Search Results (1,196)

Eye tracking (ET) provides process-level indices of how students sample task-relevant information during core academic activities. In school-age learners (6–18 years) with specific learning disorders (SLDs; dyslexia, dysgraphia, and dyscalculia), ET can complement behavioural assessment by quantifying oculomotor patterns linked to decoding, model–production coordination, and stepwise strategy execution. This narrative review synthesises ET findings in SLD across reading, handwriting/copying, and arithmetic and translates them into an applied framework for school-oriented use. We summarise key metrics and Areas of Interest (AOI)-based analyses, highlight technical and data-quality requirements for valid acquisition in educational settings, and outline compact functional assessment protocols integrated with standard academic and neuropsychological measures. Building on these foundations, we propose six hypothesis-driven gaze-contingent paradigms (H1–H6) as preliminary models for future experimental testing rather than as established interventions, and we map each to its current level of empirical support, specifying primary gaze outcomes and curriculum-relevant behavioural endpoints. We emphasise that eye-movement findings in specific learning disorders are heterogeneous and may vary as a function of age, task demands, and comorbidity. Accordingly, credible training effects require retention and transfer probes under standard, non-contingent display conditions, appropriate controls, and explicit developmental interpretation. Eye tracking is positioned as complementary functional evidence and as a platform for experimentally testable, mechanism-based interventions in school-age specific learning disorders. Full article

Background: Behavioural therapy (BT), including Comprehensive Behavioural Intervention for Tics (CBIT), is an evidence-based first-line treatment for patients with tic disorders. However, access remains limited due to a shortage of trained providers, geographical barriers, costs, and high treatment burden for patients and families. Rapid advances in digital health technologies including telemedicine, web-based treatment platforms, and mobile applications offer new opportunities to expand access to BT for individuals with tic disorders across the lifespan. Methods: For the purpose of this narrative review, we conducted a literature search in PubMed, Europe PMC, and the Cochrane Library to identify relevant studies investigating the effectiveness of digital health treatment approaches in tic disorders. Results: A total of 16 original studies were included. Although the available evidence remains limited and heterogeneous, existing studies suggest that emerging technologies for delivering behavioural interventions for tic disorders, including telehealth-based CBIT, digital therapy platforms, and app-supported habit reversal training (HRT), are feasible, cost-effective, user-friendly, flexible, and safe. These approaches also appear effective for symptom monitoring and personalized treatment support in both pediatric and adult populations. Conclusions: Recent technological advances have the potential to reduce the treatment gap in tic disorders, provided that these approaches are implemented within rigorous, evidence-based, and ethically grounded frameworks. Full article

The progression of chronic bone diseases is intricately linked to dysregulated macrophage polarisation. However, a comprehensive understanding of the complex interplay between macrophage polarisation and metabolic reprogramming in the context of bone disorders remains elusive. Thus, this review conducted a systematic search of major databases, including PubMed, using combinations of keywords such as “macrophage polarisation,” “immunometabolism,” “metabolic reprogramming,” and “chronic bone diseases” (including “osteoporosis,” “osteoarthritis,” and “periodontitis”). Inclusion criteria prioritised original research published within the last five years to capture recent advances. Diverging from previous reviews constrained by the classical M1/M2 dichotomy, this article aims to delineate the heterogeneity and functional plasticity of macrophages within the bone microenvironment, emphasising metabolic reprogramming as a central mechanism driving the dynamic behaviour of macrophages across various skeletal pathologies. Furthermore, this review highlights the pivotal roles of specific metabolites—such as succinate, itaconate, and citrate—within the osseous microenvironment, underscoring their influence on macrophage phenotypic transitions and the regulation of bone metabolic homeostasis. Finally, this article envisages innovative therapeutic strategies targeting the “metabolism–immunity axis,” encompassing the design of nano-delivery systems to modulate macrophage metabolism, the utilisation of engineered extracellular vesicles, the development of immunometabolism-modulating biomaterials, and the exploration of naturally occurring bioactive molecules. Based on these findings, the present work proposes the “metabolism–immunity–skeleton” axis as a theoretical framework, thereby establishing a robust foundation for the development of precision metabolic immunotherapy tailored to a spectrum of chronic bone diseases. Full article

