cognitive dysfunction

Mild cognitive impairment is a common aging phenomenon, and the absence of problem-solving abilities significantly contributes to memory decline. This study aimed to investigate the effect of video games on cognitive performance and problem-solving ability in the elderly with mild cognitive impairment.

In 2023, a double-blind, randomized clinical trial was done on mild cognitive impairment aged randomly divided into control and intervention groups with permuted blocks randomization. The participants in the intervention group played selected smartphone video games thrice a week for 12 weeks, but the control group did not do any intervention. Mini Mental Status Examination and Problem-solving Questionnaire were completed before, 8 weeks after the start, and 4 weeks after the end of the intervention. Statistical tests were done at the significance level considered less than 0.05 and analyzed in SPSS version 16.

The mean±SD age of the 60 elderly participants who finished the study was 71.43±2.59. The mean±SD scores of cognitive performance and problem-solving ability improved in the intervention group (25.18±0.93 and 21.15±1.36) but worsened in the control group (19.43±0.76 and 13.72±1.98) (P<0.001). Before the intervention, no significant difference was observed between both groups in cognitive performance and problem-solving ability. However, there was a significant difference 8 weeks after the start and 4 weeks after the end of the intervention (P<0.001).

Playing video games thrice a week for 12 weeks can improve cognitive performance and problem-solving ability in the elderly with mild cognitive impairment. This approach is suggested for implementation.

Lactoferrin, a glycoprotein, has known neuroprotective effects, yet its role in the pathophysiology of neuropsychiatric disorders, particularly schizophrenia, remains unclear. This study aims to assess changes in lactoferrin levels during different phases of schizophrenia and explore its relationship with cognitive symptoms and performance.

This before/after interventional study involved 30 patients diagnosed with schizophrenia. Participants were evaluated at two time points: upon hospital admission and after the resolution of acute symptoms. The Positive and Negative Syndrome Scale (PANSS) was utilized to measure symptom severity, while the Brief Assessment of Cognition in Schizophrenia (BACS) assessed the neurocognitive function. Serum lactoferrin levels were quantified using the Enzyme-Linked Immunosorbent Assay (ELISA) method.

Serum lactoferrin levels significantly decreased from 130.63 ± 52.49 ng/mL at admission to 85.42 ± 29.03 ng/mL at discharge (P < 0.001). No significant correlation was found between lactoferrin levels and PANSS scores (r = 0.011, P = 0.975). However, an inverse correlation was observed between changes in lactoferrin levels and the executive function subscale of the BACS (r = -0.360, P = 0.050). Cognitive assessments indicated significant improvements in verbal memory (P = 0.033), working memory (P = 0.002), and executive function (P = 0.039) post-treatment.

The study demonstrates a significant reduction in serum lactoferrin levels during the acute phase of schizophrenia, suggesting its potential role in modulating cognitive functions, particularly the executive function, rather than influencing positive or negative symptoms.

Chronic kidney disease (CKD) is a pervasive health issue associated with various complications, including cognitive impairment and depression among patients undergoing hemodialysis. This study aimed to assess the impact of melatonin on depression and cognitive function in hemodialysis patients.

A randomized, double-blinded, placebo-controlled clinical trial was conducted in 50 hemodialysis patients, with half of the patients receiving 3 mg daily melatonin and the other half receiving a placebo for two months. Depression and cognitive function were evaluated using the Beck Depression Inventory (BDI) and Mini-Mental State Examination (MMSE) questionnaire, respectively. Quantitative variables were analyzed using a t-test. The Chi-square test also evaluated qualitative variables. Quantitative data were analyzed by covariance analysis before and after the intervention.

Hypertension was the most prevalent underlying condition among study participants, affecting 40% of the intervention group. The intervention group exhibited baseline depressive symptoms (mean BDI score: 16.12 ± 7.12), which significantly improved post-intervention (13.6 ± 6.6). Notably, both the intervention and control groups demonstrated significant reductions in depressive symptoms, as assessed by paired t-tests (P = 0.033 and P = 0.02, respectively). Cognitive function, as measured by the MMSE, improved in both groups (1.28 ± 0.81 for melatonin, 1.52 ± 0.1 for placebo), with significant within-group differences (P = 0.048 and P = 0.002, respectively). ANCOVA analysis revealed no significant between-group differences in BDI scores (F(1,47) = 0.196, P = 0.66, partial eta-squared = 0.004). and in MMSE scores (F(1,47) = 0.003, P = 0.954, partial eta-squared = 0.00) post-intervention.

