In the past two decades, advances in microbiomics and neuroimmunology have reframed the concept of "central immune privilege." Rather than simply proving a gut-brain connection, the translational challenge now lies in identifying how gut-derived signals are transmitted, filtered, amplified, or buffered across different neural, immune, metabolic, vascular, and barrier-related routes. Based on a structured narrative synthesis of experimental, translational, and clinical literature, this review presents barrier-immune-coupled gating failure as a working hypothesis and conceptual framework, rather than as a unifying explanation for all gut-brain interactions. Within this framework, three analytically separable but interacting dimensions are emphasized: (1) entry gating, referring to the threshold at which peripheral signals influence CNS boundary states; (2) boundary translation, in which signals are filtered or reshaped at interfaces such as the blood-brain barrier (BBB), blood-cerebrospinal fluid barrier (BCSFB), and meningeal immune zones; and (3) clearance gating, involving CSF drainage, meningeal lymphatics, glymphatic exchange, and protein or inflammatory-signal clearance. We highlight how gut-derived signals-filtered by the intestinal mucosa and gut-associated lymphoid tissue (GALT)-interact with immune set points and structural barriers. These interactions are modulated by factors such as short-chain fatty acids (SCFAs) and metabolite load, influencing whether signals are buffered or amplified. Recent findings show that skull bone marrow can directly supply immune cells to the meninges via transcortical vascular channels (TCVs), forming a responsive border niche susceptible to intestinal inflammation. At the cellular level, the review focuses on boundary-associated macrophages (BAMs) and disease-associated microglia (DAM) states, which bridge peripheral disruptions and central neuroinflammation. In selected contexts, reduced boundary buffering or impaired clearance may increase the likelihood that interface inflammation extends toward the parenchyma, particularly in proteinopathies with persistent inflammatory or protein burden. Finally, we propose a biomarker matrix for mechanistic stratification, which may help prioritize hypothesis-guided evaluation of barrier repair, drainage enhancement, immune set-point modulation, and cell-state reprogramming, while acknowledging that current human intervention evidence remains modest, inconsistent, or context-specific. By defining its scope and testable predictions, this framework may help move selected gut-brain studies from broad association toward more stratified and mechanism-oriented investigation.
BACKGROUND:This bibliometric analysis is aimed at mapping global trends and research hotspots in postoperative depression, providing insights into the evolution and development of research in this field. METHODS:A comprehensive search was conducted in the Web of Science Core Collection database, focusing on literature from 1994 to 2024. Data extraction and visualization were performed using VOSviewer (Version 1.6.20), CiteSpace (Version 6.3.R1), and R (Version 4.3.3). RESULTS:This study encompassed 687 scholarly articles from 54 countries. The United States contributed the largest number of articles, followed by China and the United Kingdom. High-output institutions from the United States include the University of California System and Harvard University. The Journal of Psychosomatic Research and Epilepsy were among the top journals by h-index. Aalto Timo, Airaksinen Olavi, and Sinikallio Sanna were among the most productive authors. High-frequency keywords included "quality-of-life," "anxiety," and "symptoms." Recent burst keywords "risk," "elderly patients," and "double blind" indicate emerging trends in the field, pointing toward an increased interest in identifying factors that may precipitate postoperative depression, the unique vulnerabilities of older adults, and the methodological rigor of double-blind studies in assessing interventions. CONCLUSION:The research hotspots and trends in postoperative depression are centered around the impact of depression on surgical outcomes, the role of anxiety, and quality of life assessments. This study reveals a growing interest in predictors of postoperative depression and the exploration of novel therapeutic interventions, indicating an evolving and dynamic research area.
