JMIR neurotechnology最新文献

{"title":"Feasibility of Interleaving Computerized Cognitive Training With Repetitive Transcranial Magnetic Stimulation: Pilot Studies in Mild Cognitive Impairment Due to Alzheimer's Disease and Stroke.","authors":"Laura M Campbell, Stephanie Aghamoosa, Olivia Horn, Holly H Fleischmann, James Lopez, Katrina S Rbeiz, Katrina Madden, Michael Antonucci, Gonzalo Revuelta, Lisa M McTeague, Andreana Benitez","doi":"10.2196/81437","DOIUrl":"10.2196/81437","url":null,"abstract":"<p><strong>Background: </strong>Repetitive transcranial magnetic stimulation induces neural plasticity, which may be maximized via adjunctive interventions.</p><p><strong>Objective: </strong>This study aimed to examine the feasibility and acceptability of interleaving computerized cognitive training (CCT) with accelerated intermittent theta burst (iTBS) repetitive transcranial magnetic stimulation in 2 open-label phase I trials of amnestic mild cognitive impairment (aMCI; NCT04503096) and poststroke mild cognitive impairment (psMCI; NCT04655963).</p><p><strong>Methods: </strong>Participants (aMCI: n=21; and psMCI: n=14) received 24 sessions of accelerated iTBS over 3 days (8 sessions per day). During the 10- to 15-minute intervals between iTBS sessions, participants engaged in CCT via the BrainHQ platform. During the 4-week follow-up period, participants were asked to complete 20 minutes daily of BrainHQ. Both studies offered identical compensation for daily practice, but the aMCI group received weekly reminders, whereas the psMCI group did not. Study-specific questionnaires assessed BrainHQ acceptability (administered post-treatment and at follow-up).</p><p><strong>Results: </strong>During in-laboratory treatment, the groups completed similar amounts of BrainHQ (aMCI: median 107, IQR 92-121 min; and psMCI: median 111, IQR 93-137 min; <i>P</i>=.51). However, engagement differed during the unmonitored follow-up (aMCI: median 450, IQR 167-581 min,; and psMCI: median 142, IQR 0-477 min); practice time increased in the aMCI group but decreased in the psMCI group over the 4 weeks (<i>P</i>=.001). Both groups generally rated BrainHQ positively at both time points in terms of their experience with the platform, exercises, and perceived benefit for their mood and functioning.</p><p><strong>Conclusions: </strong>Combined treatment with CCT and accelerated iTBS is feasible and acceptable in people with mild cognitive impairment. Standardized dosing of CCT is feasibly achieved when interleaved with iTBS sessions and completed in-laboratory, but ecological adherence to CCT in an unmonitored, self-directed context likely requires additional supports and may be influenced by patient characteristics.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"5 ","pages":"e81437"},"PeriodicalIF":0.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"xHD-Vox, an Automated Speech Model for Estimating Motor and Cognitive Scores in Huntington Disease: Development and Longitudinal Validation.","authors":"Tiphaine Le Ludec, Andres Gil-Salcedo, Hadrien Titeux, Robin Louiset, Clément Le Moine Veillon, Renaud Massart, Anne-Catherine Bachoud-Lévi","doi":"10.2196/83838","DOIUrl":"10.2196/83838","url":null,"abstract":"<p><strong>Background: </strong>Huntington disease (HD) is a rare genetic neurodegenerative disease that causes progressive motor, cognitive, and psychiatric symptoms over decades after onset. Clinical care is typically provided in specialized centers with only annual clinical assessments, highlighting the need for more frequent and cost-effective monitoring.</p><p><strong>Objective: </strong>This study aimed to develop and validate xHD-Vox, a fully automated, interpretable, speech-based model for predicting the composite Unified Huntington Disease Rating Scale (cUHDRS) and its cognitive, motor, and functional components.</p><p><strong>Methods: </strong>We included 181 HD gene carriers (341 annual visits) from three French prospective cohorts: BIO-HD (NCT01412125), REPAIR-HD (NCT03119246), and MIG-HD (NCT00190450). Participants had ≥40 cytosine-adenine-guanine (CAG) repeats, available cUHDRS scores, and audio recordings of forward and backward counting (1-20). For model development and feature selection, we used a speech pathologist-annotated subset (145 visits and 90 participants). Selected speech features were then automated using Whisper, an open-source speech recognition tool. The final linear regression model, xHD-Vox, was calibrated on the training set of 269 visits (157 participants, and annotated subset included). Performance was evaluated on an independent longitudinal test set (24 participants, with 3 annual visits each) using mean absolute error, explained variance (<i>R</i> ^²), and intraclass correlation coefficient. Longitudinal decline was assessed with 2-way repeated-measures ANOVAs. Predicted 1-year and 2-year changes were compared with clinician-assessed 95% CIs.