Search Results (193)

Background: Glioblastoma (GBM) is an aggressive brain tumor, with surgery being an integral part of treatment. Aggressive resections improve clinical outcomes but need to be balanced against potential functional impairment. Neuropsychological (NP) testing is an important tool neurosurgeons use to assess cognitive functioning. Importantly, associations between NP test scores and imaging biomarkers could enable a testable baseline by which to track patient outcomes over time and aid in presurgical counseling. Methods: We identified 44 patients diagnosed with primary GBM and who had detailed NP testing and presurgical imaging. Regression models for NP indices were created with tumor size, hemisphere, and lobar location as predictors. Lesion–symptom mapping (LSM) analyses were used to identify more detailed structure–function relationships. Results: Larger tumor volumes predicted worse attention, immediate memory, language, visuospatial, and overall NP performance (p < 0.05 for all). Left hemisphere involvement predicted worse attention, language, and immediate memory NP performance (p < 0.01 for all). Only visuospatial testing had lobar location significantly associated with worse scores (occipital lobe; p < 0.05). The LSM analyses identified areas around the left sagittal stratum as significantly associated with language performance (p < 0.05), with no other structure–function relationships being identified. Conclusions: These findings support the growing evidence that outside of a small number of truly critical regions, high-grade gliomas impair cognition generally, likely due to progressive tumor infiltration-associated neuroplasticity of complex parallel and interconnected networks. To investigate this, future studies should incorporate larger cohort sizes and should examine the relationship of glioma-induced network-level perturbations on cognitive decline. Full article

Shaken Baby Syndrome (SBS) is one of the primary causes of fatal head trauma in infants and young children, occurring in about 33 per 100,000 infants annually in the U.S., with mortality rates being between 15% and 38%. Survivors frequently endure long-term disabilities, such as cognitive deficits, visual impairments, and motor dysfunction. Diagnosing SBS remains difficult due to the lack of visible injuries and delayed symptom onset. Existing detection methods—such as neuroimaging, biomechanical modeling, and infant monitoring systems—cannot perform real-time detection and face ethical, technical, and accuracy limitations. This study proposes an inertial measurement unit (IMU)-based detection system enhanced with machine learning to identify aggressive shaking patterns. Findings indicate that wearable-based motion analysis is a promising method for recognizing high-risk shaking, offering a non-invasive, real-time solution that could minimize infant harm and support timely intervention. Full article

Background/Objectives: The objective of this study was to validate a new parent-reported scale for tracking Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). PANS is a condition characterized by a sudden and severe onset of neuropsychiatric symptoms. To meet diagnostic criteria, an individual must present with either obsessive–compulsive disorder (OCD) or severely restricted food intake, accompanied by at least two additional cognitive, behavioral, or emotional symptoms. These may include anxiety, emotional instability, depression, irritability, aggression, oppositional behaviors, developmental or behavioral regression, a decline in academic skills such as handwriting or math, sensory abnormalities, frequent urination, and enuresis. The onset of symptoms is usually triggered by an infection or an abnormal immune/inflammatory response. Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) is a subtype of PANS specifically linked to strep infections. Methods: We developed a 101-item PANS/PANDAS and Related Inflammatory Brain Disorders Treatment Evaluation Checklist (PTEC) designed to assess changes to a patient’s symptoms over time along 10 subscales: Behavior/Mood, OCD, Anxiety, Food intake, Tics, Cognitive/Developmental, Sensory, Other, Sleep, and Health. The psychometric quality of PTEC was tested with 225 participants. Results: The internal reliability of the PTEC was excellent (Cronbach’s alpha = 0.96). PTEC exhibited adequate test–retest reliability (r = 0.6) and excellent construct validity, supported by a strong correlation with the Health subscale of the Autism Treatment Evaluation Checklist (r = 0.8). Conclusions: We hope that PTEC will assist parents and clinicians in the monitoring and treatment of PANS. The PTEC questionnaire is freely available at neuroimmune.org/PTEC. Full article