BACKGROUND:Social determinants of health (SDoH) have not been comprehensively studied in relation to Parkinson's disease (PD), although they are well known to be associated with other chronic diseases. Here we assessed the relationship of a multidimensional, comprehensive measure of SDoH with the prevalence of PD in US adults. METHODS:Among 48,637 adults in the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2020, we identified PD cases based on self-reported antiparkinsonian medication use. We formed a weighted multidomain SDoH score from eight indicators that assessed economic security, education, healthcare access, and social environment. Both multivariable logistic regression and restricted cubic spline (RCS) were used to estimate odds ratios and dose-response relationships and were adjusted for demographic and lifestyle factors. RESULTS:More intensive adverse SDoH burden was significantly associated with higher PD prevalence (fully adjusted OR 1.31, 95% CI 1.16-1.47 per unit increase), and RCS analysis showed no evidence of nonlinearity (p for nonlinearity = 0.370). Unemployment (OR 4.15, 95% CI 2.70-6.40) and food insecurity (OR 1.96, 95% CI 1.39-2.76) were strongly associated with higher PD prevalence, whereas reported lack of health care access was associated with lower identified PD (OR 0.27, 95% CI 0.15-0. 49), pointing to likely ascertainment bias. When stratifying, we observed meaningful effect modification by age (p < 0.001), with stronger effects in middle-aged individuals (≤ 60 years: OR 1.35, 95% CI 1.13-1.61), compared with an attenuation in older individuals. CONCLUSION:Poor SDoH were independently associated with higher PD prevalence, particularly among adults aged 60 years and younger. Unemployment and food insecurity showed strong positive associations, whereas the inverse association with healthcare access likely reflects ascertainment bias. These findings are hypothesis-generating and suggest that SDoH may be relevant to PD screening and epidemiologic research. Longitudinal studies are needed to clarify temporality and causality.
Tobacco consumption has significantly increased globally, contributing to various degenerative diseases such as lung cancer and cardiovascular disorders. Nicotine, the primary addictive component in tobacco, exerts its effects by stimulating nicotinic acetylcholine receptors (nAChRs), leading to excessive dopamine release in the ventral tegmental area (VTA) and nucleus accumbens (NAc), which underlies its rewarding and addictive properties. Additionally, nicotine enhances orexin activity in the hypothalamus and prepro-glucagon expression in the nucleus tractus solitarius (NTS), further reinforcing addictive behaviors. This study is aimed at investigating the effects of liraglutide, a GLP-1 receptor agonist, on nicotine-induced reward. Male mice strain ddy were divided into four groups: control, nicotine, nicotine + liraglutide (50 μg/kg), and nicotine + liraglutide (100 μg/kg). The conditioned place preference (CPP) test was used to evaluate nicotine's rewarding effects, whereas RT-PCR assessed the expression of prepro-orexin and prepro-glucagon mRNA in the hypothalamus and NTS, respectively. The results confirmed that nicotine administration (0.5 mg/kg) significantly increased CPP scores, indicating enhanced reward-related behaviors. Correspondingly, nicotine elevated prepro-orexin and prepro-glucagon mRNA expression levels. Treatment with liraglutide (50 and 100 μg/kg) significantly reduced nicotine-induced CPP scores, suggesting an attenuation of addictive behavior. Liraglutide downregulated the expression of prepro-orexin and prepro-glucagon, with the 100 μg/kg dose demonstrating greater efficacy in normalizing prepro-glucagon levels. These findings indicate that liraglutide mitigates nicotine reward by modulating neuropeptide pathways, including orexin and glucagon signaling. The dual impact of liraglutide on behavioral and molecular markers highlights its potential as a therapeutic agent for treating nicotine induce reward-related behavior. Further research is warranted to explore its long-term efficacy and underlying mechanisms in addiction modulation.
BackgroundVisual neglect is one of the most frequent neuropsychological consequences of acute brain damage. Generally, paper-and-pencil tests, administered in the peripersonal space, are used to establish the presence of neglect. However, the multidimensional nature of neglect makes the diagnostic process challenging. Neglect varies, among other things, in spatial regions; that is, personal, peripersonal, and extrapersonal space.ObjectiveIn this feasibility study, we aim to establish the reliability and validity of a newly developed Functional ExtraPersonal Space Neglect Test (FEPSNeT) executed on a virtual reality system.MethodsStroke patients with a first stroke in the right hemisphere, treated in four rehabilitation centers in the Netherlands equipped with a GRAIL (Gait Real-Time Analysis Interactive Lab), were included in this study. The participants performed the FEPSNeT twice a week on separate days. The Line Bisection Test (LBT), the Star Cancelation Test (SCT), and the Catherine Bergego Scale (CBS) were also administered.ResultsThe test-retest reliability of the FEPSNeT was nearly acceptable. The construct validity of the FEPSNeT was considered sufficient because the subjects with the most asymmetrical reaction times all responded slower to stimuli on their left side. There was no significant correlation between the FEPSNeT and paper-and-pencil tests (LBT and SCT), and there was a low but significant correlation between the FEPSNeT and CBS.ConclusionsThe FEPSNeT appears to assess neglect in a different region (extrapersonal space) than paper-and-pencil tests (peripersonal space), and therefore, it can be of added value to paper-and-pencil tests in the assessment of visual neglect.
