Brain Sciences最新文献

Background/Objectives: The study examined the relationships between specific Theory-of-Mind (ToM) dimensions, cognitive planning, and sleep duration in aging adults. Methods: The sample included 179 participants, comprising 46 cognitively healthy individuals, 75 diagnosed with amnestic Mild Cognitive Impairment (aMCI), and 58 with non-amnestic (naMCI). The mean age of the participants was 70.23 years (SD = 4.74), with a mean educational attainment of 12.35 years (SD = 3.22) and gender distribution of 53 men and 126 women. ToM assessment included tasks measuring the understanding and interpretation of non-literal speech, proverbs and metaphors, as well as an emotion-recognition test. For cognitive planning, a Tower Test was utilized. Sleep duration was measured using actigraphy. Results: We identified significant differences in various ToM tasks' performance between the groups, particularly in non-literal speech tasks and third-order ToM stories. The HC group consistently outperformed both MCI groups in these tasks, with aMCI showing higher performance than naMCI. Mediation analysis applied to examine potential direct and indirect effects of sleep duration on ToM tasks indicated that total sleep time had significant indirect effects through cognitive planning-mainly as rule violation total score-on specific ToM aspects. Hence, besides the effects of MCI pathologies and especially of naMCI, sleep duration seems also to be associated with ToM performance in aging via specific executive functioning decrements. Conclusions: The findings underscore the social implications of ToM deficits due to MCI and/or sleep duration decrease, particularly in naMCI older adults, as they can seriously impair their social interactions. Targeted interventions could improve emotional understanding, communication, and overall quality of life.

Background/objectives: A neurobiological framework of bi- or multilingual neurocognitive development must consider the following: (i) longitudinal behavioral and neural measures; (ii) brain developmental constraints across structure and function; and (iii) the development of global multilingual competence in a homogeneous social environment. In this study, we investigated whether multilingual competence yields early changes in executive attention control mechanisms and their underlying neural structures in the frontal-striatal system, such as the dorsal anterior cingulate cortex/pre-supplemental area and the left caudate.

Methods: We employed longitudinal neuroimaging and functional connectivity methods in a small group of multilingual children over two years.

Results: We found that the dACC/preSMA is functionally influenced by changes in multilingual competence but not yet structurally adapted, while the left caudate, in a developmental stage, is influenced, adapts, and specializes due to multilingual experience. Furthermore, increases in multilingual competence strengthen connections between the dACC/preSMA, left caudate, and other structures of the cognitive control network, such as the right inferior frontal gyrus and bilateral inferior parietal lobules.

Conclusions: These findings suggest that multilingual competence impacts brain "adaptation" and "specialization" during childhood. The results may provide insights and guide future research on experience-expectant and experience-dependent brain plasticity to explain the "interaction" between multilingualism and neurodevelopment.

Acute vertigo or dizziness is a frequent presentation to the emergency department (ED), making up between 2.1% and 4.4% of all consultations. Given the nature of the ED where the priority is triage, diagnostic delays and misdiagnoses are common, with as many as a third of vertebrobasilar strokes presenting with acute vertigo or dizziness being missed. Here, we review diagnostic errors identified in the evaluation and treatment of the acutely dizzy patient and discuss strategies to overcome them. Lessons learned include focusing on structured history taking, asking about timing and triggers to inform a targeted examination, assessing subtle ocular motor findings (e.g., by use of HINTS(+)), and avoiding overreliance on brain imaging (including early magnetic resonance imaging including diffusion-weighted sequences [DWI-MRI]). Importantly, up to 20% of DWI-MRI may be false negatives if obtained within the first 24-48 h after symptom onset. Likewise, overreliance on focal neurologic findings to confirm a stroke diagnosis should be avoided because isolated dizziness, vertigo, or even unsteadiness may be the only symptoms in some patients with vertebrobasilar stroke. Furthermore, in patients with triggered episodic vestibular symptoms provocation maneuvers should be preferred over HINTS(+), and a potential diagnosis of stroke should not be immediately dismissed in younger patients presenting with a headache (where migraine may be more common), but the possibility of a vertebral artery dissection should be further evaluated. Importantly, moderate training of non-experts allows for significant improvement in diagnostic accuracy in the acutely dizzy patient and thus should be prioritized.

Background/objectives: While most studies on the postoperative condition of patients with spinal cord tumors describe long-term outcomes, data are needed on immediate surgical outcomes demanding rehabilitation to make informed assessments for postoperative planning. The aim of this study was to identify factors predicting function and rehabilitative needs after intradural spinal tumor surgery.

