Theory of Mind and Empathy in Preclinical and Clinical Huntington's Disease

We investigated cognitive and affective Theory of Mind (ToM) and empathy in patients with premanifest and manifest Huntington\u27s disease (HD). The relation between ToM performance and executive skills was also examined. 16 preclinical and 23 clinical HD patients, and 39 healthy subjects divided in 2 control groups were given a French adaptation of the Yoni test (Shamay-Tsoory and Aharon-Peretz, 2007) that examines first and second-order cognitive and affective ToM processing in separate conditions with a physical control condition. Participants were also given questionnaires of empathy and cognitive tests which mainly assessed executive functions (inhibition and mental flexibility). Clinical HD patients made significantly more errors than their controls in the first-and second-order cognitive and affective ToM conditions of the Yoni task, but exhibited no empathy deficits. However, there was no evidence that ToM impairment was related to cognitive deficits in these patients. Preclinical HD patients were unimpaired in ToM tasks and empathy measures compared to their controls. Our results are consistent with the idea that impaired affective and cognitive mentalising emerges with the clinical manifestation of HD, but is not necessarily part of the preclinical stage. Furthermore, these impairments appear independent of executive dysfunction and empathy

Sleep and psychological factors are associated with meeting discharge criteria to return to sport following ACL reconstruction in athletes

INTRODUCTION: This study aimed to determine if sleep quality and psychological factors were associated with time to meet the discharge criteria to return to sport (RTS) following anterior cruciate ligament reconstruction (ACL-R) among athletes experiencing better quality of sleep and psychological responses returning faster to full activity. METHOD: A cohort-study design included 89 athletes following ACL-R. Each participant completed a battery of questionnaires at 6 different time points: within 3 days of injury occurrence and at post-surgery (1.5m, 3m, 4.5m, 6m and when discharge criteria were met). Assessment included sleep quality and quantity, symptoms of depression, anxiety, stress, psychological readiness to RTS and fear of re-injury. The primary outcome was the time needed to meet all discharge criteria to RTS. RESULTS: Sleep parameters and psychological factors were not associated with time to meet the discharge criteria to RTS. However, athletes that had low anxiety and insomnia scores at baseline and better sleep quality at 3m, 4.5m, 6m and at discharge were more adherent to the rehabilitation program and more likely to meet the RTS discharge criteria OR 1.2 (95% CI 1.0-1.34), 1.3 (95% CI 1.1, 1.7) and 2.0 (95% CI 1.1-3.4) respectively. CONCLUSIONS: Sleep quality and psychological factors were not associated with time to meet the discharge criteria to RTS but impacted whether athletes adhered and completed their rehabilitation program or not. Monitoring sleep quality and psychological factors of athletes before and following ACL-R surgery is important to identify athletes who could have difficulties in adhering to and completing their rehabilitation program to RTS

Dissociation between decision-making under risk and decision-making under ambiguity in premanifest and manifest Huntington's disease

We investigated decision-making under ambiguity (DM-UA) and decision making under risk (DM-UR) in individuals with premanifest and manifest Huntington\u27s disease (HD). Twenty individuals with premanifest HD and 23 individuals with manifest HD, on one hand, and 39 healthy individuals divided into two control groups, on the other, undertook a modified version of the Iowa Gambling Task (IGT), an adaptation of a DM-UA task, and a modified version of the Game of Dice Task (GDT), an adaptation of a DM-UR task. Participants also filled in a questionnaire of impulsivity and responded to cognitive tests specifically designed to assess executive functions. Compared to controls, individuals with premanifest HD were unimpaired in performing executive tests as well as in decision-making tasks, except for the Stroop task. In contrast, individuals with manifest HD were impaired in both the IGT and executive tasks, but not in the GDT. No sign of impulsivity was observed in individuals with premanifest or manifest HD. Our results suggest that the progression of HD impairs DM-UA without affecting DM-UR, and indicate that decision-making abilities are preserved during the premanifest stage of HD

Impaired Decision Making and Loss of Inhibitory-Control in a Rat Model of Huntington Disease

