Is there a connection between neurocognitive profile in treatment naïve non-cirrhotic HCV patients and level of systemic inflammation?

Hepatitis C virus (HCV) infection is a progressive, systemic disease which leads to the development of end-stage liver disease. In 70% of patients, HCV infection is followed by the development of extrahepatic manifestations (EHM). A common EHM is HCV associated neurocognitive disorder (HCV-AND), characterized by neuropsychological changes in attention, working memory, psychomotor speed, executive function, verbal learning, and recall. The aim of this study is to examine the correlation between the neurocognitive profile and routine, available laboratory parameters of inflammation, liver function tests, grade of liver fibrosis, and clinical and laboratory parameters of mixed cryoglobulinemia in treatment naïve non-cirrhotic HCV patients. This is a single-center exploratory study in which we examined 38 HCV + treatment naïve patients. The complete blood count and hematological parameters of systemic inflammation, liver function tests, biopsy confirmed grade of liver fibrosis, and clinical and laboratory parameters of mixed cryoglobulinemia caused by chronic HCV infection were observed. In the study, we used a battery of neuropsychological tests assessing multiple cognitive domains: executive functions, verbal fluency, delayed memory, working memory and learning, and one measure for visuo-constructive performance. Before the Bonferroni correction for multiple comparisons, the results show significant correlations between the scores in the neurocognitive variables and the single measures of inflammation, liver function parameters, and mixed cryoglobulinemia. It has not found a statistically significant correlation between systemic inflammation and neurocognitive variables. After the Bonferroni adjustment, no correlations remained significant. Certainly, the obtained results can be a recommendation for additional validation through future research.

Corrected evaluation of the breech presentation outcome based on etiology of this presentation in congenitally malformed uterus.

Background: Breech presentation (BP) results from at random filling of the intrauterine cavity, with an equal probability for a BP or cephalic presentation (CP). Each fetus in BP has its "pair" in CP randomly assumed CP. Direct comparison of BP and CP makes bias to less expressed differences between these two groups. It is therefore necessary to subtract the number of fetuses/newborns from the CP set that are identical to the number of fetuses/newborns in the BP set, with identical characteristics, and add this group to the BP set before comparing them to the rest of the CP fetuses/newborns in the matching process. Methods: The procedure encompasses nine variables in pregnancies with a congenitally malformed uterus (CMU) identified at the Department of Obstetrics (1985-2014): gestational age, birth mass, birth length, head circumference, shoulders circumference, umbilical length, placental weight, newborn mass/newborn length ratio, and newborn mass/placental mass ratio. Firstly, the probability of BP was determined and its relation to gestational age, physical characteristics, and previous presentations. Then direct comparison as well as case-control matching of the CP and BP were performed. Case-control matching was based on either a single specific variable (M1) or all combined variables (M2). Findings: 462 deliveries were identified with CMU. In 81 cases of multiparity, a fetal presentation was found to be an independent event regardless of the previous presentation, gestational age, and newborn physical characteristics. In four types of CMU with 337 deliveries (Bicornuate, Didelphys, Unicornuate, Arcuate), 9 variables with 36 instances of comparison were observed. M1 in 10 instances and M2 in 6 instances showed a statistically significant lower value of breech/random presentation compared with CP. CP have lower value in 2 instances in M1 and 1 in M2. Statistically significant differences were absent without the matching process. Interpretations: The study confirms the maximum probability for the BP is 50%. The case-control matching procedure shows that it is able to detect the difference between the breech/random presentation and CP, while the classic method of direct comparison was unable to detect any differences. The outcome of the breech/random presentation in CMU should be evaluated with the described case-control matching procedure.

Patients with neuropathic pain from lumbosacral radiculopathy demonstrate similar pressure pain thresholds and conditioned pain modulation to those with fibromyalgia.

OBJECTIVE: The purpose of the study was to evaluate pain thresholds, impairment of the endogenous pain modulatory system, and self-reported cognitive-emotional and central sensitization-related symptoms among three subject groups: a rarely studied patient cohort with neuropathic pain from lumbosacral radiculopathy (NPLSR), patients with fibromyalgia (FM) and healthy controls (HC). METHODS: Patient-reported pain-related symptomology was evaluated with psychometricallyvalidated questionnaires. Pressure pain threshold (PPT), heat pain threshold (HPT), and cold pain threshold (CPT) were assessed in the low back and contralateral forearm. Conditioned pain modulation (CPM) was evaluated with a recently introduced methodology that accounts for a standard error of measurement. RESULTS: Compared to the HC subjects, the FM and NPLSR subjects had significantly lower pain thresholds and more CPM impairment. No significant differences in PPT and CPM were observed between the FM and NPLSR groups. Significant group differences were found in self-reported symptoms of depression, anxiety, stress, and central sensitization. Self-reported symptom severity increased in a stair-step fashion, with the HC group scoring lowest and FM group scoring highest. CONCLUSION: The NPLSR group manifested CPM dysfunction and pressure hyperalgesia at similar levels to the FM group, indicating that these two chronic pain syndromes, likely based on different pathophysiological mechanisms, in fact share some common pain processing features. However, though both patient groups demonstrated similarities in pain processing, self-reported cognitive-emotional and central sensitization-related symptom severity was significantly higher in the FM cohort, which distinguished them from the chronic NPLSR cohort.

