Chronic total occlusions are common in contemporary catheterization laboratory practice. Prospective studies are needed to ascertain the benefits of treatment strategies of these complex patients.

Attention-deficit hyperactivity disorder (ADHD) has historically been considered a disorder of childhood and adolescence. However, it is now recognized that ADHD symptoms persist into adulthood in up to 60% of individuals. Some of the cognitive symptoms that characterize ADHD (inability to provide sustained attention or mental effort, difficulty organizing or multi-tasking, forgetfulness) may closely resemble symptoms of prodromal dementia, also often referred to as mild cognitive impairment (MCI), particularly in patients over age 50. In addition to the overlap in cognitive symptoms, adults with ADHD and those with MCI may also share a number of behavioral and psychiatric symptoms, including sleep disturbances, depression, and anxiety. As a result, both syndromes may be difficult to distinguish clinically in older patients, particularly those who present to memory clinics with subjective cognitive complaints and fear the onset of a neurodegenerative process: is it ADHD, MCI, or both? Currently, it is unclear whether ADHD is associated with incipient dementia or is being misdiagnosed as MCI due to symptom overlap, as there exist data supporting either possibility. Here, we aim to elucidate this issue by outlining three hypothetical ways in which ADHD and MCI might relate to each other, providing an overview of the evidence relevant to each hypothesis, and delineating areas for future research. This is a question of considerable importance, with implications for improved diagnostic specificity of early dementia, improved accuracy of disease prevalence estimates, and better identification of individuals for targeted treatment.

IMPORTANCEUnderstanding the role of chorioamnionitis, a major factor leading to preterm birth, in the pathogenesis of neonatal brain injury and adverse neurodevelopmental outcomes may help in identifying potentially modifiable perinatal variables affecting brain health and outcomes among children born preterm.OBJECTIVE To evaluate whether histologic chorioamnionitis among neonates born very preterm is associated with intraventricular hemorrhage (IVH) and punctate white matter injury (WMI) or with adverse neurodevelopmental outcomes during early childhood. DESIGN, SETTING, AND PARTICIPANTSProspective cohort study conducted across 3 academic

IMPORTANCE Understanding the role of chorioamnionitis, a major factor leading to preterm birth, in the pathogenesis of neonatal brain injury and adverse neurodevelopmental outcomes may help in identifying potentially modifiable perinatal variables affecting brain health and outcomes among children born preterm. OBJECTIVE To evaluate whether histologic chorioamnionitis among neonates born very preterm is associated with intraventricular hemorrhage (IVH) and punctate white matter injury (WMI) or with adverse neurodevelopmental outcomes during early childhood.

Objective: Some features of attention-deficit/hyperactivity disorder (ADHD) may resemble those of mild cognitive impairment (MCI) in older adults, contributing to diagnostic uncertainty in individuals seeking assessment in memory clinics. We systematically compared cognition and brain structure in ADHD and MCI to clarify the extent of overlap and identify potential features unique to each. Method: Older adults from a Cognitive Neurology clinic (40 ADHD, 29 MCI, 37 controls) underwent neuropsychological assessment. A subsample ( n = 80) underwent structural neuroimaging. Results: Memory was impaired in both patient groups, but reflected a storage deficit in MCI (supported by relatively smaller hippocampi) and an encoding deficit in ADHD (supported by frontal lobe thinning). Both groups displayed normal executive functioning. Semantic retrieval was uniquely impaired in MCI. Conclusion: Although ADHD has been proposed as a dementia risk factor or prodrome, we propose it is rather a pathophysiologically-unique phenotypic mimic acting via overlap in memory and executive performance.

Angiogenic therapy appears to be a promising strategy to improve neovascularisation and guidewire crossing rates in CTO.

Background: Attention deficit/hyperactivity disorder (ADHD) is increasingly being recognized in adults and older adults. Some of its behavioral features (e.g., distractibility, forgetfulness, impulsivity) may resemble those of mild cognitive impairment (MCI), which contributes to diagnostic uncertainty in later life. The present study aimed to systematically compare ADHD and MCI on measures of cognition and structural neuroimaging to clarify the extent of their overlap (i.e., cognitive features of ADHD that are most likely to be taken for signs of MCI) and identify potential features unique to each disorder (i.e., that may be used to guide diagnostic impressions). Methods: One hundred and six adults aged 50 years or above were recruited from a Cognitive Neurology clinic (40 ADHD, 29 MCI and 37 controls) completed a comprehensive neuropsychological battery. A subsample (n=80) underwent structural neuroimaging.Results: Memory was impaired in both patient groups, but reflected a storage deficit in MCI (supported by imaging findings of reduced hippocampal volumes) and an encoding deficit in ADHD (supported by frontal-lobe cortical thinning). Both groups performed normally on executive measures. Semantic retrieval was uniquely impaired in MCI.Conclusions: Behavioral and structural imaging features strongly suggest that ADHD and MCI are similar manifestations of separate pathophysiological processes. Although ADHD has been proposed as a risk factor or prodromal stage of neurodegeneration, we propose it is rather acting as a phenotypic mimic of MCI via overlap in memory and executive performance.

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