Search Results (748)

Background: Endothelial dysfunction and renal injury are emerging as a common feature of long COVID, especially in those with hypertension. It is not yet well characterised whether SARS-CoV-2 infection exacerbates podocyte dysfunction, fibrotic signalling and renal hemodynamic remodelling, over and above the effects of hypertension alone and there are no reliable early biomarkers in this population. Methods: We conducted a comparative cross-sectional study with prospective 6-month treatment response follow-up in 120 adult patients (aged 30–60 years) with essential hypertension (Stage I, II or III; n = 40 per stage), at Bukhara Regional Multidisciplinary Hospital. Each stage subgroup was further divided into post-COVID (3–6 months after recovery; n = 20) and non-COVID (n = 20) strata. Patients with diabetes, known chronic kidney disease, previous myocardial infarction or stroke and other major comorbidities were excluded. Serum cystatin-C, creatinine, aldosterone, TGF-β1 and VEGF-A; urinary nephrin and microalbumin; cystatin-C-derived eGFR (CKD-EPI) and oral protein-loaded renal functional reserve (RFR); and renal Doppler indices (Vps, Ved, RI, PI) of the main, segmental and interlobar arteries were assessed before and after 6 months of guideline-based renin–angiotensin–aldosterone system (RAAS) blockade (enalapril 5–10 mg or azilsartan 40–80 mg, ±eplerenone). Comparisons were made by Student’s t-test—associations by Pearson correlation. Results: At baseline, post-COVID hypertensive patients exhibited consistently higher endothelial–podocyte injury markers than non-COVID counterparts. Urinary nephrin was elevated across all stages (Stage I: 126.5 ± 9.1 vs. 91.9 ± 8.3 pg/mL, p < 0.01; Stage III: 203.3 ± 11.2 vs. 164.5 ± 9.7 pg/mL, p < 0.05), as were VEGF-A (Stage III: 286.1 ± 16.4 vs. 223.2 ± 12.6 pg/mL, p < 0.01) and TGF-β1 (Stage III: 186.4 ± 10.1 pg/mL, 1.3-fold higher; p < 0.01). The detection of microalbuminuria was 100% in Stage III post-COVID patients and 85% in non-COVID controls. The post-COVID groups had selective loss of renal functional reserve (7.8 ± 1.1% in Stage III compared to 12.5 ± 1.6% in non-COVID controls, p < 0.001). Nephrinuria correlated strongly with RFR (r = −0.824, p < 0.001), eGFR (r = −0.797, p < 0.001) and aldosterone (r = 0.613, p < 0.001). Six months of RAAS blockade reduced nephrinuria, microalbuminuria and TGF-β1 in both arms but the magnitude of biomarker reduction appeared smaller in the post-COVID group, particularly in Stage III. Conclusions: Long COVID appears to be associated with persistent endothelial dysfunction and podocyte injury in hypertensive patients. These results indicate that nephrinuria, VEGF-A, TGF-β1 and renal functional reserve are potential exploratory markers of endothelial and renal abnormalities in hypertensive patients following COVID-19. Before clinical utility can be determined, larger studies with multivariable modelling, diagnostic-performance analyses and correction for multiple testing are needed. The differences in biomarker response between groups observed in this study need to be confirmed in larger prospective studies with multivariable modelling and formal interaction analyses. Full article

Virtual reality (VR)-based rehabilitation is an established modality for upper extremity motor recovery; however, existing systems frequently rely on fixed, random, or therapist-tuned target placement that disregards patient-specific motor capacity and population-level priors. This study proposes a cross-patient collaborative swarm intelligence framework that derives zone-based patient profiles from real VR trajectories and augments them with a similarity-weighted cohort prior distilled from clinically similar patients’ successful trajectory clouds and zone-transition graphs. A hybrid Ant Colony Optimization (ACO)–Particle Swarm Optimization (PSO) algorithm optimizes 12 targets per session across a 27-zone ($3\times 3\times 3$) workspace using a five-component fitness function encompassing reachability, zone balance, movement efficiency, heatmap-guided challenge coverage, and swarm-flow consistency. The framework was evaluated retrospectively on a single-center cohort of 36 post-stroke patients and 6373 sessions under a leakage-safe simulation protocol with 70/30 chronological splits; outcomes are model-based proxy success rates derived from each patient’s profile rather than directly observed task success. The hybrid strategy achieved a mean simulated success rate of 85.5% ± 5.5%, a 36.4% relative improvement over random placement (Wilcoxon $p<{10}^{-7}$, Cohen’s $d=4.91$); the leakage-safe split yielded 80.1% on the held-out segment versus 61.1% for random, with no statistically significant train–test gap ($p=0.470$). Ablation confirmed both PSO and ACO are individually necessary ($\mathsf{\Delta }\ge 2.7$ pp, $p<0.001$). Total session-start computation is 78 ms on standard CPU hardware. These findings constitute a proof-of-concept that collaborative personalized swarm optimization can substantially outperform heuristic target placement under in silico evaluation; clinical efficacy in terms of standardized motor outcome measures remains to be established in a prospective randomized controlled trial, and the findings should be replicated across centers, task modes, and a larger cohort before generalization. Full article

