Targeting the brain's glymphatic pathway: A novel therapeutic approach for cerebral small vessel disease

Cerebral small vessel disease encompasses a group of neurological disorders characterized by injury to small blood vessels, often leading to stroke and dementia. Due to its diverse etiologies and complex pathological mechanisms, preventing and treating cerebral small vessel vasculopathy is challenging. Recent studies have shown that the glymphatic system plays a crucial role in interstitial solute clearance and the maintenance of brain homeostasis. Increasing evidence also suggests that dysfunction in glymphatic clearance is a key factor in the progression of cerebral small vessel disease. This review begins with a comprehensive introduction to the structure, function, and driving factors of the glymphatic system, highlighting its essential role in brain waste clearance. Afterwards, cerebral small vessel disease was reviewed from the perspective of the glymphatic system, after which the mechanisms underlying their correlation were summarized. Glymphatic dysfunction may lead to the accumulation of metabolic waste in the brain, thereby exacerbating the pathological processes associated with cerebral small vessel disease. The review also discussed the direct evidence of glymphatic dysfunction in patients and animal models exhibiting two subtypes of cerebral small vessel disease: arteriolosclerosis-related cerebral small vessel disease and amyloid-related cerebral small vessel disease. Diffusion tensor image analysis along the perivascular space is an important non-invasive tool for assessing the clearance function of the glymphatic system. However, the effectiveness of its parameters needs to be enhanced. Among various nervous system diseases, including cerebral small vessel disease, glymphatic failure may be a common final pathway toward dementia. Overall, this review summarizes prevention and treatment strategies that target glymphatic drainage and will offer valuable insight for developing novel treatments for cerebral small vessel disease.

Neuromodulation technologies improve functional recovery after brain injury: From bench to bedside

Spontaneous recovery frequently proves maladaptive or insufficient because the plasticity of the injured adult mammalian central nervous system is limited. This limited plasticity serves as a primary barrier to functional recovery after brain injury. Neuromodulation technologies represent one of the fastest-growing fields in medicine. These techniques utilize electricity, magnetism, sound, and light to restore or optimize brain functions by promoting reorganization or long-term changes that support functional recovery in patients with brain injury. Therefore, this review aims to provide a comprehensive overview of the effects and underlying mechanisms of neuromodulation technologies in supporting motor function recovery after brain injury. Many of these technologies are widely used in clinical practice and show significant improvements in motor function across various types of brain injury. However, studies report negative findings, potentially due to variations in stimulation protocols, differences in observation periods, and the severity of functional impairments among participants across different clinical trials. Additionally, we observed that different neuromodulation techniques share remarkably similar mechanisms, including promoting neuroplasticity, enhancing neurotrophic factor release, improving cerebral blood flow, suppressing neuroinflammation, and providing neuroprotection. Finally, considering the advantages and disadvantages of various neuromodulation techniques, we propose that future development should focus on closed-loop neural circuit stimulation, personalized treatment, interdisciplinary collaboration, and precision stimulation.

Blood-brain barrier disruption and neuroinflammation in the hippocampus of a cardiac arrest porcine model: Single-cell RNA sequencing analysis

JOURNAL/nrgr/04.03/01300535-202602000-00043/figure1/v/2025-05-05T160104Z/r/image-tiff Global brain ischemia and neurological deficit are consequences of cardiac arrest that lead to high mortality. Despite advancements in resuscitation science, our limited understanding of the cellular and molecular mechanisms underlying post-cardiac arrest brain injury have hindered the development of effective neuroprotective strategies. Previous studies primarily focused on neuronal death, potentially overlooking the contributions of non-neuronal cells and intercellular communication to the pathophysiology of cardiac arrest-induced brain injury. To address these gaps, we hypothesized that single-cell transcriptomic analysis could uncover previously unidentified cellular subpopulations, altered cell communication networks, and novel molecular mechanisms involved in post-cardiac arrest brain injury. In this study, we performed a single-cell transcriptomic analysis of the hippocampus from pigs with ventricular fibrillation-induced cardiac arrest at 6 and 24 hours following the return of spontaneous circulation, and from sham control pigs. Sequencing results revealed changes in the proportions of different cell types, suggesting post-arrest disruption in the blood-brain barrier and infiltration of neutrophils. These results were validated through western blotting, quantitative reverse transcription-polymerase chain reaction, and immunofluorescence staining. We also identified and validated a unique subcluster of activated microglia with high expression of S100A8, which increased over time following cardiac arrest. This subcluster simultaneously exhibited significant M1/M2 polarization and expressed key functional genes related to chemokines and interleukins. Additionally, we revealed the post-cardiac arrest dysfunction of oligodendrocytes and the differentiation of oligodendrocyte precursor cells into oligodendrocytes. Cell communication analysis identified enhanced post-cardiac arrest communication between neutrophils and microglia that was mediated by neutrophil-derived resistin, driving pro-inflammatory microglial polarization. Our findings provide a comprehensive single-cell map of the post-cardiac arrest hippocampus, offering potential novel targets for neuroprotection and repair following cardiac arrest.

Investigation of epilepsy-related genes in a Drosophila model

Complex genetic architecture is the major cause of heterogeneity in epilepsy, which poses challenges for accurate diagnosis and precise treatment. A large number of epilepsy candidate genes have been identified from clinical studies, particularly with the widespread use of next-generation sequencing. Validating these candidate genes is emerging as a valuable yet challenging task. Drosophila serves as an ideal animal model for validating candidate genes associated with neurogenetic disorders such as epilepsy, due to its rapid reproduction rate, powerful genetic tools, and efficient use of ethological and electrophysiological assays. Here, we systematically summarize the advantageous techniques of the Drosophila model used to investigate epilepsy genes, including genetic tools for manipulating target gene expression, ethological assays for seizure-like behaviors, electrophysiological techniques, and functional imaging for recording neural activity. We then introduce several typical strategies for identifying epilepsy genes and provide new insights into gene‒gene interactions in epilepsy with polygenic causes. We summarize well-established precision medicine strategies for epilepsy and discuss prospective treatment options, including drug therapy and gene therapy for genetic epilepsy based on the Drosophila model. Finally, we also address genetic counseling and assisted reproductive technology as potential approaches for the prevention of genetic epilepsy.

Emerging role of microglia in the developing dopaminergic system: Perturbation by early life stress

Early life stress correlates with a higher prevalence of neurological disorders, including autism, attention-deficit/hyperactivity disorder, schizophrenia, depression, and Parkinson's disease. These conditions, primarily involving abnormal development and damage of the dopaminergic system, pose significant public health challenges. Microglia, as the primary immune cells in the brain, are crucial in regulating neuronal circuit development and survival. From the embryonic stage to adulthood, microglia exhibit stage-specific gene expression profiles, transcriptome characteristics, and functional phenotypes, enhancing the susceptibility to early life stress. However, the role of microglia in mediating dopaminergic system disorders under early life stress conditions remains poorly understood. This review presents an up-to-date overview of preclinical studies elucidating the impact of early life stress on microglia, leading to dopaminergic system disorders, along with the underlying mechanisms and therapeutic potential for neurodegenerative and neurodevelopmental conditions. Impaired microglial activity damages dopaminergic neurons by diminishing neurotrophic support (e.g., insulin-like growth factor-1) and hinders dopaminergic axon growth through defective phagocytosis and synaptic pruning. Furthermore, blunted microglial immunoreactivity suppresses striatal dopaminergic circuit development and reduces neuronal transmission. Furthermore, inflammation and oxidative stress induced by activated microglia can directly damage dopaminergic neurons, inhibiting dopamine synthesis, reuptake, and receptor activity. Enhanced microglial phagocytosis inhibits dopamine axon extension. These long-lasting effects of microglial perturbations may be driven by early life stress-induced epigenetic reprogramming of microglia. Indirectly, early life stress may influence microglial function through various pathways, such as astrocytic activation, the hypothalamic-pituitary-adrenal axis, the gut-brain axis, and maternal immune signaling. Finally, various therapeutic strategies and molecular mechanisms for targeting microglia to restore the dopaminergic system were summarized and discussed. These strategies include classical antidepressants and antipsychotics, antibiotics and anti-inflammatory agents, and herbal-derived medicine. Further investigations combining pharmacological interventions and genetic strategies are essential to elucidate the causal role of microglial phenotypic and functional perturbations in the dopaminergic system disrupted by early life stress.

Current understanding and prospects for targeting neurogenesis in the treatment of cognitive impairment

Adult hippocampal neurogenesis is linked to memory formation in the adult brain, with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons. Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases. Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits. This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment. Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment, including cerebrovascular diseases, Alzheimer's disease, aging-related conditions, and issues related to anesthesia and surgery. The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized, and targeting AHN is considered a promising approach for treating cognitive impairment. However, the underlying mechanisms of this role are not yet fully understood, and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited, with a need for further development of treatment methods and detection techniques. By reviewing recent studies, we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories: immunity, energy metabolism, aging, and pathological states. In immunity-related mechanisms, abnormalities in meningeal, brain, and peripheral immunity can disrupt normal adult hippocampal neurogenesis. Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis. During aging, the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients. Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis. Among the current strategies used to enhance this form of neurogenesis, physical therapies such as exercise, transcutaneous electrical nerve stimulation, and enriched environments have proven effective. Dietary interventions, including energy intake restriction and nutrient optimization, have shown efficacy in both basic research and clinical trials. However, drug treatments, such as antidepressants and stem cell therapy, are primarily reported in basic research, with limited clinical application. The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention, and targeting the former may be an important strategy for treating the latter. However, the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear, and treatments are lacking. This highlights the need for greater focus on translating research findings into clinical practice.

