Functional significance of the dorsolateral prefrontal cortex during exhaustive exercise

Integrating neural substrates, diabetes self-management, and behavior change for tailored lifestyle interventions in type-2 diabetes: A neurobehavioral perspective

Understanding the neural mechanisms that underlie behavior change is critical for improving lifestyle management in type 2 diabetes. Individuals with type 2 diabetes face unique challenges in adopting and maintaining healthy behaviors, which can be influenced by alterations in brain function and plasticity, potentially leading to cognitive impairment. Diabetes self-management education and support (DSMES) programs aim to enhance lifestyle changes and promote better health outcomes while reducing cognitive decline. However, complex neural disruptions in critical regions for cognitive processes like the prefrontal cortex and parietal lobe present significant challenges. Given the likely role of neural mechanisms in behavioral choices, understanding how type 2 diabetes affects these neural substrates is crucial for developing effective interventions. Despite considerable research efforts aimed at testing lifestyle interventions, a critical gap remains in understanding the cognitive and behavioral components of successful diabetes self-management, the neural substrates of those components, and the impact of diabetes on those neural substrates. Bridging this gap necessitates a comprehensive examination integrating neural processes, DSMES strategies, and behavior change models. Thus, this perspective review highlights the urgent need to address the knowledge gaps surrounding the neural correlates of diabetes self-management and the integration of behavioral models into intervention frameworks. We propose a hypothesis-generating question and present preliminary findings comparing neural plasticity, executive functions, and lifestyle behavior among individuals with type 2 diabetes, pre-diabetes, and healthy controls. By elucidating the neural substrates underpinning diabetes and exploring their implications for DSMES and readiness to change, we can pave the way for more effective, personalized approaches to diabetes care.

Modulation of beta oscillatory dynamics in motor and frontal areas during physical fatigue

Beta-band oscillations have been suggested to promote the maintenance of the current motor (or cognitive) set, thus signaling the 'status quo' of the system. While this hypothesis has been reliably demonstrated in many studies, it fails to explain changes in beta-band activity due to the accumulation of physical fatigue. In the current study, we aimed to reconcile the functional role of beta oscillations during physical fatigue within the status quo theory. Using an innovative electroencephalography design, we identified two distinct beta-band power dynamics in the motor areas as fatigue rises: (i) an enhancement at rest, supposedly promoting the resting state, and (ii) a decrease during contraction, thought to reflect the increase in motor cortex activation necessary to cope with muscular fatigue. We then conducted effective connectivity analyses, which revealed that the modulations during contractions were driven by frontal areas. Finally, we implemented a biologically plausible model to replicate and characterize our results mechanistically. Together, our findings anchor the physical fatigue paradigm within the status quo theory, thus shedding light on the functional role of beta oscillations in physical fatigue. We further discuss a unified interpretation that might explain the conflicting evidence previously encountered in the physical fatigue literature.

Perceptual Acuity Ability Applied for Endurance Runners: The Validity of a Just Noticeable Difference Approach

Endurance runners need to self-regulate their pace continuously in a race so that the ideal performance can be sustained without fatigue. Hence, we are interested in validating an approach to measure individual perceptual acuity ability using just noticeable differences (JND) in a physical stimulus, and its related psychophysiological demands. Fifteen male runners (M age = 34.27, SD = 6.91 years) first performed a maximal treadmill test to determine the speed of a standard exercise bout for the JND trials. The JND trials consisted of four 5-min running bouts on a treadmill with 5-min rest between bouts. For bouts 1 and 3, participants ran at the standard stimulus (SS) pace, but for bouts 2 and 4, they adjusted their speeds to achieve a level of exertion at a JND above/below the SS. They achieved differences in the final 30 seconds of the VO2 between each JND bout and the previous SS at just above (JND-A) and just below (JND-B) the JND perceived exertions. We assessed the JND approach validity by intraclass correlation coefficient (ICC), coefficient of variation (CoV), concordance correlation coefficient (CCC), Bland-Altman and Cohen's d for VO2 of two standard stimuli within each JND trial. All validity statistical tests indicated a high level of concordance and agreement within both JND at 70%VO2max and 80%VO2max (ICC = .896 and .940; CoV 2.77 and 2.05; CCC = .889 and .936; respectively); with low standard error of measurement and of the estimate (1.261 and 1.0105; 1.6932 and 1.3868; respectively) (all p = .05). The data also showed a high level of agreement since the measures are within 95% limits in each JND trial. Our findings established the validity and reproducibly of the JND approach to identify the perceptual acuity ability applied to endurance male runners.

Differential effects of high-frequency repetitive transcranial magnetic stimulation over the left and right dorsolateral prefrontal cortex for post-stroke cognitive impairment

OBJECTIVE

In this study, it is aimed to explore the different effects of repetitive transcranial magnetic stimulation (HF-rTMS)over the left and right dorsolateral prefrontal cortex (DLPFC) for post-stroke cognitive impairment (PSCI).

METHOD

In this study, we allocated 40 patients with PSCI who were divided into the left DLPFC group (n = 20) and the right DLPFC group (n = 20). Patients received 20HZ rTMS over the ipsilateral DLPFC respectively, for 20 consecutive days (20 min/time, 1 time/day). Cognitive performance was assessed before and after treatment using the Montreal Cognitive Assessment (MoCA), the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and the Modified Barthel Index (MBI). Furthermore, event-related potential (ERP) detection was also conducted in patients at baseline and after treatment.

RESULTS

After treatment, the global cognition, orientation, and language of patients in the left DLPFC group were significantly improved (P < 0.05). While the enhancement of visual perception and spatial perception in the right DLPFC group was significant (P < 0.05). MBI scores in both groups were increased (P < 0.05), but there was no significant difference between the two groups after treatment (P > 0.05).The decrease of latency in the left DLPFC group was more significant than that in the right DLPFC group (P < 0.05), but there was no significant difference in amplitude (P > 0.05).

