Journal of Neurorestoratology最新文献

The brain–computer interface (BCI) plays an important role in neural restoration. Current BCI systems generally require complex experimental preparation to perform well, but this time-consuming process may hinder their use in clinical applications. To explore the feasibility of simplifying the BCI system setup, a wearable BCI system based on the steady-state visual evoked potential (SSVEP) was developed and evaluated. Fifteen healthy participants were recruited to test the fast-setup system using dry and wet electrodes in a real-life scenario. In this study, the average system setup time for the dry electrode was 38.40 seconds and that for the wet electrode was 103.40 seconds, which are times appreciably shorter than those in previous BCI experiments, enabling a rapid setup of the BCI system. Although the electroencephalogram (EEG) signal quality was low in this fast-setup BCI experiment, the BCI system achieved an information transfer rate of 138.89 bits/min with an eight-channel wet electrode and an information transfer rate of 70.59 bits/min with an eight-channel dry electrode, showing that the overall performance was close to that in traditional experiments. In addition, the results suggest that the solutions of a multi-channel dry electrode or few-channel wet electrode may be suitable for the fast-setup SSEVP-BCI. This fast-setup SSVEP-BCI has the advantages of simple preparation and stable performance and is thus conducive to promoting the use of the BCI in clinical practice.

Background

Stroke is one of the leading causes of death and disability among adults worldwide, and severely impairs the quality of life of patients. Circulating adiponectin (APN) is an endogenous bioactive protein secreted by adipocytes that may have important value in predicting ischemic stroke. In the present study, we aimed to investigate the relationship between circulating APN levels and ischemic stroke.

Methods

The PubMed, Embase, Cochrane Library, and Chinese National Knowledge Infrastructure databases (CNKI) were systematically searched for articles on ‘‘circulating APN’’ and “stroke” published from inception to December 2023. Our analysis included peer-reviewed observational and clinical trial studies reporting odds ratios (OR) and 95% confidence intervals (CI) for ischemic stroke in relation to APN levels. The meta-analysis was performed using a random-effects model to account for between-study heterogeneity. Statistical analyses were performed in STATA 16.

Results

In our analysis, 13 studies and 22,714 individuals were included. There was a significant pooled OR of 1.163 (95% CI: 1.03 to 1.32), suggesting that higher circulating APN levels are associated with an increased risk of ischemic stroke. Furthermore, subgroup analysis indicated region-specific and study design-specific variations in the association between circulating APN levels and ischemic stroke risk. Egger's test revealed no significant publication bias among the included studies (p > 0.05).

Conclusions

Our meta-analysis results suggest that elevated APN levels are associated with an increased risk of ischemic stroke, and support the possible use of APN as a biomarker in stroke prevention strategies. Future research should focus on longitudinal studies and standardized measurement approaches to better understand the potential of APN for predicting and mitigating stroke risk.

Study design

Longitudinal prospective cohort study.

Objectives

To assess the coefficient of efficacy and the influence of various demographic and neurological factors on changes in Spinal Cord Independence Measure III (SCIM-III) scores over time in traumatic spinal cord injury (TSCI) patients.

Setting

Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Research Center in Imam Khomeini Hospital Complex, Tehran, Iran.

Methods

The study was performed over an 8-year period in our outpatient rehabilitation setting. Changes in SCIM-III scores were assessed in 559 TSCI patients (of 1460 enrolled patients) who fit the inclusion criteria. All included patients participated in our outpatient rehabilitation program, which consisted of a multidisciplinary education program combined with occupational therapy, physical therapy, and home nursing as a rehabilitation package for a 6-month period. Patients then received follow-up assessments every 6 months.

Results

Predictors of the SCIM-III score as a rehabilitation outcome tool, and of its change over time, included age (younger patients had better outcomes, p = 0.067), marital status (married patients had better outcomes, p = 0.031), education level (patients with university education had better outcomes, p = 0.003), occupation status (employed patients had better outcomes, p = 0.009), and neurological level of injury (patients with injuries at lower levels had better outcomes, p < 0.001). However, sex and injury severity as per the American Spinal Injury Association Impairment Scale (AIS) had no significant effects on functional outcomes (i.e., SCIM-III score changes over time).

