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Summary. Background: Most preterm infants are still preterm and have a low birth weight when they are discharged from the hospital. An important issue is whether the long-term consequences of early growth restriction can be diminished by nutritional intervention in preterm infants after discharge from the hospital. Aim: To evaluate differences in growth and in weight gain composition of preterm infants fed standard term formula (SF) or enriched formula (PDF) after discharge from hospital during the first 2 months of life. Methods: Thirty-three healthy preterm infants, birth weight < 1750 g at gestational age < 35 weeks, were randomised to SF or PDF at the time of discharge from hospital. Anthropometric variables were studied longitudinally and body composition was measured using dual energy x-ray absorptiometry (DEXA) twice, before hospital discharge and two months later. Weight gain composition was calculated as the difference between the two determinations. Results: Seventeen infants were fed SF and 16 PDF. Anthropometric variables and whole body composition were similar at birth, at the start of the nutritional study (mean age 45 days), and at the end of the study 2 months later. Over the whole study period, weight gain and weight gain composition were similar in the two groups. Sex did not appear to influence weight gain and weight gain composition. In infants with growth restriction at discharge there was a significant reduction of weight gain, fat mass gain, and bone mineral content deposition independently of the formula provided. Conclusions: There is no immediate effect on preterm infants of a nutrient enriched formula compared with a standard formula on growth, weight gain, or weight gain composition. [ABSTRACT FROM AUTHOR]

The effects of Ni2+ were evaluated on slowly-decaying, high-voltage-activated (HVA) Ca2+ currents expressed by pyramidal neurons acutely dissociated from guinea-pig piriform cortex. Whole-cell, patch-clamp recordings were performed with Ba2+ as the charge carrier. Ni2+ blocked HVA Ba2+ currents (IBas) with an EC50 of approximately 60 μm. Additionally, after application of nonsaturating Ni2+ concentrations, residual currents activated with substantially slower kinetics than both total and Ni2+-sensitive IBas. None of the pharmacological components of slowly decaying, HVA currents activated with kinetics significantly different from that of total currents, indicating that the effect of Ni2+ on IBas kinetics cannot be attributed to the preferential inhibition of a fast-activating component. The effect of Ni2+ on IBa amplitude was voltage-independent over the potential range normally explored in our experiments (-60 to +20 mV), hence the Ni2+-dependent decrease of IBa activation rate is not due to a voltage- and time-dependent relief from block. Moreover, Ni2+ significantly reduced IBa deactivation speed upon repolarization, which also is not compatible with a depolarization-dependent unblocking mechanism. The dependence on Ni2+ concentration of the IBa activation-rate reduction was remarkably different from that found for IBa block, with an EC50 of ∼20 μm and a Hill coefficient of ∼1.73 vs.∼1.10. These results demonstrate that Ni2+, besides inhibiting the IBas under study probably by exerting a blocking action on the pore of the underlying Ca2+ channels, also interferes with Ca2+-channel gating kinetics, and strongly suggest that the two effects depend on Ni2+ occupancy of binding sites at least partly distinct. [ABSTRACT FROM AUTHOR]

Thirty jaundiced neonates with diarrhoea who were being treated with phototherapy and 30 matched control infants were studied to try and find out the cause of the diarrhoea. Faecal osmolality and electrolyte concentrations were measured, which gave clear evidence that the diarrhoea arose from intestinal secretion. Rectal water and electrolyte absorption in 10 jaundiced infants receiving phototherapy, in 10 jaundiced infants not receiving phototherapy, and in 10 healthy controls was measured with a rectal dialysis bag. A further group of eight jaundiced infants was also studied both during and after phototherapy to document the reversal of ion transport changes. Absorption of water, sodium chloride, and potassium was significantly impaired in the patients receiving phototherapy compared with each of the control groups. Such impairment was transient, as it was not apparent when the jaundice faded and phototherapy was stopped. These data show that the colon plays a part in the pathogenesis of secretory diarrhoea and that both hyperbilirubinaemia and phototherapy are necessary for such an effect to develop. [ABSTRACT FROM AUTHOR]

Significant production of breath hydrogen has been shown in premature infants, suggesting limited intestinal capacity for digestion of carbohydrate. To evaluate net absorption of carbohydrate 24 three day balance studies were carried out in seven preterm infants fed pasteurised banked human milk and in 17 preterm infants fed a formula containing 75% lactose and 25% glucose polymers. Because carbohydrate reaching the colon may be converted to organic acids by bacterial flora, carbohydrate net absorption was determined by quantitating the faecal excretion of energy derived from carbohydrate. The carbohydrate derived energy content of milk and stools was calculated as the difference between the measured gross energy and the sum of energy related to nitrogen and fat. Faecal loss of carbohydrate derived energy was lower in the group fed formula (1.9 (SD 1.2) kcal/kg/day) than in the group fed human milk (4.0 (SD 1.8) kcal/kg/day). Net absorption of carbohydrate derived energy was 97.0 (SD 1.9)% as opposed to 92.6 (SD 3.9)%, respectively. Within each group there was no significant relation between carbohydrate energy absorption and fat, nitrogen, or gross energy absorption. Thus, although less complete with human milk than with formula, apparent absorption of energy derived from carbohydrate seemed quite satisfactory in these preterm infants. [ABSTRACT FROM AUTHOR]

Cranial Ultrasound (cUS) may not be sensitive enough to detect subtle white matter (WM) injuries. Our study compared serial cUS with MRI at term equivalent age (TEA) to determine if it is possible to identify an ultrasound representation of subtle diffuse WM injuries such as punctate lesions (PWMLs) and diffuse excessive high signal intensity (DEHSI). Fifty-six very preterm infants were scanned sequentially from birth to TEA, an MRI was performed at TEA. Each echodensity found on cUS was classified as absent, transient (≤7 days), or prolonged (>7 days). A transient periventricular echodensity was detected in seven infants (12.5%), and a prolonged echodensity in 15 (26.8%). MRI examinations were performed in all 56 infants. No altered signal intensity was found in 18 infants (32.1%). DEHSI was detected in 14 infants (25%), and PWMLs were detected in eight babies (14.3%). Both abnormalities were found in 16 infants (28.6%). The positive predictive values of the prolonged echodensity for DEHSI and PWMLs were 86.7% and 46.7% respectively. However, a significant statistical correspondence (p=0.002, Odds Ratio 11.9) was found comparing DEHSI with cUS abnormal echodensities. Serial cUS during the neonatal period in preterm infants is essential and cannot be replaced with MRI at TEA. MRI seems to be more reliable in detecting mild or moderate WM abnormalities. However, serial cUS performed by an experienced neonatologist can provide valuable information on early WM changes such as prolonged echodensities that could potentially lead to a diffuse injury. [ABSTRACT FROM AUTHOR]

