Brain Sciences

Repetitive Transcranial Magnetic Stimulation (rTMS) is a promising treatment for tobacco use disorder (TUD). Although at a group level, active stimulation outperforms sham, at an individual level, variability exists in clinical response. The behavioral and neurobiological factors that differentiate those who respond to rTMS from those who do not remain unclear. To explore individual factors that influence acute responses to rTMS, N = 60 human participants received one session of rTMS to the dorsolateral prefrontal cortex (DLPFC) and to a control region (visual cortex; V5) in a randomized order. They completed behavioral assessments and neuroimaging before and after rTMS sessions. Hypotheses involving behavioral and neuroimaging predictors of response were pre-registered prior to completion of data collection. rTMS to the DLPFC led to significant reductions in self-reported cigarette craving compared with rTMS to a control brain region (p = 0.0006) and participants were classified as n = 38 responders and n = 22 nonresponders. Responders used significantly more cigarettes per day (M = 11.441) compared to nonresponders (M = 7.952), reported higher levels of cigarette craving (d = 1.059), and more severe nicotine withdrawal (d = 0.803) prior to rTMS. Neuroimaging analyses based on preregistered hypotheses indicated that DLPFC-frontoparietal and insula whole-brain functional connectivity did not differ significantly between responders and nonresponders. However, exploratory analyses revealed that responders had reduced pre-rTMS functional connectivity between the insula and nucleus accumbens, precuneus, and occipital pole. These findings suggest that response to rTMS for TUD is associated with greater baseline cigarette consumption, craving, and withdrawal, in addition to distinct functional connectivity patterns related to salience, reward, and self-referential processes, providing candidate behavioral and neural markers for personalized rTMS interventions for TUD.

Aphasia diagnosis in Indonesia remains challenging due to limited culturally and linguistically appropriate instruments. Widely used tools such as the Boston Diagnostic Aphasia Examination (BDAE) and Western Aphasia Battery (WAB) are not adapted to the Indonesian context, while Tes Afasia untuk Diagnosis, Informasi, dan Rehabilitasi (TADIR) provides screening but lacks diagnostic accuracy. To address this gap, we developed the Instrumen Diagnosis dan Evaluasi Afasia (IDEA) for native Indonesian speakers and evaluated its validity, reliability, and normative cutoff values in cognitively healthy Indonesian adults. Eighty-three cognitively normal adults (screened using MoCA-Ina) with no history of neurological disease were assessed using IDEA, which evaluates six language domains. Items were adapted from existing tools and reviewed by experts. Content validity, internal consistency (Cronbachs alpha), and construct validity (Exploratory Factor Analysis) were analyzed using SPSS v25. A total of 83 participants were included (median age = 55.81 years, 54% secondary education). IDEA demonstrated good feasibility, with an average completion time of 45-60 minutes depending on participant engagement. Content validity was established by unanimous expert consensus. Construct validity showed meritorious sampling adequacy (KMO = .872) and significant sphericity (Bartletts test {chi}^2 (15) = 278.523, p<.001), supporting factor analysis. Internal consistency showed good reliability across six domains (Cronbachs = 0.896). IDEA is a valid and reliable tool for assessing aphasia in Indonesian natives. It is a culturally appropriate assessment tool which offers structured, domain-based evaluation and supports differential diagnosis of both classical and progressive aphasia syndromes. Keywords: Aphasia, Language Assessment, Indonesian, IDEA, Validity

