Current Neuropharmacology - Online First
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73 results
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Non-excitatory Amino Acids Worsen Synaptic Transmission under Ischemia-like Conditions: Hypoxia and Hypoglycemia
Available online: 23 February 2026More LessIntroductionStroke is the leading cause of adult disability and the second leading cause of death worldwide. Understanding mechanisms of neuronal damage and developing new treatments to stop its progression are key goals in brain ischemia research. We previously showed that a mixture of non-excitatory amino acids at plasma concentrations (PlasmaAA: L-alanine, glycine, L-glutamine, L-histidine, L-serine, taurine, L-threonine) worsens the deleterious effects on synaptic transmission caused by hypoxia.
MethodWe hypothesized that this amino acid combination could be especially harmful in the ischemic penumbra, a region potentially recoverable. We used a hypoxia-hypoglycemia model (20 min hypoxia-5 mM glucose) that allows recovery of synaptic transmission after normoxia.
ResultsIn this model, PlasmaAA induced complete and irreversible depression of excitatory synaptic potentials through activation of NMDA-type glutamate receptors. The effect was mimicked by glutamate application (110 μM) during hypoxia-hypoglycemia.
DiscussionOur data demonstrate that non-excitatory amino acids, at physiological plasma levels, irreversibly aggravate hippocampal synaptic damage under hypoxia-hypoglycemia via NMDA receptor activation. As seen under hypoxia alone, this damage is linked to intracellular amino acid accumulation, cell swelling, and excessive glutamate release. We propose that amino acids released in the ischemic core spread to cells in the penumbra, fostering cytotoxic edema and expanding damage.
ConclusionThese findings suggest that targeting cellular uptake of non-excitatory amino acids could represent a novel neuroprotective strategy for stroke.
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Modulation of the PR Interval after Electroconvulsive Therapy in
Authors: Xiaofang Chen, Xiaoni Guan, Meihong Xiu and Fengchun WuAvailable online: 20 February 2026More LessIntroductionDepression is a common mental disorder, often accompanied by suicidal ideation (SI). Modified electroconvulsive therapy (MECT) is widely used as an effective treatment for severe depression, especially when pharmacotherapy has failed. However, concerns regarding the potential cardiovascular effects of MECT have prompted further investigation.
MethodsA total of 100 patients with depressive disorders undergoing MECT were recruited in this study. Among them, 70 had suicide ideation (SI group) and 30 did not (non-SI group). Electrocardiogram (ECG) recordings were obtained before MECT and on the second day after several sessions of MECT treatment.
ResultsAfter treatment with MECT, no significant differences were observed in ECG parameters, including PR intervals, QT intervals, and heart rates. However, a significant interaction between time and group on PR intervals was observed (F(1,98)=5.5, p=0.02). Specifically, patients in the non-SI group exhibited a slight increase in PR intervals compared with baseline values, whereas those in the SI group showed a slight decrease. More importantly, significant differences were observed between the SI and non-SI groups (Z= 2.3, p=0.02). Further linear regression analysis showed that, after controlling for gender and medication types (antidepressants versus antipsychotics), the presence of suicide ideation was independently associated with changes in PR intervals following MECT treatment (β= 0.20, t= 2.04, p= 0.04).
DiscussionOur findings suggested a significant interaction between time and group on PR intervals after treatment with MECT in patients.
ConclusionConsidering that the within-group changes did not reach statistical significance, future research with a large sample size is warranted to focus on the differential effects of MECT on ECG indicators in depressed patients with or without suicide ideation.
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Repetitive Transcranial Magnetic Stimulation Alters Brain Communication Networks to Improve the Cognitive Function in Patients with Amnestic Mild Cognitive Impairment - A Clinical Trial
Authors: Zhiyuan Yang, Moran Tangli, Yi Tan, Haojie Chen, Ni Shu, Zhihong Ke, Zheqi Hu, Qing Ye, Hailan Meng, Haifeng Chen and Yun XuAvailable online: 12 February 2026More LessIntroductionRepetitive Transcranial Magnetic Stimulation (rTMS) is a non-invasive intervention that could effectively enhance the cognitive function in patients with amnestic mild cognitive impairment (aMCI). However, the mechanism and predictive biomarkers for therapeutic response remain poorly understood.
MethodsFifty-three aMCI patients underwent either neuro-navigated rTMS (n=28) or sham stimulation (n=25) targeting the left angular gyrus over four weeks (registered in 2021: ChiCTR2100050496). Multimodal MRI and comprehensive neuropsychological assessments were conducted pre- and post-intervention. Changes in brain communication networks and their correlation with cognitive improvements were analysed, with random forest models applied to predict treatment efficacy.
ResultsEpisodic memory (p<0.001) and general cognitive function (p<0.05) of aMCI patients were significantly improved after intervention. Novel alterations in brain communications networks were identified in 5 sensorimotor areas, executive control regions, and emotion-cognition processing hubs. Communication alterations between the right precentral gyrus and right angular gyrus were positively correlated with the improvements in episodic memory (r=0.38, p=0.046), while the alterations between right precentral gyrus and right angular gyrus were negatively correlated with improvements in general cognitive function (MMSE, r=-0.44, p=0.019; MoCA, r=-0.43, p=0.024). Notably, the random forest model integrating communication network patterns with baseline demographic and neuropsychological data showed strong power in predicting rTMS effects.
DiscussionThese findings advance understanding of rTMS mechanisms by linking network plasticity to cognitive gains, addressing critical knowledge gaps.
ConclusionNeuro-navigated rTMS targeting the left angular gyrus may enhance cognitive function in aMCI patients by improving inter-brain regions communication. Baseline communication patterns hold promise as predictive biomarkers, facilitating personalized treatment strategies.
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Mitochondrial and Antioxidant Activity as the Basis of the Neuroprotective Effect of Potential Multitarget Drugs for the Treatment of Neurodegenerative Diseases
Available online: 19 January 2026More LessBackgroundThe mechanisms of neurodegeneration common to many neurodegenerative diseases include oxidative stress, mitochondrial dysfunctions, excitotoxicity, and others. Beyond the broad spectrum of strategies for developing neuroprotective agents that target stage-specific mechanisms in each neurodegenerative disease, considerable attention is also being given to approaches aimed at developing compounds that can effectively modulate general pathogenic mechanisms and enhance the overall resilience of neuronal cells to cell death induction.
ObjectiveThis review discusses some of the results on new multitarget multipharmacophore agents with neuroprotective effects, particularly through their influence on mitochondrial permeability transition and antioxidant properties. We conducted comprehensive online searches on PubMed to gather the latest data on multitarget multipharmacophore agents consisting of pre-defined pharmacophores that have already demonstrated neuroprotective properties.
Results and DiscussionTo create compounds with a desirable spectrum of biological activity, an approach based on the conjugation of specific structural fragments of pharmacologically active substances into a single molecular entity could be used. Core fragments of compounds that have already demonstrated neuroprotective properties due to mitochondrial and antioxidant mechanisms of action can be used as neuroactive scaffolds.
ConclusionThe combination of several pharmacophores in one molecule may not only result in the mere addition of the useful properties of each component, but may also give rise to new types of biological activity. The examples of the appearance of new properties in such multipharmacophore compounds, not inherent in the reference agents, discussed in our review, may be considered a prospective approach for creating a novel generation of neuroprotective agents.
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Blockade of Interleukin-6 Receptor with Tocilizumab During the Acute Phase of Childhood Immune-Mediated Epilepsy can Lead to a Favorable Outcome - an Observational Study
Authors: Xiaolu Deng, Jielu Tan, Miriam Kessi, Zhanwei Zhang, Fang He, Ciliu Zhang, Fei Yin, Lifen Yang and Jing PengAvailable online: 15 January 2026More LessIntroductionTo explore the role of tocilizumab in treating childhood immune-mediated epilepsy and determine the role of interleukin-6 (IL-6) in its pathogenesis.
MethodsWe collected and analyzed clinical information of pediatric patients diagnosed with immune-mediated epilepsy and treated with tocilizumab at Xiangya Hospital.
ResultsThis study included four males with a median age of onset of 4.3 years. They presented with seizures, fever, and neuropsychiatric manifestations. A combination of different anti-seizure medications (ASMs) and first-line immunotherapy could not control seizures. All patients had elevated levels of IL-6 in their serum and/or cerebrospinal fluid at some points. The median time from disease onset to the first dose of tocilizumab was 25 days. Patients 2 and 3 received tocilizumab in the acute phase of the disease, but patients 1 and 4 received this therapy in the subacute phase. At the last follow-up, patients 2 and 3 had no seizures, while patients 1 and 4 still had chronic epilepsy, but with > 50% reduction of seizure frequency. All patients regained normal cognition.
DiscussionIL-6 may play a role in the pathogenesis of immune-mediated epilepsy, and introducing tocilizumab in the acute phase might be effective in preventing the disease from progressing into the chronic phase.
ConclusionTocilizumab is effective for the management of immune-mediated epilepsy in children when given early enough.
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Investigating the Multiple Regulatory Mechanisms and Therapeutic Targets of PHLDA1 in Neurological Diseases
Authors: Xiaodong Liu, Zhengxiang Lv, Gaoyuan Xu, Yu Chen, Haijun Liu and Ping XuAvailable online: 13 January 2026More LessPHLDA1 (pleckstrin homology-like domain family A member 1) is a pleiotropic regulatory protein that affects key biological processes such as apoptosis, pyroptosis, immune inflammation, autophagy, metabolism, and oxidative stress. PHLDA1 plays a significant role in the pathological mechanisms of neurological diseases. This article systematically reviews the molecular characteristics of PHLDA1 and its core role in cerebrovascular diseases such as cerebral ischemia/ reperfusion injury, cerebral hemorrhage, subarachnoid hemorrhage, epilepsy, amyotrophic lateral sclerosis (ALS), and Parkinson's disease (PD). Studies have shown that PHLDA1 promotes disease progression by regulating signalling pathways such as the NF-κB, MAPK, NLRP3 inflammasome, PPARγ, and Nrf2 pathways, thereby exacerbating neuroinflammation, mitochondrial dysfunction, endoplasmic reticulum stress, and pyroptosis in neurons. Its expression is regulated by the dynamic balance of miRNAs (such as miR-194 and miR-101), transcription factors (Egr1 and BHLHE40), and heat shock proteins (HSPs/HSF1). In addition, PHLDA1 has become a potential target for intervention in neurodegenerative and ischemic injuries by inhibiting FundC1-mediated mitochondrial autophagy, regulating microglial polarization, and activating TRAF6-dependent neuroinflammation. This article not only clarifies the pathogenic mechanism of PHLDA1 but also summarizes the relevant intervention strategies targeting PHLDA1, hoping to provide a corresponding theoretical basis and reference for the development of precision therapies for neurological diseases.
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Efgartigimod in Very-Late-Onset Generalized Myasthenia Gravis: A Real-World Study on Effectiveness and Safety
Authors: Chi Ma, Jingyi Shen, Ying Zhu, Benqiao Wang and Ruixia ZhuAvailable online: 13 January 2026More LessIntroductionThis study evaluated the safety and effectiveness of efgartigimod in patients with Very-Late-Onset Generalized Myasthenia Gravis (VLOGMG), a population that often presents with more severe symptoms and limited treatment responses.
MethodsForty-two patients aged ≥ 65 years were retrospectively included. Clinical assessments, including MG activities of Daily Living (MG-ADL), Quantitative Myasthenia Gravis (QMG) scores, prednisone dosage, laboratory data, and adverse events, were recorded at each follow-up.
ResultsAt week 4, 97.6% (41/42; 95% CI, 87.4-99.9) of patients were MG-ADL responders (≥ 2-point improvement). Notably, 83.3% (95% CI, 69.4-92.8) maintained response through week 12 (p < 0.001). Clinically meaningful improvement (CMI, ≥3-point QMG decrease) occurred in 97.6% of patients (41/42; 95% CI, 87.4-99.9), with a mean response time of 6.37 ± 5.46 days (95% CI, 4.63-8.11). Minimal symptom expression (MSE, MG-ADL score of 0 or 1) was achieved in 45% (95% CI, 30-61%), 60% (95% CI, 44-74%), and 45% (95% CI, 30-61%) of patients at weeks 4, 8, and 12, respectively. Prednisone dosage was tapered from a median of 20 (20, 30) mg/day to 10 (5, 15) mg/day by week 12. Most patients (88.1%) had ≥ 1 comorbidity, and 61.9% had multimorbidity. Efgartigimod was well tolerated, without evidence of worsening of pre-existing conditions.
DiscussionEfgartigimod provided rapid symptom relief in older adults with VLOGMG and demonstrated steroid-sparing benefits across patients with various comorbidities. The high response rates and sustained improvement suggest that early use of fast-acting therapies may serve as a bridge to conventional long-term treatments. Larger prospective studies are warranted to confirm these findings.
ConclusionEfgartigimod is associated with clinical benefit in patients with VLOGMG, allowing corticosteroid reduction without compromising comorbidity stability. Early initiation may enable faster disease control and more durable responses.
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Cathepsins in Ischemic Stroke: Unveiling Neuropharmacological Roles and Therapeutic Potential
Authors: Rui Meng, Xin Zhong, Simeng Zhang, Yunjie Qiu, Zhenzhen Quan, Hong Qing, Hui Li and Junjun NiAvailable online: 09 January 2026More LessIschemic stroke is a complex and heterogeneous neurological disorder with high mortality and long-term disability rates, yet effective clinical biomarkers and targeted therapies remain elusive. Despite extensive research, the molecular mechanisms driving ischemic stroke pathophysiology are still not fully understood. Cathepsins, a family of endo/lysosomal proteases, play a crucial role in modulating neuronal protein activation and degradation, thereby exerting both neuroprotective and neurotoxic effects. This review synthesizes current findings on the neuropharmacological roles of cathepsins in ischemic stroke, highlighting their dual functions and potential as therapeutic targets. By providing an integrated perspective, this article aims to uncover novel molecular pathways implicated in stroke progression and identify innovative therapeutic strategies centered on cathepsin modulation. Furthermore, this review explores the potential of cathepsins as biomarkers, paving the way for more precise, personalized interventions that could ultimately improve patient outcomes and mitigate long-term disability in ischemic stroke survivors.
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Baicalin Attenuates Ferroptosis after Subarachnoid Hemorrhage via the PI3K/AKT/GPX4 and NLRP3 Axis
Authors: Hai-ping Ling, Peng-fei Ding, Jia-tong Zhang, Ting-ting Yue, Qing-rong Zhang and Chun-Hua HangAvailable online: 09 January 2026More LessIntroductionSubarachnoid hemorrhage (SAH) is a common subtype of stroke characterized by bleeding into the subarachnoid space. Increasing evidence suggests that neuronal ferroptosis—an iron-dependent, non-apoptotic form of cell death—contributes significantly to the secondary brain injury and poor prognosis observed in SAH patients. However, there are currently no effective pharmacological interventions specifically targeting ferroptosis in this context.
MethodsIn this study, network pharmacology was combined to explore the potential mechanism of baicalin in alleviating neuronal ferroptosis after SAH by Western blot, qPCR, DHE probe, TMRE probe, and transmission electron microscopy in in vivo and in vitro SAH models.
