Brain Sciences

17 pages, 1023 KiB

Open AccessArticle

Maintenance of Bodily Expressions Modulates Functional Connectivity Between Prefrontal Cortex and Extrastriate Body Area During Working Memory Processing

by Jie Ren, Mingming Zhang, Shuaicheng Liu, Weiqi He and Wenbo Luo

Brain Sci. 2024, 14(12), 1172; https://doi.org/10.3390/brainsci14121172 - 22 Nov 2024

Abstract

Background/Objectives: As a form of visual input, bodily expressions can be maintained and manipulated in visual working memory (VWM) over a short period of time. While the prefrontal cortex (PFC) plays an indispensable role in top-down control, it remains largely unclear whether this [...] Read more.

Background/Objectives: As a form of visual input, bodily expressions can be maintained and manipulated in visual working memory (VWM) over a short period of time. While the prefrontal cortex (PFC) plays an indispensable role in top-down control, it remains largely unclear whether this region also modulates the VWM storage of bodily expressions during a delay period. Therefore, the two primary goals of this study were to examine whether the emotional bodies would elicit heightened brain activity among areas such as the PFC and extrastriate body area (EBA) and whether the emotional effects subsequently modulate the functional connectivity patterns for active maintenance during delay periods. Methods: During functional magnetic resonance imaging (fMRI) scanning, participants performed a delayed-response task in which they were instructed to view and maintain a body stimulus in working memory before emotion categorization (happiness, anger, and neutral). If processing happy and angry bodies consume increased cognitive demands, stronger PFC activation and its functional connectivity with perceptual areas would be observed. Results: Results based on univariate and multivariate analyses conducted on the data collected during stimulus presentation revealed an enhanced processing of the left PFC and left EBA. Importantly, subsequent functional connectivity analyses performed on delayed-period data using a psychophysiological interaction model indicated that functional connectivity between the PFC and EBA increases for happy and angry bodies compared to neutral bodies. Conclusions: The emotion-modulated coupling between the PFC and EBA during maintenance deepens our understanding of the functional organization underlying the VWM processing of bodily information. Full article

(This article belongs to the Section Cognitive, Social and Affective Neuroscience)

20 pages, 10048 KiB

Open AccessReview

Creativity and Mental Illness: A Case Study of a Patient with Progressive Bulbar Palsy

by Felix Geser, Tibor C. G. Mitrovics, Laura Obexer, Peter Streicher, Johannes Haybaeck and Deniz Yilmazer-Hanke

Brain Sci. 2024, 14(12), 1171; https://doi.org/10.3390/brainsci14121171 - 22 Nov 2024

Abstract

Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently [...] Read more.

Creativity and the production of artwork can have an impact on the course and treatment of comorbid severe mental illness and neurodegeneration. We report on a 70-year-old male patient with highly original artistic behavior, who suffered from lifelong recurrent major depression and subsequently developed symptoms of progressive bulbar palsy (PBP). In the context of a systematic literature review, we detail the patient’s personal and artistic biographies and portray artwork from his artistic portfolio together with his disease history, clinical examination, psychopathological and neuropsychological evaluations, blood and cerebrospinal fluid analyses, neuroimaging, neurophysiological testing, and psychotherapeutic treatment. The patient’s 1–2-year history of primarily bulbar motor symptoms and signs aligned with electromyography, showing widespread signs of continuing denervation/chronic neurogenic changes. Slight impairments in semantic fluency, executive control, and visuoconstructive abilities were observed in neuropsychological testing, in conjunction with right-sided medial temporal lobe atrophy in an MRI. He was prescribed medication, including extended-release venlafaxine, trazodone, pramipexole, and zolpidem, and took his medication regularly, usually at high doses. For most of his life, the patient had attributed professional “success” and artistic output to, at times, excessive alcohol consumption. Later, however, his interest in creative work continued despite alcohol reduction and cessation. Psychotherapy grounded him in reality via goal-centered behaviors, making him realize that his physical and mental ailments rather hindered his creative output. In summary, creative behavior can be utilized in the treatment of patients with psychiatric conditions (affective or addictive disorders) and/or neurodegenerative diseases. In the reported case, specific psychopharmacology and psychotherapy that address goal-directed self-efficacy experiences of reality were critical to the patient’s treatment. Full article

(This article belongs to the Section Neuropsychology)

► Show Figures

Figure 1

17 pages, 466 KiB

Open AccessArticle

Obsessive–Compulsive Traits and Problematic Internet Use Are Increased Among Adults with Autism Spectrum Disorder: Is There a Role of Obsessive Doubts and Communication Impairment?

by Barbara Carpita, Benedetta Nardi, Francesca Parri, Gianluca Cerofolini, Chiara Bonelli, Cristina Gaia Bocchino, Gabriele Massimetti, Ivan Mirko Cremone, Stefano Pini and Liliana Dell’Osso

Brain Sci. 2024, 14(12), 1170; https://doi.org/10.3390/brainsci14121170 - 22 Nov 2024

Abstract

Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits [...] Read more.