CONCLUSION

The results support that high-frequency rTMS over the left DLPFC is a more effective treatment for improving global cognition and suggest that the left and right DLPFC are associated with different cognitive functions.

Chronic stress-induced neuroplasticity in the prefrontal cortex: Structural, functional, and molecular mechanisms from development to aging

Chronic stress profoundly affects the structure and function of the prefrontal cortex (PFC), a brain region critical for executive functions and emotional regulation. This review synthesizes current knowledge on stress-induced PFC plasticity, encompassing structural, functional, and molecular changes. We examine how chronic stress leads to dendritic atrophy, spine loss, and alterations in neuronal connectivity within the PFC, particularly affecting the medial PFC. These structural changes are accompanied by disruptions in neurotransmitter systems, most notably glutamatergic and GABAergic signaling, and alterations in synaptic plasticity mechanisms. At the molecular level, we discuss the intricate interplay between stress hormones, neurotrophic factors, and epigenetic modifications that underlie these changes. The review highlights the significant behavioral and cognitive consequences of stress-induced PFC plasticity, including impairments in working memory, decision-making, and emotional regulation, which may contribute to the development of stress-related psychiatric disorders. We also explore individual differences in stress susceptibility, focusing on sex-specific effects and age-dependent variations in stress responses. The role of estrogens in conferring stress resilience in females and the unique vulnerabilities of the developing and aging PFC are discussed. Finally, we consider potential pharmacological and non-pharmacological interventions that may mitigate or reverse stress-induced changes in the PFC. The review concludes by identifying key areas for future research, including the need for more studies on the reversibility of stress effects and the potential of emerging technologies in unraveling the complexities of PFC plasticity. This comprehensive overview underscores the critical importance of understanding stress-induced PFC plasticity for developing more effective strategies to prevent and treat stress-related mental health disorders.

A Functional Magnetic Resonance Imaging Investigation of Hot and Cool Executive Functions in Reward and Competition

Social and environmental influences are important for learning. However, the influence of reward and competition during social learning is less understood. The literature suggests that the ventromedial prefrontal cortex is implicated in hot executive functioning (EF), while the dorsolateral prefrontal cortex is related to cool EF. In addition, reward processing deficits are associated with atypical connectivity between the nucleus accumbens and the dorsofrontal regions. Here, we used functional magnetic resonance imaging (fMRI) to determine the role of hot and cool EF in reward processing and their relationship to performance under social competition. We adapted a reward-based n-back task to examine the neural correlates of hot and cool EF and the reward influence on performance during competition. A total of 29 healthy adults showed cortical activation associated with individual differences in EF abilities during fMRI scans. Hot and cool EF activated distinct networks in the right insula, hippocampus, left caudate nucleus, and superior parietal gyrus during the no-competition task, while they differentially activated the right precuneus and caudate nucleus in the competition condition. Further analysis revealed correlations between the Hot-Cool network and reward sensitivity and risk-taking behaviour. The findings provided further insights into the neural basis of hot and cool EF engagement in the socio-emotional regulation for learning.

Improving brain health via the central executive network

Cognitive and physical stress have significant effects on brain health, particularly through their influence on the central executive network (CEN). The CEN, which includes regions such as the dorsolateral prefrontal cortex, anterior cingulate cortex and inferior parietal lobe, is central to managing the demands of cognitively challenging motor tasks. Acute stress can temporarily reduce connectivity within the CEN, leading to impaired cognitive function and emotional states. However a rebound in these states often follows, driven by motivational signals through the mesocortical and mesolimbic pathways, which help sustain inhibitory control and task execution. Chronic exposure to physical and cognitive challenges leads to long-term improvements in CEN functionality. These changes are supported by neurochemical, structural and systemic adaptations, including mechanisms of tissue crosstalk. Myokines, adipokines, anti-inflammatory cytokines and gut-derived metabolites contribute to a biochemical environment that enhances neuroplasticity, reduces neuroinflammation and supports neurotransmitters such as serotonin and dopamine. These processes strengthen CEN connectivity, improve self-regulation and enable individuals to adopt and sustain health-optimizing behaviours. Long-term physical activity not only enhances inhibitory control but also reduces the risk of age-related cognitive decline and neurodegenerative diseases. This review highlights the role of progressive physical stress through exercise as a practical approach to strengthening the CEN and promoting brain health, offering a strategy to improve cognitive resilience and emotional well-being across the lifespan.

Effects of Dual-Site Anodal Transcranial Direct Current Stimulation on Attention, Decision-Making, and Working Memory during Sports Fatigue in Elite Soccer Athletes

BACKGROUND

Sports fatigue in soccer athletes has been shown to decrease neural activity, impairing cognitive function and negatively affecting motor performance. Transcranial direct current stimulation (tDCS) can alter cortical excitability, augment synaptic plasticity, and enhance cognitive function. However, its potential to ameliorate cognitive impairment during sports fatigue remains largely unexplored. This study investigated the effect of dual-site tDCS targeting the dorsolateral prefrontal cortex (DLPFC) or primary motor cortex (M1) on attention, decision-making, and working memory in elite soccer athletes during sports fatigue.

METHODS

Sports fatigue was induced in 23 (non-goalkeeper) elite soccer athletes, who then participated in three counterbalanced intervention sessions: dual-site tDCS over the M1, dual-site tDCS over the DLPFC, and sham tDCS. Following tDCS, participants completed the Stroop, Iowa Gambling, and 2-back tasks.

RESULTS

We found a significant improvement in Stroop task accuracy following dual-site anodal tDCS over the M1 compared with the sham intervention in the incongruent condition (p = 0.036). Net scores in the Iowa Gambling task during blocks 4 (p = 0.019) and 5 (p = 0.014) significantly decreased under dual-site tDCS targeting the DLPFC compared with the sham intervention. No differences in 2-back task performance were observed between sessions (all p > 0.05).

