Background: Dementia with Lewy bodies (DLB) includes various core clinical features that result in different phenotypes. In addition, Alzheimer's disease (AD) and cerebrovascular pathologies are common in DLB. All this increases the heterogeneity within DLB and hampers clinical diagnosis. We addressed this heterogeneity by investigating subgroups of patients with similar biological, clinical, and demographic features.

Methods: We studied 107 extensively phenotyped DLB patients from the European DLB consortium. Factorial analysis of mixed data (FAMD) was used to identify dimensions in the data, based on sex, age, years of education, disease duration, Mini-Mental State Examination (MMSE), cerebrospinal fluid (CSF) levels of AD biomarkers, core features of DLB, and regional brain atrophy. Subsequently, hierarchical clustering analysis was used to subgroup individuals based on the FAMD dimensions.

Results: We identified 3 dimensions using FAMD that explained 38% of the variance. Subsequent hierarchical clustering identified 4 clusters. Cluster 1 was characterized by amyloid-beta and cerebrovascular pathologies, medial temporal atrophy, and cognitive fluctuations. Cluster 2 had posterior atrophy and showed the lowest frequency of visual hallucinations and cognitive fluctuations and the worst cognitive performance. Cluster 3 had the highest frequency of tau pathology, showed posterior atrophy, and had a low frequency of parkinsonism. Cluster 4 had virtually normal AD biomarkers, the least regional brain atrophy and cerebrovascular pathology, and the highest MMSE scores.

Conclusions: This study demonstrates that there are subgroups of DLB patients with different biological, clinical, and demographic characteristics. These findings may have implications in the diagnosis and prognosis of DLB, as well as in the treatment response in clinical trials.

Objective: This study investigated age-dependent and subtype-related alterations in electroencephalography (EEG) power spectra and current source densities (CSD) in children with attention deficit and hyperactivity disorder (ADHD).

Methods: We performed spectral and cortical source (exact low-resolution electromagnetic tomography, eLORETA) analyses using resting state EEG recordings from 40 children (8-16 years) with combined and inattentive subtypes of ADHD and 41 age-matched healthy controls (HC). Group differences in EEG spectra and CSD were investigated at each scalp location, voxel and cortical region in delta, theta, alpha and beta bands. We also explored associations between topographic changes in EEG power and CSD and age.

Results: Compared to healthy controls, combined ADHD subtype was characterized with significantly increased diffuse theta/beta power ratios (TBR) with a widespread decrease in beta CSD. Inattentive ADHD subtype presented increased TBR in all brain regions except in posterior areas with a global increase in theta source power. In both ADHD and HC, older age groups showed significantly lower delta source power and TBR and higher alpha and beta source power than younger age groups. Compared to HC, ADHD was characterized with increases in theta fronto-central and temporal source power with increasing age.

Conclusions: Our results confirm that TBR can be used as a neurophysiological biomarker to differentiate ADHD from healthy children at both the source and sensor levels.

Significance: Our findings emphasize the importance of performing the source imaging analysis in order to better characterize age-related changes in resting-state EEG activity in ADHD and controls.

The COVID-19 pandemic precipitated numerous changes in daily life, including the cancellation and restriction of sports globally. Because sports participation contributes positively to the development of student-athletes, restricting these activities may have led to long-term mental health changes in this population. Using a repeated cross-sectional study design, we measured rates of depression using the Patient Health Questionnaire-2 and anxiety using the Generalized Anxiety Disorder-2 scale in student-athletes attending elite sport high schools in Sweden during the second wave of the pandemic (February 2021; n = 7021) and after all restrictions were lifted (February 2022; n = 6228). Depression among student-athletes decreased from 19.8% in 2021 to 17.8% in 2022 (p = .008, V = .026), while anxiety screening did not change significantly (17.4% to 18.4%, p > .05). Comparisons between classes across years revealed older students exhibited decreases in depressive symptoms, while younger cohorts experienced increases in symptoms of anxiety from 2021 to 2022. Logistic regressions revealed that being female, reporting poorer mental health due to COVID-19, and excessive worry over one’s career in sports were significant predictors of both depression and anxiety screenings in 2022. Compared to times when sports participation was limited, the lifting of restrictions was associated with overall reduced levels of depression, but not anxiety. 