While this study did not demonstrate significant effects of melatonin on depression and cognitive impairment in hemodialysis patients, positive changes were observed, warranting further research to optimize treatment regimens and explore the potential therapeutic benefits of melatonin in this patient population.

This study aimed to investigate the effect of 8-week high-intensity interval training (HIIT) on lactate-induced mitophagy in the hippocampus of rats with type 2 diabetes.

28 Wistar male rats were divided into four groups randomly: (i) control (Co), (ii) exercise (EX), (iii) type 2 diabetes (T2D), and (iv) type 2 diabetes + exercise (T2D + Ex). The rats in the T2D and T2D + Ex groups were fed a high-fat diet for two months, then a single dose of STZ (35 mg/kg) was injected to induce diabetes. The EX and T2D + Ex groups performed 4–10 intervals of treadmill running at 80–100% of Vmax. Serum and hippocampal levels of lactate, as well as hippocampal levels of monocarboxylate transporter2 (MCT2), sirtuin1 (SIRT1), forkhead box protein O (FOXO3), light chain 3 (LC3), PTEN-induced kinase 1 (PINK1), parkin, beta-amyloid (Aβ), hyperphosphorylated tau protein (TAU), Malondialdehyde (MDA), and antioxidant enzymes were measured. One-way ANOVA and Tukey post-hoc tests were used to analyze the data. 

Serum and hippocampal levels of lactate as well as hippocampal levels of MCT2, SIRT1, FOXO3, LC3, PINK1, Parkin, and antioxidant enzymes were higher while hippocampal levels of Aβ, TAU, and MDA were lower in T2D+EX compared to T2D group (P-value<0.05)

HIIT could improve mitophagy through Lactate-SIRT1-FOXO3-PINK1/Parkin signaling in the hippocampus of rats with T2D reducing the accumulation of Tau and Aβ, which may reduce the risk of memory impairments.

Opioids can lead to mood disorders, anxiety, depression, and cognitive impairment. Valproic acid (VPA) has neuroprotective effects that can prevent neural degeneration. This study aims to examine the impact of VPA on learning, social interaction, and depression in mice dependent on morphine.

Subjects were divided into four groups and received injections of saline, VPA, morphine, or a combination of VPA and morphine for eight days. Behavioral tests were conducted on day 8, and then administration of VPA and morphine was stopped, leading to spontaneous withdrawal syndrome. Behavioral tests were repeated on day 11, and histological analysis was performed on the hippocampus.

The preference index (PI%) decreased in the novel object recognition test in the VPA and morphine sulfate (MOR) groups compared to the control (CTL) group in the chronic phase. The concomitant administration of VPA and morphine caused an increase in social interaction criteria in both the chronic and withdrawal phases. The decrease in immobility time in the VPA and MOR + VPA groups compared to the CTL group in the withdrawal phase was not statistically significant in the tail suspension test (TST). In Nissl staining, the combination of MOR + VPA led to a significant decrease in the DC/All cell ratio compared to the individual MOR and VPA groups (P < 0.05).

VPA may improve social relationships and depression indices during morphine withdrawal. VPA may potentially mitigate the cellular changes in the CA1 of the hippocampus induced by morphine.

Cognitive disorders, characterized by transient stages and potential Alzheimer's disease, are influenced by changes in iron deposits in the brain. These changes can lead to toxicity and neuron death. Quantitative susceptibility mapping is used to accurately represent these changes, allowing for a more accurate evaluation of the time window of each cognitive disorder stage and the need for targeted treatment. The Alzheimer's Disease Neuroimaging Initiative research database was used to download the data and eight healthy participants and twenty-one participants with cognitive disorders based on MMSE cognitive test scores in 5 groups of cognitively normal, Subjective Memory Concern , Early Mild Cognitive Impairment, Late Mild Cognitive Impairment and Alzheimer's disease were included in this study. Quantitative Susceptibility Mapping processing was performed using the SEPIA toolbox in MATLAB, and segmentation was performed using FSL software. Finally, statistical analyzes were performed using SPSS V26 software. Statistically significant changes were observed in the QSM values of the right thalamus (p-value = 0.043) in the LMCI group and the right hippocampal nucleus (p-value = 0.050) in the control group. After one year, the right hippocampal nucleus shows increased iron accumulation in healthy individuals, suggesting that the nucleus is susceptible to the highest rate of iron deposition in healthy individuals. Based on this result, the hypothesis that iron deposits are the cause of the unknown cause-and-effect relationship between iron deposits and Alzheimer's disease may be confirmed.

Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Cognitive impairments following TBI are the most disabling and prevalent after-effects. These impairments have substantial and lasting implications on an individual's daily functioning and quality of life. In the acute and chronic phases after TBI, they can affect various cognitive domains, including attention, executive functions, learning and memory, language, perceptual-motor function, and social cognition. The significance of these cognitive deficits is underscored by their association with difficulties in vocational reintegration, social interactions, and overall independence. Furthermore, the long-term consequences of TBI-related cognitive deficits extend to increased risk for mood disorders. Addressing these challenges necessitates practical assessment and management. Comprehensive neuropsychological assessments play a pivotal role in diagnosing and characterizing cognitive deficits. In addition to medication, cognitive rehabilitation therapy suggests using rehabilitation methods such as cognitive training, compensatory strategies, and assistive technologies. By recognizing the substantial impact of cognitive impairments post-TBI and implementing evidence-based techniques, clinicians and caregivers can optimize recovery and enhance the quality of life for those affected. This article aims to provide an overview of the epidemiology, pathophysiology, assessment, rehabilitation approaches, and challenges of cognitive impairment in patients with TBI.

Recent findings suggest that the plasma axonal structural protein, neurofilament light (NFL) chain, may serve as a potential blood biomarker for early signs of neurodegenerative diseases, such as Alzheimer’s disease (AD). Given the need for early detection of neurodegenerative disorders, the current study investigated the associations between regional cerebral blood flow (rCBF) in brain regions associated with neurodegenerative disorders and memory function with plasma NFL in AD, mild cognitive impairment (MCI), and healthy controls (HCs). We recruited 29 AD, 76 MCI, and 39 HCs from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database in the current cross-sectional study. We used Pearson’s correlation models adjusted for the effect of age, sex, and APOE genotype to investigate the association between plasma NFL and rCBF. We found non-significant differences in age (F(2, 141) = 1.304; P = 0.275) and years of education (F(2, 141) = 0.013; P = 0.987). Additionally, we found significant differences between groups in terms of MMSE scores (F(2, 141) = 100.953; P < 0.001). Despite the observation of significantly reduced rCBF in AD and MCI groups versus HCs, we did not detect significant differences in plasma NFL between these groups. We found significant negative associations between plasma NFL and rCBF in various AD-related regions, these findings were only observed after analyses in all participants, and were observed in HCs alone and no significant associations were observed in the AD or MCI groups. These outcomes add to our current understanding surrounding the use of rCBF and plasma NFL biomarkers as tools for early detection and diagnosis of neurodegenerative diseases. A conclusion might be that the association between NFL and impaired rCBF exists before the clinical symptoms appear. Further longitudinal studies with a large sample size should be performed to examine the correlation between plasma NFL and rCBF in order to understand these complex relationships.

While the beneficial effects of PA on the mental and physical well-being of elderly individuals are recognized, there has been little focus on its effects on older adults with mild cognitive impairment (MCI). Therefore, the objective of this investigation was to examine the correlations between physical activity (PA) and depression, perceived health, physical function, and quality of life (QoL) among older women with Mild Cognitive Impairment (MCI).

This study employed a descriptive-correlation design. The statistical population comprised women with MCI (scoring 21 to 24 on the Mini–Mental State Examination) over 65 years residing in nursing homes in Tehran, Iran in 2023. The sample of this study consisted of 334 women (mean age=69.12±3.68) with MCI who were selected using a purposive sampling method. Standard tools were utilized for measuring PA, depression, balance, muscle strength, and QoL, respectively. Perceived health status was assessed using one item. Pearson correlation test and independent t-test were employed for data analysis.

The results showed that 66% of the entire sample suffered from depression. The participants engaged, on average, in 14.69 minutes of moderate physical activity (MPA) per day. Only 22% of the participants met the WHO’s guidelines of 30 minutes of MPA daily. It was found that higher MPA was significantly correlated with lower depression (P<0.001) and higher perceived health, physical function (both balance and muscle strength), and QoL (all P<0.001). On the other hand, higher sedentary time was significantly correlated with higher depression (P<0.001) and lower perceived health, physical function (both balance and muscle strength), and QoL (all P<0.001).

The results suggested that strategies to improve health-oriented PA status in the elderly with MCI are necessary. In this regard, it is especially recommended that nurses plan recreational physical and sports activities for the elderly in groups or individually so that they can enjoy the benefits of PA.

Schizophrenia (SZ) is a chronic brain disorder characterized by diverse cognitive dysfunctions due to abnormal brain connectivity. Evaluating these connectivity alterations between and within such networks (intra- and inter-connectivity) may improve the understanding of disrupted information processing patterns in SZ patients. 

