Brain Sciences

21 pages, 1541 KB

Open AccessEditor’s ChoiceReview

The Impact of Inotropes and Vasopressors on Cerebral Oxygenation in Patients with Traumatic Brain Injury and Subarachnoid Hemorrhage: A Narrative Review

by Michele Salvagno, Federico Geraldini, Giacomo Coppalini, Chiara Robba, Elisa Gouvea Bogossian, Filippo Annoni, Eva Vitali, Elda Diletta Sterchele, Costantino Balestra and Fabio Silvio Taccone

Brain Sci. 2024, 14(2), 117; https://doi.org/10.3390/brainsci14020117 - 24 Jan 2024

Cited by 12 | Viewed by 9265

Abstract

Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are critical neurological conditions that necessitate specialized care in the Intensive Care Unit (ICU). Managing cerebral perfusion pressure (CPP) and mean arterial pressure (MAP) is of primary importance in these patients. To maintain targeted MAP [...] Read more.

Traumatic brain injury (TBI) and subarachnoid hemorrhage (SAH) are critical neurological conditions that necessitate specialized care in the Intensive Care Unit (ICU). Managing cerebral perfusion pressure (CPP) and mean arterial pressure (MAP) is of primary importance in these patients. To maintain targeted MAP and CPP, vasopressors and/or inotropes are commonly used. However, their effects on cerebral oxygenation are not fully understood. The aim of this review is to provide an up-to date review regarding the current uses and pathophysiological issues related to the use of vasopressors and inotropes in TBI and SAH patients. According to our findings, despite achieving similar hemodynamic parameters and CPP, the effects of various vasopressors and inotropes on cerebral oxygenation, local CBF and metabolism are heterogeneous. Therefore, a more accurate understanding of the cerebral activity of these medications is crucial for optimizing patient management in the ICU setting. Full article

(This article belongs to the Section Molecular and Cellular Neuroscience)

► Show Figures

Figure 1

21 pages, 1844 KB

Open AccessEditor’s ChoiceReview

Rett Syndrome and the Role of MECP2: Signaling to Clinical Trials

by Adele Gaspar Lopes, Sampath Kumar Loganathan and Jayalakshmi Caliaperumal

Brain Sci. 2024, 14(2), 120; https://doi.org/10.3390/brainsci14020120 - 24 Jan 2024

Cited by 10 | Viewed by 11892

Abstract

Rett syndrome (RTT) is a neurological disorder that mostly affects females, with a frequency of 1 in 10,000 to 20,000 live birth cases. Symptoms include stereotyped hand movements; impaired learning, language, and communication skills; sudden loss of speech; reduced lifespan; retarded growth; disturbance [...] Read more.

Rett syndrome (RTT) is a neurological disorder that mostly affects females, with a frequency of 1 in 10,000 to 20,000 live birth cases. Symptoms include stereotyped hand movements; impaired learning, language, and communication skills; sudden loss of speech; reduced lifespan; retarded growth; disturbance of sleep and breathing; seizures; autism; and gait apraxia. Pneumonia is the most common cause of death for patients with Rett syndrome, with a survival rate of 77.8% at 25 years of age. Survival into the fifth decade is typical in Rett syndrome, and the leading cause of death is cardiorespiratory compromise. Rett syndrome progression has multiple stages; however, most phenotypes are associated with the nervous system and brain. In total, 95% of Rett syndrome cases are due to mutations in the MECP2 gene, an X-linked gene that encodes for the methyl CpG binding protein, a regulator of gene expression. In this review, we summarize the recent developments in the field of Rett syndrome and therapeutics targeting MECP2. Full article

(This article belongs to the Special Issue Molecular Mechanisms of Brain Development and Psychiatric Diseases)

► Show Figures

Figure 1

21 pages, 342 KB

Open AccessEditor’s ChoiceArticle

Associations between Gross and Fine Motor Skills, Physical Activity, Executive Function, and Academic Achievement: Longitudinal Findings from the UK Millennium Cohort Study

by Yuxi Zhou and Andrew Tolmie

Brain Sci. 2024, 14(2), 121; https://doi.org/10.3390/brainsci14020121 - 24 Jan 2024

Cited by 27 | Viewed by 12900

Abstract

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor–cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The [...] Read more.

Accumulating evidence from behavioral studies and neuroscience suggests that motor and cognitive development are intrinsically intertwined. To explore the underlying mechanisms of this motor–cognition link, our study examined the longitudinal relationship of early motor skills and physical activity with later cognitive skills. The sample was 3188 children from the United Kingdom Millennium Cohort Study, followed at 9 months and 5, 7, and 11 years. Early motor skills were examined at 9 months. Children’s daily physical activity level was measured using accelerometers at 7 years and a questionnaire was conducted at 11 years. Cognitive skills, including executive function and academic achievement, were measured at age 11. The results suggest that gross motor skills were positively associated with spatial working memory, whereas fine motor skills were predictive of good English and science outcomes. Moderate-to-vigorous activity was found to be negatively associated with English performance, although self-reported activity frequency was positively linked to math. Our results highlight the significant role of both gross and fine motor skills in cognitive development. This study also elucidates the limitations of using activity intensity to assess the impact of motor activity on children’s cognitive development, suggesting that attention to the effects of specific types of physical activity would better elucidate the motor/cognition link. Full article

(This article belongs to the Special Issue Executive Functioning Development—Measurements and Promotion in Naturalistic Setups)

14 pages, 823 KB

Open AccessEditor’s ChoiceSystematic Review

Dual-Process Theory of Thought and Inhibitory Control: An ALE Meta-Analysis

by Giorgio Gronchi, Gioele Gavazzi, Maria Pia Viggiano and Fabio Giovannelli

Brain Sci. 2024, 14(1), 101; https://doi.org/10.3390/brainsci14010101 - 20 Jan 2024

Cited by 9 | Viewed by 10257

Abstract

The dual-process theory of thought rests on the co-existence of two different thinking modalities: a quick, automatic, and associative process opposed to a slow, thoughtful, and deliberative process. The increasing interest in determining the neural foundation of the dual-process distinction has yielded mixed [...] Read more.

The dual-process theory of thought rests on the co-existence of two different thinking modalities: a quick, automatic, and associative process opposed to a slow, thoughtful, and deliberative process. The increasing interest in determining the neural foundation of the dual-process distinction has yielded mixed results, also given the difficulty of applying the fMRI standard approach to tasks usually employed in the cognitive literature. We report an activation likelihood estimation (ALE) meta-analysis to investigate the neural foundation of the dual-process theory of thought. Eligible studies allowed for the identification of cerebral areas associated with dual-process theory-based tasks without differentiating between fast and slow thinking. The ALE algorithm converged on the medial frontal cortex, superior frontal cortex, anterior cingulate cortex, insula, and left inferior frontal gyrus. These structures partially overlap with the cerebral areas recurrently reported in the literature about the neural basis of the dual-process distinction, where the PARCS theory-based interpretation emphasizes the role of the right inferior gyrus. The results confirm the potential (but still almost unexplored) common ground between the dual-process literature and the cognitive control literature. Full article

(This article belongs to the Section Behavioral Neuroscience)

► Show Figures

Figure 1

15 pages, 318 KB

Open AccessEditor’s ChoiceReview

Single-Sided Deafness and Hearing Rehabilitation Modalities: Contralateral Routing of Signal Devices, Bone Conduction Devices, and Cochlear Implants

by Alessandra Pantaleo, Alessandra Murri, Giada Cavallaro, Vito Pontillo, Debora Auricchio and Nicola Quaranta

Brain Sci. 2024, 14(1), 99; https://doi.org/10.3390/brainsci14010099 - 20 Jan 2024

Cited by 13 | Viewed by 8057

Abstract

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, [...] Read more.

Single sided deafness (SSD) is characterized by significant sensorineural hearing loss, severe or profound, in only one ear. SSD adversely affects various aspects of auditory perception, including causing impairment in sound localization, difficulties with speech comprehension in noisy environments, and decreased spatial awareness, resulting in a significant decline in overall quality of life (QoL). Several treatment options are available for SSD, including cochlear implants (CI), contralateral routing of signal (CROS), and bone conduction devices (BCD). The lack of consensus on outcome domains and measurement tools complicates treatment comparisons and decision-making. This narrative overview aims to summarize the treatment options available for SSD in adult and pediatric populations, discussing their respective advantages and disadvantages. Rerouting devices (CROS and BCD) attenuate the effects of head shadow and improve sound awareness and signal-to-noise ratio in the affected ear; however, they cannot restore binaural hearing. CROS devices, being non-implantable, are the least invasive option. Cochlear implantation is the only strategy that can restore binaural hearing, delivering significant improvements in speech perception, spatial localization, tinnitus control, and overall QoL. Comprehensive preoperative counseling, including a discussion of alternative technologies, implications of no treatment, expectations, and auditory training, is critical to optimizing therapeutic outcomes. Full article

(This article belongs to the Special Issue Middle Ear and Bone Conduction Implants)

27 pages, 1067 KB

Open AccessEditor’s ChoiceReview

International Trends in Lithium Use for Pharmacotherapy and Clinical Correlates in Bipolar Disorder: A Scoping Review

by Yao Kang Shuy, Sanjana Santharan, Qian Hui Chew and Kang Sim

Brain Sci. 2024, 14(1), 102; https://doi.org/10.3390/brainsci14010102 - 20 Jan 2024

Cited by 16 | Viewed by 5384

Abstract

Lithium remains an effective option in the treatment of bipolar disorder (BD). Thus, we aim to characterize the pharmaco-epidemiological patterns of lithium use internationally over time and elucidate clinical correlates associated with BD using a scoping review, which was conducted using the methodological [...] Read more.

Lithium remains an effective option in the treatment of bipolar disorder (BD). Thus, we aim to characterize the pharmaco-epidemiological patterns of lithium use internationally over time and elucidate clinical correlates associated with BD using a scoping review, which was conducted using the methodological framework by Arksey and O’Malley (2005). We searched several databases for studies that examined the prescriptions for lithium and clinical associations in BD from inception until December 2023. This review included 55 articles from 1967 to 2023, which collected data from North America (n = 24, 43.6%), Europe (n = 20, 36.4%), and Asia (n = 11, 20.0%). The overall prescription rates ranged from 3.3% to 84% (33.4% before and 30.6% after the median year cutoffs). Over time, there was a decline in lithium use in North America (27.7% before 2010 to 17.1% after 2010) and Europe (36.7% before 2003 to 35.7% after 2003), and a mild increase in Asia (25.0% before 2003 to 26.2% after 2003). Lithium use was associated with specific demographic (e.g., age, male gender) and clinical factors (e.g., lower suicide risk). Overall, we found a trend of declining lithium use internationally, particularly in the West. Specific clinical correlates can support clinical decision-making for continued lithium use. Full article

(This article belongs to the Special Issue Neuropsychopharmacology in Mood Disorders)

► Show Figures

Figure 1

29 pages, 498 KB

Open AccessEditor’s ChoiceReview

Rethinking Clozapine: Lights and Shadows of a Revolutionary Drug

by Liliana Dell’Osso, Chiara Bonelli, Benedetta Nardi, Federico Giovannoni, Cristiana Pronestì, Ivan Mirko Cremone, Giulia Amatori, Stefano Pini and Barbara Carpita

Brain Sci. 2024, 14(1), 103; https://doi.org/10.3390/brainsci14010103 - 20 Jan 2024

Cited by 11 | Viewed by 18050

Abstract

The current literature globally highlights the efficacy of Clozapine in several psychiatric disorders all over the world, with an FDA indication for reducing the risk of repeated suicidal behavior in patients with schizophrenia or schizoaffective disorder. A growing field of research is also [...] Read more.

