Brain and Behavior最新文献

Background and purpose: The treatment effect of consciousness after brain injury is currently uncertain. Thus, this study aimed to retrieve the evidence from neurologists around the world on the management of consciousness disorders in patients with severe brain injury and evaluate and summarize the evidence, providing the guidance on the related management for clinicians.

Methods: Following the evidence summary report standard of Fudan University Center for Evidence-Based Nursing, clinical guidelines, expert consensuses, systematic reviews, and evidence summaries were systematically retrieved from UpToDate; BMJ Best Practice; Guidelines International Network; the Cochrane Library; Embase; PubMed; Sinomed; Web of Science; CNKI; WanFang database; American Academy of Neurology (AAN); American Congress of Rehabilitation Medicine (ACRM); European Academy of Neurology; and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). The publishing timeline for articles was limited from January 2017 to January 2024.

Results: Fourteen articles were finally identified. The 26 best pieces of evidence were recommended by inducting and integrating the evidence from these articles, covering the following seven aspects: consciousness assessment, multidisciplinary team, intervention in facilitating arousal, sensory stimulation programs, drug administration, rehabilitation program, and prevention of complications.

Conclusion: This study summarized the evidence of consciousness management in patients with brain injury, providing guidance for clinicians to develop and apply those interventions to improve the patient's clinical outcomes and quality of life. In addition, relevant factors such as the clinical environment and cooperation with the patient's family members should be evaluated and adjusted before applying such evidence. Future studies should focus on more targeted randomized clinical trials.

Background: The diagnostic and prognostic values of serum neurofilament light chain (sNfL), in comparison to cerebrospinal fluid (CSF) neurofilament light chain (cNfL), and other clinical parameters in amyotrophic lateral sclerosis (ALS) at the time of diagnosis remain elusive.

Methods: We examine paired serum and CSF samples from 80 ALS patients and 21 control subjects, all obtained at the time of diagnosis. Additional serum samples were collected from 51 other ALS patients. NfL concentrations were quantified using the single molecule array (Simoa) technique.

Results: Our findings demonstrate a robust correlation between NfL levels in matched CSF and serum samples. Notably, both sNfL (p < 0.0001) and cNfL (p < 0.0001) exhibited significantly elevated levels in ALS patients compared to controls. Furthermore, baseline sNfL concentrations, as well as cNfL levels, emerged as predictive indicators of subsequent disease progression rate (sNfL: p < 0.0001, cNfL: p = 0.0005) and overall survival (sNfL: p = 0.0073, cNfL: p = 0.0044). Employing a Cox regression model, we identified baseline sNfL level (HR = 1.01, p = 0.013), and diagnostic delay (HR = 0.94, p = 0.003) as independent prognostic factors for mortality. Furthermore, we constructed a nomogram model that incorporates both sNfL and pertinent clinical variables, which substantially enhances the accuracy of predicting disease outcomes (Concordance Index, 0.808).

Conclusion: Our study underscores the robust correlation between sNfL and cNfL in ALS patients and establishes baseline sNfL as a potent and independent prognostic marker for mortality.

Purpose: Pain is inherently salient and so draws our attention in addition to impacting performance on attention-demanding tasks. Individual variability in pain-attention interactions can be assessed by two kinds of behavioral phenotypes that quantify how individuals prioritize pain versus attentional needs. The intrinsic attention to pain (IAP) measure quantifies the degree to which a person attends to pain (high-IAP) or mind-wanders away from pain (low-IAP). The A/P categorization quantifies how pain impacts cognitive performance during an attention-demanding task classifying individuals into P type (pain dominates, worse performance during pain in comparison to no pain) and A type (attention to task dominates, better performance during pain in comparison to no pain). Although previous MRI-based studies have linked these phenotypes with the dynamic pain connectome (DPC), the underlying neural oscillations are not known. This paper aims to examine the brain-behavior relationship between alpha and theta oscillations within nodes of the DPC and pain-attention phenotypes.

Method: Fifty participants (27 F, 23 M) underwent resting-state magnetoencephalography (MEG). Individual IAP scores were determined by assessing mind-wandering during pain and A/P type was based on interference of pain with cognitive task performance.

