Search Results (873)

Multiple sclerosis (MS), a chronic disease of the central nervous system, is known to cause structural and vascular changes in the retina. Although optical coherence tomography (OCT) and fundus photography can detect retinal thinning and circulatory abnormalities, these findings are not specific to MS. This study explores the potential of Infrared Scanning-Laser-Ophthalmoscopy (IR-SLO) imaging to uncover vascular morphological features that may serve as MS-specific biomarkers. Using an age-matched, subject-wise stratified k-fold cross-validation approach, a deep learning model originally designed for color fundus images was adapted to segment optic disc, optic cup, and retinal vessels in IR-SLO images, achieving Dice coefficients of 91%, 94.5%, and 97%, respectively. This process included tailored pre- and post-processing steps to optimize segmentation accuracy. Subsequently, clinically relevant features were extracted. Statistical analyses followed by SHapley Additive exPlanations (SHAP) identified vessel fractal dimension, vessel density in zones B and C (circular regions extending 0.5–1 and 0.5–2 optic disc diameters from the optic disc margin, respectively), along with vessel intensity and width, as key differentiators between MS patients and healthy controls. These findings suggest that IR-SLO can non-invasively detect retinal vascular biomarkers that may serve as additional or alternative diagnostic markers for MS diagnosis, complementing current invasive procedures. Full article

Among brain regions, the cerebellum (CBL) has traditionally been associated with motor control. However, increasing evidence from connectomics and functional imaging has expanded this view, revealing its involvement in a wide range of cognitive and integrative processes. Despite this emerging relevance, the CBL has received comparatively less attention in aging research, which has focused mainly on other central nervous system (CNS) regions such as the neocortex and hippocampus. This review synthesizes the current evidence on glial cell aging across the CNS, emphasizing how cerebellar circuits follow distinct trajectories in terms of cellular remodeling, transcriptional reprogramming, and structural vulnerability. Recent findings highlight that cerebellar astrocytes and microglia exhibit specific signatures related to aging compared to their cortical counterpart, including moderate reactivity, selective immune response, and spatial reorganization. Cerebellar white matter (WM) undergoes structural alteration, suggesting that oligodendroglial cells may undergo region-specific alterations, particularly within WM tracts, although these aspects remain underexplored. Despite the presence of glial remodeling, the CBL maintains a notable degree of structural and functional integrity during aging. This resilience may be the result of the CBL’s ability to maintain synaptic adaptability and homeostatic balance, supported by its highly organized and compartmentalized architecture. A better understanding of the dynamics of cerebellar glial cells in aging may provide new insight into the mechanisms of brain maintenance and identify potential biomarkers for healthy brain aging. Full article

Background: Cognitive decline is a growing public health concern in Latin America, driven by rapid aging, widespread micronutrient inadequacies, and socioeconomic disparities. Despite the recognized importance of nutrition, many older adults struggle to meet daily dietary micronutrients requirements, increasing the risk of mild cognitive impairment (MCI). This study aimed to establish expert consensus on the role of Multivitamin and Mineral supplements (MVMs) in promoting cognitive healthy aging among older adults in Latin America. Methods: A panel of nine experts in geriatrics, neurology, and nutrition applied a modified Delphi methodology to generate consensus statements. The panel reviewed the literature, engaged in expert discussions, and used structured voting to develop consensus statements. Results: Consensus was reached on 14 statements. Experts agreed that cognitive aging in Latin America is influenced by neurobiological, lifestyle, and socioeconomic factors, including widespread micronutrient inadequacies (vitamins B-complex, C, D, E, and minerals such as zinc, magnesium, chromium, copper, iron and selenium), which were identified as critical for global cognitive function and brain structures, yet commonly inadequate in the elderly. While a balanced diet remains essential, MVMs can be recommended as a complementary strategy to bridge nutritional gaps. Supporting evidence, including the COSMOS-Mind trials, demonstrate that MVM use improves memory and global cognition, and reduces cognitive aging by up to 2 years in older adults. Conclusions: MVMs offer a promising, accessible adjunct for cognitive healthy aging in Latin America’s elderly population, particularly where dietary challenges persist. Region-specific guidelines, public health initiatives, and targeted research are warranted to optimize outcomes and reduce health inequities. Full article

