International review of neurobiology最新文献

Microbiome-based dietary supplements have gained attention for their role in enhancing brain development and cognitive health. The gut microbiome influences neurological functions through the gut-brain axis, impacting neurotransmitter production, immune regulation, and metabolic pathways. Dysbiosis is linked to neurological disorders such as Alzheimer's, Parkinson's, and autism spectrum disorders. This chapter explores dietary interventions targeting the microbiome, emphasising probiotics, prebiotics, and postbiotics. Additionally, AI and machine learning are transforming microbiome research by enabling personalised supplementation strategies tailored to individual gut profiles. Ethical challenges, including data privacy and algorithmic bias, are also discussed. Advances in big data analytics and predictive modelling are paving the way for precision-targeted interventions to optimise brain health. While microbiome-based therapies hold great promise, further clinical validation and regulatory frameworks are needed to ensure their efficacy and accessibility. This chapter highlights the future potential of microbiome-targeted strategies in neuroprotection and cognitive well-being.

Cryptococcal meningitis (CM) is a severe central nervous system infection primarily affecting immunocompromised patients, significantly contributing to global morbidity and mortality. This chapter explores the link between altered mental status (AMS) and CM, focusing on pathophysiological mechanisms and clinical correlations. Cryptococcus neoformans invades the central nervous system, evading immune defenses and causing increased intracranial pressure, inflammation, and neuronal damage. AMS, a frequent early symptom in CM, signals neurological involvement and disease severity, ranging from subtle cognitive issues to severe deficits. Retrospective studies highlight AMS as a prognostic marker, often associated with worse outcomes. Diagnostic challenges are discussed, emphasizing early recognition for timely intervention. Advances in artificial intelligence and machine learning are proposed to enhance diagnostic accuracy, prognosis, and management of CM. The chapter also covers antifungal therapies and supportive interventions to mitigate AMS-related complications. Future research directions include AI-driven diagnostics and novel treatments to improve outcomes in CM and its neurological manifestations.

This paper explores the therapeutic potential of DMT in neuroprotective strategies, particularly concerning ischemia-reperfusion injury (IRI) and neurodegenerative disorders. Besides its potent serotonin receptor actions, DMT is also an endogenous agonist of the sigma-1 receptor (Sig-1R). Sigma receptors are a unique family of proteins with high expression in the brain and spinal cord and have been involved in the etiology, symptom course and treatment of several central nervous system disorders. Our previous theoretical and experimental work strongly suggest that targeting sigma (and serotonin) receptors via DMT may be particularly useful for treatment in a number of neurological conditions like stroke, global brain ischemia, Alzheimer's disease, and amyotrophic lateral sclerosis. In this article, we briefly overview the function of Sig1-R in cellular bioenergetics with a focus on the processes involved in IRI and summarize the results of our previous preclinical (in vitro and in vivo) DMT studies aiming at mitigating IRI and related cellular neuropathologies. We conclude that the effect of DMT may involve a universal role in cellular protective mechanisms suggesting therapeutic potentials against different components and types of IRIs emerging in local and generalized brain ischemia after stroke or cardiac arrest. The multiple neuroprotective mechanisms facilitated by DMT may position it as a model molecule for developing pharmacological treatments for neurodegenerative disorders.

Non-Invasive Brain Stimulation (NIBS) techniques, including Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS), have emerged as valuable tools in neuroscience, clinical interventions, and hypnosis research. NIBS enables the modulation of neural activity to explore brain-behaviour relationships through causal approaches. TMS, relying on magnetic fields to induce cortical stimulation, has demonstrated its utility in enhancing hypnotic suggestibility, albeit with limitations such as imprecise targeting of stimulated neuronal populations and variability in individual responses. These limitations, including imprecise targeting and inter-individual variability in responses, are also common to tDCS, which applies weak electrical currents to influence cortical excitability, offer more practical adaptability, making it a promising alternative for applications in hypnosis. In hypnosis research, NIBS studies have primarily targeted the dorsolateral prefrontal cortex (DLPFC), a region implicated in executive processes and hypnotic phenomena. Findings from TMS and tDCS studies suggest a modulatory role of the DLPFC in hypnotizability, with inhibitory stimulation enhancing hypnotic depth and responsiveness for some individuals. However, methodological challenges highlight the need for further exploration. Additionally, both TMS and tDCS suffer from further issues such as the challenge of ensuring effective blinding, the presence of placebo effects (which may interfere with the genuineness of observed effects), and high inter-subject variation even within the same study population. Despite these challenges, NIBS suggests clinical potential in augmenting hypnotic responsiveness, which could enhance pain management, emotional regulation, and broaden the applicability of hypnotherapy to resistant individuals. Further, these advancements promise to deepen our understanding of the neurophysiological basis of hypnosis, opening avenues for personalized and targeted neuromodulation strategies.

