Cognitive Training to Reduce Memory Disturbance Associated With Postoperative Cognitive Impairment After Elective Noncardiac Surgery: An Experimental Study.

PURPOSE: Assess the efficiency of a cognitive training program using an artificial intelligence application to optimize cognitive reserve and reduce memory disturbance in patients aged 55 to 75 after Class II-III elective noncardiac surgery. DESIGN: Experimental with random assignment. METHODS: The study was conducted on 80 patients undergoing surgery at the Teknon Medical Center Hospital in Barcelona, from April 2018 to June 2021. Both groups were evaluated with cognitive tests before surgery and 7 and 30 days after surgery. The experimental group was subjected to cognitive training for 10 days before surgery to improve their cognitive reserve. FINDINGS: Significant differences were found between the study groups 30 days after surgery in the three screening tests (Mini-Cog, T@M, and MFE). The intervention group presented with fewer cognitive and memory alterations. Age and pre-existing comorbidities were not correlated with an impact on memory impairment or cognitive function. CONCLUSIONS: A cognitive training program based on artificial intelligence, prescribed and monitored by anesthesia nurses has a positive impact on increasing cognitive reserve and reducing memory disturbance in patients aged 55 to 75 undergoing Class II to III elective, noncardiac surgery. This intervention may serve as a prehabilitation strategy in patients with a risk of cognitive dysfunction evaluated by anesthesia nurses for the purpose of preserving their cognitive function and optimizing their recovery.

A thalamic epidermoid cyst presenting with memory disturbances: a case report.

Epidermoid cysts are benign, slow-growing tumors. They account for 0.2-1.8% of all intracranial tumors and rarely appear as intraparenchymal masses. The most prevalent symptom in people of middle age is an insidious-onset headache. Case presentation: We present a 20-year-old college student who presented with memory disturbances. The imaging revealed a left thalamic mass. The tumor was excised and diagnosed histopathologically as an epidermoid cyst. Clinical discussion: Epidermoid cysts resemble epidermal skin cells in histology. The lesion of the thalamus involving the ventrolateral and anterior regions is involved with memory and language. Of note, to our knowledge, no cases of memory issues associated with thalamic epidermoid cysts have been reported in the literature. Conclusion: The ideal treatment is cystic component removal with complete capsule excision. Sometimes, in cases of incomplete excision, radiotherapy can be another option.

Highly Reliable Memory Operation of High-Density Three-Terminal Thyristor Random Access Memory.

Three-terminal (3-T) thyristor random-access memory is explored for a next-generation high-density nanoscale vertical cross-point array. The effects of standby voltages on the device are thoroughly investigated in terms of gate-cathode voltage (VGC,ST) and anode-cathode voltage (VAC,ST) in the standby state for superior data retention characteristics and low-power operation. The device with the optimized VGC,ST of - 0.4 V and VAC,ST of 0.6 V shows the continuous data retention capability without refresh operation with a low standby current of 1.14 pA. In addition, a memory array operation scheme of 3-T TRAM is proposed to address array disturbance issues. The presented array operation scheme can efficiently minimize program, erase and read disturbances on unselected cells by adjusting gate-cathode voltage. The standby voltage turns out to be beneficial to improve retention characteristics: over 10 s. With the proposed memory array operation, 3-T TRAM can provide excellent data retention characteristics and high-density memory configurations comparable with or surpass conventional dynamic random-access memory (DRAM) technology.

Recurrent Episodes of Transient Global Amnesia: A Rare Clinical Entity.

Transient global amnesia (TGA) is a syndrome characterized by anterograde amnesia with otherwise intact cognitive function, resolving within 24 h of onset, occurring in the absence of neurological changes. Recurrent episodes remain rare. We report an interesting case of recurrent episodes of TGA in a 63-year-old woman presenting with altered mental status. She had no memory of antecedent events and demonstrated repetitive questioning but retained awareness of self. Physical examination and laboratory diagnostics were unremarkable. Brain magnetic resonance imaging revealed scattered foci of increased FLAIR signal within the bilateral periventricular and subcortical white matter. She was notably diagnosed with TGA a few months prior when she had presented with similar symptoms. During the current hospitalization, she remained alert and fully oriented, with resolution of perseveration. This case emphasizes the recognition of TGA as an important neurological diagnosis, uniquely describes not only the recurrence, but the short interval between recurrent episodes.