Background/Objectives: Given the heterogeneous nature of long COVID, its treatment and management remain challenging. This study aimed to investigate whether poor pre-pandemic sleep quality, its deterioration during the peak of the pandemic, and circadian preference increase the risk of long COVID symptoms. Methods: An online survey was conducted between 9 October and 12 December 2022, with 384 participants who had recovered from COVID-19 at least three months prior to data collection. Participants were categorized based on the presence of at least one long COVID symptom. Logistic regression models assessed associations between sleep-related variables and long COVID symptoms. Results: Participants with long COVID symptoms reported significantly poorer sleep quality, higher perceived stress, greater somatic and cognitive pre-sleep arousal, and elevated levels of post-traumatic stress symptoms, anxiety, depression, and aggression. Fatigue (39.8%) and memory problems (37.0%) were the most common long COVID symptoms. Sleep deterioration during the pandemic peak was reported by 34.6% of respondents. Pre-pandemic poor sleep quality, its deterioration during the pandemic, and poor sleep at the time of the survey were all significantly associated with long COVID. An extreme morning chronotype consistently predicted long COVID symptoms across all models, while an extreme evening chronotype was predictive only when accounting for sleep quality changes during the pandemic. COVID-19 frequency, severity, financial impact, and somatic pre-sleep arousal were significant predictors in all models. Conclusions: Poor sleep quality before the pandemic and its worsening during the pandemic peak are associated with a higher likelihood of long COVID symptoms. These findings underscore the need to monitor sleep health during pandemics and similar global events to help identify at-risk individuals and mitigate long-term health consequences, with important clinical and societal implications. Full article

Background: Anabolic–androgenic steroids (AASs) are commonly used for performance enhancement but have been linked to significant neurobiological consequences. This review explores the impact of AASs on neurochemical pathways, cognitive function, and psychiatric disorders, highlighting their potential neurotoxicity. Methods: A narrative review of current literature was conducted to examine AASs-induced alterations in neurotransmitter systems, structural and functional brain changes, and associated psychiatric conditions. The interplay between AASs use and other substances was also considered. Results: Chronic AASs exposure affects serotonin and dopamine systems, contributing to mood disorders, aggression, and cognitive deficits. Structural and functional changes in the prefrontal cortex and limbic regions suggest long-term neurotoxicity. AASs use is associated with increased risks of depression, anxiety, and psychosis, potentially driven by hormonal dysregulation and neuroinflammation. Co-occurring substance use exacerbates neurocognitive impairments and behavioral disturbances. Discussion: While evidence supports the link between AASs use and neurotoxicity, gaps remain in understanding the precise mechanisms and long-term effects. Identifying biomarkers of brain damage and developing targeted interventions are crucial for mitigating risks. Increased awareness among medical professionals and policymakers is essential to address AASs-related neuropsychiatric consequences. Conclusions: AASs abuse poses significant risks to brain health, necessitating further research and prevention efforts. Evidence-based strategies are needed to educate the public, enhance early detection, and develop effective interventions to reduce the neuropsychiatric burden of AASs use. Full article

Background: Pediatric-onset multiple sclerosis (POMS) is a rare but often more aggressive form of multiple sclerosis, associated with early cognitive impairment and significant impact on quality of life. Multiple sclerosis and primary headaches, particularly migraine, are well established in adults, but data on pediatric populations remain limited. Methods: The purpose of this retrospective study was to examine 64 POMS patients, divided into groups with and without headaches, to determine potential correlations between headache presence, age at POMS onset, and MRI lesion burden. Results: Headaches were reported by 78% of patients, predominantly migraines (68%), with a significantly higher prevalence in females (74%). No significant differences were found in age at MS onset or lesion load on brain MRI between patients with and without headaches. Among those with headaches, migraines represented a higher frequency of attacks and a greater need for prophylactic treatment compared to other headache types. Headache characteristics, including pain location and associated symptoms, showed no correlation with age at MS onset or lesion burden. Conclusions: These findings indicate that while headaches are common in POMS and more frequent in females, their presence and features do not appear to directly influence the clinical or neuroradiological course of the disease. Further research with larger cohorts and longitudinal follow-up is warranted to better understand the underlying mechanisms and long-term impact of headaches in pediatric MS. Full article

Background and clinical significance: Acute reduction in vigilance is a frequent reason for emergency department admissions, especially among the elderly. While intracranial causes or infections with fluid depletion are often responsible, there remain cases where imaging, laboratory tests, and clinical examination fail to provide a clear diagnosis. Case presentation: A 91-year-old woman was presented to the emergency department with recurrent episodes of somnolence to deep coma. On admission, her vital signs were stable, and cerebral CT imaging revealed no intracranial pathology. Laboratory analyses, including blood gas measurements, were unremarkable. Empirical treatment for possible intoxications with benzodiazepines or opioids using flumazenil and naloxone had no effect. An Addison’s crisis was considered but excluded following methylprednisolone administration without improvement in consciousness. Eventually, an isolated elevation of serum ammonia was identified as the cause of the reduced vigilance. Further investigation linked the hyperammonemia to abnormal intestinal bacterial colonization, likely due to a prior ureteroenterostomy. There was no evidence of liver dysfunction, thus classifying the condition as non-hepatic hyperammonemia. Therapy was initiated with rifaximin, supported by aggressive laxative regimens. Ammonia levels and vital parameters were closely monitored. The patient’s condition improved gradually, with serum ammonia levels returning to normal and cognitive function fully restored. Conclusions: This case highlights an uncommon cause of coma due to non-hepatic hyperammonemia in the absence of liver disease, emphasizing the diagnostic challenge when standard evaluations are inconclusive. It underscores the need for broad differential thinking in emergency settings and the importance of considering rare metabolic disturbances as potential causes of altered mental status. Full article

