NeuroSci, Volume 7, Issue 1 (February 2026) – 27 articles

Purpose: The aim of this narrative review is to update current knowledge on Moyamoya vasculopathy (MMV) by addressing key diagnostic debates—including laterality; genetic subtypes; regional epidemiology; and features distinguishing Moyamoya Disease (MMD), Moyamoya Syndrome (MMS) and their mimics. Methods: Key and representative studies were identified through PubMed/MEDLINE and Scopus, focusing on publications from 2014–2025 while also considering earlier seminal works. Results: MMD typically presents with bilateral steno-occlusion of the terminal internal carotid arteries (ICAs) and proximal middle and anterior cerebral arteries (MCAs/ACAs) due to concentric vascular thickening, accompanied by characteristic ‘puff-of-smoke’ collaterals, whereas MMS shows a similar but more often unilateral pattern with fewer collaterals, influenced by the underlying condition. However, this distinction often fails to reflect the full clinical and radiological variability of the Moyamoya spectrum. Atypical moyamoya-like patterns, often confined to M1 or A1 segments, further complicate diagnosis. Clinical manifestations ranged from asymptomatic cases to ischemic or hemorrhagic strokes, and occasionally seizures. Diagnosis relied on multimodal imaging (DSA, MRA, CTA), but genetic mutations, contributing to radiological variability, often complicate differentiation between MMD, MMS, and mimics. Management is pattern-specific: MMS and atypical forms are generally managed conservatively, whereas MMD frequently requires surgical revascularization, particularly in children and symptomatic adults. Nevertheless, variability within diagnostic categories limits the applicability of rigid treatment protocols. Conclusions: Current diagnostic algorithms remain limited. Integrating advanced imaging findings with clinical, genetic, and epidemiological data is essential to define the full disease spectrum, improve diagnostic accuracy, and inform patient management and outcome assessment. Full article

Multiple sclerosis (MS) pathogenesis involves not only immune-mediated myelin injury but also glial responses. We examined how three charge isomers of myelin basic protein (MBP)—native (C1), phosphorylated (C4), and citrullinated (C8)—modulate rat astrocytes. Cytokines were quantified and grouped (pro/anti-inflammatory, chemotactic, neurotrophic, angiogenic, tissue remodeling), and regulatory markers assessed. C1 strongly upregulated the lipid-sensing receptor LXR, and reduced global DNA methylation; C4 moderately enhanced LXR; C8 failed to activate LXR or alter methylation. Functionally, C1 attenuated IL-1β, IL-6 and GM-CSF while increasing IL-10 and certain chemokines. C4 elicited an intermediate pattern, inducing CX3CL1 (fractalkine), CCL20, VEGF-A and TIMP-1 with minor effects on classical cytokines. In contrast, C8 triggered a robust pro-inflammatory phenotype, increasing IL-1α/β, TNF-α and GM-CSF, with higher IL-10, fractalkine, CCL20, VEGF-A and TIMP-1. All isomers suppressed IFN-γ, IL-4 and CNTF. These data indicate that MBP post-translational modifications drive distinct astrocyte phenotypes through integrated cytokine, metabolic and epigenetic pathways: C1 favors immune regulation and repair, C4 blends inflammatory and reparative cues, and C8 amplifies neuroinflammation. Understanding how modified MBP shapes astrocyte behavior provides mechanistic insight into lesion evolution in MS and suggests astrocyte-directed strategies to modulate neuroinflammation and promote remyelination. Full article

Traditional interoception research investigates cardioception, respiroception, or gastroception as a proxy for the sense of the body as a whole. These single-organ tasks sacrifice construct and ecological validity for a content validity that has been elusive. We propose that interoception is better captured by one’s sense of their own autonomic nervous system, or ANSception. The ANS integrates multimodal signals via lesser-myelinated neurons, making it an integral part of the interoceptive nervous system. Thirty-four participants moved a slider to reflect their perceived sympathetic activation (ANSception) while their physiology was monitored. Most participants reported integrating information from two or more organ systems during ANSception. The relationship between ANSception and physiology showed unique but often robust responses by condition and physiological measure. For example, one participant had a negative-to-positive-to-negative pattern for ANSception-EDA correlations from baseline to stimulus to recovery (r = −0.677; 0.657; −0.507, p < 0.001). Another participant had a strong positive correlation between their ANSception and blood pressure (r = 0.601, p < 0.001) during a five-minute reportedly meditative state. We propose that the role of interoception is to scan, integrate and manage information across organ systems, and we conclude that ANSception better captures this role than traditional single-organ tasks. Full article

