The P300 Auditory Evoked Potential in Cochlear Implant Users: A Scoping Review

Abstract Introduction The P300 auditory evoked potential is a long-latency cortical potential evoked with auditory stimulation, which provides information on neural mechanisms underlying the central auditory processing. Objectives To identify and gather scientific evidence regarding the P300 in adult cochlear implant (CI) users. Data Synthesis A total of 87 articles, 20 of which were selected for this study, were identified and exported to the Rayyan search software. Those 20 articles did not propose a homogeneous methodology, which made comparison more difficult. Most articles (60%) in this review compare CI users with typical hearing people, showing prolonged P300 latency in CI users. Among the studies, 35% show that CI users present a smaller P300 amplitude. Another variable is the influence of the kind of stimulus used to elicit P300, which was prolonged in 30% of the studies that used pure tone stimuli, 10% of the studies that used pure tone and speech stimuli, and 60% of the studies that used speech stimuli. Conclusion This review has contributed with evidence that shows the importance of applying a controlled P300 protocol to diagnose and monitor CI users. Regardless of the stimuli used to elicit P300, we noticed a pattern in the increase in latency and decrease in amplitude in CI users. The user's experience with the CI speech processor over time and the speech test results seem to be related to the P300 latency and amplitude measurements.

Synaptic plasticity after ischemic brain injury / 国际脑血管病杂志

Ischemic stroke is a common disease of the nervous system, which is characterized by high incidence, recurrence, disability and mortality rate. The pathological mechanism of ischemic brain injury is complex. Synaptic plasticity injury is considered to be the earliest pathological change after cerebral ischemia, and regulating synaptic plasticity is one of the important mechanisms to promote the recovery of neurological function after stroke. This article reviews the advances in synaptic plasticity after ischemic brain injury, which provides theoretical basis for the development of neuroprotective drugs in the future.

Impacto do metilfenidato no estresse oxidativo e na plasticidade cerebral / Methylphenidate impact on oxidative stress and brain plasticity

Esse estudo avaliou o impacto do tratamento com cloridrato de metilfenidato (MFD) em crianças com Transtorno de Déficit de Atenção e Hiperatividade. O estudo incluiu metodologia variada, contendo estudo de revisão sobre efeito de metilfenidato sobre BDNF e estudo de coorte experimental. O estudo de revisão seguiu as diretrizes do PRISMA e foi registrado no PROSPERO. No estudo experimental, coorte aberta de centro único foi desenhada, com amostra de conveniência recrutada entre os anos de 2020 e 2022, no ambulatório de ensino da faculdade de Medicina da Universidade Federal de Viçosa (MG). Amostra de 62 crianças, 6 a 14 anos incompletos, sem tratamento prévio, diagnosticadas por psiquiatra infantil segundo os critérios do Manual Diagnóstico e Estatístico dos Transtornos Mentais (DSM5). Média de 8 consultas de acompanhamento clínico realizadas, com coletas de amostras biológicas em 3 delas: antes do início do MFD, com 12 e 24 semanas após uso da medicação. Amostra caracterizada quanto a dados sociodemográficos, sintomas de TDAH, avaliações clínica e psiquiátrica e testagem de inteligência pela psicologia. Amostras biológicas para dosagens séricas de marcadores oxidativos (níveis de capacidade antioxidante total -FRAP -, atividade de superóxido dismutase ­ SOD-, catalase ­ CAT -, glutathione -S-transferase -GST-, níveis de peroxidação lipídica e de proteínas carboniladas) foram coletadas de cada criança nos três momentos da avaliação. Metilfenidato de liberação imediata foi administrado na dosagem de média de 0,65mg/kg/dia. Usou-se o teste de Shapiro-Wilk e Kolmogorov-Smirnov para análise de normalidade. Frequências absolutas e relativas foram determinadas para as variáveis numéricas que foram descritas por suas médias e desvios padrões. Para comparações múltiplas dos parâmetros oxidativos foi realizado pós teste paramétrico de Tukey e para as demais variáveis análise de variância ANOVA (f). Análises dos parâmetros oxidativos foram realizadas no programa GraphPad Prism 7.0 (GraphPad Software, Inc. San Diego, CA, USA) e dos dados sociodemográficos e clínicos no software SPSS (versão 23.0 para Windows). Significância estatística foi considerada com p <0.05. Os resultados mostram: Sexo masculino predominante (71%), idade média 8,58 ± 1,91, predominância de apenas um cuidador - mãe e/ou pai biológico como chefe de família e maior frequência de tipo combinado de TDAH. Pressão arterial sistólica, frequência cardíaca e temperatura corporal alterações significativas, porém sem significância clínica. Índice massa corporal com diferença estatística, 37%, 19,3% e 21% das crianças apresentaram IMC acima do esperado para idade na avaliação 1, 2 e 3 respectivamente. Adesão ao tratamento medicamentoso permaneceu acima de 93,5% na 24ª semana. Durante o tratamento: FRAP não se alterou; atividade de SOD reduziu na 12ª semana em comparação à linha de base; atividade de CAT aumento significativo à 24ª em comparação 12ª semana; aumento significativo dos níveis de peroxidação lipídica à 24ª semana em comparação à 12ª semana. Aumento significativo das proteínas carboniladas na linha de base em comparação aos níveis da 12ª e 24ª semanas. O metilfenidato parece influenciar os parâmetros redox de crianças com TDAH, aumentando o estresse oxidativo. Porém, mecanismos cerebrais tamponam e desconhecemos o resultado dessas interações na estrutura cerebral. Níveis de BDNF não foram influenciados significativamente por metilfenidato em crianças com TDAH, quando comparados a controles em nossa metanálise.

