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Brain Sciences

MDPI AG

Preprints posted in the last 30 days, ranked by how well they match Brain Sciences's content profile, based on 52 papers previously published here. The average preprint has a 0.05% match score for this journal, so anything above that is already an above-average fit.

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Investigating the Usability, Feasibility, and Effect of a Virtual Reality Cognitive Training System on Brain Cancer Patients with Mild Cognitive Impairment: A Quasi-Experimental (Single-Arm) Pilot Study

Faiola, A.; Villano, J. L.; Soroya, S. H.

2026-05-19 neurology 10.64898/2026.05.18.26353031 medRxiv
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(1) Background: Brain cancer is the ninth leading cause of cancer death in the US, with approximately 76,000 newly diagnosed cases annually. Studies show that at time of diagnosis, up to six-months post-treatment, 50%-80% of brain cancer survivors (BCS) report cognitive dysfunction. Mild cognitive impairment (MCI) has gained increasing attention as a persistent disability experienced by up to 75% of all BCS, which affects memory, concentration, executive function, etc. Studies show cognitive training with computerized gaming as improving cognitive function for patients with stroke, dementia, and Parkinsons. It is of significant clinical interest to develop innovative interventions that reduce MCI. Aim: To improve cognitive performance of BCS suffering with MCI by evaluating the feasibility, acceptability and effect of a Virtual Reality Cognitive Rehabilitation Training (VR-CRT) platform during four weeks of cognitive training. (2) Methods: We employed a quasi-experimental pretest/posttest non-randomized/non-blinded single-arm design for 4 weeks, with an experimental group (n=6, after attrition) using VR-CRT. Participants were selected based on convenience sampling using the electronic medical record to identify qualified patients, guided by inclusion/exclusion criteria. Feasibility was defined by retention as >80%, with usability testing using the System Usability Scale (SUS) and NASA-TLX surveys. The Hopkins Verbal Learning Test (HVLT), Controlled Oral Word Association (COWA) test, and Trail Making A-B (TM-A/B) test were used to measure cognitive performance, comparing baseline to post week-four. (3) Results: The feasibility criteria of >80% was met. All SUS and NASA scores were in the higher index, suggesting a high degree of usability, with low workload demand. For effect, the COWA findings showed a significant improvement (41.38%), with a paired sample T-Test confirming that the participants COWA scores improved significantly from pre- to post-intervention (p = 0.03), indicating enhanced verbal fluency and executive functioning after intervention. HVLT (combined) showed improvements of 18.75% for Form A and 11.32% for Form B, which also showed a significant improvement (p = .04) in the retention discrimination index from pre- to post-test. The TM-A/B test showed an improvement (25.97%), suggesting that the participants spent less time completing both parts A and B, but was not statistically significant. (4) Conclusion: This study fulfilled our aim to demonstrate modest to significant cognitive improvement using VR-CRT with brain cancer patients with MCI. Despite the small sample size, we believe the use of virtual reality will lead to important advances for patients with MCI, particularly the frontal lobe brain region, expressed in executive function.

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Cortical activity during narrative discourse production in individuals with post-stroke aphasia and controls measured via functional near-infrared spectroscopy

Braun, E. J.; Carpenter, E. A.; Gao, Y.; Yucel, M. A.; Boas, D. A.; Kiran, S.

2026-06-10 rehabilitation medicine and physical therapy 10.64898/2026.06.05.26354921 medRxiv
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Introduction: Aphasia is an acquired language disorder with a significant negative functional impact. Much of the research on aphasia has focused on word-level language comprehension and production. Further evaluation of discourse-level tasks, both at behavioral and neural levels, will allow for an ecologically valid understanding of the functional implications of language impairment in this population. Method: This study evaluated bilateral frontal, temporal, and parietal cortical activity during computer-based narrative production in 14 young neurotypical individuals, 17 individuals with post-stroke aphasia, and 15 age-matched neurotypical participants using functional near-infrared spectroscopy (fNIRS). Oxygenated hemoglobin (HbO) was measured during narrative production following short video clips and compared to HbO during counting aloud. In addition, behavioral measures quantifying in-task performance were correlated with averaged HbO values. Results: Young neurotypical individuals showed greater cortical activity in bilateral language regions for narrative production compared to counting aloud. In contrast, people with aphasia showed positive condition-related effects in the right frontal ROI and the age-matched group showed positive condition-related effects in the left frontal and right precentral ROIs. Each group showed different patterns in relationships between cortical activity and discourse performance measures. Conclusion: Overall, young participants showing more consistent condition-related effects for narrative discourse production than individuals with aphasia and age-matched controls. This study shows the potential for fNIRS to evaluate cortical activity for ecologically valid language tasks in individuals with post-stroke aphasia.

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Cortical activation in healthy young adults performing a verbal fluency task during gait: A near-infrared functional spectroscopy (f-NIRS) study.

Mendes, F. A. d. S.; Silva, P. R. d.; Garcia, D. F.; Miamoto, M. S.; Macena, R. G.; Santos, L. B. R.; Aranha, L. d. M.; Santos, G. V.; Sato, J. R.; Piemonte, M. E. P.

