Frontiers in Neuroscience最新文献

Objective: To explore the clinical features and treatment approaches for leukoencephalopathy with calcifications and cysts (LCC).

Methods: We retrospectively analyzed a 22-year-old male patient with genetically confirmed LCC admitted to Qingdao University Affiliated Hospital in April 2019. The patient's clinical presentation, imaging characteristics, treatment course, and outcomes were summarized alongside a comprehensive literature review.

Results: The patient underwent resection of bilateral frontal lobe cysts followed later by resection of a parietal lobe cyst. Postoperative pathology confirmed LCC with calcification and cystic changes. No severe postoperative complications occurred. Follow-up imaging demonstrated gradual cyst regression and symptom resolution. Genetic testing identified heterozygous SNORD118 variants (n.3C>T and n.74G>A).

Conclusion: Surgical resection is an effective treatment for LCC cysts causing significant mass effect or neurological deficits, requiring regular follow-up. For smaller, asymptomatic cysts without mass effect, treatment with VEGF inhibitors (e.g., bevacizumab) may be beneficial. Management should be individualized.

Objective: To examine prefrontal hemodynamic changes in patients with post-stroke anxiety (PSA), both at rest and during cognitive task engagement, with the aim of elucidating the underlying neural mechanisms of PSA and identifying potential neural correlates for clinical application.

Methods: Fifty patients with PSA and 45 post-stroke patients without anxiety symptoms were recruited. PSA was diagnosed using the Hamilton Anxiety Rating Scale (HAMA ≥ 7), and comorbid depression was screened using the 17-item Hamilton Depression Rating Scale (HAMD-17 ≥ 8). Patients with significant cognitive impairment were excluded. Functional near-infrared spectroscopy (fNIRS) was used to measure resting-state functional connectivity in the frontopolar cortex (FPC) and dorsolateral prefrontal cortex (DLPFC), as well as task-evoked activation during the verbal fluency task (VFT). Demographic and clinical characteristics showed no significant differences between groups except for stroke type. Between-group comparisons were conducted to identify PSA-related differences in prefrontal network characteristics. Subgroup analyses were performed to explore the influence of comorbid depression on neural alterations.

Results: There were no significant differences between the PSA and non-PSA groups in demographic or clinical characteristics, including age, sex, and disease duration (P > 0.05). Compared to the non-PSA group, patients with PSA exhibited significantly reduced activation in the bilateral FPC during the VFT (P < 0.05). Within the PSA group, those with comorbid depression showed further reductions in activation in the bilateral FPC and the left DLPFC (P < 0.05). No significant differences in resting-state functional connectivity were observed between groups (P > 0.05).

Conclusion: Reduced activation in the bilateral FPC may represent a key neural substrate associated with post-stroke anxiety. In addition, altered activation patterns in the bilateral FPC and left DLPFC may reflect neural correlates related to depressive symptoms in patients with PSA, providing candidate targets for future mechanistic and clinical studies.

Each year, approximately 2.9 million people in the United States sustain a traumatic brain injury (TBI), many of whom go on to experience chronic secondary complications such as post-traumatic epilepsy (PTE) and sleep-wake disturbances. These outcomes arise from complex secondary injury processes, including neuroinflammation, oxidative stress, and disruptions in neuroendocrine signaling. While inflammatory and excitotoxic mechanisms have been extensively studied, growing evidence highlights sex hormone dysregulation-particularly involving estrogen, progesterone, and testosterone-as an important yet underrecognized contributor to post-TBI physiology. Clinical and preclinical studies indicate that TBI can alter systemic and brain-derived hormone levels, influencing neuroinflammation, glial activation, neuronal survival, and synaptic plasticity. These hormone-related changes have been associated with altered seizure susceptibility and disrupted sleep architecture, suggesting that sex hormone dysregulation may represent one interacting pathway influencing both outcomes. Additionally, the bidirectional relationship between epilepsy and sleep-where seizures disrupt sleep architecture and sleep loss increases cortical excitability-may further compound vulnerability after TBI. Given the heterogeneity of injury mechanisms and hormonal responses across individuals, these relationships remain incompletely understood but biologically plausible. This narrative review examines how TBI-related alterations in estrogen, progesterone, and testosterone may intersect with sleep regulation and seizure susceptibility. We summarize their physiological roles in the brain, evaluate how post-injury disruptions may shape chronic outcomes, and highlight how early identification of hormonal abnormalities could inform future research on therapeutic strategies. By addressing this understudied interface between endocrine, neural, and behavioral dysfunction, we aim to advance understanding of modifiable pathways that may contribute to long-term morbidity after TBI.