Background: The link between autism spectrum disorder (ASD) and obsessive–compulsive disorder (OCD) and the complexity of their differential diagnosis has been vastly investigated. Growing attention has been paid to the presence of problematic Internet use (PIU) in autistic individuals. Studies assessing OCD traits in autistic individuals are scarce and even less take into account the role that this overlap may have on the development and maintenance of PIU. We aimed to investigate OCD features in ASD individuals and their association with autism severity and the prevalence of PIU, and the potential dimensions associated with a greater probability of PIU. Methods: a total of 46 participants with ASD and 53 controls were assessed with the Adult Autism Subthreshold Spectrum questionnaire and the Obsessive–Compulsive Spectrum—Short Version. Results: There were significantly higher OCD features in ASD participants along with important correlations between OCD and ASD dimensions and a higher prevalence of PIU in the ASD group. Participants with putative PIU reported greater scores on some ASD and OCD dimensions, the with Doubt and Non-verbal communication domains emerging as significant predictors of the presence of putative PIU. Conclusions: These results support the three-way link between ASD, OCD, and PIU, contributing to the hypothesis of a neurodevelopmental basis for those conditions. Full article

(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)

10 pages, 1080 KiB

Open AccessArticle

Real-World Open-Label Experience with Rimegepant for the Acute Treatment of Migraine Attacks: A Multicenter Pilot Study

by Emmanouil V. Dermitzakis, Dimitrios Rikos, Michail Vikelis, Georgia Xiromerisiou, Styliani Zisopoulou, Dimitrios Rallis, Panagiotis Soldatos, George S. Vlachos, Georgios G. Vasiliadis and Andreas A. Argyriou

Brain Sci. 2024, 14(12), 1169; https://doi.org/10.3390/brainsci14121169 - 22 Nov 2024

Abstract

Objectives: The present open-label multicenter pilot study sought to prospectively evaluate the efficacy and safety of rimegepant in treating migraine attacks. Methods: The primary endpoint was pain freedom at two hours post-dose, while the co-primary efficacy endpoints included a reduction in the headache [...] Read more.

Objectives: The present open-label multicenter pilot study sought to prospectively evaluate the efficacy and safety of rimegepant in treating migraine attacks. Methods: The primary endpoint was pain freedom at two hours post-dose, while the co-primary efficacy endpoints included a reduction in the headache intensity and freedom from the most bothersome symptoms (MBS) associated with migraine at the same time point. To test the potential efficacy of rimegepant, patients were asked to record in a questionnaire all the relevant changes with each migraine attack treated with rimegepant at two hours post-dose vs. two hours before. The attending neurologists provided information on the basic demographics, medical anamnesis, and migraine history as well as the triptan use history. Results: A total of 54 patients (32 with episodic and 22 with chronic migraine) received rimegepant 75 mg at least once during a single migraine attack (overall, 140 dosage intakes). Pain freedom at 2 h was achieved in 45/140 (32.1%) intakes. Regarding the efficacy of the first rimegepant dose (n = 54), significant reductions in the headache intensity were observed between the pre- and 2 h post-treatment average VAS scores (−4.8 ± 2.8 mean; p < 0.001). Likewise, the same mean reductions in the average VAS scores occurred when the 2 h response to all 140 doses was analyzed (−5 ± 2.8; p < 0.001). Freedom from MBS at 2 h post-dose was achieved for photophobia in 43%, for phonophobia in 53%, and for nausea in 57%. The ability to fully return to everyday activities at 2 h post-dose was achieved in 83/140 instances (59%). We only recorded mild adverse events in 24/140 dosages. Conclusions: Our preliminary results demonstrate that rimegepant is effective, safe, and well tolerated in treating acute migraine attacks. Full article

(This article belongs to the Section Neuroscience of Pain)

► Show Figures

Figure 1

29 pages, 1859 KiB

Open AccessSystematic Review

Face Processing in Prematurely Born Individuals—A Systematic Review

by Tiffany Tang, Kasper Pledts, Matthijs Moerkerke, Stephanie Van der Donck, Bieke Bollen, Jean Steyaert, Kaat Alaerts, Els Ortibus, Gunnar Naulaers and Bart Boets

Brain Sci. 2024, 14(12), 1168; https://doi.org/10.3390/brainsci14121168 - 22 Nov 2024

Abstract

Background/Objectives: Prematurely born individuals are at risk for developing socio-emotional difficulties and psychopathologies such as autism spectrum disorder. Particular difficulties processing social information conveyed by the face may underlie these vulnerabilities. Methods: This comprehensive review provides an overview of 27 studies published between [...] Read more.

Background/Objectives: Prematurely born individuals are at risk for developing socio-emotional difficulties and psychopathologies such as autism spectrum disorder. Particular difficulties processing social information conveyed by the face may underlie these vulnerabilities. Methods: This comprehensive review provides an overview of 27 studies published between 2000 and mid-2022 concerning face processing in individuals born preterm and/or born with low birth weight across different age ranges, paradigms, and outcome measures. The results were interpreted across different developmental stages. Results: Behavioural studies indicated that prematurity is associated with poorer facial identity and expression processing compared to term-born controls, especially for negative emotions. Structural alterations and delayed maturation in key neural face processing structures could explain these findings. Neuroimaging also revealed functional atypicalities, which may either be rooted in the structural alterations or may partly compensate for the delayed maturation. Conclusions: The results suggest that altered face processing may be associated with an increased risk of developing psychopathologies in individuals born prematurely. Future studies should investigate the preterm behavioural phenotype and the potential need for face processing rehabilitation programs. Full article

(This article belongs to the Special Issue Face and Person Perception: Recent Updates and Future Perspectives)

► Show Figures

Figure 1

23 pages, 7363 KiB

Open AccessArticle

Relevant Factors in the Schooling of Children with Autism Spectrum Disorder in Early Childhood Education

by Francisco Villegas Lirola and Antonio Codina Sánchez

Brain Sci. 2024, 14(12), 1167; https://doi.org/10.3390/brainsci14121167 - 22 Nov 2024

Abstract

Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD [...] Read more.