The Borg centiMax Scale, is a psychophysically composed general intensity ratio scale, which could enable more precise inter‐ and intraindividual comparisons of the intensity of depressive symptoms. In the present study, the properties of the centiMax scale were examined in 38 patients with clinical depression and 109 students. Additionally, preliminary centiMax cut‐off scores for mild, moderate and severe depression were estimated. The psychometric properties of the centiMax were found to be satisfactory regarding internal consistency, convergent, discriminative and predictive validity. Moreover, the centiMax was demonstrated to provide meaningful comparisons of symptom intensity, which makes it possible to evaluate the relative importance of individual symptoms in a profile and make more precise comparisons within and between individuals. With regard to intraindividual comparisons, patients rated , for example, the intensity of feeling “guilt” twice as strong as feelings of “being punished,” and the intensity of “loss of pleasure” almost three times as strong as “being punished.” With regard to interindividual comparisons, patients rated e.g., the intensity of “being punished” as 12 times stronger than controls, and the intensity of “worthlessness” about nine times stronger. In conclusion, the centiMax was shown to be reliable and valid for assessing depressive symptoms. The centiMax with level anchored ratio data, appears to be highly advantageous as it permits rather precise values of symptom intensity for intra‐ and interindividual comparisons that could be useful in the diagnostic process and in treatment planning.

Background: Self-rated subjective cognitive decline (SCD) and subjective olfactory impairment (SOI) are associated with objective cognitive decline and dementia. However, their relationship and co-occurrence is unknown. We aimed to (a) describe the occurrence of SOI, SCD and their overlap in the general population; (b) compare SOI and SCD in terms of longitudinal associations with corresponding objective olfactory and cognitive measures; and (c) describe how SOI and SCD may lead to distinct sensory and cognitive outcomes.

Methods: Cognitively unimpaired individuals from the third wave of the Swedish population-based Betula study (n = 784, aged 35–90 years; 51% females) were split into self-rated SOI, SCD, overlapping SCD + SOI, and controls. Between-subject and within-subject repeated-measures MANCOVA were used to compare the groups regarding odor identification, cognition, age, sex, and education. Spearman correlation was used to assess the different patterns of association between olfaction and cognition across groups.

Results: SOI was present in 21.1%, whereas SCD was present in 9.9% of participants. According to a chi-square analysis, the SCD + SOI overlap (2.7%) is on a level that could be expected if the phenomena were independent. Odor identification in SOI showed decline at the 10-year follow-up (n = 284) and was positively associated with cognition. The SOI and SCD groups showed distinct cognitive-olfactory profiles at follow-up.

Conclusions: SOI occur independently of SCD in the population, and these risk factors are associated with different cognitive and olfactory outcomes. The biological causes underlying SOI and SCD, as well as the risk for future cognitive impairment, need further investigation.

Aims: To investigate the interplay between gray matter (GM) and white matter (WM) neurodegeneration in subjective cognitive decline (SCD), including thickness across the whole cortical mantle, hippocampal volume, and integrity across the whole WM.

Methods: We included 225 cognitively unimpaired individuals from a community-based cohort. Subjective cognitive complaints were assessed through 9 questions covering amnestic and non-amnestic cognitive domains. In our cohort, 123 individuals endorsed from one to six subjective cognitive complaints (i.e. they fulfilled the diagnostic criteria for SCD), while 102 individuals reported zero complaints. GM neurodegeneration was assessed through measures of cortical thickness across the whole mantle and hippocampal volume. WM neurodegeneration was assessed through measures of mean diffusivity (MD) across the whole WM skeleton. Mediation analysis and multiple linear regression were conducted to investigate the interplay between the measures of GM and WM neurodegeneration.