This study evaluated the impact of methylphenidate hydrochloride (MFD) treatment (MFD) in children with Attention Deficit Hyperactivity Disorder. The study included varied methodology, including a review study about methylphenidate effects on BDNF and an experimental cohort study. The review study followed the PRISMA guidelines and was registered in PROSPERO. In the experimental study, a single-center open cohort was designed, with a convenience sample recruited between the years 2020 and 2022, at the teaching outpatient clinic of the Faculty of Medicine at Viçosa Federal University (UFV-MG). Sample with 62 children, 6 to 14 years old, without previous treatment, diagnosed by a child psychiatrist according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM5). Eight clinical follow-up visits were carried out, and biological samples were collected in 3 visits: before MFD beginning and after 12- and 24-weeks medication. Sociodemographic data, ADHD symptoms, clinical and psychiatric assessments were performed, as well as intelligence testing by psychology. Biological samples for oxidative markers serum dosages (total antioxidant capacity levels -FRAP -, superoxide dismutase activity - SOD-, catalase - CAT -, glutathione S transferase -GST-, lipid peroxidation and carbonyl proteins levels) were collected of each child in the 3 evaluation moments. Immediate-release methylphenidate was administered at approximately 0.65mg/kg/day. The Shapiro-Wilk and Kolmogorov-Smirnov test was used for normality analysis. Absolute and relative frequencies were used for numeric variables that were described by their means and standard deviations. Tukey's parametric test and variance analysis ANOVA (f) were performed for multiple comparisons in redox parameters and other variables respectively. Redox parameters analysis was performed using GraphPad Prism 7.0 program (GraphPad Software, Inc. San Diego, CA, USA) and other variables using SPSS software (version 23.0 for Windows). Statistical significance was considered at p<0.05. Male was predominant (71%), with a mean age of 8.58 ± 1.91, mother and/or biological father were the householder in most homes. Systolic blood pressure, heart rate and body temperature had significant changes, but without clinical significance. Body mass index showed a statistical difference, with 37%, 19.3% and 21% of the children having a BMI above the expected for their age in assessment 1, 2 and 3 respectively. Combined-ADHD occurred in 58.1% of the children, inattentive in 32.3% and hyperactive/impulsive in 9.7%. Drug treatment adherence was 98.4% (12th week) and 93.5% (24th week). There were no changes in FRAP levels; SOD activity had significant decreased at week 12 compared to baseline activity; CAT activity showed a significant increase at the 24th week compared to 12th week; Significant increase in lipid peroxidation levels at 24th week compared to 12th week. Significant increase in protein carbonyls levels at baseline (before methylphenidate use) compared to levels at 12 and 24 weeks. Methylphenidate can influence the oxidative and antioxidative parameters of ADHD children, increasing oxidative stress. However, buffer brain mechanisms may act and the result of these interactions in brain structure is not completely known. BDNF levels were not significantly affected by methylphenidate treatment in ADHD children and do not differ from controls in our meta-analysis.

¿Estar depresivo o tener depresión? El modelo biomédico y la diferencia entre estado de ánimo y enfermedad / Being Depressed or Having Depression. The biomedical model and the difference between mood and illness

Along with the increase in reported figures of depression in the world's population, organizations such as the WHO have begun to promote screening and pharmacological treatment of mild symptomatic cases. The problem in this context is that the manifestations of 'normal' and 'pathological' depressive mood do not differ much from each other, which creates difficulties at a diagnostic and scientific level. This article explores an approach that could facilitate the clinical and scientific task of differentiating between non-specific affective disturbances (depressive mood) and depression as an illness as such. It is proposed that various causal stressors interact with individual predispositions to trigger a transient change in mood as an adaptive response. In turn, the greater the intensity of the stressors (psychological, social, etc.), the greater the neuroinflammation, which would diminish neuronal plasticity and the possibilities of mood compensation and behavioral change of the subject. The existence of this neurobiological alteration (decreased neuronal plasticity), rather than depressive mood, would help us to categorize depression as a disease.

Application of resting state functional magnetic resonance imaging in post-stroke aphasia / 国际脑血管病杂志

Post-stroke aphasia (PSA) is an acquired language disorder, which can seriously affect daily communication and lead to long-term disability. Previous studies were mostly limited to the changes of brain morphology, and it was difficult to reveal the functional changes of brain tissue after aphasia. Resting-state functional magnetic resonance imaging (rs-fMRI) can observe the functional changes of brain regions and brain networks. This article reviews the literature on the use of rs-fMRI to explore the pathogenesis and recovery mechanism of aphasia and the changes of brain function before and after treatment, in order to provide valuable information on the neural remodeling mechanism of PSA and guide more accurate treatment.

Application of comprehensive cognitive intervention in patients with Alzheimer's disease / 中华老年医学杂志

Alzheimer's disease is the most common cause of dementia.Current treatment options for Alzheimer's disease are very limited, and non-drug treatment is receiving more and more attention.Cognitive intervention is a relatively new non-drug treatment for Alzheimer's disease.A large number of previous studies have confirmed that cognitive intervention can prevent and mitigate clinical symptoms of Alzheimer's disease.In this review, we systematically introduce cognitive intervention as a prevention tool for Alzheimer's disease and its ability to alleviate clinical symptoms of the disease, and put forward suggestions for the future application of cognitive intervention in Alzheimer's disease.

