Progress in brain research最新文献

The ability to reduce sensory uncertainty by integrating information across different senses develops late in humans and depends on cross-modal, sensory experience during childhood and adolescence. While the dependence of audio-haptic integration on vision suggests cross-modal neural reorganization, evidence for such changes is lacking. Furthermore, little is known about the neural processes underlying audio-haptic integration even in sighted adults. Here, we examined electrophysiological correlates of audio-haptic integration in sighted adults (n = 29), non-sighted adults (n = 7), and sighted adolescents (n = 12) using a data-driven electrical neuroimaging approach. In sighted adults, optimal integration performance was predicted by topographical and super-additive strength modulations around 205-285 ms. Data from four individuals who went blind before the age of 8-9 years suggests that they achieved optimal integration via different, sub-additive mechanisms at earlier processing stages. Sighted adolescents showed no robust multisensory modulations. Late-blind adults, who did not show behavioral benefits of integration, demonstrated modulations at early latencies. Our findings suggest a critical period for the development of optimal audio-haptic integration dependent on visual experience around the late childhood and early adolescence.

Multiple studies have shown that vision impairment impacts adults' well-being, mental health, and sleep. However, little attention has been given to these areas in children and young people with vision impairment. This narrative review explores the relationship between vision impairment, well-being, mental ill-health, and sleep in children and young people with vision impairment. Studies examined include children and young people with all levels of vision impairment and those with congenital or acquired vision loss. The evidence suggests that vision impairment affects children's and young people's well-being and mental health with particular links to anxiety, depression, and PTSD. Theoretical mechanisms include low self-esteem affecting mental health and well-being, and loneliness reducing well-being. The efficacy of social and psychological interventions on the mental health of children and young people with vision impairment were reviewed. Psychological therapies, sports, exercise, music, art, and relaxation have all been found to have positive impacts. Gaps in existing knowledge are highlighted, and suggestions are made for future research in this important and under-researched area.

Digital health technologies, including patient portals, wearables, telemedicine, and AI-driven tools, are transforming patient-centered care (PCC) by improving engagement, self-management, and accessibility. Integrated personal health records (PHRs) enhance data sharing, adherence, and chronic disease management, yet challenges like interoperability, privacy, and the digital divide remain. Emerging innovations-AI chatbots, digital therapeutics, and intelligent digital twins (IDTs)-leverage IoT and machine learning to enable predictive, personalized care. For example, IDTs combine wearable and EHR data to simulate real-time health states, optimizing interventions for conditions like heart failure. Similarly, text-based therapy and CBT apps offer scalable mental health support with efficacy comparable to traditional methods. Despite their potential, barriers such as algorithmic bias, health literacy gaps, and inadequate co-design hinder equitable adoption. Participatory approaches involving patients and providers are essential to developing inclusive, user-centered solutions. Future research must prioritize rigorous, evidence-based evaluations to ensure scalability, security, and long-term effectiveness. By addressing these challenges, digital health can fulfill its promise of accessible, high-quality PCC.

Stress, a common life experience, impacts both mental and physical health, contributing to conditions such as anxiety and cardiovascular disease. It triggers physiological and psychological responses, primarily through the Hypothalamic-Pituitary-Adrenal (HPA) and Sympathetic-Adrenal-Medullary (SAM) axes, which are coordinated by the autonomic nervous system. Dysregulation of the glucocorticoid system, mediated by mineralocorticoid and glucocorticoid receptors, plays a critical role in neurodegenerative disorders like Alzheimer's disease. Cellular pathways like PI3K/Akt, NF-κB, and AP-1 transcription factors maintain homeostasis during stress and are targets for therapeutic research. Epigenetic influences and genomic modifications highlight the long-lasting effects of stress on gene expression. Adaptive responses, such as allostasis, allow the body to maintain stability amid stress. However, excessive stress leads to allostatic load, negatively impacting the immune, endocrine, and nervous systems. Current treatments include pharmacological and lifestyle interventions, with emerging approaches such as psychobiotics and precision medicine offering future potential.