2026-05-15 neurology 10.64898/2026.05.12.26353003 medRxiv
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BACKGROUND: Dual task walking requires simultaneous management of cognitive and motor demands and is associated with changes in gait and cortical activation. However, the relationship between task related cortical recruitment and dual task related gait adjustments in healthy young adults remains unclear. This study aimed to investigate the effects of dual tasking on gait performance and cortical activation, and to examine the association between changes in cortical activity and dual-task costs. METHODS: This cross sectional study included 33 healthy young adults. Participants performed three conditions: single task walking, cognitive single task (verbal fluency), and dual task walking. Each condition was repeated 10 times using a repeated short block design with randomized trial presentation. Gait performance was assessed using an instrumented walkway, and cortical activation was measured using functional near infrared spectroscopy. Dual task costs were calculated for gait and cognitive outcomes. Statistical analysis included repeated measures analysis of variance (ANOVA) and Wilcoxon signed rank tests, with false discovery rate correction for multiple comparisons. Associations between changes in cortical activation and dual task costs were examined using correlation analyses. RESULTS: Dual task walking resulted in significant changes in gait, including reduced speed, step and stride length, and increased base of support, stance, and double support (all p < 0.05), while cognitive performance remained unchanged. Dual tasking was associated with increased cortical activation in left prefrontal and motor related regions. Greater increases in cortical activation were associated with lower dual task costs across most gait parameters, with significant correlations observed in the left dorsolateral prefrontal cortex (r {approx} 0.42 to 0.47 for speed and stride length; p < 0.05). Double support showed a distinct pattern, suggesting a specific temporal adjustment within the gait cycle. CONCLUSIONS: Dual task walking in young adults is associated with coordinated behavioral and cortical adaptations. Increased cortical recruitment is linked to reduced motor interference, suggesting that broader engagement of cortical networks may contribute to performance under cognitive motor load.

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A Stronger Association Between Screen Time and Externalizing Problems in Typically Developing Children than in Children with Autism Spectrum Disorder

Miyashita, S.; Hirosawa, T.; Yoshimura, Y.; Hasegawa, C.; Tanaka, S.; Miyagishi, Y.; Naito, N.; Kikuchi, M.

2026-05-28 scientific communication and education 10.64898/2026.05.24.727542 medRxiv
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Excessive screen use is associated with childhood behavioral problems, but whether associations differ between typically developing (TD) children and those with autism spectrum disorder (ASD) is unclear. Our cross-sectional study included 108 children aged 5-9 years (61 TD, 47 ASD). ASD was diagnosed using standardized clinical instruments. Measures included parent-reported screen time (excluding TV/DVD), cognitive ability (K-ABC), and behavioral problems (Vineland-II). Screen time and externalizing problems were associated in the TD group (Spearmans {rho} = 0.361, p < 0.01), but not in the ASD group. In the regression model, screen time ({beta} = 0.40, t = 2.60, p < 0.05), ASD status ({beta} = 0.70, t = 8.30, p < 0.001), and their interaction ({beta} = -0.34, t = -2.06, p < 0.05) significantly predicted externalizing problems. Considering the diversity within the autism spectrum, future studies with larger sample sizes should consider individual heterogeneity when examining the association between behavioral outcomes and screen time.

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Shortened Cortical Silent Period in Children with Attention Deficit Hyperactivity Disorder

Feier, D. S.; Gilbert, D. L.; Crocetti, D.; Migneault, K. Y.; Huddleston, D. A.; Horn, P. S.; Mostofsky, S. H.; Wu, S. W.

2026-05-28 neurology 10.64898/2026.05.26.26354157 medRxiv
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Background and Objectives In ADHD, a heterogeneous neurodevelopmental condition, behavioral and motor manifestations may reflect multiple inefficient or perturbed inhibitory systems. To evaluate Transcranial Magnetic Stimulation (TMS) evoked cortical silent period (CSP) duration, an indicator of GABA(B) receptor-mediated inhibition in motor cortex, as a potential biomarker of Attention-Deficit/Hyperactivity Disorder (ADHD) in children. Method We retrospectively analyzed TMS data, obtained using both round and figure-of-8 coils, from three cross-sectional studies conducted in 8- to 12-year-old children with ADHD (n=79; 10.7 +/- 1.5 years old) and age-and-sex-matched typically developing controls (n=96; 10.5 +/- 1.4 years old). Results Median CSP was 32% shorter in ADHD (p=0.02). Regression analysis demonstrated a relationship between shorter CSP and both lower active motor thresholds (p < 0.0001) and more severe hyperactivity symptom rating (p = 0.026). Test-retest CSP measures in 83 children showed moderate reliability (intraclass correlation 0.77 [ADHD], 0.75 [controls]). Conclusion TMS-evoked CSP may be a useful biomarker in future investigations of ADHD subtypes, domains of impaired function, or treatment outcomes.