Research progress on the structural plasticity of neurons in the visual cortex / 中华实验眼科杂志

During the development of visual cortex, the structure of neurons will adaptively change and adjust according to the changes of external environment, which shows structural plasticity.The experience-dependent plasticity of visual cortex is based on the structural changes of neurons, which mainly include change of synaptic connections, disappearance or increase of dendritic spines, turnover of dendritic spines, changes in the size of dendritic spines, changes in postsynaptic density and alterations of perineuronal nets.The structural changes of neurons have significant influence on the plasticity of visual cortex function and structure, and are highly associated with some molecules or non-neuronal components such as paired immunoglobulin-like receptor B, Ly-6/neurotoxin-like protein 1, Nogo, microglia and extracellular matrix and so on.In addition, external intervention factors such as abnormal visual experience and environmental enrichment can have significant impact on the regulation of the structural changes of neurons, and finally influence the development of visual function and the recovery from visual impairment.In comparison with the functional studies, studies on the structural plasticity of visual cortical neurons depend on the state-of-the-art imaging techniques at cellular or sub-cellular level with more visualizable and convincing results.The constant exploration of the structural plasticity of visual cortex will enhance our understanding of visual development-related diseases, such as amblyopia, and lay the foundation for related basic research and innovative treatments.Advances in the structural plasticity of visual cortex were reviewed in this article.

Effects of aerobic physical exercise on neuroplasticity after stroke: systematic review / Efeitos do exercício físico aeróbico na neuroplasticidade após o acidente vascular cerebral: revisão sistemática de literatura

ABSTRACT Background: Stroke is among the leading causes of death and disability worldwide. Interventions for stroke rehabilitation aim to minimize sequelae, promote individuals' independence and potentially recover functional damage. The role of aerobic exercise as a facilitator of post-stroke neuroplasticity in humans is still questionable. Objective: To investigate the impact of aerobic exercise on neuroplasticity in patients with stroke sequelae. Methods: A systematic review of randomized clinical trials and crossover studies was performed, with searches for human studies in the following databases: PUBMED, EMBASE, LILACS and PeDRO, only in English, following the PRISMA protocol. The keywords used for selecting articles were defined based on the PICO strategy. Results: This systematic review evaluated the impacts of aerobic exercise on neuroplasticity through assessment of neural networks and neuronal excitability, neurotrophic factors, or cognitive and functional assessment. Studies that evaluated the effects of aerobic exercise on neuroplasticity after stroke measured through functional resonance (fMRI) or cortical excitability have shown divergent results, but aerobic exercise potentially can modify the neural network, as measured through fMRI. Additionally, aerobic exercise combined with cognitive training improves certain cognitive domains linked to motor learning. Studies that involved analysis of neurotrophic factors to assess neuroplasticity had conflicting results. Conclusions: Physical exercise is a therapeutic intervention in rehabilitation programs that, beyond the known benefits relating to physical conditioning, functionality, mood and cardiovascular health, may also potentiate the neuroplasticity process. Neuroplasticity responses seem more robust in moderate to high-intensity exercise training programs, but dose-response heterogeneity and non-uniform neuroplasticity assessments limit generalizability.

RESUMO Antecedentes: O acidente vascular cerebral (AVC) é a segunda causa principal de morte no mundo. Intervenções para reabilitação dos pacientes com AVC visam minimizar sequelas, promover sua independência e potencialmente recuperar danos funcionais. O papel do exercício aeróbico como facilitador da neuroplasticidade pós-AVC em humanos ainda é questionável. Objetivo: Investigar o impacto do exercício aeróbico na neuroplasticidade em pacientes com sequelas de AVC. Métodos: Foi realizada revisão sistemática de literatura, pesquisando nas seguintes bases de dados: PUBMED, EMBASE, LILACS e PeDRO. Foram selecionados trabalhos em língua inglesa, realizados apenas com humanos, seguindo o protocolo PRISMA. As palavras-chave utilizadas para a seleção de artigos foram definidas com base na estratégia PICO. Resultados: Esta revisão sistemática avaliou os impactos do exercício aeróbico na neuroplasticidade através da avaliação das redes neurais e da excitabilidade neuronal, por meio de fatores neurotróficos, por meio da avaliação cognitiva e funcional. Estudos que avaliaram os efeitos do exercício aeróbico sobre neuroplasticidade após o AVC medido através de ressonância funcional ou excitabilidade cortical, são controversos, mas há dados sugerindo uma modificação da rede neural na ressonância funcional após o exercício aeróbico. Há evidências de que, associar exercício aeróbico com treinamento cognitivo melhora certos domínios cognitivos ligados à aprendizagem motora. Estudos que envolveram a análise de fatores neurotróficos, como avaliação da neuroplasticidade, tiveram resultados conflitantes. Conclusões: Exercício aeróbico é uma intervenção terapêutica em programas de reabilitação, pois, além de proporcionar os benefícios no condicionamento físico, funcionalidade, humor e saúde cardiovascular, pode potencializar a neuroplasticidade.

