scholarly journals Disruptive and protective outcomes to memory and attention when treating diffuse glioma

2019 ◽  
Author(s):  
R Romero-Garcia ◽  
J Suckling ◽  
M Owen ◽  
M Assem ◽  
R Sinha ◽  
...  
Keyword(s):  
Surgical Resection ◽  
Cognitive Deficits ◽  
Brain Networks ◽  
Cognitive Outcomes ◽  
Attention Deficits ◽  
Diffuse Glioma ◽  
Cognitive Recovery ◽  
Memory And Attention ◽  
Neurite Density ◽  
With Memory

ABSTRACTSurgical resection with adjuvant chemotherapy and radiotherapy are effective treatments to delay glioma progression and improve survival. Nevertheless, a large proportion of patients have treatment-induced cognitive deficits that dramatically reduce their life quality. Predicting the treatment-induced functional impairments is difficult due to the complex interlocking and diffusely spread networks that underpin different aspects of cognition. Here we investigated glioma interactions with brain networks in relation to cognitive recovery after surgical resection and during chemo-radiotherapy treatment. Seventeen patients with diffuse non-enhancing glioma (aged 22-56 years) were longitudinally MRI-scanned and cognitively assessed using a tablet-based screening tool before and after surgery, and during a 12-months recovery period. Using structural MRI and Neurite Orientation Dispersion and Density Imaging (NODDI) derived from diffusion-weighted images, we respectively estimated tumour overlap and Neurite Density (as an in-vivo proxy measure of axon and dendrite concentration) with brain networks and functional maps derived from normative data in healthy participants. We found that neither total lesion volume nor tumour location based on traditional lobular divisions were associated with memory or attention deficits. However, tumour and lesion overlap with the Default Mode Network (DMN), Attention Network and attention-related regions located in frontal and parietal cortex was associated with memory and attention deficits. This association was above and beyond the contributions of preoperative cognitive status and tumour volume (Linear Mixed Model, Pfdr<0.05). On the other hand, Neurite Density was reduced not only within the tumour, but also beyond the tumour boundary, revealing a distal effect with global consequences to brain networks. High preoperative Neurite Density outside the tumour, but within the Frontoparietal Network was associated with better memory and attention recovery. Moreover, postoperative and follow-up Neurite Density within the DMN, Frontoparietal and Attention Networks were associated with memory and attention improvements (Pfdr<0.05). We conclude that gliomas located on brain networks that are fundamental for cognitive processing mediate cognitive deficits and they exert a distal effect on Neurite Density in these networks that is also associated with cognitive recovery. Our work provides insights into the brain reorganisation that occurs due to the presence of a tumour and its subsequent removal, which has potential capability to predict cognitive outcomes. Understanding the pathophysiology underlying tumour related cognitive outcomes will be vital to the development of novel prognostic biomarkers, subgroup stratification in clinical trials, and individualised rehabilitation programmes.

scholarly journals Memory recovery in relation to default mode network impairment and neurite density during brain tumor treatment

2021 ◽  
pp. 1-11
Author(s):  
Rafael Romero-Garcia ◽  
John Suckling ◽  
Mallory Owen ◽  
Moataz Assem ◽  
Rohitashwa Sinha ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Default Mode Network ◽  
Verbal Memory ◽  
Digit Span ◽  
Brain Networks ◽  
Imaging Biomarkers ◽  
Default Mode ◽  
Neurite Density ◽  
Memory Recovery ◽  
With Memory

