NeuroSci

In ulnar neuropathy at the elbow (UNE), the degree of neuropathic changes, the sensitivity of needle electromyography (EMG) in individual ulnar muscles, and the utility of individual EMG parameters are controversial. I compared qualitative needle EMG findings in two ulnar-innervated hands muscles and two ulnar-innervated forearm muscles in a group of previously reported UNE patients. Altogether, 170 UNE patients (175 arms) were studied. I found spontaneous denervation activity (SDA) most frequently in the first dorsal interosseus (FDI) (62%) and neuropathic changes in the abductor digiti minimi (ADM) muscle (88%). In the forearm muscles, SDA was more common (29% vs. 20%; p = 0.02), and neuropathic changes were similar in the flexor carpi ulnaris (FCU) and the flexor digitorum profundus (FDP) muscles. SDA and neuropathic changes were more common in the ulnar hand (88% and 77%) than in the ulnar forearm muscles (71% and 68%). Needle EMG is sensitive to diagnose UNE. For the detection of SDA FDI and neuropathic changes, ADM is the best muscle. Ulnar forearm muscles are less useful than ulnar hand muscles for UNE diagnosis. Full article

Exposure to valproic acid (VPA) during embryogenesis has become a valuable tool for modeling neurodevelopmental disorders in animal models such as zebrafish (Danio rerio). This article examines the effects of embryonic exposure to VPA in zebrafish on the basis of 39 articles sourced from PubMed and Google Scholar. We conducted a systematic review and meta-analysis to elucidate the common impacts of VPA exposure and reported that VPA significantly altered development at various levels. Behaviorally, zebrafish exposed to VPA exhibit notable changes in their social interaction patterns. Physiologically, VPA exposure leads to significant alterations, including decreased heart rates, increased mortality rates, and pronounced morphological abnormalities. Pharmacological exposure has been linked to neuroanatomical and neurochemical changes. At the genetic level, VPA exposure is associated with the differential expression of genes involved in neurodevelopment and neuronal function. The synthesized data from these studies underscore the utility of zebrafish as a model organism for investigating the effects of teratogen exposure on neurodevelopment. Full article

Volatile organic compounds, colloquially referred to as “terpenes”, have been proposed to impact the therapeutic qualities that are traditionally ascribed to cannabis. However, the contribution of these terpenes in anxiety, at relevant levels and exposure methods common with cannabis use, is lacking empirical assessment. We tested the anxiolytic properties of two prominent cannabis terpenes, linalool and β-myrcene, in male and female mice using short duration vapor pulls to model human inhalation when combusting flower or vaping cannabis oil. We observed sex differences in the locomotor effects in the open field and anxiolytic properties in the elevated plus maze of these terpenes that depended on their exposure characteristics. Both linalool and β-myrcene had anxiolytic effects in female mice when delivered in discrete vapor pulls over the course of 30 min. In male mice, only a single vapor hit containing linalool or β-myrcene had anxiolytic effects. The combination of sub-effective levels of linalool and the phytocannabinoid, cannabidiol (CBD), had synergistic anxiolytic effects in females, but these entourage effects between CBD and terpenes were absent with β-myrcene for females and for either terpene in males. Together, our findings reveal sex differences in the anxiolytic properties of common cannabis terpenes and highlight the potential benefits of unique combinations of CBD and terpenes in expanding the therapeutic dose window. Full article

Cauda equina nerve roots may become damaged during neuraxial anesthesia, and post-puncture headache may appear in the case of cerebrospinal fluid leakage if needle tips are deformed due to bone contact when several attempts are needed. Our aim was to verify the correlation between skin–transverse process distance (st) and skin–dural sac distance (d) for calculation of optimal angles in a free visual guide and as a reference for the maximal depth to be traversed by the needle. Randomly selected ex vivo samples (n = 10) were flexed to reproduce the position of the lumbosacral spine during spinal anesthesia. Spinal needles were inserted perpendicular to the skin either blindly or following the inferred paramedian angle corresponding to ultrasound-measured (d). After computed tomography and three-dimensional reconstruction, both (st) and (d) were measured, and the Pearson correlation index was calculated. A free 3D-PDF tool was used to illustrate the potential affectation of nerve cuffs by needles located lateral to the dural sac. Correlation between (d) and (st) was 0.84–0.93 at L4L5-L3L4 intervertebral levels, and most needle tips were located within the spinal canal, but some traversed the zone where nerve cuffs emerge. In conclusion, ultrasound may determine if a perpendicular needle insertion is viable at midline. If not, the optimal paramedian angle and maximal depth may be determined by measuring (st). Full article