Black individuals are disproportionately exposed to adverse childhood experiences (ACEs) in comparison to White individuals, including greater violence exposure, neighborhood disadvantage, and poverty. Neural circuitry that includes the amygdala, hippocampus, prefrontal cortex (ventromedial, dorsomedial, and dorsolateral), and inferior parietal lobule support stress-related emotional processes. ACEs may modify emotion-related activity within these brain regions, which, in turn, may modulate emotional behavior. However, the extent to which ACEs underlie race-related differences in emotional function remains to be determined. Therefore, this study investigated whether stress-elicited brain activity varies with race-related differences in ACEs. Functional magnetic resonance imaging (fMRI) data from 301 Black and White participants were acquired during the Montreal Imaging Stress Task. Violence exposure, neighborhood disadvantage, and family income were measured during adolescence to assess ACEs, whereas stress-elicited brain function was assessed in emerging adulthood. Behavioral (stress ratings) and psychophysiological data (skin conductance and heart rate) were collected alongside fMRI. Race-related differences were observed in behavioral (stress ratings), psychophysiological (heart rate), and neural (fMRI) responses to stress. Further, a significant relationship was observed between stress reactivity and ACEs. Importantly, adjusting for ACEs reduced race-related differences in stress reactivity (stress ratings and brain function), suggesting that the neurobehavioral response to stress may be shaped, in part, by ACEs. These findings provide new insight into the socioenvironmental factors that influence emotional function.
Annonaceae fruits such as soursop (Annona muricata) may worsen symptoms of Parkinson's disease (PD) in tropical regions. Here, we investigate whether PD is more severe in an Annonaceae-exposed compared with a nonexposed population. Motor and cognitive symptoms of two PD groups (Caribbean, N = 74; mainland France, N = 104) were compared after imputation, propensity matching, and multivariate adjustment according to age, disease duration, education, and dopaminergic therapy. Ninety-six percent of Caribbean (71/74) but none of interviewed mainland France (0/20) PD patients had been exposed to Annonaceae fruits. Caribbean PD patients exhibited more severe motor and cognitive symptoms than mainland France PD patients (Unified PD Rating Scale - 3 = 24.39 [± 14.06] vs. 18.50 [± 11.13], p < 0.001; Mattis Dementia Rating Scale = 127.21 [±14.30] vs. 130.80 [± 11.15], p = 0.005). Given the growing evidence supporting Annonaceae fruits toxicity, health policy makers should raise public awareness about the risks of such consumption. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT03368300.
OBJECTIVES:Temporal lobe epilepsy (TLE) is often accompanied by executive function (EF) impairment, highlighting the need for accessible and quantitative assessment approaches. In this study, we applied our previously developed game-based executive function assessment tool (EFAT) to evaluate EF performance in TLE patients. METHODS:Thirty-two TLE patients and 29 healthy controls (HCs) completed a comprehensive battery of standardized tests, including the Stroop Color-Word Test (SCWT) and the Trail Making Test (TMT), as well as the EFAT. Metrics from the EFAT (number of touches, number of correct guesses, accuracy, and learning latency) were selected and analyzed. RESULTS:Compared with HCs, TLE patients showed significant EF deficits, including longer completion times on TMT-A (t(59) = 4.42, p < 0.001) and TMT-B (t(59) = 3.50, p = 0.001), as well as poorer SCWT-1 performance (t(59) = 2.22, p = 0.036). In the EFAT, TLE patients exhibited more touches (t(59) = -2.75, p = 0.008), fewer correct guesses (t(59) = -3.74, p < 0.001), and lower accuracy (t(59) = -2.65, p = 0.010). Game-derived metrics were significantly correlated with TMT scores. CONCLUSIONS:EFAT detected executive deficits in TLE patients across social and nonsocial conditions and offered an objective, engaging complementary tool for EF assessment. These findings support its preliminary clinical applicability.
