bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of transcranial direct current stimulation in mild cognitive impairment – a meta‐analysis
Authors: G Sandhya , Malo Palash Kumar , Issac Thomas Gregor 
Published: December 2023

AbstractBackgroundMCI or Mild Cognitive Impairment is a state of cognitive decline which is in between that of normal ageing and dementia. People with MCI have a higher chance of progressing to dementia because of which introducing interventions at this stage becomes increasingly important. Transcranial Direct Current Stimulation (tDCS) is one non‐invasive brain stimulation technique that is considered as an effective intervention strategy for people with MCI to prevent their progression to dementia.MethodFrom 221 and 686 results obtained from PubMed and Google Scholar respectively using the search term ‘(“tDCS”) AND (“MCI”) AND (Randomized) AND (sham controlled)’, 8 studies were included for the current meta‐analysis. Among these studies, the most commonly used cognitive tests namely MMSE (Mini Mental State Examination), MoCA (Montreal Cognitive Assessment), TMT (Trail Making Test) A and B, DST (Digit Span Test) forward and backward and Logical Memory Test were considered for the analysis. The standard mean difference between active and sham treatments in different tests were computed.ResultThe standard mean difference and the 95% confidence interval for the test scores are MoCA: 0.37 (‐0.22,0.95), MMSE: 0.26 (‐0.25, 0.77), TMT A: ‐0.01 (‐0.42, 0.40), TMT B: 0.07 (‐0.41, 0.55), DST F: ‐0.09 (‐0.44, 0.25), DST B: ‐0.11 (‐0.54, 0.31) and Logical memory test: 0.80 (‐0.24, 1.83). It is found that there is an improvement in the performance in MoCA, MMSE, TMT A and logical memory test after treatment with active tDCS but the improvement is statistically insignificant.ConclusionAlthough there is an evident clinical effectiveness, the study identified no significant improvement in cognitive performance with active tDCS in comparison with sham tDCS. This might be due to difference in protocols followed among studies, lower duration of stimulation in a few studies and smaller sample size in each.
Health economic evaluations of interventions for the diagnosis of Dementia and Cognitive Impairment from Primary Care: a systematic review
Authors: Almirall‐Sanchez Arianna , Rodriguez‐Velasco Arianne , Rodriguez Juan J Llibre 
Published: December 2023

AbstractBackgroundDementia is a leading global cause of morbidity and mortality. There is evidence that population and community‐based interventions on early diagnosis of Dementia and Cognitive Impairment represent around US$10,000 of net savings per person with dementia across the disease course. They also avoid early or unnecessary admission to a care home or hospital and allows patients and their families to receive timely practical information, advice, and support. Only through receiving a diagnosis can they get access to available drug and non‐drug therapies that may improve their cognition and enhance their quality of life. This study aim is to identify existing evidence concerning the cost of implementing interventions strategies for the early diagnosis of Dementia and Cognitive Impairment from primary Care.MethodsWe systematically reviewed economic studies of community‐based interventions for diagnosing Dementia and Cognitive impairment from primary care. Medline, EMBASE, Web of Science, CINAHL, PsycInfo, Scopus were searched on 05/09/2022. Cost‐effectiveness, cost‐benefit, and cost‐utility studies were included, provided that the direct outcome of the intervention was the diagnosis of Dementia or Cognitive Impairment and was measured empirically. Quality appraisal was completed using the Consensus on Health Economic Criteria checklist. A narrative synthesis was performed.ResultsWe included 45 studies, from 2,749 records offering economic evidence on dementia diagnosis. Most of the reviewed studies were cost‐effectiveness analysis (n = 15 34.4%) followed by cost‐utility analysis (n = 8 19.6%). Among 20,330 patients screened, 9555 scored positive for Dementia (47%), 33% had cognitive impairment (CI), and 20% were considered to have no cognitive deficit. The prevalence of dementia was 6.0% (95%CI: 4.8%‐7.3%) and the mean of interventions strategies cost was $120 (95%CI: $112‐$136) per patient screened for dementia and $3798 (95%CI: $3702‐$3823) per patient diagnosed with dementia. Only 19% of patients with confirmed dementia diagnosis had documentation of dementia in their medical record. Most studies (56.1%) didn’t meet the methodological requirements contained in the quality assessment framework.ConclusionsOverall, interventions were cost‐effective and/or cost‐saving. However, there is a scarcity and low methodological quality of existing studies and the generalization from the available evidence is difficult because of the narrowness of cost measures in the literature.
Reproducible Python workflow for multi‐site resting‐state EEG analysis: From raw data to group classification
Authors: Jaramillo‐Jimenez Alberto , Mantilla‐Ramos Yorguin Jose , Tovar Diego , Ochoa John F , Brønnick Kolbjørn , Aarsland Dag , Bonanni Laura 
Published: December 2023

