Search Results (6,227)

Prolonged exposure to cold air can impair reaction time and cognitive function, which can lead to serious consequences. One mitigation strategy is to develop models that can predict cognitive performance by tracking physiological metrics associated with cold stress. As females are evidenced to be more sensitive to cold exposure, this study investigated the relationship between physiological metrics and cognitive performance deterioration of female subjects under cold stress. Wearable electrodermal activity (EDA) and electrocardiogram (ECG) were collected from nineteen females who underwent five sessions of a cognitive task battery—assessing reaction time, memory, and attention—in a cold (10 °C) environment. Machine learning classifiers showed higher cognitive performance classification accuracies with heart rate variability (HRV) features than with EDA features. Particularly in detecting performance deterioration in a task associated with assessing short-term memory, our support vector machine classifier with HRV features showed an 82.4% accuracy, with a sensitivity of 84.2% and a specificity of 80.6%, whereas a 55.4% accuracy with a sensitivity of 44.7% and a specificity of 66.7% was obtained with EDA features. Our results demonstrate the feasibility of detecting performance deterioration from females who underwent cold exposure using wearable EDA and ECG, allowing for preventive measures to reduce risk in cold environments, especially for female military personnel. Full article

Identifying and diagnosing cognitive impairment remains challenging. Some diagnostic procedures are invasive, expensive, and not always accurate. Meanwhile, evidence suggests that cognitive impairment is associated with changes in gait parameters. Certain gait parameters manifesting differences between people with and without cognitive impairment are more pronounced when adding a secondary task (dual-task scenario). In this systematic review, the capability of gait analysis to identify cognitive impairment is investigated. Twenty-three studies published between 2014 and 2024 met the inclusion criteria. A significantly lower gait speed and cadence as well as higher gait variability were found in people with mild cognitive impairment (MCI) and/or dementia, compared with the group with no cognitive impairment. While dual tasks appeared to amplify the differences between the two populations, the type of secondary tasks (e.g., calculations and recalling phone numbers) had an effect on gait changes. The activity and volume of different brain regions were also different between the two populations during walking. In conclusion, while this systematic review supported the potential of using gait analysis to identify cognitive impairment, there are a number of parameters researchers need to consider such as gait variables to be studied, types of dual tasks, and analysis of brain changes while performing the movement tasks. Full article

Purpose: Sex classification is a major benchmark of previous work in learning on the structural connectome, a naturally occurring brain graph that has proven useful for studying cognitive function and impairment. While graph neural networks (GNNs), specifically graph convolutional networks (GCNs), have gained popularity lately for their effectiveness in learning on graph data, achieving strong performance in adult sex classification tasks, their application to pediatric populations remains unexplored. We seek to characterize the capacity for GNN models to learn connectomic patterns on pediatric data through an exploration of training techniques and architectural design choices. Methods: Two datasets comprising an adult BRIGHT dataset (N = 147 Hodgkin’s lymphoma survivors and N = 162 age similar controls) and a pediatric Human Connectome Project in Development (HCP-D) dataset (N = 135 healthy subjects) were utilized. Two GNN models (GCN simple and GCN residual), a deep neural network (multi-layer perceptron), and two standard machine learning models (random forest and support vector machine) were trained. Architecture exploration experiments were conducted to evaluate the impact of network depth, pooling techniques, and skip connections on the ability of GNN models to capture connectomic patterns. Models were assessed across a range of metrics including accuracy, AUC score, and adversarial robustness. Results: GNNs outperformed other models across both populations. Notably, adult GNN models achieved 85.1% accuracy in sex classification on unseen adult participants, consistent with prior studies. The extension of the adult models to the pediatric dataset and training on the smaller pediatric dataset were sub-optimal in their performance. Using adult data to augment pediatric models, the best GNN achieved comparable accuracy across unseen pediatric (83.0%) and adult (81.3%) participants. Adversarial sensitivity experiments showed that the simple GCN remained the most robust to perturbations, followed by the multi-layer perceptron and the residual GCN. Conclusions: These findings underscore the potential of GNNs in advancing our understanding of sex-specific neurological development and disorders and highlight the importance of data augmentation in overcoming challenges associated with small pediatric datasets. Further, they highlight relevant tradeoffs in the design landscape of connectomic GNNs. For example, while the simpler GNN model tested exhibits marginally worse accuracy and AUC scores in comparison to the more complex residual GNN, it demonstrates a higher degree of adversarial robustness. Full article

