Search Results (1,177)

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder frequently associated with impairments in executive functions (EF). These deficits have been linked to difficulties across various cognitive domains, including metaphonological skills (MS), essential for phonological awareness and processing abilities. Background/Objectives: This pilot study examines the correlations between EF and MS in ADHD children. Methods: A total of 84 children aged 6–14 years, diagnosed with ADHD and an IQ ≥ 70, were assessed using the NEPSY-II test to evaluate executive functions and the Assessment of Metaphonological Skills Test to assess phonological processing abilities. Results: Correlational analyses and multiple regression models were employed to explore the relationships between EF and MS, focusing on attention, cognitive flexibility, and response inhibition. Rhyme was positively correlated with processing speed and negatively correlated with response inhibition. Phonemic segmentation was significantly related to auditory attention and response inhibition. Age emerged as a significant predictor of phonemic synthesis and final syllable deletion, consistent with the developmental maturation of executive and phonological abilities. Conclusions: The findings suggest that deficits in executive functioning in ADHD children are closely linked to metaphonological abilities, which play a crucial role in the acquisition of reading and writing skills. Integrating EF training into phonological interventions can help reduce learning difficulties and improve cognitive and language outcomes. Full article

Background: Adolescents in residential care frequently face functional challenges, yet few interventions integrate functional-cognitive models with motivational theories to support their daily function. Methods: This mixed-methods feasibility study is an innovative conceptual integration that links motivational and metacognitive approaches with growth-mindset principles to address both beliefs about the ability to change and functional performance. Quantitative data were collected from staff (n = 44), alumnae (n = 5), and current residents (n = 3), assessing mindset and functional-skill confidence among three focus groups (n = 16). The qualitative insights highlighted the motivational processes, strategy use, and barriers each group faced. Results: The findings informed the development of structured intervention psychoeducation protocol to facilitate goal-setting and reflective questioning. The feasibility and acceptability were tested by a pilot study among five staff members. Before implementation, staff demonstrated lower confidence in promoting daily autonomy and providing strategy-focused feedback. Alumnae and residents reported high emotional support, yet persistent gaps in functional independence. Conclusions: The pilot findings may inform the development of structured staff practices for delivering functional guidance, pending further evaluation. This study offers a novel conceptual contribution by positioning growth mindset as an active mechanism that supports functional-cognitive processes to enhance autonomy among adolescents in residential care settings. Full article

Background/Objectives: To analyze the parent-perceived quality of life (QoL) in children with cerebral palsy (CP) and to study the relationship between sociodemographic and clinical factors and this perception, under the perspective of the International Classification of Functioning, Disability and Health (ICF). Methods: A cross-sectional study was conducted with 95 participants (ages 5–19 years) with CP. Participants’ parents were asked about sociodemographic and clinical characteristics and compiled Cerebral Palsy Quality of Life (CP-QoL) and Pediatric Disability Inventory-Computer Adaptive Test (PEDI-CAT). Participants were assessed and classified into the following functional domains: gross motor function (GMFM-88, GMFCS), manual ability (MACS), eating and drinking abilities (EDACS), and communication function (CFCS). Correlations between CP-QoL domains and variables were investigated using Spearman’s correlation coefficient and multivariate predictive models were used to investigate the variables predicting CP-QoL scores for each domain. Results: A total of 95 children with a mean age of 12.4 ± 3.5 years (range 5–19 years) were included. Participants demonstrated moderate-high GMFM-88 level (228.8 ± 44.7) and high functional performance across PEDI-CAT domains: Activity (57.2 ± 5.1), Mobility (63.1 ± 5.6), and Social/Cognitive (70.2 ± 4.3). Parent-perceived QoL was significantly higher when children did not require AFOs, botulinum toxin, or recent hospitalizations, and lower among children who attended physical therapy >2 h/week. Moderate correlations were consistently found between the ‘Feelings about Functioning’ domain and functional variables, being positive for GMFM-88 and all PEDI-CAT domains, and negative for GMFCS, MACS, EDACS and CFCS. That domain of CP-QoL was best explained by the regression model (R² = 0.619, p < 0.001), with the combination of three variables: GMFM-88, PEDI-CAT Activity and PEDI-CAT Social/Cognitive. Among them, PEDI-CAT Activity was the strongest predictor (β = 0.1436). Conclusions: In children with CP, to enhance family well-being, interventions should prioritize social participation and carefully balance the intensity and frequency of therapy against family burden and daily life demands, as QoL is primarily driven by manual ability and functional performance. Full article

