Primary School Education May Be Sufficient to Moderate a Memory-Hippocampal Relationship

According to the cognitive reserve theory, intellectual stimuli acquired during life can prevent against developing cognitive impairment. The underlying cognitive reserve mechanisms were underexplored in low-educated individuals. Because episodic memory impairment due to hippocampal dysfunction is a key feature of Alzheimer’s dementia (AD), we sought to look at a possible cognitive reserve mechanism by determining whether few years of education moderated the relationship between the hippocampal volumes and the episodic-memory scores. The sample was composed by 183 older adults, 40.1% male, with the median age of 78[76,82] years and the median years of education of 4[2,10] who had undergone an episodic-memory test and a 3-Tesla MRI scan to access the hippocampal volumes. Overall, 112 were cognitively healthy, 26 had cognitive impairment-no dementia (CIND) and 45 had dementia. We used multiple linear regression to assess whether the interaction between years of education and each hippocampal volume significantly predicted the episodic-memory scores’ variance, controlling for cognitive diagnosis and nuisance variables. The interaction term with the left hippocampus (ß = 0.2, p = 0.043, CI = 1.0, 1.4), but not with the right (ß = 0.1, p = 0.218, CI = 0.9, 1.2) significantly predicted the variation on memory scores. The mechanism by which the left hippocampus seems to play a more important role on memory processing in more educated individuals needs to be further investigated and might be associated with a better use of mnemonic strategies or higher hippocampal connectivity. Because the sample’s median years of education was four, which corresponds to primary school, we may infer that this level might be sufficient to contribute for building cognitive reserve

The impact of SARS-CoV-2 in dementia across Latin America : A call for an urgent regional plan and coordinated response

The SARS-CoV-2 global pandemic will disproportionately impact countries with weak economies and vulnerable populations including people with dementia. Latin American and Caribbean countries (LACs) are burdened with unstable economic development, fragile health systems, massive economic disparities, and a high prevalence of dementia. Here, we underscore the selective impact of SARS-CoV-2 on dementia among LACs, the specific strain on health systems devoted to dementia, and the subsequent effect of increasing inequalities among those with dementia in the region. Implementation of best practices for mitigation and containment faces particularly steep challenges in LACs. Based upon our consideration of these issues, we urgently call for a coordinated action plan, including the development of inexpensive mass testing and multilevel regional coordination for dementia care and related actions. Brain health diplomacy should lead to a shared and escalated response across the region, coordinating leadership, and triangulation between governments and international multilateral networks

Dementia in Latin America : paving the way towards a regional action plan

Regional challenges faced by Latin American and Caribbean countries (LACs) to fight dementia, such as heterogeneity, diversity, political instabilities, and socioeconomic disparities, can be addressed more effectively grounded in a collaborative setting based on the open exchange of knowledge. In this work, the Latin American and Caribbean Consortium on Dementia (LAC-CD) proposes an agenda for integration to deliver a Knowledge to Action Framework (KtAF). First, we summarize evidence-based strategies (epidemiology, genetics, biomarkers, clinical trials, nonpharmacological interventions, networking and translational research) and align them to current global strategies to translate regional knowledge into actions with transformative power. Then, by characterizing genetic isolates, admixture in populations, environmental factors, and barriers to effective interventions and mapping these to the above challenges, we provide the basic mosaics of knowledge that will pave the way towards a KtAF. We describe strategies supporting the knowledge creation stage that underpins the translational impact of KtAF

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P < 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Influências da educação e de doenças neurodegenerativas sobre as relações entre a memória episódica e seus correlatos neurais

