Dementia Care Practice.

Background: Stratifying risk of cognitive decline for an individual patient can be difficult in primary care settings where advanced biomarkers are usually not available. Passive risk calculators that capitalize on existing information contained in the electronic medical record (EMR) hold promise, but most are developed using EMR documentation of cognitive decline which is highly unreliable. This prospective study used objective cognitive testing to build a multivariable cognitive risk model based on EMR records.

Technology and Dementia Preconference.

Background: Stratifying risk of cognitive decline for an individual patient can be difficult in primary care settings where advanced biomarkers are usually not available. Passive risk calculators that capitalize on existing information contained in the electronic medical record (EMR) hold promise, but most are developed using EMR documentation of cognitive decline which is highly unreliable. This prospective study used objective cognitive testing to build a multivariable cognitive risk model based on EMR records.

Technology and Dementia Preconference.

Background: Test-retest reliability for existing cognitive screening tests is typically poor and most have ceiling effects and restricted score ranges that mask the presence of subtle decline. The Brief Assessment of Cognitive Health (BACH) is a computerized cognitive screening tool that patients complete independently. It includes a complex memory test without ceiling effects and brief mood and history questions.

Neuroanatomical heterogeneity drives divergent cognitive and motor trajectories in Parkinson's disease subtypes.

Introduction: Cognitive symptoms of Parkinson's disease (PD) may initially present subtly, often overshadowed by more noticeable motor symptoms. However, as PD progresses, predicting which individuals will experience significant cognitive decline becomes challenging due to variability, suggesting distinct PD subtypes with varying cognitive trajectories. This study aimed to identify early PD subtypes based on patterns of gray matter atrophy in brain regions associated with cognition and assess their distinct patterns of cognitive change over time.

Multidisciplinary lifestyle interventions for neurological disorders during the Silent phase (MINDS) study: a multi-omics randomized controlled trial protocol.

Introduction: Given the prevalence and staggering cost of neurological disorders, there is dire need for effective early detection and intervention tools. Emerging evidence suggests that multidisciplinary lifestyle interventions (MLI) may mitigate the risk and progression of neurological disorders. The objectives of this protocol are (1) to test the impact of MLI on the progression of neurological disorders and (2) to identify multi-omic biomarkers for early stages of neurological disease and the impact of MLIs on these biomarkers.

Automated detection of cognitive impairment in clinical practice.

Objective: Cognitive impairment is now recognized as an impending public health crisis. About one-third of adults are concerned about their cognition, and the prevalence of objective cognitive impairment is much higher among those with neurological disorders. Existing screening tools are narrowly focused on detecting dementia in older adults and must be clinician-administered and scored, making them impractical for many neurology practices.

Utility of automated memory measures in identifying cognitive impairment in adults with epilepsy.

Objective: Cognitive impairment is prevalent in epilepsy and often presents at the time of initial diagnosis. This study sought to validate brief, self-administered, iPad-based recognition memory tasks in a sample of patients with epilepsy and to examine their screening utility in identifying patients with cognitive impairment.

Methods: The Words and Faces tests were administered to 145 adult patients with epilepsy along with a neuropsychological battery.

Loss of Efficacy in Ventral Intermediate Nucleus Stimulation for Essential Tremor.

Objective: The primary aim of this study is to report long-term outcomes associated with deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) performed at our institution. We further aimed to elicit the factors associated with loss of efficacy and to discuss the need for exploring and establishing reliable rescue targets.

Methods: To study long-term outcomes, we performed a retrospective chart review and extracted tremor scores of 43 patients who underwent VIM DBS lead implantation for essential tremor at our center.

Utility of the Brief Assessment of Cognitive Health (BACH) computerized screening tool in identifying MS-related cognitive impairment.

Background: Current guidelines recommend that individuals with MS are screened annually for processing speed deficits, often using the Symbol Digit Modalities Test (SDMT). However, given the heterogeneity of cognitive deficits in individuals with MS, other screening measures that assess a range of cognitive domains are necessary. The current cross-sectional study aimed to examine the ability of the computerized, self-administered Brief Assessment of Cognitive Health (BACH) screening measure to detect the presence of cognitive impairment in adults with MS as determined by performance on a standard neuropsychological test battery.

Validation of Self-Administered Visual and Verbal Episodic Memory Tasks in Healthy Controls and a Clinical Sample.

This study evaluated the performance characteristics, construct validity, and reliability of two computerized, self-administered verbal and visual recognition memory tests based on the Remember-Know paradigm. Around 250 healthy control participants and 440 patients referred for neuropsychological assessment used an iPad to complete the Words and Faces recognition memory tests before or after concurrent neuropsychological testing. Performance accuracy was high but without ceiling effects.

Deep cerebellar stimulation enhances cognitive recovery after prefrontal traumatic brain injury in rodent.

Functional outcome following traumatic brain injury (TBI) varies greatly, with approximately half of those who survive suffering long-term motor and cognitive deficits despite contemporary rehabilitation efforts. We have previously shown that deep brain stimulation (DBS) of the lateral cerebellar nucleus (LCN) enhances rehabilitation of motor deficits that result from brain injury. The objective of the present study was to evaluate the efficacy of LCN DBS on recovery from rodent TBI that uniquely models the injury location, chronicity and resultant cognitive symptoms observed in most human TBI patients.

Neuropsychological outcomes after thalamic deep brain stimulation for essential tremor.

Introduction: Non-motor DBS outcomes have received little attention in ET relative to PD. This study examines neuropsychological outcomes in ET following thalamic VIM DBS.

Methods: Fifty patients completed neuropsychological evaluations preoperatively and approximately seven months postoperatively.