The current literature globally highlights the efficacy of Clozapine in several psychiatric disorders all over the world, with an FDA indication for reducing the risk of repeated suicidal behavior in patients with schizophrenia or schizoaffective disorder. A growing field of research is also stressing a possible broader beneficial effect of Clozapine in promoting neuroprotection and neurotrophism. However, this drug is linked to several life-threatening side effects, such as agranulocytosis, myocarditis and seizures, that limit its use in daily clinical practice. For this work, a search was performed on PubMed using the terms “Clozapine indications”, “Clozapine adverse effects”, “Clozapine regenerative effects”, and “Clozapine neuroplasticity” with the aim of reviewing the scientific literature on Clozapine’s treatment indications, adverse effects and potential regenerative role. The results confirmed the efficacy of clozapine in clinical practice, although limited by its adverse effects. It appears crucial to raise awareness among clinicians about the potential benefits of using Clozapine, as well educating medical personnel about its risks and the early identification of possible adverse effects and their management. Full article

(This article belongs to the Section Neuropsychiatry)

15 pages, 5109 KB

Open AccessEditor’s ChoiceReview

The Role of Calcium and Iron Homeostasis in Parkinson’s Disease

by Ji Wang, Jindong Zhao, Kunying Zhao, Shangpeng Wu, Xinglong Chen and Weiyan Hu

Brain Sci. 2024, 14(1), 88; https://doi.org/10.3390/brainsci14010088 - 17 Jan 2024

Cited by 18 | Viewed by 6700

Abstract

Calcium and iron are essential elements that regulate many important processes of eukaryotic cells. Failure to maintain homeostasis of calcium and iron causes cell dysfunction or even death. PD (Parkinson’s disease) is the second most common neurological disorder in humans, for which there [...] Read more.

Calcium and iron are essential elements that regulate many important processes of eukaryotic cells. Failure to maintain homeostasis of calcium and iron causes cell dysfunction or even death. PD (Parkinson’s disease) is the second most common neurological disorder in humans, for which there are currently no viable treatment options or effective strategies to cure and delay progression. Pathological hallmarks of PD, such as dopaminergic neuronal death and intracellular α-synuclein deposition, are closely involved in perturbations of iron and calcium homeostasis and accumulation. Here, we summarize the mechanisms by which Ca²⁺ signaling influences or promotes PD progression and the main mechanisms involved in ferroptosis in Parkinson’s disease. Understanding the mechanisms by which calcium and iron imbalances contribute to the progression of this disease is critical to developing effective treatments to combat this devastating neurological disorder. Full article

(This article belongs to the Special Issue Molecular Mechanism and Pathology of Parkinson's Disease)

► Show Figures

Figure 1

13 pages, 2296 KB

Open AccessEditor’s ChoiceReview

Update on How to Approach a Patient with Locked-In Syndrome and Their Communication Ability

by Kaitlyn Voity, Tara Lopez, Jessie P. Chan and Brian D. Greenwald

Brain Sci. 2024, 14(1), 92; https://doi.org/10.3390/brainsci14010092 - 17 Jan 2024

Cited by 13 | Viewed by 12715

Abstract

Locked-in syndrome (LIS) is a rare and challenging condition that results in tetraplegia and cranial nerve paralysis while maintaining consciousness and variable cognitive function. Once acute management is completed, it is important to work with the patient on developing a plan to maintain [...] Read more.

Locked-in syndrome (LIS) is a rare and challenging condition that results in tetraplegia and cranial nerve paralysis while maintaining consciousness and variable cognitive function. Once acute management is completed, it is important to work with the patient on developing a plan to maintain and improve their quality of life (QOL). A key component towards increasing or maintaining QOL within this population involves the establishment of a functional communication system. Evaluating cognition in patients with LIS is vital for evaluating patients’ communication needs along with physical rehabilitation to maximize their QOL. In the past decade or so, there has been an increase in research surrounding brain–computer interfaces to improve communication abilities for paralyzed patients. This article provides an update on the available technology and the protocol for finding the best way for patients with this condition to communicate. This article aims to increase knowledge of how to enhance and manage communication among LIS patients. Full article

(This article belongs to the Special Issue Recent Advances in Assessment and Rehabilitation of Individuals with Communication and Language Disorders)

► Show Figures

Figure 1

15 pages, 278 KB

Open AccessEditor’s ChoiceReview

The Clinical Relevance of Artificial Intelligence in Migraine

by Angelo Torrente, Simona Maccora, Francesco Prinzi, Paolo Alonge, Laura Pilati, Antonino Lupica, Vincenzo Di Stefano, Cecilia Camarda, Salvatore Vitabile and Filippo Brighina

Brain Sci. 2024, 14(1), 85; https://doi.org/10.3390/brainsci14010085 - 16 Jan 2024

Cited by 22 | Viewed by 6135

Abstract

Migraine is a burdensome neurological disorder that still lacks clear and easily accessible diagnostic biomarkers. Furthermore, a straightforward pathway is hard to find for migraineurs’ management, so the search for response predictors has become urgent. Nowadays, artificial intelligence (AI) has pervaded almost every [...] Read more.

Migraine is a burdensome neurological disorder that still lacks clear and easily accessible diagnostic biomarkers. Furthermore, a straightforward pathway is hard to find for migraineurs’ management, so the search for response predictors has become urgent. Nowadays, artificial intelligence (AI) has pervaded almost every aspect of our lives, and medicine has not been missed. Its applications are nearly limitless, and the ability to use machine learning approaches has given researchers a chance to give huge amounts of data new insights. When it comes to migraine, AI may play a fundamental role, helping clinicians and patients in many ways. For example, AI-based models can increase diagnostic accuracy, especially for non-headache specialists, and may help in correctly classifying the different groups of patients. Moreover, AI models analysing brain imaging studies reveal promising results in identifying disease biomarkers. Regarding migraine management, AI applications showed value in identifying outcome measures, the best treatment choices, and therapy response prediction. In the present review, the authors introduce the various and most recent clinical applications of AI regarding migraine. Full article

(This article belongs to the Special Issue Deep into the Brain: Artificial Intelligence in Brain Diseases)

38 pages, 4875 KB

Open AccessEditor’s ChoiceReview

Minimal Clinically Important Difference of Scales Reported in Stroke Trials: A Review

by Biswamohan Mishra, Pachipala Sudheer, Ayush Agarwal, Nilima Nilima, Madakasira Vasantha Padma Srivastava and Venugopalan Y. Vishnu

Brain Sci. 2024, 14(1), 80; https://doi.org/10.3390/brainsci14010080 - 13 Jan 2024

Cited by 16 | Viewed by 12375

Abstract

There is a growing awareness of the significance of using minimum clinically important differences (MCIDs) in stroke research. An MCID is the smallest change in an outcome measure that is considered clinically meaningful. This review is the first to provide a comprehensive summary [...] Read more.

There is a growing awareness of the significance of using minimum clinically important differences (MCIDs) in stroke research. An MCID is the smallest change in an outcome measure that is considered clinically meaningful. This review is the first to provide a comprehensive summary of various scales and patient-reported outcome measures (PROMs) used in stroke research and their MCID values reported in the literature, including a concise overview of the concept of and methods for determining MCIDs in stroke research. Despite the controversies and limitations surrounding the estimation of MCIDs, their importance in modern clinical trials cannot be overstated. Anchor-based and distribution-based methods are recommended for estimating MCIDs, with patient self-evaluation being a crucial component in capturing the patient’s perspective on their health. A combination of methods can provide a more comprehensive understanding of the clinical relevance of treatment effects, and incorporating the patient’s perspective can enhance the care of stroke patients. Full article

(This article belongs to the Section Neurorehabilitation)

► Show Figures

Figure 1

10 pages, 1982 KB

Open AccessEditor’s ChoiceOpinion

Adaptation of the Concept of Brain Reserve for the Prediction of Stroke Outcome: Proxies, Neural Mechanisms, and Significance for Research

by Roza M. Umarova, Laura Gallucci, Arsany Hakim, Roland Wiest, Urs Fischer and Marcel Arnold

Brain Sci. 2024, 14(1), 77; https://doi.org/10.3390/brainsci14010077 - 12 Jan 2024

Cited by 10 | Viewed by 2639

Abstract

The prediction of stroke outcome is challenging due to the high inter-individual variability in stroke patients. We recently suggested the adaptation of the concept of brain reserve (BR) to improve the prediction of stroke outcome. This concept was initially developed alongside the one [...] Read more.

The prediction of stroke outcome is challenging due to the high inter-individual variability in stroke patients. We recently suggested the adaptation of the concept of brain reserve (BR) to improve the prediction of stroke outcome. This concept was initially developed alongside the one for the cognitive reserve for neurodegeneration and forms a valuable theoretical framework to capture high inter-individual variability in stroke patients. In the present work, we suggest and discuss (i) BR-proxies—quantitative brain characteristics at the time stroke occurs (e.g., brain volume, hippocampus volume), and (ii) proxies of brain pathology reducing BR (e.g., brain atrophy, severity of white matter hyperintensities), parameters easily available from a routine MRI examination that might improve the prediction of stroke outcome. Though the influence of these parameters on stroke outcome has been partly reported individually, their independent and combined impact is yet to be determined. Conceptually, BR is a continuous measure determining the amount of brain structure available to mitigate and compensate for stroke damage, thus reflecting individual differences in neural resources and a capacity to maintain performance and recover after stroke. We suggest that stroke outcome might be defined as an interaction between BR at the time stroke occurs and lesion load. BR in stroke can potentially be influenced, e.g., by modifying cardiovascular risk factors. In addition to the potential power of the BR concept in a mechanistic understanding of inter-individual variability in stroke outcome and establishing individualized therapeutic approaches, it might help to strengthen the synergy of preventive measures in stroke, neurodegeneration, and healthy aging. Full article

(This article belongs to the Section Behavioral Neuroscience)

► Show Figures

Figure 1

11 pages, 958 KB

Open AccessEditor’s ChoiceReview

Neuralgic Amyotrophy and Hourglass Nerve Constriction/Nerve Torsion: Two Sides of the Same Coin? A Clinical Review

by Giuseppe Granata, Fabiola Tomasello, Maria Ausilia Sciarrone, Vito Stifano, Liverana Lauretti and Marco Luigetti

Brain Sci. 2024, 14(1), 67; https://doi.org/10.3390/brainsci14010067 - 10 Jan 2024

Cited by 13 | Viewed by 4554

Abstract

Neuralgic amyotrophy, also called Parsonage–Turner syndrome, in its classic presentation is a brachial plexopathy or a multifocal neuropathy, involving mainly motor nerves of the upper limb with a monophasic course. Recently, a new radiological entity was described, the hourglass constriction, which is characterized [...] Read more.

Neuralgic amyotrophy, also called Parsonage–Turner syndrome, in its classic presentation is a brachial plexopathy or a multifocal neuropathy, involving mainly motor nerves of the upper limb with a monophasic course. Recently, a new radiological entity was described, the hourglass constriction, which is characterized by a very focal constriction of a nerve, or part of it, usually associated with nerve thickening proximally and distally to the constriction. Another condition, which is similar from a radiological point of view to hourglass constriction, is nerve torsion. The pathophysiology of neuralgic amyotrophy, hourglass constriction and nerve torsion is still poorly understood, and a generic role of inflammation is proposed for all these conditions. It is now widely accepted that nerve imaging is necessary in identifying hourglass constrictions/nerve torsion pre-surgically in patients with an acute mononeuropathy/plexopathy. Ultrasound and MRI are useful tools for diagnosis, and they are consistent with intraoperative findings. The prognosis is generally favorable after surgery, with a high rate of good motor recovery. Full article

(This article belongs to the Section Sensory and Motor Neuroscience)

► Show Figures

Figure 1

30 pages, 1472 KB

Open AccessEditor’s ChoiceReview

Pathophysiology to Risk Factor and Therapeutics to Treatment Strategies on Epilepsy

by Ana Paula de Araújo Boleti, Pedro Henrique de Oliveira Cardoso, Breno Emanuel Farias Frihling, Luiz Filipe Ramalho Nunes de Moraes, Ellynes Amancio Correia Nunes, Lincoln Takashi Hota Mukoyama, Ellydberto Amancio Correia Nunes, Cristiano Marcelo Espinola Carvalho, Maria Lígia Rodrigues Macedo and Ludovico Migliolo

Brain Sci. 2024, 14(1), 71; https://doi.org/10.3390/brainsci14010071 - 10 Jan 2024

Cited by 17 | Viewed by 13855

Abstract

Epilepsy represents a condition in which abnormal neuronal discharges or the hyperexcitability of neurons occur with synchronicity, presenting a significant public health challenge. Prognostic factors, such as etiology, electroencephalogram (EEG) abnormalities, the type and number of seizures before treatment, as well as the [...] Read more.