Background: Educational professionals face significant challenges in determining the most appropriate educational placement for each child with ASD, which is a major concern for their parents. The purpose of this paper is to identify the factors in the development of students with ASD (language development, cognitive development, and socio-emotional development) that are most relevant in determining the modalities of schooling in early childhood education. Methods: A total of 381 Psychopedagogical Evaluation Reports from students with ASD aged 3 to 5 years were reviewed. The importance of each variable was identified using artificial neural network analysis. Classification trees were used to determine their distribution in the two schooling modalities. Results: A total of 42.9% of boys aged 3–5 years with ASD and 54.12% of girls aged 3–5 years with ASD were enrolled in specific modalities. Conclusions: Cognitive development and comprehensive language were the two variables that best explained whether children with ASD were educated in specific or ordinary modalities. The presence of a significantly impaired level of cognitive development was the best predictor of schooling in specific modalities, and for the rest of the cognitive levels, the greater the difficulties in comprehensive language, the greater the likelihood of schooling in specific modalities. Full article

(This article belongs to the Special Issue Exploring the Mental Health of People with Autism)

► Show Figures

Figure 1

16 pages, 4866 KiB

Open AccessArticle

Emotion Recognition Based on a EEG–fNIRS Hybrid Brain Network in the Source Space

by Mingxing Hou, Xueying Zhang, Guijun Chen, Lixia Huang and Ying Sun

Brain Sci. 2024, 14(12), 1166; https://doi.org/10.3390/brainsci14121166 - 22 Nov 2024

Abstract

Background/Objectives: Studies have shown that emotion recognition based on electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) multimodal physiological signals exhibits superior performance compared to that of unimodal approaches. Nonetheless, there remains a paucity of in-depth investigations analyzing the inherent relationship between EEG [...] Read more.

Background/Objectives: Studies have shown that emotion recognition based on electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS) multimodal physiological signals exhibits superior performance compared to that of unimodal approaches. Nonetheless, there remains a paucity of in-depth investigations analyzing the inherent relationship between EEG and fNIRS and constructing brain networks to improve the performance of emotion recognition. Methods: In this study, we introduce an innovative method to construct hybrid brain networks in the source space based on simultaneous EEG-fNIRS signals for emotion recognition. Specifically, we perform source localization on EEG signals to derive the EEG source signals. Subsequently, causal brain networks are established in the source space by analyzing the Granger causality between the EEG source signals, while coupled brain networks in the source space are formed by assessing the coupling strength between the EEG source signals and the fNIRS signals. The resultant causal brain networks and coupled brain networks are integrated to create hybrid brain networks in the source space, which serve as features for emotion recognition. Results: The effectiveness of our proposed method is validated on multiple emotion datasets. The experimental results indicate that the recognition performance of our approach significantly surpasses that of the baseline method. Conclusions: This work offers a novel perspective on the fusion of EEG and fNIRS signals in an emotion-evoked experimental paradigm and provides a feasible solution for enhancing emotion recognition performance. Full article

(This article belongs to the Section Neurotechnology and Neuroimaging)

► Show Figures

Figure 1

14 pages, 889 KiB

Open AccessArticle

Reliability and Validity of the KFORCE Sens^® Inertial Sensor for Measuring Cervical Spine Proprioception in Patients with Non-Specific Chronic Neck Pain

by George A. Koumantakis, Stamatina Gkouma, Christina Floka, Petros I. Tatsios, Maria Moutzouri and Vasiliki Sakellari

Brain Sci. 2024, 14(12), 1165; https://doi.org/10.3390/brainsci14121165 - 22 Nov 2024

Abstract

Background/Objectives: Patients with non-specific chronic neck pain (NSCNP) exhibit sensorimotor disturbances, with proprioception impairment considered an important aspect. The aim of this study was to assess the reliability and validity of a novel inertial sensor-based electrogoniometer (KFORCE Sens^®) for cervical spine [...] Read more.

Background/Objectives: Patients with non-specific chronic neck pain (NSCNP) exhibit sensorimotor disturbances, with proprioception impairment considered an important aspect. The aim of this study was to assess the reliability and validity of a novel inertial sensor-based electrogoniometer (KFORCE Sens^®) for cervical spine (CS) proprioception measurement in patients with NSCNP. Methods: The within-day intra-rater reliability of CS proprioception and its association with patient demographics and clinical status were examined in fifty-nine patients with NSCNP, aged between 25–65 years, recruited from primary care. CS proprioception was examined via angle reproduction, in angles set mid-range in the available CS range of motion (ROM) in each motion direction. The clinical status evaluation comprised the maximum and average pain intensity in the last week, disability, fear of movement/re-injury, catastrophizing, neck awareness, and CS-ROM. Reliability was assessed using the intraclass correlation coefficient (ICC_2,1), standard error of the measurement (SEM), and minimum detectable change (MDC_95%). Pearson’s R assessed between-measures associations. Results: CS proprioception reliability was good (ICC_2,1 = 0.75–0.89), with low measurement error (SEM = 1.38–3.02° and MDC_95% = 3.83–8.38°). Correlations between participants’ CS proprioception and their clinical status or demographics were not significant. Conclusions: The reliability of CS proprioception assessment with the KFORCE Sens^® was good in a sample of mildly to moderately disabled patients with CNP and thus deemed suitable for further research in this field. Full article

