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The effect of Alzheimer's biomarker positivity on neuropsychological networks. 阿尔茨海默病生物标志物阳性对神经心理网络的影响。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-21 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag015
Laura M Wright, Matteo De Marco, Cameron E Ferguson

Although network neuropsychology is a promising approach to the study of clinical profiles, the link between Alzheimer's disease (AD) biomarkers and neuropsychological networks is still undetermined. We hypothesized that network differences would exist between biomarker-positive and biomarker-negative participants, and that these would be driven by network nodes corresponding to performance on tests of episodic memory, as this is the cognitive domain most distinctively affected by AD since the earliest clinical stages. In this case-control study, we investigated sub-cohorts of individuals who had been (i) enrolled in the National Alzheimer's Coordinating Center initiative and (ii) tested with Version 3 of the Uniform Data Set neuropsychological battery (i.e. consisting of 11 tests). These included 1263 'β-amyloid positive' (A+), 1594 'β-amyloid negative' (A-), 442 'β-amyloid and hyperphosphorylated tau positive' (A + T+) and 734 'β-amyloid and hyperphosphorylated tau negative' (A-T-) participants. We first calculated neuropsychological residuals by regressing out age, years of education, sex, Clinical Dementia Rating scores and timepoint distance between neuropsychological and biomarker assessment. Secondly, we used rank-based correlations to define conditional associations across all pairs of test scores (i.e. the nodes of the network). Thirdly, we imposed a penalty (i.e. via the Least Absolute Shrinkage and Selection Operator method) to control for network sparsity. We then tested for differences in global network metrics and node centrality between A+ and A- and between A+T+ and A-T- participants using permutation-based inferential models. Differences were found between biomarker-positive and biomarker-negative sub-cohorts in global network metrics but, contrarily to our hypothesis, no differences were found in relation to episodic memory nodes. A significant node difference, however, was instead found in relation to category fluency (i.e. a test of semantic memory), with increased centrality observed among A+ participants. A similar, yet non-significant trend was also observed between A+T+ and A-T- participants. Network neuropsychology can complement and expand the study of cognitive performance carried out via 'traditional' univariate approaches. While univariate analyses reveal episodic memory decline in people with AD, this is not accompanied by any abnormalities at a neuropsychological network level. Our findings, however, highlight the importance of semantic memory alterations in A+ individuals. The wide set of neural and cognitive resources that sustain semantic memory may play a supportive role in the presence of neuropathology.

尽管网络神经心理学是一种很有前途的临床研究方法,但阿尔茨海默病(AD)生物标志物与神经心理学网络之间的联系仍不确定。我们假设生物标志物阳性和生物标志物阴性的参与者之间存在网络差异,并且这些差异将由情景记忆测试中相应的网络节点驱动,因为这是自早期临床阶段以来受AD影响最明显的认知领域。在这项病例对照研究中,我们调查了(i)在国家阿尔茨海默病协调中心倡议中登记的个体,(ii)使用统一数据集神经心理学电池版本3进行测试(即由11项测试组成)。其中包括1263名“β-淀粉样蛋白阳性”(A+), 1594名“β-淀粉样蛋白阴性”(A-), 442名“β-淀粉样蛋白和过度磷酸化的tau阳性”(A+ T+)和734名“β-淀粉样蛋白和过度磷酸化的tau阴性”(A-T-)参与者。我们首先通过回归年龄、受教育年限、性别、临床痴呆评分以及神经心理学和生物标志物评估之间的时间点距离来计算神经心理学残差。其次,我们使用基于等级的相关性来定义所有对测试分数(即网络节点)之间的条件关联。第三,我们施加惩罚(即通过最小绝对收缩和选择算子方法)来控制网络稀疏性。然后,我们使用基于排列的推理模型测试了A+和A-以及A+T+和A-T-参与者之间全球网络指标和节点中心性的差异。在全球网络指标中,生物标志物阳性和生物标志物阴性亚队列之间存在差异,但与我们的假设相反,在情景记忆节点方面没有发现差异。然而,在类别流畅性(即语义记忆测试)方面发现了显著的节点差异,在A+参与者中观察到中心性增加。在A+T+和A-T参与者之间也观察到类似但不显著的趋势。网络神经心理学可以补充和扩展通过“传统的”单变量方法进行的认知表现研究。虽然单变量分析显示AD患者的情景记忆下降,但这并不伴随着神经心理网络水平的任何异常。然而,我们的研究结果强调了A+个体语义记忆改变的重要性。维持语义记忆的广泛的神经和认知资源可能在神经病理学的存在中发挥支持作用。
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引用次数: 0
Alterations in the brain lipidome of Alzheimer's disease donors with rare TREM2 risk variants. 罕见TREM2风险变异的阿尔茨海默病供体脑脂质组的改变
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-21 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcaf452
Petroula Proitsi, Amera Ebshiana, Asger Wretlind, Jin Xu, Angela K Hodges, Cristina Legido-Quigley

