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23 pages, 1245 KiB  
Article
Relationship Between Obesity and Impairment of Cognitive Functions: An Investigation into the Integrated Role of Nutritional Education and Physical Activity in Lower Secondary School
by Maria Giovanna Tafuri, Domenico Tafuri and Francesca Latino
Nutrients 2025, 17(15), 2531; https://doi.org/10.3390/nu17152531 - 31 Jul 2025
Viewed by 295
Abstract
Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. [...] Read more.
Background/Objectives: Obesity in adolescence is associated with a deterioration in cognitive functions, with significant implications for psychophysical well-being and academic performance. Recent studies highlight the importance of integrated interventions that combine nutrition education and physical activity to promote the overall health of students. The present study aims to evaluate the efficacy of an integrated intervention based on nutritional education and conscious body movement in improving cognitive functions, perceived well-being and nutritional knowledge in lower secondary school students with indicators of overweight and obesity. Methods: A quasi-experimental design with randomization at the class level was adopted, involving 60 students divided into an experimental group and control group. The intervention was divided into twelve weeks of activities, divided between nutritional education modules and physical activity courses. Standardized tests for the assessment of cognitive functions (Digit Span Forward, Digit Span Backward, Stroop Test, Trail Making Test B), motor tests (6-Minute Walk Test, Sit and Reach Test) and a food knowledge questionnaire were administered before and after the intervention. Results: The experimental group showed significant improvements compared to the control group in all cognitive, motor, and nutritional knowledge measures, indicating the effectiveness of the integrated intervention in promoting cognitive and physical well-being. Conclusions: The findings support the role of school as a generative environment of integrated well-being, suggesting the need to develop and implement curricular programs that integrate nutrition education and physical activity to counteract the negative effects of obesity on cognitive function in adolescents. Full article
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28 pages, 3228 KiB  
Article
Examination of Eye-Tracking, Head-Gaze, and Controller-Based Ray-Casting in TMT-VR: Performance and Usability Across Adulthood
by Panagiotis Kourtesis, Evgenia Giatzoglou, Panagiotis Vorias, Katerina Alkisti Gounari, Eleni Orfanidou and Chrysanthi Nega
Multimodal Technol. Interact. 2025, 9(8), 76; https://doi.org/10.3390/mti9080076 - 25 Jul 2025
Viewed by 408
Abstract
Virtual reality (VR) can enrich neuropsychological testing, yet the ergonomic trade-offs of its input modes remain under-examined. Seventy-seven healthy volunteers—young (19–29 y) and middle-aged (35–56 y)—completed a VR Trail Making Test with three pointing methods: eye-tracking, head-gaze, and a six-degree-of-freedom hand controller. Completion [...] Read more.
Virtual reality (VR) can enrich neuropsychological testing, yet the ergonomic trade-offs of its input modes remain under-examined. Seventy-seven healthy volunteers—young (19–29 y) and middle-aged (35–56 y)—completed a VR Trail Making Test with three pointing methods: eye-tracking, head-gaze, and a six-degree-of-freedom hand controller. Completion time, spatial accuracy, and error counts for the simple (Trail A) and alternating (Trail B) sequences were analysed in 3 × 2 × 2 mixed-model ANOVAs; post-trial scales captured usability (SUS), user experience (UEQ-S), and acceptability. Age dominated behaviour: younger adults were reliably faster, more precise, and less error-prone. Against this backdrop, input modality mattered. Eye-tracking yielded the best spatial accuracy and shortened Trail A time relative to manual control; head-gaze matched eye-tracking on Trail A speed and became the quickest, least error-prone option on Trail B. Controllers lagged on every metric. Subjective ratings were high across the board, with only a small usability dip in middle-aged low-gamers. Overall, gaze-based ray-casting clearly outperformed manual pointing, but optimal choice depended on task demands: eye-tracking maximised spatial precision, whereas head-gaze offered calibration-free enhanced speed and error-avoidance under heavier cognitive load. TMT-VR appears to be accurate, engaging, and ergonomically adaptable assessment, yet it requires age-specific–stratified norms. Full article
(This article belongs to the Special Issue 3D User Interfaces and Virtual Reality—2nd Edition)
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17 pages, 1437 KiB  
Article
Acute Neurochemical, Psychophysiological, and Cognitive Responses to Small-Sided Games vs. Running-Based HIIT in Young, Male Soccer Players
by Yakup Zühtü Birinci, Serkan Pancar, Yusuf Soylu, Hüseyin Topçu, Aygül Koçyiğit, Emre Sarandöl, Hasan Şimşek and Şenay Şahin
Healthcare 2025, 13(14), 1738; https://doi.org/10.3390/healthcare13141738 - 18 Jul 2025
Viewed by 443
Abstract
Background: This study aimed to compare the immediate effects of small-sided games (SSGs) and running-based high-intensity interval training (HIITrb) on serum brain-derived neurotrophic factor (BDNF) levels, cognitive performance, and enjoyment in young, male soccer players. Methods: Twenty-four soccer players [age: 19.2 ± 0.8 [...] Read more.