A 2-year, cross-sectional study was conducted to identify risk factors for Cryptosporidium sp. infection in bovine farms in central Italy. Faecal samples were collected on 248 farms, from 2024 calves and analysed using ELISA and immunofluorescent assay (IFA) commercial kits. In all 101 samples confirmed to be positive with IFA, the aetiological agent was identified as Cryptosporidium parvumand a large genetic variability was detected by subtype analysis. The prevalence of farm infection ranged from 3.4% to 35.6%. Univariate analysis showed a number of putative risk factors, including the type of farm, stalling of calves, late supply of colostrum, number of heads and contact between calves and adults. However, multivariate analysis confirmed that the higher risk for calves was associated with housing calves separately from their dams, a characteristic practice of dairy herd, whereas calves being nursed by their dams, a characteristic of cow–calf herd resulted as a protective factor. [ABSTRACT FROM AUTHOR]

The article discusses the use of intrauterine growth charts, or birth weight-for-gestational age charts, for the anthropometric classification of neonates. Key issues examined include the distinction between neonatal anthropometric charts and intrauterine growth charts and the difference between the terms "small-for-gestational age" and "intrauterine growth restricted."

Interictal spiking is seen in the EEG of epileptic patients between seizures. To date, the roles played by interictal events in seizure occurrence and in epileptogenesis remain elusive. While interictal spikes may herald the onset of electrographic seizures, experimental data indicate that hippocampus-driven interictal events prevent seizure precipitation. Even less clear than the role of interictal events in seizure occurrence is whether and how interictal spikes contribute to epileptogenesis. Thus, while plastic changes within limbic neuronal networks may result from ongoing interictal activity, experimental evidence supports the view that epileptogenesis is accompanied by a decrease in hippocampus-driven interictal activity. [ABSTRACT FROM AUTHOR]

The objective was to evaluate pravastatin modulation on peripheral blood mononuclear cell (PBMC) migration across endothelial monolayers. Eleven hypercholesterolaemic patients were treated with pravastatin 20 mg/day. At baseline (T0), after 40 days (T40) and after 6 months (T6 months) of treatment total serum cholesterol, low-density lipoprotein (LDL), high-density lipoprotein, triglycerides, C-reactive protein, as well as tumour necrosis factor-α (TNF-α) and metalloproteinases-9 plasma levels were evaluated. At the same time points the effect of pravastatin on migration of PBMCs through a monolayer of murine brain endothelial cells was studied both in basal conditions and after endothelial stimulation with recombinant mouse TNF-α 10 ng/ml for 24 h. Seven volunteers were used as healthy controls. Significant decreases in total cholesterol, LDL and triglycerides as well as inhibition of transmigration were observed. PBMCs transmigration in patients prior to pravastatin therapy was higher than in healthy controls. These results suggest that pravastatin could be of benefit in a spectrum of diseases characterised by extravasation of PBMCs into the central nervous system. [ABSTRACT FROM AUTHOR]

Objective: To observe and measure the morphological and temporal evolutionary features of the hypersynchronous (HYP) pattern in the mesial temporal seizure. Methods: The HYP patterns during preictal and interictal states of 16 mesial temporal epileptic patients were analyzed. The wave components of the HYP transients were firstly observed and measured. The dynamic deformations and parameter changes of the components were further analyzed along the preictal-ictal axis. The difference of emergence rate of HYP transients and typical interictal spike during interictal periods was also compared. Results: The HYP transients were invariably composed of slow-wave proper, sharp wave and post-slow component among studied patients for all the 93 seizures. During preictal epoch, all of the seizures incorporated present evolutionary manner of type 1 characterized by smooth modification of HYP transients in morphology, including gradual shortening of the inter-transient interval, increase of amplitude and time duration of slow-wave proper and sharp wave, amplitude decrease of the post-slow component, as well as amplitude increases of ripple and fast ripple, and 2/3 seizures showed some more sophisticated transitional manners (type 2) following type 1, including reduction in amplitude with decrease of inter-transient intervals, superimposed or followed by the emergent low amplitude rhythmic activities, or both of them. The HYP transients and typical interictal spikes were found to mutually "repelling" each other in interictal period. Conclusion: The HYP transients showed a combinational feature and temporal evolution manners during preictal state. The emergence of HYP transients in cluster reflects the transitional trend from interictal to ictal state. Significance: HYP should be viewed as an index of ictogenesis in the mesial temporal seizure. [ABSTRACT FROM AUTHOR]

Epilepsy is a prevalent neurological disorder that affects approximately 1% of the global population. Approximately 30-40% of patients respond poorly to antiepileptic medications, leading to a significant negative impact on their quality of life. Closed-loop deep brain stimulation (DBS) is a promising treatment for individuals who do not respond to medical therapy. To achieve effective seizure control, algorithms play an important role in identifying relevant electrographic biomarkers from local field potentials (LFPs) to determine the optimal stimulation timing. In this regard, the detection and classification of events from ongoing brain activity, while achieving low power consumption through computationally inexpensive implementations, represents a major challenge in the field. To address this challenge, we here present two algorithms, the ZdensityRODE and the AMPDE, for identifying relevant events from LFPs by utilizing time series segmentation (TSS), which involves extracting different levels of information from the LFP and relevant events from it. The algorithms were validated validated against epileptiform activity induced by 4-aminopyridine in mouse hippocampus-cortex (CTX) slices and recorded via microelectrode array, as a case study. The ZdensityRODE algorithm showcased a precision and recall of 93% for ictal event detection and 42% precision for interictal event detection, while the AMPDE algorithm attained a precision of 96% and recall of 90% for ictal event detection and 54% precision for interictal event detection. While initially trained specifically for detecting ictal activity, these algorithms can be fine-tuned for improved interictal detection, aiming at seizure prediction. Our results suggest that these algorithms can effectively capture epileptiform activity, supporting seizure detection and, possibly, seizure prediction and control. This opens the opportunity to design new algorithms based on this approach for closed-loop stimulation devices using more elaborate decisions and more accurate clinical guidelines. [ABSTRACT FROM AUTHOR]