Triggering Receptor Expressed on Myeloid Cells 2 (TREM2) is a microglial receptor, sensitive to Phospholipids and Sphingomyelins, associated with neurodegeneration. Hypomorphic variants in the TREM2 gene significantly increase the risk of developing Alzheimer's disease (AD). The aim of this study was to characterize networks of lipids in post-mortem brain tissue from AD and Control donors, and to identify lipids associated with AD and impacted by dysfunctional TREM2. We studied human post-mortem brain tissue from the hippocampus and Brodmann area 9 (BA9) from 102 brains. Brain tissue from BA9 was available from n = 55 donors (14 Ad donors with a non-synonymous TREM2 risk variant [AD(TREM2+)], 20 Ad donors with no TREM2 risk variants [Ad(TREM2-)] and 21 Control donors), and brain tissue from the Hippocampus was available for n = 47 brain donors (7 Ad[TREM2+], 20 Ad[TREM2-] and 20 Control donors). Mass Spectrometry was performed to obtain lipidomic signatures spanning 99 lipid species that included the following lipid classes: Ceramides, Sphingomyelins, Phosphatidic acids, Phosphatidyl-cholines, Phosphatidyl-ethanolamines, Phosphatidyl-glycerols, Phosphatidyl-inositols, Phosphatidyl-serines and Triglycerides. Weighted gene co-expression network analysis (WGCNA) was used to identify highly correlated lipid modules and hubs in each brain region. Generalized least squares and linear regression analyses, adjusted for age at death, biological sex, number of Apolipoprotein E (APOE) ε4 alleles, and post-mortem delay, were used to assess the associations of lipid modules and hubs with AD and TREM2, in combined analyses across regions and in each region separately. Four lipid modules were relatively well-preserved between the two brain regions, and three of these modules were altered in AD donors and/or in AD TREM2 carriers. Levels of the BA9 'turquoise' module ('blue' hippocampus module), enriched in Sphingolipids and Phospholipids, were elevated in AD donors and particularly in AD TREM2 carriers [AD(TREM2+)]. The hub lipid of the BA9 'turquoise'/hippocampus 'blue' module, Phosphatidyl-serine [PS(32:1)], was increased in AD versus Control donors (beta = 0.677, 95% CI 0.28-1.08, P = 1.14E-03), and in AD(TREM2+) versus Control donors (beta = 1.00, 95% CI 0.53-1.48, P = 5.57E-03), whereas the strongest association was observed with Ceramide [Cer(d38:1)] increased in AD versus Control donors (beta = 0.929, 95% CI 0.46-1.40, P = 1.67E-04) and in AD(TREM2+) versus Controls donors (beta = 1.31, 95% CI 0.78-1.84, P = 4.35E-06). The consistent increase in TREM2 ligands such as Ceramides and Phosphatidyl-serines in the brains of AD donors, particularly TREM2 risk variants carriers, could reflect the presence of AD-associated damage signals in the form of stressed or apoptotic cells and damaged myelin.

髓样细胞2触发受体(TREM2)是一种对磷脂和鞘磷脂敏感的小胶质受体,与神经退行性变有关。TREM2基因的半胚变异显著增加患阿尔茨海默病(AD)的风险。本研究的目的是表征阿尔茨海默病和对照组供者死后脑组织中的脂质网络,并确定与阿尔茨海默病相关的脂质并受功能失调的TREM2的影响。我们研究了来自102个大脑的海马和Brodmann区9 (BA9)的人类死后脑组织。来自BA9的脑组织来自n = 55名供者(14名Ad供者具有非同音TREM2风险变异[Ad(TREM2 +)], 20名Ad供者没有TREM2风险变异[Ad(TREM2-)]和21名对照供者),海马组织来自n = 47名脑供者(7名Ad[TREM2+], 20名Ad[TREM2-]和20名对照供者)。质谱分析获得了99种脂质的脂质组学特征,包括以下脂类:神经酰胺、鞘磷脂、磷脂酸、磷脂酰胆碱、磷脂酰乙醇胺、磷脂酰甘油、磷脂酰肌醇、磷脂酰丝氨酸和甘油三酯。加权基因共表达网络分析(WGCNA)用于识别每个脑区高度相关的脂质模块和枢纽。采用广义最小二乘和线性回归分析,对死亡年龄、生物性别、载脂蛋白E (APOE) ε4等位基因数量和死后延迟进行校正,评估脂质模块和枢纽与AD和TREM2的关联,并进行跨地区和每个地区的联合分析。四个脂质模块在两个脑区之间相对较好地保存,其中三个模块在AD供体和/或AD TREM2携带者中发生改变。富含鞘脂和磷脂的BA9“绿松石”模块(“蓝色”海马模块)的水平在AD供体中升高,特别是在AD TREM2携带者[AD(TREM2+)]中。AD与对照组相比,BA9“绿松石”/海马“蓝色”模块的中心脂质磷脂酰丝氨酸[PS(32:1)]增加(β = 0.677, 95% CI 0.28-1.08, P = 1.14E-03), AD(TREM2+)与对照组相比(β = 1.00, 95% CI 0.53-1.48, P = 5.57E-03),而AD与神经酰胺[Cer(d38:1)]的最强关联在AD与对照组相比(β = 0.929, 95% CI 0.46-1.40, P = 1.67E-04)和AD(TREM2+)与对照组相比(β = 1.31, P = 1.31), AD与神经酰胺[Cer(d38:1)]增加(β = 0.929, 95% CI 0.46-1.40, P = 1.67E-04)。95% ci 0.78-1.84, p = 4.35e-06)。在AD供者,特别是TREM2风险变异携带者的大脑中,TREM2配体如神经酰胺和磷脂酰丝氨酸的持续增加,可能反映了AD相关损伤信号的存在,其形式是应激或凋亡细胞和受损髓磷脂。
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引用次数: 0
Modulating food intake by nasal application of peptides targeting melanocortin 4 receptor and ghrelin receptor systems. 通过鼻腔应用靶向黑素皮质素4受体和胃饥饿素受体系统的肽来调节食物摄入。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-21 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcaf450
Benginur Özbay, Eva-Maria Jülke, Moritz List, Marcin Nowicki, Sylvia Els-Heindl, Kerstin Immig, Karin Mörl, Ingo Bechmann, Annette G Beck-Sickinger

