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The Therapeutic Role of Exercise and Probiotics in Stressful Brain Conditions. Int J Mol Sci 2022; 23:ijms23073610. [PMID: 35408972 PMCID: PMC8998860 DOI: 10.3390/ijms23073610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 02/04/2023] Open
Abstract
Oxidative stress has been recognized as a contributing factor in aging and in the progression of multiple neurological disorders such as Parkinson’s disease, Alzheimer’s dementia, ischemic stroke, and head and spinal cord injury. The increased production of reactive oxygen species (ROS) has been associated with mitochondrial dysfunction, altered metal homeostasis, and compromised brain antioxidant defence. All these changes have been reported to directly affect synaptic activity and neurotransmission in neurons, leading to cognitive dysfunction. In this context two non-invasive strategies could be employed in an attempt to improve the aforementioned stressful brain status. In this regard, it has been shown that exercise could increase the resistance against oxidative stress, thus providing enhanced neuroprotection. Indeed, there is evidence suggesting that regular physical exercise diminishes BBB permeability as it reinforces antioxidative capacity, reduces oxidative stress, and has anti-inflammatory effects. However, the differential effects of different types of exercise (aerobic exhausted exercise, anaerobic exercise, or the combination of both types) and the duration of physical activity will be also addressed in this review as likely determinants of therapeutic efficacy. The second proposed strategy is related to the use of probiotics, which can also reduce some biomarkers of oxidative stress and inflammatory cytokines, although their underlying mechanisms of action remain unclear. Moreover, various probiotics produce neuroactive molecules that directly or indirectly impact signalling in the brain. In this review, we will discuss how physical activity can be incorporated as a component of therapeutic strategies in oxidative stress-based neurological disorders along with the augmentation of probiotics intake.
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Méndez M, Fidalgo C, Arias JL, Arias N. Methylene blue and photobiomodulation recover cognitive impairment in hepatic encephalopathy through different effects on cytochrome c-oxidase. Behav Brain Res 2021; 403:113164. [PMID: 33549685 DOI: 10.1016/j.bbr.2021.113164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 01/02/2021] [Accepted: 02/01/2021] [Indexed: 10/22/2022]
Abstract
Mitochondrial dysfunction plays a central role in hepatic encephalopathy (HE), due to changes in enzyme cytochrome c-oxidase (CCO), causing a decline in brain metabolism. We used an HE animal model and applied intracranial administration of methylene blue (MB) and transcranial photobiomodulation (PBM), both targeting CCO, to determine their differential effects on recovering cognition. Five groups of rats were used: sham-operated group + saline (SHAM + SAL, n = 6), hepatic encephalopathy + SAL (HE + SAL, n = 7), SHAM + methylene blue (SHAM + MB, n = 7), HE + MB (n = 7), HE + PBM (n = 7). PBM animals were exposed transcranially to 670 +/- 10 nm LED light at a dose of 9 J/cm2 once a day for 7 days, and the MB and SAL groups were injected with 2.2 μg/0.5 μL in the accumbens. Cognitive dysfunction was evaluated on a striatal stimulus-response task using the Morris water maze. Our results showed cognitive improvement in the HE group when treated with MB. This improvement was accompanied by a decrease in CCO activity in the prefrontal cortex, dorsal striatum, and dorsal hippocampus. When comparing MB and PBM, we found that, although both treatments effectively improved the HE-memory deficit, there was a differential effect on CCO. A general decrease in CCO activity was found in the prefrontal and entorhinal cortices, dorsal striatum, and hippocampus when PBM, compared to MB, was applied. Our results suggest that mitochondrial dysfunction and brain metabolic decline in HE might involve CCO alteration and can be improved by administering MB and PBM.
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Affiliation(s)
- Marta Méndez
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, Oviedo, 33003, Spain; INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Camino Fidalgo
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain; Departamento de Psicología y Sociología, IIS Aragón, Universidad de Zaragoza, Ciudad Escolar s/n, Teruel, 44003, Spain
| | - Jorge L Arias
- Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, Oviedo, 33003, Spain; INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain
| | - Natalia Arias
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Oviedo, Spain; UK Dementia Research Institute, Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, UK.