AbstractBackgroundAmong promising markers for neurodegenerative disorders, electroencephalogram (EEG) represents a non‐invasive and potentially portable alternative. Standardized methods for preprocessing may contribute to less inter‐observer variability, while pooling multi‐centric EEG data may provide more generalizable results. We aim to formulate a reproducible pipeline for group‐level classification (of Parkinson’s Disease ‐PD‐) based on various features of resting‐state EEG recordings (rsEEG) collected in multi‐site studies.MethodsWe used four datasets (acquired in Colombia, Finland, and the USA) consisting of 169 subjects (84 PD; 85 non‐PD healthy controls). Our workflow included rsEEG raw files standardization, preprocessing, spectral bandpowers and multiple entropy features extraction on sensor space, harmonization of multi‐site features, and group‐level multiclass classification using supervised machine learning methods. Center/scanner‐related variability effects in the extracted features were harmonized using the ComBat approach and its variants 1. Finally, sequential feature selection (SFS) and binary classification (Non‐PD vs. PD) was conducted using XGradientBoosting 2. The full workflow is detailed in Figure 1.Resultst‐distributed stochastic neighbor embedded (tSNE) plots showed that center‐related variability in spectral features was reduced after harmonization using the ComBat method and its bootstrapped variant, Figure 2. SFS of rsEEG features was performed on 224 harmonized features, showing the highest performance when alpha, pre‐alpha, and slow‐theta bands were considered for subsequent classification. The XGradientBoosting classifier showed an AUC of 0.826 in separating PD from non‐PD, Figure 3.ConclusionsIn multicenter studies, the harmonization of rsEEG features at the sensor space using ComBat can contribute to controlling batch effects. XGradientBoosting with rsEEG features and SFS performed well in classifying non‐PD vs. PD.Intended to be a practical tool for group‐level analysis of neurodegenerative disorders based on sensor space rsEEG features, our workflow is openly available at (https://github.com/alberto‐jj/raw_to_classification) and can be easily adapted to multi‐class classification and regression tasks.
References
1. Da‐ano, R., et al. Sci. Rep.
10, 10 (2020).2. Moguilner, S., et al. J. Neural Eng.
19, 046048 (2022).
Anti‐amyloidogenic effect of BACE1 expression lowering compound identified using high‐throughput gene promoter assay
Authors: Byun Yujung , Baek Seung Hyun , Jo Dong‐Gyu 
Published: December 2023

AbstractBackgroundAccumulation of Aβ in a brain is one of the pathological hallmarks of Alzheimer’s disease (AD). Aβ is generated through sequential cleavage of amyloid precursor protein (APP) by β‐secretase (BACE1) and γ‐secretase complex. BACE1 is one of the crucial targets for AD given that BACE1 expression is significantly upregulated in AD patients compared with non‐AD. However, direct and complete inhibition of BACE1 activity can cause unpredictable or unintended effects because of numerous physiological substrates of BACE1.MethodWe screened small compounds, including drugs approved by the U.S. Food and Drug Administration to identify medicines that reduce promoter activity of BACE1. TG reduced the levels of BACE1 protein and mRNA in APP‐SH‐SY5Y cells. In order to confirm the effect of TG regulating the expression BACE1, we constructed the RFP (BACE1 expression indicator) ‐GFP (cell body) U2OS cell line and compared the TG and analogs. After administration of TG,we carried out Morris Water Maze(MWM) test in APP/PS1 AD model mice. We did immunofluorescence assay in each group of mouse brains. We conducted an ELISA assay to determine quantitative changes in Aβ accumulation.ResultWe have found a new candidate drug that reduces promoter activity, mRNA, and protein levels of BACE1 in neuronal cells. We have confirmed that the drug decreases the BACE1 gene expression, prevents accumulation of Aβ, and improves cognitive function in APP/PS1 transgenic mice.ConclusionThe ability of this compound reverses a wide range of deficits suggests that BACE1 expression reducing agents may have therapeutic utility in the treatment of AD
Effects of creative expression program on patients with mild cognitive impairment: based on Transcranial Doppler
Authors: Zhao Junyu , Baoying Zhang , Rong Lin , Lili Chen , Yuanjiao Yan , Lijuan Yu , Hong Li 
Published: December 2023

