The field of surgical neuro-oncology continues to evolve at a rapid pace, driven by innovative advances from neurosurgeons, neuro-oncologists, and other experts across the clinical and basic sciences [...].
The field of surgical neuro-oncology continues to evolve at a rapid pace, driven by innovative advances from neurosurgeons, neuro-oncologists, and other experts across the clinical and basic sciences [...].
Background: Approach-avoidance behaviors are fundamental mechanisms guiding our interactions with the environment, driven by the emotional valence of stimuli. While previous research has extensively explored behavioral aspects of the AAB, the neural dynamics underlying these processes remain insufficiently understood.
Objectives: The present study employs electroencephalography (EEG) to systematically investigate the neural correlates of AAB in a non-clinical population, focusing on stimulus- and response-locked event-related potentials (ERPs).
Methods: Forty-three participants performed a classic Approach-Avoidance Task (AAT) while EEG activity was recorded.
Results: Behavioral results confirmed the AAB effect, with faster reaction times in congruent compared to incongruent trials, as well as for positive versus negative trials. ERP analyses revealed significant differences in the Valence factor, with early effects for stimulus-locked trials and late differences at the parietal-occipital region for response-locked trials. However, no significant effects were found for the Condition factor, suggesting that the neural mechanisms differentiating congruent and incongruent responses might not be optimally captured through EEG. Additionally, frontal alpha asymmetry (FAA) analyses showed no significant differences between conditions, aligning with the literature.
Conclusions: These findings provide novel insights into the temporal and spatial characteristics of AAB-related neural activity, emphasizing the role of early visual processing and motor preparation in affect-driven decision-making. Future research should incorporate methodological approaches for assessing AAB in ecologically valid settings.
Background/Objectives: Magnesium sulfate (MgSO4) has historically been used in obstetrics as a tocolytic and to prevent eclamptic seizures. MgSO4 has also been investigated as a potential neonatal neuroprotectant for infants born preterm. However, randomized controlled trials of prenatal MgSO4 have shown mixed results, with single-center observational studies also suggesting differential effects by sex. We sought to evaluate sex-dependent associations between prenatal MgSO4 exposure and standardized neurodevelopmental outcomes in a large, multi-center cohort of extremely preterm neonates (24-0/7 to 27-6/7 weeks' gestation) from the Preterm Erythropoietin Neuroprotection Trial (PENUT). Methods: The relationship between maternal MgSO4 exposure and neurodevelopmental outcomes assessed at 2 years using the Bayley Scales of Infant and Toddler Development Index, 3rd edition was examined by sex in n = 666 infants (n = 328 female, n = 338 male). To account for confounding by indication, we performed both matching and inverse probability weighting using 17 maternal predictors of MgSO4 exposure. Results: In both unadjusted and adjusted (weighted and matched) analyses, no relationship between MgSO4 exposure and neurodevelopmental outcomes was seen, either overall or by sex. Conclusions: This study reaffirms the safety of MgSO4, but appropriate clinical trials of MgSO4 in extremely preterm infants are still required to better understand any effects on neurodevelopmental outcomes.
Background/Objectives: Endophenotypes-quantifiable biological markers bridging genetic variations and clinical manifestations-have significantly evolved since their introduction to psychiatric genetics. This study presents the first comprehensive analysis of endophenotype research in epilepsy, examining validation frameworks, methodological approaches, and the potential for clinical translation. Methods: We employed a dual-methodological approach combining the bibliometric analysis with a systematic review and a meta-analysis. Literature searches in the Web of Science and Scopus databases (17 July 2025) employed comprehensive strategies that incorporated endophenotype and epilepsy terminology. In the bibliometric analysis, the 'Bibliometrix' R package (version 4.4.3 (R Core Team, 2024) was used for publication trends, collaboration networks, and thematic evolution. The meta-analysis quantitatively synthesized validation outcomes across studies. For the systematic review, we compared traditional validation criteria with the Endophenotype 2.0 framework and applied machine learning-based validation techniques across 53 studies meeting rigorous inclusion criteria. Results: An analysis of 169 publications (2001-2025) revealed moderate annual growth (6.94%) with acceleration after 2015. Neuroimaging features achieved exceptional validation rates (77.8% perfect scores under Endophenotype 2.0), with functional MRI studies reaching 87.5% success. The Endophenotype 2.0 framework significantly outperformed traditional criteria (58.5% vs. 43.4%), particularly for genetic/molecular endophenotypes (83.3% vs. 0%). Family-based designs emerged as the strongest validation predictors (96% vs. 25% for population-based studies). International collaboration remained limited (4.1%). Conclusions: The endophenotype research in epilepsy has evolved toward validated biomarkers. The more comprehensive performance of the novel validation framework positions multiple endophenotypes-particularly neuroimaging and genetic markers-for the implementation of precision medicine. Our findings reveal opportunities for transdiagnostic biomarkers that could revolutionize risk assessment, early intervention, and personalized treatment across neurodevelopmental conditions.