Background: This study aimed to compare the immediate effects of small-sided games (SSGs) and running-based high-intensity interval training (HIITrb) on serum brain-derived neurotrophic factor (BDNF) levels, cognitive performance, and enjoyment in young, male soccer players. Methods: Twenty-four soccer players [age: 19.2 ± 0.8 years] completed one session each of four-a-side SSG or HIITrb in a randomized, counterbalanced, and crossover design, with a one-week washout period. Blood samples and Trail Making Tests (TMTs) A and B were measured before and after exercise. Heart rate (HR) was monitored throughout the games, and ratings of perceived exertion (RPE) and enjoyment were collected at the end of the measurements. Results: The results show no significant effects of time (p > 0.775), group (p > 0.276) or time × group interaction (p > 0.199) on BDNF levels. For TMT-A, the time effect (p = 0.866) and group effect (p = 0.057) were not significant; however, the time × group interaction was significant (p < 0.019), indicating a superior performance in the SSG compared to HIITrb. In the TMT-B, significant effects were observed for both time (p < 0.001) and group (p < 0.001), while the time × group interaction effect was not statistically significant (p > 0.061). Furthermore, enjoyment levels did not differ significantly between conditions (p = 0.976). Conclusions: These findings suggest that four-a-side SSG may enhance processing speed compared to HIITrb without changes in serum BDNF levels. Coaches may consider using 4v4 SSG formats in early training sessions or warm-ups to stimulate processing speed and mental readiness in young soccer players. Full article
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18 pages, 1258 KiB  
Article
Cerebral Haemodynamics and Cognitive Impairment in Chronic Haemodialysis Patients: A Pilot Study
by Giulia Belluardo, Dario Galeano, Concetto Sessa, Giuseppe Zelante, Walter Morale and Paola De Bartolo
J. Clin. Med. 2025, 14(14), 4890; https://doi.org/10.3390/jcm14144890 - 10 Jul 2025
Viewed by 329
Abstract
Background: Patients with chronic kidney disease (CKD) have a substantially higher risk of developing cognitive impairment (CI) than the general population. Patients with CKD undergoing haemodialysis (HD) treatment also have an elevated risk of developing cerebrovascular and cardiovascular diseases. This study aims [...] Read more.
Background: Patients with chronic kidney disease (CKD) have a substantially higher risk of developing cognitive impairment (CI) than the general population. Patients with CKD undergoing haemodialysis (HD) treatment also have an elevated risk of developing cerebrovascular and cardiovascular diseases. This study aims to investigate the relationship between the cognitive performance of haemodialysis patients and cerebral and carotid haemodynamic indices. Methods: This study was a non-interventional observational study; the sample consisted of 32 patients (age 65 ± 12 years) undergoing chronic HD treatment. The patients underwent neuropsychological and haemodynamic instrumental investigations, including Supra-Aortic Trunk Echodoppler (SAT) and Transcranial Doppler (TCD). Results: Patients were 17% deficient at Montreal Cognitive Assessment (MoCA), 45% deficient at Frontal Assessment Battery (FAB), 55% deficient at Trail-Making Test-A (TMT-A) and 65% deficient at TMT-B. The TCD investigation detected a decrease in flow (MFV) and an increase in Breath Hold Index (BHI) predominantly in the right cerebral arterial district. The SAT investigation revealed an altered IMT, plaques and the presence of severe carotid stenosis. A strong association between cerebral and carotid indices and cognitive scores was also observed. Correlation analyses reported statistically significant correlations between TMT-A and TMT-B and cerebral flow indices. Conclusions: Among haemodialysis patients, there is a high percentage of cognitive impairment associated and correlated with alterations in cerebral and carotid haemodynamics. Cerebral haemodynamics are a factor to be taken into consideration as a possible pathological mechanism underlying cognitive impairment in haemodialysis. Full article
(This article belongs to the Section Nephrology & Urology)
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10 pages, 220 KiB  
Brief Report
Financial Capacity Assessment in Female Euthymic Bipolar Patients: Catching Up on a Long Neglected Vulnerable Group
by Vaitsa Giannouli
Healthcare 2025, 13(13), 1607; https://doi.org/10.3390/healthcare13131607 - 4 Jul 2025
Viewed by 308
Abstract
Background: Patients with bipolar disorder (BD) face many challenges as many basic cognitive and non-cognitive domains can be affected by their disease. Financial capacity requires complex cognitive functioning and is little investigated in BD, especially in the Greek cultural context. Objectives: [...] Read more.