Clinical trials using full doses of psychedelics have provided preliminary evidence supporting their safety and efficacy in treating a variety of physical and psychological conditions. Anecdotal reports indicate that even very small amounts of these substances may provide therapeutic benefits, though robust clinical studies are still needed. This chapter reviews the current experimental studies in humans using psychedelics in small doses to better understand their therapeutic potential. Research in both neurotypical individuals (n = 18 studies) and patients (n = 3) suggests that small doses of LSD and psilocybin produce subtle, acute, effects on neural connectivity, brain electrophysiology, blood pressure, sleep duration, pain perception, temporal processing, and mood; and show reductions in symptoms of depression and obsessive-compulsive behavior in patient samples. The chapter also discusses the influence of extra-pharmacological factors, such as the baseline subjective state, expectations, and individual differences in drug metabolism, on treatment outcomes. Overall, controlled microdosing studies suggest the potential therapeutic applications of small psychedelic doses, warranting further exploration through large-scale trials in clinical populations.

Patients with a life-threatening disease (LTD) sometimes suffer from end-of-life distress (EOLD) which refers to the physical, psychological, emotional, and spiritual suffering related to chronic illness and the possibility of death. Palliative care interventions seek to improve the quality of life of patients with EOLD and their significant others. Currently, a range of psychological and pharmacological palliative care interventions may be used to mitigate the various symptoms related to EOLD. However, the evidence for their efficacy is inconclusive with only short- to moderate effects. Another significant and relevant limitation in the context of LTDs is that palliative care interventions often require months to take effect. In the past decade, psychedelic-assisted therapy (PAT) has been increasingly investigated for its therapeutic potential in addressing EOLD in various LTDs characterized by highly significant and sometimes sustained decreases in symptoms of depression and (death) anxiety along with other EOLD-related improvements (e.g., meaning, spiritual well-being, optimism, life satisfaction, and change attitudes towards LTDs). The current chapter will provide a detailed description of the concept of EOLD followed by estimated prevalence rates in a range of LTDs. Next, the chapter provides a brief overview of palliative interventions and their limitations. The chapter then introduces a description of PAT, its evidence-base, and why it seems to work in particular for patients with EOLD. The chapter is concluded with future perspectives.

The age at disease onset significantly influences the clinical course, pathophysiology, and treatment response in Myasthenia Gravis (MG). This chapter examines how immunological profiles, autoantibody prevalence, thymic pathology, genetic associations, treatment responses, and disease severity vary across early-onset (EOMG), late-onset (LOMG), and very late-onset MG (VLOMG). EOMG often presents with distinct immunological and genetic profiles, a predominance of female patients, and a higher incidence of thymic hyperplasia. In contrast, LOMG and VLOMG are characterized by thymic atrophy, differing genetic associations, and milder long-term disease courses with variable treatment responses. Recognizing these age-related variations is essential for optimizing diagnostic approaches and therapeutic strategies, highlighting the need for individualized patient management across different age groups.

Parkinson's Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, with emerging research suggesting a critical link between intestinal dysbiosis and PD progression. This review explores the pathophysiological mechanisms underlying PD, such as alpha-synuclein aggregation, mitochondrial dysfunction, neuroinflammation, and oxidative stress, while focusing on the impact of gut dysbiosis on intestinal barrier function and its role in reduced neurochemical production. The clinical features of PD, including dopamine, serotonin, and GABA deficiencies, are examined, with a focus on how dysbiosis contributes to neurotransmitter depletion. Current treatments of PD, such as levodopa and dopamine agonists, are discussed alongside gut health therapies such as probiotics, prebiotics, and Fecal Microbiota Transplantation (FMT). Future therapeutic directions, including synbiotics, engineered microbes, phage therapy, and the integration of machine learning (ML) and artificial intelligence (AI), are explored. The chapter also considers preventive strategies, such as lifestyle adjustments and early gut health monitoring using modern diagnostic tools and biosensors. Furthermore, a strong need for continued research into the gut-brain axis (GBA) to develop more effective, gut-targeted therapies for managing PD is discussed.

Myasthenia Gravis (MG) often affects young women, in whom reproductive issues are of importance, including the possibility of MG exacerbation during pregnancy, potential obstetric risks in pregnancy and treatment-related risks to the fetus. Apart from pregnancy, hormonal changes throughout a woman's lifespan may also affect MG symptoms. In this chapter, we discuss the role of sex hormones in MG and the disease burden in women. We also review the effects of pregnancy on MG, the evidence regarding pregnancy outcomes and current recommendations regarding MG treatments during pregnancy.