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Neuroscience Letters

Elsevier BV

Preprints posted in the last 7 days, ranked by how well they match Neuroscience Letters's content profile, based on 32 papers previously published here. The average preprint has a 0.02% match score for this journal, so anything above that is already an above-average fit.

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Trait Resilience Modulates the Association Between Cortisol and Aperiodic Neural Dynamics

Lee, K. F. A.; Asharaf, S. T.; Liang, L.; Lee, T. M. C.

2026-07-15 neuroscience 10.64898/2026.07.09.737399 medRxiv
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Cortisol, our stress hormone, exerts widespread influence on neural activity. However, its influence on the aperiodic component of the electroencephalography power spectrum remains to be investigated. Given individual differences in the capacity to cope with stress and adversity, it also remains unclear whether trait resilience moderates this relationship. Hence, the present study examined whether individual differences in trait resilience moderates the association between resting cortisol and aperiodic activity. Participants (N=145) completed various self-report questionnaires (e.g., trait resilience). Electroencephalography was recorded over a 20-minute baseline period, followed by salivary cortisol collection. The results revealed a significant moderating effect of trait resilience in the occipital scalp region. Specifically, higher cortisol concentration was associated with flatter 1/f slopes amongst individuals with low trait resilience, whereas this association was reversed amongst those with high trait resilience. Overall, our findings highlight the role of individual differences in trait resilience in shaping hypothalamic-pituitary-adrenal axis-related neural dynamics.

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Electrophysiological features of signals recorded from white matter

Jafri, R.; Ortega, F. A.; Manivannan, P.; Jourahmad, Z.; Devara, D.; Mattar, L.; Krishna, S.; Liu, G.; Chamarthi, S.; Goldman, A. M.; Lin, L.; Krishnan, V.; Maheshwari, A.; Banks, G. P.; Hasen, M.; Paulo, D.; Watrous, A. J.; Hayden, B. Y.; Yau, J.; Sheth, S. A.; Provenza, N. R.; Murphy, N.; Heilbronner, S. R.; Bartoli, E.

2026-07-15 neuroscience 10.64898/2026.07.11.737939 medRxiv
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Intracranial neurophysiology studies have typically ignored signals from electrodes located in white matter (WM), assuming that their information content is artifactual or related to nearby gray matter (GM). Here, we tested the electrophysiological and functional features of signals recorded from different WM locations. Signals were recorded from 19 patients undergoing intracranial monitoring for drug-resistant epilepsy by means of stereo-electroencephalography (sEEG). Each sEEG electrode was classified into WM or GM based on the surrounding tissue. We obtained recordings from a total of 1,717 sEEG electrode contacts, 36% in WM, while the patients were in awake resting state (5 minutes). For each sEEG electrode, we employed a model-based spectral decomposition to separate periodic and aperiodic components, and we computed signal complexity metrics. For a subset of participants, we computed WM structural information from diffusion-weighted magnetic resonance imaging and we evaluated functional signals during a cognitive control task. Our results show that signals recorded from WM have different spectral features and higher complexity than GM. Complexity correlates positively with fractional anisotropy, and modulations related to behavior during the task were detected in WM. Overall, this indicates that WM signals carry information that may reflect signal propagation across WM fiber tracts.

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Autism Research at a Crossroads: Global Progress, Persistent Gaps, and Future Pathways: A Bibliometric Analysis

zhong, Q.; Chen, L.; Ji, Y.; Zhu, F.; Zou, X.

2026-07-16 psychiatry and clinical psychology 10.64898/2026.07.14.26358066 medRxiv
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Background The global prevalence of autism spectrum disorder (ASD) has significantly increased over the past two decades. Despite substantial research advances, critical aspects, including etiology, diagnostic biomarkers, and pharmacological interventions, remain incompletely elucidated. This persistent knowledge gap warrants systematic mapping of the field's evolution to inform future research priorities. Methods A bibliometric analysis of ASD-related publications indexed in Web of Science was conducted from January 2020 to May 2025. Following a systematic deduplication process, original articles, reviews, case reports, and clinical trials were included in the analysis. The analytical framework comprised co-authorship networks, institutional collaboration patterns, national research contributions, and keyword co-occurrence structures, all of which were examined using CiteSpace (version 5.8.R3) and VOSviewer. Results After deduplication, 8,162 publications (January 2020-May 2025) were analyzed. The annual output grew steadily, confirming ASD as a sustained priority in neuroscience. Research remains academia-driven, led by the United States, with China as the second-largest contributor. Chinese institutions place greater emphasis on mechanistic and developmental phenotyping, which aligns with national priorities. These studies maintain strong methodological rigor, and their growing volume underscores the central role of ASD in translational neuroscience. Conclusion Future research on ASD should focus on strengthening case identification, refining clinical phenotyping, and expanding large-scale cohort studies to advance our understanding of its etiology and identify reliable diagnostic biomarkers. It is equally important to develop and evaluate targeted interventions for core symptoms and integrate telemedicine into service delivery models. A critical yet understudied priority is improving the quality of life for autistic individuals and their families, an area in which research globally, including in China, requires greater depth and consistency. With China's growing investment in autism research, it is well-positioned to contribute to these pressing international challenges.

