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Background: Restoration of kidney function after kidney transplant generally improves cognitive function. It is unclear whether frail recipients, with higher susceptibility to surgical stressors, achieve such post-transplant cognitive improvements or whether they experience subsequent cognitive decline as they age with a functioning graft.
Methods: In this two-center cohort study, we assessed pretransplant frailty (Fried physical frailty phenotype) and cognitive function (Modified Mini-Mental State Examination) in adult kidney transplant recipients. To investigate potential short- and medium-term effects of frailty on post-transplant cognitive trajectories, we measured cognitive function up to 4 years post-transplant. Using an adjusted mixed effects model with a random slope (time) and intercept (person), we characterized post-transplant cognitive trajectories by pretransplant frailty, accounting for nonlinear trajectories.
Results: Of 665 recipients (mean age 52.0 years) followed for a median of 1.5 years, 15.0% were frail. After adjustment, pretransplant cognitive scores were significantly lower among frail patients compared with nonfrail patients (89.0 versus 90.8 points). By 3 months post-transplant, cognitive performance improved for both frail (slope =0.22 points per week) and nonfrail (slope =0.14 points per week) recipients. Between 1 and 4 years post-transplant, improvements plateaued among nonfrail recipients (slope =0.005 points per week), whereas cognitive function declined among frail recipients (slope =-0.04 points per week). At 4 years post-transplant, cognitive scores were 5.8 points lower for frail recipients compared with nonfrail recipients.
Conclusions: On average, both frail and nonfrail recipients experience short-term cognitive improvement post-transplant. However, frailty is associated with medium-term cognitive decline post-transplant. Interventions to prevent cognitive decline among frail recipients should be identified.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6362628 | PMC |
http://dx.doi.org/10.1681/ASN.2018070726 | DOI Listing |
CNS Neurosci Ther
December 2024
Department of Functional Neurosurgery, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China.
Aims: Cognitive functions are reduced in Parkinson's disease (PD) patients after deep brain stimulation (DBS) surgery. However, the underlying mechanisms remain unclear. The current study attempted to elucidate whether DBS alters the functional connectivity (FC) pattern of cognitive networks in PD patients.
View Article and Find Full Text PDFArch Clin Neuropsychol
December 2024
Centro de Estudos Egas Moniz, Faculty of Medicine, University of Lisbon, Avenida Professor Egas Moniz, Lisbon 1649-028, Portugal.
Objective: This study aims to adapt and provide psychometric support for the validation of version B of the Edinburgh Cognitive and Behavioural ALS Screen (ECAS) for the Portuguese population, addressing the need for consistent cognitive evaluations in amyotrophic lateral sclerosis (ALS). A second culturally adapted ECAS screen facilitates the accurate characterization of ALS progression, mitigates learning effects, and supports tailored care management.
Methods: The adaptation process included forward-backward translation, cultural adaptation, and cognitive debriefing on a prospective sample of 193 ALS patients and 106 controls.
BMC Neurosci
December 2024
Department of Anatomy, Faculty of Basic Medical Sciences, University of Ibadan, Ibadan, Oyo State, Nigeria.
Diethylnitrosamine (DEN), a common dietary carcinogen, is associated with neurotoxicity in humans and animals. This study investigated the neuroprotective effects of diphenyl diselenide (DPDS) against DEN-induced neurotoxicity in male Albino Wistar rats (n = 40). Rats were randomly distributed into cohorts and treated as follows: vehicle control (corn oil 2 mL/kg; gavage), DPDS-only (5 mg/kg; gavage) and DEN-only (200 mg/kg; single dose i.
View Article and Find Full Text PDFBMC Med Educ
December 2024
Shanxi Provincial People's Hospital, No. 29 Shuangta East Street, Yingze District, Taiyuan City, Shanxi Province, China.
Objective: This study examined the longitudinal development of metacognitive skills and clinical decision-making abilities in nursing students, focusing on the interactions between metacognitive processes, situational factors, and individual differences.
Methods: A longitudinal, quantitative design was employed, following 185 third-year nursing students from a major university in China over one academic year. Data were collected at six time points using the Metacognitive Awareness Inventory, Nursing Decision-Making Instrument, and custom-designed clinical scenario assessments.
BMC Neurol
December 2024
Department of Neurology, The Affiliated Changsha Central Hospital, University of South China, No. 161 Shaoshan South Road, Changsha, 410004, Hunan, China.
Background: Stroke is the main cause of death and disability. Post-stroke cognitive impairment (PSCI) is one of the most severe complications of stroke, which lacks effective biomarkers for its early detection.
Objective: This study evaluated the significance of lncRNA SIX3OS1 in acute stroke and PSCI aiming to identify a novel biomarker.
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