Vascular cognitive impairment (VCI), a syndrome induced by cerebrovascular disease and its risk factors, has become a major public health challenge worldwide. Especially in the context of an increasingly aging population, its impact is becoming more significant. In recent years, research has gradually revealed the crucial role of chronic cerebral hypoperfusion (CCH) in the occurrence and development of VCI. CCH leads to long-term ischemia and hypoxia in brain tissue, which seriously threatens mitochondrial function and triggers a series of problems such as mitochondrial oxidative stress, calcium homeostasis disturbance, dynamic abnormalities, autophagy dysregulation, and impaired biogenesis. These issues are extensively involved in the pathological process of VCI. This article provides an overview of the correlation between mitochondrial dysfunction and VCI under CCH conditions, aiming to explore new directions for the treatment of VCI.
This article combines researches and experiments of mild cognitive impairment (MCI) from 2005 to 2018. It makes a conclusion among psychological evaluation, imaging studies, nerve electrophysiology, neural circuit and mental models, and concludes the changes of patients with MCI, which helps to make a definite diagnosis of MCI in clinical practice. Due to the research above we can find the suitable way to improve the sensitivity and specificity of discovery of MCI, improve the predictive power of its development, and intervene potential Alzheimer’s disease effectively.
Objective To systematically review the efficacy of six cognitive interventions on cognitive function of patients with mild cognitive impairment after stroke. Methods The PubMed, EMbase, Cochrane Library, SinoMed, WanFang Data and CNKI databases were electronically searched to collect randomized controlled trials on the effects of non-drug interventions on the cognitive function of patients with mild cognitive impairment after stroke from inception to March 2023. Two reviewers independently screened the literature, extracted data, and assessed the risk of bias of the included studies. Network meta-analysis was then performed using Openbugs 3.2.3 and Stata 16.0 software. Results A total of 72 studies involving 4 962 patients were included. The results of network meta-analysis showed that the following five cognitive interventions improved the cognitive function of stroke patients with mild cognitive impairment: cognitive control intervention (SMD=−1.28, 95%CI −1.686 to −0.90, P<0.05) had the most significant effect on the improvement of cognitive function, followed by computer cognitive training (SMD=−1.02, 95%CI −1.51 to −0.53, P<0.05), virtual reality cognitive training (SMD=−1.20, 95%CI −1.78 to −0.62, P<0.05), non-invasive neural regulation (SMD=−1.09, 95%CI −1.58 to −0.60, P<0.05), and cognitive stimulation (SMD=−0.94, 95%CI −1.82 to −0.07, P<0.05). Conclusion Five cognitive interventions are effective in improving cognitive function for stroke patients with mild cognitive impairment, among which cognitive control intervention is the most effective. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
We in the present research proposed a classification method that applied infomax independent component analysis (ICA) to respectively extract single modality features of structural magnetic resonance imaging (sMRI) and positron emission tomography (PET). And then we combined these two features by using a method of weight combination. We found that the present method was able to improve the accurate diagnosis of Alzheimer's disease (AD) and mild cognitive impairment (MCI). Compared AD to healthy controls (HC): the study achieved a classification accuracy of 93.75%, with a sensitivity of 100% and a specificity of 87.64%. Compared MCI to HC: classification accuracy was 89.35%, with a sensitivity of 81.85% and a specificity of 99.36%. The experimental results showed that the bi-modality method performed better than the individual modality in comparison to classification accuracy.
ObjectiveTo explore the association between prediabetes and early vascular cognitive impairment (VCI) in patients with acute cerebral infarction. MethodsNon-diabetes mellitus patients with first-ever acute cerebral infarction hospitalized in the Department of Neurology, the First Affiliated Hospital of Henan University of Science and Technology between January and April 2019 were retrospectively enrolled. The enrolled patients were divided into prediabetes group and normal blood glucose group according to the level of glycosylated hemoglobin, and the patients were divided into normal cognitive function group and cognitive impairment group according to the Montreal Cognitive Assessment score. The general information and clinical related data of the included patients were compared. Results A total of 129 patients were enrolled. Among them, 46 cases were in the prediabetes group and 83 cases were in the normal blood glucose group. There were 82 cases in the normal cognitive function group and 47 cases in the cognitive impairment group. Multivariate logistic regression analysis showed that compared with the normal blood glucose group, the prediabetes group was associated with early VCI in patients with acute cerebral infarction [odds ratio (OR)=4.172, 95% confidence interval (CI) (1.786, 9.754), P=0.001]; the higher the NationalInstitutes of Health Stroke Scale score at the first admission was, the higher the risk of early VCI was [OR=1.379, 95%CI (1.183, 1.650), P<0.001]. Conclusion In patients with first-ever acute cerebral infarction, prediabetes is associated with early VCI.
Alzheimer’s disease (AD) is a common and serious form of elderly dementia, but early detection and treatment of mild cognitive impairment can help slow down the progression of dementia. Recent studies have shown that there is a relationship between overall cognitive function and motor function and gait abnormalities. We recruited 302 cases from the Rehabilitation Hospital Affiliated to National Rehabilitation Aids Research Center and included 193 of them according to the screening criteria, including 137 patients with MCI and 56 healthy controls (HC). The gait parameters of the participants were collected during performing single-task (free walking) and dual-task (counting backwards from 100) using a wearable device. By taking gait parameters such as gait cycle, kinematics parameters, time-space parameters as the focus of the study, using recursive feature elimination (RFE) to select important features, and taking the subject’s MoCA score as the response variable, a machine learning model based on quantitative evaluation of cognitive level of gait features was established. The results showed that temporal and spatial parameters of toe-off and heel strike had important clinical significance as markers to evaluate cognitive level, indicating important clinical application value in preventing or delaying the occurrence of AD in the future.
