Psychophysiological Effects of Sideritis and Bacopa Extract and Three Combinations Thereof—A Quantitative EEG Study in Subjects Suffering from Mild Cognitive Impairment (MCI)

Mild cognitive impairment (MCI) is regarded as a transitional stage during the development of Alzheimer’s disease. Diagnosis of MCI can be obtained by the questionnaire “DemTect” in German speaking countries. Quantitative assessment has been successfully performed using psychometric testing concomitantly with quantitative EEG recording. The present investigation aimed at the possible treatment of MCI with two botanicals, namely extracts from Sideritis scardica (500 mg) or Bacopa monnieri (320 mg) and three combinations thereof using this method in order to find a new treatment. The performance of the d2-test, an arithmetic calculation test (CPT) and a memory-test revealed better performance for the d2-test only in the presence of Sideritis extract or the combinations with Bacopa extract. Quantitative EEG assessment during the different experimental conditions showed massive differences between both extracts. Whereas Sideritis extract and its combination with a low amount of Bacopa extract (160 mg) induced increases of spectral power in fronto-temporal brain areas, Bacopa and the combination of Sideritis with high amounts of Bacopa extract produced attenuation of all waves except for delta in fronto-temporal brain areas. These differences were also documented by quantitative EEG maps in comparison to Placebo. A different action of both extracts was confirmed by discriminant analysis, where Sideritis extract and its combination with low Bacopa grouped together quite at distance to Bacopa and the combination of Sideritis with high Bacopa. A combination of Sideritis extract with a low amount of Bacopa should be tested with daily repetitive dosing for at least 4 weeks as a consequence.

MCI患者高阶动态功能连接的图论网络构建方法及分类

针对在低阶脑网络应用图论忽视了功能连接高阶动态性的问题,提出了一种基于高阶动态功能连接的图论网络构建方法(GNC-HodFC),提取高阶FC网络的图论特征以对轻度认知障碍患者和健康被试者进行差异性分析及分类。首先定义了表征高阶动态脑网络连接的图论节点和边;然后利用滑动窗相关技术提取低阶功能连接信息,提出平稳性判据,选取最优特征子集以构建图论的节点;最后提出自适应阈值策略对高阶动态功能连接信息进行选取以构建图论的边,最终完成高阶动态脑网络的图构建。实验结果表明,GNC-HodFC的平均分类准确率可以达到70.5%,优于其他三种对比方法,且患者组和健康组的图论特征中存在显著性差异,GNC-HodFC方法可以为轻度认知障碍的诊断提供新的辅助手段。

Memory Training and Task Specificity in 90-99-Year-Old Seniors with Mild Cognitive Impairment

Managing memory deficits is a central problem among older adults with mild cognitive impairment (MCI). This study examined the effects of memory training on memory performance in an understudied “oldest-old” population ranging in age from 90 to 99 years. Eighteen mild to moderately cognitive-impaired older seniors, 90 years and older were recruited from memory clinics established in senior living communities. Treatment sessions took place, on average, twice weekly, for 55 minutes. Memory intervention included nineteen computer-based exercises customized to focus on memory loss. The specificity of memory training was very clear;memory training produced significant effects (F(3,51) = 2.81, p = 0.05) on memory performance, especially after 6 months of training, while other outcome measures showed no effects as predicted. Based on the results, it can be concluded that interventions targeting cognition and memory in the oldest-old MCI population can significantly improve memory function and reduce cognitive deficits.

