Neuroscience and Biobehavioral Reviews最新文献_第7页

Craving in eating disorders: Mapping the concept through a systematic review 饮食失调中的渴望：通过系统回顾绘制概念。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-08 DOI: 10.1016/j.neubiorev.2025.106515

A. Cornil , C. Lakritz , S. Iceta , V. Flaudias

Purpose

Craving, long considered a hallmark of addictive disorders, has increasingly been recognized as a clinically significant phenomenon in eating disorders (ED). Yet, its conceptualization, measurement, and role in ED pathology remain inconsistent and fragmented. This review aimed to map existing knowledge through a systematic review.

Methods

Searches were conducted in July 2025 in Embase, PsycInfo, and Web of Science. Eligible records were peer-reviewed studies including adults clinically diagnosed with ED. Fifty studies and fifteen reviews met the inclusion criteria.

Results

Most studies examined bulimia nervosa (BN) and binge-eating disorder (BED), while anorexia nervosa (AN) and non-food-related cravings (e.g., exercise, vomiting, purging) were rarely addressed. Definitions of craving varied, sometimes conflating strong desire with loss of control or subsequent behaviors. Theoretical models were inconsistent, often borrowed from addiction research, and rarely integrated neurobiological findings. Craving assessment relied mainly on visual analogue scales (VAS) and the Food Cravings Questionnaire (FCQ), with limited use of qualitative, psychophysiological, or neurocognitive methods. Interventions specifically targeting craving were scarce. Cue exposure therapy (including virtual reality), neurofeedback, and non-invasive brain stimulation—repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—showed encouraging but mixed effects. Across ED, craving was consistently associated with binge eating, with trait craving emerging as a stronger predictor than state craving.

Conclusions

Craving is central yet conceptually elusive in ED. Establishing a consensual definition, developing theory-driven and transdiagnostic assessment tools, and expanding research beyond food and binge-related disorders are priorities to advance understanding and improve interventions.

目的：渴望，长期以来被认为是成瘾性疾病的标志，越来越多地被认为是饮食失调（ED）的临床显著现象。然而，其概念、测量和在ED病理中的作用仍然不一致和分散。这篇综述旨在通过系统的综述来绘制现有的知识图谱。方法：于2025年7月在Embase、PsycInfo和Web of Science中进行检索。符合条件的记录是同行评议的研究，包括临床诊断为ED的成年人。50项研究和15篇综述符合纳入标准。结果：大多数研究检查了神经性贪食症（BN）和暴饮暴食症（BED），而神经性厌食症（AN）和非食物相关的渴望（如运动、呕吐、排便）很少得到解决。渴望的定义多种多样，有时会将强烈的欲望与失控或随后的行为混为一谈。理论模型不一致，经常借用成瘾研究，很少整合神经生物学的发现。渴望评估主要依赖于视觉模拟量表（VAS）和食物渴望问卷（FCQ），有限地使用定性、心理生理学或神经认知方法。专门针对渴望的干预措施很少。提示暴露疗法（包括虚拟现实）、神经反馈和非侵入性脑刺激——重复经颅磁刺激（rTMS）和经颅直流电刺激（tDCS）——显示出令人鼓舞但效果不一的效果。在ED中，渴望一直与暴饮暴食有关，特质渴望比状态渴望更能预测。结论：渴望是ED的核心，但在概念上难以捉摸。建立共识定义，开发理论驱动和跨诊断评估工具，扩大研究范围，超越食物和暴饮暴食相关疾病，是促进理解和改进干预措施的优先事项。

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引用次数: 0

Disengaged: A systematic review of community engagement in psychedelic-assisted therapy research 脱离：对迷幻药辅助治疗研究中社区参与的系统回顾。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-07 DOI: 10.1016/j.neubiorev.2025.106516

Mallet R. Reid , Jonathan Song , Kevin F. Boehnke , NiCole T. Buchanan , Jacob S. Aday