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Validity and Reliability of the Novel Indonesian Instrument for Aphasia Diagnosis (IDEA)

Prawiroharjo, P.; Fakhri, A.; Gabrielle, A.; Martalia, V.; Rahmayani, S. A.; Wijaya, V. G.

2026-07-19 neurology 10.64898/2026.07.17.26358303 medRxiv
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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

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Decoding and Characterizing the Intracranial Representation of Semantic Information

Smith, C.; Inchyna, S.; Barrentine, B.; Nelson, M. J.

2026-07-15 neuroscience 10.64898/2026.07.13.738249 medRxiv
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Brain-computer interfaces (BCIs) have achieved impressive performance by decoding motor and articulatory signals associated with speech production. However, considerably less is known about whether higher-level semantic representations can be decoded from human cortical activity. Demonstrating semantic decoding would advance both our understanding of language organization and the development of BCIs that rely on conceptual rather than purely articulatory information. We recorded intracranial neural activity from patients undergoing stereotactic electroencephalography (sEEG) for clinical epilepsy monitoring while they performed language tasks requiring semantic processing. High-gamma power was extracted from local field potentials and used to generate trial-level features for supervised machine-learning classification. Classification performance was evaluated using cross-validation. Semantic category information was decoded significantly above chance, with mean classification accuracy reaching 29.8% across 15 semantic categories (chance = 6.7%). These findings demonstrate that high-gamma activity contains information about conceptual category membership that can be extracted on individual trials. These results provide evidence that semantic information is accessible from intracranial population recordings and support the feasibility of semantic decoding as a complementary direction for future language BCIs. Beyond neuroprosthetic applications, this work contributes to understanding how conceptual knowledge is represented in the distributed human language network.

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Diagnosing Others, Hiding Self: Shame and Non-Disclosure Among Autistic Psychiatrists - An Interpretive Phenomenological Analysis

Doherty, M.; Chown, N.; Martin, N.; Grosjean, B.; Chaplin, E.; Dolezal, L.; Shaw, S. C.

2026-07-15 psychiatry and clinical psychology 10.64898/2026.07.13.26357917 medRxiv
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Autistic psychiatrists occupy a paradoxical position: trained to recognise and assess autism in others, yet navigating a professional culture in which their own autistic identity remains largely concealed. Despite growing visibility of autistic clinicians, the barriers autistic psychiatrists face to formal diagnosis and professional disclosure remain unexplored. This study used interpretive phenomenological analysis to examine the experiences of seven autistic psychiatrists in relation to diagnosis and disclosure. Data were generated through in-depth interviews and Retzinger's framework for identifying shame in discourse was applied as an analytical tool within the interpretive process. Shame emerged as the overarching theme across the dataset, operating through four group experiential themes. Its origins lay in childhood experiences of difference and perceived defectiveness, transmitted through family, peers, and the broader social environment. In professional life, shame was sustained and amplified by colleagues' misconceptions about autism, anticipated loss of credibility, and the deficit-based diagnostic criteria - which rendered self-recognition difficult and made formal diagnosis a perceived professional liability. Critically, shame did not only create barriers: it functioned as an override mechanism, rendering the known benefits of disclosure - to participants themselves, to colleagues, and to patients - insufficient to translate into action. This override function was not explained by fear of discrimination or rational career protection alone; it reflected shame's operation as an internal prohibition, dissociated from its original social source and persisting even where stigma had been intellectually processed and rejected. These findings reposition shame not as one barrier among many but as the organising force through which all barriers operate. Interventions aimed at increasing disclosure by raising awareness of its benefits misread the operative mechanism. Creating conditions in which autistic psychiatrists can make decisions about their identities freely requires naming and addressing shame - in research, in clinical training, and in the culture of psychiatry.