Background/Objectives: Stroke remains the second leading cause of death worldwide, and cell therapy is among the most actively investigated strategies for its treatment. Recent transcriptomic evidence has revealed that 293T cells—the most widely used transient transfection model—possess a neural crest/neuronal lineage, making them a candidate for acute neural tissue engineering. Methods: We implanted iron oxide nanoparticle-labeled 293T cells (293T-ION) into an ischemic rat brain and monitored them longitudinally by 7T MRI, using ION-labeled bone marrow-derived mesenchymal stem cells (rMSC-ION) as a direct comparison. Functional recovery was assessed via mNSS and corner test scores, and infarct size was quantified by MRI. Results: 293T-ION cells showed no migration throughout the 40-day observation period, and functional recovery plateaued early compared with the progressive improvement seen with rMSC-ION. 293T cell implantation provoked pronounced, localized CD68-positive microglial hyperactivation at both implantation and ischemic sites, without migration toward the choroid plexus (CP). In contrast, rMSC-ION actively migrated to the CP and drove superior neuroplasticity marker expression (Ki67, Nestin, NeuN). Conclusions: 293T cells produce transient localized microglial activation and limited brain plasticity, whereas rMSCs drive sustained neurorestoration. Synergistic co-administration of these cell types may represent a future therapeutic strategy bridging hyper-acute and chronic recovery phases. Full article

Objectives: Bilateral robotic arm training (BRT) may enhance poststroke motor recovery by reducing interhemispheric inhibition and promoting bilateral motor network engagement. However, previous reviews have often pooled bilateral and unilateral robotic approaches, potentially masking differential effects. This systematic review and meta-analysis compared the effects of BRT with those of unilateral robotic training (URT) and conventional rehabilitation on upper-limb motor function after stroke. Methods: Randomized controlled trials were identified through systematic searches of major electronic databases and trial registries in accordance with PRISMA guidelines. The risk of bias was assessed via the Cochrane Risk of Bias 2 tool. Random effects meta-analyses were performed using standardized mean differences (SMDs). Predefined subgroup and sensitivity analyses were used to examine the influence of participant characteristics, training dose, intervention duration, and robotic device type. Results: Fourteen randomized controlled trials involving 440 participants were included. Overall, compared with control interventions, BRT did not significantly improve upper-limb motor function, as measured using the Fugl–Meyer Assessment for Upper Extremity (SMD = 0.18, 95% CI −0.01–0.36). Significant effects were observed in participants younger than 60 years, with training doses > 15 h, intervention durations > 4 weeks, and use of Bi-Manu-Track systems. Conclusions: BRT did not demonstrate a significant overall advantage over URT or conventional rehabilitation. However, subgroup analyses suggest that treatment effects may vary according to patient characteristics, training dose, duration of the intervention, and device type. Full article

