Search Results (1,010)

Objective: To characterize neurodevelopmental disorders in children and adolescents with Tuberous Sclerosis Complex (TSC) and explore associations with epilepsy onset and cortical tuber burden. Methods: This exploratory cross-sectional study included 18 children and adolescents with TSC followed at a tertiary pediatric neurology center in Brazil. Standardized neuropsychological, behavioral, and neuroimaging assessments were performed. Participants were stratified according to epilepsy onset and cortical tuber burden. Results: Epilepsy was present in 94.4% of participants, and pharmacoresistance in 52.9%. Neurodevelopmental disorders were highly prevalent, particularly autism spectrum disorder and attention-deficit/hyperactivity disorder, frequently occurring as comorbidities. Children with earlier epilepsy onset demonstrated exploratory trends toward poorer cognitive outcomes, whereas greater cortical tuber burden showed exploratory trends toward greater behavioral and emotional dysregulation, although these differences did not reach statistical significance. Conclusions: Neurodevelopmental disorders are highly prevalent in pediatric TSC. Exploratory findings suggest that epilepsy characteristics and lesion burden may be related to cognitive and behavioral outcomes. These exploratory findings support systematic multidisciplinary neurodevelopmental monitoring in children with TSC. Full article

Background/Objectives: Constructional apraxia (CA) is an impairment in combining simple elements into coherent spatial configurations without basic motor deficits. Although common in neurodegenerative disorders, the qualitative features of visuo-constructional errors and their role in differentiating dementia types remain unclear. This systematic review aimed to synthesize patterns of visuo-constructional errors in dementia and mild cognitive impairment (MCI), exploring distinctive qualitative features associated with different neurodegenerative conditions. Methods: A systematic literature search was conducted in PubMed, Scopus, and Web of Science for studies published between January 1990 and January 2026, following PRISMA guidelines. Studies on adults with dementia or MCI assessing drawing/copying abilities through standardized tasks and qualitative error analysis were included. Reviews, meta-analyses, case reports, non-English articles, and studies not explicitly assessing constructional apraxia were excluded. The quality of evidence was assessed using an adapted version of the Newcastle–Ottawa Scale. Results: A total of 25 studies were included, showing heterogeneous and condition-specific visuo-constructional deficits. Spatial errors and simplifications were the most common across disorders, while perseverations, rotations, and closing-in phenomena were less frequent. Alzheimer’s disease was mainly associated with spatial disorganization, omissions, and conceptual errors linked to temporo-parietal dysfunction; frontotemporal dementia with executive deficits such as perseverations and planning impairments; Lewy body and Parkinson’s disease dementias with visuospatial and attentional alterations; and Huntington’s disease with simplifications and executive dysfunction related to fronto-striatal involvement. Conclusions: No single error pattern was pathognomonic, but qualitative assessment of constructional errors may provide clinically useful information when integrated with the broader neuropsychological profile. Full article

Background: EEG neurofeedback has been proposed as a non-pharmacological approach to enhance attention and cognitive performance in neurodevelopmental conditions. However, its efficacy in individuals with intellectual disability (ID) remains limited. Methods: We conducted a systematic review of treatment studies evaluating EEG-based neurofeedback targeting attention and executive function outcomes in participants with ID. Searches were performed in Embase, Web of Science, Scopus, PubMed, and the Cochrane Library from inception to 12 March 2026. Two reviewers independently completed screening, eligibility assessment, data extraction, and risk-of-bias appraisal, with disagreements resolved by a third reviewer. Due to heterogeneity in study designs, neurofeedback protocols, participant characteristics, and outcome measures, data were synthesized narratively. Results: Six studies met the inclusion criteria, comprising small randomized or controlled experimental studies, case series, and single-case reports. Several studies suggested improvements in attention-related neuropsychological performance and behavioral or task-based outcomes, and in some cases were accompanied by parallel EEG changes. Nevertheless, the overall body of evidence was constrained by small sample sizes, heterogeneous populations, limited blinding, infrequent sham or active controls, variable follow-up durations, and incomplete effect-size reporting. Conclusions: EEG neurofeedback appears to confer benefits for attention-related outcomes in individuals with ID, but current findings are preliminary and warrant larger, well-controlled trials with standardized protocols and reporting. Full article

