Brain Sciences最新文献

{"title":"Nonconvulsive and Electrographic Status Epilepticus in Comatose Adult Survivors of Cardiac Arrest: A Systematic Review and Meta-Analysis of Prevalence, EEG-Based Diagnosis, Treatment, and Neurological Outcomes.","authors":"Vivek Gupta, Viswanath Vasudevan","doi":"10.3390/brainsci16090994","DOIUrl":"10.3390/brainsci16090994","url":null,"abstract":"<p><p><b>Objectives</b>: This systematic review and meta-analysis aimed to estimate the prevalence of nonconvulsive status epilepticus (NCSE), electrographic status epilepticus (ESE), post-anoxic status epilepticus (PSE), and electrographic seizures in comatose adult survivors of cardiac arrest and to summarize associated diagnostic approaches, treatment strategies, neurological outcomes, and mortality. <b>Methods</b>: PubMed/MEDLINE, MEDLINE Core, Cochrane CENTRAL, Web of Science, and Scopus were searched from inception to May 2026. Eligible studies included adult comatose survivors of cardiac arrest who underwent EEG monitoring and reported NCSE, ESE, PSE, electrographic seizures, or related rhythmic/periodic EEG patterns. Random-effects meta-analysis of proportions was performed, separating strict NCSE/ESE/PSE constructs from broader electrographic seizure/status and epileptiform/IIC constructs. <b>Results</b>: Seventeen studies were included. In the primary analysis of four non-overlapping EEG-monitored cohorts, strict NCSE/ESE/PSE occurred in 112 of 457 patients; the pooled prevalence was 22% (95% CI, 10-41%; 95% prediction interval, 4-64%; I² = 77.8%). The expanded sensitivity analysis including selected, historical, or restricted cohorts yielded a similar pooled prevalence of 22% (95% CI, 16-31%). Broad electrographic seizure/status prevalence was 10% (95% CI, 2-33%; I² = 94.7%), and broad epileptiform/ictal-interictal continuum pattern prevalence was 29% (95% CI, 7-70%; I² = 86.0%); these analyses represented distinct EEG constructs. Poor neurological outcome and mortality were frequent, with pooled estimates of 91% (95% CI, 85-94%) and 87% (95% CI, 78-93%), respectively. <b>Conclusions</b>: The pooled prevalence of NCSE/ESE/PSE was 22% among EEG-monitored comatose survivors of cardiac arrest, although the exact prevalence remains uncertain across settings. Poor neurological outcome and mortality were frequent, but recovery occurred in selected patients with continuous EEG background, later SE onset, fewer multimodal poor-outcome markers, or electrographic cessation. These findings support multimodal, phenotype-guided interpretation rather than reliance on EEG status alone. Future studies should use standardized EEG definitions, consistent denominators, and phenotype-enriched randomized designs.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Contrast-Enhanced MRI in Neuro-Oncology: A Narrative and Translational Review.","authors":"Francesca Bozzetti, Ana Ramos-González, Alessandro Leonetti, Chiara Tommasi, Marcello Tiseo, Francesco Salaroli, Giovanni Ceccon, Ilaria Renna, Marco Galaverni, Nicola Sverzellati, Daniele Corbo","doi":"10.3390/brainsci16090991","DOIUrl":"10.3390/brainsci16090991","url":null,"abstract":"<p><strong>Background/objectives: </strong>Dynamic contrast-enhanced MRI (DCE-MRI) is emerging as a key technique in neuro-oncologic imaging by enabling quantitative assessment of vascular permeability and blood-brain barrier integrity, two central features of tumor progression and treatment-related tissue injury. Its clinical relevance is particularly evident in the post-treatment setting, where conventional MRI lacks specificity and entities such as tumor progression, pseudoprogression, and radiation necrosis frequently overlap.</p><p><strong>Methods: </strong>This narrative review focuses on the role of DCE-MRI in differentiating treatment-related alterations from true tumor progression, primarily in gliomas and, secondarily, in brain metastases and primary CNS lymphoma.</p><p><strong>Results: </strong>We review quantitative and semiquantitative parameters, their biological interpretation, and their diagnostic performance in gliomas, metastases, and primary CNS lymphoma. We further discuss the role of DCE-MRI within multiparametric imaging workflows and highlight emerging contributions from artificial intelligence, radiomics, and automated pharmacokinetic modeling.