This study aimed to assess the immediate effects of transcutaneous spinal direct current stimulation (tsDCS) on pain outcomes, measured using the visual analog scale (VAS) and pressure pain thresholds in a cohort of 55 participants experiencing chronic pain using a controlled, randomized trial with 55 participants allocated into 2 groups: 2 mA and 0.5 mA of tsDCS for 20 min. Anodal stimulation was applied on the 12th thoracic vertebra, with the cathode positioned on the 7th cervical vertebra. Pain outcomes were assessed before and post intervention using the VAS and pressure algometry. Between- and within-group differences, along with chi-square tests, were used to determine the differences and responsiveness. Significance was established at p < 0.05. Findings showed significant temporal effects for both VAS (p < 0.001) and pressure algometry (p = 0.04). However, no between-group differences were noted for the time × group factor for VAS (p = 0.46) and pressure algometry (p = 0.78). No significant between-group differences were observed for the responsiveness analysis. The results indicate that a single 20-min session of 2 and 0.5 mA tsDCS improves pain scores for both intensities equally. However, there were no statistically significant between-group differences in pain perception or pressure pain threshold. Full article

Classification of disease and healthy volunteer cohorts provides a useful clinical alternative to traditional group statistics due to individualized, personalized predictions. Classifiers for neurodegenerative disease can be trained on structural MRI morphometry, but require large multi-scanner datasets, introducing confounding batch effects. We test ComBat, a common harmonization model, in an example application to classify subjects with Parkinson’s disease from healthy volunteers and identify common pitfalls, including data leakage. We used a multi-dataset cohort of 372 subjects (216 with Parkinson’s disease, 156 healthy volunteers) from 11 identified scanners. We extracted both FreeSurfer and the determinant of Jacobian morphometry to compare single-scanner and multi-scanner classification pipelines. We confirm the presence of batch effects by running single scanner classifiers which could achieve wildly divergent AUCs on scanner-specific datasets (mean:0.651 ± 0.144). Multi-scanner classifiers that considered neurobiological batch effects between sites could easily achieve a test AUC of 0.902, though pipelines that prevented data leakage could only achieve a test AUC of 0.550. We conclude that batch effects remain a major issue for classification problems, such that even impressive single-scanner classifiers are unlikely to generalize to multiple scanners, and that solving for batch effects in a classifier problem must avoid circularity and reporting overly optimistic results. Full article

Purpose: Stroke is one of the leading causes of disability with life-long implications requiring assessment and treatment of several functional domains. This review identifies the results from research into music-based interventions (MBIs), including music therapy (MT), for executive functions (EFs) and emotional well-being (EWB) in adults with stroke and highlights opportunities for clinical practice and future research. Methods: APA PsycInfo (EBSCOhost), and CINAHL (EBSCOhost) were searched, in addition to grey literature. Results: A total of 49 studies were included and encompassed experimental, analytic, and descriptive observational studies, and case reports, involving a total of 1663 participants. In total, 32 studies included MT interventions, and 17 were MBIs. EFs were an outcome in 20.41%, and EWB in 61.22% of studies, for which active interventions were the most utilized. Overall, 73.47% of the studies reported positive results. Conclusions: This scoping review indicates that music interventions can be beneficial for the improvement of different aspects of EFs and EWB at different stages of stroke recovery. Further research may benefit clinical practice by including standardized protocols, outcome and self-reported measures, and brain imaging data to determine the effects of interventions and support evidence-based decisions for treatment policies for stroke survivors. Full article

Age-related decline in episodic memory is often linked to structural and functional changes in the brain. Here, we investigated how these alterations might affect functional connectivity during memory retrieval following exposure to emotional stimuli. Using functional magnetic resonance imaging (fMRI), participants viewed images with varying emotional valences (positive, negative, and neutral) followed by unrelated non-arousing videos and were then asked to retrieve an episodic detail from the previously shown video. We conducted Multivariate Pattern Analysis (MVPA) to identify regions with divergent responses between age groups, which then served as seeds in Seed-Based Connectivity (SBC) analyses. The results revealed an age-related decline in behavioural performance following exposure to negative stimuli but preserved performance following positive stimuli. Young adults exhibited increased functional connectivity following negative valence. Conversely, old adults displayed increased connectivity more scarcely, and only following positive valence. These findings point to an adaptive response of the impact of emotions on task performance that depends on neural adaptations related to ageing. This suggests that age-related changes in functional connectivity might underlie how emotions influence memory, highlighting the need to tailor memory support strategies in older adulthood. Full article