Objectives: This study aimed to assess the validity of aphasic depression and anxiety rating scales (Signs of Depression Scale [SODS], Hospital version of Stroke Aphasic Depression Questionnaire [SADQH-10], Behavioural Outcomes of Ansxiety scale [BOA]) in the local setting and describe clinical outcomes of a local aphasic stroke population. Methods: Records of 236 aphasic stroke patients from an existing database of a proactive post-stroke depression screening service in a tertiary stroke centre in Singapore with rehabilitation facilities met review criteria for having available data for the SODS, SADQH-10 and carer-rated version of BOA (BOA-C). The reference standard was a psychiatrist’s diagnosis of post-stroke mood disorder. Clinical outcomes at 1-year post-stroke were analysed. Results: The areas under the Receiver Operator Characteristic curve (AUC) compared against the psychiatrist’s diagnosis of post-stroke mood disorder were 0.805, 0.844 and 0.780 for the SODS, SADQH-10 and BOA-C respectively. Optimal cut-off scores were found for the SODS (four and above) and SADQH (seven and above), with a sensitivity of 60.00% and 55.56%, respectively, and a specificity of 94.62% and 96.17%, respectively. No appropriate cut-off score was found for the BOA-C. Of the patients, 58.6% were found to have poor outcomes at 1-year post-stroke, and recurrent and haemorrhagic strokes were significant predictors of poor outcomes. Conclusions: The SODS and SADQH-10 are appropriate tools for assessing post-stroke depression in hospitalised aphasic stroke patients in Singapore based on their predictive values and likelihood ratios. The BOA-C has poor validity. At 1-year post-stroke, more than 50% of aphasic stroke patients have poor clinical outcomes not associated with clinician-diagnosed depression status, but predicted by recurrent and haemorrhagic strokes. Full article

Overweight and obesity are prevalent among companion dogs and cats in the Western world. Affected animals are at risk of comorbidities and reduced longevity. This narrative review found that veterinary literature generally characterises overweight and obesity as nutritional disorders that are primarily addressed by reducing caloric intake. However, veterinary management of overweight and obesity has limited success outside research settings. The Five Domains model for animal welfare assessment is applied to explore impacts of overweight and obesity and their management in dogs and cats by focusing on nutrition, health, physical environment, behavioural interactions and mental state. A second focus is on the practical strategies for addressing non-diet-related barriers and client communication through the provision of management recommendations. This novel and integrative approach aims to inform veterinarians and improve the success of weight management protocols. Full article

Background: TNRC6B encodes a core effector of the RNA-induced silencing complex and is essential for miRNA-mediated gene silencing. Pathogenic variants in TNRC6B have recently been associated with a neurodevelopmental disorder characterised by developmental delay, intellectual disability, and behavioural difficulties. Methods: We report a three-generation family with a 22q13.1 deletion encompassing only exons 2–23 of TNRC6B. Clinical data were collected from medical records and family interviews, and the findings were compared with those of published cohorts. Results: Affected individuals presented with developmental delay, speech and language impairment, autism spectrum disorder, ADHD, oppositional defiant disorder, craniosynostosis, joint laxity, clinodactyly, and cardiac valve anomalies. The father and paternal grandmother had learning difficulties and neurobehavioral features, while the proband exhibited a more severe phenotype. Conclusions: This report expands the phenotypic spectrum of TNRC6B-related neurodevelopmental disorder, highlighting craniosynostosis, joint and connective tissue features, and cardiac involvement. Our findings also underscore variable expressivity across generations and emphasise the relevance of both copy-number and sequence variants in TNRC6B in patients with neurodevelopmental disorders. Full article

Background/Objectives: The use of physical and mechanical restraints and seclusion in psychiatric facilities to manage violent and aggressive behaviours has long been a contentious issue, balancing patient safety with ethical considerations. With advancements in psychiatry and increased understanding of mental illness, there have been expectations that such interventions would no longer be required; however, their use persists in clinical practice. Management policies differ across countries and are largely influenced by legal frameworks. This study aimed to identify the factors influencing the incidence of these interventions across two psychiatric facilities in Saudi Arabia and to examine associations among inpatient variables. Methods: A prospective cohort study was conducted over six months (September 2021–March 2022) across two psychiatric facilities in Saudi Arabia (Eradah Complex, n = 1120; King Fahd University Hospital (KFUH), n = 268). Data from 333 restriction events were analysed using descriptive statistics, chi-square tests, and negative binomial regression to calculate incidence rates and explore associated factors. Results: The findings revealed a complex interplay of factors related to patient characteristics and clinical and environmental conditions within the facilities. Key contributing variables included symptom deterioration and the duration of observation required. Longer observation periods were associated with certain diagnoses, particularly schizophrenia and mood disorders. Conclusions: Restraints and seclusion remain influenced by multiple interacting factors within psychiatric settings. These findings highlight the need to reduce their use and ensure they are applied cautiously, with greater emphasis on minimising patient trauma and promoting safer, person-centred care. Full article