Stress is a significant determinant for a range of neurological and psychiatric illnesses, and comprehending its influence on the brain is vital for developing effective interventions. Caenorhabditis elegans (C. elegans), a tiny nematode, has become a potent model system for investigating the impact of stress on neuronal integrity, behavior, and lifespan. This chapter presents a comprehensive summary of the existing understanding of stress-induced neurodegeneration, behavioral abnormalities, and changes in lifespan in C. elegans. We explored the stress response pathways in C. elegans, specifically focusing on the heat shock response and insulin-like signaling (ILS) pathway, targeting how these pathways affect neural integrity and functions. Additionally, this chapter highlighted behavioral modifications such as changes in locomotion, feeding, pharyngeal pumping, defecation, and copulation behaviors that occur in C. elegans following exposure to stressors, and how these findings contribute to our comprehension of stress-related illnesses. Furthermore, the evolutionary preservation of stress responses in both C. elegans and humans, underscoring the significance of C. elegans studies for translational research were highlighted. In conclusion, the possible implications of C. elegans research on human well-being, with a specific emphasis on the discovery of targets for treatment and the creation of innovative approaches to address stress-related conditions are discussed in this chapter.

Exercise has been central to human brain evolution. Genus Homo was a nomadic species that constantly explored novel environments, which requires the encoding of new spatial and contextual patterns and the consolidation and recall of details to localize potential food and avoid danger, functions associated with the hippocampus. Interestingly, no primates other than humans run long distances over extended periods using aerobic metabolism, a capacity described as endurance running (ER). It has been hypothesized that ER capacity may have had relevant effects on the evolution of brain structure and cognition in the genus Homo. Paradoxically, modern humans have become sedentary and no longer need to run for food or survival. The lack of exercise in the population has increased the risk of brain disorders. Studies in human and animal models show that exercise elicits functional and structural changes throughout the brain, which may serve as a mechanism to counteract the changes induced by aging and reduced physical activity. Here, we describe the cortico-hippocampal circuitry and summarize evidence from human and animal models of aging-induced and exercise-induced changes in cortical and subcortical areas that provide polymodal information and modulatory inputs to the hippocampus, respectively. We discuss how exercise-induced plasticity in the cortico-hippocampal circuit may improve brain health.

Changes in energy homeostasis in aging have significant implications for brain health. Decreased glucose utilization efficiency, mitochondrial dysfunction, loss of metabolic flexibility, and increased oxidative stress can compromise cognitive functions and increase vulnerability to neurodegenerative diseases. Understanding these changes provides valuable insights for prevention and treatment strategies, such as dietary interventions, physical exercise, and pharmacological therapies, aimed at restoring or preserving energy homeostasis in the brain and thus improving cognitive health throughout life. This chapter explores the metabolic changes in the brain associated with aging, examining the underlying biochemical and molecular mechanisms, as well as therapeutic strategies that may alleviate the detrimental effects of brain aging.

Existential and spiritual suffering are frequently reported by individuals facing serious illnesses, particularly at the end of life, and are associated with diminished quality of life, increased psychological distress, and requests for hastened death. While Palliative Care (PC) aims to provide holistic support, existing therapeutic options often fail to adequately address the profound disruptions in meaning, connection, and dignity experienced by patients. Psychedelic-Assisted Therapies (PAT), notably those using psilocybin, have re-emerged as promising interventions capable of eliciting transformative experiences that may alleviate existential and spiritual distress. This chapter explores the potential role of PAT in PC, beginning with a historical and conceptual overview of PC and an analysis of existential and spiritual suffering in this context. It then reviews scientific evidence on the therapeutic applications of classical psychedelics, with a focus on existential and spiritual suffering. Practical, clinical, ethical, and legal considerations for the integration of PAT into PC are discussed, including the challenges of implementation and the need for spiritually and existentially informed treatment models. The chapter concludes by reinforcing the urgency of innovative and compassionate responses to existential suffering and highlighting PAT as an emerging pathway toward improving the quality of life-and death-of individuals with serious illnesses.

Psychedelic experiences, especially those induced by substances such as N,N-Dimethyltryptamine (DMT), are often characterized by high subjective intensity, complex visual content, and notable ineffability-that is, the difficulty of being fully expressed in words. This expressive limitation poses a significant challenge to the integration of the experience, which is essential for the therapeutic processing of these experiences. In this context, clinical studies with psychedelics are increasingly demanding innovative approaches to facilitate the assimilation of such experiences into daily life. Art, as a form of nonverbal expression, has been proposed as a promising tool in this regard. Accordingly, this article discusses the use of the mandala as a complementary expressive resource in the process of psychedelic integration, based on a Phase I clinical trial with DMT. The analysis draws on the mandalas and narratives produced by participants. The findings suggest that the creation of mandalas facilitated the symbolic expression of subjective content that was difficult to verbalize, supporting the integration process. Despite its potential, the use of expressive tools remains underexplored and unsystematized in current psychedelic clinical protocols. We concluded that the inclusion of art may represent a valuable advancement in optimizing the therapeutic benefits of psychedelics, expanding the understanding and meaning of experience.