Sustained attention in mild cognitive impairment with Lewy bodies and Alzheimer\u27s disease

\ua9 The Author(s), 2023. Published by Cambridge University Press on behalf of International Neuropsychological Society. Objective: Attentional impairments are common in dementia with Lewy bodies and its prodromal stage of mild cognitive impairment (MCI) with Lewy bodies (MCI-LB). People with MCI may be capable of compensating for subtle attentional deficits in most circumstances, and so these may present as occasional lapses of attention. We aimed to assess the utility of a continuous performance task (CPT), which requires sustained attention for several minutes, for measuring attentional performance in MCI-LB in comparison to Alzheimer\u27s disease (MCI-AD), and any performance deficits which emerged with sustained effort. Method: We included longitudinal data on a CPT sustained attention task for 89 participants with MCI-LB or MCI-AD and 31 healthy controls, estimating ex-Gaussian response time parameters, omission and commission errors. Performance trajectories were estimated both cross-sectionally (intra-task progress from start to end) and longitudinally (change in performance over years). Results: While response times in successful trials were broadly similar, with slight slowing associated with clinical parkinsonism, those with MCI-LB made considerably more errors. Omission errors were more common throughout the task in MCI-LB than MCI-AD (OR 2.3, 95% CI: 1.1-4.7), while commission errors became more common after several minutes of sustained attention. Within MCI-LB, omission errors were more common in those with clinical parkinsonism (OR 1.9, 95% CI: 1.3-2.9) or cognitive fluctuations (OR 4.3, 95% CI: 2.2-8.8). Conclusions: Sustained attention deficits in MCI-LB may emerge in the form of attentional lapses leading to omissions, and a breakdown in inhibitory control leading to commission errors

Clinical diagnosis of Lewy body dementia

This is the final version. Available on open access from Cambridge University Press via the DOI in this recordBackground Lewy body dementia consisting of both dementia with Lewy bodies (DLB) and Parkinson’s disease (PD) dementia (PDD) is considerably under-recognised clinically compared to its frequency in autopsy series. Aims This study investigated the clinical diagnostic pathways of patients with Lewy body dementia to assess if difficulties in diagnosis maybe contributing to these differences. Methods We reviewed the medical notes of 74 DLB and 72 non-DLB dementia cases matched for age, gender and cognitive performance, together with 38 PDD cases and 35 PD cases, matched for age and gender, from two geographically distinct UK regions. Results DLB cases took longer to reach a final diagnosis (1.2v0.6 years, p=0.003), underwent more scans (1.7v1.2, p=0.017) and had more alternative prior diagnoses (0.8v0.4, p=0.002), than non-DLB cases. Cases diagnosed in one region had significantly more core features (2.1v1.5, p=0.007) than in the other and were less likely to have dopamine transporter imaging (p<0.001). For PDD cases, more than 1.4 years prior to receiving a dementia diagnosis, 46% had documented impaired activities of daily living due to cognitive impairment, 57% had cognitive impairment in multiple domains, with 38% having both, and 39% already receiving anti-dementia drugs. 3 Conclusions Our results show the pathway to diagnosis of DLB is longer and more complex than nonDLB dementia. There were also marked differences between regions in the thresholds clinicians adopt for diagnosing DLB and also in the use of dopamine transporter imaging. Whilst for PDD, a diagnosis of dementia was delayed well beyond symptom onset and even treatment.National Institute for Health Research (NIHR

The bed nucleus of stria terminalis and the amygdala as targets of antenatal glucocorticoids: implications for fear and anxiety responses

Rationale: Several human and experimental studies have shown that early life adverse events can shape physical and mental health in adulthood. Stress or elevated levels of glucocorticoids (GCs) during critical periods of development seem to contribute for the appearance of neurospyschiatric conditions such as anxiety and depression, albeit the underlying mechanisms remain to be fully elucidated. Objectives: The aim of the present study was to determine the long-term effect of prenatal erxposure to dexamethasone- DEX (synthetic GC widely used in clinics) in fear and anxious behavior and identify the neurochemical, morphological and molecular correlates. Results: Prenatal exposure to DEX triggers a hyperanxious phenotype and altered fear behavior in adulthood. These behavioral traits were correlated with increased volume of the bed nucleus of the stria terminalis (BNST), particularly the anteromedial subivision which presented increased dendritic length; in parallel, we found an increased expression of synapsin and NCAM in the BNST of these animals. Remarkably, DEX effects were opposite in the amygdala, as this region presented reduced volume due to significant dendritic atrophy. Albeit no differences were found in dopamine and its metabolite levels in the BNST, this neurotransmitter was substantially reduced in the amygdala, which also presented an up-regulation of dopamine receptor 2. Conclusions: Altogether our results show that in utero DEX exposure can modulate anxiety and fear behavior in parallel with significant morphological, neurochemical and molecular changes; importantly, GCs seem to differentially affect distinct brain regions involved in this type of behaviors.This study was supported by a grant from the Institute for the Study of Affective Neuroscience (ISAN). AJR is supported by a Fundação para a Ciência e Tecnologia (FCT) grant

Ultralight vector dark matter search using data from the KAGRA O3GK run

Among the various candidates for dark matter (DM), ultralight vector DM can be probed by laser interferometric gravitational wave detectors through the measurement of oscillating length changes in the arm cavities. In this context, KAGRA has a unique feature due to differing compositions of its mirrors, enhancing the signal of vector DM in the length change in the auxiliary channels. Here we present the result of a search for U(1)B−L gauge boson DM using the KAGRA data from auxiliary length channels during the first joint observation run together with GEO600. By applying our search pipeline, which takes into account the stochastic nature of ultralight DM, upper bounds on the coupling strength between the U(1)B−L gauge boson and ordinary matter are obtained for a range of DM masses. While our constraints are less stringent than those derived from previous experiments, this study demonstrates the applicability of our method to the lower-mass vector DM search, which is made difficult in this measurement by the short observation time compared to the auto-correlation time scale of DM

Gender perceptions and the law

Published in 1998. This collection of papers, written by leading lawyers and sociologists in the UK, focuses on the relationships between gender and the law in the context of three areas of law: family law, criminal law and equal rights. The papers argue that gender roles within society affect the legal rights of individuals and impact on procedures they go through to enforce their rights or to gain redress for wrongs done to them. By failing to recognize the social and economic situations in which men and women are placed, the law perpetuates inequalities in their positions. Where attempts are made to ensure equality between the sexes, the result is often the exact opposite, because the legal system treats individuals as equals operating in a vacuum, ignoring the argument that equal treatment does not necessarily mean the same treatment, but can mean different treatment to ensure equality of result. Topics include: ¢ Disputes in the area of parental child custody rights ¢ The rights of surviving spouses to their deceased partner’s estate ¢ Theories for violent behaviour in women as contrasted with men ¢ Gender bias in criminal sentencing ¢ The role of European law in promoting sex equality in the work place ¢ Pornography and free speech ¢ Homosexuality as a civil right of citizenshi