ResultsThe results of network pharmacology showed that baicalin mainly acted on the ferroptosis marker PTGS2, and the results of KEGG analysis suggested that the effect of baicalin in attenuating ferroptosis might be realized by activating the PI3K/AKT pathway. Baicalin partially restored the SAH-induced reduction of GPX4 expression and effectively suppressed the upregulation of NLRP3. These effects were abolished by the PI3K/AKT inhibitor LY294002. Baicalin was found to be effective in improving neurological function in mice in an in vivo SAH model.
DiscussionThis study demonstrated that baicalin attenuates neuronal ferroptosis after SAH by activating the PI3K/AKT pathway, which in turn upregulates GPX4 and suppresses NLRP3. These findings offer new insights into the pharmacological treatment of neuronal ferroptosis following SAH.
ConclusionBaicalin can alleviate ferroptosis after SAH by activating the PI3K/AKT pathway.
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Psychoactive Synthetic Adulterants in Tablets Sold as MDMA after the COVID-19 Pandemic: Implications for Central Effects
Available online: 09 January 2026More LessIntroductionPreclinical and clinical studies reported that 3,4-methylenedioxymeth-amphetamine (MDMA, ‘ecstasy’) can cause adverse effects in the central nervous system (CNS). Recently, preclinical studies have demonstrated that certain psychoactive substances may exacerbate the noxious central effects of MDMA when co-administered, including substances that are contained as adulterants in tablets sold as MDMA in the illegal market. Since the quality and quantity of adulterants in tablets sold as MDMA vary based on factors, such as the year and the geographical region of production, this may result in diverse health risks for people who use MDMA.
ObjectivesThis review provides a concise overview of: i) composition of tablets sold as MDMA in Continental Europe, UK, USA and Australia in the post COVID-19 pandemic period; ii) recent preclinical and clinical findings about the central effects of the psychoactive adulterants most commonly found in tablets sold as MDMA in the above areas; and iii) the possible adverse CNS effects of these adulterants in humans when taken in combination with MDMA.
MethodsWe systematically searched PubMed, Scopus, and Web of Science for studies published between 2020 and 2025 using terms related to “adulterants”, “MDMA tablets composition,” “COVID-19”. Eligible articles were screened for quality, with emphasis on recent, high-impact contributions. Extracted papers included cytotoxicity studies, neurobehavioral outcomes, and mechanistic insights.
ResultsTablets sold as MDMA are frequently and differently adulterated in Continental Europe, the UK, the USA, and Australia.
DiscussionThe possible interactions between MDMA and psychoactive adulterants contained in tablets sold as MDMA deserve attention, since they may potentially explain some of the noxious neurological and psychiatric effects that have been described in people who use MDMA.
ConclusionOngoing public health efforts and expansion of drug checking are essential to properly inform MDMA users about the risks associated with psychoactive contaminants, first responders, healthcare professionals, and the general public about the possible detrimental consequences for health associated with the use of MDMA obtained from illicit sources and unintended contaminant consumption.
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Non-anesthetic Effects of Anesthetics and Organ Protection
Authors: Lucas Gabrovic, Xiaofeng Chen, Han Huang and Hailin ZhaoAvailable online: 08 January 2026More LessIschaemia reperfusion (I/R) injury is a physiological phenomenon whereby hypoxic tissue damage can be perpetuated by tissue reperfusion; this can occur in the setting of pathology or as a surgical complication. Naturally, tissues sensitive to hypoxic episodes such as the brain, heart, kidney, liver and lung tissue are most often affected. Current treatments for I/R injury focus of limiting the pathological response to reperfusion through ischemic preconditioning (IPC) and medications that mimic the IPC response. Anesthetic preconditioning (APC) and anesthetic postconditioning (APoC) can produce protective responses similar to IPC, thus modulating the effects of I/R injury, with a far longer impact on organ systems than their sedative or analgesic effects. The pathological process and molecular mechanism of I/R injury involve calcium overload, mitochondrial dysfunction, oxidative stress, inflammation, autophagy, and other key signaling pathways. However, how anesthetics are involved remains to be further investigated. Elucidating its underlying mechanism is vital to prevent perioperative I/R injury and benefit our patients. Importantly, the protective mechanisms differ between the types of anesthetics and between types of tissue. Understanding the differences can lead to more informed clinical decisions. Here, we systematically review and compare the molecular mechanisms that can explain how inhalational and intravenous anesthesia regulate I/R injury and provide a comprehensive analysis of recent basic clinical studies for APC and APoC in the context of different organ I/R injury.
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CBD-Rich Cannabis Therapy in Children with Autism Spectrum Disorder May Improve Symptoms of Hyperactivity and Attention Deficit: An Open-Label Study
Available online: 05 January 2026More LessIntroductionMedical cannabis has gained growing attention as a potential treatment for children with Autism Spectrum Disorder (ASD), particularly in cases where conventional pharmacological approaches have proven ineffective. Emerging evidence suggests that cannabinoid-based therapies may alleviate Attention Deficit Hyperactivity Disorder (ADHD) related symptoms in children with ASD. The objective of this study is to evaluate changes in ADHD symptoms over six months of treatment with a CBD-rich cannabis oil, using the Conners' Teacher Rating Scale as the assessment tool.
MethodsThis was a prospective, single-arm, open-label study conducted at a single center. A total of 109 children and young adults diagnosed with ASD and ADHD symptoms were recruited between November 2019 and April 2021. Of these, 53 participants were assessed by their schoolteachers using the Conners' Teacher Rating Scale (CTRS) questionnaire, both before and after a three- to six-month treatment period with a CBD-rich, cannabis oil-based product. Blood samples were collected before and after treatment to measure cannabinoid levels, including CBD, 6-OH-CBD, 7-COOH-CBD, and 7-OH-CBD.
ResultsSignificant improvements were observed in the following categories: anxious-shyness, perfectionism, ADHD index, emotional lability, and hyperactivity-impulsivity (p < 0.001). Additional trends toward improvement were identified in oppositional behavior (p = 0.009), cognitive inattention (p = 0.009), hyperactivity (p = 0.006), the Conners’ Global Index (p = 0.007), and DSM-IV inattention scores (p = 0.003). No significant correlations were found between cannabinoid dosage or blood levels and changes in CTRS scores, except for emotional lability, where higher CBD concentrations were predictive of greater symptom improvement.
DiscussionThis is the first prospective study to evaluate the effects of CBD-rich cannabis on ADHD symptoms in children with ASD using standardized teacher-based Assessments (CTRS). The findings indicate improvements in core behavioral domains. While previous studies have focused primarily on parent-reported outcomes or small-scale trials, our results support emerging evidence on the role of cannabinoids in modulating attention and emotional regulation. The main limitations of the study were its open-label design.
ConclusionCBD-rich cannabis oil may reduce ADHD symptoms in children with ASD. These findings support the need for future clinical trials to validate efficacy and determine optimal dosing.
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Astrocytes in Neurofluid Drainage and Brain Disorders: Mechanisms and Therapeutic Implications
Authors: Wenzhi Wang, Yichen Tsai, Yaojian Ding, Qinhan Yao, Jingru Tian, Yanrong Sun, Lihua Qin and Junhao YanAvailable online: 05 January 2026More LessOver the past decade, increasing attention has been paid to neurofluid (NF) drainage in the brain, particularly to the glymphatic system and intramural periarterial drainage (IPAD) pathway, which are responsible for substance transport in the brain and are highly dependent on astrocyte function. The dysfunction of these drainage pathways can lead to the accumulation of toxic substances and fluids, and contribute to various brain diseases, such as stroke and Alzheimer’s disease. Since astrocytes in the brain closely connect to the microvascular system with their endfeet, in this work, the roles of astrocytes in regulating the glymphatic system and IPAD pathway and their dysfunction in neurodegenerative diseases have been comprehensively reviewed. Additionally, the effects of aquaporin 4, a water channel protein located on astrocytic endfeet, on these two pathways are explored. Furthermore, the possible therapeutic strategies for brain diseases targeting the NF drainage systems have also been proposed and thoroughly discussed.
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Evaluation of Hemodynamic and Blood Oxygen Metabolism Alterations in Parkinson's Disease Using Quantitative MRI
Available online: 02 December 2025More LessObjectiveTo investigate hemodynamic and blood oxygen metabolism and their associations with disease progression, dopaminergic transporter (DAT) activity, and glucose uptake in patients with Parkinson’s disease (PD).
MethodsThis cross-sectional study included 73 patients with PD (mean age: 61.10 years) and 67 healthy controls (mean age: 58.99 years). Oxygen metabolism parameters—deoxygenated hemoglobin (Cdeoxy), oxygen extraction fraction (OEFrel), deoxygenated cerebral blood volume (dCBV), and R2* were measured using qMRI. DAT availability and glucose metabolism were assessed using PET with [18F]FP-CIT and [18F]FDG, respectively. Regional analyses were conducted using standardized brain atlases.
ResultsCompared with the controls patients with PD exhibited elevated Cdeoxy, OEFrel, and R2* in the substantia nigra, whereas Cdeoxy and dCBV levels were reduced in the bilateral caudate nucleus and frontal cortex (p < 0.05). The Hoehn-Yahr (H-Y) 2.5–3 subgroup exhibited higher levels of Cdeoxy and OEFrel in the left putamen than the H-Y 1-2 subgroup (p < 0.05). In the H-Y 1-2 subgroup, Cdeoxy, OEFrel, and R2* correlated with UPDRS scores in the substantia nigra and red nucleus (p < 0.05). In advanced stages (H-Y stages 2.5-3), significant correlations were observed in the striatal structures/the left dorsolateral putamen/posterior right caudate (p < 0.05). OEFrel and R2* values were positively correlated with glucose metabolism in the left putamen and right caudate. (p < 0.05).
ConclusionqMRI demonstrated alterations in hemodynamics and oxygen metabolism in patients with PD, particularly within the nigrostriatal system, suggesting that metabolic indicators could serve as supplementary biomarkers for diagnosing and monitoring the progression of PD.
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Therapeutic Values of General Anesthetics: From Developmental Neurotoxicity to Neurotherapeutic Agents
Authors: Tianyun Zhao, Xinying Guo, Ziwen Shi, Haiping Xu, Shiqi Deng, HangChao Tang, Hui Cai and Xingrong SongAvailable online: 29 November 2025More LessThe development of the central nervous system is characterized by precisely orchestrated, dynamic processes that commence at the embryonic stage and continue throughout postnatal life. Maintaining the balance between excitation/inhibition (E/I) in cortical neuronal circuits is crucial for normal brain function. General anesthetics (GAs) powerfully modulate neuronal activity by enhancing inhibition and/or inhibiting excitability, resulting in temporary loss of consciousness. Therefore, these agents can also induce aberrant neuroplasticity contributing to neurological dysfunction and abnormal behavioural phenotypes, particularly in the developing brain. While this impaired plasticity poses a risk, it also creates an opportunity to treat diseases characterised by abnormal neuroplasticity as core pathologies, such as neuropsychiatric disorders (NPDs). Over recent decades, intense investigations have revealed the neuroprotective and psychotherapeutic potential of GAs in treating neurological injuries and NPDs. Although promising, significant challenges remain, including optimizing dosages, administration duration, and intervals for non-anesthetic uses while minimizing adverse effects. Additionally, the molecular mechanisms underlying the dual roles of GAs - as neurotoxic agents and neurotherapeutic tools - require further elucidation. This review explores developmental neuroplasticity during critical periods, the mechanisms of GAs' action on neural circuits, and the current understanding of their neurotoxic and neuroprotective effects based on alterations in neuroplasticity. Furthermore, we highlight the therapeutic potential of GAs for neurological disorders with impaired neuroplasticity as the core pathological mechanism and propose directions for future research to unlock their full clinical utility.
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Low-dose Olanzapine and Sertraline Combination Therapy for Metabolic Disturbance in Patients with Schizophrenia: A Large-scale, Open-label Randomized Trial
Authors: Xiaoni Guan, Meihong Xiu and Fengchun WuAvailable online: 03 November 2025More LessIntroductionOlanzapine-associated metabolic adverse effects lead to medication discontinuation and non-compliance in Schizophrenia (SCZ). This study aimed to examine the efficacy of a low dose of olanzapine in combination with sertraline in mitigating metabolic adverse effects by reducing the olanzapine dose in first-episode SCZ (FE-SCZ) patients.
MethodsThis randomized clinical trial with a blinded endpoint design was conducted among FE-SCZ patients. During a 12-week treatment, 196 patients with FE-SCZ were randomly assigned to the combined low-dose olanzapine/sertraline (OS group) or standard-dose olanzapine (control group). The body weight and levels of fasting glucose and blood lipids were determined at baseline and the end of weeks 4, 8, 12, and 24. Additionally, the clinical symptoms were also assessed at baseline and follow-up.
ResultsRelative to the control group, the OS group had a lower percentage of weight gain from baseline to week 24 across two thresholds (7% and 10%) for changes in bodyweight (100% vs. 97.8%; 98.7% vs. 28.3%). In addition, combination treatment mitigated olanzapine-associated weight gain and other metabolic abnormalities compared with the control group (all p < 0.01). Notably, clinical symptom improvements were similar between the two treatment groups.
DiscussionOur study suggests that low-dose olanzapine/sertraline combination therapy was correlated with significantly less weight gain and improved other metabolic parameter levels than standard-dose olanzapine in patients with FE-SCZ. Clinical symptom improvements in the combination group were comparable to those of the olanzapine monotherapy group.
ConclusionThese findings suggest a potential strategy to improve medication adherence and overall patient outcomes by mitigating metabolic side effects.
Trial RegistrationClinicalTrials.gov, NCT04076371.
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Emerging Potential of Ras-proximate-1 (Rap1) in Mediating Neurodegenerative Diseases
Authors: Yuan Wang, Jun Hu, Qiong Zhu, Shaoyu Wang and Shijia YuAvailable online: 31 October 2025More LessNeurodegenerative diseases have posed a rising global threat to the aging population, presenting structural and functional impairments in the central nervous system. These progressive disorders, which affect the brain and spinal cord, develop due to the continuous loss of neurons and myelin sheaths. Such specific pathophysiological changes lead to neurological dysfunction in Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease, resulting in typical motor dysfunctions and cognitive disorders, as well as symptoms like behavioral abnormalities and personality changes. To date, despite various treatments attempting to manage these symptoms, patients’ quality of life remains severely deteriorated. A few effective therapeutics are available to mitigate the progression of neurodegenerative injuries. Increasing attention is now focused on molecular regulatory mechanisms, particularly the association between immune regulation and the neurovascular unit. A critical component in this process is Ras-proximate-1 (Rap1), a small Guanosine Triphosphatase (GTPase). Rap1 is determined to regulate glia-mediated immunoinflammatory responses, vascular endothelial function, and neuronal activity. It also modulates synaptic plasticity and mitochondrial function via autophagy-dependent modulation, which are significantly impacted during neuronal degeneration. Additionally, signaling pathways, including PI3K/Akt and ERK, are identified as its downstream effectors. Furthermore, by mediating the permeability of the blood-brain barrier, Rap1 probably influences neuroimmune-vascular modulation throughout the development of neurological disorders. In this review, we investigate recent studies to explore the emerging therapeutic potential of Rap1 in the inflammation-related regulation within neurodegenerative diseases. We also discuss novel treatments and possible targets, including natural medicines and genetic modulation, to enhance therapeutic effects and improve prognosis.