The purpose of this study is to assess the impact of progressive muscle relaxation exercises on fatigue, stress, and quality of life among individuals with epilepsy. This study was conducted as a randomized controlled intervention, incorporating a control group and pretest and posttest assessments. Between July 2019 and April 2020, a total of 75 patients with epilepsy participated, with 35 assigned to the intervention group and 40 to the control group. Participants in the intervention group were instructed to perform progressive muscle relaxation exercises three times per week for 6 weeks. No interventions were provided to the control group. Data were gathered using the personal information form, the Perceived Stress Scale (PSS), the Fatigue Severity Scale (FSS), and the Quality of Life in Epilepsy Inventory (QOLIE-31). The mean FSS total score of the patients in the intervention group decreased significantly compared to those in the control group after the intervention (p < 0.05). No statistically significant change was observed in the stress scores. Cognitive and social function scores of the QOLIE-31 scale subdimensions of the patients in the control and intervention groups were found to be significant (p < 0.05). Cognitive and social function scores of the patients in the intervention group were higher than those in the control group. Progressive muscle relaxation exercises were determined that progressive relaxation exercises did not reduce stress in patients with epilepsy but had a positive effect on fatigue and cognitive and social function scores, which are subscales of quality of life. Progressive relaxation exercises may be proposed as a complementary nursing intervention for patients undergoing epilepsy treatment. Trial Registration: ClinicalTrials.gov identifier: 1370445
BACKGROUND:The burden of stroke is largely due to modifiable risk factors. Lack of knowledge about stroke and its risk factors hinders prevention and treatment. Effective health promotion programs need context-specific data on the target population's knowledge and practices. However, there is a shortage of data on the public's understanding of stroke and its risk factors in sub-Saharan Africa. OBJECTIVE:This study is aimed at assessing the knowledge of chronic disease patients about stroke risk factors, prevention methods, treatment options, and associated factors. METHODS:This cross-sectional study was conducted in southern Ethiopia from February to April 2024. A total of 430 chronic disease patients were included by systematic random sampling. Data were collected using a structured questionnaire and medical records. Statistical analysis was performed using SPSS. Ethical clearance was obtained. RESULT:A total of 430 patients participated, with hypertension being the most prevalent chronic disease. Only 25.1% demonstrated good knowledge of stroke risk factors. In multivariable analysis, good knowledge of stroke risk factors was significantly associated with receiving care in private institutions (AOR = 2.6; 95% CI: 1.1-5.9), having a degree or higher education (AOR = 6.5; 95% CI: 1.9-21.9), urban residence (AOR = 3.3; 95% CI: 1.4-7.9), family history of stroke (AOR = 5.3; 95% CI: 2.1-13.0), appropriate follow-up (AOR = 3.4; 95% CI: 1.4-8.4), and prior information from healthcare providers (AOR = 2.2; 95% CI: 1.0-4.5). In contrast, merchants, farmers/housewives, and other occupational groups had significantly lower odds of good knowledge compared with employees. Some estimates showed wide confidence intervals, indicating limited precision and the need for cautious interpretation. Awareness of treatment and prevention methods was limited, with only 33.3% answering over 50% of prevention questions correctly. CONCLUSION:The study revealed a significant lack of knowledge about stroke risk factors and prevention methods among chronic disease patients in southern Ethiopia. This highlights the urgent need for targeted health education interventions. Implementing comprehensive health promotion programs that address stroke-related knowledge gaps is crucial. These should be tailored to specific demographics and delivered through various channels, healthcare settings, communities, and media.