Background: Predicting rehabilitation outcomes at admission supports tailored therapy plans and efficient use of resources for patients undergoing intensive inpatient rehabilitation, including those with stroke, orthopedic, and other neurological conditions. Nonetheless, current machine learning (ML) methods face limitations, including the ceiling effect in absolute functional gain measures, the uniform treatment of diverse patient groups, and reliance on black-box models that lack clinical transparency. Methods: This retrospective observational study analyzed a fully anonymized, publicly available dataset of 3419 patients admitted to the intensive rehabilitation unit at IRCCS San Raffaele Hospital, Rome, Italy, from 2015 to 2018. To mitigate the ceiling effect, a normalized Barthel Index gain metric was developed. K-means clustering (K = 2, trained solely on the training set) identified patient admission profiles based on functionality, which were then used as predictive features. Eight machine learning classifiers were tested across three groups (All Patients, Orthopedic, Neurological). SHAP-based explainability was employed at four levels: global, diagnostic group, patient functional profile, and individual. Finally, clinical decision rules and bedside stratification profiles were derived and validated with an internal held-out test set (n = 684). Results: Normalization significantly increased the correlation between admission BI and gain (r = 0.130 to r = 0.520), supporting the presence of a ceiling-related limitation in absolute gain metrics. Two distinct functional admission profiles with statistically significant group differences were identified—High-Burden (38% below-median recovery) and Moderate-Burden (21%)—with cluster membership the third most important predictor (13.9% SHAP importance). The highest AUC-ROC values were 0.831 for all patients (XGBoost), 0.864 for neurological patients (Gradient Boosting), and 0.839 for orthopedic patients (Gradient Boosting). Multilevel SHAP analysis showed age as the primary predictor for neurological patients (mean |SHAP| = 0.360) but the third for orthopedic patients (0.350), highlighting clinical relevance. Validation using SHAP values from the Gradient Boosting model showed a Spearman correlation of ρ = 0.925 (p = 1.13 × 10⁻³⁰), with eight of the top ten features overlapping, indicating that these patterns are not model-specific but reflect the underlying data. Risk zone stratification found 80.7% of patients in high-confidence zones (accuracy > 80%). The clinical decision rules achieved 70.8% accuracy with full transparency, and the elderly (≥75 years) combined with a low BI (<25) profile showed an 89.6% model accuracy with only 10.4% recovery above the median. Conclusions: This explainable, profile-informed ML pipeline addresses key methodological limitations in predicting rehabilitation outcomes. It also provides a foundation for integrating models into clinical practice, pending prospective, external validation of the results. Before clinical implementation, validation across multicenter cohorts is essential. Full article

Clinical outcomes after acute ischemic stroke remain highly heterogeneous, even among patients with comparable lesion characteristics and successful reperfusion, challenging traditional lesion-based models. Increasing evidence suggests that stroke should be conceptualized as a disorder of distributed brain networks, yet the mechanisms linking focal ischemia to large-scale dysfunction remain incompletely understood. In this review, we propose that diaschisis constitutes a central physiological mechanism underlying this transition from focal injury to network-level impairment. Building on advances in functional imaging, connectomics, and cerebellar physiology, we propose that diaschisis may be conceptualized, at least in part, as a disruption of cerebello-cortical loop dynamics rather than solely a nonspecific remote effect. These closed, polysynaptic circuits linking cortex, cerebellum, and thalamus support the integration of motor and cognitive processes and are particularly vulnerable to perturbation. Focal ischemia may therefore induce a cascade of dysfunction that propagates across these loops, leading to widespread impairment despite limited structural damage. Within this framework, outcome variability emerges from the interaction of three key factors: lesion characteristics, brain reserve and network vulnerability, and the extent of diaschisis. We further highlight that functional suppression of cerebellar output, even in the absence of structural degeneration, may play a critical role in mediating network dysfunction. This circuit-based perspective provides a mechanistic explanation for inter-individual variability in stroke outcomes and shifts the focus from lesion localization to network dynamics. Understanding diaschisis as a potential manifestation of cerebello-cortical loop dysfunction opens new avenues for prognosis and therapeutic intervention, emphasizing the potential of targeting network-level restoration to improve recovery after stroke. Full article

Stroke is the second leading cause of death globally and a major contributor to lower-limb disability, affecting gait, balance, and functional independence in elderly populations. While robot-assisted rehabilitation has demonstrated effectiveness in motor recovery, access remains limited due to high costs and geographic barriers, particularly in Latin America. This study presents ExoKnee, a low-cost knee exoskeleton designed through biomimetic principles and 3D-printed fabrication as a proof-of-concept device targeting gait rehabilitation in elderly adults. The system integrates a single-degree-of-freedom pneumatic actuator controlled by electromyography (EMG) signals from the quadriceps muscle, enabling knee flexion and extension (90° to 180°). The design was evaluated through finite element analysis and dynamic simulations in MATLAB/Simulink R2024a under constant, stepwise, and sinusoidal reference inputs in a digital-twin environment. Expert validation using the Content Validity Coefficient yielded a mean score of 0.8747, reflecting preliminary expert agreement on the conceptual design’s coherence and relevance. The prototype demonstrated controlled movements through a 6-bar pneumatic system with EMG-triggered relay activation, validated at the proof-of-concept level through simulation and single-subject threshold calibration. ExoKnee addresses critical gaps by offering an anthropometrically informed, biosignal-driven, and locally manufacturable rehabilitation platform for low- and middle-income countries, pending clinical validation. Future work will focus on clinical trials and adaptive EMG control strategies. Full article