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The emotional impact of gambling-related advertising: an experimental functional Near-Infrared Spectroscopy study protocol

Daniel, L.-I.; Ros-Leon, A.; Molina-Rodriguez, S.; Pellicer-Porcar, O.; Cabrera-Perona, V.; Ibanez-Ballesteros, J.

2026-05-27 addiction medicine 10.64898/2026.05.20.26353682 medRxiv
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The proliferation of gambling advertising has intensified concerns regarding its influence on vulnerable populations, yet the neural mechanisms underlying cue-reactivity to these stimuli remain underexplored in ecologically valid settings. This study protocol proposes a novel methodological framework to investigate prefrontal cortical responses to gambling advertisements in individuals with varying degrees of gambling experience. Materials and methods: This cross-sectional study will recruit 44 participants, divided into a clinical group (individuals with high-frequency gambling or gambling disorder) and a matched control group. Neural activity will be recorded using fNIRS while participants view gambling-related, neutral, violent, and sexual stimuli. Secondary measures include validated scales for gambling severity (SOGS), impulsivity, sensation seeking, and alexithymia. Data analysis will primarily utilize inter-subject correlation (ISC) to quantify neural synchronization and multiband frequency decomposition to capture dynamic affective processing. Advanced preprocessing, including short-channel regression, will be applied to ensure signal robustness. Discussion: By combining portable neuroimaging with a data-driven ISC approach, this study aims to identify objective neural markers of gambling vulnerability. The findings will provide novel insights into the idiosyncratic processing of commercial stimuli, potentially informing public health policies and the development of more effective evidence-based regulations for gambling marketing.

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Morphological feature remodeling of intracranial arteries in the context of inflammation and HIV-associated cognitive impairment

Hoang, N.; Yang, H.; Uddin, M. N.; Zhong, J.; Faiyaz, A.; Singh, M. V.; Boodoo, Z. D.; Sutton, K. R.; Wang, H. Z.; Sahin, B.; Khan, M. W.; Weber, M. T.; Yuan, C.; Chen, L.; Schifitto, G.

2026-05-27 hiv aids 10.64898/2026.05.19.26353071 medRxiv
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Background: Despite the success of combination antiretroviral therapy (cART), vascular comorbidities, including cerebrovascular disease, are more prominent in people living with HIV (PLWH) compared to people without HIV (PWOH). However, quantitative assessments of cerebrovascular morphometry and their associations with cognitive outcomes in the context of HIV are still limited. In this study, we explore this missing link. Methods: Magnetic Resonance Angiography (MRA) data, blood markers, and neurocognitive assessments were collected from 73 PWOH subjects (male: 57, female: 16; age: 53 {+/-} 16) and 99 PLWH subjects (male: 66, female: 30, age: 53 {+/-} 11). Vessel morphometric features were quantified using intraCranial Artery Feature Extraction (iCafe) to investigate associations between vessel morphometry, markers of monocytes, endothelial cell activation, and cognitive performance. Results: HIV status predicted a lower total number of branches ({beta} = -0.224, p = 0.001, d = -0.517) and shorter total distal length ({beta} = -0.173, p = 0.021, d = -0.370) with a moderate effect size. Total branch number was found to be negatively associated with plasma levels of monocyte markers (sCD14: r = -0.167, p = 0.033; sCD163: r = -0.157, p = 0.045) and positively correlated with white matter cerebral blood flow (r = 0.550; p [&le;] 0.05). HIV status was the strongest predictor of overall cognitive performance in ANCOVA model ({beta} = -0.219, p = 0.006, d = -0.453). Conclusions: Our results suggest that cognitive impairment in PLWH is associated with vessel morphology metrics. Monocyte immune activation may contribute to changes in vessel morphology.

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Phase of transcranial alternating current stimulation modulates working memory processing speed

Dimmendaal, J.; Wang, X.; Dijkslag, B. J.; Huizinga, L. E.; Maalderink, S.; Priest, M.; van Dam, F. J. E.; Span, M. M.; Wischnewski, M.

2026-05-29 neuroscience 10.64898/2026.05.26.727793 medRxiv
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BackgroundTheta-frequency transcranial alternating current stimulation (tACS) over prefrontal cortex has been proposed to modulate working memory (WM), yet behavioral effects are often inconsistent. One potential source of variability is the tACS phase during stimulus presentation. ObjectiveWe tested whether behavioral performance during WM depends on the phase of prefrontal theta-tACS. MethodsTwenty participants completed two sessions of prefrontal 4 Hz tACS in a within-subject design, receiving active and sham stimulation in separate sessions. Participants performed a visuospatial change detection task (CDT) and a verbal N-back task. Stimulation effects on overall accuracy and reaction time were analyzed. Subsequently, phase-specific analyses related stimulation phase at task-relevant stimulus presentation to behavioral performance using circular regression models. Preferred phases across participants were tested using Rayleigh tests. ResultsNo significant overall effects of active compared with sham tACS on accuracy or reaction time were observed in either task. However, phase-specific analyses revealed stronger phase-dependent modulation of reaction time during active tACS compared with sham. In the CDT, this effect was present across difficulty levels, whereas in the N-back task it was observed only in the 3-back condition. No reliable phase-dependent effects were observed for accuracy. Preferred phases varied across participants and did not cluster around a common phase. ConclusionsPrefrontal theta-tACS can modulate WM performance in a phase-dependent manner even in the absence of average behavioral effects. The observation of phase-dependent reaction-time modulation across visuospatial and verbal WM tasks suggests that stimulation phase may be a relevant source of variability across cognitive domains.