Background: Intravenous thrombolysis (IVT) is relatively contraindicated in acute ischemic stroke (AIS) patients with intracranial vascular malformations per current guidelines. Thus, the presence of cerebral cavernous malformations (CCMs) may complicate treatment decision-making. Methods: We performed a literature review of the PubMed, Embase, Scopus, and Web of Science databases through July 2025, identifying reported cases of IVT administration in AIS patients with CCMs. Additionally, we conducted a retrospective cohort study using the Nationwide Readmissions Database (2016–2022) of AIS patients with CCM, and assessed outcomes with IVT versus no IVT treatment. The primary outcome was functional independence at discharge; secondary outcomes included mortality and intracranial hemorrhage (ICH). Results: Only 34 CCM patients across 7 studies were identified in the literature, with symptomatic ICH occurring in 2 cases (5.9%). In the nationwide cohort, 846 AIS patients with CCMs were included, of whom 240 (28.4%) received IVT. Compared to no IVT treatment, IVT was associated with significantly higher rates of functional independence (46.4% vs. 24.6%, adjusted OR [aOR] 3.04 [95% CI 1.98–4.68], p < 0.001), without significant differences in mortality (8.5% vs. 8.3%, aOR 1.40 [95% CI 0.52–3.76], p = 0.50) or ICH (20.3% vs. 16.1%, adjusted OR 1.01 [95% CI 0.53–1.93], p = 0.97). Conclusions: The current literature on the safety and efficacy of IVT in AIS patients with CCMs is limited. Our nationwide study suggests that IVT was associated with higher rates of early functional independence without increased risks of hemorrhage or death among patients with CCM. Full article

Alzheimer’s disease (AD) is marked by amyloid plaques, hyperphosphorylated TAU proteins, and neuroinflammation. The APP/PS1 mouse model is widely used to study AD pathogenesis. In this study, we investigated the expression of chemokines and their receptors, which may play a role in AD’s pathological mechanisms, using brain cortex tissue from female APP/PS1 mice aged 20–21 months. We analyzed several chemokine receptors (CCR1, CCR2, CCR3, CCR4, CCR6, CCR7, CCR9, and CCR10) by Western blot and focused on CCR6, CCR7, and CCR10 using RT-PCR. Additionally, we quantified the levels of chemokines (CCL6, CCL8, CCL19, CCL20, CCL24, and CCL27) by RT-PCR. Our results showed a significant decrease in CCL8 and CCL19, along with their respective receptors, in the APP/PS1 mice compared to controls. On the other hand, we observed a notable increase in CCL6, CCL24, CCL20, CCL27, and their receptors. Chemokines like CCL8 and CCL20, involved in inflammatory responses, may reveal how neuroinflammation contributes to AD. CCL19 and CCL27 are linked to immune cell trafficking, which may help explain immune cell interactions with amyloid plaques and TAU tangles in the CNS. Overall, the altered expression of chemokines such as CCL24 could serve as biomarkers for early AD detection and monitoring disease progression. These findings suggest potential therapeutic targets to modulate immune responses and reduce neuroinflammation in AD. Full article

Background: Prior SMA mortality studies have shown excess mortality in people with SMA, but the literature lacks data on disparities in SMA-related mortality. This study examined disparities in SMA-related mortality in the United States in the post-treatment era (2018–2023). Methods: This was a population-based study using the CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. The International Classification of Disease (ICD), 10th Revision, Clinical Modification codes, G12.0, G12.1, G12.8, and G12.9, were used to identify SMA. The data were stratified by biological sex, race/ethnicity (Non-Hispanic/NH White, NH Black, Hispanic, Asian) and Census regions (West, Northeast, Midwest, South). The analysis was conducted by calculating rate ratios (RR) of age-adjusted mortality rate (AAMR). Results: There were 821 (45.8% female) SMA-related deaths across the study period. Males were associated with higher AAMR than females (RR = 1.189, 95% CI: 1.035 to 1.366). The SMA-AAMR for NH White individuals was the highest compared to Hispanic individuals (RR = 1.808, 95% CI: 1.420 to 2.300), followed by NH Black and Asian individuals. The West carried the highest AAMR compared to the Northeast (RR = 1.581, 95% CI: 1.263 to 1.978), followed by the Midwest and the South. The age at death distribution showed a bimodal pattern, as follows: 5–14 years and 65–74 years. The infant age group (<1 year) was associated with the highest AAMR compared to all other age groups. Conclusion: Our findings showed that SMA-related mortality was highest in infants, NH White individuals, the West, and males. These data may assist future efforts to reduce the burden of SMA. Full article