Background and Objectives: Cognitive deficits are common in obstructive sleep apnea (OSA), and both intermittent hypoxemia and cardiovascular comorbidity may contribute to poorer outcomes. Arterial hypertension (HTN) has been suggested as a potential modifier of cognitive function in OSA, but findings remain inconsistent. This study examined whether HTN influences baseline cognition or cognitive improvement after continuous positive airway pressure (CPAP) therapy in moderate-to-severe OSA and identified predictors of poorer post-treatment cognitive status. Materials and Methods: This prospective study involved 71 adults with newly diagnosed moderate-to-severe OSA (AHI ≥ 15). Participants underwent baseline polysomnography, Montreal Cognitive Assessment (MoCA) testing, and P300 assessments. Cognitive impairment was defined as MoCA < 26 and HTN by antihypertensive therapy, documented diagnosis, or repeatedly elevated blood pressure. All participants initiated auto-adjusting CPAP and were reassessed after three months for adherence, residual respiratory indices, MoCA, and P300 parameters. Multivariate logistic regression and receiver operating characteristic (ROC) analyses were used to identify independent predictors of poorer cognitive outcomes. Results: CPAP therapy significantly improved apnea severity, daytime sleepiness, global cognition, and P300 latency, while P300 amplitude did not change significantly. After three months, hypertensive and normotensive patients showed similar MoCA scores, respiratory outcomes, and P300 amplitude; P300 latency remained marginally longer in hypertensive individuals. Across multivariate models, lower mean nocturnal oxygen saturation and reduced CPAP adherence independently predicted poorer cognitive outcome at follow-up. CPAP adherence demonstrated greater discriminative ability than mean nocturnal oxygenation. Conclusions: In adequately treated moderate-to-severe OSA, HTN did not significantly affect baseline cognition or short-term cognitive recovery with CPAP. Although P300 latency remained slightly prolonged in hypertensive individuals, this difference was marginal and not accompanied by cognitive deficits. Nocturnal oxygenation and CPAP adherence emerged as the strongest predictors of post-treatment cognitive status, underscoring the importance of sustained and effective therapy. These findings suggest that effective CPAP adherence and improved nocturnal oxygenation are crucial for cognitive recovery in OSA patients, regardless of hypertensive status. Full article

Background and Objectives: Evidence on motor performance in children with autism spectrum disorder (ASD) is scarce and inconsistent. The association of motor impairments with autism severity and intelligence remains insufficiently studied. We aimed to examine motor performance parameters in children with ASD compared with typically developing (TD) peers. Materials and Methods: In this cross-sectional study, a convenience sample of 26 children with ASD, aged 4–10 years, was recruited from specialized centers in KSA, alongside 27 age- and sex-matched TD children. For the ASD group, severity (Childhood Autism Rating Scale, CARS-2) and intelligence quotient (Stanford–Binet Intelligence Scale, SB5) were extracted from medical records. CARS-2 score was utilized to categorize children with ASD into two groups (mild-to-moderate and severe groups). All study children were assessed for gross and fine motor skills using the Movement Assessment Battery for Children-2 (MABC-2), balance, muscle strength, endurance, and flexibility. Results: ASD groups recorded significantly lower scores in all MABC-2 component areas when compared to the TD group (p < 0.001). Aiming and catching percentile was significantly lower in the severe ASD group compared to the mild-to-moderate group (p = 0.05). Furthermore, children with ASD exhibited increased hypermobility, predominantly at the elbow joints, reduced grip strength, shorter distance in the modified 6 min walk test, and lower standing long-jump performance (p < 0.001) when compared to TD group; however, no significant difference was recorded between the ASD groups. Spearman correlation revealed that aiming and catching was negatively correlated with autism severity (CARS-2) (r = −0.38, p = 0.05) and positively with IQ (r = 0.51, p = 0.03). Aiming and catching was positively correlated with grip strength (r = 0.55, p = 0.003), endurance (r = 0.58, p = 0.002), and jump distance (r = 0.44, p = 0.03), while balance was positively correlated with grip strength (r = 0.44, p = 0.02). Conclusions: Children with ASD exhibit significant impairments in gross and fine motor performance compared with TD peers, accompanied by hypermobility, reduced strength, and diminished endurance. Notably, aiming and catching ability correlated with both IQ and autism severity as well as specific motor parameters, suggesting its potential as a clinical marker of motor–cognitive interaction in ASD. Full article