Background: Patients with bipolar disorder (BD) face many challenges as many basic cognitive and non-cognitive domains can be affected by their disease. Financial capacity requires complex cognitive functioning and is little investigated in BD, especially in the Greek cultural context. Objectives: This study, for the first time, is focusing on whether financial capacity shows deficits in female euthymic BD patients compared to controls and what the self-estimations of the patients for their performance are. Materials and Methods: Patients and a sample of one-to-one matched healthy controls were examined with a detailed neuropsychological battery and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). Before their neuropsychological assessment, participants responded to a single-item five-point Likert scale about their financial capacity. Results: Findings extend earlier work in other groups of older patients and indicate that euthymic BD patients’ performance is lower than that of the control group in various subdomains and total score of LCPLTAS (p < 0.001), resembling the performance of patients with a diagnosis of Mild Cognitive Impairment (MCI). However, euthymic BD patients are not aware of their cognitive deficits compared to healthy controls and overestimate their financial capacities as they have more positive estimations regarding their financial capacity than controls (χ2(1) = 8.315, p = 0.004) despite their lower real performance. In addition, from a number of classic neuropsychological tests administered, only Trail Making Part B correlates with LCPLTAS scores for the group of euthymic BD patients (rho = −0.561, p = 0.005). Conclusions: The results support that special care must be provided for euthymic BD individuals, so we can prevent financial exploitation. Full article
13 pages, 480 KiB  
Article
The Effect of Flywheel Resistance Training on Executive Function in Older Women: A Randomized Controlled Trial
by Amanda dos Reis Cota, Édison Andrés Pérez Bedoya, Pablo Augusto Garcia Agostinho, Luciano Bernardes Leite, André Schneider, Pedro Forte, António M. Monteiro, Luís Branquinho, José E. Teixeira, Claudia Eliza Patrocínio de Oliveira, Osvaldo Costa Moreira and Miguel Araújo Carneiro-Júnior
Physiologia 2025, 5(3), 22; https://doi.org/10.3390/physiologia5030022 - 3 Jul 2025
Viewed by 898
Abstract
Background/Objectives: Executive function, which includes inhibitory control, working memory, and cognitive flexibility, tends to decline with aging. While traditional resistance training (TRT) has shown positive effects in mitigating these declines, limited evidence is available regarding flywheel resistance training (FRT). This study aimed to [...] Read more.