The regulation of appetite by pharmaceuticals has gained significant interest for the treatment of obesity and cachexia. The melanocortin 4 receptor (MC4R) and the ghrelin receptor (GhrR) are known to play a crucial role in the regulation of energy homeostasis. Thus, peptide ligands, which modulate these receptors, have become attractive therapeutic lead structures. A key challenge is the efficient delivery of such peptides to the targeted receptors, which are expressed in the hypothalamus. Therefore, direct nose-to-brain delivery is a compelling strategy. Here, we report on food intake that is modulated by using intranasal applied peptides. We synthesized fluorescently labelled variants of the MC4R agonist setmelanotide, the GhrR agonist ghrelin (Ghr) and the GhrR inverse agonist KbFwLL-NH2 [β-(3-benzothienyl)-D-alanine (b)] and assessed their receptor activity. Further, we measured the permeability and stability of these peptides on Calu-3 cells as a model system for the nasal mucosa. Next, the uptake of peptides after intranasal application was analysed in vivo by quantification of fluorescent signals in the olfactory bulb, cortex and hypothalamus. In addition, we monitored the effects of the two most promising peptides on food intake in vivo. Although no significant changes in body weight were observed, we detected differences in the daily change in food intake: this parameter was reduced for mice treated with setmelanotide variants and increased for mice treated with GhrR agonists compared to a control group. Taken together, our findings clearly underline the high potential of intranasal peptide administration for modulating food intake.

药物对食欲的调节在肥胖和恶病质的治疗中引起了极大的兴趣。黑素皮质素4受体(MC4R)和生长素受体(GhrR)在调节能量稳态中起着至关重要的作用。因此,调节这些受体的肽配体已成为有吸引力的治疗先导结构。一个关键的挑战是如何有效地将这些肽传递到下丘脑中表达的目标受体。因此,直接从鼻子到大脑的输送是一种令人信服的策略。在这里,我们报告了通过使用鼻内应用肽来调节食物摄入。我们合成了MC4R激动剂setmelanotide、GhrR激动剂ghrelin (Ghr)和GhrR逆激动剂KbFwLL-NH2 [β-(3-苯并噻吩基)- d -丙氨酸(b)]的荧光标记变体,并评估了它们的受体活性。此外,我们测量了这些肽在Calu-3细胞上的通透性和稳定性,作为鼻黏膜的模型系统。接下来,通过量化嗅球、皮层和下丘脑的荧光信号,分析了鼻内应用后肽的体内摄取情况。此外,我们还监测了两种最有希望的肽对体内食物摄入的影响。虽然没有观察到体重的显著变化,但我们发现了每日食物摄入量变化的差异:与对照组相比,使用setmelanotide变体治疗的小鼠减少了该参数,而使用GhrR激动剂治疗的小鼠增加了该参数。综上所述,我们的研究结果清楚地强调了鼻内肽管理调节食物摄入的巨大潜力。
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引用次数: 0
Brain age trajectories and cognition after stroke in two longitudinal cohorts. 脑年龄轨迹和脑卒中后认知在两个纵向队列。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-20 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcaf509
Gisle Berg Helland, Håkon Ihle-Hansen, Anne Hege Aamodt, Esten H Leonardsen, Tobias Kaufmann, Brian Anthony B Enriquez, Mona K Beyer, Stein Andersson, Helle Stangeland, Hege Ihle-Hansen, Hanne F Harbo, Einar August Høgestøl, Guri Hagberg