Background/Objectives: Unruptured aneurysms of the anterior communicating artery (AComA) are associated with a higher risk of rupture and present unique anatomical challenges. Although endovascular techniques have advanced considerably, microsurgical clipping continues to represent an essential treatment option, particularly for complex cases. We conducted a retrospective analysis to evaluate outcomes of microsurgical clipping for unruptured AComA aneurysms over an 18-year period at a high-volume tertiary neurosurgical center. Methods: A retrospective analysis was conducted on 106 patients who underwent microsurgical clipping for unruptured AComA aneurysms between 2002 and 2020. Preoperative, intraoperative, and postoperative parameters were assessed. Excluded were previously ruptured or previously surgically treated aneurysms. Logistic regression models were used to identify predictors of postoperative complications with a focus on aneurysm projection. Results: Complete angiographic occlusion was achieved in 92.2% of cases, with a retreatment rate of 0.9%, which is comparable to the recent literature. Permanent neurological deficits occurred in 5.7% of patients. Posterior aneurysm projection was significantly associated with postoperative infarction and permanent neurological deficits. Intraoperative ICG angiography was associated with a reduced risk of ischemic complications. Conclusions: Microsurgical clipping remains a safe and effective treatment for unruptured AComA aneurysms in selected patients, offering durable occlusion and low complication rates. Aneurysm projection is a key predictor of outcome, and intraoperative ICG angiography significantly enhances surgical safety. These findings support the continued role of microsurgery in the interdisciplinary management of AComA aneurysms.
Positron emission tomography (PET) allows for minimally invasive in vivo localization of amyloid and tau deposition, and visualization of glucose metabolism using amyloid PET, tau PET, and FDG PET. Clinically, these scans are used to determine A, T, and N (amyloid-β plaques, tau tangles, and neurodegeneration) status in Alzheimer's disease. In light of the recent anti-amyloid therapies, determination of the A, and the associated T and N status is increasingly important. This review explores the potential of a single PET scan to define multiple biomarkers. A literature search using the PubMed database and an additional citation search using Google Scholar identified 76 relevant publications up to 30 July 2025. Original work reporting amyloid, tau or FDG PET to determine two or more ATN-related biomarkers were included. Non-English, animal, and non-dementia related studies were excluded. For each study, quantitative outcomes such as correlations and ROC AUC scores were extracted and compared. Early phase amyloid and tau PET (n = 58) were consistently found to be good indicators of N status with a median (IQR) correlation of 0.82 (0.76-0.86). Limited research (n = 7) was performed for amyloid or tau PET to infer both A and T status, with tau-based studies having slightly higher ROC AUC scores (0.88-0.99) than amyloid-based studies (0.84-0.9). Initial results are promising (median ROC AUC scores of 0.88 (0.81-0.96)) but need to be validated. FDG PET was found to be less accurate for A or T status (n = 12) prediction (median ROC AUC scores of 0.83 (0.80-0.87)). Among the modalities, tau PET seems to be the most promising candidate for a single tracer approach to predict all three biomarkers.
Background/Objectives: Subcortical local field potentials (LFPs) provide a valuable in vivo window into the neurophysiology of the dystonia network. These signals can be recorded through Deep Brain Stimulation (DBS) devices and combined with whole-head techniques such as magnetoencephalography (MEG) to study cortical-subcortical interactions. However, simultaneous LFP-MEG acquisition poses challenges, including interference from the DBS device and synchronization issues. We present preliminary data on the feasibility and signal quality of concurrent LFP and MEG recordings in dystonia patients. Methods: We assessed simultaneous MEG-LFP recordings in 11 patients with inherited or idiopathic dystonia who underwent bilateral DBS lead implantation in the Globus Pallidus Internus (GPi). Two synchronization strategies were tested: (1) the Tapping method, using an accelerometer placed on the DBS device, and (2) the Stimulation method, which generated detectable artifacts during sham stimulation. Results: Both methods successfully aligned MEG and LFP signals with a mean temporal delay of 91 ± 22 ms for the Tapping method and 288 ± 166 ms for the Stimulation method. Post-implantation signal-to-noise ratio analysis revealed slight degradation but no significant impact on MEG quality (gradiometers: -0.12 ± 1.85 dB; magnetometers: -0.47 ± 2.03 dB). Conclusions: Simultaneous MEG-LFP recordings in dystonic patients are feasible, yielding high-quality signals, and reliable synchronization. Temporal alignment improved with practice, suggesting a short learning curve. This method opens new opportunities to study cortical-subcortical dynamics and strengthens the potential of combining MEG-LFP approaches for investigating dystonia.
