Assessment of neuropsychological impairments in regular cannabis users

BackgroundCannabis is the most widely used illicit drug in the world. It is responsible for cognitive dysfunction of memory, speed of information processing, attention, and executive functions. Cognitive performance depends on the level of study, tolerance, and duration of abstinence from cannabis use. This study analyses cognitive function in a large population of regular cannabis consumers taking into account level of education.MethodsA battery of neuropsychological tests using the Cambridge Neuropsychological Test Automated Battery was performed on a population of 58 cannabis users categorized into two groups according to their level of education with a threshold of 12 years of study, and 25 non-users.ResultsIn Attention Switching Task percent correct trials, significant differences were found between the group of cannabis smokers with less than 12 years of study and the non-smoker group (P = 0.022), and between the cannabis users with more than 12 years of study and the non-smoker group (P = 0.008). A significantly lower performance in the Rapid Visual Information Processing (Mean latency, Probability of hit, Total hits, Total misses, Correct rejections) was found in the cannabis users with less than 12 years of study compared with the non-user group.ConclusionIn our population, chronic cannabis users presented divided and sustained attention and working memory disorders. Rapid Visual Information Processing performance may be influenced by education level in cannabis smokers.     

Associations of accelerometer-based sleep duration and self-reported sleep difficulties with cognitive function in late mid-life: the Finnish Retirement and Aging Study

ObjectivesPrior evidence suggests that sleep duration and sleep difficulties may be associated with cognitive function in old age, but little is known about the sleep–cognition association in late mid-life. Our aim was to examine the associations of accelerometer-based sleep duration as well as subjective sleep difficulties with different domains of cognitive function among aging workers.MethodsThe study population consisted of 289 participants (mean age 62.4 years, SD 1.02; 83% women) from the Finnish Retirement and Aging Study (FIREA). Sleep difficulties were measured using Jenkins Sleep Problem Scale (difficulties falling asleep, difficulties maintaining sleep, waking up too early in the morning, and nonrestorative sleep). Sleep duration was measured with wrist-worn accelerometer and self-report, and participants were divided into short (<7 h/night), mid-range (7–9 h/night) and long (≥9 h/night) sleepers. Participants underwent extensive cognitive testing covering three domains: (1) memory, (2) executive function, and (3) attention and information processing.ResultsGreater difficulties in waking up too early in the morning were associated with poorer executive function measured with Spatial Working Memory (SWM) test (p = 0.005). Additionally, nonrestorative sleep was associated with poorer executive function measured with Trail Making Test, B–A, (p = 0.036) and borderline significantly with lower SWM (p = 0.056). Compared to mid-range sleepers, long sleepers tended to have poorer cognitive function (all memory function tests and SWM), but the associations were not statistically significant due to small number of long sleepers.ConclusionsSubjective sleep difficulties may be linked to poorer executive function in a relatively healthy population of older workers in their 60 s. Thus, promoting good sleep quality may translate into better cognitive health in late mid-life.     

Restless legs syndrome in children and adolescents with attention-deficit/hyperactivity disorder: prevalence,mimic conditions,risk factors,and association with functional impairment

ObjectivesTo determine the prevalence of restless legs syndrome (RLS) and RLS-mimic conditions, the risk factors for RLS, and whether RLS contributes to functional impairment in children and adolescents with attention-deficit/hyperactivity disorder (ADHD).MethodsADHD children and adolescents were prospectively studied at the outpatient psychiatric clinic. A trained registered nurse used the 2012 Revised International Restless Legs Syndrome Study Group diagnostic criteria to diagnose RLS. Sociodemographic data and medical records were reviewed. Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P) Thai version was used to identify association between RLS and 6 domains of function [family, school (learning), school (behavior), life skills, child self-concept, social activities, and risky activities].ResultsA total of 217 patients were included. Of those, 23 (11%) patients met the criteria for RLS, and 49 (23%) had RLS-mimic conditions. Those conditions included myalgia (30/49), habitual foot tapping (23/49), positional discomfort (20/49), leg ulcer/bruise (1/49), and arthralgia/arthritis (1/49). Binary logistic regression revealed first-degree relative having RLS symptom to be significantly associated with RLS in study patients (OR: 5.06, p < 0.01). Multivariate linear regression showed RLS to be independently associated with school (behavior) (Β = 1.18, p = 0.05) and life skills (Β = 2.36, p = 0.05) impairment.ConclusionsRLS was found to be common in ADHD children and adolescents. RLS-mimic conditions were found in two-thirds of patients who previously met 4 essential RLS criteria. First-degree relative with RLS symptom was associated with RLS, and RLS was associated with functional impairment in the life skills and school (behavior) domains.     