Brain age is a promising neuroimaging biomarker, reflecting biological aging, but long-term trajectories and predictive value for cognitive outcomes post-stroke remains unclear. This study aimed to characterize brain aging trajectories over 8 years following a first-ever stroke and to evaluate the predictive value of brain age estimates for long-term cognitive outcomes. We analysed data from working-age (<65 years) ischaemic stroke patients with small- and medium-sized strokes (lesion volumes <70 ml), using two longitudinal stroke cohorts. T1-weighted MRI was acquired in the acute phase and at multiple time points up to 8 years post-stroke. Montreal cognitive assessment (MoCA) was assessed at follow-up sessions. Brain age was estimated using a state-of-the-art deep learning model. Brain-predicted age difference (Brain-PAD) was calculated as estimated brain age minus chronological age and corrected by regressing on age, age² and sex. Linear mixed-effects models examined Brain-PAD over multiple time points (whole-brain, ipsilesional and contralesional). Normalized brain volume was derived from FreeSurfer and included in the whole-brain analysis. Linear regression models evaluated whether brain age was associated with cognitive performance (MoCA) at long-term follow-up. We included 120 patients [n = 50 (42%) female, mean ± SD age at discharge was 54.9 ± 9 and National Institutes of Health Stroke Scale was 3.7 ± 6.4], with a mean follow-up of 3.4 ± 2.5 years. The mean MoCA score at follow-up was 24.7 ± 3.7. Brain-PAD increased significantly over time in the whole-brain analysis (β = 0.6/year, P < 0.01), indicating 60% acceleration in brain aging after stroke, with the association remaining significant after adjusting for normalized brain volume (β = 0.5/year, P < 0.01). Accelerated brain aging was observed in the ipsilesional hemisphere (β = 0.7/year, P < 0.01), but not the contralesional hemisphere (β = 0.3/year, P = 0.12). Higher brain age in the acute phase of stroke predicted lower MoCA scores at follow-up (β = -0.12, P < 0.05), whereas chronological age was not a significant predictor (P = 0.12). The association between brain age estimations and cognitive performance remained significant after adjusting for age, sex and education (β = -0.42, P < 0.01). In this longitudinal study, we found accelerated brain aging following stroke. Furthermore, brain age was associated with cognitive outcomes several years later, highlighting its potential as an early biomarker for long-term cognitive prognosis.

脑年龄是一种很有前途的神经成像生物标志物,反映了生物衰老,但对中风后认知结果的长期轨迹和预测价值尚不清楚。本研究旨在描述首次中风后8年内的大脑衰老轨迹,并评估脑年龄估计对长期认知结果的预测价值。我们分析的数据来自工作年龄(n = 50(42%)女性,出院时平均±SD年龄为54.9±9,美国国立卫生研究院卒中量表为3.7±6.4),平均随访时间为3.4±2.5年。随访时MoCA平均评分为24.7±3.7分。Brain-PAD显著增加随着时间在整个大脑分析(β = 0.6 /年,P β = 0.5 /年,P β = 0.7 /年,P β = 0.3 /年,P = 0.12)。急性期脑年龄越大,随访时MoCA评分越低(β = -0.12, P < 0.05),而实足年龄不是显著预测因子(P = 0.12)。在调整年龄、性别和教育程度后,脑年龄估计与认知表现之间的相关性仍然显著(β = -0.42, P < 0.01)。在这项纵向研究中,我们发现中风后大脑衰老加速。此外,大脑年龄与几年后的认知结果有关,突出了其作为长期认知预后的早期生物标志物的潜力。
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引用次数: 0
Quantitative susceptibility mapping in myotonic dystrophy: clinical relevance of subcortical iron accumulation. 肌强直性营养不良的定量易感性制图:皮质下铁积累的临床意义。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-20 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag017
Cristiana Fiscone, Magali J Rochat, Silvia De Pasqua, Micaela Mitolo, Gianfranco Vornetti, Fiorina Bartiromo, Lorenzo Cirignotta, Fabio Pizza, Marianna Nardozza, Greta Venturi, David Neil Manners, Patrizia Avoni, Rocco Liguori, Caterina Tonon, Raffaele Lodi