AbstractBackgroundIn this study, patients with mild cognitive impairment (MCI) were treated with the creative expression program (CrExp) and assessed for changes in cognitive function, while the correlation between changes in cognitive function and cerebral hemodynamic parameters was explored based on Transcranial Doppler (TCD) ultrasound.MethodWe studied 35 older adults with MCI aged 60 years or older. A creative expression program (CrExp) intervention was implemented in these 35 older adults with MCI for a total of 24 intervention sessions lasting approximately 0.5‐1 hour each over 24 weeks. All participants underwent a pre‐and post‐intervention MoCA to assess and compare changes in the cognitive function of patients before and after the intervention. And their cerebral hemodynamic parameters were measured by (TCD) ultrasound after the intervention.ResultsAfter the intervention, MCI patients treated with CrExp had significantly higher cognitive function scores than before the intervention (MoCA; t = ‐2.15, P = 0.036). TCD parameter measurements showed that the mean blood flow velocity (MBFV) and the resistance index (RI) values of the vertebral artery (VA), the basilar artery (BA), and the middle cerebral artery (MCA) in MCI patients were significantly lower than the normal mean (P<0.05), while the pulsatility index (PI) values of VA and MCA were significantly higher than the normal mean(P<0.05). MBFV in MCA was positively correlated with changes in cognitive function, whereas RI was negatively correlated with changes in cognitive function(P<0.05).ConclusionsThis study provides evidence that the CrExp intervention is effective in improving cognitive function in patients with MCI, while transcranial Doppler ultrasound can provide an objective basis for the diagnosis of mild cognitive impairment and can be tested by TCD ultrasound to determine the correlation between the effect of the cognitive intervention and changes in hemodynamic parameters.KeywordsMild cognitive impairment (MCI); Creative expression program intervention (CrExp); Transcranial Doppler (TCD) ultrasound.
Exploring the association between VLOM ratio and years of education in MCI and normal aging urban cohort
Authors: R Meghana , Malo Palash Kumar , Mallikarjun Divya N , Stezin Albert , Narayanasamy Rajitha , Menon Meenakshi , Lingegodwa Abhishek Mensegere , Partha Ajith , Velavarajan Goutham , Hameed Shafeeq K Shahul , HS Sunitha , M Amitha C , Singh Sadhana , Arvind Prathima , Diwakar Latha , Kommaddi Reddy Peera , Sundarakumar Jonas S. , Issac Thomas Gregor 
Published: December 2023

AbstractBackgroundMild Cognitive Impairment (MCI) is a transition state of cognitive decline from healthy brain to dementia. It is a prodrome of Alzheimer’s disease. Verbal‐Language/Orientation‐Memory (VLOM) ratio, a simply calculated index compares its language and memory scores helps to differentiate between Alzheimer’s disease and frontotemporal dementia (Mathuranath, et al.,2000). VLOM ratio is helpful in prognosticating and planning future management of the disease. The previous studies have shown the association of scores in cognitive domains with years of education (Nieto A, et al.,2016). Therefore, the objective of the study is to explore the association of years of education with VLOM ratio in MCI participants and normal participants.MethodCross sectional analysis was done using the baseline data from the cohort study Tata Longitudinal Study of Ageing (TLSA) from urban Bengaluru, India. Clinical dementia rating scale (CDR) was used to classify participants into normal and MCI category. CDR score of 0 was considered as normal, score of 0.5 as MCI. ACE III‐R (Addenbrooke’s Cognitive Examination III‐R) a neuropsychological test was administered and verbal fluency plus language to orientation plus memory (VLOM) ratio was calculated. Further, years of education was classified into three levels and comparison of VLOM ratio was made within these levels of education groups in both MCI and normal participants. Mann Whitney U test was used to compare the VLOM ratio between MCI and normal participants. VLOM ratio and years of education among the MCI and normal participants was compared using Kruskal‐Wallis test.ResultsAmong 953 participants, 69 had MCI and 884 participants had normal cognition. Comparison of VLOM ratio between MCI and normal participants showed a significant difference, with higher VLOM ratio in MCI participants (Median (IQR)) = 0.97 (0.11) vs 0.95 (0.09); p = 0.01). There was no significant difference in VLOM ratio between years of education in both normal and MCI participants.ConclusionThe VLOM ratio found to be higher in MCI group indicating that the scores in orientation and memory domain might be lower in MCI compared to Normal participants. There was no association of VLOM ratio with years of education in normal and MCI participants.
Keep your brain healthy: development and evaluation of an e‐learning tool on dementia risk reduction
Authors: Van Asbroeck Stephanie , Wimmers Sophie C.P.M. , van Boxtel Martin P.J. , Köhler Sebastian , Deckers Kay 
Published: December 2023

