A Novel Pre-Screening Kit for Cerebral Amyloid Deposition Using QPLEXTM-Alz Plus Assay Kit: Application to Cognitively Normal Individuals

BackgroundThe deposition of beta-amyloid (Ab) in the brain precedes the onset of symptoms such as cognitive abnormality in Alzheimer’s disease (AD); therefore, it is best to detect Ab accumulation early as possible.MethodsWe previously reported that QPLEXTM Alz plus assay could be used for pre-screening of Ab accumulation in the brain. In this study, we applied QPLEXTM Alz plus assay kit to the cognitively normal (CN) group for the brain Ab positivity. Total 221 CN participants with or without brain Ab were included. ResultsReceiver operating characteristics (ROC) curve analysis showed that the discrimination power reached 0.878 area under curve (AUC) with 69.7% sensitivity and 98.4% specificity in the CN group over 65 years. ConclusionsWe suggest that QPLEXTM Alz plus assay is a useful method for pre-screening brain Ab in the CN group, especially over 65 years, to prevent disease progression by early detection of disease initiation.

Preoperative Cognitive Abnormality, Intraoperative Electroencephalogram Suppression, and Postoperative Delirium

Background Postoperative delirium is a common complication that hinders recovery after surgery. Intraoperative electroencephalogram suppression has been linked to postoperative delirium, but it is unknown if this relationship is causal or if electroencephalogram suppression is merely a marker of underlying cognitive abnormalities. The hypothesis of this study was that intraoperative electroencephalogram suppression mediates a nonzero portion of the effect between preoperative abnormal cognition and postoperative delirium. Methods This is a prespecified secondary analysis of the Electroencephalography Guidance of Anesthesia to Alleviate Geriatric Syndromes (ENGAGES) randomized trial, which enrolled patients age 60 yr or older undergoing surgery with general anesthesia at a single academic medical center between January 2015 and May 2018. Patients were randomized to electroencephalogram-guided anesthesia or usual care. Preoperative abnormal cognition was defined as a composite of previous delirium, Short Blessed Test cognitive score greater than 4 points, or Eight Item Interview to Differentiate Aging and Dementia score greater than 1 point. Duration of intraoperative electroencephalogram suppression was defined as number of minutes with suppression ratio greater than 1%. Postoperative delirium was detected via Confusion Assessment Method or chart review on postoperative days 1 to 5. Results Among 1,113 patients, 430 patients showed evidence of preoperative abnormal cognition. These patients had an increased incidence of postoperative delirium (151 of 430 [35%] vs.123 of 683 [18%], P < 0.001). Of this 17.2% total effect size (99.5% CI, 9.3 to 25.1%), an absolute 2.4% (99.5% CI, 0.6 to 4.8%) was an indirect effect mediated by electroencephalogram suppression, while an absolute 14.8% (99.5% CI, 7.2 to 22.5%) was a direct effect of preoperative abnormal cognition. Randomization to electroencephalogram-guided anesthesia did not change the mediated effect size (P = 0.078 for moderation). Conclusions A small portion of the total effect of preoperative abnormal cognition on postoperative delirium was mediated by electroencephalogram suppression. Study precision was too low to determine if the intervention changed the mediated effect. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

The concept of mild cognitive impairment: a victim of its ubiquity

Mild cognitive impairment (MCI) is a term used to describe individuals with cognitive impairment that is not severe enough to affect daily functioning (e.g. Petersen, 2004; Winblad et al., 2004). Although MCI has been used to describe cognitive abnormality due to any number of causes that can be progressive, stable, or reversible, it is most often considered to be a transition phase between normal cognition and dementia.

Investigation of neuroprotective activity of apolipoprotein E peptide mimetic Cog1410 in transgenic lines of drosophila melanogaster

The neuroprotective activity of apolipoprotein E (apoE) peptide mimetic Cog1410, containing amino acid sequence of the receptor-binding domain apoE, has been investigated in transgenic lines of Drosophila melanogaster expressing human APP and beta-secretase. Expression of two transgenes caused neuropathological processes attributed to Alzheimer's disease: neurodegeneration, cognitive abnormality and amyloid deposits formation in brain. It was shown that Cog 1410 reduces neurodegeneration in brain of transgenic flies and improves cognitive functions (odor recognition). These data suggest that Cog1410 is a potential neuroprotector that can be used in AD treatment.

Motion Perception in Migraineurs: Abnormalities are Not Related to Attention

Migraine groups have impaired ability to identify global motion direction in noisy random dot stimuli, an observation that has been used as evidence for cortical hyperexcitability. Several studies have also suggested abnormalities in cognitive processing, particularly in the domains of attention, visuo-spatial processing and memory. This study aimed to determine whether poor performance by migraineurs in motion coherence tasks could be explained by non-visual cognitive factors such as attention. Twenty-nine migraineurs and 27 non-headache controls participated. Global motion coherence thresholds were measured along with measures of neuropsychological function, using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The migraine group had significantly higher motion coherence thresholds than controls. No significant difference in attention or any other RBANS index score was found between groups. Index scores did not correlate with motion perception thresholds. This study does not support inattention or other cognitive abnormality as an explanation for motion perception anomalies in migraine.