Background/Objectives: Executive function, which includes inhibitory control, working memory, and cognitive flexibility, tends to decline with aging. While traditional resistance training (TRT) has shown positive effects in mitigating these declines, limited evidence is available regarding flywheel resistance training (FRT). This study aimed to evaluate and compare the effects of TRT and FRT on executive function in older women. Methods: In this randomized controlled trial (clinicaltrials.gov NCT05910632), 29 older women were allocated into two groups: TRT (n = 15) and FRT (n = 14). The intervention lasted eight weeks with two weekly sessions conducted at the Federal University of Viçosa. The TRT group performed exercises using machines and free weights, while the FRT group used a multi-leg isoinertial device. Executive function was assessed using the Victoria Stroop Test (inhibitory control), Digit Span Test (working memory), and Trail Making Tests A and B (cognitive flexibility). Data were analyzed using a Multivariate Analysis of Covariance (p < 0.05). Results: No significant changes were observed in inhibitory control (p = 0.350). Working memory improved significantly within both groups in forward (p = 0.002) and backward (p = 0.002) span tasks. For cognitive flexibility, Trail Making Test A showed no significant changes (p > 0.05), but Test B showed significant within-group (p = 0.030) and between-group (p = 0.020) improvements. The B-A difference was also significant (p = 0.040). Conclusions: Both resistance training modalities enhanced working memory and cognitive flexibility. However, FRT produced greater improvements in cognitive flexibility, suggesting potential advantages in cognitive aging interventions. Full article
(This article belongs to the Special Issue Resistance Training Is Medicine)
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12 pages, 880 KiB  
Article
The Influence of Workplace-Integrated Exercise Snacks on Cognitive Performance in Sedentary Middle-Aged Adults—A Randomized Pilot Study
by Jonas P. Mues, Stefan Flohr and Nicolas Kurpiers
Sports 2025, 13(6), 186; https://doi.org/10.3390/sports13060186 - 13 Jun 2025
Viewed by 1187
Abstract
Sedentary behavior is increasingly recognized as a risk factor for various health issues, including cognitive decline. Objectives: This pilot study examined the acute and chronic effects of workplace-integrated exercise snacks—short, vigorous bouts of exercise—on cognitive performance in middle-aged adults. Methods: Twenty-five sedentary but [...] Read more.
Sedentary behavior is increasingly recognized as a risk factor for various health issues, including cognitive decline. Objectives: This pilot study examined the acute and chronic effects of workplace-integrated exercise snacks—short, vigorous bouts of exercise—on cognitive performance in middle-aged adults. Methods: Twenty-five sedentary but healthy office workers (51.4 ± 5.3 years; 6 m/19 f) participated. The intervention group (n = 12) performed three 1 min bouts of vigorous exercise (running on the spot) daily, four days a week, for four weeks, while the control group (n = 13) maintained their usual routine. Cognitive performance was assessed pre-intervention, shortly following the first exercise bout (acute effects), and post-intervention (chronic effects) using the Trail Making Test and the Stroop Color–Word Test. Results: Significant acute improvements (p ≤ 0.05) were observed across all cognitive outcomes following a single bout of exercise. Significant interaction effects (p ≤ 0.05) were found across all cognitive outcomes after four weeks, indicating sustained cognitive benefits. Conclusion: These findings suggest that workplace-integrated brief, vigorous exercise may lead to both immediate and sustained enhancement in executive functions such as working memory, processing speed, and inhibitory control. They highlight the potential cognitive health benefits of incorporating exercise snacks into sedentary workplace environments. Full article
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13 pages, 648 KiB  
Article
Associations Between Trail-Making Test Black and White Performance and Gray Matter Volume in Community-Dwelling Cognitively Healthy Adults Aged 40 to 80 Years
by Chanda Simfukwe, Seong Soo A. An and Young Chul Youn
J. Clin. Med. 2025, 14(12), 4041; https://doi.org/10.3390/jcm14124041 - 7 Jun 2025
Viewed by 515
Abstract
Background/Objective: The Trail Making Test (TMT) is a widely used neuropsychological tool to assess processing speed (Part A) and executive function (Part B). However, the neuroanatomical substrates underlying its Black & White variant (TMT-B&W) and the influence of demographic factors remain poorly understood. [...] Read more.
