Brain Sciences最新文献

Introduction: Alzheimer's disease (AD) is a neurodegenerative disorder characterized by memory loss and cognitive decline, primarily due to dysfunction of acetylcholine caused by acetylcholinesterase and butyrylcholinesterase. While synthetic cholinesterase inhibitors like donepezil, rivastigmine, and galantamine are commonly used, they have notable side effects, prompting interest in natural alternatives. Medicinal plants, rich in bioactive compounds like flavonoids and alkaloids, have shown potential as cholinesterase inhibitors with additional antioxidants and anti-inflammatory benefits. This study aimed to evaluate the cholinesterase-inhibiting effects of various plant species and their compounds to identify new therapeutic candidates and reduce side effects.

Method: A PRISMA-compliant review was conducted, screening studies from multiple databases, with a final inclusion of 64 in vivo studies.

Results: These studies highlighted plant extracts such as Ferula ammoniacum, Elaeagnus umbellata, Bacopa monnieri, and Centella asiatica, which improved memory, reduced oxidative stress, and provided neuroprotection. Some extracts also reduced amyloid plaques, enhanced neuronal integrity, and restored cholinesterase activity, indicating their potential as therapeutic agents for AD and other neurodegenerative diseases.

Conclusions: The findings underscore the promise of plant-based compounds in treating cognitive decline and cholinergic dysfunction in AD, advocating for further research into their therapeutic potential.

Background: Prenatal stress has been reported to harm the physiological and biochemical functions of the brain of the offspring, potentially resulting in anxiety- and depression-like behaviors later in life. Trans-Resveratrol (RESV) is known for its anti-inflammatory, anxiolytic, and antidepressant properties. However, whether administering RESV during pregnancy can counteract the anxiety- and depression-like behaviors induced by maternal stress is unknown.

Objective: This study aimed to assess the protective potential of RESV against molecular and behavioral changes induced by prenatal stress.

Methods: During pregnancy, the dams received 50 mg/kg BW/day of RESV orally. They underwent a movement restriction for forty-five minutes, three times a day, in addition to being exposed to artificial light 24 h before delivery. The male offspring were left undisturbed until early adulthood, at which point they underwent behavioral assessments, including the open field test, elevated plus maze, and forced swim test. Subsequently, they were euthanized, and the hippocampus and prefrontal cortex were extracted for RT-qPCR analysis to measure Bdnf mRNA expression.

Results: By weaning, results showed that prenatal stress led to reduced weight gain and, in adulthood, increased anxiety- and depression-like behaviors and changes in Bdnf mRNA expression. However, these effects were attenuated by maternal RESV supplementation.

Conclusions: The findings suggest that RESV can prevent anxiety- and depression-like behaviors induced by prenatal stress by modulating Bdnf mRNA expression.

Background: Coccygodynia presents significant challenges in diagnosis and treatment. While coccygectomy has emerged as a crucial intervention for refractory cases, significant heterogeneity exists in surgical techniques. Traditional approaches are increasingly complemented by novel methods, necessitating a comprehensive review of current surgical options.

Methods: A comprehensive literature review was conducted using Ovid MEDLINE, Cochrane Library and Embase databases from inception to present. Search terms included "coccygectomy", "coccydynia", "coccygodynia", "coccyx pain" and "tailbone pain". We analyzed peer-reviewed studies focusing on surgical techniques, outcomes and complications of coccygectomy. Studies were excluded if non-peer-reviewed, non-English without translation, or not directly addressing surgical management.

Results: Traditional midline approaches, while common, demonstrate increased wound complications compared to paramedian techniques. Minimally invasive methods, including coccygeoplasty and endoscopic coccygectomy, show promising early outcomes with reduced recovery times. Both partial and complete resections provide significant pain relief, with complete resection potentially offering superior results in severe cases. Wound closure technique significantly impacts surgical success.

Conclusions: Optimal outcomes in coccygectomy require individualized surgical approaches incorporating modern techniques like paramedian incision and advanced wound closure. Emerging minimally invasive procedures may further reduce complications and enhance recovery. Treatment success depends on careful patient selection and surgical technique optimization.

