Artificial intelligence-based prescription of personalized scalp cosmetics improved the scalp condition: efficacy results from 100 participants

Background: Scalp-related symptoms such as dandruff and itching are common with diverse underlying etiologies. We previously proposed a novel classification and scoring system for scalp conditions, called the scalp photographic index (SPI); it grades five scalp features using trichoscopic images with good reliability. However, it requires trained evaluators.Aim: To develop artificial intelligence (AI) algorithms for assessment of scalp conditions and to assess the feasibility of AI-based recommendations on personalized scalp cosmetics.Methods: Using EfficientNet, convolutional neural network (CNN) models (SPI-AI) ofeach scalp feature were established. 101,027 magnified scalp images graded according to the SPI scoring were used for training, validation, and testing the model Adults with scalp discomfort were prescribed shampoos and scalp serums personalized according to their SPI-AI-defined scalp types. Using the SPI, the scalp conditions were evaluated at baseline and at weeks 4, 8, and 12 of treatment.Results: The accuracies of the SPI-AI for dryness, oiliness, erythema, folliculitis, and dandruff were 91.3%, 90.5%, 89.6%, 87.3%, and 95.2%, respectively. Overall, 100 individuals completed the 4-week study; 43 of these participated in an extension study until week 12. The total SPI score decreased from 32.70 ± 7.40 at baseline to 15.97 ± 4.68 at week 4 (p < 0.001). The efficacy was maintained throughout 12 weeks.Conclusions: SPI-AI accurately assessed the scalp condition. AI-based prescription of tailored scalp cosmetics could significantly improve scalp health.

The impact of simultaneous intracranial recordings on scalp EEG: A finite element analysis

BACKGROUND

In this study, we examined the utility of simultaneous scalp and stereotactic intracranial electroencephalography (SSIEEG) in epilepsy patients. Although SSIEEG offers valuable insights into epilepsy and cognitive function, its routine use is uncommon. Challenges include interpreting post-craniotomy scalp EEG due to surgically implanted electrodes.

NEW METHOD

We describe our methodology for conducting SSIEEG recordings. To simulate the potential impact on EEG interpretation, we computed the leadfield of scalp electrodes with and without burrholes using Finite Element Analysis to compare the resulting sensitivity volume and waveforms of simulated intracranial signals between skulls with and without burrholes.

RESULTS

The presence of burr holes in the skull layer of the leadfield models did not discernibly modify simulated waveforms or scalp EEG topology. Using realistic SEEG burr hole diameter, the difference in the average leadfield of scalp electrodes was 0.12% relative to the effect of switching two nearby electrodes, characterized by the cosine similarity difference. No patients experienced adverse events related to SSIEEG.

COMPARISON WITH EXISTING METHODS

Although there is increasing acceptance and interest in SSIEEG, few studies have characterized the technical feasibility. Here, we demonstrate through modelling that scalp recordings from SSIEEG are comparable to that through an intact skull.

CONCLUSION

The placement and simultaneous acquisition of scalp EEG during invasive monitoring through stereotactically inserted EEG electrodes is routinely performed at the Hospital for Sick Children. Scalp EEG recordings may assist with clinical interpretation. Burr holes in the skull layer did not discernibly alter EEG waveforms or topology.

Effect of Stimulus Bandwidth on the Auditory Steady-State Response in Scalp- and Ear-EEG

OBJECTIVES

The auditory steady-state response (ASSR) enables hearing threshold estimation based on electroencephalography (EEG) recordings. The choice of stimulus type has an impact on both the detectability and the frequency specificity of the ASSR. Amplitude modulated pure tones provide the most frequency-specific ASSR, but responses to pure tones are weak. The ASSR can be enhanced by increasing the bandwidth of the stimulus, but this comes at the cost of a decrease in the frequency specificity of the measured response. The objective of the present study is to investigate the relationship between stimulus bandwidth and ASSR amplitude.

DESIGN

The amplitude of ASSR was measured for five types of stimuli: 1 kHz pure tone and band-pass noise with 1/3, 1/2, 1, and 2 octave bandwidths centered at 1 kHz. All stimuli were amplitude modulated with a 40 Hz sinusoid. Responses to all stimulus types were measured at 30, 40, and 50 dB SL. ASSRs were measured concurrently using both conventional scalp-EEG and ear-EEG.

RESULTS

Stimulus bandwidth and sound intensity were both found to have a significant effect on the ASSR amplitude for scalp- and ear-EEG recordings. In scalp-EEG ASSRs to all bandwidth stimuli were found to be significantly larger than ASSRs to pure tone at low sound intensity. At higher sound intensities, however, significantly larger responses were only obtained for 1- and 2-octave bandwidth stimuli. In ear-EEG, only the ASSR to 2 octave bandwidth stimulus was significantly larger than the ASSR to amplitude modulated pure tones.

CONCLUSIONS

At low presentation levels, even small increases in stimulus bandwidth (1/3 and 1/2 octave) improve the detectability of ASSR in scalp-EEG with little or no impact on the frequency specificity. In comparison, a larger increase in stimulus bandwidth was needed to improve the ASSR detectability in the ear-EEG recordings.

Automatic Detection of Scalp High-Frequency Oscillations Based on Deep Learning

Scalp high-frequency oscillations (sHFOs) are a promising non-invasive biomarker of epilepsy. However, the visual marking of sHFOs is a time-consuming and subjective process, existing automatic detectors based on single-dimensional analysis have difficulty with accurately eliminating artifacts and thus do not provide sufficient reliability to meet clinical needs. Therefore, we propose a high-performance sHFOs detector based on a deep learning algorithm. An initial detection module was designed to extract candidate high-frequency oscillations. Then, one-dimensional (1D) and two-dimensional (2D) deep learning models were designed, respectively. Finally, the weighted voting method is used to combine the outputs of the two model. In experiments, the precision, recall, specificity and F1-score were 83.44%, 83.60%, 96.61% and 83.42%, respectively, on average and the kappa coefficient was 80.02%. In addition, the proposed detector showed a stable performance on multi-centre datasets. Our sHFOs detector demonstrated high robustness and generalisation ability, which indicates its potential applicability as a clinical assistance tool. The proposed sHFOs detector achieves an accurate and robust method via deep learning algorithm.

Intracerebral Dynamics of Sleep Arousals: A Combined Scalp-Intracranial EEG Study

As an intrinsic component of sleep architecture, sleep arousals represent an intermediate state between sleep and wakefulness and are important for sleep-wake regulation. They are defined in an all-or-none manner, whereas they actually present a wide range of scalp-electroencephalography (EEG) activity patterns. It is poorly understood how these arousals differ in their mechanisms. Stereo-EEG (SEEG) provides the unique opportunity to record intracranial activities in superficial and deep structures in humans. Using combined polysomnography and SEEG, we quantitatively categorized arousals during nonrapid eye movement sleep into slow wave (SW) and non-SW arousals based on whether they co-occurred with a scalp-EEG SW event. We then investigated their intracranial correlates in up to 26 brain regions from 26 patients (12 females). Across both arousal types, intracranial theta, alpha, sigma, and beta activities increased in up to 25 regions (p < 0.05; d = 0.06-0.63), while gamma and high-frequency (HF) activities decreased in up to 18 regions across the five brain lobes (p < 0.05; d = 0.06-0.44). Intracranial delta power widely increased across five lobes during SW arousals (p < 0.05 in 22 regions; d = 0.10-0.39), while it widely decreased during non-SW arousals (p < 0.05 in 19 regions; d = 0.10-0.30). Despite these main patterns, unique activities were observed locally in some regions such as the hippocampus and middle cingulate cortex, indicating spatial heterogeneity of arousal responses. Our results suggest that non-SW arousals correspond to a higher level of brain activation than SW arousals. The decrease in HF activities could potentially explain the absence of awareness and recollection during arousals.