Background/Objective: The Trail Making Test (TMT) is a widely used neuropsychological tool to assess processing speed (Part A) and executive function (Part B). However, the neuroanatomical substrates underlying its Black & White variant (TMT-B&W) and the influence of demographic factors remain poorly understood. This study aimed to identify gray matter (GM) correlates of TMT-B&W performance across unadjusted and covariate-adjusted models in cognitively healthy adults. Methods: In this cross-sectional study, 87 participants (40–80 years) underwent structural magnetic resonance imaging (MRI) and completed TMT-B&W. Whole-brain voxel-based morphometry (VBM) was conducted using FreeSurfer for preprocessing and Computational Anatomy Toolbox (CAT12)/Statistical Parametric Mapping (SPM12) for analysis. Two voxel-wise regression models (unadjusted and adjusted for age, education, gender, and total intracranial volume (TICV)) assessed GM associations with TMT-B&W-A-B performance. Statistical thresholds were voxel-level p < 0.001 (uncorrected) and cluster-level Family-Wise Error (FWE) correction (p < 0.001). Results: In unadjusted models, TMT-B&W-A performance correlated with GM reductions in the right orbitofrontal cortex (T = 42.64, equivk = 515.60, representing peak voxel level T-statistic and cluster size in voxels), while TMT-B&W-B linked to the right insular cortex (T = 50.65, equivk = 515.50). After adjustment, both tasks converged on the left thalamus (TMT-A: T = 8.05, equivk = 594; TMT-B: T = 8.11, equivk = 621), with TMT-B&W-B showing a denser thalamic cluster. Demographic covariates attenuated cortical associations, revealing thalamic integration as a shared mechanism. Conclusions: The thalamus emerges as a critical hub for TMT-B&W performance when accounting for demographic variation, while distinct cortical regions mediate task-specific demands in unadjusted models. These findings support the TMT-B&W as a practical, low-cost neurobehavioral marker of brain integrity in older populations. Full article
(This article belongs to the Section Clinical Neurology)
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22 pages, 6517 KiB  
Article
Study on the Impact of Cooling Air Parameter Changes on the Thermal Fatigue Life of Film Cooling Turbine Blades
by Huayang Sun, Xinlong Yang, Yingtao Chen, Yanting Ai and Wanlin Zhang
Aerospace 2025, 12(6), 512; https://doi.org/10.3390/aerospace12060512 - 6 Jun 2025
Viewed by 439
Abstract
Film cooling has been increasingly applied in turbine blade cooling design due to its excellent cooling performance. Although film-cooled blades demonstrate superior cooling effectiveness, the perforation design on blade surfaces compromises structural integrity, making fatigue failure prone to occur at cooling holes. Previous [...] Read more.
Film cooling has been increasingly applied in turbine blade cooling design due to its excellent cooling performance. Although film-cooled blades demonstrate superior cooling effectiveness, the perforation design on blade surfaces compromises structural integrity, making fatigue failure prone to occur at cooling holes. Previous studies by domestic and international scholars have extensively investigated factors influencing film cooling effectiveness, including blowing ratio and hole geometry configurations. However, most research has overlooked the investigation of fatigue life in film-cooled blades. This paper systematically investigates blade fatigue life under various cooling air parameters by analyzing the relationships among cooling effectiveness, stress distribution, and fatigue life. Results indicate that maximum stress concentrations occur at cooling hole locations and near the blade root at trailing edge regions. While cooling holes effectively reduce blade surface temperature, they simultaneously create stress concentration zones around the apertures. Both excessive and insufficient cooling air pressure and temperature reduce thermal fatigue life, with optimal parameters identified as 600 K cooling temperature and 0.75 MPa pressure, achieving a maximum thermal fatigue life of 3400 cycles for this blade configuration. A thermal shock test platform was established to conduct fatigue experiments under selected cooling conditions. Initial fatigue damage traces emerged at cooling holes after 1000 cycles, with progressive damage expansion observed. By 3000 cycles, cooling holes near blade tip regions exhibited the most severe failure, demonstrating near-complete functional degradation. These findings provide critical references for cooling parameter selection in practical aeroengine applications of film-cooled blades. Full article
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17 pages, 1810 KiB  
Systematic Review
Neurocognitive Outcomes After Extracranial Surgery and General Anesthesia in Patients with a History of Mild-to-Moderate Traumatic Brain Injury: Systemic Review and Meta-Analysis
by Zeeshan A. Khan, Tahiris A. Duran, Dewan Md. Sumsuzzman, Ling-Sha Ju, Christoph N. Seubert and Anatoly E. Martynyuk
Biology 2025, 14(6), 640; https://doi.org/10.3390/biology14060640 - 31 May 2025
Viewed by 635
Abstract
Accelerated neurocognitive decline associated with surgeries under general anesthesia (GA), a phenomenon referred to as postoperative neurocognitive disorder (PND), is a significant public health concern. It not only poses inherent risks but may also contribute to the development of other neurodegenerative disorders. We [...] Read more.
