Search Results (8,714)

Cognitive impairment and memory decline represent major health concerns affecting older adults worldwide, and systemic metabolic dysfunction plays a critical role in their progression. Black lychee is produced from Litchi chinensis Sonn. through postharvest thermal processing. It contains polyphenolic compounds known for their neuroprotective properties. This study investigated the cognitive-enhancing effects of black lychee in a rat model of scopolamine-induced cognitive impairment. Male rats (n = 8 per group) received scopolamine (2 mg/kg, i.p.) alone or in combination with black lychee at 100, 200, or 400 mg/kg/day for 20 days. Untargeted blood metabolites and the phytochemical composition of black lychee were identified using ¹H-NMR spectroscopy. Cognitive performance was assessed using the passive avoidance test. Phytochemical analysis confirmed that black lychee is rich in polyphenols. All black lychee-treated groups showed a significant increase in step-through latency compared with the scopolamine group. Blood metabolomic analysis revealed alterations in 26 metabolic pathways associated with oxidative stress and energy metabolism. These findings suggest that polyphenols in black lychee attenuate scopolamine-induced cognitive impairment by reducing oxidative stress and restoring key metabolites involved in energy metabolism. These results support the potential of black lychee as a functional food for mitigating age-related cognitive decline. Full article

Background/Objectives: Individuals with autism spectrum disorder (ASD) represent a special population whose characteristics may adversely affect both their own and their families’ quality of life. These characteristics include poor oral health, sensory hypersensitivity, restrictive and repetitive behaviours, communication difficulties, medication-related adverse effects, and associated comorbidities. This scoping review aimed to evaluate the oral health-related quality of life (OHRQoL) of children and adolescents with ASD, as perceived by their parents/caregivers, and to identify the factors associated with these outcomes. Methods: Literature searches were conducted in the MEDLINE/PubMed, Scopus, Web of Science, Embase, and Google Scholar databases. Studies published between 2016 and May 2026 were considered for inclusion. Results: Of the 799 records identified, 23 studies met the eligibility criteria. Among these, 15 used the Parental-Caregiver Perceptions Questionnaire (P-CPQ), an instrument specifically developed for children with cognitive impairments. Most studies reported statistically significant associations between poorer OHRQoL and dental caries experience, lower household income, older age, male sex, and lower parental oral health literacy. Conversely, preventive interventions and comprehensive dental rehabilitation performed under general anaesthesia were associated with improvements in the quality of life of both children and their families. Parents of children with ASD also reported a greater emotional burden, primarily related to responsibility for toothbrushing, dental attendance, the child’s general health status, and the family’s financial situation. Conclusions: The majority of the included studies indicate that, according to parental reports, children and adolescents with ASD experience poor OHRQoL, particularly in the domains of emotional well-being, social well-being, functional limitations, and oral symptoms. These findings highlight the need for targeted preventive strategies and multidisciplinary interventions aimed at improving both oral health and overall quality of life in this vulnerable population. Full article

Background: Dementia develops through the combined influence of genetic vulnerability, biological processes, and environmental exposures. The apolipoprotein E (APOE) ε4 allele is a well-known genetic contributor to dementia risk, and growing evidence links gut microbial alterations to cognitive decline and cerebrovascular-related pathology. Nevertheless, studies jointly evaluating genetic, microbiome, and clinical information remain relatively scarce. This study examined an integrated framework combining APOE genotype and gut microbiome data for cross-sectional dementia classification. Methods: We analyzed 292 participants representing three cognitive stages: subjective memory impairment (SMI), mild cognitive impairment, and dementia. Clinical variables, APOE genotype, and gut microbial metagenomic profiles were examined. Associations among genetic risk, Alzheimer’s disease pathology, and brain structural changes were assessed, and multivariable models were used to distinguish participants with dementia from those with SMI or MCI. Results: APOE ε4 carriage was most frequent among participants with dementia, while no ε4 carriers were observed in the SMI group. Gut microbial profiles differed according to the dementia-related genetic-risk category (mild vs. moderate-to-high). The fully integrated model showed a numerically higher cross-validated AUC than models constructed from fewer data domains. Streptococcus, Akkermansia, and Fusicatenibacter were more abundant in the moderate-to-high genetic-risk group; these taxon-level findings were exploratory and based on nominal p-values. Conclusions: The findings support an exploratory integrated framework for cross-sectional dementia classification based on genetic and gut microbiome information. Independent longitudinal and multicenter validation is required before the framework can be interpreted as predicting future dementia risk or supporting personalized clinical decisions. Full article