Mechanical epilation exerts complex biological effects on human hair follicles and perifollicular skin: An ex vivo study approach

OBJECTIVE

Electrical epilation of unwanted hair is a widely used hair removal method, but it is largely unknown how this affects the biology of human hair follicles (HF) and perifollicular skin. Here, we have begun to explore how mechanical epilation changes selected key biological read-out parameters ex vivo within and around the pilosebaceous unit.

METHODS

Human full-thickness scalp skin samples were epilated ex vivo using an electro-mechanical device, organ-cultured for up to 6 days in serum-free, supplemented medium, and assessed at different time points by quantitative (immuno-)histomorphometry for selected relevant read-out parameters in epilated and sham-epilated control samples.

RESULTS

Epilation removed most of the hair shafts, often together with fragments of the outer and inner root sheath and hair matrix. This was associated with persistent focal thinning of the HF basal membrane, decreased melanin content of the residual HF epithelium, and increased HF keratinocyte apoptosis, including in the bulge, yet without affecting the number of cytokeratin 15+ HF epithelial stem cells. Sebocyte apoptosis in the peripheral zone was increased, albeit without visibly altering sebum production. Epilation transiently perturbed HF immune privilege, and increased the expression of ICAM-1 in the bulge and bulb mesenchyme, and the number of perifollicular MHC class II+ cells as well as mast cells around the distal epithelium and promoted mast cell degranulation around the suprabulbar and bulbar area. Moreover, compared to controls, several key players of neurogenic skin inflammation, itch, and/or thermosensation (TRPV1, TRPA1, NGF, and NKR1) were differentially expressed in post-epilation skin.

CONCLUSION

These data generated in denervated, organ-cultured human scalp skin demonstrate that epilation-induced mechanical HF trauma elicits surprisingly complex biological responses. These may contribute to the delayed re-growth of thinner and lighter hair shafts post-epilation and temporary post-epilation discomfort. Our findings also provide pointers regarding the development of topically applicable agents that minimize undesirable sequelae of epilation.

Enhancing assisted diagnostic accuracy in scalp psoriasis: A Multi-Network Fusion Object Detection Framework for dermoscopic pattern diagnosis

BACKGROUND

Dermoscopy is a common method of scalp psoriasis diagnosis, and several artificial intelligence techniques have been used to assist dermoscopy in the diagnosis of nail fungus disease, the most commonly used being the convolutional neural network algorithm; however, convolutional neural networks are only the most basic algorithm, and the use of object detection algorithms to assist dermoscopy in the diagnosis of scalp psoriasis has not been reported.

OBJECTIVES

Establishment of a dermoscopic modality diagnostic framework for scalp psoriasis based on object detection technology and image enhancement to improve diagnostic efficiency and accuracy.

METHODS

We analyzed the dermoscopic patterns of scalp psoriasis diagnosed at 72nd Group army hospital of PLA from January 1, 2020 to December 31, 2021, and selected scalp seborrheic dermatitis as a control group. Based on dermoscopic images and major dermoscopic patterns of scalp psoriasis and scalp seborrheic dermatitis, we investigated a multi-network fusion object detection framework based on the object detection technique Faster R-CNN and the image enhancement technique contrast limited adaptive histogram equalization (CLAHE), for assisting in the diagnosis of scalp psoriasis and scalp seborrheic dermatitis, as well as to differentiate the major dermoscopic patterns of the two diseases. The diagnostic performance of the multi-network fusion object detection framework was compared with that between dermatologists.

RESULTS

A total of 1876 dermoscopic images were collected, including 1218 for scalp psoriasis versus 658 for scalp seborrheic dermatitis. Based on these images, training and testing are performed using a multi-network fusion object detection framework. The results showed that the test accuracy, specificity, sensitivity, and Youden index for the diagnosis of scalp psoriasis was: 91.0%, 89.5%, 91.0%, and 0.805, and for the main dermoscopic patterns of scalp psoriasis and scalp seborrheic dermatitis, the diagnostic results were: 89.9%, 97.7%, 89.9%, and 0.876. Comparing the diagnostic results with those of five dermatologists, the fusion framework performs better than the dermatologists' diagnoses.

CONCLUSIONS

Studies have shown some differences in dermoscopic patterns between scalp psoriasis and scalp seborrheic dermatitis. The proposed multi-network fusion object detection framework has higher diagnostic performance for scalp psoriasis than for dermatologists.

Reconstruction of large scalp defect in a brown howler monkey (Alouatta guariba clamitans): A case report

This case report describes different repair techniques used to reconstruct a large scalp defect in a brown howler monkey (Alouatta guariba clamitans) hit by a vehicle. Three reconstructive procedures were performed in two surgical stages. The repair techniques had successful outcomes on the patient's rehabilitation.

Efficacy and safety of botulinum toxin A in the treatment of female pattern hair loss

BACKGROUND

Female pattern hair loss (FPHL) is the most prevalent type of alopecia among adult women. Presently, topical minoxidil stands as the sole treatment endorsed by the FDA. Addressing cases of FPHL in individuals who develop contact dermatitis in response to minoxidil can pose a challenge for dermatologists.

OBJECTIVE

To assess the efficacy and safety of subcutaneous injections of Botulinum Toxin Type A (BTA) in treating FPHL.

METHODS

Enrolled outpatients with FPHL who exhibited an allergic reaction to minoxidil solution. Diagnosis of FPHL was established through clinical examination and trichoscopy. Inclusion criteria involved patients with no prior treatment within the last year and without any comorbidities. BTA, specifically 100 units, was mixed with 2 mL of 0.9% normal saline. Twenty injection target sites, spaced 2-3 cm apart, were symmetrically marked on the hairless area of the scalp. A dosage of five units was intradermally injected at each target site. Representative photographs and dermoscopic images of the scalp were captured before and after 3 months of treatment.

RESULTS

A total of 10 FPHL, aged between 26 and 40 years, were included. The average age was 30.3 ± 4.64 years, and all patients had a positive family history of Androgenetic Alopecia. The average duration of the disease was 3.70 ± 1.42 years. According to patients' self-assessment, after 1 month of treatment, 10 FPHL patients reported experiencing moderate to marked improvement in symptoms related to scalp oil secretion. Three months later, dermatological assessments showed that three had mild improvement, six had no change, and one had a worsening condition. No adverse effects were observed.

CONCLUSIONS

Our study suggests that the effectiveness of BTA for FPHL is limited to 3 months. However, it can be considered for tentative use after effective communication with patients. The long-term efficacy and safety of BTA in treating FPHL require further observation and study.

Scalp Eschar and Neck Lymphadenopathy Associated with Rickettsial Infection After a Tick Bite: A Case Report

N/a.

Efficacy of a wheat polar lipid complex in reducing hair loss and improving hair growth in healthy women: A randomized, double-blind, placebo-controlled clinical study

OBJECTIVE

Hair loss is a major source of psychological distress for affected people. Safe and natural ingredients are therefore needed to help reduce hair loss and stimulate hair growth. This pilot clinical study aimed at exploring the efficacy of a wheat polar lipid complex (WPLC, Ceramosides™), containing sphingolipids and digalactosyl diglycerides, on hair characteristics improvement in women showing acute hair shedding.

METHODS

Sixty-six women presenting a proportion of hair in the telogen phase greater than 15% were recruited and allocated to two groups, each including at least 10 postmenopausal women. For 84 days, participants consumed 30 mg/day of the WPLC supplement, or the placebo. Their hair characteristics were assessed after 56 and 84 days using phototrichogram evaluations of hairs in anagen/telogen phases, measuring hair shedding by a pull test, hair diameter and elongation at break point, hair growth and scalp sebum content. Hair density and volume were also clinically evaluated. All these parameters were also investigated in the subgroup of postmenopausal women.