Background: The efficacy of tenecteplase for acute ischemic stroke (AIS) beyond 4.5 h remains uncertain, particularly across care pathways with and without endovascular thrombectomy (EVT). We performed an updated systematic review and meta-analysis using an EVT-stratified framework. Methods: PubMed, Embase, Scopus, and the Cochrane Library were searched through February 2026 for randomized controlled trials comparing tenecteplase with control in imaging-selected patients with AIS presenting 4.5–24 h from last known well. The primary outcome was excellent functional outcome (mRS 0–1) at 90 days. Secondary outcomes were good functional outcome (mRS 0–2), recanalization, early neurological improvement, symptomatic intracranial hemorrhage, and 90-day mortality. Random-effects models with Hartung–Knapp adjustment were used. Subgroup analyses by EVT availability were interpreted as exploratory because of the limited number of trials. Results: Five trials including 1844 patients were analyzed. Tenecteplase improved excellent functional outcome (RR 1.25, 95% CI 1.10–1.42; p = 0.0005) with no heterogeneity (I² = 0%) and no interaction by EVT status (p-interaction = 0.961). Good functional outcome was not significantly different overall (RR 1.10, 95% CI 0.97–1.24; p = 0.135). Significant subgroup interactions were observed for recanalization (p-interaction = 0.004) and early neurological improvement (p-interaction = 0.002), with benefits concentrated in non-EVT settings. However, the larger effect on recanalization did not translate proportionally into functional recovery, supporting separation of vessel-opening outcomes from patient-centered outcomes. Symptomatic intracranial hemorrhage showed a nonsignificant increase in four estimable studies (RR 1.88, 95% CI 0.94–3.78; p = 0.074), whereas 90-day mortality did not differ significantly (RR 1.11, 95% CI 0.85–1.43; p = 0.43). Conclusions: In imaging-selected AIS presenting 4.5–24 h after onset, tenecteplase improved excellent functional outcome irrespective of EVT availability, while benefits for recanalization and early neurological improvement were largely confined to non-EVT settings. Because recanalization is an intermediate endpoint, these findings should not be interpreted as proof of a proportional clinical benefit. Future extended-window trials should specify EVT status. Full article

Background/Objectives: Post-stroke dysphagia (PSD) is a common complication following cerebrovascular events, and many affected patients also present with pre-existing dementia or post-stroke cognitive impairment (PSCI). PSD primarily affects the oropharyngeal phase of swallowing, whereas cognitive impairment often compromises the oral phase. This overlap complicates diagnosis and highlights the importance of accurate assessment to guide appropriate treatment strategies. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising therapeutic intervention for both cognitive impairment and dysphagia. Methods: In this study, we report a case of a patient with pre-existing dementia who experienced an ischemic stroke, resulting in PSD and PSCI. Videofluoroscopic swallowing study (VFSS) revealed oral-phase-predominant dysphagia. rTMS targeting the dorsolateral prefrontal cortex (DLPFC) was administered with the aim of enhancing cognitive function. Results: Following two cycles of rTMS in combination with ongoing swallowing therapy, the patient demonstrated notable improvement in both cognitive and swallowing function. Conclusions: Although limited by a single-case design and the possibility of spontaneous recovery, this case demonstrates that rTMS targeting the DLPFC combined with swallowing therapy may be a potential intervention for managing concurrent post-stroke dysphagia and cognitive impairment. Full article

