Behavioural Neurology

Background: According to the International League Against Epilepsy (ILAE) 2015 classification, status epilepticus (SE) is a seizure that lasts longer than 5 min or a frequency of more than one seizure within 5 min, without returning to a normal level of consciousness between episodes. In this study, we aimed to evaluate the prognostic factors of SE and compare our patients with those of patients treated internationally with the modified status epilepticus severity score (mSTESS) to determine the reliability of this scoring system. Methods: The medical records of patients aged 1 month–17 years with SE who were treated at Çukurova University–Balcalı Training and Research Hospital between September 2018 and September 2021 and who were followed in the intensive care unit were included in the study. Results: Seventy-two patients were included in this study. The mean age of the patients with SE was 5 years (3–8). The male/female ratio was 34 (47%)/38 (53%). A history of epilepsy was present in 53% of the patients. The most common etiologies behind SE were meningoencephalitis (19%), febrile status (8%), unknown status (12%), and genetic causes (7%). Comorbidities, including developmental delay/intellectual disability, cerebral palsy, hyperactivity, and autism spectrum disorder, were present in 44 (61%) of the patients. The cutoff was ≥ 2 for unfavorable outcomes and 4 for mortality in our patients according to the mSTESS system. The case mortality rate was 1% in our study. Nonconvulsive SE, slowing and abnormal ground on EEG, being stuporous or comatose, having abnormal MRI–CT, and having a comorbid condition were associated with an unfavorable prognosis in SE patients. Conclusion: The mSTESS is a useful and practical scoring system for predicting the prognosis of SE patients. Nonconvulsive SE, slowing and abnormal ground in EEG, being stuporous or comatose, abnormal MRI–CT, and the presence of comorbid conditions indicated poor prognosis of SE in children.

Multiple sclerosis (MS) is the most common cause of disability in young adults due to several motor, sensory, and cognitive symptoms. However, little is still known about the impact of psychological, cognitive, and social-support variables on subjective disability. This study is aimed at exploring the role of clinical, psychological, cognitive, and social-support variables in predicting disability levels as perceived by persons with multiple sclerosis (pwMS). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) and the Expanded Disability Status Scale (EDSS) were used as subjective and objective measures of disability, respectively. State-Trait Anxiety Inventory and Beck Depression Inventory-II assessed symptoms of anxiety and depression; 19-item Medical Outcome Study–Social Support Survey assessed social support; and Rao’s Brief Repeatable Battery assessed cognitive functioning. A multivariable regression analysis was applied using the WHODAS 2.0 as an outcome. One hundred and fifty-one pwMS (93 females, mean age 51.6, standard deviation (SD) 5.8) were enrolled. EDSS (β=7.190; p<0.001), state anxiety (β=0.265; p=0.009), and symptoms of depression (β=0.835; p<0.001) explained a large amount of the variance of subjective disability (Adj.R2=0.705; p<0.001) measured through the WHODAS 2.0. Contrarily, cognitive functioning and perceived social support are not independently associated with the WHODAS 2.0 score. Psychosocial interventions in rehabilitation settings, aimed at reducing the overall perceived disability of pwMS, should be implemented in rehabilitation programs.