Canine Cognitive Dysfunction Syndrome (CCDS) is a progressive neurodegenerative disease affecting older dogs that shares many pathological mechanisms with human Alzheimer’s disease (AD). Although it is common in geriatric dogs, CCDS is often underdiagnosed in veterinary medicine. Both CCDS and AD involve a gradual decline in cognitive functions such as memory, learning and executive abilities. From a pathological perspective, dogs with CCDS show brain changes similar to those seen in AD, including cerebral atrophy, loss of neurons and accumulation of amyloid-beta plaques. CCDS is diagnosed by exclusion, meaning that other medical or neurological conditions that could cause similar behavioural signs must first be ruled out. Clinical evaluation mainly relies on structured questionnaires completed by owners. Magnetic resonance imaging is used to confirm cerebral atrophy and, at the same time, to exclude other brain disorders, such as cerebrovascular accidents and neoplasia. Current research focuses on identifying fluid biomarkers, such as amyloid-beta, neurofilament light chain and glial fibrillary acidic protein, to support an early and objective diagnosis. The most effective management combines pharmacological therapy, targeted nutrition and non-pharmacological strategies, including environmental enrichment and behavioural support. Early intervention, ideally during mild cognitive impairment, is crucial to slow disease progression and maintain quality of life. Full article

Background: Gaucher disease (GD) is a rare lysosomal storage disorder caused by mutations in the GBA1 gene. Traditionally, GD is classified into three subtypes based on the severity of neurological involvement; however, overlapping clinical features increasingly suggest a continuum of phenotypes rather than distinct categories. In this prospective observational cohort study, we conducted a multidisciplinary assessment of patients with GD to identify and monitor neurological, cognitive, auditory, and visual impairments. Materials and Methods: A comprehensive clinical and instrumental evaluation was performed at baseline and repeated at follow-up, with a median interval of 37 months (IQR 36–38). Neurological assessments included physical examination, clinical rating scales, video-EEG, and brain MRI. Cognitive status was assessed using a standardized battery of neuropsychological tests. Detailed audiological and ophthalmological evaluations were also conducted. Paired parametric or non-parametric tests were applied as appropriate, with Bonferroni correction for cognitive outcomes (p < 0.05). Results: Of the 22 patients assessed at baseline, 18 completed the follow-up evaluation. Neurological assessments showed a worsening of subtle parkinsonian signs, with significant increases in Movement Disorder Society–Unified Parkinson’s Disease Rating Scale Part III scores (p = 0.04) and non-motor symptom scores (p = 0.01). Two of the eighteen patients developed epilepsy during follow-up. A high prevalence of sleep disturbances was confirmed, with 27.8% exhibiting excessive daytime sleepiness and 16.7% reporting REM sleep behaviour disorder on standardized questionnaires. Compared with baseline, cognitive assessments revealed a higher proportion of patients with performance below normative population scores in at least one cognitive domain, particularly memory. Sensorineural hearing loss was confirmed in 11 of 15 patients (73.3%) who underwent audiological evaluation, with progressive worsening of audiometric thresholds observed in 7 of 11 (64%). Ophthalmological evaluations showed no changes in visual acuity or OCT findings; however, multifocal electroretinography abnormalities were detected in 12 of 13 patients. Conclusions: Through in-depth phenotyping, this study identifies measurable neurological, cognitive, and sensory progressive changes in patients with GD over time, supporting the value of tailored, multidisciplinary long-term care strategies to monitor and address emerging clinical needs in this rare disease. Full article

Background/Objectives: Schizophrenia is a severe psychiatric disorder frequently characterised by sleep and circadian disturbances, which are closely linked to cognitive dysfunction, symptom exacerbation, and poor functional outcomes. A growing body of evidence implicates the orexin (hypocretin) system—an essential regulator of arousal, sleep–wake stability, metabolic processes, and motivated behaviour—in the pathophysiology and treatment response of psychotic disorders. We aimed to investigate the relationships between the orexinergic system and psychoses. Methods: On 3 March 2026, we searched the PubMed, Scopus, PsycInfo/Articles and Cinahl databases for studies dealing with the orexin system and psychotic disorders and treatment response. Results: We found 20 eligible studies reporting variable and inconsistent alterations in orexin signalling in patients with schizophrenia. Studies were mostly cross-sectional and heterogeneous in design. Antipsychotic medications interfere with orexin-dependent pathways, potentially contributing to both therapeutic effects and adverse outcomes such as sleep disruption and metabolic dysregulation. Conclusions: While evidence from preclinical studies could point to an influence of dopaminergic activity through orexinergic mechanisms, with possible attenuation of antipsychotic-induced motor side effects and improvement of attentional deficits associated with NMDA receptor hypofunction, the utility of dual orexin receptor antagonists (DORAs) in psychoses is unclear. Despite the high prevalence of insomnia in schizophrenia, its pharmacological management remains suboptimal, with current treatments often limited by reduced efficacy or tolerability concerns. DORAs, which are currently approved medications for the treatment of insomnia, represent a novel and mechanistically distinct therapeutic option that may improve sleep while modulating arousal- and cognition-related circuits relevant to psychosis. Full article