Developmental dyslexia (DD) often involves difficulties in phonological processing of speech. Objectives: While underlying neural changes have been identified in terms of stimulus- and task-related responses within specific brain regions and their neural connectivity, there is still limited understanding of how these changes affect the overall organization of brain networks. Methods: This study used EEG and functional network analysis, focusing on small-world propensity across various frequency bands (from δ to γ), to explore the global brain organization during the auditory discrimination of words and pseudowords in children with DD. Results: The main finding revealed a systemic inefficiency in the functional network of individuals with DD, which did not achieve the optimal small-world propensity. This inefficiency arises from a fundamental trade-off between localized specialization and global communication. During word listening, the δ-/γ1-networks (related to impaired syllabic and phonemic processing of words) and the θ-/β-networks (related to pseudoword listening) in the DD group showed lower local clustering and connectivity compared to the control group, resulting in reduced functional segregation. In particular, the θ-/β-networks for words in the DD group exhibited a less optimal balance between specialized local processing and effective global communication. Centralized midline hubs, such as the postcentral gyrus (PstCG) and inferior frontal gyrus (IFG), which are crucial for global coordination, attention, and executive control, were either absent or inconsistent in individuals with DD. Consequently, the DD network adopted a constrained, motor-compensatory, and left-lateralized strategy. This led to the redirection of information flow and processing effort toward the left PstCG/IFG loop, interpreted as a compensatory effort to counteract automatic processing failures. Additionally, the γ1-network, which is involved in phonetic feature binding, lacked engagement from posterior sensory hubs, forcing this critical process into a slow and effortful motor loop. The γ2-network exhibited unusual activation of right-hemisphere posterior areas during word processing, while it employed a simpler, less mature routing strategy for pseudoword listening, which further diminished global communication. Conclusions: This functionality highlights the core phonological and temporal processing deficits characteristic of dyslexia. Full article

5a-reductase (5a-R) isozymes are essential for androgen metabolism and neurosteroid biosynthesis, linking endocrinology and neuropsychiatry. This systematic review, conducted in accordance with PRISMA 2020 guidelines, aimed to synthesize current evidence on the tissue distribution of SRD5A1, SRD5A2, and SRD5A3 and their implications in mental health. A systematic search of the PubMed, Scopus, and Web of Science databases up to February 2025 identified 257 articles, of which 83 met the inclusion criteria. SRD5A1 is broadly expressed in the liver, skin, and central nervous system, contributing to allopregnanolone synthesis; SRD5A2 is mainly restricted to androgen-dependent tissues, playing a key role in prostate development and alopecia; and SRD5A3 is associated with glycosylation processes and oncogenesis. Converging evidence suggests that impaired neurosteroidogenesis due to 5α-R inhibition may underlie vulnerability to anxiety, depression, and suicidality. While earlier epidemiological findings were heterogeneous, recent pharmacovigilance data have strengthened the evidence supporting this association. Pharmacovigilance and clinical reports show that a subset of patients treated with finasteride or dutasteride may experience persistent psychiatric and sexual adverse effects, known as post-finasteride syndrome. The current findings underscore the need for careful patient counseling, systematic monitoring, and further translational studies integrating genetics, neuroendocrine markers, and standardized psychiatric outcomes to identify individuals at risk and advance personalized medicine in this field. Full article

Objective: The safety of intravenous thrombolysis (IVT) for acute ischemic stroke (AIS) patients with pituitary neoplasms is unclear. This study aims to assess IVT’s safety and efficacy in this patient population. Methods: We reviewed PubMed, Scopus, EMBASE, and Web of Science through July 2025 for reports of IVT administration in AIS patients with pituitary neoplasia. We also performed a retrospective analysis of the Nationwide Readmissions Database (NRD) from 2016 to 2022 to compare outcomes of IVT versus no IVT for AIS patients with pituitary neoplasia, and outcomes of IVT-treated AIS patients with versus without pituitary neoplasia. Outcomes of interest include post-stroke functional status, intracranial hemorrhage (ICH), mortality, and pituitary apoplexy. Multivariate regression analyses were performed to adjust for confounders. Results: The literature review identified 5 AIS patients with pituitary neoplasia, of whom 3/5 (60%) experienced intracranial hemorrhage and none developed apoplexy. In the nationwide analysis of 1,246,750 AIS patients, 1661 (0.13%) had concomitant pituitary neoplasm. Among these patients, IVT was associated with higher odds of functional independence at discharge (adjusted OR 2.46 [95%CI 1.56–3.87]), without increased risk of ICH or in-hospital death (p > 0.05). No cases of pituitary apoplexy were observed. Outcomes among all IVT-treated AIS patients did not differ between those with and without pituitary neoplasms (all p > 0.05). Interpretation: Only five cases of IVT for AIS patients with pituitary neoplasia were identified, highlighting a striking lack of clinical data. In a large U.S. cohort of AIS patients, IVT was associated with improved hospitalization outcomes without increased risk of ICH or pituitary apoplexy. Full article