Amnesia is a memory disorder marked by the inability to recall or acquire information. Hence, drugs that also target the neurogenesis process constitute a hope to discover a cure against memory disorders. This study is aimed at evaluating the antiamnesic and neurotrophic effects of the aqueous extract of Parkia biglobosa (P. biglobosa) on in vivo and in vitro models of excitotoxicity. For the in vivo study, 42 adult male rats were divided into six groups of seven rats each and treated daily for 30 days as follows: normal control group (distilled water, 10 mL/kg, po), negative control group (distilled water, 10 mL/kg, po), positive control group (piracetam, 200 mg/kg, po), and 03 test groups (extract, 44, 88, and 176 mg/kg, po). Scopolamine (0.5 mg/kg, ip) was administered once daily, 45 min after these treatments, for 14 days, except in the normal control group. The animals were then subjected to short-term memory (new object recognition and T-maze) and long-term memory (radial arm maze) tests for 15 following days. Animals were then euthanized, and biochemical analyses (neurotransmitters, oxidative status, and neuroinflammation) were performed in the prefrontal cortex, hippocampus, and serum. Histological analysis of these organs was also carried out. In the in vitro study, the effect of the extract (5, 10, 19, 40, 77, 153, 306, 615, 1225, and 2450 μg/mL) was assessed on the viability of primary cortical neurons exposed to L-glutamate (0.1 mg/mL). Scopolamine induced memory impairment and increased oxidative stress, neuroinflammation, and neuronal loss. P. biglobosa extract (44 mg/kg) reduced (p<0.001) short- and long-term memory deficit. It also increased (p<0.01) the concentration of acetylcholine, reduced (p<0.001) that of malondialdehyde, and limited (p<0.001) neuroinflammation and neuronal loss (p<0.001). In addition, the extract (2450 μg/mL) increased (p<0.001) the percentage of viable cells. These results suggest that the extract has effects on amnesia and neurogenesis. These effects seem to be mediated by antioxidant and anti-inflammatory modulations.

Astrocytes are the primary cell type in the central nervous system, responsible for maintaining the stability of the brain’s internal environment and supporting neuronal functions. Researches have demonstrated the close relationship between astrocytes and the pathophysiology and etiology of major depressive disorder. However, the regulatory mechanisms of astrocytes during depression remain unclear. The aim of this study is to examine the alterations of calcium signaling of astrocytes in the dorsal raphe nucleus (DRN), the calcium signaling alterations of neurons in both the DRN and medial prefrontal cortex (mPFC), and the alteration of depressive-like behaviors by activation of DRN astrocytes using chemogenetics in chronic social defeat stress (CSDS) mice. The results showed that the intensity of calcium signaling in DRN astrocytes was decreased and the frequency of calcium signaling was lower after CSDS. The activation of DRN astrocytes increased the calcium signaling of the neurons including CaMKIIα neurons in both DRN and mPFC (via neural circuit between DRN and mPFC). The depressive-like behaviors were improved by activating DRN astrocytes in CSDS mice. Our results suggest that the astrocytes in DRN have an important role in depression and the findings offer new insights for the treatment of depression.

People with Cushing’s disease (CD) often experience both mood/anxiety disorders and cognitive impairments that persist during long-term biochemical remission. The relationship between persistent neurocognitive and psychiatric problems in patients with CD is not well understood. Also, mechanisms other than hypercortisolism are poorly understood, and studies comparing CD with nonfunctioning adenomas (NFA) patients postoperatively are scarce. We compared neuropsychological functioning in two groups: individuals with CD in remission (n=20; 80% female; 61.6 [44.13] months since remission) and individuals with NFAs (n=20). Evaluation was performed, on average, 4.9 years following pituitary surgery. We used mediation models to evaluate psychiatric dysfunction as a possible mediator of cognitive outcomes and assessed the influence of demographic and medical factors (age at diagnosis, remission duration, and radiation therapy) on neuropsychological outcomes. Neuropsychological outcomes did not differ significantly between groups; however, up to 30% of patients demonstrated mild impairments in attention, processing speed, executive functioning, and visual memory. Time since remission in the CD group was inversely correlated with processing speed; however, this relationship was no longer significant after controlling for the presence of hypertension and diabetes mellitus. Levels of anxiety, depression, or somatization were reported in up to 40% of people with CD. Further, 70% of people with CD and 35% of people with NFA reported continuous depressive symptoms lasting at least 2 years. In conclusion, neuropsychological screening in clinical practice and longitudinal studies in individuals with NFA and CD are needed to identify patients at risk for long-term neuropsychological dysfunction. Appropriate support and treatment are recommended for persistent cognitive and/or psychiatric dysfunction for both patient groups.