People of color have been significantly underincluded in psychedelic-assisted therapy (PAT) research, despite facing challenges commonly addressed in PAT and often more severe symptoms. It may be the case that people of color are underincluded because PAT researchers have not used approaches designed to promote sample diversity. Community-engaged research (CEnR) is a research paradigm that has demonstrated success in promoting participant diversity. We hypothesize that the absence of CEnR in psychedelic science may be a contributing factor to the lack of diversity in psychedelic studies. To examine the prevalence of CEnR practices in PAT research, we conducted a systematic review of the past 10 years of psilocybin, MDMA, and LSD clinical trials in the United States. We reviewed each study (N = 27) to assess whether researchers incorporated CEnR using the Continuum of Community Engagement and reached out to each individual study team to ensure comprehensiveness. Our analysis revealed that only 3/27 (11.11 %) studies incorporated CEnR. In the rare instances CEnR was integrated, PAT researchers used community consultation, which involves relatively little engagement with community members. To improve representation in PAT trials, we recommending incorporating the CEnR principles of 1) mapping and engaging local stakeholders, 2) leveraging existing university-hospital infrastructures, 3) co-designing research and outreach initiatives, 4) securing dedicated CEnR resources, and 5) establishing mechanisms for ongoing evaluation. This systematic review supports that there has been a paucity of community-engaged practices in PAT research, which can be addressed by incorporating our recommendations for implementing CEnR in PAT studies.

有色人种在迷幻辅助治疗（PAT）研究中被明显低估，尽管他们面临着PAT中常见的挑战，而且往往症状更严重。有色人种没有被包括在内可能是因为PAT研究人员没有使用旨在促进样本多样性的方法。社区参与研究（CEnR）是一种在促进参与者多样性方面取得成功的研究范式。我们推测，迷幻科学中缺乏CEnR可能是导致迷幻研究缺乏多样性的一个因素。为了研究PAT研究中CEnR实践的普遍性，我们对美国过去10年的裸盖菇素、MDMA和LSD临床试验进行了系统回顾。我们回顾了每一项研究（N = 27），以评估研究人员是否使用社区参与连续体（Continuum of Community Engagement）纳入了CEnR，并与每个单独的研究团队进行了接触，以确保全面性。我们的分析显示，只有3/27（11.11%）的研究纳入了CEnR。在少数整合了CEnR的情况下，PAT研究人员使用了社区咨询，这涉及到与社区成员相对较少的接触。为了提高PAT试验的代表性，我们建议将以下原则纳入：1)绘制地图并让当地利益相关者参与；2)利用现有的大学-医院基础设施；3)共同设计研究和推广计划；4)确保专用的CEnR资源；5)建立持续评估机制。该系统综述表明，在PAT研究中社区参与的实践一直很缺乏，这可以通过纳入我们在PAT研究中实施CEnR的建议来解决。

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引用次数: 0

Using computational semantics to study meaning in the brain 使用计算语义学来研究大脑中的意义。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-06 DOI: 10.1016/j.neubiorev.2025.106514

James Fodor , Shinsuke Suzuki

How do humans understand the meaning of individual words? How do we combine the meaning of multiple words to comprehend novel sentences? Cognitive neuroscience has addressed these questions by studying patterns of neural activation across the cerebral cortex, identifying the regions responsible for language processing. Meanwhile, computational linguistics has approached these questions by constructing vector-based models demonstrating how meaning can be represented as patterns of activation in artificial neural networks. In recent years, increasing recognition of these commonalities, along with the rapidly developing linguistic capabilities of large language models, has led to a surge in research applying computational semantics models to study human language processing in the brain. In this cross-disciplinary review, we aim to better integrate theoretical and experimental approaches by providing an overview of vector-based semantics models, including a summary of major approaches to modelling word and sentence meaning. We next review different approaches to studying semantics in the brain, including traditional approaches focusing on localisation of lexical and compositional semantics, and newer methods using word embeddings and syntactic parsing algorithms. We then discuss provide a comparative analysis of 57 studies utilising vector-based semantics models to study language processing with functional Magnetic Resonance Imaging (fMRI), in which we highlight both common trends as well as significant methodological inconsistencies across studies which hinders interpretation. We conclude by emphasising the value of vector-based semantics models for understanding semantic processing in the brain, while highlighting the need for greater methodological standardisation.

