Neurological Research最新文献

Objectives: This study explored whether dexmedetomidine (DEX) can promote functional restoration following spinal cord injury (SCI) through the PKR-like endoplasmic reticulum kinase (PERK)/activating transcription factor 4 (ATF4) pathway.

Methods: A rat T10 SCI model was established with 5 groups including sham, SCI, PERK agonist, DEX, and DEX + PERK agonist. The protective role of the PERK/ATF4 pathway in DEX was investigated by comparing autophagy, inflammatory cytokines, and neurological function recovery in each group.

Results: Seven days after the surgical procedure, DEX administration facilitated neurological recovery by activating autophagy and restraining inflammatory cytokines through the PERK/ATF4 pathway.

Conclusion: The PERK signaling may be associated with DEX-mediated neuroprotection, potentially involving the induction of autophagy and suppression of inflammation.

Objective: This study evaluated the impact of a specialized dementia nursing program on cognitive function, self-care ability, psychological status, and quality of life in patients with Alzheimer's disease (AD).

Methods: Data from 131 AD patients admitted to our hospital between January 2019 and August 2021 were analyzed. Based on the nursing method, the patients were divided into a control group that received routine nursing care (n = 58) and an intervention group that implemented routine nursing care combined with specialized nursing (n = 73). Psychological status, daily living and self-care ability, cognitive function, quality of life, and nursing satisfaction were compared between the two groups.

Results: After specialized nursing, the intervention group showed significantly greater reductions in HAMA and HAMD scores and greater increases in CD - RISC, ADL, and ESCA scores compared with the control group (p < 0.05). The intervention group also had higher MMSE, ADCS - ADL, and DQOL scores and lower ADAS - Cog scores compared to the control group (p < 0.05). Nursing satisfaction was also higher in the intervention group than in the control group (p < 0.05).

Conclusion: Specialized dementia nursing can enhance cognitive function, self-care ability, psychological resilience, and quality of life in AD patients, and increases satisfaction with nursing care.

Objective: Cerebral microbleeds (CMBs) represent a key imaging marker of cerebral small vessel disease (CSVD). This study aimed to investigate the relationship between CMB burden and domain-specific cognitive impairment in acute stroke patients.

Methods: We enrolled 163 acute stroke patients stratified by Montreal Cognitive Assessment (MoCA) scores into cognitively impaired (MoCA ≤22, n = 79) and preserved (MoCA > 22, n = 84) groups. Demographic, clinical, laboratory, and neuroimaging data were collected. Multivariable logistic regression was used to identify factors associated with global cognitive impairment, while linear regression models were applied to evaluate the associations between CMB burden and specific cognitive domains.

Results: Patients with cognitive impairment were older, less educated, and exhibited a higher CSVD burden (all p < 0.05). In multivariate analyses, only age was independently associated with global cognitive impairment (OR = 1.082, p = 0.002). However, linear regression revealed that total CMB number was inversely correlated with visuospatial/executive function (β = -0.156) and memory recall (β = -0.201) after adjustment for confounding factors. Location-specific analysis demonstrated that mixed CMBs (involving both lobar and deep regions) were independently associated with visuospatial/executive deficits (β = -0.255), while deep CMBs specifically impacted abstract reasoning (β = -0.220).

Conclusion: CMB burden, particularly mixed and deep distributions, is independently associated with specific cognitive domain impairments in acute stroke patients, highlighting the importance of CMB assessment for cognitive risk stratification.

Introduction: Neuromyelitis optica spectrum disorders (NMOSD) are rare antibody-mediated disorders of the central nervous system with a predilection for the spinal cord and optic nerves.

Objective: Our objective is to evaluate the dorsolemniscal system using the somatosensory evoked potential, specifically the registration of the N20 and P40 waves.

Methods: The Somatosensory evoked potentials (SSEP) were prospectively performed in 13 patients with NMOSD. All the patients were recruited from the outpatient clinic of a demyelinating diseases center from Southern Brazil.

Results: We evaluated 12 female with mean age of 42 years-old and one man of 25 years-old. When categorized in relation to the variable SSEP (Normal vs. Abnormal), there was a statistical difference in relation to N20, N21 and P40 latencies.