CONCLUSIONS

We conclude that dual-site anodal tDCS applied to the M1 enhanced attention performance while tDCS targeting the DLPFC increased risk propensity in a decision-making task during sports fatigue in elite soccer athletes. However, dual-site anodal tDCS targeting either the M1 or DLPFC did not significantly influence working memory performance during sports fatigue in this population. These preliminary findings suggest that dual-site tDCS targeting the M1 has beneficial effects on attention performance, potentially informing future research on sports fatigue in athletes.

CLINICAL TRIAL REGISTRATION

No: NCT06594978. Registered 09 September, 2024; https://clinicaltrials.gov/search?cond=NCT06594978.

Time Estimation Following an Exhaustive Exercise

Background/Objectives: Time estimation was investigated in 24 healthy adults, including 12 women and 12 men, before and after an exhaustive exercise. Methods: We compared the ability of estimating time intervals in the range 1 to 5 s using tasks requiring mental counting and tasks that did not allow it. Time estimation and blood lactate levels were evaluated before and at the end of the exercise. Results: We found that the perception of time intervals between 1 and 5 s was affected at the end of the exercise. The observed effects, associated with a significant increase in blood lactate levels, were different in the two types of time estimation used in the present study. When participants had to evaluate the duration of the time interval using mental counting, a significant reduction in the overestimation of time made at rest was observed at the end of exercise. On the other hand, when participants had to assess the difference in duration between two events without the possibility of mental counting, a significant deterioration in performance was observed at the end of the exercise. In both cases, no differences were seen between genders. Conclusions: It could be hypothesized that an increase in blood lactate, acting as a type of physiological arousal, could contribute to the distortion of perceived time intervals. On the other hand, it does not yet seem possible to propose a model to explain the worsening of the perception of time when mental counting is not possible.

Fractional utilization of the 10-minute treadmill test velocity in running performance

This study aimed to evaluate the applicability of the 10-minute submaximal treadmill test (T10 test), a self-paced test, in determining critical speed (CS) and predicting running performance. Specifically, we sought to identify the percentage of T10 velocity (vT10) that runners performed in official distance races, and to compare physiological and performance indicators between sexes. 60 recreational runners (n=34 males and n=26 females) underwent a maximum incremental test, the novel T10 test, and ran 1200-m and 2400-m on the track. Runners self-reported their best performance times. Generalized Linear Model was used to compare running performances between sexes. For both males and females, the %vT10 in 5 km, 10 km, and half-marathon races occurred at 107.5% and 106.5%, 99.9% and 100.8%, and 92.6% and 97.1%, respectively. There was no interaction effect (p=0.520) and no main effect of sex (p=0.443). There was a main effect of distance (p<0.001), indicating that %vT10 in the 5km race differed from that found in the 10 km race (p=0.012), as well as in the half-marathon (p<0.001). Our findings suggest that %vT10 values can be used to determine pace in recreational endurance runners for race distances regardless of sex.

The impact of sleep disorders on brain network connectivity in postpartum women: a functional near-infrared spectroscopy-based study

Sleep disorder is an important risk factor for postpartum depression. Although previous research has explored brain activity in postpartum depression, it has not fully revealed how insomnia affect mood by altering interactions between brain regions. This study aim to investigate the relationship between insomnia and depressive status in postpartum women, utilizing functional near-infrared spectroscopy (fNIRS) to explore brain network topological properties. Among 143 postpartum women, 40 were diagnosed with insomnia and 103 without. The results indicated that the Edinburgh Postnatal Depression Scale (EPDS) scores were significantly higher in the insomnia group compared to the control group. Compared with the control group, the insomnia group showed significantly increased connection strength of triangularis Broca's between middle and superior temporal gyrus and left between right dorsolateral prefrontal cortex (p < 0.001). Brain network topological analysis revealed that the small-world properties, clustering coefficient (p = 0.009), and local efficiency (p = 0.009) were significantly lower in the insomnia group compared to the control group. Notably, the local efficiency and clustering coefficient of the left temporal pole were significantly reduced and negatively correlated with EPDS scores. These findings elucidate how insomnia may exacerbate postpartum depression through changes in brain network properties. While the observed alterations in connectivity suggest a correlation, causation cannot be definitively established. Improving sleep quality remains a promising intervention, but further research is needed to clarify causal links and therapeutic targets.

Physical activity indexed using table tennis skills modulates the neural dynamics of involuntary retrieval of negative memories

Memory intrusion is a characteristic of posttraumatic stress disorder manifesting as involuntary flashbacks of negative events. Interference of memory reconsolidation using cognitive tasks has been employed as a noninvasive therapy to prevent subsequent intrusive retrieval. The present study aims to test whether physical activity, with its cognitive demands and unique physiological effects, may provide a novel practice to reduce later involuntary retrieval via the reconsolidation mechanism. In addition, the study investigates the EEG representation of neural function in interpreting the interplay of intrusion and recognition. Eighty-seven participants were tested on successive sessions comprised encoding (Day 0), reconsolidation (24-hr) and priming retrieval (Day 7) in a between-subject design with random assignment to 3 different groups: whole-body exercise, sensorimotor engagement and sitting groups. Of the key results, when involuntary retrieval was subsequently triggered by relevant stimuli, reduced subjective recognition was observed, and working memory maintenance was shortened, indicated by shorter Negative Slow Wave duration. The study implicates the potential neurophysiological mechanism of cognitive and behavioral interventions, specifically those aimed at reducing intrusion frequency through the reconsolidation mechanism; these are proposed to facilitate accelerated recovery from involuntary memories.