Invasion of small cell lung cancer into the limbic system from leptomeningeal metastases.

The diagnosis of leptomeningeal metastases is sometimes difficult when the cytology of cerebrospinal fluid is negative. We report a rare case of leptomeningeal metastases that required differentiation from paraneoplastic limbic encephalitis. A 67-year-old man with extensive-stage small cell lung cancer was admitted for a sudden decrease in the level of consciousness. He suffered memory disturbances that began the day before admission. Diffusion-weighted and fluid-attenuated inversion recovery images of brain magnetic resonance imaging (MRI) showed bilateral symmetric areas of hyperintensity in the hippocampus, amygdala, insular cortex, and medial temporal lobe; contrast enhancement was positive. Cytology of the cerebrospinal fluid (CSF) was negative. Anti-N-methyl-d-aspartate receptor antibody and herpes simplex virus DNA were not detected in the CSF. Paraneoplastic Limbic encephalitis was suspected due to his symptoms and brain MRI scan. The patient developed generalized seizures after admission. High-dose methylprednisolone and intravenous immune globulin were administered, but his condition did not improve. Uncontrollable seizures persisted and he died in the hospital at day 13. Autopsy revealed leptomeningeal metastasis and invasion of cancer cells into the limbic system. Contrast-enhanced MRI should be performed even if limbic encephalitis is suspected, and leptomeningeal metastases should be suspected if the lesions are enhanced.

The Fornix May Play a Key Role in Korsakoff's Amnesia Secondary to Subcallosal Artery Infarction.

BACKGROUND: Subcallosal artery infarction injures the fornix and anterior corpus callosum and sometimes causes Korsakoff's amnesia. We hypothesized that Korsakoff's amnesia might be caused by fornix dysfunction rather than anterior corpus callosum dysfunction in subcallosal artery infarction. METHODS: A systematic review approach was applied to search PubMed and Google Scholar for articles to compare patients who had both bilateral fornix and corpus callosum infarction due to subcallosal artery territory ischemia (vascular event group; V group) with patients who had undergone anterior corpus callosotomy (callosotomy group; C group). RESULTS: The V group comprised 10 patients (mean age, 63 years; median, 69 years; standard deviation (SD), 14.5 years; 5 males, 5 females). The C group comprised 6 patients (mean age, 23.7 years; median, 20 years; SD, 7.3 years; 3 males, 3 females). Six of 10 patients (60%) with subcallosal artery infarction exhibited Korsakoff's amnesia. One patient showed neither confabulation nor amnesia. Conversely, no amnesia episodes were seen in any patients from the C group (p = 0.034). CONCLUSION: Fornix injury, rather than anterior corpus callosum injury, might be the major cause of Korsakoff's amnesia in patients with subcallosal artery infarction.

Verbal and memory deficits caused by aphasic status epilepticus after resection of a left temporal lobe glioma.