Epilepsy represents a condition in which abnormal neuronal discharges or the hyperexcitability of neurons occur with synchronicity, presenting a significant public health challenge. Prognostic factors, such as etiology, electroencephalogram (EEG) abnormalities, the type and number of seizures before treatment, as well as the initial unsatisfactory effects of medications, are important considerations. Although there are several third-generation antiepileptic drugs currently available, their multiple side effects can negatively affect patient quality of life. The inheritance and etiology of epilepsy are complex, involving multiple underlying genetic and epigenetic mechanisms. Different neurotransmitters play crucial roles in maintaining the normal physiology of different neurons. Dysregulations in neurotransmission, due to abnormal transmitter levels or changes in their receptors, can result in seizures. In this review, we address the roles played by various neurotransmitters and their receptors in the pathophysiology of epilepsy. Furthermore, we extensively explore the neurological mechanisms involved in the development and progression of epilepsy, along with its risk factors. Furthermore, we highlight the new therapeutic targets, along with pharmacological and non-pharmacological strategies currently employed in the treatment of epileptic syndromes, including drug interventions employed in clinical trials related to epilepsy. Full article

(This article belongs to the Special Issue Recent Advances in Pathophysiology and Therapeutic Approaches in Epilepsy)

► Show Figures

Figure 1

24 pages, 3328 KB

Open AccessEditor’s ChoiceReview

Being in Virtual Reality and Its Influence on Brain Health—An Overview of Benefits, Limitations and Prospects

by Beata Sokołowska

Brain Sci. 2024, 14(1), 72; https://doi.org/10.3390/brainsci14010072 - 10 Jan 2024

Cited by 21 | Viewed by 12678

Abstract

Background: Dynamic technological development and its enormous impact on modern societies are posing new challenges for 21st-century neuroscience. A special place is occupied by technologies based on virtual reality (VR). VR tools have already played a significant role in both basic and clinical [...] Read more.

Background: Dynamic technological development and its enormous impact on modern societies are posing new challenges for 21st-century neuroscience. A special place is occupied by technologies based on virtual reality (VR). VR tools have already played a significant role in both basic and clinical neuroscience due to their high accuracy, sensitivity and specificity and, above all, high ecological value. Objective: Being in a digital world affects the functioning of the body as a whole and its individual systems. The data obtained so far, both from experimental and modeling studies, as well as (clinical) observations, indicate their great and promising potential, but apart from the benefits, there are also losses and negative consequences for users. Methods: This review was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) framework across electronic databases (such as Web of Science Core Collection; PubMed; and Scopus, Taylor & Francis Online and Wiley Online Library) to identify beneficial effects and applications, as well as adverse impacts, especially on brain health in human neuroscience. Results: More than half of these articles were published within the last five years and represent state-of-the-art approaches and results (e.g., 54.7% in Web of Sciences and 63.4% in PubMed), with review papers accounting for approximately 16%. The results show that in addition to proposed novel devices and systems, various methods or procedures for testing, validation and standardization are presented (about 1% of articles). Also included are virtual developers and experts, (bio)(neuro)informatics specialists, neuroscientists and medical professionals. Conclusions: VR environments allow for expanding the field of research on perception and cognitive and motor imagery, both in healthy and patient populations. In this context, research on neuroplasticity phenomena, including mirror neuron networks and the effects of applied virtual (mirror) tasks and training, is of interest in virtual prevention and neurogeriatrics, especially in neurotherapy and neurorehabilitation in basic/clinical and digital neuroscience. Full article

(This article belongs to the Special Issue Perception, Motor Imagery, and Action in Real Research and Virtual Environments)

► Show Figures

Figure 1

18 pages, 1338 KB

Open AccessEditor’s ChoiceArticle

Autistic Traits as Predictors of Increased Obsessive–Compulsive Disorder Severity: The Role of Inflexibility and Communication Impairment

by Liliana Dell’Osso, Benedetta Nardi, Chiara Bonelli, Giulia Amatori, Maria Alessandra Pereyra, Enrico Massimetti, Ivan Mirko Cremone, Stefano Pini and Barbara Carpita

Brain Sci. 2024, 14(1), 64; https://doi.org/10.3390/brainsci14010064 - 9 Jan 2024

Cited by 11 | Viewed by 6726

Abstract

Due to similar manifestations, some authors have proposed a potential correlation between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD). This link has long been recognized and debated, with some authors arguing that these disorders frequently occur comorbid but distinct while others believe [...] Read more.

Due to similar manifestations, some authors have proposed a potential correlation between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD). This link has long been recognized and debated, with some authors arguing that these disorders frequently occur comorbid but distinct while others believe they are part of the same spectrum. The aim of our study was to explore the prevalence and correlates of autistic traits in 55 OCD patients and 55 matched controls and to assess possible autistic dimensions predictive of higher OCD symptoms. All participants were assessed with the Obsessive–Compulsive Spectrum-Short Version (OBS-SV) and the Adult Autism Subthreshold Spectrum (AdAS Spectrum). The OCD group scored significantly higher in both questionnaires. Total OBS-SV scores and domains were significantly correlated with all AdAS Spectrum domains and total score. The AdAS Spectrum total, Verbal Communication and Inflexibility and adherence to routine domain scores were significant positive predictors of higher OBS-SV scores. Lastly, when two clusters of subjects (high and low autism) were determined, Inflexibility and adherence to routine domain presented the greatest influence in forming the clusters. Our findings support the association between OCD and autistic traits in the adult population, supporting the hypothesis of a neurodevelopmental basis for these psychiatric conditions. Full article

(This article belongs to the Section Neuropsychiatry)

► Show Figures

Figure 1

11 pages, 865 KB

Open AccessEditor’s ChoiceArticle

The Association between Working Memory and Divergent Thinking: The Moderating Role of Formal Musical Background

by Maria Chiara Pino, Marco Giancola, Massimiliano Palmiero and Simonetta D’Amico

Brain Sci. 2024, 14(1), 61; https://doi.org/10.3390/brainsci14010061 - 8 Jan 2024

Viewed by 6481

Abstract

Divergent thinking (DT) is widely considered an essential cognitive dimension of creativity, which involves goal-oriented processes, including working memory (WM), which allows for retrieving and loading of information into the attentional stream and, consequently, enhancing divergence of thinking. Despite the critical role of [...] Read more.

Divergent thinking (DT) is widely considered an essential cognitive dimension of creativity, which involves goal-oriented processes, including working memory (WM), which allows for retrieving and loading of information into the attentional stream and, consequently, enhancing divergence of thinking. Despite the critical role of WM in DT, little work has been done on the mechanism affecting this interplay. The current study addressed the involvement of a formal musical background in the relationship between WM and DT and was conducted with 83 healthy young adults (M = 19.64 years; SD = 0.52 years; 33 females). The participants were requested to indicate if they had a formal background in music in the conservatory (M = 4.78 years; SD = 5.50 years) as well as perform the digit span forward test (DSFT) and the alternative uses task—AUT from the Torrance test of creative thinking (TTCT). The results indicated that years of formal musical background moderated the association between WM and DT. These findings suggest that music enhances the positive effect of high-order cognitive processes, such as WM, on the ability to think divergently. Theoretical and practical implications as well as limitations were discussed. Full article

(This article belongs to the Special Issue The Role of Sounds and Music in Emotion and Cognition)

► Show Figures

Figure 1

16 pages, 1928 KB

Open AccessEditor’s ChoiceReview

Brain Health and Cognition in Older Adults: Roadmap and Milestones towards the Implementation of Preventive Strategies

by Federico Emanuele Pozzi, Giulia Remoli, Lucio Tremolizzo, Ildebrando Appollonio, Carlo Ferrarese and Luca Cuffaro

Brain Sci. 2024, 14(1), 55; https://doi.org/10.3390/brainsci14010055 - 6 Jan 2024

Cited by 5 | Viewed by 7659

Abstract

In this narrative review, we delve into the evolving concept of brain health, as recognized by the WHO, focusing on its intersection with cognitive decline. We emphasize the imperative need for preventive strategies, particularly in older adults. We describe the target population that [...] Read more.

In this narrative review, we delve into the evolving concept of brain health, as recognized by the WHO, focusing on its intersection with cognitive decline. We emphasize the imperative need for preventive strategies, particularly in older adults. We describe the target population that might benefit the most from risk-based approaches—namely, people with subjective cognitive decline. Additionally, we consider universal prevention in cognitively unimpaired middle-aged and older adults. Delving into multidomain personalized preventive strategies, we report on empirical evidence surrounding modifiable risk factors and interventions crucial in mitigating cognitive decline. Next, we highlight the emergence of brain health services (BHS). We explain their proposed role in risk assessment, risk communication, and tailored interventions to reduce the risk of dementia. Commenting on ongoing BHS pilot experiences, we present the inception and framework of our own BHS in Monza, Italy, outlining its operational structure and care pathways. We emphasize the need for global collaboration and intensified research efforts to address the intricate determinants of brain health and their potential impact on healthcare systems worldwide. Full article

(This article belongs to the Special Issue Advances in Research on Brain Health and Dementia: Prevention and Early Detection of Cognitive Decline and Dementia)

► Show Figures

Figure 1

14 pages, 662 KB

Open AccessEditor’s ChoiceSystematic Review

Effects of Resistance Training on Spasticity in People with Stroke: A Systematic Review

by Juan Carlos Chacon-Barba, Jose A. Moral-Munoz, Amaranta De Miguel-Rubio and David Lucena-Anton

Brain Sci. 2024, 14(1), 57; https://doi.org/10.3390/brainsci14010057 - 6 Jan 2024

Cited by 9 | Viewed by 10477

Abstract

Resistance training induces neuromuscular adaptations and its impact on spasticity remains inadequately researched. This systematic review (PROSPERO: CRD42022322164) aimed to analyze the effects of resistance training, compared with no treatment, conventional therapy, or other therapies, in people with stroke-related spasticity. A comprehensive search [...] Read more.

Resistance training induces neuromuscular adaptations and its impact on spasticity remains inadequately researched. This systematic review (PROSPERO: CRD42022322164) aimed to analyze the effects of resistance training, compared with no treatment, conventional therapy, or other therapies, in people with stroke-related spasticity. A comprehensive search was conducted up to October 2023 in PubMed, PEDro, Cochrane, Web of Science, and Scopus databases. Selection criteria were randomized controlled trials involving participants with stroke-related spasticity intervened with resistance training. The PEDro scale was used to evaluate the methodological quality. From a total of 274 articles, 23 full-text articles were assessed for eligibility and nine articles were included in the systematic review, involving 225 participants (155 males, 70 females; mean age: 59.4 years). Benefits were found to spasticity after resistance training. Furthermore, studies measuring spasticity also reported benefits to function, strength, gait, and balance. In conclusion, resistance training was superior to, or at least equal to, conventional therapy, other therapies, or no intervention for improving spasticity, as well as function, strength, gait, and balance. However, the results should be taken with caution because of the heterogeneity of the protocols used. Further research is needed to explore the effects of resistance training programs on people with stroke. Full article

(This article belongs to the Special Issue Post-stroke Rehabilitation)

► Show Figures

Figure 1

30 pages, 1610 KB

Open AccessEditor’s ChoiceReview

Understanding the Neurotrophic Virus Mechanisms and Their Potential Effect on Systemic Lupus Erythematosus Development

by Felipe R. Uribe, Valentina P. I. González, Alexis M. Kalergis, Jorge A. Soto and Karen Bohmwald

Brain Sci. 2024, 14(1), 59; https://doi.org/10.3390/brainsci14010059 - 6 Jan 2024

Cited by 6 | Viewed by 8208

Abstract

Central nervous system (CNS) pathologies are a public health concern, with viral infections one of their principal causes. These viruses are known as neurotropic pathogens, characterized by their ability to infiltrate the CNS and thus interact with various cell populations, inducing several diseases. [...] Read more.