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Brain Structural and Resting-state Functional Network Changes Following Expiratory Musculature Targeted Resistance Training in Healthy Young Adults: A Pilot Study

Krishnamurthy, R.; Schultz, D.; Wang, Y.; Barlow, S. M.; Dietsch, A. M.

2026-07-15 neuroscience 10.64898/2026.07.09.737407 medRxiv
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Multimodal imaging approaches that combine structural and functional neuroimaging provide a robust framework for examining neuroplastic adaptations that may not be captured by any single modality. The present study investigated the effects of a four-week expiratory muscle strength training (EMST) program on structural and resting-state functional connectivity in healthy young adults. Five healthy young adult males (aged 19-35 years) completed a standard four-week EMST protocol and underwent pre- and post-training imaging assessments. Structural neuroimaging included T1-weighted and diffusion-weighted MRI, which were analyzed using voxel-based morphometry, surface-based morphometry, and white-matter structural connectivity. Functional neuroimaging consisted of resting-state fMRI to assess training-related changes in functional architecture, network connectivity, and global network measures. Structural MRI analyses revealed no significant changes in gray or white matter volume, cortical morphology, or white-matter structural connectivity following EMST (all FWE- or FDR-corrected p > .05). In contrast, resting-state fMRI demonstrated a significant increase in whole-brain functional connectivity (FDR-corrected p = .036), accompanied by greater network integration, reflected in increased local efficiency and transitivity and reduced modularity. Network-level analyses showed enhanced within- and between-network connectivity in sensorimotor and cognitive circuits. Our findings demonstrate robust functional reorganization following EMST, despite the absence of detectable macrostructural or large-scale white-matter connectivity changes, at least within the timescale and sample characteristics of the current study. These results reflect early-stage neuroplasticity, both globally and within the networks underlying speech and swallowing control and suggest that functional reorganization occurs early in training and likely precedes longer-term structural modifications in these networks.

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Personality Traits, Trust, and Acceptance of Artificial Intelligence Assistive Systems: Evidence from Nigeria Population

Onah, C.; Ogwuche, C. H.; Haruna, A. I.

2026-07-17 psychiatry and clinical psychology 10.64898/2026.07.16.26358233 medRxiv
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The increasing deployment of artificial intelligence (AI) assistive systems across healthcare, education, and organisational domains necessitates a deeper understanding of dispositional factors shaping trust and acceptance. This study investigated the Big Five personality traits as predictors of trust in and acceptance of AI assistive systems among a large adult sample (N = 380) in Makurdi Benue State. Anchored in the Technology Acceptance Model (TAM) developed by Davis (1989), the study examined both direct and indirect pathways linking personality traits to AI acceptance through trust. Participants completed standardised measures of the Big Five Inventory, Trust in AI Scale, and AI Acceptance Scale. Data were analysed using structural equation modelling (SEM) with maximum likelihood estimation. The hypothesised model demonstrated good fit indices (CFI = .84, TLI = .82, RMSEA = .05). Openness to experience ({beta} = .34, p < .001) and agreeableness ({beta} = .27, p < .01) significantly predicted trust in AI systems, which in turn strongly predicted AI acceptance ({beta} = .62, p < .001). Neuroticism negatively predicted trust ({beta} = -.29, p < .001), while conscientiousness showed a modest positive direct effect on acceptance ({beta} = .18, p < .05). Extraversion was not a significant direct predictor but exerted an indirect effect through trust. Mediation analysis confirmed that trust significantly mediated the relationship between personality traits and AI acceptance. The findings underscore the centrality of dispositional traits in shaping technological trust formation and highlight the psychological architecture underlying human AI interaction. These results contribute to social psychological theory and provide empirical guidance for designing personality sensitive AI systems to enhance user adoption and sustained engagement.

9
Neurobehavioural correlates of changing one's mind in ADHD and OCD

Zuhlsdorff, K.; Dalley, J. W.; Robbins, T.; Morein-Zamir, S.