人类如何理解单个单词的意思？我们如何结合多个单词的意思来理解新句子？认知神经科学通过研究大脑皮层的神经激活模式，确定负责语言处理的区域，解决了这些问题。与此同时，计算语言学通过构建基于向量的模型来解决这些问题，这些模型展示了如何将意义表示为人工神经网络中的激活模式。近年来，随着对这些共性的日益认识，以及大型语言模型语言能力的迅速发展，应用计算语义模型研究人类大脑语言处理的研究激增。在这篇跨学科的综述中，我们的目标是通过提供基于向量的语义模型的概述，包括对单词和句子意义建模的主要方法的总结，更好地整合理论和实验方法。接下来，我们回顾了研究大脑语义的不同方法，包括专注于词汇和组合语义定位的传统方法，以及使用词嵌入和句法解析算法的新方法。然后，我们讨论了57项利用基于向量的语义模型研究功能磁共振成像（fMRI）语言处理的研究的比较分析，其中我们强调了共同趋势以及阻碍解释的研究中显着的方法不一致。最后，我们强调基于向量的语义模型对于理解大脑中的语义处理的价值，同时强调需要更大的方法标准化。

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引用次数: 0

The sound of silence: Omission responses and how the brain predicts in the absence of sound 寂静之声：遗漏反应和大脑如何在没有声音的情况下预测。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-05 DOI: 10.1016/j.neubiorev.2025.106505

Ana B. Lao-Rodríguez , Erich Schröger , Manuel S. Malmierca

Omission responses have been proposed as neural signatures of predictive coding mechanisms that arise when expected sensory events fail to occur. These responses support the view that the brain actively generates and updates internal models to anticipate future events, rather than passively processing incoming sensory input. Importantly, omission responses offer a direct index of prediction error and prediction. They are modulated by the behavioral relevance and predictability of the omitted stimulus. Emerging studies have shown that omission responses occur across a range of auditory paradigms and involve complex interactions between excitatory and inhibitory neurons, particularly via feedforward inhibition of pyramidal cells by specific interneuron populations. When an anticipated stimulus is omitted, the resulting disinhibition of pyramidal neurons generates a prediction error signal; crucial for updating internal models and driving synaptic plasticity. This mechanism shares key features with mismatch negativity and corollary discharge, suggesting that overlapping cortical circuits are engaged in predictive processing. Taken together, these findings highlight the value of omission responses as electrophysiological markers of the brain’s active prediction and prediction error signaling in auditory perception.

遗漏反应被认为是预测编码机制的神经特征，当预期的感觉事件没有发生时，这种机制就会出现。这些反应支持了大脑主动生成和更新内部模型来预测未来事件的观点，而不是被动地处理传入的感觉输入。重要的是，遗漏反应提供了预测误差和预测的直接指标。它们受到被忽略的刺激的行为相关性和可预测性的调节。新兴研究表明，遗漏反应发生在一系列听觉范式中，涉及兴奋性和抑制性神经元之间的复杂相互作用，特别是通过特定中间神经元群对锥体细胞的前馈抑制。当预期的刺激被忽略时，锥体神经元的去抑制产生预测误差信号；对更新内部模型和驱动突触可塑性至关重要。这一机制与失配负性和必然放电具有共同的关键特征，表明重叠的皮层回路参与了预测加工。综上所述，这些发现突出了遗漏反应作为听觉感知中大脑主动预测和预测错误信号的电生理标记的价值。

