Early Intervention Facilitates Neuropsychological Development in Children with Autism and Attention Deficit Hyperactivity Disorder

Objective:This study aims to investigate the impact of early intervention on neuropsychological development in children with autism and attention deficit hyperactivity disorder(ADHD),providing effective intervention strategies for clinical practice.Methods:A total of 130 children with autism and ADHD who visited the hospital between June 2023 and June 2024 were selected as study subjects and randomly divided into an intervention group and a control group,with 65 children in each group.The intervention group received a one-year early comprehensive intervention,including behavioral therapy,cognitive training,and family guidance,while the control group only received routine medical care.The neuropsychological development assessment scale was used to evaluate both groups before and after the intervention to compare changes in their neuropsychological development levels.Results:Children in the intervention group showed significant improvements in cognitive function,social skills,language ability,and attention concentration,with an average improvement score of 23.5 points.Children in the control group did not show significant improvements in these areas,with an average improvement score of only 5.8 points.The difference between the two groups was statistically significant(P<0.05).Conclusion:Early comprehensive intervention has a significant promoting effect on the neuropsychological development of children with autism and ADHD.Targeted behavioral therapy,cognitive training,and family guidance can effectively enhance children’s cognitive,social,language,and attention abilities,laying a solid foundation for their future overall development.Therefore,it is recommended to actively promote and apply early intervention strategies in clinical practice.

Efficacy of Children Neuropsychological and Behavioral Scale in Screening for Autism Spectrum Disorders through a Combination of Developmental Surveillance

Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.

Association between Hearing Loss and Vestibular Disorders: A Review of the Interference of Hearing in the Balance

Introduction: Dizziness is very prevalent and makes a great impact on people’s life. Because of anatomical and functional similarities of hearing and vestibular systems, it is noted that there is a big relation between hearing loss and vestibular disorders. Depending on the age onset of hearing loss, it can cause even delay on motor development. Objective: To find literature that demonstrates the relation between hearing and balance. Confirming that hearing loss or even intervention to improve quality of hearing can interfere on vestibular system. Methodology: Revision of literature was carried out, preferring recent research only in English. Conclusion: Cochlea and vestibular systems have a close relationship;changes in one of them can cause big damage in the other. So, a complete evaluation of vestibular system is recommended before ear surgeries. Video Head Impulse Test is a new procedure able to evaluate high frequency movements of the head. It was an additional exam of vestibular status and came to help detect problems that were not diagnosed before. Efforts must be directed in order to protect the balance.

Recent Advances in HIV-Associated Neurocognitive Disorders

HIV-associated neurocognitive disorders (HAND) are chronic complications of HIV infection in the central nervous system. Clinical presentations include asymptomatic neurocognitive impairment (ANI), mild neurocognitive impairment (MND), and HIV-associated dementia (HAD). In the era of combination antiretroviral therapy (cART), the prevalence of HAD has significantly decreased, but the rates of ANI and MND have increased, impairing patients’ daily functioning, medical adherence, employment, driving abilities, risk of HIV transmission, overall quality of life, and posing challenges to society, economy, families, and public health. This article reviews the latest research findings regarding the pathogenesis, clinical diagnosis and treatment, neuroimaging, and neuropsychological assessment of HAND, aiming to provide insights into the prevention and management of HAND.

Cognitive impairment in patients with bipolar disorder alone versus those with bipolar disorder comorbid with borderline personality disorder