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Real-Time fMRI Neurofeedback Targeting Cue Reactivity in Alcohol Use Disorder: Challenges and Insights from a Randomized Controlled Trial

Halli, P.; Weiss, F.; Gerhardt, S.; Zhang, J.; Sommer, W. H.; Kiefer, F.; Kirsch, P.; Gerchen, M. F.

2026-06-01 psychiatry and clinical psychology 10.64898/2026.05.29.26354435 medRxiv
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In a single-blind randomized controlled trial, we investigated the effectiveness of real-time fMRI neurofeedback delivered in 7 runs over three sessions across two weeks in N = 65 patients with alcohol use disorder. The intervention targeted modulation of ventral striatal cue reactivity to alcohol-related cues as well as enhancement of prefrontal control mechanisms in the right inferior frontal gyrus. The study design incorporate three experimental groups that either were instructed to downregulate a ventral striatum signal, upregulate the right inferior frontal gyrus, or upregulate negative functional connectivity between these two structures. In two active control groups participants were instructed to either up- or downregulate the primary auditory cortex. We did not find an effect of ventral striatal downregulation or negative connectivity feedback, and a reduced striatal activation in the right inferior frontal gyrus upregulation group was accompanied by concurrent lower activation in the target structure, suggesting that our intended modulation approaches were not effective. Identified problems that might have contributed to this unexpected outcome might have been the use of continuous feedback presentation that potentially confuses regulation target and reward processing in the ventral striatum, counterintuitive regulation directions, a lack of explicit strategy guidance and transparency about the targeted process, and generally the difficulty to recruit a sufficient number of eligible voluntary participants for a well-powered study with a complex design. These insights emphasize the complex challenges of real-time fMRI neurofeedback interventions for the treatment of substance use disorders and could provide guidance for the development of more effective future approaches.

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Activation of mGlu2 receptors reverses persistent post-methamphetamine deficit in object-in-place recognition memory.

Galbava, V.; Wu, L.; Schwendt, M.

2026-05-28 neuroscience 10.64898/2026.05.25.727633 medRxiv
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Background/ObjectivesPersistent cognitive impairments are prevalent in methamphetamine (meth) use disorder and contribute to maladaptive decision-making and increased relapse vulnerability. There are currently no effective treatments for meth-associative cognitive deficits, and their neurobiological underpinnings remain incompletely understood. This study investigated the effects of chronic meth self-administration on episodic-like recognition memory and evaluated whether pharmacological potentiation of metabotropic glutamate receptor subtype 2 (mGlu2) could rescue these deficits. MethodsAdult male Sprague-Dawley rats underwent 7 days of limited- (1h/day) followed by 14 days of extended-access (6h/day) meth self-administration, followed by 30 days of abstinence. Recognition memory was assessed using the object-in-place (OIP) task. A positive allosteric modulator of mGlu2 receptors, LY-487379 (25 mg/kg, s.c.), was administered prior to the memory test. In parallel, changes in total and surface mGlu2/3 protein levels in the prelimbic and perirhinal cortices were evaluated. ResultsRats with extended access to meth self-administration exhibited escalated drug intake and persistent deficits in OIP memory. Administration of LY-487379 reversed this deficit. Total mGlu2/3 protein levels were unaltered; however, meth exposure was associated with a significant increase in surface mGlu2/3 receptor expression in both cortical regions examined. ConclusionsThese results demonstrate that chronic meth produces persistent cognitive dysfunction that can be rescued by mGlu2 receptor potentiation. The observed increase in surface mGlu2/3 expression may represent a compensatory response to chronic glutamatergic dysregulation, but it appears to be insufficient to restore cognitive function alone, without pharmacological enhancement. The current data encourage further exploration of mGlu2 role in stimulant-associated cognitive dysfunction. HighlightsChronic methamphetamine self-administration produced persistent deficits in episodic-like recognition memory in male rats and dysregulation of mGlu2/3 receptors in the prelimbic and perirhinal cortices. Systemic pharmacological potentiation of mGlu2 receptors rescued meth-associated memory deficits. mGlu2 receptor potentiation may represent a promising therapeutic strategy for treating stimulant-associated cognitive dysfunction. Increased surface mGlu2/3 expression may represent a compensatory adaptation to post-methamphetamine glutamatergic dysfunction, but it is not sufficient to restore cognition alone, without pharmacological enhancement.

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Descending Brainstem Systems Contribute to Ankle Clonus in Humans with Spinal Cord Injury

Curuk, E.; Chen, B.; Benedetto, A.; Farley, M.; Sangari, S.; De Santis, D.; Rymer, W. Z.; Hultborn, H.; Pearcey, G. E. P.; Tyselling, V. M.; Heckman, C. J.; Perez, M. A.