(This article belongs to the Section Sensory and Motor Neuroscience)

► Show Figures

Figure 1

14 pages, 1132 KiB

Open AccessPerspective

Noninvasive Ultra Low Intensity Light Photodynamic Treatment of Glioblastoma with Drug Augmentation: LoGlo PDT Regimen

by Richard E. Kast, Anton P. Kast, Jürgen Arnhold, Felix Capanni, Laura N. Milla Sanabria, Nicolas Bader, Bruno Marques Vieira, Alex Alfieri, Georg Karpel-Massler and Erasmo Barros da Silva, Jr.

Brain Sci. 2024, 14(12), 1164; https://doi.org/10.3390/brainsci14121164 - 21 Nov 2024

Abstract

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis. Oral 5-aminolevulinic acid (5-ALA) is an FDA/EMA [...] Read more.

This paper presents the basis for LoGlo PDT, a new treatment for glioblastoma. Glioblastoma is currently treated with maximal safe resection, temozolomide, and ionizing irradiation. Mortality in 2024 remains over 80% within several years from diagnosis. Oral 5-aminolevulinic acid (5-ALA) is an FDA/EMA approved drug that is selectively taken up by malignant cells, including by glioblastoma. In photodynamic treatment of glioblastoma, intense intraoperative light causes glioblastoma tissue that has taken up 5-ALA to generate cytotoxic reactive oxygen species. The requirement for intense light flux has restricted photodynamic treatment to a single one-hour intraoperative session. We analyze here published data showing that external light, illuminating the entire intact scalp, can attain low μW/cm² flux several cm into intact brain that would be sufficient to mediate 5-ALA photodynamic treatment of glioblastoma if the light and 5-ALA are delivered continuously over 24 h. At the core of LoGlo PDT regimen is the dataset showing that, for a given fluence, as the duration of PDT light delivery goes down, light intensity (flux) delivered must go up to achieve the same glioblastoma cell cytotoxicity as would a weaker light (lower flux) delivered over a longer time. Thus, a repetitive, noninvasive PDT of glioblastoma using an external light source may be possible. We analyze 5-ALA cellular physiology to show that three non-oncology drugs, ciprofloxacin, deferiprone, and telmisartan, can be repurposed to increase light energy capture after 5-ALA, thereby increasing photodynamic treatment’s glioblastoma cell cytotoxicity. The LoGlo PDT approach uses both drug augmentation and prolonged ultra-low noninvasive transcranial light delivery for a repetitive, noninvasive 5-ALA photodynamic treatment of glioblastoma. Full article

(This article belongs to the Special Issue Innovation in Brain Tumor Treatment)

► Show Figures

Figure 1

22 pages, 1348 KiB

Open AccessReview

Galantamine-Memantine Combination in the Treatment of Parkinson’s Disease Dementia

by Emma D. Frost, Swanny X. Shi, Vishnu V. Byroju, Jamir Pitton Rissardo, Jack Donlon, Nicholas Vigilante, Briana P. Murray, Ian M. Walker, Andrew McGarry, Thomas N. Ferraro, Khalid A. Hanafy, Valentina Echeverria, Ludmil Mitrev, Mitchel A. Kling, Balaji Krishnaiah, David B. Lovejoy, Shafiqur Rahman, Trevor W. Stone and Maju Mathew Koola

Brain Sci. 2024, 14(12), 1163; https://doi.org/10.3390/brainsci14121163 - 21 Nov 2024

Abstract

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson’s disease dementia (PDD). Currently, the only US Food and [...] Read more.

Parkinson’s disease (PD) is a progressive neurodegenerative disorder that affects over 1% of population over age 60. It is defined by motor and nonmotor symptoms including a spectrum of cognitive impairments known as Parkinson’s disease dementia (PDD). Currently, the only US Food and Drug Administration-approved treatment for PDD is rivastigmine, which inhibits acetylcholinesterase and butyrylcholinesterase increasing the level of acetylcholine in the brain. Due to its limited efficacy and side effect profile, rivastigmine is often not prescribed, leaving patients with no treatment options. PD has several derangements in neurotransmitter pathways (dopaminergic neurons in the nigrostriatal pathway, kynurenine pathway (KP), acetylcholine, α7 nicotinic receptor, and N-methyl-D-aspartate (NMDA) receptors) and rivastigmine is only partially effective as it only targets one pathway. Kynurenic acid (KYNA), a metabolite of tryptophan metabolism, affects the pathophysiology of PDD in multiple ways. Both galantamine (α7 nicotinic receptor) and memantine (antagonist of the NMDA subtype of the glutamate receptor) are KYNA modulators. When used in combination, they target multiple pathways. While randomized controlled trials (RCTs) with each drug alone for PD have failed, the combination of galantamine and memantine has demonstrated a synergistic effect on cognitive enhancement in animal models. It has therapeutic potential that has not been adequately assessed, warranting future randomized controlled trials. In this review, we summarize the KYNA-centric model for PD pathophysiology and discuss how this treatment combination is promising in improving cognitive function in patients with PDD through its action on KYNA. Full article