Background: Given the increasing consumption of ultra-processed foods (UPFs) and the public health importance of cognitive decline in ageing, understanding how UPFs impact cognitive performance is highly relevant. However, evidence in older adults - particularly in Italy—remains scarce, despite the country’s rapidly ageing population, its comparatively low UPF intake, and its distinct Mediterranean dietary context. Methods: We analysed cross-sectional data from 809 community-dwelling adults aged ≥ 65 years (59.4% women) participating in the NutBrain population-based cohort. Dietary intake was assessed using a 102-item semi-quantitative food frequency questionnaire, and daily grams of foods were classified according to the NOVA system into groups, which were analysed using a compositional data analysis approach. Global cognition and domain-specific performance were measured using standardised neuropsychological tests. Associations between NOVA groups and cognitive outcomes were estimated using multiple linear regression models adjusted for potential confounders. Gender-stratified analyses were also performed. Results: UPFs accounted for 21% of total energy intake, with bakery products as the main contributors. A relative increase of unprocessed or minimally processed foods was associated with better cognitive function (B = 0.36, p = 0.014), whereas a greater contribution of UPFs relative to the overall diet was associated with worse global cognitive function (B = −0.26, p = 0.003). The strongest associations were observed for episodic memory, particularly among women. Conclusions: A higher relative consumption of UPF was associated with worse global and memory-related cognitive performance. Longitudinal and experimental studies are warranted to clarify causality and underlying mechanisms. Full article

Background: Cognitive impairment (CI) may be overdiagnosed in individuals with vision impairment (VI) due to the vision-dependent design of current cognitive assessment tools. This cross-sectional study evaluated the acceptability and diagnostic accuracy (pilot) of the Visually Independent Test Battery of Neurocognition (VISION-Cog) protocol, against gold-standard neurologist diagnosis. Methods: Community-dwelling older adults with near binocular presenting VI (near visual acuity [NVA] ≥0.2 logarithm of the minimum angle of resolution [LogMAR] units) were recruited from the Population Health and Eye Disease Profile in Elderly Singaporeans (PIONEER) study. Participants underwent VISION-Cog and the Singapore-validated Montreal Cognitive Assessment (MoCA-SG) testing and were referred for neurologist evaluation based on standardized referral protocols. The acceptability of the VISION-Cog was assessed through study completion rates, test duration, and the qualitative feedback. Vision-Cog’s diagnostic accuracy (pilot) against neurologist evaluation was analyzed using binary logistic regression and C-statistics to estimate area under the receiver operating curve (AUC) with corresponding sensitivity and specificity. Results: Out of forty-five participants (mean age [SD]: 73.8 [6.1 years]; mean NVA [SD]: 0.47 [0.14] LogMAR; and 54.1% female), 37 (82.2%) completed the protocol. The mean VISION-Cog completion time [SD] was 59 m 57 s (7 m 18 s). Qualitatively, participants found the testing time acceptable. The VISION-Cog achieved an AUC of 0.930 against neurologist diagnosis, with 100.0% sensitivity and 78.0% specificity. Conclusions:The VISION-Cog demonstrated satisfactory preliminary diagnostic accuracy and good acceptability indices in older Asian adults, supporting the need of larger studies to confirm its diagnostic accuracy of CI and clinical utility in those with VI.: Full article

Repetitive head impacts (RHIs) in combat and contact sports are associated with long-term neuropsychological consequences. The present study explores episodic memory performance, with a focus on pattern separation, a memory process associated with hippocampal function, in athletes characterized by different exposure profiles to RHIs. The study included 26 fighters (boxing, Mixed Martial Arts, Muay Thai), 20 rugby players, and 26 age-matched controls. Participants completed the Mnemonic Similarity Task (MST) and additional cognitive measures (Digit Span, Digit Symbol Substitution Test, Attentional Matrices, and N-back tasks). Group differences were assessed using ANCOVAs. Results indicated that fighters exhibited significantly poorer pattern separation performance compared to both rugby players and controls. Rugby players also performed worse than controls on the pattern separation measure, revealing a graded pattern of performance across groups. Additionally, fighters demonstrated slower reaction times during the MST and lower performance on the N-back tasks relative to both comparison groups. Overall, athletes participating in sports characterized by different exposure profiles to RHIs showed distinct patterns of cognitive performance, with the most pronounced differences observed in fighters. These findings highlight pattern separation as a potentially sensitive cognitive marker in athletes participating in combat and contact sports and underscore the need for longitudinal studies incorporating objective measures of head-impact exposure. Full article