Accelerated neurocognitive decline associated with surgeries under general anesthesia (GA), a phenomenon referred to as postoperative neurocognitive disorder (PND), is a significant public health concern. It not only poses inherent risks but may also contribute to the development of other neurodegenerative disorders. We systematically searched five databases for studies examining cognitive function in patients with mild-to-moderate TBI with (participant) or without (control) subsequent extracranial surgeries/GA. A random effects model was applied to calculate mean differences (MDs) and 95% confidence intervals (CIs). Five outcomes were analyzed post hoc: trail-making tests A and B (TMT-A/B), Glasgow Outcome Scale–Extended (GOSE), and length of stay (LOS) in intensive care units (ICUs) and hospitals. Five studies met the criteria for our meta-analysis. Patients with a history of mild-to-moderate TBI who underwent extracranial surgeries/GA exhibited worse outcomes in TMT-A [MD = 2.04; CI 0.38–3.70; p = 0.016] and TMT-B [MD = 16.59; CI 9.58–23.60; p < 0.001]. Differences in the ICU and hospital LOS and GOSE between the study groups were insignificant. Our results suggest that extracranial surgeries/GA may worsen neurocognitive outcomes without affecting functional recovery in mild-to-moderate TBI patients. Given the limited number of studies identified and the high incidence of TBI, more research on PND in TBI patients is warranted. Full article
(This article belongs to the Special Issue Neurobiology of Traumatic Brain Injury)
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18 pages, 2431 KiB  
Article
Modeling Dual-Task Performance: Identifying Key Predictors Using Artificial Neural Networks
by Arash Mohammadzadeh Gonabadi, Farahnaz Fallahtafti, Judith Heselton, Sara A. Myers, Ka-Chun Siu and Julie Blaskewicz Boron
Biomimetics 2025, 10(6), 351; https://doi.org/10.3390/biomimetics10060351 - 29 May 2025
Viewed by 576
Abstract
Dual-task paradigms that combine cognitive and motor tasks offer a valuable lens for detecting subtle impairments in cognitive and physical functioning, especially in older adults. This study used artificial neural network (ANN) modeling to predict clinical, cognitive, and psychosocial outcomes from integrated gait, [...] Read more.
Dual-task paradigms that combine cognitive and motor tasks offer a valuable lens for detecting subtle impairments in cognitive and physical functioning, especially in older adults. This study used artificial neural network (ANN) modeling to predict clinical, cognitive, and psychosocial outcomes from integrated gait, speech-linguistic, demographic, physiological, and psychological data collected during single- and dual-task conditions. Forty healthy adults (ages 20–84) completed physical, cognitive, and psychosocial assessments and a dual-task walking task involving cell phone use. ANN models were optimized using hyperparameter tuning and k-fold cross-validation to predict outcomes such as the Montreal Cognitive Assessment (MOCA), Trail Making Tests (TMT A and B), Activities-Specific Balance Confidence (ABC) Scale, Geriatric Depression Scale (GDS), and measures of memory, affect, and social support. The models achieved high accuracy for MOCA (100%), ABC (80%), memory function (80%), and social support satisfaction (75%). Feature importance analyses revealed key predictors such as speech-linguistic markers and sensory impairments. First-person plural pronoun used and authenticity of internal thoughts during dual-task emerged as strong predictors of MOCA and memory. Models were less accurate for complex executive tasks like TMT A and B. These findings support the potential of ANN models for the early detection of cognitive and psychosocial changes. Full article
(This article belongs to the Special Issue Artificial Intelligence (AI) in Biomedical Engineering)
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9 pages, 384 KiB  
Article
Cognitive Impairment in ANCA-Associated Vasculitis: A Cross-Sectional Pilot Study
by Marion Camard, Ana Moises, Katia Bourdic, Laura Venditti, Christian Denier, Julien Henry, Raluca Sterpu, Perla David, Mathilde De Menthon, Olivier Lambotte, Anne-Cécile Petit, Matthias Babin, Nicolas Noel and Fanny Urbain
J. Clin. Med. 2025, 14(10), 3582; https://doi.org/10.3390/jcm14103582 - 20 May 2025
Viewed by 480
Abstract
Objectives: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) comprises rare systemic vasculitides that can present with cognitive dysfunction. However, data on the screening and characterization of cognitive dysfunction in AAV remain limited. Methods: Cognitive complaints in AAV patients were screened using self-report questionnaires. Objective [...] Read more.