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El Khiat A, Tamegart L, Draoui A, El Fari R, Sellami S, Rais H, El Hiba O, Gamrani H. Kinetic deterioration of short memory in rat with acute hepatic encephalopathy: Involvement of astroglial and neuronal dysfunctions. Behav Brain Res 2019; 367:201-209. [DOI: 10.1016/j.bbr.2019.03.046] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Revised: 03/25/2019] [Accepted: 03/26/2019] [Indexed: 02/07/2023]
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Banqueri M, Martínez JA, Prieto MJ, Cid-Duarte S, Méndez M, Arias JL. Photobiomodulation rescues cognitive flexibility in early stressed subjects. Brain Res 2019; 1720:146300. [PMID: 31226326 DOI: 10.1016/j.brainres.2019.146300] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 06/10/2019] [Accepted: 06/17/2019] [Indexed: 12/17/2022]
Abstract
Neglectful parenting is one of the most prevalent forms of child mistreatment. This early life stress leads to long-term alterations in all the psychological domains, as well as brain alterations. Animal models have been developed to emulate and further study this early life stress, and one of most widely used models is maternal separation. In both human and animal models, cognitive flexibility has been found to be altered. In this study, we performed maternal separation (10 days, 4 h per day) in rats, and in adulthood, we tested their spatial navigation and cognitive flexibility. In addition, we delivered photobiomodulation treatment (Low-level light therapy: 1064 nm, 30 mW, 60 cycles) on the rats' brains, and we tested energy oxidative metabolism using cytochrome c oxidase histochemistry. Early life stress delivered in the form of maternal separation on the first 10 postnatal days leads to cognitive flexibility impairment and a general increase in energy metabolism in adulthood. Low-level light therapy seems to be useful for treating these unwanted outcomes, because it rescued cognitive flexibility and returned the oxidative energy metabolism to balanced scores, without harming controls' brains or behavior. Photobiomodulation is a promising tool in the treatment of chronic stress-related consequences because it rescued cognitive flexibility.
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Affiliation(s)
- María Banqueri
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.
| | - Juan A Martínez
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Electronic Technology Area, University of Oviedo, Torres Quevedo Building (West), 2, Gijón, Spain
| | - Miguel J Prieto
- Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Electronic Technology Area, University of Oviedo, Torres Quevedo Building (West), 2, Gijón, Spain
| | - Sandra Cid-Duarte
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain
| | - Marta Méndez
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain; Electronic Technology Area, University of Oviedo, Torres Quevedo Building (West), 2, Gijón, Spain
| | - Jorge L Arias
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
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Taoro-González L, Cabrera-Pastor A, Sancho-Alonso M, Arenas YM, Meseguer-Estornell F, Balzano T, ElMlili N, Felipo V. Differential role of interleukin-1β in neuroinflammation-induced impairment of spatial and nonspatial memory in hyperammonemic rats. FASEB J 2019; 33:9913-9928. [PMID: 31162953 DOI: 10.1096/fj.201900230rr] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Activated microglia and increased brain IL-1β play a main role in cognitive impairment in much pathology. We studied the role of IL-1β in neuroinflammation-induced impairment of the following different types of learning and memory: novel object recognition (NOR), novel object location (NOL), spatial learning, reference memory (RM), and working memory (WM). All these processes are impaired in hyperammonemic rats. We assessed which of these types of learning and memory are restored by blocking the IL-1 receptor in vivo in hyperammonemic rats and the possible mechanisms involved. Blocking the IL-1 receptor reversed microglial activation in the hippocampus, perirhinal cortex, and prefrontal cortex but not in the postrhinal cortex. This was associated with the restoration of NOR and WM but not of tasks involving a spatial component (NOL and RM). This suggests that IL-1β would be involved in neuroinflammation-induced nonspatial memory impairment, whereas spatial memory impairment would be IL-1β-independent and would be mediated by other proinflammatory factors.-Taoro-González, L., Cabrera-Pastor, A., Sancho-Alonso, M., Arenas, Y. M., Meseguer-Estornell, F., Balzano, T., ElMlili, N., Felipo, V. Differential role of interleukin-1β in neuroinflammation-induced impairment of spatial and nonspatial memory in hyperammonemic rats.