RESULTS

WPLC supplementation decreased telogen hair density/proportion while increasing the anagen hair density/proportion. These effects were significant compared with the placebo as early as within 56 days. It also led to reduced hair shedding upon pull test analyses. If no changes were evidenced in hair diameter, WPLC improved hair growth and resistance to breakage after 84 days. Clinical evaluations also showed hair density and volume improvement. Furthermore, supplementation decreased scalp sebum content in women with oily hair. The beneficial effects were also observed in the subgroup of postmenopausal women. Finally, WPLC supplementation improved participants' perception of their hair conditions.

CONCLUSION

Through a reducing effect on hair shedding and a stimulating effect on hair reappearance and growth, WPLC dietary supplementation was shown to significantly reduce hair loss in women.

Deucravacitinib, a selective, allosteric tyrosine kinase 2 inhibitor, in scalp psoriasis: A subset analysis of two phase 3 randomized trials in plaque psoriasis

BACKGROUND

Scalp involvement in plaque psoriasis is challenging to treat.

OBJECTIVE

To evaluate the efficacy and safety of deucravacitinib (DEUC) in scalp psoriasis.

METHODS

POETYK PSO-1 and PSO-2 were global phase 3, 52-week, double-blinded trials in adults with moderate to severe psoriasis. Patients were randomized 1:2:1 to oral placebo, DEUC 6 mg once daily, or apremilast 30 mg twice daily. This pooled secondary analysis evaluated scalp-specific Physician Global Assessment score of 0 or 1 (0/1), ≥90% improvement from baseline in Psoriasis Scalp Severity Index, and change from baseline in Psoriasis Scalp Severity Index. Adverse events were evaluated through week 16.

RESULTS

Overall, 1084 patients with moderate to severe scalp psoriasis at baseline were included. At week 16, response rates were greater with DEUC versus placebo or apremilast for scalp-specific Physician Global Assessment 0/1 (64.0% vs 17.3% vs 37.7%; P < .0001), ≥90% improvement from baseline in Psoriasis Scalp Severity Index (50.6% vs 10.5% vs 26.1%; P < .0001), and change from baseline in Psoriasis Scalp Severity Index. Responses were maintained through 52 weeks with continuous DEUC. Safety was consistent with the entire study population.

LIMITATIONS

Lack of data in milder scalp psoriasis.

CONCLUSION

DEUC was significantly more efficacious than placebo or apremilast in improving moderate to severe scalp psoriasis and was well tolerated.

Weekly hair washing: The recommended solution for women with afro-textured hair to alleviate dandruff and scalp discomfort

Dandruff and scalp discomfort are common concerns for women and men in Africa. Moreover, women with afro-textured hair are prone to scalp discomfort owing to irregular hair washing, frequent use of oil-based products on their scalp, and harsh chemical treatments. Current literature does not, however, provide data on the pathophysiological mechanisms of these conditions in this population. In this study, we investigated the mechanisms behind scalp discomfort and dandruff in women of African descent before and after hair washing. We conducted the in Durban, South Africa, over a 3-week period with 60 women of African descent aged 20-40 years. The respondents were equally divided into a "dandruff" and a "no dandruff" group, based on clinical grading of adherent dandruff by a dermatologist. Malassezia spp. and bacterial loads were quantified by quantitative polymerase chain reaction. Evaluations of scalp condition and sample collection were performed at five time points during the 3 weeks. Data on discomfort symptoms were collected via a self-assessment questionnaire. We observed that the dandruff severity peaked at the end of the first week after hair washing and plateaued from thereon in both groups. Dandruff was associated with higher Malassezia and bacterial load counts and there was a direct correlation between the Malassezia spp. load and dandruff score. Via self-assessment questionnaire responses submitted by participants, we observed that itching was the most pronounced scalp discomfort, compared with the sensation of tingling and burning at baseline, while an improvement of the scalp symptoms of dandruff and itch was observed in both groups after one hair wash. The study also showed that higher colonization with Malassezia spp. and bacteria is associated with dandruff independently of the time point, confirming a scalp microbiome contribution to the dandruff pathophysiology in the study population. The benefits of washing were, however, not sustained after 1 week and we thus recommend weekly hair washing for long-term management of dandruff and scalp itchiness in this population.

The promotion-like effect of the M1-STN hyperdirect pathway induced by ccPAS enhanced balance performances: From the perspective of brain connectivity

AIMS

The present study aimed to explore the effect of cortico-cortical paired-associative stimulation (ccPAS) in modulating hyperdirect pathway and its influence on balance performance.

METHODS

Forty healthy participants were randomly allocated to the active ccPAS group (n = 20) or the sham ccPAS group (n = 20). The primary motor cortex and subthalamic nucleus were stimulated sequentially with ccPAS. Unlike the active ccPAS group, one wing of coil was tilted to form a 90° angle with scalp of stimulation locations for the sham ccPAS group. Magnetic resonance imaging, functional reach test (FRT), timed up and go (TUG) test, and limit of stability (LOS) test were performed, and correlation between them was also analyzed.

RESULTS

Three participants in the sham ccPAS group were excluded because of poor quality of NIfTI images. The active group had strengthened hyperdirect pathway, increased functional connectivity (FC) between orbital part of frontal cortex and bilateral precuneus, and decreased FC among basal ganglia (all p < 0.05). Regional network properties of triangular and orbital parts of IFG, middle cingulate cortex, and hippocampus increased. The active group performed better in FRT and LOS (all p < 0.05). FRT positively correlated with FC of the hyperdirect pathway (r = 0.439, p = 0.007) and FCs between orbital part of frontal cortex and bilateral precuneus (all p < 0.05).

CONCLUSION

The ccPAS enhanced balance performance by promotion-like plasticity mechanisms through the hyperdirect pathway.

Protocol for optimized dissociation of human scalp tissue for hair follicle transcriptomics by scRNA-seq

Single-cell RNA sequencing (scRNA-seq) is a powerful tool for studying transcriptomics. Here, we present an optimized protocol for dissociating human scalp tissue and acquiring high-quality single-cell suspension for scRNA-seq to study transcriptomics of human hair follicles. We describe steps for human scalp tissue cleaning, subcutaneous fat removal, mechanical mincing, and enzymatic digestion. We then detail procedures for cleaning, resuspending, a cell viability assay, and library construction.

Retrospective evaluation of Penguin Cold Caps for chemotherapy-induced alopecia

BACKGROUND

Scalp cooling is an increasingly recognized non-pharmacologic approach to minimize chemotherapy-induced alopecia (CIA). Several commercially available machine-based and manual scalp cooling systems are available; however, literature reports of effectiveness are highly variable. The purpose of this study was to determine real-world tolerability and subjective effectiveness of a manual cold capping system in minimizing CIA across a variety of patient race and hair types. This study was a single-institution review of outcomes from manual cold capping.

METHODS

We identified retrospective cohort of adult patients who presented to discuss cold capping between January 14, 2019, and March 31, 2022. Data collected from medical records included demographics, decision to pursue/continue cold capping, diagnoses, chemotherapy regimens, hair characteristics (length, thickness, coarseness, type), and subjective perception of percentage of hair retained. Those with successful vs. unsuccessful cold capping (≥ 50% vs. < 50% of hair retained) were compared based on the patient-level factors of interest.

