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Women in Brain Science: Achievements, Challenges and Perspectives

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A special issue of Brain Sciences (ISSN 2076-3425).

Deadline for manuscript submissions: closed (15 September 2023) | Viewed by 24130

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Prof. Dr. Soňa Nevšímalová

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Department of Neurology and Clinical Sciences, 1st Faculty of Medicine, Charles University and General Hospital, 12000 Prague, Czech Republic
Interests: disorders of sleep; narcolepsy; idiopathic hypersomnia; parasomnias; circadian sleep disorders; movement disorders in sleep
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Prof. Dr. Rosalia Silvestri

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Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy
Interests: sleep-related movement disorders, especially RLS; gender differences in sleep pathology; epilepsy and parasomnias and sleep dysfunction associated with neurological disorders

Prof. Dr. Teresa Paiva

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Electroencephalography and Clinic Neurophysiology Centre (CENC)-Sleep Medicine Center Rua Conde das Antas, 1070-179 Lisboa, Portugal
Interests: sleep medicine; sleep education; polysomnography; BME; neurophysiology; headache

Dr. Caroline Schnakers

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Guest Editor

Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, CA 91767, USA
Interests: brain injury; consciousness; coma; vegetative state; unresponsive wakefulness syndrome; minimally conscious state; post-traumatic confusional state; locked-in syndrome
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

To celebrate and highlight the achievements of women in the research area of brain science, it is our pleasure to present this special collection of articles, highlighting the achievements of women scientists in the field of brain science from all around the world. We also hope that this Special Issue will further encourage and promote the scientific contributions of female researchers in this field.

We cordially invite researchers to submit their work on topics across all areas of brain science. Review articles, original research papers, and communications are all welcome.

Articles for which women are lead or senior authors are encouraged. We welcome submissions from all authors, irrespective of gender.

Prof. Dr. Soňa Nevšímalová
Prof. Dr. Rosalia Silvestri
Prof. Dr. Teresa Paiva
Dr. Caroline Schnakers
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

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Published Papers (9 papers)

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11 pages, 695 KiB

Open AccessArticle

Sleep Quality Should Be Assessed in Inpatient Rehabilitation Settings: A Preliminary Study

by Benjamin Winters, Dylan Serpas, Niko Fullmer, Katie Hughes, Jennifer Kincaid, Emily R. Rosario and Caroline Schnakers

Brain Sci. 2023, 13(5), 718; https://doi.org/10.3390/brainsci13050718 - 25 Apr 2023

Cited by 1 | Viewed by 1872

Abstract

Objectives: In this preliminary, longitudinal study, our objective was to assess changes in sleep quality during an inpatient stay in a rehabilitation setting in the United States and to relate changes to patients’ demographic and clinical characteristics (i.e., age, gender, BMI, ethnicity, reason for hospitalization, pre-hospital living setting, prior diagnosis of sleep disorders, and mental health status). Methods: A total of 35 patients participated in this preliminary study (age = 61 ± 16 years old, 50% <65; BMI = 30 ± 7 kg/m²; 51% female; 51% Caucasian). The average length of hospitalization was 18 ± 8 days. Reasons for hospitalization included orthopedic-related issues (28%), spinal cord injury (28%), stroke (20%), and other (23%). In this sample, 23% had prior sleep disorders (mostly sleep apnea), and 60% came from an acute care unit. Patients’ sleep quality was assessed using the Pittsburgh sleep quality index (PSQI) at admission and before discharge. Demographic and medical data were collected. Patients’ mental health status was also assessed at the same intervals. Nighttime sound levels and the average number of sleep disturbances were also collected throughout the study (6 months). Results: Our data revealed that most patients had poor sleep (PSQI > 5) at admission (86%) and discharge (80%). Using a repeated ANOVA, a significant interaction was obtained between sleep quality and the presence of a diagnosed sleep disorder [F (1, 33) = 12.861, p = 0.001, η²_p = 0.280]. The sleep quality of patients with sleep disorders improved over their stay, while the sleep of patients without such disorders did not. The mean nighttime sound collection level averages and peaks were 62.3 ± 5.1 dB and 86.1 ± 4.9 dB, respectively, and the average number of sleep disturbances was 2.6 ± 1.1. Conclusion: The improved sleep observed in patients with vs. without sleep disorders might be related to the care received for treating such disorders over the stay. Our findings call for the better detection and management of poor sleep in acute inpatient rehabilitation settings. Furthermore, if our findings are replicated in the future, studies on the implementation of quiet times for medical staff, patients, and family should be performed to improve sleep quality in the inpatient rehabilitation setting. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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9 pages, 690 KiB