Concussions exert a massive cost on our economic and healthcare systems. Many of the most commonly employed neurocognitive measures in concussion assessment have been shown to be psychometrically problematic. Additionally, norms are established from largely male populations. The present study investigates the use of a validated and reliable measure of concussion sequelae, the mobile half-version of the Connors Continuous Performance Test 3rd Edition (CCPT-3), on a representative population to study the influence of sex and age on normative values collected at baseline. Baseline data were analyzed from 71,976 participants across a wide range of academic and athletic contexts, as well as healthcare settings. Multiple regressions examined the influence of sex as a function of age in different developmental groups: children, adolescents, young adults, adults, and older adults. Sex effects emerged during childhood, peaked during adolescence, and decreased in adulthood. Females showed better accuracy (fewer commission and omission errors), whereas males had faster response speeds (hit-rate RT). Effect sizes were generally in the small to very small range (sex effect sizes ranged from Cohen’s d = 0.02 to 0.39). The findings highlight the importance of accounting for sex and age in cognitive test performance and underscore the impact of correcting for even small effects when working with large samples. Full article

Cancer-related cognitive impairment (CRCI), also known as chemobrain or chemofog, is characterized by subjective and/or objective changes in attention, executive functions, memory, and processing speed in patients with non-CNS cancers, particularly women with breast cancer. This structured narrative review synthesizes current evidence on mechanisms, neuropsychological assessment, neuroimaging correlates, clinical and demographic risk factors, emerging artificial intelligence and machine learning applications, and non-pharmacological approaches to CRCI in breast cancer. A structured literature search was conducted using PubMed/MEDLINE, PsycInfo, and Clinical Key up to May 2026, with emphasis on studies published between 2023 and 2026. Peer-reviewed English-language studies involving adult breast cancer populations and addressing predefined thematic domains of CRCI were considered. Given the heterogeneity of study designs, assessment tools, interventions, and outcomes, the findings were synthesized narratively. Current evidence supports a multifactorial model of CRCI involving neurobiological, treatment-related, psychological, and behavioral mechanisms. Neuroinflammation, endocrine disruption, oxidative stress, glial alterations, and structural or functional brain changes may contribute to cognitive symptoms; however, the strength of evidence varies, and many findings remain correlational or preclinical. Non-pharmacological interventions, including cognitive training, physical activity, mindfulness-based and psychological approaches, and multimodal digital programs, appear promising as supportive strategies. However, evidence remains heterogeneous, with benefits more consistently reported for patient-reported outcomes, fatigue, emotional distress, and quality of life than for objective neuropsychological performance. CRCI in breast cancer should be approached as a heterogeneous condition requiring early recognition, standardized assessment, and multidisciplinary supportive care. Future research should prioritize longitudinal designs, harmonized endpoints, and a clearer distinction between subjective and objective outcomes. Full article

Background/Objectives: The Diabetes-Specific Dementia Risk Score (DSDRS) integrates clinical and metabolic markers to predict cognitive decline in Type 2 diabetes mellitus (T2DM), yet its association with key modifiable risk factors remains unvalidated in Latin American cohorts. This study aimed to assess the relationship between the DSDRS and clinical, biochemical, anthropometric, and neuropsychological variables in older adults with T2DM. Methods: A cross-sectional study of 291 Mexican adults aged ≥ 60 with T2DM was conducted, including assessments of cognitive function (MoCA), depression (BDI), sleep quality (AIS), and metabolic parameters. Results: Higher DSDRS correlated with lower cognitive scores, poorer sleep quality, reduced muscle mass, and smoking status. Multiple regression explained 32% of DSDRS variance, highlighting these factors as significant contributors. Conclusions: The DSDRS reflects multifactorial influences on dementia risk in older adults with T2DM and may aid early identification of individuals at increased cognitive vulnerability in this population. Full article