Finding: The main findings were: (1) peak alpha frequency (PAF) power did not differ between low/high-IAP individuals or A/P-type individuals within the nodes of the DPC; (2) compared to high-IAP individuals, those with low-IAP have slower PAF in the left primary somatosensory cortex, posterior cingulate cortex and precuneus and higher theta power in the ascending nociceptive pathway and default mode network; (3) males with low-IAP, compared to females, had higher PAF power throughout the DPC.

Conclusion: Alpha and theta oscillations within the DPC may underlie aspects of attentional focus and pain-attention interactions.

Background: The underlying mechanism of quetiapine (QET) in treating cognitive impairment in sleep deprivation is unclear. The present study aimed to evaluate the effects of treatment with QET on novel object recognition and hippocampal (hippo) brain-derived neurotrophic factor (BDNF) levels in rats submitted to 72 h sleep deprivation (SD).

Materials and methods: A total of 42 adult male Wistar albino rats were assigned into six experimental groups: non-sleep-deprived (NSD) control, short-term control group (n = 7) received a single intraperitoneal (i.p.) injection 10 mg/kg QET of 1 mL saline (4 days) (NSD-STQET), long-term control group (n = 7) received single i.p. injection 10 mg/kg QET of 1 mL saline (30 days) (NSD-LTQET); 72 h sleep-deprived (SD) group, 72 h SD short-term group received short-term i.p. injection 10 mg/kg QET of either (n = 7) (SD-STQET), and 72 h SD long-term group received long-term i.p. injection 10 mg/kg QET of either (n = 7) QET (SD-LTQET). SD was performed using the modified multiple-platform technique in a water tank for 72 h. Additionally, we aim to reveal the consequences of 72 h SD and QET effects on memory processes with hippo BDNF levels by testing rats in the novel object recognition (NOR) test and ELISA method.

Results: Long-term QET administration in healthy rats decreased NOR and BDNF protein expression in the hippocampus, as did 72 h SD. Long- and short-term QET administration reversed SD effects, but only short-term QET administration increased hippo BDNF.

Conclusion: These results suggest that the beneficial effects of QET on SD may be partly related to the upregulation of recognition memory and neuroprotective proteins such as BDNF. However, long-term QET treatment in the absence of a disease model may have the potential to negatively impact recognition memory and BDNF levels, which support synaptic plasticity and cognitive function.

Introduction: Intimate partner violence (IPV) and depression are global health concerns with high prevalence rates and substantial negative impacts on individuals and the wider community. Women are particularly vulnerable to both IPV victimization and depressive disorders, and both are recognized worldwide as priorities for women's health. The aim of this systematic review and meta-analysis was to determine whether recent longitudinal empirical evidence supports exposure to IPV as a contributing factor to the subsequent onset of depression in women.

Methods: A search was performed in August 2024 of the Medline, PsychInfo, and EBSCOHost databases for longitudinal studies published after the year 2013, and 1193 studies were identified. Studies were included if they were written in English and measured IPV as an independent variable with depression as a dependent variable. Studies were excluded if depression was not measured separately from other variables or did not report primary quantitative data. Eleven studies with 118,544 female participants met the inclusion criteria for review.

Results: Ten of the 11 reviewed studies reported a statistically significant positive association between exposure to IPV and depression in women. A random effects meta-analysis was used to generate pooled odds ratios from nine estimates, which demonstrated that female IPV survivors have significantly increased odds of developing subsequent depression (OR = 1.92, (95% CI: 1.28, 2.86); although, there was high heterogeneity across studies (I² = 98.3%, p < 0.001). Ten of the 11 studies were from high-income, industrialized countries, which limits the global application of these findings.

Conclusions: These findings suggest that IPV may be one of many contributing factors for depression in women. However, variability in the definition of IPV and inconsistent adjustment for confounders across studies limits firm conclusions. The findings of this review suggest that strategies to prevent IPV could play a role in reducing the prevalence of depression. They also support the inclusion of depression screening for survivors of IPV in clinical approaches and a review of the effectiveness of IPV-related depression intervention strategies.