In order to promote healthy aging, it is important to know older people’s perceptions of healthy aging. The aim of this study is to conduct a Turkish validity and reliability study of the Healthy Aging Perception Scale for Older People with Chronic Diseases. This study was conducted between November and December 2023 with older adult people living in a region in eastern Turkey. A total of 210 older people were included in the sample for the exploratory factor analysis and 214 for the confirmatory factor analysis. A Sociodemographic Information Form and Healthy Aging Perception Scale was used to collect the data of the study. The collected data were analyzed using SPSS 27.0 and AMOS 22.0. Confirmatory factor analysis for the 18-item scale, a four-factor structure with an eigenvalue exceeding 1, was obtained, and it was determined that the factor loadings ranged between 0.834 and 0.637 and the total variance explained was 64.619%. The confirmatory factor analysis of the goodness of fit indices was found to be at an acceptable level. CMIN/DF = 2.834, RMSEA = 0.05, CFI = 0.929, TLI = 0.910, NFI = 0.920, and GFI = 0.901. Cronbach’s alpha of the scale was determined to be 0.826, and the test–retest reliability coefficient was determined to be 0.822. Factor analysis showed a better model fit, and it was determined that the Healthy Aging Perception Scale is a valid and reliable measurement tool in determining the perceptions of the healthy aging of older people with chronic diseases. Full article

Affecting over 50% of stroke patients, dysphagia is still challenging to diagnose and manage due to its complex multifactorial nature and can be the result of disruptions in the coordination of cortical and subcortical neural activity as reflected in electroencephalographic (EEG) signal patterns. Sample Entropy (SampEn), a signal complexity or predictability measure, could serve as a tool to identify any abnormalities associated with dysphagia. The present study aimed to identify quantitative dysphagia biomarkers using SampEn from EEG recordings in post-stroke patients. Sample entropy was calculated in the theta, alpha, and beta bands of EEG recordings in a repetitive swallowing task performed by three groups: 22 stroke patients without dysphagia (controls), 36 stroke patients with dysphagia, and 21 healthy age-matched individuals. Post-stroke patients, both with and without dysphagia, exhibited significant differences in SampEn compared to healthy subjects in the alpha and theta bands, suggesting widespread alterations in brain dynamics. These changes likely reflect impairments in sensorimotor integration and cognitive control mechanisms essential for effective swallowing. A significant cluster was identified in the left parietal region during swallowing in the beta band, where dysphagic patients showed higher entropy compared to healthy individuals and controls. This finding suggests altered neural dynamics in a region crucial for sensorimotor integration, potentially reflecting disrupted cortical coordination associated with dysphagia. The precise quantification of these neurophysiological alterations offers a robust and objective biomarker for diagnosing neurogenic dysphagia and monitoring therapeutic interventions by means of EEG, a non-invasive and cost-efficient technique. Full article