Background: The interaction between sex, APOE ε4 status, and clinical progression in Alzheimer’s Disease (AD) remains a subject of debate. While females are often considered at higher risk for AD, the underlying structural neuroanatomical trajectories and how they are modulated by genotype are not fully elucidated. This study aims to evaluate how sex and the APOE ε4 genotype interact to influence longitudinal brain atrophy across three clinical groups. Methods: We analyzed longitudinal data from 2400 participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI), stratified by clinical group (i.e., cognitively normal, mild cognitive impairment, and AD), sex, and APOE ε4 carrier status. Using Type III Sum of Squares ANCOVA, we modeled the longitudinal variation in brain volume, controlling for baseline brain volume, and baseline severity of neurocognitive impairment and age at entry. Results: While main effects of sex and APOE genotype were not significant, the triple interaction (APOE * Sex * Clinical Group) was marginally significant (p = 0.051). Post hoc analysis revealed a distinct pattern of structural dimorphism within the AD cohort among APOE ε4-negative individuals with females exhibiting significantly greater structural preservation compared to males (Mean difference = 11.32, p = 0.051). Among APOE ε4 carriers, atrophy trajectories for males and females were statistically indistinguishable (p = 0.922), potentially suggesting that the ε4 allele exerts a dominant neurodegenerative influence that overrides sex-specific physiological differences. Conclusions: These emerging findings highlight the importance of jointly considering biological sex and APOE ε4 status to improve the characterization of Alzheimer’s disease heterogeneity and support precision medicine approaches. Full article

Alzheimer’s disease (AD) extends beyond the brain to the visual system, offering a promising window for pathology, monitoring, and intervention. This review synthesizes evidence on AD-related visual impairments across molecular, cellular, circuit, and cortical levels. We examine the eye–brain pathological relationship as a working framework, noting experimental evidence for brain-to-eye amyloid-β (Aβ) transport in mouse models and associations between retinal and cerebral pathology in humans, while emphasizing that bidirectional pathological transport has not been established. Structural and functional changes in the retina, optic nerve, and visual cortex are reviewed, alongside white matter damage and posterior cortical atrophy patterns. We evaluate emerging multimodal tools (OCTA, ERG, and hyperspectral imaging) that shift diagnosis toward an integrated “structure–vessel–function” assessment. We critically examine non-pharmacological interventions, including 40 Hz gamma stimulation and photobiomodulation, discussing their mechanisms, translational challenges, and the dissociation between structural and cognitive outcomes. We propose the visual system as a candidate pathological window, a quantitative monitoring platform, and an investigational intervention entry point in Alzheimer’s disease. However, clinical translation of these applications requires standardized acquisition protocols, prospective longitudinal validation, and robust mechanistic evidence. To advance this agenda, we identify three priorities: multimodal data integration, closed-loop neuromodulation strategies, and methodologically rigorous validation frameworks. Full article

Gambling disorder (GD) is associated with severe psychosocial impairment, impulsive dyscontrol, affective instability, and increased suicidal risk. Pharmacological options remain limited, particularly for patients whose presentation is dominated by transdiagnostic dimensions such as impulsivity, emotional dysregulation, and suicidal vulnerability. Lithium may be relevant because of its anti-suicidal properties and potential effects on affective instability and behavioral dyscontrol. We describe a 40-year-old man with sports-betting-related GD who presented after a suicidal crisis in the context of financial collapse and marital conflict. He entered a structured multimodal program including psychiatric care, lithium carbonate, individual psychotherapy, psychoeducational and self-help groups, family intervention, and social support. During multimodal treatment, which included lithium carbonate titrated to 600 mg/day, the patient was observed to show progressive affective stabilization, remission of suicidal ideation, reduced gambling urges, and sustained abstinence, with one brief lapse that was rapidly contained. Psychometric reassessment showed selective improvement across gambling-related and functional domains, including reduced functional impairment and markedly reduced gambling-related cognitive distortions; however, global psychopathological distress remained substantially stable, and the GPQ subtype shift was interpreted only descriptively. Although causal inference is limited by the single-case design and multimodal treatment context, this case raises the hypothesis that lithium may have contributed, within a multimodal intervention, to the stabilization of core vulnerability dimensions in selected GD presentations, particularly impulsivity, affective dysregulation, and suicidality. Full article