Introduction: Bipolar disorder (BD) affects over 1% of the global population and significantly impacts psychosocial functioning and life expectancy. This manuscript has the objective of investigating gender differences in the clinical and biochemical parameters of patients affected by BD. Methods: This retrospective cross-sectional study examined 672 patients diagnosed with BD in psychiatric wards in Milan and Monza. Clinical data and biochemical parameters were collected on the first day of hospitalization. Independent sample t-tests, chi-square tests and binary logistic regressions were performed to identify gender differences in BD. Results: With regard to univariate analyses, women were found to be more susceptible to psychiatric comorbidities (χ² = 12.75, p < 0.01), medical comorbidities (χ² = 45.38, p < 0.01), obesity (χ² = 6.75, p = 0.01) and hypercholesterolemia (χ² = 23.54, p < 0.01), as well as to having more mood episodes in the year prior to hospitalization (t = 5.69, p < 0.01). Men were found to be more likely to develop psychotic symptoms (χ² = 4.40, p = 0.04), to be tobacco smokers (χ² = 15.13, p < 0.01) and to have substance abuse disorders (χ² = 14.66, p = <0.01). Logistic regression analyses showed that women compared to men showed more psychiatric comorbidity (p < 0.01), higher Global Assessment of Functioning (GAF) scores (p = 0.05) and higher total cholesterol plasma levels (p < 0.01); however, they also had fewer red blood cells (p < 0.01) and lower creatinine plasma levels (p < 0.01). Conclusions: Female patients (compared to males) exhibited higher levels of global functioning despite the higher frequency of psychiatric comorbidity and susceptibility to metabolic complications; consistent with earlier studies, female patients also showed higher cholesterol levels. Further studies will have to confirm the present findings and identify gender-related clinical pathways for the management of BD.

Background: Isocitrate dehydrogenase (IDH) wild-type (wt) glioblastoma is an aggressive malignancy associated with poor clinical outcomes, marked by high heterogeneity and resistance to treatment. This study aims to investigate the prognostic significance of B7-H3 expression in IDH wt glioblastoma and its potential association with clinical outcomes, including overall survival (OS) and progression-free survival (PFS). Additionally, the relationship between B7-H3 and PD-L1 expression was explored.

Methods: A retrospective cohort of 86 IDH wt glioblastoma patients, all of whom underwent surgery, radiotherapy, and temozolomide treatment, was analyzed. B7-H3 expression was quantified using an immunoreactivity score (IRS), classifying samples as low (IRS ≤ 4) or high (IRS > 4). PD-L1 expression was evaluated based on tumor and immune cell staining, with >5% positivity indicating significant expression.

Results: High B7-H3 expression was significantly associated with poorer OS and PFS. Co-expression of B7-H3 and PD-L1 was prevalent, particularly among younger male patients with unifocal tumors; however, PD-L1 expression did not show a significant correlation with clinical outcomes.

Conclusions: B7-H3 appears to be a promising prognostic biomarker in IDH wt glioblastoma and may serve as a target for developing combination therapies, integrating B7-H3-targeting treatments with immune checkpoint inhibitors. Further prospective studies are necessary to validate these findings and to explore potential therapeutic strategies.

Background/Objectives: Bilateral steno-occlusive disease of the internal carotid artery (ICA) carries an increased stroke risk with associated high morbidity and mortality. Management of these patients is often complex. In this study, we evaluate the value of non-invasive optimal vessel analysis quantitative magnetic resonance angiography (NOVA-qMRA) for studying flow and collateral patterns in patients with bilateral carotid steno-occlusive disease. Methods: Patients with bilateral ICA-stenosis ≥ 50% who received NOVA-qMRA were included in this study. The volume flow rates (VFRs) of the A2-segment of the anterior cerebral artery (A2-ACA), M1-segment of the middle cerebral artery (M1-MCA), and P2-segment of the posterior cerebral artery (P2-PCA) were analyzed. Demographic, clinical, and treatment data were collected. Results: Twenty-two patients (mean age ± SD: 68 ± 10 years) were included. Nineteen patients (86%) were symptomatic. Thirteen patients (59%) were revascularized; among them, M1-VFR was significantly lower (p-value = 0.01) on the side selected for revascularization (88 mL/min ± 53) compared to the contralateral one (130 mL/min ± 56). P2-VFR was significantly higher (p-value = 0.04) in the treated subgroup (108 mL/min ± 41) than in the non-treated one (83 mL/min ± 34). Conclusions: The present study supports the use of NOVA-qMRA to study flow and collateral patterns in patients with bilateral steno-occlusive carotid disease, especially M1- and P2-VFR. This information may be helpful for decision-making and to tailor revascularization treatment.

