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The Role of Exercise in Regulating Brain Health and Aging through Glymphatic Function. 运动通过淋巴功能调节大脑健康和衰老的作用。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-30 DOI: 10.1177/10738584251404010
Junli Wang, Junhua Li

The glymphatic system is a recently discovered brain clearance pathway that removes metabolic waste, including toxic proteins, via cerebrospinal fluid flow along perivascular spaces. It helps maintain neural homeostasis, and its dysfunction is linked to neurodegenerative diseases like Alzheimer's. Emerging evidence suggests that physical exercise can enhance glymphatic function and promote cerebral clearance, offering a potential nonpharmacological approach to support brain health. In rodent studies, voluntary wheel running has been shown to increase glymphatic flux, likely through improvements in cerebrospinal fluid circulation, vascular pulsatility, and the exchange of interstitial fluid along perivascular routes. Exercise also upregulates the expression and polarization of aquaporin 4 on astrocytic endfeet, which is essential for directing fluid movement and facilitating efficient glymphatic transport, potentially reducing the accumulation of neurotoxic proteins such as β-amyloid and tau. Beyond these direct effects, exercise-induced enhancements in cerebral blood flow, arterial compliance, and sleep quality may indirectly optimize the physiological environment for glymphatic clearance. Together, these mechanisms suggest that regular physical activity is an established, noninvasive intervention to maintain cerebral homeostasis, accelerate metabolic waste removal, and support long-term cognitive function. This review summarizes evidence linking exercise to glymphatic function and its role in brain waste clearance and cognitive function.

淋巴系统是最近发现的一种脑清除途径,它通过脑脊液沿血管周围间隙流动来清除代谢废物,包括有毒蛋白质。它有助于维持神经稳态,其功能障碍与阿尔茨海默氏症等神经退行性疾病有关。新出现的证据表明,体育锻炼可以增强淋巴功能,促进大脑清除,为支持大脑健康提供了一种潜在的非药物方法。在啮齿类动物的研究中,自愿滚轮运动已被证明可以增加淋巴通量,可能是通过改善脑脊液循环、血管搏动性和沿血管周围途径的间质液交换。运动还上调星形细胞终足上水通道蛋白4的表达和极化,这对于指导液体运动和促进有效的淋巴运输至关重要,可能减少神经毒性蛋白(如β-淀粉样蛋白和tau)的积累。除了这些直接影响外,运动诱导的脑血流量、动脉顺应性和睡眠质量的增强可能间接优化淋巴清除的生理环境。综上所述,这些机制表明,有规律的身体活动是维持大脑稳态、加速代谢废物清除和支持长期认知功能的一种既定的、无创的干预手段。本文综述了运动与淋巴功能及其在脑废物清除和认知功能中的作用的证据。
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引用次数: 0
Neuromodulation of the Cingulate Cortex for Pain. 扣带皮层对疼痛的神经调节。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-06-26 DOI: 10.1177/10738584251337652
Andrew Strohman, Wynn Legon

The subgenual (sACC) and pregenual (pACC) anterior cingulate and anterior midcingulate (aMCC) cortices are structurally and functionally distinct subregions of the cingulate cortex with critical roles in pain processing. These regions may be promising therapeutic targets using non-invasive neuromodulation techniques, including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), and low-intensity focused ultrasound (LIFU). In this review, we synthesize emerging evidence on the function and connectivity of these subregions in both acute and chronic pain, highlighting their differential roles in the sensory, affective, and autonomic contributions to pain processing. We compare the strengths and limitations of the different non-invasive neuromodulatory methods for accessing these deep midline structures and examine how technique-specific and target-specific effects influence analgesic outcomes. We also explore the influence of placebo mechanisms and stimulation context on therapeutic effects. Finally, we discuss emerging strategies such as personalized connectivity-based targeting to overcome anatomical and technical limitations to advance precision non-invasive neuromodulation for pain.