Many psychiatric disorders are associated with major cognitive deficits. However, it is uncertain whether these deficits develop as a result of psychiatric disorders and what shared risk factors might mediate this relationship. Here, we utilized the Mendelian randomization (MR) analysis to investigate the complex causal relationship between nine major psychiatric disorders and three cognitive phenotypes, while also examining the potential mediating role of oxidative stress as a shared biological underpinning. Schizophrenia (SZ), major depressive disorder (MDD), and attention deficit hyperactivity disorder (ADHD) showed a decreasing effect on cognitive performance, intelligence, and education, while bipolar disorder (BPD) increased educational attainment. MR-Clust results exhibit the shared genetic basis between SZ and other psychiatric disorders in relation to cognitive function. Furthermore, when oxidative stress was considered as a potential mediating factor, the associations between SZ and the three dimensions of cognition, as well as between MDD and intelligence and ADHD and intelligence, exhibited larger effect sizes than the overall. Mediation MR analysis also supported the causal effects between psychiatric disorders and cognition via oxidative stress traits, including carotene, vitamin E, bilirubin, and uric acid. Finally, summary-based MR identified 29 potential causal associations of oxidative stress genes with both cognitive performance and psychiatric disorders. Our findings highlight the importance of considering oxidative stress in understanding and potentially treating cognitive impairments associated with psychiatric conditions. Full article

Background/Objectives: Mitochondrial dysfunction is increasingly recognized as a central contributor to neurodegenerative diseases and age-related cognitive decline. Individuals with Down syndrome (DS) are at high risk of neurodegeneration due to Alzheimer’s disease (AD). This study aims to explore the relationship between mitochondrial dysfunction, brain amyloid-beta (Aβ) deposition, and cognitive decline in this population. Methods: We investigated mitochondrial function, brain amyloid-beta burden, and cognitive performance in a pilot study of a cohort of 10 eligible adults with DS selected from a sample of 28 individuals with DS. Phosphorus-31 magnetic resonance spectroscopy (³¹P-MRS) was used to assess mitochondrial function in skeletal muscle using a post-exercise paradigm, while positron emission tomography using ¹¹C-Pittsburgh compound B (PiB-PET) measured brain Aβ deposition. Cognitive performance was evaluated using the Cambridge Cognitive Examination adapted for individuals with Down syndrome (CAMCOG-DS) and executive function batteries. Results: Significant correlations were observed between slowed phosphocreatine (PCr) recovery in muscle and increased Aβ deposition in key brain regions, particularly the striatum. Cognitive performance inversely correlated with mitochondrial function, with pronounced deficits in memory and executive function tasks. Notably, an individual carrying the APOE-ε4 allele exhibited the poorest mitochondrial function, highest Aβ burden, and most severe cognitive impairment, suggesting a potential interaction between genetic risk and mitochondrial health. Conclusions: These findings highlight the role of mitochondrial dysfunction in DS-associated AD (DSAD) and its impact on cognition in adults. The results support targeting mitochondrial pathways as a potential therapeutic strategy to mitigate AD progression in DS populations. Further research with larger cohorts and longitudinal designs is needed to clarify causative mechanisms and develop effective interventions. Full article