FINDINGS

A total of 100 patients initiated cold capping during the study period, and 95% of them completed cold capping. The majority of patients who started cold capping completed it. The median-reported percentage of hair maintained was 75%, and 82/89 (92.1% of patients) had favorable results, defined as ≥ 50% of hair retained. The only patient-level factor associated with favorable response was chemotherapy regimen, with fewer patients receiving doxorubicin-containing regimens having successful hair retention compared to other chemotherapy types (71.4% successful results vs. 95.7% for those receiving paclitaxel-containing regimens and 96.6% for those receiving docetaxel-containing regimens (p = 0.018). There was no difference in success based on patient race/ethnicity or hair characteristics.

INTERPRETATION

The overall effectiveness (92.1%) in this study is consistent to higher than many literature reports. One possible reason for the high success in our cohort is compliance with cold capping protocols, meaning applying the cap in the appropriate manner and wearing the cap for the prescribed durations, which may impact effectiveness.

Effect of MEP-oriented scalp acupuncture combined with transcranial magnetic stimulation on limb motor ability in patients with ischemic stroke hemiplegia

OBJECTIVES

To observe the effect of motor evoked potential (MEP)-oriented scalp acupuncture combined with transcranial magnetic stimulation (TMS) on limb motor ability in patients with ischemic stroke hemiplegia.

METHODS

A total of 60 patients with ischemic stroke hemiplegia were randomized into an observation group and a control group, 30 cases in each one. In addition to the medication treatment of internal medicine and comprehensive training of hemiplegic limbs, MEP-oriented scalp acupuncture combined with TMS was applied in the observation group, conventional scalp acupuncture at bilateral anterior oblique line of parietal and temporal regions combined with TMS was applied in the control group. The treatment was given once a day, 5 days a week for 4 weeks totally in the two groups. Before and after treatment, the scores of Fugl-Meyer assessment (FMA), modified Ashworth scale (MAS) and modified Barthel index (MBI) were observed in the two groups.

RESULTS

After treatment, the FMA and MBI scores were increased compared with those before treatment in the two groups (P<0.001), and the FMA and MBI scores in the observation group were higher than those in the control group (P<0.05). After treatment, the MAS scores of upper and lower limbs in the observation group were decreased compared with those before treatment (P<0.01, P<0.001), the MAS score of lower limb in the control group was decreased compared with that before treatment (P<0.05).

CONCLUSIONS

MEP-oriented scalp acupuncture combined with TMS can effectively improve the limb motor ability, daily living ability and limb spasticity in patients with ischemic stroke hemiplegia.

Guselkumab in Patients with Scalp Psoriasis: A post hoc Analysis of the VOYAGE 2 Phase III Randomized Clinical Trial

Scalp psoriasis affects approximately 80% of patients with psoriasis and can negatively impact their quality of life. This post hoc analysis of the VOYAGE 2 Phase III randomized clinical trial evaluated scalp response to guselkumab treatment and its association with skin response and patient-reported outcomes. The study included patients with moderate-to-severe plaque psoriasis and baseline scalp psoriasis who were initially randomized to receive guselkumab. Patients were divided into 3 groups based on their achievement of a Psoriasis Area and Severity Index 90 response at week 28: responder continuation, non-responder continuation and responder withdrawal. In all 3 groups, mean Psoriasis Area and Severity Index head and scalp-specific Investigator's Global Assessment scores improved through week 28. In the responder withdrawal group, these scores worsened after treatment withdrawal at week 28, but remained stable through week 48 in both continuation groups. Trends in Dermatology Life Quality Index and Psoriasis Symptoms and Signs Diary itch scores mirrored those of mean scalp-specific Investigator's Global Assessment scores through week 48. Within-subject correlations were 0.83 between scalp-specific Investigator's Global Assessment and Psoriasis Area and Severity Index head scores and 0.78 between scalp-specific Investigator's Global Assessment and Psoriasis Symptoms and Signs Diary itch scores. Through week 252, Psoriasis Area and Severity Index head scores remained stable in the responder continuation group, improved in the non-responder continuation group and rapidly improved by week 84 in the responder withdrawal group after retreatment.

Electrocorticographic Activation Patterns of Electroencephalographic Microstates

Electroencephalography (EEG) microstates are short successive periods of stable scalp field potentials representing spontaneous activation of brain resting-state networks. EEG microstates are assumed to mediate local activity patterns. To test this hypothesis, we correlated momentary global EEG microstate dynamics with the local temporo-spectral evolution of electrocorticography (ECoG) and stereotactic EEG (SEEG) depth electrode recordings. We hypothesized that these correlations involve the gamma band. We also hypothesized that the anatomical locations of these correlations would converge with those of previous studies using either combined functional magnetic resonance imaging (fMRI)-EEG or EEG source localization. We analyzed resting-state data (5 min) of simultaneous noninvasive scalp EEG and invasive ECoG and SEEG recordings of two participants. Data were recorded during the presurgical evaluation of pharmacoresistant epilepsy using subdural and intracranial electrodes. After standard preprocessing, we fitted a set of normative microstate template maps to the scalp EEG data. Using covariance mapping with EEG microstate timelines and ECoG/SEEG temporo-spectral evolutions as inputs, we identified systematic changes in the activation of ECoG/SEEG local field potentials in different frequency bands (theta, alpha, beta, and high-gamma) based on the presence of particular microstate classes. We found significant covariation of ECoG/SEEG spectral amplitudes with microstate timelines in all four frequency bands (p = 0.001, permutation test). The covariance patterns of the ECoG/SEEG electrodes during the different microstates of both participants were similar. To our knowledge, this is the first study to demonstrate distinct activation/deactivation patterns of frequency-domain ECoG local field potentials associated with simultaneous EEG microstates.

Re-evaluating fetal scalp pH thresholds: An examination of fetal pH variations during labor

INTRODUCTION

Since the 1970s, fetal scalp blood sampling (FSBS) has been used as a second-line test of the acid-base status of the fetus to evaluate fetal well-being during labor. The commonly employed thresholds that delineate normal pH (>7.25), subnormal (7.20-7.25), and pathological pH (<7.20) guide clinical decisions. However, these experienced-based thresholds, based on observations and common sense, have yet to be confirmed. The aim of the study was to investigate if pH drop rate accelerates at the common thresholds (7.25 and 7.20) and to explore the possibility of identifying more accurate thresholds.

MATERIAL AND METHODS

A retrospective study was conducted at a tertiary maternity hospital between June 2017 and July 2021. Patients with at least one FSBS during labor for category II fetal heart rate and delivery of a singleton cephalic infant were included. The rate of change in pH value between consecutive samples for each patient was calculated and plotted as a function of pH value. Linear regression models were used to model the evolution of the pH drop rate estimating slope and standard errors across predefined pH intervals. Exploration of alternative pH action thresholds was conducted. To explore the independence of the association between pH value and pH drop rate, multiple linear regression adjusted on age, body mass index, parity, oxytocin stimulation and suspected small for gestational age was performed.

RESULTS

We included 2047 patients with at least one FSBS (total FSBS 3467); with 2047 umbilical cord blood pH, and a total of 5514 pH samples. Median pH values were 7.29 1 h before delivery, 7.26 30 min before delivery. The pH drop was slow between 7.40 and 7.30, then became more pronounced, with median rates of 0.0005 units/min at 7.25 and 0.0013 units/min at 7.20. Out of the alternative pH thresholds, 7.26 and 7.20 demonstrated the best alignment with our dataset. Multiple linear regression revealed that only pH value was significantly associated to the rate of pH change.

CONCLUSIONS

Our study confirms the validity and reliability of current guideline thresholds for fetal scalp pH in category II fetal heart rate.