OBJECTIVE The aim of this study was to test brain tumor interactions with brain networks, thereby identifying protective features and risk factors for memory recovery after resection. METHODS Seventeen patients with diffuse nonenhancing glioma (ages 22–56 years) underwent longitudinal MRI before and after surgery, and during a 12-month recovery period (47 MRI scans in total after exclusion). After each scanning session, a battery of memory tests was performed using a tablet-based screening tool, including free verbal memory, overall verbal memory, episodic memory, orientation, forward digit span, and backward digit span. Using structural MRI and neurite orientation dispersion and density imaging (NODDI) derived from diffusion-weighted images, the authors estimated lesion overlap and neurite density, respectively, with brain networks derived from normative data in healthy participants (somatomotor, dorsal attention, ventral attention, frontoparietal, and default mode network [DMN]). Linear mixed-effect models (LMMs) that regressed out the effect of age, gender, tumor grade, type of treatment, total lesion volume, and total neurite density were used to test the potential longitudinal associations between imaging markers and memory recovery. RESULTS Memory recovery was not significantly associated with either the tumor location based on traditional lobe classification or the type of treatment received by patients (i.e., surgery alone or surgery with adjuvant chemoradiotherapy). Nonlocal effects of tumors were evident on neurite density, which was reduced not only within the tumor but also beyond the tumor boundary. In contrast, high preoperative neurite density outside the tumor but within the DMN was associated with better memory recovery (LMM, p value after false discovery rate correction [Pfdr] < 10−3). Furthermore, postoperative and follow-up neurite density within the DMN and frontoparietal network were also associated with memory recovery (LMM, Pfdr = 0.014 and Pfdr = 0.001, respectively). Preoperative tumor and postoperative lesion overlap with the DMN showed a significant negative association with memory recovery (LMM, Pfdr = 0.002 and Pfdr < 10−4, respectively). CONCLUSIONS Imaging biomarkers of cognitive recovery and decline can be identified using NODDI and resting-state networks. Brain tumors and their corresponding treatment affecting brain networks that are fundamental for memory functioning such as the DMN can have a major impact on patients’ memory recovery.

scholarly journals Cognitive Functioning and Late-Life Depression

2014 ◽  
Vol 20 (5) ◽  
pp. 461-467 ◽  
Author(s):  
Aaron M. Koenig ◽  
Rishi K. Bhalla ◽  
Meryl A. Butters
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Functioning ◽  
Neuropsychological Assessment ◽  
Cognitive Deficits ◽  
Late Life ◽  
Cognitive Outcomes ◽  
Review Of The Literature ◽  
Late Life Depression ◽  
The Relationship

AbstractThis brief report provides an introduction to the topic of cognitive functioning in late-life depression (LLD). In addition to providing a review of the literature, we present a framework for understanding the heterogeneity of cognitive outcomes in this highly prevalent disorder. In addition, we discuss the relationship between LLD and dementia, and highlight the importance of regularly assessing cognitive functioning in older adults who present with depressive symptoms. If cognitive deficits are discovered during a neuropsychological assessment, we recommend referral to a geriatric psychiatrist or cognitive neurologist, for evaluation and treatment of the patient’s symptoms. (JINS, 2014, 20, 1–7)

Abstract WP404: Stroke Cognitive Recovery Model

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Susan Alderman
Keyword(s):  
Cognitive Deficits ◽  
Cognitive Abilities ◽  
Belief Systems ◽  
Healthcare Providers ◽  
The Body ◽  
Patient Needs ◽  
Coordinated Care ◽  
Recovery Model ◽  
Cognitive Recovery ◽  
Transitional State

Background: After an acute stroke, 90% of patients have cognitive deficits; 50% remain impaired and 30% develop dementia within one year. Cognitive recovery may not occur without early and coordinated care. Many cognitive deficits, i.e. memory and neglect, are not addressed early, care is not coordinated, and depends on each institution’s guidelines. Nurses must consider all patient needs yet no holistic cognitive recovery model exists to guide them. Purpose: To create a holistic, post-stroke, patient-centered cognitive recovery model capable of guiding care. Methods: Concept synthesis is a new way of grouping or ordering information when relevant data is unclear or unknown. A concept synthesis was performed due to limitations in prior biomedical models, specifically in psychology and rehabilitation, which resulted in ill-defined terms and bias. Results: Cognitive recovery is defined as a transitional state in which a person’s cognitive abilities can be modified to approach pre-injury levels, by the interactions of personal capabilities and four encompassing Environments. Personal capabilities (acceptance, agency and congruence) are internally oriented forces which control self-care behavior. The Environments (resources or forces interacting to help/hinder recovery) are depicted as the Physical (the body), External (social support, therapists, etc.), Internal (psychiatric or emotional forces), and Created (belief systems, attitudes, etc.). Conclusions: When interactions between personal capabilities and Environments are adequate cognitive recovery will progress. Recovery should be comprehensive and nurses are uniquely qualified to ensure all aspects of the person are addressed. This model promotes collaboration among healthcare providers and guidance in identifying and addressing patient needs.