Conclusion

Age, marital status, education level, employment, and neurological level all affected the final SCIM-III scores of SCI patients. By contrast, sex and AIS grade were not significant predictors of SCIM-III outcomes. Further studies that include additional factors may be useful for future SCIM-III models.

Background

Blood pressure management is critical for the treatment of traumatic brain injury (TBI). The purpose of this study was to determine the safe systolic blood pressure (SBP) range during the emergent phase that reduces negative outcomes after TBI surgery.

Methods

Patients with isolated TBI who received surgical treatment were enrolled. We retrospectively analyzed the outcomes of the TBI patients with different admission SBP (mmHg) ranges. In addition, the safe SBP ranges for patients in different age groups (<50 or ≥50 years old) were identified.

Results

Among the TBI patients, those with an admission SBP ranging from 100 to 140 mmHg had the lowest mortality rate: 18.97% for the 100–120-mmHg group and 19.52% for the 120–140-mmHg group. Among the patients with an admission SBP of ≥140 mmHg, the mortality rate decreased dramatically when the SBP was controlled to 100–140 mmHg during the emergent phase (22.22% vs. 37.542%, p = 0.022). However, this control had no effect on the extended Glasgow outcome scale (GOSE) score of the survivals (p = 0.920). Multivariate regression analysis further revealed that an admission SBP of 100–140 mmHg is an independent factor for favorable outcomes, but only in patients who are ≥50 years old (p = 0.017).

Conclusions

This study identified the optimal range of SBP during the emergent phase for isolated TBI patients. We emphasize the beneficial effects of reducing blood pressure before surgery in TBI, especially for patients who are ≥50 years old. The study provides new evidence for a blood pressure management target in TBI.

Cubital tunnel syndrome (CTS) is a chronic condition caused by the compression of the ulnar nerve at the elbow. The ulnar nerve is susceptible to entrapment at multiple sites along its path, with the elbow joint being the most critical. Symptoms typically include numbness in the ulnar nerve distribution area, hand muscle atrophy, and weakness. Patients exhibiting mild symptoms can be treated conservatively, whereas those with moderate to severe symptoms often require surgical intervention. Extensive research has been conducted on the clinical treatment of CTS. The complex etiology of this condition, coupled with the unique anatomical structure of the ulnar nerve, has led to less-than-satisfactory clinical outcomes. Physiotherapy plays an important role in aiding nerve recovery and reducing disability rates. Initiating physiotherapy early can address the cause of the disease, mitigate nerve damage, improve functional impairment due to nerve injury, and enhance the quality of patients’ daily activities. However, definitive guidelines for the treatment and evaluation of cubital tunnel syndrome are lacking. This review compiles the various modalities and advancements in the diagnosis and rehabilitation of CTS, drawing from recent domestic and international literature. It summarizes and compares the diagnostic tools currently employed in clinical practice and offers suggestions for physicians and therapists in selecting personalized diagnostic tools for patient assessment. Additionally, the review describes various rehabilitation methods, providing fresh insights for patients with cubital tunnel syndrome who have received conservative or surgical treatment.

Background

Observational studies have reported a link between particulate matter 2.5 (PM_2.5) and the risk of mental disorders; however, the causality is unclear.

Methods

Using publicly available genome-wide association studies, we conducted a two-sample Mendelian randomization (MR) study to assess the causal relationship between PM_2.5 and six mental disorders: attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD), schizophrenia (SCZ), and anxiety disorder (ANX). The inverse-variance weighting method was used as the main method for estimating causal effects. MR-Egger, weighted median, simple mode, weighted mode, and MR-PRESSO were applied as supplementary analyses.

Results

Using the inverse-variance weighting method, genetically predicted PM_2.5 exposure increased the risk of ADHD (odds ratio [OR] = 1.52, 95% confidence interval [CI] = 1.16 to 1.99, p = 0.002), ANX (OR = 2.96, 95% CI = 1.29 to 6.81, p = 0.01), and SCZ (OR = 2.21, 95% CI = 1.40 to 3.47, p = 0.001). However, there was no evidence to suggest that genetically predicted exposure to PM_2.5 increased the risk of the other three mental disorders (p > 0.05).