Purpose: Essential tremor (ET) is a prevalent movement disorder, yet current therapeutic options remain limited. Emerging evidence implicates leucine-rich repeat and immunoglobulin-like domain-containing protein (Lingo-1) and neuroinflammation in the pathophysiology of ET. This study aimed to investigate whether agmatine, a biogenic amine neuromodulator attenuates tremors and modulates the expression of Lingo-1 and proinflammatory markers in a rodent model of ET.

Methods: Tremor was induced in male Swiss Webster mice through intraperitoneal injections of harmaline (10 mg/kg) on Days 1, 3, and 5 of the study. During the same period, agmatine (40 mg/kg) was administered for 5 consecutive days. Behavioral assessments of tremor severity, gait, balance, muscular strength, locomotion, anxiety-like behavior, and memory were conducted. Moreover, Lingo-1 and interleukin (IL)-6 gene expression was examined in the cerebellum using real-time polymerase chain reaction (RT-PCR).

Findings: Our findings demonstrated that agmatine administration significantly reduced tremors, ameliorated anxiety-like behaviors, and attenuated harmaline-induced locomotor deficits. At the molecular level, agmatine treatment significantly suppressed the overexpression of Lingo-1 elicited by harmaline. Moreover, IL-6 expression was attenuated to an extent comparable to control levels.

Conclusions: Collectively, this study provides the first evidence that agmatine dampens tremor severity, improves behavioral outcomes, and modulates key pathways implicated in ET pathogenesis in a rodent model. The ability of agmatine to normalize Lingo-1 and IL-6 expression suggests regulation of these pathways could underlie its neuroprotective action. These results suggest promise for agmatine as a prospective therapeutic agent in ET.

Purpose: The neurobiological heterogeneity present in schizophrenia remains poorly understood. This likely contributes to the limited success of existing treatments and the observed variability in treatment responses. Our objective was to employ magnetic resonance imaging (MRI) and machine learning (ML) algorithms to improve the classification of schizophrenia and its subtypes.

Method: We utilized a public dataset provided by the UCLA (University of California, Los Angeles) Consortium for Neuropsychiatric Research, containing structural MRI and resting-state fMRI (rsfMRI) data. We integrated all individuals within the dataset diagnosed with schizophrenia (N = 50), along with age- and gender-matched healthy individuals (N = 50). We extracted volumetrics of 66 subcortical and thickness of 72 cortical regions. Additionally, we obtained four graph-based measures for 116 intracranial regions from rsfMRI data, including degree, betweenness centrality, participation coefficient, and local efficiency. Employing conventional ML methods, we sought to distinguish the patients with schizophrenia from healthy individuals. Furthermore, we applied the methods for discriminating subtypes of schizophrenia. To streamline the feature set, various feature selection techniques were applied. Moreover, a validation phase involved employing the model on a dataset domestically acquired using the same imaging assessments (N = 13). Finally, we explored the correlation between neuroimaging features and behavioral assessments.

Finding: The classification accuracy reached as high as 79% in distinguishing schizophrenia patients from healthy in the UCLA dataset. This result was achieved by the k-nearest neighbor algorithm, utilizing 12 brain neuroimaging features, selected by the feature selection method of minimum redundancy maximum relevance (MRMR). The model demonstrated effectiveness (72% accuracy) in estimating the patient's label for a new dataset acquired domestically. Using a linear support vector machine (SVM) on 62 features obtained from MRMR, patients with schizophrenic subtypes were classified with an accuracy of 64%. The highest Spearman correlation coefficient between the neuroimaging features and behavioral assessments was observed between the degree of the postcentral gyrus and mean reaction time in the verbal capacity task (r = 0.49, p = 0.001).

Conclusion: The findings of this study underscore the utility of MRI and ML algorithms in enhancing the diagnostic process for schizophrenia. Furthermore, these methods hold promise for detecting both brain-related abnormalities and cognitive impairments associated with this disorder.

Background: Different modes of motor acquisition, including motor execution (ME), motor imagery (MI), action observation (AO), and mirror visual feedback (MVF), are often used when learning new motor behavior and in clinical rehabilitation.

Purpose: The aim of this study was to investigate differences in brain activation during different motor acquisition modes among healthy young adults.