2026-07-15 neuroscience 10.64898/2026.07.09.737533 medRxiv
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Cognitive flexibility is an executive function that allows individuals to adjust behaviour in response to changing environmental demands. We assessed volitional switching under uncertainty, without rule-based learning, in the Change Your Mind task. Nineteen patients with obsessive-compulsive disorder (OCD), 19 patients with attention-deficit hyperactivity disorder (ADHD) and matched control participants (20 per group) completed the task whilst undergoing a functional MRI scan. The task was a two-alternative forced choice paradigm where each stimulus was presented twice successively, with spurious feedback following the first presentation. This allowed participants the opportunity to repeat or change their response. Participants with ADHD changed their response more frequently than controls following a previously correct response, associated with reduced accuracy on the second trial. This was accompanied with smaller differences between change and repeat trials in the superior frontal gyrus, paracingulate gyrus and frontal pole compared to controls. Participants with OCD did not differ from healthy controls in their performance but exhibited greater activity on both change and repeat trials in the pre- and postcentral gyri than controls. These results point to distinct neurobehavioural differences in patients with ADHD and OCD underlying what is often termed more broadly inflexible behaviour.

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Teneurins Are SPARCL1 Receptors

Zhang, X.; Chen, X.; Miao, Y.; Sudhof, T. C.

2026-07-15 neuroscience 10.64898/2026.07.13.738299 medRxiv
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Extensive experiments document that SPARCL1, a secreted protein that is produced primarily by astrocytes in brain and endothelia throughout the body and that is also known as Hevin, enhances synapse formation. However, the mode of action of SPARCL1 at synapses remains unclear owing to divergent results in the literature. Here, we use cultured neurons from newborn male and female mouse embryos to show that the C-terminal follistatin-like and Ca2+-binding domains of SPARCL1, which account for only 35% of the total SPARCL1 sequence, are sufficient to potently enhance synapse numbers. SPARCL1 acts at nanomolar concentrations at which SPARCL1 does not robustly bind to neurexins, neuroligins or neurexin/neuroligin complexes but avidly interacts with all teneurins. Strikingly, the follistatin-like domain of SPARCL1 on its own strongly binds to teneurins but is unable to stimulate synapse formation. Only when combined with the SPARCL1 Ca2+- binding domain does the follistatin-like domain induce synapses, suggesting that SPARCL1 enhances synapse numbers by binding to teneurins via its C-terminal follistatin-like domain and by activating synapse formation via its Ca2+-binding domain. SIGNIFICANCE STATEMENTSPARCL1 (also known as Hevin) is a synaptogenic factor that is produced primarily by astrocytes in brain, and that enhances synapse formation. How SPARCL1 acts at synapses, however, remains unclear because divergent results describe its binding partners at synapses and the sequences involved in its synaptogenic activity remain unclear. In the present study, we show that SPARCL1 avidly binds to the presynaptic teneurins adhesion molecules, that this binding is mediated by its small follistatin-like domain, and that its synaptogenic activity requires both its follistatin-like and its Ca2+-binding EC domains. Thus, our results suggest that SPARCL1 is recruited to developing synapses by binding of its follistatin-like domain to teneurins and then induces synapse assembly via its Ca2+-binding domain.

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A Culturally Embedded Augmented Reality Task as a Neurocognitive Biomarker of Executive Function in Schizophrenia

Chatthong, W.; Rueankam, M.; Khemthong, S.

2026-07-16 psychiatry and clinical psychology 10.64898/2026.07.14.26358053 medRxiv
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Executive function (EF) deficits are central features of schizophrenia and strongly influence long-term functional outcomes. Conventional cognitive assessments often lack ecological validity and cultural relevance. This study introduces the Luk Chup Augmented Reality (LCAR) tool a video guided, clay modeling task delivered through wearable AR that integrates culturally familiar activity with realtime neurophysiological monitoring. Thirty individuals diagnosed with schizophrenia (mean age = 38.9, SD. = 7.15 years) completed a series of modeling and memory tasks using LCAR while undergoing quantitative EEG (QEEG). Task duration and theta/beta power were analyzed across procedural and color shape memory phases. Memory phases took significantly longer to complete and were associated with decreased lateral prefrontal theta and increased frontal midline theta activity (Fz, Cz), indicating higher EF demand. A repeated-measures ANOVA revealed significant condition, site, and interaction effects on theta power. The LCAR tool shows promise as a culturally grounded, dual-mode assessment of EF in schizophrenia. It offers a novel integration of performance-based and neurophysiological metrics that may inform future interventions in psychiatric rehabilitation.

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Pediatric traumatic brain injury elicits acute neuroinflammation and long-term changes in social, cognitive, and decision-making behaviors in male and female rats

Smail, M. A.; McDonald, M. Y.; Boland, R.; Breach, M. R.; Dye, C. N.; McCloskey, J. E.; Martens, K. M.; Walters, A. E.; Zaleta Lastra, A.; Roush, J.; Yeung, E.; Weinstein, A.; Gorman-Sandler, E.; Vonder Haar, C.; Kokiko-Cochran, O. N.; Lenz, K. M.