Engagement of Preschool-Aged Children in Daily Routines.

Child engagement refers to the time spent interacting with physical and social environments according to age, abilities, and a situation. The aim of this study is to assess the functioning of children in early childhood routines using engagement assessment instruments relative to the presence of developmental disabilities, age, gender, and parental characteristics within the contexts of preschool and family routines. The sample comprised 150 children aged 3-5 (AS = 4.02, D = 0.78), including typically developing children (N = 49) and children with developmental disabilities (N = 101). To assess the children's engagement in preschool classrooms, we used the Classroom Measure of Engagement, Independence, and Social Relationships (ClaMEISR), and the Child Engagement in Daily Life Measure was used to assess the children's engagement in family routines. The results obtained indicate a significantly higher rate of engagement in routines and activities among girls and older children. Parental characteristics associated with children's engagement included employment and marital status. Children with developmental disabilities, compared to their typically developing peers, had lower levels of engagement in social relationships and functional independence in daily routines. The results indicate that both instruments have a high internal consistency and are thus suitable for future use in the Republic of Serbia.

The Relationship Between Behavior Aspects of Executive Functions and Personality Traits in Healthy Young Adults.

Executive functions (ЕF) are complex cognitive processes that govern our behavior and thoughts. Associations between personality traits and executive functions clarify the mechanisms of a person's ability to function in everyday situations. The main goal of this study was to explore different personality dimensions relevant to the prediction of two different executive functions - Inhibition and Working Memory. The Big Five Inventory and the Adult Executive Functioning Inventory (ADEXI) were administered on a community sample comprising 549 young adults aged 18-35 years (mean age 22.10 years, SD 3.13). After controlling for age, gender and level of education, Conscientiousness and Extraversion were the most predictive personality traits, while Neuroticism and Agreeableness made specific contributions to the prediction of one of the two executive measures: Working Memory or Inhibition. Specifically, high Conscientiousness and Extraversion with low Neuroticism were significant predictors of Working Memory ability. On the other hand, high Conscientiousness and Agreeableness with low Extraversion predicted better Inhibition ability. These findings support the conclusion that these dimensions of individual differences seem to have numerous points of overlap at both psychological and neurobiological levels, but differences between these constructs are still significant.

Changes in the first anti-seizure medication prescribed for children and adolescents with epilepsy in a tertiary clinical center in Serbia over two decades.

OBJECTIVES: We assessed the prevalence of the use of new anti-seizure medications and valproate in the female population over two decades. MATERIALS AND METHODS: We conducted a retrospective observational cross-sectional study of medical records of children and adolescents (4 - 19 years old) with newly diagnosed epilepsy in a tertiary clinical center in Serbia from 1997 to 1999 and 2017 to 2019. RESULTS: The statistical analysis revealed significant changes in the treatment of generalized and focal seizures and all etiologies of epilepsy. Valproate use in the adolescent girl population decreased significantly from 2017 to 2019. CONCLUSION: The prescription pattern of the initial anti-seizure medication changed significantly over the two decades. The results correspond to current guidelines and recommendations.

Latent, genetic, and molecular genetic structure of the Wisconsin Card Sorting Test.

OBJECTIVE: The main goal of this study was to explore the latent structure and genetic basis of cognitive processes involved in the Wisconsin Card Sorting Task (WCST) within phenotypic, behavioral genetic, and molecular genetic research paradigms. METHOD: The sample used in phenotypic and behavioral genetic analyses comprised 468 twins (154 monozygotic and 80 dizygotic twin pairs), while molecular genetic analyses were performed on 404 twins from the same sample. The zygosity of most twin pairs (96.8%) was determined via deoxyribonucleic acid (DNA) analysis of buccal swabs. Trained researchers administered the Wisconsin Card Sorting Test (WCST; Heaton et al., 1993) to the entire sample. RESULTS: A phenotypic factor analysis of WCST variables suggested a single-factor solution. Overall heritability ranged from 0.19 to 0.23 across different measures of the WCST. The presence of a single general genetic factor, which could be identified from different measures of the WCST, indicated the unity of various WCST indicators and the existence of a common basic ability. Performance on the WCST did not reveal significant differences between the three genotypes on catechol-O-methyltransferase (COMT) and dopamine receptor D2 (DRD2). Carriers of the brain-derived neurotrophic factor (BDNF) Met + genotype exhibited better performance in cognitive functions in comparison to the BDNF Met- genotype. CONCLUSIONS: This study highlighted similarities in the phenotypic and genetic structures of the WCST, suggesting one general factor underlying different cognitive functions. The BDNF Met + genotype showed significant main effects on different WCST measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Differences in MB-COMT DNA methylation in monozygotic twins on phenotypic indicators of impulsivity.

