Frontiers in Aging Neuroscience最新文献

{"title":"Abnormal resting-state EEG neural oscillations and functional connectivity in mild cognitive impairment.","authors":"Yi Jiang, Zhiwei Guo, Rubing Jiao, Haoru He, Ning Jiang, Jiayuan He","doi":"10.3389/fnagi.2025.1640966","DOIUrl":"10.3389/fnagi.2025.1640966","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment (MCI) exhibits abnormal resting-state EEG oscillations in delta (1-4 Hz), theta (4-7 Hz), and alpha (8-13 Hz) bands, though findings remain inconsistent. Moreover, dynamic functional connectivity (FC) alterations in these bands are poorly understood. To address this, we aimed to characterize resting-state EEG oscillations and dynamic FC in these frequency bands in MCI.</p><p><strong>Method: </strong>We recruited 21 MCI and 20 age-/education-matched normal controls (NC). Resting-state EEG was recorded for 5 min (eyes-open). We utilized power spectral density to investigate abnormalities in neural oscillations, and employed the directed transfer function (DTF) to explore dynamic functional connectivity (FC) alterations within the delta, alpha, and theta frequency bands 4among two groups.</p><p><strong>Results: </strong>Compared to NC, for neural oscillation, MCI showed significantly increased delta oscillation (prefrontal, parietal, temporal, and central regions) mainly located in the frontal and parietal lobes, significantly decreased alpha oscillation of the entire brain region mainly located in the frontal lobe, and both significantly increased and decreased theta oscillation (prefrontal, parietal, and occipital lobes) with fewer electrodes. For dynamic brain FC, in the delta band, the MCI exhibited significantly enhanced bidirectional FC between the prefrontal and parietal lobes, as well as two bottom-up FC from the occipital lobe to the central and parietal regions; In the theta band, the MCI showed significant enhancement of two FC from the temporal lobe to the frontal lobe, two FC from the occipital lobe to the parietal lobe, and one FC from the parietal lobe to the frontal lobe; In the alpha band, the MCI had one significantly enhanced bottom-up FC from the occipital lobe to the prefrontal lobe.</p><p><strong>Conclusion: </strong>During the eyes-open resting-state, differences of two groups in neural oscillations were primarily observed in the alpha and delta bands. The MCI exhibited significantly decreased alpha oscillations in the frontal lobe and increased delta oscillations in the frontal and parietal lobes. However, dynamic FC differences were most prominent in the delta and theta bands, including significantly increased interconnectivity of the prefrontal parietal network and significantly increased bottom-up FC. These findings emphasize the necessity of comprehensive analysis of local activity and large-scale network dynamics in MCI.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1640966"},"PeriodicalIF":4.5,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12463927/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commentary: Sensorimotor dysfunction and postural instability in older adults with type 2 diabetes mellitus: the role of proprioception and neuropathy.","authors":"Datian Chen, Hui Gong","doi":"10.3389/fnagi.2025.1658306","DOIUrl":"10.3389/fnagi.2025.1658306","url":null,"abstract":"","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1658306"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interaction between resilience framework and neuron-astrocyte-synapse dynamics in AD.","authors":"Hongyue Ma, Haizhen Zhao, Xinhong Feng, Fengli Gao","doi":"10.3389/fnagi.2025.1644532","DOIUrl":"10.3389/fnagi.2025.1644532","url":null,"abstract":"<p><p>The concept of resilience can be used to explain why there are differences in the degree to which the brain functions of different individuals are impaired due to aging and pathological factors associated with neurodegenerative diseases. It encompasses cognitive reserve, brain reserve, and brain maintenance. Long-term research has identified a default mode network (DMN) related to cognitive reserve. This mode can modulate the negative impact of Alzheimer's disease (AD) pathological burden on cognitive performance. Meanwhile, the association between neurons and glial cells plays a crucial role in the strength of neural network connections. Glial cells are widely distributed in the brain and interact closely with neurons. Among them, astrocytes are essential for maintaining the normal functions of the central nervous system. In both healthy and diseased states, astrocytes perform a variety of functions, including participating in the regulation of synaptic plasticity, synaptogenesis, maintaining glutamate and ion homeostasis, participating in cholesterol and sphingolipid metabolism, and being able to respond to environmental factors. All of these functions are associated with Alzheimer's disease. In this review, first, we provided an overview of Cognitive Reserve, Brain Maintenance, and Brain Reserve. Then, we expounded on the possible mechanisms of action related to glial cells. Finally, we described their roles in Alzheimer's disease and therapeutic development. This review may provide information and relevant therapeutic strategies for future research as well as the design of diagnostic and therapeutic interventions.