard web-camera with simultaneous measurement of the electrocardiogram and noninvasive finger BP. The iPPG waveform was from the averaged green channel intensity of regions of the forehead or cheek. PAT was calculated from the R-wave ofthe electrocardiogram to the foot of the iPPG or finger BP waveform respectively for direct comparison. Handgrip exercise caused a steady increase in DBP (75±9 to 87±13 mmHg, p<0.001). Beat-to-beat iPPG-PAT and DBP was negatively correlated (mena ±SE -1.33±1.70 ms/mmHg, P=0.0024) as was finger-PAT (mean ±SE -0.5S ±0.39 ms/mmHg, P<0.001). The proportion of individual significant negative regression slopes between DBP and finger-PAT and between DBP and iPPG-PAT was not significantly different. Despite high variability of the correlation between iPPG-PAT and DBP among subjects, iPPG-PAT can track dynamic changes in BP.

Effects of instructed meditation augmented by computer-rendered artificial virtual environment on heart rate variability.

Previous research has supported the use of virtual reality (VR) to decrease stress, anxiety, perceptions of pain, and increase positive affect. However, the effect of VR on blood pressure (BP) and autonomic function in healthy populations have not been explored. This study quantifies the effect of instructed meditation augmented by a virtual environment (VE) on BP and heart rate variability (HRV) during rest and following physical (isometric handgrip) or mental (serial sevens subtraction) stress. Sixteen healthy participants underwent all conditions, and those that responded to the stress tests were included in the analysis of stress recovery. Results showed that under resting conditions, VE had no significant effect on BP or HRV when compared to seated rest and the VE video on a 2D screen. Following serial sevens, VE maintained the increased low frequency (LF) power of HRV $( 66 \pm 4$ normalized units (n.u.)) compared to seated rest $( 55 \pm 5\mathrm {n}$.u., $\mathrm {p}=0.0060)$; VE maintained the decreased high frequency (HF) power of HRV $( 34 \pm 4\mathrm {n}$.u.) compared to seated rest $( 44 \pm 5\mathrm {n}$.u., $\mathrm {p}=0.014)$; and VE maintained the increased LF/HF ratio $( 2.4 \pm 0.5)$ compared to seated rest $( 1.6 \pm 0.3$, $\mathrm {p}=0.012)$. Hence, after mental stress, VE sustains the increased sympathetic drive and reduced parasympathetic drive. VE may act as a stimulatory driver for autonomic activity and BP. Further studies are required to investigate the effect of different types of VE on BP and autonomic function.