Synaptic and synchronic impairments in subcortical brain regions associated with early non-cognitive dysfunction in Alzheimer's disease

For many decades, Alzheimer's disease research has primarily focused on impairments within cortical and hippocampal regions, which are thought to be related to cognitive dysfunctions such as memory and language deficits. The exact cause of Alzheimer's disease is still under debate, making it challenging to establish an effective therapy or early diagnosis. It is widely accepted that the accumulation of amyloid-beta peptide in the brain parenchyma leads to synaptic dysfunction, a critical step in Alzheimer's disease development. The traditional amyloid cascade model is initiated by accumulating extracellular amyloid-beta in brain areas essential for memory and language. However, while it is possible to reduce the presence of amyloid-beta plaques in the brain with newer immunotherapies, cognitive symptoms do not necessarily improve. Interestingly, recent studies support the notion that early alterations in subcortical brain regions also contribute to brain damage and precognitive decline in Alzheimer's disease. A body of recent evidence suggests that early Alzheimer's disease is associated with alterations (e.g., motivation, anxiety, and motor impairment) in subcortical areas, such as the striatum and amygdala, in both human and animal models. Also, recent data indicate that intracellular amyloid-beta appears early in subcortical regions such as the nucleus accumbens, locus coeruleus, and raphe nucleus, even without extracellular amyloid plaques. The reported effects are mainly excitatory, increasing glutamatergic transmission and neuronal excitability. In agreement, data in Alzheimer's disease patients and animal models show an increase in neuronal synchronization that leads to electroencephalogram disturbances and epilepsy. The data indicate that early subcortical brain dysfunctions might be associated with non-cognitive symptoms such as anxiety, irritability, and motivation deficits, which precede memory loss and language alterations. Overall, the evidence reviewed suggests that subcortical brain regions could explain early dysfunctions and perhaps be targets for therapies to slow disease progression. Future research should focus on these non-traditional brain regions to reveal early pathological alterations and underlying mechanisms to advance our understanding of Alzheimer's disease beyond the traditionally studied hippocampal and cortical circuits.

Dual effects of GABA A R agonist anesthetics in neurodevelopment and vulnerable brains: From neurotoxic to therapeutic effects

Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years. A consensus has been reached that prolonged, repeated, high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function, while single exposure has a relatively minor effect on long-term neurological function. In this review, we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists, a representative group of sedatives, on developing brains or central nervous system diseases. Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways. However, recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period. These findings are incomprehensible for the general "dose-effect" principles of pharmacological research, which has attracted researchers' interest and led to the following questions: What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain? To what extent can their protective effects be maximized? What are the underlying mechanisms involved in these effects? Consequently, this issue has essentially become a "mathematical problem." After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases, we believe that all such anesthetics exhibit specific threshold effects unique to each drug. These effects range from neuroprotection to neurotoxicity, depending on different brain functional states. However, the exact values of the specific thresholds for different drugs in various brain states, as well as the underlying mechanisms explaining why these thresholds exist, remain unclear. Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.

Cerebellar microglia: On the edge between neuroinflammation and neuroregulation

The cerebellum is receiving increasing attention for its cognitive, emotional, and social functions, as well as its unique metabolic profiles. Cerebellar microglia exhibit specialized and highly immunogenic phenotypes under both physiological and pathological conditions. These immune cells communicate with intrinsic and systemic factors and contribute to the structural and functional compartmentalization of the cerebellum. In this review, we discuss the roles of microglia in the cerebellar microenvironment, neuroinflammation, cerebellar adaptation, and neuronal activity, the associated molecular and cellular mechanisms, and potential therapeutic strategies targeting cerebellar microglia in the context of neuroinflammation. Future directions and unresolved questions in this field are further highlighted, particularly regarding therapeutic interventions targeting cerebellar microglia, functional mechanisms and activities of microglia in the cerebellar circuitry, neuronal connectivity, and neurofunctional outcomes of their activity. Cerebellar morphology and neuronal performance are influenced by both intrinsic and systemic factors that are actively monitored by microglia in both healthy and diseased states. Under pathological conditions, local subsets of microglia exhibit diverse responses to the altered microenvironment that contribute to the structural and functional compartmentalization of the cerebellum. Microglia in the cerebellum undergo early maturation during the embryonic stage and display specialized, highly immunogenic phenotypes. In summary, cerebellar microglia have the capacity to serve as regulatory tools that influence outcomes across a wide range of neurological and systemic conditions, including neurodevelopmental, neurodegenerative, metabolic, and stress-related disorders.

Associations of anxiety and depression with prognosis in chronic obstructive pulmonary disease: A systematic review and meta-analysis

The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.

Acetaldehyde-driven mRNA methylation and expression changes in ethanol-metabolizing enzyme genes

This study examines how the alcohol metabolite acetaldehyde modulates mRNA methylation and expression of ethanol-metabolizing genes, uncovering its epigenetic role in ethanol metabolism. Using neuron-like (SH-SY5Y) and non-neuronal (SW620) cellular models, we examined the effects of chronic intermittent acetaldehyde (CIA) exposure and subsequent withdrawal (CIA+WD) on global RNA m6A modifications and the methylation and expression of three brain ethanol-metabolizing genes: CAT (catalase), CYP2E1 (cytochrome P450 2E1), and ALDH2 (aldehyde dehydrogenase 2). A 3-week CIA exposure, with or without 24-hour withdrawal, did not significantly alter global m6A methylation levels in either cell line. However, acetaldehyde exposure/withdrawal induced hypermethylation at the mRNA stop codon regions of ALDH2 (CIA: p = 0.002; CIA+WD: p = 0.055) and CAT (CIA: p = 0.077; CIA+WD: p = 0.036) in SH-SY5Y cells, but not in SW620 cells. Furthermore, ALDH2 mRNA expression was significantly upregulated in both cell types following exposure (SH-SY5Y: p = 0.073 [CIA] and 0.00002 [CIA+WD]; SW620: p = 0.0009 [CIA] and 0.00008 [CIA+WD]). In contrast, CYP2E1 mRNA methylation and the expression of CYP2E1 and CAT remained unchanged. These findings highlight the cell-specific epigenetic effects of acetaldehyde, particularly its role in modulating mRNA methylation and expression of ALDH2, a key enzyme in alcohol metabolism.

Gut-derived lactic acid enhances tryptophan to 5-hydroxytryptamine in regulation of anxiety via Akkermansia muciniphila

The gut microbiota plays a pivotal role in anxiety regulation through pathways involving neurotransmitter production, immune signaling, and metabolic interactions. Among these, gut-derived serotonin (5-hydroxytryptamine, 5-HT), synthesized from tryptophan metabolism, has been identified as a key mediator. However, it remains unclear whether specific microbial factors regulate tryptophan metabolism to influence 5-HT production and anxiety regulation. In this study, we analyzed 110 athletes undergoing closed training and found that fecal lactate levels were significantly associated with anxiety indicators. We observed a significant negative correlation between Akkermansia abundance and anxiety levels in athletes. Co-supplementation with lactate and Akkermansia muciniphila (A. muciniphila) modulated tryptophan metabolism by increasing key enzyme TPH1 and reducing IDO1, thus shifting metabolism from kynurenine (Kyn) to 5-HT. In addition, lactate enhanced the propionate production capacity of A. muciniphila, potentially contributing to anxiety reduction in mice. Taken together, these findings suggest that enteric lactate and A. muciniphila collaboratively restore the imbalance in tryptophan metabolism, leading to increased 5-HT activity and alleviating anxiety phenotypes. This study highlights the intricate interplay between gut metabolites and anxiety regulation, offering potential avenues for microbiota-targeted therapeutic strategies for anxiety.

Respiratory modulation of beta corticomuscular coherence in isometric hand movements

Respiration is a fundamental physiological function in humans, often synchronized with movement to enhance performance and efficiency. Recent studies have underscored the modulatory effects of respiratory rhythms on brain oscillations and various behavioral responses, including sensorimotor processes. In light of this connection, our study aimed to investigate the influence of different respiratory patterns on beta corticomuscular coherence (CMC) during isometric hand flexion and extension. Utilizing electroencephalogram (EEG) and surface electromyography (sEMG), we examined three breathing conditions: normal breathing, deep inspiration, and deep expiration. Two experimental protocols were employed: the first experiment required participants to simultaneously breathe and exert force, while the other involved maintaining a constant force while varying breathing patterns. The results revealed that deep inspiration significantly enhanced beta CMC during respiration-synchronized tasks, whereas normal breathing resulted in higher CMC compared to deep respiration during sustained force exertion. In the second experiment, beta CMC was cyclically modulated by respiratory phase across all breathing conditions. The difference in the outcomes from the two protocols demonstrated a task-specific modulation of respiration on motor control. Overall, these findings indicate the complex dynamics of respiration-related effects on corticomuscular neural communication and provide valuable insights into the mechanisms underpinning the coupling between respiration and motor function.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-025-10245-x.

