Clin. Transl. Neurosci., Volume 10, Issue 1 (March 2026) – 8 articles

Mild traumatic brain injury (mTBI) in adults is extremely common worldwide, but only a small fraction of these patients harbor clinically significant intracranial injuries. Computed tomography (CT) of the head is the standard diagnostic tool to detect traumatic brain hemorrhages or lesions, yet indiscriminate CT scanning of all mTBI patients is inefficient, costly, and exposes patients to ionizing radiation. To optimize patient care, numerous clinical decision rules and guidelines have been developed internationally to identify which adult patients with mTBI should undergo head CT. This review provides a global perspective on the indications for head CT in adult mTBI, comparing key decision rules including the Canadian CT Head Rule, New Orleans Criteria, UK NICE Head Injury Guidelines, and others. Methods: We conducted a comprehensive analysis of major international guidelines and decision rules for head CT in adult mTBI, focusing on their inclusion criteria, risk factors, and diagnostic performance. Results: All the examined rules prioritize near-100% sensitivity for identifying patients who need neurosurgical intervention, but they differ greatly in specificity and recommended CT utilization rates. North American rules such as the New Orleans Criteria tend to favor higher sensitivity, scanning almost all patients with any symptom, whereas the Canadian CT Head Rule and certain European guidelines (NICE, Scandinavian) are more selective, significantly reducing CT usage while maintaining safety. Discussion: We discuss how these variations reflect different healthcare settings and risk tolerances, and we examine the implications for neurosurgical practice. We also highlight challenges in guideline implementation, the impact on global CT utilization, and emerging approaches (such as biomarker-assisted triage) that may further refine decision-making. In conclusion, appropriate use of clinical decision rules for head CT in mTBI can safely minimize unnecessary imaging, but local adaptation and clinician judgment remain crucial to ensure that no significant injuries are missed while avoiding over-scanning. Full article

Electroencephalogram (EEG) methods for the diagnosis of Benign Epilepsy with Centrotemporal Spikes (BECTS) are reviewed. The focus is on procedures reported for EEG analysis and diagnosis in BECTS, since some recent and potential applications of artificial intelligence (AI) aim to enhance the diagnostic accuracy and time reduction process, thereby moving a step closer to advancing our knowledge of the electrical nuclei sources and dynamics of energy distribution through the scalp in patients with epilepsy. The advantages of AI classification techniques have an increasing publication rate in the specialist literature, with no clear agreement on methodology. Hence, a better understanding of the procedures, arguments, and achievements is needed. To achieve this goal, (1) we review the background knowledge of the clinical characteristics of BECTS, (2) we analyze the results and advantages of computational processing methods for source and connectivity analyses of EEG in BECTS, and finally, (3) we explore the AI methods published in specialized journals for BECTS analysis. In conclusion, we argue in favor of the combined use of a priori information, which is the basis of the clinical visual analysis of EEG, as a potential feature to be included in AI methods for the classification of epileptiform graphoelements in EEG in BECTS diagnosis. Full article

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder marked by both motor and non-motor symptoms. The home-based wearable sensor monitoring Parkinson’s KinetiGraph (PKG) evaluates clinical efficacy, caregiver satisfaction, and cost-effectiveness in the clinical management of Parkinson’s disease (PD) compared to prior usual standard care. Methods: We analyzed 50 patients with Parkinson’s disease, comparing baseline clinical outcomes, healthcare utilization, and caregiver burden without PKG to follow-up data after 12 months with PKG. We used IBM SPSS Statistics for the analysis. Statistical significance was set at p < 0.05 for hypothesis testing. We employed the Wilcoxon signed-rank test to evaluate differences between the two time points, while exploratory bivariate associations between caregiver burden (Zarit score) and various outcomes were examined using Spearman’s rank correlation. Results: Over a 12-month period following the implementation of PKG-guided care, significant improvements were observed in various clinical, functional, and economic areas for the patients. Key findings include the following: motor function improved, with UPDRS Part III scores showing a 20% median reduction (from 25 to 20); medication adjustments decreased by 40% (from 5 to 3); outpatient visits were reduced by 60% (from 5 to 2); hospital admissions decreased by 100% (from 1 to 0); caregiver burden, as measured using the Zarit caregiver burden score, declined by 37.5% (from 48 to 30); and total direct medical costs decreased by 17.9% (from AED 261,800 to AED 215,000). Conclusions: These findings indicate substantial reductions in healthcare utilization, costs, and caregiver burden following the integration of PKG monitoring into clinical practice. Full article