Examining the relationship between subjective exercise tolerance and psychophysiological reactivity during physical stress

It has been hypothesized that one's ability to control impulses aids in sustaining effort despite experiencing painful physical sensations. Physical exercise has been used extensively as an intervention to strengthen the inhibitory control system and protect an individual's cognitive plan of action. It is unclear, however, whether the high levels of exercise tolerance could facilitate inhibitory control under varied stressors. The present study explored the relationship between subjective exercise tolerance and psychophysiological characteristics that indicate reactivity capacity when exposed to the cold pressor test. Thirty-six participants were divided into two groups based on their subjective exercise tolerance profiles. During the test, participants' psychophysiological reactivity was monitored via heart rate variability. Participants were also required to answer questions about their perceptual and affective states at the beginning and immediately after the stress test. The study revealed insights into dominance perception and emotional states among individuals with varying subjective exercise tolerance levels. High-tolerant individuals endured physical discomfort longer (~50 s) and exhibited higher perceived dominance at the outset of the test when compared to their low-tolerant counterparts. Despite differences in task performance, both groups experienced more positive affective states post-task, potentially as a result of a heightened sense of self-accomplishment. Notably, both groups showed similar levels of psychophysiological reactivity, suggesting a protective effect of physical tolerance on ensuing biological responses. Overall, this study sheds light on the complex relationship between exercise tolerance, dominance perception, and psychophysiological reactivity during physically demanding tasks, enriching our understanding of how developing physical tolerance may impact inhibitory control under stress.

Circadian Rhythm and Physical Fatigue Separately Influence Cognitive and Physical Performance in Amateur Athletes

BACKGROUND/OBJECTIVES

Circadian rhythm (CR) influences various physiological functions, including physical and cognitive performance, which fluctuate throughout the day. The present study aimed to investigate the combined and separate effects of CR and physical fatigue on cognitive and physical performance.

METHODS

A sample of 18 amateur athletes was subjected to a series of tests at three different times of the day: morning, afternoon, and evening. Fatigue was induced following an isokinetic concentric exercise combined with a 20 min treadmill run, followed by assessments of selected physical and cognitive tasks.

RESULTS

A repeated measure ANOVA did not reveal an interaction between CR and fatigue in cognitive performance (p > 0.05). However, a significant main effect of fatigue was observed in visual reaction time (VisRT) across all three timepoints. Moreover, peak torque (PT) and the peak torque fatigue index (PTFI) showed significant differences between the three times of the day, peaking in the evening.

CONCLUSIONS

Although we found no interaction between CR and the physical fatigue state on selected cognitive parameters at the three times of the day, a separate effect of fatigue on cognitive performance was identified. Additionally, physical parameters exhibited peak values occurring in the evening hours. Future research should further explore underlying mechanisms that potentially influence cognitive performance at different times of the day.

Determinants of exercise adherence in sedentary middle-aged and older adults

Regular exercise positively impacts neurocognitive health, particularly in aging individuals. However, low adherence, particularly among older adults, hinders the adoption of exercise routines. While brain plasticity mechanisms largely support the cognitive benefits of exercise, the link between physiological and behavioral factors influencing exercise adherence remains unclear. This study aimed to explore this association in sedentary middle-aged and older adults. Thirty-one participants underwent an evaluation of cortico-motor plasticity using transcranial magnetic stimulation (TMS) to measure changes in motor-evoked potentials following intermittent theta-burst stimulation (iTBS). Health history, cardiorespiratory fitness, and exercise-related behavioral factors were also assessed. The participants engaged in a 2-month supervised aerobic exercise program, attending sessions three times a week for 60 min each, totaling 24 sessions at a moderate-to-vigorous intensity. They were divided into Completers (n = 19), who attended all sessions, and Dropouts (n = 12), who withdrew early. Completers exhibited lower smoking rates, exercise barriers, and resting heart rates compared to Dropouts. For Completers, TMS/iTBS cortico-motor plasticity was associated with better exercise adherence (r = -.53, corrected p = .019). Exploratory hypothesis-generating regression analysis suggested that post-iTBS changes (β = -7.78, p = .013) and self-efficacy (β = -.51, p = .019) may predict exercise adherence (adjusted-R2 = .44). In conclusion, this study highlights the significance of TMS/iTBS cortico-motor plasticity, self-efficacy, and cardiovascular health in exercise adherence. Given the well-established cognitive benefits of exercise, addressing sedentary behavior and enhancing self-efficacy are crucial for promoting adherence and optimizing brain health. Clinicians and researchers should prioritize assessing these variables to improve the effectiveness of exercise programs.

Altered functional connectivity of primary olfactory cortex-hippocampus-frontal cortex in subjective cognitive decline during odor stimulation

Subjective cognitive decline (SCD) is a high-risk population in the preclinical stage of Alzheimer's disease (AD), and olfactory dysfunction is a risk factor for dementia progression. The present study aimed to explore the patterns of functional connectivity (FC) changes in the olfactory neural circuits during olfactory stimulation in SCD subjects. A total of 56 SCD subjects and 56 normal controls (NCs) were included. All subjects were assessed with a cognitive scale, an olfactory behavior test, and olfactory task-based functional magnetic resonance imaging scanning. The FC differences in olfactory neural circuits between the two groups were analyzed by the generalized psychophysiological interaction. Additionally, we calculated and compared the activation of brain regions within the olfactory neural circuits during odor stimulation, the volumetric differences in brain regions showing FC differences between groups, and the correlations between neuroimaging indicators and olfactory behavioral and cognitive scale scores. During odor stimulation, the FC between the bilateral primary olfactory cortex (bPOC) and the right hippocampus in the SCD group was significantly reduced; while the FC between the right hippocampus and the right frontal cortex was significantly increased in the SCD group. The bPOC of all subjects showed significant activation, but no significant difference in activation between groups was found. No significant differences were observed in the volume of the brain regions within the olfactory neural circuits or in olfactory behavior between groups. The volume of the bPOC and right frontal cortex was significantly positively correlated with olfactory identification, and the volume of the right frontal cortex and right hippocampus was significantly correlated with cognitive functions. Furthermore, a significant correlation between the activation of bPOC and the olfactory threshold was found in the whole cohort. These results suggested that while the structure of the olfactory neural circuits and olfactory behavior in SCD subjects remained stable, there were significant changes observed in the FC of the olfactory neural circuits (specifically, the POC-hippocampus-frontal cortex neural circuits) during odor stimulation. These findings highlight the potential of FC alterations as sensitive imaging markers for identifying high-risk individuals in the early stage of AD.