Submitted by Elisa Franca ([email protected]) on 2019-12-27T14:54:46Z No. of bitstreams: 2 license_rdf: 811 bytes, checksum: cfd6801dba008cb6adbd9838b81582ab (MD5) Tese_doutorado_Elisa_final_repositorio.pdf: 8658015 bytes, checksum: e6b7ac9a6e29cf00383bb3563f7065b0 (MD5)Rejected by Jane Campos ([email protected]), reason: Prezada, Conforme as “Diretrizes para Normalização de Trabalhos Acadêmicos da UFMG” detectamos que seu trabalho necessita de algumas correções na formatação: 1) Capa; 2) Folha de Rosto; 3) Ficha Catalográfica; 4) Ata de defesa ou folha de aprovação... (a sua ficha catalográfica está junto com a folha de rosto). Considerando a visibilidade nacional e internacional do RI/UFMG, os trabalhos disponibilizados devem seguir padrões e protocolos de integração qualificados e normalizados. Diante disso, gentileza executar as devidas alterações, conforme o link abaixo. https://repositorio.ufmg.br/custom/instructions.jsp https://repositorio.ufmg.br/static/politica/check-list-para-composicao-do-arquivo-de-autoarquivamento.pdf Atenciosamente, Equipe do Repositório. on 2020-02-04T13:40:50Z (GMT)Submitted by Elisa Franca ([email protected]) on 2020-02-05T13:52:05Z No. of bitstreams: 2 Tese_doutorado_Elisa_repositorio_corrigida.pdf: 8770013 bytes, checksum: 53bb0bc4e41917a4dfbc7f07b4bfc21c (MD5) license_rdf: 811 bytes, checksum: cfd6801dba008cb6adbd9838b81582ab (MD5)Approved for entry into archive by Jane Campos ([email protected]) on 2020-02-05T16:29:47Z (GMT) No. of bitstreams: 2 Tese_doutorado_Elisa_repositorio_corrigida.pdf: 8770013 bytes, checksum: 53bb0bc4e41917a4dfbc7f07b4bfc21c (MD5) license_rdf: 811 bytes, checksum: cfd6801dba008cb6adbd9838b81582ab (MD5)Made available in DSpace on 2020-03-12T19:39:45Z (GMT). No. of bitstreams: 2 Tese_doutorado_Elisa_repositorio_corrigida.pdf: 8770013 bytes, checksum: 53bb0bc4e41917a4dfbc7f07b4bfc21c (MD5) license_rdf: 811 bytes, checksum: cfd6801dba008cb6adbd9838b81582ab (MD5) Previous issue date: 2019-12-03Introdução: A interferência de fatores extrínsecos e intrínsecos do indivíduo sobre a relação entre os substratos neurais da memória episódica e o desempenho em testes específicos é motivo de debate na literatura. O nível educacional, exemplo de fator extrínseco, parece promover maior capacidade do cérebro em se adaptar a lesões e, assim, prevenir o declínio cognitivo, possivelmente por modificar a relação entre estruturas cerebrais e suas funções. Doenças neurodegenerativas, como a doença de Alzheimer (DA) e a variante comportamental da demência frontotemporal (DFTvc) são exemplos de fatores intrínsecos. Enquanto na DA existe um déficit clássico de memória episódica por acometimento hipocampal, na DFTvc a memória episódica também pode estar acometida, mas seus correlatos neurais são controversos. Para explorar esses fatores, realizamos dois estudos: um analisando o papel da escolaridade e outro investigando o papel de doenças neurodegenerativas (DA e DFTvc) na relação entre a memória episódica e seus correlatos neurais. Estudo 1 – Objetivo: Identificar como os anos de escolaridade influenciariam a relação entre o volume do hipocampo e o desempenho em teste de memória episódica. População: Cento e oitenta e três idosos (112 cognitivamente saudáveis, 26 com comprometimento cognitivo não-demência e 45 com demência), 40,1% homens, com idade mediana de 78 anos, [intervalo interquartil (IIQ): 76,82] e escolaridade mediana de quatro [IIQ: 2,10] anos. Métodos: O volume do hipocampo foi medido por RM estrutural e a memória episódica avaliada por meio da pontuação na evocação tardia do teste de figuras da Bateria Cognitiva Breve (BCB). Usando modelos de regressão linear múltipla, calculamos o papel da interação nível educacional x volumes hipocampais no desempenho de memória (desfecho). Resultado: Quanto maior o nível educacional, mais robusta foi a relação entre o volume do hipocampo esquerdo e a memória episódica, após ajustes para idade, diagnóstico cognitivo, sexo, etapa de aprendizagem do teste, volume de outras regiões cerebrais importantes para processamento de memória episódica e presença/intensidade de lesões de substância branca. Estudo 2 – Objetivos: Comparar os correlatos neurais de memória episódica entre os pacientes com DA e DFTvc e, dentro do grupo DFTvc, comparar aqueles com perfil amnéstico (n=8) com os não amnésticos (n=11). População: Sessenta e um idosos (19 com DFTvc, 21 com DA e 21 cognitivamente saudáveis), 50,8% homens, idade mediana de 67 [IIQ: 59,74] anos e escolaridade mediana de 11 [IIQ:11,16] anos. Métodos: Cálculo das correlações entre o desempenho de memória episódica avaliada pela evocação tardia do teste de figuras da BCB e os volumes de substância cinzenta cerebral avaliados por RM nos pacientes com DA e DFTvc. Contraste em termos de volume de substância cinzenta dos pacientes com DFTvc amnésticos versus não-amnésticos. Resultados: O desempenho de memória episódica nos pacientes com DA se associou inversamente à atrofia dos hipocampos bilateralmente e precuneus e giro do cíngulo posterior à esquerda. Já nos pacientes com DFTvc houve associação inversa apenas com os hipocampos bilateralmente. A memória episódica não se correlacionou com teste de funções executivas em nenhum grupo, sugerindo que o