Study on EEG power and coherence in patients with mild cognitive impairment during working memory task

To investigate the features of electroencephalography (EEG) power and coherence at rest and during a working memory task of patients with mild cognitive impairment (MCI). Thirty-five patients (17 males, 18 females; 52～71 years old) and 34 sex- and age-matched controls (17 males, 17 females; 51～63 years old) were recruited in the present study. Mini-Mental State Examination (MMSE) of 35 patients with MCI and 34 normal controls revealed that the scores of MCI patients did not differ significantly from those of normal controls (P＞0.05). Then, EEGs at rest and during working memory task with three levels of working memory load were recorded. The EEG power was computed over 10 channels: right and left frontal (F3, F4), central (C3,C4), parietal (P3, P4), temporal (TS, T6) and occipital (O1, O2); inter-hemispheric coherences were computed from five electrode pairs of F3-F4, C3-C4, P3-P4, T5-T6 and O1-O2 for delta (1.0～3.5 Hz), theta (4.0～7.5 Hz), alpha-1 (8.0～10.0 Hz), alpha-2 (10.5～13.0 Hz), beta-1 (13.5～18.0 Hz) and beta-2 (18.5～30.0 Hz) frequency bands. All values of the EEG power of MCI patients were found to be higher than those of normal controls at rest and during working memory tasks. Furthermore, the values of EEG power in the theta, alpha-1, alpha-2 and beta-1 bands of patients with MCI were significantly high (P＜0.05) in comparison with those of normal controls. Correlation analysis indicated a significant negative correlation between the EEG powers and MMSE scores. In addition, during working memory tasks, the EEG coherences in all bands were significantly higher in the MCI group in comparison with those in the control group (P＜0.05). However, there was no significant difference in EEG coherences between two groups at rest. These findings comprise evidence that MCI patients have higher EEG power at rest, and higher EEG power and coherence during working conditions. It suggests that MCI may be associated with compensatory processes at rest and during working memory tasks. Moreover, failure of normal cortical connections may be exist in MCI patients.

Usefulness of the Japanese version of Rapid Dementia Screening Test for mild cognitive impairment in older patients with cardiovascular disease:a cross-sectional study

BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.

VR支持训练联合中医情志护理对MCI人群认知领域的影响研究

目的探讨虚拟现实技术(VR)支持训练联合中医情志护理对轻度认知障碍(MCI)人群认知领域的影响。方法选择2023年7月-11月我院收治的MCI患者60例,按随机数字表法分为观察组和对照组,各30例。对照组开展常规认知康复训练,观察组在对照组的基础上开展VR支持训练联合中医情志护理,两组均连续训练6周。比较两组训练前后蒙特利尔认知评价量表(MoCA)、简易智力状态检查量表(MMSE)评分。结果对照组训练后MoCA总分及注意与集中力、记忆力评分均升高(P<0.05),MMSE总分及记忆力、计算和注意力评分均升高(P<0.05);观察组训练后MoCA总分及注意与集中力、记忆力、视空间执行力评分均升高(P<0.05),MMSE总分及记忆力、计算和注意力评分均升高(P<0.05);观察组训练后MoCA总分及注意与集中力、记忆力、视空间执行力评分,MMSE总分及记忆力、计算和注意力评分均高于对照组(P<0.05)。结论VR支持训练联合中医情志护理可有效改善MCI人群的认知功能,康复训练效果好,可应用于临床。