Methodological rigour and reporting quality of the literature on wildlife rescue, rehabilitation, and release: a global systematic review

Wildlife rescue, rehabilitation, and release is a global practice with a broad body of scientific literature; nonetheless, no studies have assessed and quantified the methodological rigour and reporting quality of this literature. In this PRISMA systematic review, we assessed and quantified the reporting of controls, randomisation, blinding, experimental animal data, and housing and husbandry data in 152 primary studies on wildlife rescue, rehabilitation, and release published between 1980 and 2021. We then tested for associations between reporting and study characteristics. Of the 152 reviewed studies, one study reported a control, randomisation, and blinding; 17 studies reported species, age, sex, weight, and body condition; and 14 studies reported housing size, housing location, type of food, provision of water, and provision of enrichment. No study reported all 13 of these elements. Studies published in veterinary-focused journals reported lower methodological rigour and had lower reporting quality than studies published in other types of journals. Studies on mammals had higher reporting quality than studies on birds and on reptiles, and studies that included the word "welfare" had higher reporting quality than studies that did not. The overall low methodological rigour and reporting quality of the literature limits study replicability and applicability and impedes meta-analyses.

The influence of national origin cues in HPV vaccination advertising: An eye-tracking study of visual attention and vaccine perception using quantitative and qualitative analysis

This study is among the first to investigate how national origin cues influence visual attention and perception in HPV vaccine advertisements, using eye-tracking technology to provide objective insights into consumer responses. By integrating methods from public health, psychology, and advertising research, this study explores how visual attention is shaped by national affiliation cues. In a controlled experimental setting with a sample of 40 UK university students, we investigated visual attention and effectiveness of HPV vaccination advertisements by comparing ads disclosing the national origin of the vaccine and without any origin information. We assessed total fixation duration and time to first fixation to various elements of the ad, along with intention and attitude measures. Contrary to one of our hypotheses, we did not find significant differences in intention (p = .758) and attitude (p = .620) measures. However, there was significant difference in total fixation duration toward one of the ad images between conditions (p = .043). The qualitative analysis reveals the role of country-of-origin (COO) in HPV vaccination advertising, suggesting a shift in attention from that image to the COO cue. Furthermore, eight out of the 20 participants in the treatment condition did not fixate at the COO cue. Findings provide critical insights for public health communication strategies, suggesting that the use (or omission) of national origin cues in vaccine advertisements could influence vaccine perception and hesitancy. These results highlight the need for strategic messaging approaches to enhance HPV vaccine acceptance and improve public trust in domestic and international vaccines.

The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals' age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].

Extracellular vesicles of Limosilactobacillus fermentum SLAM216 ameliorate skin symptoms of atopic dermatitis by regulating gut microbiome on serotonin metabolism

Atopic dermatitis (AD) is a globally prevalent chronic inflammatory skin disorder. Its pathogenesis remains incompletely understood, resulting in considerable therapeutic challenges. Recent studies have highlighted the significance of the interaction between AD and gut microbiome. In this study, we investigated the effects of probiotic-derived extracellular vesicles on AD. Initially, we isolated and characterized extracellular vesicles from Limosilactobacillus fermentum SLAM 216 (LF216EV) and characterized their composition through multi-omics analysis. Gene ontology (GO) and pathway analysis classified LF216EV proteins into biological processes, molecular functions, and cellular components. Importantly, specific abundance in linoleic, oleic, palmitic, sebacic, and stearic acids indicating upregulated fatty acid metabolism were observed by metabolomic analysis. Furthermore, featured lipid profiling including AcylGlcADG and ceramide were observed in LF216EV. Importantly, in an atopic dermatitis-like cell model induced by TNFα/IFNγ, LF216EV significantly modulated the expression of immune regulatory genes (TSLP, TNFα, IL-6, IL-1β, and MDC), indicating its potential functionality in atopic dermatitis. LF216EV alleviated AD-like phenotypes, such as redness, scaling/dryness, and excoriation, induced by DNCB. Histopathological analysis revealed that LF216EV decreased epidermal thickness and mast cell infiltration in the dermis. Furthermore, LF216EV administration reduced mouse scratching and depression-related behaviors, with a faster onset than the classical treatment with dexamethasone. In the quantitative real-time polymerase chain reaction (qRT-PCR) analysis, we observed a significant increase in the expression levels of htrb2c, sert, and tph-1, genes associated with serotonin, in the skin and gut of the LF216EV-treated group, along with a significant increase in the total serum serotonin levels. Gut microbiome analysis of the LF216EV-treated group revealed an altered gut microbiota profile. Correlation analysis revealed that the genera Limosilactobacillus and Desulfovibrio were associated with differences in the intestinal metabolites, including serotonin. Our findings demonstrate that LF216EV mitigates AD-like symptoms by promoting serotonin synthesis through the modulation of gut microbiota and metabolome composition.

Indirubin-3'-oxime as a dual-action agent: mitigating heat-induced male infertility in Drosophila melanogaster and inhibiting soluble epoxide hydrolase

This study investigated the potential of the indirubin-3'-oxime (I3O) compound to mitigate temperature-induced male infertility in Drosophila melanogaster. Elevated temperatures significantly reduced egg-hatching rates, but I3O supplementation improved these rates, suggesting it can partially restore fertility under heat stress. Additionally, I3O was found to inhibit soluble epoxide hydrolase (sEH), an enzyme involved in the metabolism of epoxyeicosatrienoic acids, which are vital for reproductive health. I3O exhibited sEH inhibitions with an IC50 value of 59.74 ± 0.41 µM. Enzyme kinetics revealed that I3O acts as a non-competitive inhibitor of sEH with a Ki value of 78.88 µM. Molecular docking showed strong interactions between I3O and key residues in the allosteric regions within the sEH enzyme, with a binding affinity of -9.2 kcal/mol. These interactions were supported by 100 ns molecular dynamics simulations, which confirmed the stability of the sEH-I3O complex.

Acute effects of isolated and combined dietary nitrate and caffeine ingestion on ergometer-based 1000 m time trial performance in highly trained kayakers

BACKGROUND

Dietary nitrate (BR) and caffeine (CAF) ingestion have been shown to increase sports performance. However, the isolated and combined effects of BR and CAF ingestion on time trial (TT) performance as well as the accompanying physiological and perceptual responses have never been investigated in highly trained kayak athletes. Therefore, the present study examined the impact of an isolated and combined supplementation with BR (140 ml beetroot concentrate, ~12.5 mmol nitrate) and CAF (3 mg/kg bodyweight) on 1000 m ergometer TT performance as well as the accompanying physiological (i.e. cardiorespiratory function, muscle oxygenation, muscle activity) and perceptual responses (i.e. fatigue, effort, and exercise-induced pain perception) in male highly trained kayakers. It was hypothesized that the isolated ingestion of BR and CAF would both improve ergometer-based 1000 m TT performance and induce supplement-specific physiological and perceptual responses. Considering the primary effects of BR on muscle function and of CAF on the central nervous system, it was further assumed that the combined ingestion will result in an additional performance increase and supplement-specific physiological and perceptual responses.

METHODS

Using a prospective, randomized, controlled, double-blind crossover design, 12 male highly trained kayak athletes from local clubs were investigated. They completed four measurement sessions resulting in four randomized conditions: (i) BR+CAF; (ii) BR+CAF placebo (BR+PLA); (iii) CAF+BR placebo (CAF+PLA); and (iv) BR placebo + CAF placebo (PLA+PLA). An air-braked instrumented kayak-ergometer was used to record 1000 m TT performance, power output, and stroke frequency. Heart rate (HR), oxygen uptake (VO2), maximum VO2 (VO2max), respiratory equivalent of O2 (VE/VO2), and carbon dioxide (VE/VCO2) were measured continuously. Furthermore, oxygenation of the deltoid muscle was measured with near-infrared spectroscopy (mNIRS) and muscle activity of nine unilateral muscles with surface electromyography (i.e. deltoideus, serratus anterior, triceps brachii caput lateralis, trapezius, infraspinatus, latissimus dorsi, obliquus externus, flexor carpi radialis, and vastus lateralis muscle) during the 1000 m TT. After the TT, fatigue, effort, and exercise-induced pain perception were queried. One- and two-way analysis of variance with repeated measures were conducted to determine differences between conditions for the entire 1000 m TT and predefined sections (0-50 m, 50-100 m, 100-150 m, 150-250 m, 250-500 m, 500-750 m, 750-1000 m), respectively (p ≤ 0.05).

RESULTS

The supplements did not have an ergogenic effect on TT performance compared to the PLA+PLA condition, either in isolation or in combination. The same applied to the majority of physiological parameters and the perceptual responses. Nevertheless, VE/VO2 was lower during the sections 150-250 m (-5.00%; p = 0.02) and 250-500 m (-3.49%; p = 0.03) in the BR+PLA condition, whereby VE/VCO2 was higher during the section 150-250 m (4.19%; p = 0.04) in the CAF+PLA compared to the PLA+PLA condition, respectively.