BRAFv600e mutated gliomas: From biology to radiology and treatments.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13552-e13552
Author(s):  
Benoit Lhermitte ◽  
Eric Guerin ◽  
Agathe Chammas ◽  
Izzie Jacques Namer ◽  
Guillaume Gauchotte ◽  
...  
Keyword(s):  
Surgical Resection ◽  
De Novo ◽  
Mapk Signaling ◽  
Braf V600e ◽  
Glioneuronal Tumor ◽  
Low Grade ◽  
Diffuse Glioma ◽  
Metabolomic Profile ◽  
Cdkn2a Deletion ◽  
The Impact

e13552 Background: BRAF V600E mutation is encountered in brain tumor, mostly low grade pediatric diffuse glioma (LGG) and epileptogenic glioneuronal tumor such as gangliogliomas (GG) or pleomorphic xanthoastrocytomas (PXA). Less frequently this mutation is present in high grade glial or glioneuronal tumors such as pleomorphic xanthoastrocytomas with anaplasia, anaplastic ganglioglioma, anaplastic diffuse astrocytomas or glioblastomas. Recently, few publications were highlighting differently the impact of BRAF mutation and CDKN2A deletion, as independent prognostic factors linked to a worst outcome in low grade forms. Methods: We studied retrospectively a monocentric cohort of 12 LGGs and 9 HGG with BRAFv600e positivity. The patients were aged from 1 to 47 years. Most of the LGG were under 25 years and only 3 patients with HGGs had less than 18 years old. We focused on extended biology assessment by Next generation sequencing of the tumors and their relapses, tumor metabolomics analyses, radiology comprising MRI, PET-scanning and spectroscopy and correlate them to tumor’s evolution and its treatment. Results: Among the LGGs, we had 9 GG and 3 pilocytic astrocytomas and only one had a CDKN2A deletion and one a gain on chromosome 5. 6 had a complete surgical resection, 2 had a minimal residue and 4 had chemotherapeutic treatment after partial surgery and underwent relapses. All HGGs had a surgical resection followed by chemotherapy (mainly Stupp protocol) and radiotherapy. 5 relapsed rapidly, benefit from targeted therapy with vemurafenib and are still in long term remission. In this HGG group, we had two subgroups: 4 patients with “de novo” tumors and 5 patients with a past history of LGG tumors in the same brain region. Both were responding well to targeted treatments and all had an additional CDKN2A deletion. Specific radiological and spectroscopic signs were linked to those two groups and seem to be associated to a specific metabolomic profile in each group. Currently, we are going further in the correlation between MAPK signaling pathway and metabolomic profile to be able to predict in LGG their potential evolution. Conclusions: BRAF mutated gliomas seem to have specific radiological and metabolomic correlations associated to their biology

scholarly journals Brain networks disconnection in early multiple sclerosis cognitive deficits: An anatomofunctional study

2014 ◽  
Vol 35 (9) ◽  
pp. 4706-4717 ◽  
Author(s):  
Céline Louapre ◽  
Vincent Perlbarg ◽  
Daniel García-Lorenzo ◽  
Marika Urbanski ◽  
Habib Benali ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Cognitive Deficits ◽  
Brain Networks

Integrating psychopharmacology and cognitive remediation to treat cognitive dysfunction in the psychotic disorders

CNS Spectrums ◽  
2013 ◽  
Vol 19 (2) ◽  
pp. 115-120 ◽  
Author(s):  
Alice Medalia ◽  
Lewis A. Opler ◽  
Alice M. Saperstein
Keyword(s):  
Cognitive Deficits ◽  
Psychotic Disorders ◽  
Cognitive Remediation ◽  
Preliminary Evidence ◽  
Cognitive Outcomes ◽  
Medium Effect ◽  
Future Research ◽  
Pharmacological Agents ◽  
Cognitive Interventions ◽  
Significant Barrier

