Competitive organized electronic video gaming, termed "esports," has become an international industry. The physiological and cognitive health results of prolonged esport practice and competition have not been adequately studied. The current study examined physiological and cognitive changes after a session of esport gameplay for two types of games, first-person shooter and multiplayer online battle arena games. Increases in systolic blood pressure, increases in speed, and decreases in accuracy and inhibitory processes were found for esport gamers overall. For peak heart rate change, first-person shooter games elicited a larger change than did multiplayer online battle arena games. These results have implications for the management of esport player cognitive and physical health as well as for the optimization of performance in competitive esport tournaments.

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Introduction The extent of working memory (WM) and executive function (EF) impairment in mild cognitive impairment (MCI) is not well‐characterized. Methods We compared 48 patients with MCI, 124 noncognitively impaired elderly healthy controls, and 57 patients with Alzheimer's disease (AD) on multiple WM/EF measures, frontal lobe integrity indexes, and functioning. Results Patients with MCI demonstrated worse performance on nearly all WM/EF tests. This profile of impairment was refined in a factor analysis that identified three primary WM/EF constructs: WM storage; speed and controlled visual search; and manipulation of information and problem solving. EF impairments were associated with reductions in prefrontal cortical thickness. WM/EF accounted for over 50% of the variance in functional competence. Discussion In MCI, WM/EF impairments are far from rare, based on specific compromises to frontal cortex circuitry, and are associated with loss of everyday functioning. WM/EF impairments, even at this potentially prodromal stage of AD, have clinically deleterious consequences.

BackgroundThe neural and cognitive substrates of measures of orientation as used in clinical trials and examinations have not been comprehensively examined.MethodsWe studied 473 subjects diagnosed with mild cognitive impairment (MCI) and Alzheimer's disease (AD) at baseline in Alzheimer's Disease Neuroimaging Initiative. Regression analyses at baseline were conducted to find significant predictors of orientation score among cognitive, brain morphometry, and glucose metabolism measures. Mixed model longitudinal analysis was performed to examine consequences of orientation on functional decline, and Cox hazard models examined the risk of conversion to AD in the MCI group.ResultsIn MCI and AD subjects, orientation was predicted by poorer neurocognitive performance on immediate and delayed episodic memory and attention and processing speed. Among magnetic resonance imaging measures, orientation was predicted by entorhinal cortex thickness, hippocampal volume, and inferior temporal cortex thickness. Glucose metabolism in both middle-inferior temporal cortex and hippocampus were also predictive of orientation score. Functioning was significantly lower in disoriented subjects after 4 years of follow-up, and MCI patients who also were disoriented showed a higher rate of conversion to AD with a hazard ratio of 1.5.ConclusionsOrientation is associated with medial temporal lobe structure, temporal lobe glucose metabolism, and episodic memory function. In MCI individuals orientation was a risk factor for progression to AD, also associated with rapid functional decline and worse prognosis. Thus, orientation may serve as a surrogate for episodic memory in clinical examination. These results have direct implications for the use of orientation in MCI and AD clinical trials including ceiling effects in healthy controls and issues of redundancy with measures of memory, when both are used in composite scores.

Symptoms of psychosis in patients with Alzheimer disease may be the expression of a pathological subtype associated with an accelerated cognitive and functional deterioration portending a hastened mortality. 1 The proposed National Institute of Mental Health Research Domain Criteria initiative provides a framework for conceptualizing the common neurobiological underpinnings of symptom domains such as psychosis that transcend individual diagnostic categories to facilitate translational research. 2 Gur et al 3 suggest that highly implementable tasks measuring facial affective processing can be used to assay social cognitive integrity in psychotic disorders within the National Institute of Mental Health Research Domain Criteria framework. Although McLellan et al 4 report that facial affective processing is degraded in Alzheimer disease, to our knowledge no published studies have investigated the association between this impairment and the psychotic phenotype. We report on facial affective processing performance in a longitudinal cohort of healthy elderly control individuals and participants with mild cognitive impairment (MCI) or Alzheimer disease at baseline, with and without symptoms of psychosis over the course of the study.