2026-05-22 neurology 10.64898/2026.05.21.26353256 medRxiv
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Ankle clonus is a sustained, involuntary, rhythmic muscle contraction frequently observed in humans with spinal cord injury (SCI). Although its pathophysiology remains incompletely understood, converging evidence suggests a role for brainstem systems in its generation. Following SCI, brainstem neuromodulatory inputs partially compensate for the loss of descending motor pathways by regulating motoneuron excitability during involuntary contractions, suggesting their involvement in the generation of clonus. To test this hypothesis, motoneuron excitability in response to Ia synaptic input was quantified using the soleus H reflex and maximal motor response (H/M ratio), and brainstem involvement was probed using the long lasting component of the cutaneous reflex (LLR) in the tibialis anterior and soleus muscles, as well as the StartReact response-an involuntary release of a movement triggered by a startling stimulus thought to engage the reticulospinal tract. We studied individuals with chronic SCI, both with and without ankle clonus, using standardized clinical tests across two days. Participants with clonus showed elevated H/M ratios, indicating increased motoneuron excitability, whereas those without clonus exhibited lower values than controls. Additionally, individuals with clonus exhibited longer LLR duration and greater LLR magnitude in both muscles, along with shorter reaction times to startle stimuli, consistent with enhanced monoaminergic and reticulospinal contributions. Notably, LLR duration was positively correlated with both StartReact response and H/M ratio. Together, these findings support a role for descending brainstem systems-particularly monoaminergic and reticulospinal pathways-in the maintenance of clonus in chronic SCI.

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Adapting a Regulation of Craving Magnetic Resonance Imaging Task to Generate Functional Repetitive Transcranial Magnetic Stimulation Targets for the Ventromedial and Dorsolateral Prefrontal Cortex in Treatment-Seeking Participants with Cannabis Use Disorder

Geoly, A.; McCalley, D. M.; Struckmann, W.; Azeez, A.; Wong, B.; Kim, B.; Ninomiya, S.; Ahmed, S.; Kim, J. P.; McRae-Clark, A. L.; Froeliger, B.; Sahlem, G. L.

2026-06-06 addiction medicine 10.64898/2026.06.04.26353616 medRxiv
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Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising treatment across addictive disorders including Cannabis Use Disorder (CUD). Targeting incentive-salience circuitry via the ventromedial prefrontal cortex (vmPFC) and central-executive circuitry via the left dorsolateral prefrontal cortex (LDLPFC) are both promising treatment approaches; however, to date structural targets have predominated whereas functional targeting may allow for more precision. In this pilot trial we adapted a functional Magnetic Resonance Imaging (fMRI) Regulation of Craving (ROC) task to generate fMRI-based rTMS targets in the vmPFC and LDLPFC. Methods: We recruited treatment-seeking participants with moderate or severe CUD as a part of an open-label trial and administered an adapted ROC-task during fMRI following 24-hours of cannabis abstinence. We identified sub-portions of maximal activation of the LDLPFC when participants thought of long-term consequences of cannabis use (Later) and of the vmPFC when participants thought of short-term positive aspects of cannabis use (Now). We hypothesized that our task would generate acceptable rTMS targets in >66% of baseline fMRI scans. Results: A total of 20-participants enrolled in the trial (50%F, age=33.3+9.8) and completed the baseline fMRI. The adapted ROC-task elicited group level activation in the LDLPFC and precuneus in the Later>Now and in the bilateral vmPFC, ACC, and striatum in the Now>Later contrast. Acceptable functional targets resolved in both the vmPFC and LDLPFC in 19 of 20 participants (one participant did not tolerate MRI). Conclusions: The adapted ROC-task elicits activation in incentive salience and central executive circuitry and can feasibly generate rTMS targets when using a cluster selection algorithm.

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Cortical activation and motor-cognitive performance during dual-task walking across healthy aging and Parkinsons disease: a standardized longitudinal fNIRS and gait analysis protocol

Aranha, L. d. M.; da Silva, P. R.; Garcia, D. F.; dos Santos, L. B. R.; Sato, J. R.; Santos, G. V.; Braghetto, K. R.; Piemonte, M. E. P.