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Probiotics Decrease C-Reactive Protein Levels in Depression Depending on Metabolic Syndrome Presence or Antidepressant Treatment – Secondary Results of a Randomized Clinical Trial
Available online: 29 October 2025More LessIntroductionThere is a need to search for new treatment options not only for depression but also for its concomitant diseases. Particularly, depression and metabolic health abnormalities often coexist, while inflammation and microbiota imbalance may play a part in their pathophysiological overlap. Thus, trials of interventions targeting the microbiota may result in establishing a safe adjunctive treatment option. This secondary analysis aimed to assess the effect of a probiotic formulation on inflammatory parameters in adult patients with depressive disorders depending on baseline clinical and immunometabolic characteristics.
MethodThe parent trial was a two-arm, 60-day, prospective, randomized, double-blind, controlled study. The probiotic formulation contained Lactobacillus helveticus Rosell®-52 and Bifidobacterium longum Rosell®-175. The change in inflammatory parameters after the intervention in the context of baseline lifestyle, clinical, metabolic, and inflammatory parameters was assessed.
ResultsIn per-protocol analysis, data from 88 participants were finally analyzed. Probiotic supplementation decreased the levels of C-reactive protein (CRP) compared to placebo by 21.3% with a small effect size (p = .047, d = .249). There were no significant differences in complete blood count-derived parameters or in tumor necrosis factor-α levels. The impact of probiotics was different when stratified by baseline metabolic syndrome (MetS) presence, liver steatosis non-invasive biomarkers, chronic low-grade inflammation status, and antidepressant use.
DiscussionThe intake of probiotics by people with depression may offer some improvement in lowering CRP levels, especially in patients with comorbid MetS, liver abnormalities, or the use of antidepressants. The future potential of probiotic supplementation in the management of depression seems to be targeted at individuals with comorbidities of metabolic diseases, particularly suspected liver steatosis. Furthermore, patients treated with antidepressants may gain additional advantages from probiotic use, not only in terms of alleviating depression, but also in decreasing inflammation.
ConclusionDue to the preliminary character of our results, we emphasize the need for future studies in this area. ClinicalTrials.gov identifier: NCT04756544.
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Global Emerging Trends of Neural Regeneration Knowledge Structures Using Bibliometrics and Visual Analytics based on 3941 Studies from 2015 to 2024
Authors: Yu-Han Wu, Ya-Lan Tian, Jia-Zhen Chen, Zhan Zhang, Yue Zhang and Chao ZhangAvailable online: 28 October 2025More LessIntroductionNeural regeneration remains a highly debated topic, yet it lacks a systematic bibliometric analysis. The objective of this study is to utilize bibliometric methods to identify research trends and significant topics within this domain, thereby providing a comprehensive overview of the current state of knowledge in this field.
MethodsThe Web of Science Core Collection (January 1, 2015 to October 3, 2024) served as the basis for analyzing 3,941 documents using CiteSpace and VOSviewer. The analysis focused on country/institution collaboration networks, keyword co-occurrence, and hotspot evolution.
ResultsBetween 2015 and 2024, the number of publications in this field demonstrated an upward trend, characterised by fluctuations. China and the United States were the leading contributors to global research output, with China contributing 1,387 papers, accounting for 35.19% of the total, and boasting an H-index of 62. In contrast, the United States contributed 1,047 papers, with an h-index of 74. In recent years, research has been concentrated on four major technological directions, including neural electrical stimulation, biomaterial scaffolds, gene editing, and neural modulation.
DiscussionThis transformation in scholarly focus reflects the convergence of multiple catalytic factors, which have enabled the sophisticated simulation of neural systems, provided unprecedented analytical tools for neuroscience inquiry, and intensified societal demands for artificial intelligence applications and neurotechnology innovations, thereby stimulating accelerated research investment.
ConclusionOver the past decade, researchers worldwide have focused on neural regeneration. Bibliometric analyses have assessed scholarship, identified research hotspots, summarized core concepts, and provided valuable insights for future research in this field.
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A Randomized Clinical Trial on the Effect of a Two-Week Treatment with Capsaicin on Older Patients with Oropharyngeal Dysphagia
Authors: Noemí Tomsen, Nicolau Guanyabens, Pere Clavé and Omar OrtegaAvailable online: 27 October 2025More LessBackgroundAcute studies have shown that TRPV1 agonists have improved both the biomechanics and neurophysiology of the swallowing response. The aim of this study was to assess the effect of a two-week treatment with capsaicin in older patients with oropharyngeal dysphagia (OD).
MethodsA prospective, double-blind, randomized clinical trial was conducted. A total of 51 older patients with OD (PAS > 2) were included and treated for two weeks with 10 mL capsaicin 10 µM before meals (three times a day). Videofluoroscopy was used to examine swallowing biomechanics, and pharyngeal sensory (pSEP) and motor evoked potentials (pMEP) were used to assess neurophysiological responses. Salivary neuropeptides SP and CGRP were quantified using ELISA.
ResultsThe mean age of patients was 78.51 ± 6.04 years. The 32 patients treated with capsaicin showed a significant reduction in PAS score (4.7 ± 1.7 vs 3.9 ± 1.5, p = 0.02), time to LVC (405.3 ± 124.2 ms vs. 366.6 ± 154.4 ms, p = 0.04), and latency of the N1 peak of pSEPs (88.3 ± 17.1 ms vs 74.4 ± 17.6 ms, p = 0.007) and had significant changes in brain activation. Improvement in time to LVC correlated significantly with N1 peak latency (p = 0.03), and salivary substance P increased by 75.8%. In contrast, the biomechanics and neurophysiology of the swallowing response in the 19 patients of the placebo group did not show significant improvement.
DiscussionTwo weeks of capsaicin stimulation in older patients with OD were found to improve sensory and motor swallowing functions by enhancing pharyngeal sensitivity and reducing the time to LVC.
ConclusionCapsaicin administered over 2 weeks was found to improve swallowing safety and the biomechanics and neurophysiology of the swallowing response. TRPV1 agonists could be the basis of long-term pharmacological treatments for OD.
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Post-Herpetic Neuralgia: Review of Pathophysiology, Mechanisms, and Drug Treatment
Authors: Xin Yan, Yufan He, Yuwan Yue, Chuan Zhang, Hanfeng Yang and Peilin ZhaoAvailable online: 27 October 2025More LessPost-herpetic neuralgia (PHN) is the most common complication of Herpes zoster infection. Although numerous targeted therapeutic drugs have been developed, it is difficult to achieve a complete cure. Abnormalities in neural circuits, ion channels, inflammatory factors, and gene regulation are crucial factors contributing to the development of PNH; however, the underlying mechanism remains unclear. Therefore, a comprehensive understanding of the underlying mechanisms of PNH is critical for advancing research and developing novel therapeutic strategies. Based on the latest findings, we systematically reviewed the current understanding of PHN mechanisms and corresponding treatment options and provided a comprehensive reference for future studies.
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Pleiotropic Actions of Gastrodia Elata Glucosides in the Treatment of Painful Neuropathies and CNS Disorders: Focus on Mitochondrial Dysfunction and Modulation of Ion Channels
Available online: 24 October 2025More LessGlycosides contained in Gastrodia elata have consistently shown neuroprotective and anti-inflammatory activity in preclinical models of neurological disorders, including peripheral neuropathies, cerebrovascular disorders, and chronic neurodegenerative disorders. In a commercial product used in Italy, gastrodin has replaced α-lipoic, the use of which is now limited by unexpected adverse effects, such as severe hypoglycemia. The clinical efficacy of gastrodin in traditional Chinese medicine has been ascribed to a plethora of mechanisms, which involve the modulation of intracellular signaling pathways and membrane ion channels. Moving from the pathophysiology of diabetic neuropathy, Alzheimer’s disease, and Parkinson’s disease, we now focus on what we consider a key mechanism in the action of gastrodin, i.e., the regulation of mitochondrial quality control. Gastrodin is able to enhance mitochondrial fusion and biogenesis, as shown by the induction of specific biochemical markers, such as mitofusins and mitochondrial transcription factors. This supports mitochondrial health, preventing the loss of energy production and formation of reactive oxygen species associated with disorders of the central and peripheral nervous system. In addition, gastrodin physically interacts with, and restrains the expression and activity of, voltage-sensitive ion channels and acid-sensing ion channels, which play a central role in pain transmission and nociceptive sensitization. Thus, gastrodin and other constituents of Gastrodia elata show promising potential to support first-line treatments, based on preclinical evidence in models of neurological disease.
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Impaired Glucose Metabolism in Young Patients with First-episode Schizophrenia Aged from 16 to 35 Years
Authors: Jing Yao, Nan Chen, Meihong Xiu, Fengchun Wu and Yuanyuan HuangAvailable online: 22 October 2025More LessBackgroundPrevious studies in drug-naïve, first-episode patients with schizophrenia (FES) suggest glucose metabolism differences in the early stage of psychosis. However, we have limited knowledge of abnormalities in glucose metabolism in young and drug-naïve FES patients.
MethodsA total of 162 drug-naïve patients with schizophrenia (aged from 18 to 35 years) and 110 age-, sex-matched healthy control subjects were enrolled. Fasting glucose, fasting insulin, glycated hemoglobin (HbA1c), and insulin resistance (HOMA-IR) index were measured in patients and control subjects.
ResultsWe found that young drug-naïve FES patients exhibited abnormal glucose metabolism compared with control subjects. Fasting insulin, fasting glucose, and HOMA-IR were higher in patients than in controls (all p<0.05). In addition, female patients had significantly higher fasting insulin levels and HOMA-IR than male patients (both p<0.05), as well as in the healthy controls. Binary logistic regression analysis further identified that smoking status, HOMA-IR, and HbA1c were the contributing factors to schizophrenia, after controlling for age and sex.
ConclusionThis study suggests abnormal glucose metabolism in young drug-naïve FES patients, highlighting that these glucose metabolic issues are present at the very early stage of the disease. The identification of abnormal glucose metabolism at the early stages of schizophrenia provides insights into the biological underpinnings of schizophrenia and may lead to more targeted interventions for patients in the early stages of the disease.
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Gender Differences in Suicidal and Self-Harming Responses to Esketamine: A Real-World Retrospective Study
Available online: 20 October 2025More LessIntroductionTreatment-resistant depression (TRD) is a severe psychiatric condition that may increase the risk of suicidal thoughts and self-harming behaviors. Intranasal esketamine has emerged as an effective treatment for TRD, also addressing depression-related emergencies such as suicidal ideation.
MethodsThis retrospective observational study analyzed 26 outpatients with TRD treated with adjunctive intranasal esketamine alongside ongoing oral antidepressants for 4 weeks. Suicidal ideation and behaviors were assessed using the Columbia-Suicide Severity Rating Scale (C-SSRS), and depressive symptoms were evaluated with the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline, week 2, and week 4. Statistical analyses included repeated-measures ANOVA and subgroup analyses by gender and baseline self-harm profile.
ResultsEsketamine significantly reduced suicidal ideation and depressive symptoms from baseline to week 2 and week 4 (all p<.001). Additionally, non-suicidal self-harm declined, exhibiting gender-specific patterns: women demonstrated a faster reduction in non-suicidal self-harm, whereas men showed slower improvement in suicidal self-harm. A strong correlation between depressive symptoms and suicidality confirmed their interplay.
DiscussionIn our real-world TRD sample, adjunctive intranasal esketamine led to a rapid and sustained reduction in suicidality and depressive symptoms, with distinct gender-related patterns in self-harm trajectories. These findings may inform individualized monitoring strategies. Limitations include the small sample size, retrospective design, and lack of a control group.
ConclusionEsketamine rapidly improved suicidality and depression in TRD, with preliminary evidence suggesting gender-specific responses, and highlighting the importance of tailored interventions to maximize outcomes. Further research is needed to confirm these differences, explore the long-term effects, and understand the underlying mechanisms.
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MRS Perspectives: Neurotransmitter and Metabolic Alterations in Cognitive Decline and Mental/Neurological Disorders
Authors: Ruijuan Chen, Huimin Zhang, Lengjie Huang, Silin Liu, Huiquan Wang and Fei GaoAvailable online: 20 October 2025More LessCognitive function refers to the brain's ability to process information and perform various cognitive tasks. These include sustaining attention, acquiring knowledge, storing memories, executing complex functions, accurately expressing language, perceiving external stimuli, and maintaining spatial orientation. Numerous studies have demonstrated that good cognitive function is closely linked to the balance and normal function of neurobiochemical metabolites. Magnetic Resonance Spectroscopy (MRS), as a non-invasive and quantitative advanced neuroimaging technique, can accurately measure the concentration and distribution of neurobiochemical metabolites in the brain. This provides rich data and key insights for in-depth research on cognitive function and related clinical disorders. This paper comprehensively reviews MRS and its quantitative research on biochemical metabolites in the field of cognitive function. It aims to deeply evaluate the clinical value and significance of the metabolic substances involved in this technology for the early detection and diagnosis of mental and neurological diseases caused by cognitive decline. The goal is to provide useful references and inspiration for research and practice in this domain.
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Role of Traditional Chinese Medicine Formulations in Reducing Neuroinflammation and Oxidative Stress in Alzheimer’s Disease
Authors: Qi Qu, Yanfei Tong, Shengwu Liao and Shaogang QuAvailable online: 17 October 2025More LessAlzheimer’s disease (AD) is the most prevalent neurodegenerative disease among older people. AD can cause memory loss and neuropsychiatric abnormalities. AD pathogenesis is complicated. Oxidative stress and chronic neuroinflammation are believed to contribute to the occurrence and progression of AD. Oxidative stress refers to a harmful state of neurons caused by an impaired antioxidant system and abnormal accumulation of reactive oxygen species (ROS) in the brain of a patient with AD. Neuroinflammation often results from a series of harmful responses to neurons induced by the overactivated microglia and astrocytes, such as the secretion of proinflammatory cytokines and promotion of neuronal apoptosis. Several studies have demonstrated that inhibition of oxidative stress and neuroinflammation can alleviate AD symptoms, suggesting that they may serve as potential targets for drug development. Herein, we review the mechanism of oxidative stress and neuroinflammation. Additionally, we have summarized data from preclinical studies published between 2019 and 2024 that investigate traditional Chinese medicine (TCM) formulations used to treat AD through the modulation of oxidative stress and neuroinflammation. We have included information on the extracts, compounds, modified compounds, and novel delivery systems for TCM formulations and summarized the key mechanisms involved in their actions.
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Therapeutic Potentials of Anesthetics
Authors: Cheng Zhou and Ji HuAvailable online: 15 October 2025More Less
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Delivery of Nerve Growth Factor via Exosome Attenuates Neuropathic Pain in a Rat Model of Chronic Constriction Injury
Authors: Yangyi Li, Chengbo Chen, Changsheng Su, Shunyuan Li, Zhibin Wen and Yifan ZhengAvailable online: 08 October 2025More LessIntroductionThe nerve growth factor (NGF) is a crucial neurotrophic factor with the ability to induce neuronal differentiation. However, whether NGF-loaded exosomes (Exo-NGF) can alleviate neuropathic pain in chronic constriction injury (CCI) rats remains unclear.
MethodsA neuropathic pain model was established using CCI rats. The pain was assessed using the von Frey test and the hot plate test. Exo-NGF was collected from HEK293 cells transfected with an NGF plasmid. The diameter of Exo-NGF was determined using transmission electron microscopy. Protein levels of inflammatory factors, including IL-18, IL-1β, and TNF-α, were measured using enzyme-linked immunosorbent assay, and their mRNA levels were evaluated using qPCR. The NOD-like receptor family pyrin domain-containing protein 3 (NLRP3) protein levels were determined using immunostaining and Western blot.