Objectives: This study is aimed at evaluating gender differences in neural activity change response to the acupuncture on left Jianyu (LI 15) in healthy volunteers. Methods: Forty healthy volunteers (20 males and 20 females) received 20-min acupuncture on left LI 15 and underwent functional magnetic resonance imaging (fMRI) scans before and after acupuncture. Amplitude of low-frequency fluctuations (ALFF) in the 0.01–0.08 Hz range were determined for both scans. Paired t-tests were performed on ALFF between two scans separately for the male and female groups to identify neural changes related to acupuncture. Results: After acupuncture, males showed significantly increased ALFF in the left cerebellum and right angular gyrus but decreased ALFF in the left precentral gyrus, left inferior occipital gyrus, and right fusiform gyrus. However, the ALFF change in females is almost negligible. Conclusions: Brain functional activity in response to acupuncture on left LI 15 is noticeably different between males and females. This is preliminary evidence that gender may be an important factor for optimal clinically personalized acupuncture therapy for poststroke shoulder pain in the future.

Aim: Our study is aimed at exploring the correlation between consumption of dietary fiber and the severity of depression symptoms. Methods: This study utilized data from the National Health and Nutrition Examination Survey spanning from 2007 to 2018, employing a cross-sectional design. The relationship between the severity of depression symptoms and intake of total cereals, vegetables, and fruits dietary fiber was assessed using both univariate and multivariate linear/logistic regression analyses. Stratified analyses were conducted based on hypertension, diabetes, dyslipidemia, cancer or malignancy, and cardiovascular disease. Results: This study included 28,852 participants who were classified into 21,696 with nondepression symptoms, 4614 with mild depression symptoms, 1583 with moderate depression symptoms, 684 with moderately severe depression symptoms, and 275 with severe depression symptoms. After adjusting all confounding factors, we observed a negative correlation between total dietary fiber and depression symptoms (beta=−0.004, 95% confidence intervals [CIs]: −0.006, −0.002). Taking nondepression symptoms as a reference, total dietary fiber was found to have an inverse association with moderate (OR=0.976, 95% CI: 0.962–0.991), moderately severe (OR=0.963, 95% CI: 0.938–0.990), and severe depression symptoms (OR=0.960, 95% CI: 0.921–1.001; marginal significance), respectively. Conclusion: The intakes of total dietary fibers might be related to moderate/moderately severe/severe depression symptoms, and a negative association was shown between total dietary fiber intakes and the risk of depression symptoms.

Objective: The objective of the study is to investigate whether quercetin ameliorates Alzheimer’s disease (AD)–like pathology in APP/PS1 double transgenic mice and its hypothesized mechanism, contributing to the comprehension of AD pathogenesis. Methods: A total of 30 APP/PS1 transgenic mice were randomized into model group (APP/PS1), quercetin group (APP/PS1+Q), and donepezil hydrochloride group (APP/PS1+DON). Simultaneously, there were 10 C57 mice of the same age served as a control group. Three months posttreatment, the effects of quercetin on AD mice were evaluated using the Morris water maze (MWM) test, Y maze experiment, immunohistochemistry, immunofluorescence, and western blotting. Results: Results from the water maze and Y maze indicated that quercetin significantly improved cognitive impairment in APP/PS1 transgenic AD mice. Additionally, serum enzyme-linked immunosorbent assay (ELISA) results demonstrated that quercetin elevated MDA, superoxide dismutase (SOD), CAT, GSH, acetylcholine (ACh), and acetylcholinesterase (AChE) levels in AD mice. Hematoxylin-eosin (HE) staining, Nissl staining, and hippocampal tissue thioflavine staining revealed that quercetin reduced neuronal damage and Aβ protein accumulation in AD mice. Western blot validated protein expression in the Kelch-like ECH-associated protein 1 (Keap1)/nuclear factor erythroid 2–related factor 2 (Nrf2)/HO-1 pathway associated with oxidative stress and apoptosis, confirming quercetin’s potential molecular mechanism of enhancing AD mouse cognition. Furthermore, western blot findings indicate that quercetin significantly alters protein expression in the Keap1/Nrf2/HO-1 pathway. Moreover, molecular docking analysis suggests that Keap1, NQO1, HO-1, caspase-3, Bcl-2, and Bax proteins in the Keap1/Nrf2/HO-1 pathway may be potential regulatory targets of quercetin. These findings will provide a molecular basis for quercetin’s clinical application in AD treatment. Conclusion: Quercetin can improve cognitive impairment and AD-like pathology in APP/PS1 double transgenic mice, potentially related to quercetin’s activation of the Keap1/Nrf2/HO-1 pathway and reduction of cell apoptosis.