BACKGROUND: Nonconvulsive status epilepticus (NCSE) is induced by common neurosurgical conditions, for example, trauma, stroke, tumors, and surgical interventions in the brain. The aggressiveness of the treatment for NCSE depends on its neurological prognosis. Aphasic status epilepticus (ASE) is a subtype of focal NCSE without consciousness impairment. The impact of ASE on neurological prognosis is poorly documented. We describe a case of postoperative ASE resulting in verbal and memory deficits. CASE DESCRIPTION: A 54-year-old, right-handed man with focal impaired awareness seizures underwent partial resection for a left temporal lobe tumor. No neurological deficits were observed immediately after surgery. Three days later, however, a focal to bilateral tonic-clonic seizure (FBTCS) occurred, followed by aphasia. Electroencephalography revealed 1.5 Hz left-sided periodic discharges. He was diagnosed with ASE. Multiple anti-seizure drugs were ineffective for the resolution of the patient's verbal disturbance. Nine days after the FBTCS, deep sedation with intravenous anesthetics was performed and the ASE stopped. Thereafter, his symptoms gradually improved. However, the prolonged ASE resulted in verbal and memory deficits. Automated hippocampal volumetry revealed an approximate decrease of 20% on the diseased side on magnetic resonance imaging 3 months after surgery. CONCLUSION: Prolonged ASE can induce verbal and memory deficits. Early intervention with intravenous anesthetics is required to obtain a favorable neurological prognosis.

The Coexistence of Olfactory Groove with Optic Nerve Sheath Meningioma Presenting with Anosmia: A Case Report.

INTRODUCTION: Meningiomas are the third most common intracranial tumors in adults after glial tumors and metastases. Olfactory groove meningiomas often grow without symptoms due to their slow growth rates and location in the frontal lobe. Optic nerve sheath meningiomas are benign neoplasms of the meninges surrounding the optic nerve. The coexistence of olfactory groove and optic nerve sheath meningiomas without any history of neurofibromatosis or radiotherapy has never been reported in the literature. CASE REPORT: A 36-year-old female patient was reported with anosmia, headache, memory disturbance, and visual impairment and with the diagnosis of olfactory groove meningioma. In the postoperative period, optic nerve sheath meningioma was detected in the imaging performed due to persistence of visual impairment. CONCLUSION: Olfactory groove and optic nerve sheath meningiomas are rare tumors and can be diagnosed late because they progress slowly. Early diagnosis and treatment may affect the prognosis and morbidity of these patients favorably.

Dementia and outcomes from coronavirus disease 2019 (COVID-19) pneumonia: A systematic review and meta-analysis.

BACKGROUND: The number of positive and death cases from coronavirus disease 2019 (COVID-19) is still increasing until now. One of the most prone individuals, even in normal situations is patients with dementia. Currently, no study provides clear evidence regarding the link between dementia and COVID-19. This study aims to analyze the relationship between dementia and poor outcomes of COVID-19 infection. MATERIALS AND METHODS: We systematically searched the PubMed and Europe PMC database using specific keywords related to our aims until October 25th, 2020. All articles published on COVID-19 and dementia were retrieved. The quality of the study was assessed using the Newcastle Ottawa Scale (NOS) tool for observational studies. Statistical analysis was done using Review Manager 5.4 software. RESULTS: A total of 24 studies with 46,391 dementia patients were included in this meta-analysis. This meta-analysis showed that dementia was associated with composite poor outcome [RR 2.67 (95% CI 2.06 - 3.47), p < 0.00001, I2 = 99%, random-effect modeling] and its subgroup which comprised of risk of COVID-19 infection [RR 2.76 (95% CI 1.43 - 5.33), p = 0.003, I2 = 99%, random-effect modeling], severe COVID-19 [RR 2.63 (95% CI 1.41 - 4.90), p = 0.002, I2 = 89%, random-effect modeling], and mortality from COVID-19 infection [RR 2.62 (95% CI 2.04 - 3.36), p < 0.00001, I2 = 96%, random-effect modeling]. CONCLUSIONS: Extra care and close monitoring should then be provided to patients with dementia to minimize the risk of infections, preventing the development of severe and mortality outcomes.

Peroxisome Deficiency Impairs BDNF Signaling and Memory.