One-HIIT wonder: Can music make high-intensity interval training more pleasant?

The use of music as an aid to recovery during and after exercise is an area of growing scientific interest. We investigated the effects of in-task, asynchronous music and respite-active music (i.e., music used for active recovery in between high-intensity exercise bouts) on a range of psychological, psychophysical and psychophysiological outcomes. Participants (N = 28; 14 females) made five laboratory visits for: (a) pre-test/familiarisation; (b) fast-tempo music during supramaximal exercise bouts and medium-tempo music during active-recovery periods; (c) fast-tempo music during exercise and no music during recovery; (d) no music during exercise and medium-tempo music during recovery; and (e) a no-music (throughout) control. A cycle ergometer-based HIIT protocol comprising 6 × 60-s bouts at 100% Wmax with 75-s active recovery was administered. Measures were taken at the end of supramaximal bouts and active recovery periods (RPE, state attention, core affect, state motivation), then upon cessation of the protocol (remembered pleasure and exercise enjoyment). Heart rate and heart rate variability (HRV) measures were taken throughout. The music manipulations only had an effect on state motivation, which was higher (p = 0.036) in the fast tempo-medium tempo condition compared to no-music control (Cohen's d = 0.49), and the SDNN component of HRV, which was lower (p = 0.007) in the fast-tempo-no-music condition compared to control (Cohen's d = 0.32). Collectively, the present findings do not support any of the study hypotheses regarding the music-related manipulations, and do not concur with the findings of related studies (e.g., Karageorghis et al., 2021). The unexpected results are discussed with reference to extant theory, and recommendations are offered in regard to music-related applications.

Adenosine A2A and dopamine D2 receptor interaction controls fatigue resistance

Introduction: Caffeine and the selective A2A receptor antagonist SCH58261 both have ergogenic properties, effectively reducing fatigue and enhancing exercise capacity. This study investigates in male Swiss mice the interaction between adenosine A2A receptors and dopamine D2 receptors controlling central fatigue, with a focus on the striatum where these receptors are most abundant. Methods: We employed DPCPX and SCH58261 to antagonize A1 and A2A receptors, caffeine as a non-competitive antagonist for both receptors, and haloperidol as a D2 receptor antagonist; all compounds were tested upon systemic application and caffeine and SCH58261 were also directly applied in the striatum. Behavioral assessments using the open field, grip strength, and treadmill tests allowed estimating the effect of treatments on fatigue. Results and discussion: The results suggested a complex interplay between the dopamine and adenosine systems. While systemic DPCPX had little effect on motor performance or fatigue, the application of either caffeine or SCH58261 was ergogenic, and these effects were attenuated by haloperidol. The intra-striatal administration of caffeine or SCH58261 was also ergogenic, but these effects were unaffected by haloperidol. These findings confirm a role of striatal A2A receptors in the control of central fatigue but suggest that the D2 receptor-mediated control of the ergogenic effects of caffeine and of A2A receptor antagonists might occur outside the striatum. This prompts the need of additional efforts to unveil the role of different brain regions in the control of fatigue.

Decreased grey matter volume in dorsolateral prefrontal cortex and thalamus accompanied by compensatory increases in middle cingulate gyrus of premature ejaculation patients

INTRODUCTION

The prefrontal-cingulate-thalamic areas are associated with ejaculation control. Functional abnormalities of these areas and decreased grey matter volume (GMV) in the subcortical areas have been confirmed in premature ejaculation (PE) patients. However, no study has explored the corresponding GMV changes in the prefrontal-cingulate-thalamic areas, which are considered as the important basis for functional abnormalities. This study aimed to investigated whether PE patients exhibited impaired GMV in the brain, especially the prefrontal-cingulate-thalamic areas, and whether these structural deficits were associated with declined ejaculatory control.

METHODS

T1-weighted structural magnetic resonance imaging (MRI) data were acquired from 50 lifelong PE patients and 50 age-, and education-matched healthy controls (HCs). The PE diagnostic tool (PEDT) was applied to assess the subjective symptoms of PE. Based on the method of voxel-based morphometry (VBM), GMV were measured and compared between groups. In addition, the correlations between GMV of brain regions showed differences between groups and PEDT scores were evaluated in the patient group.

RESULTS

PE patients showed decreased GMV in the right dorsolateral superior frontal gyrus (clusters = 13, peak T-values = -4.30) and left thalamus (clusters = 47, T = -4.33), and increased GMV in the left middle cingulate gyrus (clusters = 12, T = 4.02) when compared with HCs. In the patient group, GMV of the left thalamus were negatively associated with PEDT scores (r = -0.35; P = 0.01). Receiver operating characteristic (ROC) analysis showed that GMV of the right dorsolateral superior frontal gyrus (AUC = 0.71, P < 0.01, sensitivity = 60%, specificity = 78%), left thalamus (AUC = 0.72, P < 0.01, sensitivity = 92%, specificity = 46%) and middle cingulate gyrus (AUC = 0.69, P < 0.01, sensitivity = 50%, specificity = 90%), and the combined model (AUC = 0.84, P < 0.01, sensitivity = 78%, specificity = 80%) all had the ability to distinguish PE patients from HCs.

CONCLUSION

Disturbances in GMV were revealed in the prefrontal-cingulate-thalamic areas of PE patients. The findings implied that decreased GMV in the dorsolateral prefrontal cortex and thalamus might be associated with the central pathological neural mechanism underlying the declined ejaculatory control while increased GMV in the middle cingulate gyrus might be the compensatory mechanism underlying PE.