Recently developed optogenetic technology, which allows high-fidelity control of neuronal activity, has been applied to investigate the neural circuits underlying sensory processing and behavior. The nasal cavity is innervated by the olfactory nerve and trigeminal nerve, which are closely related to common symptoms of rhinitis, such as impairment of smell, itching, and sneezing. The olfactory system has an amazing ability to distinguish thousands of odorant molecules at trace levels. However, there are many issues in olfactory sensing mechanisms that need to be addressed. Optogenetics offers a novel technical approach to solve this dilemma. Therefore, we review the recent advances in olfactory optogenetics to clarify the mechanisms of chemical sensing, which may help identify the mechanism of dysfunction and suggest possible treatments for impaired smell. Additionally, in rhinitis patients, alterations in the other nerve (trigeminal nerve) that innervates the nasal cavity can lead to hyperresponsiveness to various nociceptive stimuli and central sensitization, causing frequent and persistent itching and sneezing. In the last several years, the application of optogenetics in regulating nociceptive receptors, which are distributed in sensory nerve endings, and amino acid receptors, which are distributed in vital brain regions, to alleviate overreaction to nociceptive stimuli, has gained significant attention. Therefore, we focus on the progress in optogenetics and its application in neuromodulation of nociceptive stimuli and discuss the potential clinical translation for treating rhinitis in the future.

The most common and aggressive tumor is brain malignancy, which has a short life span in the fourth grade of the disease. As a result, the medical plan may be a crucial step toward improving the well-being of a patient. Both diagnosis and therapy are part of the medical plan. Brain tumors are commonly imaged with magnetic resonance imaging (MRI), positron emission tomography (PET), and computed tomography (CT). In this paper, multimodal fused imaging with classification and segmentation for brain tumors was proposed using the deep learning method. The MRI and CT brain tumor images of the same slices (308 slices of meningioma and sarcoma) are combined using three different types of pixel-level fusion methods. The presence/absence of a tumor is classified using the proposed Tumnet technique, and the tumor area is found accordingly. In the other case, Tumnet is also applied for single-modal MRI/CT (561 image slices) for classification. The proposed Tumnet was modeled with 5 convolutional layers, 3 pooling layers with ReLU activation function, and 3 fully connected layers. The first-order statistical fusion metrics for an average method of MRI-CT images are obtained as SSIM tissue at 83%, SSIM bone at 84%, accuracy at 90%, sensitivity at 96%, and specificity at 95%, and the second-order statistical fusion metrics are obtained as the standard deviation of fused images at 79% and entropy at 0.99. The entropy value confirms the presence of additional features in the fused image. The proposed Tumnet yields a sensitivity of 96%, an accuracy of 98%, a specificity of 99%, normalized values of the mean of 0.75, a standard deviation of 0.4, a variance of 0.16, and an entropy of 0.90.