ResultsNGF protein and mRNA were highly expressed in Exo-NGF. The mRNA in Exo-NGF was successfully delivered into neural stem cells and promoted their differentiation. Injection of Exo-NGF into the spinal dorsal horn significantly alleviated mechanical allodynia and thermal hyperalgesia. Additionally, Exo-NGF reduced levels of IL-18, IL-1β, and TNF-α. NLRP3 and its key components, including apoptosis-associated speck-like protein and caspase-1, were also reduced by Exo-NGF treatment in CCI rats.
DiscussionOur findings highlight the therapeutic potential of exosome-based NGF delivery for treating chronic pain conditions.
ConclusionExo-NGF significantly alleviates neuropathic pain by suppressing inflammation and NLRP3 activation.
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Protein Kinases in Alzheimer’s Disease: Pioneering Insights into Pathogenesis and Therapeutic Breakthroughs
Authors: Mohd Qasid Lari, Ajay Kumar, Astik Manju Ashesh, Deepak Kumar, Bhupendra Singh and Dileep KumarAvailable online: 08 October 2025More LessAlzheimer's Disease (AD) is an exhausting neurodegenerative condition marked by the build-up of abnormal protein aggregates in the brain and a progressive loss of cognitive function. The complicated role that protein kinases play in the pathophysiology of AD has come to light more and more in recent years. The symptoms of AD include memory loss, cognitive impairment, and neuronal malfunction. Many cellular processes, including synaptic plasticity, neuronal survival, and protein homeostasis, have been linked to protein kinases, a class of enzymes that control phosphorylation. The etiology of AD has been closely related to the dysregulation of protein kinases, including those implicated in the phosphorylation of tau and the formation of amyloid-beta. GSK-3, also known as glycogen synthase kinase, is one of the most studied protein kinases in Alzheimer's disease. It is known that GSK-3 phosphorylates tau protein, causing it to clump together and create neurofibrillary tangles. Moreover, GSK-3 activation increases the development of amyloid-beta, which furthers the disease's progression. Additional protein kinases, including Cyclin-Dependent Kinase 5 (CDK5) and calcium/calmodulin-dependent protein kinase II (CaMKII), have also been connected to tau phosphorylation and synaptic dysfunction in AD. Protein kinases play a crucial role in the pathophysiology of AD, extending beyond tau phosphorylation. Research has shown that Amyloid Precursor Protein (APP) processing is regulated by Protein Kinases A (PKA) and C (PKC), which affects the production and clearance of amyloid-beta. Furthermore, AD etiology involves oxidative stress, neuroinflammation, and mitochondrial dysfunction, all of which are regulated by protein kinases. This study will cover the effects of protein kinases in AD, focusing on their role in tau phosphorylation, an attribute of the disease. We will also address the role of protein kinase in the development of amyloid-beta, synaptic malfunction, and neuroinflammation.
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Lurasidone vs. Other Antipsychotics as Augmentation Strategies for Clozapine in Treatment-resistant Schizophrenia: An Observational Multicenter Prospective Study
Available online: 08 October 2025More LessIntroductionClozapine, after its introduction, reshaped the landscape of Treatment-Resistant Schizophrenia (TRS) treatment, becoming the first-line treatment for that condition. However, many patients fail to respond to this drug alone. Clozapine-resistant schizophrenia (CRS) is associated with a more severe clinical presentation than TRS, manifesting in exacerbated symptoms and significantly diminished quality of life. The complex nature of CRS has prompted the development of augmentation strategies, which most commonly include another antipsychotic. The present multicenter observational study aimed to assess and compare the efficacy of Lurasidone augmentation alongside clozapine versus other second-generation antipsychotic combinations in patients with a schizophrenia spectrum disorder.
MethodsA total of 45 patients with a diagnosis of a schizophrenia spectrum disorder and labeled as “treatment resistant” were included. Functional and psychometric assessments were made at the baseline, one month, and six months after the treatment. A linear mixed-effect regression was performed along with other appropriate statistical analyses.
ResultsA significant improvement over time was observed in the two groups for both the clinical and functional outcomes assessed, demonstrating the efficacy of a proper augmentation strategy in CRS management. Moreover, significantly lower psychiatric ward admissions were observed in the lurasidone group (p<.05).
DiscussionOur findings suggest that lurasidone augmentation in CRS offers significant improvements in psychopathological domains similar to alternative augmentation strategies.
ConclusionAlthough further studies are needed to confirm our findings, lurasidone’s favorable side-effect profile should be considered.
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In Vitro and In Vivo Evaluation of Kai-Xin-San Polysaccharides: Antioxidant, Anti-Inflammatory, and Anti-Alzheimer's Disease Activities
Authors: Yongchang Xiong, Lifen Zhou, Min Zhang, Jian Liang, Qin Zheng, Ying Chen, Zhinan Cai, Lide Yu and Jinbin YuanAvailable online: 07 October 2025More LessIntroductionAlzheimer's disease (AD) brings a considerable burden to families and society. Kai-Xin-San (KXS) is a traditional Chinese medicine formula used to treat AD with a good curative effect. The existing literature and our previous work suggest that KXS polysaccharides (KXS-P) may play an important role in the anti-AD effect of KXS. However, there is limited research available on the KXS-P and its potential anti-AD activities.
ObjectiveTo investigate the in vitro antioxidant, acetylcholinesterase (AChE) inhibitory effects, and anti-inflammatory activities of KXS-P, as well as to evaluate its anti-AD effect in vivo.
MethodsKXS-P was characterized using scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FT-IR), and high-performance liquid chromatography (HPLC). The in vitro antioxidant activity and AChE inhibitory effects were evaluated. The in vitro anti-inflammatory activity of KXS-P was assessed using LPS-stimulated RAW264.7 cells. The in vivo anti-AD effects of KXS-P were evaluated using a rat model induced by D-galactose and Aβ25-35. The pharmacodynamic experiments included general behavior, open field test, Morris water maze, laser Doppler flowmetry, histopathological analysis (Nissl and HE staining), enzyme-linked immunosorbent assay (ELISA), and immunohistochemistry.
ResultsKXS-P exhibited stronger antioxidant activity than single herb polysaccharides. KXS-P showed significant AChE inhibitory effects. KXS-P significantly inhibited the release of NO, TNF-α, IL-1β, and IL-6 in LPS-stimulated RAW264.7 cells. KXS-P effectively alleviated symptoms in AD model rats. Open-field tests and water maze tests demonstrated that KXS-P improved cognitive, learning, and memory functions in AD model rats. Laser Doppler flowmetry showed that KXS-P had a limited effect on cerebral blood flow in AD model rats. Nissl staining and immunohistochemistry of rat hippocampal tissue indicated that KXS-P protected hippocampal neurons. HE staining of rat colon revealed that KXS-P alleviated inflammation induced by intestinal flora imbalance.
ConclusionKXS-P exhibited potent anti-oxidation, anti-inflammatory activities and AChE inhibitory effects in vitro, as well as anti-AD effects in vivo. The anti-AD mechanism may be related to antioxidant effects, AChE inhibition, anti-inflammatory properties, and neuroprotection.
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Resveratrol Supplementation Modulates Endothelial Dysfunction in Alzheimer’s Disease (AD): In Vitro Effects on Human Aortic Endothelial Cells Exposed to AD Plasma
Available online: 06 October 2025More LessIntroductionIncreasing evidence indicates a connection between Alzheimer’s disease (AD) and endothelial dysfunction. Given the lack of a definitive cure for AD, the purpose of this research was to explore the impact of a short incubation with plasma samples obtained from 30 patients with sporadic AD and 21 age- and sex-matched control subjects on cultured human aortic endothelial cells (HAECs), as well as to assess the effects of resveratrol (RSV) supplementation to the plasma.
MethodsSpecifically, the study analyzed: the production of nitric oxide (NO) and peroxynitrite; the activities of superoxide dismutase (SOD) and Na+/K+-ATPase; membrane fluidity; and levels of thiobarbituric acid-reactive substances (TBARS).
ResultsWhen incubated with AD plasma, cells showed a decrease in NO levels, enzymatic activities, and membrane fluidity, as well as an increase in peroxynitrite and TBARS production, compared to those exposed to plasma from healthy controls. In contrast, supplementation with RSV-enriched plasma, reduced reactive oxygen species (ROS) levels, and enhanced SOD activity. RSV also improved endothelial function, by increasing membrane fluidity, Na+/K+-ATPase activity, and enhancing NO production and bioavailability, potentially benefiting cerebral perfusion.
DiscussionThough preliminary, our findings highlight the critical role played by vascular health in Alzheimer’s disease, and the potential impact of resveratrol in maintaining the endothelial integrity, thus mitigating the progression of AD .
ConclusionIn conclusion, our study supports the use of dietary natural compounds to reduce oxidative stress and prevent or reverse vascular endothelial dysfunction associated with AD.
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A Novel Network Pharmacology Strategy for Retrieving a Key Functional Component Group and Mechanisms in the Di-Huang-Yin-Zi Treatment of Parkinson's Disease
Authors: Qi Qu, Yanfei Tong, Yi Li, Han Zhang, Jianhua Yang, Zongwei Cai, Siqiang Ren, Daogang Guan and Shaogang QuAvailable online: 02 October 2025More LessIntroductionParkinson’s Disease (PD) is a common and difficult-to-cure chronic neurodegenerative disorder. Current medications often target a single pathway and can have certain side effects. In contrast, traditional Chinese medicine formulas, such as Di-Huang-Yin-Zi (DHYZ), with their multi-component and multi-target characteristics, offer potential advantages by addressing these limitations, making them worthy of in-depth study.
MethodsComponents of DHYZ were collected from public databases and literature. After screening, the remaining components underwent target prediction, and the predicted component-target pairs were used to construct the complex component-target network. A novel node importance algorithm, known as the fusion model, was applied to construct an effective space from the component-target network, thereby reducing redundancy. Meanwhile, the pathological genes were extracted from DisGeNET and GeneCards to judge the quality of effective space. The effective space was compared with other widely used network parameters to validate its efficiency, and the Key Functional Compound Group (KFCG) was inferred from the effective space. Finally, the protective mechanism of DHYZ was inferred based on the KFCG and was validated in the in vitro PD model.
ResultsCompared to other commonly used algorithms, the effective space identified by the fusion model more accurately represented the full spectrum of DHYZ’s targets and demonstrated stronger correlation with PD. Additionally, we utilized the component contribution ratio algorithm to identify the KFCG within the effective space. Through enrichment analysis, we hypothesized that KFCG may exert its anti-PD effects via the PI3K-Akt, MAPK, and AMPK pathways and validated these mechanisms in vitro.
DiscussionCollectively, the results of this study not only deepen our understanding of the therapeutic potential of DHYZ in the treatment of PD but also enhance the clinical translatability of DHYZ through formula optimization. However, this study has certain limitations. For instance, the pathogenic genes of PD were not incorporated into the network in this study, and the use of an undirected network may offer lower biological interpretability compared to a directed network.
ConclusionThis robust and precise algorithm allowed us to optimize Di-Huang-Yin-Zi. This provided preliminary insights into its potential molecular mechanisms for treating PD, laying a foundation for the secondary development of other formulas.
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Ginsenoside Rg2 Ameliorates Alzheimer's Disease by Alleviating Neuroinflammation in APP/PS1 Mice
Authors: Dilida Yeerkenbieke, Yue Guan, Jing Cui, Qianqian Zhang, Gong Wang, Yifa Zhou, Zhiping Li, Chunyue Wang and Di WangAvailable online: 26 September 2025More LessIntroductionGinsenoside Rg2 (GRg2), a naturally occurring triterpenoid derived from ginseng rhizomes, exhibits neuroprotective properties. Neuroinflammation is recognized as one of the key pathogenic mechanisms underlying Alzheimer's disease (AD). This research aims to investigate the beneficial effects of GRg2 on AD and explore its potential mechanisms.
MethodsIn APP/PS1 mice, cognitive and behavioral assessments were first performed. Subsequently, brain tissue analyses were performed using immunohistochemical analysis and Western blot. A combined analysis of the gut microbiome and metabolomics was conducted to explore potential mechanisms. Finally, key findings were further validated through immunofluorescence and enzyme-linked immunosorbent assay.
ResultsGRg2 enhanced learning, memory, and cognitive functions. And inhibits the deposition of β-amyloid and phosphorylated tau. GRg2 effectively inhibits the production of Bacteroides and Helicobacter. In addition, it reduced the levels of pyruvaldehyde and trimethylamine N-oxide, metabolites closely related to neuroinflammation. GRg2 effectively inhibited the activation of astrocytes and microglia in the brains of APP/PS1 mice, and also reduced the expression of neuroinflammatory mediators IL-6, IL-1β, and TNF-α.
DiscussionsThe findings of this study substantiate the neuroprotective efficacy of GRg2, providing a novel therapeutic strategy and theoretical foundation for natural product-based interventions against AD.
ConclusionGRg2 improves cognitive function and mitigates AD pathology, which is at least partially attributed to its regulation of gut microbiota and metabolites, as well as its anti-neuroinflammatory effects.
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Molecular Mechanisms of cGAS-STING Axis and Mitochondrial Dysfunction-Related Diseases in Humans: A Comprehensive Review
Authors: Xingtong Shen, Hantao Chen, Jishan Zheng, Yunyan Ma, Zhengzhen Tang, Hongqin Sun, Qian Zhang, Jidong Zhang and Tao SongAvailable online: 25 September 2025More LessMitochondria play a critical role in immune cell differentiation, activation, and the regulation of innate immune responses. The cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway is a key mediator of cytosolic DNA sensing and contributes to a broad spectrum of pathological processes, including infectious diseases, sterile inflammation, cancer, and autoimmune disorders. STING is activated in response to cytosolic DNA during infection and can restrict translation in RNA virus-infected cells as part of the innate immune response. Studies have shown that mitochondrial dysfunction, particularly the release of mitochondrial DNA (mtDNA), can act as a potent trigger of cGAS-STING signaling, linking mitochondrial damage to immune activation. Additionally, this pathway intersects with autophagy, metabolic regulation, and cell death mechanisms. This comprehensive review summarizes current advances in understanding the cGAS-STING axis and mtDNA release in the context of mitochondrial dysfunction, with a focus on their roles in disease pathogenesis and potential as therapeutic targets. We highlight recent progress in the development of targeted interventions and emphasize the importance of elucidating the regulatory mechanisms underlying STING activation in various pathological conditions, including neuroinflammation, cancer, ischemia/reperfusion injury, and autoimmune diseases.