</p><p><strong>Conclusion: </strong>As a narrative, translational review, this work aims to contextualize DCE-MRI within contemporary neuro-oncologic practice and research. Its clinical translation, however, remains limited by methodological heterogeneity and the lack of standardized acquisition and analysis protocols, highlighting the need for harmonization and prospective multicenter validation.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial Interventions, Recovery, and Mediating Mechanisms in Schizophrenia-Spectrum Disorders: A Systematic Review and Meta-Analysis of Longitudinal Studies.","authors":"Evgenia Gkintoni, Ignatia Farmakopoulou, Maria Theodoratou, Maria Panagioti","doi":"10.3390/brainsci16090993","DOIUrl":"10.3390/brainsci16090993","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Background/Objectives&lt;/b&gt;: Recovery from schizophrenia-spectrum disorders is increasingly recognized as achievable, yet no synthesis has simultaneously examined long-term outcome rates, intervention effectiveness, cognitive predictors, social determinants, personal-recovery trajectories, and mediating mechanisms within a unified framework. This systematic review aimed to address these six domains and to propose an integrative theoretical model of functional recovery, applying meta-analysis where the evidence permitted and structured narrative synthesis elsewhere. &lt;b&gt;Methods&lt;/b&gt;: Seven databases (PubMed/MEDLINE, PsycINFO, Embase, Cochrane CENTRAL, Web of Science, Scopus, CINAHL) were searched through December 2025 following PRISMA 2020 and MOOSE guidance. We extracted eligible records (longitudinal designs, ≥6 months, adults with schizophrenia-spectrum disorders reporting functional outcomes) into two structured databases, then consolidated and de-duplicated them, yielding 467 unique papers. After topical screening and a duplicate audit, we retained 368 studies (1980-2025) and grouped them into six thematic clusters. A pre-specified rule pooled only clusters with at least five independent primary studies. Proportions were pooled with the Freeman-Tukey transformation and associations with Fisher's z under DerSimonian-Laird random-effects models; certainty was appraised with GRADE. &lt;b&gt;Results&lt;/b&gt;: Three pools met the threshold. Long-term functional recovery was 35.4% (95% CI 22.6-49.4; k = 11) and symptomatic remission 39.6% (95% CI 29.3-50.5; k = 7), both with very high heterogeneity (I&lt;sup&gt;2&lt;/sup&gt; = 92-98%) and low certainty. The pooled association between psychological mediators and functional outcome was weak and imprecise (r = 0.23; 95% CI -0.09-0.51; k = 7; very low certainty), reflecting facilitators (positive mental health, social support, self-efficacy, hope) and barriers (internalized stigma, substance-use comorbidity, longer duration of untreated psychosis, persistent negative symptoms) acting in opposite directions. The questions concerning specific interventions, cognitive prediction, rehabilitation, and personal recovery were synthesized narratively: structured psychosocial and combined interventions and integrated rehabilitation were associated with small-to-medium functional gains; cognition, particularly social cognition and motivation, predicted later functioning; and personal recovery followed a course partly independent of clinical status. &lt;b&gt;Conclusions&lt;/b&gt;: Recovery and remission are attainable for a substantial minority but remain heterogeneous and modestly certain. The proposed Multi-Pathway Dynamic Recovery Model organizes the evidence into five testable principles-an ordered recovery hierarchy, social-cognitive mediation of the cognition-function link, an early-phase intervention window, social-ecological embedding, and self-reinforcing feedback loops, offered as a hypothesis-generating framework rather than a vali","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Alexithymia Matters: Distinct Schema-Emotion Processing Profiles of Narcissistic Admiration and Rivalry.","authors":"Dawid Konrad Ścigała, Matteo Angelo Fabris, Elżbieta Zdankiewicz-Ścigała","doi":"10.3390/brainsci16090990","DOIUrl":"10.3390/brainsci16090990","url":null,"abstract":"<p><strong>Background/objectives: </strong>Alexithymia may constrain emotion regulation, but its relevance may differ across personality configurations. This study examined whether narcissistic Admiration and Rivalry are embedded in distinct early maladaptive schema and alexithymia profiles.