Background Motor imagery is widely used in post-stroke rehabilitation research, as it is thought to promote neuroplastic mechanisms underlying motor recovery. The characterization of the associated neurophysiological patterns is therefore crucial to improve our understanding and eventually optimize rehabilitative brain-computer interface applications. Emerging evidence suggests that cardiac dynamics are actively related to motor-related brain processes, yet the role of brain-heart interactions (BHI) in post-stroke recovery remains largely unexplored. This study aimed to investigate how BHI evolve during motor imagery interventions in stroke patients, with the hypothesis that BHI would exhibit a progressive change across motor imagery interventions. Methods We analyzed two independent cohorts comprising a total of 15 stroke survivors with upper or lower limb motor impairments undergoing motor imagery-based interventions. BHI were quantified by assessing the coupling between cardiac sympathetic activity and EEG-derived brain network metrics, including clustering and assortativity, across multiple sessions. We examined BHI in three different contexts: i) when motor imagery was combined with electrical stimulation, ii) throughout longitudinal motor imagery interventions, and iii) across longitudinal assessments of behavioral changes. Results Motor imagery combined with electrical stimulation on the affected limb modulated BHI across a wide range of frequencies. In longitudinal interventions, BHI showed a progressive increase, specifically reflected in stronger coupling between the cardiac-sympathetic index (CSI) and beta-band clustering. Moreover, changes in functional independence were tracked by variations in the coupling between CSI and EEG gamma-band networks assortativity. Conclusions Our findings suggest that BHI dynamically reorganize during post-stroke recovery and are modulated by motor imagery interventions. The observed change in BHI suggests that these interactions may reflect underlying neuroplastic processes. As such, BHI represent a promising class of multisystem biomarkers for tracking recovery and could inform the development of more adaptive and physiologically grounded BCI-based rehabilitation strategies.

Background. Cognitive impairment in Parkinson's disease (PD) is highly prevalent and heterogeneous. Assessing multiple cognitive domains is challenging and risks redundancy. This study evaluated whether a discriminant analysis approach could optimize the selection of specific tasks and measures for identifying attention and memory deficits in PD. Methods. Thirty PD patients and 25 cognitively unimpaired (CU) controls completed four experimental tasks: two assessing attention (flanker and spatial Stroop), one for recognition memory, one for working memory (n-back). Following group-level difference analyses, a discriminant analysis was performed to identify which tasks, and performance metrics possessed the highest sensitivity for distinguishing PD patients from CU individuals. Results. At the group level, PD patients exhibited significantly worse conflict costs in both attention tasks and lower sensitivity scores (d') in the recognition memory task compared to CU controls. The discriminant analysis revealed that time-based measures from the spatial Stroop task and the sensitivity score from the recognition memory task provided the highest discriminating power to differentiate between the two groups. Conclusion. These findings suggest that cognitive deficits in PD can be identified with high diagnostic accuracy using a targeted subset of metrics, eliminating the need for extensive and redundant neuropsychological testing batteries for attention and memory, without needing an extensive number of cognitive tasks for attention and memory.

Repetitive transcranial magnetic stimulation (rTMS) is an established treatment for major depressive disorder (MDD), yet variability in treatment response remains a significant challenge. Network control theory provides a framework to quantify how brain networks facilitate state transitions, but prior work has focused primarily on node level metrics. Here, I investigate whether edge based controllability of the structural connectome is associated with rTMS outcomes. Twenty five patients with treatment-resistant depression underwent diffusion MRI prior to a five week course of high frequency rTMS targeting the dorsolateral prefrontal cortex. Structural connectomes were constructed using MRtrix3 and the Destrieux atlas, and edge based controllability metrics were computed at baseline. Controllability of specific middle frontal gyrus centered edges showed significant associations with changes in HAMD-24 scores, including connections to the superior frontal gyrus, hippocampus, angular gyrus, and orbital gyrus (r = 0.470-0.597, p < 0.05). These findings suggest that edge based controllability captures circuit level properties relevant to treatment response and may inform personalized neuromodulation strategies.

Optimising the currently heterogenous efficacy of transcranial direct current stimulation (tDCS) interventions for motor learning requires identifying stimulation parameters facilitating performance while accounting for age-related differences in baseline performance and mechanisms underlying neuroplasticity. We systematically explored anodal tDCS intensity effects on implicit motor sequence learning (IMSL) in young and older adults. The study utilised a randomised, double-blind, counterbalanced crossover design. Ninety-six healthy participants (48 young adults, 48 older adults) completed a serial reaction time task (SRTT) with online sham or anodal tDCS over M1 at intensities of 1, 2, and 3 mA. The next day, memory consolidation was assessed in a recall test. Both age groups demonstrated IMSL and consolidation across conditions. While 1 mA tDCS improved IMSL in young adults by reducing reaction times, higher intensities had no significant benefit compared to sham. In older adults, anodal tDCS did not affect general task performance compared to sham, but 1mA tDCS acutely impaired selective sequence learning. The results demonstrate age-dependent and non-linear dose-dependent effects of anodal tDCS on IMSL. This underscores the necessity for age-adapted protocols for experimental and clinical tDCS applications. Future research should explore neurophysiological reasons for reduced tDCS efficacy in older adults found in the present study.