Conclusion: SSEP showed a significant increase in N20 and P40 latencies. SSEP is a non-invasive, painless, fast and low-cost exam which provides neurophysiological data for diagnosis of NMOSD.

Background: Deep brain stimulation (DBS) neurofeedback enables Parkinson's disease (PD) patients to voluntarily control pathological subthalamic beta-oscillations. While neurofeedback has shown promise in improving motor performance, the clinical factors that influence individual modulation capacity remain unclear.

Methods: We retrospectively analysed 26 PD patients from three previously published deep DBS-neurofeedback cohorts. Participants were classified as cognitively normal (MoCA score ≥26) or cognitively impaired ( < 26) based on their preoperative scores. Neurofeedback performance was quantified as the percentage reduction in subthalamic beta-peak power during the final training round compared to baseline, z-normalised within each cohort. Group comparisons were conducted using t-tests and non-parametric tests. Correlations and stepwise linear regression were employed to examine associations between neurofeedback performance and clinical variables, including MoCA, age, Hoehn and Yahr stage, levodopa equivalent dose, and MDS-UPDRS scores.

Results: Participants with cognitive impairment (n = 9) showed significantly better neurofeedback performance compared to cognitively normal participants (p = 0.0108). Additionally, a negative correlation was found between MoCA scores and neurofeedback capacity. Stepwise regression revealed that MoCA was the sole significant predictor of performance (, p = 0.0032), while age, motor symptom severity, and medication status did not contribute independently.

Conclusions: Cognitive impairment in PD is associated with enhanced modulation of subthalamic beta-oscillations during DBS-neurofeedback. This finding challenges the assumption that preserved cognition is necessary for effective neurofeedback, suggesting that compensatory or disease-related network dynamics may underpin modulation capacity. Future studies should investigate mechanistic explanations and assess whether stratifying patients by cognitive status can optimise personalised neuromodulation strategies.

Objective: To compare the outcomes of flow diversion treatment with Pipeline Embolization Device (PED) and Tubridge Flow Diverter (TFD) in unruptured intracranial aneurysms.

Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. The primary outcome was complete aneurysm occlusion. Secondary outcomes included favorable functional outcomes (modified Rankin Scale 0-2), perioperative ischemic and hemorrhagic complications, and in-stent stenosis. Risk ratios (RR) with 95% confidence intervals (CI) were pooled using the Mantel-Haenszel method under a random-effects model. Heterogeneity was assessed using the I² statistic. Statistical analyses were performed using R software (version 4.4.0).

Results: Four studies including 913 patients were analyzed; 462 underwent treatment with TFD and 451 with PED. Complete aneurysm occlusion was achieved in 75.96% of TFD cases and 81.64% of PED cases (RR: 0.93; 95% CI: 0.87-1.00; I² = 0%). Favorable functional outcomes occurred in 97.07% (TFD) and 96.84% (PED) (RR: 1.00; 95% CI: 0.98-1.02; I² = 0%). Ischemic complications were slightly higher in TFD (4.11%) than in PED (2.44%) (RR: 1.67; 95% CI: 0.39-7.10; I² = 53.7%). Hemorrhagic complications were low in both groups (0.26% vs. 0.54%; RR: 0.55; 95% CI: 0.07-4.39; I² = 0%). In-stent stenosis occurred in 15.06% (TFD) and 16.08% (PED) (RR: 0.94; 95% CI: 0.66-1.33; I² = 0%).

Conclusion: PED and TFD demonstrate comparable efficacy and safety profiles for the treatment of unruptured intracranial aneurysms. Both devices are effective options for endovascular therapy.

Objective: Previous studies evaluating central auditory processing in migraine have used conventional tests, but the findings have remained inconsistent. This study aimed to assess the central auditory abilities of individuals with migraine using the Intensity Discrimination Test (IDT), Frequency Discrimination Test (FDT), Modulation Detection Test (MDT), and Temporal Fine Structure - Adaptive Frequency (TFS-AF) test, and to compare the results with those of healthy controls.

Methods: The study comprised 40 migraine sufferers and 30 healthy people (control group). The 24-hour Migraine Quality of Life Questionnaire and the Migraine Disability Assessment were given, and migraine features were noted. Temporal auditory processing was assessed using the TFS-AF and MDT, whereas suprathreshold frequency and intensity discrimination abilities were evaluated using the FDT and IDT.