Objective To analyze the efficacy of music therapy on the rehabilitation of post-stroke cognitive impairment (PSCI) and to provide a reference for rehabilitation intervention methods for PSCI. Methods Patients hospitalized in Beijing Bo’Ai Hospital, China Rehabilitation Research Center and diagnosed with PSCI between December 2020 and July 2022 were prospectively selected. According to the random number table method, patients were divided into a music therapy group and a control group. Both groups were given conventional neurology medication, nursing care, and conventional rehabilitation. The music therapy group received additional music therapy training, and both groups received treatment for one month. The Montreal Cognitive Assessment (MoCA), National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment Scale (FMA), and modified Barthel Index (MBI) were used before and after treatment to assess patients’ cognitive function, degree of neurological deficits, motor function and activities of daily live. Results A total of 48 patients were included, with 24 patients in both groups. There was no statistically significant difference in gender, age, education level, stroke type, lesion location, comorbidities, history of myocardial infarction or peripheral vascular disease, and smoking status between the two groups of patients (P>0.05). Before and after treatment, most patients in the two groups did not score in terms of language and delayed recall scores, and the difference were not statistically significant (P>0.05). There was no statistically significant difference in MoCA scores, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores between the two groups of patients before treatment (P>0.05). After treatment, the MoCA score, visual space and executive function, naming, attention, calculation, abstract thinking, and orientation scores of the music therapy group improved compared to before treatment (P<0.05), while the MoCA score, visual space and executive function, naming, attention, and orientation scores of the control group improved compared to before treatment (P<0.05). After treatment, the improvement in MoCA scores [5.0 (3.0, 6.0) vs. 2.5 (1.0, 4.0)], attention [1.0 (0.0, 1.0) vs. 0.0 (0.0, 1.0)], and abstract thinking scores [0.0 (0.0, 1.0) vs. 0.0 (0.0, 0.0)] in the music therapy group were better than that in the control group (P<0.05). There was no statistically significant difference in NIHSS, FMA, and MBI scores between the two groups of patients before treatment (P>0.05), and both groups improved after treatment compared to before treatment (P<0.05). After treatment, there was no statistically significant difference in the improvement of NIHSS, FMA, and MBI scores between the two groups of patients (P>0.05). Conclusions Compared with conventional rehabilitation therapy, training combined with music therapy is more beneficial for improving cognitive function in PSCI patients, especially in the cognitive domains of attention and abstract thinking. However, significant advantages have not been found in improving the degree of neurological impairment, limb motor function, and daily living activities.
Due to the aging population intensifies, the number of people suffering from mild cognitive impairment (MCI) or dementia is expected to increase, which may lead to a series of public health and social health problems. In the absence of drugs to prevent the transformation of MCI into dementia, it is urgent to find effective non-pharmacological therapies to delay the progress of cognitive impairment. This article will review the diagnosis of MCI and the research progress of non-pharmacological therapies, focusing on the non-pharmacological therapies related to MCI in recent years, including exercise intervention, cognitive intervention, physical and mental exercise, dietary intervention, electroacupuncture, repeated transcranial magnetic stimulation, and multi-component intervention, in order to provide an effective treatment for preventing or delaying the progression of MCI to dementia.
Objective To investigate the changes in mitochondrial morphology, structure and function in rats with severe intermittent hypoxia, as well as the effects of intermittent hypoxia and its severity on cognitive function. Methods A total of 18 rats were selected to construct a model of severe intermittent hypoxia, which were divided into a normal control group, an intermittent air control group, and a 5% intermittent hypoxia group for 8 weeks, with 6 rats in each group. The structural and functional changes of mitochondria in the hippocampal CA1 region were observed. A total of 30 rats were randomly divided into 5 groups: a normal control group, an intermittent air control group, a 5% intermittent hypoxia 4-week group, a 5% intermittent hypoxia 6-week group, and a 5% intermittent hypoxia 8-week group, with 6 rats in each group. The cognitive function of the rats in each group was evaluated by Morris water maze experiment. Results In the mitochondria of the hippocampal CA1 region of severely intermittent hypoxic rats, bilayer membranes or multilayer membranes were visible, the mitochondria were swollen, cristae were broken and vacuolated, and their respiratory function was significantly weakened, the membrane permeability was increased, and the membrane potential was reduced. In the Morris water maze, there was no significant difference in swimming speed between the rats. With the prolongation of intermittent hypoxia action time, the latency of finding the hidden platform in each group of rats increased significantly, and the residence time of the target quadrant decreased significantly. Conclusions Mitochondrial structure in the hippocampal CA1 region of the rat brain is destroyed during severe intermittent hypoxia, and dysfunction and cognitive impairment occur. With the prolongation of intermittent hypoxic injury, the degree of cognitive impairment worsens.
This study uses mind-control game training to intervene in patients with mild cognitive impairment to improve their cognitive function. In this study, electroencephalogram (EEG) data of 40 participants were collected before and after two training sessions. The continuous complexity of EEG signals was analyzed to assess the status of cognitive function and explore the effect of mind-control game training on the improvement of cognitive function. The results showed that after two training sessions, the continuous complexity of EEG signal of the subject increased (0.012 44 ± 0.000 29, P < 0.05) and amplitude of curve fluctuation decreased gradually, indicating that with increase of training times, the continuous complexity increased significantly, the cognitive function of brain improved significantly and state was stable. The results of this paper may show that mind-control game training can improve the status of the brain cognitive function, which may provide support and help for the future intervention of cognitive dysfunction.