Methods: Eighty-five prospectively recruited patients underwent surgery for intradural intramedullary (ID-IM; n = 23) and extramedullary (ID-EM; n = 62) tumors. Neurological and functional status were assessed before surgery, after surgery, and at discharge using the modified McCormick scale (MMS), Karnofsky performance status (KPS) scale, Barthel index (BI), and the gait index (GI).

Results: There were no significant predictors of early postoperative rehabilitation in the ID-IM group. In the ID-EM group, age, thoracic level, subtotal resection (STR), repeat surgery, and functional scale scores predicted the need for rehabilitation. In multivariable analysis, MMS (odds ratio (OR) 8.7; 95% confidence interval (CI): 2.37-32.44) and STR (OR 13.00; 95%CI: 1.56-107.87) remained independent predictors of rehabilitation need (area under curve, 92%). Despite their younger age, most patients with ID-IM tumors, especially ependymomas, required rehabilitation but improved quickly (KPS, BI, p < 0.001). Among ID-EM tumors, meningiomas were characterized by poorer preoperative function and low gross total resection (GTR) rates, but did not deteriorate neurologically after surgery. Patients with schwannoma and ID-EM ependymomas achieved the highest GTR rate and had the best function both before and after surgery.

Conclusions: These results may be useful for estimating early rehabilitation needs after intradural tumor surgery and counseling patients before surgery about the expected postoperative course.

Background: Chronic postoperative pain (CPOP) is among the main consequences of surgical procedures, directly affecting the quality of life. Although many strategies have been used to treat this symptom, they are often ineffective. Thus, studies investigating CPOP-associated mechanisms may help to develop more effective treatment strategies. Therefore, the present study investigated the spinal participation of the transient potential receptor vanilloid type 1 (TRPV1) and PI3K/AKT/mTOR pathway activation during CPOP.

Methods: In this study C57BL/6 male mice were used, and CPOP was induced by muscle retraction and incision. The nociceptive threshold was measured by the von Frey filament test. For pharmacological evaluation, TRPV1 and PI3K/AKT/mTOR inhibitors were administered intrathecally. TRPV1 and PI3K/AKT/mTOR protein levels were evaluated by Western blotting.

Results: The results showed that CPOP increased TRPV1 and mTOR protein levels, and pretreatment with the specific inhibitors alleviated CPOP. In addition, pretreatment with the TRPV1 antagonist SB-366791 attenuated mTOR protein levels.

Conclusions: The results suggest that TRPV1 and the PI3K/AKT/mTOR pathway are involved in CPOP at the spinal level, and TRPV1 may activate mTOR during this process.

Background/objectives: Sustaining the human brain's hippocampus from atrophy throughout ageing is critical. Exercise is proven to be effective in promoting adaptive hippocampal plasticity, and the hippocampus has a bidirectional relationship with the physical environment. Therefore, this systematic review explores the effects of walking, a simple physical activity in the environment, on hippocampal formation volume changes for lifelong brain and cognitive health.

Method: PubMed, Scopus, and Web of Science were searched for studies on humans published up to November 2022 examining hippocampal volume changes and walking. Twelve studies met the inclusion criteria. Study quality was assessed using the PEDro scale and ROBINS-I tool. A narrative synthesis explored walking factors associated with total, subregional, and hemisphere-specific hippocampal volume changes.

Results: Overall, walking had positive effects on hippocampal volumes. Several studies found benefits of higher-intensity and greater amounts of walking for total hippocampal volume. The subiculum increased after low-intensity walking and nature exposure, while the parahippocampal gyrus benefited from vigorous intensity. The right hippocampus increased with spatial navigation during walking. No studies examined the effect of walking on the dentate gyrus.

Conclusions: This systematic review highlights walking as a multifaceted variable that can lead to manifold adaptive hippocampal volume changes. These findings support the promotion of walking as a simple, effective strategy to enhance brain health and prevent cognitive decline, suggesting the design of physical environments with natural and biophilic characteristics and layouts with greater walkability and cognitive stimulation. Future research is encouraged to explore the hippocampal subregional changes instead of focusing on total hippocampal volume, since the hippocampal formation is multicompartmental and subfields respond differently to different walking-related variables.

Background: Decoding motor intentions from electroencephalogram (EEG) signals is a critical component of motor imagery-based brain-computer interface (MI-BCIs). In traditional EEG signal classification, effectively utilizing the valuable information contained within the electroencephalogram is crucial.