Background: Impaired attention is a key feature of HIV-associated brain damage, and people living with HIV (PLWH) often have potential visual-auditory perceptual deficits. This study aimed to explore functional alterations in divided attention in PLWH using a parallel audio-visual spatiotemporal task with multimodal functional magnetic resonance imaging (fMRI) and to explore candidate neuroimaging markers of HIV-related attention impairment.

Methods: Thirty-one cognitively unimpaired PLWH and 34 healthy controls (HC) completed a divided attention task during fMRI via a modified Posner paradigm. Behavioral performance and task-related brain activation were compared between the two groups. Seed-based whole-brain functional connectivity (FC) maps were computed in resting-state fMRI (rs-fMRI) using a priori anatomical regions of interest (ROIs) from the audiovisual attention network, defined based on previous independent fMRI studies employing similar spatial-temporal attention paradigms.

Results: The PLWH showed lower accuracy than HC. Task-related brain activation was more extensive in PLWH, including increased activation in occipital/temporal lobes, plus frontal/parietal lobes, insula, and limbic system. Using a priori anatomical regions of interest from the audiovisual attention network as seeds, PLWH exhibited increased resting-state FC between these frontal-parietal-temporal-insular regions and bilateral posterior cerebellar lobules VIII-IX, as well as with multimodal associative cortices. Within the PLWH group, percent BOLD signal change showed significant positive correlations with HIV infection duration in a subset of task-difference ROIs-7 regions identified under spatial cueing and 13 regions identified under temporal cueing.

Conclusion: The HIV impairs audio-visual divided attention, with fMRI revealing neural alterations in cognitively unimpaired PLWH. These findings suggest that task-related activation patterns and resting-state connectivity measures may serve as sensitive candidate markers of HIV-related brain involvement and help identify individuals at increased risk of cognitive decline, although longitudinal studies are needed to establish their prognostic value.

The global rise in non-communicable diseases, alongside an aging population, is expected to increase the prevalence of motor impairments and, therefore, the need for assistive care. Upper limb impairments can significantly affect independent living and increase long-term care costs. Wearable assistive devices incorporating electrical stimulation (ES) offer a promising solution to support independence and help alleviate pressures on both formal and informal care provision. The development of hybrid systems, which integrate aspects of robotics and electrical stimulation, aim to overcome the limitations associated with single-modality devices. However, there is limited information on the most appropriate electrical stimulation protocols to use, or on what challenges may be faced in doing so. Correspondingly, this narrative review addresses this gap through assessing the role of electrical stimulation in upper limb assistive technology. By evaluating user requirements and identifying challenges with current stimulation strategies, this review highlights the potential benefits of exploring alternative protocols, beyond conventional functional electrical stimulation (FES) techniques, for upper limb assistance. In particular, addressing practical difficulties of stimulation is likely to be critical for successful user uptake and minimizing device abandonment. The paper subsequently reviews several stimulation strategies which may offer novel research directions and opportunities in the development of upper limb assistive technologies.

Background: Social cognition impairments-including difficulties in recognizing personally familiar faces-occur early in mild cognitive impairment (MCI) and can lead to social withdrawal, reduced motivation, and secondary depression. Face recognition is central to social cognition, yet its neural basis in MCI remains insufficiently understood. This study examined whether task-based fMRI during famous face recognition could capture early alterations in the parahippocampal gyrus (PHG) and posterior cingulate cortex (PCC), key nodes supporting semantic access and internally directed cognition within the default mode network (DMN).

Methods: Thirty-two participants (20 healthy controls, 12 MCI) completed two fMRI tasks: famous vs. non-famous face judgment and face vs. object categorization. A 2 × 2 factorial analysis assessed Group and Task effects, and small-volume correction was applied to PHG and PCC.

Results: Behavioral accuracy was comparable between groups; however, whole-brain analyses revealed markedly reduced activation in the left PHG and PCC in the MCI group during socially meaningful face processing. ROI analyses further demonstrated that the left PHG reduction remained significant after FWE correction, whereas PCC showed a weaker reduction that did not survive correction for multiple comparisons.

Conclusion: These findings suggest early alterations in PHG-PCC networks that precede observable behavioral decline in MCI. In particular, reduced activation in the left PHG may reflect early disruptions in semantic access and internally directed processing. Assessing these socially relevant neural circuits alongside established amyloid and tau biomarkers may provide complementary functional insight into early cognitive vulnerability in individuals at risk for dementia.

