Neuromonitoring-guided working memory intervention in children with ADHD.

We proposed a personalized intervention that integrates computerized working memory (WM) training with real-time functional neuromonitoring and neurofeedback (NFB) to enhance frontoparietal activity and improve cognitive and clinical outcomes in children with attention-deficit/hyperactivity disorder (ADHD). The study involved 77 children with ADHD aged 7-11 years, who were assigned to either 12 sessions of NFB or treatment-as-usual (i.e., received standard clinical care) groups. Real-time neuromonitoring with functional near-infrared spectroscopy (fNIRS) and fMRI measured frontoparietal activity during n-back task at baseline and post-intervention. Thirty-six participants (21 NFB, 15 treatment-as-usual) completed the study. Significant improvements in NFB group were observed in frontoparietal brain activity and WM performance (primary outcomes). NFB group also showed improvements in Behavior Rating Inventory of Executive Function (BRIEF-2) WM t-scores and Conners 3 ADHD index scores (secondary outcomes) compared to treatment-as-usual group. These findings suggest that neuromonitoring-guided NFB effectively enhances cognitive and clinical outcomes in children with ADHD by targeting brain mechanisms underlying WM deficits

Attention as an object of knowledge, intervention and valorisation:exploring data-driven neurotechnologies and imaginaries of intensified learning

Innovations in mobile neuromonitoring and brain–computer interfaces are increasingly used to inform understandings of human brains and behaviours while also catalysing imaginaries of neuroscientifically measured and enhanced economic productivity. In this paper, we focus on neurotechnologies that claim to capture, monitor, measure and train learners’ attention. We analyse a corpus of relevant scientific, governance, and commercial texts to explore how they reconfigure learners’ attention as an object of knowledge, intervention, and valorisation. We demonstrate that outcomes-driven neuroscience research and technological development tends to split attention into optimal and undesirable forms: externally versus internally oriented, and synchronised versus unsynchronised with others, which become the variables of intervention to optimise attention. Commercial wearables, in turn, envelop desirable forms of attention under logics of brain control, social discipline, and valorisation. This process is enacted within an international context of speculation on neurotechnology investments and their anticipated outcome of enhancing future human productivity. Circumscribing desirable forms of learner attention and subjectivity, these technologies provide expanded means to mould and monitor learners’ attention towards performativity regimes of economised education governance while enabling profit-making based on learners’ activity

Anaesthesiologic and surgical perspectives of patients born with esophageal atresia:The knife cuts both ways

We found that neonates undergoing primary esophageal atresia repair suffer great metabolic derangements, such as acidosis, hypercapnia and hypoxia. These are all risk factors for the developing brain. In addition to these possibly neurotoxic derangements, putative neurotoxic anesthetics are used in this patient population. We found that, in animal studies, dexmedetomidine has neuroprotective effects when added to these commonly used anesthetics. There are no data on the neurotoxic effects of dexmedetomidine in humans. According to our survey study, dexmedetomidine is increasingly used in the field of pediatric anesthesiology all over the world, with satisfying results.We aimed to assess the long-term neurodevelopment of patients born with esophageal atresia. We found that they undergo a median number 4 procedures requiring general anesthesia, mainly in the first two years of life. We found that patients born with esophageal atresia suffer both impairment of motor function and of cognitive development. The number of procedures the patients undergo is a risk factor for impaired neurodevelopmental outcome at 5 years of age. In addition to this, the number of days of postoperative endotracheal intubation is also a risk factor for impaired neurodevelopment. By monitoring the brain during general anesthesia, we might be able to gain more insight into the events that occur in the brain. However, the neuromonitoring devices that are currently available for pediatric use lack specificity and the data are not related to clinical outcome or prognosis.<br/

Optical imaging and spectroscopy for the study of the human brain: status report

This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions

Optical imaging and spectroscopy for the study of the human brain: status report

This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions. (c) The Authors. Published by SPIE under a Creative Commons Attribution 4.0 International License. Distribution or reproduction of this work in whole or in part requires full attribution of the original publication, including its DOI

Optical imaging and spectroscopy for the study of the human brain: status report

This report is the second part of a comprehensive two-part series aimed at reviewing an extensive and diverse toolkit of novel methods to explore brain health and function. While the first report focused on neurophotonic tools mostly applicable to animal studies, here, we highlight optical spectroscopy and imaging methods relevant to noninvasive human brain studies. We outline current state-of-the-art technologies and software advances, explore the most recent impact of these technologies on neuroscience and clinical applications, identify the areas where innovation is needed, and provide an outlook for the future directions. Keywords: DCS; NIRS; diffuse optics; functional neuroscience; optical imaging; optical spectroscop