Conclusions

The present findings enhance our understanding of the role of PM_2.5 exposure on ADHD, ANX, and SCZ risk. It may be necessary to search for novel components with neuroprotective effects to provide new preventive and therapeutic strategies for PM_2.5-induced brain damage.

Mitochondrial dysfunction is pivotal in the occurrence and development of Parkinson's disease (PD). Interventions to increase mitochondrial biogenesis and maintain the balance in mitochondrial turnover have the potential to protect against neurological damage. In addition to their crucial role in the tricarboxylic acid cycle, mitochondria impact diverse activities, including cellular metabolism, cellular quality control, and the production of reactive oxygen species. Thus, it has become imperative to better understand the regulation and function of mitochondria in PD. With this review, we aim to stimulate research that explores mitochondria-oriented neuroprotection strategies to maintain the balance in mitochondrial turnover. First, we summarize research on newly discovered genes that regulate PD mitochondrial autophagy through PTEN-induced kinase 1 (PINK1), namely AMBRA1, SYNJ2BP, and SIAH3. Second, we review PD-related mitochondrial proteins, including STRT3 and SIRT6, and the mitochondrial unfolded protein response, covering their mechanisms of involvement in PD. Third, we emphasize the roles of the mitochondrial complex, pyroptosis, and copper-induced cell death in mitochondrial damage in PD. Finally, we present a brief overview of new therapeutic strategies to correct mitochondrial defects that may be applicable for targeting mitochondria in PD patients.

Objective

Nicotinamide riboside (NR) is neuroprotective; however, its low permeability through the blood‒brain barrier restricts its therapeutic efficacy in central nervous system diseases. Compared with oral NR administration, liposome-based NR loading is hypothesized to improve its pharmacological properties during cerebral ischemia, especially when administered intravenously.

Methods

NR chloride (NRC) was encapsulated in an optimized liposome composition and administered by bolus intravenous injection. This was followed by examination of its pharmacokinetics, organ distribution, and effects on cerebral ischemia in mice.

Results

Compared with conventional NRC solution, the liposome form led to a 2.76-fold higher C_max and a 5.32-fold higher AUC_0–24h in plasma after a bolus injection of 40 mg/kg. In healthy mouse brain, it caused a significant elevation of C_max (2.93-fold) and AUC_0.25–24h (2.68-fold). In cerebral ischemia model mice, NRC liposomes increased the drug concentration at 1 and 6 h post-ischemia, increased tissue NAD⁺ and ATP levels, reduced infarct volume (by a further decrease of 35.4%), ensured neuronal survival, attenuated glial activation, and significantly improved behavioral recovery compared with conventional NRC treatment.

Conclusion

Liposome loading enhances the brain distribution and therapeutic effects of NRC, which strengthens its possibility for clinical translation and neurorestoration in stroke.

Introduction

The non-stationarity of electroencephalograms (EEG) has a substantial effect on the performance of classifiers in brain-computer interface (BCI) systems. To tackle this challenge, an adaptable version of the linear discriminant analysis (LDA) classifier was proposed. Accuracy is crucial when using BCIs for neurorestorative tasks or memory improvement. The accurate comprehension of brain responses facilitates more focused interventions, which may improve neurorestorative outcomes. BCIs equipped with adaptive classifiers are useful for personalizing therapies to individual requirements and for improving neurorestorative processes. Notably, neurorestorative interventions that yield consistent, accurate, and reliable outcomes are more likely to inspire trust and elicit satisfaction in users.

Methods

The proposed classifier continuously modified its parameters in accordance with EEG signals. The covariance matrix and mean values for each pair of classes were the updating parameters. The proposed classifier modified the model parameters by prioritizing current signal data over older signal history. The proposed classifier was tested using a hybrid SSVEP + P300 BCI system.

Results and conclusions

The proposed classifier had an estimated classification accuracy of 97.4%, and was more effective than pooled mean LDA and conventional multiclass LDA classifiers. Increased classification accuracy may increase the responsiveness of neurorestorative interventions and increase the usefulness of BCIs in neurorestoration.