Background. The phenomenon of burnout among healthcare workers during the COVID-19 pandemic is a widespread problem with several negative consequences for the healthcare system. The many stressors of the pandemic have led to an increased development of anxiety and depressive disorders in many healthcare workers. In addition, some manifested symptoms of the so-called postpandemic stress syndrome and the emergence of occupational burnout syndrome, commonly referred to as “COVID-19 burnout.” The aim of this study was to assess the burnout and life satisfaction of healthcare workers during the COVID-19 pandemic. Materials and Methods. The study was conducted in 2020-2022 among medical staff working in hospitals in Silesia, Poland. The instruments used to assess life satisfaction and burnout were the Satisfaction with Life Scale (SWLS) and the Maslach Burnout Inventory (MBI), which assesses three dimensions: emotional exhaustion (EE), depersonalisation (DEP), and sense of reduced professional accomplishment (SRPA). Results. The study group included 900 participants. There were 300 physicians (mean age 38±7 years), 300 nurses (mean age 35±6 years), and 300 paramedics (mean age 31±5 years). Life satisfaction as measured by the SWLS was lowest among nurses and paramedics in 2021 and among doctors in 2022. Male respondents and those with fewer years of work had higher levels of life satisfaction. People with more years of work had higher scores in EE and DEP and lower scores in SRPA (p=0.001). We found a negative correlation between life satisfaction and EE (p=0.001), DEP (p=0.001), and SRPA (p=0.002). Conclusions. The results highlight the need for further research into the causes of burnout among medical professionals and the need for effective interventions to promote well-being and prevent burnout in this group.

Introduction. AADCd is an ultrarare, underdiagnosed neurometabolic disorder for which a screening test (3-OMD dosing on dried blood spot (DBS)) and targeted gene therapy (authorized in the EU and the UK) are available. Therefore, it is mandatory to raise awareness of presenting symptoms and signs among practitioners. Delivering scientifically sound information to promote screening of patients with the correct cluster of symptoms and signs would be critical. Materials and Methods. In light of the lack of sound evidence on this issue, expert opinion level of evidence was elicited with the Delphi method. Fourteen steering committee members invited a panel of 29 Italian experts to express their opinions on a series of crucial but controversial topics related to using 3-OMD DBS as a screening method in AADCd. Clusters of symptoms and signs were divided into typical or atypical, depending on age groups. Inclusion in newborn screening programs and the usefulness of a clinical score were investigated. A five-point Likert scale was used to rate the level of priority attributed to each statement. Results. The following statements reached the highest priority: testing pediatric patients with hypotonia, developmental delay, movement disorders, and oculogyric crises; inclusion of 3-OMD dosing on DBS in neonatal screening programs; development of a clinical score to support patients’ selection for 3-OMD screening; among atypical phenotypes based on clinical characteristics of Italian patients: testing patients with intellectual disability and parkinsonism-dystonia. Discussion. Clusters of symptoms and signs can be used to prioritize testing with 3-OMD DBS. A clinical score was rated as highly relevant for the patient’s selection. The inclusion of 3-OMD dosing in newborn screening programs was advocated with high clinical priority.

Obsessive-compulsive disorder (OCD) is a disabling disease characterized by distressing obsessions and repetitive compulsions. The etiology of OCD is poorly known, and mouse modeling allows to clarify the genetic and neurochemical basis of this disorder and to investigate potential treatments. This study evaluates the impact of the 5-HT1B agonist RU24969 on the induction of OCD-like behaviours in female BALB/c mice ( n = 30 ), distributed across five groups receiving varying doses of RU24969. Behavioural assessments, including marble test, tail suspension test, sucrose preference test, forced swim test, and nestlet shredding test, were conducted. Gene expression and protein quantitation of Gabra1 and serotonin transporter in mouse brain were also performed. Marble-burying behaviour increased significantly at high doses of RU24969 (15-20 mg/kg). The forced swimming test consistently showed elevated values at the same high concentrations, compared to the control. Altered reward-seeking behaviour was indicated by the sucrose preference test, notably at 15 and 20 mg/kg doses of RU24969. Nestlet shredding results did not show statistical significance among the tested animal groups. Gene expression analysis revealed reduced Gabra1 expression with increasing doses of RU, while serotonin transporter was not related to varying doses of RU24969. Western blotting corroborated these trends. The results underscore complex interactions between the serotonin system, GABAergic signaling, and OCD-relevant behaviours and suggest the use of intraperitoneal injection of 15 mg/kg of RU24969 to induce OCD-like behaviour in BALB/c mouse models.