N-methyl-D-aspartate receptors (NMDARs) play a context-dependent role in ischemic stroke (IS), contributing to acute excitotoxic injury while also supporting subsequent neuroplasticity. This functional divergence has constrained the therapeutic efficacy of non-selective NMDAR antagonists. During the acute phase, neuronal injury is associated with the redistribution of NMDARs toward extrasynaptic sites and the activation of aberrant non-ionotropic signaling pathways. As the disease progresses, NMDAR-dependent signaling becomes increasingly involved in activity-dependent plasticity, including motor engram consolidation, dendritic remodeling, and large-scale network reorganization. Post-stroke cognitive impairment and depression are increasingly recognized as potential consequences of sustained NMDAR dysregulation, involving interactions with immune signaling and metabolic processes. These observations support a shift toward activity-dependent modulation of NMDAR function, in which neurotoxic signaling is selectively dissociated from physiological receptor activity. Emerging strategies aimed at subunit-specific modulation and disruption of pathological receptor complexes provide a basis for more targeted intervention. Preservation of physiological excitation–inhibition balance may therefore represent a key requirement for optimizing functional recovery after stroke. Full article

Impairment in blood supply to the brain deprives its cells of the much-needed nutrients and molecules such as oxygen and glucose necessary for its development, growth and survival. This will set up a host of pathological processes such as impaired homeostasis, energy failure, excitotoxicity, oxidative stress, impaired protein synthesis, inflammation, cytokine-mediated toxicity and impairment of blood–brain barrier. These pathological processes will result in the damage or death of the cells depending on the extent of the deprivation. Similarly, they will impair synthesis of acetylcholine (Ach) and norepinephrine (NE), which are important neurotransmitters in the cholinergic and adrenergic systems responsible for cellular communication and functions. Thus, interventions to help arrest and/or modulate the initial and subsequent pathological states and help recover the functions of the brain are needed. One of such interventions is vagus nerve stimulation, which helps activate the cholinergic and the adrenergic systems via projections of the afferent fibers of the vagus nerve to the nucleus of the solitary tract (NTS). Activation of the cholinergic and the adrenergic systems results in reduction in pro-inflammatory factors such as tumor necrosis α, increase in pro-angiogenic factors and increase in firing of adrenergic neurons in the central nervous system (CNS). Full article

Background: Chronic critical illness (CCI) following acute brain injury involves persistent immune dysfunction, yet its genetic determinants remain unclear. We investigated whether the rate of T-cell receptor excision circle (TREC) depletion—a proposed marker of adaptive homeostatic resilience—is associated with the burden of rare damaging genetic variants. Methods: Whole-exome sequencing (WES) was performed on a cohort of 84 patients (64 with traumatic brain injury, 20 with stroke). In a longitudinal sub-cohort (n = 27), patients were stratified into quartiles (Q1–Q4) based on the slope of their TREC trajectories. “Qualifying variants” (QVs) were defined using strict rarity (gnomAD allele frequency ≤ 0.001) and pathogenicity criteria. Gene-level burden (collapsing) analysis and permutation-based statistical testing (10,000 iterations) were employed to evaluate genetic enrichment in the extreme quartiles. Results: While baseline TREC levels were strictly age dependent (p < 0.0001), the rate of change (TREC slope) was age independent. Rapid TREC decline (Q1) correlated with significantly higher final SOFA scores (p = 0.001) and neutrophil-to-lymphocyte ratios (p = 0.020). Rare variant burden analysis revealed that Q1 patients were significantly more likely to harbor QVs in immune-related genes compared to the Q4 recovery group (odds ratio = 8.25; permutation p = 0.016). Patients with rapid decline were enriched for QVs in putative core “housekeeping” pathways essential for T-cell maintenance and DNA repair (e.g., ERCC3, FANCM), whereas variants in recovering patients were restricted to peripheral effector or structural pathways. Conclusions: Our findings suggest, as a conceptual framework, that an individual’s ability to maintain T-cell homeostasis during critical illness is influenced by their underlying genetic buffering capacity. We propose a hypothetical “two-hit” framework where physiological stress unmasks pre-existing fragilities in core homeostatic pathways—potentially reflecting a state of functional haploinsufficiency under extreme proliferative demand—leading to accelerated immune exhaustion. These results position the TREC slope as a dynamic, age-independent biomarker of genomic resilience in the ICU. All findings are exploratory and hypothesis generating. Full article