Catgut embedding in acupoints combined with repetitive transcranial magnetic stimulation for the treatment of postmenopausal osteoporosis: study protocol for a randomized clinical trial

Background

To date, the clinical modulation for bone metabolism based on the neuro-bone mass regulation theory is still not popular. The stimulation of nerve systems to explore novel treatments for Postmenopausal osteoporosis (PMOP) is urgent and significant. Preliminary research results suggested that changes brain function and structure may play a crucial role in bone metabolism with PMOP. Thus, we set up a clinical trial to investigate the effect of the combination of repetitive transcranial magnetic stimulation (rTMS) and catgut embedding in acupoints (CEA) for PMOP and to elucidate the central mechanism of this neural stimulation in regulating bone metabolism.

Method

This trial is a prospective and randomized controlled trial. 96 PMOP participants will be randomized in a 1:1:1 ratio into a CEA group, an rTMS group, or a combined one. Participants will receive CEA, rTMS, or combined therapy for 3 months with 8 weeks of follow-up. The primary outcomes will be the changes in Bone Mineral Density scores, total efficiency of Chinese Medicine Symptoms before and after treatment. Secondary outcomes include the McGill Pain Questionnaire Short-Form, Osteoporosis Symptom Score, Mini-Mental State Examination, and Beck Depression Inventory-II. The leptin, leptin receptor, and norepinephrine levels of peripheral blood must be measured before and after treatment. Adverse events that occur during the trial will be recorded.

Discussion

CEA achieves brain-bone mass regulation through the bottom-up way of peripheral-central while rTMS achieves it through the top-down stimulation of central-peripheral. CEA combined with rTMS can stimulate the peripheral-central at the same time and promote peripheral bone mass formation. The combination of CEA and rTMS may play a coordinating, synergistic, and side-effect-reducing role, which is of great clinical significance in exploring better treatment options for PMOP.Clinical trial registration: https://www.chictr.org.cn/, identifier ChiCTR2300073863.

Modulatory effects of aerobic training on the degree centrality of brain functional activity in subthreshold depression

BACKGROUND

Aerobic training has been shown to effectively prevent the progression of depressive symptoms from subthreshold depression (StD) to major depressive disorder (MDD), and understanding how aerobic training promotes changes in neuroplasticity is essential to comprehending its antidepressant effects. Few studies, however, have quantified the alterations in spontaneous brain activity before and after aerobic training for StD.

METHODS

Participants included 44 individuals with StD and 34 healthy controls (HCs). Both groups underwent moderate aerobic training for eight weeks, and resting state functional magnetic resonance imaging (rs-fMRI) data were collected before and after training. The degree centrality (DC) changes between the two groups and the DC changes in each group before and after training were quantified.

RESULTS

The rs-fMRI results showed that compared with the HCs, the DC values of the StD group in the orbital region of the left inferior frontal gyrus significantly depreciated at baseline. After aerobic training, the results of the follow-up examination revealed no significant difference in the DC values between the two groups. In addition, compared with baseline, the StD group exhibited an significant decrease in the DC values of the left dorsolateral superior frontal gyrus; while the HCs group exhibited an significant decrease in the DC values of the left thalamus. No statistically significant connection was seen between changes in DC values and psychological scale scores in the StD group.

CONCLUSIONS

Our findings suggest that regular aerobic training can enhance brain plasticity in StD. In addition, we demonstrated that DC is a relevant and accessible method for evaluating the functional plasticity of the brain induced by aerobic training in StD.

Effect of Repetitive Transcranial Magnetic Stimulation on Post-Stroke Comorbid Cognitive Impairment and Depression: A Randomized Controlled Trial

Background

There are currently no uniform treatments for post-stroke comorbid cognitive impairment and depression (PSCCID).

Objective

To verify whether repetitive transcranial magnetic stimulation (rTMS) can improve PSCCID symptoms and explore the underlying roles of resting-state functional magnetic resonance imaging (rs-fMRI).

Methods

Thirty PSCCID patients were randomized in a 1 : 1 ratio to receive 4 weeks of rTMS (intervention group) or sham rTMS (control group) over the left dorsolateral prefrontal cortex (DLPFC). rs-fMRI was acquired to analyze the functional plasticity of brain regions at baseline and immediately after the last intervention.

Results

Cognition, depression status, and neural electrophysiology were improved in both intervention and control groups after treatment (p = 0.015-0.042), and the intervention group had more significant improvement than the control group. Analysis of functional connectivities (FCs) within the default mood network (DMN) showed that the connection strength of the left temporal pole/left parahippocampal cortex and right lateral temporal cortex/right retrosplenial cortex in the intervention group were enhanced compared with its pre-intervention and that in the control group after treatment (p < 0.05), and the both FC values were positively correlated with MMSE scores (p < 0.001). The intervention group had stronger FCs within the DMN compared with the control group after treatment, and some of the enhanced FCs were correlated with the P300 latency and amplitude.

Conclusions

rTMS over the left DLPFC is an effective treatment for improving both cognitive impairment and depression among patients with PSCCID. The enhanced FCs within the DMN may serve as a compensatory functional recombination to promote clinical recovery.

Prefrontal cortex hemodynamic activity during a test of lower extremity functional muscle strength in children with cerebral palsy: A functional near-infrared spectroscopy study

Children with cerebral palsy (CP) exhibit impaired motor control and significant muscle weakness due to a brain lesion. However, studies that assess the relationship between brain activity and performance on dynamic functional muscle strength assessments in CP are needed. The aim of this study was to determine the effect of a progressive lateral step-up test on prefrontal cortex (PFC) hemodynamic activity in children with CP. Fourteen ambulatory children with spastic CP (Gross Motor Function Classification System level I; 5-11 y) and 14 age- and sex-matched typically developing control children completed a progressive lateral step-up test at incremental step heights (0, 10, 15 and 20 cm) using their non-dominant lower limb. Hemodynamic activity in the PFC was assessed using non-invasive, portable functional neuroimaging (functional near-infrared spectroscopy). Children with CP completed fewer repetitions at each step height and exhibited lower PFC hemodynamic activity across step heights compared to controls. Lower PFC activation in CP was maintained after statistically controlling for the number of repetitions completed at each step height. PFC hemodynamic activity was not associated with LSUT task performance in children with CP, but a positive relationship was observed in controls at the most challenging 20 cm step height. The results suggest there is an altered PFC recruitment pattern in children with CP during a highly dynamic test of functional strength. Further studies are needed to explore the mechanisms underlying the suppressed PFC activation observed in children with CP compared to typically developing children.