Amyotrophic lateral sclerosis (ALS) is the most frequent neurodegenerative disease of the motor system that affects upper and lower motor neurons, leading to progressive muscle weakness, spasticity, atrophy, and respiratory failure, with a life expectancy of 2–5 years after symptom onset. In addition to motor symptoms, patients with ALS have a multitude of nonmotor symptoms; in fact, it is currently considered a multisystem disease. The purpose of our narrative review is to evaluate the different types of pain, the correlation between pain and the disease’s stages, the pain assessment tools in ALS patients, and the available therapies focusing above all on the benefits of cannabis use. Pain is an underestimated and undertreated symptom that, in the last few years, has received more attention from research because it has a strong impact on the quality of life of these patients. The prevalence of pain is between 15% and 85% of ALS patients, and the studies on the type and intensity of pain are controversial. The absence of pain assessment tools validated in the ALS population and the dissimilar study designs influence the knowledge of ALS pain and consequently the pharmacological therapy. Several studies suggest that ALS is associated with changes in the endocannabinoid system, and the use of cannabis could slow the disease progression due to its neuroprotective action and act on pain, spasticity, cramps, sialorrhea, and depression. Our research has shown high patients’ satisfaction with the use of cannabis for the treatment of spasticity and related pain. However, especially due to the ethical problems and the lack of interest of pharmaceutical companies, further studies are needed to ensure the most appropriate care for ALS patients.

Background. Low vision (LV) has a significant negative impact on the activities of daily life as well as on the psychological health of patients. Objectives. The objective of this study is to investigate psychological, clinical, and demographic factors that may impact the daily functionality of patients with LV. Methods. A convenience sample of 53 patients, meeting the WHO criteria for LV, was recruited. Questionnaires on daily functionality, depression, and life orientation (in terms of optimism/pessimism) were administered along with a semistructured personal interview. Key Findings. The main results revealed a significant negative correlation between daily functionality and depression ( r = − 0.423 , p < 0.001 ). Conversely, there is a positive correlation between daily functionality and visual acuity ( r = 0.415 , p < 0.001 ), while years since diagnosis were negatively correlated with depression ( r = − 0.345 , p < 0.001 ). Depression seems to be a moderate predictor of a person’s daily functionality ( β = − 0.389 , p < 0.002 ), followed by visual acuity ( β = − 0.344 , p = 0.006 ), explaining the 31.1% of the total variance. Conclusions. The study supports a correlation between daily functionality and both depression and visual acuity. Optimism as a personality characteristic did not factor into the prediction model for daily functionality, but it showed a strong correlation with lower levels of depressive symptoms. This highlights the potential for developing coping strategies for chronic disease management. Recommendations. The study could serve as a useful guide and may urge clinicians to pay attention to the psychological evaluation of these patients, supporting their unique emotional needs. Mental health professionals can use patients’ positive resources to provide appropriate counseling and embrace the coping skills that encourage their engagement in activities of daily life.

