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Autonomic dysfunctions may precede the development of cognitive impairment, but the connection between these dimensions is unclear. This systematic review aims to analyze the relationship between heart rate variability (HRV) and cognitive functions. The review process was conducted according to the PRISMA-Statement. Restrictions were made, selecting the studies in English and published in peer-review journals, including at least one cognitive measure and presenting the measurement of HRV. Studies that included participants with medical conditions, dementia, psychiatric disorders, strokes, and traumatic brain injury were excluded. Twenty studies were selected, with a total of 19,431 participants. The results were divided into different cognitive domains determined : global cognitive functioning, attention, processing speed, executive functions, memory, language and visuospatial skills. Both increased sympathetic activity and decreased parasympathetic activity seem to be associated with a worse performance in the cognitive domains considered, in the absence of dementia and severe cardiovascular diseases or other medical and psychiatric diseases. The results highlight the influence of the autonomic nervous system (ANS) in cognitive functioning. However, the marked interest facing toward a specific domain, i.e., the executive functions, and the relatively small number of the studies on this topic do not allow understanding better this relationship. Despite these limits, HRV could be considered a promising early biomarker of cognitive impairment in populations without dementia or stroke. This index should be evaluated within a preventative perspective to minimize the risk of developing cognitive impairment.

In backward immediate serial recall, participants recall lists of items immediately after their presentation by beginning with the last presented item and ending with the first presented one. Despite the similarities with forward recall in which participants recall the items from the first to the last presented, benchmark memory phenomena reliably found in forward recall are not constantly observed in backward recall. Here, we proposed a new framework called the encoding-retrieval matching (ERM) hypothesis to account for backward recall. The ERM retains the main features of the visuospatial hypothesis and the item-order trade-off hypothesis, the two dominant accounts of backward recall. According to the ERM, output modality and foreknowledge of recall direction influence the availability of visuospatial representations and the weight devoted to item and order processing. We tested the ERM with irrelevant speech, a well-known working memory factor disrupting forward recall. In two experiments, we manipulated recall direction (forward vs. backward), irrelevant speech (control vs. irrelevant speech), and response modality (manual vs. oral). As predicted by the ERM, when recall direction was unpredictable in Experiment 1, the magnitude of the irrelevant speech effect was larger in backward manual recall than in backward oral recall. In Experiment 2, recall direction was predictable. As predicted by the ERM, in backward recall, the irrelevant speech effect was reduced with a manual response and absent with an oral response. We concluded that ERM effectively accounts for the complex interplay between response modality, foreknowledge of recall direction, and benchmark memory effects in backward recall. Lors du rappel sériel immédiat dans l'ordre inverse, les participants doivent se remémorer des listes d'éléments immédiatement après qu'on leur ait présenté ceux-ci, du dernier élément présenté au premier. Malgré les similitudes avec le rappel dans l'ordre, où les participants doivent se remémorer les éléments du premier au dernier présenté, les phénomènes de mémoire de référence que l'on observe de manière fiable lors du rappel dans l'ordre ne sont pas constamment observés lors du rappel dans l'ordre inverse. Nous proposons ici un nouveau cadre - appelé hypothèse d'« appariement par encodage/remémoration » (encoding-retrieval matching, ou ERM) pour rendre compte du rappel dans l'ordre inverse. L'ERM conserve les principales caractéristiques de l'hypothèse visuospatiale et de l'hypothèse du compromis item-ordre de présentation, les deux éléments prépondérants à l'œuvre lors du rappel dans l'ordre inverse. Selon l'hypothèse de l'ERM, la nature de la modalité de réponse et le fait de connaître à l'avance la direction du rappel (dans l'ordre ou dans l'ordre inverse) influent sur la disponibilité des représentations visuospatiales, ainsi que sur le poids accordé aux éléments donnés et au traitement de l'ordre dans lequel ces éléments sont présentés. Nous avons mis à l'essai l'ERM en recourant au discours hors sujet, un facteur de la mémoire primaire bien connu pour son effet perturbateur dans le rappel dans l'ordre. Lors de deux expériences, nous avons manipulé la direction du rappel (dans l'ordre ou dans l'ordre inverse), le caractère du discours (contrôlé ou hors sujet) et la modalité de réponse (manuelle ou orale). Comme prédit par l'hypothèse de l'ERM, lorsque la direction du rappel était imprévisible durant l'expérience 1, l'amplitude de l'effet du discours hors sujet était supérieure en rappel manuel dans l'ordre inverse par rapport au rappel oral dans l'ordre inverse. Lors de l'expérience 2, la direction du rappel était prévisible. Comme prédit par l'hypothèse de l'ERM, lors du rappel dans l'ordre inverse, l'effet du discours hors sujet se trouvait diminué en réponse manuelle, et absent en réponse orale. Nous en avons donc conclu que l'ERM traduit efficacement l'interaction complexe des effets de la modalité de réponse, de la prescience de la direction du rappel, et de la mémoire de référence lors du rappel dans l'ordre inverse. Public Significance Statement For more than a century, backward immediate recall, requiring participants to recall the sequence of to-be-remembered items from the last to the first presented one, has been used as a measure of memory span in intelligence and neuropsychological tests. However, the processes involved remained misunderstood. Here, we present a novel theoretical framework called the encoding-retrieval matching (ERM) hypothesis which highlights the importance of visuospatial representations, output modality, and foreknowledge of recall direction. Our novel hypothesis can successfully account for the complex set of findings observed in immediate backward recall.