亚属(sACC)和前属(pACC)前扣带和前中扣带(aMCC)皮质是扣带皮层在结构和功能上不同的亚区,在疼痛处理中起着关键作用。使用非侵入性神经调节技术,包括经颅磁刺激(TMS)、经颅电刺激(TES)和低强度聚焦超声(LIFU),这些区域可能是有希望的治疗靶点。在这篇综述中,我们综合了这些亚区域在急性和慢性疼痛中的功能和连通性的新证据,强调了它们在疼痛处理的感觉、情感和自主贡献中的不同作用。我们比较了不同的非侵入性神经调节方法的优势和局限性,以进入这些深层中线结构,并研究了技术特异性和靶点特异性效应如何影响镇痛结果。我们还探讨了安慰剂机制和刺激环境对治疗效果的影响。最后,我们讨论了新兴的策略,如个性化的基于连接的靶向,以克服解剖学和技术上的限制,以推进精确的非侵入性疼痛神经调节。
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引用次数: 0
Beyond the synapse: neuron-to-neuron crosstalk via nanotubes. 超越突触:通过纳米管的神经元间的串扰。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1177/10738584251395520
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引用次数: 0
Lessons from the use of in vivo cellular calcium imaging in primary sensory neurons and spinal cord. 初级感觉神经元和脊髓体内细胞钙成像的应用经验。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-08-14 DOI: 10.1177/10738584251360724
John Shannonhouse, Yan Zhang, Hyeonwi Son, Eungyung Kim, Deoksoo Han, Joon Tae Park, Yu Shin Kim

Primary somatosensory neurons, glial cells in the peripheral ganglia, and neural circuits in the spinal cord function as dynamic network circuits that transmit information to the brain. Although a variety of methods and techniques have been used to study individual neurons or tissue explants, the number of neurons that can be monitored is limited. Imaging intact primary sensory neurons, such as those in the dorsal root ganglion and trigeminal ganglia, and the spinal cord in vivo using fluorescent calcium markers helps overcome the limitations of previous methods and techniques by allowing researchers to monitor tens to thousands of cells simultaneously. This allows researchers to conduct experiments to elucidate somatosensory mechanisms and responses to axonal injury that were previously difficult or impossible to observe. Using this approach, researchers have studied dynamic neural network circuits, connectivity, responses to soft and deep touch, heat, cold, chemicals, inflammation, and injury, and they have repeatedly imaged individual neurons over long periods of time. Approaches include using calcium-sensitive fluorescent dyes and genetically encoded markers, performing terminal exposure surgeries, using chambers designed to monitor large numbers of cells or repeatedly imaging small numbers of cells, and imaging animals with or without anesthesia. This review discusses the advantages and disadvantages of in vivo calcium imaging for studying somatosensory and axonal injury in peripheral sensory ganglia and the dorsal spinal cord, as well as anticipated future directions.

初级体感神经元、外周神经节中的胶质细胞和脊髓中的神经回路作为动态网络回路向大脑传递信息。尽管各种各样的方法和技术已经被用于研究单个神经元或组织外植体,但可以监测的神经元数量是有限的。利用荧光钙标记物对完整的初级感觉神经元(如背根神经节和三叉神经节中的神经元)和脊髓进行体内成像,有助于克服以前方法和技术的局限性,使研究人员能够同时监测数十到数千个细胞。这使得研究人员可以通过实验来阐明体感觉机制和对轴索损伤的反应,这在以前是很难或不可能观察到的。利用这种方法,研究人员研究了动态神经网络回路、连通性、对柔软和深度触摸、热、冷、化学物质、炎症和损伤的反应,并在很长一段时间内反复对单个神经元进行成像。方法包括使用钙敏感的荧光染料和基因编码标记,进行终末暴露手术,使用设计用于监测大量细胞或重复成像少量细胞的腔室,以及在麻醉或不麻醉的情况下对动物进行成像。本文就体内钙显像技术在外周感觉神经节和脊髓背侧体感觉损伤和轴索损伤研究中的优缺点进行了综述,并展望了未来的发展方向。
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引用次数: 0
Neurosteroids as therapeutics. 神经类固醇作为治疗药物。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1177/10738584251395521
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引用次数: 0
Phosphoinositides: Nanoscale Effects on Neuronal Membranes. 磷酸肌苷:对神经元膜的纳米效应。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-05-29 DOI: 10.1177/10738584251337664
Kohgaku Eguchi