Background: Congenital anosmia (CA) is a rare condition characterized by a lifelong inability to perceive odors, which significantly affects daily life and may be linked to broader neurodevelopmental alterations. This study aimed to investigate structural brain differences in patients with CA using MRI, focusing on gray matter (GM) and white matter (WM) changes and their implications for neurodevelopment. Methods: This retrospective study included 28 patients with CA and 28 age- and gender-matched healthy controls. Patients with CA were diagnosed at a single medical center between 1 January 2001 and 30 August 2024. Controls were randomly selected from an imaging database and had no history of olfactory dysfunction. Brain Magnetic Resonance Imaging (MRI)was analyzed using volumetric analysis in SPM12.GM and WM volumes were quantified across 11 anatomical brain regions based on theWFU_PickAtlas toolbox, including frontal, temporal, parietal, occipital, limbic, sub-lobar, cerebellum (anterior/posterior), midbrain, the pons, and the frontal–temporal junction. Left–right hemispheric comparisons were also conducted. Results: Patients with CA exhibited significantly smaller GM volumes compared to healthy controls (560.6 ± 114.7 cc vs. 693.7 ± 96.3 cc, p < 0.001) but larger WM volumes (554.2 ± 75.4 cc vs. 491.1 ± 79.7 cc, p = 0.015). Regionally, GM reductions were observed in the frontal (131.9 ± 33.7 cc vs. 173.7 ± 27.0 cc, p < 0.001), temporal (81.1 ± 18.4 cc vs. 96.5 ± 14.1 cc, p = 0.001), parietal (52.4 ± 15.2 cc vs. 77.2 ± 12.4 cc, p < 0.001), sub-lobar (57.8 ± 9.7 cc vs. 68.2 ± 10.2 cc, p = 0.001), occipital (39.1 ± 13.0 cc vs. 57.8 ± 8.9 cc, p < 0.001), and midbrain (2.0 ± 0.5 cc vs. 2.3 ± 0.4 cc, p = 0.006) regions. Meanwhile, WM increases were notable in the frontal(152.0 ± 19.9 cc vs. 139.2 ± 24.0 cc, p = 0.027), temporal (71.5 ± 11.5 cc vs. 60.8 ± 9.5 cc, p = 0.001), parietal (75.8 ± 12.4 cc vs. 61.9 ± 11.5 cc, p < 0.001), and occipital (58.7 ± 10.3 cc vs. 41.9 ± 7.9 cc, p < 0.001) lobes. A separate analysis of the left and right hemispheres revealed similar patterns of reduced GM and increased WM volumes in patients with CA across both sides. An exception was noted in the right cerebellum-posterior, where patients with CA showed significantly greater WM volume (5.625 ± 1.667 cc vs. 4.666 ± 1.583 cc, p = 0.026). Conclusions: This study demonstrates widespread structural brain differences in individuals with CA, including reduced GM and increased WM volumes across multiple cortical and sub-lobar regions. These findings suggest that congenital olfactory deprivation may impact brain maturation beyond primary olfactory pathways, potentially reflecting altered synaptic pruning and increased myelination during early neurodevelopment. The involvement of the cerebellum further implies potential adaptations beyond motor functions. These structural differences may serve as potential neuroimaging markers for monitoring CA-associated cognitive or emotional comorbidities. Full article

Blue Zones (BZs) are regions across the world associated with exceptional human longevity, where individuals routinely live into their 90s and beyond. These areas share distinct lifestyle and environmental factors that promote healthy aging. The established BZs include Sardinia, Okinawa, Ikaria, and Nicoya, while several “emerging” BZs have been reported in various parts of the globe. This study investigates an area in Sicily for similar longevity patterns. Demographic data from the Italy National Institute of Statistics and local civil registries identify the municipality of Caltabellotta, home to approximately 3000 residents, and the nearby Sicani Mountains as a potential emerging BZ. The area exhibits a significantly higher prevalence of nonagenarians and centenarians compared to national and regional averages. Between 1900 and 1924, the proportion of newborns in Caltabellotta who reached age 90 and above rose from 3.6% to 14%, with 1 out of 166 individuals during this period reaching the age of 100. Historical, dietary, environmental, and sociocultural characteristics align with known BZ traits, including adherence to the Mediterranean diet, physical activity through agrarian routines, strong social cohesion, and minimal environmental pollution. A comparative analysis with the validated Sardinia BZ supports the hypothesis that this Sicilian area may represent an emerging longevity hotspot. Further multidisciplinary investigation is warranted to substantiate these findings. Full article

Background: Spirituality is increasingly seen as a key component of patient-centered care, especially in serious illness or surgery. However, its role among surgical patients in Eastern Europe remains underexplored. Objective: To assess daily spiritual experiences among surgical patients compared to healthy individuals in the Bucovina region (northeastern Romania). Methods: This observational case-control study included 102 participants (51 surgical patients and 51 healthy controls), recruited between March 2023 and April 2024. Participants completed the validated Romanian version of the Daily Spiritual Experiences Scale (DSES). Results: Surgical patients reported significantly higher mean DSES scores (M = 66.27, SD = 16.40) than healthy individuals (M = 55.06, SD = 12.81; p < 0.001). Higher scores were also associated with female gender (p = 0.002), older age, and oncological conditions. Widowed and highly educated participants showed a trend toward higher spirituality, though it was not statistically significant. Conclusions: Surgery may intensify spiritual experiences, possibly as a coping response to perceived risk. Addressing spiritual needs in perioperative care—particularly among women, older adults, and oncology patients—could enhance holistic care and improve patient well-being. Full article