Recurrent spontaneous seizures with an extended epileptic discharge are the hallmarks of epilepsy. At present, there are several available anti-epileptic drugs (AEDs) in the market. Still no adequate treatment for epilepsy treatment is available. The main disadvantages of AEDs are their associated adverse effects. It is a challenge to develop new therapies that can reduce seizures by modulating the underlying mechanisms with no adverse effects. In the last decade, the neuromodulatory potential of phytoconstituents has sparked their usage in the treatment of central nervous system disorders. Curcumin is an active polyphenolic component that interacts at cellular and molecular levels. Curcumin's neuroprotective properties have been discovered in recent preclinical and clinical studies due to its immunomodulatory effects. Curcumin has the propensity to modulate signaling pathways involved in cell survival and manage oxidative stress, apoptosis, and inflammatory mechanisms. Further, curcumin can persuade epigenetic alterations, including histone modifications (acetylation/deacetylation), which are the changes responsible for the altered expression of genes facilitating the process of epileptogenesis. The bioavailability of curcumin in the brain is a concern that needs to be tackled. Therefore, nanonization has emerged as a novel drug delivery system to enhance the pharmacokinetics of curcumin. In the present review, we reviewed curcumin's modulatory effects on potential biomarkers involved in epileptogenesis including dendritic cells, T cell subsets, cytokines, chemokines, apoptosis mediators, antioxidant mechanisms, and cognition impairment. Also, we have discussed the nanocarrier systems for encapsulating curcumin, offering a promising approach to enhance bioavailability of curcumin. [ABSTRACT FROM AUTHOR]

Epilepsy is a chronic neurological disorder that affects nearly 50 million people worldwide. Experimental evidence suggests that epileptic neurons are linked to the endocannabinoid system and that inhibition of the FAAH enzyme could have neuroprotective effects by increasing the levels of endogenous endocannabinoid anandamide. In this context, the use of macamides as therapeutic agents in neurological diseases has increased in recent years. With a similar structure to anandamide, several theories point to the FAAH–macamide interaction as a possible cause of FAAH enzymatic inhibition. In this work, we used in silico and in vivo techniques to analyze the potential therapeutic effect of three synthetic macamides in the treatment of epilepsy: N-3-methoxybenzyl-oleamide (3-MBO), N-3-methoxybenzyl-linoleamide (3-MBL), and N-3-methoxybenzyl-linolenamide (3-MBN). In the first stage, an in silico analysis was conducted to explore the energetic affinity of these macamides with rFAAH and their potential inhibitory effect. MD simulations, molecular docking, and MM/PBSA calculations were used for these purposes. Based on our results, we selected the two best macamides and performed an in vivo study to analyze their therapeutic effect in male Sprague Dawley rat models. Rats were subjected to an in vivo induction of epileptic status by the intraperitoneal injection of pilocarpine and analyzed according to the Racine scale. In silico results showed an energetic affinity of three macamides and a possible "plugging" effect of the membrane access channel to the active site as a potential cause of FAAH inhibition. On the other hand, the in vivo results showed an anticonvulsant effect of both macamides, with 3-MBL being the most active, resulting in a higher survival probability in the rats. This work represents one of the first studies on the use of macamides for the treatment of epilepsy. [ABSTRACT FROM AUTHOR]

Background/Objectives: While studies in rat pups suggest that early zinc exposure is critical for optimal brain structure and function, associations of prenatal zinc intake with measures of brain development in infants are unknown. This study aimed to assess the associations of maternal zinc intake during pregnancy with MRI measures of brain tissue microstructure and neurodevelopmental outcomes, as well as to determine whether MRI measures of the brain mediated the relationship between maternal zinc intake and neurodevelopmental indices. Methods: Forty-one adolescent mothers were recruited for a longitudinal study during pregnancy. Maternal zinc intake was assessed during the third trimester of pregnancy using a 24 h dietary recall. Infant MRI scans were acquired at 3 weeks postpartum using a 3.0 Tesla scanner to measure fractional anisotropy (FA) and mean diffusivity (MD). Cognitive, language, and motor skills were assessed at 4, 14, and 24 months postpartum using the Bayley Scales of Infant Development. Results: Greater prenatal zinc intake was associated with reduced FA in cortical gray matter, particularly in the frontal lobe [medial superior frontal gyrus; β (95% CI) = −1.0 (−1.5, −0.5)], in developing white matter, and in subcortical gray matter nuclei. Greater prenatal zinc intake was associated with reduced MD in cortical gray matter and developing white matter [superior longitudinal fasciculus; −4.4 (−7.1, −1.7)]. Greater maternal zinc intake also was associated with higher cognitive development scores at 14 [0.1 (0.0, 0.1)] and 24 [0.1 (0.0, 0.2)] months of age; MRI indices of FA and MD did not mediate this relationship. Conclusions: Maternal prenatal zinc intake was associated with more favorable measures of brain tissue microstructural maturation and cognitive development during infancy. [ABSTRACT FROM AUTHOR]