A spinal cord injury is a life-changing experience that results in functional limitations and an increased risk of secondary health conditions. People with spinal cord injury identify pain as the most devastating health problem following their injury that not only affects their social life but their mental well-being as well. This study is aimed at exploring the lived experience of living with pain by community-dwelling manual wheelchair users with spinal cord injuries. An explorative qualitative design was used to explore their experiences. In-depth interviews were recorded and transcribed, and the data were analysed using inductive thematic content analysis in the MAXQDA v2020. Fifteen manual wheelchair users with paraplegia participated in this study, and four themes were identified from their experience of living with pain: pain constantly lurks, pain is worse than the direct consequences of the SCI, pain is restrictive, and life continues despite the pain. Categories and subcategories included the participants being one with the pain; pain interfering with sleep; feelings of anger, isolation, and suicidal ideation; and uncertainties about what the future holds living with pain. Living with pain after SCI is a challenging feat, and effective management of pain is necessary to improve not only functioning and mobility but also mental health and life satisfaction.

Objective. The aim of this study was to explore the resting-state functional connectivity (rsFC) of amygdala subregions in healthy controls (HCs) and in patients with Crohn’s disease (CD) both with and without anxiety or depression. Materials and Methods. A total of 33 patients with CD and with anxiety or depression (CDad group), 31 patients with CD but without anxiety or depression (CDnad group), and 29 age-, sex-, and education level-matched HCs underwent functional magnetic resonance imaging. rsFC analysis was used to analyze the FC between the amygdala subregions and other areas of the brain. Results. Compared with the HC group, the CDad group demonstrated decreased rsFC between the right laterobasal subregion and the left hippocampus ( P < .001 ) and right middle frontal gyrus ( P < .001 ) and between the left superficial subregion and the left insula ( P < .001 ). Compared with the HC group, the CDnad group demonstrated decreased rsFC between the left centromedial subregion and the left insula ( P < .001 ). Compared with the CDnad group, the CDad group demonstrated decreased rsFC between the left centromedial subregion and the right precuneus ( P < .001 ) and postcentral gyrus ( P < .001 ), between the right laterobasal subregion and the left hippocampus ( P < .001 ), and between the left superficial subregion and the right middle frontal gyrus ( P < .001 ). Conclusions. There are significant FC changes in the amygdala subregions in patients with CD. These changes may be related to the disease itself or to the symptoms of anxiety and depression.

Objective People with visual snow syndrome (VSS) experience a range of perceptual phenomena, in addition to visual snow (VS; flickering pinpricks of light throughout the visual field). We investigated the patterns of perceptual phenomena associated with VSS in a large sample of people without prior knowledge of VSS or its associated symptoms. Methods and Measures. Two thousand participants completed a screening questionnaire assessing the frequency and severity of perceptual phenomena associated with VSS. We used latent class analysis (LCA), a clustering technique which identifies qualitatively different subgroups within a given population, to investigate whether the presence (or absence) of VS impacted class structure. Results Of 1,846 participants included for analysis, 41.92% experienced VS some of the time, including 4.49% who had VSS without prior knowledge. The mean number of perceptual phenomena experienced was 2.03. Optimal four-class LCA solutions did not substantially differ whether VS was included in the model; instead, classes differed in the frequency and total number of symptoms experienced. Discussion. Our results suggest that the perceptual phenomena associated with VSS are likely to be common in the general population and do not necessarily indicate an underlying pathology. We also showed that visual snow itself does not explain the presence of other perceptual phenomena.

Mice are social animals that change their behaviour primarily in response to visual, olfactory, and auditory information from conspecifics. Rearing conditions such as cage size and colour are important factors influencing mouse behaviour. In recent years, transparent plastic cages have become standard breeding cages. The advantage of using a transparent cage is that the experimenter can observe the mouse from outside the cage without touching the cage. However, mice may recognise the environment outside the cage and change their behaviour. We speculated that mice housed in transparent cages might recognise mice in neighbouring cages. We used only male mice in this experiment. C57BL/6 mice were kept in transparent rearing cages with open lids, and the cage positions were maintained for 3 weeks. Subsequently, we examined how mice behaved toward cagemate mice, mice from neighbouring cages, and mice from distant cages. We compared the level of interest in mice using a social preference test. Similar to previous reports, subject mice showed a high degree of interest in unfamiliar mice from distant cages. By contrast, subject mice reacted to mice from neighbouring cages as familiar mice, similar to cagemate mice. This suggests that mice housed in transparent cages with open lids perceive the external environment and identify mice in neighbouring cages. Researchers should pay attention to the environment outside the mouse cage, especially for the social preference test.