CONCLUSIONS

Data indicate that the isolated and combined ingestion of BR and CAF had no effect on 1000 m TT performance, the majority of physiological responses, and perceptual responses in highly trained kayakers. These findings might be related to the dosage and/or a ceiling effect due to the already efficient vascular, metabolic, and muscle function, including high amounts of endogenous produced nitric oxide, in athletes.

Individual responses to encapsulated caffeine and caffeine chewing gum on strength and power in strength-trained males

BACKGROUND

Liquid-dissolved and encapsulated powder are two popular ways to consume caffeine for performance-enhancing effects. Caffeine in other delivery methods, such as chewing gums, orally dissolvable strips, gels, mouthwashes, energy drinks, and nasal sprays, is believed to be absorbed more quickly into the bloodstream. Inter-individual responses to caffeine's enhancing effects are recognized. The present study examined the inter-individual responses to the acute effects of encapsulated caffeine and caffeinated chewing gum on the lower-body isokinetic and isometric strength and power in strength-trained males.

METHOD

A randomized, cross-over, placebo-controlled study was conducted with 15 strength-trained males (age: 25  ±  4 years, height: 176  ±  7 cm, weight: 75  ±  11 kg, habitual caffeine intake: 66  ±  15 mg·day-1). Participants were randomly assigned to three conditions: i) caffeinated chewing gum (CG), ii) caffeine capsule (CC), and iii) starch capsule as a placebo (PLA). Participants consumed approximately 3 to 4.5 mg·kg-1 of caffeine 60 minutes before testing. The washout period between conditions was one week. Participants performed the Sargent jump test, followed by a 5-minute active recovery (walking). Subsequently, isokinetic strength and power (60°/s and 180°/s) and isometric strength (45° and 60°) parameters were measured for knee extensor and flexor muscles. Data were analyzed using one-way repeated measures ANOVA and Bonferroni post hoc tests, with significance set at p ≤ 0.05. Responders to the caffeine conditions were identified using the smallest worthwhile change (SWC) analysis.

RESULTS

In knee extensors, 1) average peak torque and power at 60°/s were higher in CC (p = 0.045; + 11.2% and p = 0.038; + 14.1%) and CG (p = 0.044; + 7.3% and p = 0.015; + 11.4%) compared to PLA with a co-response rate of 60% and 66%, 2) maximum voluntary isometric contraction at 45° (MVIC-45°) was higher in CC compared to PLA (p = 0.031; + 10.1%), and 3) MVIC-60° was higher in CG compared to PLA (p = 0.037; + 10.1%) with a co-response rate of 60%. In knee flexors, 1) time to peak torque at 60°/s was higher in CG compared to PLA (p = 0.011; + 18.2%) with a co-response rate of 46%, 2) average rate of force development at 60°/s was higher in CC (p = 0.007; + 24.1%) and CG (p = 0.050; + 20.6%) compared to PLA with a co-response rate of 53%, and 3) average power at 180°/s was higher in CC compared to PLA (p = 0.033; + 18%) with a co-response rate of 46%. However, there were no differences between other strength indicators in the knee extensors and flexors between the different conditions. Vertical jump height (VJH) was higher in CC (p = 0.001; + 5.5%) and CG (p = 0.001; + 6.) compared to PLA, with a co-response rate of 53%.

CONCLUSION

Caffeine supplementation in CC and CG forms significantly enhanced lower-body strength, power, and vertical jump height in strength-trained males, with over  ~50% of participants exceeding the SWC thresholds across key performance metrics. CC showed slightly higher responder rates for strength parameters, while CG excelled in time-dependent measures, supporting their use as effective and flexible ergogenic aids.

Comparative analysis of emotional factors in patients with somatic symptom disorder and panic disorder

OBJECTIVE

This study investigated the emotional symptom profiles and treatment responses in patients exhibiting overlapping physical symptoms to compare differences between Somatic Symptom Disorder (SSD) and Panic Disorder (PD).

METHODS

Pharmacotherapy outcomes were analysed in 208 outpatients with SSD (n = 94) and PD (n = 114). Stepwise multivariable logistic regression identified predictors of treatment response, considering variables such as the Clinical Global Impression-Severity (CGI-S), Beck Depression Inventory-II (BDI-II), State-Trait Anxiety Inventory, and State-Trait Anger Expression Inventory. Network analysis explored emotional patterns by estimating network structures for each group.

RESULTS

The overall response rate to pharmacotherapy was 23.6% (49/208), with no significant difference between groups. Baseline CGI-S and BDI-II scores were significant predictors of treatment response in both groups, while social phobia score was a significant predictor in PD. Depression and anxiety were related to physical symptoms in both groups, but anger was significantly associated only in SSD. Network analysis revealed that depression was central to other symptoms in SSD, while anxiety was the core symptom in PD, indicating different emotional drivers between the disorders.

CONCLUSIONS

This study suggests the differences in emotional symptom profiles between SSD and PD. Findings suggest different mechanisms, considering the role of anger in SSD, highlighting the need for more personalised treatments for each disorder.

Aberrant regional neural fluctuations and functional connectivity in insomnia comorbid depression revealed by resting-state functional magnetic resonance imaging

Insomnia is a common mental illness seriously affecting people lives, that might progress to major depression. However, the neural mechanism of patients with CID comorbid MDD remain unclear. Combining fractional amplitude of low-frequency fluctuation (fALFF) and seed-based functional connectivity (FC), this study investigated abnormality in local and long-range neural activity of patients with CID comorbid MDD. Here, we acquired resting-state blood oxygenation level dependent (BOLD) data from 57 patients with CID comorbid MDD and 57 healthy controls (HC). Compared with the controls, patients with CID comorbid MDD exhibited abnormal functional activity in posterior cerebral cortex related to the visual cortex, including the middle occipital gyrus (MOG), the cuneus and the lingual gyrus, specifically, lower fALFF values in the right MOG, left cuneus, and right postcentral gyrus, increased FC between the right MOG and the left cerebellum, and decreased FC between the right MOG and the right lingual gyrus. Neuropsychological correlation analysis revealed that the decreased fALFF in the right MOG was negatively correlated with all the neuropsychological scores of insomnia and depression, reflecting common relationships with symptoms of CID and MDD. While the decreased fALFF of the left cuneus was distinctly correlated with the scores of depression related scales. The decreased FC between the right MOG and the right lingual gyrus was distinctly correlated with the scores of insomnia related scales. This study not only widened neuroimaging evidence that associated with insomnia and depressive symptoms of patients with CID comorbid MDD, but also provided new potential targets for clinical treatment.

The role of beta band phase resetting in audio-visual temporal order judgment

The integration of auditory and visual stimuli is essential for effective language processing and social perception. The present study aimed to elucidate the mechanisms underlying audio-visual (A-V) integration by investigating the temporal dynamics of multisensory regions in the human brain. Specifically, we evaluated inter-trial coherence (ITC), a neural index indicative of phase resetting, through scalp electroencephalography (EEG) while participants performed a temporal-order judgment task that involved auditory (beep, A) and visual (flash, V) stimuli. The results indicated that ITC phase resetting was greater for bimodal (A + V) stimuli compared to unimodal (A or V) stimuli in the posterior temporal region, which resembled the responses of A-V multisensory neurons reported in animal studies. Furthermore, the ITC got lager as the stimulus-onset asynchrony (SOA) between beep and flash approached 0 ms. This enhancement in ITC was most clearly seen in the beta band (13-30 Hz). Overall, these findings highlight the importance of beta rhythm activity in the posterior temporal cortex for the detection of synchronous audiovisual stimuli, as assessed through temporal order judgment tasks.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11571-024-10183-0.

Prevalence of attention deficit hyperactivity disorder in homeless children and adolescents: A systematic review and meta-analysis

INTRODUCTION

This systematic review and meta-analysis aimed to examine the prevalence of Attention deficit hyperactivity disorder (ADHD) in homeless children and adolescents, and the factors that may influence its prevalence.

METHODS

Relevant publications in Medline, Web of Science, Scopus and PsycINFO were systematically searched to identify studies on the prevalence of ADHD in homeless children and adolescents (≤19 years). The extracted data were pooled using a random-effects model.

RESULTS

Thirteen studies involving 2878 homeless children and adolescents were included (mean age: 12.0 years, sex F/M: 0.43). The prevalence rates of ADHD vary considerably across studies, ranging from 1.6% to 64.5%. The pooled prevalence of ADHD was 22.8% (95% CI 12.9-34.4%, I2 =98%). Meta-regression analyses indicated that age (slope = 0.046; p = .042) significantly increased ADHD prevalence. The prevalence of ADHD in studies with a mean age ≥ 12 years (43.1%, 95% CI 26.5-60.4%) was higher than those with a mean age < 12 years (13.1%, 95%CI 4.3-25.6).