Open AccessArticle

Parasomnias in Pregnancy

by Jitka Bušková, Eva Miletínová, Radana Králová, Tereza Dvořáková, Adéla Tefr Faridová, Hynek Heřman, Kristýna Hrdličková and Antonín Šebela

Brain Sci. 2023, 13(2), 357; https://doi.org/10.3390/brainsci13020357 - 18 Feb 2023

Cited by 3 | Viewed by 3396

Abstract

Objectives: Pregnancy is often associated with reduced sleep quality and an increase in sleep disorders, such as restless leg syndrome, obstructive sleep apnea, and insomnia. There are few studies investigating the prevalence of parasomnias in pregnancy, although they may be expected to be a significant problem, as disturbed sleep in this time period in addition to these sleep disorders may trigger parasomnia episodes. Methods: We conducted a survey using an online questionnaire focusing on a comparison of the prevalence of parasomnias in three time periods: 3 months before pregnancy, during pregnancy, and 3 months after delivery. We also inquired about psychiatric and neurological comorbidities, current anxiety and depression symptoms, and pregnancy complications. Results: A total of 325 women (mean age 30.3 ± 5.3 years) participated in the online survey. The overall number of reported parasomnias increased during pregnancy compared to the 3 months before pregnancy (p < 0.001) and decreased after childbirth (p < 0.001). Specifically, we found a significant increase in sleepwalking (p = 0.02) and night terrors (p < 0.001), as well as in vivid dreams (p < 0.001) and nightmares (p < 0.001) during pregnancy. A similar significant increase during pregnancy was reported for head explosion (p < 0.011). In contrast, the number of episodes of sleep paralysis increased after delivery (p = 0.008). At the individual level, an increase in the severity/frequency of individual parasomnia episodes was also observed during pregnancy. Participants whose vivid dreams/nightmares persisted after delivery had higher BDI-II and STAI-T scores. Our data also suggest a significant impact of migraines and other chronic pain, as well as complications during pregnancy, on the presence of parasomnia episodes in our cohort. Conclusions: We have shown that the prevalence of parasomnias increases during pregnancy and needs to be targeted, especially by non-pharmacological approaches. At the same time, it is necessary to inquire about psychiatric and neurological comorbidities and keep in mind that more sleep disorders may be experienced by mothers who have medical complications during pregnancy. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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17 pages, 1398 KiB

Open AccessArticle

Needs and Quality of Life of Caregivers of Patients with Prolonged Disorders of Consciousness

by Olivia Gosseries, Caroline Schnakers, Audrey Vanhaudenhuyse, Charlotte Martial, Charlène Aubinet, Vanessa Charland-Verville, Aurore Thibaut, Jitka Annen, Didier Ledoux, Steven Laureys and Charlotte Grégoire

Brain Sci. 2023, 13(2), 308; https://doi.org/10.3390/brainsci13020308 - 11 Feb 2023