Results: A higher number of complaints was associated with reduced hippocampal volume, cortical thinning in several frontal and temporal areas and the insula, and higher MD across the WM skeleton, with a tendency to spare the occipital lobe. SCD-related cortical thinning and increased MD were associated with each other and jointly contributed to complaints, but the contribution of cortical thinning to the number of complaints was stronger.

Conclusions: Neurodegeneration processes affecting the GM and WM seem to be associated with each other in SCD and include brain areas other than those typically targeted by Alzheimer's disease. Our findings suggest that SCD may be a sensitive behavioral marker of heterogeneous brain pathologies in individuals recruited from the community.

Background and Objectives

Several pathologic processes might contribute to the degeneration of the cholinergic system in aging. We aimed to determine the contribution of amyloid, tau, and cerebrovascular biomarkers toward the degeneration of cholinergic white matter (WM) projections in cognitively unimpaired individuals.

Methods

The contribution of amyloid and tau pathology was assessed through CSF levels of the Aβ_42/40 ratio and phosphorylated tau (p-tau). CSF Aβ₃₈ levels were also measured. Cerebrovascular pathology was assessed using automatic segmentations of WM lesions (WMLs) on MRI. Cholinergic WM projections (i.e., cingulum and external capsule pathways) were modeled using tractography based on diffusion tensor imaging data. Sex and APOE ε4 carriership were also included in the analysis as variables of interest.

Results

We included 203 cognitively unimpaired individuals from the H70 Gothenburg Birth Cohort Studies (all individuals aged 70 years, 51% female). WM lesion burden was the most important contributor to the degeneration of both cholinergic pathways (increase in mean square error [IncMSE] = 98.8% in the external capsule pathway and IncMSE = 93.3% in the cingulum pathway). Levels of Aβ₃₈ and p-tau also contributed to cholinergic WM degeneration, especially in the external capsule pathway (IncMSE = 28.4% and IncMSE = 23.4%, respectively). The Aβ_42/40 ratio did not contribute notably to the models (IncMSE<3.0%). APOE ε4 carriers showed poorer integrity in the cingulum pathway (IncMSE = 21.33%). Women showed poorer integrity of the external capsule pathway (IncMSE = 21.55%), which was independent of amyloid status as reflected by the nonsignificant differences in integrity when comparing amyloid-positive vs amyloid-negative women participants (T₂₀₁ = −1.55; p = 0.123).

Discussion

In cognitively unimpaired older individuals, WMLs play a central role in the degeneration of cholinergic pathways. Our findings highlight the importance of WM lesion burden in the elderly population, which should be considered in the development of prevention programs for neurodegeneration and cognitive impairment.

The reminiscence bump is the disproportionally high reporting of autobiographical memories from adolescence and early adulthood and is typically observed when memories are evoked by cues, such as words, pictures, and sounds. However, when odors are used the bump shifts to early childhood. Although these findings indicate that sensory modality affects the bump, the influence of the individual's sensory function on the reminiscence bumps is unknown. We examined the reminiscence bumps of sound- and odor-evoked autobiographical memories of early blind and sighted individuals, since early blindness implies considerable effects on sensory experience. Despite differences in sensory experience between blind and sighted individuals, the groups displayed similar age distributions of both sound- and odor-evoked memories. The auditory bump spanned the first two decades of life, whereas the olfactory bump was once again found in early childhood. These results demonstrate that the reminiscence bumps are robust to fundamental differences in sensory experience.