Objectives: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) comprises rare systemic vasculitides that can present with cognitive dysfunction. However, data on the screening and characterization of cognitive dysfunction in AAV remain limited. Methods: Cognitive complaints in AAV patients were screened using self-report questionnaires. Objective cognitive impairment was assessed with a standardized neurocognitive test battery. Results were compared with clinical evaluations, brain MRI findings, treatment history, and neuropsychiatric symptoms. All test results were standardized for the overall population. Results: Twelve patients (five women, seven men) with a median [IQR] age of 68 [59–71] and a median [IQR] disease duration of 92 months [55–127] were included. None of the patients showed evidence of vasculitis activity on brain MRI. Cognition was assessed using a standardized neurocognitive test battery in all patients except one. Four patients (36%) were found to have cognitive impairment, defined as three or more altered tests. The most affected functions were attentional and executive, with the d2-R (4/4), Rey–Osterrieth Complex Figure Delayed Recall (3/4), and Trail Making Test Part B (3/4) showing the most frequent deficiencies. Objective cognitive disorders were not associated with self-reported cognitive complaints. No significant association was found between cognitive impairment and vasculitis activity or sequelae, corticosteroid and immunosuppressive treatments, or neuropsychiatric symptoms. Conclusions: This study highlights the presence of cognitive impairments in AAV, predominantly affecting attentional and executive functions, which may reflect vascular involvement. Early and tailored approaches to cognitive screening and management are essential to improve patient care and quality of life. Full article
(This article belongs to the Section Immunology)
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16 pages, 254 KiB  
Article
The Preoperative Level of Pain Predicts Chronic Pain in Patients Operated on for Degenerative Disc Disease—A Prospective Study
by Agnieszka Pawełczyk, Rusłan Jekimov, Weronika Lusa, Redwan Jabbar, Katarzyna Kruzerowska, Tomasz Pawełczyk and Maciej Radek
J. Clin. Med. 2025, 14(10), 3467; https://doi.org/10.3390/jcm14103467 - 15 May 2025
Viewed by 473
Abstract
Background: Postoperative pain is an unpleasant experience for the patient and impairs postoperative functional outcomes. The current literature on the influence of preoperative predictors on postoperative pain outcomes remains limited. This study aimed to identify sociodemographic, clinical, psychological, and temperamental predictors of postoperative [...] Read more.
Background: Postoperative pain is an unpleasant experience for the patient and impairs postoperative functional outcomes. The current literature on the influence of preoperative predictors on postoperative pain outcomes remains limited. This study aimed to identify sociodemographic, clinical, psychological, and temperamental predictors of postoperative pain in patients undergoing surgery for degenerative disc disease (DDD). Methods: Eighty-one adults with DDD, qualified for neurosurgical intervention, were enrolled. All patients underwent neurological and psychiatric evaluations, as well as preoperative pain assessments using the Visual Analogue Scale (VAS) and the West Haven-Yale Multidimensional Pain Inventory (WHYMPI). Psychological assessments included the Perceived Stress Scale, Hospital Anxiety and Depression Scale, Somatic Symptom Scale, temperament, and personality inventories (e.g., FCB-TI, NEO-FFI), and cognitive tests (Trail Making Test, Digit Span Test). Postoperative pain was re-evaluated with the VAS 12 weeks after surgery. Data were analyzed using univariate and multivariate statistical methods. Results: Univariate analyses revealed significant differences between the defined groups regarding lack of improvement of pain 12 weeks after surgery compared to preoperative VAS, systolic blood pressure, and four scales from the WHYMPI. However, stepwise logistic regression identified only preoperative VAS score as an independent predictor of postoperative pain improvement. Receiver Operating Characteristic analysis and Youden’s index indicated a preoperative VAS cut-off score of 6 as the most predictive. Conclusions: A VAS score of 6 or more before surgery independently predicts the absence of chronic pain 12 weeks postoperatively for patients without neurological deficits. Moreover, given the complexity of this topic, further prospective, randomized controlled research is essential. Full article
(This article belongs to the Section Clinical Neurology)
19 pages, 2194 KiB  
Article
Cardiac Autonomic Modulation and Cognitive Performance in Community-Dwelling Older Adults: A Preliminary Study
by Paula Andreatta Maduro, Luiz Alcides Ramires Maduro, Polyana Evangelista Lima, Ana Clara Castro Silva, Rita de Cássia Montenegro da Silva, Alaine Souza Lima Rocha, Maria Jacqueline Silva Ribeiro, Juliana Magalhães Duarte Matoso, Bruno Bavaresco Gambassi and Paulo Adriano Schwingel
Neurol. Int. 2025, 17(5), 74; https://doi.org/10.3390/neurolint17050074 - 12 May 2025
Viewed by 598
Abstract
Background/Objectives: Cognitive decline has been increasingly linked to cardiac autonomic regulation; however, its specific associations with cognitive domains, such as information processing speed and executive function, remain unclear. This preliminary study examined the relationship between cardiac autonomic modulation and cognitive performance in older [...] Read more.