Cited by 7 | Viewed by 2845

Abstract

Background. Many patients with severe brain damage may survive and remain in a prolonged disorder of consciousness (PDoC), impacting the quality of life (QoL) and needs of their family caregivers. However, the current literature on the factors influencing these needs is contradictory. We aim to describe the needs, QoL, and emotional distress of caregivers of patients with PDoC. Methods. Questionnaires investigating the importance and satisfaction of six categories of needs (i.e., health information, emotional, instrumental, and professional supports, community support network, and involvement in care), QoL, and emotional distress were completed by the main caregivers of PDoC patients. Results. We analyzed 177 questionnaires. Seventy-nine percent of the needs were considered as important or very important, and 44% were partially met or unmet. The needs for health information and professional support were the most important, while the needs for involvement in care and for health information were the most satisfied. Mean QoL was low and emotional distress high. Variables such as care setting and time since brain injury affected the level of QoL and distress. Conclusion. The needs for health information and professional support should receive particular attention. Given their low QoL and high distress, adequate support structures should be provided to caregivers of PDoC patients. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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21 pages, 2548 KiB

Open AccessArticle

The Possible Role of Apathy on Conflict Monitoring: Preliminary Findings of a Behavioral Study on Severe Acquired Brain Injury Patients Using Flanker Tasks

by Mariagrazia D’Ippolito, Giuseppe Spinelli, Marco Iosa, Salvatore Maria Aglioti and Rita Formisano

Brain Sci. 2023, 13(2), 298; https://doi.org/10.3390/brainsci13020298 - 10 Feb 2023

Cited by 2 | Viewed by 2141

Abstract

The diagnosis of apathy, one of the most common behavioral changes after acquired brain injury (ABI), is important for improving clinical understanding and treatment of persons with ABI. The main aim of this study was to determine the possible role of apathy in conflict monitoring, by using choice reaction time tasks. Methods: We examined behavioral responses of conflict monitoring during three different flanker tasks in 10 severe ABI patients with or without diagnosis of apathy (3 M, mean age = 56.60; 3 M, mean age ± SD = 58.60, respectively), and 15 healthy controls (9 M, mean age = 54.46) Reaction times (RTs), accuracy, and global index of performance (GIP) were analyzed for each task. Results: Only apathetic ABI patients showed a significant difference from healthy subjects (p-value ≤ 0.001), while the performance of patients without apathy was not significantly different from that of healthy controls (p-value = 0.351). Healthy participants had higher accuracy in comparison to both ABI patients with (p < 0.001) and without (p-value = 0.038) apathy, whilst slower RTs were shown by ABI patients without apathy in comparison to both healthy subjects (p-value = 0.045) and apathetic ABI patients (p-value = 0.022). Only patients with apathy exhibited a significantly higher number of missing trials (p-value = 0.001). Conclusions: Our results may suggest a potential link between apathy following severe ABI and conflict monitoring processes, even though further investigations with larger sample size are needed. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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9 pages, 280 KiB

Open AccessArticle

Back on the Road: Comparing Cognitive Assessments to Driving Simulators in Moderate to Severe Traumatic Brain Injuries

by Debra S. Ouellette, Stephanie Kaplan and Emily R. Rosario

Brain Sci. 2023, 13(1), 54; https://doi.org/10.3390/brainsci13010054 - 28 Dec 2022

Cited by 1 | Viewed by 1850

Abstract

Objective: To compare established clinical outcome assessments for predicting behind the wheel driving readiness and driving simulator results across age groups and in traumatic brain injury. Methods: Participants included adults who had a traumatic brain injury ranging in age from 31 to 57 years and a non-impaired adult population ranging in age from 18 to 80 years. Physical and cognitive outcomes measures were collected included range of motion and coordination, a “Rules of the Road Test” a “Sign Identification Test,” Trails A and B, and the clock drawing test. Visual measures included the Dynavision D2 system and motor-free visual perceptual test-3 (MVPT-3). Finally, the driving simulators (STI^Ò version M300) metro drive assessment was used, which consisted of negotiating several obstacles in a metropolitan area including vehicles abruptly changing lanes, pedestrians crossing streets, and negotiating construction zones. Results: Our findings suggest that the standard paper-pencil cognitive assessments and sign identification test significantly differentiate TBI from a non-impaired population (Trails A, B and Clock drawing test p < 0.001). While the driving simulator did not show as many robust differences with age, the TBI population did have a significantly greater number of road collisions (F_{3, 78} = 3.5, p = 0.02). We also observed a significant correlation between the cognitive assessments and the simulator variables. Conclusions: Paper-pencil cognitive assessments and the sign identification test highlight greater differences than the STI Driving Simulator between non-impaired and TBI populations. However, the driving simulator may be useful in assessing cognitive ability and training for on the road driving. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