Central nervous system (CNS) pathologies are a public health concern, with viral infections one of their principal causes. These viruses are known as neurotropic pathogens, characterized by their ability to infiltrate the CNS and thus interact with various cell populations, inducing several diseases. The immune response elicited by neurotropic viruses in the CNS is commanded mainly by microglia, which, together with other local cells, can secrete inflammatory cytokines to fight the infection. The most relevant neurotropic viruses are adenovirus (AdV), cytomegalovirus (CMV), enterovirus (EV), Epstein–Barr Virus (EBV), herpes simplex virus type 1 (HSV-1), and herpes simplex virus type 2 (HSV-2), lymphocytic choriomeningitis virus (LCMV), and the newly discovered SARS-CoV-2. Several studies have associated a viral infection with systemic lupus erythematosus (SLE) and neuropsychiatric lupus (NPSLE) manifestations. This article will review the knowledge about viral infections, CNS pathologies, and the immune response against them. Also, it allows us to understand the relevance of the different viral proteins in developing neuronal pathologies, SLE and NPSLE. Full article

(This article belongs to the Special Issue Immune Responses to Viruses in the Central Nervous System)

► Show Figures

Graphical abstract

17 pages, 1302 KB

Open AccessEditor’s ChoiceReview

Neurobiological Underpinnings of Hyperarousal in Depression: A Comprehensive Review

by Musi Xie, Ying Huang, Wendan Cai, Bingqi Zhang, Haonan Huang, Qingwei Li, Pengmin Qin and Junrong Han

Brain Sci. 2024, 14(1), 50; https://doi.org/10.3390/brainsci14010050 - 4 Jan 2024

Cited by 19 | Viewed by 6945

Abstract

Patients with major depressive disorder (MDD) exhibit an abnormal physiological arousal pattern known as hyperarousal, which may contribute to their depressive symptoms. However, the neurobiological mechanisms linking this abnormal arousal to depressive symptoms are not yet fully understood. In this review, we summarize [...] Read more.

Patients with major depressive disorder (MDD) exhibit an abnormal physiological arousal pattern known as hyperarousal, which may contribute to their depressive symptoms. However, the neurobiological mechanisms linking this abnormal arousal to depressive symptoms are not yet fully understood. In this review, we summarize the physiological and neural features of arousal, and review the literature indicating abnormal arousal in depressed patients. Evidence suggests that a hyperarousal state in depression is characterized by abnormalities in sleep behavior, physiological (e.g., heart rate, skin conductance, pupil diameter) and electroencephalography (EEG) features, and altered activity in subcortical (e.g., hypothalamus and locus coeruleus) and cortical regions. While recent studies highlight the importance of subcortical–cortical interactions in arousal, few have explored the relationship between subcortical–cortical interactions and hyperarousal in depressed patients. This gap limits our understanding of the neural mechanism through which hyperarousal affects depressive symptoms, which involves various cognitive processes and the cerebral cortex. Based on the current literature, we propose that the hyperconnectivity in the thalamocortical circuit may contribute to both the hyperarousal pattern and depressive symptoms. Future research should investigate the relationship between thalamocortical connections and abnormal arousal in depression, and explore its implications for non-invasive treatments for depression. Full article

(This article belongs to the Section Neuropsychiatry)

► Show Figures

Figure 1

20 pages, 510 KB

Open AccessEditor’s ChoiceSystematic Review

The Relationship between Language and Technology: How Screen Time Affects Language Development in Early Life—A Systematic Review

by Valentina Massaroni, Valentina Delle Donne, Camillo Marra, Valentina Arcangeli and Daniela Pia Rosaria Chieffo

Brain Sci. 2024, 14(1), 27; https://doi.org/10.3390/brainsci14010027 - 25 Dec 2023

Cited by 27 | Viewed by 36207

Abstract

Screen time refers to the amount of time a child is exposed to a screen, that is, television, computer, smartphone, or any other digital medium. Prolonged screen time in the first years of life may affect a child’s cognitive abilities, especially language acquisition. [...] Read more.

Screen time refers to the amount of time a child is exposed to a screen, that is, television, computer, smartphone, or any other digital medium. Prolonged screen time in the first years of life may affect a child’s cognitive abilities, especially language acquisition. A systematic review was conducted, following the PRISMA-P guidelines, with the aim to explore the available literature relating to the impact of screen time on children’s language development. This review identified 18 articles. The articles reviewed showed that prolonged screen time and exposure to screens in the first 2 years of life can negatively affect language development and communication skills, in terms of comprehension and vocabulary range. In addition, overexposure to screens in the early years can affect overall cognitive development, especially attention to environmental stimuli, social experiences, problem solving, and communication with others, e.g., the alternance of rhythms and roles in a conversation. In conclusion, our systematic review supports the idea that preschool screen time has negative effects on children’s cognitive and language development. Television seems to be the medium most detrimental to children’s skills, as it is used in a passive manner and is often characterised by language and content that do not suit the child’s processing mode. Future studies should increasingly focus on the digital media that children possess at an early age, such as mobile phones and tablets, and on how children relate to the online world, such as social networks. Full article

(This article belongs to the Special Issue Neurodevelopmental Disorders and Early Language Acquisition)

► Show Figures

Figure 1

20 pages, 1559 KB

Open AccessEditor’s ChoiceReview

Neuroinflammation and Neurodegenerative Diseases: How Much Do We Still Not Know?

by Carmela Rita Balistreri and Roberto Monastero

Brain Sci. 2024, 14(1), 19; https://doi.org/10.3390/brainsci14010019 - 23 Dec 2023

Cited by 24 | Viewed by 10428

Abstract

The term “neuroinflammation” defines the typical inflammatory response of the brain closely related to the onset of many neurodegenerative diseases (NDs). Neuroinflammation is well known, but its mechanisms and pathways are not entirely comprehended. Some progresses have been achieved through many efforts and [...] Read more.

The term “neuroinflammation” defines the typical inflammatory response of the brain closely related to the onset of many neurodegenerative diseases (NDs). Neuroinflammation is well known, but its mechanisms and pathways are not entirely comprehended. Some progresses have been achieved through many efforts and research. Consequently, new cellular and molecular mechanisms, diverse and conventional, are emerging. In listing some of those that will be the subject of our description and discussion, essential are the important roles of peripheral and infiltrated monocytes and clonotypic cells, alterations in the gut–brain axis, dysregulation of the apelinergic system, alterations in the endothelial glycocalyx of the endothelial component of neuronal vascular units, variations in expression of some genes and levels of the encoding molecules by the action of microRNAs (miRNAs), or other epigenetic factors and distinctive transcriptional factors, as well as the role of autophagy, ferroptosis, sex differences, and modifications in the circadian cycle. Such mechanisms can add significantly to understanding the complex etiological puzzle of neuroinflammation and ND. In addition, they could represent biomarkers and targets of ND, which is increasing in the elderly. Full article

(This article belongs to the Special Issue Advances in Neuroinflammation)

► Show Figures

Figure 1

26 pages, 1285 KB

Open AccessEditor’s ChoiceSystematic Review

Limitations in Evaluating Machine Learning Models for Imbalanced Binary Outcome Classification in Spine Surgery: A Systematic Review

by Marc Ghanem, Abdul Karim Ghaith, Victor Gabriel El-Hajj, Archis Bhandarkar, Andrea de Giorgio, Adrian Elmi-Terander and Mohamad Bydon

Brain Sci. 2023, 13(12), 1723; https://doi.org/10.3390/brainsci13121723 - 16 Dec 2023

Cited by 28 | Viewed by 4988

Abstract

Clinical prediction models for spine surgery applications are on the rise, with an increasing reliance on machine learning (ML) and deep learning (DL). Many of the predicted outcomes are uncommon; therefore, to ensure the models’ effectiveness in clinical practice it is crucial to [...] Read more.

Clinical prediction models for spine surgery applications are on the rise, with an increasing reliance on machine learning (ML) and deep learning (DL). Many of the predicted outcomes are uncommon; therefore, to ensure the models’ effectiveness in clinical practice it is crucial to properly evaluate them. This systematic review aims to identify and evaluate current research-based ML and DL models applied for spine surgery, specifically those predicting binary outcomes with a focus on their evaluation metrics. Overall, 60 papers were included, and the findings were reported according to the PRISMA guidelines. A total of 13 papers focused on lengths of stay (LOS), 12 on readmissions, 12 on non-home discharge, 6 on mortality, and 5 on reoperations. The target outcomes exhibited data imbalances ranging from 0.44% to 42.4%. A total of 59 papers reported the model’s area under the receiver operating characteristic (AUROC), 28 mentioned accuracies, 33 provided sensitivity, 29 discussed specificity, 28 addressed positive predictive value (PPV), 24 included the negative predictive value (NPV), 25 indicated the Brier score with 10 providing a null model Brier, and 8 detailed the F1 score. Additionally, data visualization varied among the included papers. This review discusses the use of appropriate evaluation schemes in ML and identifies several common errors and potential bias sources in the literature. Embracing these recommendations as the field advances may facilitate the integration of reliable and effective ML models in clinical settings. Full article

(This article belongs to the Special Issue Advances of AI in Neuroimaging)

► Show Figures

Figure 1

19 pages, 1059 KB

Open AccessEditor’s ChoiceReview

Low-Grade Gliomas: Histological Subtypes, Molecular Mechanisms, and Treatment Strategies

by Corneliu Toader, Lucian Eva, Daniel Costea, Antonio Daniel Corlatescu, Razvan-Adrian Covache-Busuioc, Bogdan-Gabriel Bratu, Luca Andrei Glavan, Horia Petre Costin, Andrei Adrian Popa and Alexandru Vlad Ciurea

Brain Sci. 2023, 13(12), 1700; https://doi.org/10.3390/brainsci13121700 - 9 Dec 2023

Cited by 24 | Viewed by 5433

Abstract

Low-Grade Gliomas (LGGs) represent a diverse group of brain tumors originating from glial cells, characterized by their unique histopathological and molecular features. This article offers a comprehensive exploration of LGGs, shedding light on their subtypes, histological and molecular aspects. By delving into the [...] Read more.

Low-Grade Gliomas (LGGs) represent a diverse group of brain tumors originating from glial cells, characterized by their unique histopathological and molecular features. This article offers a comprehensive exploration of LGGs, shedding light on their subtypes, histological and molecular aspects. By delving into the World Health Organization’s grading system, 5th edition, various specificities were added due to an in-depth understanding of emerging laboratory techniques, especially genomic analysis. Moreover, treatment modalities are extensively discussed. The degree of surgical resection should always be considered according to postoperative quality of life and cognitive status. Adjuvant therapies focused on chemotherapy and radiotherapy depend on tumor grading and invasiveness. In the current literature, emerging targeted molecular therapies are well discussed due to their succinctly therapeutic effect; in our article, those therapies are summarized based on posttreatment results and possible adverse effects. This review serves as a valuable resource for clinicians, researchers, and medical professionals aiming to deepen their knowledge on LGGs and enhance patient care. Full article

(This article belongs to the Special Issue Advances in the Development of New Drugs and Treatment Targets for Brain Cancers)

► Show Figures

Figure 1

11 pages, 255 KB

Open AccessEditor’s ChoiceReview

Delirium after Cardiac Surgery—A Narrative Review

by Daniel Mattimore, Adrian Fischl, Alexa Christophides, Jerry Cuenca, Steven Davidson, Zhaosheng Jin and Sergio Bergese

Brain Sci. 2023, 13(12), 1682; https://doi.org/10.3390/brainsci13121682 - 7 Dec 2023

Cited by 24 | Viewed by 4894

Abstract

Postoperative delirium (POD) after cardiac surgery is a well-known phenomenon which carries a higher risk of morbidity and mortality. Multiple patient-specific risk factors and pathophysiologic mechanisms have been identified and therapies have been proposed to mitigate risk of delirium development postoperatively. Notably, cardiac [...] Read more.

Postoperative delirium (POD) after cardiac surgery is a well-known phenomenon which carries a higher risk of morbidity and mortality. Multiple patient-specific risk factors and pathophysiologic mechanisms have been identified and therapies have been proposed to mitigate risk of delirium development postoperatively. Notably, cardiac surgery frequently involves the use of an intraoperative cardiopulmonary bypass (CPB), which may contribute to the mechanisms responsible for POD. Despite our greater understanding of these causative factors, a substantial reduction in the incidence of POD remains high among cardiac surgical patients. Multiple therapeutic interventions have been implemented intraoperatively and postoperatively, many with conflicting results. This review article will highlight the incidence and impact of POD in cardiac surgical patients. It will describe some of the primary risk factors associated with POD, as well as anesthetic management and therapies postoperatively that may help to reduce delirium. Full article

(This article belongs to the Section Neurodegenerative Diseases)

16 pages, 1574 KB

Open AccessEditor’s ChoiceReview

Cerebellum’s Contribution to Attention, Executive Functions and Timing: Psychophysiological Evidence from Event-Related Potentials

by Daniela Mannarelli, Caterina Pauletti, Paolo Missori, Carlo Trompetto, Filippo Cotellessa, Francesco Fattapposta and Antonio Currà

Brain Sci. 2023, 13(12), 1683; https://doi.org/10.3390/brainsci13121683 - 7 Dec 2023

Cited by 23 | Viewed by 6261

Abstract

Since 1998, when Schmahmann first proposed the concept of the “cognitive affective syndrome” that linked cerebellar damage to cognitive and emotional impairments, a substantial body of literature has emerged. Anatomical, neurophysiological, and functional neuroimaging data suggest that the cerebellum contributes to cognitive functions [...] Read more.