Although previous studies have shown that parental burnout is a risk factor for adolescents’ development, much remains unknown about the associations between mothers’ parental burnout and adolescents’ aggression as well as the potential mechanisms underlying this relation. To fill these gaps, the current study tested the relationship between mothers’ parental burnout and adolescents’ aggression, as well as the mediating role of maternal rejection and the moderating role of adolescent empathy and gender. A total of 578 Chinese adolescent–mother dyads (for adolescents, 52.42% girls, M_age = 15.30, SD = 1.67; for mothers, M_age = 42.71, SD = 5.49) completed questionnaires regarding mothers’ parental burnout, adolescent aggression, and perceived maternal rejection, as well as empathy. The results showed that mothers’ parental burnout was significantly and positively associated with adolescent aggression and that this relationship was partially mediated by adolescent-perceived maternal rejection. Furthermore, the moderated mediation analysis further revealed that adolescents’ cognitive empathy served as a buffer in the relationship between parental burnout and adolescents’ aggression. In addition, the relation between parental burnout and aggression as well as parental burnout and maternal rejection was stronger for boys. These findings emphasize the need to improve social cognitive abilities in aggression intervention programs. Full article

Amyotrophic lateral sclerosis (ALS) and frontotemporal dementia (FTD) are linked by shared genetic mutations and overlapping clinical features, forming a clinical spectrum. This systematic review and meta-analysis analysed 97 studies, including 3212 patients with key ALS/FTD gene mutations, to identify gene-specific behavioural profiles. Chromosome 9 open reading frame 72 (C9orf72) mutations were strongly associated with psychotic symptoms and aggression, while superoxide dismutase 1 (SOD1) mutations had minimal cognitive effects. Progranulin (PGRN) mutations correlated with apathy and hallucinations, microtubule-associated protein tau (MAPT) mutations with disinhibition, and charged multivesicular body protein 2B (CHMP2B) with social impairments. Fused in sarcoma (FUS) mutations caused early sleep disturbances, TANK-binding kinase 1 (TBK1) led to disinhibition, and presenilin 1 and 2 (PSEN1/2) was linked to severe aggression. Prodromal cognitive changes in PGRN, MAPT, and CHMP2B mutations suggested early disease onset. Despite overlapping symptoms and clinical heterogeneity, understanding gene-specific patterns could inform tailored care strategies to enhance the quality of life for ALS and FTD patients. This study calls for refined guidelines integrating genetic behavioural profiles to improve patient and family support. Full article

Small cell lung cancer (SCLC) is an aggressive form of lung cancer characterized by rapid growth and early metastases. As a neuroendocrine tumour, SCLC is especially notorious for various paraneoplastic syndromes, one of which is a rare neurological syndrome called paraneoplastic limbic encephalitis (PLE) that manifests with amnestic cognitive impairment and seizures. Here, we describe a case of a 53-year-old female who presented with neuropsychiatric symptoms of delusions, hallucinations, and cognitive impairment that started months prior to being diagnosed with extensive-stage SCLC. With no previous neuropsychiatric history, this raised the question of whether her presentation was related to PLE rather than a primary psychiatric condition, as initially diagnosed. Her symptoms improved with chemotherapy and radiation treatment of the underlying cancer, favouring a paraneoplastic etiology. Overall, this case underscores the importance of considering paraneoplastic syndromes in patients presenting with new neuropsychiatric symptoms, as early recognition and treatment can improve prognosis. Full article

The research analyzed the cognitive styles, sexist attitudes and social competencies that hinder gender equality in secondary education students. It identified sexist attitudes, cognitive styles and social skills that hinder change towards gender equality; explored significant differences in sexist attitudes and cognitive strategies and social attitudes by age; studied the relationship between sexist attitudes and cognitive and social strategies that perpetuate gender inequality; and analyzed how age may predict the use of these strategies. A total of 1034 students aged 11 to 18 participated in a cross-sectional study. The Ambivalent Sexism Inventory for Adolescents and the Questionnaire of Attitudes and Cognitive Social Strategies were administered. The results indicate that young people exhibit moderate levels of cognitive and social strategies that hinder the change in sexist behaviors. At ages 12–14, the acceptance of ambivalent and benevolent attitudes such as paternalism and heterosexual intimacy increases. We found greater aggressiveness–stubbornness, apathy–withdrawal, impulsivity, and rigidity of thought at ages 15–17. Age explains a small proportion of the variance in sexist attitudes, cognitive styles, and social competencies that hinder gender equality. The study highlights the need for coeducational measures that ensure equal cognitive and socio-emotional development in women and men. Full article