BACKGROUND:Despite BRI being a novel measure for chronic disease risk, the relationship between BRI and stroke risk under varying circadian syndrome (CircS) conditions is still unclear. METHODS:The analysis utilized data from 7535 participants involved in the China Health and Retirement Longitudinal Study (CHARLS). CircS was defined by at least four concurrent metabolic disturbances due to circadian rhythm disruption. To ensure robustness, the BRI-stroke association was assessed using Cox models, restricted cubic splines, Kaplan-Meier curves, and mediation analyses, along with subgroup and sensitivity analyses. The receiver operating characteristic (ROC) analysis was used to compare the stroke risk prediction performance of BRI with conventional metabolic indices. RESULTS:Following full adjustment, higher log (BRI) values were significantly associated with an increased risk of stroke (HR = 2.50, 95% CI: 1.81-3.44, p < 0.001), with Q4 showing a greater risk than Q1 (HR = 2.23, 95% CI: 1.63-3.04, p < 0.001). In CircS patients, no significant association was observed (log (BRI) HR = 1.23, 95% CI: 0.55-2.76; Q4 vs. Q1 HR = 0.61, 95% CI: 0.21-1.77; all p > 0.05). However, the association remained significant in non-CircS individuals (log (BRI) HR = 2.36, 95% CI: 1.61-3.47; Q4 vs. Q1 HR = 2.08, 95% CI: 1.46-2.98; all p < 0.001). Subgroup and sensitivity analyses bolstered the robustness of our findings. CircS mediated 21.0% of the association between BRI and stroke risk (95% CI: 18%-91%, p < 0.001). With an area under the curve (AUC) of 0.656, BRI demonstrated moderate predictive capability for stroke, outperforming other anthropometric indices. CONCLUSIONS:An increased BRI is associated with a higher stroke risk, partially mediated by CircS, highlighting the potential role of circadian health in stroke prevention.
Anxiety and depression are a major health problem worldwide with increasing prevalence and limitations in pharmacologic treatment. The gut-brain axis has emerged as a potential therapeutic target, with probiotics showing promise in the regulation of mental health. To evaluate the anxiolytic and antidepressant-like effects of a probiotic mixture HMLH123 and its pharmacologic interaction with fluoxetine, 60 male Wistar rats were divided into six experimental groups that received either vehicle, fluoxetine (0.5 or 1 mg/kg), probiotic mixture HMLH123 200 μL to a concentration of 109 CFU/mL (Lactiplantibacillus sp. LH01, Lactiplantibacillus sp. LH02, and Lactiplantibacillus sp. LH3), or a combination of fluoxetine and probiotic mixture HMLH123. Behavioral assessments included the locomotor activity test (LAT), the elevated plus maze (EPM), and the forced swim test (FST). Data were analyzed using one-way ANOVA with a significance level of p ≤ 0.05. Administration of probiotic mixture HMLH123 or in combination with fluoxetine significantly increased the time spent in the open arms of the EPM, indicating anxiolytic-like effects. In the FST, groups treated with probiotic mixture HMLH123 showed reduced immobility time and increased swimming behavior, suggesting a possible modulation of the serotonergic system. These findings support the potential of probiotic mixture HMLH123 as a preclinical alternative approach for the treatment of anxiety and depression. While no synergistic interaction with fluoxetine was observed, treatment with the probiotic mixture showed positive effects independently. Further research should explore its mechanisms of action and therapeutic applications as a standalone intervention.
BACKGROUND:Fifty-five to ninety percent of people with multiple sclerosis (MS) report disabling fatigue, but a previous survey found that only 31% of UK adults with MS experiencing fatigue report being offered any treatment. The aim of this study was to capture the service perspective of routine care for MS fatigue and resource availability. METHODS:A cross-sectional online survey was distributed to NHS services across the United Kingdom to be completed by healthcare professionals working with people with MS. RESULTS:Eighteen services completed the survey. Services supported a median of 1100 patients. Allied healthcare professional availability varied across services but was generally low (median range 0-6 staff per type). On average, services estimated that only 28% (SD = 26.51) of patients were receiving fatigue treatments. CONCLUSIONS:Findings highlighted the unmet need around MS fatigue management, complementing previously captured patient perspectives. Although the study included a small, self-selecting subset of services and may have been influenced by the COVID-19 pandemic, it demonstrates the necessity of accounting for resource availability to successfully implement new fatigue interventions.