Background and Objectives: To assess the risk of osteoporotic fractures in patients with rheumatic diseases (RDs), we introduced a new approach for predicting incident osteoporotic fractures (OF), employing a risk-weight calculation for each candidate risk factor. Materials and Methods: RD outpatients were picked up, and their histories, including OFs, were studied. A Cox regression analysis that evaluated candidate risk factors was conducted with a multivariate model. The variants were selected as candidate risk factors that showed statistical significance using a univariate model. Using the risk ratio or the β-value and p-value, different approaches to acquire a total risk weight (TRW) for each patient were determined to compare the sensitivity and specificity among the approach methods. The cut-off index (COI) was determined using receiver operating characteristic analysis. Sensitivity and specificity for incident OFs were determined using the Kaplan–Meier survival analysis. Results: In a total of 1228 patients, incidental OF occurred in 179 (14.58%) who were included. Factors with significantly higher risk ratios were a history of vertebral and non-vertebral fractures (p < 0.001), cognitive impairment (p < 0.001), anti-osteoporosis drug intervention (p < 0.001), and rehabilitation (p < 0.001). The excellent approach to acquire the best sensitivity and specificity was to calculate the β-value multiplied by the logarithm of the p-value based on 0.05, including non-significant factors (sensitivity: 31.2%, specificity: 94.9%, and area under the curve (AUC): 0.774) compared to 29.4%, 91.6%, and 0.723, respectively, with a counted significant risk factors approach. Conclusions: This novel approach, which includes non-significant factors, can achieve a more accurate sensitivity and specificity to accidental OF in patients with RDs. Full article

Speech and language deficits often occur in preschool children, and empirical studies have indicated an association between language impairments and challenges in different cognitive domains. The primary aim of the current study was to evaluate the associations between speech and language deficits, executive function (EF) impairments, Attention Deficit/Hyperactivity Disorder (ADHD), and aspects of giftedness in Greek preschoolers based on assessments from their teachers. Investigating the associations between aspects of EFs, ADHD, and giftedness was another objective of the current study. Finally, we examined on a sample of Greek preschool children the convergent validity of the LAMP screening test in relation to the following questionnaires: the Childhood Executive Functioning Inventory (CHEXI), the ADHD-IV Questionnaire, the Gifted Rating Scales-Preschool/Kindergarten Form (GRS-P), and the Scales for Rating the Behavioral Characteristics of Superior Students (SRBCSS). For the purpose of the present study, 20 kindergarten teachers and 71 Greek preschoolers (41 boys and 30 girls) were included in the sample. Data analysis revealed that according to teachers’ estimations, speech and language deficits are positively associated to a statistically significant degree with ADHD and with deficits in working memory (WM) and inhibition. On the other hand, aspects of preschool-aged creativity and giftedness were significantly correlated negatively with speech and language deficits. Additionally, the findings demonstrated a negative correlation between aspects of giftedness and ADHD symptoms as well as poor achievement on working memory (WM) and inhibition assessment tests. Furthermore, there was no association between hyperactivity/inhibition deficit and creativity, which is an aspect of giftedness. The moderate positive associations of the LAMP screening test with the psychometric tools of measurement of ADHD and executive function (EF) deficits, and the negative associations with the scales of giftedness showed the good convergent and distinct validity of the LAMP assessment test. Full article