comprometimento de memória não é decorrente de disfunção executiva. Finalmente, identificamos que os pacientes DFTvc amnésticos tinham maior atrofia dos giros fusiforme e parahipocampal esquerdos e cíngulo e precuneus direitos do que os não amnésticos. Comparados com os pacientes com DA, os DFTvc amnésticos apresentaram maior atrofia do giro fusiforme esquerdo, pólos temporais, giro temporal inferior direito, ínsula e cerebelo. Conclusão: Identificamos que diferentes aspectos intrínsecos e extrínsecos podem influenciar a relação entre a memória episódica e seus correlatos neurais como o hipocampo e outras estruturas.Introduction: How extrinsic and intrinsic factors of the individual interfere in the relationship between the neural substrates of episodic memory and performance in specific tests is a matter under debate in the scientific literature. Education, an example of an extrinsic factor, seems to promote the brain's greater ability to adapt to injury and prevent cognitive decline, possibly by modifying the relationship between brain structures and their functions. Neurodegenerative diseases, such as Alzheimer's disease (AD) and behavioral variant frontotemporal dementia (bvFTD) are examples of intrinsic factors. While in AD there is a classic deficit of episodic memory due to hippocampal involvement, in bvFTD episodic memory may also be affected, but the neural correlates of this impairment are controversial. To explore these factors, we conducted two studies: one analyzing the role of education and the other analyzing the role of neurodegenerative diseases (AD and bvFTD) in the relationship between episodic memory and its neural correlates. Study 1 - Objectives: To identify how years of education would influence the relationship between hippocampal volume and episodic memory performance. Population: One hundred and eighty-three older adults (112 cognitively healthy, 26 with cognitive impairment non-dementia and 45 with dementia), 40.1% men, median age 78, [interquartile range (IQI): 76, 82] and median education of four [IIQ: 2,10] years. Methods: Hippocampal volume was measured by structural MRI and episodic memory was assessed by the Brief Cognitive Battery (BCB) delayed score. Using multiple linear regression models, we calculated the role of educational level x hippocampal volume interaction in memory performance (outcome). Result: The higher the educational level, the stronger the relationship between left hippocampal volume and episodic memory, after adjusting for age, cognitive diagnosis, gender, the BCB learning phase, the volume of other important brain regions for episodic memory processing and the presence / intensity of white matter lesions. Study 2 - Objectives: To compare the neural correlates of episodic memory between patients with AD and bvFTD and, within the bvFTD group, to compare those with amnestic profile (n = 8) with non- amnestic profile (n = 11). Population: Sixty-one older adults (19 with bvFTD, 21 with AD and 21 cognitively healthy), 50.8% men, median age of 67 [IIQ: 59,74] years and median education of 11 [IIQ: 11,16 years. Methods: We calculated the correlations between episodic memory performance assessed by the BCB delayed recall and gray matter volumes assessed by MRI in AD and bvFTD patients. Next, we contrasted the gray matter volumes of amnestic versus non-amnestic bvFTD patients. Results: Episodic memory performance in AD patients was inversely associated with atrophy in bilateral hippocampi and left precuneus and posterior cingulate gyrus. In patients with bvFTD, there was an inverse association with hippocampi volumes bilaterally. Episodic memory did not correlate with executive functioning in any group, suggesting that memory impairment was not associated with executive dysfunction. Finally, we found that amnestic bvFTD patients had greater atrophy of the left fusiform and parahypocampal gyrus and right cingulate and precuneus regions than non-amnestic ones. Compared with AD patients, amnestic bvFTD had greater atrophy of the left fusiform gyrus, temporal poles, right inferior temporal gyrus, insula and cerebellum. Conclusion: We identified that different extrinsic and intrinsic aspects may influence the relationship between episodic memory and its neural correlates including the hippocampus and other structures

Klüver & Bucy Syndrome: An investigation of social and affective cognition

International audienceKlüver-Bucy syndrome (KBS) leads to important behavioural symptoms and social maladaptation. Rarely described in humans, no previous study has investigated the social and affective cognitive profile of KBS. Here, we report the case of ASP, a patient with history of herpetic encephalitis who developed a complete KBS at 9 years old that evolved into an incomplete KBS. Imaging examinations evidenced orbitofrontal and temporal damages. While a classic neuropsychological assessment showed a preserved global functioning, an extensive evaluation of her social and affective cognition (reversal-learning, decision-making, emotion recognition, theory of mind, creative-thinking) showed remarkable deficits. The relevancy of such findings for the characterization of cognitive damage in KBS and the field of neuropsychology are discussed