Normal adult aging is associated with decline in some socioemotional abilities, such as the ability to recognize emotions in others, and age-related neurobiological processes may contribute to these deficits. There is increasing evidence that the neuropeptide oxytocin plays a key role in social cognition, including emotion recognition. The mechanisms through which oxytocin promotes emotion recognition are not well understood yet, and particularly in aging. In a randomized, double-blind, placebo-controlled within-subjects design, we investigated the extent to which a single dose of 40 IU of intranasal oxytocin facilitates emotion recognition in 40 younger (M = 24.90 yrs., SD = 2.97, 48% women) and 40 older (M = 69.70 yrs., SD = 2.99, 55% women) men and women. During two fMRI sessions, participants viewed dynamic positive and negative emotional displays. Preliminary analyses show that younger participants recognized positive and negative emotions more accurately than older participants (p < .001), with this behavioral effect not modulated by oxytocin. In the brain data, however, we found an age x treatment interaction in medial prefrontal cortex (xyz [14, 14, 6], p = .007) and superior temporal gyrus (xyz [53, 9, 2], p = .031). In particular, oxytocin (vs. placebo) reduced activity in these regions for older participants, while it enhanced activity in these regions for younger participants. In line with previous research, these findings support the notion that the effects of oxytocin vary by context and individual factors (e.g., social proficiency, age).

Age-related differences in emotion recognition have predominantly been investigated using static pictures of facial expressions, and positive emotions beyond happiness have rarely been included. The current study instead used dynamic facial and vocal stimuli, and included a wider than usual range of positive emotions. In Task 1, younger and older adults were tested for their abilities to recognize 12 emotions from brief video recordings presented in visual, auditory, and multimodal blocks. Task 2 assessed recognition of 18 emotions conveyed by non-linguistic vocalizations (e.g., laughter, sobs, and sighs). Results from both tasks showed that younger adults had significantly higher overall recognition rates than older adults. In Task 1, significant group differences (younger > older) were only observed for the auditory block (across all emotions), and for expressions of anger, irritation, and relief (across all presentation blocks). In Task 2, significant group differences were observed for 6 out of 9 positive, and 8 out of 9 negative emotions. Overall, results indicate that recognition of both positive and negative emotions show age-related differences. This suggests that the age-related positivity effect in emotion recognition may become less evident when dynamic emotional stimuli are used and happiness is not the only positive emotion under study.

Experts have better memory for items within their domain of expertise. Critically, this does not depend on more efficient use of language. However, this conclusion is based mainly on findings from experts in visual and auditory domains. Olfactory experts constitute an interesting potential counterexample since language has been implicated to be critically involved in odor memory in previous studies. We examined the role language plays in odor recognition memory for wine experts, who typically display better wine odor memory than novices and who are also able to name odors better than lay people. This suggests wine experts' superior recognition memory for odors may be verbally mediated. In 2 experiments, recognition memory for wine odors, wine-related odors, and common odors was tested in wine experts and novices. The use of language was manipulated in Experiment 1 with an overt naming versus no-naming condition, and in Experiment 2, with a verbal interference task inhibiting covert verbalization. Across the two experiments the results showed wine experts have better recognition memory for wines, but not for wine-related or common odors, indicating their memory advantage is expertise specific. Critically, this effect was not verbally mediated, as there was no relationship between experts' ability to name wines and their memory for them. Likewise, directly inhibiting online use of verbalization did not affect memory for wine odors in experts. In sum, once expertise has been acquired, language does not play a causal role in recognition memory for odors.

Although taste and smell seem hard to imagine, some people nevertheless report vivid imagery in these sensory modalities. We investigate whether experts are better able to imagine smells and tastes because they have learned the ability, or whether they are better imaginers in the first place, and so become experts. To test this, we first compared a group of wine experts to yoked novices using a battery of questionnaires. We show for the first time that experts report greater vividness of wine imagery, with no difference in vividness across sensory modalities. In contrast, novices had more vivid color imagery than taste or odor imagery for wines. Experts and novices did not differ on other vividness of imagery measures, suggesting a domain-specific effect of expertise. Critically, in a second study, we followed a group of students commencing a wine course and a group of matched control participants. Students and controls did not differ before the course, but after the wine course students reported more vivid wine imagery. We provide evidence that expertise improves imagery, exemplifying the extent of plasticity of cognition underlying the chemical senses.