Myotonic dystrophy type 1 is a dominantly inherited disorder, affecting musculoskeletal and central nervous systems and mainly characterized by progressive muscular atrophy and multisystemic damages including cardiac, respiratory and sleep dysfunctions. Neuroimaging studies conducted in myotonic dystrophy type 1 patients have documented widespread cerebral alterations encompassing structural, microstructural, functional and metabolic aspects of the brain, while comparatively few studies have investigated the role of iron concentration in the pathophysiology of central nervous system impairment. We report here the use of quantitative susceptibility (χ) mapping to explore iron content of both cortical and subcortical structures in myotonic dystrophy type 1 patients and to assess its possible clinical relevance, combining imaging and clinical data. Thirty-four myotonic dystrophy type 1 participants (20 females, 46.8 ± 12.0 years old) and 35 age- and sex- matched healthy controls (20 females, 50.5 ± 17.3 years old) were included in the study. All participants underwent MRI examinations in the same 3-Tesla scanner. The MRI protocol included 3D morphological T1-weighted magnetization prepared rapid gradient echo and T2*weighted multi-echo gradient echo for quantitative susceptibility mapping reconstruction. Cortical and subcortical structures were automatically segmented, and a volume of interest-based analysis was performed; χ distributions were compared between the two groups and myotonic dystrophy type 1 χ values were correlated with clinical and laboratory data. In the myotonic dystrophy type 1 group, a significant increase of χ was found in almost all cortical gyri, as a non-specific sign of neurodegeneration. Among subcortical structures, χ was significantly higher in myotonic dystrophy type 1 group in both thalamus (ventral and pulvinar nuclei) and brainstem (pons and medulla), compared to healthy controls. Additionally, correlation analysis showed some links between χ in subcortical structures and clinical signs, suggesting greater iron concentration with deterioration of clinical conditions. Thalamic χ values were associated with cardiological parameters and disability scores and, as with brainstem χ, they were also positively correlated with the number of central apnoeas; finally, thalamic and brainstem χ were negatively correlated with the age of onset. This study showed a correlation between autonomic dysfunction related to certain subcortical structures and their χ; higher values of χ correlated with greater functional impairment, suggesting iron accumulation detected by the quantitative susceptibility mapping technique is a possible biomarker of disease progression.

1型肌强直性营养不良是一种主要的遗传性疾病,影响肌肉骨骼和中枢神经系统,主要表现为进行性肌肉萎缩和多系统损害,包括心脏、呼吸和睡眠功能障碍。在1型肌强直性营养不良患者中进行的神经影像学研究记录了广泛的大脑改变,包括大脑的结构、微观结构、功能和代谢方面,而相对较少的研究调查了铁浓度在中枢神经系统损伤病理生理中的作用。我们在此报告使用定量敏感性(χ)作图来探索1型肌强直性营养不良患者皮质和皮质下结构的铁含量,并结合影像学和临床数据评估其可能的临床相关性。34名1型肌强直性营养不良患者(20名女性,46.8±12.0岁)和35名年龄和性别匹配的健康对照组(20名女性,50.5±17.3岁)纳入研究。所有参与者都在同一台3特斯拉扫描仪上进行了核磁共振检查。MRI方案包括三维形态t1加权磁化制备的快速梯度回波和T2*加权多回波梯度回波,用于定量敏感性作图重建。自动分割皮层和皮层下结构,并进行大量基于兴趣的分析;比较两组患者的χ分布,1型强直性肌营养不良患者的χ值与临床及实验室资料的相关性。在肌强直性营养不良1型组中,几乎所有皮质回中都发现χ显著增加,这是神经变性的非特异性体征。在皮层下结构中,1型肌强直性营养不良组丘脑(腹侧核和枕核)和脑干(脑桥和脑髓)的χ均显著高于健康对照组。此外,相关分析显示皮质下结构χ与临床体征之间存在一定联系,提示铁浓度越高,临床病情越严重。丘脑χ值与心脏学参数和残疾评分相关,与脑干χ值一样,它们也与中枢呼吸暂停次数呈正相关;丘脑和脑干χ与发病年龄呈负相关。本研究显示与某些皮质下结构相关的自主神经功能障碍与其χ;较高的χ值与更大的功能损害相关,表明定量易感性制图技术检测到的铁积累可能是疾病进展的生物标志物。
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引用次数: 0
White matter microstructure alterations from alcohol use disorder persist into early abstinence. 酒精使用障碍导致的白质微结构改变持续到早期戒酒。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-20 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag018
Nicolas Delinte, Melissa Salavrakos, Manon Dausort, Laurence Dricot, Pauline Hermans, Philippe de Timary, Benoit Macq

Alcohol use disorder (AUD) is a complex condition including affective, cognitive and motivational dimensions. Although AUD is known to induce diffuse brain damage, including grey matter shrinkage and ventricular enlargement, the microstructural changes it induces in white matter remain incompletely understood. This study leverages multi-shell diffusion MRI and multi-fixel models to (i) undertake whole-brain and tract-specific analyses to investigate the microstructure of white matter (WM) tracts affected by AUD, (ii) evaluate whether these differences persist in early abstinence, and (iii) correlate these results with clinical measures evaluated by validated psychological questionnaires. We recruited a final cohort of 37 AUD patients, admitted for alcohol withdrawal and selected for their ongoing alcohol consumption at the time of admission, and a demographically matched control group of 19 healthy subjects. Both groups underwent MRI scans at baseline and 18 days later, with assessments of depression, obsession-compulsion, and anxiety conducted in both sessions for the AUD patients and once for the control group. The imaging results confirmed the presence in AUD participants of clusters microstructural alterations in the fornix, corpus callosum, cingulum, uncinate fasciculus and anterior thalamic radiations. These white matter tracts presented global and localized microstructural changes in axial diffusivity and fractional anisotropy, which are linked to axonal damage and inflammation. There was no significant improvement in the diffusion metrics after almost three weeks of abstinence, although clinical measures did improve significantly. Depression scores were significantly elevated in the patients at admission and decreased with time. Depression scores before withdrawal showed correlations with microstructural metrics across the right anterior thalamic radiations, the isthmus of the corpus callosum, and the right uncinate fasciculus. Lower fractional anisotropy and higher radial diffusivity were predictive of higher depression scores. Overall, these findings highlight the long-term vulnerability of WM tracts affected by AUD and the link between tract microstructure, brain function and behaviour.