(This article belongs to the Section Neuropharmacology and Neuropathology)

► Show Figures

Figure 1

16 pages, 2647 KiB

Open AccessArticle

Personalized Dose Selection for Treatment of Patients with Neuropsychiatric Disorders Using tDCS

by Sagarika Bhattacharjee, Rajan Kashyap, Vanteemar S. Sreeraj, Palanimuthu T. Sivakumar, Ganesan Venkatasubramanian, John E. Desmond, S. H. Annabel Chen, T. N. Sathyaprabha and Kaviraja Udupa

Brain Sci. 2024, 14(12), 1162; https://doi.org/10.3390/brainsci14121162 - 21 Nov 2024

Abstract

Background: Individualizing transcranial direct current stimulation (tDCS) parameters can improve precision in neuropsychiatric disorders. One important decision for the clinician is the selection of an appropriate montage—conventional or high-definition (HD)—to implement dose-controlled tDCS while maintaining the patient’s safety. Method: The present [...] Read more.

Background: Individualizing transcranial direct current stimulation (tDCS) parameters can improve precision in neuropsychiatric disorders. One important decision for the clinician is the selection of an appropriate montage—conventional or high-definition (HD)—to implement dose-controlled tDCS while maintaining the patient’s safety. Method: The present study simulated tDCS administration using T1-weighted brain images of 50 dementia, 25 depression patients, and 25 healthy individuals for two conventional and HD montages, targeting the regions of interest (ROIs) in the dorsal and ventral pathways that support language processing. For each tDCS configuration, the electric fields at the ROIs and the individualized dose required to achieve the desired current intensity at the target ROI across the subjects were estimated. Linear regression was performed on these parameters. Result: A significant relationship between atrophy and current dose that varies according to the disease was found. The dementia patients with significant brain atrophy required a higher personalized dosage for HD montage, as the current intensity at the target ROIs was lower and more variable than that of conventional montage. For dementia, tDCS individualization is pathway-dependent, wherein HD configuration of the dorsal route requires current dosages above the safety limit (>4 mA) for 46% of individuals. However, there was no significant difference in electrode configurations between the HD and traditional setups for depression and healthy volunteers without significant brain atrophy. Conclusions: HD-tDCS with fixed locations is limited, making conventional tDCS more effective for dose-controlled applications. In patients with atrophy, individualized adjustments based on simulations are needed due to the variable stimulation strength in the ROI. Full article

(This article belongs to the Special Issue Brain Stimulation for Psychiatric Disorders: Emerging Evidence and New Perspectives)

► Show Figures

Figure 1

13 pages, 1417 KiB

Open AccessArticle

Cross-Section of Neurological Manifestations Among SARS-CoV-2 Omicron Subvariants—Single-Center Study

by Justyna Jachman-Kapułka, Aleksander Zińczuk, Krzysztof Simon and Marta Rorat

Brain Sci. 2024, 14(11), 1161; https://doi.org/10.3390/brainsci14111161 - 20 Nov 2024

Abstract

Background/Objectives: The Omicron variant of SARS-CoV-2 is undergoing constant mutation. New strains vary in neuropathogenicity and the neurological spectrum of disease. The aim of this study was to assess the frequency and clinical characteristics of neurological manifestations during the Omicron dominance among [...] Read more.

Background/Objectives: The Omicron variant of SARS-CoV-2 is undergoing constant mutation. New strains vary in neuropathogenicity and the neurological spectrum of disease. The aim of this study was to assess the frequency and clinical characteristics of neurological manifestations during the Omicron dominance among hospitalized patients, including the differences between three subsequent periods. Methods: This retrospective single-center study included 426 hospitalized adults with confirmed COVID-19 divided into three periods (O1, O2, and O3) dependent on the dominance of Omicron subvariants in Poland. Demographic and clinical data, in particular neurological manifestations, were collected and compared. Results: The median age of the group was 74, older in subsequent (later) periods. The number of patients with a history of previous SARS-CoV-2 infection or vaccination increased with the duration of the pandemic. The severity of COVID-19 became lower in successive periods. Neurological manifestations were observed in 55.4% of patients, and the most frequent were delirium, headache, myalgia, dizziness, cerebrovascular diseases, and encephalopathy. In subsequent periods of Omicron dominance, a higher frequency of neurological manifestations such as delirium, transient ischemic attack (TIA), and encephalopathy was observed. Headache or myalgia was related to a shorter hospitalization while delirium, cerebrovascular diseases, and ischemic stroke were linked with an increased risk of death. Conclusions: The Omicron variant of SARS-CoV-2 presents a wide spectrum of neurological manifestations. Although there is an improvement in the survival rate of patients with COVID-19, the frequency of neurological manifestations increases. The occurrence of delirium, cerebrovascular diseases, and ischemic stroke results in higher mortality. Full article

(This article belongs to the Section Neurovirology)

► Show Figures

Figure 1

12 pages, 266 KiB

Open AccessArticle

Neuropsychological Abnormalities Associated with Alcohol Dependence During Long-Term Rehabilitation Treatment of German Inpatients

by Josef Rabl, Dieter Geyer, Dario Kroll, Fabrizio Schifano and Norbert Scherbaum

Brain Sci. 2024, 14(11), 1160; https://doi.org/10.3390/brainsci14111160 - 20 Nov 2024

Abstract

Background: Alcohol dependence is associated with several neuropsychological abnormalities, such as increased impulsivity or attentional bias towards drug-related stimuli. However, it is debated whether these abnormalities are on the decline after long-term abstinence from alcohol. Inpatient rehabilitation treatment enables the longitudinal investigation of [...] Read more.