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Neural Circuit Mechanisms of General Anaesthesia Induction: Current Advances and Future Directions
Authors: Yanfang Yin, Yaxin Teng, Wenying Chi, Xinyuan Zhang, Haozhe Qiao, Xiaoyong Zhao and Meiyan SunAvailable online: 24 September 2025More LessGeneral anaesthesia is traditionally divided into three distinct stages: induction, maintenance, and recovery. However, much of the existing literature has primarily focused on elucidating the mechanisms involved in the recovery phase, yielding several notable advancements. It is essential to recognize, however, that the induction and recovery phases represent two distinct processes. Studies in the induction phase have mainly centred on the impact of inhalational and intravenous anaesthetics on neural circuits, particularly those in the cortical and subcortical nuclei, as well as their specific effects on various neurotransmitters. Yet, the precise neural circuit mechanisms underlying anaesthetic induction still require further exploration. General anaesthetics influence neural circuitry by targeting neurons in particular nuclei, with their effects varying according to the distinct properties of individual anaesthetic agents. During the induction of anaesthesia, both the cortex and subcortical nuclei are significantly involved, with the inhibition of the subthalamic nucleus considered a core mechanism underlying this process. Notably, the periventricular thalamus, as part of the thalamus structure, holds particular importance in regulating the loss of consciousness. Additionally, the spinal cord and peripheral nervous system may play a potentially important role during the induction phase of general anaesthesia. Gaining a deeper understanding of the mechanisms underlying anaesthetic induction could reveal potential neuroanatomical targets that elucidate the alterations in consciousness during this phase of general anaesthesia. Such insights are invaluable in the quest for more effective, precise, and controllable anaesthetic practices, thereby enhancing the selection and combination of anaesthetic agents.
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PGx-Based in silico Analyses Identifies the Interactive Role of Genes, Glucose Metabolism and Dopaminergic Dysfunctional Pathways with Chronic Cocaine Use and Misuse
Authors: Alireza Sharafshah, Panayotis K. Thanos, Albert Pinhasov, Abdalla Bowirrat, Colin Hanna, Kai-Uwe Lewandrowski, Christopher Rowan, Igor Elman, Mark S. Gold, Catherine A. Dennen, Edward J. Modestino, Rajendra D. Badgaiyan, David Baron, Brian Fuehrlein, Ashim Gupta, Jean Lud Cadet, Aryeh R. Pollack, Jag Khalsa, Milan Makale, Alexander P.L. Lewandrowski and Kenneth BlumAvailable online: 23 September 2025More LessIntroductionOur team conducted a pharmacogenomics (PGx) analysis to evaluate the interactions between cocaine, glucose metabolism, and functional connectivity using in-depth silico PGx methods.
MethodsUtilizing PharmGKB, we extracted PGx annotations related to cocaine, glucose, and dopamine (raw data). After filtering, we refined a list of 49 unrepeated, brain-expressed genes and examined their interactions in a protein-protein interaction (PPI) network through STRING-MODEL, identifying top candidate genes.
ResultsTargeting key protein-coding genes with the highest connectivity, we identified COMT, DRD2, and SLC6A3, along with their 17 connected genes. A deep dive into gene-miRNA interactions (GMIs) using NetworkAnalyst revealed that COMT, DRD2, and hsa-miR-16-5p have multiple interactions with OPRM1 and BDNF. Enrichment analysis via Enrichr confirmed that this refined set of 17 impacts dopamine function and are interactive with dopaminergic pathways. Notably, Substance Use disorders (SUD) were the most significant manifestation predicted for the interplays among these genes.
DiscussionReviewing all PGx annotations for the 17 genes, we found 4,665 PGx entries, among which 1,970 were significant, with a p-value above 0.045. These were ultimately filtered down to 32 potential PGx annotations excluded in association with “Cocaine,” “Glucose or Diabetes,” and “Dopamine”. Accordingly, 12 Pharmacogenes represented 32 PGx-associated with Cocaine, Glucose, and Dopamine, including DRD2, COMT, OPRD1, OPRM1, SLC6A3, CHRNA5, CNR1, CYP2C19, DBH, GABRA2, NOS1AP, and SYT1.
ConclusionThis in silico PGx analysis demonstrates strong, validated connections based on prior published data and robust computational predictions. Among the findings, the COMT gene was found to be the best-scoring gene here.
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Unraveling the Role of Perivascular Macrophages in Alzheimer's Disease: Insights from the Crosstalk between Immunometabolism and Ferroptosis
Authors: Xiaolei Miao, Wei Yue, Jinxu Wang, Jiahui Chen, Lei Qiu, Halisa Paerhati, Qin Zhou, Pengyi Li, Anshi Wu and Minhao ZhangAvailable online: 18 September 2025More LessIntroductionRecent evidence increasingly supports a potential role of Perivascular Macrophages (PVMs), a unique subpopulation of brain immune cells, in the pathogenesis of Alzheimer’s disease (AD). Strategically positioned at the brain-vasculature interface, PVMs sense the redox status, modulate immunity, and potentially influence ferroptosis—an iron-dependent form of regulated cell death increasingly implicated in AD. However, whether the involvement of PVMs in AD pathology specifically entails mechanisms related to the crosstalk between immunometabolism and ferroptosis, and the precise molecular pathways linking PVMs, immunometabolism, and ferroptosis to AD, remains unclear.
MethodsWe first obtained single-cell RNA sequencing data of PVMs from AD patients and control subjects via the GEO database, identified Differentially Expressed Genes (DEGs), and applied Mendelian Randomization (MR), with robustness validated via leave-one-out analysis to pinpoint key genes among the DEGs with causal relevance to AD. Next, we identified ferroptosis-related genes within these key genes and examined their associations with immune cell infiltration and immunometabolic signaling pathways, while also predicting their regulatory transcription factors to inform potential therapeutic strategies.
ResultsWe identified 149 DEGs in PVMs between AD and control groups, which were primarily enriched in immune and metabolic pathways. MR analysis established eight genes (ACSL1, SPATA6, RAB31, NIBAN1, HDAC4, GRAMD1B, GCC2, and DENND3) as causally and negatively associated with AD risk (IVW analysis identified all P < 0.05, with robustness confirmed by leave-one-out analysis), with ACSL1 being recognized as a known ferroptosis driver. Immune cell infiltration analysis revealed significant differences in monocyte and neutrophil proportions in AD, with DENND3 identified as the sole gene significantly correlated with monocyte abundance. The Key genes demonstrated distinct associations with immunometabolic pathways: GRAMD1B expression was positively associated with PI3K/AKT/mTOR signaling, whereas both NIBAN1 and SPATA6 showed enrichment in cells with high Notch signaling activity. ACSL1 exhibited robust associations with multiple pathways implicated in ferroptosis, including the IL-6/JAK/STAT3, interferon-γ, TGF-β, bile acid metabolism, and cholesterol homeostasis pathways, suggesting potential mechanisms that mediate the crosstalk between immunometabolism and ferroptosis. Transcription factor analysis highlighted shared regulation by CEBPD and the SP1/2/3/4 family, indicating convergent transcriptional control of these genes.
ConclusionThis study identifies eight key genes in PVMs that may protect against AD through mechanisms involving the interplay between immunometabolism and ferroptosis. Our findings provide novel insights into the function of PVMs in AD pathophysiology and suggest potential therapeutic targets for this devastating neurodegenerative disease.
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An Efficient Neuro-framework for Brain Tumor Classification Using a CNN-based Self-supervised Learning Approach with Genetic Optimizations
Authors: Paripelli Ravali, Pundru Chandra Shaker Reddy and Pappula PraveenAvailable online: 15 September 2025More LessIntroductionAccurate and non-invasive grading of glioma brain tumors from MRI scans is challenging due to limited labeled data and the complexity of clinical evaluation. This study aims to develop a robust and efficient deep learning framework for improved glioma classification using MRI images.
MethodsA multi-stage framework is proposed, starting with SimCLR-based self-supervised learning for representation learning without labels, followed by Deep Embedded Clustering to extract and group features effectively. EfficientNet-B7 is used for initial classification due to its parameter efficiency. A weighted ensemble of EfficientNet-B7, ResNet-50, and DenseNet-121 is employed for the final classification. Hyperparameters are fine-tuned using a Differential Evolution-optimized Genetic Algorithm to enhance accuracy and training efficiency.
ResultsEfficientNet-B7 achieved approximately 88-90% classification accuracy. The weighted
ensemble improved this to approximately 93%. Genetic optimization further enhanced accuracy by 3-5% and reduced training time by 15%.
DiscussionThe framework overcomes data scarcity and limited feature extraction issues in traditional CNNs. The combination of self-supervised learning, clustering, ensemble modeling, and evolutionary optimization provides improved performance and robustness, though it requires significant computational resources and further clinical validation.
ConclusionThe proposed framework offers an accurate and scalable solution for glioma classification from MRI images. It supports faster, more reliable clinical decision-making and holds promise for real-world diagnostic applications.
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Myocardial Inflammation as Key Mediator of Heart-brain Interaction After Myocardial Ischemia/Infarction: Mechanistic Exploration of Post-Myocardial Infarction Cognitive Dysfunction
Authors: Linhan Wang, Meng Mao, Hailong Bing, Wei Xu, Wangli Tian, Xuan Wang, Zhengyuan Xia and Qinjun ChuAvailable online: 15 September 2025More LessMyocardial Infarction (MI) is a severe cardiovascular event, causing not only substantial damage to the heart but also potentially exerting a profound impact on brain function through a complex cardiac-brain interaction mechanism. The pathological process of MI encompasses myocardial cell necrosis, inflammatory cell infiltration, and the release of a substantial amount of inflammatory mediators. Through the bloodstream, these myocardial mediators may traverse the Blood-Brain Barrier (BBB), eliciting a neuroinflammatory response that can lead to cognitive dysfunction. This article proposes a critical research direction: investigating whether MI mediates the effects of myocardial-derived mediators on the permeability of the BBB, as well as the potential consequences of these mediators on cognitive functions. This review is aimed at triggering future research to elucidate the underlying mechanisms governing heart-brain interactions after MI in order to facilitate the development of more effective cognitive protection strategies for patients with MI.
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Advances in the Mechanism of ceRNA Regulation in Postoperative
Authors: Qiang Liu, Lin-Hui Ma, Chen-Rui Zhou, Tian-Qi Chen, Wei-Feng Wu, Hui-Hui Miao, Yu-Qing Wu and Cheng-Hua ZhouAvailable online: 11 September 2025More LessPostoperative cognitive dysfunction (POCD) is a common central nervous system complication in elderly patients after surgery, characterized by cognitive changes, including impaired learning and memory, reduced attention, and mental disorders and personality changes in severe cases. Despite extensive research, effective targeted therapies remain elusive, underscoring the urgent need to elucidate their molecular mechanisms and identify novel therapeutic targets. Non-coding RNAs (ncRNAs), major transcription products of the human genome, are highly expressed in the central nervous system and play critical roles in regulating neuronal and synaptic complexity through interactions with other biomolecules. Notably, certain ncRNAs modulate gene expression networks by regulating miRNAs, a phenomenon known as the competing endogenous RNA (ceRNA) mechanism. In this review, we summarized and analyzed emerging evidence on ceRNA-mediated regulatory mechanisms in POCD pathogenesis, aiming to establish a foundation for future mechanistic exploration and therapeutic development.
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MAPT Haplotype Variation and Alzheimer’s Disease Risk: A Narrative Review with Focus on the Jordanian Population
Authors: Alaa A.A. Aljabali, Almuthanna K. Alkaraki and Mohammad A. ObeidAvailable online: 10 September 2025More LessIntroductionGenetic variations in the microtubule-associated protein tau (MAPT) gene play a central role in Alzheimer's disease (AD) pathogenesis. Two major MAPT haplotypes, H1 and H2, show differential associations with tau expression and AD risk. However, data from Middle Eastern populations remain limited, restricting our understanding of population-specific disease susceptibility patterns and therapeutic responses.
MethodsWe conducted a comprehensive literature review using PubMed, Scopus, and Web of Science databases. Search terms included “MAPT haplotype,” “Alzheimer's disease,” “H1 H2,” “tau pathology,” and “pharmacogenetics.” We analyzed peer-reviewed articles published between 2000 and 2024, focusing on studies reporting haplotype frequencies, MAPT expression levels, APOE interactions, and clinical outcomes. This review synthesizes published data without generating new experimental results.
ResultsThe H1 haplotype consistently associates with increased MAPT expression, tau accumulation, and elevated AD risk, particularly in APOE ε4 noncarriers. Conversely, the H2 haplotype appears protective, correlating with reduced tau burden and slower cognitive decline. Notably, recent reports reveal significant overrepresentation of the H2 haplotype in the Jordanian population compared to European and East Asian cohorts, where H2 frequency is substantially lower or absent. This distinct genetic architecture suggests altered regional AD risk profiles.
DiscussionsThe elevated H2 frequency in Jordan represents a unique population-specific genetic signature that may influence regional AD susceptibility patterns. These findings challenge current risk models predominantly based on European populations and suggest the need for population-tailored approaches in neurodegenerative disease research. The naturally H2-enriched Jordanian cohort provides an exceptional opportunity to investigate protective mechanisms against tau pathology.
ConclusionMAPT haplotype distributions show significant population variation with important implications for AD risk assessment and therapeutic targeting. The high H2 frequency in Jordan warrants integration into personalized medicine frameworks and population-specific disease models, potentially informing more effective regional prevention and treatment strategies.
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The Role of Gut Bacteria and Plasma Metabolites in Predicting Post-Stroke Depression in Patients with Acute Ischemic Stroke
Authors: Lulu Wen, Tong Si, Chuming Yan, Huixin Shen, Wancheng Zheng, Meihong Xiu and Miao QuAvailable online: 09 September 2025More LessIntroductionEarly diagnosis of Post-Stroke Depression (PSD) is challenging. This study aimed to identify possible biomarkers in gut microbiota and plasma metabolites within 72 hours after Acute Ischemic Stroke (AIS) to predict PSD occurring 2 weeks later.
MethodIn this study, 86 patients with AIS were observed within 3 days of stroke onset and followed up for 2 weeks. We collected the feces and plasma within 72 hours of AIS onset for 16S rRNA sequencing and liquid chromatography-mass spectrometry analysis, respectively.
ResultsAt the genus level, PSD patients at 2 weeks following a stroke had a higher relative abundance of Blautia, Eubacterium_hallii_group, Tyzzerella, and a lower abundance of Ellin6067, Massilia, Luedemannella, and Gemmataceae_others within 3 days of AIS onset. Meanwhile, when all metabolites in plasma collected within 72 hours after AIS onset were used to predict 2-week PSD, 31 altered metabolites were identified, of which 28 metabolites increased and 3 decreased, belonging predominantly to steroid and steroid derivatives, glycerophospholipids, fatty acyls, and prenol lipids. The Area Under the Curve (AUC) values for the clinical data, metabolic profiles, gut microbiota, and combined dataset were 0.664 (0.549,0.779), 0.739 (0.621, 0.857), 0.870 (0.781,0.960), and 0.955 (0.888,1), respectively.
DiscussionOur study identified potential biomarkers from clinical data, gut bacteria, and plasma metabolites that contribute to PSD. Within 72 hours after AIS, combining these biomarkers from all three sources showed preliminary ability to predict PSD at 2 weeks. Metabolites had the highest contribution, followed by gut bacteria and clinical data.
ConclusionA biomarker panel including metabolites, gut microbiota, and clinical data within 72 hours after AIS onset could preliminarily predict PSD 2 weeks later.