BACKGROUND Bipolar disorder(BD)is a severe mental illness.BD often coexists with borderline personality disorders,making the condition more complex.AIM To explore the differences in cognitive impairment between patients with BD and those with BD comorbid with borderline personality disorder.METHODS Eighty patients with BD and comorbid borderline personality disorder and 80 patients with BD alone were included in groups A and B,respectively,and 80 healthy volunteers were included as controls.Cognitive function in each group was evaluated using the Chinese version of the repeatable battery for the assess-ment of neuropsychological status(RBANS),the Stroop color-word test,and the Wechsler intelligence scale-revised(WAIS-RC).RESULTS The indices of the RBANS,Stroop color-word test,and WAIS-RC in groups A and B were significantly lower than those of the control group(P<0.05).Group A had significantly longer Stroop color-word test times for single-character,single-color,double-character,and double-color,lower scores of immediate memory,visual breadth,verbal function dimensions and total score of the RBANS,as well as lower scores of verbal IQ,performance IQ,and overall IQ of the WAIS-RC compared with group B(P<0.05).Compared to group B,group A exhibited significantly longer single-character time,single-color time,double-character time,and double-color time in the Stroop color-word test(P<0.05).CONCLUSION The cognitive function of patients with BD complicated with borderline personality disorder is lower than that of patients with BD.

Bibliographical Review on Rehabilitation of Executive Functions in Patients With Developmental Coordination Disorder(DCD)

The present study aims to establish a literature review on intervention programs for executive functions(EFs)through the use of fundamental motor skills,from a neuropsychopedagogical perspective in subjects with Developmental Coordination Disorder(DCD).An exploratory study was carried out through an integrative literature review.The research was carried out in the Scientific databases Electronic Library Online(SciELO),Latin American and Caribbean Literature in Health Sciences(LILACS),Virtual Health Library-Psychology Brazil(BVSPSI),Electronic Journals of Psychology(PePSIC),in the periodicals available in the Brazilian Digital Library of Theses and Dissertations(BDTD)and on the website of the Coordination for the Improvement of Higher Education Personnel(CAPES).The covering publications took place from 2018 to 2023,14 articles were selected for analysis.This literature review made it possible to create strategies for stimulating EF and Visuomotor Functions so that educators and other professionals can better deal with students with DCD.It was perceived the need to carry out and develop more empirical research regarding the intervention of EFs and Visuomotor Functions by educators and professionals,with a greater sampling amplitude,to increase the number of studies that enable interventions both in children and in teenagers with DCD.

Skin reactions caused by bone-anchored hearing aid(BAHA) implantation

Objective: To report a case of intractable skin reactions caused by bone-anchored hearing aid (BAHA) implantation to improve our under-standing and treatment of BAHA implantation-caused skin reactions. Methods:We reported a case of severe skin reactions caused by BAHA implantation. Related literature were also reviewed. Results:We found grade IV skin reactions, including hyperplasia around the implant, which led to the removal of the BAHA implant 10 months after implantation. The findings indicated poor skin hygiene, allergy to titanium and inadequate surgicals skills as the possible causes of the skin reaction. Conclusion: Skin adverse reactions, usually rare in BAHA implantation patients, may cause implant removal and implantation failure. We suggest to further investigate the mechanisms underlying titanium allergy. Copyright ? 2016, PLA General Hospital Department of Otolaryngology Head and Neck Surgery. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Neuropsychological and Neurological Deficits in Obsessive-Compulsive Disorder: The Role of Comorbid Depression

Past research has found a high prevalence of neuropsychological deficits and neurological soft signs in patients with obsessive-compulsive disorder (OCD). A close relationship between OCD and depression has also been indicated in the literature. However, many aspects of this association remain unclear. In this study we compared neuropsychological functioning and neurological soft signs of 46 OCD patients who were off psychotropic medication (21 with significant depressive symptoms and 25 without) with 25 non-patient comparison subjects. The patients were matched to the comparison group with regard to age, sex, education, marital status and handedness. There were significant differences between OCD patients and the non-patient comparison group on neuropsychological functioning but not on neurological soft signs. As far as working memory concerns there was a significant difference between the OCD depressed and non-depressed groups. But we found no evidence that the neuropsychological functions such as cognitive flexibility, problem solving and spatial perception in OCD to be attributable to comorbid depression. The pattern of neuropsychological deficits in this sample of OCD patients is suggestive of orbito-frontal as well as dorsolateral prefrontal cortical dysfunction.