Neurodegenerative disorders (NDs) cause progressive neuronal loss and are a significant public health concern, with NDs projected to become the second leading global cause of death within two decades. Huntington’s disease (HD) is a rare, progressive ND caused by an autosomal-dominant mutation in the huntingtin (HTT) gene, leading to severe neuronal loss in the brain and resulting in debilitating motor, cognitive, and psychiatric symptoms. Given the complex pathology of HD, biomarkers are essential for performing early diagnosis, monitoring disease progression, and evaluating treatment efficacy. However, the identification of consistent HD biomarkers is challenging due to the prolonged premanifest HD stage, HD’s heterogeneous presentation, and its multiple underlying biological pathways. This study involves a 10-year bibliometric analysis of HD biomarker research, revealing key research trends and gaps. The study also features a comprehensive literature review of emerging HD biomarkers, concluding the need for better stratification of HD patients and well-designed longitudinal studies to validate HD biomarkers. Promising candidate wet HD biomarkers— including neurofilament light chain protein (NfL), microRNAs, the mutant HTT protein, and specific metabolic and inflammatory markers— are discussed, with emphasis on their potential utility in the premanifest HD stage. Additionally, biomarkers reflecting brain structural deficits and motor or behavioral impairments, such as neurophysiological (e.g., motor tapping, speech, EEG, and event-related potentials) and imaging (e.g., MRI, PET, and diffusion tensor imaging) biomarkers, are evaluated. The findings underscore that the discovery and validation of reliable HD biomarkers urgently require improved patient stratification and well-designed longitudinal studies. Reliable biomarkers, particularly in the premanifest HD stage, are crucial for optimizing HD clinical management strategies, enabling personalized treatment approaches, and advancing clinical trials of HD-modifying therapies. Full article

Dementia’s escalating incidence, coupled with its economic burden, highlights the need for architectural designs and forms that benefit people living with dementia. This research explores strategies and design principles that focus on establishing supportive spaces for the prolonged autonomy, well-being, and safety of dementia patients. Contemporary research emphasizes the implementation of effective navigational techniques, via visual cues, familiar landmarks, and simplified layouts. For greater navigational signage, the intentional use of contrasting colors, textures, and lighting are recommended to demarcate functional areas within a structure. Incorporating familiar objects in personalized areas enhances treatment outcomes, e.g., reminiscence therapy leverages familiar objects, environmental cues, scents, sounds, and tactile features to trigger and retain memory. Integrating safety precautions such as slip-resistant flooring, handrails, and accessible bathrooms helps mitigate falls for the cognitively impaired. From a therapeutic perspective, this study draws attention towards incorporating gardens and outdoor spaces, which offers sensory stimulation, encourages physical activity, and fosters social engagement. Additionally, the integration of scents, sounds, and tactile features enriches the sensory experience for individuals with dementia. Through comprehensive consideration of design elements, this research highlights how intentionally crafted, dementia-friendly environments can convert spaces into empowering therapeutic settings tailored to address the unique need of this vulnerable group. This architectural approach acts as a valuable complement to the medical and therapeutic interventions in the treatment and care of people living with dementia and their families. Full article

Introduction: Traumatic brain injury (TBI) in pediatric population is responsible for significant mortality and morbidity, particularly among children aged 0–4 and young adults aged 15–24. The developing brain’s unique characteristics may increase vulnerability to injuries, potentially leading to long-term cognitive and motor deficits. Current therapeutic options for neuronal regeneration post-TBI are limited, although neurotrophins, especially nerve growth factor (NGF), show promise in enhancing recovery. NGF can mitigate excitotoxicity and promote neuroprotection, particularly by intranasal administration, which is attractive because of its non-invasive nature. Case Presentation: A three-year-old boy suffered from severe TBI due to a car accident, leading to multiple complications, including a basilar skull fracture and cerebral venous sinus thrombosis. Initial assessments revealed significant neurological impairments. After intensive care and rehabilitation, the child exhibited gradual improvements in consciousness and motor functions but continued to face challenges, particularly with left-sided hemiparesis. Nine months post-injury, he began intranasal administration of human-recombinant NGF (hr-NGF) as part of a clinical trial. Discussion: Following hr-NGF treatment, the child demonstrated notable advancements in motor function, achieving independent standing and walking. Cognitive assessments indicated improvements in various domains, including verbal comprehension and executive functioning. EEG results showed reduced epileptiform activity. These findings suggest that hr-NGF may facilitate recovery in pediatric TBI cases by enhancing both motor and cognitive outcomes. Conclusions: This case highlights the potential role of intranasal hr-NGF administration as a therapeutic strategy for improving neurological recovery in children with severe TBI. The positive clinical outcomes support further exploration of NGF as a viable treatment option to mitigate long-term sequelae associated with pediatric brain injuries. Full article