Electroencephalography spectral coherence analysis during cycle ergometry in low- and high-tolerant individuals

The main objective of this study was to further understanding of the patterns of spectral connectivity during exercise in low- and high-tolerant individuals. Thirty-nine healthy individuals (i.e., 17 low- and 22 high-tolerant participants) took part in the present study. A state-of-the-art portable electroencephalography system was used to measure the brain's electrical activity during an incremental exercise test performed until the point of volitional exhaustion on a cycle ergometer. Spectral coherence was used to explore the patterns of connectivity in the frontal, central, and parietal regions of the brain. Physiological, perceptual, and affective responses were assessed throughout the exercise bout. The spontaneous eyeblink rate was also calculated prior to commencement and upon completion of the exercise trial as an indirect assessment of the dopaminergic system. The present findings indicate that high-tolerant individuals reported lower levels of perceived activation, especially during the preliminary stages of the exercise test. Participants in the high-tolerance group also reported greater levels of remembered pleasure upon completion of the exercise test. The data also revealed that high-tolerant individuals exhibited increased connectivity of theta waves between frontal, central, and parietal electrode sites and increased connectivity of beta waves, primarily within the parietal cortex. Correlational analysis indicated the possibility that low- and high-tolerant individuals make use of different neural networks to process and regulate their psychophysiological state during exercise-related situations. This strategy could potentially represent a conscious decision to downregulate affective arousal and facilitate the neural control of working muscles during situations of physical stress.

Prefrontal activation in response to a plantar contact task under open and closed eye conditions in patients with cerebral infarction

Objective

This study investigates the effect of a bilateral (paralyzed side, healthy side) plantar contact task on dorsolateral prefrontal activation in patients recovering from cerebral infarction under open and closed eye conditions.

Methods

We selected 10 patients with cerebral infarction, admitted to the neurorehabilitation center of Beijing Rehabilitation Hospital, affiliated with Capital Medical University, from January 2019 to July 2020, who met our established criteria. Under open-eye and closed-eye conditions, the paralyzed and healthy sides performed the plantar contact tasks separately. The dorsolateral prefrontal region was monitored simultaneously with functional near-infrared spectroscopy (fNIRS), and activation was analyzed according to the curve-type changes of oxyhemoglobin and deoxyhemoglobin changes in the dorsolateral prefrontal cortex with 560 near-infrared monitoring channels.

Results

After stratifying the data based on the eyes-open and eyes-closed conditions, some degree of heterogeneity was observed between the layers. Under the eyes-closed condition, the Pearson χ2 was 0.142, with a p value of 0.706, indicating no significant impact of the eyes-closed condition on the activation of the dorsolateral prefrontal cortex during the plantar task, whether performed on the paralyzed or the healthy side.In contrast, the Pearson χ2 value was 15.15 for the eyes-open condition, with a p value of 0.002. This suggests that carrying out the plantar task, either on the paralyzed or the healthy side, with eyes open significantly influenced the activation of the dorsolateral prefrontal cortex. Furthermore, activation of the dorsolateral prefrontal cortex was 1.55 times higher when the task was executed with the paralyzed side compared to the healthy side. This implies that the paralyzed side was more likely to activate the dorsolateral prefrontal lobe when performing the plantar contact task under eyes-open conditions.

Conclusion

Observations via fNIRS revealed that the plantar contact task elicited dorsolateral prefrontal cortex activation. Moreover, the activation effect was intensified when performed on the paralyzed side under eyes-open conditions. Therapeutic methods that leverage these findings-namely cognitive-motor therapies that promote the recovery of motor functions by activating cognitive control brain regions via perception (information construction)-may hold promise.

Evaluation of volumetric asymmetry of the dorsolateral prefrontal cortex and medial temporal lobe in Alzheimer's disease using the atlas-based method

Brain areas affected during neurodegenerative disease progression are considered anatomically connected to the first affected areas. The dorsolateral prefrontal cortex (DLPFC) has connections with the medial temporal lobe (MTL), which includes regions that become atrophic in Alzheimer's disease. In this study, we aimed to investigate the degree of volumetric asymmetry of DLPFC and MTL structures. This is a cross-sectional volumetric study involving 25 Alzheimer's disease patients and 25 healthy adults who underwent MRI with a 3D turbo spin echo sequence at 1.5 Tesla. The atlas-based method incorporated MRIStudio software to automatically measure the volume of brain structures. We compared the asymmetry index and volumetric changes across study groups and correlated them with Mini-Mental State Examination scores. We observed significant volumetric rightward lateralization in the DLPFC and superior frontal gyrus in Alzheimer's disease patients compared to the healthy controls. There was a significant volume loss in the MTL structures of Alzheimer's disease patients. Atrophy of MTL structures was positively correlated with right DLPFC volume changes in Alzheimer's disease patients. Volumetric asymmetry of the DLPFC may be a characteristic for determining disease progression in Alzheimer's disease patients. Future studies are recommended to evaluate whether these volumetric asymmetrical changes are specific to Alzheimer's disease and whether asymmetry measurements can serve as diagnostic markers.