Background: Preterm infants (PIs) are more susceptible to neurodevelopmental impairment compared with term newborns. Adequate postnatal growth has been associated with improved neurocognitive outcomes; therefore, optimization of nutrition may positively impact the neurodevelopment of PIs. Objective: This study focused on macronutrient parenteral nutrition (PN) intake during the Neonatal Intensive Care Unit stay and their associations with neurodevelopmental outcomes in PIs in the first two years of life. Methods: The Embase, MEDLINE, and Cochrane Library databases were searched using the following subject headings and terms (MeSH): "premature infants", "parenteral nutrition", "growth", "brain", "neurodevelopment", and "central nervous system diseases". All relevant papers' reference lists were manually searched. PN and neurodevelopment studies concerning the first two years of life were collected and analyzed. Results: 275 potential studies were retrieved, 64 were selected for full-text reading, and 22 were included (12 randomized controlled trials). While glucose intakes should be immediately provided and strictly monitored avoiding hyperglycemia, the long-term outcomes of aggressive PN caloric intakes are uncertain. Early amino acid (AA) supplementation is mandatory and improves short-term growth, though it is questionable whether increased AA and better neurodevelopment are directly related. Lipid infusion should be initiated right after birth, and further investigation will enable us to ascertain the potential impacts of lipid emulsions, particularly fish oil, on PI neurodevelopment. Conclusions: An aggressive PN and its possible metabolic complication could not favor neurodevelopment; the way forward could be a customized approach, depending on the patient's clinical state and tolerance. Long-term follow-up studies and the search for specific markers of tolerance are warranted. [ABSTRACT FROM AUTHOR]

Epilepsy is a chronic neurological disorder marked by recurrent seizures, significantly impacting individuals worldwide. Current treatments are often ineffective for a third of patients and can cause severe side effects, necessitating new therapeutic approaches. Glial cells, particularly astrocytes, microglia, and oligodendrocytes, are emerging as crucial targets in epilepsy management. Astrocytes regulate neuronal homeostasis, excitability, and synaptic plasticity, playing key roles in maintaining the blood–brain barrier (BBB) and mediating neuroinflammatory responses. Dysregulated astrocyte functions, such as reactive astrogliosis, can lead to abnormal neuronal activity and seizure generation. They release gliotransmitters, cytokines, and chemokines that may exacerbate or mitigate seizures. Microglia, the innate immune cells of the CNS, contribute to neuroinflammation, glutamate excitotoxicity, and the balance between excitatory and inhibitory neurotransmission, underscoring their dual role in seizure promotion and protection. Meanwhile, oligodendrocytes, primarily involved in myelination, also modulate axonal excitability and contribute to the neuron–glia network underlying seizure pathogenesis. Understanding the dynamic interactions of glial cells with neurons provides promising avenues for novel epilepsy therapies. Targeting these cells may lead to improved seizure control and better clinical outcomes, offering hope for patients with refractory epilepsy. [ABSTRACT FROM AUTHOR]

Background: Purulent meningitis (PM) is a commonly encountered infectious condition in newborns, which unfortunately can result in infant mortality. Newborns with PM often present nonspecific symptoms. The success of lumbar puncture, an invasive test, relies on the operator's expertise. Preterm infants pose diagnostic challenges compared to full-term babies. The objective of this study is to establish a convenient and effective clinical prediction model based on perinatal factors to assess the risk of PM in very preterm infants, thereby assisting clinicians in developing new diagnostic and treatment strategies. Methods: This study involved very preterm infants (gestational age < 32 weeks) admitted to the Qilu Hospital of Shandong University from January 2020 to December 2023. All included infants underwent lumbar puncture. We gathered comprehensive data that included information on maternal health conditions and the clinical features of very preterm infants. The PM was diagnosed according to the diagnostic criteria. This study conducted data analysis and processing using R version 4.1.2. A stepwise regression method was applied for multivariate Logistic regression analysis to select the best predictors for PM and to develop a predictive model. Differences were considered statistically significant at P < 0.05. Results: This study enrolled a total of 201 preterm infants, including 117 boys and 84 girls. The gestational age was 28.7 ± 1.7 weeks, and the weight was 1166.2 ± 302.7 g. Ninety infants were diagnosed with PM, while 111 did not have PM. The influencing factors include birth weight, PCT within 24 h after birth, cesarean delivery, and premature rupture of membranes. These were used to construct a risk prediction nomogram and verified its accuracy. The Brier score was 0.157, the calibration slope was 1.0, and the concordance index was 0.849. Conclusions: We developed and validated a personalized nomogram to identify high-risk individuals for early prediction of purulent meningitis in very preterm infants. This practical predictive model may help reduce unnecessary lumbar puncture procedures. [ABSTRACT FROM AUTHOR]

Neurological disorders are characterized by high mortality and disability rates. Furthermore, the burden associated with disability and mortality resulting from neurological disorders has been increasing at an alarming rate. Botanical drugs and their bioactive components have emerged as a prominent area of research, offering a promising avenue for developing novel alternatives for treating neurological diseases. Gastrodin is the principal active component derived from the traditional Chinese medicinal plant Gastrodia elata Blume (GEB). Existing literature reveals that gastrodin exerts various pharmacological protective actions against neurological disorders. This review aimed to collate novel literature on gastrodin for treating neurological disorders from Web of Science, PubMed, Embase and CNKI. The pharmacokinetics of gastrodin, its therapeutic role in neurological disorders, the main mechanisms of action and clinical application were addressed. Furthermore, a detailed overview of gastrodin drug delivery systems and physical enhancement methods was presented, offering invaluable insights into potential research and the extensive applications of gastrodin. [ABSTRACT FROM AUTHOR]

Neonatal sepsis remains a significant cause of neonatal morbidity and mortality globally. At present, no clear consensus definition for sepsis in neonates exists, even though a positive blood culture is considered as the gold standard for definitive diagnosis. The accurate and timely diagnosis of sepsis in neonates presents significant difficulties, since "culture negative" or "suspected" sepsis varies widely worldwide. Antibiotic overuse and resistance are emerging problems, but on the other hand, under-recognition of sepsis and delayed antibiotic treatment could have serious or even fatal adverse outcomes in this vulnerable population. In the context of rapid recognition of sepsis and timely initiation of appropriate antibiotic therapy, various sepsis risk assessment tools have been developed, a variety of biomarkers are in clinical use or under research for future use, and new diagnostic techniques are under evaluation. In this review, we summarize the most recent data on neonatal sepsis, the utility of sepsis risk assessment tools for term and preterm infants with sepsis, and current diagnostic and preventive tools. [ABSTRACT FROM AUTHOR]