Early postnatal development is a critical period for hippocampal circuit maturation. While postnatal hippocampal development has been mostly studied in rats, less is known about the developmental trajectory of electrophysiological properties in mice, despite the wide use of these animal models for molecular and genetic studies of nervous system. In this study, we investigated the postnatal maturation of hippocampal CA1 pyramidal neurons in male and female wild-type mice. Whole-cell patch-clamp recordings were performed in acute hippocampal slices to assess passive and active membrane properties as well as spontaneous excitatory synaptic activity. We found that maturation of neuronal firing properties was associated with faster responses to stimulation, higher-amplitude and shorter-duration action potentials, and more precise control of neuronal firing. Simultaneously, synaptic activity changed across development, with decreased sEPSC inter-event intervals and stable event amplitudes, suggesting enhanced functional connectivity without major changes in synaptic strength. Sex-dependent differences in electrophysiological properties were observed primarily during the first postnatal week, indicating that sex influences the early trajectory of neuronal maturation. Together, our findings provide a comprehensive electrophysiological baseline for mouse hippocampal CA1 pyramidal neurons during postnatal development.

Background. Alcohol use impacts sleep; however, sleep is also impacted by other 24-hour movement behaviors, including sedentary behavior (SB) and physical activity (PA). This study used compositional data analysis (CoDA) to simultaneously account for SB and PA and investigate within- and between-person associations between sleep and alcohol use behaviors. Methods. Participants were 21-44-year-old overweight/obese adults. Across 21 days, participants wore an activPAL monitor to assess sleep, PA, and SB hours, and completed morning surveys of past day alcohol use to assess drinks/day. CoDA identified the daily proportions of time spent in sleep, PA, and SB. Multilevel models investigated within- and between-person associations between sleep, demographic factors, and alcohol use. Differences in sleep, SB, and PA across drinking versus non-drinking days were investigated with individual MANOVAs for each participant. Results. Participants (N=91, Mage=30.7{+/-}6.5, 57% female, 75% White) reported drinking on 23% (n=437) of days, consumed 1 drink/day, and averaged 8.5{+/-}2.3 sleep hours, 7.4{+/-}2.8 SB hours, and 8.0{+/-}2.7 PA hours per day. Multilevel models indicated that participants slept 16.6 fewer minutes on drinking days (p=.046) each additional drink corresponded with 4.4 fewer minutes of sleep (p=.04). There was large between-person variability in time use allocations across drinking versus non-drinking days. For many the change was non-significant; however, three participants spent significantly less time sleeping on drinking days (1.16-4.74 fewer hours of sleep) and one participant spent significantly (2.62) more hours sleeping on drinking versus non-drinking days. Conclusions. Drinking days and greater alcohol consumption were associated with fewer minutes of sleep within-people; however, shifts towards PA and SB were inconsistent. Investigating contextual factors, such as the physical/social context of alcohol use, the time-of-day drinking occurs, the type of alcohol consumed, or the type of PA a person engages in could provide deeper insight into the conditions under which alcohol use detrimentally impacts sleep.