Background: Alcohol dependence is associated with several neuropsychological abnormalities, such as increased impulsivity or attentional bias towards drug-related stimuli. However, it is debated whether these abnormalities are on the decline after long-term abstinence from alcohol. Inpatient rehabilitation treatment enables the longitudinal investigation of such variables during a long, largely secured, period of abstinence. Methods: This study involved alcohol-dependent patients consecutively admitted for a duration of 14–26 weeks to an inpatient rehabilitation treatment center located in a hospital specializing in substance use disorders. Craving and impulsivity were assessed with the means of two questionnaires (e.g., OCDS-G and BIS-11); conversely, attentional bias and problems with inhibition were measured with the help of two computer-based experiments (e.g., dot–probe task and stop–signal–reaction task). Investigations were conducted at entry, after 6 weeks, and during the last two weeks of the inpatient treatment. Results: A total of 130 patients with alcohol dependence (mean age 43.3 years; 78.5% male) completed the first, N = 102 the second, and N = 83 the final assessment. Over the whole period of inpatient treatment, there was a significant decrease in patients’ scores for both craving (t(83) = 7.8, p < 0.001) and impulsivity (t(82) = −3.75, p < 0.001, t(82) = 4.4, p < 0.001). However, there were no significant changes regarding attentional bias (t(82) = 0.16, p = 0.494) and inhibitory control (t(76) = 0.04, p = 0.482) scores. Conclusions: Neuropsychological abnormalities associated with alcohol dependence might persist even after a long abstinence period. The decrease in both craving and impulsivity levels may be explained by the protected, alcohol-free, hospital environment; however, patients’ risk of post-discharge relapse may remain high, as the basic neurobiological mechanisms of alcohol dependence may persist for long periods, and possibly for more than 3–6 months. Full article

(This article belongs to the Special Issue Psychiatry and Addiction: A Multi-Faceted Issue)

15 pages, 748 KiB

Open AccessReview

Polyneuropathy in Cerebrotendinous Xanthomatosis: Diagnostic Challenges and Potential for Therapeutic Intervention

by Antonio Edvan Camelo-Filho, Pedro Lucas Grangeiro Sá Barreto Lima, Francisco Luciano Honório Barreto Cavalcante, Oliver Reiks Miyajima, Carolina Figueiredo Santos, Rodrigo Fagundes da Rosa, André Luiz Santos Pessoa, Pedro Braga-Neto and Paulo Ribeiro Nóbrega

Brain Sci. 2024, 14(11), 1159; https://doi.org/10.3390/brainsci14111159 - 20 Nov 2024

Abstract

Cerebrotendinous xanthomatosis (CTX) is a rare metabolic disorder caused by mutations in the CYP27A1 gene, leading to cholestanol accumulation in various tissues, including peripheral nerves. Polyneuropathy is an underrecognized feature with considerable variability in clinical presentation and neurophysiological findings in CTX. This review [...] Read more.

Cerebrotendinous xanthomatosis (CTX) is a rare metabolic disorder caused by mutations in the CYP27A1 gene, leading to cholestanol accumulation in various tissues, including peripheral nerves. Polyneuropathy is an underrecognized feature with considerable variability in clinical presentation and neurophysiological findings in CTX. This review assesses the prevalence, clinical manifestations, and diagnostic methodologies of polyneuropathy in CTX, exploring its underlying mechanisms and potential treatment outcomes. A literature review was conducted using PubMed, Embase, and the Virtual Health Library databases with search terms related to CTX and polyneuropathy. A total of 892 articles were initially identified, with 59 selected for in-depth analysis. The review focused on studies examining peripheral nerve involvement in CTX, including nerve conduction studies, electromyography, and nerve ultrasound. Polyneuropathy in CTX was observed in 50% to 77.7% of patients across multiple case series. Neurophysiological findings varied, with reports of axonal, demyelinating, and mixed polyneuropathies. Clinical presentation included lower limb atrophy, pes cavus, and distal weakness, with sensory symptoms less frequently reported. Treatment with chenodeoxycholic acid (CDCA) showed potential in improving nerve conduction parameters, although the response was variable and dependent on the timing of intervention. Polyneuropathy in CTX presents significant diagnostic challenges due to its heterogeneous presentation and varying neurophysiological findings. Early recognition and intervention are crucial for improving patient outcomes. Peripheral nerve ultrasound is a promising diagnostic tool, complementing traditional neurophysiological assessments. Further research is needed to standardize protocols and explore the full therapeutic potential of CDCA in managing CTX-related polyneuropathy. Full article

(This article belongs to the Special Issue Advances in the Molecular Genetics of Neurological Disorders)

► Show Figures

Figure 1

13 pages, 4184 KiB

Open AccessArticle

Reassessing the Neural Correlates of Social Exclusion: A Replication Study of the Cyberball Paradigm Using Arterial Spin Labeling

by Karin Labek and Roberto Viviani

Brain Sci. 2024, 14(11), 1158; https://doi.org/10.3390/brainsci14111158 - 20 Nov 2024

Abstract

Background/Objectives: The cyberball paradigm has been used in numerous neuroimaging studies to elicit activation in neural substrates of social exclusion, which have been interpreted in terms of activity associated with “social pain”. The objectives of the study were to assess not only the [...] Read more.

