NeuroSci

Background: Age at multiple sclerosis (MS) diagnosis may be associated with clinical course, inflammatory activity, and disability accrual, but evidence across the full age spectrum remains limited. We compared clinical and radiological features, phenotype distribution, and time to first post-diagnosis relapse across early-onset MS (EOMS), adult-onset MS (AOMS), and late-onset MS (LOMS). Methods: This observational study included patients with MS treated at two tertiary centers in Isfahan, Iran, combining a retrospective review of clinical records with a cross-sectional assessment at the most recent study visit. Patients were categorized as EOMS (MS diagnosis at ≤18 years), AOMS, or LOMS (diagnosis at or after 50 years) according to age at diagnosis. Demographic, clinical, MRI, and comorbidity data were compared across groups. Time to first post-diagnosis relapse was analyzed in RRMS using Cox regression, and continuous age effects were explored with spline models. Results: Among 3994 patients, 257 had EOMS, 3587 had AOMS, and 150 had LOMS. EOMS had a higher hazard of first post-diagnosis relapse (adjusted HR: 1.27, 95% CI: 1.05–1.54) and more frequent enhancing brain lesions. LOMS had a more progressive phenotype, higher EDSS at diagnosis and qualitative brain atrophy, and more age-associated comorbidities. The adjusted LOMS relapse estimate (HR: 0.58, 95% CI: 0.34–0.99) was borderline significant. Progressive MS became more common with increasing diagnosis age, largely reflecting PPMS, although unequal follow-up and last-visit classification limit causal interpretation. Female predominance persisted across all groups but was less pronounced in LOMS. Conclusions: Age at diagnosis was associated with clinical and radiological differences across the MS spectrum from a more relapsing phenotype to a more progressive, disability-associated phenotype. These findings should be verified in prospective studies based on symptomatic onset age.

Traumatic cervical spine injury in children and adolescents is uncommon but may cause major disability and prolonged critical care. This retrospective descriptive cohort characterizes patients aged 18 years or younger admitted to the Neurosurgical Intensive Care Unit (ICU) of a tertiary trauma center in New Delhi, India, during 2008–2015. Discharge status was classified as favorable (American Spinal Injury Association [ASIA] Impairment Scale D–E) or unfavorable (ASIA A–C or in-hospital death). We used chi-square tests with Yates’ continuity correction, with unadjusted odds ratios (ORs) and 95% confidence intervals (CIs). Among 112 patients, 83.0% were male, 85.7% were aged 9–18 years, and 77.7% had spinal canal compromise. Forty-seven patients (42.0%) had favorable and 65 (58.0%) had unfavorable discharge status, including nine in-hospital deaths (8.0%). Favorable status was associated with absence of spinal canal compromise (OR 6.67, 95% CI 2.40–18.54) and absence of the composite ICU complication indicator (OR 6.44, 95% CI 2.61–15.93), and with fracture rather than subluxation, absence of tracheostomy, and favorable admission ASIA category. No multivariable adjustment was performed; these exploratory, unadjusted associations do not establish independent or causal effects. The cohort provides descriptive data from an under-reported tertiary trauma setting and identifies variables for prospective multicenter study.

Background: Slow Cortical Potential (SCP) neurofeedback trains voluntary regulation of cortical excitability states linked to anticipatory control and prefrontal executive function. In competitive sport contexts, these neural mechanisms may translate into changes in psychological constructs that shape performance under pressure. Objective: To explore between-group differences in psychological outcomes assessed during a standardized simulated putting task before and after an eight-week SCP neurofeedback program in golfers, including affective state, self-efficacy and confidence, perceived task workload, and causal attribution patterns, compared with a wait-list control condition. Methods: Forty-two active competitive golfers were randomized to a Training group (n = 21), completing an eight-week SCP neurofeedback protocol, or a wait-list Control group (n = 21). Psychological outcomes were assessed before and after the intervention during standardized competitive settings (simulated putting competitions). Validated instruments included the Self-Assessment Manikin (SAM), the Positive and Negative Affect Schedule (PANAS), self-efficacy and confidence ratings, a Task Evaluation questionnaire, and a sport-adapted causal attribution checklist. Non-parametric statistics (Mann–Whitney U, Wilcoxon signed-rank) were used where normality assumptions were not met, with rank-biserial correlation (RBC) as the effect size measure. Results: Affective dimensions (SAM valence, activation, dominance; PANAS negative affect; and STAI state anxiety) remained stable across simulated competitions in both groups. Within the Training group only, state anxiety decreased from pre- to post-task at the second simulated competition (p = 0.012), but the corresponding Group × Simulated Competition × Task-phase estimate was not significant (estimate = −1.76, 95% CI [−7.82, 4.30], p = 0.560, FDR-adjusted p = 0.958), indicating that this within-group change was not differential relative to the Control group, which changed in the same direction. Across the full direct between-group treatment contrasts, none reached statistical significance before or after false-discovery-rate correction (all raw p ≥ 0.24; all FDR-adjusted p ≥ 0.96). A within-group increase in luck attribution in the Training group (p = 0.007) reflected a fully one-directional pattern of change (rank-biserial correlation = 1.00, driven by zero decreases among the nine participants who changed) rather than an unusually large effect. Conclusions: These results did not find evidence that this eight-week SCP neurofeedback program produced differential psychological effects relative to a wait-list control. The within-group anxiety, self-efficacy, and luck-attribution patterns reported, before FDR corrections, could serve as hypothesis-generating observations.