Fast-food for thought: Retail food environments as resources for cognitive health and wellbeing among aging Americans?

In this exploratory sequential mixed-methods study, interviews with 125 adults aged 55–92 (mean age 71) living in the Minneapolis (Minnesota) metropolitan area suggested that eateries, including coffee shops and fast-food restaurants, represent popular neighborhood destinations for older adults and sources of wellbeing. Thematic analysis of how older adults perceived and utilized local eateries included sites of familiarity and comfort; physical and economic accessibility; sociability with friends, family, staff, and customers; and entertainment (e.g., destinations for outings and walks, free newspapers to read). To test the hypothesis that these sites, and the benefits they confer, are associated with cognitive welfare, we analyzed data from urban and suburban community-dwelling participants in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study, a national racially diverse sample of older Americans followed since 2003 (n = 16,404, average age at assessment 72 years). Results from multilevel linear regression models of these data demonstrated a positive association between kernel density of local eateries and cognitive functioning, which corroborated qualitative findings. Taken together, these results complicate our understanding of casual eatery settings as possible sites of wellbeing through social interaction and leisure activities. Results prompt further research investigating whether and how retail food environments can serve as community spaces for older adults that may help buffer against cognitive decline.     

Cost of illness study for adult atopic dermatitis in Japan: A cross-sectional Web-based survey

Atopic dermatitis is a pruritic, eczematous dermatitis, the symptoms of which chronically fluctuate with remissions and relapses. Although a high psychosomatic and economic burden caused by atopic dermatitis is expected, few studies have been conducted estimating the cost of illness, including the self-medication costs and productivity loss due to atopic dermatitis. The aim of this study was to conduct a cross-sectional, Web-based survey of the direct medical costs, self-medication costs and productivity loss for adult atopic dermatitis patients, and estimate the burden of Japanese adult atopic dermatitis patients by disease severity. In a physician survey, the medical resource consumption related to medical treatments was surveyed by disease severity. The direct medical costs were calculated by multiplying the medical resource consumption and medical fee corresponding to each treatment. Based on the results of a patient survey, the self-medication costs and productivity loss were estimated by sex and disease severity. Atopic dermatitis-related productivity loss was calculated based on absenteeism, presenteeism, overall work impairment for employed workers and activity impairment for housewives. The nationwide estimations were calculated based on the estimated number of atopic dermatitis patients, employed workers with atopic dermatitis, and housewives with atopic dermatitis in their 20s–50s in Japan. Based on the surveys, all costs per patient and the scores increased with disease severity. The cost of illness for adult atopic dermatitis patients in Japan was estimated to be approximately JPY 3 trillion/year. Considering the physical and mental burdens, the burden of illness for adult atopic dermatitis was demonstrated to be vast.     

强迫症团体认知行为治疗与药物治疗的随机对照研究

目的分析团体认知行为治疗(group cognitive-behavioral therapy,GCBT)对强迫症患者的疗效。方法本研究采用随机对照试验设计,与常规抗强迫药物治疗做对照。将符合入组标准的94例未用药强迫症患者,采用Excel软件中的RAND函数产生随机数字表形成随机分组序列的简单随机分组法,随机分为GCBT组(47例)和药物治疗组(47例)。经12周的结构化GCBT治疗和常规抗强迫药物治疗,采用t检验、卡方检验和方差分析比较2组间Y-BOCS、HAMA14和HAMD24平均减分率和减分值的差异。结果(1)2组基线Y-BOCS及HAMA14评分差异无统计学意义(t=0.281,P=0.779;t=0.795,P=0.429),但GCBT组HAMD24评分显著低于药物治疗组(t=2.316,P<0.05)。2组各有16例患者退出治疗,总脱落率为34%(32/94)。(2)12周治疗结束时,2组患者的Y-BOCS评分较基线显著降低,GCBT组和药物治疗组治疗前后Y-BOCS平均减分率[(37.0±27.4)%比(45.5±22.9)%]和平均减分值[(9.0±6.3)分比(11.0±5.8)分]比较差异无统计学意义[F(1,62)=0.069,P=0.794;F(1,62)=0.001,P=0.975]。GCBT组和药物治疗组的有效率和治愈率差异无统计学意义(χ^2=1.653,P=0.199;χ^2=0.088,P=0.767)。(3)GCBT组HAMA14减分率和减分值与药物治疗组治疗前后比较差异无统计学意义(t=-0.922,P=0.362;t=1.082,P=0.286)。(4)GCBT组HAMD24减分率与药物治疗组治疗前后比较差异无统计学意义,但药物治疗组HAMD24减分值显著高于GCBT组(t=2.239,P=0.029)。结论GCBT与常规抗强迫药物治疗强迫症患者的强迫和焦虑症状的疗效相当,常规药物治疗对抑郁症状的疗效优于GCBT。     