The National Institutes of Health (NIH) Toolbox cognition battery and Trail Making Tests (TMT) are widely used to quantify cognitive aging and to detect early cognitive vulnerability in Alzheimer’s disease and related conditions. However, these tests are often treated as interchangeable markers of global cognition, despite likely differences in their dependence on specific brain systems, limiting interpretability across studies and clinical contexts. To address this gap, we examined associations between four commonly used cognitive measures—fluid cognition, crystallized cognition, TMT-A, and TMT-B—and multimodal MRI metrics in 725 healthy volunteers aged 36 to 100 years from the Human Connectome Project–Aging. Voxel-wise diffusion MRI and vertex-wise cortical thickness and volume analyses were adjusted for age, sex, and years of education. Higher crystallized and fluid cognition scores and faster TMT-A/B completion times were generally associated with greater white matter integrity. TMT-B showed the most extensive diffusion and cortical associations, involving major projection, commissural, and association pathways and frontoparietal and temporo-occipital cortices. TMT-A and crystallized cognition demonstrated intermediate, overlapping patterns, whereas fluid cognition showed only focal brainstem and limited cortical correlates. These findings demonstrate systematic differences in the neuroanatomical substrates underlying commonly used cognitive tests and provide normative structure–cognition reference maps that can improve test selection, mechanistic interpretation, and sensitivity to brain health in studies of aging, vascular risk, and preclinical neurodegenerative disease. Full article

Background: Recent studies have highlighted the significant impact of combined thermal and lighting conditions on human comfort. However, there is limited understanding of how these factors influence cognitive performance in older adults. This study explored the effects of complex thermal and lighting conditions on various cognitive functions and physiological responses in older adults. Additionally, a predictive cognitive model was developed using physiological indicators as well as demographic factors. Methods: Twenty-two older adults participated in a within-subject design experiment under different thermal and lighting combinations. The study focused on two temperature conditions, 18 °C and 28 °C, and two lighting conditions, 480 nm with 5500 K and 644 nm with 3200 K. Conclusions: The finding showed that males significantly performed better at 18 °C under 480 nm lighting, while females excelled at 28 °C under 644 nm lighting. Electrodermal activity (EDA) increased in warmer conditions with warmer lighting, and pupil size expanded similarly but decreased under cooler conditions. Males’ EDA was negatively correlated with cognitive performance, while females’ pupil size and BMI were positively correlated. Using the classification and regression tree (CART) algorithm, predictive model demonstrated 89.7% accuracy. These findings emphasize the potential of optimizing thermal and lighting conditions to enhance cognitive functions and predict performance in older adults Full article

Background: The management of asymptomatic lumbosacral lipomas remains controversial, with studies reporting both prophylactic surgery and conservative management. This review compares conservative and surgical treatment approaches for asymptomatic lumbosacral lipomas in children, analyzing outcomes, complications and secondary treatment. Methods: A systematic literature review was conducted using PubMed, Cochrane, and Web of Science databases. Data were extracted and analyzed based on demographic characteristics, lipoma classification, treatment modality, complications and secondary treatment. Results: A total of 22 retrospective studies comprising 1215 patients were included. The mean age was 1.87 years, with a 1.12:1 female-to-male ratio. Dorsal lipomas were the most common subtype (31.6%). At first, a total of 1017 (83.7%) patients underwent surgery, whereas 198 (16.3%) patients had conservative management. Total resection was achieved in 422 (41.9%) patients, whereas subtotal resection and partial resections were performed in 261 (25.9%) and in 334 (33.29%) patients, respectively. Neurological worsening occurred in 17.2% of patients treated conservatively at first diagnosis, with urological dysfunction being the most common symptoms reported (15.2%), followed by neurological deficit to the lower limbs (12.6). Conservative management following prior surgical intervention was performed in 2.6% of cases. A favorable outcome was observed in 88.7% of patients following surgical resection and in 81.8% of patients who were not treated surgically. Conclusion: While surgical intervention is associated with operative risk, it provides a lower risk of long-term neurological deterioration compared to conservative management. The decision to operate should be individualized, considering patient age, anatomical complexity and based on risk of progression. Full article