Implantes cocleares: prioridad para niños con pérdida sensorial dual en Cuba / Cochlear implants: priority for children with dual sensory loss in Cuba

RESUMEN Fundamento: desde el año 2005 se crea el Programa Cubano de Implantes Cocleares para niños sordos y sordociegos, con prioridad para niños con pérdida sensorial dual. Objetivo: describir el comportamiento de la pérdida sensorial dual en niños del Programa Cubano de Implantes Cocleares. Métodos: se realizó un estudio observacional, descriptivo, retrospectivo de niños con pérdida sensorial dual que recibieron implante coclear entre febrero de 2005 y marzo de 2013 en Cuba. De las historias clínicas y la base de datos del programa fue obtenida la información que permitió elaborar el informe. Con antelación, se ilustran los primeros resultados sobre neuroplasticidad obtenidos con potencial evocado somatosensorial de nervio mediano realizado con parte del protocolo de estudio de investigación preimplante coclear en el Programa Cubano de Implantes Cocleares. Resultados: con el programa se han beneficiado 27 niños con pérdida sensorial dual con implantes cocleares, con cobertura a todas las provincias del país. Seis niños presentaron una enfermedad asociada, predominaron los factores pre/peri-natales y el síndrome de Usher como principales agentes causales de la sordoceguera. La pérdida auditiva fue prelocutiva en 24 niños, confirmada y caracterizada mediante electroaudiometría. Los estudios de imágenes de oídos no mostraron malformaciones. La implantación fue unilateral, sobre todo el oído derecho, sin complicaciones quirúrgicas en ninguno de los niños. Mientras que el estudio de neuroplasticidad evidencia reorganización cortical somestésica en niños con pérdida sensorial dual. Conclusiones: el Programa Cubano de Implantes Cocleares ha logrado un trabajo sostenido en la evaluación e implantación de niños con pérdida sensorial dual, distinguiéndose la investigación sobre neuroplasticidad, la cual ha dado evidencias de representación cortical somestésico preimplante coclear en estos niños. Ello será útil para evaluar la reorganización cortical post-implante coclear y correlacionarlo con el aprovechamiento del uso del implante coclear.

ABSTRACT Background : since 2005 the Cuban Cochlear Implant Program for deaf and deaf-blind children has been created, with priority for children with dual sensory loss. Objective: is to describe the work of the Cuban Cochlear Implant Program with children with dual sensory loss. Methods : a descriptive, retrospective study of children with dual sensory loss who received a cochlear implant between February 2005 and March 2013 in Cuba. The information to conform this descriptive report was obtained from the clinical histories and the database of the program; it also illustrates the first results on neuroplasticity obtained with the somatosensory evoked potential of the median nerve carried out with part of the pre-cochlear implant research study protocol in the Cuban Cochlear Implant Program. Results : the program has benefited 27 children with dual sensory loss with cochlear implants, covering all provinces of the country. Six children presented an associated pathology, with pre/peri-natal factors and Usher Syndrome as the main causal agents of deaf-blindness. Hearing loss was pre-lingual in 24 children, confirmed and characterized by electro-audiometry. No malformations were found in the ear images. The implantation was unilateral, mostly the right ear, without surgical complications in all the children. While the neuroplasticity study shows somesthetic cortical reorganization in children with dual sensory loss. Conclusions : the Cuban Cochlear Implant Program has achieved sustained work in the evaluation and implantation of children with dual sensory loss, a distinctive aspect being the research on neuroplasticity, which has provided evidence of somesthetic cortical representation pre-cochlear implantation in these children. This will be useful to assess cortical reorganization post- cochlear implant and correlate it with the use of the cochlear implant.

Neuroplasticidad en adolescente con agenesia del cuerpo calloso asociado a epilepsia / Neuroplasticity in an Adolescent with Corpus Callosum Agenesis Associated with Epilepsy

RESUMEN La plasticidad neuronal representa la facultad del cerebro para recuperarse y reestructurarse, esto le permite reponerse a trastornos o lesiones y reducir los efectos de alteraciones estructurales ya sean congénitas o adquiridas. La agenesia del cuerpo calloso es una malformación del sistema nervioso central que se produce por falta del desarrollo o del entrecruzamiento de los axones provenientes de la corteza cerebral, lo que puede asociarse a otras malformaciones o ser producto de lesiones destructivas con atrofia. Desde el punto de vista clínico son frecuentes las afectaciones neurológicas como retraso psicomotor, del aprendizaje, trastornos motores, visuoespaciales y convulsiones. Se presenta el caso de un paciente de sexo masculino, que inició con epilepsia a los 17 años con hallazgo en resonancia magnética de agenesia total del cuerpo calloso y paquigiria, con desarrollo psicomotor y cognitivo normal y evolución clínica favorable. La neuroplasticidad como mecanismo fisiológico adaptativo permitió se establecieran alternativas de comunicación interhemisférica y por consiguiente manifestaciones clínicas poco floridas y buena evolución de la epilepsia, conservando estado neurocognitivo normal. Se presenta este reporte con el objetivo de describir la forma clínica inhabitual de la agenesia del cuerpo calloso asociado a epilepsia y la participación del mecanismo de plasticidad neuronal en esta forma oligosintomática, en un adolescente.