Background: Language mapping is a critical component of epilepsy surgery, as postoperative language deficits can significantly impact patients' quality of life. Electrical stimulation mapping has emerged as a valuable tool for identifying eloquent areas of the brain and minimising post-surgical language deficits. However, recent studies have shown that language deficits can occur despite language mapping, potentially due to variability in stimulation techniques and language task selection. The validity of specific linguistic tasks for mapping different cortical regions remain inadequately characterised. Objective: To systematically evaluate the validity of linguistic tasks used during electrical cortical stimulation (ECS) for language mapping in epilepsy surgery, analyse task-specific responses across cortical regions, and assess current evidence supporting optimal task selection for different brain areas. Methods: Following PRISMA [2020] guidelines, a systematic literature search was conducted in PubMed and Scopus covering articles published from January 2013 to November 2025. Studies on language testing with electrical cortical stimulation in epilepsy surgery cases were screened. Two reviewers independently screened 956 articles, with 45 meeting the inclusion criteria. Data extraction included language tasks, stimulation modalities (ECS, SEEG, ECoG, DECS), cortical regions and language error types. Results: Heterogeneity in language testing techniques across various centres was identified. Visual naming deficits were primarily associated with stimulation of the posterior and basal temporal regions, fusiform gyrus, and parahippocampal gyrus. Auditory naming elicited impairments in the posterior superior and middle temporal gyri, angular gyrus, and fusiform gyrus. Spontaneous speech errors varied, with phonemic dysphasic errors linked to the inferior frontal and supramarginal gyri, and semantic errors arising from superior temporal and perisylvian parietal regions. Conclusions: Task-specific language mapping reveals distinct cortical specialisations, with systematic patterns emerging across studies. However, marked variability in testing protocols and inadequate standardisation limit reproducibility and cross-centre comparisons. Overall, refining and standardising the language task implementation process could lead to improved outcomes, ultimately minimising resection-related language impairment. Future research should validate task-region associations through prospective multicentre studies with long-term outcome assessment.
Background/Objectives: Loneliness can be differentiated from social isolation. The first is the subjective perception of being isolated from others, while the other is the entire emotional and social experience. The feeling of loneliness defines the discrepancy between desired and actual social relations. Loneliness is an unpleasant phenomenon that involves quantitative and qualitative impoverishment of interpersonal relationships. The aim of this study was to analyze feelings of loneliness-including intimacy, social connections, and belonging-among adolescents and how these feelings relate to different aspects of family relationships, such as communication, cohesion, autonomy-control, and identity. Methods: The study was conducted among 136 adolescents (aged 15-17, 70% of girls and 30% of boys). The following self-report measures were used: the R-UCLA Loneliness Scale, the State-Trait Anxiety Inventory (STAI)-X2, and the Family Relations Questionnaire, version: My Family. Correlation analyses were performed, followed by stepwise regression for three loneliness sub-scales. Results: The results have shown that anxiety and adverse family relationship factors were identified as significant predictors of adolescent loneliness. Communication, cohesion, autonomy-control, and identity within the family context each contributed uniquely to the experience of loneliness. Conclusions: The conclusion is that trait anxiety and the evaluation of family functioning are very strong predictors of loneliness among young people. Moreover, distinct aspects of family relationships shape different forms of loneliness, highlighting the multifaceted nature of adolescent social experiences.
Background: Repetitive transcranial magnetic stimulation (rTMS) is an established neuromodulatory method, yet its multiscale neurophysiological effects in autism spectrum disorder (ASD) remain insufficiently characterized. Recent EEG analytic advances-such as spectral parameterization, long-range temporal correlation (LRTC) assessment, and connectivity modeling-enable quantitative evaluation of excitation-inhibition (E/I) balance and network organization. Objective: This study aimed to examine whether an eight-session, EEG-guided mixed-frequency rTMS protocol-combining inhibitory 1 Hz and excitatory 10 Hz trains individualized to quantitative EEG (qEEG) abnormalities-produces measurable changes in spectral dynamics, temporal correlations, and functional connectivity in a pediatric ASD case. Methods: An 11-year-old right-handed female with ASD (DSM-5-TR, ADOS-2) underwent resting-state EEG one week before and four months after intervention. Preprocessing used a validated automated pipeline, followed by spectral parameterization (FOOOF), detrended fluctuation analysis (DFA), and connectivity analyses (phase-lag index and Granger causality) in MATLAB (2023b). No inferential statistics were applied due to the single-case design. The study was conducted at Cosmos Healthcare (London, UK) with in-kind institutional support and approved by the Atlantic International University IRB (AIU-IRB-22-101). Results: Post-rTMS EEG showed (i) increased delta and reduced theta/alpha/beta power over central regions; (ii) steeper aperiodic slope and higher offset, maximal at Cz, suggesting increased inhibitory tone; (iii) reduced Hurst exponents (1-10 Hz) at Fz, Cz, and Pz, indicating decreased long-range temporal correlations; (iv) reorganization of hubs away from midline with marked Cz decoupling; and (v) strengthened parietal-to-central directional connectivity (Pz→Cz) with reduced Cz→Pz influence. Conclusions: Mixed-frequency, EEG-guided rTMS produced convergent changes across spectral, aperiodic, temporal, and connectivity measures consistent with modulation of cortical E/I balance and network organization. Findings are preliminary and hypothesis-generating. The study was supported by in-kind resources from Cosmos Healthcare, whose authors participated as investigators but had no influence on analysis or interpretation. Controlled trials are warranted to validate these exploratory results.
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