Brain Sciences

IntroductionIntracranial pressure (ICP) monitoring is commonly used in neuro-intensive care, but its utility may be limited by a suboptimal use. The brain pressure-volume relationship, a potential predictor of neurological health, is now approached using time-domain methods, which can be challenging to implement. Frequency-domain methods may offer an alternative, but their relationship with time-domain metrics remains unclear. This study compares time- and frequency-domain methods for assessing ...

PurposeReal-world evidence (RWE) is of practical significance as it enables the evaluation of whether findings observed in rigorously controlled clinical trial settings are generalizable to routine clinical practice. While Lenire, a bimodal neuromodulation tinnitus treatment device, has demonstrated efficacy and safety within controlled trials, further RWE from clinics is needed to reinforce these results. This is the first real-world study to assess the therapeutic effects of Lenire on tinnitus...

Repetitive transcranial magnetic stimulation (rTMS) of non-motor cortical targets, including the left dorsolateral prefrontal cortex (DLPFC), anterior cingulate cortex (ACC), and posterosuperior insula (PSI), has been proposed as a treatment for chronic pain with variable clinical outcomes. Pre-treatment local cortical dynamics were hypothesized to serve as markers of chronic pain reduction. In this secondary analysis of a large clinical trial comparing different rTMS targets for pain relief, it...

Background and PurposeThe magnetic resonance imaging (MRI) access for patients with active and passive implants is limited by radiofrequency (RF) safety. The time-averaged root-mean-square RF field (B1+rms) and specific absorption rate (SAR) are being evaluated to monitor and control RF-induced heating near conductive metallic implants, such as deep brain stimulation (DBS) leads, during MRI. However, experimental methods to assess the relationship between RF power, B1+rms, and SAR are lacking fo...

Executive dysfunction affects nearly 50% of individuals with traumatic brain injuries (TBI), yet interventions targeting the underlying neural mechanisms remain limited. This study examined whether aerobic exercise modulates functional connectivity to improve executive function in individuals with mild TBI and identified the neural pathways mediating these improvements. In this secondary analysis of a 12-week pilot randomized controlled trial, participants with mild TBI (n=24) were randomized to...

Patients with amyotrophic lateral sclerosis (ALS) often experience dysphagia, leading to malnutrition and weight loss. Percutaneous endoscopic gastrostomy (PEG) tubes help address these issues, but complications and limited patient education may diminish their benefits. This project evaluated the patient experience from an educational pamphlet created by a multi-disciplinary team at our academic centers ALS Clinic. The pamphlet was distributed at the time of PEG placement and covered tube functi...

ObjectiveTo evaluate whether novice, non-specialist operators can rapidly learn to use a handheld near-infrared (NIR) head scanner and maintain scan quality after brief training, supporting its use for point-of-care triage when computed tomography is unavailable or delayed. MethodsThirty-two right-handed adults with no prior NIR experience received a brief standardized training session ([~]2 minutes) on the ArcheOptix NIRD(R) device, which detects intracranial hemorrhage by tracking hemoglobin ...

BackgroundAssessing consciousness at the bedside in the neurocritical care unit is complicated by sedation and other treatment effects. While EEG is commonly used, it offers a limited view of the neurovascular unit. We evaluated whether combining cerebral blood flow (CBF) features with EEG improves binary classification of consciousness in patients with severe brain injury. MethodsWe retrospectively analyzed 35 adults who underwent multimodal neuromonitoring. Signals were segmented into 30-min ...

A major consequence of the COVID-19 pandemic has been the emergence of post-COVID syndrome (PCS), and more specifically, post-COVID fatigue (pCF), with an estimated prevalence of [~]2%. We previously showed that, compared to healthy controls, people with pCF exhibit changes in muscle physiology, cortical circuitry, and autonomic function. Here we present results from a cohort of people with pCF (N=145), between 12 weeks and 45 months post-infection. We report self-perception of fatigue; objecti...

BackgroundDeep brain stimulation has emerged as an effective investigational treatment for select cases of severe Gilles de la Tourette Syndrome. Defining the optimal stimulation sites within different targets and the specific tic improvement network across targets will be important to guide neuromodulation therapies. MethodsThis retrospective multi-center cohort study analyzed stimulation locations in patients who received bilateral deep brain stimulation for Gilles de la Tourette Syndrome acr...