9 pages, 261 KiB

Open AccessArticle

Psychotic Episode and Schizophrenia in Slovakian Narcolepsy Database

by Eva Feketeová, Jozef Dragašek, Katarína Klobučníková, Peter Ďurdík, Simona Čarnakovič, Miriam Slavkovská and Martina Chylová

Brain Sci. 2023, 13(1), 43; https://doi.org/10.3390/brainsci13010043 - 24 Dec 2022

Cited by 2 | Viewed by 1918

Abstract

Narcolepsy type 1 (NT1), a central disorder of hypersomnolence, is associated with mood, anxiety or hyperactivity mental disorders. Association with psychotic episode or schizophrenia is rare and could be the source of diagnostic and therapeutic difficulties. Their frequency in the national narcolepsy database has not been systematically studied. The aim of the presented study was to calculate the frequency of NT1 patients diagnosed with psychosis and/or schizophrenia, to identify clinical characteristics of these cases, and to look for narcoleptic and psychotic symptoms during re-evaluation years later. We identified three (4%) cases diagnosed with a psychotic episode in the course of NT1. They were diagnosed with NT1 by age ≤18 years. In the re-evaluation (mean follow-up 9.8 years), we identified one case with a dual diagnosis of NT1 and schizophrenia; two cases were diagnosed with a solitary psychotic episode in the course of NT1. NT1 patients diagnosed in the age ≤18 years are at higher risk of psychotic episode, and this may be related to higher vulnerability during the ongoing neurodevelopmental period. Comorbid schizophrenia with NT1 in the Slovakian Narcolepsy Database was within the prevalence expected in the general population. The solitary psychotic episode in the course of NT1 did not reduce the possibility of subsequent symptomatic treatment afterwards. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

12 pages, 887 KiB

Open AccessArticle

Central Disorders of Hypersomnolence: Association with Fatigue, Depression and Sleep Inertia Prevailing in Women

by Sona Nevsimalova, Jelena Skibova, Karolina Galuskova, Iva Prihodova, Simona Dostalova, Eszter Maurovich-Horvat and Karel Šonka

Brain Sci. 2022, 12(11), 1491; https://doi.org/10.3390/brainsci12111491 - 3 Nov 2022

Cited by 10 | Viewed by 3456

Abstract

Fatigue, depression, and sleep inertia are frequently underdiagnosed manifestations in narcolepsy and idiopathic hypersomnia. Our cross-sectional study design included diagnostic interview accompanied by assessment instruments and aimed to explore how these factors influence disease severity as well as to elucidate any sex predisposition. One hundred and forty-eight subjects (female 63%) were divided into narcolepsy type 1 (NT1; n = 87, female = 61%), narcolepsy type 2 (NT2; n = 22, female = 59%), and idiopathic hypersomnia (IH; n = 39, female = 69%). All subjects completed a set of questionnaires: Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scales (HADS), Fatigue Severity Scale (FSS), and Sleep Inertia Questionnaire (SIQ). In narcoleptic subjects, questionnaire data were correlated with the Narcolepsy Severity Scale (NSS), and in subjects with idiopathic hypersomnia, with the Idiopathic Hypersomnia Severity Scale (IHSS). The highest correlation in narcoleptic subjects was found between NSS and ESS (r = 0.658; p < 0.0001), as well as FSS (r = 0.506; p < 0.0001), while in subjects with idiopathic hypersomnia, the most prominent positive correlations were found between IHSS and SIQ (r = 0.894; p < 0.0001), FSS (r = 0.812; p < 0.0001), HADS depression scale (r = 0.649; p = 0.0005), and HADS anxiety scale (r = 0.528; p < 0.0001). ESS showed an analogic correlation with disease severity (r = 0.606; p < 0.0001). HADS anxiety and depression scores were higher in females (p < 0.05 and p < 0.01), with similar results for FSS and SIQ scales (p < 0.05 for both), and a trend toward higher ESS values in females (p = 0.057). Our study illustrates that more attention should be focused on pathophysiological mechanisms and associations of fatigue, depression, as well as sleep inertia in these diseases; they influence the course of both illnesses, particularly in women. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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7 pages, 262 KiB