Results: The migraine group exhibited significantly lower TFS-AF thresholds and significantly higher FDT thresholds compared with the control group (p < 0.05). On the other hand, MDT and IDT thresholds did not significantly differ across the groups (p > 0.05). Aura and phonophobia status had no significant effect on TFS-AF, MDT, IDT, or FDT performance (p > 0.05). Moderate correlations were observed between migraine severity and both FDT and MDT thresholds, as well as between attack frequency and TFS-AF thresholds (p < 0.05).

Conclusion: Migraine was found to impair CAP abilities, particularly TFS, while aura and phonophobia had no significant effect. Reduced TFS ability in individuals with migraine may lead to difficulties in understanding speech in noisy environments and problems with sound localization. Early auditory rehabilitation may help improve CAP abilities and quality of life in these individuals.

Aims: To investigate the neural mechanisms underlying the decline in alert attention performance following sleep deprivation (SD) using functional connectivity and graph theoretical analysis and identify potential intervention targets.

Methods: A total of 44 participants underwent resting-state fMRI scans and psychomotor vigilance task (PVT) assessments under normal sleep (RW) and 30 h of SD conditions. Brain networks were constructed within a graph theoretical framework, and functional connectivity between networks as well as regional nodal properties, including degree and efficiency, were analyzed.

Results: Compared to the RW state, SD led to a significant deterioration in PVT performance, evidenced by increased reaction time (p = 0.0012) and lapse frequency (p = 5.13e^-5). Neuroimaging results revealed a complex pattern of FC alterations, including increased connectivity between the dorsal attention network (DAN) and default mode network (DMN) but decreased connectivity within the visual network post-SD. Crucially, we identified a significantly attenuated FC between the visual network and the DAN, specifically between the medio-ventral occipital cortex (MVOcC) and DAN regions (e.g., precentral gyrus, inferior parietal lobule, and fusiform gyrus). The strength of these specific inter-network connections was negatively correlated with increased PVT lapses. Furthermore, graph theory analysis demonstrated that SD significantly reduced the nodal degree and efficiency of the bilateral MVOcC, and these reductions were also negatively correlated with impaired PVT performance.

Conclusion: Our findings identify the MVOcC as a critical vulnerability hub where disrupted inter-network connectivity (DAN-Visual) and diminished regional topological organization contribute to SD-induced alert attention deficits, highlighting its potential as a target for interventions.

Objectives: Vagus nerve stimulation (VNS) is increasingly recognized as a therapeutic approach for neurological disorders, such as epilepsy, migraine, and stroke rehabilitation. However, clinical outcomes vary considerably among individuals, underscoring the importance of elucidating the distinct effects of left versus right VNS. In this study, we aimed to investigate how lateralized VNS influences cortical spreading depression (CSD) in mice.

Materials and methods: Left or right VNS and sciatic nerve stimulation (SNS) were delivered directly by electrodes placed around the vagus or sciatic nerve. CSD was induced by both near-threshold (0.125 M) and supra-threshold (1 M) KCl, and hemispheric responses were assessed in 64 mice. A custom-built intrinsic optical signal (IOS) imaging system integrated with artificial intelligence algorithms was utilized to record and analyze the CSD.

Results: Notably, VNS significantly reduced the incidence and slowed CSD propagation at 0.125 M KCl, whereas only minimal effects were observed at 1 M KCl, suggesting that VNS efficacy may depend on the cortical excitability threshold. Right VNS effectively decreased CSD occurrence in the ipsilateral hemisphere, whereas left VNS selectively slowed propagation in the contralateral hemisphere. Additionally, left SNS exerted a modest yet significant reduction in CSD within the left hemisphere, reinforcing the importance of stimulation modality and site. Furthermore, reduced c-Fos expression following VNS, particularly within the stimulated hemisphere, indicates a dampened state of neuronal excitability, thereby supporting the hemisphere-specific neuromodulatory potential of VNS.

Conclusion: These findings indicate that lateralized VNS may enable more precise, patient-specific interventions in neurological conditions characterized by cortical hyperexcitability.