Monosynaptic reflexes (MSRs) elicited by constant-intensity group I afferent stimulation exhibit marked amplitude variability, commonly attributed to stochastic presynaptic modulation and dynamic postsynaptic excitability. Here, we tested whether this variability could be attenuated using the Ott–Grebogi–Yorke (OGY) chaos–control algorithm, which stabilizes unstable periodic orbits in low-dimensional nonlinear systems. In spinalized, anesthetized cats, real-time implementation of the OGY method failed to reduce MSR amplitude variability, as quantified by the coefficient of variation, and the return map structure showed no evidence of orbit stabilization. These negative results contrast with successful applications of OGY control in physical systems, cardiac tissue, hippocampal slices, and stochastic neuronal models. We interpret this failure in the context of the intense, ongoing synaptic bombardment characteristic of dorsal horn circuitry, which likely obscures or destroys the low-dimensional geometric structure required for OGY-based control. Our findings delineate a fundamental limit to classical chaos–control algorithms in intact neural circuits and highlight the need for control strategies explicitly robust to high dimensionality and physiological noise. Full article

The management of spinal cord cavernous malformations (SCCMs) involves critical decisions between surgical and conservative treatments, informed by the patient’s preoperative neurological status, lesion characteristics, and timing of intervention (early or delayed surgery). Surgery remains an option for symptomatic patients, especially those with significant or progressive neurological deficits and large lesions, aiming for gross total excision to prevent (re)hemorrhage and improve outcomes. Conversely, conservative management is appropriate for small, asymptomatic lesions, with regular monitoring to detect changes necessitating surgery. Studies highlight the benefits and risks of both approaches. Surgical resection typically leads to neurological recovery, although worse preoperative status and larger lesions predict poorer outcomes. Other factors influencing surgical success include lesion location and timing of surgery, with early surgery (within 3 months) generally yielding better long-term outcomes. Future research should focus on the optimal timing of surgery, particularly the benefits of urgent intervention. Full article

Voluntary movement arises from a sequence of neural processes that involve planning, preparation, and execution within distributed cortical networks. The readiness potential, a slow negative brain signal preceding self-initiated actions, represents a sensitive indicator of motor preparation. However, it remains unclear how this signal reflects concurrent variations in mechanical and temporal demands. In this study, twenty-eight healthy participants performed self-paced elbow flexions under nine combinations of mechanical load and movement duration while brain electrical activity, muscle activity, and movement kinematics were simultaneously recorded. Linear mixed-effects analyses revealed that the amplitude of the readiness potential increased progressively with greater mechanical load, indicating that cortical readiness scales with the intensity of preparatory effort. In contrast, longer movement durations produced smaller amplitudes, suggesting that extended temporal windows reduce the efficiency of preparatory synchronization. No significant interaction between load and duration was observed, supporting the idea of partially independent neural mechanisms for effort and timing. These findings identify the readiness potential as a neural marker integrating the energetic and temporal dimensions of voluntary movement and provide a basis for understanding how cortical readiness dynamically optimizes human motor performance. Full article

Rosemary (Salvia rosmarinus) has been linked to improvements in psychological wellbeing through cholinergic mechanisms. However, this study investigated whether individual differences in eye blink rate (EBR) and blink variability (EBV), which are proxies of dopaminergic activity and attentional control, influence the cognitive and mood-enhancing properties of a rosemary-containing drink. Forty-eight healthy adults completed a three-stimulus odd-ball cognitive task under rosemary or control conditions, while vertical electrooculograms were recorded. Event-related brain potentials (ERPs) were also measured using the P3a component at the Cz scalp electrode as an additional index of dopaminergic activity. Subjective mood and arousal (alert, contented, calm) were collected pre- and post-task using Bond–Lader visual analogue scales. Reaction times during the task were modelled with ex-Gaussian parameters (μ, σ, τ). Rosemary ingestion led to increased alertness and contentedness following the task. Cognitive effects were moderated by blink metrics, with significant interactions between rosemary and blink metrics for mean reaction time μ and response variability σ. Rosemary also increased P3a amplitudes, indicative of dopaminergic contribution. The effects of rosemary on cognition and mood were moderated by individual blink profiles, indicating that baseline neurocognitive state plays a role. Although cholinergic accounts are well established, this study highlights the use of proxies of dopamine to investigate broader neurotransmitter involvement in rosemary’s enhancing properties. Full article