Executive functions (EFs) are essential cognitive processes involved in concentration, planning, decision-making, and impulse control during adolescence. Executive Dysfunction (ED) can lead to significant academic and socio-emotional difficulties, particularly with impairments in emotion regulation (ER). This study aims to assess a virtual reality (VR) cognitive training intervention on EFs, ER, and internalizing symptoms in adolescents at risk for ED. Thirty-eight adolescents aged 12–14 years, identified as being at moderate to high risk for ED, were randomly assigned to two groups. The experimental group (n = 22) received gamified VR cognitive training, while the control group (n = 16) received VR nature-based relaxation training. Both interventions lasted five weeks, twice a week for 30 min each. Pre- and post-assessments included ER skills, internalizing symptoms, and cognitive performance measures. Two-way mixed ANOVAs showed significant group × time interactions (p < 0.05) in measures of depression and internalizing symptoms. The experimental group showed significant reductions in these symptoms compared with the control group. Significant main effects of time (p < 0.05) were also found on some measures. Both groups experienced reduced anxiety, improved emotional control and cognitive functioning, and VR cognitive training was particularly effective in reducing internalizing symptoms, while both interventions showed promising results in improving some ER skills and cognitive performance. The findings demonstrate the preliminary effects of VR-based cognitive training in improving the psychological and cognitive well-being of adolescents at risk for ED and suggest that integrating VR technologies into educational settings can effectively address the cognitive and emotional challenges faced by these students. Full article

Introduction: Parkinson’s disease (PD) is characterized by motor and cognitive impairments that often manifest as distinct motor subtypes: Postural Instability Gait Difficulty (PIGD) and Tremor-Dominant (TD). Motor–cognitive interference, especially under dual-task (DT) walking conditions, may vary by subtype, providing insights into specific impairments. This study explored DT interference effects in PD subtypes, focusing on the potential impact of self-reported physical activity, which may help mitigate subtype-specific impairments and improve motor–cognitive function. Methods: PD patients classified as PIGD or TD and healthy controls completed single-task (ST) and DT walking assessments involving different cognitive tasks (Serial Subtraction, Auditory Stroop, and Clock Task). Physical activity levels were evaluated using the CHAMPS questionnaire, analyzing the self-reported frequency and duration of weekly exercise-related activities. Results: Interference effects were significantly different between PD patients and controls, with the PIGD group showing greater motor impairment under high cognitive load, primarily affecting gait, than the TD and control groups. Performance differences between groups diminished as cognitive load increased. Self-reported physical activity does not significantly moderate motor performance under DT conditions, suggesting that activity levels in this sample are insufficient to offset motor–cognitive interference. However, like group affiliation, physical activity directly influences motor performance during DT conditions, indicating that both factors independently impact motor–cognitive function in PD. Discussion: These findings suggest that DT assessments help differentiate PD motor subtypes, as group differences were minimal in ST conditions. While physical activity is associated with general improvements in motor ST and DT performance in PD and controls, the lack of a significant moderating effect from self-reported exercise-related physical activity indicates that current activity levels may not be high enough to counter motor–cognitive interference. More intensive or DT-specific exercise may be required to reduce interference effects. Future research should examine the role of structured physical activity programs, potentially incorporating DT training, to evaluate their impact on motor–cognitive interference in PD. Full article