Substance use disorder (SUD) is a major worldwide health problem with a historic global high of 316 million people using drugs, representing a 15% rise in prevalence over the previous decade. A comprehensive understanding of the pathophysiology of SUD will enable the development of novel therapeutic strategies to improve patient outcomes. Preclinical research on the neurobiology of SUD primarily focuses on the immediate monoaminergic systems response, changes in gene expression, and long-term maladaptive synaptic and circuit-level alterations as the key pathophysiological mechanisms. A few recent publications point to a novel role for the proteostatic process, autophagy, in the rewarding and stimulant effects in animal models of SUD. In this minireview, we summarize the key findings of these reports and discuss potential future directions. These emerging roles expand our understanding of autophagy in the nervous system-from a housekeeping recycling process to a multifunctional regulator of signal transduction, neurotransmission, and behavior-and suggest that autophagy may be a novel therapeutic target in SUD.

Objective: To investigate the levels of early postoperative post-traumatic stress disorder (PTSD) and their association with serum inflammatory factors in patients undergoing digit replantation, and to analyze the influencing factors.

Methods: A total of 96 patients who underwent digit replantation at Rizhao People's Hospital between March 2022 and December 2024 were enrolled 7 days postoperatively. PTSD levels were assessed using the PTSD Checklist-Civilian Version (PCL-C). Morning fasting blood samples were collected, and serum levels of interferon-γ (IFN-γ), tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-6, and IL-10 were measured by ELISA. Data were analyzed using univariate analysis, Spearman's correlation, multiple linear regression, and Receiver Operating Characteristic (ROC) curve analysis.

Results: The mean PCL-C score for the 96 patients was 38.21 ± 9.31, with 44 patients (45.83%) presenting PTSD symptoms. Univariate analysis revealed that gender, education level, injury type, complete amputation, involvement of the dominant hand, and number of amputated digits significantly influenced PCL-C scores (p < 0.05). PCL-C scores showed positive correlations with both anxiety and depression scores (r = 0.285 and 0.679, respectively, p < 0.01). Multiple linear regression identified gender, education level, complete amputation, number of injured digits, and levels of anxiety and depression as independent influencing factors for PTSD (p < 0.05). Correlation analysis indicated that PCL-C scores were positively correlated with IFN-γ, TNF-α, IL-1β, and IL-6 levels (r = 0.581, 0.521, 0.552, and 0.507, respectively), and negatively correlated with IL-10 (r = -0.474, p < 0.01). ROC curve analysis suggested that serum inflammatory factors have good predictive value for PTSD.

Conclusion: Patients exhibit a certain degree of PTSD in the early stage after digit replantation. Its occurrence is closely associated with female gender, lower education level, severity of the trauma, and co-morbid anxiety and depression, and is significantly correlated with an imbalance between pro-inflammatory and anti-inflammatory serum factors. Serum inflammatory factors may serve as potential biological markers for the early identification of PTSD risk.

Introduction: Generative mechanisms of perception such as predictive coding are used to explain how the brain perceives the world; such mechanisms are often experimentally probed using "deviant" stimuli that violate established patterns (including mismatch negativity), which also elicit responses related to lower-level processes such as stimulus-specific adaptation. However, little is still known about brain responses that indicate the strength of sensory predictions or reinforcement of sensory representations. Repetition positivity (RP) is a positive polarity evoked potential that gradually increases with each repetition of a stimulus, and is thought to reflect progressive strengthening of auditory sensory memory and/or habituation to repetitive stimuli. The aim of this study was to compare RP that follows a change in stimulus frequency with that following a change in stimulus intensity, the latter having not previously been studied.

Methods: We used roving sequences of isochronous 5 kHz pure tones (300 ms duration, 300ms inter-stimulus interval), which changed in frequency by 1 kHz (Experiment 1) or in intensity by 12 dB (Experiment 2) after every 30 stimuli. All changes were roving, such that an increase would be followed by a decrease, and vice versa.

Results: Event-related potentials recorded with EEG indicated that frequency changes in either direction were followed by RP, whilst only intensity increases were followed by RP, and only a weak visual trend toward RP was apparent for intensity decreases. Observed RP was best explained by a logarithmic function over successive stimuli.

Conclusions: RP robustly follows increases, but not necessarily decreases, in stimulus intensity, which appears smaller in amplitude than that elicited by similarly salient frequency changes, and reaches a plateau sooner. These observations offer insight into how intensity is processed similarly yet differently to other sensory attributes in an adaptive or predictive coding framework, and might have future utility in the study of clinical conditions related to aberrant predictive mechanisms.