2026-07-15 neuroscience 10.64898/2026.07.09.737495 medRxiv
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Traumatic brain injury (TBI) is one of the leading causes of emergency room visits in children under 10. Children are potentially more vulnerable to the adverse effects of TBI, given that their brains are still developing at the time of injury. Indeed, early life TBI has been linked to cognitive, social, and mood-related impairments later in life. The neuroimmune system has been implicated in adult TBI mechanisms and plays numerous key roles in brain development, making it an interesting candidate for linking pediatric TBI and prolonged behavioral alterations. Here we establish a rat model of mild pediatric TBI to investigate the relationship between early life TBI, acute responses of neuroimmune cells, and chronic behavioral dysregulation. At postnatal day 15, which is roughly equivalent to toddler age, male and female rat pups received a TBI via lateral fluid percussion injury. At 3 days post injury, TBI increased microglia and astrocyte coverage locally in the Perilesional Cortex but not in more distant corticolimbic regions. However, the hippocampus and prefrontal cortex did exhibit increased expression of the phagocytic marker CD68 in microglia, suggesting widespread glial activation even in the absence of gross coverage change. TBI also impacted mast cells, early-response innate immune cells, increasing their number and degranulation in multiple regions. In the juvenile and early adult periods, TBI impaired cognitive function, reduced sociability, and increased avoidance, with no change in anxiety-like behavior. Later in adulthood, TBI continued to impact cognitive behavior, increasing risky decision-making and impairing optimization months after injury. Together, these results suggest that pediatric TBI causes lasting cognitive and social dysregulation, possibly via acute neuroimmune alterations following injury at a critical period of brain development.

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From Menarche to Menopause: Hormonal Influences on Functional Neurological Disorder

Palmer, D. D. G.; Warren, N.; Morton, A.; Lehn, A.

2026-07-18 neurology 10.64898/2026.07.16.26358260 medRxiv
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Background Functional neurological disorder (FND), one of the most common neurological conditions, affects women almost twice as frequently as men. The reasons for this are unknown, and there has been minimal research into how physiological and pathological features of women's health interact with symptoms of FND. Methods We conducted an online survey assessing the effect of several aspects of women's health with the severity of symptoms of FND. Results 484 people completed the survey. Among the 223 who had regular or fairly regular menstrual cycles, a strong difference across the menstrual cycle was seen, with symptoms at their best in the follicular phase, worsening in the luteal phase, and worst in the pre-menstrual period and the menses. This effect was not moderated by a proxy measure of pre-menstrual dysphoric disorder (PMDD). Participants who were taking the combined oral contraceptive (COC, n=43) and progesterone-based contraception (n=80) were more likely to report symptom improvement from starting the medication than worsening. When compared to menstruating participants who were not taking the COC, participants taking the COC reported less worsening in their symptoms of FND in the luteal, pre-menstrual, and menstrual phases. Of the 99 women who had passed menopause since developing FND, 76% reported worsening of their FND symptoms after menopause. Discussion This study demonstrates interactions between several aspects of women's health and symptoms of FND. The observed pattern of symptom fluctuation across hormonal states suggests a potential modulatory role of oestrogen, warranting further targeted investigation.

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Transcriptomic signatures associated with mania-to-depression and depression-to-mania transitions in bipolar disorder: a case report using induced microglia-like (iMG) cells

Inamine, S.; Kyuragi, S.; Ohgidani, M.; Kimura, T.; Inoue, I.; Nakao, T.; Kato, T. A.

2026-07-15 neuroscience 10.64898/2026.07.12.735946 medRxiv
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IntroductionBipolar disorder (BD) is characterized by recurring episodes of mania and depression. Despite extensive research, the pathophysiology underlying these mood swings remains elusive. Emerging evidence indicates a potential role for neuroinflammation and microglial activation in the pathophysiology of BD. MethodsWe employed a reverse-translational approach to generate directly induced microglia-like (iMG) cells from peripheral blood monocytes of a single patient with BD, repeatedly sampled across depressive, manic, and subsequent depressive phases. RNA sequencing was performed on iMG cells at each time point to identify differentially expressed genes related to mood state transitions. ResultsA thorough analysis of longitudinal gene expression data has led to the identification of three functional gene categories: "state-dependent genes", "depression-to-mania transition genes (named: firing genes)", and "mania-to-depression transition genes (named: extinguishing genes)". A total of 168 firing, 59 extinguishing, and 77 state-dependent genes were identified. Notably, functional annotation revealed that, compared to the extinction gene set, the firing gene set was enriched in immune and inflammatory response pathways, particularly early-response cytokines such as IL1B and TNF. ConclusionsBased on these findings, we propose that inflammatory immunomodulation by microglia contributes to mood switching in BD, especially in the process of depression-to-mania transition. The classification of genes by their relationship to state transitions offers a novel framework for understanding the molecular mechanisms underlying this complex disorder and may identify potential therapeutic targets to stabilize mood. Further validation with larger cohorts is warranted.