High-Density (HD) Scalp EEG Findings in "Benign" Childhood Epilepsy with Centrotemporal Spikes (BCECTS)

Despite characteristic clinical and scalp EEG findings, BCECTS pathophysiology is unclear regarding involvement of large-scale neuronal networks. Higher number of scalp electrodes with HD-EEG may promote accurate localization of the cortical generators in BCECTS providing additional insight in those with neurocognitive problems. We aimed to determine the value of visual interpretation of topographical maps using 256 channels (when compared to standard 21 channel array) HD-EEG in BCECTS and attempted to source localize interictal discharges (IEDs) using Geosource 2 software. Patient records were reviewed for demographic, seizure, brain magnetic resonance imaging (MRI) details; scalp and HD-EEG findings. HD-EEG software was used to review raw EEG data (21 scalp EEG electrodes were compared to 256 HD-EEG electrodes); select, average, and source localize IEDs.Five BCECTS patients with HD-EEG were identified. Seizure onset age ranged from 5-11 years with 1-18 lifetime seizures; both focal (n = 3) and focal to bilateral tonic-clonic (n = 2). Neurocognitive co-morbidities noted in our cohort included attention deficit hyperactivity disorder, speech/developmental delay and a specific learning disorder. Scalp EEG showed typical findings with IEDs over the centrotemporal regions (bilateral n = 3; unilateral n = 2). Visualization and inspection of expanded coverage topographic maps with HD-EEG showed well-defined islands of maximum negativity and positivity of a dipole compared to conventional channels where boundary delineation was obscured. Further, HD-EEG localized IEDs/"spike-generator" to areas such as the pre-and post-central, middle-frontal and temporal gyrus, and the inferior parietal lobule. In BCECTS, HD-EEG may show affection for a broader neural network and may provide a better insight into the associated neurocognitive morbidities.

Craniofacial phenotyping with fetal MRI: a feasibility study of 3D visualisation, segmentation, surface-rendered and physical models

This study explores the potential of 3D Slice-to-Volume Registration (SVR) motion-corrected fetal MRI for craniofacial assessment, traditionally used only for fetal brain analysis. In addition, we present the first description of an automated pipeline based on 3D Attention UNet trained for 3D fetal MRI craniofacial segmentation, followed by surface refinement. Results of 3D printing of selected models are also presented.Qualitative analysis of multiplanar volumes, based on the SVR output and surface segmentations outputs, were assessed with computer and printed models, using standardised protocols that we developed for evaluating image quality and visibility of diagnostic craniofacial features. A test set of 25, postnatally confirmed, Trisomy 21 fetal cases (24-36 weeks gestational age), revealed that 3D reconstructed T2 SVR images provided 66-100% visibility of relevant craniofacial and head structures in the SVR output, and 20-100% and 60-90% anatomical visibility was seen for the baseline and refined 3D computer surface model outputs respectively. Furthermore, 12 of 25 cases, 48%, of refined surface models demonstrated good or excellent overall quality with a further 9 cases, 36%, demonstrating moderate quality to include facial, scalp and external ears. Additional 3D printing of 12 physical real-size models (20-36 weeks gestational age) revealed good/excellent overall quality in all cases and distinguishable features between healthy control cases and cases with confirmed anomalies, with only minor manual adjustments required before 3D printing.Despite varying image quality and data heterogeneity, 3D T2w SVR reconstructions and models provided sufficient resolution for the subjective characterisation of subtle craniofacial features. We also contributed a publicly accessible online 3D T2w MRI atlas of the fetal head, validated for accurate representation of normal fetal anatomy.Future research will focus on quantitative analysis, optimizing the pipeline, and exploring diagnostic, counselling, and educational applications in fetal craniofacial assessment.

The scalp prefrontal-limbic functional connectivity moderates stress-related rumination effects on stress recovery

BACKGROUND

Mood disorders are often associated with hypothalamic-pituitary-adrenal (HPA) axis dysfunction, and rumination has been implicated in delayed cortisol recovery. However, research findings on the impact of rumination on cortisol recovery have been inconsistent. The moderating effects of scalp prefrontal-limbic connections on the relationship between rumination and cortisol recovery may explain these discrepancies.

METHOD

Acute stress was induced by a 5-min simulated job interview. Salivary samples and affective ratings were collected at seven pre-determined time points. After the simulated job interview, 35 healthy adult participants were randomly assigned to either the rumination condition (n = 17) or the distraction condition (n = 18).

RESULTS

Inducing stress and rumination led to increased cortisol levels, negative mood, and state rumination. Compared with the distraction group, the rumination group displayed delayed cortisol recovery and decreased scalp prefrontal-limbic connectivities, that is, left ventrolateral prefrontal cortex (LVLPFC) and left temporal area (LTMP) [ps < .05], and right dorsolateral prefrontal cortex (RDLPFC) and anterior cingulate cortex (ACC) [ps < .05]. The relationship between rumination and cortisol recovery was moderated by connectivities between the left dorsolateral prefrontal cortex (LDLPFC) and LTMP, RDLPFC and LTMP, LDLPFC and ACC, and RDLPFC and ACC [B = -0.98 to -0.35, SE = 0.15-0.34, ps < .05]. Higher rumination combined with reduced scalp prefrontal-limbic connectivities to predict delayed cortisol recovery.

CONCLUSION

The current findings suggest that scalp prefrontal-limbic connectivity is a neural underpinning related to emotion regulation for the effects of state rumination on stress recovery. These findings also provide a potential target for non-invasive intervention in HPA axis dysregulation.

Safety and efficacy of REGENDIL™ infused hair growth promoting product in adult human subject having hair fall complaints (alopecia)

BACKGROUND

Hair serum is recommended therapy for the management of hair fall problems. People of all ages suffer from hair fall.

AIM

To evaluate safety and efficacy of hair growth promoting product in healthy adult subjects with hair fall complaints (Alopecia).

METHODS

In this safety and efficacy clinical study, 32 healthy individuals (aged 18-45 years) experiencing hair loss were enrolled. Participants applied 0.5 mL of the product to the affected scalp area daily for 60 days. The study evaluated various factors, including hair growth rate, thickness, density, scalp condition using CASLite-Nova, anagen-to-telogen ratio, hair fall reduction, overall hair and scalp appearance, hair strength, and participants' subjective perceptions of the product.

RESULTS

Highly statistically significant improvement was observed in hair growth rate, thickness, and density at Day 30 and Day 60. Hair growth rate increased (p-value <0.01) by 10.52% in 30 days and 31.62% in 60 days after test product application. Average hair growth increased by 424.21 μm/day and 487.31 μm/day at Day 30 and 60 respectively. The hair growth improved by up to 1.5 times after 60 days of usage in healthy subjects with hair fall complaints. No adverse events or product-related adverse events were reported.

CONCLUSION

Hair serum containing REGENDIL™ (Redensyl, AnaGain, Procapil, Capilia longa), and 5 kDa hyaluronic acid was efficacious and well tolerable in reducing hair fall (Alopecia). Hair serum significantly improved hair growth, hair density, hair thickness, and hair strength within 60 days of usage, thereby demonstrating it worth as a beneficial inclusion as a daily haircare product.

Keratolytics can replace curettage in daylight photodynamic therapy for actinic keratosis on the face/scalp: A randomized clinical trial

BACKGROUND

Methyl aminolevulinate (MAL) photodynamic therapy (PDT) is commonly used for field treatment of actinic keratoses (AKs). In standard natural daylight PDT (n-DL-PDT) the first step, after the application of chemical solar filter, is removal of crusts and scales by curettage, followed by the application of MAL cream. Some patients experience intense pain during curettage and stinging after application of the photosensitizer to just curettaged skin.

OBJECTIVES

To evaluate whether n-DL-PDT without curettage, but preceded by application of keratolytics, would maintain a similar efficacy, based on clinical, dermoscopic, reflectance confocal microscopy (RCM) assessments, safety and patient satisfaction as standard n-DL-PDT with curettage.