Background Mild cognitive impairment (MCI), an intermediate stage between normal aging and dementia, has emerged as a prominent research area in geriatric care due to its heightened propensity for progressing toward dementia. Sleep plays a pivotal role in cognitive function, with dyssomnias not only exacerbating cognitive and affective symptoms associated with neurodegenerative diseases but also contributing to disease progression. Aim This bibliometric analysis investigates the global research on MCI with dyssomnias over the past two decades, aiming to discern key findings, research domains, and emerging trends in this field. Methods In this study, a bibliometric analysis was conducted using the search terms “MCI” and “sleep”. Data were extracted from the Web of Science Core Collection database, and visualization and collaborative analysis were performed using CiteSpace and VOSviewer. Results This study encompassed 546 publications from 2003 to 2023. The publication volume and citation rate consistently increased over time. Neurosciences, Clinical Neurology, and Geriatrics Gerontology emerged as the top three research fields. The Journal of Alzheimer's Disease had the highest publication count, while Sleep Medicine received the most citations. USA, China, and Italy led in publication output. Collaborative clusters among authors and institutions were identified, but cooperation between clusters was limited. Active cocited reference clusters included “obstructive sleep apnea”, “possible mediating pathways”, and “isolated rapid eye movement sleep behaviour disorder”. The top frequently mentioned keywords, besides “MCI”, were “Alzheimer's disease”, “dementia”, “risk factor”, and “Parkinson's Disease”. Notable keyword clusters spanned circadian rhythm, Parkinson's disease, MCI, dementia with Lewy body, subjective cognitive impairment, Lewy body disease, Alzheimer's disease, and dietary patterns. Conclusion The field of MCI with dyssomnias is rapidly expanding, encompassing a wide range of neurodegenerative disorders and sleep disturbances. Current research endeavors are primarily focused on elucidating the underlying pathogenesis, predicting disease progression, and developing innovative treatment strategies for individuals affected by MCI with dyssomnias.

This retrospective cross-sectional study is aimed at investigating the prevalence and characteristics of behavioral and psychological symptoms (BPS) in subacute stroke patients with cognitive impairment. The Neuropsychiatric Inventory-Questionnaire (NPI-Q) was used to assess BPS. A total of 358 consecutive patients with first-ever stroke admitted to rehabilitation wards and with Mini-Mental State Examination (MMSE) scores < 24 on admission were included. BPS was defined as a total NPI-Q Severity or Distress score ≥ 1 . Differences between the severity and presence of BPS among patients with severe cognitive impairment (MMSE scores 0–17) and those with mild cognitive impairment (MMSE scores 18–23) were analyzed using the Mann–Whitney U test and chi-squared test, respectively. Eighty-one patients (mean (standard deviation) age, 73.5 (13.1) years) were enrolled for analysis. BPS were observed in 69.1% and 74.1% of patients when assessed with NPI-Q Severity and NPI-Q Distress, respectively. The most frequently observed BPS was apathy, followed by depression (approximately 44% and 40%, respectively). The severity and frequency of delusions, euphoria, apathy, and disinhibition were significantly higher in the severe cognitive impairment group than in the mild cognitive impairment group. However, the severity, distress, and frequency of depression were not dependent on the severity of cognitive impairment. The presence of BPS, especially apathy and depression, in subacute stroke patients with cognitive impairment is high. The severity and frequency of some BPS are higher in patients with severe cognitive impairment than in those with mild cognitive impairment. However, depression is highly prevalent among the patients regardless of the severity of cognitive impairment.