Introduction: Leptospirosis is an under-recognized zoonosis that affects both tropical and temperate regions. While it is often associated with exposure to contaminated water or infected animals, its presentation and epidemiology in Mediterranean countries remain incompletely understood. This retrospective cohort study investigates the clinical and epidemiological profile of leptospirosis in Crete, Greece, a region where data are scarce. Methods: All adult patients with laboratory-confirmed leptospirosis admitted to three major public hospitals in Crete, Greece, between January 2019 and December 2023 were included in the analysis. Diagnosis was made through serologic testing along with compatible clinical symptoms. Results: A total of 17 patients were included. Their median age was 48 years, with a predominance of males (70.6%). Notably, more than half of the patients had no documented exposure to classic risk factors such as rodents or standing water. Clinical presentations were varied but commonly included fever, fatigue, acute kidney injury, and jaundice. Of the patients who underwent imaging, most showed hepatomegaly. The median delay from symptom onset to diagnosis was 11 days, underscoring the diagnostic challenge in non-endemic areas. Ceftriaxone was the most frequently administered antibiotic (76.5%), often in combination with tetracyclines or quinolones. Despite treatment, three patients (17.6%) died, all presenting with severe manifestations such as ARDS, liver failure, or shock. A concerning increase in cases was noted in 2023. Conclusions: Leptospirosis can present with severe and potentially fatal outcomes even in previously healthy individuals and in regions not traditionally considered endemic. The relatively high mortality and disease frequency noted emphasize the importance of maintaining a high index of suspicion. Timely diagnosis and appropriate antimicrobial therapy are essential to improving patient outcomes. Additionally, the need for enhanced public health awareness, diagnostic capacity, and possibly environmental surveillance to control this neglected but impactful disease better, should be emphasized. Full article

Reward processing is a vital function for health and survival and is impaired in various psychiatric and neurological disorders. Using a monetary gambling task, the current study aims to elucidate neural substrates in the reward network underlying the evaluation of win versus loss outcomes and their association with behavioral characteristics, such as impulsivity and task performance, and neuropsychological functioning. Functional MRI was recorded in thirty healthy, male community volunteers (mean age = 27.4 years) while they performed a monetary gambling task in which they bet with either 10 or 50 tokens and received feedback on whether they won or lost the bet amount. Results showed that a set of key brain structures in the reward network, including the putamen, caudate nucleus, superior and inferior parietal lobule, angular gyrus, and Rolandic operculum, had greater blood oxygenation level-dependent (BOLD) signals during win relative to loss trials, and the BOLD signals in most of these regions were highly correlated with one another. Furthermore, exploratory bivariate analyses between these reward-related regions and behavioral and neuropsychological domains showed significant correlations with moderate effect sizes, including (i) negative correlations between non-planning impulsivity and activations in the putamen and caudate regions, (ii) positive correlations between risky bets and right putamen activation, (iii) negative correlations between safer bets and right putamen activation, (iv) a negative correlation between short-term memory capacity and right putamen activity, and (v) a negative correlation between poor planning skills and left inferior occipital cortex activation. These findings contribute to our understanding of the neural underpinnings of monetary reward processing and their relationships to aspects of behavior and cognitive function. Future studies may confirm these findings with larger samples of healthy controls and extend these findings by investigating various clinical groups with impaired reward processing. Full article

Introduction: Gynoid lipodystrophy (GL) affects most women, manifesting itself from puberty to adulthood. Its multifactorial etiology generates controversy in the literature about the most suitable treatment. Several methods are used, from the smallest to the most invasive, in the search for an effective fight against the severity of GL. The positive effect of ultrasound therapy (US) in decreasing subcutaneous adipose tissue is in increasing the skin permeability of pharmacological molecules, and it has aroused interest in the effect of a combination of the two techniques on the severity of GL. However, the results of this technique associated with an exercise program are unknown. Objective(s): To analyze the effect of three sessions of US + 5% caffeine in association with the realization of an exercise program, in females, on the level of severity of GL in the gluteal region and on the posterior proximal third part of the thigh. Methods: A total of 36 healthy women, aged between 18 and 55, who were considered to have GL, were randomly allocated in two experimental groups and one placebo group. The placebo group (PG) performed only physical exercise during the study. Experimental group 1 (EP1) performed US with 5% caffeine alongside a physical exercise protocol and experimental group 2 (EP2) performed US with a conventional US gel alongside a physical exercise protocol. The three groups completed three intervention sessions over 3 weeks, with one session per week. In addition to the level of severity assessed by the Cellulite Several Scale (CSS), anthropometric measures, body composition, and lipid profile of the participants were evaluated. The first assessment was carried out before the intervention (M0) and the last assessment after the three interventions (M1). The results were analyzed using the ANOVA test. The Tukey test was used for multiple comparisons of the groups in all variables, except for those related to the CSS, where the Kruskal–Wallis test was used with a significance level of 0.05. Results: A total of 29 women completed the study. There was a significant decrease inside the PG related to triglycerides (p = 0.012). In M1, all groups started to present median values below 200 mg of triglycerides. In cholesterol, a significant reduction was observed in all groups (p = 0.05). On the gluteal level at 5 cm, there was a decrease in EP1 and EP2 between M0 and M1 with p = 0.006 and p = 0.002, respectively. On the CSS there were no significant differences between groups or between moments. Conclusions: Three sessions of 5% caffeine and US in association with a physical exercise protocol have no effect on reducing the level of severity of GL. Full article

Background/Objectives: Childhood stunting remains a critical public health issue in low- and middle-income countries. Despite Malaysia’s economic growth, there is limited large-scale evidence on the determinants of stunting among children from infancy to primary school age. This cross-sectional study, part of South East Asian Nutrition Surveys II (SEANUTS II), aimed to determine sociodemographic and environmental risk factors for stunting among 2989 children aged 0.5–12 years. Methods: Children were recruited from four regions in Peninsular Malaysia (Central, East Coast, 2022–2030Northern, Southern). Standing height or recumbent length was measured, and stunting was classified based on WHO criteria (height-for-age Z-score below −2 standard deviations). Parents reported information on socioeconomic status, sanitation facilities, and hygiene practices. Multivariate binary logistic regression was used to determine the determinants of stunting. Results: Stunting prevalence was 8.9%, with infants (aOR = 2.92, 95%CI:1.14–7.52) and young children (aOR = 2.92, 95%CI:1.80–4.76) having higher odds than school-aged children. Key biological predictors included low birth weight (aOR = 2.41; 95%CI:1.40–4.13) and maternal height <150 cm (aOR = 2.24; 95%CI:1.36–3.70). Chinese (aOR = 0.56; 95%CI:0.35–0.88) and Indian children (aOR = 0.16; 95%CI:0.05–0.52) had a lower risk of stunting compared to Malays. Conclusions: This study highlights the ongoing challenge of childhood stunting in Malaysia, with age, birth weight, ethnicity, and maternal height identified as key determinants. These findings call for early identification of at-risk households and targeted support, especially through education and financial aid to foster healthy child growth. Full article

Background/Objectives: The glymphatic system plays a crucial role in clearing brain metabolic waste, and its dysfunction has been correlated to various neurological disorders. The Diffusion Tensor Imaging Analysis Along the Perivascular Space (DTI-ALPS) index has been proposed as a non-invasive marker of glymphatic function by measuring diffusivity along perivascular spaces; however, its sensitivity to sleep-related changes in glymphatic activity has not yet been validated. This study aimed to evaluate the feasibility of using the DTI-ALPS index as a quantitative marker of dynamic glymphatic activity during sleep. Methods: Diffusion tensor imaging (DTI) data were obtained from 12 healthy male participants (age = 24.44 ± 2.5 years; Pittsburgh Sleep Quality Index (PSQI) < 5), once while awake and 16 times during sleep, following 24 h sleep deprivation and administration of 10 mg zolpidem. Simultaneous MR-compatible electroencephalography was used to determine whether the subject was asleep or awake. DTI preprocessing included eddy current correction and tensor fitting. The DTI-ALPS index was calculated from nine regions of interest in projection and association areas aligned to standard space. The final analysis included nine participants (age = 24.56 ± 2.74 years; PSQI < 5) who maintained a continuous sleep state for 1 h without awakening. Results: Among nine ROI pairs, three showed significant increases in the DTI-ALPS index during sleep compared to wakefulness (Friedman test; p = 0.027, 0.029, 0.034). These ROIs showed changes at 14, 19, and 25 min after sleep induction, with FDR-corrected p-values of 0.024, 0.018, and 0.018, respectively. Conclusions: This study demonstrated a statistically significant increase in the DTI-ALPS index within 30 min after sleep induction through time-series DTI analysis during wakefulness and sleep, supporting its potential as a biomarker reflecting glymphatic activity. Full article

Background: The ability of Graph Neural Networks (GNNs) to analyse brain structural patterns in various kinds of neurodegenerative diseases, including Parkinson’s disease (PD), has drawn a lot of interest recently. One emerging technique in this field is brain age prediction, which estimates biological age to identify ageing patterns that may serve as biomarkers for such disorders. However, a significant problem with most of the GNNs is their depth, which can lead to issues like oversmoothing and diminishing gradients. Methods: In this study, we propose SAGEFusionNet, a GNN architecture specifically designed to enhance brain age prediction and assess PD-related brain ageing patterns using T1-weighted structural MRI (sMRI). SAGEFusionNet learns important ROIs for brain age prediction by incorporating ROI-aware pooling at every layer to overcome the above challenges. Additionally, it incorporates multi-layer feature fusion to capture multi-scale structural information across the network hierarchy and auxiliary supervision to enhance gradient flow and feature learning at multiple depths. The dataset utilised in this study was sourced from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. It included a total of 580 T1-weighted sMRI scans from healthy individuals. The brain sMRI scans were parcellated into 56 regions of interest (ROIs) using the LPBA40 brain atlas in CAT12. The anatomical graph was constructed based on grey matter (GM) volume features. This graph served as input to the GNN models, along with GM and white matter (WM) volume as node features. All models were trained using 5-fold cross-validation to predict brain age and subsequently tested for performance evaluation. Results: The proposed framework achieved a mean absolute error (MAE) of $4.24\pm 0.38$ years and a mean Pearson’s Correlation Coefficient (PCC) of $0.72\pm 0.03$ during cross-validation. We also used 215 PD patient scans from the Parkinson’s Progression Markers Initiative (PPMI) database to assess the model’s performance and validate it. The initial findings revealed that out of 215 individuals with Parkinson’s disease, 213 showed higher and 2 showed lower predicted brain ages than their actual ages, with a mean MAE of 13.36 years (95% confidence interval: 12.51–14.28). Conclusions: These results suggest that brain age prediction using the proposed method may provide important insights into neurodegenerative diseases. Full article

Background: In rapidly aging societies like Japan, socioeconomic status (SES) plays a critical role in shaping older adults’ health behaviors. Disparities in SES influence access to healthcare, engagement in health-promoting activities, and the adoption of digital health technologies. This narrative review synthesizes current evidence on how SES affects health behaviors among older adults and highlights challenges in promoting equitable and sustainable healthcare in aging populations. Methods: A PubMed search was conducted for English-language articles published up to May 2025 using the keywords “socioeconomic status”, “older adults”, and terms related to health behaviors. Studies were included if they focused on individuals aged 65 or older and examined associations between SES and healthcare use, digital health, complementary and alternative medicine (CAM), supplements, or lifestyle behaviors. Results: A total of 24 articles were identified. Higher SES—typically measured by income, education, and occupation—was consistently associated with an increased use of preventive services, digital health tools, CAM, and healthier lifestyle behaviors such as diet, physical activity, and sleep. In contrast, lower SES was linked to healthcare underuse or overuse, digital exclusion, and less healthy behaviors. Structural and regional disparities often reinforce individual-level SES effects. Comorbidity burden and shifting health perceptions with age may also modify these associations. Conclusions: SES is a key determinant of health behavior in older adults. Policies should focus on redistributive support, digital inclusion, and SES-sensitive health system strategies to reduce disparities and promote healthy aging in super-aged societies. Full article