AIM To test associations between statin use and cognitive impairment in adults with childhood-onset type 1 diabetes(T1D).METHODS In 2010-13, n = 108 middle-aged participants from ongoing observational Pittsburgh Epide...AIM To test associations between statin use and cognitive impairment in adults with childhood-onset type 1 diabetes(T1D).METHODS In 2010-13, n = 108 middle-aged participants from ongoing observational Pittsburgh Epidemiology of Diabetes Complications Study underwent neurocognitive assessment(mean age and T1 D duration of 49 and 41 years, respectively). All were diagnosed with childhoodonset(i.e., prior to age 18) T1 D between 1950 and 1980 and were seen within one year of diagnosis at Children's Hospital of Pittsburgh. Self-reported statin use(yes/no and if yes, name of statin) was collected biennially from parent study baseline(1986-1988) to time of neurocognitive testing. Logistic regression models tested associations between statin use groups and cognitive impairment(defined as having two or more cognitive test scores 1.5SD or worse than published norms) while linear regression models tested associations between statin use groups and cognitive domain z-scores(domains: Verbal IQ, memory, executive function, psychomotor speed, and visuo-construction). All models controlled for education and age. To address confounding by indication, models were repeated using a propensity score for statin use.RESULTS Of the 108 participants, 51 reported never using statins. Median duration of statin use among the 57 ever users was 6 years. These 57 ever statin users were split to create two groups(≤ or > median years of statin use): 1-6 years(n = 25), and 7-12 years(n = 32). Compared with never users, using statins 1-6 years tripled the odds of cognitive impairment(OR = 3.16; 95%CI: 0.93-10.72; P = 0.06) and using statins 7-12 years almost quintupled the odds of cognitive impairment(OR = 4.84; 95%CI: 1.63-14.44; P = 0.005). Compared with never users, using statins 1-6 or 7-12 years was related to worse performance in the memory domain(β =-0.52; P = 0.003, and-0.39; P = 0.014, respectively). Adjusting for coronary artery disease, low density lipoprotein cholesterol, and Apo E4 status did not substantially alter results, and none of these covariates were significantly related to cognitive outcomes(all P > 0.05). Propensity score analyses support that associations between poor cognitive outcomes and statin use were not due merely to confounding by indication. CONCLUSION Statin use was associated with cognitive impairment, particularly affecting memory, in these middle-aged adults with childhood-onset T1 D, whom at this age, should not yet manifest age-related memory deficits.展开更多
There are presently no in-depth published neuropsychological studies of West Nile Virus (WNV) encephalitis patients that have been well-correlated with high resolution structural MRI. In this study a middleaged male w...There are presently no in-depth published neuropsychological studies of West Nile Virus (WNV) encephalitis patients that have been well-correlated with high resolution structural MRI. In this study a middleaged male who developed West Nile Virus encephalitis five years previously was examined three times over a two year period. We examined him with the Wechsler Adult Intelligence Scales—Fourth Edition and the Wechsler Memory Scale—Fourth Edition (WAIS-IV/WMS-IV) and Advanced Clinical Solutions battery supplemented by tests of attention, executive, motor and sensory functions. Neuroradiological imaging revealed hypodensities within the left hippocampus in the axial and coronal planes with T2-FLAIR MRI. The man was previously high functioning and although he had prior history of well-controlled epilepsy it seems unlikely that the epilepsy could fully account for the neuropathological changes. The patient had previously completed a demanding six year double science degree program before he became ill with WNV and he had been a successful manager and director of a research company. Delayed auditory memory scores were at least two standard deviation units below age expected levels and semantic fluency and Booklet Category Tests of executive function were also in the impaired range. Moreover the illness onset profile of muscle weakness, extreme fatigue, memory complaints as well as inability to carry out research projects involving planning on the job were highly consistent with WNV encephalitis. If the memory and executive function deficits had been premorbid manifestations of epilepsy it is unlikely he would have attained the levels he did educationally and occupationally. This left hippocampal lesion is characteristic of other encephalitic viral infections such as herpes simplex virus. To our knowledge this is the first lateralized WNV encephalitis medial temporal lobe patient in the published literature.展开更多
Parkinson’s disease (PD) is associated with an increased incidence of cognitive impairment and dementia. Population-based cohort of 25 patients with incident PD underwent a large neuropsychological battery. Executive...Parkinson’s disease (PD) is associated with an increased incidence of cognitive impairment and dementia. Population-based cohort of 25 patients with incident PD underwent a large neuropsychological battery. Executive functions were the most affected cognitive domain including particularly initiation, mental flexibility and inhibition. Episodic memory and visuo-spatial functions were less affected. We found that 92% of patients were classified as having Mild Cognitive Impairment (MCI);most of them experienced PD-MCI Single-Domain (17 patients) with disturbances on executive functions. Less frequently, we identified a group of patients with multiple-domain PD-MCI demonstrating deficits on executive functions as well as on episodic memory and/or visuospatial capacities.展开更多