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Affiliation(s)
- Lucas Taoro-González
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Andrea Cabrera-Pastor
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain.,Fundación Investigación Hospital Clínico, Instituto de Investigación Sanitaria (INCLIVA), Valencia, Spain
| | - María Sancho-Alonso
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Yaiza M Arenas
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | | | - Tiziano Balzano
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Nisrin ElMlili
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
| | - Vicente Felipo
- Laboratory of Neurobiology, Centro de Investigación Príncipe Felipe, Valencia, Spain
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Lier J, Winter K, Bleher J, Grammig J, Mueller WC, Streit W, Bechmann I. Loss of IBA1-Expression in brains from individuals with obesity and hepatic dysfunction. Brain Res 2019; 1710:220-229. [PMID: 30615888 DOI: 10.1016/j.brainres.2019.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/16/2018] [Accepted: 01/03/2019] [Indexed: 02/06/2023]
Abstract
Microglia, the brain's resident immune cells, exhibit constitutive expression of the ionized calcium binding adaptor molecule 1 (IBA1), a cytoplasmic protein with actin and calcium-binding functions involved in membrane ruffling. Microglia are long-lived cells that exhibit a senescent morphology (dystrophy) with aging, which may be indicative of cell dysfunction. It has been reported that dystrophy of IBA1-positive microglia is exacerbated in obese humans. Our own preliminary studies of microglia in the medial temporal lobe of obese subjects have revealed another microglial abnormality, which is the loss of IBA1 immunoreactivity that can create large areas in the brain seemingly devoid of all microglial cells. Here, we systematically compared microglial appearance in human hippocampi derived from obese individuals compared to controls (nobese = 33, nnon-obese = 30). In both groups, we found areas that were negative for IBA1, but contained P2YR12 and glutathione-peroxidase 1 (GPX)-positive microglia. The number and extent of IBA1-negative regions was increased in obese cases. Since some cases of non-obese individuals also exhibited loss of IBA-1 immunoreactivity, we searched for possible confounders and found that hepatic dysfunction strongly impacts the distribution of microglial cells: By computational analysis of scanned IBA1-stained sections, we detected increased Mean Empty Space distances (p = 0.016) and IBA1-negative areas (p = 0.090) which were independent from the cause of liver dysfunction, but also from aging. Thus, we report on a novel type of microglia pathological change, i.e. localized loss of IBA1 that is linked, at least in part, to obesity and hepatic dysfunction.
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Affiliation(s)
- Julia Lier
- Institute of Anatomy, University of Leipzig, Germany.
| | | | - Johannes Bleher
- University of Tuebingen - Department of Statistics and Econometrics, Germany
| | - Joachim Grammig
- University of Tuebingen - Department of Statistics and Econometrics, Germany
| | - Wolf C Mueller
- Department of Neuropathology, University Hospital, University of Leipzig, Germany
| | - Wolfgang Streit
- Department of Neuroscience, University of Florida College of Medicine and McKnight Brain Institute, Gainesville, FL, United States
| | - Ingo Bechmann
- Institute of Anatomy, University of Leipzig, Germany.
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Banqueri M, Méndez M, Arias JL. Why are maternally separated females inflexible? Brain activity pattern of COx and c-Fos. Neurobiol Learn Mem 2018; 155:30-41. [PMID: 29908971 DOI: 10.1016/j.nlm.2018.06.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 06/06/2018] [Accepted: 06/13/2018] [Indexed: 12/23/2022]
Abstract
Subjects' early life events will affect them later in life. When these events are stressful, such as child abuse in humans or repeated maternal separation in rodents, subjects can show some behavioral and brain alterations. This study used young adult female Wistar rats that were maternally raised (AFR), maternally separated from post-natal day (PND) 1 to PND10 (MS10), or maternally separated from PND1 to PND21 (MS21), in order to assess the effects of maternal separation (MS) on spatial learning and memory, as well as cognitive flexibility, using the Morris Water Maze (MWM). We performed quantitative cytochrome oxidase (COx) histochemistry on selected brain areas in order to identify whether maternal separation affects brain energy metabolism. We also performed c-Fos immunohistochemistry on the medial prefrontal cortex (mPFC), thalamus, and hippocampus to explore whether this immediate early gene activity was altered in stressed subjects. We obtained a similar spatial learning pattern in maternally raised and maternally separated subjects on the reference memory task, but only the controls were flexible enough to solve the reversal learning successfully. Separated groups showed less c-Fos activity in the mPFC and less complex neural networks on COx.
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Affiliation(s)
- María Banqueri
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain.
| | - Marta Méndez
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
| | - Jorge L Arias
- Laboratory of Neuroscience, Department of Psychology, University of Oviedo, Plaza Feijoo, s/n, E-33003 Oviedo, Spain; Instituto de Neurociencias del Principado de Asturias (INEUROPA), Spain
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Galland F, Negri E, Da Ré C, Fróes F, Strapazzon L, Guerra MC, Tortorelli LS, Gonçalves CA, Leite MC. Hyperammonemia compromises glutamate metabolism and reduces BDNF in the rat hippocampus. Neurotoxicology 2017; 62:46-55. [PMID: 28506823 DOI: 10.1016/j.neuro.2017.05.006] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Revised: 03/31/2017] [Accepted: 05/11/2017] [Indexed: 12/31/2022]
Abstract
Ammonia is putatively the major toxin associated with hepatic encephalopathy (HE), a neuropsychiatric manifestation that results in cognitive impairment, poor concentration and psychomotor alterations. The hippocampus, a brain region involved in cognitive impairment and depressive behavior, has been studied less than neocortical regions. Herein, we investigated hippocampal astrocyte parameters in a hyperammonemic model without hepatic lesion and in acute hippocampal slices exposed to ammonia. We also measured hippocampal BDNF, a neurotrophin commonly related to synaptic plasticity and cognitive deficit, and peripheral S100B protein, used as a marker for brain damage. Hyperammonemia directly impaired astrocyte function, inducing a decrease in glutamate uptake and in the activity of glutamine synthetase, in turn altering the glutamine-glutamate cycle, glutamatergic neurotransmission and ammonia detoxification itself. Hippocampal BDNF was reduced in hyperammonemic rats via a mechanism that may involve astrocyte production, since the same effect was observed in astrocyte cultures exposed to ammonia. Ammonia induced a significant increase in S100B secretion in cultured astrocytes; however, no significant changes were observed in the serum or in cerebrospinal fluid. Data demonstrating hippocampal vulnerability to ammonia toxicity, particularly due to reduced glutamate uptake activity and BDNF content, contribute to our understanding of the neuropsychiatric alterations in HE.