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1644532"},"PeriodicalIF":4.5,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145185148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive performance, sleep quality and physical activity as predictors of functional mobility in older adults.","authors":"Daniela Smirni, Garden Tabacchi, Roberta Cottone, Giovanni Angelo Navarra, Giulio Muscarnera, Vincenzo Di Noto, Antonino Scardina, Marianna Bellafiore","doi":"10.3389/fnagi.2025.1649682","DOIUrl":"10.3389/fnagi.2025.1649682","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the relationships between functional mobility and cognitive performance, sleep quality and physical activity in older adults according to age, sex, weight status and education, and whether these variables could be predictors of functional mobility and fall risk.</p><p><strong>Method: </strong>Eighty-five physically independent older adults (72.3 ± 5.67 years; 83.5% female), without significant cognitive impairments, were involved in this cross-sectional study. Functional mobility, cognitive functions as phonemic fluency, attention, memory, processing speed, and manual dexterity were, respectively, assessed with Timed Up and Go (TUG) test, phonemic fluency test, Grooved Pegboard Test, (GPT) and Symbol Digit Modalities Test, Stroop Color-Word Test. Sleep quality and physical activity were evaluated with self-reported questionnaires. Correlational and multiple regression analyses were performed.</p><p><strong>Results: </strong>Poorer TUG performance was significantly associated with older age (<i>ρ</i> = 0.46, <i>p</i> < 0.001), lower educational level, reduced GPT performance, and lower scores on working memory, and processing speed. Age and GPT performance showed the strongest associations with TUG results. Regression analysis confirmed age and manual dexterity as significant predictors of functional mobility.</p><p><strong>Conclusion: </strong>Older age and reduced manual dexterity were linked to greater fall risk. These findings suggest that early interventions targeting fine motor skills may help preserve mobility and prevent falls in aging populations.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1649682"},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457295/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Subcutaneous foslevodopa/foscarbidopa initiation in a Parkinson's day-clinic - a suitable setting to ensure treatment efficacy, tolerability and psychosocial adaption.","authors":"Alina Jander, Sarah Bergner, Beate Schönwald, Monika Pötter-Nerger, Carsten Buhmann, Ute Hidding","doi":"10.3389/fnagi.2025.1619850","DOIUrl":"10.3389/fnagi.2025.1619850","url":null,"abstract":"<p><strong>Background: </strong>Subcutaneous foslevodopa/foscarbidopa (LDp/CDp) has expanded the treatment options in advanced Parkinson's disease (aPD). However, the most appropriate therapeutic setting for therapy implementation is not clear.</p><p><strong>Objective: </strong>To present a concept for LDp/CDp therapy implementation in a Parkinson's day-clinic and efficacy and safety outcome data from patients under the new therapeutic regimen.</p><p><strong>Methods: </strong>Retrospective clinical data were collected from the first 24 patients with aPD who were initiated on LDp/CDp treatment at the Hamburg Parkinson's day-clinic. Outcome parameters were analyzed in terms of motor symptoms (MDS -UPDRS II-IV), safety aspects and effects on patients' quality of life (PDQ-39).</p><p><strong>Results: </strong>The concept of the Parkinson's Day-clinic enabled the successful implementation of LDp/CDp therapy in patients with advanced Parkinson's disease (aPD). It provided individualized medical supported via neurologists, specialized nurses and therapists and thus facilitated the transition from clinic-based care to home-based support. Compared to previous optimized oral treatment, the application of LDp/CDp significantly reduced motor complications such as dyskinesias and motor fluctuations by 53% on the MDS-UPDRS IV (<i>p</i> = 0.0094). Motor function improvements were paralleled by a numerical increase in activities of daily living scores (MDS-UPDRS II) and improvement in long-term mobility (PDQ-39 mobility subscale), suggesting potential benefits in daily functioning and perceived mobility.