Background and Clinical Significance: Giant sphenoid wing meningiomas are generally viewed as skull base masses that compress frontal centers and their respective pathways gradually enough to cause a dysexecutive–apathetic syndrome, which can mimic primary neurodegenerative disease. The aim of this report is to illustrate how bedside phenotyping and multimodal imaging can disclose similar clinical presentations as surgically treatable network lesions. Case Presentation: An independent, right-handed older female developed an incremental, two-year decline of her ability to perform executive functions, extreme apathy, lack of instrumental functioning, and a frontal-based gait disturbance, culminating in a first generalized seizure and a newly acquired left-sided upper extremity pyramidal sign. Standardized neuropsychological evaluation revealed a predominant frontal-based dysexecutive profile with intact core language skills, similar to behavioral-variant frontotemporal dementia (bvFTD). MRI demonstrated a large, right fronto-temporo-basal extra-axial tumor attached to the sphenoid wing with homogeneous postcontrast enhancement, significant vasogenic edema within the frontal projection pathways, and a marked midline displacement of structures with an open venous pathway. With the use of a skull-base flattening pterional craniotomy with early devascularization followed by staged internal debulking, arachnoid preserving dissection, and conservative venous preservation, the surgeon accomplished a Simpson Grade I resection. Sequential improvements in the patient’s frontal “re-awakening” were demonstrated through postoperative improvements on standardized stroke, cognitive and functional assessment scales that correlated well with persistent decompression and symmetric ventricles on follow-up images. Conclusions: This case illustrates the possibility of a non-dominant sphenoid wing meningioma resulting in a pseudo-degenerative frontal syndrome and its potential for reversal if recognized as a network lesion and treated with tailored, venous-sparing skull-base surgery. Contrast-enhanced imaging and routine frontal testing in atypical “dementia” presentations may aid in identifying additional patients with potentially surgically remediable cases. Full article

Spatial cognition refers to the mental processing, perception, and interpretation of spatial information. It is often operationalized through self-assessments like sense of direction and mental rotation ability or field-based real-world tasks like pointing to a specific building and wayfinding; however, the former and latter entail unclear ecological validity and high participant burdens, respectively. Since the advent of smartphones, this repertoire has been extended substantially through the use of sensors or apps. This study used a large longitudinal experience sampling method (ESM) in two different countries (Canada and Australia, N = 217) and analyzed spatial cognition both conventionally (i.e., sense of direction and speeded mental rotation test) and through new techniques like self-rated and objectively assessed daily Google Maps usage, movement patterns throughout the 14-day assessment phase (using H3 tiles for geolocation), and a Point North task. The Point North task objectively assessed deviation from the celestial direction, North, by using smartphone compass sensors. In both countries, spatial orientation was found to be associated only with the Point North task, while no significant associations were found for daily Google Maps usage (subjectively and objectively measured) and moving distance throughout the assessment phase. Although further validation is required, the Point North task shows promise as an objective, ecologically valid, and easily employable smartphone-based measure for assessing spatial cognition in real-world contexts. Full article