IntroductionIt was shown that children with specific language impairments (SLI) have deficits not only in producing and understanding language but also in visuospatial abilities (Kiselev et al., 2016). We assume that training programs that are aimed to develop the visuospatial abilities can help children with SLI.ObjectivesThe goal of this study was to assess the impact of visuospatial training on the language abilities in 6–7 years old children with SLI.MethodsThe participants were 20 children aged 6–7 years with SLI. Children were randomly assigned to the intervention and comparison group. Children from intervention group participated in 8 weeks of visuospatial training. This programme trains the child to do different visuospatial exercises both on motor and cognitive level. This programme is built on the conceptual framework derived from the work of Luria’s theory of restoration of neurocognitive functions (Luria, 1963, 1974). We used the subtests from Luria’s child neuropsychological assessment battery to assess language abilities in children before and after the intervention period.ResultsAnalysis of covariance tested the effect of visuospatial training programme on five language subtest from Luria’s child neuropsychological assessment battery. Group differences (p<.05) were found for subtest that assess understanding prepositions that describe the spatial relations between objects. Posttest mean for the intervention group were significantly (p<.05) greater than the control group.ConclusionsIt can be assumed that visuospatial training in children with SLI benefits specific language abilities for understanding sentences with spatial prepositions.

Humans make frequent movements of the eyes (saccades) to explore the visual environment. Here, we argue that visuospatial working memory (VSWM) is a fundamental component of the eye movement system. Memory representations in VSWM are functionally integrated at all stages of orienting: (a) selection of the target; (b) maintenance of visual features across the saccade; (c) the computation of object correspondence after the saccade, supporting the experience of perceptual continuity; and (d) the correction of gaze when the eyes fail to land on the intended object. VSWM is finely tuned to meet the challenges of active vision.

Cognitive function represents a complex neurophysiological capacity of the human brain, encompassing a higher level of neural processing and integration. It is widely acknowledged that the cerebrum plays a commanding role in the regulation of cognitive functions. However, the specific role of the cerebellum in cognitive processes has become a subject of considerable scholarly intrigue. In 1998, Schmahmann first proposed the concept of “cognitive affective syndrome (CCAS),” linking cerebellar damage to cognitive and emotional impairments. Since then, a substantial body of literature has emerged, exploring the role of the cerebellum in cognitive neurological function. The cerebellum’s adjacency to the cerebral cortex, brainstem, and spinal cord suggests that the cerebral-cerebellar network loops play a crucial role in the cerebellum’s participation in cognitive neurological functions. In this review, we comprehensively examine the recent literature on the involvement of the cerebellum in cognitive functions from three perspectives: the cytological basis of the cerebellum and its anatomical functions, the cerebellum and cognitive functions, and Crossed cerebellar diaschisis. Our aim is to shed light on the role and mechanisms of the cerebellum in cognitive neurobrain networks.

Mild cognitive impairment due to Alzheimer's disease (MCI due to AD) is a crucial stage for the early identification of Alzheimer's disease (AD), and timely detection at this stage may provide opportunities for earlier intervention and potentially delay disease progression. This study proposed a digital early-screening method based on a touchscreen maze hand-interaction kinetic paradigm, which integrates digital biomarkers from the visuospatial/executive and episodic memory domains to support the screening of MCI due to AD. A customized maze task was administered to 40 patients with clinically diagnosed MCI due to AD and 40 healthy controls (HC). Behavioral data were collected, and two categories of digital biomarkers were extracted: (1) visuospatial/executive digital biomarkers, such as task completion time ( ) and average movement speed ( ); and (2) episodic memory digital biomarkers, such as episodic memory total time ( ) and number of correct choices ( ). Significant digital biomarkers were identified through between-group comparisons, and their combined classification performance was evaluated using binary logistic regression and receiver operating characteristic (ROC) analysis. The integrated digital biomarker model showed promising apparent discriminative performance in the full cohort, with an AUC of 0.899 (95% CI: 0.831-0.967). To reduce potential optimism associated with biomarker selection, model development, and model evaluation within the same dataset, internal validation was performed using full-pipeline repeated stratified five-fold cross-validation with all 16 candidate digital biomarkers entered into the validation procedure and biomarker selection repeated within each training fold. The internally validated model retained good discriminative performance, with a mean cross-validated AUC of 0.842, an empirical 95% interval of 0.779-0.878, an accuracy of 0.783, a sensitivity of 0.772, and a specificity of 0.795. These findings suggest that the proposed touchscreen maze-based digital assessment method may provide a promising and objective approach to supporting the early screening of MCI due to AD.