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Intermittent theta burst stimulation modulates working memory-related theta-gamma coupling in adolescents with ADHD

Kavanaugh, B.; Vigne, M.; Legere, C.; Borden, Z.; Lynott, E.; Cheong, D.; Warren, A.; Acuff, W. L.; Tirrell, E.; Festa, E.; Jones, S.; Jones, R.; Spirito, A.; Carpenter, L.

2026-07-15 psychiatry and clinical psychology 10.64898/2026.07.13.26357958 medRxiv
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Objective: Working memory (WM) deficits are a co-occurring feature to numerous neuropsychiatric disorders, particularly attention-deficit/hyperactivity disorder (ADHD), and there remain no treatments that directly target WM. The coupling between the phase of theta band activity and amplitude of gamma band activity (i.e., TGC) is an established neural correlate of WM. However, no studies have examined WM-related TGC in ADHD or whether neuromodulation can modulate these oscillatory dynamics in youth. This set of studies examined the effects of intermittent theta burst stimulation (iTBS) to the left dorsolateral prefrontal cortex (DLPFC) and left posterior parietal cortex (PPC) on TGC in youth with ADHD. Methods: In two randomized, double-blind, sham-controlled crossover trials, adolescents with ADHD and clinically significant parent-reported WM symptoms first completed a single-session study comparing DLPFC versus PPC iTBS targeting (n = 47) and then a multi-session clinical trial comparing 10 sessions of active versus sham left DLPFC iTBS (n = 29). Participants completed a computerized visuospatial Sternberg WM task with concurrent electroencephalography (EEG) before and after the single sessions, as well as at baseline, midway through treatment, and approximately 24 hours after the final session within the multi-session trial. Phase-amplitude coupling between theta phase and gamma amplitude was quantified using the Kullback Leibler modulation index at frontoparietal electrodes. Linear mixed-effects models examined treatment effects and associations between change in TGC and WM status (including accuracy, reaction time, and clinical symptoms). Results: Across participants, lower TGC was associated with lower symptoms and better WM performance, including higher accuracy, faster and more consistent RT. Active iTBS increased frontoparietal TGC relative to sham stimulation, with effects observed both acutely after a single session and ~24 hours after multiple sessions. DLPFC-targeted iTBS increased TGC, whereas PPC-iTBS had no measurable effect. Change in TGC was associated with change in WM, such that a decrease in TGC was associated with faster RT and decreased RT variability. Higher baseline TGC was associated with greater improvement in WM. Active iTBS decoupled the TGC-WM association observed during sham iTBS, and greater electric field intensity of iTBS was associated with greater improvement in WM accuracy and greater decrease in TGC. Conclusions: Active iTBS to the left DLPFC modulated WM-related TGC in youth with ADHD. These findings provide preliminary evidence that neuromodulation may improve WW by modifying oscillatory dynamics within frontoparietal networks. Larger clinical trials with higher stimulation doses are needed to determine whether targeting oscillatory coupling represents a potential therapeutic strategy for WM deficits.

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Articulatory timing and form support distinct neural benefits during audiovisual speech

Nidiffer, A.; O'Sullivan, A.; Lalor, E. C.