Neurophysiological Biomarker of Mild Cognitive Impairment

Mild cognitive impairment is sometimes regarded as related to aging. However, statistically every second case turns into full dementia, which still is resistant to any treatment. It is therefore desir-able to recognize deviations from normality as early as possible. This might be feasible by using quantitative EEG analysis in the presence of mental work. The present retrospective data analysis revealed a new quantitative biomarker indicating the degree of impairment. Current source density was calculated from 16 channel EEG using CATEEM?? software. Four different conditions were analyzed: relaxed state, performing a d2-concentration test, a calculation performance test and a memory test for 5 min each. Subjects older than 40 years were divided into two groups according to their DemTect score: 13 - 18 (HC;n = 44) or 8 - 12 (MCI;n = 45). Spectral power was chopped into six frequency ranges (delta, theta, alpha 1, alpha 2, beta 1 and beta 2). Average spectral power was enhanced in the MCI group in comparison to healthy subjects with respect to delta (p = 0.05) during relaxed state when all electrode positions were regarded. With respect to EEG recording during performance of three different psychometric tests it was recognized that mainly spectral changes during performance of the d2-concentration test were related to mild cognitive impairment. With regard to all electrode positions statistically significantly lower spectral power values were reached during the d2-test for delta (p = 0.001), theta (p = 0.0001) and alpha 1 waves (p = 0.08) in impaired subjects in comparison to healthy subjects. Regarding regions of interest increases of delta and theta power were seen in the fronto-temporal brain during performance of the d2-concentration test. These increases disappeared when looking at MCI data. In the centro-parietal region decreases of alpha and beta 1 power emerged, which were even larger in MCI subjects. No MCI-dependent changes were observed in the other two tests. A correlation was found between psychometric performance of the d2-test and the DemTect score (r = 0.51). MCI subjects had statistically significant worse performance in all three mental challenges in comparison to healthy volunteers. It is concluded that MCI can be characterized at an early stage by EEG recording in the relaxed state. High spectral delta and theta power in general and specifically at fronto- temporal electrode positions (especially at T3) was recognized as a biomarker for MCI. A DemTect score of 8-12 was validated as indicative for MCI.

Nine Months of Memory Training Increases Cognistat Measured Memory in 79 - 89 Year-Old Mild Cognitively Impaired Individuals

The effects of a memory training paradigm on performance across multiple cognitive domains, measured via the Cognistat, in 70 - 89 year-old individuals with mild cognitive impairment (MCI), were examined. Memory training sessions were conducted on average twice weekly, for 55 minutes each session, for 9 months. Across the testing period, Cognistat-measured memory increased relative to performance in other cognitive domains. Additionally, performance on non-memory measures remained stable or declined. Thus, memory training in older adult, MCI individuals may result in improved memory, but not in improvement in other, non-memory, cognitive domains. Results replicate previous work examining “oldest-old” individuals ranging in age from 90 to 99 years old at the time of study start.

基于多尺度熵特征优化算法的MCI早期诊断及敏感脑区分析

轻度认知障碍(MCI)是阿尔兹海默病诊疗的关键时期,迫切需要早发现,早干预。针对MCI早期诊断问题,特别是早期诊断的敏感脑区定位问题,提出一种基于多尺度熵的脑电信号特征提取优化算法,即多尺度熵特征优化算法。该算法通过构建多重尺度序列,并充分考虑各序列贡献程度,最大程度挖掘细节信息。共采集49名受试者临床脑电信号数据,其中实验组(MCI组)28名,正常对照组21名。对比分析实验组与对照组,MCI组16通道多尺度熵特征优化算法熵值均低于对照组,且前额叶、前颞叶以及中颞叶脑区具有显著性差异(P<0.01)。仅以此特征作为分类器输入特征,分析前额叶、前颞叶以及中颞叶3个脑区,其脑区诊断测试集识别率分别为83.33%、86.67%、73.33%。进一步,分析识别率最高的前颞叶两通道的AUC值分别为0.753与0.733。多尺度熵特征优化算法熵特征能够充分反应脑电信号变化,是可以作为MCI早期诊断的一种特征标记,前颞叶脑区可以为评估MCI患者脑认知功能状态的敏感脑区提供研究支持。

AB099.Cognitive impairment and age-related macular degeneration:a possible genetic link