ABSTRACT Neural plasticity represents the brain's ability to recover and restructure itself, allowing it to recover from disorders or injuries and reduce the effects of structural alterations, whether congenital or acquired. The agenesis of the corpus callosum is a malformation of the central nervous system that occurs due to lack of development or crossing of axons from the cerebral cortex, which can be associated with other malformations or be the product of destructive lesions with atrophy. From a clinical point of view, neurological disorders such as psychomotor retardation, learning, motor, visual-spatial disorders and seizures are frequent. The case of a male patient, who began with epilepsy at 17 years of age, with a magnetic resonance imaging finding of total agenesis of the corpus callosum and pachygyria, with normal psychomotor and cognitive development and favorable clinical evolution. Neuroplasticity as an adaptive physiological mechanism allowed the establishment of interhemispheric communication alternatives and consequently little flowery clinical manifestations and a good evolution of epilepsy, maintaining a normal neurocognitive state is presented. The objective of this research is to describe the unusual clinical form of agenesis of the corpus callosum associated with epilepsy and the participation of the neuronal plasticity mechanism in this oligosymptomatic form, in an adolescent.

Treinamento cognitivo e auditivo acusticamente não controlado para população idosa: um estudo de caso / Cognitive and acoustically uncontrolled auditory training for elderly: a case study

RESUMO O objetivo do trabalho foi criar um protocolo de treinamento auditivo e cognitivo para idosos e analisar a sua eficácia. O estudo foi realizado em três etapas: (1) seleção de materiais, compreendendo materiais existentes e outros confeccionados pelos autores; (2) análise de juízes especialistas, para consenso quanto às habilidades avaliadas e tipo de treinamento; (3) aplicação do protocolo em um caso clínico, com realização de uma bateria de testes para avaliação pré e pós-intervenção, consistindo em avaliação cognitiva e auditiva (comportamental e eletrofisiológica). Foi possível a estruturação do protocolo de acordo com as sugestões das juízas especialistas, o que gerou uma nova proposta de treinamento auditivo e cognitivo com 39 tarefas, dispostas em seis sessões. Com a aplicação do protocolo no caso clínico, observaram-se modificações positivas nos dois aspectos treinados. A nova proposta terapêutica foi concluída e aplicada. O sujeito do caso clínico obteve melhoras pós-intervenção e a eficácia foi verificada por meio dos testes comportamentais de processamento auditivo central, de rastreio cognitivo e do potencial evocado auditivo de longa latência.

ABSTRACT The objective of the work was create an auditory and cognitive training protocol for the elderly and to analyze its effectiveness. This study was carried out in three stages: (1) Selection of materials, composed of existing materials and others made by the authors, (2) Analysis of expert judges, for consensus regarding the assessed skills and type of training, and (3) Application of the protocol in a clinical case, with a battery of tests for pre-and post-intervention, composed of cognitive and auditory assessment (behavioral and electrophysiological). It was possible to structure the protocol according to the suggestions of the expert judges, which generated a new proposal for auditory and cognitive training with 39 tasks arranged in six sessions. With the application of the protocol in the clinical case, it was possible to observe positive changes in both trained aspects. The new therapeutic proposal has been completed and applied. The clinical case has shown improvement after the intervention, and the effectiveness was verified through behavioral tests of central auditory processing, cognitive screening, and long-latent auditory evoked potential.

Plasticidade neuronal da via auditiva em crianças com transtorno dos sons da fala: estudo dos Potenciais Evocados Auditivos de Longa Latência / Neuronal plasticity of the auditory pathway in children with speech sound disorder: a study of Long-Latency Auditory Evoked Potentials

Resumo Objetivo Avaliar os achados dos Potenciais Evocados Auditivos de Longa Latência (PEALL) em crianças com Transtorno dos Sons na Fala (TSF) após terapia fonoaudiológica. Método Estudo clínico longitudinal e prospectivo em um grupo de 14 crianças com TSF, de cinco a sete anos de idade, de ambos os sexos. Foram aplicadas as provas de Nomeação de Figuras e Imitação de palavras, para as quais foi calculado o índice de gravidade Porcentagem de Consoantes Corretas. Foram registrados os PEALL com estímulo de fala e foram analisados os valores de latência e amplitude dos componentes P1, N1, P2, N2 e P3. Cada criança foi avaliada em dois diferentes momentos: avaliação inicial e após 12 sessões de terapia fonoaudiológica. Resultados Os resultados mostraram que após terapia fonoaudiológica, o valor do índice de gravidade Porcentagem de Consoantes Corretas aumentou e um maior número de componentes foi observado nos registros dos PEALL nas crianças com TSF. Também foi observado um aumento estatisticamente significativo na amplitude do componente P3, demostrando que modificações anatomofisiológicas ocorreram no sistema nervoso auditivo central após intervenção, proporcionando melhora nos resultados dos PEALL. Conclusão Após terapia fonoaudiológica, foi observada melhora no desempenho fonológico das crianças, aumento no número de componentes presentes nos PEALL, bem como aumento na amplitude do componente P3, demonstrando que ocorreu plasticidade na via auditiva após um curto período de intervenção fonoaudiológica.

Abstract Purpose To analyze the results of Long-latency Auditory Evoked Potentials (LLAEP) in children with Speech Sounds Disorder (SSD) after speech therapy. Methods Longitudinal and prospective clinical study at 14 children with SSD, with ages ranging from five to seven years, of both genders. Were applied Picture Naming task and Imitation task, and from these tasks it was calculated the Percentage of Consonants Correct index. For an analysis of the LLAEP with speech stimulus and recorded the latency and amplitude values ​​of P1, N1, P2, N2 and P3 components. Each child was evaluated in two different moments: initial evaluation and after 12 sessions of speech therapy. Results It was observed that after twelve sessions of speech therapy the value of Percentage of Consonants Correct index increased, and a greater number of components were observed in the LLAEP records of children with SSD, as well as a statistically significant increase in the amplitude of the P3 component, demonstrating that anatomical and physiological changes occurred in the central auditory nervous system after intervention, resulting in improved of the LLAEP results. Conclusion After speech therapy, improvement in the children's phonology was observed, and there was an increase in the number of components present in the LLAEP, as well as an increase in the amplitude of the P3 component, demonstrating that plasticity occurred in the auditory pathway during these three months of therapeutic intervention.