酒精使用障碍(AUD)是一种包括情感、认知和动机维度的复杂疾病。虽然已知AUD会引起弥漫性脑损伤,包括灰质萎缩和心室增大,但它在白质中引起的微结构变化仍不完全清楚。本研究利用多壳扩散MRI和多固定模型(i)进行全脑和通道特异性分析,以研究AUD影响的白质(WM)束的微观结构,(ii)评估这些差异是否在早期戒断中持续存在,以及(iii)将这些结果与经验证的心理学问卷评估的临床测量结果相关联。我们最终招募了37名AUD患者,这些患者因戒酒而入院,并在入院时选择了他们正在进行的酒精消费,以及19名人口统计学匹配的健康受试者的对照组。两组在基线和18天后都进行了MRI扫描,对AUD患者进行了两次抑郁、强迫症和焦虑评估,对对照组进行了一次。影像学结果证实AUD参与者在穹窿、胼胝体、扣带、钩侧束和丘脑前区存在簇状微结构改变。这些白质束在轴向弥散性和分数各向异性方面表现出全面和局部的微结构变化,这与轴突损伤和炎症有关。在几乎三周的戒断后,扩散指标没有显著改善,尽管临床指标确实有显著改善。患者的抑郁评分在入院时显著升高,随着时间的推移而降低。戒断前的抑郁评分与右丘脑前辐射、胼胝体峡部和右钩状束的微观结构指标相关。分数各向异性越低,径向扩散系数越高,抑郁评分越高。总的来说,这些发现强调了受AUD影响的WM束的长期脆弱性,以及束微观结构、脑功能和行为之间的联系。
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引用次数: 0
Does white matter structure relate to hemispheric language lateralization? A systematic review. 白质结构与半球语言侧化有关吗?系统回顾。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-19 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag009
Ieva Andrulyte, Eszter Demirkan, Francesca M Branzi, Laura J Bonnett, Simon S Keller

The relationship between functional language lateralization and diffusion MRI-based white matter metrics remains a subject of considerable interest and complexity. This systematic review aims to synthesize existing diffusion MRI studies examining white matter correlates of functional language dominance. Twenty-five studies were identified through searches of Web of Science, Scopus and Ovid MEDLINE (search period: inception to 16th May 2023), involving adults with epilepsy, tumours or healthy controls. The results suggest that while the arcuate fasciculus and corpus callosum are commonly associated with language lateralization in clinical populations, the findings in healthy individuals are more variable, often influenced by factors such as handedness. Other white matter tracts, such as uncinate fasciculus, showed less consistent associations with language dominance across studies. Interestingly, temporal lobe regions, especially those involved in semantic processing, exhibited stronger correlations with diffusion measures compared to frontal areas associated with phonological tasks. Methodological inconsistencies, such as variability in sample selection, task design and analytical techniques, were identified as significant challenges in comparing findings across studies. Future research should aim for larger, more diverse sample sizes, whole-brain approaches and a wider range of functional MRI tasks to better elucidate the role of white matter in language lateralization. If regions of interest-based studies are utilized, a more standardized approach to tract segmentation should be adopted to ensure consistency and improve comparability across studies.

功能性语言偏侧化和基于核磁共振成像的白质测量之间的关系仍然是一个相当有趣和复杂的主题。本系统综述旨在综合现有的弥散MRI研究,研究白质与功能性语言优势的相关性。通过Web of Science、Scopus和Ovid MEDLINE检索(检索期:开始至2023年5月16日)确定了25项研究,涉及患有癫痫、肿瘤或健康对照的成人。结果表明,弓状神经束和胼胝体通常与临床人群的语言偏侧有关,但在健康个体中的发现则更为多变,通常受到惯用手等因素的影响。其他白质束,如钩状束,在研究中显示出与语言优势的不太一致的联系。有趣的是,颞叶区域,特别是那些涉及语义处理的区域,与与语音任务相关的额叶区域相比,表现出更强的与扩散测量的相关性。方法上的不一致,如样本选择、任务设计和分析技术的可变性,被认为是比较研究结果的重大挑战。未来的研究应该以更大、更多样化的样本量、全脑方法和更广泛的功能性MRI任务为目标,以更好地阐明白质在语言偏侧化中的作用。如果利用基于兴趣的研究区域,则应采用更标准化的通道分割方法,以确保一致性并提高研究之间的可比性。
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引用次数: 0
JAK4D, a first-in-class thyrotropin-releasing hormone analogue, reverses scopolamine-induced memory deficits. JAK4D是一种一流的促甲状腺激素释放激素类似物,可以逆转东莨菪碱引起的记忆缺陷。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-16 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag006
Roisin McMackin, Smita Price, Gillian R Slator, Orla Hardiman, Julie A Kelly