Phosphoinositides (PIs) are essential regulators of neuronal function, playing pivotal roles in processes such as synaptic transmission, membrane excitability, and long-term synaptic plasticity. The seven PI isoforms, including PI(4)P, PI(4,5)P2, and PI(3,4,5)P2, exhibit distinct subcellular distributions that are tightly regulated by specific kinases and phosphatases. These isoforms contribute to key neuronal processes by modulating protein interactions and signaling pathways. Recent advances in visualization techniques, such as biosensor-based live imaging and SDS-digested freeze-fracture replica labeling, have provided new insights into the spatial distributions and dynamic behaviors of PI isoforms in neurons, particularly at synapses.However, significant questions remain, such as how specific PI isoforms coordinate signaling events in distinct subcellular compartments and how these lipids influence critical neuronal processes like vesicular trafficking and synaptic plasticity. Addressing these challenges will require the continued development of advanced imaging technologies, which are essential for mapping nanoscale distributions of PIs and their dynamic roles in neuronal processes. Here, I will review current findings, advancements in visualization methodologies, and key research directions. This review will be helpful for understanding the roles of PIs in neuronal physiology, their broad impacts on neuronal signaling, and the technological breakthroughs needed to uncover these complex processes.

磷酸肌苷(phosphoinosidtides, pi)是神经元功能的重要调节因子,在突触传递、膜兴奋性和长期突触可塑性等过程中发挥关键作用。PI(4)P、PI(4,5)P2和PI(3,4,5)P2等7种PI异构体表现出不同的亚细胞分布,受特定激酶和磷酸酶的严格调控。这些异构体通过调节蛋白质相互作用和信号通路参与关键的神经元过程。可视化技术的最新进展,如基于生物传感器的实时成像和sds消化的冷冻断裂复制标记,为神经元(特别是突触)中PI同工异构体的空间分布和动态行为提供了新的见解。然而,重要的问题仍然存在,例如特定的PI异构体如何协调不同亚细胞区室中的信号事件,以及这些脂质如何影响关键的神经元过程,如囊泡运输和突触可塑性。解决这些挑战需要先进成像技术的持续发展,这对于绘制pi的纳米级分布及其在神经元过程中的动态作用至关重要。在这里,我将回顾当前的发现,可视化方法的进展,以及主要的研究方向。这一综述将有助于理解pi在神经元生理学中的作用,它们对神经元信号传导的广泛影响,以及揭示这些复杂过程所需的技术突破。
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引用次数: 0
The mind-machine connection: adaptive information processing and new technologies promoting mental health in older adults. 脑机连接:适应性信息处理和促进老年人心理健康的新技术。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-02-19 DOI: 10.1177/10738584251318948
S S Magalhães, A M Lucas-Ochoa, A M Gonzalez-Cuello, E Fernández-Villalba, M B Pereira Toralles, M T Herrero

The human brain demonstrates an exceptional adaptability, which encompasses the ability to regulate emotions, exhibit cognitive flexibility, and generate behavioral responses, all supported by neuroplasticity. Brain-computer interfaces (BCIs) employ adaptive algorithms and machine learning techniques to adapt to variations in the user's brain activity, allowing for customized interactions with external devices. Older adults may experience cognitive decline, which could affect the ability to learn and adapt to new technologies such as BCIs, but both (human brain and BCI) demonstrate adaptability in their responses. The human brain is skilled at quickly switching between tasks and regulating emotions, while BCIs can modify signal-processing algorithms to accommodate changes in brain activity. Furthermore, the human brain and BCI participate in knowledge acquisition; the first one strengthens cognitive abilities through exposure to new experiences, and the second one improves performance through ongoing adjustment and improvement. Current research seeks to incorporate emotional states into BCI systems to improve the user experience, despite the exceptional emotional regulation abilities of the human brain. The implementation of BCIs for older adults could be more effective, inclusive, and beneficial in improving their quality of life. This review aims to improve the understanding of brain-machine interfaces and their implications for mental health in older adults.