This paper suggests a statistical framework for describing the relations between the physical and conceptual entities of a brain-like model. Features and concept instances are put into context, where the paper suggests that features may be the electrical wiring; although, chemical connections are also possible. With this idea, the actual length of the connection is important, because it is related to firing rates and neuron synchronization, but the signal type is less important. The paper then suggests that concepts are neuron groups that link feature sets and concept instances are determined by chemical signals from those groups. Therefore, features become the static horizontal framework of the neural system and concepts are vertically interconnected combinations of these. With regards to functionality, the neuron is then considered to be functional, and the more horizontal memory structures can even be glial. This would also suggest that features can be distributed entities and not concentrated to a single area. Another aspect could be signal ‘breaks’ that compartmentalise a pattern and may help with neural binding. Full article

Essential tremor (ET) is a prevalent movement disorder characterized by action tremors, predominantly affecting the upper limbs. While various pharmacological and non-pharmacological interventions have shown efficacy in managing ET, the therapeutic role of repetitive transcranial magnetic stimulation (rTMS) remains uncertain. This systematic review synthesizes evidence from clinical trials investigating rTMS as a treatment for ET. Despite some open-label trials reporting reductions in tremor severity, double-blinded studies revealed no significant difference between active and sham rTMS, suggesting a strong placebo effect. The findings indicate that while rTMS can reduce tremor scores, its therapeutic efficacy in ET remains unproven. Future research should focus on improving sham designs and conducting larger, rigorously controlled trials to clarify rTMS’s role in ET management. Current evidence supports considering alternative treatments, such as deep brain stimulation, over rTMS for ET. Full article

Plasmalogens are brain-enriched phospholipids with a vinyl–ether bond at the sn-1 position between the glycerol backbone and the alkyl chain. Previous studies have suggested that plasmalogens modulate locomotor activity, anxiety-like behavior, and cognitive functions in rodents; however, the specific moieties contributing to behavioral regulation are unknown. In this study, we examined the behavioral modulation induced by specific phospholipid moieties. To confirm the permeability of phospholipids in injected liposomes, we measured the fluorescence intensity following intravenous injection of liposomes containing ATTO 740-labeled dioleoylphosphatidylethanolamine. Then, we compared the behavioral effects following injection of liposomes composed of egg phosphatidylcholine (PC) and 1-stearoyl-2-docosahexaenoyl-sn-glycero-3-phosphoethanolamine (PE 18:0/22:6), PC 18:0/22:6, 1-(1Z-octadecenyl)-2-docosahexaenoyl-sn-glycero-3-phosphoethanolamine (PE P-18:0/22:6), or PC P-18:0/22:6, into the tail vein of male rats. The time spent in the central region of the open field was significantly reduced after injection of PE 18:0/22:6, harboring an ester bond at sn-1 compared to controls. Furthermore, the discrimination ratio in the novel object recognition test was significantly higher in PC 18:0/22:6 compared to PE 18:0/22:6, suggesting that the substitution of ethanolamine with choline can enhance recognition memory. We demonstrate that the structures of the sn-1 bond and the hydrophilic moiety in the phospholipids can modulate exploratory behaviors and recognition memory in rodents. Full article

Background: Among the cognitive markers, the deterioration of semantic and phonemic verbal fluency seems to be an early indicator of Alzheimer’s disease (AD). The aims of this study are (1) to evaluate both types of verbal fluency in the early stages of AD in order to know which of them deteriorates earlier and (2) to investigate if verbal fluency tasks can help to differentiate between patients with Mild Cognitive Impairment (MCI) who will progress to AD two years later (progress) and those who will not (non-progress). Method: A verbal fluency task was administered to 25 patients with MCI and their respective control subjects. All patients underwent a neuropsychological evaluation twice in order for us to follow up on their global cognitive status. The second time, eight of them converted to AD. Results: On the one hand, phonemic verbal fluency deteriorates earlier than semantic verbal fluency in MCI patients; on the other hand, although we found statistically significant differences between patients with MCI and AD in both types of fluency tasks, none were found when comparing the performance of progress and non-progress. Conclusions: These results point to a greater impairment in phonemic verbal fluency in MCI patients and its potential capacity to predict conversion to AD. Full article