Acoustically controlled binaural auditory training with vocal duets: assessment and effectiveness

OBJECTIVES: We aimed to evaluate the effectiveness of a binaural auditory training program with vocal duets by comparing skills through outcomes from behavioral and electrophysiological assessment instruments at three moments: before the intervention, moment one (M1); immediately after training, moment two (M2); and 3 months after, moment three (M3). METHODS: This interventional, longitudinal, prospective, and uncontrolled study was approved by our Research Ethics Committee. Binaural auditory training with vocal duets (ATVD) was applied in 10 adults with normal audiometric thresholds and auditory processing disorders. ATVD used four different vocals of a public domain song sung in a cappella as stimuli. Participants were asked to register any perceived difference in frequency for each syllable of the song during 30-minute sessions twice a week. The number of sessions required ranged from 12 (6 hours) to 20 (10 hours). RESULTS: Regarding behavioral tests, the dichotic consonant-vowel test showed significant evidence of an improved advantage in the left ear (LE) in the non-forced condition and a significant reduction in the number of errors at M2 and M3 in the forced left condition. The speech-in-noise test and frequency pattern test showed a significant reduction in impaired results at M2 and M3. Electrophysiological results showed a significant increase in the LE amplitude in the P3 long-latency auditory evoked potentials test, as well as a decrease in the auditory brainstem response test (III-V and I-V inter-peak latencies in the right ear and wave I and I-III inter-peak latencies in LE). CONCLUSION: The effectiveness of ATVD was evidenced, and the results were maintained after 3 months.

Effects of sevoflurane combined with propofol anesthesia on synaptic plasticity in hippocampus after operation in rats with mild cognitive impairment: relationship with KCC2/NKCC1 / 中华麻醉学杂志

Objective:To evaluate the effects of sevoflurane combined with propofol anesthesia on the synaptic plasticity in the hippocampus after operation in rats with mild cognitive impairment (MCI) and the relationship with potassium-chloride cotransporter-2 (KCC2)/sodium-potassium-chloride cotransporter 1 (NKCC1).Methods:Clean-grade healthy male Sprague-Dawley rats, aged 16-18 months, weighing 440-540 g, in which MCI was induced by severe bilateral common carotid artery stenosis (BCAS). Forty-eight rats with MCI were divided into 4 groups ( n=12 each) using a random number table method: sham operation group (group Sham), sevoflurane anesthesia group (group S), propofol anesthesia group (group P), and sevoflurane and propofol anesthesia group (group SP). After disappearance of eyelash reflex, open reduction and internal fixation was performed after tibial fracture was induced in S, P and SP groups.Anesthesia method was as follows: 1.7% sevoflurane was inhaled and propofol 20 mg·kg -1·h -1 was intravenously infused for 3 h in group SP, 3% sevoflurane was inhaled for 3 h in group S, and propofol was intravenously infused at rate of 40 mg·kg -1·h -1 for 3 h in group P. The novel object recognition (NOR) test was performed at 14 days after operation, and the discrimination index in NOR test was calculated.The in vivo electrophysiological experiment was performed on 19 days after operation to measure long-term potentiation and amplitude of the field excitatory postsynaptic potential (fEPSP). The expression of KCC2 and NKCC1 was determined by Western blot, and the ratio of KCC2/NKCC1 was calculated.The density of dendritic spines in the hippocampal CA1 region was determined by Golgi-COX staining performed at 30 days after operation. Results:Compared with Sham group, the discrimination index in NOR test, hippocampal KCC2/NKCC1 ratio, density of dendritic spines in hippocampal CA1 region, and amplitude of fEPSP were significantly decreased in S and P groups ( P<0.05), and no significant change was found in the parameters mentioned above in group SP ( P>0.05). Compared with group S or group P, the discrimination index in NOR test, hippocampal KCC2/NKCC1 ratio, density of dendritic spines in hippocampal CA1 region, and amplitude of fEPSP were significantly increased in group SP ( P<0.05). Conclusion:Sevoflurane combined with propofol anesthesia does not aggravate postoperative cognitive dysfunction in the rats with MCI, which may be related to maintaining the balance of hippocampal KCC2/NKCC1 and protecting the synaptic plasticity in hippocampi.

Neurobiological mechanism of post-stroke depression / 国际脑血管病杂志

Post-stroke depression (PSD) is one of the common complications of stroke, which can seriously affect the functional rehabilitation of patients with stroke and increase their mortality and disability rate. As for the pathogenesis of PSD, endogenous theory emphasizes that it is closely associated with biological mechanism, while reactive theory believes that it is associated with psychosocial factors. At present, the research on the pathogenesis and treatment of PSD focuses on inflammation, immune response, stress, nerve regeneration, brain network, biological rhythm disorder, sleep disorder, melatonin and so on. This article reviews the research progress on the neurobiological mechanism of PSD and the related treatment for the pathogenesis.