There is a pressing unmet clinical and health economic need for effective drugs to treat cognitive impairment that occurs in neurodegenerative diseases. JAK4D is a first-in-class thyrotropin releasing hormone (TRH) analogue that overcomes the pharmacological limitations of thyrotropin releasing hormone and enables delivery of the long-recognized multifactorial neurotherapeutic actions of thyrotropin releasing hormone without inducing endocrine side effects. JAK4D is demonstrated to be neuroprotective and significantly reduce excitotoxic-induced hippocampal-dependent memory deficits in rat. In the present study, we used the scopolamine challenge test coupled with the novel object recognition test to evaluate the effect of JAK4D on scopolamine-induced recognition memory deficits in the male, Lister-Hooded rat. Scopolamine administration has been shown by others to mimic cholinergic and brain network disruption in neurodegenerative diseases. Although the scopolamine challenge test does not fully replicate the pathophysiology of neurodegenerative disease, such as Alzheimer's disease, it is a well-recognized acute pharmacological model for assessing the ability of pharmacological interventions to counteract memory deficits relevant to neurodegenerative diseases. In this model of cholinergic dysfunction, we also assessed the effects of thyrotropin releasing hormone, taltirelin (a degradation-stabilized thyrotropin releasing hormone analogue) and the acetylcholinesterase inhibitor, donepezil, as a positive reference compound. The discrimination (d2) index was used as the primary measure to assess the effect of treatment on scopolamine-induced performance deficit in the novel object recognition test. d2 is a standard well-recognized measure of discrimination between a novel and familiar object in the novel object recognition test, which advantageously takes into account individual differences in exploration levels. Across all investigations, JAK4D (1 mg/kg i.p.) significantly reversed scopolamine-induced recognition memory impairment (P = 0.0274, P = 0.0002, P < 0.0001). The degree of reversal of scopolamine-induced memory deficits by JAK4D (1 mg/kg i.p.) was indistinguishable from that observed for donepezil (0.1 mg/kg p.o.) (P = 0.026). Subcutaneously administered JAK4D (0.3-10.0 mg/kg) also significantly reversed this deficit (P = 0.0432-0.0021). Furthermore, similar pro-cognitive effects were exerted by thyrotropin releasing hormone (5 mg/kg i.p., P = 0.0055) and taltirelin (10 mg/kg p.o., P = 0.0002). Together, these results underscore the relevance of the central thyrotropin releasing hormone signalling system for the treatment of memory impairment. Data from the current study provide further evidence in support of the potential of JAK4D as a novel therapeutic for cognitive deficits in neurodegenerative diseases.

对于治疗神经退行性疾病中发生的认知障碍的有效药物,存在着迫切的临床和卫生经济需求。JAK4D是一种一流的促甲状腺激素释放激素(TRH)类似物,克服了促甲状腺激素释放激素的药理学限制,使促甲状腺激素释放激素的多因素神经治疗作用得以实现,而不会引起内分泌副作用。JAK4D被证明具有神经保护作用,可显著减少大鼠兴奋性毒性诱导的海马依赖性记忆缺陷。在本研究中,我们采用东莨菪碱激发试验结合新型物体识别试验来评估JAK4D对东莨菪碱诱导的雄性李斯特兜头大鼠识别记忆缺陷的影响。其他研究表明,东莨菪碱管理可以模拟神经退行性疾病中的胆碱能和脑网络破坏。虽然东莨菪碱激发试验不能完全复制神经退行性疾病(如阿尔茨海默病)的病理生理学,但它是一个公认的急性药理学模型,用于评估药物干预抵消与神经退行性疾病相关的记忆缺陷的能力。在这个胆碱能功能障碍模型中,我们还评估了促甲状腺激素释放激素他替雷林(一种降解稳定的促甲状腺激素释放激素类似物)和乙酰胆碱酯酶抑制剂多奈哌齐作为阳性对照化合物的作用。以区分(d2)指数为主要指标,评价治疗对东莨菪碱诱导的新目标识别成绩缺陷的影响。D2是在新物体识别测试中区分新物体和熟悉物体的标准的公认的度量,它有利地考虑了探索水平的个体差异。在所有研究中,JAK4D (1 mg/kg i.p)显著逆转东莨菪碱诱导的识别记忆障碍(P = 0.0274, P = 0.0002, P < 0.0001)。JAK4D (1 mg/kg i.p)对东莨菪碱诱导的记忆缺陷的逆转程度与多奈哌齐(0.1 mg/kg i.p)的逆转程度没有区别。(p = 0.026)。皮下注射JAK4D (0.3-10.0 mg/kg)也显著逆转了这种缺陷(P = 0.0432-0.0021)。此外,促甲状腺激素释放激素(5 mg/kg i.p., P = 0.0055)和他替雷林(10 mg/kg i.p., P = 0.0002)也有类似的促认知作用。总之,这些结果强调了中枢促甲状腺激素释放激素信号系统与治疗记忆障碍的相关性。当前研究的数据进一步证明了JAK4D作为神经退行性疾病认知缺陷的新疗法的潜力。
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引用次数: 0
The relationship between corticospinal excitability and behavioural measures of movement imagery ability. 皮质脊髓兴奋性与运动想象能力行为测量的关系。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-16 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag013
Marcos Moreno-Verdú, Laurine Boidequin, Baptiste M Waltzing, Elise E Van Caenegem, Charlène Truong, Gautier Hamoline, Robert M Hardwick