</p><p><strong>Conclusion: </strong>The value of our data is limited by its retrospective design and small sample size. However, the data suggest that a proper day-clinic setting enables the successful implementation of subcutaneous LDp/CDp therapy with improvement of motor functions and reduction of side effects. It also ensures the necessary intensive medical support and offers comprehensive device-related and psychosocial guidance for both patients and caregivers.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1619850"},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative efficacy of deep transcranial magnetic stimulation versus repetitive transcranial magnetic stimulation in improving lower extremity motor function in subacute stroke patients.","authors":"Chengshuo Wang, Linli Zhang, Mingyue Liu, Aomeng Xiang, Jingman Qi, Yanxin Fu, Ruoxuan Zhao, Zheyu Xiong, Liang Wu, Qin Zhang","doi":"10.3389/fnagi.2025.1623039","DOIUrl":"10.3389/fnagi.2025.1623039","url":null,"abstract":"<p><strong>Background: </strong>Deep transcranial magnetic stimulation (dTMS) is more beneficial in activating the leg muscle cortical representation. However, to date, no studies have evaluated the advantages of dTMS compared to repetitive transcranial magnetic stimulation (rTMS) in improving lower extremity motor function in subacute stroke patients. This study aims to compare the efficacy of dTMS and rTMS in treating lower extremity motor dysfunction in subacute stroke patients.</p><p><strong>Methods: </strong>In this single-blind, randomized controlled trial, fifty subacute stroke patients with lower extremity motor dysfunction were randomized to receive either dTMS or rTMS treatment. Patients' Fugl-Meyer Assessment of Lower Extremity (FMA-LE), 10 m Maximum Walking Speed (10 m MWS), Berg Balance Scale (BBS), Timed Up and Go Test (TUGT), walking velocity, stride rate, stride length, gait cycle, double support percentage, and Resting Motor Threshold (RMT) were assessed before the intervention and after the 4-week intervention. Treatment effects were compared using two-way repeated-measures ANOVA. Correlations between lower extremity motor function and cortical excitability were analyzed using Pearson correlation analysis.</p><p><strong>Results: </strong>Forty-five patients completed the study (dTMS group: <i>n</i> = 22; rTMS group: <i>n</i> = 23). Two-way repeated measures ANOVA showed significant group × time interaction effects for FMA-LE, 10 m MWS, BBS, TUGT, walking velocity, stride length, gait cycle, and double support percentage. <i>Post hoc</i> analyses revealed both groups improved significantly from baseline in FMA-LE, 10 m MWS, BBS, TUGT, RMT, walking velocity, stride length, and double support percentage. The dTMS group additionally improved stride rate and gait cycle, while the rTMS group did not. Post-intervention, the dTMS group demonstrated significantly greater improvements than rTMS in FMA-LE, 10 m MWS, TUGT, and walking velocity. After 4 weeks, RMT was significantly negatively correlated with FMA-LE, 10 m MWS, BBS, and walking velocity. RMT was positively correlated with TUGT.</p><p><strong>Conclusion: </strong>Both dTMS and rTMS can improve lower extremity motor dysfunction in subacute stroke patients. Compared to rTMS, dTMS may provide more facilitative and accelerative effects to promote FMA-LE, TUGT, 10 m MWS, and walking velocity. Therefore, as an adjunct to conventional rehabilitation therapies, dTMS is a valuable therapeutic option in stroke rehabilitation programs.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1623039"},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the research landscape of Mild Cognitive Impairment in Parkinson's disease: a bibliometric and visualization analysis.","authors":"Yufeng Peng, Hao Chen, Kewei Peng, Luyao Li, Zihua Ma","doi":"10.3389/fnagi.2025.1624420","DOIUrl":"10.3389/fnagi.2025.1624420","url":null,"abstract":"<p><strong>Background: </strong>Mild Cognitive Impairment in Parkinson's disease, a common non-motor symptom of Parkinson's disease, significantly impacts individuals' quality of life and predicts dementia risk, underscoring its clinical research importance. This study aimed to characterize the global bibliometric landscape and identify research hotspots, knowledge gaps, and future trends in the PD-MCI field over the past two decades using bibliometric and visualization methods.</p><p><strong>Methods: </strong>Literature related to PD-MCI published between 2005 and 2024 was retrieved from the Web of Science Core Collection database. Tools such as CiteSpace and VOSviewer were employed for visual analysis of annual publication volume, country/institutional distribution, author collaborations, journal co-citations, and keyword co-occurrence and bursts, constructing knowledge maps.