Effect of tDCS targeting the M1 or left DLPFC on physical performance, psychophysiological responses, and cognitive function in repeated all-out cycling: a randomized controlled trial

BACKGROUND

Despite reporting the positive effects of transcranial direct current stimulation (tDCS) on endurance performance, very few studies have investigated its efficacy in anaerobic short all-out activities. Moreover, there is still no consensus on which brain areas could provide the most favorable effects on different performance modalities. Accordingly, this study aimed to investigate the effects of anodal tDCS (a-tDCS) targeting the primary motor cortex (M1) or left dorsolateral prefrontal cortex (DLPFC) on physical performance, psychophysiological responses, and cognitive function in repeated all-out cycling.

METHODS

In this randomized, crossover, and double-blind study, 15 healthy physically active men underwent a-tDCS targeting M1 or the left DLPFC or sham tDCS in separate days before performing three bouts of all-out 30s cycling anaerobic test. a-tDCS was applied using 2 mA for 20 min. Peak power, mean power, fatigue index, and EMG of the quadriceps muscles were measured during each bout. Heart rate, perceived exertion, affective valence, and arousal were recorded two minutes after each bout. Color-word Stroop test and choice reaction time were measured at baseline and after the whole anaerobic test.

RESULTS

Neither tDCS montage significantly changed peak power, mean power, fatigue index, heart rate, affective valence, arousal, and choice reaction time (p> 0.05). a-tDCS over DLPFC significantly lowered RPE of the first bout (compared to sham; p=0.048, Δ=-12.5%) and third bout compared to the M1 (p=0.047, Δ=-12.38%) and sham (p=0.003, Δ=-10.5%), increased EMG of the Vastus Lateralis muscle during the second (p=0.016, Δ= +40.3%) and third bout (p=0.016, Δ= +42.1%) compared to sham, and improved the score of color-word Stroop test after the repeated all-out task (p=0.04, Δ= +147%). The qualitative affective response (valence and arousal) was also higher under the M1 and DLPFC compared to the sham.

CONCLUSION

We concluded that tDCS targeting M1 or DLPFC does not improve repeated anaerobic performance. However, the positive effect of DLPFC montage on RPE, EMG, qualitative affective responses, and cognitive function is promising and paves the path for future research using different tDCS montages to see any possible effects on anaerobic performance.

TRIAL REGISTRATION

This study was approved by the Ethics Committee of Razi University (IR.RAZI.REC.1400.023) and registered in the Iranian Registry of Clinical Trials (IRCT id: IRCT20210617051606N5; Registration Date: 04/02/2022).

Effects of excitatory transcranial magnetic stimulation over the different cerebral hemispheres dorsolateral prefrontal cortex for post-stroke cognitive impairment: a systematic review and meta-analysis

Background

Post-stroke cognitive impairment (PSCI) is a significant health concern. Transcranial magnetic stimulation (TMS) is considered a promising rehabilitation therapy for improving cognition, and the effects of excitatory TMS on PSCI have received much attention in recent years. However, the effects of different cerebral hemispheres on excitatory TMS treatment of cognitive impairment have not been studied. This review aimed to study the effects of excitatory TMS over the dorsolateral prefrontal cortex (DLPFC) of different cerebral hemispheres on the cognitive function of patients with PSCI.

Methods

Literature published in PubMed, Web of Science, Embase, Cochrane Library, Scopus, and Wiley from inception to September 30, 2022, were searched. Two researchers independently performed literature screening, data extraction, and quality assessment. Furthermore, we conducted a meta-analysis using RevMan software (version 5.4) and rated the strength of evidence using GRADEpro.

Results

A total of 19 studies were included in this meta-analysis. The results showed that excitatory TMS over the left hemisphere DLPFC was significantly better in improving global cognition (SMD = 2.26, 95% CI 1.67-2.86, P < 0.00001; vs. SMD = 2.53, 95% CI 1.86-3.20, P < 0.00001), memory (SMD = 1.29, 95% CI 0.72-1.87, P < 0.0001), attention (SMD = 2.32, 95% CI 1.64-3.01, P < 0.00001), executive (SMD = 0.64, 95% CI 0.21-1.07, P = 0.004), P300 latency (SMD = 2.69, 95% CI 2.13-3.25, P < 0.00001), and depression (SMD = 0.95, 95% CI 0.26-1.63, P = 0.007) than that of the control group, but the effect on improving activities of daily living (ADL) was unclear (P = 0.03 vs. P = 0.17). Subgroup analysis further showed that excitatory TMS over the right hemisphere DLPFC was effective in improving the global cognition of PSCI patients (P < 0.00001), but the stimulation effect over the ipsilateral hemisphere DLPFC was unclear (P = 0.11 vs. P = 0.003). Additionally, excitatory TMS over the ipsilateral hemisphere DLPFC showed no statistical difference in improving ADL between the two groups (P = 0.25).

Conclusions

Compared to other hemispheric sides, excitatory TMS over the left hemisphere DLPFC was a more effective stimulation area, which can significantly improved the global cognitive function, memory, attention, executive, P300 latency, and depression in patients with PSCI. There was no apparent therapeutic effect on improving activities of daily living (ADL). In the future, more randomized controlled trials with large-sample, high quality, and follow-up are necessary to explore a usable protocol further.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier: CRD42022369096.

A neurocognitive perspective on the relationship between exercise and reward: Implications for weight management and drug addiction

The impact of exercise on food reward is increasingly being discussed as an interplay between executive function (EF), homeostasis and mechanisms promoting or undermining intentional behaviour change. Integrating current knowledge of neurocognitive processes encompassing cognitive and affective networks within an energy balance framework will provide a more comprehensive account. Reward circuitry affected by recreational drugs and food overlap. Therefore the underlying processes explaining changes in drug-taking behaviour may offer new insights into how exercise affects the reward value of recreational drugs and food. EF is important for successful self-regulation, and training EF may boost inhibitory control in relation to food- and drug-related reward. Preclinical and clinical observations suggest that reward-seeking can transfer within and between categories of reward. This may have clinical implications beyond exercise improving metabolic health in people with obesity to understanding therapeutic responses to exercise in people with neurocognitive deficits in non-food reward-based decision making such as drug dependence.