Stroke is a leading cause of chronic disability, with heterogeneous sensorimotor impairments that are not well captured by standard clinical assessments. While advanced motion capture and robotic systems provide precise measurements, they are not scalable for widespread clinical use. We developed C-MORE (Computer Vision for Movement Observation and Recovery Enhancement), a smartphone-based framework that uses computer vision and machine learning to automatically score the Box and Blocks Test (BBT) and extract quantitative kinematic metrics. The system combines hand tracking with a custom machine learning (ML) architecture to identify valid block transfers and segment task phases. We evaluated C-MORE in 7 individuals with chronic stroke and a cohort of 10 healthy adults. The system achieved 99.0% agreement with ground-truth scoring, with errors below clinically meaningful thresholds. Kinematic measures derived from the system were sensitive to stroke-related impairments, including reduced movement velocity and increased task duration in affected limbs. Exploratory analyses indicated that grasp-related metrics, particularly the ratio of grasp-to-transfer duration, were correlated with independent measures of proprioception. These findings demonstrate that smartphone-based computer vision can provide accurate, scalable assessment of upper-extremity function. C-MORE offers a practical approach for enhancing clinical evaluation and enabling more precise, individualized rehabilitation strategies. Full article

Objective: To systematically evaluate the rehabilitation effect of brain-computer interface (BCI)-controlled hand robot training on post-stroke motor functions, especially upper limb functions. Methods: PubMed, Embase, Web of Science, Cochrane Library, CNKI, SinoMed, WanFang Data, and VIP Database were searched from inception to 13 March 2026. Randomized controlled trials (RCTs) with dose-matched designs were included, where the test group underwent BCI-controlled hand robot training and the control group received either pure hand robot training or routine rehabilitation. Meta-analysis was performed on RevMan 5.4. Results: Totally 11 RCTs involving 380 patients were included. Compared with hand robot training alone, BCI-controlled hand robot training significantly improved Fugl-Meyer Assessment for Upper Extremity (FMA-UE) scores (MD = 4.87, 95% CI: 1.04 to 8.69) and FMA-UE proximal scores (MD = 4.44, 95% CI: 0.15 to 8.74), and significantly reduced finger flexor spasticity (MD = −0.44, 95% CI: −0.68 to −0.21), but showed no significant difference in distal upper limb motor function or Action Research Arm Test (ARAT) scores. Compared with routine rehabilitation, BCI-controlled hand robot training significantly improved FMA-UE scores (MD = 6.55, 95% CI: 3.49 to 9.61). Conclusions: BCI-controlled hand robot training can effectively improve overall upper limb and proximal motor function after stroke and alleviate finger flexor spasticity, but the evidence for distal hand function and long-term efficacy remains limited. Full article

Growth hormone (GH) and insulin-like growth factor 1 (IGF-1) play essential roles in the brain, influencing neuronal and dendritic growth, as well as neurotransmission. These effects persist throughout life. Numerous studies in animals and humans have demonstrated the beneficial effects of GH therapy on memory and cognitive function, as well as on the restoration of neuronal function following injury. All nerve cells, including neurons, glia, endothelial, epithelial, and perivascular cells, are affected by the actions of GH/IGF-1. IGF-1, in particular, has been associated with cognitive function. The GH-IGF-1 axis increases the proliferation of neuronal progenitor cells and the formation of new neurons, oligodendrocytes, and astrocytes. In this study, we searched databases such as PubMed, Google Scholar, and Embase for human clinical trials evaluating the effect of growth hormone (GH) therapy on dementia, Alzheimer’s disease (AD), post-traumatic brain injury (PTI), and stroke. The following search terms were used: “GH and dementia,” “GH and Alzheimer’s disease,” “GH and TBI,” and “GH and stroke.” Inclusion criteria were all randomized controlled trials and observational studies. Exclusion criteria included the lack of cognitive and memory assessments. We found 28 articles. Most studies show the beneficial effects of GH therapy on memory and recovery of brain function after traumatic injury and stroke; however, consistent data are still lacking. The limited number of clinical trials, the small number of patients, and the lack of data on plasma levels of sex hormones that clearly contribute to brain function are limiting factors. This is the case, for example, with androgens. Other critical factors are dosage and treatment duration. Prolonged administration and supraphysiological doses are more effective in inducing positive clinical changes. Growth hormone (GH) therapy is a very promising intervention for preventing and treating dementia and early-stage Alzheimer’s disease, and it contributes significantly to the recovery of brain function in patients after traumatic injury and stroke. Further studies with more robust methodologies are needed to confirm these results. Full article