Objective: Traumatic brain injury (TBI) is disproportionately prevalent in incarcerated populations, yet the potential impact on cognitive functioning remains underexplored. This study examined the relationship between TBI history and cognitive performance in a male prison population. Method: Sixty-three participants from Tongariro Prison completed a comprehensive neuropsychological assessment including measures of executive function, memory, processing speed, and perceptual reasoning, with embedded performance validity metrics. TBI history was assessed using the Ohio State University TBI Identification Method (OSU-TBI ID), premorbid function was assessed using the Speed and Capacity of Language Processing (SCOLP) Spot-the-Word task, mood was assessed using the Depression, Anxiety and Stress Scales (DASS-21), and alcohol and substance use were measured using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). Regression analyses explored the relationship between TBI history and cognitive functioning, controlling for premorbid function, mood, alcohol and substance use, and ethnicity. Results: Contrary to hypotheses, TBI frequency and severity were not associated with poorer cognitive performance in this population. However, a self-reported history of pervasive TBI—defined as repeated head impacts over a narrow time frame—was significantly associated with reduced performance on the Color–Word Interference Test (CWIT) inhibition task, indicating links to greater cognitive disinhibition. Conclusions: Findings suggest that experiencing at least one period of pervasive TBI may be associated with an impact on inhibition (but not other aspects of executive functioning) in men in prison. These results underscore the importance of nuanced TBI history assessment and highlight inhibition as a potential target for rehabilitation in incarcerated individuals exposed to repetitive head trauma. Full article

Background: Cognitive changes after minor surgery may affect patient safety, functional recovery, and readiness for hospital discharge, even after low-risk procedures with early discharge protocols. In this regard, patients require neuropsychological assessment at discharge, which may have important clinical implications for return to daily activities and postoperative decision-making. Our study investigated postoperative cognitive changes after minor surgery under general anesthesia using a neuropsychological assessment and a non-surgical group. Methods: Patients undergoing laparoscopic cholecystectomy received propofol or sevoflurane anesthesia. A non-surgical control group was included. Cognitive performance was assessed at baseline and discharge using the Computerized Visual Attention Test (CVAT), the controlled oral word association test (COWAT), and the symbol digit modalities test (SDMT). Relative change scores were calculated as ((baseline − postoperative performance)/baseline). Group differences were analyzed using two-tailed multivariate analysis of variance (MANOVA), followed by ANOVAs and Bonferroni-adjusted pairwise comparisons. Results: A total of 105 participants were included (37 non-surgical, 34 propofol, 34 sevoflurane). MANOVA showed a significant group effect (Pillai’s trace = 0.332, p < 0.001, η² = 0.196). The ANOVAs revealed significant differences in sustained attention (CVAT), verbal fluency (COWAT) and executive function (SDMT). The propofol group showed evident decline in sustained attention compared to non-surgical. In verbal fluency, non-surgical improved at day after, whereas both surgical groups showed no improvement, indicating worse performance. In SDMT the sevoflurane group had worse performance. Conclusions: Minor surgery under general anesthesia may lead to transient impairments in attention and learning at discharge, supporting the need for postoperative cognitive monitoring and individualized discharge decisions. Full article

Aim: This review summarizes the current evidence on cognitive impairment in patients with glioma, with particular emphasis on the underlying mechanisms, methods for objective assessment of cognitive deficits, and currently available therapeutic strategies. Methods: Relevant literature was identified through searches of the PubMed, Cochrane Library, and Google Scholar databases. Studies addressing the mechanisms, assessment, and management of cognitive impairment in patients with glioma published between January 2000 and February 2026 were reviewed to summarize current evidence and emerging therapeutic strategies. A structured literature search and study selection process was performed. Results: Cognitive deficits represent a heterogeneous clinical problem affecting the majority of patients diagnosed with gliomas. These impairments are multifactorial in origin, resulting both from direct infiltration of white matter by the tumor process and from the cumulative toxicity of treatment modalities, including radiotherapy, chemotherapy, corticosteroid therapy, and long-term use of antiseizure medications. Analysis of the current literature confirms that modern radiotherapy techniques (e.g., hippocampal-sparing approaches) and isocitrate dehydrogenase (IDH)-targeted therapies, such as vorasidenib, may significantly delay cognitive decline. Standardized neuropsychological batteries for the objective assessment of these disturbances remain the preferred tools recommended by the International Cognition and Cancer Task Force (ICCTF). Regarding therapeutic interventions, potential benefits have been demonstrated for supportive pharmacotherapy (including memantine), while individualized neuropsychological rehabilitation has also been shown to improve patients’ quality of life. Full article