Dementia is a growing global health challenge, yet many determinants of late-life cognitive decline emerge decades before symptoms appear. Midlife is a practical window for prevention because hypertension, diabetes, obesity, dyslipidemia, smoking, physical inactivity, unhealthy diet, sleep disturbance, and social isolation can be identified and modified before substantial brain injury becomes apparent. This narrative review synthesizes evidence linking midlife vascular and lifestyle exposures to late-life cognitive impairment and dementia. The most consistent data support a life-course model in which cumulative vascular, metabolic, inflammatory, and behavioral risks interact with neurodegenerative pathology and cognitive reserve. Vascular and metabolic factors act largely through small-vessel disease, endothelial dysfunction, and inflammation, whereas physical activity, healthy diet, sleep, and social engagement may strengthen resilience. Although observational evidence is vulnerable to confounding and single-risk trials may underestimate cumulative benefit, multidomain prevention remains biologically plausible and clinically actionable, as recent trials reaffirm. These priorities are especially salient in the rapidly transitioning Gulf Cooperation Council (GCC) countries, where midlife cardiometabolic risk is high and local evidence is limited. Dementia prevention should be embedded in routine midlife care, with vascular risk management and sustained lifestyle support treated as core elements of lifelong brain health. Full article

Background/Objectives: Multiple sclerosis (MS) is frequently accompanied by cognitive impairment, yet the neurobiological mechanisms underlying cognitive heterogeneity remain incompletely understood. The choroid plexus (CP), a blood–CSF barrier structure involved in cerebrospinal fluid production and neuroimmune signaling, has recently emerged as a potential MRI marker of inflammatory and neurodegenerative activity in MS. This scoping review mapped evidence on associations between CP features and cognitive functions in adults with MS. Methods: A broad search of PubMed, Scopus, Web of Science Core Collection, and the Cochrane Library identified 1163 records; after deduplication, screening, and full-text assessment, seven studies were included. Results: CP volume or normalized CP volume was assessed in all seven studies, and one study additionally examined the CP T1/T2 ratio. The Symbol Digit Modalities Test was used in six studies, while five applied multidomain cognitive assessment. Larger CP volume was associated in several studies with poorer baseline information-processing speed, visuospatial memory, or multidomain cognition, but longitudinal findings did not show consistent predictive value for CP volume. One study reported that a higher CP T1/T2 ratio predicted faster visuospatial-memory decline. Conclusions: CP-related measures may reflect broader neuroinflammatory and neurodegenerative processes relevant to cognition in MS, but the evidence remains limited and methodologically heterogeneous. Standardized acquisition and segmentation, harmonized cognitive assessment, and adequately powered longitudinal studies are needed to establish their independent and predictive value. Full article

Autism spectrum disorder (ASD) is characterized by persistent impairments in social communication together with restricted and repetitive patterns of behavior. Although ASD has traditionally been viewed primarily as a disorder of neural circuitry, increasing evidence indicates that interactions between the immune and nervous systems contribute substantially to brain development and cognitive function. This review develops a neuroimmune–cognitive–account of ASD by examining how immune signaling may influence neural organization and, in turn, cognitive function. Evidence from neuroimmunology, systems neuroscience, and experimental studies of neuromodulation is synthesized to examine relationships among immune signaling, neural network organization, and cognition. Disturbances in these processes have been associated with alterations in excitation–inhibition –balance and atypical large-scale connectivity, especially within networks supporting social cognition. We also examine the role of neuromodulatory systems, with particular emphasis on oxytocin and vasopressin, as intermediaries between biological regulation and cognitive processing. Experimental findings indicate that oxytocin can transiently modulate activity within social brain networks and increase the salience of socially relevant stimuli, although effects across clinical studies remain modest and inconsistent. The reviewed evidence suggests that disturbances in neuroimmune regulation may contribute to altered communication among distributed neural systems, providing one possible account of cognitive dysfunction in ASD. Social deficits, repetitive behaviors, and sensory differences reflect disturbances in the coordination of distributed neural systems rather than isolated impairments within single regions or pathways. This view has important implications for intervention, suggesting that approaches directed at individual molecular or neural targets alone are unlikely to produce broad or lasting effects. More effective strategies may require interventions that address interactions among immune function, neural dynamics, and cognitive processes. The resulting neuroimmune–cognitive account generates testable hypotheses concerning how immune processes may influence neural organization and cognition in ASD while providing a conceptual basis for future experimental and clinical research. Full article