Background: Patients with primary central nervous system (CNS) tumors often experience fatigue and sleep disturbances, significantly impacting their quality of life. Exercise has been shown to improve these symptoms in various cancer populations. The aim of this study is to evaluate the effects of different types of exercise on fatigue and sleep in less-investigated CNS tumor patients. Methods: A literature search was conducted in PubMed, Scopus, Cochrane Library, and CINAHL. Eligible randomized and non-randomized studies evaluating exercise interventions in patients diagnosed with primary brain tumors were systematically reviewed, primarily using a narrative synthesis approach. Cancer-related fatigue and sleep-related outcomes were extracted as variables of interest. Where possible [≥2 Randomized Control Trials (RCTs) available for glioma patients], meta-analyses were conducted to assess the overall effects of physical therapy on the above-mentioned outcomes. Results: A total of 15 relevant intervention studies were identified, either RCTs or other types of studies, such as prospective feasibility cohort studies and case studies. A total of 448 participants were enrolled, with the majority diagnosed with glioma. There were single reports on pituitary adenoma after surgery and meningioma patients. In glioma patients, the overall effect of various modality exercise interventions on fatigue was non-significant, reflecting the heterogeneous characteristics of studies with diverse outcomes. However, meta-analysis focusing on combined exercise interventions (aerobic and resistance training) showed a positive effect on reducing fatigue in these patients [Standardized Mean Difference (SMD) = 0.866, p = 0.03]. Fatigue in glioma patients may also improve through yoga and Pilates. Aerobic but not strength exercise seems to improve sleep in glioma patients (SMD = 1.14, p = 0.02). Sleep quality may also improve through yoga and combined exercise. Conclusions: Certain types of exercise appear to effectively reduce fatigue and improve sleep in patients with CNS tumors. Future, well–controlled, multi-arm, larger-scale studies are necessary to resolve discrepancies, as well as to explore long-term outcomes and define factors influencing individualized exercise responses. Full article

Alzheimer’s disease (AD) remains an unmet medical challenge, as there are no effective therapies that alter the disease’s progression. While approaches have targeted molecules like acetylcholine (ACh) and glutamate, these strategies have provided only limited benefits and do not address the complex molecular mechanisms underlying AD development. This review suggests that β-alanine (3-aminopropanoic acid) is an underexplored neurotransmitter that could serve as a potential AD drug target. Existing evidence indicates that β-alanine modulates GABAergic and glutamatergic neurotransmission, thereby affecting neuronal hyperexcitability. Additionally, studies suggest that β-alanine has antioxidant effects, reducing oxidative stress caused by reactive oxygen species (ROS). We propose that β-alanine might bind to Aβ/tau proteins, possibly targeting the six-amino acid sequences EVHHQK/DDKKAK, which are involved in protein aggregation. β-Alanine may also influence the release of pro-inflammatory cytokines from microglia, potentially reducing neuroinflammation. We also hypothesize that β-alanine may help regulate metal dyshomeostasis, which leads to ROS production. Taurine, structurally like β-alanine, appears to influence comparable mechanisms. Although structural similarity doesn’t ensure therapeutic effectiveness, this evidence supports considering β-alanine as a treatment for AD. Furthermore, β-alanine and its analogues face challenges, including crossing the blood–brain barrier (BBB) and optimizing structure–activity relationships (SAR). This review includes articles through September 2025, sourced from four databases. Full article

Hand representation maps of the primate primary motor (M1) and somatosensory (SI) cortices exhibit plasticity, with their spatial extent modifiable through training. While activation and map enlargement during tapping tasks are well documented, the directionality of information flow between these regions remains unclear. We applied Information Imbalance Gain Causality (IIG) to examine the propagation and temporal dynamic of BOLD activity among Area 4 (precentral gyrus), Area 3a (fundus of the central sulcus), and SI areas (postcentral gyrus). Data were collected from both hemispheres of nine participants performing alternating right–left hand finger tapping inside a 1.5T fMRI scan. The results revealed strong information flow from both the precentral and postcentral gyri toward the sulcus during tapping task, with weaker bidirectional exchange between the gyri. When not engaged in tapping, both gyri communicated with each other and the sulcus. During active tapping, flow bypassed the sulcus, favoring a more direct postcentral to precentral way. Overtime, postcentral to sulcus influence strengthened during non task periods, but diminished during tapping. These findings suggest that M1, Area 3a, and SI areas form a dynamic network that supports rapid learning processing, where Area 3a of the sulcus may contribute to maintaining representational plasticity during complex tapping tasks. Full article