Background/Objectives: Since high frequencies are susceptible to disruption in various types of hearing loss, a symptom which is common in people with tinnitus, the aim of the study was to investigate EEG cortical auditory evoked and P300 responses to both a high- and low frequency-centered oddball paradigm to begin to establish the most suitable cognitive physiologic testing conditions for those with both unimpaired hearing and those with hearing impairments. Methods: Cortical auditory evoked potential (CAEP) P1, N1, P2 and P300 (subtraction wave) peaks were identified in response to high- (standard: 6000 Hz, deviant: 8000 Hz) and low frequency (Standard: 375 Hz, Deviant: 500 Hz) oddball paradigms. Each paradigm was presented at various intensity levels. Latencies and amplitudes were then computed for each condition to assess the effects of frequency and intensity. Results: Stimulus intensity had no effect on either the high- or low frequency paradigms of P300 characteristics. In contrast, for the low frequency paradigm, intensity influenced the N1 latency and P2 amplitude, while for the high frequency paradigm intensity influenced P1 and P2 latency and P2 amplitude. Conclusions: Obligatory CAEP components responded more readily to stimulus frequency and intensity changes, and one possible consideration is that higher frequencies could play a role in the response characteristics exhibited by N1 (except for N1 amplitude) and P2, given their involvement in attentional processes linked to the detection of warning cues. P300 latency and amplitude were not influenced by such factors. These findings support the hypothesis that disentangling the cognitive from the more sensory-based response is possible, even in those with hearing loss, provided that the patient's hearing loss is considered when determining the presentation level. While the present study was performed in participants with unimpaired hearing, these data set up future studies investigating the effectiveness of using similar methods in hearing-impaired persons.

Background: Recently proposed brain-tumor treatment strategies prioritize fast reduction of tumor cell population while often neglecting the radiation or chemotherapeutic drug dosage requirements to achieve it. Moreover, these techniques provide chemotherapy based treatment strategies, while ignoring the toxic side effects of the drugs employed by it. Methods: This study updates the recently proposed brain-tumor system dynamics by incorporating radiotherapy along with chemotherapy to simultaneously initiate both therapies for a more comprehensive and effective response against tumor proliferation. Afterwards, based on the upgraded system dynamics, this study proposes a novel multi-input sigmoid-based smooth synergetic nonlinear controller with the aim to reduce the dosage requirements of both therapies while keeping the overall system response robust and efficient. The novelty of this study lies in the combination of radiotherapy and chemotherapy inputs in a way that prioritizes patients health and well-being, while integrating advanced synergetic control technique with a sigmoid function based smoothing agent. Results: The proposed method reduced baseline radiation and chemo drug dosages by 57% and 33% respectively while effectively suppressing tumor growth and proliferation. Similarly, the proposed controller reduced the time required for complete tumor mitigation by 60% while reducing the radiation and chemotherapeutic drug intensity by 93.8% and 21.3% respectively. Conclusions: This study offers significant improvement in tumor treatment methodologies by providing a safer, less riskier brain-tumor treatment strategy that has promising potential to improve survival rates against this menacing health condition so that the affected patients may lead a healthier and better quality of life.

Background/Objectives: Hemispatial neglect is common after stroke but is often evaluated only after right hemisphere (RH) stroke. We sought to determine the prevalence of two types of neglect, viewer-centered neglect (VCN) and stimulus-centered neglect (SCN), after left hemisphere (LH) and RH strokes. Additionally, we identified lesion load in each vascular territory and areas of hypoperfusion, estimated with FLAIR hyperintense vessels (FVHs) that contribute to neglect. Methods: A series of 233 stroke patients (73 LH and 160 RH) were administered a task to detect VCN and SCN and received brain MRI within 5 days of onset. We used multivariable logistic regression to identify vascular territories where lesion load and/or hypoperfusion contributed to each type of neglect. Results: While VCN was more prevalent after RH stroke, SCN occurred at a similar rate after LH and RH stroke. In RH stroke, lesion load in the middle cerebral artery occipital region and anterior cerebral artery territory and age predicted left VCN, whereas parietal hypoperfusion independently predicted left SCN. In LH stroke, lesion load across regions and age predicted right VCN, while lesion load in posterior cerebral artery occipital and anterior cerebral artery regions, as well as age, predicted right SCN. The addition of information about hypoperfusion improved the prediction of both VCN and SCN. Conclusions: VCN and SCN are each common after RH stroke, and SCN is common after LH stroke. Each type of neglect is accounted for by distinct areas of infarct and hypoperfusion. Results will aid in the detection of neglect after stroke and may guide reperfusion interventions to improve neglect.

Fibromyalgia is a common, high-impact condition of chronic widespread pain and sensory dysfunction associated with altered central and peripheral sensory processing. A growing body of evidence supports the role of neuroinflammation and immune changes in fibromyalgia, and a narrative review of this literature was undertaken. Published data suggest that the interactions between the neural pain networks and the immune system in fibromyalgia appear to be bidirectional and operate both centrally and peripherally. There is a growing focus on processes occurring in the dorsal root ganglia and the role of maladaptive microglial cell activation. Ongoing insight into neuroinflammatory mechanisms in fibromyalgia opens potential avenues for the development of mechanism-based therapies in what is, at present, a challenging-to-manage condition.