Sex Differences in Cognition in Alzheimer's Disease

Inspection of the published research shows that sex differences in cognition in the general population have been widely cited with the direction of the advantage depending on the domain being examined. The most prevalent claims are that men are better than women at visuospatial and mathematical tasks whereas women have superior verbal skills and perform better than men on tasks assessing episodic memory. There is also some evidence that women are more accurate than men at identifying facial expressions of emotion. A more in-depth examination of the literature, however, reveals that evidence of such differences is not as conclusive as would at first appear. Not only is the direction and magnitude of sex differences dependent on the cognitive domain but also on the individual tasks. Some visuospatial tasks show no difference (e.g. figure copying) whist men have been shown to be better than women at confrontation naming (a verbal task). Alzheimer’s disease is a heterogeneous illness that affects the elderly. It manifests with deficits in cognitive abilities and behavioural difficulties. It has been suggested that some of the behavioural issues may arise from difficulties with recognising facial emotion expressions. There have been claims that AD affects men and women differently: women have been reported as being more likely to develop AD and showing a greater dementia severity than men with equivalent neuropathology. Despite this, research into sex differences in cognition in AD is scarce, and conflicting. This research was concerned with the effect of sex on the cognitive abilities of AD patients. The relative performance of men and women with AD was compared to that of elderly controls. The study focused on the verbal, visuospatial and facial emotion recognition domains. Data was collected and analysed from 70 AD patients (33 male, 37 female), 62 elderly controls (31 male, 31 female) and 80 young adults (40 male, 40 female). Results showed those with AD demonstrate cognitive deficits compared to elderly controls in verbal and visuospatial tasks but not in the recognition of facial emotions. There were no significant sex differences in either the young adults or the healthy elderly controls but sex differences favouring men emerged in the AD group for figure copying and recall and for confrontation naming. Given that elderly men and women perform equivalently for these tasks, this represents a deterioration in women’s cognitive abilities, relative to men’s. Further evidence of such an adverse effect of AD was apparent in other tasks, too: for most verbal and visuospatial tasks, either an effect favouring women in the elderly is reversed or a male advantage increases in magnitude. There is no evidence of sex differences in facial emotion recognition for any group. This suggests that the lack of published findings reporting on sex differences in this domain is due to the difficulty in getting null findings accepted for publication. The scarcity of research examining sex differences in other domains is also likely to be due to this bias

Facing Neurotypical Normativity: An Ethical Call for Therapeutic Sensitivity to Neurodiversity

This paper explores the relationship between counseling education, clinicians-in-training, and neurodivergent client populations. Arguing that there is an absence of adequate training to address the specific needs of clients with developmental disabilities, this paper introduces the term neurotypical normativity in order to delimit deeply embedded biases operating within the mental health profession. These biases generate modes of treatment that overlook emotional and relational need in favor of symptoms and behavioral management. Through the critical examination of the connection between fundamental presuppositions, education, and treatment, this paper initiates an ethical call for therapeutic sensitivity to neurodiversity

Study to investigate the effectiveness of using a humanoid robot (Kaspar) to improve the social skills of children with an Autism Spectrum Disorder: a randomised controlled feasibility trial

Peer reviewe

Evaluation of the personal health budget pilot programme

1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. Giving people greater choice and control, with patients working alongside health service professionals to develop and execute a care plan, given a known budget, is intended to encourage more responsiveness of the health and care system. 2. The personal health budget programme was launched by the Department of Health in 2009 after the publication of the 2008 Next Stage Review. An independent evaluation was commissioned alongside the pilot programme with the aim of identifying whether personal health budgets ensured better health and care outcomes when compared to conventional service delivery and, if so, the best way for personal health budgets to be implemented

Sex differences in cognitive impairment in Alzheimer's disease

Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/Sex differences in neurocognitive abilities have been extensively explored both in the healthy population and in many disorders. Until recently, however, little work has examined such differences in people with Alzheimer's disease (AD). This is despite clear evidence that AD is more prevalent in women, and converging lines of evidence from brain imaging, post-mortem analyses, hormone therapy and genetics suggesting that AD affects men and women differently. We provide an overview of evidence attesting to the poorer cognitive profiles in women than in men at the same stage of AD. Indeed, men significantly outperform women in several cognitive domains, including: Language and semantic abilities, visuospatial abilities and episodic memory. These differences do not appear to be attributable to any differences in age, education, or dementia severity. Reasons posited for this female disadvantage include a reduction of estrogen in postmenopausal women, greater cognitive reserve in men, and the influence of the apolipoprotein E ε4 allele. Assessment of cognitive abilities contributes to the diagnosis of the condition and thus, it is crucial to identify the role of sex differences if potentially more accurate diagnoses and treatments are to emerge.Peer reviewedFinal Published versio