CONCLUSION

Despite the high heterogeneity of the studies, we observed that ADHD could affect almost a quarter of homeless children and adolescents. Reintegrating them into care systems and ensuring access to public health interventions tailored for homeless families and youth is imperative for breaking the cycle of homelessness and improving long-term trajectories.

Functional abnormalities of the glymphatic system in cognitive disorders

Various pathological mechanisms represent distinct therapeutic targets for cognitive disorders, but a balance between clearance and production is essential for maintaining the stability of the brain's internal environment. Thus, the glymphatic system may represent a common pathway by which to address cognitive disorders. Using the established model of the glymphatic system as our foundation, this review disentangles and analyzes the components of its clearance mechanism, including the initial inflow of cerebrospinal fluid, the mixing of cerebrospinal fluid with interstitial fluid, and the outflow of the mixed fluid and the clearance. Each section summarizes evidence from experimental animal models and human studies, highlighting the normal physiological properties of key structures alongside their pathological manifestations in cognitive disorders. The same pathologic manifestations of different cognitive disorders appearing in the glymphatic system and the same upstream influences are main points of interest of this review. We conclude this article by discussing new findings and outlining the limitations identified in current research progress.

Assessing neurocognitive outcomes in PTSD: a multilevel meta-analytical approach

Background: Evidence supporting the association between posttraumatic stress disorder (PTSD) and cognitive impairment is accumulating. However, less is known about which factors influence this association.Objective: The aims of this meta-analysis were to (1) elucidate the association between PTSD and a broad spectrum of cognitive impairment, including the risk of developing neurocognitive disorder (NCD) later in life, using a multilevel meta-analytic approach, and (2) identify potential moderating factors of this association by examining the effects of age (20-39, 40-59, 60+), study design (cross-sectional or longitudinal), study population (war-exposed populations/veterans or the general population), neurocognitive outcome assessed (i.e. a diagnosis of NCD or type of cognitive domain as classified according to A Compendium of Neuropsychological tests), gender (≥50% women or <50% women), study quality (high vs low), type of PTSD measure (self-report or clinical diagnosis), as well as the presence of comorbidities such as traumatic brain injury (TBI), depression, and substance use (all coded as either present or absent).Method: Peer-reviewed studies on this topic were extracted from PubMed and Web of Science with predetermined keywords and criteria. In total, 53 articles met the criteria. Hedge's g effect sizes were calculated for each study and a three-level random effect meta-analysis conducted.Results: After accounting for publication bias, the results suggested a significant association between PTSD and cognitive impairment, g = 0.13 (95% CI: 0.10-0.17), indicating a small effect. This association was consistent across all examined moderators, including various neurocognitive outcomes, age, gender, study design, study population, study quality, type of PTSD measure, and comorbidities such as depression, substance use, and TBI.Conclusions: These findings collectively suggest that PTSD is associated with both cognitive impairment and NCD. This emphasizes the need for early intervention (including prevention strategies) of PTSD, alongside monitoring cognitive function in affected individuals.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42021219189, date of registration: 02.01.2021.

Dissecting the shared molecular mechanisms underlying polycystic ovary syndrome and schizophrenia etiology: a translational integrative approach

Recent evidence suggests that individuals with polycystic ovary syndrome (PCOS) have an increased risk of developing mental health disorders and comorbidities linked to nervous system dysfunction. Interestingly, patients with schizophrenia (SCZ) often exhibit PCOS symptoms, indicating a possible connection between the two conditions. However, the underlying molecular links between these diseases remain poorly understood. We employed a comprehensive in-silico approach, utilizing publicly available datasets to investigate shared biomarkers candidates and key regulators involved in the development of PCOS and SCZ. We retrieved the datasets from the NCBI GEO database and differentially expressed genes (DEGs) were identified for each dataset. Common DEGs (cDEGs) were determined, and transcription factors (TFs) and miRNA targeting cDEGs were examined using the mirDIP portal and TRRUST database, respectively. We also assessed the TF-miRNA interactions by TransmiR database and constructed a regulatory network including TFs-microRNAs-cDEGs. Our analysis identified a total of 15 cDEGs that are regulated by 15 TFs and 8 mRNAs. Among our findings, we prioritized RELA as a potential TF regulator for both diseases, demonstrating synergistic interaction with four cDEGs (EGR1, CXCL8, IL1RN, IL1B) and seven microRNAs (hsa-miR-580, hsa-miR-5695, hsa-miR-936, hsa-miR-3675, hsa-miR-634, hsa-miR-603, hsa-miR-222) that target these genes. Our data highlights potential common biomarkers for PCOS and SCZ, presenting a novel regulatory network that elucidates the molecular mechanisms underlying both conditions. This emphasizes the importance of further research to explore new translational approaches, which may ultimately lead to improved diagnostic and therapeutic strategies for affected individuals.

The relationship between childhood trauma, rs1360780 genotypes, FKBP5 intron 7 methylation and posttraumatic stress disorder in women who have experienced rape

Background: Posttraumatic stress disorder (PTSD) is a common sequela of rape. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, a core regulator of the stress response, has been implicated in the aetiology and chronicity of PTSD. FK506 binding protein (FKBP5) is a co-chaperone and functional regulator of the glucocorticoid receptor and the HPA-axis.Objective: This study investigated main and interaction effects of childhood trauma and the FKBP5 rs1360780 genotype on longitudinal FKBP5 intron 7 methylation, and whether change in FKBP5 methylation over time was associated with PTSD symptom severity over time.Method: Women who experienced rape (n = 96) were recruited from post-rape care services in KwaZulu Natal, South Africa. Total PTSD symptom scores, derived from the Davidson Trauma Scale, were assessed at baseline, 3-months and 6-months post-rape. Methylation levels at five FKBP5 intron 7 CpG sites were determined using EpiTYPER Sequenom MassArray technology. Genotyping of rs1360980 was completed using the Agena MassArray genotyping system. Mixed linear regression models were used to analyse the data.Results: The interaction between rs1360780 genotype and childhood trauma was a significant predictor of FKBP5 methylation over time. There was a significant positive correlation between childhood trauma and methylation levels in participants with the CT and TT genotypes, while there was a significant negative correlation between childhood trauma and methylation in CC genotype carriers. FKBP5 methylation was not a predictor of PTSD scores over time.Conclusion: This is the first study to investigate longitudinal change in FKBP5 methylation in a demographically homogenous same-trauma sample. The findings implicate childhood trauma and FKBP5 rs1360980 genotype in the trajectory of FKBP5 methylation levels in the aftermath of rape. Further research is needed to investigate the longitudinal role of FKBP5 intron 7 methylation in relation to PTSD symptom trajectories post-rape.

Psychometric evaluation of the UCLA PTSD Reaction Index (PTSD RI-5) in a Turkish Clinical sample of trauma-exposed children

Objective: Trauma victimization is common among children, however, a significant proportion of trauma victims go unrecognized unless they are thoroughly assessed, even in child psychiatry clinics. The aim of this study was to evaluate the psychometric properties and diagnostic accuracy of the Turkish version of the UCLA PTSD Reaction Index for DSM-5 (PTSD RI-5) in a clinical sample of trauma-exposed children and adolescents.Method: A total of 208 children and adolescents admitted to the child psychiatry clinic, each of whom had a history of at least one traumatic event, were evaluated with the PTSD RI-5 to investigate trauma history and PTSD symptoms. All participants also completed the Revised Child Anxiety and Depression Scale (RCADS) and 64 participants were assessed with a semi-structured diagnostic interview for PTSD and depression.Results: Internal consistency for the total scale was high (Cronbach's α = 0.91) and the confirmatory factor analysis (CFA) supported the four-factor structure of the PTSD RI-5 (CFI =  0.915, TLI = 0.902, RMSEA =0.062). ROC analysis showed strong diagnostic accuracy (AUC = 0.94).Conclusion: The Turkish version of the PTSD RI-5 may a reliable and valid tool for diagnosing PTSD in clinical samples and may improve diagnosis and treatment outcomes by identifying unrecognized trauma-related symptoms.

Myeloperoxidase as a therapeutic target for oxidative damage in Alzheimer's disease

Alzheimer's disease (AD) is a major neurodegenerative disorder more common in older adults. One of the leading AD hypotheses involves the amyloid beta (A) production, it is associated to oxidative stress, neuroinflammation, and neurovascular damage. The interaction of A with the blood vessel wall contributes to the disruption of the blood-brain barrier (BBB), allowing neutrophil infiltration containing the myeloperoxidase enzyme (MPO), which produces hypochlorous acid (HOCl) a potent oxidant. Also, MPO could be released from the microglia cells and interact with the amyloid beta plaques. This review aims to study the role of MPO in the progression of AD, in particular its contribution to oxidative stress and neuroinflammation. Furthermore, to explore the MPO-potential as AD-biomarker to evaluate the therapeutic potential of its inhibitors to mitigate the neurotoxicity. Finally, revise MPO inhibitors that could act as dual inhibitors acting on MPO and acetylcholinesterase and or another target involved in AD.

"What I do not see and others see in me": mutual aid for suicide recovery in Colombia

PURPOSE

In response to the rise in suicidal behaviour and the strategies to address it, community actions represent a comprehensive approach to the factors influencing this situation. The aim of this study was to analyse the influence of mutual support on the recovery of individuals who experienced suicidal behaviour and attended community mental health groups.