Cognitive deficits are a prominent and enduring aspect of schizophrenia, which pose a significant barrier to achieving functional goals. The most promising intervention for treating cognitive impairment is cognitive remediation (CR), a behaviorally based therapy associated with medium effect sizes for cognitive and functional outcomes. However, there is a sizeable group of nonresponders whose CR outcomes become limited when the therapeutic approach fails to address individual differences in baseline cognition, motivation variables, and the extent to which CR offers opportunities for generalization. This speaks to a need to develop cognitive interventions that are both personalized and scalable. Emerging data suggest that specific pharmacological agents have the potential to enhance and accelerate behaviorally based CR effects. This article will review the rationale and preliminary evidence to support combining CR and pharmacotherapy. We will review crucial aspects of cognitive interventions that offer the most promise for improving not only cognitive outcomes, but also for enhancing improvement in real-world functioning. Finally, we will address methodological issues to be considered for future research on combined pharmacological and CR interventions.

scholarly journals Repetitive and Prolonged Omega-3 Fatty Acid Treatment after Traumatic Brain Injury Enhances Long-Term Tissue Restoration and Cognitive Recovery

2017 ◽  
Vol 26 (4) ◽  
pp. 555-569 ◽  
Author(s):  
Hongjian Pu ◽  
Xiaoyan Jiang ◽  
Zhishuo Wei ◽  
Dandan Hong ◽  
Sulaiman Hassan ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Fish Oil ◽  
Cognitive Deficits ◽  
Combined Treatment ◽  
Tissue Loss ◽  
Sham Operation ◽  
Omega 3 ◽  
Cognitive Recovery

Traumatic brain injury (TBI) is one of the most disabling clinical conditions that could lead to neurocognitive disorders in survivors. Our group and others previously reported that prophylactic enrichment of dietary omega-3 polyunsaturated fatty acids (n-3 PUFAs) markedly ameliorate cognitive deficits after TBI. However, it remains unclear whether a clinically relevant therapeutic regimen with n-3 PUFAs administered after TBI would still offer significant improvement of long-term cognitive recovery. In the present study, we employed the decline of spatial cognitive function as a main outcome after TBI to investigate the therapeutic efficacy of post-TBI n-3 PUFA treatment and the underlying mechanisms. Mice were subjected to sham operation or controlled cortical impact, followed by random assignment to receive the following four treatments: (1) vehicle control; (2) daily intraperitoneal injections of n-3 PUFAs for 2 weeks, beginning 2 h after TBI; (3) fish oil dietary supplementation throughout the study, beginning 1 day after TBI; or (4) combination of treatments (2) and (3). Spatial cognitive deficits and chronic brain tissue loss, as well as endogenous brain repair processes such as neurogenesis, angiogenesis, and oligodendrogenesis, were evaluated up to 35 days after TBI. The results revealed prominent spatial cognitive deficits and massive tissue loss caused by TBI. Among all mice receiving post-TBI n-3 PUFA treatments, the combined treatment of fish oil dietary supplement and n-3 PUFA injections demonstrated a reproducible beneficial effect in attenuating cognitive deficits although without reducing gross tissue loss. Mechanistically, the combined treatment promoted post-TBI restorative processes in the brain, including generation of immature neurons, microvessels, and oligodendrocytes, each of which was significantly correlated with the improved cognitive recovery. These results indicated that repetitive and prolonged n-3 PUFA treatments after TBI are capable of enhancing brain remodeling and could be developed as a potential therapy to treat TBI victims in the clinic.

scholarly journals Linking flexibility of brain networks to cognitive development in preschool children

2020 ◽  
Author(s):  
Lily Chamakura ◽  
Syed Naser Daimi ◽  
Katsumi Watanabe ◽  
Joydeep Bhattacharya ◽  
Goutam Saha
Keyword(s):  
Preschool Children ◽  
Brain Development ◽  
Cognitive Ability ◽  
Temporal Variability ◽  
Short Term Memory ◽  
Brain Networks ◽  
Brain Network ◽  
Memory And Attention ◽  
Functional Brain Networks ◽  
Human Adults

