Daytime variation in performance and tiredness/sleepiness ratings in patients with insomnia, narcolepsy, sleep apnea and normal controls

Daytime tiredness or sleepiness and deficits in cognitive performance are common complaints in sleep disordered patients. Till now there are few studies comparing patients from different diagnostic groups of sleep disorders in the same experimental protocol. We studied the time course of cognitive functions and subjective alertness in a parallel group design with four groups of patients [narcolepsy, untreated or treated obstructive sleep apnea (OSA), or psychophysiological insomnia] and a control group of subjects without sleep complaints. Each group consisted of 10 subjects, matched for age and gender. After a night with polysomnography, subjects were studied for 10 h from 08:00 hours to 18:00 hours at 20 min intervals under standardized environmental conditions. Four psychological tests were applied, (1) a critical flicker fusion (CFF) test to measure optical fusion threshold (alertness); (2) a paper-and-pencil visual line tracking test (selective attention); (3) a visual analog scale (VAS) for tiredness/sleepiness; and (4) the Tiredness Symptoms Scale (TSS), a 14 items check list. Each test session lasted for 8 min, followed by a 12 min pause. The level and time course of cognitive performance and self-rating data were analysed with hierarchical linear mixed effects models. Cognitive tests showed decrements in alertness and selective attention in untreated patients with insomnia, narcolepsy, and sleep apnea. Narcoleptic patients and untreated OSA had a lower CFF threshold than controls, and for narcoleptic patients the time course differed from that of all other groups. In the visual tracking test the performance of all groups of patients was worse compared with normal controls. Self-rated tiredness/sleepiness was significantly more pronounced in the three groups of untreated patients than in control subjects.     

Motor and cognitive deficits in apolipoprotein E-deficient mice after closed head injury

Previous studies suggest that traumatic brain injury is associated with increased risk factor for developing Alzheimer's disease. Furthermore, the extent of the risk seems to be most pronounced in Alzheimer's disease patients who carry the ε4 allele of apolipoprotein E, suggesting a connection between susceptibility to head trauma and the apolipoprotein E genotype. Apolipoprotein E-deficient mice provide a useful model for investigating the role of this lipoprotein in neuronal maintenance and repair. In the present study apolipoprotein E-deficient mice and a closed head injury experimental paradigm were used to examine the role of apolipoprotein E in brain susceptibility to head trauma and in neuronal repair. Apolipoprotein E-deficient mice were assessed up to 40 days after closed head injury for neurological and cognitive functions, as well as for histopathological changes in the hippocampus. A neurological severity score used for clinical assessment revealed more severe motor and behavioural deficits in the apolipoprotein E-deficient mice than in the controls, the impairment persisting for at least 40 days after injury. Performance in the Morris water maze, which tests spatial memory, showed a marked learning deficit of the apolipoprotein E-deficient mice when compared with injured controls, which was apparent for at least 40 days. At this time, histopathological examination revealed overt neuronal cell death bilaterally in the hippocampus of the injured apolipoprotein E-deficient mice.

The finding that apolipoprotein E-deficient mice exhibit an impaired ability to recover from closed head injury suggests that apolipoprotein E plays an important role in neuronal repair following injury and highlights the applicability of this mouse model to the study of the cellular and molecular mechanisms involved.     

Improvement of cognitive function by blood flow restriction training: mechanisms and applications北大核心

BACKGROUND: Blood flow restriction training is a new resistance training. Blood flow restriction training can not only influence muscle strength, mass and physical ability, but also induce and activate related signaling pathways such as neural plasticity and cognitive function. However, current studies have not systematically evaluated the effects of blood flow restriction training on the cognitive ability of different populations, and the neurobiological mechanism by which blood flow restriction training improves cognitive function is not fully understood. Moreover, the application solutions of blood flow restriction training are still not fully understood. OBJECTIVE: To review the existing experimental studies on the influence of blood flow restriction training on cognitive function of different populations, deeply analyze the potential neurobiological mechanisms, and summarize the previous rational programs of blood flow restriction training that improve cognitive function, in order to provide theoretical support and practical guidance for the safe and effective application of this technology. METHODS: PubMed, Web of Science, and CNKI databases were retrieved using “blood flow restriction training, pressure training, blood flow restriction therapy, blood flow restriction, pressure blood block training, blood block, cognitive function, cognitive ability” as Chinese keywords and “blood flow restriction therapy, KAATSU training, KAATSU volume, resistance training, BFR therapy, BFRT, blood flow restriction exercise, cognition, cognitive function” as English keywords. The search deadline was October 2022. Relevant inclusion criteria were established according to the research needs and finally 84 articles were included for further review. RESULTS AND CONCLUSION: The experimental studies regarding the influence of blood flow restriction training on cognitive ability mainly select healthy people as subjects in an attempt to explore its application value in healthy elderly populations. However, in general, there are few studies on elderly people and patients with cognitive dysfunction. Blood flow restriction training can be used as a key factor to trigger positive neural adaptation to a certain extent by applying hypoxic stimulation to the extremity to induce transient brain oxygen deficiency. Blood flow restriction training can significantly improve the levels of bioactive molecules related to the improvement of cognitive function, mainly including insulin-like growth factor 1, growth hormone, vascular endothelial growth factor, brain-derived neurotrophic factor, lactic acid, hypoxia-inducible factor 1α, peroxisome proliferator-activated receptor-γ coactivation factor 1α and norepinephrine. The formulation of blood flow restriction training application programs involves the selection of training participants, the determination of exercise factors and the setting of cuff pressure and its width. Future studies should pay attention to the comparison of the application effects of different blood flow restriction training methods in different populations, so as to make the clinical application of blood flow restriction training more perfect and reasonable, providing more theoretical basis for blood flow restriction training to improve cognitive function in patients with cognitive dysfunction. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.     