Open AccessBrief Report

Gender Specificities in Sleep Disturbances following Mild Traumatic Brain Injury: A Preliminary Study

by Géraldine Martens, Mohammad Hossein Khosravi, Nicolas Lejeune, Jean-François Kaux and Aurore Thibaut

Brain Sci. 2023, 13(2), 323; https://doi.org/10.3390/brainsci13020323 - 14 Feb 2023

Cited by 4 | Viewed by 2060

Abstract

Mild traumatic brain injury (mTBI), or concussion, can lead to persistent cognitive and functional symptoms that impede quality of life to a varying extent. This condition is referred to as post-concussive syndrome (PCS). Sleep disturbances are part of it but their distribution among different genders remains scarcely investigated. This pilot cross-sectional anonymous web-based survey interviewed volunteer 18–55 years old participants with a recent (i.e., less than 5 years) reported history of mTBI. Questionnaires related to persistent post-concussive symptoms (PPCS; Rivermead post-concussion symptoms questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and daytime sleepiness (Epworth Sleepiness Scale) were administered as part of the survey. Ninety-one participants’ responses were analysed (61 female; 30 male); 43% of them suffered from post-concussive syndrome, 60% reported poor sleep quality and 34% experienced excessive daytime sleepiness. The proportion of PPCS was significantly higher in female participants as compared to males (female: 57%; male: 13%; Fisher’s exact test p < 0.001). Excessive daytime sleepiness was also significantly more present in females (female: 44%; male: 13%; p < 0.001) whereas poor sleep quality was present in similar proportions between females and males (female: 66%; male: 50%; p = 0.176). Even though based on a relatively small sample, these findings highlight important gender differences that should be accounted for in PPCS medical care and management. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

9 pages, 618 KiB

Open AccessOpinion

Arousal Regulation by the External Globus Pallidus: A New Node for the Mesocircuit Hypothesis

by Zhong Sheng Zheng, Nicco Reggente and Martin M. Monti

Brain Sci. 2023, 13(1), 146; https://doi.org/10.3390/brainsci13010146 - 14 Jan 2023

Cited by 3 | Viewed by 3339

Abstract

In the decade since its debut, the Mesocircuit Hypothesis (MH) has provided researchers a scaffolding for interpreting their findings by associating subcortical-cortical dysfunction with the loss and recovery of consciousness following severe brain injury. Here, we leverage new findings from human and rodent lesions, as well as chemo/optogenetic, tractography, and stimulation studies to propose the external segment of the globus pallidus (GPe) as an additional node in the MH, in hopes of increasing its explanatory power. Specifically, we discuss the anatomical and molecular mechanisms involving the GPe in sleep-wake control and propose a plausible mechanistic model explaining how the GPe can modulate cortical activity through its direct connections with the prefrontal cortex and thalamic reticular nucleus to initiate and maintain sleep. The inclusion of the GPe in the arousal circuitry has implications for understanding a range of phenomena, such as the effects of the adenosine (A2A) and dopamine (D2) receptors on sleep-wake cycles, the paradoxical effects of zolpidem in disorders of consciousness, and sleep disturbances in conditions such as Parkinson’s Disease. Full article

(This article belongs to the Special Issue Women in Brain Science: Achievements, Challenges and Perspectives)

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