Objectives: This pilot study examined telerehabilitation, which has emerged as a crucial modality in light of recent global challenges such as the COVID-19 pandemic. We examined the effectiveness of a mobile health telerehabilitation intervention developed for older adults with frailty. Methods: Six participants received a telerehabilitation intervention (Rehab Studio) that included exercise training videos. The participants were aged ≥65 years, had no history of dementia or psychiatric disorders, and had mild-to-moderate care needs. For 1 month, the participants received 1 h live online rehabilitation sessions with real-time communication with rehabilitation specialists (physical therapists and occupational therapists: PTs/OTs). The quality of life (QoL) (EuroQol 5 dimensions 5-level [EQ-5D-5L] questionnaire) and self-rated health scores were recorded before and after the intervention, and the data were analyzed using paired t-tests to determine whether the service was effective. Results: Significant differences were found in the total EQ-5D-5L and self-rated health scores (p < 0.05). The mean EQ-5D-5L score increased from 0.63 ± 0.13 before the intervention to 0.77 ± 0.14 after the intervention (p = 0.010), while the mean self-rated health score increased from 66.0 ± 18.0 to 83.3 ± 10.3, respectively (p = 0.019). Conclusions: This study revealed that the mobile health telerehabilitation intervention is safe and can improve QoL for older adults with frailty. However, the effectiveness of the intervention needs to be further investigated in patients with poor performance in daily living activities. Telerehabilitation could help to reduce the burden of nursing care in aging societies with declining birthrates. However, given the extremely small sample size (N = 6), these p-values should be interpreted with considerable caution. Statistical significance in such a small sample does not provide strong evidence for population-level effects, and our findings should be regarded as hypothesis-generating rather than confirmatory. Full article

Background: Currently, there is a considerable number of studies addressing vagus nerve stimulation (VNS) for the treatment of different stroke-related outcomes. We aimed to promote a broad view of the outcomes studied and what are the opportune outcomes to be studied involving this therapeutic strategy for the treatment of post-stroke complications. Methods: This is a scoping review that followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two investigators conducted independent searches on PubMed/MEDLINE, Scopus, and Embase till July 2025. Randomized clinical trials and preclinical studies using invasive or non-invasive vagus nerve stimulation conducted with a population diagnosed with stroke were included. Results: Forty-one experimental studies and sixteen clinical trials were included. The outcomes found were neuroprotection; motor, functional, and cognitive rehabilitation; dysphagia; comparison of different stimulation intensities; safety, efficacy, and feasibility of the non-invasive approach; comparison between transcutaneous auricular vagus nerve stimulation (taVNS) and transcutaneous cervical vagus nerve stimulation (tcVNS); and comparison between two models of ischemia (permanent and transient). Preclinical studies mostly investigated molecular elements involved in neuroprotection, neuroinflammation, and cellular apoptosis, while clinical studies evaluating the effectiveness of this technique used for rehabilitation and its comparison or combination with other techniques remain scarce. Conclusions: Most studies investigating the effects of VNS on different post-stroke outcomes are experimental studies. Clinical studies are still scarce and with limited analysis of outcomes. Full article

Neonatal seizures are common complications in neonatal intensive care units. They have been noticed to be more common in preterm infants, but they can also affect term infants. Levetiracetam is a broad-spectrum antiepileptic drug that has been studied to manage seizures, yet limited data are available on its use in neonatal seizures. Objectives: Study the effect of levetiracetam on neonatal seizures in terms of maintaining seizure freedom after the initiation of levetiracetam and investigating its safety profile in the neonate population. Method: Retrospective cohort study comparing two groups of patients identified through accessing their medical profiles after searching the following keywords: phenobarbital, levetiracetam, and neonatal seizures amongst all NICU admissions in King Abdulaziz Medical City, Ministry of National Guard Health Affairs, from the period between December 2016 and January 2020. Forty-eight patients were included based on the inclusion/exclusion criteria. The selected sample was further subclassified into 28 neonates who received phenobarbital and 20 who received levetiracetam. Results: Seizure control was significantly observed in neonates with onset <24 h and those born at <37 weeks GA. In the first arm, 22 out of 28 neonates achieved seizure freedom while using phenobarbital; in the second arm, 11 out of 20 neonates achieved seizure control on levetiracetam after failing with phenobarbital. While seizure control was better achieved by phenobarbital, it was found that almost 57% of the first arm developed side effects on phenobarbital; however, only 10% of the neonates on levetiracetam developed side effects. While PB remains effective for acute suppression, LEV demonstrated a superior safety profile with no serious adverse events and a high rate of successful seizure management as an add-on therapy (83% control in combined cohorts). Conclusions: The study concluded that using levetiracetam could result in improved outcomes. LEV is a safe and effective alternative or adjunct to PB. Its use may mitigate the neurotoxic risks associated with GABAergic drugs, though continuous EEG monitoring is essential to ensure electrical seizure cessation and avoid electroclinical dissociation. The number of patients who received levetiracetam initially is not considered a representative sample to reach a conclusion on the use of levetiracetam as an effective monotherapy. Full article

Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment disorder, with a lifetime prevalence estimated at approximately 10%. This narrative review explores the historical evolution, current management strategies, and emerging trends in CTS diagnosis and treatment. Early recognition of CTS led to the development of conservative interventions, including splinting, corticosteroid injections, and physical therapy, aimed at alleviating median nerve compression and associated symptoms. The advent of open carpal tunnel release established surgery as the definitive treatment for moderate-to-severe CTS, with subsequent refinements—such as mini-open and endoscopic techniques—focused on minimizing tissue trauma and expediting recovery. Comparative studies demonstrate similar long-term efficacy between surgical modalities, though endoscopic approaches often provide faster short-term recovery. Advances in diagnostic imaging, including high-resolution ultrasound, have improved early detection and dynamic assessment of median nerve compression. Emerging therapies, such as regenerative biologics, neuromobilization, and minimally invasive surgical innovations, offer promising adjuncts to current care. Despite substantial progress, further research is needed to clarify optimal patient selection, refine minimally invasive techniques, and explore regenerative interventions. This review underscores the importance of individualized, evidence-based, and patient-centered approaches to CTS management, integrating both established and emerging strategies to optimize functional outcomes and quality of life. Full article

Neurodegenerative diseases such as Alzheimer’s, Parkinson’s, amyotrophic lateral sclerosis, and Huntington’s disease represent a major challenge in neuroscience due to their complex, multifactorial nature and the absence of curative treatments. These disorders share common molecular mechanisms, including oxidative stress, mitochondrial dysfunction, proteostasis collapse, calcium dyshomeostasis, chronic neuroinflammation, and the prion-like propagation of misfolded proteins. Together, these processes trigger a cascade of cellular damage that culminates in synaptic dysfunction and programmed neuronal death. This review integrates current evidence on the sequential stages of neurodegeneration, emphasizing the convergence of oxidative, inflammatory, and proteotoxic pathways that drive neuronal vulnerability. Moreover, it explores emerging therapeutic strategies aimed at restoring cellular homeostasis, such as Nrf2 activation, modulation of the unfolded protein response (UPR), enhancement of autophagy, immunotherapy against pathological proteins, and gene therapy approaches. The dynamic interplay among mitochondria, endoplasmic reticulum, and glial cells is highlighted as a central element in disease progression. Understanding these interconnected mechanisms provides a foundation for developing multi-targeted interventions capable of halting or delaying neuronal loss and improving clinical outcomes in neurodegenerative disorders. This work provides an integrative and introductory overview of the convergent mechanisms underlying neurodegeneration rather than an exhaustive mechanistic analysis. Full article

REM sleep behavioral disorder (RBD) is of increasing interest in Parkinson’s disease (PD). Previous studies exploring the association between REM sleep without atonia (RWA) and clinical PD features or other objective sleep metrics are scarce and have used PSG findings. A mobile electroencephalography (EEG)/electrooculography (EOG) recording system with two channels can objectively measure sleep parameters, including RWA, during natural sleep at home. We investigated whether RWA measured on a portable recording device at home could be associated with clinical PD features or other sleep metrics using baseline data from the ZEAL study. Differences between patients with and without RWA was analyzed using ANCOVA test. REM sleep length was significantly longer in patients with RWA than in those without RWA. A multivariate comparison using ANCOVA showed a significant difference in log-transformed REM sleep duration of patients with RWA after adjustment for potential confounders (adjusted mean difference of 1.203; 95% confidence interval 0.468 to 1.937; p = 0.003). The strength of this study was that it evaluated the association between RWA during natural sleep at home and clinical variables as well as other sleep metrics. The major result was that patients with and without RWA did not differ in their clinical variables, and there was no relation between RWA and objective sleep metrics other than REM sleep. The duration of REM sleep may be associated with RWA during natural sleep at home. Full article

In non-vasculitic immune-mediated neuropathies, imaging studies demonstrate an enlargement not only of clinically involved but also of clinically intact nerves. The present study aimed to present a pattern of nerve swelling and its relation to nerve function. In a group of patients with dysimmune motor and sensorimotor mononeuropathies, nerve cross-sectional areas (CSAs) were measured using ultrasonography (US) and compound muscle action potential (CMAP) amplitudes using electrodiagnostic (EDx) studies. Nerve CSAs were compared in (1) clinically involved, (2) swollen and clinically uninvolved, and (3) non-swollen (clinically uninvolved) nerves. Patients’ non-swollen nerves were also compared to those of controls. In swollen nerves, the correlation between nerve CSA and CMAP amplitude was calculated. Twenty-two patients (12 men) and 50 controls (28 men) were included in the study. Clinically involved nerves were thicker than swollen segments of clinically intact nerves (p < 0.001). The patients’ non-swollen (clinically uninvolved) nerves were thicker than the controls’. In swollen nerves, CSA was strongly negatively correlated with CMAP amplitude (r = −0.54, p < 0.001). In patients with immune-mediated mononeuropathies, nerve swelling correlates with clinical and EDx findings. Patients’ clinically uninvolved nerves were also swollen, but to a lesser degree. Full article