Background:The number of older adults affected by age-related macular degeneration(AMD)and early cognitive changes is on the rise.Recent studies have shown a high co-occurrence of these conditions.This,along with shared risk factors and similar histopathology suggests they may share genetic risk factors as well.The goal of this study was to explore the possibility of known AMD SNPs contributing to the co-morbidity.Methods:Participants(AMD and controls)aged 70 years or older with no known neurological or cognitive impairments were recruited for this study.Visual function was evaluated using ETDRS visual acuity,Mars Contrast sensitivity and the scanning laser ophthalmoscope.Cognitive status was measured using the Mini-Mental State Exam(MMSE)and the Montreal Cognitive Assessment(MoCA).Genotyping was conducted using a panel of AMD single nucleotide polymorphisms(SNPs).Analysis was focused on the CFH Y402H and ARMS2 A69S SNPs due their association with drusen and evidence of their association with cognitive impairment.Results:According to the MMSE,two participants from the AMD group(N=21)and none from the control group(N=18)scored positive for cognitive impairment.The MoCA indicated 33.3%of the AMD group and 27.7%of the control group had MCI.There were no significant differences between MoCA scores based on the carrier versus non-carrier status of either the CFH or ARMS SNPs.The SNP in FADS1(rs174547)that was part of the original panel,but not in the analysis,was found in a large number of participants.All those who scored positive for MCI were homozygous carriers of the FADS1 SNP.Conclusions:Although more people from the AMD group scored positive for MCI,scores between groups were significantly different.The AMD and control groups did differ on which cognitive domains they had difficulty with,indicating those with AMD and MCI may be at a higher risk of converting to AD.There were no significant differences on cognitive scores between CFH and ARMS2 SNP carriers and non-carriers.The FADS1 SNP,not originally intended to be part of this study,will be included in future analyses to explore the possibility of a founder effect and a potential link to mild cognitive impairment(MCI).

MCI患者的注意功能障碍反应时研究

目的探讨轻度认知功能障碍(mildcognitiveimpairment,MCI)患者大脑注意功能的改变。方法应用精确计时软件DMDX编制程序,在计算机上系统的测查MCI患者的注意功能,并与正常老年人(normalcon trol,NC)对比。分别采用持续操作任务实验(continuousperformancetest,CPT)测查持续注意功能(MCI17例、NC18名),斯特鲁普(Stroop)实验测查选择注意功能(MCI19名、NC20名),双任务实验测查分散注意能力(MCI18例、NC19名)。结果CPT实验中,MCI患者的反应时、漏报率和虚报率与NC组间无差别。Stroop实验中,2组被试均表现出明显的干扰效应;尽管MCI组反应时干扰量和错误率干扰量与NC组差异无显著性,但一致和中性条件下的反应时长于NC组,总错误率以及一致和中性条件下的错误率高于NC组。双任务实验中MCI组和NC组间无差别。结论与NC相比,MCI患者选择注意功能有下降趋势,持续和分散注意能力正常。

肝主疏泄功能与MCI相关性理论探讨

肝主疏泄,调节气机,调畅精气血的运行、输布及情志活动。精气血是人体生命活动的物质基础,精气血亏虚、瘀滞是MCI发生之根本,情志失调是导致MCI重要因素之一。因此,肝主疏泄功能与MCI关系密切。从肝入手,探讨传统中医对MCI的认识、梳理肝主疏泄的生理和病理变化与MCI的关系,以期为中医探讨防治MCI相关机制提供更为宽广的领域。