A marked reduction in estrogen levels during perimenopause substantially elevates the risk of Alzheimer’s disease (AD) and cognitive dysfunction in women. While the endocrine etiology is well established, applying this understanding to effective clinical prevention remains difficult. Recent findings of diminished cerebral glucose metabolism and lower mitochondrial cytochrome oxidase activity in menopausal women have shifted research attention toward mitochondrial homeostasis disruption and neuroimmune–inflammatory network imbalance as central mechanisms underlying menopausal cognitive decline. This article examines the characteristics and underlying mechanisms of mitochondrial and immune imbalances induced by estrogen withdrawal during menopause. Estrogen deficiency is shown to disrupt mitochondrial–immune homeostasis, particularly via ERβ-mediated mitochondrial oxidative phosphorylation system (OXPHOS) dysfunction and subsequent excessive activation of the NLRP3 inflammasome. The analysis further addresses enhanced inflammatory signaling resulting from excessive reactive oxygen species generation and mitochondrial DNA (mtDNA) release, as well as reduced synaptic plasticity due to impaired neurotransmitter synthesis and an inflammatory microenvironment. Additionally, the dysregulation of the estrogen-neuromodulatory system in menopausal cognitive decline is investigated. Recent studies demonstrate that intervention strategies targeting estrogen receptors, especially selective ERβ agonists, possess significant neuroprotective potential. Future approaches should incorporate biomarkers, including neuroimaging and genetic polymorphisms, to facilitate risk-stratified and individualized precision medicine. This integration may enhance the prevention or delay of menopause-associated cognitive decline in women. Full article

Background: White Matter Hyperintensities (WMH) are common MRI markers of cerebral small-vessel disease and are associated with cognitive impairment and dementia. Deep Learning (DL) tools have improved WMH segmentation, enabling faster and more reproducible lesion quantification. However, the lack of normative reference frameworks limits the clinical and translational use of WMH volumes. Aims: to develop and validate normative reference curves for automated WMH quantification and to define clinically useful thresholds for rule-out and rule-in interpretation in memory-clinic settings. Methods: We developed age- and sex-adjusted WMH normative models for 2D (n = 788) and 3D (n = 895) FLAIR acquisitions in cognitively normal individuals aged 40–95 years. WMH volumes were segmented using LST-AI and normalized to total intracranial volume. Normative percentiles were derived using Generalized Additive Models for Location, Scale and Shape (GAMLSS) with a Johnson’s SU distribution and externally validated in 458 individuals spanning cognitively normal (CN), mild cognitive impairment (MCI), and dementia groups from two validation cohorts. Normative distributions have been made available through neuGRID, an online platform providing AI-based tools for neuroimaging analysis. Results: WMH burden increased progressively with age in both normative datasets and showed a stepwise increase across the cognitive continuum from CN to MCI and dementia. The optimal balanced thresholds corresponded to the 92nd percentile for the 2D model and the 85th percentile for the 3D model, yielding areas under the receiver operating characteristic curve (ROC-AUCs) of 0.71 (95% CI: 0.63–0.78) and 0.68 (95% CI: 0.61–0.74), respectively. Secondary threshold analyses highlighted complementary operating characteristics, with the 2D model favoring sensitivity and the 3D model favoring specificity, supporting their potential use in sequential diagnostic workflows. Conclusion: This study provides an externally validated normative framework for interpreting LST-AI-derived WMH burden through the neuGRID single-case service. The proposed modality-specific norms enable standardized identification and contextualization of elevated WMH burden and may support clinical stratification, second-opinion assessment, and research applications in cognitive disorders. Full article

Background: With the rising demand for fast and reliable diagnosis the radiology departments struggle to keep up. In Slovakia however it is difficult to find more employees for radiology clinics and departments, therefore the employees are ever more overburdened, which may lead to burnout. Objective: The aim of our study was to assess the burnout situation among radiology clinics and departments employees and asses the specific causes that increase the risk of burnout. Compare the burnout profile of radiologists and technicians. And look for potential targets for intervention in order to stabilize and improve the situation. Methods: Standardized Burnout assessment tool (BAT), validated in Slovak and an author-developed exploratory instrument were distributed among employees of ten hospitals in Slovakia. Convenience sampling was used in ten radiology clinics and departments in big, small and specialized hospitals. The entire questionnaire consisted of 55 questions. The received responses were processed statistically and correlations were analyzed. Results: There have been 213 questionnaires distributed and 105 complete and valid responses received. 26 respondents (24.76%) had an overall BAT score at or above 3.02 and can be considered at risk of burnout. The dominants dimensions of burnout in our set were exhaustion (3.06) and cognitive impairment (2.76). The highest score in the author-developed exploratory instrument was in visual exhaustion of radiologists (3.78). In the group of workers with 5 or more 24 shifts monthly mental distance is elevated (3.05). Burnout profiles in equal groups (N = 46) of radiologists and radiology technicians were compared with significantly higher levels of cognitive impairment found in radiologist. Conclusions: In our study 24.76% of respondents can be considered in risk of burnout, with highest scores in exhaustion and cognitive impairment dimensions, emotional impairment was relatively lower. Cognitive impairment seems to be more prevalent among radiologist compared to radiology technicians. Higher number of 24-h shifts was associated with higher mental distance scores. The highest Likert scale scores in the author developed exploratory instrument are in visual exhaustion, professional isolation and the feeling of anonymous service. Full article