奎的平和氯丙嗪对精神分裂症认知功能影响的双盲对照研究

目的 :探讨奎的平和氯丙嗪对精神分裂症患者认知功能的影响。方法 :40例精神分裂症患者随机均分为奎的平组和氯丙嗪组 ,在治疗前、治疗后 4、 6周作知识、算术、数字符号、数字广度 (顺、逆 )、木块拼图、瞬时逻辑记忆、视觉再生即刻和延迟、STROOPC测验、词汇流畅、TOH总分 ,计划时间、延迟逻辑记忆、WCST等神经心理测验 ,整个研究过程采用双盲双模拟法。为观察学习效应 ,12例健康者在相同间隔时间作神经心理测验。所得数据用SPSS10 0进行统计分析。结果 :治疗后 ,奎的平组大部分患者神经心理测验成绩提高而氯丙嗪组的测验结果变化不大 ,尤其在注意、执行功能方面。奎的平对精神分裂症患者认知功能的改善作用优于氯丙嗪 (P <0 0 5 )。结论 :奎的平对精神分裂症患者的注意和执行功能有改善作用而氯丙嗪不明显。     

社会技能训练对慢性精神分裂症疗效的对照研究

目的:探讨社会技能训练对慢性精神分裂症阳性症状、阴性症状及认知功能的疗效.方法:将100例慢性精神分裂症患者随机分为训练组(50例)和对照组(50例).对训练组按照Liberman RP编写的<社会独立生活技能>训练程式进行训练,共12周.用BPRS、SANS、SDSI和WCST进行评定.结果:(1)训练组BPRS在总分和焦虑抑郁及缺乏活力因子分低于对照组,差异有显著性(P<0.05).(2)接受12周社交技能训练后,训练组的SANS量表全部五个因子和总分低于对照组,均有显著差异(P<0.05).(3)训练组和对照组在WCST的5个指标,差异有显著性(P<0.05).(4)SDSI评定结果表明,训练后明显降低,差异有显著性(P<0.05).结论:社会技能训练能够改善慢性精神分裂症的阳性症状、阴性症状及认知功能.     

College student attitudes toward forcible date rape: I. Cognitive predictors

Students completed a questionnaire measuring acceptance of forcible date rape, attitudes toward women, sexual knowledge, sexual experience, tolerance of socially unapproved sexual behavior, and religiosity. Findings suggested that persons relatively more accepting of forcible date rape are less sure it really is rape, have more traditional attitudes toward women, are more selfsexually permissive (i.e., more tolerant of their own socially unapproved of sexual behavior, such as premarital and extramarital sex with friends or casual acquaintances), have less accurate sexual knowledge and, though a large majority blame the male, are slightly more inclined than others to blame society or the situation. These predictor variables accounted for 35% of the variance in attitudes toward forcible date rape and identified correctly about two-thirds of the students classified as nonrejectors of forcible date rape, i.e., those who did not consider the male's behavior definitely unacceptable under any one of nine circumstances, including He spent a lot of money on her. In addition to the emotional and personality variables often cited in rapists, the cognitive predictor variables found may be salient to understanding the etiology of rape.This paper was first presented at meetings of the Society for the Scientific Study of Sex, September 1985, in San Diego, California.     