Epilepsy is a prevalent chronic neurological disorder that can significantly impact patients' lives. The incidence and risk of psychosis in individuals with epilepsy are notably higher than in the general population, adversely affecting both the management and rehabilitation of epilepsy and further diminishing patients' quality of life. This review provides an overview of the classification and clinical features of psychosis of epilepsy, with the aim of offering insights and references for the clinical diagnosis and treatment of various types of psychosis of epilepsy. Additionally, we examine the potential pathophysiological mechanisms underlying the psychosis of epilepsy from three perspectives: neuroimaging, neurobiology, and genetics. The alterations in brain structure and function, neurotransmitters, neuroinflammatory mediators, and genetic factors discussed in this review may offer insights into the onset and progression of psychotic symptoms in epilepsy patients and are anticipated to inform the identification of novel therapeutic targets in the future. [ABSTRACT FROM AUTHOR]

Second-person neuroscience focuses on studying the behavioral and neuronal mechanisms of real-time social interactions within single and across interacting brains. In this review article, we describe the developments that have been undertaken to study socially interactive phenomena and the behavioral and neurobiological processes that extend across interaction partners. More specifically, we focus on the role that synchrony across brains plays in enabling and facilitating social interaction and communication and in shaping social coordination and learning, and we consider how reduced synchrony across brains may constitute a core feature of psychopathology. [ABSTRACT FROM AUTHOR]

Intracranial potentials are used as functional biomarkers of neural networks. As potentials spread away from the source populations, they become mixed in the recordings. In humans, interindividual differences in the gyral architecture of the cortex pose an additional challenge, as functional areas vary in location and extent. We used source separation techniques to disentangle mixing potentials obtained by exploratory deep arrays implanted in epileptic patients of either sex to gain access to the number, location, relative contribution, and dynamics of coactive sources. The unique spatial profiles of separated generators made it possible to discern dozens of independent cortical areas for each patient, whose stability maintained even during seizure, enabling the follow up of activity for days and across states. Through matching these profiles to MRI, we associated each with limited portions of sulci and gyri and determined the local or remote origin of the corresponding sources. We also plotted source-specific 3D coverage across arrays. In average, individual recording sites are contributed to by 3–5 local and distant generators from areas up to several centimeters apart. During seizure, 13–85% of generators were involved, and a few appeared anew. Significant bias in location assignment using raw potentials is revealed, including numerous false positives when determining the site of origin of a seizure. This is not amended by bipolar montage, which introduce additional errors of its own. In this way, source disentangling reveals the multisource nature and far intracranial spread of potentials in humans, while efficiently addressing patient-specific anatomofunctional cortical divergence. [ABSTRACT FROM AUTHOR]

We adapt non-linear optimal control theory (OCT) to control oscillations and network synchrony and apply it to models of neural population dynamics. OCT is a mathematical framework to compute an efficient stimulation for dynamical systems. In its standard formulation, it requires a well-defined reference trajectory as target state. This requirement, however, may be overly restrictive for oscillatory targets, where the exact trajectory shape might not be relevant. To overcome this limitation, we introduce three alternative cost functionals to target oscillations and synchrony without specification of a reference trajectory. We successfully apply these cost functionals to single-node and network models of neural populations, in which each node is described by either the Wilson-Cowan model or a biophysically realistic high-dimensional mean-field model of exponential integrate-and-fire neurons. We compute efficient control strategies for four different control tasks. First, we drive oscillations from a stable stationary state at a particular frequency. Second, we switch between stationary and oscillatory stable states and find a translational invariance of the state-switching control signals. Third, we switch between in-phase and out-of-phase oscillations in a two-node network, where all cost functionals lead to identical OC signals in the minimum-energy limit. Finally, we (de-) synchronize an (a-) synchronously oscillating six-node network. In this setup, for the desynchronization task, we find very different control strategies for the three cost functionals. The suggested methods represent a toolbox that enables to include oscillatory phenomena into the framework of non-linear OCT without specification of an exact reference trajectory. However, task-specific adjustments of the optimization parameters have to be performed to obtain informative results. [ABSTRACT FROM AUTHOR]

The piriform cortex (PC) plays a pivotal role in the onset and propagation of temporal lobe epilepsy (TLE), making it a potential target for therapeutic interventions. This review delves into the anatomy and epileptogenic connections of the PC, highlighting its significance in seizure initiation and resistance to pharmacological treatments. Despite its importance, the PC remains underexplored in surgical approaches for TLE. We examine the specific neuroanatomy of the PC as well as the limitations of current imaging techniques and surgical interventions, emphasizing the need for improved imaging protocols to safely target the PC, especially in minimally invasive procedures. Furthermore, the PC's proximity to vital structures, such as the lenticulostriate arteries, presents challenges that must be addressed in future research. By developing multimodal imaging techniques and refining surgical strategies, the PC could emerge as a crucial node in improving seizure freedom outcomes for TLE patients. [ABSTRACT FROM AUTHOR]

Objective: The study aims to assess the relationship between epilepsy and circadian rhythms. Method: This study included a cohort of 7,410 participants sourced from the 2013–2014 National Health and Nutrition Examination Survey (NHANES) database. The investigation focused on the comparative analysis of seven nonparametric indices associated with circadian rhythms (Interdaily Stability (IS), Intradaily Variability (IV), Relative Amplitude (RA), L5, M10, L5 start time, and M10 start time) between the overall population and patients with epilepsy. Logistic regression analysis was utilized to assess the potential correlation between the rest-activity circadian rhythm patterns and the presence of epilepsy within the cohort. Results: Compared to the general population, individuals with epilepsy exhibited lower values of IS and M10. Multivariable logistic regression analysis, when IS, RA, and M10 were categorized into four groups based on quartiles, revealed that the odds ratio (IS: OR = 0.36, 95% CI: 0.13, 0.89; RA: OR = 0.25, 95% CI: 0.06, 0.77; M10: OR = 0.24, 95% CI: 0.06, 0.73) for the highest quartile was lower than that for the lowest quartile. Furthermore, after adjustment for confounding factors, participants in the highest quartile compared to those in the lowest quartile of IV and M10 start time demonstrated a higher prevalence of epilepsy. Conclusion: Individuals with epilepsy demonstrate significant alterations in circadian rhythms. [ABSTRACT FROM AUTHOR]

