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Feng W.,Tongji University | Li C.,Shanghai JiaoTong University | Chen Y.,Shanghai Yangpu District Mental Health Center | Cheng Y.,Tongji University | Wu W.,Tongji University
Shanghai Archives of Psychiatry | Year: 2014

Background: Cognitive training, a safe non-pharmacological intervention, may help mitigate cognitive decline and prevent the development of dementia in elderly individuals. Objective: Evaluate the long-term effects of cognitive training among healthy elderly community members. Methods: Healthy individuals 70 years of age or older from one urban community in Shanghai were screened and the 151 individuals who met inclusion criteria were assigned either to an intervention group (n=90) or a control group (n=61). The intervention involved twice-weekly training in reasoning, memory, and strategy that continued for 12 weeks (a total of 24 sessions). Participants were assessed at baseline and at 12 weeks, and 5 years after enrollment using the Chinese versions of the Neuropsychological Test Battery for Elderly persons (NTBE), the Stroop Color-Word Test, and a general health questionnaire. Results: Forty-nine (54%) intervention group subjects and 33 (54%) control group subjects completed the 5-year follow-up. There were few differences in the baseline neurocognitive measures of those who did and did not complete the 5-year follow-up, and there were few differences between those who dropped out of the intervention group compared to those who dropped out of the control group. At the 5-year follow-up, individuals in the intervention group performed better than those in the control group on only 5 measures (in the Trails Making A Test and the Cancellation Test 3) of the 61 measures assessed by NTBE and the Stroop tests, but none of these differences met the pre-determined required level of statistical significance (p=0.0008). Conclusion: We do not confirm the results of previous studies that report long-term benefits of brief cognitive training courses for elderly community residents. Our failure to identify differences in cognitive functioning five years after cognitive training is not likely due to differential dropout between the intervention and control groups but may be related to the relatively small sample and the large number of measures being assessed. Future intervention studies for cognitive training in the elderly should be hypothesis driven (i.e., focused on a single outcome measure of interest), use much larger samples, and include regular booster sessions as part of the cognitive training package. Source

Wu H.,Catholic University of Leuven | Van Dyck-Lippens P.J.,Catholic University of Leuven | Santegoeds R.,Catholic University of Leuven | Santegoeds R.,University Hospitals Leuven | And 10 more authors.
World Neurosurgery | Year: 2013

Objective: Anorexia nervosa (AN) is a complex and severe, sometimes life-threatening, psychiatric disorder with high relapse rates under standard treatment. After decades of brain-lesioning procedures offered as a last resort, deep-brain stimulation (DBS) has come under investigation in the last few years as a treatment option for severe and refractory AN. Methods and Results: In this jointly written article, Sun et al. (the Shanghai group) report an average of 65% increase in body weight in four severe and refractory patients with AN after they underwent the DBS procedure (average follow-up: 38 months). All patients weighed greater than 85% of expected body weight and thus no longer met the diagnostic criteria of AN at last follow-up. Nuttin et al. (the Leuven group) describe other clinical studies that provide evidence for the use of DBS for AN and further discuss patient selection criteria, target selection, and adverse event of this evolving therapy. Conclusion: Preliminary results from the Shanghai group and other clinical centers showed that the use of DBS to treat AN may be a valuable option for weight restoration in otherwise-refractory and life-threatening cases. The nature of this procedure, however, remains investigational and should not be viewed as a standard clinical treatment option. Further scientific investigation is essential to warrant the long-term efficacy and safety of DBS for AN. © 2013 Elsevier Inc. All rights reserved. Source

Feng W.,Tongji University | Yokoyama J.S.,University of California at San Francisco | Yu S.,Shanghai JiaoTong University | Chen Y.,Shanghai Yangpu District Mental Health Center | And 6 more authors.
Journal of Alzheimer's Disease | Year: 2015

Background: Cognitive training may contribute to the ability to maintain cognitive function in healthy elderly adults. Whether genotype modifies training effects remains unknown. Objective: Assess influence of APOE on cognitive function over time in community-dwelling elderly adults participating in multi-domain cognitive training. Methods: Healthy individuals ?70 years of age were screened from one urban community in Shanghai. 145 healthy Chinese older adults met inclusion criteria and were assigned to intervention (n = 88) or control (n = 57) groups. Multi-domain cognitive training involved 24 sessions of different content taking place over 12 weeks. Neuropsychological testing was administered at baseline, immediately after training, six months and twelve months post-intervention; composite measures of cognitive function were identified via factor analysis. Results: Three factors explained the majority of variance in function (verbal memory, processing speed, executive function). The intervention attenuated 12-month declines in processing speed, regardless of APOE genotype (p = 0.047). Executive function declined in APOE ε4 carriers over 12 months, regardless of intervention (p = 0.056). There was a significant interaction after 12 months where intervention ε4 carriers had better processing speed than ε4 controls (p = 0.003). Intervention ε2 carriers had better executive function immediately after training (p = 0.02) and had better verbal memory 6-months post-intervention (p = 0.04). These effects remained significant after false-discovery rate correction. Conclusion: Multi-domain cognitive training reduces declines in processing speed over time. APOE ε4 is associated with reductions in executive function over time, and training may attenuate ε4-associated declines in processing speed. APOE ε2 carriers may also benefit from training, particularly on measures of executive function and verbal memory. © 2015 - IOS Press and the authors. All rights reserved. Source

Wang J.,Shanghai Yangpu District Mental Health Center | Jiang H.-F.,Shanghai JiaoTong University | Du J.,Shanghai JiaoTong University | Dong A.-Z.,Shanghai Yangpu District Mental Health Center | And 7 more authors.
Journal of Shanghai Jiaotong University (Medical Science) | Year: 2015

Objective: To explore the effect of enhancing motivation (EM) of methadone maintenance treatment (MMT) clinic in Yangpu district of Shanghai. Methods: A total of 60 heroin dependents who recently underwent MMT were randomly divided into the control group (n=30) and intervention group (n=30). Patients of the intervention group underwent MMT and 12 weeks of EM and patients of the control group only underwent MMT. Results of MMT, morphine test, and addiction Severity Index (ASI) of two groups were compared. Results: The differences of average medication days (66 d versus 54 d) and number of negative urine tests (8.1 versus 6.2) between two groups were not statistically significant after 12 weeks of EM (P>0.05). But the professional and social supports, severity of drug use, alcohol addiction, and family/society relation of the intervention group were remarkably better than those of the control group during the 24 weeks of observation. Conclusion: The EM conducted in Yangpu district of Shanghai does not significantly improve the effect of MMT, but is helpful for improving the physical health and professional and social supports of heroin dependents, and decreasing the severity of drug use. © 2015, Editorial Department of Journal of Shanghai Second Medical University. All right reserved. Source

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