Cognitive outcomes following frontal lobe resection for treatment of epilepsy in children and adolescents.

Objective: To use reliable change indices (RCIs) developed specifically for pediatric patients with epilepsy to examine cognitive outcomes after frontal lobe resection for pharmacoresistant epilepsy.

Methods: Forty-one pediatric patients (25 male, M = 10 years) completed comprehensive neuropsychological evaluations before and an average of 6.5 months after frontal lobe resections for treatment of epilepsy.

Long-Term Neurocognitive Outcome in Patients With Continuous Flow Left Ventricular Assist Device.

Objectives: The authors sought to examine the long-term cognitive outcome of patients with continuous flow left ventricular assist device (CF-LVAD).

Background: Data on long-term neurocognitive outcome in LVAD are limited. We examined the neurocognitive outcome of patients who received a CF-LVAD as destination therapy.

Cortical thickness in visuo-motor areas is related to motor outcomes after STN DBS for Parkinson's disease.

Introduction: Deep brain stimulation (DBS) is a widely accepted therapy for Parkinson's disease. While outcome predictors such as levodopa-response are well established, there remains a need for objective and unbiased predictors in clinical practice. We performed an exploratory study to examine whether cortical thickness, derived from preoperative MRI, correlates with postoperative outcome.

Factors Associated With Postoperative Confusion and Prolonged Hospital Stay Following Deep Brain Stimulation Surgery for Parkinson Disease.

Background: Several patient and disease characteristics are thought to influence DBS outcomes; however, most previous studies have focused on long-term outcomes with only a few addressing immediate postoperative course.

Objective: To evaluate predictors of immediate outcomes (postoperative confusion and length of postoperative hospitalization) following deep brain stimulation surgery (DBS) in Parkinson disease (PD) patients.

Methods: We conducted a retrospective study of PD patients who underwent DBS at our institution from 2006 to 2011.

BDNF and COMT, but not APOE, alleles are associated with psychiatric symptoms in refractory epilepsy.

Objective: The objective of this study was to determine whether three common genetic polymorphisms [apolipoprotein (APOE) ε4 (rs42938 and rs7412), brain derived neurotrophic factor (BDNF) Met (rs6265), and catechol-O-methyltransferase (COMT) Val (rs4680)] are associated with increased psychiatric symptomatology in individuals with pharmacoresistant epilepsy.

Methods: One hundred forty-eight adults (M = 38 years; 53% female) with refractory epilepsy completed self-report measures of mood, anxiety, and/or personality/psychopathology. Mann-Whitney U, t-tests, and Fisher's exact tests were used to determine if APOE4, BDNF Val66Met, or COMT Val158Met are associated with increased psychiatric symptomatology in people with epilepsy.

Lack of Accurate Self-appraisal is Equally Likely in MCI from Parkinson's Disease and Alzheimer's Disease.

Background: How accurate are mild cognitive impairment (MCI) patients in assessing their cognitive and functional deficit is often unclear to the clinician. The accuracy of patient self-appraisal in Parkinson's disease-MCI (PD-MCI) has received less attention than amnestic MCI (a-MCI) often associated with Alzheimer's disease. We evaluated if PD-MCI patients demonstrate accurate self-appraisal of their cognitive deficits compared to patients with amnestic a-MCI or non-amnestic MCI (na-MCI).

Quality of Life Improvement Following Deep Brain Stimulation for Parkinson Disease: Development of a Prognostic Model.

Background: There is a growing attention to determine the factors that predict quality of life (QoL) improvement after deep brain stimulation (DBS) for Parkinson's disease. Prior literature has largely focused on examining predictors one at a time, sometimes controlling for covariates.

Objective: To develop a model that could be used as a nomogram to predict improvement in QoL following DBS surgery in patients with Parkinson's disease.

Validation of computerized episodic memory measures in a diverse clinical sample referred for neuropsychological assessment.

Objective: To examine the convergent and discriminant validity of two brief computerized episodic memory measures in a large, diverse clinical sample of adults undergoing neuropsychological assessment.

Method: Computerized measures of word and face memory were administered to 233 adults (age 30 and over) who also completed comprehensive neuropsychological testing.

Results: Moderate correlations were observed between the computerized memory tests and a wide range of traditional neuropsychological measures of episodic memory (e.

Predicting early cognitive decline in newly-diagnosed Parkinson's patients: A practical model.

Objective: To create a multivariable model to predict early cognitive decline among de novo patients with Parkinson's disease, using brief, inexpensive assessments that are easily incorporated into clinical flow.

Methods: Data for 351 drug-naïve patients diagnosed with idiopathic Parkinson's disease were obtained from the Parkinson's Progression Markers Initiative. Baseline demographic, disease history, motor, and non-motor features were considered as candidate predictors.

Iowa Gambling Task Performance in Parkinson Disease Patients with Impulse Control Disorders.

Objective: A subgroup of patients with Parkinson disease (PD) develops impulse control disorders (ICD) associated with their dopamine replacement therapy. Patients and their families may be reluctant to report ICD symptoms or unaware these symptoms are related to PD medication, which can make detecting an ICD difficult for clinicians. Ideally, a behavioral measure that is sensitive to ICD could be employed to ensure that patients with these behaviors are identified and treated.

Deep brain stimulation of the ventral striatal area for poststroke pain syndrome: a magnetoencephalography study.

Poststroke pain syndrome (PSPS) is an often intractable disorder characterized by hemiparesis associated with unrelenting chronic pain. Although traditional analgesics have largely failed, integrative approaches targeting affective-cognitive spheres have started to show promise. Recently, we demonstrated that deep brain stimulation (DBS) of the ventral striatal area significantly improved the affective sphere of pain in patients with PSPS.