2026-06-03 neurology 10.64898/2026.06.02.26354715 medRxiv
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BACKGROUND: Aging and Parkinsons disease (PD) reduce gait automaticity and increase cognitive demand during walking. Although dual task (DT) paradigms investigate cognitive motor interference, evidence remains limited by heterogeneous tasks, predominant focus on prefrontal cortex (PFC) activity, and variability in functional near infrared spectroscopy (fNIRS) methods. This study investigates whether longitudinal changes in cortical activation during DT walking differ among young adults, older adults, and individuals with PD, and how these changes relate to DT costs over 5 years. METHODS: This longitudinal observational study follows STROBE and fNIRS guidelines and will be conducted in a controlled laboratory (Rede Amparo, CEPID NeuroMat, University of Sao Paulo). Participants will be evaluated annually under three randomized conditions: motor single-task walking, cognitive single task phonemic verbal fluency and DT walking with phonemic verbal fluency, each repeated 10 times. The primary outcome measure will be longitudinal changes in cortical activation during DT walking, quantified by oxygenated hemoglobin (HbO) signals measured with fNIRS in prefrontal and premotor cortical regions. The main predictors of interest will be motor and cognitive DT costs. Covariates will include age, sex, education, cognition, balance, mood, and disease severity in the PD group. Spatiotemporal gait parameters, including gait speed, step length, stride length, step time, base of support, double support, stance phase, and variability, will be recorded using the GAITRite system, and DT costs will be calculated for selected parameters. Cortical activation will be assessed using a 66 channel wearable fNIRS system with short separation channels. DISCUSSION: By combining randomized task blocks, separate motor and cognitive conditions, broader cortical coverage, and concurrent neural and gait assessment across three groups annually, this protocol is expected to provide a comprehensive characterization of cognitive motor interference during walking and its evolution, supporting interpretation of cortical and behavioral responses. The study may help distinguish age related adaptations from PD specific alterations and clarify whether increased cortical recruitment during DT gait reflects compensation, reduced neural efficiency, or ceiling effects, refining understanding of gait automaticity decline and informing rehabilitation and non invasive brain stimulation approaches.

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Reliability and Concurrent Validity of a Computer Vision-Based Tool for Quantitative Finger Movement Analysis

Maharshi, A.; Ladha, B.; Malani, R.; Palaskar, P.

2026-06-01 rehabilitation medicine and physical therapy 10.64898/2026.05.21.26353446 medRxiv
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Background: Accurate evaluation of fine motor abilities is a key aspect of neurological rehabilitation. However, conventional approaches like goniometry are limited by variations among raters and their difficulty in detecting active movement. On the other hand, computer vision-based software delivers non-invasive and quantitative analysis of hand movements. An innovative computer-vision-based software tool, F.A.I.R. Chance(C), was developed to track and analyze individual finger joint movements on a camera-equipped laptop and give real-time numerical feedback. However, its metrics require validation in a healthy population before the tool can be used for clinical purposes. Objective: To assess the reliability and validity of finger movement assessment by the F.A.I.R. Chance computer vision-based tool in healthy adult participants. Methods: An observational cross-sectional study was done at MGM School of Physiotherapy, comprising 30 healthy participants between 18 and 60 years of age. Finger movements like flexion, extension, abduction, and adduction were measured with a standard handheld goniometer. These same finger movements were then measured with the tool at two time points separated by a 30-minute interval to determine the test-retest reliability. The tool's measurements were compared with the goniometric measurements to determine its concurrent validity. Test retest reliability was checked by the Intra-class Correlation Coefficient ICC (2,1), while concurrent validity was tested through Pearson's correlation coefficients. Results: Metacarpophalangeal and proximal interphalangeal joint motions demonstrated moderate to good test-retest reliability (ICC: 0.716-0.953) for the F.A.I.R. Chance tool. However, distal interphalangeal joint movements had lower consistency. Good reliability (ICC: 0.754-0.908) was seen for movements of abduction and adduction in the fingers. Strong concurrent validity for extension movements of the metacarpophalangeal joints (r=0.760-0.914) and moderate concurrent validity for flexion movements of the metacarpophalangeal joints (r=0.427-0.604) was demonstrated for all fingers for the F.A.I.R. Chance tool. Concurrent validity for adduction and abduction movements demonstrated a low to fair correlation with goniometric measurements (r=0.210-0.440). This is consistent with previous research showing poor agreement between goniometry and adduction-abduction movements of the fingers. Conclusion: The F.A.I.R. Chance tool shows good reliability and acceptable concurrent validity to assess fine motor movements in the healthy adult population. This sets a basis for further clinical study of the tool in the target population with fine motor impairments. Keywords: artificial intelligence; assistive technology; computer vision; fine motor evaluation; hand function;

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Behavioral and Functional Neuroimaging Effects of Delivering a Course of Repetitive Transcranial Magnetic Stimulation to Personalized Targets Within the Ventrolateral Or Dorsolateral Prefrontal Cortex in Treatment-Seeking Participants with Cannabis Use Disorder

McCalley, D.; Wong, B.; Geoly, A.; Struckman, W.; Azeez, A.; Kaloiani, I.; Kim, B.; Ninomiya, S.; Ehrie, J.; Austelle, C. W.; Rolle, C. E.; Kim, J. P.; Froeliger, B.; McRae-Clark, A. L.; Sahlem, G.