(1) Background/Objectives: Sarcopenia is common in older surgical candidates and may affect perioperative risk and recovery after total hip arthroplasty (THA). Quantifying its burden and severity gradient in THA pathways can inform surgeon-led optimization. (2) Methods: A cross-sectional analysis of baseline preoperative data at a tertiary center (December 2019 to December 2022) was conducted. Consecutive adults with hip osteoarthritis undergoing primary THA were screened. Sarcopenia was staged per EWGSOP2: probable (low handgrip), confirmed (probable and low skeletal muscle index by whole-body DXA), and severe (confirmed and low gait speed). (3) Results: Of 312 screened patients, 203 completed baseline assessment (95 men, 108 women). According to the EWGSOP2 algorithm, 57 patients (28.1%; 95% CI 22.3–34.6%) had low handgrip strength, 30 (14.8%; 95% CI 10.6–20.3%) fulfilled criteria for confirmed sarcopenia, and 21 (10.3%; 95% CI 6.9–15.3%) had severe sarcopenia. No significant association was observed for sex. Sarcopenia diagnosis was associated with older age, lower body mass index (BMI), higher comorbidity burden, lower functional independence, greater cognitive impairment, poorer mental health, and worse hip-related function (all p < 0.05). In multivariable analysis, older age (OR 1.51 per 5-year increase; 95% CI 1.11–2.12), lower BMI (OR 0.88 per kg/m²; 95% CI 0.79–0.98), and lower functional independence (Barthel Index: OR 2.02 per 10-point decrease; 95% CI 1.20–3.60) were independently associated with confirmed sarcopenia. Across EWGSOP2 categories, differences in age, BMI, pain, comorbidity, functional independence, cognition, mental health and hip function showed significant differences (all p < 0.05), with ordered trends in most domains but no uniform monotonic pattern. (4) Conclusions: In THA candidates, sarcopenia is prevalent and is related to older age, lower BMI and lower functional independence. Integrating sarcopenia screening by EWGSOP2 may help to identify THA candidates with greater clinical vulnerability who may warrant further preoperative assessment and targeted optimization strategies. Full article

Accurate estimation of Alzheimer’s disease (AD) severity from structural magnetic resonance imaging (MRI) remains difficult, as disease-associated anatomical alterations are often subtle and publicly available datasets are typically too small to support robust deep learning model training. This feasibility study sought to determine how much Alzheimer’s disease spectrum-related information could be extracted from a small structural MRI cohort using a deliberately lightweight two-dimensional convolutional neural network (2D CNN), and whether transfer learning improves model performance. This study was intended as a methodological proof of concept rather than the development of a clinically deployable diagnostic tool. Structural scans and Clinical Dementia Rating (CDR) labels from the OASIS-1 dataset were filtered to 214 subjects: 124 cognitively normal (CN), 65 with mild cognitive impairment (MCI; CDR = 0.5), and 25 with AD-level impairment (CDR ≥ 1). A compact 2D CNN trained from scratch and a transfer learning model (frozen ImageNet MobileNetV2 features) were evaluated on four binary tasks (CN vs. AD, MCI vs. AD, CN vs. MCI, and CN vs. any impairment) under identical pre-processing and subject-level repeated 5-fold cross-validation (10 repeats), with the decision threshold tuned only on an inner split. Discrimination was summarized by ROC-AUC with 95% confidence intervals (CIs), permutation tests against chance, and per-task sensitivity and specificity. The from-scratch CNN recovered only a broad normal-versus-impaired signal (CN vs. any impairment AUC 0.59) and was at chance on adjacent-stage tasks (MCI vs. AD 0.41; CN vs. MCI 0.51). Transfer learning improved every task: CN vs. AD AUC 0.745 (95% CI 0.730–0.763), CN vs. any impairment 0.642, CN vs. MCI 0.601, and MCI vs. AD 0.599. On an independent OASIS-2 cohort, the transfer learning CN vs. AD model retained AUC 0.748. In this small-data regime, transfer learning recovers substantially more Alzheimer-spectrum signals than a from-scratch CNN, but performance remains modest because it is bounded by CDR-based, non-biomarker-confirmed labels, suggesting the model separates CDR-defined cognitive-status groups rather than detecting AD pathology. Full article