AbstractBackgroundMany people are unaware of the potential for dementia risk reduction, but state they would appreciate more information on this topic (1). Raising awareness is important as a first step towards behavior change (2). The knowledge that a set of lifestyle behaviors is beneficial for your cognitive health may also provide additional motivation (2).MethodAn online, free e‐learning on the topic of dementia risk reduction for the Dutch adult population will be developed (in co‐creation with Alzheimer Netherlands). It will cover the following topics: physical activity, healthy diet and alcohol consumption, cognitive activity, mental wellbeing including social wellbeing and sleep, cardiovascular health, and tips from lifestyle coaches and end‐users on how to make sustainable lifestyle changes. The content of the e‐learning will be delivered in stages, so that completion of the full course takes approximately seven weeks.ResultThe e‐learning’s effectiveness in terms of knowledge acquisition, evolution in motivation for health behavior and actual health behavior improvements will be assessed with validated questionnaires in a pre‐post study. Participants (minimum N = 300) will complete an online survey before starting the course, immediately thereafter and again three months later. User experiences and engagement with the e‐learning materials will also be evaluated.ConclusionAwareness of the potential for dementia risk reduction is currently lacking in the general population. An e‐learning is a low‐level means that can be used to increase knowledge and awareness, and could further easily be implemented as a stand‐alone tool or as part of current or future dementia risk reduction initiatives.
References
1.	Heger I, Kohler S, van Boxtel M, de Vugt M, Hajema K, Verhey F, et al. Raising awareness for dementia risk reduction through a public health campaign: a pre‐post study. BMJ Open. 2020;10(11):e041211.2.	Rosenberg A, Coley N, Soulier A, Kulmala J, Soininen H, Andrieu S, et al. Experiences of dementia and attitude towards prevention: a qualitative study among older adults participating in a prevention trial. BMC Geriatr. 2020;20(1):99.
Ethnic Variation in Modifiable Risk Factors for Dementia
Authors: Bothongo Phazha LK , Waters Sheena , Chandra Avinash , Uchegbu Ijeoma , Jeraldo Rosario Isabel Espinoza , Anjum Rifah , Byford Michelle , Livingston Gill , Marshall Charles R , Mukadam Naheed 
Published: December 2023

AbstractBackgroundWe aimed to estimate the population attributable fraction (PAF) of 12 modifiable risk factors (defined by the Lancet Commission 2020), for incident dementia cases in the UK Biobank (UKB), stratified by ethnicity. We considered if ethnic differences in dementia risk, were accounted for by modifiable risk factors. To identify appropriate priorities in dementia prevention, tailored to ethnicity.MethodThe UKB is a cohort study with 502,656 volunteer participants registered between 2006‐2010, aged 40‐60 years at baseline, and followed for up to 16.8 years. To estimate the PAF of 12 modifiable risk factors (diabetes, hypertension, depression, hearing loss, obesity, traumatic brain injury (TBI), less education, social isolation, physical inactivity, air pollution, and smoking), we first estimated hazard ratios (HRs)(adjusted for age, gender, and Townsend quintiles), or when ethnicity interacted with risk factors, then we estimated HRs stratified by ethnicity. HRs were then converted to relative risk for PAF calculation.Results6,624 incident cases of dementia developed in 1.3%(95%CI = 1.3‐1.3)(n = 6316/471297){of Whites}, in 1.3%(95%CI = 1.1‐1.5)(n = 104/8031){of Blacks}, and in 1.0%(95%CI = 0.8‐1.2)(n = 79/8001){of South Asians (S.Asian)}. The mean age at dementia diagnosis was 71.6 years(SD,6.1){in S.Asians}; 71.8 years(SD,6.8){in Blacks}; and 73.6 years(SD,5.5){in Whites}. The combined PAF(95%CI) for dementia were: 35.6%(35.5‐35.8){in Whites}, 33.9%(32.8‐34.9){in Blacks}, and 41.0%(39.9‐42.0){in S.Asians}. The highest individual PAFs in each ethnic group, compared to the rest, were as follow. Blacks and S.Asians, respectively, for midlife hypertension: 9.6%(9.0‐10.3) and 10.1%(9.5‐10.8) vs 6.5%(6.4‐6.5){in Whites}. S.Asians for (1)Depression: 8.5%(7.9‐9.1) vs 4.0%(3.6‐4.4){in Blacks}, and 5.8%(5.7‐5.9){in Whites}; (2)Diabetes: 6.0%(5.4‐6.5) vs 5.1%(4.6‐5.6){in Blacks}, and 3.5%(3.4‐3.5){in Whites}; (3)Excessive alcohol: 1.4%(1.2‐1.7) vs 0.0%{in Blacks and Whites}. Whites for (1)Hearing loss: 3.6%(3.6‐3.7) vs 2.4%(2.1‐1.8){in Blacks}, and 3.0%(2.6‐3.4){in S.Asians}; (2)TBI: 2.5%(2.4‐2.5) vs 1.3%(1.1‐1.6){in Blacks}, and 1.7%(1.4‐2.0){in S.Asians}; (3)Less education: 5.0%(4.9‐5.1) vs 3.3%(2.9‐3.7){in Blacks}, and 3.2%(2.9‐3.6){in S.Asians}; (4)Physical inactivity: 2.6%(2.6‐2.7), vs 2.1%(1.8‐2.5){in Blacks}, and 2.2%(1.8‐2.5){in S.Asian; (5)Social isolation: 2.3%(2.2‐2.3) vs 1.9%(1.6‐2.1){in Blacks}, and 1.9%(1.6‐2.2){in S.Asians. The remaining risk factor PAFs did not differ between all ethnic groups.ConclusionIn this relatively wealthy, and healthy population, there remain ethnic disparities in the effect of modifiable risk factors on dementia. Interventions for midlife hypertension are a priority in South Asians and Blacks, particularly depression and alcohol consumption in South Asians.
Baseline thyroid hormone levels are not associated with cognitive decline: the ELSA‐Brasil study
Authors: Gonçalves Natalia G , Szlefj Claudia , Lotufo Paulo A , Bensenor Isabela M , Suemoto Claudia Kimie 
Published: December 2023