METHODS

A qualitative study was conducted in 2023. Focus groups were used as a data collection technique, followed by thematic analysis. Participants were selected based on convenience from mutual support groups registered with the Ministry of Health of Colombia.

RESULTS

Two main themes were identified in the thematic analysis. The first theme, "Own Reasons Through Others," was composed of categories such as "What Others See in Me" and "The Importance of Being in the Same Boat." The second theme was titled "The Community as a Space for Suicide Prevention," with categories including "Human Rights for Recovery" and "What We Can Achieve Together."

CONCLUSIONS

Pluralism, understood as the integration of diverse perspectives, is crucial for addressing complex phenomena such as mental health and community interventions. The study demonstrates how mutual aid groups and their members can generate collective and policy actions effective for managing suicidal behaviour.

Hippocampal connectivity changes after traumatic memory reactivation with propranolol for posttraumatic stress disorder: a randomized fMRI study

Background: Reactivation of traumatic memory under the influence of propranolol has shown encouraging clinical results in the treatment of posttraumatic stress disorder (PTSD), but the neural correlates remain unknown. To identify these correlates, we examined the changes in brain functional connectivity specifically associated with the influence of propranolol and their correlation with improvement in PTSD symptoms.Objectives: To identify resting-state functional connectivity (rs-FC) changes specifically associated with propranolol after a traumatic memory reactivation procedure (TMRP) in PTSD patients.Method: Thirty patients (50% of women) with PTSD were enrolled in a randomized controlled study comprised of six sessions of a traumatic memory reactivation procedure (TMRP) under the influence of propranolol (n = 16), compared to the same reactivation under a placebo (n = 14). Patients were scanned twice by functional magnetic resonance before and after treatment. Resting state functional connectivity (rs-FC) was compared across groups and over time.Results: Post versus pretreatment comparisons found an increase in rs-FC between the right hippocampus and the left parahippocampal gyrus in the propranolol group, but not in the placebo group. Symptom improvement in both groups were associated with an increase in rs-FC between the parahippocampal gyrus and both the supramarginal gyrus and the amygdala.Conclusions: During TMRP treatment, propranolol appears to constrain functional connectivity changes in the explicit memory brain system. These findings require further replication and exploration but could distinguish the effect of TMRP on the brain from other forms of PTSD psychotherapy.

Analysis of brain network effective connectivity in juvenile myoclonic epilepsy

Juvenile Myoclonic Epilepsy (JME) is a prevalent idiopathic generalized epilepsy whose neurophysiological mechanisms remain elusive. This study aims to elucidate the aberrant brain network patterns in JME through a multi-modal fMRI approach combining local consistency, functional connectivity, and causal interaction analysis. Resting-state fMRI data were acquired from 37 JME patients and 35 healthy controls. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) analyses identified eight brain regions with significant between-group differences (FDR-corrected p < 0.05), including the right middle frontal gyrus, right insula, right medial/paracingulate gyrus, bilateral superior frontal gyri, left postcentral gyrus, and left superior occipital gyrus. These regions served as regions of interest (ROIs) for subsequent functional and effective connectivity analyses. Functional connectivity analysis revealed increased connectivity strength between the right middle frontal gyrus and right medial or paracingulate gyrus, as well as between the right insula and right medial/paracingulate gyrus (two-sample t test, p < 0.01), despite decreased local synchrony in these regions. Dynamic causal modeling (DCM) demonstrated bidirectional enhancement of effective connectivity between the right insula and right medial or paracingulate gyrus in patients (Bayesian posterior probability > 0.95). These findings suggest that the observed decoupling of local neuronal synchronization and long-range connectivity may reflect compensatory neuroadaptive processes, particularly involving the salience network (insula) and cognitive control circuitry (cingulate regions).The integration of ReHo/ALFF mapping with DCM provides a novel framework for understanding the neurodevelopmental trajectory of JME, highlighting the critical role of cortico-subcortical dysregulation in its pathogenesis.

Chemogenetic inhibition of corticotropin releasing hormone neurons in the paraventricular nucleus attenuates traumatic stress-induced deficit of NREM sleep, but not REM sleep in mice

Present study was aimed to elucidate the role of corticotropin releasing hormone (CRH) neurons located in the paraventricular nucleus of the hypothalamus (PVN) in the mechanisms of stress-induced insomnia. Experiments were done in the rodent model of traumatic stress, mice exposure to the predator (rat) odor. Sleep changes associated with this model of stress were first assessed in adult male C57BL/6J wild-type mice (n = 12). The effect of chemogenetic silencing of CRH neurons within the PVN on traumatic stress-induced insomnia was examined in adult male CRH-ires-Cre mice using designer receptors exclusively activated by designer drugs (DREADD) technology. Animals received bilateral injections of inhibitory DREADD vector AAV-hSyn-DIO-hM4Di-mCherry (n = 10) or control AAV-hSyn-DIO-mCherry virus (n = 10) into the PVN during surgery. The DREADD was activated by intraperitoneal injection of clozapine-N-oxide (CNO) prior to the induction of traumatic stress. The exposure of mice to rat odor induced strong long-lasting suppression of both non-rapid eye movement (NREM) and rapid eye movement (REM) sleep stages in both experiments. Selective suppression of CRH neurons within the PVN alleviated acute insomnia by significantly increasing the time spent in NREM sleep but it did not counteract the stress-induced deficit in REM sleep. These findings suggest a specific role for CRH-secreting neurons within the PVN in the suppression of NREM sleep during acute insomnia caused by predator odor stress, whereas REM sleep suppression is controlled by a different mechanism.

Maternal-infant probiotic transmission mitigates early-life stress-induced autism in mice

Autism, a disorder influenced by both genetic and environmental factors, presents significant challenges for prevention and treatment. While maternal-infant gut microbiota has been a focus in autism research, preventive strategies targeting maternal gut microbiota remain underexplored. This study demonstrates that prenatal probiotic intake can effectively prevent maternal separation-induced autistic-like behaviors in offspring without altering the embryonic neurodevelopment in mice. Using specific PCR primers and cross-fostering experiments, we traced the vertical transmission of probiotics, primarily via fecal/vaginal contamination. Early probiotic colonization conferred resilience against stress-induced gut pathogenic microbes and Th17-mediated peripheral inflammation while significantly inhibiting hypermyelination and neuroinflammation linked to systemic inflammation. Microbial metabolites like tyrosol and xanthurenic acid alleviated neuroinflammation and hypermyelination in vitro, though the causal relationship among neuroinflammation, hypermyelination, and autism in vivo requires further validation. These findings underscore the importance of the maternal-infant microbiota transmission window in autism prevention and highlight the clinical potential of prenatal probiotic interventions.

The prognostic significance of stress-phenotyping for stroke incidence: the Malmö Diet and Cancer Study

BACKGROUND

Self-reported mental stress is not consistently recognized as a risk factor for stroke. This prompted development of a novel algorithm for stress-phenotype indices to quantify chronic stress prevalence in relation to a modified stroke risk score in a South African cohort. The algorithm is based on biomarkers adrenocorticotrophic hormone, high-density lipoprotein cholesterol, high-sensitive cardiac-troponin-T, and diastolic blood pressure which exemplifies the stress-ischemic-phenotype index. Further modification of the stroke risk score to accommodate alcohol misuse established the stress-diabetes-phenotype index. Whether positive stress-phenotype individuals will demonstrate a higher incidence of stroke in an independent Swedish cohort was unknown and investigated.

METHODS

Stress-phenotyping was done at baseline for 50 participants with incident stroke and 100 age-, and sex matched controls (aged 76 ± 5 years) from 2,924 individuals in southern Sweden. The mean time from inclusion to first stroke event was 5 ± 3 years. Stress-phenotyping comparisons and stroke incidence risk were determined.

RESULTS

A positive stress-ischemic-phenotype reflected higher incident stroke (72% vs. 28%, p = 0.019) and mortality rates (41% vs. 23%, p = 0.019). Whereas a positive stress-diabetes-phenotype reflected a higher incident stroke rate (80% vs. 20%, p = 0.008) but similar mortality rate (38% vs. 25%, p = 0.146). Both the positive stress-ischemic (OR: 2.9, 95% CI: 1.3-6.5, p = 0.011) and stress-diabetes-phenotypes (OR: 3.7, 95% CI: 1.5-8.9, p = 0.004) showed large effect size associations with incident stroke independent of cardiovascular risk confounders.

CONCLUSION

Positive stress-phenotype indices demonstrated a higher incidence of stroke. Ultimately the Malan stress-phenotype algorithms developed in South Africa could confirm incident stroke in an independent Swedish cohort. Stress-phenotyping could thus be useful in clinical routine practice in order to detect individuals at higher stroke risk.