Resting-state fMRI analysis was performed on 24 SZ patients and 27 matched healthy controls. A functional connectivity matrix was constructed for each participant based on 129 gray matter regions. All regions were classified into eight distinct functional networks. Afterward, all functional connections were segregated into inter- and intra-network connections considering the eight networks. The Mean values of connectivity weights and nodal strength were examined for within- and between-network connections in SZ patients and healthy controls. 

This analysis revealed that the within-network connections in the somatomotor  (SM) network significantly reduced (P<0.001) in SZ patients. Additionally, intra-network connections within the visual and the ventral attention (VA) networks were significantly lower (P<0.01) in the SZ group. Moreover, disrupted intra-network connectivity was detected between the following network pairs: The visual-limbic, the somatomotor-limbic, the dorsal attention-limbic, and the ventral attention-dorsal attention system. 

The results showed an extensive reduction in functional connectivity strength for SZ patients, with a particularly significant decrease in intra-network connections when compared to the inter-networks. These findings can impact the understanding of the important dysregulated connections that are implicated in the incidence of schizophrenia.

Brain atrophy is associated with physical disability in multiple sclerosis (MS), but there is a great variability between different studies and methodologies, and its use is still limited to research projects. We aimed to analyze the relationship between several volumetric measurements and physical disability and cognitive functioning in MS patients in a clinical practice setting. 

This is a cross-sectional study. A total of 41 patients (31 relapsing-remitting MS, 6 secondary-progressive MS, and 4 primary-progressive MS) were included. Whole brain volume (WBV), gray matter volume (GMV), and T2 lesion load (T2L) were obtained using Icometrix® software. Physical disability was measured with the Expanded Disability Status Scale (EDSS), and cognitive status was evaluated with the brief repeatable battery of neuropsychological tests (BRB-N). The relationship between brain volumes and EDSS was analyzed through linear multivariate regression. The association between volumetry measurements and the number of affected cognitive domains was studied with negative binomial regression.

GMV was associated with age (b=-1.7, p=0.014) and with EDSS (b=-7.55, p=0.013). T2L was associated with EDSS (b=2.29, p=0.032). The number of affected cognitive domains was associated with clinical phenotype, worse in primary progressive MS (PPMS). There was not correlations between cognitive impairment and cerebral volumes.

Brain atrophy measurement is feasible in clinical practice setting, and it is helpful in monitoring the EDSS progression. Primary progressive phenotype is associated with greater risk of cognitive dysfunction.

People with multiple sclerosis ‎(MS) and their physicians recognize cognitive retention as an important desired outcome of disease-modifying therapies (DMTs). In this study, we attempted to gather the opinions of Iranian MS experts regarding the treatment approach toward clinical cases with different physical and cognitive conditions. Opinions of 20 MS specialists regarding the best approach to 6 case scenarios (with different clinical, cognitive, and imaging characteristics) were gathered via a form. The estimated kappa of 0.16 [95% confidence interval (CI): 0.159-0.163; P < 0.001] suggested a poor degree of agreement on the treatment choice among the professionals. Although most specialists agreed with treatment escalation in cases with cognitive impairment, there was no general agreement. Furthermore, there was not enough clinical evidence in the literature to develop consensus guidelines on the matter.

Cardiovascular diseases (CVD) and cognitive decline both impart a significant burden on the life and livelihood of elderlypeople. Growing evidence suggests an association between CVD burden with changes in cognitive outcomes. This narrative review aimed to compile, synthesize, compare, and critique findings from articles of the last 10 years regarding the temporal relationship between CVD burden and cognitive function among older adults. Electronic databases of PubMed and Google Scholar were searched for prospective cohort studies that estimated CVD burden in the form of the presence of CVDs, or assessment of health through CVD risk models and determined temporal change in cognitive function by either detailing cognitive decline or incident dementia/cognitive impairment. Seventeen original articles met with eligibility criteria during the screening process and were included. The follow-up period of the prospective cohort studies ranged from 24 months- 41 years. Framingham General CVD Risk Score and Atrial Fibrillation were the most frequently found CVD risk model and cardiovascular diseases associated with cognitive change, respectively. Incidence of dementia/cognitive impairment in various studies ranged from 4.2-14.9%. All but one of the studies had shown a positive longitudinal association between CVD burden and cognitive decline among the study participants. Consistent findings of the temporal relationship between CVD risk models and cognitive decline in the review pave the way for operationalizing preventive strategies that act on multiple cardiovascular risk factors before old age. Strategic reform and capacity building in pre-existing CVD health infrastructures could effectively reduce the dementia burden of any specific country