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Affiliation(s)
- Fabiana Galland
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Elisa Negri
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Carollina Da Ré
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Fernanda Fróes
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Liliane Strapazzon
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Maria Cristina Guerra
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Lucas Silva Tortorelli
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Carlos-Alberto Gonçalves
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
| | - Marina Concli Leite
- Departamento de Bioquímica, Instituto de Ciências Básicas da Saúde, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.
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Arias N, Méndez M, Alcalde I, Íñigo-Portugués A, Merayo-Lloves J, Arias J, Arias JL. Assessing the brain through the eye: New ways to explore hepatic encephalopathy. Physiol Behav 2017; 173:263-271. [PMID: 28238775 DOI: 10.1016/j.physbeh.2017.02.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 02/21/2017] [Accepted: 02/21/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Minimal hepatic encephalopathy (mHE) has been shown to affect daily functioning, quality of life, driving and overall mortality. However, little is known about treating or diagnosing early impairments in mHE. We studied one of its precipitating factors, portal hypertension which is driving the inflammatory process behind mHE. The purpose was to describe an indirect diagnostic method able to detect the pathology at early stages based on the study of the vascularization and mast cells conjunctival hyperplasia as secondary inflammatory response associated to portal hypertension. Finally, we correlated the presence of histological changes in the eye in mHE with deficits in behavioral task acquisition. METHODS Rats were trained on a stimulus-response task and a spatial working memory task using the Morris water maze. Two groups of animals were used: a SHAM (sham-operated) group (n=10) and a portal hypertension (HT) group (n=10). The triple portal vein ligation method was used to create an animal model of mHE. Latencies to reach the platform, number of glial fibrillary acidic protein-immunoreactive astrocytes (GFAP-IR), mast cell expression and presence/absence of blood and lymphatic vessels were examined. RESULTS There were differences in stimulus-response behavioral performance, with a deficit in the acquisition in the HT group. However, no differences between groups were found on the spatial working memory task. At the same time, differences between groups were found in the GFAP-IR density, which was lower in the HT group, and in the number of mast cells and the presence of vessels, which were higher in the HT group. CONCLUSIONS In this study, we provide the first preliminary insight into the validity of exploring the eye as a possible tool to assess the diagnosis of mHE conditions.
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Affiliation(s)
- Natalia Arias
- Institute for Liver and Digestive Health, University College of London, Department of Medicine, Rowland Hill Street, London, UK; INEUROPA, Instituto de Neurociencias del Principado de Asturias, Spain.
| | - Marta Méndez
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Spain; Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
| | - Ignacio Alcalde
- Fundación de Investigación Oftalmológica (FIO), Instituto Oftalmológico Fernández-Vega, Avda. Dres Fernández-Vega, 34, 33012 Oviedo, Spain
| | - Almudena Íñigo-Portugués
- Fundación de Investigación Oftalmológica (FIO), Instituto Oftalmológico Fernández-Vega, Avda. Dres Fernández-Vega, 34, 33012 Oviedo, Spain
| | - Jesús Merayo-Lloves
- Fundación de Investigación Oftalmológica (FIO), Instituto Oftalmológico Fernández-Vega, Avda. Dres Fernández-Vega, 34, 33012 Oviedo, Spain
| | - Jaime Arias
- Surgery Department, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jorge L Arias
- INEUROPA, Instituto de Neurociencias del Principado de Asturias, Spain; Laboratorio de Neurociencias, Departamento de Psicología, Universidad de Oviedo, Plaza Feijoo s/n, 33003 Oviedo, Spain
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Low-light-level therapy as a treatment for minimal hepatic encephalopathy: behavioural and brain assessment. Lasers Med Sci 2016; 31:1717-1726. [DOI: 10.1007/s10103-016-2042-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/27/2016] [Indexed: 12/15/2022]
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