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引用次数: 0

Hemispheric asymmetry for visual information processing in 3D space 三维空间视觉信息处理的半球不对称。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-05 DOI: 10.1016/j.neubiorev.2025.106504

Noah Britt , Rafael Román-Caballero , Fion Lee , Shruthi Raghuraman , Hong-jin Sun

There is an asymmetry in the ability to process visual information in the left and right visual fields. Extensive literature has consistently shown that young, healthy human adults exhibit a visuospatial bias towards the left hemifield (pseudoneglect). This leftward bias has traditionally been demonstrated through horizontal line bisection tasks in 2D experimental settings. However, as research progressed into 3D space, where lines are presented far from the observer, the dissipation of the classical leftward bias tended to reverse into a rightward bias. The precise distances at which the leftward bias, a neutral point, and rightward biases occur remain unclear. Here, we present a meta-analysis to model how bisection performance changes across 3D space quantitatively. We identified the boundary conditions where leftward biases reverse into rightward biases and at what distances this change can be predicted using line bisection. A total of 30 samples (25 studies, 142 bisection-error effects, n = 720) were included. Overall, the analysis revealed a significant leftward bias within near space, followed by a rightward bias in far space. Three critical ranges for visuospatial asymmetries across depth were revealed in young, healthy adults: (1) significant leftward biases up to 48 cm, (2) no reliable leftward/rightward biases from 49 to 87 cm, and (3) significant rightward biases beyond 88 cm. In addition, we revealed significant moderating effects of participant age (50 + years old), the use of tools to perform bisection, and the control of retinal size across depth. The findings establish important benchmarks when investigating visuospatial asymmetries and could inform clinical assessment.

左右视野处理视觉信息的能力是不对称的。大量文献一致表明，年轻、健康的成年人表现出对左半球的视觉空间偏见（假性忽视）。这种向左偏倚传统上是通过二维实验设置中的水平线对分任务来证明的。然而，随着研究进入三维空间，线条呈现在远离观察者的地方，经典的左偏消散倾向于逆转为右偏。左偏、中性点和右偏发生的精确距离尚不清楚。在这里，我们提出了一项元分析，以定量地模拟对分性能在3D空间中的变化。我们确定了向左偏置逆转为向右偏置的边界条件，以及使用线平分可以预测这种变化的距离。共纳入30个样本（25项研究，142个切分误差效应，n=720）。总的来说，分析揭示了在近空间中有明显的左偏，其次是在远空间中有明显的右偏。在年轻健康的成年人中发现了三个跨深度的视觉空间不对称的临界范围：(1)在48cm以内有显著的左偏，(2)在49-87cm以内没有可靠的左/右偏，(3)在88cm以上有显著的右偏。此外，我们还揭示了参与者年龄（50岁以上）、使用工具进行等分和控制视网膜大小跨深度的显著调节作用。研究结果为研究视觉空间不对称建立了重要的基准，并可以为临床评估提供信息。

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引用次数: 0

The addivosome: A pathological condensate underlying addiction 附加体：成瘾背后的病理凝结物

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-02 DOI: 10.1016/j.neubiorev.2025.106503

Valentin Skryabin , Svetlana Sokolova , Anton Masyakin

Addiction is often framed as a disorder of synaptic plasticity and circuit rewiring. We propose a complementary cellular mechanism: that persistent relapse vulnerability arises when the postsynaptic density (PSD) undergoes pathological “maturation” into a maladaptive biomolecular condensate–a membraneless, phase-separated assembly–we term the “Addivosome.” Across repeated cycles of intoxication, withdrawal, and abstinence, drug exposure co-activates dopamine and glutamate pathways and progressively shifts the PSD toward a more rigid, self-maintaining state. This state enforces aberrant pathway cross-talk, biases gene regulation, and resists dispersal, creating a durable cellular mnemonic. We outline discriminative tests to evaluate this model: (i) define state-specific proteomic and post-translational signatures using proximity labeling; (ii) use optogenetic tools that acutely cluster or disperse selected synaptic proteins to establish causality; (iii) screen for compounds that restore liquid-like molecular mobility (reliquefaction) measured by fluorescence recovery after photobleaching; and (iv) pursue selective clearance with autophagy-tethering chimeras directed at drug-induced signatures. A central challenge–separating pathological from physiological condensates–can be addressed by targeting these state-specific features rather than core scaffold proteins. Framing addiction as a condensate disorder integrates synaptic biology, phase separation, and addiction neuroscience into a falsifiable, translational model that suggests new therapeutic avenues focused on restoring dynamics or clearing the pathological condensate.