Verbal Communication in HIV-1 Patients： A New Perspective on the Study of Cognitive Disorders

The aims were： （1） to study verbal communication skills presenting with verbal communication deficits by applying the MEC in HIV-1 patients, and （2） to analyze the proportion of patients Protocol. The authors evaluated 20 patients over 18 years of age HIV-1 positive; native speakers of Spanish; without alterations in language acquisition, reading, writing or history of neurological or psychiatric disease; patients undergoing antiretroviral treatment （not efavirenz） with viral load 〉 50 copies/mL, and patients not undergoing treatment. Their verbal communication abilities were evaluated with Protocol MEC. The results demonstrate that some of the skills evaluated are more vulnerable in HIV-1 patients. The tasks that showed the most frequent and systematic deficits among patients were discourse-level tasks and those that evaluate lexical semantic processing. The authors compared patients＇ performances with the ＂cut-off＇. The scores were turned into score Z. A hierarchic cluster analysis was carried out to identify subgroups with different profiles according to the areas that were affected. The detection of communication deficit profiles in HIV-1 patients would be the starting point for the identification of disorders and the admission of the patients to health care system. This research constitutes an initial approach towards the identification of clinical profiles among HIV-1 patients.

亨廷顿病多维度神经心理学评估的随访研究

目的本研究旨在通过对3个家系的亨廷顿病(Huntington's disease,HD)患者进行多维度神经心理学评估,前瞻性的研究HD患者认知功能损害的进展。方法8名来自3个家系的HD患者和8名与其性别、年龄、种族匹配的健康对照者纳入本研究,并进行3年随访观察。通过多维度认知功能评定量表来评估参与者的认知功能。使用PCR-毛细管电泳检测IT15基因的CAG重复次数。结果共有来自3个家系的8名成员参与了HTT基因检测,确诊HD患者5例,其中2例为症状前期患者。3名患者通过阳性家族史、舞蹈样不自主动作、认知功能损害和精神行为异常进行临床诊断。HD患者在以下认知功能测试中的表现为进展性恶化:蒙特利尔认知评估(MoCA)、AVLT(听觉语言学习测试)回忆、VFT-F(语言流畅性测试-水果)、VFT-动物、RCFT(Rey复杂图形测试)、DST(数字跨度测试)、Stroop C、Stroop干扰效应(SIE)、CTT-B(颜色轨迹测试B)。HD组认知障碍存在两个峰值,主要集中在执行功能维度的认知领域。3年后的随访评估分析显示HD患者认知障碍呈恶化趋势,但只有AVLT、Stroop-C和SIE测试结果有统计学差异。结论多维神经心理学评估显示HD患者存在多个认知领域损害,其中执行功能是最显着的认知受损领域,其他认知领域如记忆、语言、视觉空间结构、注意力等也有不同程度的损害。评估HD患者认知功能障碍的纵向衰减对追踪疾病进展具有重要的临床和科学研究意义。

基于构音训练的语言康复训练对听障儿童听觉言语能力及智力发育的影响

目的探讨基于构音训练的语言康复训练对听障儿童听觉言语能力及智力发育的影响。方法选择2019年2月至2021年3月本院收治的伴口腔共鸣障碍语前聋听障儿童,采用随机数字表法分为观察组(40例)及对照组(39例),两组患儿均进行常规康复干预,观察组在对照组基础上进行基于发音器官运动功能矫正训练。对比分析干预前后患儿脑干听觉诱发电位、口腔共鸣参数,采用《听障儿童听觉及语言能力评估标准及方法》及Gesell儿童发育量表对患儿听觉言语能力及智力发育情况进行评估。结果(1)两组患儿干预后Ⅰ波、Ⅲ波、Ⅴ潜伏期均显著延长(P<0.05),观察组Ⅰ波、Ⅲ波、Ⅴ波潜伏期显著高于对照组(P<0.05)。(2)两组患儿干预后共振峰/a/F_(1)、/i/F_(2)值显著升高,/u/F_(2)值显著降低(P<0.05),观察组干预后/a/F_(1)、/i/F_(2)值显著高于对照组(P<0.05),/u/F_(2)值显著低于对照组(P<0.05)。(3)两组患儿干预前听觉能力、言语能力及Gesell量表语言行为、适应行为等维度得分比较无显著差异(P>0.05),观察组干预后各项得分显著高于对照组(P<0.05)。结论基于构音训练的语言康复训练可改善听障儿童口腔共鸣障碍,提高听觉言语能力及智力发育。