Neurodegeneration and cancer are fundamentally distinct disorders: one signifies gradual neuronal loss while the latter signifies uncontrolled cell growth and survival. However, emerging evidence explores an inverse association between these conditions, suggesting that they do not arise from independent biological processes. Understanding the context-dependent behaviour of major pathways (for example, p53, PI3K/AKT/mTOR, Wnt, and immune–stress signaling) remains pivotal in elucidating the relationship between these two diseases. Pathways promoting early-life fitness, tissue repair, and tumor suppression in dividing cells can become detrimental later in life for post-mitotic neurons. Cross-species genomics studies reveal how evolution has repeatedly adapted these shared networks to balance cancer resistance with survival. Research on species exhibiting exceptional longevity and disease resistance, including naked mole rats and bowhead whales, shows that cancer resistance and longevity are not fixed traits but rather are controlled by precise regulatory mechanisms. In this review, we integrate insights from broad species genomics and multi-omic and single-cell studies to understand how evolutionarily conserved molecular crosstalks diverge at the interface of cancer and neurodegeneration. Full article

Background/Objectives: In recent years, the migrant population has been increasing. Migrants are at risk for malnutrition, mental disorders and related health problems. In this study, we aimed to examine the relationships among diet quality, eating behavior, posttraumatic stress disorders and sleep quality in Syrian migrants. Methods: This study included 78 female and 72 male Syrian adult migrants. The participants completed a questionnaire including demographic information, the Pittsburgh Sleep Quality Index, the Posttraumatic Stress Disorder Short Scale, and a three-factor eating questionnaire. For the diet quality calculation, a 24 h retrospective food consumption record was taken. Results: A total of 94.0% of the participants had mild to moderate risk of posttraumatic stress disorder. It was determined that 90.7% of Syrian migrants had low or moderate diet quality. There was a positive correlation between the PTSD score and age (r = 0.244) and the Pittsburgh sleep quality index score (r = 0.244) and between the Pittsburgh sleep quality index score and uncontrolled eating (r = 0.171) (p < 0.05). The probability of impaired sleep quality increased in individuals with PTSD scores in the T2 (11–19 points) (OR: 1.342; 95% CI: 1.073–1.678) and T3 (20–31 points) (OR: 1.485; 95% CI:1.157–1.905) groups, whereas the probability of improved diet quality increased in individuals in the T2 (11–19 points) (OR: 1.042; 95% CI: 1.000–1.086) group. Conclusions: Poor diet quality, risk of posttraumatic stress disorder and poor sleep quality are very common among Syrian migrants. In this respect, evaluating Syrian migrants and taking necessary precautions may help reduce the risk of chronic diseases related to nutrient deficiencies and mental problems. There is a need for policies and programs to manage PTSD among Syrian refugees. Full article

