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Objective Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) frequently represents the prodromal stage of alpha-synucleinopathies, and similar to these pathologies, iRBD patients show neuropsychological deficits, particularly in the domain of visuospatial abilities and executive functions. We hypothesized that the qualitative scoring of the Mini-Mental State Examination pentagon test (QSPT) may detect subtle visuospatial deficits in these subjects, and we evaluated its relationship with indexes of sleep quality, as measured by polysomnography. Methods A total of 80 polysomnography-confirmed iRBD patients and 40 healthy controls (HCs) were retrospectively recruited. Global and specific qualitative performances were evaluated according to QSPT procedure. Comparisons between iRBD and HC regarding all QSPT parameters, neuropsychological tests, and polysomnographic recordings were performed. Results Patients displayed significantly lower scores in both “closing-in” and total score parameters in comparison to HC. The QSPT total score exhibited significant positive correlations with verbal comprehension, fluency, visuospatial abilities, and executive functions. Notably, iRBD patients with impaired performance at QSPT showed decreased neuropsychological performances and higher percentages of slow wave sleep (SWS). In addition, SWS percentages negatively correlated with verbal comprehension, fluency, visuospatial abilities, executive functions, and QSPT total score. Conclusion QSPT may represent a brief and easy to administer tool for the detection of subtle visuospatial changes in iRBD patients. Furthermore, polysomnographic findings suggest a possible slowdown of electroencephalographic pattern during non-REM sleep in iRBD patients in line with the presence of cognitive decline.

Microalgae, because of their high nutritional value and bioactive molecule content, are interesting candidates for functional foods, including fermented foods, in which the beneficial effects of probiotic bacteria combine with those of biomolecules lying in microalgal biomass. The aim of this work was to evaluate the potential of Tisochrysis lutea F&M-M36 as a substrate for Lactiplantibacillus plantarum ATCC 8014 and to verify fermentation effects on functionality. Bacterium selection among three lactobacilli was based on growth and resistance to in vitro digestion. Microalgal raw biomass and its digested residue were fermented in two matrixes, water and diluted organic medium, and analysed for biochemical composition and antioxidant activity along with their unfermented counterparts. Bacterial survivability to digestion and raw biomass digestibility after fermentation were also evaluated. Fucoxanthin was strongly reduced (>90%) in post-digestion residue, suggesting high bioavailability. Raw biomass in diluted organic medium gave the highest bacterial growth (8.5 logCFU mL−1) and organic acid production (5 mg L−1), while bacterial survivability to digestion (<3%) did not improve. After fermentation, the antioxidant activity of lipophilic extracts increased (>90%). Fermentation appears an interesting process to obtain T. lutea-based functional foods, although further investigations are needed to optimize bacterial growth and fully evaluate its effects on functionality and organoleptic features.

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