成瘾通常被认为是一种突触可塑性和电路重新布线的紊乱。我们提出了一种互补的细胞机制：当突触后密度（PSD）经历病理“成熟”成为一种不适应的生物分子凝聚物（一种无膜、相分离的组装物）时，持续复发的脆弱性就会出现，我们称之为“附加体”。在中毒、戒断和戒断的反复循环中，药物暴露共同激活了多巴胺和谷氨酸通路，并逐渐将PSD转变为更严格、自我维持的状态。这种状态强制异常通路串扰，偏倚基因调控，并抵制分散，创造一个持久的细胞记忆。我们概述了判别测试来评估该模型：(i)使用接近标记定义特定状态的蛋白质组学和翻译后特征；（ii）使用光遗传学工具，急性聚集或分散选定的突触蛋白，以建立因果关系；（iii）筛选能够恢复光漂白后荧光恢复测量的液体样分子迁移率（再液化）的化合物；（iv）利用靶向药物诱导信号的自噬栓系嵌合体追求选择性清除。一个核心的挑战-从生理凝聚物中分离病理-可以通过靶向这些状态特异性特征而不是核心支架蛋白来解决。将成瘾视为一种凝聚障碍，将突触生物学、相分离和成瘾神经科学整合到一个可证伪的转化模型中，该模型提出了新的治疗途径，重点是恢复动力学或清除病理凝聚。

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引用次数: 0

Jane Goodall’s merits for the ethological community 简·古道尔对动物行为学的贡献。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-12-01 DOI: 10.1016/j.neubiorev.2025.106502

Elisabetta Visalberghi

引用次数: 0

Disgust acquisition in Pavlovian conditioning: A systematic review and meta-analysis 巴甫洛夫条件反射中的厌恶习得：系统回顾与元分析。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-11-29 DOI: 10.1016/j.neubiorev.2025.106499

Anna M. Schippers , Tim Klucken , Matthias F.J. Sperl , Ottmar V. Lipp , Johannes B. Finke

The acquisition of disgust through Pavlovian conditioning is thought to be a crucial mechanism underlying the development of mental disorders such as obsessive-compulsive disorder and eating disorders. The present systematic review and meta-analysis aims to enhance our understanding of disgust conditioning by examining research using psychophysiological (autonomic) and self-report measures (disgust, valence, expectancy). Furthermore, the role of characteristics of the unconditioned stimulus (UCS), i.e., modality and number of different stimuli paired with a single conditioned stimulus, was analyzed based on 44 studies (total N = 3832). In addition, findings from studies using facial electromyography, electroencephalography, and functional magnetic resonance imaging as well as research in clinical samples were systematically reviewed. Regarding differential conditioned responses, our results indicate medium effect sizes for valence and disgust ratings and very large effect sizes for expectancy ratings, whereas effect sizes for psychophysiological measures were small. We found no evidence for a moderator effect of UCS modality or UCS number on self-report indices, despite high between-study heterogeneity. In contrast, larger effect sizes for psychophysiological outcomes emerged for (audio-)visual UCS (as compared to olfactory UCS) and with increasing number of disgust-related UCS. Evidence for publication bias was low. In conclusion, there is robust evidence for disgust acquisition through Pavlovian conditioning based on self-report and psychophysiology. However, potential factors influencing the depth and speed of acquisition remain to be examined. Furthermore, additional research using psychophysiological and neural measures, in healthy and clinical samples, is required to gain a deeper understanding of disgust conditioning and its underlying neurobiological processes.