Adolescence is a critical period when rapid cognitive maturation coincides with heightened emotional vulnerability. This study examined the dynamic association between academic ability and mental health across early adolescence, focusing on vocabulary ability as a core indicator of academic ability. Using large-scale data from Grades 1–12 (N = 13,412), a vertically scaled vocabulary ability scale was constructed based on Item Response Theory (IRT) and the Non-Equivalent Anchor Test (NEAT) design to achieve cross-grade comparability. Fixed-parameter calibration was then applied to an independent cross-sectional sample of middle school students (Grades 7–9, N = 401) in Tianjin, combined with the DASS-21 to assess internalizing symptoms (depression, anxiety, stress). Hierarchical multiple regression analyses revealed that higher vocabulary ability was significantly associated with lower levels of depression, anxiety, and stress, with the negative association strongest in Grade 8. The present study provides new empirical evidence for understanding the interactive mechanisms between academic and psychological development during adolescence. Methodologically, the study demonstrates the value of IRT-based vertical scaling in establishing developmentally interpretable metrics for educational and psychological assessment. Full article

Background/Objectives: Children with Down Syndrome (DS) exhibit difficulties in maintaining balance and coordination in addition to limitations in functional mobility. The Cognitive–Motor Dual-Task Exercise Program (CMDT) has shown the ability to improve balance and functional mobility. This study aimed to compare the effect of CMDT versus exergaming on the balance and functional mobility of children with Down Syndrome aged 8–14 years. Methods: A randomized comparative trial was conducted, dividing participants’ children with DS into two intervention groups: CMDT group and exergaming group. Participants were recruited using convenience sampling methods from the Voice of Down Syndrome Association and the Down Syndrome Charitable Association in Riyadh, Saudi Arabia. Both interventions were implemented over a period of six weeks. Outcome measures included the Timed Up and Go (TUG), Four Square Step Test (FSST), and Pediatric Balance Scale (PBS). Results: A total of 23 children with DS participated in the study. A mixed repeated measures ANCOVA shows a significant effect of time across the two groups (p < 0.001) for TUG, FSST, and PBS, indicating improvements in balance and functional mobility. There were no significant differences between the two group interventions. Conclusions: CMDT and exergaming were equally effective in improving balance and functional mobility in children with DS. Trial Registration: Clinicaltrials.gov with ID NCT06146907. Full article

Preschool teaching is a highly demanding profession that requires constant socio-emotional attunement and the ability to engage in reflective reasoning. Despite the central role of these skills in effective early childhood education, little is known about whether preschool teachers’ socio-affective and cognitive capacities vary as a function of accumulated professional experience. To address this knowledge gap, we compared the performance of 30 professional preschool teachers with a matched control group of 30 non-teachers on tests measuring emotion recognition, active-empathic listening, interpersonal reactivity, and abstract reasoning. We found that preschool teachers were significantly better on all dimensions of active-empathic listening (sensing, processing, and responding) and better in emotional self-regulation than controls. Moreover, years of preschool teaching experience were positively correlated with emotion recognition, improved listening skills, and more deliberate abstract reasoning strategies. Notably, socio-affective competencies were correlated with abstract reasoning performance within the preschool teacher group. According to these results, long-term professional involvement in preschool teaching enhances socio-affective skills and integrates them with higher-order cognitive processes, both of which are essential for responsive teaching, efficient classroom management, and the development of children’s social and cognitive abilities. Full article

Introduction: Several studies have been conducted in the field of education for older adults, with an emphasis on teaching and learning processes related to the use of digital technologies. Among the relevant aspects to be considered in this context is the cognitive vulnerability of this age group in terms of digital security. Objective: The aim of this study was to analyze the relationship between cognitive aspects of older adults and their ability to identify digital risks, before and after participating in an educational intervention, as well as the effect of the intervention on cognition in this age group. Methodology: Analyses were conducted according to the educational intervention and control groups, further stratified by digital risk (SJT) and dementia risk, according to the ACE-R test. The Mann–Whitney test was used to identify possible differences in the likelihood of falling for digital scams, considering the dimensions generated by the simulations (SJT). Results: Overall, the educational intervention was effective for the media education dimension (delta −0.5), regardless of dementia risk. More specifically, a particular effect was observed in the post-intervention stage. Conclusions: The educational intervention was able to promote cognitive gains and reduce digital risks among older adults, particularly in the identification of misinformation, underscoring the importance of continuous and adapted programs to promote digital security in this population. Full article