Background/Objectives: Executive function (EF) impairments are common in neurodevelopmental disorders but are often examined using group-level approaches that may overlook clinically meaningful cognitive heterogeneity. This study explored EF heterogeneity in children with attention deficit hyperactivity disorder (ADHD), developmental dyslexia, and comorbid presentations using a clinically grounded mixed-method approach. Methods: Standardized neuropsychological data from the NEPSY-II, WISC-IV, and Woodcock–Johnson IV batteries were integrated with a case-based thematic synthesis of 11 clinical evaluations. Semi-inductive analysis was informed by preliminary patterns observed in a larger clinical sample. Results: Three executive function profiles were identified: (1) globally reduced executive functioning, characterized by widespread deficits in inhibition, attention, and working memory; (2) verbal–mnestic executive vulnerability, marked by weaknesses in verbal memory and attention regulation despite relative cognitive strengths; and (3) selective executive control deficit, reflecting impairments in inhibitory control and self-regulation. These profiles revealed clinically meaningful patterns that were not fully captured by categorical diagnostic classifications. Conclusions: The findings support the value of integrated, profile-based approaches for understanding executive function heterogeneity in neurodevelopmental conditions. Such approaches may enhance ecological validity in assessment and contribute to individualized intervention planning. Given the exploratory and case-based nature of the study, the findings should be considered preliminary and hypothesis-generating. Full article

Background: This pilot study investigated the potential effects of an individualized home-based cognitive training program delivered through the Neurotablet^® in individuals with Mild Cognitive Impairment (MCI). Methods: Fourteen outpatients were assigned to the experimental group (n = 7) or to the waiting-list control group (n = 7). Standardized neuropsychological and psychological measures were collected at baseline and follow-up. Outpatients of the experimental group completed an eight-week personalized home-based digital rehabilitation protocol targeting multiple cognitive domains. Longitudinal changes in standardized outcomes were analyzed using generalized linear mixed models. In addition, individual MCI trajectories were examined qualitatively by comparing MCI subtype between baseline and follow-up, whereas training performance was analyzed using within-participant linear regression models. Results: Standardized neuropsychological outcomes remained overall stable over time, with no significant differences between groups. By contrast, analyses of training performance revealed heterogeneous patterns across participants, with significant session-related changes emerging in some individuals. In particular, some tasks showed reductions in reaction times across sessions, suggesting changes in task efficiency with repeated practice. These findings highlight the heterogeneity of cognitive trajectories in MCI and suggest that individualized digital training may be associated with measurable changes in task performance, even in the absence of detectable changes in standardized neuropsychological measures. Conclusions: Despite the presence of limitations, digital cognitive interventions may offer a feasible approach to support the delivery of individualized cognitive rehabilitation in individuals reporting cognitive complaints. Further studies with larger samples, more detailed monitoring of training variables and engagement are needed to better clarify the potential cognitive impact of such interventions. Full article

Background: Mild Cognitive Impairment (MCI) is an early stage of cognitive decline and a major risk factor for dementia, typically diagnosed using neuropsychological assessments such as memory and executive function tests. While EEG-based detection has been widely explored, most approaches rely on raw signal analysis and computationally intensive deep learning models. In contrast, wearable devices use indirect behavioral proxies (e.g., activity patterns or sleep–wake patterns), limiting diagnostic specificity. Although substantial clinical evidence indicates altered sleep architecture in MCI, the use of sleep stage dynamics for MCI classification remains largely unexplored. Methods: We propose a lightweight and physiologically interpretable framework using novel features based on hypnogram-derived sleep dynamics. The method was evaluated on the MASS SS1 dataset (36 healthy, 17 MCI subjects) using five classifiers—Logistic Regression, Random Forest, XGBoost, Linear SVM, and RBF SVM—with leave-one-subject-out validation and threshold optimization. Results: RBF SVM achieved the best performance (accuracy: 77.4%, balanced accuracy: 78.7%, sensitivity: 82.4%, specificity: 75.0%, ROC AUC: 0.778), followed by Random Forest (accuracy: 77.4%, balanced accuracy: 77.1%) and XGBoost (accuracy: 71.7%, balanced accuracy: 73.0%). Conclusions: This proof-of-concept study demonstrates that features extracted from sleep stage dynamics are effective, non-invasive, and interpretable biomarkers for early MCI detection, with strong potential for integration into wearable sleep monitoring systems. Full article