乳腺术后三阴方干预三阴性乳腺癌化疗脑症状临床研究

目的:观察评价乳腺术后三阴方对三阴性乳腺癌化疗相关认知障碍临床症状的影响。方法:采用前瞻性队列研究设计,选取2020年12月至2021年6月上海龙华医院、上海肿瘤医院化疗患者130例作为研究对象,按照是否服用乳腺术后三阴方分为对照组(n=64)和观察组(n=66),对照组给予常规治疗,观察组给予中药乳腺术后三阴方,餐后温服,疗程3个月。治疗结束后,观察癌症患者功能评估-认知功能量表(FACT-cog)评分,神经心理学测验,中医症状及安全性指标。结果:随访结束后对照组认知异常为49例,占79.03%,观察组认知异常为47例,占75.81%,暴露因素相对危险度(RR)为0.93。观察组患者生命质量的提升与对照组比较,差异均有统计学意义(均P<0.05),对照组生命质量与治疗前比较有所提高,其余相关症状均逐渐加重。FACT-cog各维度症状与乳腺术后中医症状存在相关性。随访3个月后,观察组患者中医症状积分显著低于对照组(P<0.05)。结论:乳腺术后三阴方对认知能力的提升作用尚未明确,但其通过缓解化疗不适症状改善三阴性乳腺癌患者自我感知到的认知障碍相关症状,且对三阴性乳腺癌化疗相关认知能力的减退可能具有预防作用。

抑郁情绪对阿尔茨海默病患者认知功能的影响

目的:探讨抑郁情绪对阿尔茨海默病(Alzheimer's disease, AD)患者各认知领域功能的影响。方法:对2021年6月至2023年6月就诊于日照市人民医院神经内科门诊及记忆门诊的62例AD轻、中度患者进行详细的神经心理量表评估,采用简易智能状态检查量表(MMSE)、蒙特利尔认知评估量表(MoCA)评价AD轻、中度患者的整体认知功能,并分别对记忆、语言、注意力、视空间、执行功能等5个不同维度的单认知领域功能进行评估,采用汉密尔顿抑郁量表(HAMD)评价患者抑郁状况,HAMD≤7分为AD不伴发抑郁组,HAMD> 7分为AD伴发抑郁组,比较两组总体认知功能及各认知领域功能的情况。结果:62例AD患者中,有28例合并抑郁状态,占比45.16%,AD患者HAMD评分与DST-顺背呈负相关,与TMT-B和Stroop色词测验-时间呈正相关(P <0.05)。合并抑郁的AD患者与不合并抑郁的AD患者DST-顺背、TMT-B和Stroop色词测验-时间得分差异有统计学意义(P <0.05)。结论:抑郁会影响AD患者的注意力、执行功能等认知功能。

Panoramic variation analysis of a family with neurodevelopmental disorders caused by biallelic loss-of-function variants in TMEM141,DDHD2,and LHFPL5