Background/Objectives: Mild Cognitive Impairment (MCI) represents a critical transition stage between normal aging and dementia, with executive dysfunction playing a key prognostic role. Traditional neuropsychological tests show limited ecological validity and may fail to detect early executive deficits. Virtual Reality (VR) offers an innovative alternative by reproducing everyday situations in realistic environments. This study investigated whether the Picture Interpretation Test 360° (PIT 360°), a VR-based assessment, can (1) discriminate between MCI patients and healthy controls (HCs); (2) identify executive dysfunction within the MCI group; and (3) correlate with standard neuropsychological measures. Methods: One hundred and one participants aged ≥65 years (53 MCI, 48 HCs) underwent a comprehensive neuropsychological assessment and PIT 360° evaluation. The PIT 360° requires interpreting a complex scene in a 360-degree virtual environment. Hierarchical linear regression, Receiver operating characteristic (ROC) curve analysis, and binary logistic regression were performed to examine group differences and diagnostic accuracy. MCI patients were stratified based on their performance on the Modified Five Point Test to identify visuospatial dysexecutive deficits. Results: MCI patients showed significantly longer PIT 360° completion times than HCs (92.6 vs. 65.3 s, p = 0.006), independent of age. MCI patients with visuospatial dysexecutive deficits exhibited the most severe deficits (median = 105 s, p = 0.017 vs. HCs). ROC analysis revealed adequate discriminative ability (AUC = 0.64, 95% CI [0.53, 0.75]) with a preliminary, sample-derived cut-off at ≥22 s, yielding high sensitivity (86.5%) but low specificity (42.6%). This threshold requires validation in independent samples. PIT 360° completion time correlated significantly with visuospatial executive functions, visual memory, and verbal fluency. Conclusions: The PIT 360° effectively screens for visuospatial executive dysfunction in MCI with high sensitivity, making it suitable for ruling out clinically significant impairment. Its ecological validity, brief administration, and correlations with traditional measures support integration into routine clinical practice for early detection and rehabilitation planning. Full article

Background/Objective: Neuroimmune and metabolic dysregulation have been increasingly implicated in the cognitive heterogeneity of autism spectrum disorder (ASD). However, it remains unclear whether anti-inflammatory diets engage distinct biological and cognitive pathways in autistic and neurotypical children. This study examined whether a 12-week anti-inflammatory dietary protocol produces group-specific neuroimmune–metabolic signatures and cognitive responses in autistic children, neurotypical children receiving the same diet, and untreated neurotypical controls. Methods: Twenty-two children (11 with ASD, six a on neurotypical diet [NT-diet], and five neurotypical controls [NT-control]) completed pre–post assessments of plasma IFN-γ, CXCL1, RANTES (CCL5), trimethylamine-N-oxide (TMAO), and an extensive ENI-2/WISC-IV neuropsychological battery. Linear mixed-effects models were used to test the Time × Group effects on biomarkers and cognitive domains, adjusting for age, sex, and baseline TMAO. Bayesian estimation quantified individual changes (posterior means, 95% credible intervals, and posterior probabilities). Immune–cognitive coupling was explored using Δ–Δ correlation matrices, network metrics (node strength, degree centrality), exploratory mediation models, and responder (≥0.5 SD domain improvement) versus non-responder analyses. Results: In ASD, the diet induced robust reductions in IFN-γ, RANTES, CXCL1, and TMAO, with decisive Bayesian evidence for IFN-γ and RANTES suppression (posterior P(δ < 0) > 0.99). These shifts were selectively associated with gains in verbal learning, semantic fluency, verbal reasoning, attention, and visuoconstructive abilities, whereas working memory and executive flexibility changes were heterogeneous, revealing executive vulnerability in individuals with smaller TMAO reductions. NT-diet children showed modest but consistent improvements in visuospatial processing, attention, and processing speed, with minimal biomarker changes; NT controls remained biologically and cognitively stable. Network analyses in ASD revealed a dense chemokine-anchored architecture with CXCL1 and RANTES as central hubs linking biomarker reductions to improvements in fluency, memory, attention, and executive flexibility. ΔTMAO predicted changes in executive flexibility only in ASD (explaining >50% of the variance), functioning as a metabolic node of executive susceptibility. Responders displayed larger coordinated decreases in all biomarkers and broader cognitive gains compared to non-responders. Conclusions: A structured anti-inflammatory diet elicits an ASD-specific, coordinated neuroimmune–metabolic response in which suppression of CXCL1 and RANTES and modulation of TMAO are tightly coupled with selective improvements in verbal, attentional, and executive domains. Neurotypical children exhibit modest metabolism-linked cognitive benefits and minimal immune modulation. These findings support a precision-nutrition framework in ASD, emphasizing baseline immunometabolic profiling and network-level biomarkers (CXCL1, RANTES, TMAO) to stratify responders and design combinatorial interventions targeting neuroimmune–metabolic pathways. Full article