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A Decade of Research on C9orf72 in Frontotemporal Dementia (2014-2024): A Bibliometric Analysis of Global Trends and Hotspots
Authors: Miao He, Sheng Zeng, Zhenchu Tang, Lixia Qin, Weiqian Yan, Chunyu Wang, Hainan Zhang, Zhao Chen and Zhe LongAvailable online: 28 August 2025More LessIntroductionFrontotemporal dementia (FTD) is the third most frequent dementia and the leading dementia subtype in individuals under 65. The discovery of C9orf72 (chromosome 9 open reading frame 72) GGGGCC abnormal expansion is a major genetic cause of both FTD and amyotrophic lateral sclerosis (ALS), linking these diseases along a clinicopathological spectrum. This study aimed to depict the research landscape of C9orf72 in FTD over the past decade, track emerging research hotspots, and provide insights into under-researched areas.
MethodBased on the Web of Science database, a bibliometric analysis was conducted to explore publication trends, key contributors, funding sources, journal categories, co-authorship networks, and keyword co-occurrence, clustering, and bursts.
ResultsA total of 1,220 articles were identified, with sustained output of over 100 articles annually. The majority of contributions and funding support came from North America and Europe. Hot research themes included hexanucleotide repeats, nucleocytoplasmic transport, disease mechanisms, and therapeutic targets.
DiscussionNorth America and Europe were highly productive, supported by higher regional prevalence, genetic burden, and robust funding. Ploy-GR in cerebrospinal fluid has emerged as a diagnostic biomarker. Pathogenic mechanisms remain complex, involving both gain- and loss-of-function effects. Metformin and antisense oligonucleotides were considered as potential therapeutics. Further research is needed in underrepresented populations and on the translational potential of emerging molecular targets.
ConclusionThis study offers a comprehensive overview of current trends and future directions over the past decade in C9orf72-related FTD research, allowing researchers—particularly those new to the area—to quickly understand the current landscape.
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Microglia-Neuron Interactions in Alzheimer’s Disease
Authors: Yujie Ma, Xinyue Wang, Minghuang Gao, Yeze Lin, Qini Chen, Hongyin Yang, Cong Yang and Qi WangAvailable online: 26 August 2025More LessAlzheimer's disease (AD) is a progressive disease characterized by significant cognitive decline, posing a substantial threat to life. Neuronal loss and dysfunction are responsible for the cognitive decline and behavioral disturbances observed in AD. Microglia are increasingly recognized for shaping the fate of neurons. However, the role of microglia-neuron interaction in neuronal degeneration of AD remains largely unclear. This review discusses microglia-mediated excessive synaptic pruning and microglia-neuron metabolic coupling in the neuronal degeneration of AD. It also summarizes the role of microglia-neuron interactions in classical pathogenic hypotheses such as the amyloid cascade, tau protein, neuroinflammation, and metal ions. It is found that microglia can serve as protectors of neurons, yet they also exacerbate neuronal damage under stress stimulation. This bidirectional modulation of microglia-neuron interaction provides a novel direction for rescuing AD neurons.
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Pharmacodynamics and Pharmacokinetics of Ublituximab Compared with Other Anti-CD20 Monoclonal Antibodies for Multiple Sclerosis Treatment
Available online: 26 August 2025More LessThe therapeutic scenario for multiple sclerosis (MS) has expanded rapidly over the last few years. Among the available treatments, anti-CD20 monoclonal antibodies, including rituximab, ocrelizumab, ofatumumab, and ublituximab, have shown significant results in reducing disease activity and slowing progression, particularly in relapsing MS. The distinct mechanisms of action, including the pharmacokinetic and pharmacodynamic profiles as well as the immunogenicity of these drugs, require careful consideration to tailor treatment for individual patients. A comprehensive review of the literature was conducted by searching PubMed and evaluating key studies, trials, and congress abstracts related to the use of anti-CD20 monoclonal antibodies. The analysis focused on the pharmacokinetic and pharmacodynamic profiles, as well as the immunogenicity, of anti-CD20 therapies currently available, with particular emphasis on the recently approved ublituximab. Ocrelizumab is effective in both relapsing-remitting and primary-progressive MS, using antibody-dependent cellular cytotoxicity (ADCC) as its primary mechanism of action, with intravenous and subcutaneous administration options ensuring flexible treatment delivery. Ofatumumab depletes B-cells through enhanced complement-dependent cytotoxicity, offering convenient monthly subcutaneous self-administration. Ublituximab’s unique glycoengineered fragment crystallizable region enhances ADCC, resulting in rapid B-cell depletion and potentially improving its safety profile. Ublituximab allows for a shorter infusion time without requiring post-infusion monitoring after the second dose, provided there have been no prior reactions. Understanding the characteristics of different anti-CD20 monoclonal antibodies is critical for optimizing treatment, enhancing patient outcomes, and minimizing treatment burden. Ublituximab represents a promising option, offering a shorter infusion time and higher ADCC activity, which complements existing treatments such as ocrelizumab and ofatumumab.
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Structural and Functional Determinants of ARIA-H Risk in Anti-Amyloid Monoclonal Antibodies: A Comparative Mechanistic Framework for Alzheimer's Immunotherapy Development
Authors: Dinghao An, Xinxin Zou and Yun XuAvailable online: 19 August 2025More LessIntroductionAmyloid-beta-targeting monoclonal antibodies (mAbs) for Alzheimer's disease frequently induce amyloid-related imaging abnormalities with hemorrhage (ARIA-H), yet systematic comparisons of ARIA-H incidence across therapeutic agents remain limited. Post-approval research prioritizes dosing over mechanism, leaving unresolved whether ARIA-H variations originate from intrinsic mAb properties. We address two gaps: comparative ARIA-H risk stratification among clinically available/investigational mAbs, and elucidation of structural/functional features influencing ARIA-H susceptibility.
MethodsA systematic comparison of seven mAbs (donanemab, aducanumab, bapineuzumab, lecanemab, gantenerumab, crenezumab, solanezumab) was conducted, analyzing clinical trial data and molecular characteristics.
ResultsARIA-H incidence ranked as follows (highest to lowest): donanemab > aducanumab > bapineuzumab > lecanemab > gantenerumab > crenezumab > solanezumab. Five mAb-specific determinants emerged: (1) Types of Aβ Binding: Enhanced clearance of mature amyloid plaques correlated with elevated ARIA-H risk. (2) Polymer binding Affinity: Reduced small oligomer-binding capacity predicted higher ARIA-H incidence. (3) Epitope location: N-terminal-targeting mAbs showed greater ARIA-H incidence vs. mid/C-terminal binders. (4) Fc region structure: IgG4-based constructs showed higher ARIA-H incidence than IgG1 analogs. (5) Clearance kinetics: Rapid attainment of amyloid reduction thresholds amplified ARIA-H incidence.
DiscussionWe identify a risk hierarchy for ARIA-H among anti-Aβ mAbs and link specific mAb biophysical properties—Aβ binding type, affinity for soluble oligomers, epitope specificity, Fc structure, and plaque clearance dynamics—directly to ARIA-H pathogenesis.
ConclusionThese findings establish a mechanistic framework for ARIA-H risk and provide concrete molecular predictors to guide antibody engineering strategies. Prioritizing mAbs with controlled amyloid clearance, C-terminal binding domains, and IgG1 frameworks may enhance therapeutic safety, advancing precision immunotherapy for Alzheimer's disease.
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Mitochondria as a Therapeutic Target in Neurodegeneration: Strategies for Restoring Cellular Homeostasis
Authors: Bartosz Twarowski, Iwona Piątkowska-Chmiel and Mariola HerbetAvailable online: 12 August 2025More LessAgeing is a complex biological process marked by a gradual decline in bodily functions at the cellular, tissue, and organ levels, resulting from molecular damage and environmental influences. It increases disease risk, particularly in older adults with neurodegenerative conditions characterized by progressive neuronal loss and neurological symptoms such as cognitive and motor impairments. Key mechanisms include abnormal protein accumulation, oxidative stress, neuroinflammation, and mitochondrial dysfunction. Disruption of cellular homeostasis prevents the maintenance of internal conditions such as pH and glucose levels. Mitochondria, known as the cell’s “powerhouses,” are essential for ATP production, DNA protection, and metabolic regulation, supporting cellular structures. Their dysfunction plays a crucial role in the progression of neurodegenerative diseases. Factors like chronic inflammation, ATP deficiency, excessive production of reactive oxygen species (ROS), and calcium imbalance leads to oxidative stress and neuronal damage, exacerbating neurodegeneration. Current therapies mainly focus on symptom relief, emphasizing the urgent need for new treatment strategies. Given the key role of mitochondrial dysfunction, therapies aiming to restore mitochondrial homeostasis are gaining increasing attention. Mitochondrial antioxidants such as MitoQ, MitoTEMPO, and SkQ1 have shown neuroprotective, anti-inflammatory, and antioxidant properties. Research into their therapeutic potential may lead to the development of effective drugs that restore mitochondrial function and improve quality of life of the patients.
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Betaine: A Promising Natural Product for Neurological and Psychiatric Diseases
Authors: Ying Zhang, Zhaojuan Ke, Jie Luo, Qibin Chen, Xin Jiang, Jialin Xiong and Linya DengAvailable online: 08 August 2025More LessNeurological and psychiatric diseases pose a considerable global burden. Exploring additional potential prevention strategies and therapies is ongoing. As a prevalent natural product and nutraceutical from food, betaine’s pharmaceutical applications suggest benefits for both health and disease in multiple organs. Recently, its efficacy on neurological and psychiatric health has been proposed and has drawn considerable attention. This review aims to provide an updated, critical, and comprehensive profile of the promising medicinal roles of betaine in these diseases. In addition to its well-known osmotic protection, due to methyl donation, it regulates metabolism, alleviates oxidative stress, and reduces inflammation. To manifest neurological and psychiatric health benefits, betaine acts by affecting gamma-aminobutyric acid associated with its transporters, related neurotransmitters, downstream and neurological pathways, and other specific mechanisms in the nervous system. Betaine demonstrates therapeutic potential against various neurological and psychiatric diseases, such as epilepsy, neurocognitive disorders (including Alzheimer's disease), Parkinson's disease, stroke, multiple sclerosis, traumatic brain injury, depression, anxiety, schizophrenia, autism spectrum disorder, sleep disorders, fetal alcohol syndrome, syringomyelia, neonatal brain injury, neuropathic pain, and motor dysfunction. Despite the promising role of betaine in the treatment, diagnosis, and prevention of neuropsychiatric disorders, much of the present evidence appears to be fragmentary. Further studies elucidating the underlying mechanisms and direct clinical applications are required to obtain a deeper understanding of betaine and its underutilized potential. Overall, this review highlights the potential of betaine as a promising agent with benefits for neurological and psychiatric diseases, aiming to offer clues to advance this field.
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The Cathepsin Family in Disease: From Molecular Mechanisms to Therapeutic Applications
Authors: Lorca Alzoubi, Yassmen Hamzat, Alaa Alqudah and Alaa A.A. AljabaliAvailable online: 08 August 2025More LessT4he cathepsin family of proteolytic enzymes is involved in the maintenance of major physiological processes, including protein degradation, immune modulation, tissue remodeling, and apoptosis. Members of the cathepsin family include cysteine, serine, and aspartic proteases, which are implicated in diverse cellular functions. Evidence for tissue-specific expression emphasizes the specialized functions of these enzymes in many organs. However, dysregulated cathepsin activity has been implicated in a wide range of pathological conditions, including, but not limited to, cancer, cardiovascular diseases, neurodegeneration, and autoimmune disorders. There is significant therapeutic potential for intervention, whereby specific inhibitors of certain cathepsins may offer promising strategies for disease management. Despite this promise, major challenges persist in designing inhibitors that avoid off-target effects while respecting the dual physiological and pathological roles of cathepsins. Structural similarities among family members and their context-dependent functions complicate precision targeting. This review identifies the emerging strategies including structure-guided design, cathepsin-cleavable delivery systems, and real-time imaging that are reshaping therapeutic approaches toward these complex enzymes. A structured web-based literature search was conducted using PubMed, Scopus, and Google Scholar employing keywords such as “cathepsins”, “therapeutic targeting”, “proteolytic enzymes”, and “disease pathways” to inform this review. As cathepsins continue to play a key role in health and disease, much research is warranted to determine their full therapeutic potential, which would represent a foundation for treatment options for various complex diseases.
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Mediterranean Pattern Diet in Multiple Sclerosis: A Review Focusing on Immunometabolites
Available online: 07 August 2025More LessMultiple Sclerosis (MS), the most common demyelinating disease of the Central Nervous System (CNS), is characterized in its pathogenesis by an interplay of mechanisms pertaining to aberrant immune response, acute and chronic inflammation, glial housekeeping, and neuron survival, ultimately resulting in demyelination, synaptic dysfunction, and neuroaxonal loss. Experimental models as well as epidemiological observations support the hypothesis of a role of diet in the disease onset, activity, and progression. It has been suggested that Western-type diets might be detrimental, while on the other hand, certain dietary regimens, like Mediterranean, low-fat, ketogenic, or intermittent fasting, might lead to disease amelioration, possibly through differential regulatory effects upon inflammation, immunity, and regenerative processes of neurons and glia. Under this perspective, immunometabolites, small intermediates including among the others citrate, itaconate, lactate, glutamate, glutamine, alfa-ketoglutarate, 2-hydroxyglutarate, fumarate, ceramides, whose turn-over reflects metabolic reprogramming of immune cells, might be viewed as significant regulators of cellular responses against either local or systemic noxious stimuli, both in the periphery and in the CNS. The present narrative review aims at summarizing current experimental and clinical evidence regarding the role of immunometabolites in shaping MS pathology, to address whether they could be relevant either as disease markers or therapeutic targets, and whether they might be differentially influenced by dietary approaches, especially by Mediterranean Pattern Diets (MPD).
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Efficacy of Venlafaxine and Deep Brain Stimulation Against the Effects of Hippocampal Lesion with Ibotenic Acid in Animals Exposed to the Chronic Mild Stress Model of Depression
Available online: 28 July 2025More LessIntroductionDysfunction of the pathway between the ventral hippocampus (vHPC) and medial prefrontal cortex (mPFC) may be responsible for the weaker or lack of efficacy of antidepressant drugs in patients suffering from treatment-resistant depression. This study aims to evaluate the behavioural effects of vHPC lesion with ibotenic acid (IBO) in animals subjected to the chronic mild stress (CMS) procedure and treated with either chronic venlafaxine or acute deep brain stimulation (DBS) in the mPFC. In addition, electrophysiological studies are expected to reveal neuromodulatory effects on the function and plasticity of mPFC neurons in response to stress, lesion, and deep brain stimulation (DBS).
MethodsWistar Han rats were exposed to the chronic mild stress model of depression and IBO lesion in vHPC. The effects of both procedures were evaluated in a series of behavioural tests (sucrose test, elevated plus maze, novel object recognition, and social interaction) and in electrophysiological recordings (field potential recording and LTP induction).
ResultsThe CMS procedure caused a decrease in sucrose consumption, deficits in cognitive function and social interaction, and increased anxiety. The lesion in vHPC with IBO resulted in similar behavioral changes. Repeated (5 weeks) administration of venlafaxine (10 mg/kg, IP) reversed these deficits in stressed animals but was only partially effective in reversing the effects of IBO lesion in HPC. In contrast, the neuromodulation strategy with DBS of the mPFC produced a robust reversal of all behavioural changes observed in both stressed and lesioned rats. The CMS did not affect the amplitude of field potentials in mPFC slices, but the induction of Long-Term Potentiation was impaired in these animals. The IBO lesion significantly reduced the amplitude of Field potentials as compared to unstressed rats. Both repeated venlafaxine and acute DBS normalized these effects of the IBO lesion.