Highly clinical and genetic heterogeneity of neurodevelopmental disorders presents a major challenge in clinical genetics and medicine.Panoramic variation analysis is imperative to analyze the disease phenotypes resulting from multilocus genomic variation.Here,a Pakistani family with parental consanguinity was presented,characterized with severe intellectual disability(ID),spastic paraplegia,and deafness.Homozygosity mapping,integrated single nucleotide polymorphism(SNP)array,whole-exome sequencing,and whole-genome sequencing were performed,and homozygous variants in TMEM141(c.270G>A,p.Trp90^(*)),DDHD2(c.411+767_c.1249-327del),and LHFPL5(c.250delC,p.Leu84^(*))were identified.A Tmem141^(p.Trp90^(*)/p.Trp90^(*))mouse model was generated.Behavioral studies showed impairments in learning ability and motor coordination.Brain slice electrophysiology and Golgi staining demonstrated deficient synaptic plasticity in hippocampal neurons and abnormal dendritic branching in cerebellar Purkinje cells.Transmission electron microscopy showed abnormal mitochondrial morphology.Furthermore,studies on a human in vitro neuronal model(SH-SY5Y cells)with stable shRNA-mediated knockdown of TMEM141 showed deleterious effect on bioenergetic function,possibly explaining the pathogenesis of replicated phenotypes in the cross-species mouse model.Conclusively,panoramic variation analysis revealed that multilocus genomic variations of TMEM141,DDHD2,and LHFPL5 together caused variable phenotypes in patient.Notably,the biallelic loss-of-function variants of TMEM141 were responsible for syndromic ID.

儿童注意缺陷多动障碍相关认知神经心理学理论及研究进展

注意缺陷多动障碍是儿童时期最常见的一类认知和行为功能障碍,认知的神经心理学理论发展对儿童注意缺陷多动障碍的研究具有重要的推动作用。本文简要介绍儿童注意缺陷多动障碍相关认知神经心理学理论及近年来较常见的厌恶延迟模型、抑制缺陷模型、认知-能量模型和冷、热执行功能的理论模型,并对理论和上述模型在我国近年来的发展进行综述。

新辅助化疗对恶性肿瘤患者围手术期神经认知障碍的影响

目的:探讨新辅助化疗对恶性肿瘤患者围手术期神经认知障碍(perioperative neurocognitive disorders, PND)的影响,分析PND发生的危险因素,以期为降低该人群术后认知功能损害提供参考和有效的临床指导。方法:选取2022年07月至2023年03月于该院择期行手术的105例恶性肿瘤患者为研究对象,按照术前是否接受新辅助化疗将所有患者分为新辅助化疗组(N组)和对照组(C组)。患者均分别于术前1天和术后第7天接受简易精神状态检查(mini-mental state examination, MMSE)量表和各项神经心理学测试以评估认知功能改变,Z值法判断PND发生情况。结果:N组47例和C组58例术后顺利完成神经心理学测试。两组患者中N组患者年龄低于C组,术中失血量显著高于C组(P<0.05),其余变量差异均无统计学意义(P>0.05);两组患者术前MMSE评分和各项神经心理学测试差异无统计学意义(P>0.05);而N组患者术后7天数字符号转换和数字广度顺向测试较术前基础值的下降值明显高于C组(P<0.05);N组患者术后7天12例(25.5%)发生PND,C组患者术后7天6例(10.3%)发生PND,两者相比差异有统计学意义(χ2=4.216,P=0.040)。年龄是PND发生的独立危险因素。结论:新辅助化疗会加重恶性肿瘤患者术后早期认知功能的损害,显著增加术后早期PND的发生率。

人工耳蜗在孤独症谱系障碍合并听力损失患儿中的应用现状

孤独症谱系障碍是一种以社交沟通障碍及重复、受限的行为模式为主要特征的广泛性发育障碍,其患病率可能与听力损失存在相关性。近年来,人工耳蜗被广泛应用于患有重度及以上感音神经性听力损失的人群。对于合并孤独症的听力损失患儿,人工耳蜗除了能帮助其重建听觉感知外,对语言习得、社会沟通乃至生活质量等方面的改善也具有潜在效益;孤独症合并听力损失患儿的人工耳蜗植入后效果受多种因素影响,故难以预测。本文旨在从多角度对人工耳蜗在孤独症合并听力损失患儿中的应用现状进行综述。

A neuropsychological evaluation of orthorexia nervosa

Orthorexia nervosa (ON) describes a fixation for proper nutrition and healthy foods that leads to die-tary restrictions and nutritional deficiencies over time. Given symptom overlap among ON, obsessive-compulsive disorder (OCD), and anorexia nervosa (AN), this study examines whether ON has a unique neuropsychological profile. Participants completed symptom checklists and neuropsychological tests chosen for their sensitivity to AN and OCD. Results showed that, across the full sample, ON is independently associated with self-reported weaknesses in Set-Shifting, Emotional Control, Self-Monitoring, and Working Memory. After controlling for AN and OCD variables, high- and low-ON groups differed in total correct trials on the Wisconsin Card Sorting Test. These areas of executive functioning, which are explained in the context of ON symptomatology, represent what would be considered the neuropsychological overlap among OCD and AN profiles.