BACKGROUND AND OBJECTIVES:Recent studies have identified the HbA1c-to-hemoglobin ratio (HHR) as a potential indicator for increased mortality from all causes and cardiovascular diseases. This investigation sought to determine whether HHR could serve as a prognostic marker for neurological function at 90 days in patients undergoing endovascular thrombectomy procedures. METHODOLOGY:This study performed a retrospective evaluation of patients undergoing endovascular treatment (EVT) at Nanjing First Hospital from April 2022 to June 2024. The HHR was determined by dividing HbA1c levels by hemoglobin values. Poor clinical outcomes were characterized by modified Rankin Scale scores ranging from 3 to 6 at the 90-day follow-up. Multivariate logistic regression analysis was employed to examine the association between HHR values and posttreatment functional outcomes. RESULTS:The study enrolled 353 participants (average age of 70.5 years with a standard deviation of 12.2 years; 218 were male), of whom 181 (51.3%) showed adverse clinical results after 90 days. Multivariate regression analysis revealed that higher HHR levels upon hospital admission independently predicted worse functional recovery (adjusted OR: 10.484; 95% confidence interval: 4.581-23.990; p = 0.001). Additional investigation using restricted cubic spline methodology confirmed a nonlinear, dose-dependent relationship between HHR values and negative prognosis likelihood (nonlinearity p value = 0.001). When implemented in a predictive framework, continuous HHR measurements exhibited a strong discriminatory capability, achieving a receiver operating characteristic curve value of 0.760 (95% CI: 0.710-0.810). CONCLUSION:Increased HHR levels demonstrate an independent correlation with poorer 90-day recovery rates among ischemic stroke patients undergoing endovascular thrombectomy. This evidence positions HHR as a potentially valuable indicator for clinical prognosis assessment in such cases.
BACKGROUND:Epilepsy imposes both economic and quality-of-life (QOL) burdens. Therefore, this study is aimed at evaluating the costs of illness and QOL in patients with epilepsy (PWE) and their caregivers and to examine the differences in costs and QOL across patient characteristics. METHODS:This prevalence-based cost-of-illness study was conducted from a societal perspective. Data were collected from patients who attended the Epilepsy Clinic at Srinagarind Hospital, Khon Kaen University, between April and August 2023. QOLs were assessed using the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) for PWE and the EuroQoL-5D-5L (EQ-5D-5L) for caregivers. A generalized linear model was used to assess the differences in costs and QOL across patient and caregiver characteristics. RESULTS:A total of 214 subjects were enrolled in this study, comprising 129 PWE and 85 caregivers. The mean total cost of illness per outpatient visit was 452.27 PPP-USD, with 58.0% attributed to direct medical costs, 24.4% to direct nonmedical costs, and 17.6% to indirect costs. Direct medical costs differed significantly based on employment status (p value = 0.031) and seizure control (p value = 0.018). Direct nonmedical costs showed differences by residential distance (p value < 0.001). Indirect costs also showed differences by age (p value = 0.019) and residential distance (p value = 0.002). The lifetime productivity loss from unemployment reached 14638.37 PPP-USD per patient. The mean overall QOLIE-31 score was 74.04 points, and the mean EQ-5D-5L index was 0.90. There were differences in QOL based on age and seizure control in PWE, as well as age and unemployment status in caregivers. CONCLUSION:Direct medical costs were the largest component of total costs. Cost differences were found across age, employment status, residential distance, and seizure control. QOL varied by age and seizure control in PWE and by age and unemployment status in caregivers.
BACKGROUND:Spinal cord injury (SCI) significantly impacts patients, with mitochondrial dysfunction playing a critical role in its pathology. Identifying mitochondria-related genes may offer new therapeutic and prognostic insights. METHODS:RNA sequencing data from the GEO database were analyzed to identify differentially expressed genes (DEGs). Functional enrichment analyses were conducted, and weighted gene coexpression network analysis (WGCNA) alongside machine learning algorithms was used to identify key mitochondria-related genes. Immune infiltration was assessed using the EPIC algorithm, and single-cell RNA sequencing (scRNA-seq) data were analyzed for cellular diversity. RESULTS:A total of 2566 upregulated and 2634 downregulated genes were identified in SCI versus control samples. GO and KEGG enrichment analyses revealed these DEGs were primarily involved in oxidative stress, mitochondrial function, and immune pathways, including necroptosis and T cell receptor signaling. Then, 1578 genes with the strongest correlation to SCI were selected by WGCNA. By integrating DEGs, WGCNA module genes, and mitochondria-related genes, 76 candidate genes were obtained and used to construct a PPI network. Six hub genes (NDUFB3, SLC25A24, SLC25A40, GSTZ1, MAOA, and MRPL12) were identified by machine learning, all showing strong diagnostic potential (AUC > 0.77). Immune infiltration analysis indicated reduced B and T cell infiltration and increased macrophage activity in SCI samples. scRNA-seq analysis further revealed higher expression of NDUFB3 in dendritic cells and MAOA in pro-B cells, suggesting their involvement in immune regulation and mitochondrial dysfunction. CONCLUSION:These six genes represent potential biomarkers and therapeutic targets for SCI, providing insights into its molecular mechanisms and immune response.