Background/Objectives: Chemotherapy can negatively affect cognitive functioning through direct and indirect mechanisms, with 15–50% of patients experiencing a decline that impacts quality of life. While neurocognitive tests are the main assessment tool, self-reported measures provide valuable additional insights. The aim of this study was to evaluate the cognitive decline of patients during the early stages of chemotherapy treatment and its impact on their quality of life, as well as to outline future perspectives for an early intervention model. Materials and Methods: This prospective longitudinal study was conducted on 40 patients aged 18 to 64 years. Data were collected using the FACT-Cog v.3 questionnaire, administered at the beginning of the first chemotherapy cycle (T0), and then again after approximately 3–4 weeks (T1) and 6–8 weeks (T2). Results: The data show a progressive decline in perceived cognitive abilities (PCI: 72.10 → 64.43; PCA: 25.70 → 20.90) and overall quality of life (9.73 → 8.75) from T0 to T2. A significant positive correlation was found between perceived cognitive abilities and quality of life, supporting the link between cognitive decline and quality of life. Questionnaire variables reliably predicted changes in quality of life two months after chemotherapy [F(4, 35) = 3.91, p = 0.01]. Conclusions: The findings show a decline in quality of life as chemotherapy progresses. However, this decline can be predicted from the second month of treatment using the FACT-Cog v.3 questionnaire. The findings further highlight even more the value of integrating early empowerment, rehabilitative and psychoeducational programs to mitigate cognitive decline and improve quality of life. Full article

Background and Objectives: Coronary artery bypass grafting (CABG) is one of the most common cardiac surgeries worldwide. However, postoperative cognitive decline (POCD) remains a significant concern, affecting a substantial proportion of patients. One of the pathogenic mechanisms underlying POCD involves inflammatory responses and oxidative stress. Dexamethasone, a corticosteroid with potent anti-inflammatory properties, has been proposed as a potential neuroprotective agent. This study aimed to assess the effect of a single perioperative dose of dexamethasone on postoperative cognitive function in patients undergoing CABG surgery. Materials and Methods: This retrospective cohort study was conducted at the Hospital of Lithuania. Inclusion criteria: elective CABG surgery, non-neurocognitive anamnesis, Minimal Mental State Examination score ≥25 before surgery, and age >50. Patients were divided into two groups: DEXA (those who received preoperative dexamethasone 0.1 mg/kg) and non-DEXA (those who did not). Cognitive functions were assessed with the Addenbrooke’s Cognitive Examination test (ACE-III) 7 days post operation. Results: The study enrolled 60 patients (DEXA = 30, non-DEXA = 30): male (85%), female (15%). The mean age of the study was 66.1 ± 8.1 and the education was 12 (12–30) years. The groups were similar in the evaluated preoperative characteristics (sex, age, education) (p > 0.05). Cognitive impairment (ACE-III score cut–off 88 points) was identified in 40% (n = 12) of participants in the DEXA and 69.3% (n = 21) in the non-DEXA group, with no statistically significant difference between groups (p = 0.073). However, the DEXA group had significantly better cognitive scores in attention (Z = 3.145, p = 0.002), fluency (Z = 2.25, p = 0.024), and spatial ability (Z = 4.444, p < 0.001) while language (Z = 1.167, p = 0.243) and memory scores (Z = 1.906, p = 0.057) showed no significant differences. Conclusions: These findings suggest that dexamethasone may provide neuroprotective benefit, reducing postoperative cognitive function domains, such as attention, fluency, and spatial ability, after CABG surgery. Further prospective studies are needed to confirm these findings. Full article