AbstractRecent studies of functional connectivity networks (FCNs) suggest that the reconfiguration of brain network across time, both at rest and during task, is linked with cognition in human adults. In this study, we tested this prediction, i.e. cognitive ability is associated with a flexible brain network in preschool children of 3-4 years - a critical age, representing a ‘blossoming period’ for brain development. We recorded magnetoen-cephalogram (MEG) data from 88 preschoolers, and assessed their cognitive ability by a battery of cognitive tests. We estimated FCNs obtained from the source reconstructed MEG recordings, and characterized the temporal variability at each node using a novel path-based measure of temporal variability; the latter captures reconfiguration of the node’s interactions to the rest of the network across time. Using connectome predictive modeling, we demonstrated that the temporal variability of fronto-temporal nodes in the dynamic FCN can reliably predict out-of-scanner performance of short-term memory and attention distractability in novel participants. Further, we observed that the network-level temporal variability increased with age, while individual nodes exhibited an inverse relationship between temporal variability and node centrality. These results demonstrate that functional brain networks, and especially their reconfiguration ability, are important to cognition at an early but a critical stage of human brain development.

scholarly journals MUSIC THERAPY IN DEMENTIA PATIENTS: WHAT ARE THE BENEFITS?

2021 ◽  
Author(s):  
Monique Gomes ◽  
Amanda Rodrigues ◽  
Indianara Rosa ◽  
Daniel Perez Sampaio
Keyword(s):  
Music Therapy ◽  
Neuronal Degeneration ◽  
Pharmacological Therapy ◽  
Cognitive Outcomes ◽  
Cortical Activation ◽  
Language Fluency ◽  
Cognitive Domains ◽  
Memory And Attention ◽  
Dementia Patients ◽  
Musical Stimulus

Background: Dementia is an acquired status, characterized by a decline in at least two cognitive domains, severe enough to affect social or occupational functioning. The standard pharmacological treatment for dementia has limited efficacy, especially in non-cognitive outcomes. Music therapy (MT) is being studied as anon-pharmacological therapy for Dementia, due to its stimulating effects. Objective: Understand the main benefits of MT in dementia patients, through a systematic review. Methods: A literature research was carried out using the databases: PubMed and Scielo. The period of publication was limited from 2016 to 2021, with the search keywords: Music Therapy, Dementia. 297 studies were found, and 15 met the inclusion criteria for our review. Results: MT includes passive (listening to music) and active participation, such as playing instruments, singing or songwriting. Listening to music is linked with wild cortical activation and is a strong stimulus for neuroplastic changes. MT provides multimodal skills, performing integration of various cognitive functions, such as memory and attention, especially in interactive interventions. Conclusion: Studies showed mixed results, especially due to the lack of standardized methods for musical stimulus, but in general, MT was considered to improve verbal and language fluency, anxiety and depression levels, apathy, cognitive function and quality of life, and decrease neuronal degeneration by enhancing cerebral plasticity.

scholarly journals Rescue of cognitive function following fractionated brain irradiation in a novel preclinical glioma model

eLife ◽  
2018 ◽  
Vol 7 ◽  
Author(s):  
Xi Feng ◽  
Sharon Liu ◽  
David Chen ◽  
Susanna Rosi ◽  
Nalin Gupta
Keyword(s):  
Tumor Growth ◽  
Cognitive Deficits ◽  
Memory Deficits ◽  
Cognitive Outcomes ◽  
Whole Brain Irradiation ◽  
Clinical Model ◽  
Brain Irradiation ◽  
Reliable Assessment ◽  
Radiation Induced

More than half of long-term brain tumor survivors develop irreversible cognitive decline that severely affect their quality of life. However, there is no pre-clinical model that allows long-term assessment of cognition, and there is no treatment which ameliorates cognitive deficits in patients. Here, we report a novel glioma mouse model that offers manageable tumor growth and reliable assessment of cognitive functions in a post-treatment manner. Using this model, we found that fractionated whole-brain irradiation (fWBI), but not tumor growth, results in memory deficits. Transient inhibition of CSF-1R during fWBI prolongs survival of glioma-bearing mice and fully prevents fWBI-induced memory deficits. This result suggests that CSF-1R inhibition during radiotherapy can be explored as an approach to improve both survival and cognitive outcomes in patients who will receive fWBI. Taken together, the current study provides a proof of concept of a powerful tool to study radiation-induced cognitive deficits in glioma-bearing animals.

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