Since 1998, when Schmahmann first proposed the concept of the “cognitive affective syndrome” that linked cerebellar damage to cognitive and emotional impairments, a substantial body of literature has emerged. Anatomical, neurophysiological, and functional neuroimaging data suggest that the cerebellum contributes to cognitive functions through specific cerebral–cerebellar connections organized in a series of parallel loops. The aim of this paper is to review the current findings on the involvement of the cerebellum in selective cognitive functions, using a psychophysiological perspective with event-related potentials (ERPs), alone or in combination with non-invasive brain stimulation techniques. ERPs represent a very informative method of monitoring cognitive functioning online and have the potential to serve as valuable biomarkers of brain dysfunction that is undetected by other traditional clinical tools. This review will focus on the data on attention, executive functions, and time processing obtained in healthy subjects and patients with varying clinical conditions, thus confirming the role of ERPs in understanding the role of the cerebellum in cognition and exploring the potential diagnostic and therapeutic implications of ERP-based assessments in patients. Full article

(This article belongs to the Special Issue The Cerebellar Modulation for Affective and Social Functions: Novel Insights from Nonclinical and Clinical Conditions)

► Show Figures

Figure 1

52 pages, 3236 KB

Open AccessEditor’s ChoiceSystematic Review

Breathing Practices for Stress and Anxiety Reduction: Conceptual Framework of Implementation Guidelines Based on a Systematic Review of the Published Literature

by Tanya G. K. Bentley, Gina D’Andrea-Penna, Marina Rakic, Nick Arce, Michelle LaFaille, Rachel Berman, Katie Cooley and Preston Sprimont

Brain Sci. 2023, 13(12), 1612; https://doi.org/10.3390/brainsci13121612 - 21 Nov 2023

Cited by 37 | Viewed by 52500

Abstract

Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated [...] Read more.

Anxiety and stress plague populations worldwide. Voluntary regulated breathing practices offer a tool to address this epidemic. We examined peer-reviewed published literature to understand effective approaches to and implementation of these practices. PubMed and ScienceDirect were searched to identify clinical trials evaluating isolated breathing-based interventions with psychometric stress/anxiety outcomes. Two independent reviewers conducted all screening and data extraction. Of 2904 unique articles, 731 abstracts, and 181 full texts screened, 58 met the inclusion criteria. Fifty-four of the studies’ 72 interventions were effective. Components of effective and ineffective interventions were evaluated to develop a conceptual framework of factors associated with stress/anxiety reduction effectiveness. Effective breath practices avoided fast-only breath paces and sessions <5 min, while including human-guided training, multiple sessions, and long-term practice. Population, other breath paces, session duration ≥5 min, and group versus individual or at-home practices were not associated with effectiveness. Analysis of interventions that did not fit this framework revealed that extensive standing, interruptions, involuntary diaphragmatic obstruction, and inadequate training for highly technical practices may render otherwise promising interventions ineffective. Following this evidence-based framework can help maximize the stress/anxiety reduction benefits of breathing practices. Future research is warranted to further refine this easily accessible intervention for stress/anxiety relief. Full article

(This article belongs to the Special Issue Complementary and Alternative Therapies for Mental Health)

► Show Figures

Figure 1

32 pages, 714 KB

Open AccessEditor’s ChoiceReview

Exploring the Role of Neuroplasticity in Development, Aging, and Neurodegeneration

by Patrícia Marzola, Thayza Melzer, Eloisa Pavesi, Joana Gil-Mohapel and Patricia S. Brocardo

Brain Sci. 2023, 13(12), 1610; https://doi.org/10.3390/brainsci13121610 - 21 Nov 2023

Cited by 111 | Viewed by 74903

Abstract

Neuroplasticity refers to the ability of the brain to reorganize and modify its neural connections in response to environmental stimuli, experience, learning, injury, and disease processes. It encompasses a range of mechanisms, including changes in synaptic strength and connectivity, the formation of new [...] Read more.

Neuroplasticity refers to the ability of the brain to reorganize and modify its neural connections in response to environmental stimuli, experience, learning, injury, and disease processes. It encompasses a range of mechanisms, including changes in synaptic strength and connectivity, the formation of new synapses, alterations in the structure and function of neurons, and the generation of new neurons. Neuroplasticity plays a crucial role in developing and maintaining brain function, including learning and memory, as well as in recovery from brain injury and adaptation to environmental changes. In this review, we explore the vast potential of neuroplasticity in various aspects of brain function across the lifespan and in the context of disease. Changes in the aging brain and the significance of neuroplasticity in maintaining cognitive function later in life will also be reviewed. Finally, we will discuss common mechanisms associated with age-related neurodegenerative processes (including protein aggregation and accumulation, mitochondrial dysfunction, oxidative stress, and neuroinflammation) and how these processes can be mitigated, at least partially, by non-invasive and non-pharmacologic lifestyle interventions aimed at promoting and harnessing neuroplasticity. Full article

(This article belongs to the Special Issue Neuroregenerative Plasticity in Health and Disease)

41 pages, 2259 KB

Open AccessEditor’s ChoiceSystematic Review

Molecular Targeted Therapies in Glioblastoma Multiforme: A Systematic Overview of Global Trends and Findings

by Emir Begagić, Ragib Pugonja, Hakija Bečulić, Amila Čeliković, Lejla Tandir Lihić, Samra Kadić Vukas, Lejla Čejvan, Rasim Skomorac, Edin Selimović, Belma Jaganjac, Fatima Juković-Bihorac, Aldin Jusić and Mirza Pojskić

Brain Sci. 2023, 13(11), 1602; https://doi.org/10.3390/brainsci13111602 - 17 Nov 2023

Cited by 29 | Viewed by 5749

Abstract

This systematic review assesses current molecular targeted therapies for glioblastoma multiforme (GBM), a challenging condition with limited treatment options. Using PRISMA methodology, 166 eligible studies, involving 2526 patients (61.49% male, 38.51% female, with a male-to-female ratio of 1.59/1), were analyzed. In laboratory studies, [...] Read more.

This systematic review assesses current molecular targeted therapies for glioblastoma multiforme (GBM), a challenging condition with limited treatment options. Using PRISMA methodology, 166 eligible studies, involving 2526 patients (61.49% male, 38.51% female, with a male-to-female ratio of 1.59/1), were analyzed. In laboratory studies, 52.52% primarily used human glioblastoma cell cultures (HCC), and 43.17% employed animal samples (mainly mice). Clinical participants ranged from 18 to 100 years, with 60.2% using combined therapies and 39.8% monotherapies. Mechanistic categories included Protein Kinase Phosphorylation (41.6%), Cell Cycle-Related Mechanisms (18.1%), Microenvironmental Targets (19.9%), Immunological Targets (4.2%), and Other Mechanisms (16.3%). Key molecular targets included Epidermal Growth Factor Receptor (EGFR) (10.8%), Mammalian Target of Rapamycin (mTOR) (7.2%), Vascular Endothelial Growth Factor (VEGF) (6.6%), and Mitogen-Activated Protein Kinase (MEK) (5.4%). This review provides a comprehensive assessment of molecular therapies for GBM, highlighting their varied efficacy in clinical and laboratory settings, ultimately impacting overall and progression-free survival in GBM management. Full article

(This article belongs to the Special Issue Identification of Molecular Targets and Anti-cancer Agents in Glioblastoma Multiforme: New Perspectives for Cancer Therapy)

► Show Figures

Figure 1

46 pages, 750 KB

Open AccessEditor’s ChoiceSystematic Review

A Systematic Review on the Effectiveness of Antipsychotic Drugs on the Quality of Life of Patients with Schizophrenia

by Gaia Sampogna, Matteo Di Vincenzo, Luigi Giuliani, Giulia Menculini, Emiliana Mancuso, Eleonora Arsenio, Salvatore Cipolla, Bianca Della Rocca, Vassilis Martiadis, Maria Salvina Signorelli and Andrea Fiorillo

Brain Sci. 2023, 13(11), 1577; https://doi.org/10.3390/brainsci13111577 - 10 Nov 2023

Cited by 41 | Viewed by 13850

Abstract

Pharmacological antipsychotic drug interventions represent the cornerstone of the management of patients with schizophrenia and other psychotic spectrum disorders. The choice of the “best” treatment should be made on the basis of several clinical domains. However, despite available treatments, the quality of life [...] Read more.

Pharmacological antipsychotic drug interventions represent the cornerstone of the management of patients with schizophrenia and other psychotic spectrum disorders. The choice of the “best” treatment should be made on the basis of several clinical domains. However, despite available treatments, the quality of life reported by patients with schizophrenia taking antipsychotics is still very poor, and this outcome is rarely taken into account in trials assessing the efficacy and effectiveness of antipsychotic treatments. Therefore, we performed a systematic review in order to assess the impact of antipsychotic treatment on patients’ quality of life. In particular, we aimed to identify any differences in the improvement in quality of life according to the (a) type of formulation of antipsychotic drugs (i.e., oral vs. depot vs. long-acting injectable); (b) type of the drug (first vs. second vs. third generation); and (c) patients’ clinical characteristics. One hundred and eleven papers were included in the review. The main findings were as follows: (1) quality of life is usually considered a secondary outcome in trials on the efficacy and effectiveness of drugs; (2) second-generation antipsychotics have a more positive effect on quality of life; and (3) long-acting injectable antipsychotics are associated with a more stable improvement in quality of life and with a good safety and tolerability profile. Our systematic review confirms that quality of life represents a central element for selecting the appropriate treatment for people with schizophrenia. In particular, the availability of new treatments with a better tolerability profile, a proven effectiveness on patients’ cognitive and social functioning, and with a more stable blood concentration might represent the appropriate strategy for improving the quality of life of people with schizophrenia. Full article

(This article belongs to the Section Neuropsychiatry)

► Show Figures

Figure 1

30 pages, 451 KB

Open AccessEditor’s ChoiceReview

Advances in Glioblastoma Therapy: An Update on Current Approaches

by Ramcharan Singh Angom, Naga Malleswara Rao Nakka and Santanu Bhattacharya

Brain Sci. 2023, 13(11), 1536; https://doi.org/10.3390/brainsci13111536 - 31 Oct 2023

Cited by 125 | Viewed by 15846

Abstract

Glioblastoma multiforme (GBM) is a primary malignant brain tumor characterized by a high grade of malignancy and an extremely unfavorable prognosis. The current efficacy of established treatments for GBM is insufficient, necessitating the prompt development of novel therapeutic approaches. The progress made in [...] Read more.

Glioblastoma multiforme (GBM) is a primary malignant brain tumor characterized by a high grade of malignancy and an extremely unfavorable prognosis. The current efficacy of established treatments for GBM is insufficient, necessitating the prompt development of novel therapeutic approaches. The progress made in the fundamental scientific understanding of GBM is swiftly translated into more advanced stages of therapeutic studies. Despite extensive efforts to identify new therapeutic approaches, GBM exhibits a high mortality rate. The current efficacy of treatments for GBM patients is insufficient due to factors such as tumor heterogeneity, the blood–brain barrier, glioma stem cells, drug efflux pumps, and DNA damage repair mechanisms. Considering this, pharmacological cocktail therapy has demonstrated a growing efficacy in addressing these challenges. Towards this, various forms of immunotherapy, including the immune checkpoint blockade, chimeric antigen receptor T (CAR T) cell therapy, oncolytic virotherapy, and vaccine therapy have emerged as potential strategies for enhancing the prognosis of GBM. Current investigations are focused on exploring combination therapies to mitigate undesirable side effects and enhance immune responses against tumors. Furthermore, clinical trials are underway to evaluate the efficacy of several strategies to circumvent the blood–brain barrier (BBB) to achieve targeted delivery in patients suffering from recurrent GBM. In this review, we have described the biological and molecular targets for GBM therapy, pharmacologic therapy status, prominent resistance mechanisms, and new treatment approaches. We also discuss these promising therapeutic approaches to assess prospective innovative therapeutic agents and evaluated the present state of preclinical and clinical studies in GBM treatment. Overall, this review attempts to provide comprehensive information on the current status of GBM therapy. Full article

(This article belongs to the Special Issue Current Updates on Theragnostic Strategies for Intervention of Brain Diseases and Pathology)

17 pages, 541 KB

Open AccessEditor’s ChoiceArticle

GLP-1 Receptor Agonists and Related Mental Health Issues; Insights from a Range of Social Media Platforms Using a Mixed-Methods Approach

by Davide Arillotta, Giuseppe Floresta, Amira Guirguis, John Martin Corkery, Valeria Catalani, Giovanni Martinotti, Stefano L. Sensi and Fabrizio Schifano

Brain Sci. 2023, 13(11), 1503; https://doi.org/10.3390/brainsci13111503 - 24 Oct 2023

Cited by 67 | Viewed by 27059

Abstract

The emergence of glucagon-like peptide-1 receptor agonists (GLP-1 RAs; semaglutide and others) now promises effective, non-invasive treatment of obesity for individuals with and without diabetes. Social media platforms’ users started promoting semaglutide/Ozempic as a weight-loss treatment, and the associated increase in demand has [...] Read more.

