The prevalence of dementia is increasing with expansion of the older adult population. In the absence of effective therapy, preventive approaches are essential to address this public health problem. Blueberries contain polyphenolic compounds, most prominently anthocyanins, which have antioxidant and anti-inflammatory effects. In addition, anthocyanins have been associated with increased neuronal signaling in brain centers mediating memory function as well as improved glucose disposal, benefits that would be expected to mitigate neurodegeneration. We investigated the effects of daily consumption of wild blueberry juice in a sample of nine older adults with early memory changes. At 12 weeks, we observed improved paired associate learning (p = 0.009) and word list recall (p = 0.04). In addition, there were trends suggesting reduced depressive symptoms (p = 0.08) and lower glucose levels (p = 0.10). We also compared the memory performances of the blueberry subjects with a demographically-matched sample who consumed a berry placebo beverage in a companion trial of identical design and observed comparable results for paired associate learning. The findings of this preliminary study suggest that moderate-term blueberry supplementation can confer neurocognitive benefit and establish a basis for more comprehensive human trials to study preventive potential and neuronal mechanisms. Keywordsblueberries; memory; metabolism; Mild Cognitive Impairment; prevention; neurodegeneration Alzheimer's disease (AD) accounts for 60% to 80% of cases of dementia (1). The prevalence of AD threatens to reach epidemic proportions in the coming decades, with projections of 16 million cases in the US by 2050 (1). There are several age-related health conditions that increase vulnerability to AD, most prominently cardiovascular risks (2). However, metabolic disturbance appears to be a fundamental factor driving both cardiovascular disorders and neurodegeneration (3). The presence of insulin resistance and diabetes increase risk for AD substantially, and the risk attributable solely to hyperinsulinemia was determined to be as high as 39% in one longitudinal study (4).A number of concepts have been introduced to classify older adults at different stages of cognitive decline. Mild Cognitive Impairment (MCI) identifies individuals with increased risk for dementia and represents the first clinical appearance of neurodegeneration for a substantial subset of individuals who will progress to AD (5). There is no remedy for dementia, and it is not clear when or if effective therapy will be developed. However, it has been proposed that interventions initiated in individuals with pre-dementia conditions such as MCI might forestall progression of cognitive decline, and MCI may represent the final point at which intervention can be effective (6).Dietary approaches hold promise as effective and safe preventive interventions. Dietary factors represent the most potent determinants of metabolic health and have been shown to mitigate specific mechanisms o...

Concord grape juice contains polyphenol compounds, which have antioxidant and anti-inflammatory properties and influence neuronal signalling. Concord grape juice supplementation has been shown to reduce inflammation, blood pressure and vascular pathology in individuals with CVD, and consumption of such flavonoid-containing foods is associated with a reduced risk for dementia. In addition, preliminary animal data have indicated improvement in memory and motor function with grape juice supplementation, suggesting potential for cognitive benefit in ageing humans. In this initial investigation of neurocognitive effects, we enrolled twelve older adults with memory decline but not dementia in a randomised, placebo-controlled, double-blind trial with Concord grape juice supplementation for 12 weeks. We observed significant improvement in a measure of verbal learning and non-significant enhancement of verbal and spatial recall. There was no appreciable effect of the intervention on depressive symptoms and no effect on weight or waist circumference. A small increase in fasting insulin was observed for those consuming grape juice. These preliminary findings suggest that supplementation with Concord grape juice may enhance cognitive function for older adults with early memory decline and establish a basis for more comprehensive investigations to evaluate potential benefit and assess mechanisms of action.

Adolescents with type 1 diabetes are likely attending most middle and high schools. These youth often do not receive the support needed to manage their diabetes during or after school. Nurses (n=110) from 3 states responded to a survey examining perceptions of barriers to and supports for diabetes management during school and after school activities. Results indicated that adolescents need more support at school. Support could be facilitated by education of school staff; improved communication among youth, parents, school nurses, teachers, and physicians; and more communication from adolescents to others about what they need to manage well in school. Open-ended questions allowed nurses to provide recommendations for supporting youth and ideas for addressing barriers to management at school. Future studies should address ways to enable adolescents to communicate about their diabetes and ways to educate the school team.

Adolescents with type 1 diabetes are likely attending most middle and high schools. These youth often do not receive the support needed to manage their diabetes during or after school. Nurses (n=110) from 3 states responded to a survey examining perceptions of barriers to and supports for diabetes management during school and after school activities. Results indicated that adolescents need more support at school. Support could be facilitated by education of school staff; improved communication among youth, parents, school nurses, teachers, and physicians; and more communication from adolescents to others about what they need to manage well in school. Open-ended questions allowed nurses to provide recommendations for supporting youth and ideas for addressing barriers to management at school. Future studies should address ways to enable adolescents to communicate about their diabetes and ways to educate the school team.