Peroxisome is an intracellular organelle that functions in essential metabolic pathways including ß-oxidation of very-long-chain fatty acids and biosynthesis of plasmalogens. Peroxisome biogenesis disorders (PBDs) manifest severe dysfunction in multiple organs including central nervous system (CNS), whilst the pathogenic mechanisms are largely unknown. We recently reported that peroxisome-deficient neural cells secrete an increased level of brain-derived neurotrophic factor (BDNF), resulting in the cerebellar malformation. Peroxisomal functions in adulthood brain have been little investigated. To induce the peroxisome deficiency in adulthood brain, we here established tamoxifen-inducible conditional Pex2-knockout mouse. Peroxisome deficiency in the conditional Pex2-knockout adult mouse brain induces the upregulated expression of BDNF and its inactive receptor TrkB-T1 in hippocampus, which notably results in memory disturbance. Our results suggest that peroxisome deficiency gives rise to the dysfunction of hippocampal circuit via the impaired BDNF signaling.

Prevalence and factors associated with memory disturbance and dementia after acute ischemic stroke.

Prevalence and risk factors associated with memory disturbance and dementia were determined in acute ischemic stroke (AIS) patients in hospitals before discharge, three and six months after stroke. A prospective cohort study was conducted during January-December 2017 with 401 AIS patients admitted to Srinagarind Hospital, Khon Kaen Hospital and Chum Phae Hospital, Khon Kaen, Thailand. The demographics and clinical characteristics, previous illness and past medical history, and laboratory test results of the patients were collected from the medical records, while depression screening, NIH stroke scale (NIHSS) scoring and mini mental state examination (MMSE) were performed using particular medical record forms. The prevalence of memory disturbance and dementia was 56.6, 41.6 and 38.2% before discharge, three and six months after stroke, respectively. Based on logistic regression analysis, age, education and stroke severity were the risk factors associated with the studied disorders before discharge and three months after stroke. Meanwhile, age and education were the risk factors for six months after stroke. Our findings suggested that the prevalence of memory disturbance and dementia remained high at all study periods.

An autopsy case of a centenarian with the pathology of senile dementia of the neurofibrillary tangle type.

A Japanese woman showed slowly progressive memory disturbance since the age of 85 years. Later, disorientation gradually appeared. Head computed tomography revealed severe hippocampal atrophy, particularly in the posterior portion, and lateral ventricular dilatation, particularly in the inferior horn at the age of 99 years. The amygdala was relatively preserved from atrophy, and atrophy of the frontal lobe was relatively mild for her age. Apolipoprotein E gene analysis showed the ε3 homozygous phenotype. The woman died at the age of 101 years, and her clinical diagnosis was mild Alzheimer's disease. No apparent behavioural and psychological symptoms of dementia were observed during the disease course. Autopsy revealed severe hippocampal atrophy with numerous neurofibrillary tangles and ghost tangles, particularly in the hippocampal region, but senile plaques were rarely observed in the brain. The pathological findings were compatible with senile dementia of the neurofibrillary tangle type, whereas other neurodegenerative disorders were not recognized. The clinicopathologic findings of the present case are considered significant for the clinical diagnosis and pathogenesis of senile dementia of the neurofibrillary tangle type.

Rehabilitation of Patient with Anti-N-methyl-D-aspartate Receptor Encephalitis with Memory Disturbance / The Japanese Journal of Rehabilitation Medicine

　Anti-N-methyl-D-aspartate（NMDA）receptor（NMDAR）encephalitis is an autoimmune disorder typically involving ovarian teratomas and a severe neuropsychiatric disorder involving prominent memory and behavioral deficits. The purpose of this study was to evaluate the clinical symptoms and outcomes of six patients（one male, five female；age：20 to 47 years）with autoantibody-associated NMDAR encephalitis, who underwent comprehensive rehabilitation in our hospital. The five female patients underwent ovarian teratoma removal. At the beginning of rehabilitation, the mean score on the Rivermead Behavioural Memory Test was 16.7, and prospective memory was preserved in two patients and was recovered in two patients. The mean Wechsler Memory Scale-Revised score of the six patients significantly increased after rehabilitation, which suggested good recovery, compared to that in the patients with herpes encephalitis. However, in the chronic state, two patients showed persistent short-term memory disturbances that required a compensatory approach and employment assistance. Four patients who were treated with convalescent cognitive rehabilitation 4.5 months after onset improved in 4 months and showed good prognoses. Three returned to work, one returned to school, and two lived independently. Patients with anti-NMDAR encephalitis respond to immunotherapy, but they exhibit persistent cognitive deficits that are related to the distribution and functional role of NMDARs in the human brain. Early intervention for the short-term memory disturbances in convalescent rehabilitation, chronic interventions for the persistent memory disturbances, and preservation of perceptive memory are important to facilitate future employment.