Objectives: To further optimize the use of information from various domains, we propose a novel framework based on multi-domain feature rotation transformation and stacking ensemble for classifying MI tasks.

Methods: Initially, we extract the features of Time Domain, Frequency domain, Time-Frequency domain, and Spatial Domain from the EEG signals, and perform feature selection for each domain to identify significant features that possess strong discriminative capacity. Subsequently, local rotation transformations are applied to the significant feature set to generate a rotated feature set, enhancing the representational capacity of the features. Next, the rotated features were fused with the original significant features from each domain to obtain composite features for each domain. Finally, we employ a stacking ensemble approach, where the prediction results of base classifiers corresponding to different domain features and the set of significant features undergo linear discriminant analysis for dimensionality reduction, yielding discriminative feature integration as input for the meta-classifier for classification.

Results: The proposed method achieves average classification accuracies of 92.92%, 89.13%, and 86.26% on the BCI Competition III Dataset IVa, BCI Competition IV Dataset I, and BCI Competition IV Dataset 2a, respectively.

Conclusions: Experimental results show that the method proposed in this paper outperforms several existing MI classification methods, such as the Common Time-Frequency-Spatial Patterns and the Selective Extract of the Multi-View Time-Frequency Decomposed Spatial, in terms of classification accuracy and robustness.

Background/Objectives: HIV-associated neurocognitive impairment (NCI) remains a prevalent issue among people with HIV (PWH) despite advancements in antiretroviral therapy (ART). The pathogenesis of HIV-associated NCI is linked to chronic neuroinflammation caused by HIV, even in those with successful viral suppression. Growth Differentiation Factor 15 (GDF15), a protein involved in inflammatory and metabolic stress responses, has emerged as a key player and potential biomarker for various neurological conditions. This study investigates the relationship between GDF15 expression and HIV-associated NCI. Methods: PWH from the California NeuroAIDS Tissue Network (CNTN) underwent comprehensive neuropsychological exams within 12 months before death and were categorized based on cognitive performance. We examined GDF15 levels in their CSF (Cerebrospinal Fluid) and brain tissues using immunoblotting, immunohistochemistry, double immunolabeling, and ELISA. Results: The cohort was of a similar age across HIV-associated NCI statuses (mean = 40.5), with a predominance of males (77%). The mean plasma viral load was 3.56 log₁₀ copies/mL for Neurocognitively Unimpaired (NUI) PWH and 5.38 log10 copies/mL for people with HIV-associated NCI. GDF15 protein levels were significantly elevated in the frontal cortices of PWH with NCI compared to NUI PWH. Conclusions: The findings indicate that GDF15 may play a role in the pathogenesis of HIV-associated NCI, possibly through neuroinflammatory mechanisms. The strong association between GDF15 levels and cognitive impairment severity suggests its potential as a biomarker for the early detection and monitoring of NCI in PWH.

Background/objectives: Based on previous data reporting the status of health professionals' training about sleep clinical psychophysiology, insomnia, and its treatment in the US and Canada, this paper aims at providing a snapshot of the Italian situation, considering health professionals qualified to offer cognitive behavioral therapy (CBT). Adding information on different countries is important, as national health systems differ significantly, and distinct evidence-based pathways for change may be proposed.

Methods: Two hundred and thirteen CBT professionals (180 females; 33 males) answered a 5 min survey about their training and experience in recognizing and treating behavioral sleep disorders in their practice. The questionnaire was diffused through the mailing list of the Italian Behavioral and Cognitive Therapy Society (Società Italiana di Terapia Comportamentale e Cognitiva, SITCC) throughout December 2023 and January 2024.

Results: A total of 213 participants completed the survey. Only a minor proportion of respondents (37.1%) reported having received training for diagnosis and treatment of insomnia or other behavioral sleep disorders. Familiarity with psychological therapeutics for sleep was mainly associated with knowledge of sleep hygiene rules, relaxation, and mindfulness techniques, but not with core CBT strategies for insomnia (i.e., sleep restriction and stimulus control) and sleep regulation. The less familiar therapeutics were those for pediatric insomnia.

Conclusions: The results of this study highlight scarce knowledge and consideration of sleep problems in CBT practice in Italy. As insomnia is prevalent, an independent mental disorder, and a predictor for mental and somatic comorbid conditions, these findings underscore an urgency to enlarge and strengthen CBT professionals' training on sleep psychophysiology, sleep clinical psychology, insomnia, behavioral sleep problems, and their treatment.