Background/Objectives: Advanced childhood cerebral X-linked adrenoleukodystrophy (cALD) is traditionally regarded as an irreversible terminal phase of neurodegeneration driven by inflammatory demyelination and axonal loss. Experimental evidence indicates that endogenous bioelectrical fields regulate central nervous system organisation, raising the possibility that functional network collapse in cALD may be biologically modifiable, even in the presence of persistent structural damage. This study examined whether longitudinal modulation of endogenous bioelectrical network organisation is associated with sustained clinical and neurophysiological stabilisation in advanced cALD. Methods: We performed a longitudinal observational analysis of two paediatric patients with advanced childhood cerebral X-linked adrenoleukodystrophy undergoing repeated neuroregenerative treatment cycles. Standardised scalp electroencephalography was recorded during spontaneous wakefulness and repeated over months under comparable vigilance conditions. Multimodal analysis included conventional EEG, quantitative EEG, independent component analysis, and standardised low-resolution electromagnetic tomography (sLORETA). Clinical function was assessed using validated measures of consciousness, swallowing, and voluntary motor behaviour. Results: Across patients, longitudinal recordings demonstrated sustained stabilisation of consciousness, swallowing, and voluntary motor function, accompanied by reproducible reorganisation of pathological brain rhythms. Delta and theta oscillations showed a consistent topographical redistribution from limbic–frontoinsular networks towards sensorimotor and parietal integrative cortices. These changes were observed across modalities and timepoints and are unlikely to reflect spontaneous fluctuation, delayed effects of haematopoietic stem cell transplantation, or state-dependent EEG variation. Conclusions: Advanced childhood cerebral X-linked adrenoleukodystrophy is associated with disorganisation of endogenous bioelectrical network activity. In this longitudinal analysis, large-scale network reorganisation was temporally associated with sustained clinical stabilisation, supporting a view of late-stage cALD as a dynamic disorder of network-level vulnerability, rather than a fixed terminal state. Full article

Background: Tuberculosis (TB) remains a major global health challenge, with Mycobacterium tuberculosis (M. tuberculosis) causing significant morbidity and mortality mainly in high-burden countries. Following exposure to M. tuberculosis, individuals may become infected, developing TB infection (TBI) through inhalation of the bacillus: this affects approximately one-fourth of the global population and serves as a critical reservoir for potential disease reactivation and transmission. The risk of being infected with M. tuberculosis is shaped by bacterial load of people with TB, contact patterns, environmental factors, and host susceptibility, particularly in high-risk congregate settings. Elucidating these determinants is instrumental for optimising TB prevention and control strategies. Methods: A preliminary PubMed search was conducted on 25 August 2024, using the keywords “latent tuberculosis infection,” “risk factors,” and “systematic review.” Targeted reviews were then performed in November 2024 to examine factors influencing progression from exposure to M. tuberculosis to TBI. Systematic reviews published between January 2000 and November 2024 were included. Results: The scoping review analysed eight systematic reviews, grouping findings into three key themes: (1) proximity and behavioural risk factors; (2) environmental risk factors; and (3) host immune vulnerabilities. Close contact with people with TB in crowded settings, such as dormitories, healthcare facilities, and prisons, was strongly associated with an elevated risk of TBI. Healthcare workers travelling from low- to high-incidence regions faced the highest risk due to frequent exposure to M. tuberculosis, while military personnel and general travellers had lower risks. Environmental exposures, including second-hand smoke and inadequate ventilation, further heightened susceptibility among children and adults. Host immune risk factors, such as advanced age, low body mass index, lack of BCG vaccination, and metabolic disorders such as diabetes, markedly increase susceptibility to TBI. The interplay between proximity, behavioural and environmental risk factors, and host immune vulnerabilities highlights the multifactorial nature of TBI risk. Conclusion: Effective TBI control demands a multifaceted approach, combining robust infection prevention and control measures, comorbidity management, and mitigation of behavioural risk factors like smoking. Tailored strategies are crucial for high-risk settings such as healthcare facilities and prisons. Multisectoral collaboration is essential to address key risk factors and protect vulnerable populations from progressing to TBI. Full article

Background: Eye-tracking (ET) devices are gaining attention in technology-based paediatric rehabilitation through their intrinsic ability to assess patients’ engagement and visual attention within motivating, technology-based environments. We conducted a systematic review of available evidence from 2004 to 2025 on the implementation of ET in rehabilitative trainings targeting paediatric populations with neurological and neurodevelopmental disorders. This paper aims to outline the rehabilitative outcomes pursued in the clinical populations considered. Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Three electronic databases (PubMed, Web of Science, and Scopus) were consulted to summarise the state of the art of the last 20 years. Selected articles were categorised according to the type of treated disorder and the rehabilitated function. Results: ET devices have been increasingly integrated into paediatric rehabilitation with promising results across multiple neurodevelopmental conditions (e.g., ASD, ADHD, cerebral palsy). These systems have proven effective not only in training gaze control, but also in enhancing executive functions, social cognition, communication, and participation. Furthermore, they promote personalised and data-driven solutions and support high levels of engagement, feasibility, and user satisfaction. Conclusions: ET represents a promising frontier for paediatric rehabilitation, addressing various neurodevelopmental disorders. The gaze-contingent protocols employed have demonstrated potential effects in promoting adaptive behaviour across multiple developmental areas. Further research is warranted to provide shared guidance and to strengthen practice recommendations. Full article