</p><p><strong>Methods: </strong>A non-clinical adult sample (N = 311) completed the Narcissistic Admiration and Rivalry Questionnaire, the Young Schema Questionnaire-Short Form 3, and the Toronto Alexithymia Scale-20. Analyses examined 18 schemas and three alexithymia components-Difficulty Identifying Feelings (DIF), Difficulty Describing Feelings (DDF), and Externally Oriented Thinking (EOT)-using zero-order correlations, within-domain regressions, hierarchical regressions, and structural equation models.</p><p><strong>Results: </strong>Admiration was associated mainly with Approval/Recognition Seeking and Unrelenting Standards and with lower Social Isolation/Alienation, Defectiveness/Shame, Failure, Subjugation, Emotional Inhibition, and Insufficient Self-Control. Rivalry showed a threat-related profile involving Defectiveness/Shame, Subjugation, Emotional Inhibition, Negativity/Pessimism, and Insufficient Self-Control. Entitlement/Grandiosity was positively associated with both dimensions and did not reliably differentiate them. Alexithymia was essentially unrelated to Admiration and did not improve its schema model. In contrast, adding DIF, DDF, and EOT increased explained variance in Rivalry by 5.5%, a small-to-moderate increment; DIF and EOT made independent contributions, whereas DDF did not. A parsimonious Rivalry structural model reproduced these associations but showed mixed global fit.</p><p><strong>Conclusions: </strong>These cross-sectional findings indicate a modest, dimension-specific contribution of alexithymic processing to Rivalry rather than a general association with narcissistic self-regulation. The EOT findings require particular caution because of the subscale's limited reliability. Longitudinal and experimental studies are needed to test the proposed vulnerability-stress process.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604863/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walkbot-Based Robot-Assisted Gait Training and Phase-Specific Lower-Limb Torque in Parkinson's Disease: A Retrospective Comparative Study.","authors":"Gokhan Ozkocak, Rocco Salvatore Calabrò","doi":"10.3390/brainsci16090989","DOIUrl":"10.3390/brainsci16090989","url":null,"abstract":"<p><p>Gait impairment, postural instability, and freezing of gait are major contributors to mobility limitations in Parkinson's disease (PD). Robot-assisted gait training (RAGT) has emerged as a promising rehabilitation strategy; however, its association with phase-specific lower-limb kinetic outcomes remains insufficiently characterized. This study compared Walkbot-based RAGT and conventional rehabilitation in terms of Walkbot-derived phase-specific lower-limb torque, functional balance, self-reported freezing-related gait impairment, and health-related quality of life in individuals with PD. This retrospective comparative study included 60 individuals with idiopathic PD (Hoehn and Yahr stages II-III) who received either Walkbot-based RAGT (n = 30) or conventional rehabilitation (n = 30). Both groups completed 30 supervised sessions over 6 weeks. Biomechanical outcomes comprised Walkbot-derived lower-limb torque during the stance and swing phases for the clinically more affected and contralateral limbs. Clinical outcomes included the Berg Balance Scale (BBS), Freezing of Gait Questionnaire (FOG-Q), and Parkinson's Disease Questionnaire-39 (PDQ-39). Between-group post-treatment differences were evaluated using analysis of covariance (ANCOVA), adjusting each outcome for its corresponding baseline value. After baseline adjustment, post-treatment phase-specific lower-limb torque was higher in the RAGT group for the more affected limb during swing (adjusted difference, 0.057 Nm/kg; 95% CI, 0.019-0.096; <i>p</i> = 0.004) and stance (0.145 Nm/kg; 95% CI, 0.098-0.193; <i>p</i> < 0.001), and for the contralateral limb during swing (0.051 Nm/kg; 95% CI, 0.006-0.096; <i>p</i> = 0.027) and stance (0.205 Nm/kg; 95% CI, 0.088-0.321; <i>p</i> = 0.001). The RAGT group also had higher baseline-adjusted BBS scores (adjusted difference, 5.78 points; 95% CI, 3.86-7.69; <i>p</i> < 0.001) and lower FOG-Q scores (-0.94 points; 95% CI, -1.27 to -0.61; <i>p</i> < 0.001). No significant between-group difference was observed for PDQ-39 (0.77 points; 95% CI, -0.16 to 1.69; <i>p</i> = 0.102). Walkbot-based RAGT was associated with more favorable baseline-adjusted phase-specific lower-limb torque, functional balance, and self-reported freezing-related gait impairment than conventional rehabilitation, whereas disease-specific quality of life did not differ significantly between groups. These findings highlight the potential value of integrating Walkbot-derived phase-specific kinetic assessment with clinical outcomes to provide a more quantitative characterization of rehabilitation-related locomotor changes in PD. Prospective randomized studies are needed to confirm these associations and establish the clinical utility of Walkbot-derived phase-specific lower-limb torque as an outcome measure.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative Navigated Transcranial Magnetic Stimulation Motor Mapping and nTMS-Guided Corticospinal Tractography in Healthy Individuals and Patients with Motor-Eloquent Brain Tumors.","authors":"Evangelia Chatzikyriakou, Ioannis Vlachos, Konstantinos Pastiadis, Nikolaos Foroglou, Konstantinos Kouskouras, Georgios Feretos, Christos Frantzidis, Ioannis Patsalas, Vasileios Papaliagkas, Dimitris Kugiumtzis, Vasilios K Kimiskidis","doi":"10.3390/brainsci16090986","DOIUrl":"10.3390/brainsci16090986","url":null,"abstract":"<p><strong>Background/objectives: </strong>Navigated transcranial magnetic stimulation (nTMS) enables presurgical motor mapping, while nTMS-seeded diffusion tensor imaging (DTI) delineates the corticospinal tract (CST). We compared cortical and tractography measures between healthy individuals and patients with motor-eloquent brain tumors and between patient hemispheres.</p><p><strong>Methods: </strong>Twenty healthy volunteers and 18 patients underwent first dorsal interosseous (FDI) mapping at 110% resting motor threshold (rMT). Motor map metrics, maximum FDI motor-evoked potential (MEP) amplitude, and nTMS-seeded CST measures were analyzed; hotspot and center-of-gravity (CoG) dispersion were assessed in common space. DTI metrics were available for 13 healthy volunteers and 13 patients.</p><p><strong>Results: </strong>Consistent with previous nTMS literature, patients showed impaired motor performance and suprathreshold corticospinal output, with lower grip strength, maximum FDI MEP amplitude, and map volume than controls. rMT did not differ significantly, indicating that threshold excitability may be unrevealing despite motor system dysfunction. Notably, the contralateral patient hemisphere also differed from controls in grip strength, maximum FDI MEP amplitude, reconstructed CST fiber length, and mean axial diffusivity, while these measures did not differ significantly between the ipsilateral and contralateral patient hemispheres. CoG dispersion was greater in patients, whereas hotspot dispersion was not.</p><p><strong>Conclusions: </strong>The study confirms tumor-associated impairment of motor performance and suprathreshold corticospinal output while identifying two potentially novel observations: abnormalities extending to the apparently unaffected hemisphere and increased heterogeneity of the amplitude-weighted motor map center. Notably, contralateral abnormalities may reflect bilateral network changes or patient-related factors, rather than isolated contralateral CST pathology. Independent healthy controls may therefore provide information not captured by within-patient hemispheric comparisons.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of Shear Wave Elastography in Assessing Peripheral Neuropathy in Parkinson's Disease.","authors":"Yifan Song, Shuai Zheng, Lijuan Du, Hongxia Zhang, Wei Zhang, Wen He","doi":"10.3390/brainsci16090988","DOIUrl":"10.3390/brainsci16090988","url":null,"abstract":"<p><strong>Background/objectives: </strong>Parkinson's disease (PD) is a prevalent neurodegenerative disorder, and its comorbid peripheral neuropathy (PN) severely worsens patient prognosis. The diagnostic gold standard, nerve electrophysiological examination, has critical limitations, including invasiveness. This study aimed to explore the diagnostic value of high-frequency ultrasound combined with shear wave elastography (SWE) for PD-associated PN.</p><p><strong>Methods: </strong>Intra- and inter-observer reproducibility of ultrasound parameters (cross-sectional area [CSA], shear wave velocity [SWV]) of the median and common peroneal nerves was validated in 30 PD patients. A case-control study was conducted in 40 PD patients (stratified into PD-alone and PD-PN groups via the electrophysiological gold standard) and 40 healthy controls. Correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis were performed to assess diagnostic efficacy.</p><p><strong>Results: </strong>All measured parameters showed good reproducibility (intraclass correlation coefficient [ICC] > 0.855). Median nerve longitudinal SWV and common peroneal nerve SWV increased sequentially across the control, PD-alone, and PD-PN groups (after age adjustment using analysis of covariance (ANCOVA), <i>p</i> < 0.001), and showed weak-to-moderate statistically significant correlations with median nerve motor conduction latencies after Bonferroni correction for multiple comparisons. Age and common peroneal nerve SWV were identified as independent risk factors for PD-PN, while median nerve longitudinal SWV showed a positive but non-significant association in the multivariable model. A combined model incorporating age, median nerve longitudinal SWV, and common peroneal nerve SWV achieved an area under the ROC curve (AUC) of 0.938 (sensitivity 93.75%, specificity 91.67%; bootstrap-corrected AUC = 0.906).</p><p><strong>Conclusions: </strong>SWE-derived SWV has favorable diagnostic value for PD-associated PN with good reproducibility. The combination of age and multi-nerve SWV further improves diagnostic efficiency, providing a reliable non-invasive imaging biomarker for early PD-PN diagnosis. However, given the observational design and significant age imbalance between groups, residual confounding cannot be fully excluded, and prospective studies with age-matched cohorts are needed for definitive confirmation.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604399/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When Development Falls out of Sync: A Developmental Timing Framework for Learning Disabilities.","authors":"Gerry Leisman","doi":"10.3390/brainsci16090987","DOIUrl":"10.3390/brainsci16090987","url":null,"abstract":"<p><p>Learning disabilities are traditionally conceptualized as domain-specific disorders arising from deficits in reading, attention, or numerical processing. Although these approaches have substantially advanced understanding of dyslexia, attention-deficit/hyperactivity disorder (ADHD), and dyscalculia, they do not fully explain the marked heterogeneity, developmental variability, frequent comorbidity, or changing learning trajectories observed across children. This conceptual review proposes a developmental timing framework in which learning disabilities emerge, in many cases, from maturational asynchrony among interacting neural, cognitive, linguistic, sensorimotor, and executive systems rather than from isolated deficits within a single domain. Drawing on evidence from developmental neuroscience, cognitive psychology, neuroeducation, developmental systems theory, and learning sciences, we synthesize research on the developmental coordination of language, executive function, attention, motor control, working memory, symbolic learning, and numerical cognition across childhood. Within this framework, dyslexia, ADHD-related learning difficulties, dyscalculia, and mixed learning profiles are interpreted as distinct developmental expressions of differing patterns of cross-system asynchrony interacting with the increasing cognitive demands of formal education. We distinguish maturational asynchrony from related concepts, including developmental variability, developmental cascades, and multiple-deficit models, and propose measurable indicators through which the framework may be empirically evaluated. The framework further generates testable predictions concerning longitudinal developmental trajectories, educational transitions, developmental fit, and timing-sensitive intervention. Rather than replacing established cognitive accounts of learning disabilities, the developmental timing framework provides an integrative developmental architecture within which existing theories can be understood while offering a basis for future longitudinal and intervention research. This perspective highlights the importance of aligning educational expectations and instructional practices with children's evolving neurodevelopmental readiness rather than chronological age alone.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604217/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Focal Task-Specific Dystonia Beyond M1: Network Adaptations and a Causal-Architecture Taxonomy of Dystonia.","authors":"Norman Lu, Rodrigo F O Pena","doi":"10.3390/brainsci16090985","DOIUrl":"10.3390/brainsci16090985","url":null,"abstract":"<p><p>Focal task-specific dystonia (FTSD) is associated with abnormalities across primary motor cortex (M1), basal ganglia, cerebellum, primary somatosensory cortex (S1), and spinal circuits, but their causal ordering is unresolved. Starting from the companion M1-centered framework, we ask whether repeated expression of a task-specific motor synergy (TSMS) with a proposed M1 excitation-inhibition imbalance could produce task-linked adaptations elsewhere in the motor system. We propose candidate mechanisms linking abnormal M1 output to reweighting of striatal dopamine signaling and direct- and indirect-pathway function, recalibration of cerebellar teaching and corrective output, reduced functional separability of S1 sensory populations, and use-dependent weakening of spinal reciprocal inhibition. Reported FTSD findings serve as empirical constraints; these intermediate cellular and circuit links remain hypotheses rather than established causal sequences. Extra-M1 changes could later reinforce or help maintain the dystonic state, compensate for it, or interact bidirectionally with the cortical abnormality. The M1-primary claim concerns causal initiation rather than anatomical exclusivity and predicts that task-specific abnormalities of M1 recruitment and rapid inhibitory control should precede or closely track the proposed extra-M1 adaptations. We also propose a provisional causal-architecture taxonomy distinguishing typical neuroplastic, atypical neuroplastic, and non-neuroplastic dystonias by the process hypothesized to dominate symptom generation and persistence. The TSMS framework, including the symptom-threshold, overreaching sequence, a proposed state of task-specific output limitation termed true weakness, and below- or at-threshold retraining (BATR), is advanced for FTSD rather than assumed to generalize unchanged across dystonias. Longitudinal, intervention-based, and experimental-model tests are outlined to distinguish the proposed sequence from basal ganglia-primary, cerebellar-primary, sensory-primary, concurrent, and distributed alternatives and to test whether retraining-related improvement follows the predicted physiological route.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Visual Working Memory in Healthy Aging: A Review of Current Interventions and Perspectives on Future Approaches.","authors":"Virginia Tronelli, Alessandra Barbon, Veronica Mazza","doi":"10.3390/brainsci16090981","DOIUrl":"10.3390/brainsci16090981","url":null,"abstract":"<p><p>Visual working memory (vWM) undergoes age-related decline, affecting storage capacity, representational precision, feature binding, and inhibitory control, with consequences for everyday functioning. Nevertheless, accumulating evidence indicates that the aging brain retains substantial plasticity, providing an opportunity of intervention. This review synthesizes current evidence on approaches to improving vWM in healthy older adults, including classic and game-based cognitive training, non-invasive brain stimulation (NIBS), and multimodal protocols that combine cognitive training with physical exercise or brain stimulation. Across the literature, process-based cognitive training produces improvements on trained and closely related tasks, whereas evidence for durable far-transfer remains limited. NIBS demonstrates promising neurophysiological effects, particularly when targeting frontoparietal networks, although behavioral outcomes remain heterogeneous and appear to depend on stimulation parameters and individual characteristics. Emerging findings further suggest that combining interventions may enhance selected aspects of vWM, highlighting the importance of personalized approaches. Despite these advances, intervention effects are often modest, task-specific, and resource-intensive. As a complementary approach, the review proposes placebo and nocebo effects as a theoretically grounded hypothesis that warrants empirical investigation for potentially complementing existing interventions and promoting healthy cognitive aging rather than confounds.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 9","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13604317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149058190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}