2026-07-15 neuroscience 10.64898/2026.07.14.738583 medRxiv
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In noisy environments, visible speech articulations improve listening comprehension. The benefit derives from several sources, including articulatory timing and shape. Recent research has shown that visual cortex encodes a categorical representation of articulatory features and that visual speech can benefit both acoustic and phonetic feature processing separately. The present study advances the hypothesis that the shape of the articulators specifically influences the categorization of auditory speech in terms of its phonetic features. We tested this by linearly modeling electroencephalographic responses to natural, continuous speech (in noise) in terms of the acoustic and articulatory features of the speech. We compared the performance of these models in conditions where the speech was accompanied by a natural video of the speaker with their mouth visible, and a video where their mouth was covered by a dynamic ellipse obscuring articulatory shape but preserving dynamics. The dynamic mask reduced comprehension, neural processing of phonetic features, the associated multisensory benefits, and indices of visual-only linguistic processing over occipital scalp. Our findings support substantial visual involvement in speech comprehension, derived largely from the shape of the articulators. They also corroborate several proposals involving audiovisual speech processing hierarchy and the nature of the information contained in visible speech. HighlightsO_LIVisual speech provides at least two forms of information to enhance acoustic speech processing: redundant temporal dynamics and complementary articulatory information C_LIO_LICovering the mouth with a dynamic mask preserves horizontal and vertical lip movement information, but largely removes articulatory detail C_LIO_LIVisual speech with a mask preserves some general multisensory benefits but removes visual linguistic information and its ability to enhance auditory processing at the level of phonetic features. C_LI

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Interactions between Insomnia and Obstructive Sleep Apnea

Dai, Y.; Li, Y.; Heremans, E.; Gimenez, U.; Hanif, U.; Mignot, E.

2026-07-15 psychiatry and clinical psychology 10.64898/2026.07.12.26357841 medRxiv
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Study Objectives Co morbid insomnia and sleep apnea (COMISA) is challenging clinically and difficult to treat. Our goal was to assess how much COMISA is the mere addition of two phenotypes or display features indicative of genuine statistical interactions. Methods A total of 152,487 patients from 240 sleep centers across 30 US states were included. Insomnia was defined as difficulty initiating/maintaining sleep with daytime fatigue/sleepiness occurring "often"/"always". OSA was defined as having an Apnea Hypopnea Index (AHI) more than 15 events/h. Modified Poisson regression was conducted to evaluate multiplicative interactions between insomnia and OSA on common comorbidities and sleep symptoms. Additive interactions were also examined. Linear regression models were used to evaluate additive interactions for PSG parameters. The false discovery rate was controlled using the Benjamini Hochberg procedure. Results After adjustment for confounders, insomnia and OSA demonstrated positive interactions for depression, chronic muscular pain, headache, subjective excessive daytime sleepiness (EDS), naps, and pre-sleep anxious and muscular tension (adjusted p < 0.05). Furthermore, insomnia and OSA demonstrated positive interactions for parameters related to respiratory disturbance, including AHI, oxygen desaturation index (ODI), respiratory disturbance index (RDI), total arousal index (AI) and respiratory AI, and negative interactions for minimum oxygen saturation and percentage of rapid eye movement stage (REM%) (adjusted p < 0.05). Furthermore, the adverse effects of insomnia and OSA on AHI, ODI, RDI and REM% were substantially amplified in males. Conclusions Our findings demonstrate that insomnia and OSA do not merely coexist but genuinely interact synergistically to amplify selected adverse clinical outcomes.

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Evaluating Goodness of Pronunciation and Phonological Posteriors as Objective Markers of Speech Severity in Motor Speech Disorders

Wang, F.; Utianski, R. L.; Duffy, J. R.; Barnard, L. R.; Botha, H.

2026-07-16 neurology 10.64898/2026.07.14.26358076 medRxiv
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This study examined the extent to which goodness of pronunciation (GoP) scores and phonological posterior probabilities capture perceptual ratings of speech severity in individuals with motor speech disorders (MSD). Speech recordings of the word catastrophe were obtained from 489 participants, including 333 neurologically typical controls and 156 individuals with MSD. GoP scores were derived using traditional acoustic features and self-supervised speech representations, including WavLM and XLS-R, across multiple modeling approaches, while phonological posterior probabilities were extracted using Phonet. Model performance was evaluated using Kendall's rank correlations, regression, and receiver operating characteristic analyses against speech-language pathologists' perceptual ratings of sound distortion and intelligibility. Both GoP and phonological posterior probabilities were significantly associated with perceptual ratings. Self-supervised speech representations substantially outperformed traditional acoustic features, with WavLM-based GoP using k-nearest neighbors achieving the strongest performance. Across correlation, regression, and classification analyses, GoP consistently outperformed phonological posterior probabilities for both sound distortion and intelligibility. Age and gender had minimal influence on model-derived measures or their relationships with perceptual ratings. These findings demonstrate the value of self-supervised GoP as an objective measure of speech impairment while highlighting the complementary role of phonological posterior probabilities in characterizing articulatory aspects of motor speech disorders.