</p><p><strong>Results: </strong>Feature selection identified four key predictors: standardized CAG-age-product score, CAG repeat length, rate of numbers pronounced per second, and the SD of that rate. On the test set, xHD-Vox achieved a mean absolute error of 2.1 for cUHDRS and explained 57% of its variance, compared with 38% when using only demographic features. Longitudinal analyses using repeated-measures ANOVAs with post hoc Tukey tests confirmed a significant decline over the 2-year follow-up for both clinician-assessed measures and xHD-Vox predictions. At the group level, the mean 1-year and 2-year changes predicted by xHD-Vox were consistent with clinically measured changes, falling within the corresponding 95% CIs.</p><p><strong>Conclusions: </strong>We developed xHD-Vox, an interpretable and automated model that predicts clinical scores in HD using a short speech task. Predicted scores were consistent with clinician-assessed scores, supporting its potential use in mobile apps for remote monitoring. This approach could facilitate scalable, real-time tracking of disease progression, especially in underserved regions, and enable personalized and responsive clinical care.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"5 ","pages":"e83838"},"PeriodicalIF":0.0,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13345346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Accuracy of GPT-4 With Vision in Neuroradiology Board-Style Exam Questions: Cross-Sectional Case-Based Study.","authors":"Tom T Sussan, Rebekah R Brawley, Joshua Eckroth, James E Mossell, Tao Weitao","doi":"10.2196/69708","DOIUrl":"10.2196/69708","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Multimodal artificial intelligence systems combining text and image analysis represent a paradigm shift in clinical decision support. While GPT-4 with Vision (GPT-4V) has shown promise in medical imaging interpretation, existing studies report inconsistent performance (16%-80% accuracy) across radiological subspecialties. Critical knowledge gaps persist regarding GPT-4V's capability to integrate clinical history with imaging findings in complex neuroradiology scenarios, and fundamental questions remain about whether the model appropriately balances visual and textual information sources when formulating diagnoses. Furthermore, documented artificial intelligence hallucination rates of 35.5% to 63% in radiology applications raise urgent safety concerns, yet the relationship between modality utilization patterns and diagnostic accuracy remains unexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to evaluate GPT-4V's diagnostic accuracy on expert-validated neuroradiology board-style examination questions and to examine the model's self-reported reliance on imaging versus clinical text data when making diagnostic decisions. A secondary objective was to examine whether self-characterized modality utilization patterns differed systematically between correct and incorrect diagnoses, potentially identifying specific failure modes requiring targeted mitigation strategies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study evaluated GPT-4V using 29 neuroradiology cases from the RSNA (Radiological Society of North America) Case Collection, covering adult brain and central nervous system pathologies imaged via computed tomography or magnetic resonance imaging. The cases were authored by board-certified radiologists. GPT-4V was accessed via ChatGPT Plus (July 2024) with standardized prompts selecting 1 answer from 4 options, providing diagnostic rationale, and quantifying the percentage contributions of image versus text data. Binary scoring assessed diagnostic performance (correct=1, incorrect=0). Statistical analysis included Wilson score CIs, a binomial test comparing accuracy to chance, and a 2-tailed &lt;i&gt;t&lt;/i&gt; test comparing self-reported modality reliance between correct and incorrect diagnoses (α=.05, Cohen &lt;i&gt;d&lt;/i&gt; calculated).