Brain health:A concern for anaesthesiologists and intensivists

Damage to the brain can have disastrous and long-lasting consequences. The European Society of Anaesthesiology and Intensive Care (ESAIC) is aware of the importance of taking good care of the brain, both of patients and of anaesthesia and intensive care unit (ICU) caregivers, and has organised a complete learning track on brain health to bring this concern to the attention of practitioners. This learning track included an online Focus Meeting on Brain Health (November 25, 2023). We here provide readers with a digest of the information that was delivered during that meeting in an opinion paper driven by the authors’ own reading of the literature. It is divided according to the meeting’s sessions, including how to improve the health of an injured brain, how to keep a young or old brain healthy, how to keep a healthy adult brain unimpaired, how monitoring can impact brain health in the operating room and in the intensive care unit, and how to keep the anaesthesia and ICU caregivers’ brain healthy. Each part is a brief and focused summary. The main delivered messages are that the management of injured brain patients involves an adequate choice of sedation, adequate brain monitoring, and focused attention to specific points depending on the underlying pathology; that several measures can be undertaken to protect the brain of the very young needing anaesthesia; that it is possible to detect older patients at risk of postoperative neurocognitive disorders, and that dedicated perioperative management by a multidisciplinary expert team may improve their outcomes; that apparently healthy adult brains may suffer during anaesthesia; that the electroencephalogram may track peri-operative brain dysfunction, and that female patients should be given special care in this respect; that multimodal brain monitoring helps to detect pathological processes and to maintain brain homeostasis; and that burnout in anaesthesiologists can be effectively fought using personal, organisational, managerial and legal approaches.</p

Investigating severe pediatric traumatic brain injury in South Africa : a demographic profile of admissions, brain oxygenation and neuropsychological outcomes and an attention-training intervention

Includes bibliographical references.The aim of this dissertation was to investigate severe pediatric traumatic brain injury (pTBI) in South Africa. To that end, I conducted three studies, each examining a different aspect of severe pTBI. Study 1 presents a demographic profile of trends in severe pTBI admissions to the Red Cross War Memorial Children's Hospital (RXH) from June 2006 to April 2011. Study 2 examines the associations between secondary injury, as manifest by low brain oxygenation (PbtO2), and neuropsychological outcomes in severe pTBI. Study 3 evaluates the efficacy of an attention-training intervention for severe pTBI, and discusses the implementation of that intervention in the context of a low- and middle-income country. All three studies were cross-sectional and quantitative

The role of cognition in the prediction of social functioning in Recent Onset Psychosis

Cognitive impairments are among the primary symptoms in the clinical presentation of psychotic disorders. Especially in Recent Onset Psychosis (ROP), cognitive deficits emerge early in the course of the disease and adversely affect several aspects of everyday life. Despite numerous years of clinical research, addressing them effectively remains challenging. In recent years, a clear link has been established between cognition and social functioning in ROP. Cognitive impairments are associated with poor long-term social functioning, while impairments in social cognition serve as a good prognostic indicator of poor functional outcome post-episodic. Cognitive training (CT) is recommended in clinical guidelines as one of the most significant complementary therapies for enhancing cognitive impairments in the domains of attention, working memory, executive functioning, and social cognition. Although several meta-analyses reported small to moderate effects of CT on cognition, the therapy response to CT remains heterogeneous, making targeted treatment demanding. Machine learning (ML) techniques are increasingly used in psychiatric research to predict and stratify clinical outcomes at an individual level. While there are several neuroimaging-based ML studies for predicting clinical outcomes, the evidence regarding cognition-based ML predictions in psychosis is limited. We used multivariate pattern analysis (MVPA) to examine whether cognitive data can predict the enhancement of social functioning following 10 hours of CT in ROP patients. A Support Vector Machine (SVM) classifier was trained on cognitive baseline data of 70 ROP patients of the naturalistic Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study sample to predict social functioning in an independent sample. Within this original classification model, social functioning was predicted with a balanced accuracy (BAC) of 66.4%. Next, the SVM classifier was applied to an intervention sample that obtained 54 ROP patients. Participants of the intervention sample were randomly assigned to a social cognitive training (SCT) or treatment as usual (TAU) group and dichotomized into good (GF-S ≥7) and poor (GF-S <7) functioning patients based on their level of Global Functioning-Social (GF-S) score at follow-up (FU). By using out-of-sample cross-validation (OOCV), social functioning in the intervention sample was predicted with a BAC of 59.3% at baseline (T0) and with a BAC of 64.8% at FU 6 weeks after the intervention. After SCT intervention, a significant improvement in predicted social functioning values was observed in the SCT compared to TAU group (P = <0.05; ES[Cohens’d] = 0.18). These findings suggest that the use of baseline cognitive data could provide a robust individual estimate of future social functioning and therapy response to CT. Due to a small sample size and modest cognitive and functional variability in response to CT within the intervention sample, it was not feasible to analyze individual characteristics predictive of a good therapy response in the current study. Large-scale studies with participants showing greater cognitive and functional variability in response to CT are needed to replicate our results and to further analyze the cognitive pattern predictive of a good therapy response to CT