通过巴甫洛夫条件反射获得厌恶被认为是强迫症和饮食失调等精神障碍发展的关键机制。本系统综述和荟萃分析旨在通过检查使用心理生理（自主）和自我报告测量（厌恶、效价、期望）的研究来增强我们对厌恶条件反射的理解。此外，基于44项研究（总N=3,832），分析了非条件刺激（UCS）特征的作用，即不同刺激与单一条件刺激配对的模态和数量。此外，系统回顾了面部肌电图、脑电图和功能磁共振成像的研究结果以及临床样本的研究结果。关于差异条件反应，我们的研究结果表明，效价和厌恶评分的效应大小中等，期望评分的效应大小非常大，而心理生理测量的效应大小很小。我们没有发现证据表明UCS模式或UCS数量对自我报告指数有调节作用，尽管研究间异质性很高。相反，与嗅觉UCS相比，（音频）视觉UCS对心理生理结果的影响更大，并且与厌恶相关的UCS数量也在增加。发表偏倚的证据很低。综上所述，基于自我报告和心理生理学的巴甫洛夫条件反射是厌恶习得的有力证据。然而，影响采集深度和速度的潜在因素仍有待研究。此外，还需要在健康和临床样本中使用心理生理学和神经测量方法进行进一步的研究，以更深入地了解厌恶条件反射及其潜在的神经生物学过程。

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引用次数: 0

Epistemic trust as a window into the allostatic function of oxytocin: A synthesis of rodent and human studies 认知信任作为进入催产素适应功能的窗口：啮齿动物和人类研究的综合。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-11-29 DOI: 10.1016/j.neubiorev.2025.106500

Samuel Budniok , Marian Bakermans-Kranenburg , Guy Bosmans , Marinus H. van IJzendoorn

Oxytocin (OT) is a hypothalamic neurohormone extensively studied for its role in affiliative behavior, yet its influence on epistemic trust, or trust in communicated knowledge, has received less attention. We synthesized evidence from human experiments on epistemic trust and rodent experiments using the social transmission of food preference (STFP) paradigm. During STFP, rodents learn about food safety through interaction with a conspecific, a learning process that may engage cognitive processes functionally parallel to elements of human epistemic trust. We combined effect sizes from five human studies (N = 414) and three rodent studies (N = 330), revealing no significant overall effect of OT administration on epistemic trust in humans (g = 0.25, 95 % CI: –0.25 to 0.75, p = .23) or STFP acquisition in rodents (g = –0.02, 95 % CI: –0.60 to 0.56, p = .84), with substantial heterogeneity across samples. Narrative syntheses suggest that OT may dynamically modulate epistemic trust and STFP acquisition based on informant and recipient characteristics, as well as contextual factors. By integrating these complementary lines of evidence, the current study advances a translational framework to test the allostatic model of OT and probe underlying neural mechanisms. Our findings may therefore guide future research, addressing more precise questions regarding OT effects, and ultimately improve clinical outcomes.

催产素（OT）是一种下丘脑神经激素，因其在从属行为中的作用而被广泛研究，但其对认知信任的影响，或对沟通知识的信任，却很少受到关注。我们利用食物偏好的社会传递（STFP）范式，综合了人类认知信任实验和啮齿动物实验的证据。在STFP过程中，啮齿动物通过与同一个体的互动来学习食品安全，这一学习过程可能涉及与人类认知信任元素功能相似的认知过程。我们综合了5项人类研究（N = 414）和3项啮齿动物研究（N = 330）的效应大小，发现OT给药对人类认知信任（g = 0.25, 95% CI: -0.25至0.75,p = 0.23）或啮齿动物STFP获取（g = -0.02, 95% CI: -0.60至0.56,p = 0.84）没有显著的总体影响，且样本之间存在很大的异质性。叙事综合表明，基于信息提供者和接受者的特征以及语境因素，OT可能动态调节认知信任和STFP获取。通过整合这些互补的证据线，本研究提出了一个翻译框架来测试OT的适应模型和探索潜在的神经机制。因此，我们的发现可能会指导未来的研究，解决更精确的问题，并最终改善临床结果。