Systematically-designed mixtures outperform single fibers for gut microbiota support

Dietary fiber interventions to modulate the gut microbiota have largely relied on isolated fibers or specific fiber sources. We hypothesized that fibers systematically blended could promote more health-related bacterial groups. Initially, pooled in vitro fecal fermentations were used to design dietary fiber mixtures to support complementary microbial groups related to health. Then, microbial responses were compared for the designed mixtures versus their single fiber components in vitro using fecal samples from a separate cohort of 10 healthy adults. The designed fiber mixtures outperformed individual fibers in supporting bacterial taxa across donors resulting in superior alpha diversity and unexpected higher SCFA production. Moreover, unique shifts in community structure and specific taxa were observed for fiber mixtures that were not observed for single fibers, suggesting a synergistic effect when certain fibers are put together. Fiber mixture responses were remarkably more consistent than individual fibers across donors in promoting several taxa, especially butyrate producers from the Clostridium cluster XIVa. This is the first demonstration of synergistic fiber interactions for superior support of a diverse group of important beneficial microbes consistent across people, and unexpectedly high SCFA production. Overall, harnessing the synergistic potential of designed fiber mixtures represents a promising and more efficacious avenue for future prebiotic development.

A new quantum-inspired pattern based on Goldner-Harary graph for automated alzheimer's disease detection

Alzheimer's disease (AD) is a common cause of dementia. We aimed to develop a computationally efficient yet accurate feature engineering model for AD detection based on electroencephalography (EEG) signal inputs. New method: We retrospectively analyzed the EEG records of 134 AD and 113 non-AD patients. To generate multilevel features, a multilevel discrete wavelet transform was used to decompose the input EEG-signals. We devised a novel quantum-inspired EEG-signal feature extraction function based on 7-distinct different subgraphs of the Goldner-Harary pattern (GHPat), and selectively assigned a specific subgraph, using a forward-forward distance-based fitness function, to each input EEG signal block for textural feature extraction. We extracted statistical features using standard statistical moments, which we then merged with the extracted textural features. Other model components were iterative neighborhood component analysis feature selection, standard shallow k-nearest neighbors, as well as iterative majority voting and greedy algorithm to generate additional voted prediction vectors and select the best overall model results. With leave-one-subject-out cross-validation (LOSO CV), our model attained 88.17% accuracy. Accuracy results stratified by channel lead placement and brain regions suggested P4 and the parietal region to be the most impactful. Comparison with existing methods: The proposed model outperforms existing methods by achieving higher accuracy with a computationally efficient quantum-inspired approach, ensuring robustness and generalizability. Cortex maps were generated that allowed visual correlation of channel-wise results with various brain regions, enhancing model explainability.

The role of long-term hair steroids as diagnostic and intervention-related biomarkers in a multimorbid inpatient sample with posttraumatic stress disorder

Background: Steroid hormone dysregulations have frequently been implicated in posttraumatic stress disorder (PTSD) pathogenesis. However, the translation into naturalistic clinical settings as markers of symptomatology and treatment success remains complex. Particularly, there is little longitudinal data on steroid secretion over the course of interventions.Objective: This study examined the potential of long-term steroid hormone secretion assessed in hair as diagnostic and intervention-related biomarkers among medicated, multimorbid inpatients with PTSD.Method: As part of a secondary analysis of a randomised controlled trial, 54 female inpatients with a primary diagnosis of PTSD received standardised treatment and provided hair samples at pre-treatment, post-treatment, and 3-month follow-up. Cortisol, cortisone, and dehydroepiandrosterone (DHEA) were determined, alongside clinical assessments.Results: Cross-sectional results showed a negative association of pre-treatment DHEA with anxiety symptoms and a trend-level association with lifetime trauma exposure. While inpatients improved in PTSD symptomatology during treatment, neither pre-treatment steroids, nor treatment-induced steroid changes predicted PTSD symptoms at post-treatment or 3-month follow-up.Conclusion: The study highlights the challenges of establishing biomarkers in naturalistic clinical populations. While the association of attenuated DHEA with anxiety symptoms warrants further exploration, our data points towards the potential necessity of patient sub-sample selection to understand, and in the long run clinically target, the endocrine mechanisms in PTSD.

Spatial and frequency domain-based feature fusion for accurate detection of schizophrenia using AI-driven approaches

Schizophrenia is a neuropsychiatric disorder that hampers brain functions and causes hallucinations, delusions, and bizarre behavior. The stigmatization associated with this disabling disorder drives the need to build diagnostic models with impeccable performances. Neuroimaging modality such as structural MRI is coupled with machine learning techniques to perform schizophrenia diagnosis with increased reliability. We investigate the structural aberrations present in the structural MR images using machine learning techniques. In this study, we propose a new hybrid approach using spatial and frequency domain-based features for the early automated detection of schizophrenia using machine learning techniques. The spatial or texture features are extracted using the local binary pattern method, and frequency-based features, including magnitude and phase, are extracted using the fast fourier transform feature extraction technique. Hybrid features, combining spatial and frequency-based features, are utilized for schizophrenia classification using support vector machine, random forest, and k-nearest neighbor with stratified 10-fold cross-validation. The support vector machine and random forest classifiers achieve encouraging detection performances on the hybrid feature set, with 86.5% and 85.1% accuracy, respectively. Among the three classifiers, k-nearest neighbor shows outstanding detection performance with an accuracy of 98.1%. The precision and recall achieved by the k-nearest neighbor classifier are 98.1% and 98.0% respectively, reflecting accurate detection of schizophrenia by the proposed model.

The impact of intimate partner violence on facial emotion recognition among Korean baby boomers

ABSTRACTBackground: Intimate partner violence (IPV) can have lasting psychological and cognitive effects, potentially impairing facial emotion recognition (FER). This study examines the accuracy of FER among IPV survivors compared to individuals without IPV experience within the Korean baby boomer generation, aged 60-69, exploring the relationship between IPV, post-traumatic stress disorder (PTSD) symptoms, and FER abilities.Objective: To assess whether IPV impacts FER accuracy and intensity and to investigate whether symptoms of PTSD moderate this relationship.Method: The study included 80 participants, with 31 % identified as IPV survivors. A self-administered survey collected information on lifetime experiences of physical, emotional, and sexual abuse, as well as assessments for PTSD symptoms. Participants completed the Korean Montreal Cognitive Assessment (K-MOCA) and performed 70 FER tasks to evaluate accuracy and intensity of facial emotions. Logistic regressions were used to analyse the relationship between IPV, PTSD symptoms, and FER performance.Results: IPV survivors demonstrated 0.64 times lower accuracy in recognizing overall facial emotions, including anger, sadness, surprise, and neutral expressions Additionally, IPV survivors exhibited significantly lower intensity scores for overall facial expressions. Significant interaction terms between IPV and PTSD symptoms indicate that PTSD symptoms moderate the effect of IPV on the FER, as well as neutral and sad facial expressions.Conclusions: IPV can disrupt one's ability to recognize facial emotions, and PTSD symptoms may moderate this impairment. This highlights the potential benefits of assisting IPV survivors with emotion recognition as part of their recovery process, which could enhance both social connections and their safety.

Probiotic supplementation mitigates sex-dependent nociceptive changes and gut dysbiosis induced by prenatal opioid exposure

The gut microbiome has emerged as a promising target for modulating adverse effects of opioid exposure due to its significant role in health and disease. Opioid use disorder (OUD) has become increasingly prevalent, specifically in women of reproductive age, contributing to an increased incidence of offspring exposed to opioids in utero. Recent studies have shown that prenatal opioid exposure (POE) is associated with notable changes to the maternal gut microbiome, with subsequent implications for the offspring's microbiome and other adverse outcomes. However, the role of the gut microbiome in mediating sex-based differences in pain sensitivity has not yet been investigated. In this study, both male and female C57BL/6 offspring were used to determine sex-based differences in nociception and gut microbial composition as a result of POE. Our data reveals significant sex-based differences in offspring prenatally exposed to opioids. The gut microbiome of opioid-exposed females showed an enrichment of commensal bacteria including Lactobacillus compared to opioid-exposed males. Additionally, POE females demonstrated decreased nociceptive sensitivity, while males demonstrated increased nociceptive sensitivity. RNA sequencing of the prefrontal cortex showed sex-based differences in several canonical pathways, including an increase in the opioid signaling pathway of opioid-exposed females, which was not observed in males. Microbiome modification via maternal probiotic supplementation attenuated sex-based differences throughout the early stages of life. Together, our study provides further insight on sex-based differences arising from POE and highlights the pivotal role of the gut microbiome as a modifiable target for mitigating its negative effects.

Multifaceted role of nitric oxide in vascular dementia

Vascular dementia is a highly heterogeneous neurodegenerative disorder induced by a variety of factors. Currently, there are no definitive treatments for the cognitive dysfunction associated with vascular dementia. However, early detection and preventive measures have proven effective in reducing the risk of onset and improving patient prognosis. Nitric oxide plays an integral role in various physiological and pathological processes within the central nervous system. In recent years, nitric oxide has been implicated in the regulation of synaptic plasticity and has emerged as a crucial factor in the pathophysiology of vascular dementia. At different stages of vascular dementia, nitric oxide levels and bioavailability undergo dynamic alterations, with a marked reduction in the later stages, which significantly contributes to the cognitive deficits associated with the disease. This review provides a comprehensive review of the emerging role of nitric oxide in the physiological and pathological processes underlying vascular dementia, focusing on its effects on synaptic dysfunction, neuroinflammation, oxidative stress, and blood‒brain barrier integrity. Furthermore, we suggest that targeting the nitric oxide soluble guanylate cyclase-cyclic guanosine monophosphate pathway through specific therapeutic strategies may offer a novel approach for treating vascular dementia, potentially improving both cognitive function and patient prognosis. The review contributes to a better understanding of the multifaceted role of nitric oxide in vascular dementia and to offering insights into future therapeutic interventions.