Epigenetic modifications of the membrane bound catechol-O-methyltransferase (MB-COMT) gene may affect the enzymatic degradation of dopamine, and consequently, human behavior. This study investigated the association between membrane bound catechol-O-methyltransferase DNA methylation (DNAm) differences in 92 monozygotic (MZ) twins with phenotypic manifestations of cognitive, behavioral, and personality indicators associated with reward-related behaviors and lack of control. We used pyrosequencing to determine DNAm of the regulatory region of membrane bound catechol-O-methyltransferase in saliva DNA. Results of intrapair differences in the percentage of membrane bound catechol-O-methyltransferase DNAm at each of five CpG sites show that there are associations between phenotypic indicators of lack of control and membrane bound catechol-O-methyltransferase DNAm differences on CpG1, CpG2 and CpG4, suggesting the common epigenetic patterns for personality traits, cognitive functions, and risk behaviors.

Behavioral aspects of executive functions in young adults with well-controlled epilepsy.

Executive function (EF) skills involve higher-level cognitive functions, such as planning, goal formation, goal-directed behavior, and effective performance. Previous research has shown that these aspects of EF are essential for successful functioning in everyday life. This study aimed to examine differences in the behavioral aspects of EF between young adults with epilepsy and healthy controls. The study involved 62 young adults, aged 18 to 30 years, divided into two groups: a study group of young adults with well-controlled epilepsy and a control group of healthy young adults. The groups were matched according to basic sociodemographic characteristics. The Behavior Rating Inventory of Executive Function - Adult version was used to assess the behavioral aspects of executive functions. A significant difference between groups was only observed on the Organization of Materials scale, where the group with epilepsy achieved better performance. Our findings suggest that self-assessed behavioral control of EF is almost the same in healthy young adults and young adults with epilepsy who have no comorbidities and have good control of the disease as well as preserved intellectual ability and functionality in everyday activities.

Relation of Steatosis to Neurocognitive Function in People Living with HIV.

BACKGROUND: In HIV negative population metabolic syndrome and steatosis are related to poorer neurocognitive (NC) performance. We investigated if similar relation exists in people living with HIV (PLWH). METHODS: We included male PLWH aged 20-65, with undetectable viral load for at least 6 months. Data on levels of education, anthropometric measurements, CD4 levels, ART, markers of metabolic syndrome, smoking and concurrent treatment were collected from database. Concentrations of TNF-α and IL-6 were measured. An ultrasound was used to establish the presence of steatosis, visceral fat thickness and carotid intima media thickness. An extensive NC assessment was done by an experienced neuropsychologist. Cognitive domains were defined as executive functions, divergent reasoning, visuo-constructional abilities, delayed recall and working memory and learning and were measured using a battery of 12 tests. RESULTS: 88 PLWH were included (mean age 39,9 years), 51% on PIs, 46% on NNRTI; 20,4% had metabolic syndrome, 42% patients had steatosis. Weak but statistically significant negative correlations were found between the presence of metabolic syndrome, steatosis and VFT and cognitive domains (divergent reasoning, delayed recall and working memory). Poorer perfomrance in the domains of divergent reasoning and in the working memory were found in participants with steatosis (p=0,048 and 0,033 respectively). CONCLUSION: Although the sample size was relatively small, our results show consistent correlations between the observed neurocognitive variables and metabolic parameters. As central obesity is one of the contributors to NCI, it would be one of the modifiable factors to prevent further neurocognitive decline.

Serbian Twin Registry.

The first twin study in Serbia began in 2011 as a part of the research project, 'Psychological Foundations of Mental Health: Hereditary and Environmental Factors'. At the same time, the research team from the Faculty of Philosophy and Faculty of Medicine in Novi Sad established the first Serbian twin registry. The registry is intended primarily for the purpose of the research in behavioral genetics, as well as potential future studies in human genetics. It includes information on 1658 volunteers, including twin-pairs, their parent and siblings. The behavioral genetic study of adult twins has been focused on the hereditary and environmental sources of variance of different psychological characteristics, such as personality traits, cognitive abilities, executive functions and aggression, as well as some anthropometric measures and aspects of mental and physical health. Certain molecular genetic analyses have also been performed. The research team is currently starting the longitudinal twin study of children, which will be focused on different indicators of emotional, cognitive and physical development.