Emerging evidence suggests that olfactory function is closely linked to memory function. The aims of this study were to assess whether olfactory and episodic memory functions follow similar age-related decline trajectories, to identify different patterns of decline, as well as predictors of the patterns. 1023 participants from the Memory and Aging Project were followed for up to 8 years with annual episodic memory and odor identification assessments. Trajectories were modelled using growth mixture models. Multivariate logistic regression was used to identify pattern predictors. Three patterns of joint trajectories were identified; Class 1- stable average performance in both functions (n=690, 67.4%); Class 2- stable average episodic memory and declining odor identification (n=231, 22.6%); and Class 3- decline in both functions (n=102, 10.0%). Class predictors included age, sex, APOE epsilon 4 status, cognitive activity level and BMI. Participants in Class 3 were most likely to develop dementia. Episodic memory and olfactory function show similar trajectories in aging. Such classification can contribute to a better understanding of the factors related to cognitive decline and dementia.

The COVID-19 pandemic (and its aftermath) highlights a critical need to communicate health information effectively to the global public. Given that subtle differences in information framing can have meaningful effects on behavior, behavioral science research highlights a pressing question: Is it more effective to frame COVID-19 health messages in terms of potential losses (e.g., “If you do not practice these steps, you can endanger yourself and others”) or potential gains (e.g., “If you practice these steps, you can protect yourself and others”)? Collecting data in 48 languages from 15,929 participants in 84 countries, we experimentally tested the effects of message framing on COVID-19-related judgments, intentions, and feelings. Loss- (vs. gain-) framed messages increased self-reported anxiety among participants cross-nationally with little-to-no impact on policy attitudes, behavioral intentions, or information seeking relevant to pandemic risks. These results were consistent across 84 countries, three variations of the message framing wording, and 560 data processing and analytic choices. Thus, results provide an empirical answer to a global communication question and highlight the emotional toll of loss-framed messages. Critically, this work demonstrates the importance of considering unintended affective consequences when evaluating nudge-style interventions.

Leaders of today need to achieve well in terms of task performance, perceiving low stress, and having high levels of work engagement. One may ask whether trait-based leadership resource factors can be identified and how such resource factors might relate to task performance, perceived stress, and work engagement. Our aim was to test the hypothesis, derived from Hobfoll’s motivational Conservation of Resources (COR) theory, that there are trait-based leadership resource factors, which are differentially correlated to the leaders’ task performance, perceived stress, and work engagement. Leaders (N = 344) aged from 23 to 65 years (M = 49, SD = 8.6; 58% women) completed an online questionnaire including measures of task performance, perceived stress, work engagement, personality traits, trait emotional intelligence, empathy, performance-related self-esteem, compassionate and rational leadership competence, and coping resources for stress. Using exploratory factor analysis, we identified four trait-based leadership resource factors. With Bonferroni adjustment, and controlling for sex, age, number of years in the current managerial position, self-deceptive enhancement, and impression management, only Rational Mastery was significantly positively correlated with task performance. Rational Mastery, Efficient Coping, and Modesty were negatively correlated with perceived stress, and all factors except Modesty, but including the fourth (Good-Heartedness) were positively correlated with work engagement. Organizations striving for sustainable work conditions should support trait-based leadership, which depends not only on a task-oriented resource such as rational mastery, but also on human-oriented resources such as efficient coping, modesty, and good-heartedness, all of them being differentially related to task performance, perceived stress, and work engagement.