METHODS

Forty patients with multiple AKs on the face and/or scalp were enrolled in this study. Patients were randomized into two groups of treatment as follows: (i) MAL n-DL-PDT without previous curettage, preceded by skin preparation at home with keratolytics (30% urea cream, twice a day for 7 days; -Cur group) and (ii) MAL n-DL-PDT preceded by skin preparation at the hospital with curettage (+Cur group).

RESULTS

Thirty-nine participants completed the study. Four hundred and twenty-one AKs in -Cur group and 337 AKs in +Cur group were treated. The mean reduction in the number of AK lesions 3 months after the treatment was 10.7 (-54.7%) in the -Cur and 10.4 (-58.7%) in the +Cur group. We found that the differences in terms of efficacy and patient satisfaction comparing the two treatment regimens were not statistically significant. The pain score reported during and after daylight exposure was similar and low in both groups. Moreover, no unexpected adverse events occurred during the trial period.

CONCLUSIONS

According to our results, curettage is not necessary to obtain the full treatment effect of n-DL-PDT. We experienced in a real-life setting that n-DL-PDT protocol could be changed by replacing curettage with keratolytics.

Features, management, and outcomes of pediatric scalp melanomas

Pediatric melanoma of the scalp has the highest mortality of any anatomic location. We describe five pediatric patients with a diagnosis of scalp melanoma receiving care at Massachusetts General Hospital and/or Boston Children's Hospital from 2018 through 2022. Melanoma presented in diverse contexts: cellular blue nevus-associated, compound nevus-associated, spitzoid, nodular, and superficial spreading subtypes. This study describes a range of melanoma presentations and emphasizes the need for additional compilation of data on pediatric scalp melanomas to promote their recognition and improve patient care.

Study of multistep Dense U-Net-based automatic segmentation for head MRI scans

BACKGROUND

Despite extensive efforts to obtain accurate segmentation of magnetic resonance imaging (MRI) scans of a head, it remains challenging primarily due to variations in intensity distribution, which depend on the equipment and parameters used.

PURPOSE

The goal of this study is to evaluate the effectiveness of an automatic segmentation method for head MRI scans using a multistep Dense U-Net (MDU-Net) architecture.

METHODS

The MDU-Net-based method comprises two steps. The first step is to segment the scalp, skull, and whole brain from head MRI scans using a convolutional neural network (CNN). In the first step, a hybrid network is used to combine 2.5D Dense U-Net and 3D Dense U-Net structure. This hybrid network acquires logits in three orthogonal planes (axial, coronal, and sagittal) using 2.5D Dense U-Nets and fuses them by averaging. The resultant fused probability map with head MRI scans then serves as the input to a 3D Dense U-Net. In this process, different ratios of active contour loss and focal loss are applied. The second step is to segment the cerebrospinal fluid (CSF), white matter, and gray matter from extracted brain MRI scans using CNNs. In the second step, the histogram of the extracted brain MRI scans is standardized and then a 2.5D Dense U-Net is used to further segment the brain's specific tissues using the focal loss. A dataset of 100 head MRI scans from an OASIS-3 dataset was used for training, internal validation, and testing, with ratios of 80%, 10%, and 10%, respectively. Using the proposed approach, we segmented the head MRI scans into five areas (scalp, skull, CSF, white matter, and gray matter) and evaluated the segmentation results using the Dice similarity coefficient (DSC) score, Hausdorff distance (HD), and the average symmetric surface distance (ASSD) as evaluation metrics. We compared these results with those obtained using the Res-U-Net, Dense U-Net, U-Net++, Swin-Unet, and H-Dense U-Net models.

RESULTS

The MDU-Net model showed DSC values of 0.933, 0.830, 0.833, 0.953, and 0.917 in the scalp, skull, CSF, white matter, and gray matter, respectively. The corresponding HD values were 2.37, 2.89, 2.13, 1.52, and 1.53 mm, respectively. The ASSD values were 0.50, 1.63, 1.28, 0.26, and 0.27 mm, respectively. Comparing these results with other models revealed that the MDU-Net model demonstrated the best performance in terms of the DSC values for the scalp, CSF, white matter, and gray matter. When compared with the H-Dense U-Net model, which showed the highest performance among the other models, the MDU-Net model showed substantial improvements in the HD view, particularly in the gray matter region, with a difference of approximately 9%. In addition, in terms of the ASSD, the MDU-Net model outperformed the H-Dense U-Net model, showing an approximately 7% improvements in the white matter and approximately 9% improvements in the gray matter.

CONCLUSION

Compared with existing models in terms of DSC, HD, and ASSD, the proposed MDU-Net model demonstrated the best performance on average and showed its potential to enhance the accuracy of automatic segmentation for head MRI scans.

Scalp acupuncture for post-stroke spastic hemiparesis: A systematic review and meta-analysis

BACKGROUND

Spastic paralysis is one of the most common sequelae of stroke, severely affecting patients' limb function and reducing their quality of life. Scalp acupuncture (SA) has been shown to significantly improve cerebral blood supply and reduce the severity of limb spasticity. This meta-analysis aims to systematically evaluate the clinical efficacy of SA in the treatment of post-stroke spastic paralysis, providing evidence-based medicine for clinical management of this condition.

METHODS

We comprehensively searched databases including China National Knowledge Infrastructure, Wanfang Data, VIP Chinese Science and Technology Periodical Database, China Biomedical Literature Database, PubMed, Embase, and Cochrane Library. Randomized controlled trials investigating the efficacy of SA in post-stroke spastic paralysis were identified until July 28, 2023. Meta-analysis was conducted using RevMan 5.4 and Stata17.0.

RESULTS

A total of 16 studies were included. Meta-analysis showed that the modified Ashworth spasticity assessment scale in the SA group was significantly higher than that in the rehabilitation group (mean difference [MD] = -0.56, 95% confidence interval [CI] [-0.75, -0.37], Z = 5.67, P < .00001). The simplified Fugl-Meyer motor function assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.86, 95% CI [3.26, 8.46], Z = 4.41, P < .0001). The modified Barthel index assessment scale in the SA group was significantly higher than that in the rehabilitation group (MD = 5.79, 95% CI [4.73, 6.84], Z = 10.77, P < .00001). Additionally, the clinical effective rate in the SA group was significantly higher than that in the rehabilitation group (relative risk = 1.25, 95% CI [1.16, 1.36], Z = 5.42, P < .00001).

CONCLUSION

SA combined with rehabilitation therapy has certain advantages in reducing limb spasticity, improving limb function, and enhancing activities of daily living in patients with post-stroke spastic paralysis. This study provides reference and theoretical support for the promotion of SA in the treatment of this condition.

Adaptive multipole models of optically pumped magnetometer data

Multipole expansions have been used extensively in the Magnetoencephalography (MEG) literature for mitigating environmental interference and modelling brain signal. However, their application to Optically Pumped Magnetometer (OPM) data is challenging due to the wide variety of existing OPM sensor and array designs. We therefore explore how such multipole models can be adapted to provide stable models of brain signal and interference across OPM systems. Firstly, we demonstrate how prolate spheroidal (rather than spherical) harmonics can provide a compact representation of brain signal when sampling on the scalp surface with as few as 100 channels. We then introduce a type of orthogonal projection incorporating this basis set. The Adaptive Multipole Models (AMM), which provides robust interference rejection across systems, even in the presence of spatially structured nonlinearity errors (shielding factor is the reciprocal of the maximum fractional nonlinearity error). Furthermore, this projection is always stable, as it is an orthogonal projection, and will only ever decrease the white noise in the data. However, for array designs that are suboptimal for spatially separating brain signal and interference, this method can remove brain signal components. We contrast these properties with the more typically used multipole expansion, Signal Space Separation (SSS), which never reduces brain signal amplitude but is less robust to the effect of sensor nonlinearity errors on interference rejection and can increase noise in the data if the system is sub-optimally designed (as it is an oblique projection). We conclude with an empirical example utilizing AMM to maximize signal to noise ratio (SNR) for the stimulus locked neuronal response to a flickering visual checkerboard in a 128-channel OPM system and demonstrate up to 40 dB software shielding in real data.