In real-world vision, objects may appear for a short period, such as in conjunction with visual search. Presumably, this puts a premium on rapid categorization. We designed a visual categorization task cued by briefly presented images to study how visual categorization is processed in an ethologically relevant context. We compared the performance of monkeys with bilateral area TE lesions, and those with bilateral rhinal cortex lesions, to control animals. TE lesions impaired the accuracy but not the speed of visual categorization. In contrast, rhinal cortex lesions did not affect the accuracy but reduced the speed of visual categorization. A generalized drift-diffusion model (GDDM) with collapsing bounds was fitted to the data. The drift rate was equivalent across all groups, but the decision bounds collapsed more slowly in the rhinal group than in the other two groups. This suggests that, although evidence is accumulated at the same rate in all groups, the rhinal lesion results in slower decision-making. [ABSTRACT FROM AUTHOR]

Electroencephalography (EEG), which can intuitively monitor and record the discharge activities of neuronal groups in the brain, is a crucial scientific and clinical diagnostic technique in the field of neuroscience. EEG has been developed and innovated for nearly a century, and it offers advantages of non-invasiveness, convenience, real-time, and continuity. The rapid advancement and multidisciplinary integration of computer technology and other imaging techniques has led to the application of EEG technology in a wide range of areas, including epilepsy, sleep disorders, and critical care. The purpose of this article is to enhance clinical comprehension and implementation of EEG technology by reviewing its development history, clinical applications, and future prospects. [ABSTRACT FROM AUTHOR]

In this work the effect of changing extracellular potassium concentration ([K+]o) on spontaneous and evoked burst activity of glutamatergic neurons in the mouse hippocampus was investigated using the whole-cell patch clamp technique. It was shown that the increase of [K+]o from 3 to 8.5 mM (potassium load): (1) induced spontaneous tonic and pacemaker burst activity in CA1 pyramidal cells (20% and 10% of total cells, respectively) but did not result in the emergence of pacemaker granule cells in the dentate gyrus (DG). (2) Similarly, potassium load increased the evoked burst activity of CA1 pyramidal cells and, paradoxically, suppressed the burst activity of DG granule cells over the entire range of current steps from 10 to 200 pA. (3) Potassium load caused a rightward shift of the current–voltage (I/V) curves in both cell types, decreasing the reversal potential Erev and increasing the slope of the I/V curves (amplitudes of inward currents at voltages from –100 mV to –70 mV) in the CA1 and DG neurons 2–3- and 4–5-fold, respectively. (4) Potassium load produced an opposite effect on outward currents, causing a significant increase in current amplitude in pyramidal cells and a decrease in granule cells (at membrane voltages above 0 mV). The inward and outward currents of DG neurons were 4–4.5 times higher than those of CA1 neurons. The possible involvement of potassium-activated and other potassium-conducting channels in different excitability responses of glutamatergic CA1 and DG neurons under potassium load is discussed. The high sensitivity of CA1 pyramidal cells to potassium load compared to DG granule cells may play an important role in hyperexcitation of neuronal networks during epileptogenesis. [ABSTRACT FROM AUTHOR]

Background and Purpose: Noncontact forehead thermometers have become increasingly widespread because of their advantages, such as rapid measurement of temperature, noninvasiveness, ease of use, and portability. The aim of the study was to compare the body temperature values measured using a noncontact forehead thermometer and a tympanic thermometer. Methods: A cross-sectional, comparative, and quasi-experimental research design was used in this study. The research population was composed of 200 adult individuals older than 18 years who were being treated at the hospital between January 2015 and March 2015. The temperature and humidity of the environment were measured with an electronic thermo-hygrometer thermometer. The body temperature of the patient was measured with both a noncontact forehead thermometer and a tympanic thermometer by the same researcher. The data were recorded in the patient information form and the patient observation form. Results: Mean body temperature values measured with a noncontact forehead thermometer and a tympanic thermometer were 36.17°C ± 0.47°C and 36.89°C ± 0.44°C, respectively. Results showed that there was no clear relationship between differences and averages, and there was conformity between the two methods. Conclusions: The mean forehead temperature is lower than the tympanic temperature, and there is conformity between the two methods. [ABSTRACT FROM AUTHOR]

Objective: Perampanel (PER), a noncompetitive a-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor antagonist, has been approved as adjunctive therapy for focal and generalized epilepsy. Limited information is available regarding the measurable impact of anti-seizure medications (ASM). In this study, we aimed to investigate the effects of PER on electroencephalography (EEG) background activity and interictal epileptic discharge. Methods: This study included all patients with a clinical diagnosis of epilepsy who underwent routine EEG before and after PER treatment between 2018 and 2023. EEG findings were examined according to their background activity and clinical features such as risk factors of epilepsy, the occurrence of sleep-related seizures, sleep disorders, intellectual disability, abnormality of magnetic resonance imaging and EEG, multifocal features on EEG, the duration between EEG and initiation of PER treatment, frequency of seizures before and after PER treatment (seizure freedom or >50% reduction in seizures), previous epilepsy surgery, the number of current and previous ASM, and dosage of PER. Results: In a total of 11 patients, epilepsy type was focal in 8 (73%), all of the patients were on polytherapy, and 4 of them had undergone epilepsy surgery. PER treatment resulted in seizure freedom in 36% of patients and a >50% decrease in seizures in 55% of patients. There was no statistically significant relationship between background activity, phase reversal, and equipotential in EEG before and after PER treatment. In addition, pre- and posttreatment responses to activation procedures and disruption in sleep structure did not differ significantly. The relationship between seizure freedom and phase reversal decrease after PER treatment was statistically significant. The relationship between a >50% decrease in the frequency of seizures and epileptic discharges also reached statistical significance. Conclusion: To summarize, seizure freedom following PER treatment appears to be associated with reduced epileptic discharge, and EEG monitoring might help determine prognosis. [ABSTRACT FROM AUTHOR]