AbstractBackgroundThyroid dysfunction has been associated with cognitive decline and dementia. However, the role of subtle thyroid hormone alterations in cognitive function is still debatable. Additionally, most studies have been conducted in high‐income countries. The aim of this study was to investigate the longitudinal association between baseline thyrotropin (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) levels with cognitive decline in the Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil) during 8 years of follow‐up.MethodParticipants were evaluated every four years in three study waves (2008‐10, 2012‐14, and 2017‐19). Baseline TSH, FT4, and FT3 were collected after overnight fast and analyzed using immunoenzymatic assay. Cognitive performance was evaluated using the immediate and late recall, semantic and phonemic verbal fluency, and the trail‐making tests. A global composite z‐score was derived from these tests. Association of TSH, FT4 and FT3 levels with cognitive decline over time was evaluated using linear mixed‐effects models, adjusted for sociodemographic, lifestyle, and clinical variables.ResultIn 9,524 participants (mean age 51.2±8.9 y, 51% women, 52% White), the mean baseline TSH level was 2.3 ± 1.3 mIU/L, the mean baseline FT4 level was 1.2 ± 0.1 ng/dL, and the mean FT3 level was 0.2 ± 0.04 pg/mL (Table 1). There was no association between circulating TSH, FT4, and FT3 levels and cognitive decline during the follow‐up (Table 2 and Figure 1).ConclusionThyroid hormone levels were not associated with cognitive decline in middle‐aged and older adults without overt thyroid dysfunction during 8 years of follow‐up.
An update on mobile phone applications collecting data among subjects with or at risk of dementia
Authors: Piendel Lydia A , Hort Jakub , Vališ Martin 
Published: December 2023

AbstractBackgroundThe ubiquity of smart mobile phones is increasing worldwide, creating an opportunity for telemedicinal use by screening people at risk of or with dementia through monitoring daily routines, behaviors, and cognitive changes. Data logged or tracked in an app and analyzed with machine learning (ML) could be shared with physicians and specialists to allow for screening, follow‐up, and timely diagnoses, and could provide users information on preventive measures or disease management. This review comments on existing evidence of mobile device applications designed to passively and/or actively collect data on cognition relevant for Alzheimer’s disease (AD) and other dementias.MethodThe PubMed database was searched to identify existing literature on applications related to dementia and cognitive health data collection. The search deadline was December 1, 2022. Criteria for inclusion was limited to articles in English which referenced data collection via mobile app from adults 50+ concerned, at risk of, or diagnosed with dementia.ResultWe identified relevant literature (n = 25) which fit our criteria. A common theme among excluded literature was the mention of apps that provide users, primarily caregivers, with cognitive health information but fail to collect data. We found the existing library of data collecting dementia‐related apps has existed for several years yet remains underdeveloped; however, it may serve as proof of concept and feasibility as there is much supporting evidence on their predictive utility.ConclusionConcerns about the validity of mobile apps for cognitive screening and privacy issues remain prevalent. Mobile applications and use of ML is widely considered a financially and socially viable method of compiling symptomatic data but currently this large potential dataset, telemedicine communication tool, and research resource is still largely untapped.