Religious experiences represent a universal and timeless phenomenon that has accompanied humanity since its origins. In recent decades, neuroscience has explored the relationship between temporal lobe epilepsy (TLE) and hyperreligiosity phenomena, describing sudden convictions, states of ecstasy, and spiritual conversions associated with epileptic seizures. This article offers a narrative review of the literature on the relationship between epilepsy and religion, including its clinical manifestations (ictal, postictal, and interictal) and the main neurobiological models proposed to explain it, such as the limbic marker hypothesis and theory of mind (ToM). The possible role of the uncinate fasciculus as an integrative pathway between temporal and limbic regions is also explored, based on recent neuroimaging studies. Finally, we present an illustrative clinical case of a patient with meningioma and TLE associated with episodes of intense religious conviction, in whom a structural alteration of the right uncinate fasciculus was observed. This case reinforces the relevance of considering both neuronal networks and white matter tracts in the study of religious experiences, while underscoring the need for broader and more systematic studies to confirm these findings. Full article

The experience of childhood maltreatment (CM) increases the risk for depressive disorders by two-and-a-half times across the lifespan. Although stress system and immunological models offer some explanation of this vulnerability, further investigation is required to understand the underlying neurophysiological mechanisms and identify potential biomarkers for diagnosis and treatment. Resting-state electroencephalography (EEG) offers a low-cost, non-invasive, and accessible methodology for that purpose. This narrative review synthesizes resting-state EEG findings that are common to CM and depression as a primer for further research and the future formulation of a model that may link these two in a causal manner. Although evidence supports atypical beta and theta band power, frontal alpha asymmetry and altered default mode network functional connectivity as possible indicators of the CM-EEG association, there is a paucity of EEG-based CM research available to complement the extensive depression-focused literature. Large-sample, prospective EEG studies of CM that consider confounding factors and assess the neurophysiological impact of CM independent of psychopathologies are required. Full article

Mild cognitive impairment (MCI) is a nosological entity that requires special attention from a therapeutic perspective, because annual conversion rates to dementia of 5–15% in these cases are considered typical. This narrative review aimed to identify available data supporting the efficacy and tolerability of various pharmacological therapeutic interventions by searching PubMed/MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science (WoS) Core Collection for primary and secondary reports published over the last 25 years on the pharmacological treatment of MCI. The retrieved interventions were distributed in five large categories: (1) conventional cognitive enhancers; (2) disease-modifying therapeutic interventions; (3) strategies mitigating vascular risk and management of concomitant medications; (4) adjuvant and nootropic formulations; (5) case management of non-cognitive symptoms in MCI. The most broadly applicable pharmacological strategies in MCI include systematic deprescribing and optimisation of concomitant therapies, reducing anticholinergic and sedative load, avoiding iatrogenic hypoglycaemia and excessive blood pressure lowering, and careful, individualised treatment of vascular risk factors. Based on the randomised controlled trials, meta-analyses, and contemporary guidelines, a pragmatic pharmacological approach to MCI is suggested. Further trials with better design are urgently needed to document the efficacy and safety of pharmacological interventions in patients diagnosed with MCI. Full article

Objectives: The aim of this study was to investigate the effectiveness of Cryoflow cooling on forearm skin temperature and nerve conduction velocity (NCV) in normal subjects. Methods: Thirty male volunteers participated in this study, with a mean age of 20.8 ± 0.74 years. A Cryoflow hose with a nozzle was positioned approximately 10 cm from the forearm and scanned the anterior surface of the non-dominant forearm for 10 min, with temperatures adjusted to −10 °C. Participants’ average skin temperature was measured by using an infrared camera. Motor and sensory NCV for both the median and ulnar nerves were measured from both forearms. The dominant side served as a control side. The level of significance was set at p value ≤ 0.05. Results: Following treatment, the experimental group experienced a reduction in average skin temperature, dropping from 32.94 ± 1.11 °C to 16.92 ± 1.68 °C, while the control group showed no significant change. Both the median and ulnar nerves exhibited significant decreases in motor NCV (−10.37 m/s and −8.79 m/s, respectively), alongside slight increases in distal motor latency. Sensory NCV of the median and ulnar nerves decreased significantly (−5.20 m/s and −8.40 m/s, respectively), accompanied by increased onset latency. No significant changes were found in the control group. Conclusions: Cryoflow air-based cryotherapy to the forearm causes a substantial reduction in local skin temperature and significant slowing of peripheral nerve conduction. Both motor and sensory fibers of the median and ulnar nerves exhibited decreased conduction velocities and increased latencies following cooling. Full article