The hours immediately following a traumatic event may present a window of opportunity to interrupt the consolidation of memories of the traumatic event, and this may prevent PTSD development. This theory has been validated in a series of analogue studies, showing that a visuo-spatial task reduces intrusive memories, however clinical studies are scarce. This pilot RCT examined the use of a semi-immersive Virtual Reality visuospatial task, as an intervention to interrupt memory consolidation, in the Emergency Department (ED) in the immediate hours following a traumatic event. We hypothesised that participants who had received the intervention would present with lower levels of PTSD symptoms than the control group who received no intervention. Seventy-seven adult survivors of traumatic events, meeting study criteria, were recruited in the ED of a Level III Trauma Centre. Survivors arrived at the ED less than one hour, on average, after the trauma. After signing informed consent, participants were randomized to the SnowWorld intervention or control group. Both groups completed self-report questionnaires, and the intervention group used SnowWorld for up to 10 minutes. No significant differences between the intervention and control groups were found regarding PTSD symptom levels two weeks and six months following the traumatic event. These results add to the growing literature examining the use of a concurrent task to reduce intrusions following a traumatic event. In contrast to previous clinical studies, this study did not show significant group differences; however, it replicates an analogue study that used a specifically developed app. Further studies are needed to elucidate possible reasons for these conflicting results.

Cognitive training can potentially prevent cognitive decline. However, the results of recent studies using semi-immersive virtual reality (VR)-assisted cognitive training are inconsistent. We aimed to examine the hypothesis that cognitive training using fully immersive VR, which may facilitate visuospatial processes, could improve visuospatial functioning, comprehensive neuropsychological functioning, psychiatric symptoms, and functional connectivity in the visual brain network in predementia. Participants over 60 years old with subjective cognitive decline or mild cognitive impairment from a memory clinic were randomly allocated to the VR (n=23) or the control (n=18) group. The VR group participants received multidomain and neuropsychologist-assisted cognitive training in a fully immersive VR environment twice a week for 1 month. The control group participants did not undergo any additional intervention except for their usual therapy such as pharmacotherapy. Participants of both groups were evaluated for cognitive function using face-to-face comprehensive neuropsychological tests, including the Rey-Osterrieth Complex Figure Test (RCFT) copy task; for psychiatric symptoms such as depression, apathy, affect, and quality of life; as well as resting-state functional magnetic resonance imaging (rsfMRI) at baseline and after training. Repeated-measures analysis of variance was used to compare the effect of cognitive training between groups. Seed-to-voxel-based analyses were used to identify the cognitive improvement-related functional connectivity in the visual network of the brain. After VR cognitive training, significant improvement was found in the total score (F =14.69, P=.001) and basic components score of the RCFT copy task (F =9.27, P=.005) compared with those of the control group. The VR group also showed improvements, albeit not significant, in naming ability (F =3.55, P=.07), verbal memory delayed recall (F =3.03, P=.09), and phonemic fluency (F =3.08, P=.09). Improvements in psychiatric symptoms such as apathy (F =7.02, P=.01), affect (F =14.40, P=.001 for positive affect; F =4.23, P=.047 for negative affect), and quality of life (F =4.49, P=.04) were found in the VR group compared to the control group. Improvement in the RCFT copy task was associated with a frontal-occipital functional connectivity increase revealed by rsfMRI in the VR group compared to the control group. Fully immersive VR cognitive training had positive effects on the visuospatial function, apathy, affect, quality of life, and increased frontal-occipital functional connectivity in older people in a predementia state. Future trials using VR cognitive training with larger sample sizes and more sophisticated designs over a longer duration may reveal greater improvements in cognition, psychiatric symptoms, and brain functional connectivity. Clinical Research Information Service KCT0005243; https://tinyurl.com/2a4kfasa.

Abstract Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors.