Search Results (217)

Background/Objectives: Preterm infants often experience impaired swallowing function, and objective assessments for this population remain limited. In this prospective single-center study, we aimed to propose and validate an automated framework that quantitatively assesses neonatal sucking behavior by tracking facial key points in bottle feeding videos. Methods: Fifty-eight preterm infants (corrected age [CA] ≤ 2 months) were enrolled, and 2 min videos of bottle-feeding were recorded. Certified therapists manually evaluated the videos using the Neonatal Oral Motor Assessment Scale (NOMAS), and an artificial intelligence (AI)-based analysis classified the videos into the following three groups: Normal, Disorganization, and Dysfunction. At 12 months CA, developmental outcomes were assessed using the Mental Development Index (MDI) and the Psychomotor Development Index (PDI) of the Bayley Scales of Infant Development, Second Edition (BSID-II). Results: Among the 58 infants, the AI-based tool correctly classified 47 and misclassified 11. The classification accuracy was 82.76 for the Normal group, 82.76 for Disorganization, and 96.55 for Dysfunction. The mean PDI was lower in the Dysfunction group than in other groups; however, the differences were not statistically significant. Conclusions: This novel AI-based video analysis demonstrates preliminary potential as a noninvasive tool for evaluating sucking behavior in preterm infants, potentially enabling early identification of dysphagia even by non-specialists in the neonatal intensive care unit (NICU) without hazard exposure. This feasibility study demonstrates preliminary technical viability of a video-based framework for neonatal sucking behavior assessment; however, further validation is required before clinical implementation. Full article

Background: Mild traumatic brain injury (mTBI) is frequently associated with persistent cognitive and psychosocial symptoms, yet biological correlates of recovery remain poorly understood, particularly among Asian and Pacific Islander (API) populations. Pre-injury psychosocial adversity may further shape post-injury recovery trajectories. This pilot study examined associations between participation in a 2-week, home-based, dual-task cognitive–walking intervention (Daily Brain Exercise; DBE) and changes in cognitive, psychological, and salivary microRNA (miRNAs) measures among APIs with and without a self-reported history of mTBI. Methods: API participants completed remote cognitive testing (CNS Vital Signs), psychosocial assessments (Neuro-QoL), and saliva collection before and after DBE participation. Salivary RNA was purified, and miRNA expression was profiled using nCounter^® Human v3 miRNA Expression Panels (NanoString). Differential expression analyses were conducted using ROSALIND^® platform (OnRamp Bioinformatics, San Diego, CA, USA), a cloud-based bioinformatics analysis system, to calculate fold changes and p-values. Pre-injury psychosocial adversity was assessed via the Trauma History Screen and examined descriptively as a contextual modifier of functional outcomes. Results: Twenty-one APIs (mean age 22.9 years; 76.7% female) were enrolled, including 14 individuals with a self-reported history of mTBI (mean 4.64 years post-injury; 50% with multiple injuries). Following DBE participation, increases in cognitive flexibility and executive function scores were observed in both mTBI and control groups. Additional increases in psychomotor speed, processing speed, sleep disturbance, and depressive symptoms were observed descriptively within the mTBI group. Subgroup analyses suggested variability in pre–post patterns across combinations of mTBI history and pre-injury psychosocial adversity. Exploratory miRNA analyses identified seven miRNAs that were differentially expressed in the mTBI group following DBE (unadjusted p < 0.005), including hsa-miR-7-5p, previously reported in association with neurodevelopmental and neurological pathways. Conclusions: In this pilot, feasibility-focused study, participation in a brief, home-based, dual-task intervention was associated with descriptive changes in selected cognitive and psychosocial measures among APIs, particularly those with a history of mTBI and pre-injury adversity. The observed subgroup patterns warrant confirmation in adequately powered, controlled studies. Exploratory changes in salivary miRNAs co-occurred with functional improvements, thus generating a hypothesis for a future investigation. Full article

Background/Objectives: Adolescence is a critical period for executive function (EF) maturation. While sleep and physical activity (PA) are key lifestyle factors, their longitudinal impact on EF in ecologically valid settings is insufficiently characterised. This study examined the associations between objectively measured sleep duration, daily steps, and EF performance across one academic year (~9 months). Methods: A longitudinal study was conducted with 168 Spanish adolescents (13–16 years). Sleep duration and daily steps were monitored using Fitbit Charge 6 wearables for 7-day periods at baseline (M1; September 2024) and follow-up (M2; June 2025). EFs were assessed using three validated tasks: Stroop (inhibitory control), Psychomotor Vigilance Task-Brief (PVT-B; sustained attention), and Paced Auditory Serial Addition Test (PASAT; working memory). Linear Mixed Models (LMM) were employed to analyse the effects of the fixed factors (i.e., Group and Time), and their interactions. Results: PA, but not sleep duration, significantly predicted executive performance. The High_PA group demonstrated faster reaction times in inhibitory control (p = 0.007) and significantly fewer attentional lapses in sustained attention (p = 0.014). In contrast, sleep duration showed no significant main effects on EF domains (p > 0.05). Regression analyses confirmed that higher daily steps predicted faster reaction times in inhibitory control in the total sample (r = −0.173, p = 0.002), although an unexpected positive association was observed in the Low_PA group for inhibitory control, warranting cautious interpretation. Conclusions: These findings suggest that habitual PA is associated with better EF performance in adolescents, whereas sleep duration alone (without considering timing or variability) showed no significant associations with cognitive outcomes. Sensitivity analyses using clinically informed thresholds and continuous standardised predictors confirmed the robustness of these findings. Full article

Parkinson disease (PD) and mood disorders represent two substantial global health burdens that increasingly co-occur as both conditions rise in prevalence worldwide. Diagnosing Parkinson disease in patients with pre-existing mood disorders is clinically challenging due to overlapping symptoms, medication effects, and shared neurobiological mechanisms. Apathy, psychomotor slowing, and fatigue may mimic depressive symptoms, leading to delayed recognition of early parkinsonism. Development of an underlying neurodegenerative disorder could account for some treatment-resistant symptoms or treatment failures if not recognized. Therefore, the identification of PD will change the treatment and management plan significantly. Accurate diagnosis of PD requires a detailed neurologic examination focusing on bradykinesia, rigidity, and resting tremor, supported when appropriate by dopamine transporter imaging (DaT scan) or other emerging biomarkers. Understanding the temporal relationship between psychiatric and motor features helps differentiate prodromal PD from primary mood disorders. Management of patients with both mood disorders and PD integrates dopaminergic replacement therapy for motor symptoms with individualized treatment of psychiatric comorbidities. Levodopa remains the cornerstone for motor control, while dopamine agonists, MAO-B inhibitors, and COMT inhibitors can be added as needed. For depression and anxiety, SSRIs and SNRIs are first-line choices; quetiapine or clozapine are preferred when treatment for psychosis is necessary. Intentional, thoughtful polypharmacy is frequently required. Non-pharmacologic interventions—including cognitive behavioral therapy, structured exercise, and patient–caregiver education—enhance mood, function, and quality of life. Multidisciplinary collaboration between neurology, psychiatry, and allied health professionals is essential for optimal outcomes. This review offers guidance to healthcare providers as well as other interested parties involved in patients with mood disorders who may also be developing or have PD, especially to those who may have limited access to neurologic resources. Full article

Background: Deprivation of sleep (DS) might affect mood and cognitive abilities, including psychomotor functions (PF). Molecular mechanisms underlying these effects remain unclear, though studies suggest that the circadian rhythm plays a role. Methods: Seventy participants underwent polysomnography (PSG) and DS. PF was evaluated using Bimanual Eye–Hand Coordination Test (BEHCT). Mood, PF, and clock gene expression (Circadian Locomotor Output Cycles Kaput (CLOCK), Brain and Muscle ARNT-Like 1 (BMAL1), Period Circadian Regulator 1 (PER1), Cryptochrome Circadian Regulator 1 (CRY1), Nuclear Receptor Subfamily 1 Group D Member 1 (NR1D1), and Neuronal PAS Domain Protein 2 (NPAS2)) were analyzed post-PSG and post-DS. Mood changes after DS classified participants as responders (RE) or non-responders (NR). Results: In NRs, but not REs, the BEHCT error count positively correlated with the expression of BMAL1, CRY1, PER1, NR1D1 (R = 0.60, p = 0.002; R = 0.49, p = 0.018; R = 0.57, p = 0.023; and R = 0.53, p = 0.011, respectively), with PER1 explaining its variability in 57.8% (b = 0.174, R² = 0.578, F = 20.144, and p < 0.001). Conclusions: Obtained results suggest that altered clock gene expression may contribute to individual differences in mood and PF following DS. Full article

Background: Manual dexterity (MD) impairment is a frequent and disabling feature in patients with Parkinson’s disease (PD) and paranoid schizophrenia (PS), significantly affecting functional independence and activities of daily living. However, rehabilitation strategies specifically targeting fine motor control remain insufficiently integrated into routine physiotherapy (PT). Objective: This study investigated the effects of a structured, progressive PT program incorporating targeted MD training on upper limb function in patients with PD and PS. Methods: A prospective, exploratory, interventional study was conducted in 30 patients, allocated to either an experimental group (EG, n = 20) or a control group (CG, n = 10). Participants had PD (Hoehn and Yahr stages II–III) or chronic, clinically stable PS. MD was assessed using the Purdue Pegboard Test, Coin Rotation Task, and Kapandji opposition score. The EG completed a four-phase, 40-week dexterity-oriented rehabilitation program, while the CG received standard disease-specific PT. Between-group differences in change scores were analyzed using one-way ANOVA. Results: The EG showed significantly greater improvements than the CG in thumb opposition, psychomotor processing speed, and unilateral and bilateral fine motor performance (p < 0.001 for all), with large to very large effect sizes (η² = 0.45–0.76). No significant between-group differences were observed for complex sequential assembly tasks. Conclusions: Integrating targeted MD training into structured PT programs significantly improves fine motor performance in patients with PD and PS, supporting its inclusion in rehabilitation protocols for residential and outpatient care settings. Full article

Background/Objectives: Intracranial arachnoid cysts (Acs) are congenital, usually benign lesions that are frequently regarded as clinically silent in adulthood. Nonetheless, growing evidence indicates that Acs may be associated with subtle but measurable cognitive dysfunction. This systematic review synthesizes neuropsychological and functional neuroimaging findings in adults with intracranial Acs, with a focus on cognitive profiles, functional interactions with the adjacent cortex, and postoperative reversibility. Methods: In accordance with PRISMA 2020 guidelines, MEDLINE/PubMed and Scopus were searched for English-language studies published up to 2023 that reported neuropsychological assessments and/or functional neuroimaging in adult patients with Acs, including single-case reports, case series, and group studies with pre- and post-operative data. Results: Sixty studies met the inclusion criteria. Across anatomical locations, Acs were most consistently associated with impairments in verbal and visual memory and learning, attention, and executive functions, as well as reduced processing or psychomotor speed, whereas language deficits were less consistently observed. Several studies reported postoperative improvement in one or more cognitive domains, suggesting partial reversibility in selected patients. Functional neuroimaging findings revealed altered cortical function in regions adjacent to the cyst, including reduced regional metabolism or cerebral blood flow and task-related activation changes, supporting a functional interaction between Acs and the neighboring cortex. Conclusions: Overall, adults with Acs may exhibit subtle cognitive alterations that vary according to cyst location and appear to be moderated by compensatory mechanisms. These findings underscore the clinical relevance of systematic neuropsychological evaluation and highlight the need for prospective, standardized studies integrating cognitive and neuroimaging outcomes. Full article

Background/Objectives: Chronic psychomotor and cognitive slowing after stroke can persist despite standard rehabilitation, especially in young adults with subcortical injuries. Innovative, integrated interventions are crucial for patients who have reached a plateau in their rehabilitation. We present a case of a 41-year-old male with chronic psychomotor and cognitive slowing following a left lenticulostriate infarction (NIHSS score = 5 at onset), who had plateaued after conventional rehabilitation. Methods: Over 4 weeks the patient underwent 20 sessions of a multimodal approach including high-frequency repetitive transcranial magnetic resonance stimulation over the supplementary motor area and bilateral temporo-parietal junctions and simultaneous computerized cognitive training targeting attention and executive function. Both motor and cognitive assessments, along with quantitative EEG (qEEG) evaluations, were conducted before and after the treatment. Results: At the end of treatment, the patient showed significant clinical improvement: speed and coordination in upper extremities (Finger Tapping Test) increased by 66% (dominant hand) and 74% (non-dominant hand), while finger dexterity (Nine-Hole Peg Test) increased by 25% (dominant hand) and 19% (non-dominant hand). Cognitive scores improved in alertness (58%), visual exploration (25%), and flexibility (24%), while divided attention remained stable. qEEG investigation showed increases in alpha (79%), gamma (33%), and beta (10%) power, with topographic shifts in the stimulated regions. Conclusions: These findings highlight the feasibility of combining targeted rTMS and cognitive training to enhance neuroplasticity in the chronic phase of stroke. Clinical recovery was accompanied by normalized cortical rhythms, suggesting qEEG biomarkers may be useful for tracking treatment response. Multimodal precision neurorehabilitation may offer a path forward for patients with persistent cognitive–motor deficits post-stroke. Full article

Background/Objectives: Hemodialysis patients are disproportionately affected by impaired cognitive function in comparison to the general population. This systematic review aims to update and expand the current evidence regarding the effects of IET interventions on global cognition and specific cognitive domains, such as executive function, processing speed, and attention. Methods: A comprehensive search was conducted across three databases (PubMed, Scopus, and EBSCO) from database inception to 24 August 2025 for randomized controlled trials examining the effects of intradialytic exercise training on cognitive function, using combinations of the following search terms: hemodialysis, dialysis, dialy*, physical exercise, physical activity, exercise, activity, activit*, cognition, cognitive, and cognit*. Included studies were assessed for risk of bias and methodological quality using the Jadad Scale and NHLBI tools. Results: Seven studies were included in this review, encompassing (n = 332; 60.4% male) hemodialysis patients aged from 48 to 74.9 years. In comparison to standard care, IET significantly improved global cognition and specific cognitive domains. Regarding global cognitive function, interventions regardless of exercise type, which were performed thrice weekly over 12 to 16 weeks, significantly improved scores in (n = 4; 57%) studies using the Montreal Cognitive Assessment (MoCA) and in (n = 1; 14%) study using the Mini Mental State Examination. Regarding specific cognitive domains, aerobic exercise performed thrice weekly for 12 weeks were associated with statistically significant improvements in the following: executive function scores (n = 2; 29%), studied using the Trail Making Test (TMT) Part-B and TMTB-A; psychomotor processing speed (n = 1; 14%), studied using TMT-A and Symbol Digit Modality Test (SDMT); and alertness (n = 1; 14%), studied using the Test of Attentional Performance (TAP) test. Conclusions: The collective evidence confers that IET is an effective intervention that may moderately improve global and domain-specific cognitive function or, at the very least, serve in a protective capacity to stem potential future cognitive decline in this population. However, further large-scale randomized controlled trials that place emphasis on standardized reporting of exercise intervention characteristics and cognitive outcome measures are necessary to inform clinical practice. Full article

Background: Although the participation of children with autism spectrum disorder (ASD) in team sports presents challenges, group-based physical activities could offer specific benefits for their core symptoms. Therefore, the aim of this systematic review was to analyze the benefits of mini-basketball for children with ASD. Methods: A systematic review was conducted following PRISMA guidelines and was registered in PROSPERO (CRD420251144800). Four databases (Web of Science, SPORTDiscus, PubMed, and Scopus) were searched to select randomized controlled trials reporting the effects of mini-basketball interventions on children with ASD from their inception to August 2025. Results: Eight randomized controlled trials involving 436 participants (aged 3–12 years, 87.3% male) met the inclusion criteria. All studies were conducted in China using 12-week interventions (40–45 min, 2–5 days/week at moderate intensity). The quality was rated as good in two studies and fair in six. Five studies assessed social responsiveness, with four showing significant pre–post reductions in the experimental groups and all demonstrating superior outcomes versus those of the controls. One study reported significant reductions in repetitive behaviors, self-injurious behaviors, and restricted behaviors compared to that of the controls. Joint attention improvements were observed through eye-tracking measures, with increased fixation counts, shorter time to first fixation, and more accurate gaze shifts. Physical fitness benefits included improved shuttle run times and standing long jump performance. Finally, one study demonstrated better inhibition control and improvements in sleep quality, including increased sleep duration and efficiency. Conclusions: Mini-basketball interventions can improve social responsiveness and related outcomes in children with ASD. These findings support mini-basketball as a feasible, safe, and effective intervention that could be integrated with existing therapeutic approaches. Full article

Hydroxytyrosol (HXT), a phenolic compound from olive, shows great potential as a neuroprotective agent and a translational target for claim-ready nutrition and food products. Human studies increasingly report benefits for vascular function, inflammatory tone, and early cognitive/psychomotor outcomes, consistent with engagement of redox and signalling pathways (Keap1–Nrf2–ARE, PI3K/Akt–ERK, and AMPK–SIRT1–PGC-1α). HXT is rapidly absorbed and likely reaches the brain, acting on endothelial and microglial targets. On the neurovascular axis, it reduces oxidative stress, preserves nitric-oxide bioavailability, lower inflammatory markers, and favourable intrinsic connectivity. For product development, bitterness from oleuropein-rich inputs can be mitigated by hydrolysis, followed by structure-guided delivery to balance sensory quality with exposure. Viable formats include cyclodextrin inclusion, microencapsulation, and (micro)emulsions in lipid matrices, plus stability engineering for aqueous systems (acidification, chelation, low-oxygen handling, or barrier packaging). Matrix effects are consequential; some proteins and fibers may decrease HXT bioaccessibility, whereas lipid phases and microstructured carriers often enhance it. Clinically, recommended doses are ~7–15 mg/day chronically and ~30–60 mg acutely. As conclusions of this review, future work should prioritize harmonized pharmacokinetics–pharmacodynamics readouts, cognition anchored to a compact neurovascular/blood–brain barrier biomarker core, and head-to-head comparisons of manufacturable delivery formats. Full article

Background/Objective: Riboflavin transporter deficiency (RTD) is a rare neurodegenerative disease, with under 500 cases genetically confirmed since the early 2000s. Thus far, three separate subtypes of RTD2 are described—type 1, 2 and 3—but, previously, RTD was classified as two separate genetic defects: Brown–Vialetto–Van Laere syndrome and Fazio–Londe syndrome, caused by mutations in the SLC52A2 and SLC52A3 genes, respectively. The most prominent symptoms found in patients include encephalopathy, expressed as peripheral and cranial nerve neuropathy, which in turn lead to a series of complications: decreased muscle strength, hypotonia, visual impairment, sensorineural hearing loss, bulbar palsy, sensory ataxia and respiratory insufficiency secondary to diaphragmatic paresis. At the cellular level, riboflavin is modified into active flavin cofactors: FMN, mediating riboflavin phosphorylation through riboflavin kinase, and FAD, involved in FMN adenylation through the flavin dinucleotide 1 synthesis. FMN and FAD are two of approximately 100 proteins collectively described as the ‘flavoproteome’. Most of them are mitochondrial oxidoreductases, catalyzing the electron transport in many metabolic reactions, as well as regulating important cell processes, such as the production of reactive oxygen species, protein conformation and damage repair. FMN and FAD are also responsible for the conversion of B6 and B9 vitamins into their active forms, which allows for healthy cell growth and immune function. Methods: In this article, the authors describe two children, a 6-year-old girl and her 5-year-old sister, both presenting with RTD2 caused by mutations in the SLC52A2 gene (c.916G>C (p.Gly306Arg); c.477C>G (p.Cys159Trp)), in whom the disease progression was successfully inhibited by vitamin B₂ supplementation in varying doses. Results: Their clinical image consists of psychomotor developmental delay, ataxia, horizontal nystagmus, hearing loss and a lack of visual fixation. Conclusions: The phenotype and clinical signs presented by the described sisters are further discussed in relation to the previously published reports of RTD2 cases. Full article

An individual’s ability to process flickering light is expressed by critical flicker fusion frequency (CFFF), tested with the flicker test. CFFF is used to assess visual processing, arousal, and cognitive functioning, among other things, although it is unclear how it reflects these processes. Due to possible differences between CFFF values obtained in trials with increasing and decreasing frequency, it also remains questionable to use only averaged CFFF values in research. The main objective of the present study was to assess how CFFF is related to cognitive functions (attention, short-term and working memory, and executive functions), and psychomotor speed. The research objectives also included assessing the stability of CFFF and its variability with age and comparing CFFF between men and women. Thirty-six participants (17 women and 19 men) completed computerized cognitive tests (Simon and flanker tasks, the Corsi block-tapping task, and the digit span task) three times, along with the flicker test. We found that CFFF scores were stable across sessions but differed between fusion and flicker thresholds, with age significantly correlating only with the fusion frequency. Given that, we suggest that future studies analyze not only the averaged CFFF, but also examine flicker and fusion thresholds separately to better understand their distinct contributions. Our results also revealed generally weak correlations between CFFF and neuropsychological test scores, with significant associations found only in women, suggesting that CFFF may not be a reliable indicator of cognitive functioning. Full article

Background: Early childhood is crucial for motor and cognitive development, with physical activity playing a key role. Mini-trampoline exercises may offer an effective approach to enhance these domains. Methods: This study assessed the effects of a mini-trampoline program on executive functions and motor skills in Tunisian preschoolers. Fifty-four children (age 3.87 ± 0.47 years) participated in a 12-week intervention, divided into a control group (n = 27), following standard activities, and an experimental group (n = 27), engaging in mini-trampoline exercises. Pre- and post-tests measured motor skills like postural steadiness, balance, and coordination, as well as cognitive functions, including working memory (WM) and inhibition. Results: Significant improvements were observed in the experimental group for functional mobility, postural steadiness, lower body strength, and inhibition (p < 0.001), whereas the control group showed minimal changes. ANOVA revealed no significant group × time effects, except for a trend in postural steadiness (p = 0.062), suggesting a potential benefit of the intervention. Conclusions: These findings highlight the potential of mini-trampoline exercises to enhance motor skills and specific executive functions in preschoolers, supporting their overall development. Full article

Background: Driving is a coordinated psychomotor activity that involves reaction time, attention, and decision-making. Psychoactive substances such as 2-phenylethylamine (PEA) derivatives and opioids may affect these functions and contribute to traffic safety. This systematic review revealed the effects of the selected PEA derivatives and opioids on psychomotor performance among drivers and potential road safety outcomes. Methods: The review followed PRISMA 2020 standards. Using the PICO method, we conducted a systematic search in Embase, PubMed, and Web of Science (2000–2025). Included studies involved adult participants and quantified the effect of PEA derivatives or opioids on driving-related psychomotor function. Thirty-one articles, such as randomized controlled trials, crossover studies, observational studies, and simulator-based studies, were examined. Risk of bias was evaluated using the RoB2 tool. Results: Evidence indicates therapeutic amphetamine and methylphenidate doses can enhance psychomotor function and safety in patients with ADHD. Recreational or high-dose use of methamphetamine and MDMA is associated with impaired coordination, variable speed, and increased impulsivity. Opioid effects are tolerance- and dose-dependent. Small therapeutic doses of fentanyl in chronically treated patients do not notably impair driving. On the other hand, methadone and tramadol commonly cause somnolence, retardation of reaction, and increased accident risk. Conclusions: The impact of opioids and PEA derivatives on psychomotor function is multifactorial, depending on dose, time, route of administration, and patient status. These substances can either improve or impair driving safety. The findings confirm the need for individual-specific pharmacotherapy treatment. They also highlight the importance of further studies to formulate evidence-based clinical and legislative guidelines. Full article