Regulatory effect of microRNAs on neuroplasticity of ischemic stroke / 国际脑血管病杂志

Ischemic stroke is one of the main causes of disability and death. Although intravenous thrombolysis and endovascular mechanical thrombectomy can achieve cerebral vascular recanalization, most patients with ischemic stroke leave serious neurological deficits due to missed treatment window. Neural plasticity is the basis of neural function repair. Recent studies have shown that microRNAs play an indispensable role in regulating neural plasticity. This article reviews the regulatory role of microRNAs on neural plasticity in ischemic stroke, in order to provide reference for the treatment of ischemic stroke.

Puerarin ameliorates depressive symptoms in diabetic mice induced by high-fat diet / 药学学报

Our previous studies have shown that puerarin, an active component of the traditional Chinese medicine-Pueraria Lobata, can improve glycometabolism in high-fat diet (HFD) mice with diabetes by activating the glucagon-like peptide-1 receptor (GLP-1R) pathway. This study intends to further evaluate the effect of puerarin on depressive symptoms in HFD mice. Long-term HFD induces type 2 diabetes and depressive-like symptoms in mice. Animal welfare and experimental procedures follow the regulations of the Animal Ethics Committee of the Affiliated Hospital of Integrated Traditional Chinese and Western Medicine, Nanjing University of Traditional Chinese Medicine (approval No. AEWC-025). The experiment was divided into: control group, model group, model/puerarin (150 mg·kg-1·day-1) group, and model/fluoxetine (15 mg·kg-1·day-1) group. The oral glucose tolerance test (OGTT) and behavioral experimental analysis were performed after 6 weeks of continuous administration. Afterwards, enzyme-linked immunosorbent assay (ELISA) was used to detect interleukin-1β (IL-1β), interleukin-6 (IL-6), 5-hydroxytryptamine (5-HT), and corticosterone (CORT) in serum of mice for each group. Western blot assays were used to detect the level of activation and expression of proteins related to neuroplasticity and depressive disorder in the hippocampus. Moreover, HT-22 cell line was used to investigate the protective effect of puerarin on cell morphology and survival. The results show that puerarin can effectively maintain the survival of HT22 in an environment with high glucose and corticosterone. Meantime, the glycemic regulation of diabetic mice was improved after treatment of puerarin, the depressive symptoms were alleviated, the 5-HT increased, and the corticosterone, IL-1β, and IL-6 decreased in the serum. The up-regulation of related proteins in GLP-1R/Wnt/mTOR (mammalian target of rapamycin) signaling in hippocampus suggests that its effect on ameliorating depression in diabetic mice may be related to the activation of GLP-1R/Wnt/mTOR signaling pathway. This study shows that puerarin can significantly ameliorate the depressive symptoms of HFD induced diabetic mice which might be achieved through activating the GLP-1R/Wnt/mTOR signaling pathway and improving hippocampal neuroplasticity.

Privación sensorial temprana durante el neurodesarrollo y sus consecuencias cognitivas / Early sensory deprivation in neurodevelopment and its cognitive consequences / Privação sensorial precoce durante o neuro-desenvolvimento e suas consequências cognitivas

La aparición progresiva de habilidades sensoriales, motoras y cognitivo-afectivas en el humano a lo largo de su desarrollo es un reflejo de cambios fisiológicos que se gestan al interior del sistema nervioso. Dichos cambios hacen parte de procesos dinámicos y dependen, después del nacimiento, de la actividad eléctrica inducida por la experiencia. Considerando lo anterior, el sistema nervioso en desarrollo constituye una especie de protomapa, sobre el que la experiencia moldea características moleculares, neuroquímicas y de conectividad, que se reflejan en las actividades emergentes del sistema. La evidencia que soporta la importancia que la influencia experiencial tiene sobre el desarrollo del sistema nervioso viene en aumento. Esta revisión reúne información sobre estudios en modelos biológicos y en humanos sometidos a privación sensorial y ambiental. Se enfatiza en la caracterización de los rasgos cognitivos y sociales.

The progressive advent of sensory, motor, affective, and cognitive skills in the human being through its development, demonstrate physiological changes that are gestated within the nervous system. These processes are dynamic and dependent postnatally on electrical activity induced by experience. Taking this into account, the developing nervous system constitutes a protomap molded by experience dependent molecular, physiological and connectivity characteristics, which are reflected in the emergent principles of the system. The evidence that supports the importance of experience as influence over the development of this system has increased in the past years. This document gathers information about animal models and human studies enduring sensory and environmental deprivation, emphasizing in the characterization of their cognitive and social remarks.

O aparecimento progressivo de habilidades sensoriais, motoras e cognitivo-afetivas no humano ao longo do seu desenvolvimento é um reflexo de mudanças fisiológicas que se gestam no interior do sistema nervoso. Ditas mudanças fazem parte de processos dinâmicos e dependem, depois do nascimento, da atividade elétrica induzida pela experiência. Considerando o anterior, o sistema nervoso em desenvolvimento constitui uma espécie de "protomapa", sobre o que a experiência molda características moleculares, neuroquímicas e de conectividade, que se refletem nas atividades emergentes do sistema. A evidência que suporta a importância que a influência experiencial tem sobre o desenvolvimento do sistema nervoso vem em aumento. Esta revisão reúne informação sobre estudos em modelos biológicos e em humanos submetidos a privação sensorial e ambiental. Se enfatiza na caracterização das características cognitivas e sociais.