The emergence of glucagon-like peptide-1 receptor agonists (GLP-1 RAs; semaglutide and others) now promises effective, non-invasive treatment of obesity for individuals with and without diabetes. Social media platforms’ users started promoting semaglutide/Ozempic as a weight-loss treatment, and the associated increase in demand has contributed to an ongoing worldwide shortage of the drug associated with levels of non-prescribed semaglutide intake. Furthermore, recent reports emphasized some GLP-1 RA-associated risks of triggering depression and suicidal thoughts. Consistent with the above, we aimed to assess the possible impact of GLP-1 RAs on mental health as being perceived and discussed in popular open platforms with the help of a mixed-methods approach. Reddit posts yielded 12,136 comments, YouTube videos 14,515, and TikTok videos 17,059, respectively. Out of these posts/entries, most represented matches related to sleep-related issues, including insomnia (n = 620 matches); anxiety (n = 353); depression (n = 204); and mental health issues in general (n = 165). After the initiation of GLP-1 RAs, losing weight was associated with either a marked improvement or, in some cases, a deterioration, in mood; increase/decrease in anxiety/insomnia; and better control of a range of addictive behaviors. The challenges of accessing these medications were a hot topic as well. To the best of our knowledge, this is the first study documenting if and how GLP-1 RAs are perceived as affecting mood, mental health, and behaviors. Establishing a clear cause-and-effect link between metabolic diseases, depression and medications is difficult because of their possible reciprocal relationship, shared underlying mechanisms and individual differences. Further research is needed to better understand the safety profile of these molecules and their putative impact on behavioral and non-behavioral addictions. Full article

(This article belongs to the Section Neuropsychology)

15 pages, 1657 KB

Open AccessEditor’s ChoiceReview

Research Progress in Diffusion Spectrum Imaging

by Fenfen Sun, Yingwen Huang, Jingru Wang, Wenjun Hong and Zhiyong Zhao

Brain Sci. 2023, 13(10), 1497; https://doi.org/10.3390/brainsci13101497 - 23 Oct 2023

Cited by 16 | Viewed by 3536

Abstract

Studies have demonstrated that many regions in the human brain include multidirectional fiber tracts, in which the diffusion of water molecules within image voxels does not follow a Gaussian distribution. Therefore, the conventional diffusion tensor imaging (DTI) that hypothesizes a single fiber orientation [...] Read more.

Studies have demonstrated that many regions in the human brain include multidirectional fiber tracts, in which the diffusion of water molecules within image voxels does not follow a Gaussian distribution. Therefore, the conventional diffusion tensor imaging (DTI) that hypothesizes a single fiber orientation within a voxel is intrinsically incapable of revealing the complex microstructures of brain tissues. Diffusion spectrum imaging (DSI) employs a pulse sequence with different b-values along multiple gradient directions to sample the diffusion information of water molecules in the entire q-space and then quantitatively estimates the diffusion profile using a probability density function with a high angular resolution. Studies have suggested that DSI can reliably observe the multidirectional fibers within each voxel and allow fiber tracking along different directions, which can improve fiber reconstruction reflecting the true but complicated brain structures that were not observed in the previous DTI studies. Moreover, with increasing angular resolution, DSI is able to reveal new neuroimaging biomarkers used for disease diagnosis and the prediction of disorder progression. However, so far, this method has not been used widely in clinical studies, due to its overly long scanning time and difficult post-processing. Within this context, the current paper aims to conduct a comprehensive review of DSI research, including the fundamental principles, methodology, and application progress of DSI tractography. By summarizing the DSI studies in recent years, we propose potential solutions towards the existing problem in the methodology and applications of DSI technology as follows: (1) using compressed sensing to undersample data and to reconstruct the diffusion signal may be an efficient and promising method for reducing scanning time; (2) the probability density function includes more information than the orientation distribution function, and it should be extended in application studies; and (3) large-sample study is encouraged to confirm the reliability and reproducibility of findings in clinical diseases. These findings may help deepen the understanding of the DSI method and promote its development in clinical applications. Full article

(This article belongs to the Special Issue Understanding Brain Cellular Structure and Brain Diseases Using MRI-Based Methods)

► Show Figures

Figure 1

12 pages, 291 KB

Open AccessEditor’s ChoiceArticle

The Patient’s Perspective on the Effects of Intranasal Esketamine in Treatment-Resistant Depression

by Maria Pepe, Giovanni Bartolucci, Ilaria Marcelli, Francesco Pesaresi, Andrea Brugnami, Romina Caso, Alessia Fischetti, Flavia Grisoni, Marianna Mazza, Giovanni Camardese, Marco Di Nicola and Gabriele Sani

Brain Sci. 2023, 13(10), 1494; https://doi.org/10.3390/brainsci13101494 - 22 Oct 2023

Cited by 20 | Viewed by 3984

Abstract

The effectiveness of the esketamine nasal spray (ESK-NS) for treatment-resistant depression (TRD) has been confirmed by real-world studies. Available evidence derived from clinician-rated assessments might differ from patients’ perceptions about the helpfulness of treatments. We aimed to verify the effect of ESK-NS from [...] Read more.

The effectiveness of the esketamine nasal spray (ESK-NS) for treatment-resistant depression (TRD) has been confirmed by real-world studies. Available evidence derived from clinician-rated assessments might differ from patients’ perceptions about the helpfulness of treatments. We aimed to verify the effect of ESK-NS from patients’ view in 25 TRD patients (56% males, 55.1 ± 10.9 years) treated with ESK-NS (mean dose: 78.4 ± 11.43 mg) for three months and evaluated at different time-points through clinician-rated and self-administered scales, assessing changes in depression, anhedonia, sleep, cognition, suicidality, and anxiety. We observed an overall early improvement that lasted over time (endpoint total score reduction in Montgomery-Åsberg Depression Rating Scale, p < 0.001, Beck Depression Inventory, p = 0.003). Patients reported a significant self-rated decrease in anhedonia at two months (Snaith–Hamilton Pleasure Scale, p = 0.04) and in suicide ideation at endpoint (BDI subitem 9, p = 0.039) vs. earlier improvements detected by clinicians (one-month reduction in MADRS subitem 8, p = 0.005, and subitem 10, p = 0.007). These findings confirm the effectiveness of a three-month treatment with ESK-NS in TRD patients, highlighting an overall overlapping response from patients’ and clinicians’ perspectives, although with some differential effects on specific symptoms at given time-points. Including patients’ viewpoints in routine assessments could inform clinical practice, ensuring a better characterization of clinical phenotypes to deliver personalized interventions. Full article

(This article belongs to the Special Issue Neuropsychopharmacology in Mood Disorders)

20 pages, 1289 KB

Open AccessEditor’s ChoiceReview

Reelin Signaling in Neurodevelopmental Disorders and Neurodegenerative Diseases

by Aurelie Joly-Amado, Neel Kulkarni and Kevin R. Nash

Brain Sci. 2023, 13(10), 1479; https://doi.org/10.3390/brainsci13101479 - 19 Oct 2023

Cited by 25 | Viewed by 6847

Abstract

Reelin is an extracellular matrix glycoprotein involved in neuronal migration during embryonic brain development and synaptic plasticity in the adult brain. The role of Reelin in the developing central nervous system has been extensively characterized. Indeed, a loss of Reelin or a disruption [...] Read more.

Reelin is an extracellular matrix glycoprotein involved in neuronal migration during embryonic brain development and synaptic plasticity in the adult brain. The role of Reelin in the developing central nervous system has been extensively characterized. Indeed, a loss of Reelin or a disruption in its signaling cascade leads to neurodevelopmental defects and is associated with ataxia, intellectual disability, autism, and several psychiatric disorders. In the adult brain, Reelin is critically involved in neurogenesis and synaptic plasticity. Reelin’s signaling potentiates glutamatergic and GABAergic neurotransmission, induces synaptic maturation, and increases AMPA and NMDA receptor subunits’ expression and activity. As a result, there is a growing literature reporting that a loss of function and/or reduction of Reelin is implicated in numerous neurodegenerative diseases. The present review summarizes the current state of the literature regarding the implication of Reelin and Reelin-mediated signaling during aging and neurodegenerative disorders, highlighting Reelin as a possible target in the prevention or treatment of progressive neurodegeneration. Full article

(This article belongs to the Section Neurodegenerative Diseases)

► Show Figures

Figure 1

28 pages, 1535 KB

Open AccessEditor’s ChoiceReview

Cardiac 123I-Metaiodobenzylguanidine (MIBG) Scintigraphy in Parkinson’s Disease: A Comprehensive Review

by Jamir Pitton Rissardo and Ana Letícia Fornari Caprara

Brain Sci. 2023, 13(10), 1471; https://doi.org/10.3390/brainsci13101471 - 18 Oct 2023

Cited by 28 | Viewed by 9285

Abstract

Cardiac sympathetic denervation, as documented on 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, is relatively sensitive and specific for distinguishing Parkinson’s disease (PD) from other neurodegenerative causes of parkinsonism. The present study aims to comprehensively review the literature regarding the use of cardiac MIBG in PD. [...] Read more.

Cardiac sympathetic denervation, as documented on 123I-metaiodobenzylguanidine (MIBG) myocardial scintigraphy, is relatively sensitive and specific for distinguishing Parkinson’s disease (PD) from other neurodegenerative causes of parkinsonism. The present study aims to comprehensively review the literature regarding the use of cardiac MIBG in PD. MIBG is an analog to norepinephrine. They share the same uptake, storage, and release mechanisms. An abnormal result in the cardiac MIBG uptake in individuals with parkinsonism can be an additional criterion for diagnosing PD. However, a normal result of cardiac MIBG in individuals with suspicious parkinsonian syndrome does not exclude the diagnosis of PD. The findings of cardiac MIBG studies contributed to elucidating the pathophysiology of PD. We investigated the sensitivity and specificity of cardiac MIBG scintigraphy in PD. A total of 54 studies with 3114 individuals diagnosed with PD were included. The data were described as means with a Hoehn and Yahr stage of 2.5 and early and delayed registration H/M ratios of 1.70 and 1.51, respectively. The mean cutoff for the early and delayed phases were 1.89 and 1.86. The sensitivity for the early and delayed phases was 0.81 and 0.83, respectively. The specificity for the early and delayed phases were 0.86 and 0.80, respectively. Full article

(This article belongs to the Section Neurodegenerative Diseases)

► Show Figures

Figure 1

19 pages, 2039 KB

Open AccessEditor’s ChoiceSystematic Review

The Effect of Beta-Carotene on Cognitive Function: A Systematic Review

by Diana Marisol Abrego-Guandique, Maria Luisa Bonet, Maria Cristina Caroleo, Roberto Cannataro, Paola Tucci, Joan Ribot and Erika Cione

Brain Sci. 2023, 13(10), 1468; https://doi.org/10.3390/brainsci13101468 - 17 Oct 2023

Cited by 35 | Viewed by 41242

Abstract

β-carotene is a powerful antioxidant and dietary precursor of vitamin A whose role in maintaining mental health and cognitive performance, either alone or in combination with other dietary compounds, has been a topic of recent research. However, its effectiveness is still unclear. This [...] Read more.