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;GPT-4V correctly diagnosed 22 of 29 cases (76% accuracy, 95% CI 57.9%-87.8%), significantly exceeding the chance performance of 25% (&lt;i&gt;z&lt;/i&gt;=6.33; &lt;i&gt;P&lt;/i&gt;&lt;&lt;i&gt;.&lt;/i&gt;001). The model self-reported mean contributions of 66.1% from imaging (95% CI 63.5%-68.8%) and 33.9% from text (95% CI 31.2%-36.5%). Correct diagnoses (n=22) showed significantly lower self-reported image reliance (62.8%, 95% CI 61.3%-64.3%) compared to incorrect diagnoses (n=7; 76.7%, 95% CI 73.5%-80.0%), with a mean difference of 13.9 percentage points (95% CI 10.6-17.3; &lt;i&gt;P&lt;/i&gt;&lt;.001; Cohen &lt;i&gt;d&lt;/i&gt;=4.08, 95% CI 2.73-5.43). All 7 incorrect diagnoses demonstrated image-dominant attribu","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"5 ","pages":"e69708"},"PeriodicalIF":0.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13132487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147824381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tracking Cognitive Health With Wearables in Telerehabilitation Female Participants: Could Nighttime Sleep Measures Be Used as Sex-Specific Digital Endpoints?","authors":"Stephanie J Zawada, Louis Faust, Emma Fortune","doi":"10.2196/81318","DOIUrl":"10.2196/81318","url":null,"abstract":"<p><p>While changes in brain structure are common across the lifespan, it is difficult to differentiate benign variations from early disease pathogenesis, especially in patients participating in home-based rehabilitation. Cognitive decline is frequently linked with normative aging, but its early detection can facilitate preventative interventions, particularly in patients at high risk of cognitive impairment and dementia, such as older women. Although women have fewer modifiable risk factors for dementia than men, wearables have the potential to establish new digital endpoints that facilitate the management and/or prevention of abnormal brain aging. Sleep, which is necessary for maintaining overall brain health, is one behavior tracked via wearables, for which an ever-growing body of pilot and validation phase studies exists, yet endpoints defining optimal sleep are not one-size-fits-all, as individual chronotype variability necessitates new strategies to personalize care. Though sex-based differences in circadian rhythm are well established, little is understood about which sleep measures and thresholds are uniquely important to cognitive health in women, particularly those with high comorbid burden. In this viewpoint, we discuss recent findings on the use of wearables to track sleep and cognitive health in women, while highlighting challenges and opportunities for health outcomes and clinical trial researchers seeking to implement meaningful digital endpoints in future telerehabilitation programs.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"5 ","pages":"e81318"},"PeriodicalIF":0.0,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147701039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pocket Laboratory for Functional Neuroimaging Research Using Mobile Visual Oddball, Multimodal Electroencephalography, and Functional Near-Infrared Spectroscopy Imaging: Instrument Validation Study.","authors":"Peter Rokowski, Meltem Izzetoglu, Luis Gomero, Roee Holtzer","doi":"10.2196/78217","DOIUrl":"10.2196/78217","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The need to observe brain activity in more natural environments, that is, outside of laboratory settings, is critical for understanding cognition. Wearable low-cost neuroimaging modalities (electroencephalography [EEG] and functional near-infrared spectroscopy [fNIRS]) are portable, noninvasive, and robust to motion artifacts but lack similarly portable tools for use in ecologically valid studies. Smartphones are ubiquitous, programmable, wireless, and thus strong candidates for \"pocket laboratories\" companion platforms that travel with study subjects. Therefore, we developed the Wearable Cognitive Assessment and Augmentation Toolkit (WearCAAT), a cross-platform neuroimaging task platform that integrates external sensors via the lab streaming layer (LSL) and supports over 100 sensor types. We validated our implementation with healthy human participants under multimodal neuroimaging conditions prior to analysis of data collection in ongoing clinical settings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to validate WearCAAT, as a platform for functional neuroimaging research, via analysis of human participant data collected during our ongoing National Institutes of Health-funded study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We analyzed data from healthy college-aged (ages 18-30 y) adult participants, who completed a battery of shortened neurocognitive tasks (each lasting 4 min) in WearCAAT, while outfitted with research-grade multimodal EEG and fNIRS sensors. We indicated validity via the presence of task-related behavioral responses and their neuroimaging correlates. As a representative example, we analyzed the visual oddball task due to its well-documented poststimulus features for EEG and fNIRS. We extracted behavioral responses, mean response accuracies, and response times for infrequent (target) and frequent (standard) stimuli classes. We examined, poststimulus, P300, positive amplitude deflection around 300 (ms) in EEG and increased average oxygenated hemoglobin (HbO) levels in fNIRS.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We enrolled a total of 57 (male individuals: n=27, 47%; female individuals: n=30, 53%; mean age 22, SD 3.4 y) participants for data collection. We excluded the first 4 (7%) participants from our analysis due to technical errors. Our analysis revealed increased mean response times for infrequent (target) stimuli (mean 718, SD 148 ms) compared to frequent (standard) stimuli (mean 542, SD 122 ms) with the Wilcoxon test (Z=6.33; &lt;i&gt;P&lt;/i&gt;&lt;.001; &lt;i&gt;r&lt;/i&gt;=0.87); higher P300 amplitudes over midline regions (parietal and temporal) for EEG; and increased oxygenated hemoglobin over the prefrontal cortex for fNIRS. All participants completed the full battery and reported no usability concerns or app crashes. Similarly, we observed no data loss or corruption that would negatively impact analyses.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;WearCAAT-provided outcomes from our study, which analyzed multimodal neuroimaging","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"5 ","pages":"e78217"},"PeriodicalIF":0.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13080780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poststroke Neurorehabilitation Using a Soft Robotic Glove Combined With a Virtual Environment: Preliminary Study on Feasibility, Safety, Effects, and User Satisfaction.","authors":"Camille E Proulx, Johanne Higgins, Thomas Vaughan, Mark Hewko, Dany H Gagnon","doi":"10.2196/69750","DOIUrl":"10.2196/69750","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Optimizing rehabilitation intensity using a robotic-assisted hand rehabilitation exercise (RAHRE) program coupled with a virtual environment is a promising intervention as it aligns with key neuroplasticity principles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The aim of the study is to assess the feasibility, safety, preliminary effects, and satisfaction of the 2-week RAHRE program offered as an adjunct to conventional rehabilitation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In total, 11 adults with hand hemiparesis following a recent stroke and undergoing intensive functional rehabilitation were randomized into experimental and control groups. Both groups received conventional rehabilitation therapy over a 2-week period. The experimental group received 10 additional 30-minute sessions of the RAHRE program (5 times per week), incorporating 4 hand opening and closing exercises with personalized glove assistance or resistance levels with virtual reality over the same period. Measures of feasibility (ie, attendance rate, compliance rate, repetitions per session, active training time, therapist verbal cueing, and support required), safety (ie, discomfort and adverse effects), and satisfaction (ie, satisfaction questionnaire) were collected. Functional outcomes (ie, Action Research Arm Test [ARAT], Fugl-Meyer Assessment for the Upper Extremity [FMA-UE], Box and Block Test, ABILHAND) were also assessed before and after the intervention in both groups.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Attendance and compliance rates in the experimental group reached 96% (48 completed training sessions of 50 planned sessions) and 95% (1432 completed training minutes of 1500 planned minutes), respectively. Participants performed a median of 2543 (IQR 2368-2951) additional movement repetitions during the RAHRE program (median repetitions per session 260, IQR 173-365; median active training time 24 minutes 39 seconds, IQR 22 minutes 26 seconds-25 minutes 51 seconds). Minimal therapist verbal cueing and support were necessary for technology use (median glove donning time 46, IQR 27-60 seconds; median independence achieved in 6, IQR 4-7 sessions). No abnormal discomfort or adverse effects were reported. Both groups showed functional improvements in ARAT, FMA-UE, Box and Block Test, and ABILHAND. For the primary outcomes (ie, ARAT and FMA-UE), the median score changes were, respectively, 4.50 (IQR 0-9) and 4.00 (IQR 3-4) in the control group, and 4.00 (IQR 1-7.5) and 5.00 (IQR 5-6) in the experimental group. Excellent overall program satisfaction (median 5/5, IQR 5-5) was reported for the RAHRE program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The RAHRE program, as an adjunct to conventional rehabilitation therapy, emerges as being feasible, safe, beneficial, and satisfying for adults with hand hemiparesis following a recent stroke. However, careful interpretation of the results remains recommended given the strength of the evidence. Future studies providing higher-q","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"4 ","pages":"e69750"},"PeriodicalIF":0.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of a Neurofeedback-Based Mindfulness Meditation Intervention for Migraine: Qualitative Study.","authors":"Tora Levinton, Jan Gelech, Faly Golshan, Marla Mickleborough","doi":"10.2196/68369","DOIUrl":"10.2196/68369","url":null,"abstract":"<p><strong>Background: </strong>Migraine is a debilitating neurological condition often impacting the quality of life and resulting in physical, emotional, and social burdens. Pharmaceutical interventions are the conventional treatment for migraine; however, behavioral interventions provide safe alternatives. Both mindfulness meditation and neurofeedback are behavioral interventions that have been separately studied for migraine treatment. To date, no studies have investigated neurofeedback-assisted mindfulness meditation for migraine treatment and prevention.</p><p><strong>Objective: </strong>The objective of our study was to document the experiences of individuals with migraines who participated in an 8-week neurofeedback-based mindfulness meditation intervention as part of a randomized controlled trial.</p><p><strong>Methods: </strong>Semistructured interviews were undertaken with 10 participants (7 female and 3 male participants) aged 23 to 55 years who had previously completed an 8-week neurofeedback-based mindfulness meditation program using Muse wearable sensory headbands as part of a randomized control trial. The interview data were analyzed using reflexive thematic analysis.</p><p><strong>Results: </strong>Participants spoke to 3 categories of experiences: the positive impact of neurofeedback-based mindfulness meditation on migraine experiences, enhanced well-being and improved quality of life resulting from the intervention, and the benefits and drawbacks of incorporating a portable electroencephalogram technology into mindfulness meditation practices in the context of migraine treatment. In total, 9 participants felt that their ability to manage migraine symptoms was improved, and all participants expressed benefits beyond migraine prevention and pain management. Participants also spoke to the interconnectedness of migraine symptoms, daily stressors, and the framing of lived experience.</p><p><strong>Conclusions: </strong>Notably, as the first study to evaluate the experiences of individuals with migraines using an at-home, neurofeedback-based mindfulness meditation intervention, this investigation adds to our understanding of nonpharmaceutical migraine treatment. Participants reported that this neurofeedback-based mindfulness meditation intervention improved migraine management, leading to significant reductions in pain intensity, migraine frequency, and medication use. They also described improved quality of life and emotional regulation related to this intervention, which they attributed to enhanced attentional control and body awareness. This research supports the consideration of neurofeedback-based mindfulness meditation interventions using emerging technologies, such as wearable electroencephalogram devices, as an accessible behavioral intervention for migraine management.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"4 ","pages":"e68369"},"PeriodicalIF":0.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adherence to Therapy Using Neurostimulation Devices in the Treatment of Pediatric Attention-Deficit/Hyperactivity Disorder: Extraclinical Study.","authors":"Allyson Calandro, Saurabh Biswas, Anthony Guiseppi-Elie","doi":"10.2196/68736","DOIUrl":"10.2196/68736","url":null,"abstract":"<p><strong>Background: </strong>Pediatric and adolescent patients with attention-deficit/hyperactivity disorder (ADHD) present unique challenges in adherence to device-based therapies outside the clinical environment. The development, approval, and availability of neurostimulation devices for the treatment of ADHD have prompted extraclinical research (ie, outside the sphere of the clinic) on the real-world implementation of such therapies in a population that has difficulty remembering tasks and staying attentive to therapy.</p><p><strong>Objective: </strong>This study aims to explore the extraclinical pediatric ADHD treatment environment to ensure that design considerations and stakeholder contributions to future innovations are effective.</p><p><strong>Methods: </strong>Using the Lean LaunchPad methodology with its emphasis on customer discovery and the business model canvas, qualitative analysis methods were applied to elicit the most pertinent themes regarding ADHD treatment in children and the general perception of a new device-based treatment regimen.</p><p><strong>Results: </strong>Stakeholders expressed a desire that, for innovative ADHD therapies to appeal to children, they include a remote adherence monitoring component and maintain strong evidence of efficacy.</p><p><strong>Conclusions: </strong>Such barriers to access and desired design features should be strongly considered in the development of neurostimulation therapies for pediatric patients with ADHD. Pediatric and adolescent patients with ADHD require attentive device design considerations to achieve therapeutic adherence in a real-world setting.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"4 ","pages":"e68736"},"PeriodicalIF":0.0,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduction of Anxiety-Related Symptoms Using Low-Intensity Ultrasound Neuromodulation on the Auricular Branch of the Vagus Nerve: Preliminary Study.","authors":"Izzy Kohler, Jon Hacker, Ethan Martin","doi":"10.2196/69770","DOIUrl":"10.2196/69770","url":null,"abstract":"<p><strong>Background: </strong>Neuromodulation of the auricular branch of the vagus nerve using low-intensity focused ultrasound (LIFU) is an emerging mode of treatment for anxiety that could provide a complementary or alternative treatment modality for individuals who are refractory to conventional interventions. The proposed benefits of this technology have been largely unexamined with clinical populations. Further research is required to understand its clinical potential and use in improving and managing moderate to severe symptoms.</p><p><strong>Objectives: </strong>The aim of this study was to do a preliminary investigation into the efficacy, safety, and usability of the wearable headset that delivers LIFU to the auricular branch of the vagus nerve for the purpose of alleviating anxiety disorder symptoms.</p><p><strong>Methods: </strong>This study was a pre-post intervention study design for which we recruited 28 participants with a Beck Anxiety Inventory score of 16 points or greater. Participants completed 5 minutes of treatment daily consisting of LIFU neuromodulation delivered to the auricular branch of the vagus nerve. Participants did this for a period of 4 weeks. Assessments of anxiety symptom severity (Beck Anxiety Inventory), depression symptom severity (Beck Depression Inventory), posttraumatic stress disorder symptom severity (Post Traumatic Stress Disorder Checklist for the <i>Diagnostic and Statistical Manual of Mental Disorders</i> [Fifth Edition]), and sleep quality (Pittsburgh Sleep Quality Index) were taken prior to starting treatment and weekly for 4 weeks of treatment. Usability and safety were also assessed using an exit questionnaire and adverse event logging.</p><p><strong>Results: </strong>After completing 4 weeks of LIFU neuromodulation to the auricular branch of the vagus nerve, the average Beck Anxiety Inventory score decreased by 14.9 (SD 10.6) points (Cohen <i>d</i>=1.06; <i>P</i><.001), the average Beck Depression Inventory score decreased by 10.3 (SD 7.8) points (Cohen <i>d</i>=0.81; <i>P</i><.001), the average Post Traumatic Stress Disorder Checklist for the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (Fifth Edition) score decreased by 20.0 (SD 20.5) points (Cohen <i>d</i>=0.94; <i>P</i><.001), and the average Pittsburgh Sleep Quality Index score decreased by 2.2 (SD 3.1) points (Cohen <i>d</i>=0.65; <i>P</i>=.001). On the exit questionnaire, participants rated the treatment highly for ease of use, effectiveness, and worthiness of the time invested. Only 1 adverse event was reported throughout the entire trial, which was mild and temporary.</p><p><strong>Conclusions: </strong>This preliminary study provided justification for further research into the efficacy, safety, and feasibility of using LIFU to modulate the auricular branch of the vagus nerve and reduce the symptoms of anxiety, depression, and posttraumatic stress disorder.</p>","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"4 ","pages":"e69770"},"PeriodicalIF":0.0,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Artificial Intelligence-Based Platform in Administering Therapies for Children With Autism Spectrum Disorder: 12-Month Observational Study.","authors":"Harini Atturu, Somasekhar Naraganti, Bugatha Rajvir Rao","doi":"10.2196/70589","DOIUrl":"10.2196/70589","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;A 12-month longitudinal observational study was conducted on 43 children aged 2-18 years to evaluate the effectiveness of the CognitiveBotics artificial intelligence (AI)-based platform in conjunction with continuous therapy in improving therapeutic outcomes for children with autism spectrum disorder (ASD).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study evaluates the CognitiveBotics software's effectiveness in supporting children with ASD through structured, technology-assisted learning. The primary objectives include assessing user engagement, tracking progress, and measuring efficacy using standardized clinical assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A 12-month observational study was conducted on children diagnosed with ASD using the CognitiveBotics AI-based platform. Standardized assessments, include the Childhood Autism Rating Scale (CARS), Vineland Social Maturity Scale, Developmental Screening Test, and Receptive Expressive Emergent Language Test (REEL), were conducted at baseline (T1) and at the endpoint (T2). All participants meeting the inclusion criteria were provided access to the platform and received standard therapy. Participants who consistently adhered to platform use as per the study protocol were classified as the intervention group, while those who did not maintain continuous platform use were designated as the control group. Additionally, caregivers received structured training, including web-based parent teaching sessions, reinforcement strategy training, and home-based activity guidance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Participants in the intervention group demonstrated statistically significant improvements across multiple scales. CARS scores reduced from 33.41 (SD 1.89) at T1 to 28.34 (SD 3.80) at T2 (&lt;i&gt;P&lt;/i&gt;&lt;.001). Social age increased from 22.80 (SD 7.33) to 35.76 (SD 9.09; mean change: 12.96, 56.84% increase; &lt;i&gt;P&lt;/i&gt;&lt;.001). Social quotient increased from 53.26 (SD 11.84) to 64.75 (SD 16.12; mean change: 11.49, 21.57% increase; &lt;i&gt;P&lt;/i&gt;&lt;.001). Developmental age showed an improvement from 30.93 (SD 9.91) to 45.31 (SD 11.20; mean change: 14.38, 46.49% increase; &lt;i&gt;P&lt;/i&gt;&lt;.001), while developmental quotient increased from 70.94 (SD 10.95) to 81.33 (SD 16.85; mean change: 10.39, 14.65% increase; &lt;i&gt;P&lt;/i&gt;&lt;.001). REEL scores showed substantial improvements, with receptive language increasing by 56.22% (&lt;i&gt;P&lt;/i&gt;&lt;.001) and expressive language by 59.93% (&lt;i&gt;P&lt;/i&gt;&lt;.001). In the control group, while most psychometric parameters showed some improvements, they were not statistically significant. CARS scores decreased by 10.62% (&lt;i&gt;P&lt;/i&gt;=.06), social age increased by 52.27% (&lt;i&gt;P&lt;/i&gt;=.06), social quotient increased by 19.62% (&lt;i&gt;P&lt;/i&gt;=.12), developmental age increased by 44.88% (&lt;i&gt;P&lt;/i&gt;=.06), and developmental quotient increased by 11.23% (&lt;i&gt;P&lt;/i&gt;=.19). REEL receptive and expressive language increased by 34.69% (&lt;i&gt;P&lt;/i&gt;=.10) and 40.48% (&lt;i&gt;P&lt;/i&gt;=.054), respectively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/","PeriodicalId":73555,"journal":{"name":"JMIR neurotechnology","volume":"4 ","pages":"e70589"},"PeriodicalIF":0.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12671327/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145672819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}