Níveis Séricos do BDNF na Proteção Cardiovascular e em Resposta ao Exercício / Serum Levels of BDNF in Cardiovascular Protection and in Response to Exercise

Resumo As doenças cardiovasculares (DCV) são atualmente a maior causa de morte no Brasil e no mundo. Em 2016 as DCV foram responsáveis por mais de 17 milhões de mortes, representando 31% de todas as mortes em nível global. Mecanismos moleculares e genéticos podem estar envolvidos na proteção cardiovascular e devem ser considerados nas novas abordagens terapêuticas. Nesse sentido, recentes estudos têm relatado que o Fator Neurotrófico Derivado do Encéfalo (Brain-Derived Neurotrophic Factor, BDNF) está reduzido em indivíduos predispostos a desenvolverem DCV, e que o treinamento físico aeróbio aumenta as quantidades de BDNF circulante. O BDNF é uma neurotrofina encontrada em altas concentrações no hipocampo e córtex cerebral, sendo considerada molécula-chave na manutenção da plasticidade sináptica e na sobrevivência das células neuronais. Além da plasticidade neuronal, BDNF também é importante na função vascular, promovendo angiogênese por meio da regulação por espécies reativas de oxigênio (ROS). Entretanto, uma variante do gene do BDNF em humanos, o polimorfismo Val66Met (substituição do aminoácido valina por uma metionina na posição 66 do códon), que ocorre em 20-30% da população caucasiana, pode afetar as concentrações de BDNF no plasma e sua atividade em todos os tecidos periféricos contendo receptores tirosina quinase B (TrkB), como o endotélio. De fato, recentemente observamos que o polimorfismo Val66Met prejudica a reatividade vascular e o BDNF circulante em resposta ao treinamento físico. Dessa forma, apresentaremos a seguir uma discussão sobre os níveis séricos de BDNF na proteção cardiovascular, a variante genética Val66Met na reatividade vascular e o efeito do exercício físico.

Abstract Cardiovascular disease (CVD) is currently the leading cause of death in Brazil and worldwide. In 2016, CVD accounted for more than 17 million deaths, representing 31% of all deaths globally. Molecular and genetic mechanisms may be involved in vascular protection and should be considered in new therapeutic approaches. In this sense, recent studies have reported that brain-derived neurotrophic factor (BDNF) is reduced in individuals predisposed to develop CVD, and that aerobic physical training increases the amounts of circulating BDNF. BDNF is a neurotrophin found at high concentrations in the hippocampus and cerebral cortex and is considered a key molecule for the maintenance of synaptic plasticity and survival of neuronal cells. In addition to neuronal plasticity, BDNF is also important in vascular function, promoting angiogenesis through the regulation of reactive oxygen species (ROS). However, a variant of the BDNF gene in humans, the Val66Met polymorphism (substitution of the amino acid valine for a methionine at position 66 of the codon), occurring in 20-30% of the Caucasian population, may affect plasma BDNF concentrations and its activity in all peripheral tissues containing tyrosine kinase B receptors (TrkB), such as the endothelium. Thus, we will present a discussion about the role of serum BDNF levels in cardiovascular protection, Val66Met genetic variant in vascular reactivity and the effect of physical exercise.

La neuroplasticidad en la enfermedad de Alzheimer: una alternativa terapéutica a nivel molecular / Neuroplasticity in Alzheimer's disease: a therapeutic alternative at the molecular level

RESUMEN Los mecanismos de neuroplasticidad del organismo constituyen la base de disímiles terapias que buscan potenciar tales efectos para alcanzar una relativa mejoría en gran número de enfermedades neurodegenerativas. Incluida dentro de este elevado número de afecciones, se destaca la enfermedad de Alzheimer, por su relación directa con las alarmantes cifras de envejecimiento poblacional en Cuba y el mundo. La presente revisión bibliográfica tuvo como objetivo describir las principales alternativas terapéuticas que tienen su basamento en el mecanismo de neuroplasticidad, aplicables en pacientes con enfermedad de Alzheimer. Para ello se realizó una revisión de la literatura, y se identificaron publicaciones relevantes de los últimos cinco años. Se concluyó que, de acuerdo a las evidencias más sólidas encontradas, las alternativas terapéuticas fundamentales son las enfocadas en potenciar la plasticidad neuronal; destacándose dentro de este grupo de terapias, el ejercicio físico, la estimulación magnética transcraneal y el incremento de las concentraciones de factor neurotrófico derivado del cerebro. Resalta, especialmente, la estimulación magnética transcraneal repetitiva, por su demostrada capacidad para fomentar por disimiles vías plasticidad neuronal.

ABSTRACT The neuroplasticity mechanisms of the organism form the basis of dissimilar therapies that seek to potentiate such effects to achieve relative improvement in a large number of neurodegenerative diseases. Included within this high number of conditions, Alzheimer's disease stands out, due to its direct relationship with the alarming figures of population aging in Cuba and the world. The objective of this bibliographic review was to describe the main therapeutic alternatives that are based on the neuroplasticity mechanism, applicable in patients with Alzheimer's disease. For this, a literature review was carried out, and relevant publications from the last five years were identified. It was concluded that, according to the strongest evidence found, the fundamental therapeutic alternatives are those focused on enhancing neuronal plasticity; standing out within this group of therapies, physical exercise, transcranial magnetic stimulation and increased concentrations of brain-derived neurotrophic factor. Especially notable the repetitive transcranial magnetic stimulation, due to its demonstrated ability to promote neuronal plasticity through different ways.