Background/Objectives: The cyberball paradigm has been used in numerous neuroimaging studies to elicit activation in neural substrates of social exclusion, which have been interpreted in terms of activity associated with “social pain”. The objectives of the study were to assess not only the replicability but also the specificity of the areas activated by this paradigm. Methods: Functional imaging with arterial spin labeling, an approach to image longer mental states. Results: We replicated findings of previous meta-analyses of this paradigm in the inferior frontal gyrus and ventral cingular cortex. However, these areas were also active in a watch condition (in which participants were not excluded), although less so. Conclusions: These findings relativize a simple and specific interpretation of these areas as the neural substrates of social exclusion and social pain, as in previous studies. In a broader experimental context, similar activations have been reported by neuroimaging studies when semantic disambiguation and evaluation of action goals are required, an interpretation that may also apply to the effects elicited by this paradigm. Full article

(This article belongs to the Special Issue State of the Art in Human Attachment)

► Show Figures

Figure 1

17 pages, 1523 KiB

Open AccessArticle

Prognostic Role of Invasion-Related Extracellular Matrix Molecules in Diffusely Infiltrating Grade 2 and 3 Astrocytomas

by László Szivos, József Virga, Zoltán Mészár, Melinda Rostás, Andrea Bakó, Gábor Zahuczki, Tibor Hortobágyi and Álmos Klekner

Brain Sci. 2024, 14(11), 1157; https://doi.org/10.3390/brainsci14111157 - 20 Nov 2024

Abstract

Background: Astrocytoma, an IDH-mutant is a common primary brain tumor. Total surgical resection is not feasible due to peritumoral infiltration mediated by extracellular matrix (ECM) molecules. Methods: This study aimed at determining the expression pattern of ECM molecules in different prognostic groups of [...] Read more.

Background: Astrocytoma, an IDH-mutant is a common primary brain tumor. Total surgical resection is not feasible due to peritumoral infiltration mediated by extracellular matrix (ECM) molecules. Methods: This study aimed at determining the expression pattern of ECM molecules in different prognostic groups of WHO grade 2 and grade 3 patients and identifying the effect of onco-radiotherapy on tumor cell invasion of grade 3 patients. Gene and protein expression of ECM molecules was determined by qRT-PCR and immunohistochemistry, respectively. Results: In the different prognostic groups of grade 2 tumors HMMR, IDH-1, MKI-67, PDGF-A and versican, in grade 3 tumors integrin α-3, and in both groups integrin α-3 and IDH-1 mRNA expression was significantly different. Regarding protein expression, only integrin αV expression changed significantly in the prognostic groups of grade 2 tumors. Conclusions: Based on the invasion spectrum determined by this joint gene and protein expression analysis, there was a sensitivity of 87.5% and a negative predictive value of 88.9% regarding the different prognostic groups of grade 2 astrocytoma. For grade 3 tumors, the applied standard oncotherapeutic modalities apparently lacked significant anti-invasive effects. Full article

(This article belongs to the Special Issue Brain Tumors: From Molecular Basis to Therapy)

► Show Figures

Figure 1

18 pages, 2814 KiB

Open AccessArticle

Impact of Situation Awareness Variations on Multimodal Physiological Responses in High-Speed Train Driving

by Wenli Dong, Weining Fang, Hanzhao Qiu and Haifeng Bao

Brain Sci. 2024, 14(11), 1156; https://doi.org/10.3390/brainsci14111156 - 20 Nov 2024

Abstract

Background: In safety-critical environments, human error is a leading cause of accidents, with the loss of situation awareness (SA) being a key contributing factor. Accurate SA assessment is essential for minimizing such risks and ensuring operational safety. Traditional SA measurement methods have limitations [...] Read more.

Background: In safety-critical environments, human error is a leading cause of accidents, with the loss of situation awareness (SA) being a key contributing factor. Accurate SA assessment is essential for minimizing such risks and ensuring operational safety. Traditional SA measurement methods have limitations in dynamic real-world settings, while physiological signals, particularly EEG, offer a non-invasive, real-time alternative for continuous SA monitoring. However, the reliability of SA measurement based on physiological signals depends on the accuracy of SA labeling. Objective: This study aims to design an effective SA measurement paradigm specific to high-speed train driving, investigate more accurate physiological signal-based SA labeling methods, and explore the relationships between SA levels and key physiological metrics based on the developed framework. Methods: This study recruited 19 male high-speed train driver trainees and developed an SA measurement paradigm specific to high-speed train driving. A method combining subjective SA ratings and task performance was introduced to generate accurate SA labels. Results: The results of statistical analysis confirmed the effectiveness of this paradigm in inducing SA level changes, revealing significant relationships between SA levels and key physiological metrics, including eye movement patterns, ECG features (e.g., heart rate variability), and EEG power spectral density across theta, alpha, and beta bands. Conclusions: This study supports the use of multimodal physiological signals for SA assessment and provides a theoretical foundation for future applications of SA monitoring in railway operations, contributing to enhanced operational safety. Full article