Background: Force production reflects neuromuscular capacity, central regulation, and sensory feedback, making performance-based testing vulnerable when disease-related limitations could be interpreted as reduced effort. Repeated handgrip strength (HGS) testing may quantify neuromuscular fatigability in myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), but interpretation of within-subject variability as an effort-validity marker remains controversial. We tested whether the coefficient of variation (CV) distinguishes ME/CFS-related impairment from deliberate submaximal performance and compared it with the sum of residuals (SR), a trajectory-aware metric. Methods: We analyzed three cohorts using the same repeated-HGS protocol: two 10-trial sessions separated by one hour. We included 211 ME/CFS participants and 170 controls, including 28 instructed to perform at 50% perceived maximum force. CV and SR were determined as HGS variability measures and compared by probability-density overlap and receiver operating characteristic analyses. The primary comparison was ME/CFS versus deliberately submaximal controls. Results: CV distributions showed substantial overlap between groups. SR improved group-level separation, increasing non-overlapping fractions from 0.217 to 0.326 in the Jaekel cohort and from 0.180 to 0.361 in the MIRACLE cohort. In ROC analyses, SR consistently yielded higher discrimination than CV across cohorts, sessions, and sex strata. A commonly used 15% CV cutoff classified 42-48% of ME/CFS participants as submaximal, while correctly identifying only 57-64% of deliberately submaximal controls. Conclusions: CV may conflate ME/CFS-related fatigability with irregular force modulation and should not be used as stand-alone evidence of submaximal effort. Trajectory-aware SR partly reduced this bias and indicated that ME/CFS-related force impairment is distinguishable from deliberate submaximal force production at the group level. However, neither metric should be used alone to diagnose ME/CFS or evaluate sincerity of effort.

Introduction - Neurofeedback (NFB) has demonstrated efficacy in treating various disorders, often achieving substantial symptom reductions. Despite its effectiveness, a significant percentage of users (non-responders), fail to benefit from NFB. Addressing this issue, the study at hand investigates the role of NFB design on neuro-physiological responses. Method - event related potentials (ERPs) are examined in response to the application of different aesthetic principles in the context of NFB stimulus design. Drawing from Self-Determination Theory and ERP studies in the field of web design, 16 feedback stimuli were developed according to specific design principles. Stimulus design effects were inspected by means of ERPs allowing for the assessment of implicit and fast electroencephalogram (EEG) reactions. Results of n = 38 participants indicated distinct ERP response patterns at time window of interest 1 (TWOI-1; 100-200 ms) and TWOI-2 (200-300 ms), predicted by beholder-based liking and complexity of stimuli. The findings align with the proposed hypotheses suggesting that aesthetic evaluation of NFB stimuli occurs rapidly and implicitly. In response to the aesthetic vs. non-aesthetic categories, the findings were mixed. The results underscore the importance of further exploration of aesthetic design guidelines in the context of NFB applications. It is discussed how NFB aesthetics relate to Processing Fluency and Affective Prediction Error Theory, while the theoretical methodological issue of the Fixed Effect Fallacy is taken into consideration. The study contributes to the broader understanding of how design elements can affect therapeutic efficacy and engagement in NFB and Human Computer Interaction in therapeutic contexts in general.

Chemotherapy is a common treatment for women with ovarian cancer, and many women treated with chemotherapy experience cognitive dysfunction. However, few studies have investigated the mechanisms of chemotherapy-related cognitive impairment in women with ovarian cancer. The goal of this study was to assess the relationships among neurovascular coupling, iron levels and cognitive functions in women with ovarian cancer after first-line chemotherapy. Simultaneous fNIRS and EEG data were collected in women diagnosed with advanced stage ovarian cancer at baseline (N = 13) and after 3-9 rounds of chemotherapy (N = 8). The attentional network task (ANT) was administered for neurocognitive evaluation. Blood iron levels were measured using standard clinical assays. In parallel, similar concurrent fNIRS-EEG data were acquired in a group of 10 healthy participants in a test-retest design. Cognitive performance declined, as indicated by decreases in ANT sub scores after chemotherapy. Blood iron biomarkers indexing oxygen transport also declined and were related to decreases in the ANT sub scores. Both fNIRS and EEG data responses were shown to have excellent reliability in the healthy subjects, while cancer patients showed significant decreases in oxygenated hemoglobin response in fNIRS, despite no changes in EEG responses after chemotherapy. A significant dose relationship was also found in the changes of fNIRS responses. Our data indicate that chemotherapy produced cognitive deficits and decreases in the oxygenated hemoglobin response and that these may be related to reduced oxygen transport capacity. Results also suggest the utility of using fNIRS-EEG to monitor the progression of cognitive impairment and characterize those mechanisms.