人类大脑表现出一种特殊的适应性,包括调节情绪的能力,表现出认知的灵活性,以及产生行为反应,所有这些都得到神经可塑性的支持。脑机接口(bci)采用自适应算法和机器学习技术来适应用户大脑活动的变化,允许与外部设备进行定制交互。老年人可能会经历认知能力下降,这可能会影响学习和适应脑机接口等新技术的能力,但两者(人脑和脑机接口)的反应都表现出适应性。人脑擅长在不同任务之间快速切换和调节情绪,而脑机接口可以修改信号处理算法,以适应大脑活动的变化。此外,人脑和脑机接口参与知识获取;前者通过接触新体验来增强认知能力,后者通过不断调整和改进来提高表现。目前的研究试图将情绪状态纳入BCI系统,以改善用户体验,尽管人类大脑具有特殊的情绪调节能力。对老年人实施脑机接口可以更有效、更包容、更有利于改善他们的生活质量。本综述旨在提高对脑机接口及其对老年人心理健康的影响的理解。
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引用次数: 0
Intracerebral Hemorrhage: An Acute Manifestation of Small Vessel Disease? 脑出血:小血管疾病的急性表现?
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-09-06 DOI: 10.1177/10738584251364772
Li-Li Tang, Yu-Jia Jin, Xue Qun Chen, Peiran Jiang, Feng Gao, Lu-Sha Tong

Although intracerebral hemorrhage (ICH) and cerebral small vessel disease (cSVD) have long been considered distinct clinical entities, emerging evidence reveals significant overlap in their etiologies and imaging markers. This review aims to explore the relationship between ICH and cSVD, suggesting that ICH may represent an acute manifestation of small vessel disease. ICH is primarily caused by cerebral amyloid angiopathy and hypertension, while cSVD is mainly attributed to cerebral amyloid angiopathy and arteriolosclerosis. Hypertension-induced arteriolosclerosis is one of the most common pathologic changes in cSVD. This overlap in etiology suggests a close relationship between ICH and cSVD. In patients with ICH, multiple imaging markers of cSVD are often observed. Recent studies suggest that enlarged perivascular spaces, one of the imaging markers of cSVD, may serve as a pathway for hematoma expansion. Additionally, diffusion-weighted imaging lesions are frequently observed in patients with ICH. These lesions are likely to be based on underlying cSVD and may evolve into other cSVD markers, such as white matter hyperintensity, lacunar infarctions, or microbleeds. These findings highlight the complex interplay between ICH and cSVD, suggesting that ICH could be considered an acute expression of cSVD rather than an entirely separate entity.

虽然脑出血(ICH)和脑血管病(cSVD)长期以来被认为是不同的临床实体,但新出现的证据显示它们的病因和影像学标志物有显著的重叠。本文旨在探讨脑出血与cSVD之间的关系,提示脑出血可能是小血管疾病的急性表现。脑出血主要由脑淀粉样血管病和高血压引起,而cSVD主要由脑淀粉样血管病和小动脉硬化引起。高血压引起的小动脉硬化是心血管疾病最常见的病理改变之一。这种病因学上的重叠提示脑出血和心血管疾病之间的密切关系。在脑出血患者中,经常观察到cSVD的多种影像学标志物。最近的研究表明,血管周围空间的扩大,cSVD的影像学标志之一,可能是血肿扩张的途径。此外,在脑出血患者中经常观察到弥散加权成像病变。这些病变可能基于潜在的cSVD,并可能演变为其他cSVD标志物,如白质高信号、腔隙性梗死或微出血。这些发现强调了脑出血和cSVD之间复杂的相互作用,表明脑出血可能被认为是cSVD的急性表达,而不是一个完全独立的实体。
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引用次数: 0
4-D brain mapping: A new tool to unravel the mystery of MS. 4-D脑图:揭开多发性硬化症之谜的新工具。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-12-01 Epub Date: 2025-11-17 DOI: 10.1177/10738584251394963
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引用次数: 0
Forever Young. 永远年轻。
IF 3.9 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-10-01 Epub Date: 2025-09-13 DOI: 10.1177/10738584251376248
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引用次数: 0
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Neuroscientist
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