BACKGROUND:Previous studies have examined the relationship between daily sitting time and depression, yet the specific dose-response relationship remains unclear. METHODS:This study analyzed data from 29,691 participants in the 2007-2018 National Health and Nutrition Examination Survey (NHANES). To delve into the possible nonlinear link between daily sitting time and depression, smooth curve fitting and threshold effect analysis were utilized in the study. Information on daily sitting time was collected through questionnaires, and the Patient Health Questionnaire-9 (PHQ-9) was employed to measure depression. RESULTS:In the fully adjusted Model 3, each additional hour of sitting was associated with a 5% increase in the risk of depression (95% CI: 1.02, 1.07, p = 0.0002). When categorizing daily sitting time, participants who sat for 8 h or more daily exhibited a significantly higher risk of depression across all models. In Model 3, this group had an odds ratio (OR) of 1.37 (95% CI: 1.12, 1.69, p = 0.0039) compared with the reference group sitting for less than 4 h. The threshold effect analysis identified 7 h as the inflection point. Below this threshold, no significant correlation was observed. In contrast, when daily sitting time exceeded the threshold, there was a significant increase in the risk of depression, with an OR of 1.07 (95% CI: 1.01, 1.12, p = 0.0184). CONCLUSIONS:A nonlinear association exists between daily sitting time and depression risk in US adults. However, additional research is required to further validate this finding.
While cognitive functioning in multiple sclerosis has been extensively studied, the presence of social cognition deficits in persons affected by relapsing-remitting multiple sclerosis (RRMS) remains comparatively less explored. This study recruited 30 Turkish patients with RRMS and 30 healthy controls (HCs) matched for demographic characteristics and cognitive status. We tested their social cognition abilities within two main subdomains, namely, theory of mind (ToM) and emotion recognition. The combination of tests we used was novel and rather broad as ToM was evaluated in both its affective and cognitive components while emotion recognition was evaluated in two tasks requiring either naming or discriminating facial expressions. All tests required verbal responses and were scored in terms of accuracy. The results indicated that patients with RRMS exhibited significantly lower accuracy compared to the HC group across all social cognition tasks. Correlation analyses revealed a significant negative relationship between emotion discrimination performance and both level of disability and disease duration. Additionally, RRMS patients showed significant deficits in recognizing negative emotions, while no differences with the HC group were observed for positive emotion recognition. The presence of a domain-specific, selective deficit for social cognition was also confirmed after further controlling for overall cognitive functioning. Our findings capitalize on previous evidence demonstrating that social cognition impairments in RRMS have domain-specific characteristics and can be reliably detected in a new cultural context.
Objectives:To investigate the efficacy of sustained-release fampridine tablets (fampridine-SR) on walking impairment and fatigue on Chinese patients with multiple sclerosis (MS). Methods:All patients (n = 12) had the baseline Expanded Disability Status Scale (EDSS) at 4-7 and orally administered fampridine-SR at 10 mg twice per day for at least 12 weeks. All patients were assessed using EDSS, Timed 25-Foot Walk (T25FW), the 12-item Multiple Sclerosis Walking Scale (MSWS-12), and Modified Fatigue Impact Scale (MFIS) at baseline, day 1, week 1, 2, 4, 8, and 12. Results:The baseline EDSS score was 4.67 ± 0.36. Fampridine-SR significantly decreased the EDSS score by 0.63 ± 0.20 (p = 0.011) after 12-week treatment. T25FW was changed at day 1 and week 1 by - 12.73 ± 3.03% and - 14.20 ± 4.36% (p < 0.011), respectively. The statistically and clinically significant improvement of MSWS-12 was observed since week 1. The total, cognitive subscale, physical subscale, and psychosocial subscale of MFIS were significantly reduced in Chinese patients with MS. Conclusion:Fampridine-SR was a fast-acting oral potassium channel blocker on improving walking ability of MS as early as day 1. It demonstrated the positive effects on walking impairment and fatigue, including the physical, cognitive, and psychosocial subscales of MFIS, in Chinese patients with MS.