A Rare Case of Obsessive-Compulsive Disorder with Symptoms of Unexplained Somatic and Memory Problem / General Medicine

Obsessive-compulsive disorder (OCD) is characterized by multiple obsessions and compulsions. A 22 years old woman who had mental traumatic event started having laryngopharyngeal discomfort, short term mental disturbance, and urge of repetitive checking of home door, spelling, and calculations of simple arithmetic. There was no evidence of organic causes. The diagnosis of OCD was established by meeting DSM-V criteria, and cognitive behavioral therapy was started. We report this case since it is important to consider the possibility of OCD for patients with unexplained somatic symptoms as well as unusual behavioral symptoms.

Cerebral Toxocariasis Presented With Seizure and Memory Disturbance

Toxocariasis has a broad clinical spectrum, from asymptomatic to systemic illness. However, cerebral toxocariasis has rarely been reported. We experienced a patient who presented with seizure and memory disturbance after treatment for visceral larva migrans of toxocariasis. Laboratory findings included eosinophilia, cerebrospinal fluid (CSF) pleocytosis, and positive results for toxocariasis in the serum and CSF. The patient showed marked improvement after combined albendazole and steroid treatment. This case indicates that cerebral toxocariasis is an unusual cause of cognitive dysfunction and seizure.

Clinical Characteristics of Memory Disturbance in Patients with Traumatic Brain Injury Referred for Mental Disabilitiy Evaluation / 신경정신의학

OBJECTIVES: The purpose of this study is to investigate the characteristics of memory disturbance caused by traumatic brain injury. METHODS: We measured the memory functions of 90 patients who complained of memory impairment after traumatic brain injury and were referred for mental disability evaluation, using Rey-Kim Memory Test. The patients were divided into three groups according to Memory Quotient and brain imaging studies. We also examined their intelligence and emotional characteristics using K-WAIS and MMPI. RESULTS: 1) Among the patients who complained of memory impairment and had abnormal brain imaging after traumatic brain injury, more than half showed no actual memory disturbance. 2) The group with actual memory disturbance showed normal verbal short-term memory but showed deficits in verbal long-term memory. And their visuospatial functions were preserved but visual short- and long-term memory were impaired. 3) There was notable correlation between memory function and intelligence in patients with traumatic brain injury. 4) The group with abnormal brain imaging showed more social withdrawal than the group without abnormal brain imaging. The group without abnormal brain imaging showed more somatization than the group with abnormal brain imaging. CONCLUSION: We suggest the special memory function test as well as brain imaging studies for patients who complain of memory impairment after traumatic brain injury.

Effect of 2,3,5,4'—tetrahydroxystilbene—2—O—?—D—glucoside on the Learning and Memory Ability of Mouse Dementia Models Induced by Scopolamine / 中国药房

OBJECTIVE:To investigate the effect of 2,3,5,4'—tetrahydroxystilbene—2—O—?—D—glucoside(TSG) on the learning and memory ability of mouse dementia models induced by scopolamine METHODS:Mice were randomly divided into blank group,model group,TSG groups(low dose,high dose) and positive control(Piracitam) group All the mouse were intragastrically administrated by drugs After making model,all mice were subjected to Morris water maze and passive avoidance tests RESULTS:Compared with model group,swimming time were significantly reduced in the blank group,positive control group and high dose of TSG group during Morris water maze test (P