The neonatal intensive care unit (NICU) population, especially low birth weight and critically ill neonates, is at risk of invasive Candida infections, which are associated with high mortality rates and unfavorable long-term outcomes. The timely initiation of an appropriate antifungal treatment has been demonstrated to enhance the prognosis. Factors that should be considered in the choice of an antifungal agent include the causative Candida strain, the presence and location of deep tissue infection, any previous use of antifungal prophylaxis, and the presence of implanted devices. Amphotericin B and fluconazole, the first-line drugs for neonatal candidiasis, are not always suitable due to several limitations in terms of efficacy and adverse effects. Therefore, alternative antifungals have been studied and used in neonates when conventional antifungals are ineffective or contraindicated. This narrative review aims to provide an overview of the current literature regarding the use of echinocandins in the neonatal population. The three echinocandins, micafungin, caspofungin, and anidulafungin, share characteristics that make them useful for the treatment of neonatal candidiasis, including activity against a wide range of Candida strains and Candida biofilms and a favorable safety profile. [ABSTRACT FROM AUTHOR]

Gastroesophageal refluxes (GERs) are universal in newborns and may induce deleterious consequences, especially in preemies. We have previously shown that nasal continuous positive airway pressure (nCPAP) inhibits GERs in full-term lambs, complementing similar results in adult humans. The effect of high-flow nasal cannula (HFNC) on GERs, however, remains unknown. This study aimed to assess the effects of nCPAP and HFNC on GERs in our preterm lamb model. Eleven preterm lambs born 14 days before full-term (∼34 wk of human gestation) were studied. Esophageal pH-impedancemetry and polysomnography recordings were performed simultaneously for 6 h under three randomly ordered conditions: nCPAP 6 cmH2O, HFNC 7 L/min, and no respiratory support (control). The indexes (/h) of GERs and air-containing swallows were analyzed during each condition. The states of alertness and cardiorespiratory events were also analyzed during the identified GERs. nCPAP significantly decreased the GER index compared with control and HFNC during both quiet wakefulness and nonrapid eye movement sleep, whereas HFNC did not alter the GER index. In addition, nCPAP significantly increased the air-containing swallow index compared with control and HFNC. No significant differences were observed between the tested conditions for GER-related cardiorespiratory events, which were nevertheless rarely observed. Similar to full-term lambs, nCPAP strongly inhibited GERs in the preterm lamb, despite an increase in air-containing swallows. In contrast, HFNC did not impact GERs. Our results are clinically relevant when discussing the use of CPAP in preemies with GERs. NEW & NOTEWORTHY: Nasal CPAP inhibited gastroesophageal refluxes in preterm lambs, despite increasing air-containing swallows. High-flow nasal cannula did not impact GERs. Nasal respiratory support did not alter the rare cardiorespiratory events observed during GERs. [ABSTRACT FROM AUTHOR]

Purpose: Restless Legs Syndrome (RLS) is a widespread condition that affects sleep leading to daytime sleepiness, depression, and reduced quality of life. This study aims to determine and describe how patients with RLS experience their everyday life, with a focus on facilitators and barriers related to Maslow's hierarchical theory of human needs. Method: Semi-structured interviews were analysed with qualitative content analysis resulting in facilitators and barriers affecting the fulfilment of the five human needs. Results: Addressing RLS symptoms through medications and a quiet sleep environment fulfils psychological needs. Control over RLS symptoms, engagement in activities, trust in treatments, and social support meet safety and security needs. Social inclusion, close relationships, and meaningful interactions fulfil a sense of belongingness and love needs despite RLS. Competence in managing RLS, effective self-care strategies, confident communication, and trust-building support esteem needs. Finally, comprehensive understanding through person-centred interventions and coping fulfils the self-actualization needs in managing RLS. Conclusion: Holistic and person-centred interventions, including facilitators for the fulfilment of physiological, psychological, and social needs could help healthcare professionals to provide holistic care. [ABSTRACT FROM AUTHOR]

Simple Summary: Numerous findings demonstrate that the central nervous system and the peripheral organs and tissues communicate in physiological and pathological conditions thanks to the exchange of signaling molecules transported via blood, cerebrospinal fluid, and lymph. Extracellular vesicles, which can cross tissue barriers, including the blood–brain barrier, play a key role in this bidirectional communication by safely delivering these molecules, including proteins, lipids, and nucleic acids such as microRNAs (miRNAs). In particular, the latter involved in the post-transcriptional regulation of gene expression can alter recipient cells' functions and orchestrate their behavior in response to different biological events. Thus, elucidating the role played by EVs-delivered miRNAs in brain–periphery communication could offer valuable insights for advancing the treatment and management of neurological and systemic diseases. Bidirectional communication between the central nervous system (CNS) and peripheral organs and tissue has been widely documented in physiological and pathological conditions. This communication relies on the bilateral transmission of signaling molecules and substances that circulate throughout the body and reach their target site(s) via the blood and other biological fluids (e.g., the cerebrospinal fluid, the lymph). One of the mechanisms by which these molecular messengers are exchanged is through the secretion of extracellular vesicles (EVs). EVs are known to mediate cell-to-cell communication by delivering biological molecules, including nucleic acids, proteins, lipids, and various other bioactive regulators. Moreover, EVs can cross the blood–brain barrier (BBB), enabling direct communication between the periphery and the brain. In particular, the delivery of microRNAs (miRNAs) can modulate the expression profiles of recipient cells, thereby influencing their functions. This review synthesizes current findings about the brain–periphery cross-talk mediated by EVs-delivered miRNAs. Although this mechanism has been definitively shown in a few cases, much evidence indirectly indicates that it could mediate brain–peripherical organs/tissue communication, especially in pathological conditions. Therefore, understanding this process could provide valuable insights for the treatment and management of neurological and systemic diseases. [ABSTRACT FROM AUTHOR]