Methods: This cross-sectional study recruited 29 healthy young adults. Participants performed a functional reaching and grasping task under ME, MI, AO, and MVF mode with their right arms at a frequency of 0.5 Hz for 1 min per task. Each task was performed three times in a random order. Brain activation in the supplementary motor area (SMA), premotor cortices (PMC), and primary motor cortices (M1) during tasks was measured using functional near-infrared spectroscopy through 16 source-detector channels.

Results: ME showed significant activation in bilateral PMC, M1, and right SMA, with higher activation in the contralateral M1. MI induced greater activity in the PMC and SMA, particularly in the ipsilateral regions. MVF resulted in significant activation in bilateral PMC, SMA, and M1. AO showed an increasing trend in brain activation, but no significant differences in any channels. Compared to AO, ME and MVF induced significantly greater brain activity in M1.

Conclusion: Activation levels under MI and MVF were comparable to that of ME. MI and MVF induced greater activity in the PMC and SMA, and MVF showed significant activity in all brain areas, especially in the bilateral M1. These findings support the application of different motor acquisition strategies according to individual needs. When ME cannot be executed, such as for individuals with hemiparesis or severe impairments of both upper extremities, MI and MVF may be applied, respectively, to drive neuroplastic changes.

Background and purpose: Observational studies have indicated a high occurrence of coexistence between myasthenia gravis (MG) and autoimmune thyroid disease (AITD) in clinical settings, but the causal relationship between the two conditions remains ambiguous. Therefore, this study endeavors to investigate the causal links between MG, along with its subgroups, and AITD through a Mendelian randomization (MR) approach.

Methods: Genetic instrumental variables associated with MG and AITD were selected from three major publicly available GWAS databases for MR analysis. The primary method for evaluating causal effects was the inverse variance weighted (IVW) method. Supplementary methods included MR-Egger regression and weighted median. The reliability and stability of the results were ensured through tests for heterogeneity, assessment of pleiotropy, and sensitivity analysis using the leave-one-out approach.

Results: The investigation revealed reciprocal causal associations between MG and both Graves' disease and autoimmune hypothyroidism. Genetic predisposition to MG was linked to an increased likelihood of developing Hashimoto's thyroiditis (OR = 1.242(1.073-1.437, P = 0.0036)), and early-onset MG also exhibited an association with an elevated risk of HT (OR = 1.157(1.073-1.246), P = 1.269×10^-4). No statistically significant relationships were found for the other conditions.

Conclusion: This extensive MR analysis provides evidence suggesting a potential association between MG and AITD, particularly with Graves' disease and Hashimoto's thyroiditis. Consequently, proactive treatment strategies targeting either MG or autoimmune thyroid disorders may help mitigate the risk of comorbidities in affected patients.

Background: Spinal muscular atrophy (SMA) is a motor neuron disease caused by mutations in the SMN1 gene. Nusinersen, an antisense oligonucleotide, has been shown to improve motor function in SMA patients. However, concerns regarding its renal safety remain as previous studies have linked similar treatments to renal toxicity.

Objective: The aim of this study was to evaluate the effects of the nusinersen treatment on platelet counts and renal functions, specifically urine protein excretion, in SMA patients and to estimate safe urinary protein levels before administration of each intrathecal injection.

Methods: This retrospective study examined data from 33 patients with SMA to assess the effects of nusinersen on motor functions and laboratory parameters including platelet count, serum creatinine, urine protein, and urine creatinine. Measurements were taken at baseline andprior to each maintenance dose, after the completion of four initial loading doses. The baseline values were compared between SMA Type 1 and Type 2 patients, while the changes in these values over time were analyzed within each group.

Results: No significant adverse effects on platelet counts or renal functions were observed. Urine creatinine and protein levels were significantly higher in SMA Type 2 patients compared to SMA Type 1 at baseline; these parameters remained stable in SMA Type 2 but increased significantly after the loading doses in SMA Type 1. Motor function improvements were observed in both groups, with the most significant gains in SMA Type 1 after the loading doses. Thus, improvement in motor functions was associated with increase in urine creatinine.

Conclusion: Nusinersen treatment did not cause significant renal toxicity or affect platelet counts. Urine creatinine levels may serve as a potential biomarker for assessing treatment response in SMA Type 1.