</p><p><strong>Results: </strong>Mild cognitive impairment in Parkinson's disease research demonstrated significant growth, with sustained increases in annual publication volume and citation frequency. The United States dominated the field, while research output from countries like China grew rapidly. Research hotspots evolved from early explorations of molecular mechanisms toward clinical and translational studies focusing on neuroimaging, biomarkers, application of MDS diagnostic criteria, non-motor symptoms, and cognitive subtypes. Recently, machine learning, multi-omics integration, neuroinflammation, and mitochondrial function have emerged as new frontiers.</p><p><strong>Conclusion: </strong>Mild cognitive impairment in Parkinson's disease research has progressed from basic mechanism exploration to a multidisciplinary, integrated clinical-basic stage, following an evolutionary path of \"pathological mechanism - clinical phenotype - biomarker - intervention strategy.\" Future research should focus on unifying diagnostic criteria, deepening understanding of multifactorial pathological mechanisms, developing precise biomarker combinations, and exploring individualized intervention strategies to achieve early warning and disease modification for PD-MCI.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1624420"},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12457374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empathy in mild cognitive impairment: a preliminary clinical comparative study in Southern Switzerland using the interpersonal reactivity index (IRI) and the story-based empathy task (SET).","authors":"L Arnaud, L Morellini, L G Rege-Colet, A Pagnamenta, E Fontana, M Lissi, R Morese, L Sacco","doi":"10.3389/fnagi.2025.1661172","DOIUrl":"10.3389/fnagi.2025.1661172","url":null,"abstract":"<p><strong>Introduction: </strong>Mild Cognitive Impairment (MCI) is a transitional stage between normal aging and dementia, frequently associated with subtle deficits in social cognition. Empathy, a core component of social cognition, encompasses both affective and cognitive dimensions and may be compromised even in prodromal phases of neurodegenerative conditions. Despite its clinical relevance, empathy in MCI remains underexplored, and standardized assessment tools are seldom used in routine diagnostics. Theory of mind is another important aspect of social cognition, and, as with empathy, it is unclear how it is affected at the MCI stage. This study aimed to investigate empathy and theory of mind abilities in individuals with MCI, excluding cases attributable to prodromal frontotemporal dementia, using two validated instruments: the Interpersonal reactivity index (IRI) and the Story-based empathy task (SET).</p><p><strong>Methods: </strong>We conducted a case-control study involving 23 individuals with MCI and 25 cognitively healthy controls. All participants completed the IRI, while a subsample (19 MCI patients) also underwent the SET. The clinical group included both amnestic and non-amnestic MCI subtypes, with heterogeneous etiologies. Group comparisons were performed on IRI subscales and SET indices to assess both self-reported empathy traits and performance-based socio-cognitive abilities.</p><p><strong>Results: </strong>The MCI group exhibited significantly lower scores in the IRI subscales of Empathic Concern and Perspective Taking compared to controls, indicating concurrent affective and cognitive empathy impairments. While no significant differences emerged in individual SET subcomponents, the MCI group showed a significantly lower global SET score, suggesting reduced integrative socio-cognitive performance. These findings should be interpreted with caution given the limited sample size and clinical heterogeneity, which make this a preliminary study.</p><p><strong>Conclusion: </strong>These findings provide preliminary evidence of early empathy-related and theory of mind alterations in MCI, supporting the inclusion of social cognition assessments in standard neuropsychological protocols. The combined use of self-report and task-based instruments may enhance early identification of socio-emotional dysfunctions and inform personalized clinical interventions. The preliminary nature of this study is mainly due to the small sample size and the heterogeneous clinical profiles, which limit generalizability but highlight the need for replication in larger cohorts.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1661172"},"PeriodicalIF":4.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of different frequencies of repetitive transcranial magnetic stimulation on sleep disorders and depression in patients with Parkinson's disease: a systematic review and network meta-analysis.","authors":"Yuan Xia, Haili Wan, Xin Hu, Wenhui Sun, Yongjie Li","doi":"10.3389/fnagi.2025.1623917","DOIUrl":"10.3389/fnagi.2025.1623917","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising neuromodulatory approach for alleviating sleep disturbances and depressive symptoms in Parkinson's disease (PD), yet direct comparisons of different stimulation frequencies remain scarce.</p><p><strong>Objective: </strong>To evaluate and rank the efficacy of three rTMS frequencies (1 Hz, 5 Hz, and 10 Hz), each combined with conventional therapy, on sleep disorders and depression in PD patients, thereby informing clinical decision-making.</p><p><strong>Methods: </strong>We conducted a systematic search for randomized controlled trials (RCTs) in PubMed, Embase, the Cochrane Library, Web of Science, ProQuest, China National Knowledge Infrastructure, Wanfang, and the Chinese Scientific and Journal Database. A network meta-analysis was performed to compare the effects of different frequencies of rTMS (1 Hz, 5 Hz, and 10 Hz) on sleep disorders and depression in PD patients.</p><p><strong>Results: </strong>Thirty-one RCTs involving 1,977 PD patients met inclusion criteria. Compared with conventional treatment alone, adjunctive 5 Hz and 10 Hz rTMS produced significant improvements in both Pittsburgh Sleep Quality Index (PSQI) and Parkinson's Disease Sleep Scale (PDSS). Although 1 Hz rTMS yielded numerically greater PSQI and PDSS improvements than conventional therapy, these differences did not reach statistical significance, nor did differences between the three stimulation frequencies. In terms of depressive symptoms, all three frequencies (1 Hz, 5 Hz, and 10 Hz) significantly reduced HAMD scores versus standard care, with head-to-head comparisons indicating superior efficacy of 10 Hz over 1 Hz and 5 Hz. The Surface Under the Cumulative Ranking area (SUCRA) consistently identified 10 Hz rTMS as the most effective frequency for PSQI, PDSS, and HAMD outcomes.</p><p><strong>Conclusion: </strong>Adjunctive rTMS at 1 Hz, 5 Hz, and 10 Hz each confer benefits for sleep and mood in PD patients, but 10 Hz stimulation appears to offer the greatest overall improvement. These findings support the preferential use of 10 Hz rTMS when targeting non-motor symptoms in Parkinson's disease.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/recorddashboard, identifier CRD42024614337.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1623917"},"PeriodicalIF":4.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive deterioration in patients undergoing hemodialysis: how variations in age influence the development of new mechanisms and treatment approaches?","authors":"Hongyu Jiang, Dongyuan He, Yue Hu","doi":"10.3389/fnagi.2025.1645702","DOIUrl":"10.3389/fnagi.2025.1645702","url":null,"abstract":"<p><p>The mechanisms of age-related differences and innovative intervention strategies for cognitive dysfunction in hemodialysis patients are crucial for enhancing patient outcomes. This research thoroughly examined the varying pathological aspects of cognitive decline across different age groups. Children and adolescents experience heightened permeability of the blood-brain barrier during critical developmental phases, along with the disruptive effects of uremic toxins on neurotransmitters and synaptic plasticity, which result in diminished white matter integrity and abnormal functioning of the default mode network. Additionally, genomic variations, such as harmful CNVs, coexist with the central nervous system's high plasticity and susceptibility. In contrast, elderly patients face cognitive impairment due to the combined effects of vascular diseases (like small vessel disease and impaired cerebral blood flow regulation) and Alzheimer's-like pathology, exacerbated by dialysis-related hypotension, oxidative stress, and inflammation, which further contribute to reduced cerebral blood flow and neurodegeneration. Consequently, a life cycle-based layered intervention strategy is suggested: children should focus on safeguarding their neural development through collaborative gene-environment interventions and neural stem cell transplants, while elderly patients require standardized treatment for vascular diseases and comorbidities, including Alzheimer's disease. Evidence indicates that incremental dialysis, low temperature dialysis, and high-dose hemodiafiltration can significantly reduce inflammation and oxidative stress markers, slow cognitive decline across all ages, and offer new insights for targeted nephrology management due to their universal effects. Future multi-center cohort studies are necessary to confirm the long-term advantages of age-specific interventions and to support the development of personalized precision treatment systems.</p>","PeriodicalId":12450,"journal":{"name":"Frontiers in Aging Neuroscience","volume":"17 ","pages":"1645702"},"PeriodicalIF":4.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12451007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145130624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}