Objective: Epileptogenesis is linked to neuroinflammation. We hypothesized that local heat production caused by neuroinflammation can be visualized non‐invasively in vivo via brain magnetic resonance spectroscopic imaging (MRSI) and MRSI‐thermometry (MRSI‐t) and that there is a relationship in patients with temporal lobe epilepsy (TLE) between MRSI‐t and brain metabolites choline and myo‐inositol and between neuroimaging and cellular and serum biomarkers of inflammation. Methods: Thirty‐six (36) participants, 18 with temporal lobe epilepsy (13 females) and 18 age‐matched healthy controls (nine females), were enrolled prospectively and underwent MRSI/MRSI‐t; TLE participants also provided blood samples. Temperature was measured using creatine as a reference metabolite. Analysis of Functional NeuroImages 3dttest++ tool was used to analyze voxel‐level group differences in temperature, choline, and myo‐inositol. Associations with immune cell subsets, cytokines, and chemokines related to inflammation were quantified using correlation coefficients with significant relationships as noted. Results: Patients with TLE showed elevated temperature, choline, and myo‐inositol in the temporal lobes. Higher brain temperature was associated with higher levels of cytokines and chemokines, including GM‐CSF, TNF, IL‐1β, and IL − 12p70, and lower frequency of immune cells including CD3+ T‐cells, CD4+ T‐cells, CD8+ T‐cells, and classical monocytes. Higher choline was associated with higher levels of the cytokines including LT‐α, IL‐13, and IL‐4, and higher myo‐inositol was associated with a higher frequency of CD4+ T‐cell and CD19+ B‐cell subsets and higher levels of cytokines and chemokines including LT‐α, IL‐13, and CCL3. Significance: This study, for the first time, showed that in temporal lobes of patients with TLE temperature and metabolite changes correlate with cellular and serum biomarkers of inflammation. Our results provide support for further development of MRSI‐t as a measure of neuroinflammation in epilepsy and potentially other neurological disorders and as an investigative and clinical tool. Plain Language Summary: Neuroinflammation is associated with excessive heat production which can be visualized with magnetic resonance spectroscopic imaging and thermometry (MRSI‐t). We prospectively investigated the relationship between MRSI‐t and cellular and serum measures of peripheral inflammation in patients with temporal lobe epilepsy (TLE); we compared the results of MRSI‐t in patients with TLE to healthy controls. We showed a relationship between the temperature elevations in TLE and elevations of various measures of peripheral inflammation. Our results support further development of MRSI‐t as a measure of neuroinflammation in epilepsy and potentially other neurological disorders and as an investigative and clinical tool. [ABSTRACT FROM AUTHOR]

For centuries, epileptic seizures have been noticed to recur with temporal regularity, suggesting that an underlying biological rhythm may play a crucial role in their timing. In this review, we propose to adopt the framework of chronobiology to study the circadian timing of seizures. We first review observations made on seizure timing in patients with epilepsy and animal models of the disorder. We then present the existing chronobiology paradigm to disentangle intertwined circadian and sleep–wake timing mechanisms. In the light of this framework, we review the existing evidence for specific timing mechanisms in specific epilepsy syndromes and highlight that current knowledge is far from sufficient. We propose that individual seizure chronotypes may result from an interplay between independent timing mechanisms. We conclude with a research agenda to help solve the urgency of ticking seizures. [ABSTRACT FROM AUTHOR]

Background/Objectives: Ongoing challenges in epilepsy therapy warrant research on alternative treatments that offer improved efficacy and reduced side effects. Designed to enhance mitochondrial targeting and increase bioavailability, mitocurcumin (MitoCur) was evaluated for the first time as an antiepileptic agent, with curcumin (Cur) and sodium valproate (VPA), a standard antiepileptic drug, included for comparison. This study investigated the effects on seizure onset, severity, and progression in a zebrafish model of pentylenetetrazole (PTZ)-induced seizures and measured the concentrations of the compounds in brain tissue. Methods: Zebrafish were pre-treated with MitoCur and Cur (both at 0.25 and 0.5 µM doses) and VPA (0.25 and 0.5 mM) and observed for four minutes to establish baseline locomotor behavior. Subsequently, the animals were exposed to a 5 mM PTZ solution for 10 min, during which seizure progression was observed and scored as follows: 1—increased swimming; 2—burst swimming, left and right movements; 3—circular movements; 4—clonic seizure-like behavior; 5—loss of body posture. The studied compounds were quantified in brain tissue through HPLC and LC-MS. Results: Compared to the control group, all treatments reduced the distance moved and the average velocity, without significant differences between compounds or doses. During PTZ exposure, seizure latencies revealed that all treatments effectively delayed seizure onset up to score 4, demonstrating efficacy in managing moderate seizure activity. Notably, MitoCur also provided significant protection against the most severe seizure score (score 5). Brain tissue uptake analysis indicated that MitoCur achieved higher concentrations in the brain compared to Cur, at both doses. Conclusions: These results highlight the potential of MitoCur as a candidate for seizure management. [ABSTRACT FROM AUTHOR]

Background/Objectives: During the pre-conceptional period, addressing social determinants of health (SDOH) is essential for reducing maternal health disparities, particularly among disadvantaged groups. Key SDOH factors such as income, education, and healthcare access significantly influence maternal and infant outcomes, increasing risks like miscarriage, preterm birth, and pregnancy complications. Here, we aimed to explore maternal and neonatal characteristics according to socio-economic status. Thus, we identified clusters of pregnant women with similar social and behavioral characteristics and explored their variability in terms of neonatal outcomes. Methods: Data from 1512 pregnant women in the "MAMI-MED" cohort at ARNAS Garibaldi Nesima in Catania were analyzed. A two-step cluster analysis grouped the women based on education level, employment status, pre-pregnancy nutritional status, and Mediterranean diet score (MDS). Results: Two clusters of pregnant women were identified. Cluster 1 (n = 739) consisted of women with lower educational attainment who were unemployed, overweight and/or obese, and had a lower mean MDS. Instead, cluster 2 (n = 773) was mostly characterized by women with a medium–high level of education who were employed, had normal weight, and had a higher average MDS. Women in cluster 1 had significantly higher proportions of preterm births (p = 0.004), low-birth weight newborns (p = 0.002), and large-for-gestational-age newborns. Differences in gestational week (p < 0.001), birth weight (p < 0.001), and newborn length (p = 0.004) were also noted between the two clusters. Conclusions: Cluster analysis can help identify high-risk groups who may benefit from personalized public health interventions. Our results highlight the need to examine the complex interactions between socio-demographic, behavioral, and genetic factors that contribute to maternal–infant health. [ABSTRACT FROM AUTHOR]