急性脑梗死合并阻塞性睡眠呼吸暂停综合症患者认知功能障碍发生现状及相关危险因素分析

目的 探讨急性脑梗死合并阻塞性睡眠呼吸暂停综合症(obstrucyive sleep apnea syndrome, OSAS)患者认知功能障碍发生现状及相关危险因素。方法 选择2016年1月-2017年10月于本院住院治疗的急性脑梗死合并OSAS患者130例作为研究对象,观察2组患者呼吸暂停低通气指数、最低血氧饱和度、平均血氧饱和度、低氧指数等; 评估患者的认知功能; 检测2组患者血清HIF-1和Ngb水平; 根据2组患者的临床资料,对影响认知功能的因素进行Logistic回归分析。结果 认知功能障碍组夜间睡眠期的呼吸暂停低通气指数和低氧指数显著高于认知正常组,而其最低血氧饱和度和平均血氧饱和度的指数显著高于认知正常组(P<0.05); 认知障碍组视空间技能、执行技能、定向力、语言能力、记忆力(延迟记忆)、注意力以及抽象思维7个不同的认知领域的得分以及总分均低于认知正常组(P<0.05); 认知功能障碍组HIF-1和Ngb高水平患者的比例显著高于认知正常组(P<0.05); 认知障碍组P300潜伏期显著高于认知正常组,但波幅较认知正常组显著降低(P<0.05)。单因素分析显示,体重指数(χ²=7.428,P=0.006)、血脂血糖水平异常(χ²=9.917,P =0.002)、AHI(χ²=5.489,P=0.019)、脑梗死面积(χ²=5.857,P=0.016)、脑梗死部位(χ²=6.207,P=0.013)、HIF-1水平(χ2=29.138,P=0.000)和Ngb水平(χ²=32.385,P=0.000)是急性脑梗死合并OSAS患者认知障碍的影响因素; 经Logistic多因素回归分析显示,AHI≥20次/h(OR=6.417,95% CI=2.774～14.848,P=0.000)、HIF-1高水平(OR=4.768,95% CI=2.009～11.318,P=0.000)、Ngb高水平(OR=4.477,95% CI=2.443～8.204,P=0.002)、血脂血糖水平异常(OR=3.622,95% CI=1.422～9.225,P=0.004)、脑梗死部位(OR=4.428,95% CI=1.801～10.888,P=0.027)为影响认知功能障碍预后的独立危险因素。结论 影响急性脑梗死合并OSAS患者认知功能障碍的危险因素主要是AHI≥20次/h、HIF-1高水平、Ngb高水平、血脂血糖水平异常、脑梗死部位     

双相障碍的功能损害及相关因素

本文目的是探讨双相障碍社会功能和认知功能的特点及其影响因素，为临床识别与干预提供参考。研究显示，双相障碍功能损害显著，即使在稳定期，双相障碍患者仍存在不同程度的认知功能和社会功能损害，双相障碍的功能损害可能存在病理心理机制和相关影响因素。本文从双相障碍社会功能损害、认知功能损害和二者的关系等方面进行阐述，并总结当前研究的不足之处。     

重复经颅磁刺激治疗老年抑郁症研究进展

本文目的是对重复经颅磁刺激（rTMS）不同刺激模式在老年抑郁症患者的抑郁症状及认知功能的应用进行综述，进一步探究rTMS不同刺激模式对老年抑郁症治疗效果的改善，希望为老年抑郁症的临床治疗提供新思路。本综述从老年抑郁症研究现况、认知功能特点及rTMS不同刺激模式的效果、安全性等方面进行阐述。     

抑郁障碍患者认知功能与睡眠剥夺关系的研究进展

抑郁障碍患者中大部分存在睡眠剥夺问题,同时认知功能障碍是抑郁障碍的主要症状。本文目的是对抑郁障碍患者认知功能与睡眠剥夺关系的研究进展进行综述,通过总结睡眠剥夺对抑郁障碍患者认知功能的影响及潜在机制,以期为后续研究提供参考。