Background: Stroke often causes Upper Limb (UL) functional impairments. The Primary Somatosensory Cortex (S1) plays an important role in motor learning. Repetitive Transcranial Magnetic Stimulation (rTMS) over S1 could enhance UL recovery. We aimed to explore its preliminary effects on UL motor activity and function post-stroke. Methods: An exploratory parallel-group randomized controlled trial in people with chronic stroke (>3 months) and moderate hemiparesis was conducted. Participants received 20 sessions of active or sham 5Hz rTMS over affected S1, with Robot-Assisted Therapy and Task-Oriented Training, 5 days/week for 4 weeks. The primary endpoint was UL motor activity (Action Research Arm Test, ARAT). Secondary measures were the UL Fugl-Meyer Assessment (UL-FMA) and sensory outcomes. Results: The baseline-adjusted mean difference (MD) in ARAT was 4.05 points [0.78, 7.33], favoring active stimulation. Secondary measures did not favor active stimulation (UL-FMA: MD = 2.62 [-1.51, 6.76]; sensory outcomes showed no between-group differences). Conclusion: High-frequency rTMS over S1 may enhance UL motor activity (ARAT), but no evidence for motor impairment (UL-FMA) or sensory domains was found. Compensation rather than restoration may underlie this improvement. Stimulation targets should match the intended recovery domain, although larger trials are needed to confirm these preliminary findings.

Background/Objectives: This systematic review examines how different mechanisms of Traumatic Brain Injury (TBI) influence post-injury functional independence and aims to clarify whether recovery patterns vary by injury type. A total of 105 studies (n = 59,621) involving adults with TBI were synthesized. These findings can guide clinicians and researchers in predicting outcomes and effectively customizing rehabilitation plans. Methods: A review following PRISMA standards analyzed English-language studies published from 1975 to 2025, assessed functional outcomes using the Functional Independence Measure (FIM) or the Glasgow Outcome Scale-Extended (GOSE), converted them to z-scores, and aggregated them via a random-effects model with inverse-variance weighting to demonstrate their relevance. Results: Recreational TBIs show the highest functional independence (z = +1.77), followed by MVAs (z = +1.56), with falls (z = +0.70) and assault-related TBIs (z = -0.12) showing moderate outcomes, and TBIs with penetrating trauma (z = -1.15) indicating the most adverse results. Conclusions: TBI mechanisms appear to meaningfully influence long-term post-injury functional independence. Highlighting this can inspire clinicians and researchers to trust these insights to improve prognosis and rehabilitation strategies, underscoring their crucial role in advancing patient care.

Purpose This study aimed to examine the association between screen time and depressive symptoms among Chinese college students, and to investigate the mediating roles of sleep quality and emotion regulation in this relationship. Furthermore, a serial mediation model was constructed to elucidate the underlying psychological mechanisms linking screen exposure to depression. Methods A stratified cluster sampling method was employed to recruit 10,999 college students for a cross-sectional questionnaire survey. Data were collected on screen time, sleep quality, emotion regulation ability, and depressive symptoms. Descriptive statistics, correlation analyses, and regression analyses were conducted using SPSS 26.0 A serial mediation model was tested using the PROCESS macro (Model 6), and bootstrapping procedures were applied to estimate the significance of indirect effects. Results Correlation analyses indicated that screen time was significantly positively associated with depressive symptoms (r = 0.16, p < 0.01) and sleep quality (r = 0.15, p < 0.01), and significantly negatively associated with emotion regulation (r = -0.13, p < 0.01). Sleep quality was positively correlated with depressive symptoms (r = 0.31, p < 0.01), whereas emotion regulation was negatively correlated with depressive symptoms (r = -0.42, p < 0.01). Regression analyses further showed that screen time significantly positively predicted depressive symptoms ({beta} = 0.712, p < 0.001), positively predicted sleep quality ({beta} = 0.217, p < 0.001), and negatively predicted emotion regulation ({beta} = -0.085, p < 0.001). In addition, both sleep quality ({beta} = 1.318, p < 0.001) and emotion regulation ({beta} = -0.424, p < 0.001) were significant predictors of depressive symptoms. Mediation analyses demonstrated that sleep quality significantly mediated the association between screen time and depressive symptoms (95% CI [0.239, 0.332]), as did emotion regulation (95% CI [0.269, 0.416]). Moreover, a significant serial mediation effect of sleep quality and emotion regulation was observed in the relationship between screen time and depressive symptoms (95% CI [0.082, 0.117]). Conclusion Screen time is significantly associated with depressive symptoms among college students, with sleep quality and emotion regulation serving as important mediating mechanisms. Extended screen exposure may be linked to higher levels of depressive symptoms by impairing sleep quality and weakening emotion regulation capacity.