Electroacupuncture of scalp acupoint alleviates cerebral ischemic inflammatory injury by down-regulating RORγt and promoting balance of IL-17A+Th17/FOXP3+Treg in MCAO rats

OBJECTIVES

To observe the effect of electroacupuncture (EA) of scalp acupoint (Dingnieqian-xiexian, MS6) on expression of retinoid-related orphan receptor γT (ROR γ t), interleukin (IL)-17A, IL-10, transfor-ming growth factor-β1 (TGF-β1), IL-6, IL-21, and IL-17A+ Thelper cells(Th) 17 and forkhead transcription factor P3 (FOXP3)+ regulatory T cells (Treg) differentiation of ischemic cortex in ischemic stroke rats, so as to explore its molecular mechanisms underlying relief of inflammatory injury of ischemic stroke.

METHODS

A total of 120 male SD rats were randomly assigned to sham operation, model, EA, inhibitor, agonist and EA+agonist groups, with 15 rats in each group. The ischemic stroke model was established by occlusion of the left middle cerebral artery according to Longa's methods. For rats of the EA group and EA+agonist group, EA (2 Hz/100 Hz, 1 mA) was applied to bilateral MS6 for 30 min, once daily for 7 days. Rats of the inhibitor group received intraperitoneal injection of solution of SR1001 (RORγt inhibitor) (2.5 mg/mL, 10 mg/kg), once daily for 7 days. Rats of the agonist and EA+agonist groups received intraperitoneal injection of solution of SR1078 (RORγt agonist) (5 mg/mL, 5 mg/kg) before EA, once daily for 7 days. Rats of the sham operation and model groups were grabbed and fixed in the same way with the other groups. The Zea-longa's score, modified neurological severity score (mNSS) and the neurobehavioral score were assessed before and after the intervention. At the end of experiments, the ischemic cortex tissue was collected. The 2, 3, 5-Triphenyltetrazolium chloride (TTC) staining was used to detect the volume of cerebral infarction. The expression of RORγt mRNA was detected by real-time quantitative PCR；the protein expression levels of RORγt, IL-17A, IL-10 and TGF-β1 were detected by Western blot；the immunoactivity of IL-6 and IL-21 were detected by immunohistochemistry；the fluorescence areas of IL-17A+Th17 and FOXP3+Treg cells were measured by immunofluorescence and their ratio was calculated in the tissue of ischemic cortex.

RESULTS

Relevant to the sham operation group, the model group had a significant increase in the Zea-Longa's score, mNSS score, neurobehavioral score, cerebral infarct volume, expression levels of RORγt mRNA and protein, IL-17A protein, IL-6 and IL-21 immunoactivity, IL-17A+Th17 immunofluorescence intensity, and the ratio of IL-17A+Th17/FOXP3+Treg (P<0.01), and an obvious decrease in the expression levels of TGF-β1 and IL-10 proteins and FOXP3+Treg immunofluorescence intensity (P<0.01). In contrast to the model group, both EA and inhibitor groups had a significant decrease in the Zea-Longa's score, mNSS score, neurobehavioral score, cerebral infarct volume, expression levels of RORγt mRNA and protein, IL-17A protein, IL-6 and IL-21 immunoactivity, IL-17A+Th17 immunofluorescence intensity, and the ratio of IL-17A+Th17/FOXP3+Treg (P<0.01, P<0.05), and a marked increase in the expression levels of TGF-β1 and IL-10 proteins and FOXP3+Treg immunofluorescence intensity (P<0.05, P<0.01), while the above indicators of the agonist group were all reversed (P<0.01, P<0.05). Comparison between the agonist and EA+agonist groups showed that the Zea-Longa's score, mNSS score, neurobehavioral score, cerebral infarct volume, expression levels of RORγt mRNA and protein, IL-17A protein, IL-6 and IL-21 immunoactivity, IL-17A+Th17 immunofluorescence intensity, and the ratio of IL-17A+Th17/FOXP3+Treg were significantly lower (P<0.01, P<0.05), and the expression of TGF-β1 and IL-10 proteins and FOXP3+Treg immunofluorescence intensity were obviously higher (P<0.01, P<0.05) in the EA+agonist group than in the agonist group, suggesting that EA intervention can effectively weaken the effects of RORγt agonist.

CONCLUSIONS

EA of scalp acupoint MS6 can effectively improve the neurological function, behavior reaction and reduce cerebral infarct volume in ischemic stroke rats, which may be associated with its functions in down-regulating the expression of RORγt and promoting the balance of IL-17A+Th17/FOXP3+Treg to alleviate inflammatory injury after ischemic stroke.

High-resolution EEG source localization in personalized segmentation-free head model with multi-dipole fitting

Objective. Electroencephalograms (EEGs) are often used to monitor brain activity. Several source localization methods have been proposed to estimate the location of brain activity corresponding to EEG readings. However, only a few studies evaluated source localization accuracy from measured EEG using personalized head models in a millimeter resolution. In this study, based on a volume conductor analysis of a high-resolution personalized human head model constructed from magnetic resonance images, a finite difference method was used to solve the forward problem and to reconstruct the field distribution.Approach. We used a personalized segmentation-free head model developed using machine learning techniques, in which the abrupt change of electrical conductivity occurred at the tissue interface is suppressed. Using this model, a smooth field distribution was obtained to address the forward problem. Next, multi-dipole fitting was conducted using EEG measurements for each subject (N= 10 male subjects, age: 22.5 ± 0.5), and the source location and electric field distribution were estimated.Main results.For measured somatosensory evoked potential for electrostimulation to the wrist, a multi-dipole model with lead field matrix computed with the volume conductor model was found to be superior than a single dipole model when using personalized segmentation-free models (6/10). The correlation coefficient between measured and estimated scalp potentials was 0.89 for segmentation-free head models and 0.71 for conventional segmented models. The proposed method is straightforward model development and comparable localization difference of the maximum electric field from the target wrist reported using fMR (i.e. 16.4 ± 5.2 mm) in previous study. For comparison, DUNEuro based on sLORETA was (EEG: 17.0 ± 4.0 mm). In addition, somatosensory evoked magnetic fields obtained by Magnetoencephalography was 25.3 ± 8.5 mm using three-layer sphere and sLORETA.Significance. For measured EEG signals, our procedures using personalized head models demonstrated that effective localization of the somatosensory cortex, which is located in a non-shallower cortex region. This method may be potentially applied for imaging brain activity located in other non-shallow regions.