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Association between Glycemic Traits and Delayed Cerebral Infarction among Non-Diabetic Patients with Aneurysmal Subarachnoid Hemorrhage: A Nested Case-Control Study

Ji, P.; Zheng, K.; Tan, D.; Xu, J.; Chen, M.; Wu, Y.; He, Z.

2026-07-20 neurology 10.64898/2026.07.18.26358375 medRxiv
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ABSTRACT Objective Delayed cerebral infarction (DCIn) is a severe complication following aneurysmal subarachnoid hemorrhage (aSAH). Previous studies suggest that glycemic variability is associated with DCIn. However, whether diabetes status modifies the relationship between glycemic traits and DCIn remains unknown. Methods Clinical data were collected from aSAH patients admitted to the First Affiliated Hospital of Shantou University Medical College between January 2015 and April 2025. The collected data included demographic characteristics, clinical variables, and glycemic traits. Glycemic traits included mean blood glucose (GLU-M), standard deviation of blood glucose (GLU-SD), coefficient of variation of blood glucose (GLU-CV), variance of blood glucose (GLU-Var), range of blood glucose (GLU-R), average real variability of blood glucose (GLU-ARV), and variability independent of the mean (GLU-VIM). After 1:2 case-control matching, conditional logistic regression models were used to evaluate the associations between glycemic traits and DCIn risk, with stratified analyses performed according to diabetes status. Multiplicative interaction terms were additionally included to assess the potential modifying effect of diabetes status. Results A total of 306 patients with aSAH were included. Among them, 102 developed DCIn cases. For each of these 102 cases, two controls were matched by age ({+/-}5 years), sex and year of admission ({+/-}5 years). In the overall population, higher GLU-M and GLU-ARV were associated with increased DCIn risk, with odds ratios (ORs) per 1-SD increase of 1.62 (95% CI, 1.25-2.11) and 1.63 (95% CI, 1.25-2.11), respectively. Among patients without diabetes (n=266), the associations with DCIn per 1-SD were observed for GLU-M (OR, 2.23; 95% CI, 1.56-3.19), GLU-SD (OR, 1.53; 95% CI, 1.13-2.06), GLU-Var (OR, 1.48; 95% CI, 1.04-2.10), and GLU-ARV (OR, 1.88; 95% CI, 1.38-2.55). No significant associations were observed among patients with diabetes. Significant interactions were observed between diabetes status and GLU-SD and GLU-Var, with P for interaction values of 0.033 and 0.032, respectively. Conclusion Higher mean blood glucose and greater glycemic variability are associated with an increased risk of DCIn in aSAH patients, especially in those without diabetes.

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Effects of acute intranasal allergen exposure on resident immune cells and sensory neurons in the mouse olfactory epithelium

Owens, R. E.; Matthews, B. E.; Mastrangelo, M. A.; Meeks, J. P.; Rowe, R. K.

2026-07-15 neuroscience 10.64898/2026.07.09.737488 medRxiv
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The main olfactory epithelium (MOE) is the primary site of olfaction and consists of multiple cell types including olfactory sensory neurons (OSNs), sustentacular cells, and immune cells. Neuroimmune interactions in epithelial tissues are critical in maintaining tissue function, but how OSNs and immune cells interact in the MOE in healthy and diseased states is largely unknown. Cellular responses in the MOE determine how and whether OSNs maintain olfactory function and are repaired or replenished following inflammatory environmental exposures. We hypothesized that acute nasal aeroallergen exposure alters immune cell function in the MOE to elicit a neuroprotective response, thereby preserving OSN function. We developed an environmental aeroallergen exposure consisting of one week of daily intranasal house dust mite extract (HDM) instillations. Spectral flow cytometry indicated only subtle changes in resident immune cells proportions and phenotypes in the MOE. Immunohistochemical evaluation did not reveal extensive changes in immune cell distribution in the sensory epithelium or lamina propria, but instead we observed increases in axonal olfactory marker protein (OMP) expression in the lamina propria, where resident immune cells are most abundant. To evaluate the effects of HDM exposure on OSN function, we performed live ex vivo Ca2+ imaging of MOEs from HDM- and sham-exposed transgenic mice using objective-coupled planar illumination (OCPI) microscopy. OSN responses to multiple odorants revealed increased chemosensory sensitivity and decreased across-trial adaptation in HDM-treated epithelia. These results indicate that short-term nasal aeroallergen exposure minimally alters immune cell phenotypes, and instead induces functional changes in OSN physiology that preserve olfactory function.