Living at risk of a neurodegenerative condition such as inherited prion disease (IPD) is associated with substantial psychological burden, yet evidence-based supportive interventions are lacking. This unmet need is likely to grow as advances in biomarkers and predictive testing lead to increasing identification of individuals in pre-symptomatic stages of neurodegenerative disease. Acceptance and Commitment Therapy (ACT), a transdiagnostic intervention targeting psychological flexibility, has shown promise in chronic health contexts but has not been evaluated in individuals at genetic risk. We conducted a feasibility and acceptability study of a brief, group-based ACT intervention in adults at risk of IPD recruited through the UK National Prion Clinic. The intervention comprised a single 5-hour, face-to-face workshop followed by an individual booster session. Prespecified feasibility and acceptability criteria were assessed alongside secondary psychological outcomes at baseline, 1 month, and 3 months post-intervention, complemented by semi-structured qualitative interviews. Twenty-three participants completed the intervention. All predefined feasibility criteria were met, including recruitment (58%), intervention completion (80%), retention at 3 months (79%), and low missing data (10%). Acceptability was high, with all participants reporting the intervention as useful and appropriate. Quantitative analyses demonstrated improvements in psychological quality of life and behavioural awareness at 3 months, with larger effects observed in participants with elevated baseline depressive symptoms. Qualitative findings highlighted the importance of peer connection, experiential learning, and practical strategies for managing uncertainty. These findings demonstrate that a brief, hybrid ACT intervention is feasible and acceptable for individuals living at risk of IPD and provide preliminary evidence for improving psychological well-being. As the population of individuals identified as at risk for neurodegenerative disease continues to expand, scalable psychological interventions that address cost and time barriers may represent an important component of future clinical care.

Cognitive flexibility is the ability to change the way of responding when the demands of the environment change. This study tested how cognitive flexibility develops across the lifespan. We used a new computerized task that gives a continuous score instead of just right or wrong answers. 221 healthy adults aged 18 to 71 completed the Continuous-score Probabilistic Reversal Learning Test (CPRLT). We calculated mean absolute error and adjusted error for rule-based learning, and fitted a Rescorla-Wagner model to estimate each persons learning rate (alpha) for reward-based learning. All three scores have one breakpoint, performance improved rapidly from childhood to young adulthood, then declined slowly. Rule-based learning peaked around age 20. Reward-based learning peaked earlier, around age 18. This suggests that reward-based learning matures before rule-based learning. The pattern fits with brain development: reward circuits mature earlier, while prefrontal regions for rule-based learning develop later. Our continuous measure captured this difference, which binary tasks would miss.

Objective: Published P300-speller fusion schemes fix prior trust regardless of trial reliability; we tested whether a reliability estimate improves on it. Methods: We reanalyzed 3,373 archived P300-speller selections from 47 people with ALS (BigP3BCI). A fair, matched-search-space comparison, tuning both a fixed weight and an adaptive policy out-of-fold, was evaluated across 22 evaluable language-model priors up to 46.7B parameters. Two representative priors, GPT-2 and a classical 5-gram, additionally received detailed naive and mechanistic analyses. Results: No prior's 95% CI favored adaptive fusion under the fair comparison, despite unexploited oracle headroom at every scale. Under GPT-2, the naive comparison was significantly worse for adaptive fusion; both anchors converged to a degenerate or near-degenerate fair-comparison solution. For the representative anchors, three further controllers failed to convert that headroom into benefit; the fixed-fused posterior's output probability outperformed the best controller for flagging errors (2.8- to 3.8-fold enrichment). Conclusion: A tuned fixed weight is a difficult-to-beat default across the tested scale range; reliability estimation gave no deployable adaptive advantage. Significance: Adaptive weighting should be validated against a fairly tuned baseline across model families and scales; in this dataset, the fused output's confidence identified high-risk selections better than the tested purpose-built ranker.