2026-06-10 addiction medicine 10.64898/2026.06.08.26355193 medRxiv
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Background: Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising treatment across addictive disorders including Cannabis Use Disorder (CUD). Stimulation of two rTMS-targets, the ventromedial prefrontal cortex (vmPFC) and the left dorsolateral prefrontal cortex (LDLPFC), limbic and executive control network hubs respectively, may yield differential effects. In this pilot trial, we explored the differential effects of 36-sessions of rTMS applied to either the vmPFC or LDLPFC. Methods: Treatment-seeking participants with moderate or severe CUD (n=20, 10F, age=33.3+9.8SD) were randomized to 36-sessions of open-label rTMS (two sessions-per-visit, two or three visits-per-week) to either the LDLPFC (3000-pulses; 10Hz) or vmPFC (900-pulses; 1Hz) using personalized functional Magnetic Resonance Imaging (fMRI) targets along with three-sessions of Motivational Enhancement Therapy. At baseline and following rTMS, the Time-Line Follow-Back was used to measure Days-per-week of cannabis use and the fMRI Regulation of Craving (ROC) task was used to measure network activation to cues associated with long-term negative ('Later') and short-term positive ('Now') consequences of cannabis use. Results: Eighty percent of participants completed study-rTMS. There was a significant decrease in days-per-week of cannabis use in both groups (vmPFC: d=7.9; DLPFC, d=3.1) between the four-weeks of baseline and seven-weeks of follow-up. LDPFC-rTMS reduced fMRI BOLD signal magnitude and increased LDLPFC functional connectivity in response to cues, while vmPFC-TMS reduced functional connectivity. Conclusions: Treatment-seeking participants with CUD reduced the number of days-per-week they used cannabis when receiving rTMS applied to either the LDPFC or vmPFC, while fMRI effects differed by treatment target. Future larger sham-controlled trials are needed for efficacy and biomarker determination.

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Validation of video engagement assessments using electrodermal activity

Flo, E. E.

2026-05-18 scientific communication and education 10.64898/2026.05.13.723692 medRxiv
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Engagement is widely recognised as central to learning and academic achievement. Electrodermal activity (EDA) has emerged as an objective physiological indicator of engagement, as it measures sympathetic nervous system activation. However, the high cost of wearable EDA sensors has limited its widespread application. This study answers the call for affordable, high-temporal-resolution engagement measures by validating a video-based quantitative assessment method. Researchers collected 75 minutes of synchronised EDA and video data from 12 upper secondary students (aged 17-18) during regular instruction. Novel software was developed to analyse student movement and sound level for academically relevant content. The OpenPose AI model for pose estimation was also applied. This approach produced six distinct movement variables: two AI-based and four non-AI-based. Six linear models using varying movement variables and sound level were tested to predict tonic EDA levels. All models effectively predicted EDA levels, with non-AI-based movement metrics outperforming AI-based alternatives. The four non-AI-based movement models showed similar performance, indicating that compressed versions reduced computational time without sacrificing predictive power. These findings validate a novel, objective method for comparing engagement across learning activities on short timescales. This method is particularly useful for collaborative learning environments and enables controlling for movement and sound in quantitative classroom analyses.

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A Competitive Framework for Modeling EEG Microstate Durations

GOMEZ, C. M.; Angulo Ruiz, B. Y.

2026-05-22 neuroscience 10.64898/2026.05.20.726605 medRxiv
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BackgroundThis study examines a competition-based model (C-model) designed to capture the temporal dynamics of successive brain microstates derived from electroencephalography (EEG) recordings during eyes-open conditions. The analyzed data were obtained from a public repository comprising microstate sequences from 60 sessions of a single subject [1]. When applied to microstate dynamics, the C-model posits a stochastic competition among neural circuits underlying the expression of individual microstates. MethodsThe model is formulated at a conceptual level (computational level in Marrs framework) and employs a geometric distribution to account for the long right tail of microstate duration distributions, interpreted as the probability of "failure" of the currently active microstate to persist. To account for the short-lived left tail, the model incorporates a transient increase in the stability of the currently active network, or equivalently, a temporary decrease in the activation probability of competing microstates (refractory period). ResultsThe model provides a good fit to the microstate duration distributions across all 60 sessions. One third of sessions showed microstate identity sequential dependency with respect to the previous microstates. DiscussionThese results suggest that the C-model captures key aspects of microstate temporal structure. Moreover, because microstate probabilities can be modulated by psychophysiological conditions--including the influence of previously active networks--the model may serve as a building block for more comprehensive neurobiological frameworks of neural and behavioral dynamics. In such frameworks, microstate sequences could emerge from structured competition and flow among neural networks supporting microstate expression.

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Multimodal approach to identify neuropsychophysiological subgroups in myalgic encephalomyelitis/chronic fatigue syndrome and their relevance for rehabilitation: protocol for a mechanistic cross-sectional and longitudinal study

Dooms, Y.; Qiu, L.; Coppieters, I.; Vergaelen, E.; Claes, S.; Dupont, P.; Hehl, M.; Cuypers, K.; Engler, H.; Dombrowski, K.; Verbeke, K.; Van den Bergh, O.; Raes, J.; Van Oudenhove, L.; Van Den Houte, M.; Bogaerts, K.