Background: Aortic valve stenosis (AVS) is a common valvular heart disease affecting millions of people worldwide. It leads to significant neurocognitive and neuropsychological impairments, impacting patients’ quality of life. Objective: The objective of this article is to identify and discuss the potential neurocognitive effects on patients with aortic stenosis before and after undergoing surgical aortic valve replacement (SAVR). Method: Our study involved the assessment of 64 patients undergoing aortic valve replacement (SAVR) using a neurocognitive evaluation comprising a battery of 11 different cognitive tests. These tests were designed to analyze the patients’ overall cognitive functioning, executive abilities, short- and long-term memory, and attentional performance. The tests were administered to patients before the aortic valve surgery (T0) and after the surgery (T1). From a statistical perspective, numerical variables are presented as means (±standard deviation) and medians (IQR), while categorical variables are presented as counts and percentages. Normality was assessed using the Shapiro–Wilk test. T0 and T1 scores were compared with the Wilcoxon signed rank test, with p < 0.05 considered significant. Analyses were performed using SAS version 9.4. Results: Conducted as part of a fully financed Italian Ministry of Health project (RF-2016-02361069), the study found that most patients showed normal cognitive functioning at baseline. Cognitive assessments showed that executive functions, attention, language, and semantic knowledge were within the normal range for the majority of participants. After SAVR, cognitive outcomes remained stable or improved, particularly in executive functions and language. Notably, verbal episodic memory demonstrated significant improvement, with the percentage of patients scoring within the normal range on the BSRT increasing from 73.4% at T0 to 92.2% at T1 (p < 0.0001). However, visuospatial and visuoconstructive abilities showed stability or slight decline, while attentional skills remained relatively stable. The Clock Drawing Test indicated the maintenance of cognitive functions. Conclusions: The findings of our study indicate a global stability in cognitive status among patients after undergoing SAVR, with significant improvement noted in verbal episodic memory. While other cognitive domains did not demonstrate statistically significant changes, these insights are valuable for understanding the cognitive effects of SAVR and can guide future research and clinical practice in selecting the most effective surgical and rehabilitative options for patients. Monitoring cognitive outcomes in patients undergoing aortic valve replacement surgery remains crucial. Full article

Brain radiation is a crucial tool in neuro-oncology for enhancing local tumor control, but it can lead to mild-to-profound and progressive impairments in cognitive function. Radiation-induced brain injury is a significant adverse effect of radiotherapy for cranioencephalic tumors, primarily caused by indirect cellular damage through the formation of free radicals. This results in late neurotoxicity manifesting as cognitive impairment due to free radical production. The aim of this review is to highlight the role of different substances, such as drugs used in the clinical setting and antioxidants such as ascorbate, in reducing the neurotoxicity associated with radiation-induced brain injury. Currently, there is mainly preclinical and clinical evidence supporting the benefit of these interventions, representing a cost-effective and straightforward neuroprotective strategy. Full article

Attention deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, and numerous functional and structural differences have been identified in the brains of individuals with ADHD compared to controls. This study uses data from the baseline sample of the large, epidemiologically informed Adolescent Brain Cognitive Development Study of children aged 9–10 years old (N = 7979). Cross-validated Poisson elastic net regression models were used to predict a dimensional measure of ADHD symptomatology from within- and between-network resting-state correlations and several known risk factors, such as biological sex, socioeconomic status, and parental history of problematic alcohol and drug use. We found parental history of drug use and biological sex to be the most important predictors of attention problems. The connection between the default mode network and the dorsal attention network was the only brain network identified as important for predicting attention problems. Specifically, we found that reduced magnitudes of the anticorrelation between the default mode and dorsal attention networks relate to increased attention problems in children. Our findings complement and extend recent studies that have connected individual differences in structural and task-based fMRI to ADHD symptomatology and individual differences in resting-state fMRI to ADHD diagnoses. Full article

Trehalose is a naturally occurring disaccharide that has recently gained significant attention for its neuroprotective properties in various models of neurodegeneration. This review provides an overview of available experimental data on the beneficial properties of trehalose for central nervous system pathological conditions. Trehalose’s impact on neuronal cell survival and function was also examined. As a result, we identified that trehalose’s neuroprotection includes autophagy modulation as well as its capability to stabilize proteins and inhibit the formation of misfolded ones. Moreover, trehalose mitigates oxidative stress-induced neuronal damage by stabilizing cellular membranes and modulating mitochondrial function. Furthermore, trehalose attenuates excitotoxicity-induced neuroinflammation by suppressing pro-inflammatory cytokine release and inhibiting inflammasome activation. A possible connection of trehalose with the gut–brain axis was also examined. These findings highlight the potential therapeutic effects of trehalose in neurodegenerative diseases. According to the conclusions drawn from this study, trehalose is a promising neuroprotective agent as a result of its distinct mechanism of action, which makes this compound a candidate for further research and the development of therapeutic strategies to combat neuronal damage and promote neuroprotection in various neurological diseases. Full article