This study evaluates indoor environmental quality (IEQ) in childcare facilities, focusing on air quality and lighting—key factors affecting children’s health and development. The analysis examines a nursery in Seville, Spain, where continuous monitoring revealed challenges in maintaining suitable indoor conditions. Carbon dioxide (CO₂) levels often surpassed Spanish standards (770 ppm) and stricter thresholds (550 ppm) for sensitive groups, peaking at nearly 1900 ppm. These concentrations are linked to possible cognitive impairments and increased airborne pathogen risks, with Attack Rates (ARs) exceeding 70%. Passive ventilation strategies, such as window openings, proved insufficient, emphasizing the need for Controlled Mechanical Ventilation (CMV) systems to ensure consistent air renewal while maintaining thermal comfort. Lighting assessments identified insufficient circadian stimulus during key periods. Excessive lighting during nap times disrupted rest, while morning daylight levels failed to provide adequate circadian stimulation. These findings stress the importance of integrating solar protection and dynamic daylight and electric lighting systems to align with children’s biological rhythms. This research highlights the urgent need for comprehensive IEQ strategies in childcare settings, combining advanced ventilation, hygrothermal management, and circadian-friendly lighting to create safer and healthier environments for young children. Full article

Background: Insomnia disorder in childhood and adolescence has severe implications on overall well-being and development. Age-specific treatments for insomnia disorder with cognitive behavioral interventions (CBT-I) are available and effective. Nightmare disorder also has severe consequences in children and adolescents. However, less is known about children with insomnia (I) and comorbid nightmare disorder (I + N). Methods: In this retrospective study, data from 499 children and adolescents with insomnia disorder were included. The prevalence of a comorbid nightmare disorder (I + N) was calculated within three subsamples (toddlers and preschoolers 0.5–4 years, elementary school children 5–10 years, and adolescents 11–18 years). Differences between children with insomnia (I) and those with additional nightmare disorder (I + N) regarding age, sex, family background, sleep quality (SOL, WASO, TST, and SE) based on sleep logs, behavior sleep problems (based on interviews), and behavioral problems (CBCL and YSR) were calculated within each age group. Results: The overall prevalence of additional nightmares or nightmare disorder in children or adolescents with insomnia was 15–24%. We found various clinically relevant differences between I and I + N for each age group; for example, there were more sleep onset association problems in I + N elementary school children, prolonged SOL of 56 min, and about 50 min less TST and SE of 76.8% in I + N adolescents. However, most statistical tests were not significant. Especially sleep parameters but also emotional burden were more pronounced in I + N groups than in the I groups. Toddlers and preschoolers with I + N were significantly older than those with only I, had another family situation (e.g., divorced parents) significantly more often, and I + N adolescents were statistically more often anxious and depressed. Discussion: Descriptively, I + N children and adolescents seemed to be more impaired than those with insomnia only. However, a comorbid nightmare disorder cannot be recognized by insomnia-specific sleep parameters. Therefore, diagnostic procedures for insomnia should always screen for nightmares but also other sleep disorders. If necessary, CBT-I should be supplemented with nightmare-specific interventions. Full article

Background: Smart home technologies (SHTs) hold promise for supporting older adults by enabling early detection and intervention in mental health challenges such as depression, anxiety, and cognitive decline. However, adoption remains limited due to usability, accessibility, and privacy concerns. Methods: This narrative review examined the literature from 2010 to early 2024 related to SHTs and their impact on older adults’ mental health. In total, 34 relevant studies met the inclusion criteria, and also, a standardized quality assessment tool was used to evaluate the methodological soundness of the included studies. Results: Findings reveal that interface complexity, cognitive overload, high costs, and privacy concerns are significant barriers to adoption. Accessibility challenges, including physical and sensory impairments, further reduce engagement and inclusivity. Key facilitators for user acceptance include user-centric design, personalization, participatory co-development, and cultural adaptations. SHTs incorporating AI-driven features, such as behavioral monitoring, medication reminders, and social engagement tools, demonstrate significant potential for early mental health interventions. Based on these findings, we propose a holistic framework integrating technical innovation with human-centered design to address these challenges and optimize SHTs for mental healthcare. Conclusions: Tailored systems that prioritize usability, accessibility, ethical data management, and user feedback can empower older adults to maintain autonomy, support aging in place, and enhance their quality of life with dignity. Full article