Purpose To examine acute alterations in white matter (WM) diffusion based on diffusion tensor imaging (DTI) in youth with mild traumatic brain injury (mTBI) relative to orthopedic injury (OI) controls. Methods A prospective cohort study of 23 patients with mTBI and 20 OI controls ages 11–16 years were recruited from the emergency department (ED). DTI was performed within 96 hours. Voxel based analysis quantified group differences for DTI indices: fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD). The Post Concussion Symptom Scale assessed symptom burden. Results Youth with mTBI had significantly higher symptom burdens in the ED and at scanning than controls. The mTBI group had significantly higher levels of FA and AD in several WM regions including the middle temporal gyrus WM, superior temporal gyrus WM, anterior corona radiata, and superior longitudinal fasciculus. The mTBI group had significantly lower levels of MD and/or RD in a few WM regions including the middle frontal gyrus WM and anterior corona radiata. Diffusion alterations correlated poorly with acute symptom burden. Conclusions Alterations of diffusivity were detected in spatially heterogeneous WM regions shortly after mTBI in youth. The pattern of alterations may reflect restrictive water diffusion in WM early post-injury.

Assessment of ventricular size is essential in clinical management of hydrocephalus and other neurological disorders. At present, ventricular size is assessed using indices derived from the dimensions of the ventricles rather than the actual volumes. In a population of 22 children with congenital hydrocephalus and 22 controls, the authors evaluated the relationship between ventricular volume and linear indices in common use, such as the frontooccipital horn ratio, Evans' index, and the bicaudate index. Ventricular volume was measured on high-resolution anatomical MR images. The frontooccipital horn ratio was found to have a stronger correlation with both absolute and relative ventricular volume than other indices. Further analysis of the brain volumes found that congenital hydrocephalus produced a negligible decrease in the volume of the brain parenchyma.

Insulin resistance is implicated in the pathophysiological changes associated with Alzheimer's disease, and pharmaceutical treatments that overcome insulin resistance improve memory function in subjects with mild cognitive impairment (MCI) and early Alzheimer's disease. Chromium (Cr) supplementation improves glucose disposal in patients with insulin resistance and diabetes. We sought to assess whether supplementation with Cr might improve memory and neural function in older adults with cognitive decline. In a placebo-controlled, double-blind trial, we randomly assigned 26 older adults to receive either chromium picolinate (CrPic) or placebo for 12 weeks. Memory and depression were assessed prior to treatment initiation and during the final week of treatment. We also performed functional magnetic resonance imaging (fMRI) scans on a subset of subjects. Although learning rate and retention were not enhanced by CrPic supplementation, we observed reduced semantic interference on learning, recall, and recognition memory tasks. In addition, fMRI indicated comparatively increased activation for the CrPic subjects in right thalamic, right temporal, right posterior parietal, and bifrontal regions. These findings suggest that supplementation with CrPic can enhance cognitive inhibitory control and cerebral function in older adults at risk for neurodegeneration.

Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Psychophysical evidence suggests that this dysfunction results from impairments in the integration of low-level neural signals into complex cortical representations, which may also be associated with symptom formation. Despite the symptoms of schizophrenia occurring in a range of disorders, the integration deficit has not been tested in broader patient populations. Moreover, it remains unclear whether such deficits generalize across other sensory modalities. The present study assessed patients with a range of psychotic and nonpsychotic disorders and healthy controls on visual contrast detection, visual motion integration, auditory tone detection and auditory tone integration. The sample comprised a total of 249 participants (schizophrenia spectrum disorder n=98; bipolar affective disorder n=35; major depression n=31; other psychiatric conditions n=31; and healthy controls n=54), of whom 178 completed one or more visual task and 71 completed auditory tasks. Compared with healthy controls and nonpsychotic patients, psychotic patients trans-diagnostically were impaired on both visual and auditory integration, but unimpaired in simple visual or auditory detection. Impairment in visual motion integration was correlated with the severity of positive symptoms, and could not be accounted for by a reduction in processing speed, inattention or medication effects. Our results demonstrate that impaired sensory integration is not specific to schizophrenia, as has previously been assumed. Instead, sensory deficits are closely related to the presence of positive symptoms independent of diagnosis. The finding that equivalent integrative sensory processing is impaired in audition is consistent with hypotheses that propose a generalized deficit of neural integration in psychotic disorders.