Detecting stress is important for improving human health and potential, because moderate levels of stress may motivate people towards better performance at cognitive tasks, while chronic stress exposure causes impaired performance and health risks. We propose a Brain–Computer Interface (BCI) system to detect stress in the context of high-pressure work environments. The BCI system includes an electroencephalogram (EEG) headband with dry electrodes and an electrocardiogram (ECG) chest belt. We collected EEG and ECG data from 40 participants during two stressful cognitive tasks: the Cognitive Vigilance Task (CVT), and the Multi-Modal Integration Task (MMIT) we designed. We also recorded self-reported stress levels using the Dundee Stress State Questionnaire (DSSQ). The DSSQ results indicated that performing the MMIT led to significant increases in stress, while performing the CVT did not. Subsequently, we trained two different models to classify stress from non-stress states, one using EEG features, and the other using heart rate variability (HRV) features extracted from the ECG. Our EEG-based model achieved an overall accuracy of 81.0% for MMIT and 77.2% for CVT. However, our HRV-based model only achieved 62.1% accuracy for CVT and 56.0% for MMIT. We conclude that EEG is an effective predictor of stress in the context of stressful cognitive tasks. Our proposed BCI system shows promise in evaluating mental stress in high-pressure work environments, particularly when utilizing an EEG-based BCI. Full article

Background: The optimal management of CSF drainage in acute hydrocephalus, in particular when to initiate drain weaning, remains uncertain. This study aimed to evaluate the impact of timing and method of drain weaning on patient outcomes. Methods: This prospective observational study in a large-volume tertiary neuroscience centre included all adult patients who required temporary CSF drainage for acute hydrocephalus of any cause between January 2020 and March 2021. Contemporaneous data collection was conducted, including patient demographics, time to clamp, weaning methods, and clinical outcomes of hospital length of stay (LOS), rate of shunt insertion, drain-related infections, and mechanical complications. Univariate and multivariate statistical analyses were performed to identify the independent associations of timing-related factors. Results: A total of 69 patients were included (mean age = 59.4 years). A total of 59% had CSF diversion for aneurysmal subarachnoid haemorrhage, and 88% had EVD drainage. The length of drainage prior to the first clamp was significantly associated with the overall length of drainage (p < 0.0001), LOS (p = 0.004), and time to shunt (p = 0.02) following multivariate adjustment. For each day delayed in initiating the drain challenge, the overall LOS increased by an additional 1.25 days. There was no association between the weaning method and LOS, the rate of shunting, or CNS infection; however, those in the gradually weaned group had more mechanical complications, such as drain blockage or CSF leakage, than those rapidly weaned (p = 0.03) after adjustment. Discussion: This study recommends challenging the drain early via a rapid wean to reduce LOS, mechanical complications, and possibly infections. The consequences of temporary CSF diversion have significant implications at financial and patient levels, but the quality of evidence regarding weaning remains poor. Further randomised multicentre studies and national databases of practice are required to allow definitive conclusions to be drawn. Full article

Background: This study was designed to adapt the Delis–Kaplan Executive System (D-KEFS) version of the Color-Word Interference (CWIT) and Trail Making Tests (TMTs) for the Greek adult population from 20 to 49 years old, since it is of research as well as clinical importance to detect executive functions’ impairment in young adults with neurological or/and psychiatric conditions. Aims: Norms for the Greek adult population have been calculated to be available for neuropsychologists and health professionals who work in relevant settings. Methods: The study sample consisted of 101 healthy adults (41% male and 60% female) aged 20 to 49 years (M = 32.16, SD = 11.57) with education from 12 to 19 years of schooling (M = 14.51, SD = 0.89). A Pearson correlation test as well as a chi square test were conducted to examine potential associations between gender, age, education, and participants’ performance. Afterwards, we calculated normative data using raw scores and transformed them into percentile scores. Finally, Greek norms were compared to the original raw scores, which were transformed into scaled scores by Delis et al. (2001). Results: The findings showed that age was the only variable which affected CWIT, whereas level of education as well as age were predictive factors for most TMT conditions, except for the visual scanning test (Condition 1). Gender did not affect both tests. Finally, D-KEFS norms for CWIT and TMT are available for the Greek adult population to help clinicians detect executive functions’ deficits and therefore adjust tailored therapeutic strategies. Additionally, it is of great importance to use these tests for research purposes. Conclusion: Given that executive functions are assumed as high-level skills, which are highly related to everyday functionality, adapted tests contribute not only to assess the progression of any existing neurological as well as psychiatric disorders, but they can also be used to evaluate patients’ ability to live independently, as well as their access to work. Full article