The experiences of new mothers accessing feeding support for infants with Down syndrome during the COVID-19 pandemic

© 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/).Infants with Down syndrome are more likely to experience feeding problems and mothers are likely to require more feeding support than mothers of typically developing infants. During the COVID-19 pandemic, many feeding support services changed from face-to-face to online, which impacted some maternal feeding experiences negatively, but no studies to date have explored the impact for mothers of infants with Down syndrome. Thematic analysis was conducted on semi-structured interviews from thirteen new mothers of infants (aged 8-17 months) with Down syndrome in the UK. Three superordinate themes were generated: 1) Every baby with Down syndrome has a unique journey, 2) There’s no point asking, they won’t know, 3) Lack of in-person support. Many mothers expressed frustrations over health professionals’ lack of Down syndrome specific knowledge resulting in unmet needs, further magnified due to the nature of the virtual support being offered. Moreover, mothers struggled with reduced social support from other mothers when encountering feeding problems. These results hold real-world implications for health professionals who could provide more specialised face-to-face feeding support to mothers of infants with Down syndrome. This should be prioritised for children’s overall development and mothers’ wellbeing.Peer reviewe

A scoping review of the complementary feeding practices and early eating experiences of children with Down syndrome.

© The Author(s) 2023. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/).Objective: Children with Down syndrome may experience more challenges in their early feeding and may be introduced to complementary foods comparatively later than typically developing (TD) children. This scoping review aimed to identify and synthesise the existing literature which describes feeding problems and early eating experiences relating to the period of complementary feeding for children with Down syndrome. Methods: Scopus, PubMed, Medline, Web of Science, Psyc Info were searched. Journal articles published between January 1991 and June 2022 which reported on the complementary feeding period with children with Down syndrome were included. Results: Eighteen journal articles met the inclusion criteria. Children with Down syndrome were introduced to complementary foods later than TD children and progressed to more challenging food textures at a slower rate. Gross and fine motor skill delays and sensory difficulties contributed to secondary feeding problems such as difficulties chewing, biting and reduced awareness of food on lips and tongue. Parents of children with Down syndrome reported exercising more caution and employing more controlling feeding practices compared to TD and had higher levels of concern regarding their child’s weight. Conclusions: Guidelines and early feeding support specific to children with Down syndrome should be available before the first complementary foods are introduced and throughout this period. Feeding support should aim to address parental concerns and provide assistance when feeding problems occur, to minimise delays and encourage optimum 3 development of eating abilities. Future research should address the development of feeding problems during this period and to explore possible interventions.Peer reviewe

AMPA Receptor Phosphorylation and Synaptic Colocalization on Motor Neurons Drive Maladaptive Plasticity below Complete Spinal Cord Injury.

Clinical spinal cord injury (SCI) is accompanied by comorbid peripheral injury in 47% of patients. Human and animal modeling data have shown that painful peripheral injuries undermine long-term recovery of locomotion through unknown mechanisms. Peripheral nociceptive stimuli induce maladaptive synaptic plasticity in dorsal horn sensory systems through AMPA receptor (AMPAR) phosphorylation and trafficking to synapses. Here we test whether ventral horn motor neurons in rats demonstrate similar experience-dependent maladaptive plasticity below a complete SCI in vivo. Quantitative biochemistry demonstrated that intermittent nociceptive stimulation (INS) rapidly and selectively increases AMPAR subunit GluA1 serine 831 phosphorylation and localization to synapses in the injured spinal cord, while reducing synaptic GluA2. These changes predict motor dysfunction in the absence of cell death signaling, suggesting an opportunity for therapeutic reversal. Automated confocal time-course analysis of lumbar ventral horn motor neurons confirmed a time-dependent increase in synaptic GluA1 with concurrent decrease in synaptic GluA2. Optical fractionation of neuronal plasma membranes revealed GluA2 removal from extrasynaptic sites on motor neurons early after INS followed by removal from synapses 2 h later. As GluA2-lacking AMPARs are canonical calcium-permeable AMPARs (CP-AMPARs), their stimulus- and time-dependent insertion provides a therapeutic target for limiting calcium-dependent dynamic maladaptive plasticity after SCI. Confirming this, a selective CP-AMPAR antagonist protected against INS-induced maladaptive spinal plasticity, restoring adaptive motor responses on a sensorimotor spinal training task. These findings highlight the critical involvement of AMPARs in experience-dependent spinal cord plasticity after injury and provide a pharmacologically targetable synaptic mechanism by which early postinjury experience shapes motor plasticity

Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis

© 2022 Toutountzidis et al. This is an open access article distributed under the Creative Commons Attribution License, to view a copy of the license, see: https://creativecommons.org/licenses/by/4.0/The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.Peer reviewe