Cognitive mapping style relates to posterior–anterior hippocampal volume ratio

As London taxi drivers acquire “the knowledge” and develop a detailed cognitive map of London, their posterior hippocampi (pHPC) gradually increase in volume, reflecting an increasing pHPC/aHPC volume ratio. In the mnemonic domain, greater pHPC/aHPC volume ratios in young adults have been found to relate to better recollection ability, indicating that the balance between pHPC and aHPC volumes might be reflective of cross‐domain individual differences. Here, we examined participants' self‐reported use of cognitive map‐based navigational strategies in relation to their pHPC/aHPC hippocampal volume ratio. We find that greater reported cognitive map use was related to significantly greater posterior, relative to anterior, hippocampal volume in two separate samples of young adults. Further, greater reported cognitive map usage correlated with better performance on a self‐initiated navigation task. Together, these data help to advance our understanding of differences between aHPC and pHPC and the greater role of pHPC in spatial mapping.     

小血管病性血管性认知障碍非痴呆型患者神经心理学特征的研究

目的通过系列神经心理学测试对小血管病性血管性认知障碍非痴呆型(VCIND-SVD)患者的神经心理学特征进行分析,寻找适用于VCIND-SVD患者的敏感且简捷的神经心理评估工具。方法VCIND-SVD患者33例,正常对照组40例,进行MMSE及多个包括5个认知域在内的神经心理学测试,确定VCIND-SVD患者受损的认知域,筛选出识别能力较好的单项测试,检测其敏感度和特异度,以便临床使用。结果VCIND-SVD患者为多个认知域损害,包括记忆力、注意力、语言功能、视空间结构技能及执行功能均有损害;即刻逻辑记忆测试、积木测试、伦敦塔完成时间及计划时间等检测项目能敏感反映这些损害。结论各单项测试的综合对VCIND-SVD具有较强的识别能力,有重要的应用价值。     

Comparison of PASL,PCASL, and background‐suppressed 3D PCASL in mild cognitive impairment

We compared three implementations of single‐shot arterial spin labeled (ASL) perfusion magnetic resonance imaging: two‐dimensional (2D) pulsed ASL (PASL), 2D pseudocontinuous ASL (PCASL), and background‐suppressed (BS) 3D PCASL obtained in a cohort of patients with mild cognitive impairment (MCI) and elderly controls. Study subjects also underwent ¹⁸F‐fluorodeoxyglucose positron emission tomography (¹⁸F‐FDG PET). While BS 3D PCASL showed the lowest (P < 0.001) gray matter–white matter cerebral blood flow (CBF) contrast ratio, it provided the highest (P < 0.001) temporal signal‐to‐noise ratio. Mean relative CBF estimated using the PCASL methods in posterior cingulate cortex (PCC), precuneus, and hippocampus showed hypoperfusion in the MCI cohort compared to the controls consistent with hypometabolism measured by ¹⁸F‐FDG PET. BS 3D PCASL demonstrated the highest discrimination between controls and patients with effect size comparable to that seen with ¹⁸F‐FDG PET. 2D PASL did not demonstrate group differentiation with relative CBF in any ROI, whereas 2D PCASL demonstrated significant differences only in PCC and hippocampus. Mean global CBF values did not differ across methods and were highly correlated; however, the correlations were significantly higher (P < 0.001) when either the same labeling (PCASL) or the same acquisition strategy (2D) was used as compared to when both the labeling and readout methods differed. In addition, there were differences in regional distribution of CBF between the three modalities, which can be attributed to differences in sequence parameters. These results demonstrate the superiority of ASL with PCASL and BS 3D readout as a biomarker for regional brain function changes in MCI. Hum Brain Mapp 38:5260–5273, 2017. © 2017 Wiley Periodicals, Inc.     

Reducing acute stress in a 16-year old using trauma-focused cognitive behaviour therapy and eye movement desensitization and reprocessing

Objective: To assess the effects of trauma-focused cognitive behaviour therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR) for the treatment of acute stress in an adolescent.

Methods: A combination of TF-CBT and EMDR was provided to a 16-year-old girl with distressing memories, anxiety and flashbacks. For measurement of the efficacy of the treatment package, the Children's Revised Impact of Event Scale (CRIES-13) was used.

Results: Acute stress reactions decreased considerably after treatment and remained stable. CRIES-13 scores showed substantial reduction in stress scores. The girl reported no more flashbacks of the injury, sleeping difficulties or recurrent and distressing memories.

Conclusion: This case study illustrates the potential efficacy of a combination of TF-CBT and EMDR for patients with acute stress reactions. Future studies should examine the efficacy of this treatment package in a large sample of children.     

Targeting metabolic and cognitive pathways of the CNS by intranasal insulin administration

Intranasal administration effectively delivers neuropeptides to the CNS, bypassing the blood–brain barrier and avoiding systemic side effects. Using this route of administration, direct manipulations of central nervous signalling pathways involved in body weight regulation and cognition are possible. Specifically, the subchronic intranasal administration of insulin has been shown to reduce body fat and improve memory function in the absence of adverse peripheral side effects. These results may fuel the future development of therapeutic strategies in disorders such as obesity and Alzheimer's disease that are promoted by dysfunctions of central nervous neuropeptidergic pathways.     

ETNA3, a clinical randomized study assessing three cognitive-oriented therapies in dementia: Rationale and general design

Despite the popularity of cognitive-oriented therapies in dementia, very few data gathered from scientific literature provide a clear demonstration of the genuine efficacy of these techniques. Most of the results published have issued from studies suffering from important methodological limitations such as: absence of control group to compare clinical courses, very small size of study samples, absence of group randomization, absence of blind assessment of efficacy criteria or absence of long-term efficacy assessment. Randomized clinical trials are rare or even absent for some techniques and generally report more modest benefits. In this context, the ETNA3 study has been implemented. The ETNA3 study is a French nationwide prospective simple-blinded randomized clinical trial conducted to evaluate the impact of cognitive training, reminiscence therapy and an individualized cognitive rehabilitation program on the progression rate of dementia. The study was conducted in 653 outpatients with mild to moderate Alzheimer's disease followed up for 2 years (MMSE score 16 and 26). The main objective was to determine whether any or several of these non-pharmacological treatments could delay the severe stage of dementia during a 2-year follow-up compared to a usual care group without non-pharmacological treatment. The secondary outcomes assessed cognitive abilities, functional abilities in activities of daily living, behavioral disturbance, apathy, quality of life, depression, caregiver's burden and resource utilization. This article presents the rationale and methodology of the study.