特发性快速眼动睡眠期行为障碍患者认知功能特点及其与睡眠结构相关性分析

目的 总结特发性快速眼动睡眠期行为障碍(iRBD)患者认知功能特点和睡眠结构,并探讨二者之间的相关性。方法 共纳入2018年8月至2021年8月就诊于福建医科大学附属协和医院的73例iRBD患者,均进行神经心理学测验和多导睡眠图监测,采用Pearson相关分析和偏相关分析探讨认知功能与睡眠结构参数的相关性。结果(1)神经心理学测验:iRBD患者简易智能状态检查量表(MMSE)评分(t=-3.703,P=0.000)、蒙特利尔认知评价量表(MoCA)评分(t=-4.811,P=0.000)、词语流畅性测验(VFT)-词汇正确个数(t=-2.171,P=0.032)低于对照者,连线测验(TMT)-A(t=2.500,P=0.014)、TMT-B(t=2.430,P=0.016)和Stroop色词测验(SCWT)-A(t=2.507,P=0.013)、SCWT-B(t=15.042,P=0.000)、SCWT-C(t=27.228,P=0.000)完成时间长于对照者。(2)多导睡眠图监测:iRBD患者总睡眠时间(t=2.699,P=0.008)、睡眠效率(Z=-2.103,P=0.035)、睡眠分期转换次数(t=3.965,P=0.000)、非快速眼动睡眠期1期(N1期)占总睡眠时间比例(t=2.887,P=0.005)、睡眠期周期性肢体运动指数(PLMSI;t=-2.917,P=0.004)、周期性肢体运动相关微觉醒指数(Z=-2.291,P=0.022)、微觉醒总指数(Z=-2.609,P=0.009)高于对照者,入睡后清醒时间短于对照者(t=-2.230,P=0.027)。(3)认知功能与睡眠结构参数相关性:MoCA评分与N1期占比呈负相关(r=-0.184,P=0.035),与N2期占比呈正相关(r=0.173,P=0.049);SCWT-B完成时间与觉醒次数呈负相关(r=-0.186,P=0.033);SCWT-C完成时间与睡眠分期转换次数(r=0.212,P=0.015)和N1期占比(r=0.181,P=0.039)呈正相关;VFT-词汇正确个数与清醒期周期性肢体运动指数(PLMWI;r=-0.216,P=0.018)呈负相关;中文Rey听觉-词汇学习测验(C-RAVLT)即刻回忆正确个数与快速眼动睡眠期潜伏期呈正相关(r=0.183,P=0.045);C-RAVLT延迟回忆正确个数与PLMWI(r=-0.196,P=0.032)和PLMSI(r=-0.180,P=0.049)呈负相关;画钟测验评分与入睡潜伏期(r=0.192,P=0.035)和快速眼动睡眠期潜伏期(r=0.199,P=0.029)呈正相关,而与快速眼动睡眠期占比呈负相关(r=-0.189,P=0.038);Beck抑郁量表评分与总睡眠时间(r=0.347,P=0.000)、睡眠效率(r=0.319,P=0.000)、快速眼动睡眠期占比(r=0.204,P=0.026)呈正相关,而与入睡后清醒时间(r=-0.280,P=0.002)、N1期占比(r=-0.299,P=0.001)呈负相关。结论 iRBD患者存在以注意力、执行功能、语言功能下降为主要表现的认知功能障碍,而睡眠结构紊乱可能影响此类患者的认知功能。