Purpose: There is a long-standing perception that individuals who stutter are less intelligent, with the disfluencies unique to stuttered speech often assumed to be the overt reflection of lower intelligence, despite no supporting evidence. The purpose of the present study was to explore the validity of this assumption by examining the cognitive abilities of adults who stutter compared to the general population using the NIH Toolbox (C) Cognition Battery (NIHTB-CB). Method: Sixty-three adults who stutter completed the NIHTB-CB, which includes seven standardized measures assessing crystallized cognition (Picture Vocabulary, Oral Reading) and fluid cognition (List Sorting Memory Test, Pattern Comparison Processing Speed Test, Flanker Inhibitory Control Test, Dimensional Change Card Sort Test, Picture Sequence Memory Test). The NIHTB-CB generates t-scores adjusted for demographic variables based on a large sample of neurotypical adults. Results: Composite scores of overall cognition for adults who stutter were not statistically equivalent, rather, their scores were higher than the general population. Higher scores were driven by crystallized cognition, with significantly higher scores on Oral Reading subscale. Conclusions: Present findings demonstrate that adults who stutter possess cognitive skills that are comparable to or potentially higher, than the general population. These results challenge the misconception that stuttering reflects diminished intelligence and offer evidence to mitigate stereotype threat.

Background Multimorbidity is increasingly prevalent, and associated with worse clinical and psychosocial burdens. Interoception, the brain's ability to sense and interpret internal bodily signals, may contribute to multimorbidity, through its link with health behaviors, stress regulation, and mental health. This study examines whether self-reported interoceptive accuracy and attention is associated with multimorbidity, by identifying multimorbid subgroups and their interoceptive profiles. Methods Morbidity classes were identified through latent class analyses in two Dutch survey datasets, focusing on depression and alexithymia (DA-dataset; N = 671) and lifestyle factors (L-dataset; N = 1022). Linear regression analyses were used to assess interoceptive accuracy and attention (by the Interoceptive Accuracy Scale and Interoceptive Attention Scale respectively) among different subgroups. Results Multimorbid subgroups were characterized by older age, low socioeconomic position, and elevated physical, psychological, and behavioral problems. Multimorbid classes exhibited lower interoceptive accuracy (DA-dataset: B = -1.14, 95% CI = [-2.89, 0.62]; L-dataset: B = -2.36, 95% CI = [-3.83, -0.89]) and higher attention (DA-dataset: B = 3.62, 95% CI = [0.97, 6.27]; L-dataset: B = 1.07, 95% CI = [-1.42, 3.56]) compared to healthier classes. Conclusion Multimorbid populations demonstrated lower interoceptive accuracy and higher interoceptive attention. This highlights the psychosocial complexity of multimorbid populations which may impact their self-management and health behavior. These findings underscore the need to expand treatments to include psychosocial domains for multimorbid patients.

Background: Problematic Internet use (PIU) has been scarcely investigated in Parkinson's disease (PD). Objectives: To estimate the prevalence of PIU symptoms in PD using a specific screening instrument and to explore the clinical characteristics of these individuals. Methods: Two-stage observational study in a Movement Disorders clinic. In Evaluation 1, participants with PD were screened by the Brazilian Portuguese Nine-Item Problematic Internet Use Questionnaire-Short Form (BR-PIUQ-SF-9). In Evaluation 2, screening-positive participants underwent an exploratory assessment of Internet use. Results: 16.7% of participants with PD were positive for the BR-PIUQ-SF-9. The median Internet use time among these positive-screened participants was 5.5 hours per day. Most of them had impulsive-compulsive behaviors, and somatic concern, anxiety, and depressive mood were common psychiatric symptoms. Conclusions: Approximately one in six participants screened positive for PIU symptoms. Impulsive-compulsive behaviors and depressive symptoms were frequent among those undergoing subsequent exploratory assessment.