DiscussionObserved effects were fully normalized by DBS in mPFC but not by venlafaxine, which only partially reversed the IBO lesion-induced effects. The weaker sensitivity of vHPC-lesioned animals to the therapeutic action of venlafaxine provides further evidence that insufficient transmission from the vHPC to the mPFC could be responsible for antidepressant non-response.
ConclusionThese data support the hypothesis that resistance to antidepressant treatment may result from the inability of antidepressants to fully activate the impaired vHPC-PFC pathway, which could be overcome by the neuromodulatory properties of deep brain stimulation.
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Lipid Metabolism in Cerebral Ischemia: From Pathogenesis to Therapy
Authors: Xinrong Wang, Rongjia Liu, Zhong Chen, Weiwei Hu and Lei JiangAvailable online: 23 July 2025More LessCerebral ischemia, a leading global cause of death and disability, is marked by multifaceted pathological processes through dysregulation of lipid metabolism. This review examines the pivotal role of lipid metabolism in the pathogenesis of cerebral ischemia, with a particular emphasis on its dual function in neuroinflammation and neuroprotection. It delves into the mechanisms by which Arachidonic Acid (AA) metabolites, such as prostaglandins and Leukotrienes (LTs), drive neuroinflammation through Cyclooxygenase (COX) and Lipoxygenase (LOX) pathways, exacerbating ischemic injury. Conversely, the aim was to review the therapeutic potential of Specialized Pro-resolving Mediators (SPMs), including lipoxins, Resolvins (RVs), and protectins, that resolve inflammation and promote tissue repair. In addition, the roles of Peroxisome Proliferator-Activated Receptors (PPARs) and sphingolipid signaling in modulating oxidative stress, mitochondrial dysfunction, and neuronal survival were also addressed. Integrating recent advances in lipid biology and cerebral ischemia research, this review presents an overview of the role of lipid metabolism in disease progression and its potential as a target for new therapeutic interventions. These findings bridge the gap between basic science and clinical research, opening new doors for the treatment of cerebral ischemia.
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Resilience and Recalibration of Bibliometric Indicators in Neurosciences and Neuropharmacology Journals After COVID-19: A Longitudinal Rate of Change Analysis Using Mixed-Effects Models
Available online: 21 July 2025More LessIntroductionThe COVID-19 pandemic triggered unprecedented changes in the scholarly publishing landscape, particularly in biomedical fields such as Neurosciences and Neuropharmacology. Several journals experienced steep, short-term increases in citation metrics during 2020-2022. However, it remains uncertain whether these surges reflected a sustainable impact or temporary inflation. This study aimed to analyze post-pandemic bibliometric behavior by evaluating the Rate of Change (RoC) in key journal-level indicators from 2013 to 2023.
MethodsA retrospective longitudinal study was conducted on 233 neuroscience journals indexed in the Journal Citation Reports. Six indicators were analyzed: Journal Impact Factor (JIF), Eigenfactor Score, Immediacy Index, Article Influence Score, Cited Half-Life, and Total Citations. RoC was calculated for each metric on an annual basis. Mixed-effects models with random intercepts and slopes were constructed to evaluate longitudinal trajectories and identify changes associated with three defined periods: pre-pandemic (2013-2019), pandemic (2020-2022), and post-pandemic (2023). Subgroup analyses assessed journal quartiles and categories to explore variations in impact resilience.
ResultsThe pandemic period (2020-2022) showed significant increases in RoC for JIF (mean β = +4.85, p = 0.004), Immediacy Index (β = +6.22, p = 0.002), and Total Citations (β = +5.88, p < 0.001). These changes were more prominent in top-quartile journals and those classified under Neuropharmacology. In contrast, alternative metrics such as the Eigenfactor Score and Article Influence Score remained relatively stable across the same period. In 2023, most indicators exhibited a normalization trend, with JIF and Immediacy Index showing marked deceleration in RoC, suggesting a post-pandemic recalibration. Journals with sustained positive trajectories were primarily concentrated in high-impact clusters, with Current Neuropharmacology ranking among the top performers by RoC slope.
DiscussionThe findings demonstrate that the surge in citations during the pandemic was primarily transitory and varied across bibliometric indicators. Traditional metrics like JIF and Immediacy Index were more sensitive to systemic shocks, while influence-based indicators (Eigenfactor and Article Influence Score) showed higher temporal resilience. The application of RoC allowed for a nuanced interpretation of metric trajectories and minimized misinterpretation of short-term spikes. Limitations include reliance on publicly available data and potential lag effects in citation behavior not fully captured within the 10-year window.
ConclusionThis study reveals that pandemic-era citation inflation in Neuroscience journals was largely temporary and metric-dependent. RoC-based modeling offers a reproducible and adaptable approach for assessing the sustainability of bibliometric trends. These insights can help editors, funders, and academic institutions better understand journal performance, make informed decisions about research dissemination, and refine metrics-based evaluation frameworks in the post-pandemic publishing environment.
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The Role of the Microbiota-Gut-Brain Axis in Perinatal Depression: Novel Insights for Treatment
Authors: Jiajing Chao, Zhangmin Tan, Zhe Li and Chengfang XuAvailable online: 18 July 2025More LessPerinatal depression, a prevalent mood disorder complicating pregnancy and childbirth, poses significant threats to maternal health and neonatal development. While psychotherapy and antidepressants constitute current standard treatments, their clinical application faces substantial limitations during pregnancy and lactation, including safety concerns, treatment resistance, and poor adherence rates. These therapeutic constraints have spurred growing interest in novel gut-brain axis (GBA)-targeted interventions. Emerging evidence suggests that the gut microbiota communicates with the brain through a complex network of neural, immune, and endocrine pathways, playing a critical role in regulating mood, behavior, and cognitive functions. Interventions such as probiotics and fecal microbiota transplantation (FMT) are increasingly explored for their potential to restore microbial balance and alleviate depressive symptoms. This review aims to systematically examine the role of the GBA in the context of perinatal depression, offering novel insights to inform clinical treatment strategies. Furthermore, it evaluates the promise and limitations of microbiota-targeted interventions while discussing future directions for personalized microbiome therapeutics.
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Intercellular Communication Pathways in Cerebral Ischemia: Mechanisms, Molecular Insights, and Therapeutic Implications
Authors: Guoqian Cui, Wenbo Guo, Muzi Li, Shengshuang Chen, Xin Shao, Jie Liao and Xiaohui FanAvailable online: 18 July 2025More LessIntroductionCerebral ischemia (CI) is a severe neurological disorder characterized by high incidence and disability rates. Its pathogenesis is complex, involving multiple interrelated biological processes. Among these, intercellular communication has emerged as a key mechanism regulating the damage and recovery phases of CI. It controls information exchange between cells, thereby playing a crucial role in cellular responses to ischemic injury. Understanding how intercellular communication promotes the pathophysiology of CI may provide valuable insights into new therapeutic targets.
MethodsTo elucidate the role of intercellular communication in CI, recent literature was analyzed, with a focus on how intercellular communication influences cellular behaviors and metabolism. This review integrates data from molecular biology, cellular signaling studies, and cerebral ischemia models.
ResultsStudies indicate that intercellular communication significantly influences the progression and outcomes of CI. Intercellular communication not only participates in regulating the inflammatory response following injury but also plays a dual role in neuroprotection and regeneration.
DiscussionThe dual role of intercellular communication—exacerbating damage through inflammatory cascades and promoting recovery through neuroprotective mechanisms—highlights its complex contribution to the pathology of CI. Cellular crosstalk between neurons, glial cells, endothelial cells, and immune cells coordinates the dynamic response to ischemic injury. Understanding these dynamics offers promising opportunities for targeted interventions.
ConclusionIntercellular communication plays a central role in the mechanisms of injury and repair in cerebral ischemia. By influencing inflammation, neuroprotection, and regeneration, it serves as both a mediator of injury and a potential therapeutic target. Further research is needed to fully elucidate these mechanisms and translate them into effective clinical strategies for treating CI.
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Membrane Protein Modulators in Neuroinflammation
Authors: Ligang Chen, Zheng Zou, Chao Dang, Geyu Wang, Tingzhun Zhu and Guobiao LiangAvailable online: 17 July 2025More LessNeuroinflammation has emerged as a critical pathological process that significantly contributes to the development and progression of a wide range of neurological disorders, including Alzheimer’s disease, Parkinson’s disease, and multiple sclerosis. Recent advances in neuroscience have underscored the pivotal role of neuroinflammation not only in exacerbating these diseases but also in accelerating neuronal degeneration. The growing prevalence of these conditions worldwide, coupled with the limited efficacy of current therapeutic approaches, highlights the urgent need for new therapeutic strategies. Given the central role of neuroinflammation in disease progression, targeting the neuroinflammatory process offers a compelling opportunity for effective intervention. Membrane proteins are key regulators in cellular signal transduction and intercellular communication, and their dysregulation may trigger and sustain neuroinflammatory responses. Consequently, modulators of membrane proteins have emerged as promising candidates for managing neuroinflammation. Current research indicates that natural products and small-molecule compounds can modulate membrane protein activity, effectively mitigating excessive inflammatory responses and exhibiting potent anti-neuroinflammatory effects. This review systematically examines the classification and functional roles of membrane proteins in neuroinflammation, with a particular focus on the therapeutic potential of channel proteins, transporter proteins, and receptor proteins across various neurological conditions. The identification and development of membrane protein modulators present an innovative and urgent avenue for advancing anti-neuroinflammatory therapies, offering potential breakthroughs in treating these prevalent and debilitating diseases.
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Gut Microbiota and Bipolar Disorder: Advances in Translational Applications
Authors: Liujiao Yan, Shaoxia Zhang, Xiaobing Lu and Zezhi LiAvailable online: 17 July 2025More LessBipolar disorder is a severe, recurrent affective disorder that imposes significant pain and burden on both the patients themselves and the social economy. Recent studies have indicated the involvement of intestinal flora in emotional regulation, as well as its close association with the occurrence and progression of diseases such as bipolar disorder. Therefore, conducting comprehensive research on the impact of intestinal microflora and the “gut-brain axis” on bipolar disorder becomes imperative, offering novel insights into its etiology, diagnosis, and treatment options. Consequently, this article provides an overview of the role and potential mechanisms underlying intestinal microbiota in bipolar disorder.
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Venlafaxine and Delirium: Understanding the Association
Available online: 15 July 2025More LessDelirium represents a significant clinical, economic, and societal challenge, frequently arising in hospitalized patients due to multiple factors, including pharmacological triggers. Recognizing and preventing delirium is crucial to improving patient outcomes and reducing healthcare costs. This review focuses on the association between venlafaxine, a commonly used antidepressant, and delirium. We explore potential mechanisms, clinical presentations, and risk factors linked to venlafaxine-induced delirium, emphasizing the need for heightened awareness among clinicians. The findings underscore the importance of vigilance during drug initiation, dosage adjustment, or withdrawal to mitigate the risk of this neuropsychiatric condition.
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Dealing with Early-Onset Schizophrenia and the Role of Lurasidone: An Expert Opinion
Authors: Sergio De Filippis, Gabriele Masi, Gianluca Serafini, Stefano Vicari, Antonio Vita, and and Benedetto VitielloAvailable online: 15 July 2025More LessCompared to schizophrenia in adults, Early Onset Schizophrenia (EOS) features diagnostic, clinical, and therapeutic peculiarities that are the subject of ongoing discussion among psychiatrists and neuropsychiatrists. This article presents the outcomes of a meeting and a series of virtual roundtable discussions among specialists who validated practical recommendations for the diagnosis and management of EOS in light of recent literature. The identification of risk factors and prodromal symptoms, as well as the differentiation of EOS from other psychiatric conditions, is crucial for early detection. Timely identification enables the implementation of appropriate psycho-behavioural and pharmacological interventions and supports close monitoring of the developmental trajectories associated with EOS. The collaboration between the different professionals who deal with EOS patients and a therapeutic approach that allows a normal cognitive, sexual, and psychophysical development makes it possible to ensure the therapeutic alliance necessary for the optimal management of the disease over time. In a scenario that is complicated by negative prognostic factors, such as the late recognition of the disease, comorbid and latent psychiatric conditions, the increasingly widespread use of substances among adolescents, and a poor therapeutic adherence often due to antipsychotics side effects, a growing body of literature emphasizes the advantages of lurasidone in the treatment of EOS. Compared to other pharmacological agents commonly used in schizophrenia, lurasidone has been shown to intervene comprehensively and effectively against the positive and negative symptoms of EOS, with manageable side effects and the preservation of a good QoL.
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Therapeutic Approaches Interfering with Nuclear Localization Signals: An Emerging Strategy for CNS-Related Diseases
Authors: Margrate Anyanwu, Matteo Giannangeli, Alessandra Gianoncelli and Giovanni RibaudoAvailable online: 14 July 2025More LessAlthough medicinal chemistry is constantly looking for new therapeutic approaches against pathological conditions affecting the central nervous system (CNS), such as neurodegeneration and cancer, this quest has not been fully successful yet. The lack of understanding of all the complex mechanisms underlying these conditions makes the identification of new effective drugs challenging. A wide variety of pathophysiological events are regulated at both nuclear and cytoplasmic levels, and in this context, targeting the shuttle system composed of the karyopherin superfamily and their cargoes may provide an alternative strategy. Molecular recognition is highly specific and strictly related to the presence of special “tag” regions, known as nuclear localization signals, that are localized in the amino acid sequences of cargoes. Importantly, their trafficking is involved in various pathophysiological processes, including CNS diseases. Curiously, although this system has been studied intensively, much remains to be discovered to date. Throughout the years, drug discovery allowed the identification of small molecules and peptides able to target karyopherin-cargo complexes to provide new potential pharmacological treatments. Indeed, the first examples of drug candidates targeting this mechanism that reached clinical trials are appearing in the literature. With this mini-review, this study aims at presenting an updated overview on the most recent reports investigating the use of the karyopherin shuttle system as a new therapeutic target especially for CNS-related diseases.
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Targeting the cGAS-STING Pathway: Modulating Inflammation, Oxidative Stress, and Autophagy for Novel Depression Therapies
Authors: Wen Ma, Shanshan Chu, Yumei Ma, Sutian Wang and Xuehai MaAvailable online: 11 July 2025More LessThe pathological mechanisms underlying depression, a prevalent mental disorder, remain only partially elucidated despite extensive research efforts. Recent advancements have underscored the pivotal roles of multiple biological processes in the onset and progression of depression, including inflammation, oxidative stress, and autophagy. Inflammation is associated with the disruption of neurotransmitter systems and neural plasticity, whereas oxidative stress contributes to neuronal damage and impaired brain function. Moreover, moderate autophagy is essential for maintaining neuronal health. Dysregulation of autophagy may lead to the accumulation of damaged proteins and organelles, which can exacerbate depressive symptoms. Among the various molecular pathways involved, the cGAS-STING signalling pathway has emerged as a key regulator of these processes. Traditionally known for its role in detecting cytosolic DNA and initiating innate immune defences against pathogens, the cGAS-STING pathway has recently been implicated in regulating inflammatory responses, oxidative stress levels, and autophagy in the central nervous system. This dual function positions the cGAS-STING pathway as a potential link between immune dysregulation and the neurobiological foundations of depression. This paper offers a systematic overview of existing studies on the role of the cGAS-STING pathway in inflammation, oxidative stress, and autophagy within the central nervous system, particularly in the context of depression. The review reveals how modulation of the cGAS-STING pathway may influence these critical biological processes and thereby ameliorate depressive symptoms. Furthermore, the review discusses the therapeutic potential of targeting the cGAS-STING pathway and offers promising research directions. Ultimately, this paper aims to provide novel insights and approaches for developing more effective treatments for depression.