腰硬联合麻醉与全麻对老年腹部手术患者术后短期认知功能的影响

目的 探讨腰硬联合麻醉(CSEA)与全麻对老年腹部手术患者术后认知功能的影响。方法 选取本院2018年5月—2019年5月收治的82例老年腹部手术患者,按随机数表法分为观察组和对照组,各41例。观察组应用CSEA,对照组则采用全身麻醉。比较两组的麻醉相关指标,术后6 h、12 h、24 h的精神功能状态以及患者术后短期认知功能障碍的发生率。结果 观察组麻醉起效时间(min)、完全清醒时间(min)分别为(8.19±1.04)、(28.67±5.60)与对照组的(10.17±2.12)、(37.25±6.12)比较差异有统计学意义(P<0.05);观察组视觉模拟评分(VAS)(3.51±1.12)与对照组的(4.27±1.15)比较差异有统计学意义(P<0.05);观察组患者术后6 h、12 h、24 h时的MMSE评分分别为(22.27±1.46)、(26.23±1.26)、(28.19±1.24),均高于对照组的(21.46±1.35)、(24.68±1.23)、(26.37±1.19)(P<0.05);观察组短期内POCD的发生率为4.88%,低于对照组的24.39%,差异有统计学意义(P<0.05)。结论 对老年腹部手术患者采用CSEA,不仅能缩短麻醉起效时间和完全清醒的时间,减轻疼痛,而且对患者精神功能的影响小,可有效减少短期内认知功能障碍发生率。     

认知行为疗法对支气管哮喘儿童焦虑抑郁及生活质量的影响研究

目的 探讨认知行为疗法对支气管哮喘儿童焦虑、抑郁及生活质量的影响。方法 选取2022年1—6月在某专科医院哮喘专病门诊就诊的支气管哮喘患儿80例作为研究对象,采用随机数字表法将其随机分为对照组和观察组,每组各40例。对照组采取门诊随访的常规护理措施;观察组在对照组的基础上给予认知行为疗法干预,干预前后采用医院焦虑抑郁量表(HADS)、儿童哮喘生活质量问卷(PAQLQ)对患儿进行焦虑、抑郁和生活质量评估,比较采用t检验、χ2检验等。结果 干预前2组患儿焦虑、抑郁评分和PAQLQ各项得分差异均无统计学意义(P ＞0.05)。干预后,观察组焦虑评分(6.04±1.44)分,低于对照组的(9.11±2.55)分(t=6.630,P<0.001),观察组抑郁评分(5.85±1.78)分,低于对照组(9.06±2.28)分(t=7.019,P<0.001)。观察组PAQLQ的症状(54.16±11.09)分、活动(28.62±5.14)分、情感功能(46.26±7.01)分,均高于对照组的(43.88±10.06)分、(20.82±4.46)分、(33.76±5.91)分(t=4.342、7.249、8.622,P<0.001)。结论 认知行为疗法有助于改善支气管哮喘患儿的焦虑和抑郁水平,提高其生活质量,值得进一步推广应用。     

血管性认知障碍肾阳虚证的调查研究及DNA甲基化本质

目的：在病证结合背景模式下,调查血管性认知障碍肾阳虚证的分布情况并从DNA甲基化角度探讨血管性认知障碍肾阳虚证的生物学内涵,为未来中医药治疗该病证提供表观遗传学层面的靶点。方法：2020年9月至2022年11月,通过量表对北京社区居民进行认知障碍筛查,对血管性认知障碍（VCI）患者进行证候分析;后纳入VCI肾阳虚证患者与健康对照者,采集外周血,采用Illumina Human Methylation 850K BeadChip对受试者的外周静脉血进行全基因组DNA甲基化检测,筛选差异甲基化基因并对其进行生信分析。结果：研究共调查1 902人,患有VCI的人数为201例,占总调查人数的10.57%,其中肾阳虚证者占72.14%;甲基化结果显示,与正常组比较,VCI组有386个差异甲基化位点,可注释到136个基因。京都基因与基因组百科全书（KEGG）信号通路富集分析显示,两组间差异基因主要涉及哺乳动物雷帕霉素靶蛋白（mTOR）信号通路、雌激素（Estrogen）信号通路、环磷酸腺苷（cAMP）信号通路等通路。蛋白质-蛋白质相互作用（PPI）网络分析显示,表皮生长因子受体（EGFR）、EGF...     

胞磷胆碱胶囊治疗血管性认知障碍患者的疗效及对认知功能的影响

目的:研究胞磷胆碱胶囊治疗血管性认知障碍(VCI)患者的疗效及对认知功能的影响。方法:选取2016年1月至2021年12月郑州市中心医院收治的80例VCI患者作为研究对象,随机分为对照组和观察组,各40例。在口服抗血小板药物阿司匹林预防心血管事件和脑血管事件,口服降脂药物阿托伐他汀预防心血管事件,行生活方式干预、认知训练、心理治疗,缓解情绪问题和改善认知功能等基础上,对照组患者口服安慰剂治疗,观察组患者口服胞磷胆碱胶囊治疗。比较两组患者治疗效果、认知功能情况及生活质量。结果:观察组患者患者治疗有效率高于对照组,差异具有统计学意义(P <0.05)。治疗8周及16周,观察组患者认知功能评分、生活质量评分高于对照组,差异具有统计学意义(P <0.05)。结论:口服胞磷胆碱胶囊可以有效改善VCI患者的认知功能,提高治疗效果,改善患者生活质量。