Objective: Alzheimer’s disease (AD) and other forms of dementia are a heterogeneous group of neurodegenerative diseases characterized by progressive cognitive decline. Differential diagnosis between AD and other dementias is crucial for choosing the optimal treatment strategy. Currently, cerebrospinal fluid (CSF) analysis remains the most accurate diagnostic method, but its invasiveness limits its use. In this regard, the search for reliable biomarkers in the blood is an urgent task. Methods: The study included 31 dementia patients (23 women and 8 men) diagnosed via interdisciplinary consultations and neuropsychological testing (MMSE ≤ 24). CSF and blood plasma samples were collected and analyzed using Luminex technology. Biomarker concentrations were measured, and statistical analyses (ANOVA, Kruskal–Wallis, and Pearson correlation) were performed to compare groups and assess correlations. Results: Levels of Aβ40 and Aβ42 in CSF were significantly lower in patients with AD compared with non-AD dementia (p = 0.02 and p < 0.001, respectively). The Aβ42/40 ratio in CSF was higher in patients with non-AD dementia (p = 0.048). The concentration of Aβ42 in blood plasma was increased in patients with AD (p = 0.001). Positive correlations were found between Aβ42 in CSF and TDP-43 in plasma in non-AD dementia (r = 0.97, p < 0.001), as well as between neurogranin and TDP-43 in plasma in AD (r = 0.845, p < 0.001). Conclusions: The study demonstrates the potential of blood biomarkers, in particular Aβ42, for the differential diagnosis of AD and other forms of dementia. The discovered correlations between CSF and plasma biomarkers deepen the understanding of neurodegenerative processes and contribute to the development of noninvasive diagnostic methods. Full article

Down Syndrome Regression Disorder (DSRD) is a rare but severe neuropsychiatric condition characterized by abrupt loss of speech, autonomy, and cognitive abilities in individuals with Down syndrome, often associated with immune dysregulation and gut–brain axis dysfunction. We report the case of an 11-year-old girl with Down syndrome who developed developmental regression at age five, in temporal proximity to a family transition (the birth of a younger sibling), with loss of continence, language, and comprehension, alongside persistent behavioral agitation and gastrointestinal symptoms. Laboratory assessment revealed Giardia duodenalis infection, elevated fecal calprotectin and secretory IgA, and microbial imbalance with overgrowth of Streptococcus anginosus and S. sobrinus. The patient received a single oral dose of tinidazole (2 g), daily folinic acid (1 mg/kg), and a 90-day course of transcranial and abdominal photobiomodulation (PBM) (1064 nm, 10 min per site). Post-treatment, stool analysis showed normalized inflammation markers and restoration of beneficial bacterial genera (Bacteroides, Bifidobacterium, Lactobacillus) with absence of Enterococcus growth. Behaviorally, she exhibited marked recovery: CARS-2-QPC decreased from 106 to 91, ABC from 63 to 31, and ATEC from 62 to 57, alongside regained continence, speech, and fine-motor coordination. These outcomes suggest that abdominal and transcranial PBM, by modulating mitochondrial metabolism, mucosal immunity, and microbiota composition, may facilitate systemic and neurobehavioral recovery in DSRD. This translational case supports further investigation of PBM as a non-invasive, multimodal therapy for neuroimmune regression in genetic and developmental disorders including validation through future randomized controlled clinical trials. Full article