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Emerging Therapeutic Targets for Spontaneous Intracerebral Hemorrhage
Available online: 11 July 2025More Less
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Assessment Value of Electromyography for Bortezomib-Related Peripheral Neuropathy
Authors: Yijun Shen, Zhen Zhang, Yuchen Liu, Siyuan Song, Tian Li, Jihong Dong, and and Guanru NiuAvailable online: 09 July 2025More LessIntroductionThis study investigates the relationship between National Cancer Institute Common Terminology Criteria (NCI-CTC) for grading bortezomib-induced peripheral neuropathy (BIPN) and objective motor/sensory nerve dysfunctions assessed by nerve conduction studies (NCS). It also evaluates the correlation between specific nerve conduction abnormalities and progression-free survival (PFS).
MethodsThirty-three patients with multiple myeloma developing peripheral neuropathy during bortezomib treatment were enrolled. Participants were grouped based on NCI-CTC toxicity scores (< 2, n=17; ≥ 2, n=16). Comprehensive NCS were performed, assessing compound muscle action potentials (CMAP), motor conduction velocities (MCV), sensory nerve action potentials (SNAP), and sensory conduction velocities (SCV) across ulnar, median, tibial, peroneal, sural, and superficial peroneal nerves. Correlation analyses were used to examine the association between NCS parameters and PFS.
ResultsPatients with higher NCI-CTC grades (≥ 2) exhibited significant reductions in motor and sensory nerve conduction parameters. Notably, the peroneal nerve showed significant decreases in CMAP (p=0.0059) and MCV (p=0.0223). The superficial peroneal nerve displayed a significant reduction in SCV (p=0.0189). A strong positive correlation was found between median nerve SNAP and longer PFS (r=0.558, p=0.001).
DiscussionThe findings indicate that higher clinical grades of BIPN (NCI-CTC ≥ 2) are associated with objective neurophysiological evidence of worsened nerve function, with the peroneal nerve being particularly affected. The correlation between median nerve SNAP and PFS suggests that NCS parameters could potentially serve as prognostic markers in patients with BIPN.
ConclusionBortezomib-induced neurotoxicity leads to significant impairments in both motor and sensory nerve conduction. Median nerve SNAP shows promise as a predictor for PFS, underscoring the potential value of NCS in monitoring neurotoxicity and guiding clinical management in patients receiving bortezomib.
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Diabetes, Alzheimer's Disease Risk Factors, and the Cafeteria Diet: A Comprehensive Review
Available online: 08 July 2025More LessAlzheimer's disease (AD) is a progressive neurodegenerative disorder with multifaceted risk factors, including diet and metabolic dysfunction. The rising prevalence of AD and diabetes has drawn attention to their shared pathophysiological mechanisms. The “cafeteria diet,” characterized by high-fat, high-sugar, and energy-dense foods, has emerged as a significant contributor to metabolic dysfunctions, including obesity and insulin resistance, which are risk factors for both diabetes and neurodegenerative diseases. This study explores the effects of the cafeteria diet on cognitive impairment, AD pathology, and its potential role in exacerbating diabetes-related neurological complications. Animal models were subjected to cafeteria diets, mimicking human dietary patterns, to investigate changes in brain structure, amyloid-beta accumulation, tau hyperphosphorylation, and cognitive function. Additionally, metabolic profiling demonstrated the development of insulin resistance and other hallmarks of diabetes, which were closely correlated with the severity of cognitive deficits. Neuropathological analyses revealed exacerbated amyloid-beta accumulation and increased neuroinflammation, linking dietary-induced diabetes to AD pathophysiology. These findings underscore the critical role of dietary habits in modulating the risk and progression of AD, highlighting the importance of interventions targeting metabolic health to mitigate cognitive decline. This study emphasizes the need for further research to unravel the molecular mechanisms underlying the diet-diabetes-AD axis and develop targeted therapeutic strategies.
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Experimental Evaluation of QY-69: A Butyrylcholinesterase Inhibitor with Anti-Glioblastoma Efficacy
Authors: Kaixuan Wang, Ziyao Lu, Yuetong Duan, Siyu He, Weiping Lyu, Qinghong Liao, Qi Li, Xuehong Chen and Huanting LiAvailable online: 07 July 2025More LessIntroductionGlioblastoma multiforme (GBM) is the most aggressive malignant primary brain tumor, characterized by poor prognosis. Moreover, cognitive impairment from the tumor and its treatments compromises patients' quality of life. Butyrylcholinesterase (BChE) inhibition enhances cognitive function. Notably, BCHE is overexpressed in GBM tissues; its downregulation suppresses tumor cell proliferation, migration, and invasion. This study aimed to identify a BChE inhibitor with dual functionality: anti-GBM efficacy and cognitive protection via modulation of neuroinflammation.
MethodsQY-69 was identified from an in-house BChE inhibitor library through cytotoxicity-based screening. Its anti-GBM effects were evaluated through colony formation, wound healing, and transwell assays. Orthotopic GBM mice were treated with QY-69 orally for 15 days. Tumor progression, cognitive function (Morris water maze), and neuroinflammation (microglia and astrocyte immunofluorescence) were analyzed.
ResultsQY-69 exhibited significant antiproliferative activity at micromolar concentrations. In vitro assays demonstrated significant inhibition of GBM cell growth, migration, and invasion. Behavioral impairment in mice was improved, and the activation of astrocytes and microglia in peritumoral tissues was reduced, indicating a decrease in neuroinflammation.
DiscussionQY-69 demonstrated dual therapeutic potential in GBM by inhibiting tumor progression and alleviating cognitive impairment. However, its precise molecular mechanisms remain to be elucidated. Future research should employ transcriptomic and proteomic approaches to elucidate the molecular basis of its anti-GBM activity.
ConclusionQY-69, a BChE inhibitor, exhibits potent anti-GBM activity and confers cognitive protection, positioning it as a promising dual-action therapeutic candidate. By inhibiting tumor progression and reducing neuroinflammation, it may enhance both survival and quality of life in GBM patients.
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Maternal Multiple Sclerosis and Offspring’s Developmental and Behavioral Profile: A Case-control Study
Available online: 04 July 2025More LessIntroductionMaternal chronic immune and inflammatory conditions may predispose newborns to atypical developmental trajectories, identifying pregnancy as a key period for the etiopathogenesis of neurodevelopmental disorders. The possible long-term impact of maternal multiple sclerosis (MS) on the offspring’s cognitive and behavioral development and its pharmacological treatment during pregnancy is mostly unknown. This study aims to delineate the cognitive and behavioral profile of offsprings exposed to maternal MS, untreated or treated with Natalizumab throughout pregnancy, in comparison to a control group.
MethodsWe retrospectively enrolled 39 children (23 males; 16 females; mean age 45.82 ± 35.46 months) exposed to maternal MS, untreated or treated with Natalizumab throughout pregnancy, and 36 children (24 males; 12 females, mean age 38.03 ± 21.52 months) of healthy mothers. All offspring underwent a standardized evaluation of their intellectual or developmental quotient, adaptive functioning, and behavioral issues, including symptoms of autism.
ResultsThe clinical profile of the included offspring was characterized by an adequate cognitive profile and a good level of adaptive skills (MS offspring: Griffiths III mean total DQ (N = 30) 114.57; WISC-IV mean Full IQs (N= 9) 115.44; mean ABAS GAC 97.28/Control offspring: Griffiths III mean total DQ (N = 31) 105.42; WISC-IV mean Full IQs (N= 4) 119.25 ± 11.32; mean ABAS GAC 97.82 ± 21.4). Furthermore, no significant behavioural problems or autism symptoms emerged in the entire group, regardless of MS treatment.
ConclusionOffspring's developmental and behavioral phenotypes do not appear to be influenced by maternal treatment with Natalizumab until late pregnancy, nor by maternal variables directly related to MS (age at the time of MS diagnosis, disease duration, and severity).
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Exploring Mechanistic Insights by Carotenoids in Neuropathic and Inflammatory Pain
Authors: Fatemeh Abbaszadeh, Masoumeh Jorjani, Roshanak Amirian, Sajad Fakhri and Haroon KhanAvailable online: 02 July 2025More LessChronic pain, characterized by persistent discomfort and reduced quality of life, poses a significant challenge for individuals. Chronic pain is predominantly divided into central neuropathic pain, peripheral neuropathic pain, and inflammatory pain. Considering the multiple dysregulated pathways behind such pain conditions, researchers are exploring new multi-target agents that offer enhanced efficacy and reduced side effects of the present drugs. Carotenoids are natural pigments with antioxidant and anti-inflammatory properties found in various fruits, vegetables, and seafood. Through their mechanisms of action, carotenoids have shown promising efficacy in alleviating pain hypersensitivity, reducing inflammation and oxidative stress, and modulating pain-related signaling pathways. This comprehensive review delves into the potential of carotenoids and their derivatives as natural nutraceuticals for managing inflammation and relieving pain. In the current study, the mechanisms of action by which carotenoids exert their beneficial effects during preclinical and clinical studies are provided. This review could pave the road for the application of carotenoids for more pain-related clinical trials and further applications.
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Therapeutic Potential of Anesthesiology for Sleep Disorders in the
Authors: Xiao-li Pan, Yu-fan Xi, Peng Liang and Jiapeng HuangAvailable online: 30 June 2025More LessSleep is important to maintain normal physiological functions of the human body. With increased stress in modern society, the number of patients suffering from sleep disorders is gradually increasing. Many studies have shown that general anesthetics induce loss of consciousness by acting on the sleep-wake circuit. In recent years, general anesthesia and other anesthetic agents have been used in the diagnosis and treatment of sleep disorders. This article discusses the mechanism of sleep and sleep disorders, summarizes the effects of anesthetics on sleep and their regulatory mechanisms, and reviews the research progress of using anesthetics in the diagnosis and treatment of sleep disorders.
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Neuropharmacological Insights into Glutamate Homeostasis in Post-stroke Depression Regulated by Astrocytes
Authors: Na Zhang, Kaijun Han, Lixinbei Sheng, Fang Wang, Manlan He, Mengqian Wu, Zhen Han, Yichen Li and Lu ChenAvailable online: 30 June 2025More LessStroke patients often experience multiple functional impairments, including difficulties with swallowing, speech, cognition, and motor skills, which can lead to symptoms such as emotional distress and cognitive deficits. Approximately one-third of post-stroke patients may develop post-stroke depression (PSD), significantly hindering recovery and increasing the burden on families and healthcare systems. This review focuses on the underlying mechanisms of PSD, emphasizing the glutamatergic hypothesis. As the primary excitatory neurotransmitter, glutamate plays a central role in neural-signaling. However, excessive glutamate accumulation can cause neuronal damage, making it a key mechanism in the development of PSD. Astrocytes are crucial for maintaining glutamate homeostasis by clearing excess glutamate and regulating its synthesis and transport, thereby preventing excitotoxicity. Following a stroke, astrocytic dysfunction—characterized by overactivation and inflammatory responses—can exacerbate neuronal injury and further contribute to the emergence of depressive symptoms. This article also highlights potential therapeutic approaches targeting the glutamatergic system, such as NMDA receptor antagonists, AMPA receptor antagonists, and modulators of glutamate transporters, as well as other types (e.g., Chinese medicine, herbal medicine, and targeted pathways acting on neurons). These strategies offer promising avenues for PSD treatment. Future studies should delve deeper into the molecular mechanisms by which astrocytes regulate glutamate homeostasis, providing a robust foundation for the precision treatment of post-stroke depression.
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Role of Glycerophospholipid Metabolism in Epilepsy
Authors: Zijian Li, Zhen Liang, Jing Zhang and Songyan LiuAvailable online: 07 April 2025More LessEpilepsy is a prevalent and severe neurological condition characterized by recurring seizures. It impacts over 70 million individuals worldwide, posing a substantial challenge to public health and placing a heavy burden on society. Glycerophospholipids are an essential component of neuronal cell membranes. Their metabolism is strictly regulated, and maintaining their homeostasis is crucial for the optimal function of the nervous system. Research indicates that disruptions in glycerophospholipid metabolism are commonly detected in patients with epilepsy and animal models. However, the precise molecular mechanisms behind these disruptions remain unclear. Existing evidence indicates that neuroinflammation, oxidative stress, genetic mutations, and ion channel dysfunction are crucial factors contributing to glycerophospholipids imbalance and epilepsy. Further, therapeutic interventions targeting these pathological processes, such as regulating neuroinflammation and oxidative stress or restoring the balance of glycerophospholipid metabolism, may provide new avenues for epilepsy treatment. This review aims to provide an in-depth analysis of the potential mechanisms underlying the relationship between glycerophospholipid metabolism disorders and epilepsy, exploring potential therapeutic targets and diagnostic biomarkers.
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The Modulatory Effects of Anesthetics and Analgesics on Neurophysiological Monitoring and Underlying Mechanisms
Authors: Yu Leng, Yi Teng, Jin Liu, Xian Zou, Mengchan Ou, Tao Zhu, Peng Liang and Cheng ZhouAvailable online: 18 February 2025More LessIntraoperative Neurophysiological Monitoring (IONM) is an indispensable surgical tool that offers invaluable insights into neurological function across a spectrum of anatomical areas. By comprehensively assessing the integrity of the brain, brainstem, spinal cord, cranial nerves, and peripheral nerves, IONM plays a pivotal role in guiding surgical decision-making and optimizing patient outcomes, particularly in the context of high-risk procedures. Intraoperative drugs, especially anesthetics and/or analgesics, differentially modulate neurophysiological monitoring, which remarkably affects the application of neurophysiological monitoring under specific conditions and indicates the neurobiological mechanisms of anesthetics/analgesics. This review will describe various neurophysiological modalities utilized in intraoperative procedures, each employing a wide variety of physiological principles; summarize the modulatory effects of anesthetics/analgesics on these neurophysiological monitoring parameters; and elucidate their underlying mechanisms, with a particular emphasis on evoked potentials. Insights gleaned from this review can inform strategies of anesthesia management for surgeries that require IONM and guide future investigations on the mechanisms of anesthesia/analgesia.
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Withdrawn: Stable Gastric Pentadecapeptide BPC 157 as a Therapy of Severe Electrolyte Disturbances in Rats
Authors: Marija Medvidovic Grubisic, Sanja Strbe, Ivan Barisic, Dijana Balenovic, Vasilije Stambolija, Marin Lozic, Sanja Barsic Ostojic, Ivana Oreskovic, Helena Zizek, Klara Brcic, Luka Coric, Mario Staresinic, Vladimir Blagaic, Lidija Beketic Oreskovic, Zeljka Belosic Halle, Danijel Matek, Dragan Soldo, Boris Grizelj, Alenka Boban Blagaic, Anita Skrtic, Sven Seiwerth and Predrag SikiricAvailable online: 24 January 2025More LessThe article has been withdrawn at the author's request from the website of the journal Current Neuropharmacology.
Bentham Science apologizes to the readers of the journal for any inconvenience this may have caused.
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