Evaluation of Symptoms of Depression and Anxiety in Adolescents with Epilepsy in a Tertiary-Level Medical Center in Serbia.

BACKGROUNDS: Even though epilepsy is the most common neurological disorder in adolescence; studies of adolescents with epilepsy are scarce. OBJECTIVE: To evaluate whether adolescents with epilepsy are more likely to develop anxiety and depressive symptoms than their healthy peers and to determine the relationship of depression and anxiety scores to epilepsy-related variables. SETTINGS AND DESIGN: Cross-sectional observational study. METHODS AND PROCEDURES: Ninety adolescents with epilepsy aged 13-19 years were compared with healthy controls using the Beck Depression Inventory II (BDI II) and the Stait Trait Anxiety Inventory (STAI) for assessment of depressive and anxiety symptoms. Within the study group, epilepsy-related variables were also determined using the stated measures. STATISTICAL ANALYSIS USED: The independent sample t-test, One-Way ANOVA, Pearson's correlation coefficient. OUTCOMES AND RESULTS: 23.3% of the study group and 8.3% of the control group had mild to moderate depression. The mean BDI II score was significantly higher in the group of adolescents with epilepsy. Comparing the STAI scores, results on both STAI scales were higher in the study group. Regarding the epilepsy-related variables, a high frequency of seizures, symptomatic etiology and polytherapy showed strong associations with high depression and anxiety scores. CONCLUSION AND IMPLICATIONS: Symptoms of depression and anxiety are not uncommon among adolescents with epilepsy. BDI II and STAI may be used as screening tools to provide useful information to clinicians when assessing adolescents' mental status.

A Short Measure of the Revised Reinforcement Sensitivity Theory - RSQ17.

The need for a research and practical tool, such as a short, reliable, and valid personality assessment test, suggests researchers to create shortened versions of original instruments. Reinforcement sensitivity questionnaire (RSQ) was created in line with some basic premises of revised Reinforcement sensitivity theory, which proposes three motivational and emotional systems: Behavioral inhibition system (BIS), responsible for scanning environment for potential threats, Behavioral activation system (BAS), responsible for aproaching behavior, and the Fight/Flight/Freeze system (FFFS), responsible for behavior in the present threat. RSQ comprises five scales: BIS, BAS, Fight, Flight, and Freeze. The aim of this study was to develop a short version of RSQ, which would be beneficial to both research and practical purposes. Item response theory analyses were used for item selection. The study comprised two samples of participants, whereby Sample 1 (N = 837, 34.6% male, aged 18 - 82, M = 31.63, SD = 13.54) served as the derivation sample, while Sample 2 (818 participants, 43.6% male, 18-75 years, M = 29.65, SD = 12.52) served as validation sample. Factorial validity of the short RSQ was examined on both Sample 1 and Sample 2. Convergent and divergent validity of the short RSQ was examined using RST-PQ, Jackson-5, BIS/BAS scales, and Big Five Inventory. The results point to satisfactory internal consistency, factorial validity, and construct validity of the short RSQ, suggesting that it is an adequate measure for research settings or other contexts which require the use of short personality questionnaires.

Neurocognitive profile of HIV-positive adults on combined antiretroviral therapy: A single-centre study in Serbia.

The advent of combined antiretroviral therapy (cART) has prolonged the life expectancy of HIV + individuals and decreased the incidence of HIV-associated dementia. However, milder forms of neurocognitive impairment remain common and are often associated with poor daily functioning and lower medication adherence. This paper presents a research aimed at exploring the cognitive status differences between HIV + subjects (N = 39) on cART therapy and a group of demographically comparable healthy subjects (N = 39) in Serbia. The significance of differences between the HIV + group and the healthy control group in performance in six cognitive domains was tested using the multivariate analysis of variance. Results showed a lower performance of the HIV + group in the domains of attention/working memory, and learning. HIV-related clinical variables were not significantly associated with cognitive performance. An older age in HIV + patients was significantly related to a lower performance in all six cognitive domains, as opposed to healthy subjects, implying a synergistic interaction between HIV and aging, resulting in accentuated cognitive difficulties. Our findings suggest that even with the absence of a subjective experience of cognitive deficits and with a good basic control of the illness, a certain degree of cognitive deficit can be observed in the tested group.