Artificial intelligence (AI) is increasingly being integrated into healthcare, particularly in data-intensive chronic diseases that rely on longitudinal monitoring and shared decision-making. Multiple sclerosis is a prototypical example of such care, but real-world benefit will depend on whether people accept AI support in different clinical roles. We conducted a cross-sectional, web-based survey among 241 people with MS (pwMS) to assess comfort with AI across eight clinical domains and to ident...

Amyotrophic Lateral Sclerosis (Lou Gehrigs disease) is a progressive neurodegenerative disease affecting hundreds of thousands of people worldwide. It is characterized by the degeneration of the neurons in the brain and spinal cord of the patients, leading to a loss of control of muscles. Over time, without nerves to stimulate them muscles tend to atrophy. ALS may occur sporadically or run in families; many mutations have been identified for the latter. Treatment of ALS is mostly limited to thre...

Sensory gating -- the brains ability to filter out repetitive sensory input -- is essential for preventing sensory overload. Impaired gating is frequently observed in nociplastic and other chronic overlapping pain conditions, yet the specific brain regions supporting this inhibitory process in humans remains unclear. Neuroimaging studies examining pain processing implicate the anterior insula (AI), posterior insula (PI), and anterior mid-cingulate cortex (aMCC), but their deeper locations limit ...

Chronic pain is increasingly conceptualized within a stress-related framework. However, it remains unclear whether chronic pain and prototypical stress-related conditions--such as post-traumatic stress disorder (PTSD)--share common neurobiological substrates. To this end, we conducted a pre-registered transdiagnostic meta-analytic study of gray matter volume alterations in chronic pain (60 studies) and PTSD (20 studies). Disorder-specific meta-analyses revealed that chronic pain was associated w...

In this randomized, double-blind, controlled trial of 8 weeks of repetitive transcranial magnetic stimulation (rTMS) for chronic pain, we compared the classic primary motor cortex (M1) rTMS with a novel target-selection strategy based on pre-therapy cortical connectivity. Guided by principles of homeostatic plasticity, we tested whether stimulating the cortical site with the lowest pre-therapy global connectivity would be more effective than two active comparators: stimulating the site with the ...

Individuals with post-stroke aphasia live with long-term disabilities, yet they do not know whether they will improve their communication and cognitive skills over time. We propose a "Therapy Calculator" to provide patients with a better understanding of likely recovery as they engage with therapy. Using a large dataset of rehabilitation outcomes from a digital therapeutic called Constant Therapy (3.5 million therapy sessions of 18,000+ users), we developed a machine learning algorithm that esti...

BackgroundThe maintenance of wakefulness test (MWT) measures the ability of an individual to maintain wakefulness in soporific conditions and despite limitations remains the mainstay of vigilance testing. Wake and sleep states are traditionally characterised by oscillatory activity on electroencephalogram (EEG) but there is a less utilised non-oscillatory component of background neural aperiodic activity which can be derived from EEG raw data and represented as an exponent or a gradient (1/f slo...

BackgroundPropofol exposure can produce heterogenous neural responses, from the expected suppression to transient paradoxical excitation. EEG measures of signal complexity and entropy have emerged as reliable markers of consciousness, but different types of complexity and entropy measures are often conflated. We used Type I and II complexity measures on the Complexity-Entropy Causal Plane (CECP) to characterize divergent neural trajectories during propofol-induced loss of consciousness. We hypot...

Temporal interference stimulation (TIS) promises deeper and more selective neuromodulation, yet predictions remain sensitive to uncertainties in electrode setup and head modeling. We investigate the impact of coregistration error (CE) of the volume conductor and the head, electrode placement uncertainty (EP), and tissue conductivity uncertainty (CU) on the electric field generated by TIS. The stochastic model aggregates CE, EP, and CU into nineteen random variables and is evaluated for a deep ta...

BackgroundInvasive intracranial pressure (ICP) monitoring is the reference standard for detecting intracranial hypertension but requires neurosurgical expertise and carries procedural risks. Non-invasive methods with high negative predictive value (NPV) could serve as screening tools to rule out dangerous ICP elevations and guide decisions about invasive monitoring. We conducted a pilot evaluation to assess whether a smartphone-based, lighting-invariant quantitative pupillometry platform achieve...