绞股蓝皂甙改善MCI大鼠学习记忆能力的机制探讨

目的：探讨绞股蓝皂甙（GP）改善轻度认知功能障碍（MCI）大鼠学习记忆能力的作用及其机制。方法将12-15个月龄SD健康大鼠随机分为5组：假手术对照组（SSC组）、MCI模型对照组（MCI组）和GP低、中、高剂量组（LGP组、MGP组、HGP组），每组20只。通过结扎双侧颈内动脉（ICA）致其重度狭窄并大脑持续低灌注2个月，建立MCI大鼠模型。采用GP连续灌胃2个月作用于MCI大鼠，观察各组大鼠行为学、大脑皮层和海马超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-Px）活性和丙二醛（MDA）、一氧化氮合酶（NOS）、一氧化氮（NO）含量的变化。结果（1）与MCI组比较，LGP组、MGP组、HGP组的潜伏期依次变短（P〈0.01），其中HGP组的潜伏期接近SSC组（P〉0.05）。（2）与MCI组比较，LGP组、MGP组、HGP组穿过原平台位置的次数依次增多（P〈0.01）、在原平台象限游泳的时间百分比依次增高（P〈0.01）；其中HGP组的次数和时间百分比接近SSC组（P〉0.05）。（3）与MCI组比较，LGP组、MGP组、HGP组的SOD、GSH-Px活性依次升高（P〈0.01），MDA、NOS、NO含量依次降低（P〈0.01）；其中HGP组的SOD、GSH-Px活性以及MDA、NOS、NO含量接近SSC组（P〉0.05）。结论绞股蓝皂甙可能通过提高脑组织SOD、GSH-Px活性、抑制NOS活性以及降低MDA、NO含量，改善MCI大鼠学习记忆能力。

基于网络拓扑特性的MCI分类

阿尔茨海默氏病(Alzheimer′s disease,AD)和轻度认知障碍(Mild cognitive impairment,MCI)是经常发生在老年人中的脑疾病,其主要表现为认知和智力的障碍。机器学习和模式识别方法已经被应用到对AD和MCI的诊断和分类中。最近,研究人员提出利用大脑连接网络实现对疾病的诊断和分类。大部分的研究主要集中在网络中提取一些局部的特性(如聚类系数),并利用机器学习的方法(如支持向量机)来实现对疾病的分类。然而,存在的研究表明AD以及MCI是和一个大规模的脑连接网络相关,而不仅是大脑的若干区域。因此,本文提出一种新的基于网络整体拓扑结构信息的分类方法,并将其用于对MCI疾病的分类。实验结果表明,本文的方法能够对分类结果有重要的改进。

脑白质高信号的中青年轻度认知功能障碍患者认知功能特点及脑血流改变情况分析

目的分析脑白质高信号(WMH)的中青年轻度认知功能障碍(MCI)患者的认知功能特点及脑血流改变情况。方法招募2023年2月至12月扬州大学附属医院神经内科收治的WMH患者70例,年龄35~65岁,均行神经心理量表评分、颅脑MRI及经颅多普勒(TCD)检查,收集其一般临床资料。根据北京版蒙特利尔认知量表(MoCA)评分将研究对象分为MCI组(MoCA评分20~24分,36例)和对照组(MoCA评分25~30分,34例)。比较两组临床基线资料、认知亚域评分、TCD指标。采用logistic回归分析探讨大脑中动脉(MCA)搏动指数(PI)与MCI发生的关联性。结果对照组MoCA的视空间与执行功能、命名、注意力、语言、抽象思维以及延迟记忆能力显著优于MCI组(P<0.05)。MCI组的听觉词语学习测验华山版(AVLT-H)长延迟回忆得分及总分低于对照组,差异有统计学意义(P<0.05)。MCI组词语流畅性实验(VFT)得分、符号数字转化测验(SDMT)得分、画钟测验(CDT)得分低于对照组,连线测试A(TMT-A)、连线测试B(TMT-B)耗时长于对照组,差异有统计学意义(P<0.05)。MCI组MCA的PI水平高于对照组,差异有统计学意义(P<0.05),其余TCD指标比较差异无统计学意义(P>0.05)。经调整性别、高血压病史、糖尿病史、高血脂病史、吸烟史及饮酒史因素后,logistic回归分析结果显示,MCA的PI水平升高是促进MCI发生的危险因素[OR(95%CI)=348.877(2.046~59419.483),P=0.026]。结论WMH的中青年MCI患者的语言、视空间、记忆、执行、注意与处理速度等认知亚域功能均有所下降。MCA的PI水平升高有助于识别MCI高危人群。