β-carotene is a powerful antioxidant and dietary precursor of vitamin A whose role in maintaining mental health and cognitive performance, either alone or in combination with other dietary compounds, has been a topic of recent research. However, its effectiveness is still unclear. This systematic review, conducted according to the PRISMA guideline and assisted by the MySLR platform, addressed this issue. A total of 16 eligible original research articles were identified. Dietary intake or β-carotene serum levels were associated with improved measures of cognitive function in 7 out of 10 epidemiological studies included. In intervention studies, β-carotene consumption alone did not promote better cognitive function in the short term, but only in a long-term intervention with a mean duration of 18 years. However, all but one intervention study suggested the beneficial effects of β-carotene supplementation at doses ranging from 6 mg to 50 mg per day in combination with a multicomplex such as vitamin E, vitamin C, zinc, or selenium for a period of 16 weeks to 20 years. Despite the current limitations, the available evidence suggests a potential association between β-carotene dietary/supplementary intake and the maintenance of cognitive function. The β-carotene most probably does not act alone but in synergy with other micronutrients. Full article

(This article belongs to the Special Issue Nutrition in Neurodegenerative Diseases: Prevention and Treatment)

► Show Figures

Figure 1

16 pages, 341 KB

Open AccessEditor’s ChoiceReview

Non-Pharmacological Treatment of Primary Headaches—A Focused Review

by Emir Licina, Aleksandra Radojicic, Marta Jeremic, Aleksandra Tomic and Milija Mijajlovic

Brain Sci. 2023, 13(10), 1432; https://doi.org/10.3390/brainsci13101432 - 8 Oct 2023

Cited by 21 | Viewed by 13773

Abstract

Headache disorders are a significant global health burden, leading to reduced quality of life. While vast pharmacological treatments are available, they may be associated with adverse effects or inadequate efficacy for some patients, therefore there is a need for exploring alternate treatment strategies. [...] Read more.

Headache disorders are a significant global health burden, leading to reduced quality of life. While vast pharmacological treatments are available, they may be associated with adverse effects or inadequate efficacy for some patients, therefore there is a need for exploring alternate treatment strategies. This review gives a brief explanation and evaluation of some established and emerging non-pharmacological approaches for headache management, focusing on nutraceuticals and diet, acupuncture, cognitive behavioral therapy (CBT), biofeedback, relaxation techniques, autogenic training, and neuromodulation. Special consideration is given to psychological interventions as they increase patient self-efficacy and provide strategies for managing chronic pain. Future research should focus on optimizing these therapies, identifying patient-specific factors influencing their effectiveness, and integrating them into holistic headache management strategies. Full article

(This article belongs to the Section Sensory and Motor Neuroscience)

28 pages, 648 KB

Open AccessEditor’s ChoiceReview

An Overview of the Body Schema and Body Image: Theoretical Models, Methodological Settings and Pitfalls for Rehabilitation of Persons with Neurological Disorders

by Davide Sattin, Chiara Parma, Christian Lunetta, Aida Zulueta, Jacopo Lanzone, Luca Giani, Marta Vassallo, Mario Picozzi and Eugenio Agostino Parati

Brain Sci. 2023, 13(10), 1410; https://doi.org/10.3390/brainsci13101410 - 4 Oct 2023

Cited by 34 | Viewed by 14636

Abstract

Given the widespread debate on the definition of the terms “Body Schema” and “Body Image”, this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these [...] Read more.

Given the widespread debate on the definition of the terms “Body Schema” and “Body Image”, this article presents a broad overview of the studies that have investigated the nature of these types of body representations, especially focusing on the innovative information about these two representations that could be useful for the rehabilitation of patients with different neurological disorders with motor deficits (especially those affecting the upper limbs). In particular, we analyzed (i) the different definitions and explicative models proposed, (ii) the empirical settings used to test them and (iii) the clinical and rehabilitative implications derived from the application of interventions on specific case reports. The growing number of neurological diseases with motor impairment in the general population has required the development of new rehabilitation techniques and a new phenomenological paradigm placing body schema as fundamental and intrinsic parts for action in space. In this narrative review, the focus was placed on evidence from the application of innovative rehabilitation techniques and case reports involving the upper limbs, as body parts particularly involved in finalistic voluntary actions in everyday life, discussing body representations and their functional role. Full article

(This article belongs to the Special Issue State of the Art in Disorders of Consciousness)

► Show Figures

Figure 1

26 pages, 2922 KB

Open AccessEditor’s ChoiceSystematic Review

Brain MRI Biomarkers in Isolated Rapid Eye Movement Sleep Behavior Disorder: Where Are We? A Systematic Review

by Stephan Grimaldi, Maxime Guye, Marta Bianciardi and Alexandre Eusebio

Brain Sci. 2023, 13(10), 1398; https://doi.org/10.3390/brainsci13101398 - 30 Sep 2023

Cited by 18 | Viewed by 4963

Abstract

The increasing number of MRI studies focused on prodromal Parkinson’s Disease (PD) demonstrates a strong interest in identifying early biomarkers capable of monitoring neurodegeneration. In this systematic review, we present the latest information regarding the most promising MRI markers of neurodegeneration in relation [...] Read more.

The increasing number of MRI studies focused on prodromal Parkinson’s Disease (PD) demonstrates a strong interest in identifying early biomarkers capable of monitoring neurodegeneration. In this systematic review, we present the latest information regarding the most promising MRI markers of neurodegeneration in relation to the most specific prodromal symptoms of PD, namely isolated rapid eye movement (REM) sleep behavior disorder (iRBD). We reviewed structural, diffusion, functional, iron-sensitive, neuro-melanin-sensitive MRI, and proton magnetic resonance spectroscopy studies conducted between 2000 and 2023, which yielded a total of 77 relevant papers. Among these markers, iron and neuromelanin emerged as the most robust and promising indicators for early neurodegenerative processes in iRBD. Atrophy was observed in several regions, including the frontal and temporal cortices, limbic cortices, and basal ganglia, suggesting that neurodegenerative processes had been underway for some time. Diffusion and functional MRI produced heterogeneous yet intriguing results. Additionally, reduced glymphatic clearance function was reported. Technological advancements, such as the development of ultra-high field MRI, have enabled the exploration of minute anatomical structures and the detection of previously undetectable anomalies. The race to achieve early detection of neurodegeneration is well underway. Full article

(This article belongs to the Special Issue MR Imaging in Screening, Prediction, and Follow-Up of Neurological Disorders)

► Show Figures

Figure 1

23 pages, 1859 KB

Open AccessEditor’s ChoiceReview

Cognitive Crescendo: How Music Shapes the Brain’s Structure and Function

by Corneliu Toader, Calin Petru Tataru, Ioan-Alexandru Florian, Razvan-Adrian Covache-Busuioc, Bogdan-Gabriel Bratu, Luca Andrei Glavan, Andrei Bordeianu, David-Ioan Dumitrascu and Alexandru Vlad Ciurea

Brain Sci. 2023, 13(10), 1390; https://doi.org/10.3390/brainsci13101390 - 29 Sep 2023

Cited by 34 | Viewed by 23730

Abstract

Music is a complex phenomenon with multiple brain areas and neural connections being implicated. Centuries ago, music was discovered as an efficient modality for psychological status enrichment and even for the treatment of multiple pathologies. Modern research investigations give a new avenue for [...] Read more.

Music is a complex phenomenon with multiple brain areas and neural connections being implicated. Centuries ago, music was discovered as an efficient modality for psychological status enrichment and even for the treatment of multiple pathologies. Modern research investigations give a new avenue for music perception and the understanding of the underlying neurological mechanisms, using neuroimaging, especially magnetic resonance imaging. Multiple brain areas were depicted in the last decades as being of high value for music processing, and further analyses in the neuropsychology field uncover the implications in emotional and cognitive activities. Music listening improves cognitive functions such as memory, attention span, and behavioral augmentation. In rehabilitation, music-based therapies have a high rate of success for the treatment of depression and anxiety and even in neurological disorders such as regaining the body integrity after a stroke episode. Our review focused on the neurological and psychological implications of music, as well as presenting the significant clinical relevance of therapies using music. Full article

(This article belongs to the Special Issue The Role of Sounds and Music in Emotion and Cognition)

► Show Figures

Figure 1

23 pages, 1272 KB

Open AccessEditor’s ChoiceReview

The Interplay between Mitochondrial Dysfunction and Ferroptosis during Ischemia-Associated Central Nervous System Diseases

by He-Yan Tian, Bo-Yang Huang, Hui-Fang Nie, Xiang-Yu Chen, Yue Zhou, Tong Yang, Shao-Wu Cheng, Zhi-Gang Mei and Jin-Wen Ge

Brain Sci. 2023, 13(10), 1367; https://doi.org/10.3390/brainsci13101367 - 25 Sep 2023

Cited by 40 | Viewed by 6180

Abstract

Cerebral ischemia, a leading cause of disability and mortality worldwide, triggers a cascade of molecular and cellular pathologies linked to several central nervous system (CNS) disorders. These disorders primarily encompass ischemic stroke, Alzheimer’s disease (AD), Parkinson’s disease (PD), epilepsy, and other CNS conditions. [...] Read more.

Cerebral ischemia, a leading cause of disability and mortality worldwide, triggers a cascade of molecular and cellular pathologies linked to several central nervous system (CNS) disorders. These disorders primarily encompass ischemic stroke, Alzheimer’s disease (AD), Parkinson’s disease (PD), epilepsy, and other CNS conditions. Despite substantial progress in understanding and treating the underlying pathological processes in various neurological diseases, there is still a notable absence of effective therapeutic approaches aimed specifically at mitigating the damage caused by these illnesses. Remarkably, ischemia causes severe damage to cells in ischemia-associated CNS diseases. Cerebral ischemia initiates oxygen and glucose deprivation, which subsequently promotes mitochondrial dysfunction, including mitochondrial permeability transition pore (MPTP) opening, mitophagy dysfunction, and excessive mitochondrial fission, triggering various forms of cell death such as autophagy, apoptosis, as well as ferroptosis. Ferroptosis, a novel type of regulated cell death (RCD), is characterized by iron-dependent accumulation of lethal reactive oxygen species (ROS) and lipid peroxidation. Mitochondrial dysfunction and ferroptosis both play critical roles in the pathogenic progression of ischemia-associated CNS diseases. In recent years, growing evidence has indicated that mitochondrial dysfunction interplays with ferroptosis to aggravate cerebral ischemia injury. However, the potential connections between mitochondrial dysfunction and ferroptosis in cerebral ischemia have not yet been clarified. Thus, we analyzed the underlying mechanism between mitochondrial dysfunction and ferroptosis in ischemia-associated CNS diseases. We also discovered that GSH depletion and GPX4 inactivation cause lipoxygenase activation and calcium influx following cerebral ischemia injury, resulting in MPTP opening and mitochondrial dysfunction. Additionally, dysfunction in mitochondrial electron transport and an imbalanced fusion-to-fission ratio can lead to the accumulation of ROS and iron overload, which further contribute to the occurrence of ferroptosis. This creates a vicious cycle that continuously worsens cerebral ischemia injury. In this study, our focus is on exploring the interplay between mitochondrial dysfunction and ferroptosis, which may offer new insights into potential therapeutic approaches for the treatment of ischemia-associated CNS diseases. Full article

(This article belongs to the Special Issue Advances in Cell Therapy of Neurodegenerative Diseases)

► Show Figures

Graphical abstract

19 pages, 3195 KB

Open AccessEditor’s ChoiceSystematic Review

Peripheral Blood and Cerebrospinal Fluid Levels of YKL-40 in Alzheimer’s Disease: A Systematic Review and Meta-Analysis

by Yuchen Zhang, Jinzhou Tian, Jingnian Ni, Mingqing Wei, Ting Li and Jing Shi

Brain Sci. 2023, 13(10), 1364; https://doi.org/10.3390/brainsci13101364 - 23 Sep 2023

Cited by 18 | Viewed by 4282

Abstract

The pathogenesis associated with Alzheimer’s disease (AD) is particularly complicated, and early diagnosis and course monitoring of the disease are not ideal based on the available core biomarkers. As a biomarker closely related to neuroinflammation, YKL-40 provides a potential scalable approach in AD, [...] Read more.