Adolescents’ pervasive use of social media has been increasingly linked to aggression, including cyberbullying and hostile online interactions. While this association is well documented, the psychological and contextual mechanisms that mediate or moderate it remain unclear. This scoping review maps quantitative evidence on mediators and moderators between social media use and aggression among adolescents. A comprehensive search using ProQuest’s Summon platform was conducted across PsycINFO, Scopus, PubMed, and Web of Science, following the PRISMA 2020 guidelines. Eligible studies, published between January 2020 and March 2025, included adolescents aged 11–18 and reported at least one statistical mediation or moderation analysis. Forty-four studies from 19 countries (N > 90,000) were thematically synthesized. Key mediators included problematic use, moral disengagement, depression, attention-seeking, and risky digital behaviors. Moderators included gender, body satisfaction, cultural setting, school type, and family attachment. Most of the studies used structural equation modeling or PROCESS macro, although cross-sectional designs predominated. Limitations included reliance on self-reports and inconsistent social media measures. The findings suggest that social media–aggression links are indirect and shaped by emotional, cognitive, and ecological factors. Multi-level interventions targeting digital literacy, moral reasoning, and resilience are needed. This review was not registered and received no external funding. Full article

Alzheimer’s disease (AD) is characterized by the progressive loss of cognitive function and is frequently accompanied by neuropsychiatric symptoms (NPS). Pathologically, AD is defined by two hallmark features: the extracellular accumulation of β-amyloid and the intracellular hyperphosphorylation of the tau protein. In addition to these primary changes, several other abnormalities are associated with the disease, including neuroinflammation, synaptic loss, oxidative stress, neurotransmitter imbalance, and genetic and epigenetic alterations. NPS in AD encompass a range of symptoms, such as anxiety, apathy, agitation, depression, and psychosis. These symptoms are thought to arise partly from the damage caused by the pathological hallmarks of AD, which impair various neurotransmitter systems. Altered levels of several neurotransmitters, including gamma-aminobutyric acid (GABA), serotonin (5-HT), dopamine (DA), and the cholinergic and noradrenergic systems, have been implicated in the development of agitation. Additionally, reduced endocannabinoid system (ECS) functionality, particularly cannabinoid receptor 1 (CB1R), has been linked to neurobehavioral alterations. Preclinical studies suggest that a decrease in CB1R levels is associated with aggressive behavior, and CB1R agonists have demonstrated beneficial effects in alleviating agitation and related symptoms. Given these findings, the current review focuses on the therapeutic potential of targeting neurotransmitter systems and CB1R dysfunction to manage agitation in AD. Full article

Background/Objectives: Numerous research studies link the improvement in executive functions and school success. However, there is hardly any research analyzing the transfer of this improvement to behavioral problems. This study analyzed whether improving executive functions, through contextualized daily activities, decreases these behaviors. Methods: Fifty third-year kindergarten students participated, divided into experimental and active control groups, with pre- and post-intervention measurements. The students in the experimental group were trained with the EFE-P program and the students in the control group received regular curriculum activities. The EFE-P program (i) has been designed with the aim of improving their executive functions, using a game-based approach; (ii) not only involves cognitive activities, but also behavioral and emotional activities, related to the warm aspects of executive functions; and (iii) consists of three units (inhibitory control, working memory and cognitive flexibility), with each unit involving 7 sessions (21 sessions in total), with an approximate duration of 30 min each. Results: Analysis of the data using a generalized linear mixed effects model revealed that students in the experimental group scored lower for behavioral problems than those in the active control group and the effect sizes were large for all of them: aggressiveness (d = 1.25); hyperactivity (d = 0.77); attention deficit (d = 1.12); anxiety (d = 0.82); and depression (d = 1.51). Conclusions: After discussing the results, it is concluded that intervention in executive functions induces, by way of distant transfer, a decrease in behavioral problems in preschool; the role of contextualized activities in real situations is emphasized; and several implications for practice and research are discussed. Full article

Youth violence is a pressing social issue. Many well-informed interventions to reduce youth violence fail due to low uptake. Combat sports—such as boxing, judo, and mixed martial arts—appear to encourage aggression, making them appealing to individuals prone to violent behavior. However, rather than reinforcing violence, these sports instill discipline, goal-directed behavior, and self-control. This paper argues that combat sports align with the values of at-risk youth, increasing their participation, while simultaneously teaching them emotional regulation and resilience. I propose that structured combat training provides a sustainable intervention by fostering self-awareness, cognitive control, and respect within a rule-governed environment. Furthermore, training combat instructors in emotion regulation strategies could enhance these benefits. By providing motivation, capability, and opportunity, combat sports present a viable pathway to reducing violent behavior among youth. Full article