老年人轻度认知功能障碍危险因素现状研究

目的:探索老年人轻度认知功能障碍(MCI)发生的危险因素,为构建MCI风险预警模型提供数据支持。方法:选取2023年2月—8月住院老年人206例作为研究对象,收集并整理病人基本资料和MCI可能发生的因素。基于Rothman-Keller模型,构建单因素分析、多因素Logistic回归分析模型,并绘制预测模型可视化。结果:206例老年人中,69例发生MCI,发生率为33.5%。MCI的发生受到多种危险因素的影响,包括年龄、吸烟、睡眠障碍、糖尿病和高血压。积极参与社会活动是预防MCI的保护因素。但当前的结论仅能表明参与社会活动与发生MCI相关,并不能确定因果关系。结论:鼓励个体积极参与各种社交和心理刺激活动,并采取健康的生活方式,是预防和管理MCI的重要策略,今后应进一步使用更全面的设计和代表性样本以验证这些结果,并更好地理解社会活动对认知功能障碍的影响。

基于SVM的fMRI数据分类及MCI诊断应用

为了有效提高轻度认知障碍(mild cognitive impairment,MCI)的早期诊断效果,提出了基于SVM的fMRI数据分类方法,并构建分类准确率更高的集成分类器。传统的MCI诊断过程,检验周期长、主观误差较大,为此,利用数据挖掘技术,采用SVM数据分类方法,通过提取单个体素的分类特征,对fMRI图像作分类,并分析分类准确率较高的体素分布区域。通过加权平均的方法,构建集成分类器,更好地辅助临床诊断。

知信行模式联合中医治未病理论在社区轻度认知功能障碍老年人护理中的应用

目的:探讨知信行模式联合中医治未病理论在社区老年人轻度认知功能障碍护理中应用的效果。方法:选取2018年6月—2019年6月在社区轻度认知功能障碍筛查门诊筛查的200例轻度认知障碍老年人为研究对象,采用为期1年的知信行模式联合中医治未病理论进行干预管理,比较干预前后老年人认知水平及认知能力。结果:200例轻度认知功能障碍老年人干预后知-信-行调查问卷评分、简易精神状态检查量表评分、蒙特利尔认知评估量表评分均高于干预前,差异有统计学意义(P<0.001)。结论:基于知信行模式联合中医治未病理论干预社区轻度认知功能障碍老年人,可有效提高老年人认知水平,改善认知功能,阻止或延缓认知障碍进展。

5类14种运动疗法对轻度认知障碍病人总体认知功能影响的网状Meta分析

目的:运用网状Meta分析方法评价5类14种运动疗法治疗轻度认知障碍(MCI)病人总体认知功能的效果,为探讨精准化运动方案提供参考依据。方法:计算机检索PubMed、EMbase、The Cochrane Library、中国知网和万方数据库有关运动疗法治疗MCI病人的随机对照试验(RCTs),检索时限均从建库至2022年2月15日。由2名评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Stata 15.1进行网状Meta分析。结果:共纳入29项RCTs,包括2024例MCI病人。网状Meta分析结果显示,5类运动疗法中,多模式运动[SMD=1.54,95%CI(0.87,2.21)]治疗MCI病人总体认知功能最有效,其次是有氧运动[SMD=0.89,95%CI(0.37,1.40)]、抗阻运动[SMD=0.80,95%CI(0.13,1.48)]和身心运动[SMD=0.67,95%CI(0.15,1.18)];14种运动疗法中,有氧体操[SMD=2.78,95%CI(1.17,4.39)]治疗MCI病人总体认知功能最有效,其次是多模式运动[SMD=1.83,95%CI(1.15,2.51)]、有氧舞蹈[SMD=1.02,95%CI(0.17,1.87)]和八段锦[SMD=0.69,95%CI(0.07,1.30)]。结论:现有证据表明,多模式运动可能是改善MCI病人总体认知功能最有效的方式,有氧体操、有氧舞蹈和八段锦也具有较大潜力。未来可基于运动伴随音乐治疗MCI病人开展更多的RCTs。