Objective: To observe the effects of Bushen Huoxue Formula (Formula for reinforcing the kidney and activating blood circulation) on the learning and memory function and the cerebral neurotransmitters in diabetic mice....Objective: To observe the effects of Bushen Huoxue Formula (Formula for reinforcing the kidney and activating blood circulation) on the learning and memory function and the cerebral neurotransmitters in diabetic mice. Methods: Forty ICR mice were randomized into the normal control group, model group, Nimotop group and Chinese medicine group, 10 mice in each group. Tail intravenous injection of alloxan was applied to prepare diabetic model. Four weeks later, intragastric administration of Bushen Huoxue Formula for the Chinese medicine group, Nimotop for the Nimotop group, and isometric distilled water for the other two groups were respectively given for 8 weeks. The changes in the blood sugar level were observed; the learning and memory function was detected by Morris labyrinth test; and the contents of norepinephrine (NE), dopamine (DA), 5-hydroxyltryptamine (5-HT) and 5-hydroxyl indole acetic acid (5-HIAA) in cerebral cortex were determined in mice of all the groups. Results: The blood sugar levels in the diabetic model mice significantly increased as compared with those of the normal control group determined 72 h and 12 weeks later (P<0.05 or P<0.01). Latencies for Morris labyrinth test in the Nimotop group and the Chinese medicine group were significantly shortened as compared with that in the model group (P<0.01). The contents of cortical NE in the Chinese medicine group was significantly higher than that in the model group (P<0.01). Conclusion: Bushen Huoxue Formula can improve the learning and memory function in the diabetic mice, and the mechanism is possibly related with change of the cortical NE content.展开更多
目的:评估词语记忆量表在认知功能正常的军队离退休人员中的应用,并分析影响词语记忆量表得分的相关因素。方法:以军队干休所为单位,选取2846名简易精神状态检查(MMSE)在24分以上的老年人进行词语记忆量表检查,内容包括词语即刻回忆、...目的:评估词语记忆量表在认知功能正常的军队离退休人员中的应用,并分析影响词语记忆量表得分的相关因素。方法:以军队干休所为单位,选取2846名简易精神状态检查(MMSE)在24分以上的老年人进行词语记忆量表检查,内容包括词语即刻回忆、延迟回忆、延迟再认(原词再认、新词再认),并分析性别、年龄、教育程度与词语记忆量表各项得分的相关性。结果:词语记忆量表的得分中,不同性别的新词再认得分差异无统计学意义(P>0.05),其余各项均是女性得分高于男性(均P<0.05);各项词语得分均随年龄增长呈下降趋势(均P<0.01);不同教育年限组的延迟再认得分差异无统计学意义(P>0.05),即刻回忆和延迟回忆得分随教育年限增长呈上升趋势(P<0.01)。词语记忆量表各项得分与M M SE得分均呈正相关(P<0.01)。85%的老年人延迟回忆信息保存达70%及以上。结论:使用词语记忆量表评估老年人的记忆功能要考虑性别、年龄、教育程度的影响。展开更多
基金Supported by National Institutes of Health(NIH)National Institute of Diabetes and Digestive and Kidney Disorders(NIDDK)grants,Nos.R01 DK089028,PI(to Rosano C)R37 DK034818-25,PI(to Orchard TJ)R21 DK082900,PI(to Costacou T)
文摘AIM To test associations between statin use and cognitive impairment in adults with childhood-onset type 1 diabetes(T1D).METHODS In 2010-13, n = 108 middle-aged participants from ongoing observational Pittsburgh Epidemiology of Diabetes Complications Study underwent neurocognitive assessment(mean age and T1 D duration of 49 and 41 years, respectively). All were diagnosed with childhoodonset(i.e., prior to age 18) T1 D between 1950 and 1980 and were seen within one year of diagnosis at Children's Hospital of Pittsburgh. Self-reported statin use(yes/no and if yes, name of statin) was collected biennially from parent study baseline(1986-1988) to time of neurocognitive testing. Logistic regression models tested associations between statin use groups and cognitive impairment(defined as having two or more cognitive test scores 1.5SD or worse than published norms) while linear regression models tested associations between statin use groups and cognitive domain z-scores(domains: Verbal IQ, memory, executive function, psychomotor speed, and visuo-construction). All models controlled for education and age. To address confounding by indication, models were repeated using a propensity score for statin use.RESULTS Of the 108 participants, 51 reported never using statins. Median duration of statin use among the 57 ever users was 6 years. These 57 ever statin users were split to create two groups(≤ or > median years of statin use): 1-6 years(n = 25), and 7-12 years(n = 32). Compared with never users, using statins 1-6 years tripled the odds of cognitive impairment(OR = 3.16; 95%CI: 0.93-10.72; P = 0.06) and using statins 7-12 years almost quintupled the odds of cognitive impairment(OR = 4.84; 95%CI: 1.63-14.44; P = 0.005). Compared with never users, using statins 1-6 or 7-12 years was related to worse performance in the memory domain(β =-0.52; P = 0.003, and-0.39; P = 0.014, respectively). Adjusting for coronary artery disease, low density lipoprotein cholesterol, and Apo E4 status did not substantially alter results, and none of these covariates were significantly related to cognitive outcomes(all P > 0.05). Propensity score analyses support that associations between poor cognitive outcomes and statin use were not due merely to confounding by indication. CONCLUSION Statin use was associated with cognitive impairment, particularly affecting memory, in these middle-aged adults with childhood-onset T1 D, whom at this age, should not yet manifest age-related memory deficits.