2026-06-08 neurology 10.64898/2026.06.05.26354983 medRxiv
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Introduction: Myalgic Encephalomyelitis (ME)/Chronic Fatigue Syndrome (CFS) is a debilitating condition characterised by severe fatigue and post-exertional malaise (PEM). Reported neuropsychophysiological abnormalities suggest ME/CFS is multifactorial, but current knowledge remains fragmented. This study protocol outlines a multimodal investigation designed to (1) compare neuropsychophysiological mechanisms between ME/CFS patients and healthy participants, (2) test an integrative model of ME/CFS, (3) identify neuropsychophysiological subgroups within the patient population, and (4) identify predictors of symptom response during rehabilitation. Methods and analysis: This study will enroll 115 ME/CFS patients and 55 healthy participants. Groups will be comparable in age, sex, and education level, with a larger patient sample enabling subgroup and longitudinal analyses. A cross-sectional assessment at baseline will be carried out in both groups. Patients will then be evaluated longitudinally throughout a standardized cognitive-behavioral therapy rehabilitation program delivered as routine care. Baseline measures include systemic inflammation and general health biomarkers, measures of autonomic and central nervous system function, neuroinflammation (magnetic resonance spectroscopy, [18F]DPA714 PET in a subsample), serum short-chain fatty acid levels, gut microbiota composition and function, and neuroendocrine and self-reported responses to psychosocial stress. Fatigue severity (physical and cognitive) and PEM will be assessed through validated questionnaires, ecological momentary assessment, and laboratory tasks. These will be re-evaluated during therapy, and all non-neuroimaging measures will be repeated after the rehabilitation program. Statistical analyses will comprise multivariate analysis of variance, general linear models, classification algorithms, structural equation models, least absolute shrinkage selection operator principal component regression (LASSO-PCR), cluster analysis and latent class growth analysis (LCGA).

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Rapid connectivity alterations of thalamic nuclei during initial learning of goal-directed behaviour

Jarrett, C.; Fregni, S.; Kriegstein, K. v.; Ruge, H.

2026-05-16 neuroscience 10.64898/2026.05.15.725154 medRxiv
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The thalamus is essential for learning, dynamically engaging with other subcortical and cerebral cortex regions throughout the learning process. Here, the thalamus serves as a critical connector hub and synchroniser within the thalamocortical system of the brain. However, whilst higher order thalamic nuclei are known to be particularly important for this process, the exact contributions of individual higher order and first order thalamic nuclei, alongside their individual involvement with cortical networks and subcortical regions, remains unexplored within the initial phase of learning. In light of this, we analysed fMRI data obtained within a paradigm which is designed to examine initial learning processes within feedback-driven stimulus-response learning, in order to explore thalamic contributions. We investigated dynamic learning-related functional connectivity alterations between various thalamic nuclei with other subcortical regions and cortical networks. Our results show that the initial phase of learning was associated with: (1) decreasing functional connectivity between thalamic nuclei and frontoparietal and cingulo-opercular networks, (2) increasing functional connectivity between thalamic nuclei with default mode and salience networks, (3) decreasing functional connectivity between thalamic nuclei and the putamen, and (4) decreasing functional connectivity amongst higher order thalamic nuclei. Furthermore (5) these dynamic alterations were associated primarily by mediodorsal thalamus. Altogether, these results indicate that higher order thalamic nuclei play a crucial role within initial learning and in the generation of novel goal-directed behaviour. This was demonstrated through enhanced functional connectivity with selected cortical networks which drive goal-directed behaviour, alongside decreased functional connectivity with striatal regions which drive motor selectivity.

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Age- and sex- dependent effects of moderate gestational day 12 prenatal alcohol exposure on anxiety-like behaviors, ethanol intake, and mechanical sensitivity

Winchester, S.; Varlinskaya, E. I.; Diaz, M. R.

2026-05-21 neuroscience 10.64898/2026.05.19.726255 medRxiv
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RationalePrenatal alcohol exposure (PAE) can result in Fetal Alcohol Spectrum Disorder (FASD), which consists of a group of diagnosable medical conditions that can include an increased risk for anxiety disorders and/or alcohol misuse, and sensory issues, such as increased mechanical sensitivity. ObjectiveThis study investigated how a single moderate PAE on gestational day 12 (G12) alters anxiety-like behavior, ethanol (EtOH) intake, and mechanical sensitivity across the lifespan of Sprague Dawley rats. MethodsPregnant dams were exposed to vaporized EtOH or room air (control) for 6 hours (BECs [~]108 mg/dL). Testing in male and female offspring began at three different ages: juveniles ([~]postnatal day (P) 25), adolescents ([~]P45) and adults ([~]P80). ResultsThe greatest PAE effects were observed in adolescent animals, with alterations in anxiety-like behaviors demonstrated in the light-dark box and elevated plus maze. Additionally, adolescent female animals consumed more sweetened EtOH compared to males. However, PAE adolescent animals consuming less sweetened EtOH compared to their counterparts, which was also observed in adult PAE females. Interestingly, this effect is reversed in juvenile and adolescent males when tested with unsweetened EtOH, with juvenile females consuming more EtOH also. Finally, PAE and air animals exhibited increased mechanical sensitivity following post-natal EtOH consumption across all ages. ConclusionThese data demonstrate that there are age- and sex-specific effects of PAE on anxiety-like behaviors, EtOH intake, and mechanical sensitivity that are more distinct in adolescent animals.