Individual differences in behavioral responses to predator odor predict subsequent stress reactivity in female rats

Stress-induced neuropsychiatric disorders are among the most prevalent medical conditions and have widespread effects on both patients and society. Females experience over twice the rates of stress-related anxiety and depression when compared to males and often exhibit worse symptomatology and treatment outcomes. However, preclinical experiments exploring the neurobiological mechanisms of stress susceptibility in females have been traditionally understudied. Previous data from our lab has determined that females are selectively vulnerable to the consequences of vicarious witness stress, and these experiments were designed to determine specific behavioral and physiological factors that could predict which groups would be more susceptible to the effects of stress. Adult, female, Sprague-Dawley rats were first exposed to a ferret predator odor to determine baseline individual differences in behavioral responses. Rats were stratified by the duration of freezing behavior exhibited in response to the ferret odor and equally balanced into non-stressed controls and vicarious witness stress exposed groups. These female rats were then assessed on a battery of behavioral tasks including sucrose preference, elevated plus maze, acoustic startle, and the ferret odor and witness stress cue exposures to determine if baseline differences in stress responding can predict the behavioral response to future stress and stress cues. High freezing in response to the ferret odor was associated with behavioral sensitization to witness stress and hypervigilant responses to stress cues that was accompanied by exaggerated neuroimmune responses. These experiments establish a powerful behavioral predictor of stress susceptibility in females and begin to address neurobiological correlates that underlie this response.

The PKC/NOX/ROS and PYK2/MEK/ERK/PARP signalling pathways drive TRPM2 channel activation induced by non-cytolytic oxidative stress in microglial cells

OBJECTIVES

The study aimed to investigate the signalling mechanism for TRPM2 channel activation by non-cytolytic oxidative stress in microglia.

METHODS

Microglia from wild-type (WT) and TRPM2-knockout (KO) mice were exposed to 10-30 mM H2O2 for up to 24 hours. Morphological changes characteristic of microglial activation, [Ca2+]c, ROS generation and the effects of inhibiting particular signalling pathways were examined.

RESULTS

Exposure of WT microglia to H2O2 for 24 hours caused no cell death but induced salient morphological changes, which was prevented by TRPM2-KO. Exposure of WT microglia to H2O2 to 2 hours failed, and extension to 8 hours was required, to induce an increase in [Ca2+]c, which was abolished by TRPM2-KO. Exposure of microglia to H2O2 for 8 hours induced ROS generation, which was suppressed by inhibition of PKC and NADPH oxidases (NOX). H2O2-induced PARP activation in TRPM2-KO cells was lower than that in WT cells. Furthermore, H2O2-induced activation of PARP and TRPM2 and morphological changes were attenuated by inhibition of PCK and NOX as well as PYK2 and MEK/ERK.

CONCLUSION

Our results support that PKC/NOX-mediated ROS generation and TRPM2-mediated Ca2+-induced activation of the PYK2/MEK/ERK pathway form a positive feedback mechanism to drive TRPM2 channel activation by non-cytolytic oxidative stress.

The effect of rebound exercise on cognition and balance of females with overweight and obesity

Balance issues have been reported to be common among females with overweight or obesity with associated fall risks. Despite the increasing reports of the negative impacts of obesity on balance and cognition, there is a scarcity of research aimed at evaluating effective interventions. To examine the effects of rebound exercises on cognition and balance among females with overweight and obesity. This Quasi-experimental study used the purposive sampling method to recruit 20 female students (aged 17-35 years) with overweight and obese at the Evangel University Akaeze, Ebonyi State Nigeria. Rebound exercise intervention was administered to all participants at the gym for 30 minutes in each session, three times a week for six weeks, while their cognitive performances, stationary balance, and dynamic balance were measured pre-and post-trial using Trail Marking Test Apparatuses, Unilateral Pedal Tests, and Meter Backward Walk Test respectively. There was a significant (p < 0.001) difference in the participants' cognition values across weeks 1, 3, and 6 with a progressive improvement over time. There was also a significant (p < 0.05) difference in the participants' static and dynamic balance values across weeks 1, 3, and 6 with a progressive improvement in balance performance over time. Rebound exercise significantly improved the cognition and balance of females with overweight or obese. This finding suggests a promising intervention to improve balance and cognitive-related problems in this population. Registered retrospectively in the Pan African Clinical Trial Registry, identification number for the registry is PACTR202405746557031. Dated 2 May 2024.

Metacognition of one's strategic planning in decision-making: the contribution of EEG correlates and individual differences

The metacognition of one's planning strategy constitutes a "second-level" of metacognition that goes beyond the knowledge and monitoring of one's cognition and refers to the ability to use awareness mechanisms to regulate execution of present or future actions effectively. This study investigated the relation between metacognition of one's planning strategy and the behavioral and electrophysiological (EEG) correlates that support strategic planning abilities during performance in a complex decision-making task. Moreover, a possible link between task execution, metacognition, and individual differences (i.e., personality profiles and decision-making styles) was explored. A modified version of the Tower of Hanoi task was proposed to a sample of healthy participants, while their behavioral and EEG neurofunctional correlates of strategic planning were collected throughout the task with decisional valence. After the task, a metacognitive scale, the 10-item Big Five Inventory, the General Decision-Making Style inventory, and the Maximization Scale were administered. Results showed that the metacognitive scale enables to differentiate between the specific dimensions and levels of metacognition that are related to strategic planning behavioral performance and decision. Higher EEG delta power over left frontal cortex (AF7) during task execution positively correlates with the metacognition of one's planning strategy for the whole sample. While increased beta activity over the left frontal cortex (AF7) during task execution, higher metacognitive beliefs of efficacy and less willingness to change their strategy a posteriori were correlated with specific personality profiles and decision-making styles. These findings allow researchers to delve deeper into the multiple facets of metacognition of one's planning strategy in decision-making.

Commentary: Air pollution and neurodevelopmental disorders: a cause for concern in an urbanising world

The world's population is rapidly urbanising, especially in low- to middle-income countries. However, urban living is associated with an increased risk of neurodevelopmental disorders (NDD) like autism spectrum disorders (ASD) and schizophrenia. Exposure to urban air pollutants like particulate matter has been positively associated with both ASD and schizophrenia diagnosis rates. Mechanistic studies have shown that particulate matter exposure leads to brain inflammation and white matter pathologies consistent with these disorders. Children are especially susceptible to these effects due to their rapidly developing nervous systems. Despite this, few reviews on the subject recommend future steps to mitigate the teratogenic effects of particulate air pollution. This commentary both synthesises evidence and recommends research and policy goals to protect children, both present and future, from the neurodevelopmental consequences of particulate air pollution. These steps include further study of the relationship between air pollution and equitable resource distribution to address the coming global rises in NDD. Furthermore, capacity building in urbanising nations is essential to overcome barriers erected by resource extraction and pollution outsourcing by wealthy nations. With such an integrated approach, progress can be made in protecting the developing nervous systems of children and future generations in both affluent and resource-strained nations.

Constructed transferrin receptor-targeted liposome for the delivery of fluvoxamine to improve prognosis in a traumatic brain injury mouse model

The dysregulation of blood-brain barrier (BBB) activates pathological mechanisms such as neuroinflammation after traumatic brain injury (TBI), and glymphatic system dysfunction accelerates toxic waste accumulation after TBI. It is essential to find an effective way to inhibit inflammation and repair BBB and glymphatic system after TBI; however, effective and lasting drug therapy remains challenging because BBB severely prevents drugs from being delivered to central nervous system. Transferrin receptors (TfRs) are mainly expressed on brain capillary endothelial cells. Here, we report a TfR-targeted nanomedicine for TBI treatment by penetrating BBB and delivering fluvoxamine (Flv). The TfR-targeted polypeptide liposome loaded with Flv (TPL-Flv) implements cell targeting ability on human umbilical vein endothelial cells (HUVECs) in vitro detected by flow cytometry, and drug safety was proved through cell viability analysis and blood routine and biochemistry analysis. Afterwards, we established a controlled cortical impact model to explore TPL-Flv administration effects on TBI mice. We confirmed that TPL-Flv could stimulate CXCR4/SDF-1 signaling pathway, activate Treg cells, and inhibit inflammation after TBI. TPL-Flv treatment also alleviated BBB disruption and restored aquaporin-4 (AQP4) polarization, as well as reversed glymphatic dysfunction. Furthermore, TPL-Flv accomplished remarkable improvement of motor and cognitive functions. These findings demonstrate that TPL-Flv can effectively cross BBB and achieve drug delivery to cerebral tissue, validating its potential to improve therapeutic outcomes for TBI.