The pathogenesis associated with Alzheimer’s disease (AD) is particularly complicated, and early diagnosis and course monitoring of the disease are not ideal based on the available core biomarkers. As a biomarker closely related to neuroinflammation, YKL-40 provides a potential scalable approach in AD, but its association remains controversial and inconclusive with AD. We conducted this study to assess the utility of YKL-40 levels in peripheral blood and cerebrospinal fluid (CSF) of AD patients and healthy controls (HCs) by meta-analysis. We systematically searched and screened relevant trials for comparing YKL-40 levels between AD patients and HCs in PubMed, Embase, Cochrane, and Web of Science, with a search deadline of 14 March 2023 for each database. A total of 17 eligible and relevant studies involving 1811 subjects, including 949 AD patients and 862 HCs, were included. The results showed that YKL-40 levels in the peripheral blood of AD patients and HCs did not possess significant differences. Subgroup analysis showed YKL-40 significantly differed in plasma (SMD = 0.527, 95%CI: [0.302, 0.752]; p = 0.000), but did not in serum. In the case of comparison with HCs, YKL-40 was significantly higher in CSF of AD patients (SMD = 0.893, 95%CI: [0.665, 1.121]; p = 0.000). Besides that, when we performed a combined analysis of total YKL-40 in both peripheral blood and CSF, overall YKL-40 concentrations were also significantly increased among AD patients (SMD = 0.608, 95%CI: [0.272, 0.943]; p = 0.000). YKL-40 provides support and rationale for the neuroinflammatory pathogenesis of AD. The significance of CSF levels of YKL-40 for early screening of AD is definite. Plasma levels of YKL-40 also appear to assist in discriminating AD patients from HCs, which facilitates early screening and monitoring of the natural course of AD. Full article

(This article belongs to the Special Issue Advances in Research on Brain Health and Dementia: Prevention and Early Detection of Cognitive Decline and Dementia)

► Show Figures

Figure 1

22 pages, 3602 KB

Open AccessEditor’s ChoiceArticle

Brain Tumor Classification from MRI Using Image Enhancement and Convolutional Neural Network Techniques

by Zahid Rasheed, Yong-Kui Ma, Inam Ullah, Yazeed Yasin Ghadi, Muhammad Zubair Khan, Muhammad Abbas Khan, Akmalbek Abdusalomov, Fayez Alqahtani and Ahmed M. Shehata

Brain Sci. 2023, 13(9), 1320; https://doi.org/10.3390/brainsci13091320 - 14 Sep 2023

Cited by 88 | Viewed by 7645

Abstract

The independent detection and classification of brain malignancies using magnetic resonance imaging (MRI) can present challenges and the potential for error due to the intricate nature and time-consuming process involved. The complexity of the brain tumor identification process primarily stems from the need [...] Read more.

The independent detection and classification of brain malignancies using magnetic resonance imaging (MRI) can present challenges and the potential for error due to the intricate nature and time-consuming process involved. The complexity of the brain tumor identification process primarily stems from the need for a comprehensive evaluation spanning multiple modules. The advancement of deep learning (DL) has facilitated the emergence of automated medical image processing and diagnostics solutions, thereby offering a potential resolution to this issue. Convolutional neural networks (CNNs) represent a prominent methodology in visual learning and image categorization. The present study introduces a novel methodology integrating image enhancement techniques, specifically, Gaussian-blur-based sharpening and Adaptive Histogram Equalization using CLAHE, with the proposed model. This approach aims to effectively classify different categories of brain tumors, including glioma, meningioma, and pituitary tumor, as well as cases without tumors. The algorithm underwent comprehensive testing using benchmarked data from the published literature, and the results were compared with pre-trained models, including VGG16, ResNet50, VGG19, InceptionV3, and MobileNetV2. The experimental findings of the proposed method demonstrated a noteworthy classification accuracy of 97.84%, a precision success rate of 97.85%, a recall rate of 97.85%, and an F1-score of 97.90%. The results presented in this study showcase the exceptional accuracy of the proposed methodology in accurately classifying the most commonly occurring brain tumor types. The technique exhibited commendable generalization properties, rendering it a valuable asset in medicine for aiding physicians in making precise and proficient brain diagnoses. Full article

(This article belongs to the Special Issue Advances of AI in Neuroimaging)

► Show Figures

Figure 1

19 pages, 4493 KB

Open AccessEditor’s ChoiceArticle

Neurophysiological Assessment of An Innovative Maritime Safety System in Terms of Ship Operators’ Mental Workload, Stress, and Attention in the Full Mission Bridge Simulator

by Vincenzo Ronca, Esma Uflaz, Osman Turan, Hadi Bantan, Scott N. MacKinnon, Andrea Lommi, Simone Pozzi, Rafet Emek Kurt, Ozcan Arslan, Yasin Burak Kurt, Pelin Erdem, Emre Akyuz, Alessia Vozzi, Gianluca Di Flumeri, Pietro Aricò, Andrea Giorgi, Rossella Capotorto, Fabio Babiloni and Gianluca Borghini

Brain Sci. 2023, 13(9), 1319; https://doi.org/10.3390/brainsci13091319 - 14 Sep 2023

Cited by 20 | Viewed by 3715

Abstract

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. [...] Read more.

The current industrial environment relies heavily on maritime transportation. Despite the continuous technological advances for the development of innovative safety software and hardware systems, there is a consistent gap in the scientific literature regarding the objective evaluation of the performance of maritime operators. The human factor is profoundly affected by changes in human performance or psychological state. The difficulty lies in the fact that the technology, tools, and protocols for investigating human performance are not fully mature or suitable for experimental investigation. The present research aims to integrate these two concepts by (i) objectively characterizing the psychological state of mariners, i.e., mental workload, stress, and attention, through their electroencephalographic (EEG) signal analysis, and (ii) validating an innovative safety framework countermeasure, defined as Human Risk-Informed Design (HURID), through the aforementioned neurophysiological approach. The proposed study involved 26 mariners within a high-fidelity bridge simulator while encountering collision risk in congested waters with and without the HURID. Subjective, behavioral, and neurophysiological data, i.e., EEG, were collected throughout the experimental activities. The results showed that the participants experienced a statistically significant higher mental workload and stress while performing the maritime activities without the HURID, while their attention level was statistically lower compared to the condition in which they performed the experiments with the HURID (all p < 0.05). Therefore, the presented study confirmed the effectiveness of the HURID during maritime operations in critical scenarios and led the way to extend the neurophysiological evaluation of the HFs of maritime operators during the performance of critical and/or standard shipboard tasks. Full article

(This article belongs to the Special Issue Electroencephalography 3.0: From the Laboratory to the Mass-Market for a Daily-Life Use)

► Show Figures

Figure 1

18 pages, 724 KB

Open AccessEditor’s ChoiceReview

Are Sex Differences in Collegiate and High School Sports-Related Concussion Reflected in the Guidelines? A Scoping Review

by Patryk A. Musko and Andreas K. Demetriades

Brain Sci. 2023, 13(9), 1310; https://doi.org/10.3390/brainsci13091310 - 12 Sep 2023

Cited by 17 | Viewed by 3768

Abstract

Background: Sport-related concussion (SRC) is a common sport injury. Females are participating in sports at increasing rates, and there is growing awareness that female athletes may be more vulnerable to SRC. Objectives: We aimed to identify sex differences in epidemiology, clinical [...] Read more.

Background: Sport-related concussion (SRC) is a common sport injury. Females are participating in sports at increasing rates, and there is growing awareness that female athletes may be more vulnerable to SRC. Objectives: We aimed to identify sex differences in epidemiology, clinical manifestation and assessment of SRC and examine how these relate to the 6th International Conference on Concussion in Sport (ICCS). Methods: We conducted a scoping review of the Medline database and identified 58 studies examining the effects of sex on SRC in collegiate and high school athletes that were written in English and published in a peer-reviewed journal between March 2012 and March 2022. Results: We found that female athletes suffer higher rates of concussion in sex-comparable sports, in particular soccer. Female athletes experience more somatic symptoms—headache/migraine/sleep disturbance—and may take longer to recover from concussion. Sex differences were also identified regarding some aspects of sideline concussion assessment with the Sport Concussion Assessment Tool. Conclusions: Females are at greater risk and experience SRC differently than males; this is mostly likely due to a combination of biomechanical factors, differences in neck musculature and hormonal and social factors. Sex differences are not widely addressed by the 6th ICSS, which informs many sports’ concussion protocols. Full article

(This article belongs to the Special Issue New Trends and Technologies in Modern Neurosurgery)

► Show Figures

Figure 1

26 pages, 1160 KB

Open AccessEditor’s ChoiceReview

A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management

by Shampa Ghosh, Jitendra Kumar Sinha, Soumya Ghosh, Hitaishi Sharma, Rakesh Bhaskar and Kannan Badri Narayanan

Brain Sci. 2023, 13(9), 1305; https://doi.org/10.3390/brainsci13091305 - 11 Sep 2023

Cited by 54 | Viewed by 15313

Abstract

Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone [...] Read more.

Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy. Full article

(This article belongs to the Special Issue Etiology, Symptoms and Treatment of Epilepsy)

► Show Figures

Figure 1

8 pages, 222 KB

Open AccessEditor’s ChoiceArticle

Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR): A New Modular Treatment for ICD-11 Complex Posttraumatic Stress Disorder (CPTSD)

by Thanos Karatzias, Edel Mc Glanaghy and Marylene Cloitre

Brain Sci. 2023, 13(9), 1300; https://doi.org/10.3390/brainsci13091300 - 9 Sep 2023

Cited by 21 | Viewed by 6362

Abstract

ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a relatively new condition; therefore, there is limited available evidence for its treatment. Prior to the recognition of CPTSD as a separate trauma condition, people who met criteria were often diagnosed with multiple co-morbid conditions such [...] Read more.

ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a relatively new condition; therefore, there is limited available evidence for its treatment. Prior to the recognition of CPTSD as a separate trauma condition, people who met criteria were often diagnosed with multiple co-morbid conditions such as PTSD, anxiety, depression, and emotional dysregulation difficulties. In the absence of a coherent evidence base, treatment tended to involve multiple treatments for these multiple conditions or lengthy phase-based interventions, often delivered in an integrative fashion, which was not standardized. In this paper, we present Enhanced Skills Training in Affective and Interpersonal Regulation (ESTAIR), a new flexible multi-modular approach for the treatment of CPTSD and its transdiagnostic symptoms. ESTAIR is consistent with trauma-informed and patient-centered care, which highlights the importance of patient choice in identification and sequencing in targeting CPTSD symptoms. Directions for future research are discussed. Full article

(This article belongs to the Special Issue Novel Interventions for PTSD)

23 pages, 1937 KB

Open AccessEditor’s ChoiceSystematic Review

Photosensitizers for Photodynamic Therapy of Brain Cancers—A Review

by Dorota Bartusik-Aebisher, Paweł Woźnicki, Klaudia Dynarowicz and David Aebisher

Brain Sci. 2023, 13(9), 1299; https://doi.org/10.3390/brainsci13091299 - 8 Sep 2023

Cited by 31 | Viewed by 5635

Abstract

On average, there are about 300,000 new cases of brain cancer each year. Studies have shown that brain and central nervous system tumors are among the top ten causes of death. Due to the extent of this problem and the percentage of patients [...] Read more.

On average, there are about 300,000 new cases of brain cancer each year. Studies have shown that brain and central nervous system tumors are among the top ten causes of death. Due to the extent of this problem and the percentage of patients suffering from brain tumors, innovative therapeutic treatment methods are constantly being sought. One such innovative therapeutic method is photodynamic therapy (PDT). Photodynamic therapy is an alternative and unique technique widely used in dermatology and other fields of medicine for the treatment of oncological and nononcological lesions. Photodynamic therapy consists of the destruction of cancer cells and inducing inflammatory changes by using laser light of a specific wavelength in combination with the application of a photosensitizer. The most commonly used photosensitizers include 5-aminolevulinic acid for the enzymatic generation of protoporphyrin IX, Temoporfin—THPC, Photofrin, Hypericin and Talaporfin. This paper reviews the photosensitizers commonly used in photodynamic therapy for brain tumors. An overview of all three generations of photosensitizers is presented. Along with an indication of the limitations of the treatment of brain tumors, intraoperative photodynamic therapy and its possibilities are described as an alternative therapeutic method. Full article

(This article belongs to the Special Issue Advances in Diagnosis and Treatment of Brain Tumors and Nervous System Tumors)

► Show Figures

Figure 1

Journal Menu

Journal Browser

Editor’s Choice Articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI