Brain Function, Dysfunction and Post-Damage Reorganization, Two Decades of Research

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (10 June 2021) | Viewed by 39446

Special Issue Editors

1. Neuromotor and Cognitive Rehabilitation Research Center (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, 37129 Verona, Italy
2. Neurorehabilitation Unit, AOUI Verona, 37134 Verona, Italy
Interests: neurorehabilitation; rehabilitation; posture; physical rehabilitation; musculoskeletal disorders; movement analysis biomechanics; exercise science; sports injuries; muscle function
Special Issues, Collections and Topics in MDPI journals
Neuromotor and Cognitive Rehabilitation Research Centre (CRRNC), Department of Neurosciences, Biomedicine and Movement Sciences, Verona University, Neurorehabilitation Unit, Borgo Roma University Hospital, P.le. L.A. Scuro, 10, 37134 Verona, Italy
Interests: motor control; movement analysis biomechanics; rehabilitation; neurorehabilitation; posture; surface electromyography
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent decades, there has been much research leading to new understanding related to CNS function. These advancements have stimulated changes in the researcher approach toward some classical dogmas in neuroscience. Indeed, since the pioneering studies of Cajal, the brain has been considered a static and stable structure. Furthermore, classically, the leading idea has been that different functions are segregated in specific brain areas. Recently, new technologies have allowed us to investigate the physiology and architecture of the human central nervous system from a new perspective. Findings from these studies have led to a new conception of the brain as a plastic and dynamic entity. Moreover, imaging studies and computational models have suggested that complex functional and structural neuronal networks, rather than isolated brain areas, underpin the sensorimotor and cognitive aspects of human behavior. From a biomolecular perspective, updates in scientific literature have pointed out the critical role of biomarkers modulating brain functions and neural networks.

This growing body of evidence has allowed us to devise new models of CNS damage caused by either cerebrovascular, neuroinflammatory or neurodegenerative diseases and provided the rationale for innovative therapies such as thrombolysis, neurorehabilitation, and neuromodulation.

This Special Issue aims to collect and describe recent updates in brain function, dysfunction, and post-damage reorganization from a multidisciplinary perspective. In this Special Issue, several knowledgeable researchers in this field will provide new issues with significant implications in the knowledge of brain physiology, pathology, and repair.

Prof. Dr. Nicola Smania
Dr. Nicola Valè
Guest Editors

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Keywords

  • brain function
  • neuroscience
  • neural plasticity
  • brain damage
  • stroke
  • motor control
  • CNS disease
  • neural degeneration
  • neural repair
  • neural inflammation
  • computational neuroscience
  • neuromodulation
  • cognition

Published Papers (14 papers)

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Research

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15 pages, 2986 KiB  
Article
Membrane-Free Stem Cell Extract Enhances Blood–Brain Barrier Integrity by Suppressing NF-κB-Mediated Activation of NLRP3 Inflammasome in Mice with Ischemic Stroke
by Ji Hyeon Ryu, Yeonye Kim, Min Jae Kim, Jisu Park, Ji Won Kim, Hye Sook Park, Young Sil Kim, Hwa Kyoung Shin and Yong-Il Shin
Life 2022, 12(4), 503; https://0-doi-org.brum.beds.ac.uk/10.3390/life12040503 - 29 Mar 2022
Cited by 3 | Viewed by 1987
Abstract
Membrane-free stem cell extract (MFSCE) of human adipose tissues possesses various biological activities. However, the effects of MFSCE on blood–brain barrier dysfunction and brain damage are unknown. In this study, we determined the role of MFSCE in an ischemic stroke mouse model. Mice [...] Read more.
Membrane-free stem cell extract (MFSCE) of human adipose tissues possesses various biological activities. However, the effects of MFSCE on blood–brain barrier dysfunction and brain damage are unknown. In this study, we determined the role of MFSCE in an ischemic stroke mouse model. Mice were treated with MFSCE once daily for 4 days and 1 h before ischemic damage. Experimental ischemia was induced by photothrombosis. Pretreatment with MFSCE reduced infarct volume and edema and improved neurological, as well as motor functions. Evans blue leakage and water content in the brain tissue were reduced by MFSCE pretreatment relative to those in the vehicle group. MFSCE increased the expression of the tight junction proteins zonula occludens 1 and claudin-5, as well as vascular endothelial-cadherin, but decreased that of matrix metalloproteinase 9. Notably, MFSCE treatment decreased cell death and the level of NOD-like receptor protein 3 inflammasome, consistent with the downregulated expression of the pro-inflammatory cytokines interleukin (IL)-1β and IL-18 in the ischemic brain. These effects might have occurred via the suppression of the expression of Toll-like receptor 4 and activation of nuclear factor-κB. The results highlighted the potential of MFSCE treatment as a novel and preventive strategy for patients at a high risk of ischemic stroke. Full article
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17 pages, 2233 KiB  
Article
AI-Based Pipeline for Classifying Pediatric Medulloblastoma Using Histopathological and Textural Images
by Omneya Attallah and Shaza Zaghlool
Life 2022, 12(2), 232; https://0-doi-org.brum.beds.ac.uk/10.3390/life12020232 - 03 Feb 2022
Cited by 23 | Viewed by 1840
Abstract
Pediatric medulloblastomas (MBs) are the most common type of malignant brain tumors in children. They are among the most aggressive types of tumors due to their potential for metastasis. Although this disease was initially considered a single disease, pediatric MBs can be considerably [...] Read more.
Pediatric medulloblastomas (MBs) are the most common type of malignant brain tumors in children. They are among the most aggressive types of tumors due to their potential for metastasis. Although this disease was initially considered a single disease, pediatric MBs can be considerably heterogeneous. Current MB classification schemes are heavily reliant on histopathology. However, the classification of MB from histopathological images is a manual process that is expensive, time-consuming, and prone to error. Previous studies have classified MB subtypes using a single feature extraction method that was based on either deep learning or textural analysis. Here, we combine textural analysis with deep learning techniques to improve subtype identification using histopathological images from two medical centers. Three state-of-the-art deep learning models were trained with textural images created from two texture analysis methods in addition to the original histopathological images, enabling the proposed pipeline to benefit from both the spatial and textural information of the images. Using a relatively small number of features, we show that our automated pipeline can yield an increase in the accuracy of classification of pediatric MB compared with previously reported methods. A refined classification of pediatric MB subgroups may provide a powerful tool for individualized therapies and identification of children with increased risk of complications. Full article
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16 pages, 2805 KiB  
Article
Chronic, Mild Vestibulopathy Leads to Deficits in Spatial Tasks that Rely on Vestibular Input While Leaving Other Cognitive Functions and Brain Volumes Intact
by Milos Dordevic, Sabrina Sulzer, Doreen Barche, Marianne Dieterich, Christoph Arens and Notger G. Müller
Life 2021, 11(12), 1369; https://0-doi-org.brum.beds.ac.uk/10.3390/life11121369 - 09 Dec 2021
Cited by 10 | Viewed by 2565
Abstract
Objectives: In this study, based on the known vestibulo-hippocampal connections, we asked whether mild chronic vestibulopathy leads only to vestibular-related deficits or whether there are effects on hippocampal function, structure, and cognition in general. In more detail, we assessed whether chronic vestibulopathy leads [...] Read more.
Objectives: In this study, based on the known vestibulo-hippocampal connections, we asked whether mild chronic vestibulopathy leads only to vestibular-related deficits or whether there are effects on hippocampal function, structure, and cognition in general. In more detail, we assessed whether chronic vestibulopathy leads to (a) deficits in vestibular tasks without cognitive demand (balancing), (b) deficits in spatial cognitive tasks that require vestibular input (path integration, rotational memory), (c) deficits in spatial cognitive tasks that do not rely on vestibular input, (d) deficits in general cognitive function, and (e) atrophy in the brain. Methods: A total of 15 patients with chronic uni- or bilateral vestibulopathy (56.8 ± 10.1 years; 4 females) were included in this study and were age- and gender-matched by the control participants (57.6 ± 10.5) in a pairwise manner. Given their clinical symptoms and their deficits of the vestibulo-ocular reflex (VOR) the patients could be classified as being mildly affected. All participants of the underwent the following tests: clinical balance (CBT), triangle completion (TCT) for path integration, rotational memory (RM), the visuo-spatial subset of the Berlin intelligence structure test (BIS-4) and d2-R for attention and concentration, and a structural MRI for gray matter analysis using voxel-based morphometry (VBM). Results: Compared to the healthy controls, the vestibulopathy patients performed significantly worse in terms of CBT, TCT, and RM but showed no differences in terms of the BIS-4 and d2-R. There were also no significant volumetric gray matter differences between the two groups. Conclusions: This study provides evidence that both non-cognitive and cognitive functions that rely on vestibular input (balancing, path integration, rotational memory) are impaired, even in mild chronic vestibulopathy, while other cognitive functions, which rely on visual input (visuo-spatial memory, attention), are unimpaired in this condition, together with an overall intact brain structure. These findings may reflect a segregation between vestibular- and visual-dependent processes in the medial temporal lobe on the one hand and a structure–function dissociation on the other. Full article
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11 pages, 1220 KiB  
Article
Aerobic Exercise Decreases Negative Affect by Modulating Orbitofrontal-Amygdala Connectivity in Adolescents
by Li-Kun Ge, Zhuoer Hu, Weiwen Wang, Parco M. Siu and Gao-Xia Wei
Life 2021, 11(6), 577; https://0-doi-org.brum.beds.ac.uk/10.3390/life11060577 - 18 Jun 2021
Cited by 7 | Viewed by 3271
Abstract
Long-term negative affect in adolescence is associated with impairment in quality of life, interpersonal function, and social adaptation. Although physical exercise could decrease negative emotion, the underlying mechanism remains largely unknown. Acute exercise with controlled intensity might be a good experimental paradigm to [...] Read more.
Long-term negative affect in adolescence is associated with impairment in quality of life, interpersonal function, and social adaptation. Although physical exercise could decrease negative emotion, the underlying mechanism remains largely unknown. Acute exercise with controlled intensity might be a good experimental paradigm to unravel the potential neural mechanisms underlying the effects of physical exercise on negative affect. In this study, twenty-three males in late adolescence were randomly assigned to acute exercise group (AG) or control group. The experiment contained pre-test and post-test session interleaved with 30-min moderate-intensity exercise or seated rest. In each session, a resting-state fMRI scanning was conducted followed by completing Positive and Negative Affect Schedule and Profile of Mood State. Bilateral amygdala was used as seed region to calculate t voxel-wised functional connectivity (FC) of amygdala to whole brain. The results demonstrated, for the first time, that AG exhibited increased FC between right amygdala and right orbital frontal cortex. Significantly decreased negative affect was also observed in AG. Moreover, the increased rOFC-amygdala FC was also associated with the decreased depression score. Our findings suggest that exercise-induced decreased negative affect might be modulated by functional interactions of amygdala with both cognitive control and limbic networks, which offers a meaningful insight for clinical treatment and prevention of emotional disorders in late adolescence. Full article
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14 pages, 2913 KiB  
Article
The Effectiveness of Robot- vs. Virtual Reality-Based Gait Rehabilitation: A Propensity Score Matched Cohort
by Emilia Biffi, Elena Beretta, Fabio Alexander Storm, Claudio Corbetta, Sandra Strazzer, Alessandra Pedrocchi and Emilia Ambrosini
Life 2021, 11(6), 548; https://0-doi-org.brum.beds.ac.uk/10.3390/life11060548 - 11 Jun 2021
Cited by 6 | Viewed by 2695
Abstract
Robot assisted gait training (RAGT) and virtual reality plus treadmill training (VRTT) are two technologies that can support locomotion rehabilitation in children and adolescents affected by acquired brain injury (ABI). The literature provides evidence of their effectiveness in this population. However, a comparison [...] Read more.
Robot assisted gait training (RAGT) and virtual reality plus treadmill training (VRTT) are two technologies that can support locomotion rehabilitation in children and adolescents affected by acquired brain injury (ABI). The literature provides evidence of their effectiveness in this population. However, a comparison between these methods is not available. This study aims at comparing the effectiveness of RAGT and VRTT for the gait rehabilitation of children and adolescents suffering from ABI. This is a prospective cohort study with propensity score matching. Between October 2016 and September 2018, all patients undergoing an intensive gait rehabilitation treatment based on RAGT or VRTT were prospectively observed. To minimize selection bias associated with the study design, patients who underwent RAGT or VRTT were retrospectively matched for age, gender, time elapsed from injury, level of impairment, and motor impairment using propensity score in a matching ratio of 1:1. Outcome measures were Gross Motor Function Mesure-88 (GMFM-88), six-min walking test (6MWT), Gillette Functional Assessment Questionnaire (FAQ), and three-dimensional gait analysis (GA). The FAQ and the GMFM-88 had a statistically significant increase in both groups while the 6MWT improved in the RAGT group only. GA highlighted changes at the proximal level in the RAGT group, and at the distal district in the VRTT group. Although preliminary, this work suggests that RAGT and VRTT protocols foster different motor improvements, thus recommending to couple the two therapies in the paediatric population with ABI. Full article
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9 pages, 441 KiB  
Article
Effect of Sit-to-Stand Training Combined with Taping on Spasticity, Strength, Gait Speed and Quality of Life in Patients with Stroke: A Randomized Controlled Trial
by Tae-sung In, Jin-hwa Jung, Kyoung-sim Jung and Hwi-young Cho
Life 2021, 11(6), 511; https://0-doi-org.brum.beds.ac.uk/10.3390/life11060511 - 31 May 2021
Cited by 5 | Viewed by 3282
Abstract
Background and Objectives: Spasticity is one of the factors that make it more difficult to control posture in stroke patients. Taping has been used to manage muscle stiffness in various musculoskeletal disorders. Recently, it has been used to decrease spasticity in stroke patients, [...] Read more.
Background and Objectives: Spasticity is one of the factors that make it more difficult to control posture in stroke patients. Taping has been used to manage muscle stiffness in various musculoskeletal disorders. Recently, it has been used to decrease spasticity in stroke patients, but the effect of taping combined with therapeutic exercise is still unclear. The purpose of the present study was to determine whether the sit-to-stand (STS) training combined with taping improves the ankle spasticity, muscle strength, gait speed, and quality of life in stroke patients. Material and Methods: The study recruited 40 stroke patients, who were randomly divided into two groups: the taping and STS training (TSTS) group (n = 20) and the STS group (n = 20). The subjects in the TSTS group underwent STS training with Kinesio taping on the tibialis anterior, calf and ankle joint, whereas the subjects in the STS group underwent only STS training. All participants underwent 30 sessions of STS training (30 minutes, 5 days per week for 6 weeks). The present study evaluated the spasticity of ankle plantar flexors by the mean of the composite spasticity score; the muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively, and the quality of life was assessed using the stroke-specific quality of life scale. Result: The TSTS group and the STS group showed significant improvements in spasticity, muscle strength, walking speed, and quality of life after the intervention (p < 0.05). The level of improvement in the TSTS group was significantly higher in spasticity, muscle strength, and walking speed compared to the STS group (p < 0.05). Conclusions: The present study demonstrated that STS training is effective for decreasing spasticity in stroke patients and suggested that additional taping intervention further improved this effect. In addition, improvement of muscle strength and gait function was observed with a significant decrease of ankle spasticity. Full article
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24 pages, 3118 KiB  
Article
Effects of Hemispheric Stroke Localization on the Reorganization of Arm Movements within Different Mechanical Environments
by Laura Pellegrino, Martina Coscia, Camilla Pierella, Psiche Giannoni, Amel Cherif, Maddalena Mugnosso, Lucio Marinelli and Maura Casadio
Life 2021, 11(5), 383; https://0-doi-org.brum.beds.ac.uk/10.3390/life11050383 - 23 Apr 2021
Cited by 13 | Viewed by 3312
Abstract
This study investigated how stroke’s hemispheric localization affects motor performance, spinal maps and muscle synergies while performing planar reaching with and without assistive or resistive forces. A lesion of the right hemisphere affected performance, reducing average speed and smoothness and augmenting lateral deviation [...] Read more.
This study investigated how stroke’s hemispheric localization affects motor performance, spinal maps and muscle synergies while performing planar reaching with and without assistive or resistive forces. A lesion of the right hemisphere affected performance, reducing average speed and smoothness and augmenting lateral deviation in both arms. Instead, a lesion of the left hemisphere affected the aiming error, impairing the feedforward control of the ipsilesional arm. The structure of the muscle synergies had alterations dependent on the lesion side in both arms. The applied force fields reduced the differences in performance and in muscle activations between arms and among populations. These results support the hypotheses of hemispheric specialization in movement control and identify potential significant biomarkers for the design of more effective and personalized rehabilitation protocols. Full article
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14 pages, 1236 KiB  
Article
DUAL-tDCS Treatment over the Temporo-Parietal Cortex Enhances Writing Skills: First Evidence from Chronic Post-Stroke Aphasia
by Francesca Pisano, Carlo Caltagirone, Chiara Incoccia and Paola Marangolo
Life 2021, 11(4), 343; https://0-doi-org.brum.beds.ac.uk/10.3390/life11040343 - 14 Apr 2021
Cited by 3 | Viewed by 2213
Abstract
The learning of writing skills involves the re-engagement of previously established independent procedures. Indeed, the writing deficit an adult may acquire after left hemispheric brain injury is caused by either an impairment to the lexical route, which processes words as a whole, to [...] Read more.
The learning of writing skills involves the re-engagement of previously established independent procedures. Indeed, the writing deficit an adult may acquire after left hemispheric brain injury is caused by either an impairment to the lexical route, which processes words as a whole, to the sublexical procedure based on phoneme-to-grapheme conversion rules, or to both procedures. To date, several approaches have been proposed for writing disorders, among which, interventions aimed at restoring the sub-lexical procedure were successful in cases of severe agraphia. In a randomized double-blind crossover design, fourteen chronic Italian post-stroke aphasics underwent dual transcranial direct current stimulation (tDCS) (20 min, 2 mA) with anodal and cathodal current simultaneously placed over the left and right temporo-parietal cortex, respectively. Two different conditions were considered: (1) real, and (2) sham, while performing a writing task. Each experimental condition was performed for ten workdays over two weeks. After real stimulation, a greater amelioration in writing with respect to the sham was found. Relevantly, these effects generalized to different language tasks not directly treated. This evidence suggests, for the first time, that dual tDCS associated with training is efficacious for severe agraphia. Our results confirm the critical role of the temporo-parietal cortex in writing skills. Full article
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23 pages, 6859 KiB  
Article
Evaluation of In Vitro Neuronal Protection by Postconditioning with Poloxamer 188 Following Simulated Traumatic Brain Injury
by Luise J. Meyer and Matthias L. Riess
Life 2021, 11(4), 316; https://0-doi-org.brum.beds.ac.uk/10.3390/life11040316 - 06 Apr 2021
Cited by 3 | Viewed by 2119
Abstract
Traumatic brain injury (TBI) leads to morbidity and mortality worldwide. Reperfusion after ischemia adds detrimental injury to cells. Ischemia/reperfusion (I/R) injures cells in a variety of ways including cell membrane disruption. Hence, methods to improve endogenous membrane resealing capacity are crucial. Poloxamer (P) [...] Read more.
Traumatic brain injury (TBI) leads to morbidity and mortality worldwide. Reperfusion after ischemia adds detrimental injury to cells. Ischemia/reperfusion (I/R) injures cells in a variety of ways including cell membrane disruption. Hence, methods to improve endogenous membrane resealing capacity are crucial. Poloxamer (P) 188, an amphiphilic triblock copolymer, was found to be effective against I/R and mechanical injury in various experimental settings. The aim of this study was to establish an in vitro mouse neuronal TBI model and, further, to investigate if postconditioning with P188 directly interacts with neurons after compression and simulated I/R injury, when administered at the start of reoxygenation. Cellular function was assessed by cell number/viability, mitochondrial viability, membrane damage by lactated dehydrogenase (LDH) release and FM1-43 incorporation as well as apoptosis-activation by Caspase 3. Five hours hypoxia ± compression with 2 h reoxygenation proved to be a suitable model for TBI. Compared to normoxic cells not exposed to compression, cell number and mitochondrial viability decreased, whereas membrane injury by LDH release/FM1-43 dye incorporation and Caspase 3 activity increased in cells exposed to hypoxic conditions with compression followed by reoxygenation. P188 did not protect neurons from simulated I/R and/or compression injury. Future research is indicated. Full article
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11 pages, 2711 KiB  
Article
Development of the Cerebrospinal Fluid in Early Stage after Hemorrhage in the Central Nervous System
by Petr Kelbich, Aleš Hejčl, Jan Krejsek, Tomáš Radovnický, Inka Matuchová, Jan Lodin, Jan Špička, Martin Sameš, Jan Procházka, Eva Hanuljaková and Petr Vachata
Life 2021, 11(4), 300; https://0-doi-org.brum.beds.ac.uk/10.3390/life11040300 - 01 Apr 2021
Cited by 3 | Viewed by 1477
Abstract
Extravasation of blood in the central nervous system (CNS) represents a very strong damaged associated molecular patterns (DAMP) which is followed by rapid inflammation and can participate in worse outcome of patients. We analyzed cerebrospinal fluid (CSF) from 139 patients after the CNS [...] Read more.
Extravasation of blood in the central nervous system (CNS) represents a very strong damaged associated molecular patterns (DAMP) which is followed by rapid inflammation and can participate in worse outcome of patients. We analyzed cerebrospinal fluid (CSF) from 139 patients after the CNS hemorrhage. We compared 109 survivors (Glasgow Outcome Score (GOS) 5-3) and 30 patients with poor outcomes (GOS 2-1). Statistical evaluations were performed using the Wilcoxon signed-rank test and the Mann–Whitney U test. Almost the same numbers of erythrocytes in both subgroups appeared in days 0–3 (p = 0.927) and a significant increase in patients with GOS 2-1 in days 7–10 after the hemorrhage (p = 0.004) revealed persistence of extravascular blood in the CNS as an adverse factor. We assess 43.3% of patients with GOS 2-1 and only 27.5% of patients with GOS 5-3 with low values of the coefficient of energy balance (KEB < 15.0) in days 0–3 after the hemorrhage as a trend to immediate intensive inflammation in the CNS of patients with poor outcomes. We consider significantly higher concentration of total protein of patients with GOS 2-1 in days 0–3 after hemorrhage (p = 0.008) as the evidence of immediate simultaneously manifested intensive inflammation, swelling of the brain and elevation of intracranial pressure. Full article
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14 pages, 2059 KiB  
Article
Brain Structure, Cardiorespiratory Fitness, and Executive Control Changes after a 9-Week Exercise Intervention in Young Adults: A Randomized Controlled Trial
by Lina Zhu, Qian Yu, Fabian Herold, Boris Cheval, Xiaoxiao Dong, Lei Cui, Xuan Xiong, Aiguo Chen, Hengchan Yin, Zhaowei Kong, Notger Mueller, Arthur F. Kramer and Liye Zou
Life 2021, 11(4), 292; https://0-doi-org.brum.beds.ac.uk/10.3390/life11040292 - 30 Mar 2021
Cited by 14 | Viewed by 3230
Abstract
Cardiorespiratory fitness (CRF) is assumed to exert beneficial effects on brain structure and executive control (EC) performance. However, empirical evidence of exercise-induced cognitive enhancement is not conclusive, and the role of CRF in younger adults is not fully understood. Here, we conducted a [...] Read more.
Cardiorespiratory fitness (CRF) is assumed to exert beneficial effects on brain structure and executive control (EC) performance. However, empirical evidence of exercise-induced cognitive enhancement is not conclusive, and the role of CRF in younger adults is not fully understood. Here, we conducted a study in which healthy young adults took part in a moderate aerobic exercise intervention program for 9 weeks (exercise group; n = 48), or control condition of non-aerobic exercise intervention (waitlist control group; n = 72). Before and after the intervention period maximal oxygen uptake (VO2max) as an indicator of CRF, the Flanker task as a measure of EC performance and grey matter volume (GMV), as well as cortical thickness via structural magnetic resonance imaging (MRI), were assessed. Compared to the control group, the CRF (heart rate, p < 0.001; VO2max, p < 0.001) and EC performance (congruent and incongruent reaction time, p = 0.011, p < 0.001) of the exercise group were significantly improved after the 9-week aerobic exercise intervention. Furthermore, GMV changes in the left medial frontal gyrus increased in the exercise group, whereas they were significantly reduced in the control group. Likewise, analysis of cortical morphology revealed that the left lateral occipital cortex (LOC.L) and the left precuneus (PCUN.L) thickness were considerably increased in the exercise group, which was not observed in the control group. The exploration analysis confirmed that CRF improvements are linked to EC improvement and frontal grey matter changes. In summary, our results support the idea that regular endurance exercises are an important determinant for brain health and cognitive performance even in a cohort of younger adults. Full article
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15 pages, 479 KiB  
Article
Management of Infants with Brief Resolved Unexplained Events (BRUE) and Apparent Life-Threatening Events (ALTE): A RAND/UCLA Appropriateness Approach
by Giovanni Prezioso, Serafina Perrone, Giacomo Biasucci, Giovanna Pisi, Valentina Fainardi, Caterina Strisciuglio, Francesco Nonnis Marzano, Sabrina Moretti, Francesco Pisani, Bertrand Tchana, Alberto Argentiero, Cosimo Neglia, Carlo Caffarelli, Patrizia Bertolini, Maria Teresa Bersini, Andrea Canali, Emanuele Voccia, Antonella Squarcia, Tullio Ghi, Carla Verrotti, Tiziana Frusca, Rossana Cecchi, Giovanna Giordano, Filomena Colasanti, Ilenia Roccia, Paola Palanza and Susanna Espositoadd Show full author list remove Hide full author list
Life 2021, 11(2), 171; https://0-doi-org.brum.beds.ac.uk/10.3390/life11020171 - 22 Feb 2021
Cited by 5 | Viewed by 3686
Abstract
Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and [...] Read more.
Unexpected events of breath, tone, and skin color change in infants are a cause of considerable distress to the caregiver and there is still debate on their appropriate management. The aim of this study is to survey the trend in prevention, decision-making, and management of brief resolved unexplained events (BRUE)/apparent life-threatening events (ALTE) and to develop a shared protocol among hospitals and primary care pediatricians regarding hospital admission criteria, work-up and post-discharge monitoring of patients with BRUE/ALTE. For the study purpose, a panel of 54 experts was selected to achieve consensus using the RAND/UCLA appropriateness method. Twelve scenarios were developed: one addressed to primary prevention of ALTE and BRUE, and 11 focused on hospital management of BRUE and ALTE. For each scenario, participants were asked to rank each option from ‘1’ (extremely inappropriate) to ‘9’ (extremely appropriate). Results derived from panel meeting and discussion showed several points of agreement but also disagreement with different opinion emerged and the need of focused education on some areas. However, by combining previous recommendations with expert opinion, the application of the RAND/UCLA appropriateness permitted us to drive pediatricians to reasoned and informed decisions in term of evaluation, treatment and follow-up of infants with BRUE/ALTE, reducing inappropriate exams and hospitalisation and highlighting priorities for educational interventions. Full article
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Review

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12 pages, 1080 KiB  
Review
The Human Self Has Two Serial Aspects and Is Dynamic: A Concept Based on Neurophysiological Evidence Supporting a Multiple Aspects Self Theory (MAST)
by Peter Walla, Georg Northoff and Cornelia Herbert
Life 2021, 11(7), 611; https://0-doi-org.brum.beds.ac.uk/10.3390/life11070611 - 24 Jun 2021
Cited by 2 | Viewed by 2234
Abstract
The self is an increasingly central topic in current neuroscience. Understanding the neural processes that are involved in self-referential processing and functioning may also be crucial to understanding consciousness. The current short communication goes beyond the typical concept that the self is singular, [...] Read more.
The self is an increasingly central topic in current neuroscience. Understanding the neural processes that are involved in self-referential processing and functioning may also be crucial to understanding consciousness. The current short communication goes beyond the typical concept that the self is singular, as has been assumed from neuroanatomical descriptions of the self by fMRI and PET studies. Long ago, theoretically, the idea of multiple aspects of the human self-arose, highlighting a dynamic organizational structure, but an increasing number of electrophysiological brain imaging studies, searching for the temporal dynamics of self-referential brain processes, now has empirical evidence supporting their existence. This short communication focuses on the theoretical idea of a dynamic self and provides first preliminary empirical evidence, including results from own studies of the authors, in support of, and highlights the serial dynamics of the human self, suggesting a primitive Me1 and an elaborate Me2 (a non-personal and a personal self). By focusing on the temporal dimension of the self, we propose that multiple aspects of the self can be distinguished based on their temporal sequence. A multiple aspects Self Theory (MAST) is proposed. This model is meant as a theoretical framework for future studies providing further support. Full article
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14 pages, 305 KiB  
Review
Functional Weight of Somatic and Cognitive Networks and Asymmetry of Compensatory Mechanisms: Collaboration or Divergency among Hemispheres after Cerebrovascular Accident?
by Hélène Viruega and Manuel Gaviria
Life 2021, 11(6), 495; https://0-doi-org.brum.beds.ac.uk/10.3390/life11060495 - 28 May 2021
Cited by 5 | Viewed by 3697
Abstract
The human brain holds highly sophisticated compensatory mechanisms relying on neuroplasticity. Neuronal degeneracy, redundancy, and brain network organization make the human nervous system more robust and evolvable to continuously guarantee an optimal environmental-related homeostasis. Nevertheless, after injury, restitution processes appear dissimilar, depending on [...] Read more.
The human brain holds highly sophisticated compensatory mechanisms relying on neuroplasticity. Neuronal degeneracy, redundancy, and brain network organization make the human nervous system more robust and evolvable to continuously guarantee an optimal environmental-related homeostasis. Nevertheless, after injury, restitution processes appear dissimilar, depending on the pathology. Following a cerebrovascular accident, asymmetry, within- and across-network compensation and interhemispheric inhibition are key features to functional recovery. In moderate-to-severe stroke, neurological outcome is often poor, and little is known about the paths that enable either an efficient collaboration among hemispheres or, on the contrary, an antagonism of adaptative responses. In this review, we aim to decipher key issues of ipsilesional and contralesional hemispheric functioning allowing the foundations of effective neurorehabilitation strategies. Full article
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