Cognitive deficits associated with Huntington disease (HD) are generally dominated by executive function disorders often associated with disinhibition and impulsivity/compulsivity. Few studies have directly examined symptoms and consequences of behavioral disinhibition in HD and its relation with decision-making. To assess the different forms of impulsivity in a transgenic model of HD (tgHD rats), two tasks assessing cognitive/choice impulsivity were used: risky decision-making with a rat gambling task (RGT) and intertemporal choices with a delay discounting task (DD). To assess waiting or action impulsivity the differential reinforcement of low rate of responding task (DRL) was used. In parallel, the volume as well as cellular activity of the amygdala was analyzed. In contrast to WT rats, 15 months old tgHD rats exhibited a poor efficiency in the RGT task with difficulties to choose advantageous options, a steep DD curve as delays increased in the DD task and a high rate of premature and bursts responses in the DRL task. tgHD rats also demonstrated a concomitant and correlated presence of both action and cognitive/choice impulsivity in contrast to wild type (WT) animals. Moreover, a reduced volume associated with an increased basal cellular activity of the central nucleus of amygdala indicated a dysfunctional amygdala in tgHD rats, which could underlie inhibitory dyscontrol. In conclusion, tgHD rats are a good model for impulsivity disorder that could be used more widely to identify potential pharmacotherapies to treat these invasive symptoms in HD

Alterations in cognitive performance during passive hyperthermia are task dependent

The objectives of this study were to (1) assess the effect of passive heating upon attention and memory task performance, and (2) evaluate the effectiveness of the application of cold packs to the head on preserving these functions. Using a counterbalance design 16 subjects underwent three trials: a control (CON, 20°C, 40% rH), hot (HOT, 50°C, 50% rH) and hot with the head kept cool (HHC). In each condition, three attention tests and two memory tests were performed. Mean core, forehead and tympanic temperatures were all significantly higher (p< 0.05) during HOT (38.6° ±0.1°, 39.6° ±0.2° and 38.8°±0.1°C, respectively) and HHC (38°±0.2, 37.7°±0.3° and 37.7°C, respectively) than in CON (37.1°±0.6°, 33.3° ±0.2° and 35.9°±0.3°C, respectively). Results indicate that there was impairment in working memory with heat exposure (p < 0.05) without alteration in attentional processes. The regular application of cold packs only prevented the detrimental effect of hyperthermia on short-term memory. Our results show that impairments in cognitive function with passive hyperthermia and the beneficial effect of head cooling are task dependent and suggests that exposure to a hot environment is a competing variable to the cognitive processes

Motivational control over well-trained performance.

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Effect of passive hyperthermia on working memory resources during simple and complex cognitive tasks

The aim of this study was to verify the hypothesis that hyperthermia represents a cognitive load limiting available resources for executing concurrent cognitive tasks. Electroencephalographic activity (EEG: alpha and theta power) was obtained in 10 hyperthermic participants in HOT (50°C, 50% RH) conditions and in a normothermic state in CON (25°C, 50% RH) conditions in counterbalanced order. In each trial, EEG was measured over the frontal lobe prior to task engagement in each condition (PRE) and during simple (OTS-4) and complex (OTS-6) cognitive tasks. Core (39.5 ± 0.5 vs. 36.9 ± 0.2ºC) and mean skin (39.06 ± 0.3 vs. 31.6 ± 0.6ºC) temperatures were significantly higher in HOT than CON (P<0.005). Theta power significantly increased with task demand (p=0.017, η2=0.36) and was significantly higher in HOT than CON (p=0.041, η2=0.39). The difference between HOT and CON was large (η2=0.40) and significant (p=0.036) PRE, large (η2=0.20) but not significant (p=0.17) during OTS-4, and disappeared during OTS-6 (p=0.87, η2=0.00). Those changes in theta power suggest that hyperthermia may act as an additional cognitive load. However, this load disappeared during OTS-6 together with an impaired performance, suggesting a potential saturation of the available resources

Neural adaptations to progressive passive hyperthermia.

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