Background/Objectives: Cognitive decline has been increasingly linked to cardiac autonomic regulation; however, its specific associations with cognitive domains, such as information processing speed and executive function, remain unclear. This preliminary study examined the relationship between cardiac autonomic modulation and cognitive performance in older adults. Methods: A cross-sectional study was conducted with 101 older adults (aged ≥60 years) attending a university hospital outpatient clinic. Participants were classified as without cognitive impairment (WCI) or cognitively impaired and not demented (CIND) based on neuropsychological assessments. Heart rate variability (HRV) was measured at rest, focusing on the time-domain parameters (SDNN, rMSSD, and pNN50). Trail making test parts A and B (TMT-A and TMT-B) were used to assess information processing speed and executive function, respectively. Analyses of covariance (ANCOVAs) were performed, adjusting for confounding variables including age, sex, and comorbidities. Results: Participants in the CIND group had significantly lower HRV indices than those in the WCI group (SDNN, p < 0.05, d = 0.44; rMSSD, p < 0.05, d = 0.39; pNN50, p < 0.05, d = 0.40), indicating reduced parasympathetic modulation. Higher HRV values were observed in individuals with preserved processing speed and executive function. Specifically, pNN50 was significantly associated with processing speed (p = 0.04), and SDNN was significantly correlated with executive function (p = 0.02). These associations persisted even after adjusting for confounding factors. Conclusions: Reduced cardiac autonomic modulation, especially lower parasympathetic activity, is significantly associated with cognitive impairment in older adults. Lower pNN50 values were correlated with slower information processing speed, and lower SDNN was associated with poorer executive function. These findings support the potential use of HRV as a physiological biomarker to detect cognitive changes during ageing. Full article
(This article belongs to the Collection Advances in Neurodegenerative Diseases)
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14 pages, 924 KiB  
Systematic Review
A Systematic Review on Subjective Cognitive Complaints: Main Neurocognitive Domains, Myriad Assessment Tools, and New Approaches for Early Detection
by Felipe Webster-Cordero and Lydia Giménez-Llort
Geriatrics 2025, 10(3), 65; https://doi.org/10.3390/geriatrics10030065 - 9 May 2025
Cited by 1 | Viewed by 1488
Abstract
Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review [...] Read more.
Background/Objectives: Neuropsychological testing is key in defining cognitive profiles at early stages of dementia. More importantly, the detection of subtle cognitive changes, such as subjective cognitive complaints (SCCs), an understudied phenomenon, is critical for early detection and preventive interventions. Methods: This systematic review analyzes the empirical data on the cognitive domains and neuropsychological tests used in studies addressing SCC in the last 15 years (2009–2024). Results: A selection of 15 papers with exploratory, cross-sectional, and prospective scope in this field was obtained from PubMed and Embase databases. They used screening tests (17%) and a broad spectrum of neurocognitive domains. Yet, we identified three main targeted cognitive domains: executive functions (28%), language (17%), and memory (17%). Myriad assessment tools were also applied, but the most commonly used was a set of eight tests: Mini-mental Scale Examination (MMSE), Trail Making Test (A-B), Stroop test, Digit span test (DST), Semantic and Phonological fluency test, Rey Auditory Verbal Learning Test (RAVLT), Weschler Memory Scale (WMS), and Boston Naming Test (BNT). New approaches involved including the Geriatric Depression Scale (GDS) and self/informant reports. Conclusions: Despite scarce agreement in the assessment protocols, the identification of early neurocognitive symptoms to objectivate the SCC phenomenon envisions a broad field of research. Full article
(This article belongs to the Special Issue Current Issues in Cognitive Testing of Older Adults)
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