Nonverbal emotion recognition accuracy (ERA) is a central feature of successful communication and interaction, and is of importance for many professions. We developed and evaluated two ERA training programs—one focusing on dynamic multimodal expressions (audio, video, audio-video) and one focusing on facial micro expressions. Sixty-seven subjects were randomized to one of two experimental groups (multimodal, micro expression) or an active control group (emotional working memory task). Participants trained once weekly with a brief computerized training program for three consecutive weeks. Pre-post outcome measures consisted of a multimodal ERA task, a micro expression recognition task, and a task about patients' emotional cues. Post measurement took place approximately a week after the last training session. Non-parametric mixed analyses of variance using the Aligned Rank Transform were used to evaluate the effectiveness of the training programs. Results showed that multimodal training was significantly more effective in improving multimodal ERA compared to micro expression training or the control training; and the micro expression training was significantly more effective in improving micro expression ERA compared to the other two training conditions. Both pre-post effects can be interpreted as large. No group differences were found for the outcome measure about recognizing patients' emotion cues. There were no transfer effects of the training programs, meaning that participants only improved significantly for the specific facet of ERA that they had trained on. Further, low baseline ERA was associated with larger ERA improvements. Results are discussed with regard to methodological and conceptual aspects, and practical implications and future directions are explored.

Olfactory impairment is a central non-motor symptom in Parkinson's disease (PD). Previous studies have demonstrated that olfactory dysfunction is associated with mental illness and impaired cognition. The frequently investigated olfactory functions are odor detection, discrimination, and identification. However, few studies have focused on odor recognition memory (ORM). ORM tasks involves episodic memory which therefore can facilitate the detection of dementia among patients with PD and consequently adjust their treatment. Thus, the aim of this systematic review is to summarize the existing research on ORM in PD. Databases and reference lists were used for data collection. Studies were included in the review if they met the eligibility criteria derived from the PICOS-framework. Quality evaluation of the studies was based on the STROBE-statement. Six studies with small samples were included in the analysis which demonstrated the scarce research on the subject. The studies targeting ORM were heterogenous and involved two main tasks: odor recognition and odor matching. The synthesis of the data demonstrated that PD patients performed significantly lower than controls on both tasks, especially on odor matching task. Only the odor recognition task exhibited a difference between patients with PD vs. Alzheimer's disease (AD). PD patients performed significantly better than AD patients. The findings based on the available limited data support the notion that odor recognition task can be of importance in identifying Parkinson's disease dementia (PDD). To investigate this hypothesis, future research needs to include larger samples of PD, PDD and AD patients executing the same odor recognition task.

Research suggests that the electrophysiological correlates of consciousness are similar in hearing as in vision: the auditory awareness negativity (AAN) and the late positivity (LP). However, from a recently proposed signal-detection perspective, these correlates may be confounded by performance, as the strength of the internal responses differs between aware and unaware trials. Here, we tried to apply this signal-detection approach to correct for performance in an auditory discrimination and detection task (N = 28). A large proportion of subjects had to be excluded because even a small response bias distorted the correction. For the remaining subjects, the correction mainly increased noise in the measurement. Furthermore, the signal-detection approach is theoretically problematic because it may isolate post-perceptual processes and eliminate awareness-related activity. Therefore, we conclude that AAN and LP are not confounded by performance and that the contrastive analysis identifies both as correlates of awareness.

Theories disagree as to whether it is the early or the late neural correlate of awareness that plays a critical role in phenomenal awareness. According to recurrent processing theory, early activity in primary sensory areas corresponds closely to phenomenal awareness. In support, research with electroencephalography found that in the visual and somatosensory modality, an early neural correlate of awareness is contralateral to the perceived side of stimulation. Thus, early activity is sensitive to the perceived side of visual and somatosensory stimulation. Critically, it is unresolved whether this is true also for hearing. In the present study (N = 26 students), Bayesian analyses showed that the early neural correlate of awareness (auditory awareness negativity, AAN) was stronger for contralateral than ipsilateral electrodes whereas the late correlate of auditory awareness (late positivity, LP) was not lateralized. These findings demonstrate that the early but not the late neural correlate of auditory awareness reflects lateralized experiences. Thus, these findings imply that AAN is a more suitable NCC than LP because it correlates more closely with lateralized experiences.