文摘There are presently no in-depth published neuropsychological studies of West Nile Virus (WNV) encephalitis patients that have been well-correlated with high resolution structural MRI. In this study a middleaged male who developed West Nile Virus encephalitis five years previously was examined three times over a two year period. We examined him with the Wechsler Adult Intelligence Scales—Fourth Edition and the Wechsler Memory Scale—Fourth Edition (WAIS-IV/WMS-IV) and Advanced Clinical Solutions battery supplemented by tests of attention, executive, motor and sensory functions. Neuroradiological imaging revealed hypodensities within the left hippocampus in the axial and coronal planes with T2-FLAIR MRI. The man was previously high functioning and although he had prior history of well-controlled epilepsy it seems unlikely that the epilepsy could fully account for the neuropathological changes. The patient had previously completed a demanding six year double science degree program before he became ill with WNV and he had been a successful manager and director of a research company. Delayed auditory memory scores were at least two standard deviation units below age expected levels and semantic fluency and Booklet Category Tests of executive function were also in the impaired range. Moreover the illness onset profile of muscle weakness, extreme fatigue, memory complaints as well as inability to carry out research projects involving planning on the job were highly consistent with WNV encephalitis. If the memory and executive function deficits had been premorbid manifestations of epilepsy it is unlikely he would have attained the levels he did educationally and occupationally. This left hippocampal lesion is characteristic of other encephalitic viral infections such as herpes simplex virus. To our knowledge this is the first lateralized WNV encephalitis medial temporal lobe patient in the published literature.
文摘Parkinson’s disease (PD) is associated with an increased incidence of cognitive impairment and dementia. Population-based cohort of 25 patients with incident PD underwent a large neuropsychological battery. Executive functions were the most affected cognitive domain including particularly initiation, mental flexibility and inhibition. Episodic memory and visuo-spatial functions were less affected. We found that 92% of patients were classified as having Mild Cognitive Impairment (MCI);most of them experienced PD-MCI Single-Domain (17 patients) with disturbances on executive functions. Less frequently, we identified a group of patients with multiple-domain PD-MCI demonstrating deficits on executive functions as well as on episodic memory and/or visuospatial capacities.
基金supported by the Foundation of Peking Union Medical College Hospital, China (XH-020042)
文摘Objective: To observe the effects of Bushen Huoxue Formula (Formula for reinforcing the kidney and activating blood circulation) on the learning and memory function and the cerebral neurotransmitters in diabetic mice. Methods: Forty ICR mice were randomized into the normal control group, model group, Nimotop group and Chinese medicine group, 10 mice in each group. Tail intravenous injection of alloxan was applied to prepare diabetic model. Four weeks later, intragastric administration of Bushen Huoxue Formula for the Chinese medicine group, Nimotop for the Nimotop group, and isometric distilled water for the other two groups were respectively given for 8 weeks. The changes in the blood sugar level were observed; the learning and memory function was detected by Morris labyrinth test; and the contents of norepinephrine (NE), dopamine (DA), 5-hydroxyltryptamine (5-HT) and 5-hydroxyl indole acetic acid (5-HIAA) in cerebral cortex were determined in mice of all the groups. Results: The blood sugar levels in the diabetic model mice significantly increased as compared with those of the normal control group determined 72 h and 12 weeks later (P<0.05 or P<0.01). Latencies for Morris labyrinth test in the Nimotop group and the Chinese medicine group were significantly shortened as compared with that in the model group (P<0.01). The contents of cortical NE in the Chinese medicine group was significantly higher than that in the model group (P<0.01). Conclusion: Bushen Huoxue Formula can improve the learning and memory function in the diabetic mice, and the mechanism is possibly related with change of the cortical NE content.
文摘目的:评估词语记忆量表在认知功能正常的军队离退休人员中的应用,并分析影响词语记忆量表得分的相关因素。方法:以军队干休所为单位,选取2846名简易精神状态检查(MMSE)在24分以上的老年人进行词语记忆量表检查,内容包括词语即刻回忆、延迟回忆、延迟再认(原词再认、新词再认),并分析性别、年龄、教育程度与词语记忆量表各项得分的相关性。结果:词语记忆量表的得分中,不同性别的新词再认得分差异无统计学意义(P>0.05),其余各项均是女性得分高于男性(均P<0.05);各项词语得分均随年龄增长呈下降趋势(均P<0.01);不同教育年限组的延迟再认得分差异无统计学意义(P>0.05),即刻回忆和延迟回忆得分随教育年限增长呈上升趋势(P<0.01)。词语记忆量表各项得分与M M SE得分均呈正相关(P<0.01)。85%的老年人延迟回忆信息保存达70%及以上。结论:使用词语记忆量表评估老年人的记忆功能要考虑性别、年龄、教育程度的影响。