Imagining a movement without executing it has measurable effects on physical performance, learning, and rehabilitation. However, these effects rely on our ability to imagine performing actions, a complex, covert skill that is difficult to quantify. While movement imagery ability can be assessed by behavioural methods or measuring its neural correlates, the relationship between these measures is uncertain. This Registered Report will determine the association between three key behavioural processes during movement imagery - generation, maintenance and manipulation - and well-established neurophysiological measures of corticospinal excitability and intracortical inhibition during imagery, obtained via Transcranial Magnetic Stimulation. A behavioural battery including a questionnaire, a 'mental chronometry' task, and a hand rotation task will be collected alongside the amplitude of Motor Evoked Potentials and the change in Short Interval Cortical Inhibition during imagery. Bayesian correlations will assess the association between these measures to provide a comprehensive evaluation of the neuro-behavioural correlates of movement imagery.

想象一个动作而不去做,对身体表现、学习和康复都有显著的影响。然而,这些效果依赖于我们想象执行动作的能力,这是一种难以量化的复杂、隐蔽的技能。虽然运动想象能力可以通过行为方法或测量其神经相关性来评估,但这些测量之间的关系是不确定的。本注册报告将确定运动成像过程中三个关键行为过程(产生、维持和操纵)与通过经颅磁刺激获得的成像过程中皮质脊髓兴奋性和皮质内抑制的成熟神经生理学测量之间的关联。包括问卷调查、“心理计时”任务和手部旋转任务在内的行为测试将与运动诱发电位的振幅和短间隔皮层抑制在想象过程中的变化一起收集。贝叶斯相关性将评估这些测量之间的关联,从而对运动图像的神经行为相关性进行全面评估。
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引用次数: 0
Biomedical research in Alzheimer's disease in a Latin American developing country: challenges in the informed consent process. 拉丁美洲发展中国家阿尔茨海默病的生物医学研究:知情同意过程中的挑战。
IF 4.5 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-14 eCollection Date: 2026-01-01 DOI: 10.1093/braincomms/fcag011
Natalia Salvadores

Alzheimer's disease (AD) is a significant global health issue, impacting 50 million individuals with dementia worldwide, a number projected to triple by 2050. Although research has been conducted for decades, there is no effective prevention, treatment, or early diagnostic method for AD. Research on AD in Latin America (LatAm) faces unique challenges compared to developed countries due to socioeconomic, cultural, and infrastructural factors. While the prevalence of dementia is rapidly increasing in LatAm due to demographic shifts, the region is underrepresented in research, diagnostics and care. The informed consent process, a critical aspect of research, becomes particularly complex with individuals who have cognitive impairments. It requires a balance between protecting vulnerable individuals and advancing research for their benefit. By developing and implementing best practices, ethical research can be conducted with this population, ensuring they receive appropriate care. This review provides an update on informed consent for AD research in Chile.

阿尔茨海默病(AD)是一个重大的全球健康问题,影响着全世界5000万痴呆症患者,预计到2050年这一数字将增加两倍。尽管对阿尔茨海默病的研究已经进行了几十年,但目前还没有有效的预防、治疗或早期诊断方法。由于社会经济、文化和基础设施因素,与发达国家相比,拉丁美洲的AD研究面临着独特的挑战。虽然由于人口结构的变化,拉丁美洲的痴呆症患病率正在迅速上升,但该区域在研究、诊断和护理方面的代表性不足。知情同意过程是研究的一个关键方面,对于有认知障碍的个体来说,这一过程变得特别复杂。它需要在保护弱势个体和推进研究以造福他们之间取得平衡。通过制定和实施最佳实践,可以对这些人群进行伦理研究,确保他们得到适当的护理。本综述提供了智利阿尔茨海默病研究知情同意的最新情况。
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引用次数: 0
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Brain communications
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