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引用次数: 0

Postmenopausal sarcopenia and Alzheimer's disease: The interplay of mitochondria, insulin resistance, and myokines 绝经后肌肉减少症和阿尔茨海默病：线粒体、胰岛素抵抗和肌细胞因子的相互作用。

IF 7.9 1区医学 Q1 BEHAVIORAL SCIENCES

Neuroscience and Biobehavioral Reviews

Pub Date : 2025-11-29 DOI: 10.1016/j.neubiorev.2025.106501

Fardous Farhana, Most Arifa Sultana, Raksa Andalib Hia, Vijay Hegde

As life expectancy increases, cognitive impairments such as Alzheimer's disease (AD) create serious problems for older adults. Women regardless of ethnicity and age group, are disproportionately affected, accounting for two-thirds of AD cases, with post-menopausal women representing over 60 % of those affected. Sarcopenia, defined by gradual reduction of skeletal muscle mass, strength, and activities, is increasingly correlated with an elevated risk of cognitive decline in post-menopausal women. Menopause-related hormonal decline (particularly estrogen loss) and aging contribute to sarcopenia, characterized by muscle mitochondrial dysfunction, oxidative stress, and insulin resistance. This sarcopenia-driven reduction in muscle mass and functional capacity further reduces the production of myokines (e.g., BDNF, irisin), impairing neuronal proliferation, adult neurogenesis, and spatial learning/memory. These pathophysiological changes show a contributing link between sarcopenia and AD progression in post-menopausal women. This review is unique in that it discusses the triangular interplay between menopause, sarcopenia, and AD, offering an integrated mechanistic framework that links hormonal decline, muscle loss, and neurodegeneration. We aim to clarify the pathophysiological causes behind the muscle-brain axis and suggest viable treatment approaches to slow down sarcopenia and cognitive deterioration in postmenopausal women based on current evidence. The formulation of targeted strategies for enhancing the quality of life and lessening healthcare expenditures in this expanding population depends on the advancement of understanding this complex interconnection between menopause, sarcopenia and cognition.

随着预期寿命的增加，认知障碍，如阿尔茨海默病（AD）给老年人带来了严重的问题。无论种族和年龄组，妇女都不成比例地受到影响，占AD病例的三分之二，绝经后妇女占受影响妇女的60%以上。骨骼肌减少症的定义是骨骼肌质量、力量和活动逐渐减少，与绝经后妇女认知能力下降的风险增加越来越相关。与更年期相关的激素下降（尤其是雌激素减少）和衰老导致肌肉减少症，其特征是肌肉线粒体功能障碍、氧化应激和胰岛素抵抗。这种肌肉减少导致的肌肉质量和功能能力的减少进一步减少了肌肉因子（如BDNF、鸢尾素）的产生，损害了神经元增殖、成人神经发生和空间学习/记忆。这些病理生理变化显示了绝经后妇女肌肉减少症和AD进展之间的联系。这篇综述的独特之处在于，它讨论了更年期、肌肉减少症和AD之间的三角相互作用，提供了一个综合的机制框架，将激素下降、肌肉损失和神经退行性变联系起来。我们旨在阐明肌脑轴背后的病理生理原因，并根据目前的证据提出可行的治疗方法来减缓绝经后妇女肌肉减少症和认知退化。制定有针对性的战略，以提高生活质量和减少这一不断扩大的人口的医疗保健支出取决于了解更年期，肌肉减少症和认知之间的这种复杂的相互关系的进步。

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