(This article belongs to the Special Issue Brains at Work: How Wearable Technology May Benefit Research, Health and Everyday Life)

► Show Figures

Figure 1

8 pages, 217 KiB

Open AccessBrief Report

Longitudinal Insights into the Mental Health of Healthcare Workers: Emotional Shifts During Two Years of the COVID-19 Crisis

by Maia Stanisławska-Kubiak, Grażyna Teusz, Michał Ziarko and Ewa Mojs

Brain Sci. 2024, 14(11), 1155; https://doi.org/10.3390/brainsci14111155 - 19 Nov 2024

Abstract

Objective: Numerous studies have highlighted the prevalence of mental health disorders among healthcare professionals during the COVID-19 pandemic, with varying indications of emotional strain. This study compares the psychological functioning of healthcare workers at the onset of the pandemic and two years later, [...] Read more.

Objective: Numerous studies have highlighted the prevalence of mental health disorders among healthcare professionals during the COVID-19 pandemic, with varying indications of emotional strain. This study compares the psychological functioning of healthcare workers at the onset of the pandemic and two years later, offering a comprehensive assessment of their emotional and mental health status in the evolving context of COVID-19. Methods: This longitudinal analysis examined the relationship between stress, emotional processing, and their positive/negative impacts on medical personnel working in Polish hospitals and outpatient clinics in 2020 (n = 285) and 2022 (n = 252). The study employed the Toronto Alexithymia Scale-20 (TAS-20), Cohen’s Perceived Stress Scale (PSS-10), Mini-COPE, Acceptance of Illness Scale (AIS), Emotional Processing Scale (EPS), STAI, and PANAS to assess psychological responses and coping mechanisms. Results: Findings revealed a significant increase in denial, substance use, self-blame, negative mood, and impaired psychological and somatic functioning, alongside heightened symptoms of depression and anxiety. Conversely, a marked decrease in planning, positive reinterpretation, acceptance, religious coping, and seeking social support (both emotional and instrumental) was observed over the two-year period. Conclusion: The prolonged nature of the COVID-19 pandemic has profoundly affected the psychological resilience of healthcare professionals, eroding critical emotional resources necessary for maintaining interpersonal relationships and mental well-being. These results underscore the need for targeted interventions to support the mental health of medical staff in the ongoing crisis. Full article

(This article belongs to the Section Neuropsychology)

11 pages, 1749 KiB

Open AccessArticle

Window Coverage and Liquid Biopsy in the First-Line Therapy of Severe Sudden Sensorineural Hearing Loss

by Alexander Kilgue, Rayoung Kim, Lars-Uwe Scholtz, Conrad Riemann, Christoph J. Pfeiffer, Matthias Schürmann and Ingo Todt

Brain Sci. 2024, 14(11), 1154; https://doi.org/10.3390/brainsci14111154 - 19 Nov 2024

Abstract

Introduction: Based on clinical practice guidelines, the application of corticosteroids as a first-line therapy is common. Although sudden sensorineural hearing loss (SSHL) etiology is primarily idiopathic, hearing loss can result from a perilymphatic fistula (PLF). Recent findings show evidence of a specific rate [...] Read more.

Introduction: Based on clinical practice guidelines, the application of corticosteroids as a first-line therapy is common. Although sudden sensorineural hearing loss (SSHL) etiology is primarily idiopathic, hearing loss can result from a perilymphatic fistula (PLF). Recent findings show evidence of a specific rate of PLF based on a cochlin-tomoprotein (CTP) detection test. Based on this rate of PLF treatment, the concepts of SSNHL need to be re-evaluated. The present study aimed to evaluate CTP in SSNHL patients and compare pre-surgical and post-surgical pure tone hearing thresholds after round and oval window sealing as first-line treatment. Material and Methods: A total of 30 patients with unilateral SSNHL with a pure tone average (PTA) (4 Freq. of 60 dB or more were enrolled in a prospective study. All patients underwent tympanoscopy for middle ear exploration as a first-line treatment. After intraoperative observation of a possible PLF, all patients obtained middle ear lavage to gain CTP samples for following ELISA-based CTP detection tests. All patients received round window and oval window sealing with fascia. PTA hearing thresholds were analyzed post-surgically 3 weeks after treatment based on 4-frequency bone conduction (BC). Results: The average preoperative pure tone BC threshold was 97.7 dB compared with the 69 dB postoperative BC threshold. Mean BC improved by 20.3 dB after middle ear exploration and window sealing. A total of 56% (17 of 30) of patients recovered at least 10 dB. The middle ear cochlin-tomoprotein detection rate was 70% positive. Conclusions: The combination of early tympanoscopy and inner ear-specific cochlin-tomoprotein as a detection tool for suspected PLF showed evidence of PLF as a key causative in SSNHL. Full article

(This article belongs to the Special Issue Recent Advances in Hearing Impairment)

► Show Figures

Figure 1

Journal Description

Brain Sciences

Latest Articles

Journal Menu

Journal Browser

Highly Accessed Articles

Latest Books

E-Mail Alert

News

Topics

Conferences

Special Issues

Topical Collections

Further Information

Guidelines

MDPI Initiatives

Follow MDPI