Functional metabolomics of the human scalp: a metabolic niche for Staphylococcus epidermidis

Although metabolomics data acquisition and analysis technologies have become increasingly sophisticated over the past 5-10 years, deciphering a metabolite's function from a description of its structure and its abundance in a given experimental setting is still a major scientific and intellectual challenge. To point out ways to address this "data to knowledge" challenge, we developed a functional metabolomics strategy that combines state-of-the-art data analysis tools and applied it to a human scalp metabolomics data set: skin swabs from healthy volunteers with normal or oily scalp (Sebumeter score 60-120, n = 33; Sebumeter score > 120, n = 41) were analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS), yielding four metabolomics data sets for reversed phase chromatography (C18) or hydrophilic interaction chromatography (HILIC) separation in electrospray ionization (ESI) + or - ionization mode. Following our data analysis strategy, we were able to obtain increasingly comprehensive structural and functional annotations, by applying the Global Natural Product Social Networking (M. Wang, J. J. Carver, V. V. Phelan, L. M. Sanchez, et al., Nat Biotechnol 34:828-837, 2016, https://doi.org/10.1038/nbt.3597), SIRIUS (K. Dührkop, M. Fleischauer, M. Ludwig, A. A. Aksenov, et al., Nat Methods 16:299-302, 2019, https://doi.org/10.1038/s41592-019-0344-8), and MicrobeMASST (S. ZuffaS, R. Schmid, A. Bauermeister, P. W, P. Gomes, et al., bioRxiv:rs.3.rs-3189768, 2023, https://doi.org/10.21203/rs.3.rs-3189768/v1) tools. We finally combined the metabolomics data with a corresponding metagenomic sequencing data set using MMvec (J. T. Morton, A. A. Aksenov, L. F. Nothias, J. R. Foulds, et. al., Nat Methods 16:1306-1314, 2019, https://doi.org/10.1038/s41592-019-0616-3), gaining insights into the metabolic niche of one of the most prominent microbes on the human skin, Staphylococcus epidermidis.IMPORTANCESystems biology research on host-associated microbiota focuses on two fundamental questions: which microbes are present and how do they interact with each other, their host, and the broader host environment? Metagenomics provides us with a direct answer to the first part of the question: it unveils the microbial inhabitants, e.g., on our skin, and can provide insight into their functional potential. Yet, it falls short in revealing their active role. Metabolomics shows us the chemical composition of the environment in which microbes thrive and the transformation products they produce. In particular, untargeted metabolomics has the potential to observe a diverse set of metabolites and is thus an ideal complement to metagenomics. However, this potential often remains underexplored due to the low annotation rates in MS-based metabolomics and the necessity for multiple experimental chromatographic and mass spectrometric conditions. Beyond detection, prospecting metabolites' functional role in the host/microbiome metabolome requires identifying the biological processes and entities involved in their production and biotransformations. In the present study of the human scalp, we developed a strategy to achieve comprehensive structural and functional annotation of the metabolites in the human scalp environment, thus diving one step deeper into the interpretation of "omics" data. Leveraging a collection of openly accessible software tools and integrating microbiome data as a source of functional metabolite annotations, we finally identified the specific metabolic niche of Staphylococcus epidermidis, one of the key players of the human skin microbiome.

Interactive scalp acupuncture combined with suspension digital occupational therapy for upper limb motor dysfunction after stroke: a multi-center randomized controlled trial

OBJECTIVES

To observe the effects of interactive scalp acupuncture on upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

METHODS

One hundred and twenty patients with upper limb motor dysfunction after stroke were randomly divided into an observation group(60 cases, 2 cases dropped out)and a control group(60 cases, 1 case dropped out). Both groups were treated with routine medication and rehabilitation. The observation group was treated with interactive scalp acupuncture combined with suspension digital occupational therapy, interactive scalp acupuncture was applied at middle 2/5 of the parietal and temporal anterior oblique line, middle 2/5 of the parietal and temporal posterior oblique line and second lateral line of parietal of the hemiparalysis contralateral side, 30 min each time.The control group was treated with suspension digital occupational therapy alone. The treatment was given once a day, 5 times a week for 4 weeks in the two groups. The scores of Fugl-Meyer assessment scale of upper extremity(FMA-UE), action research arm test(ARAT), the modified Barthel index (MBI) and surface electromyography(sEMG)signal of the biceps and triceps on the affected side were observed before and after treatment in the two groups, and the clinical efficacy was evaluated.

RESULTS

After treatment, the FMA-UE, ARAT and MBI scores were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). After treatment, the integrated electromyography(iEMG)value and root mean square(RMS)value of the biceps and triceps on the affected side during elbow flexion and extension were increased compared with those before treatment in both groups(P<0.05), the changes of the observation group were greater than those in the control group(P<0.05). The total effective rate was 94.8%(55/58) in the observation group, which was higher than 83.1%(49/59) in the control group(P<0.05).

CONCLUSIONS

Interactive scalp acupuncture could improve upper limb motor function and activities of daily living in patients with upper limb motor dysfunction after stroke.

Rain may improve survival from direct lightning strikes to the human head

There is evidence that humans can survive a direct lightning strike to the head. Our question is: could water (rain) on the skin contribute to an increase in the survival rate? We measure the influence of rain during high-energy direct lightning strikes on a realistic three-compartment human head phantom. We find a lower number of perforations and eroded areas near the lightning strike impact points on the head phantom when rain was applied compared to no rain. Current amplitudes in the brain were lower with rain compared to no rain before a fully formed flashover. We conclude that rain on the scalp potentially contributes to the survival rate of 70-90% due to: (1) lower current exposition in the brain before a fully formed flashover, and (2) reduced mechanical and thermal damage.

Scalp and hippocampal sleep correlates of memory function in drug-resistant temporal lobe epilepsy

Seminal animal studies demonstrated the role of sleep oscillations such as cortical slow waves, thalamocortical spindles, and hippocampal ripples in memory consolidation. In humans, whether ripples are involved in sleep-related memory processes is less clear. Here, we explored the interactions between sleep oscillations (measured as traits) and general episodic memory abilities in 26 adults with drug-resistant temporal lobe epilepsy who performed scalp-intracranial electroencephalographic recordings and neuropsychological testing, including two analogous hippocampal-dependent verbal and nonverbal memory tasks. We explored the relationships between hemispheric scalp (spindles, slow waves) and hippocampal physiological and pathological oscillations (spindles, slow waves, ripples, and epileptic spikes) and material-specific memory function. To differentiate physiological from pathological ripples, we used multiple unbiased data-driven clustering approaches. At the individual level, we found material-specific cerebral lateralization effects (left-verbal memory, right-nonverbal memory) for all scalp spindles (rs > 0.51, ps < 0.01) and fast spindles (rs > 0.61, ps < 0.002). Hippocampal epileptic spikes and short pathological ripples, but not physiological oscillations, were negatively (rs > -0.59, ps < 0.01) associated with verbal learning and retention scores, with left lateralizing and antero-posterior effects. However, data-driven clustering failed to separate the ripple events into defined clusters. Correlation analyses with the resulting clusters revealed no meaningful or significant associations with the memory scores. Our results corroborate the role of scalp spindles in memory processes in patients with drug-resistant temporal lobe epilepsy. Yet, physiological and pathological ripples were not separable when using data-driven clustering, and thus our findings do not provide support for a role of sleep ripples as trait-like characteristics of general memory abilities in epilepsy.

Optimizing intracranial electric field distribution through temperature-driven scalp conductivity adjustments in transcranial electrical stimulation

Transcranial electrical stimulation (TES) is a promising non-invasive neuromodulation technique. How to increase the current intensity entering the skull and reduce scalp shunting has become a key factor significantly influencing regulatory efficacy. In this study, we introduce a novel approach for optimizing TES by adjusting local scalp temperature to modulate scalp conductivity. We have developed simulation models for TES-induced electric fields and for temperature-induced alterations in scalp conductivity. Two common types of stimulation montage (M1-SO and 4 × 1 montage) were adopted for the evaluation of effectiveness. We observed that the modulation of scalp temperature has a significant impact on the distribution of the electric field within the brain during TES. As local scalp temperature decreases, there is an increase in the maximum electric field intensity within the target area, with the maximum change reaching 18.3%, when compared to the electric field distribution observed under normal scalp temperature conditions. Our study provide insights into the practical implementation challenges and future directions for this innovative methodology.