Background: Long-term methamphetamine use disrupts brain function and impairs cognition. Currently, there is a lack of effective treatments for cognitive dysfunction in this population. This study aimed to investigate the effects of different exercise interventions on cognitive function and brain activation in methamphetamine-dependent individuals and to explore the potential neural mechanisms underlying cognitive improvement. Methods: In this randomized, assessor-blind, controlled study, 162 male methamphetamine-dependent individuals in compulsory isolation were randomly assigned to one of four groups: traditional regimen training (TR, n = 41), aerobic exercise (AE, n = 40), multimodal cognitive exercise training (MC, n = 40), and a control group (MA, n = 41). All participants completed an 8-week intervention. Cognitive function was assessed before and after the intervention using the Stroop task, while fNIRS was used to measure task-related hemodynamic responses. In addition, the Memory and Executive Screening (MES) and choice reaction time tests were used to evaluate cognitive and psychomotor performance. Results: After 8 weeks, traditional regimen training (p = 0.006), aerobic exercise (p = 0.024), and multimodal cognitive exercise training (p < 0.001) all significantly improved Stroop task accuracy. Aerobic exercise significantly increased activation in L-DLPFC (p = 0.044), R-DLPFC (p = 0.036), and L-FPA (p = 0.038), improved MES-T scores (p < 0.001) and shortened choice reaction time (p < 0.001). Traditional regimen training increased L-DLPFC activation (p = 0.026), improved MES-T scores (p < 0.001), and shortened choice reaction time (p < 0.001). Multimodal cognitive exercise training increased activation in L-DLPFC (p = 0.006), R-DLPFC (p = 0.014), and L-FPA (p = 0.002), improved MES-T scores (p < 0.001) and shortened choice reaction time (p < 0.001). Conclusions: Cognitive impairment in methamphetamine-dependent individuals may be associated with reduced prefrontal functional activity. Different exercise modalities produced different patterns of cognitive improvement and brain activation, with multimodal cognitive exercise training showing the largest overall benefit.

Background: Autobiographical memory undergoes qualitative changes across the lifespan, influencing self-understanding, emotional regulation, and psychological adaptation. Research shows memory is a dynamic process, reconstructed through retrieval, narration, and social interaction. How narrative construction and empathic engagement shape memory reconsolidation and self-continuity remains insufficiently integrated. Objectives: This narrative review synthesizes theoretical, empirical, and applied findings on autobiographical memory, narrative processes, and empathy, proposing an integrative model linking memory reconsolidation, identity reconstruction, and adaptive functioning. Methods: A theory-oriented narrative review was conducted across psychology, neuroscience, gerontology, and narrative research, drawing on literature from PubMed, PsycINFO, Web of Science, Scopus, J-STAGE, and CiNii. Peer-reviewed empirical studies, systematic reviews, and theoretical papers were organized around three interrelated conceptual domains: (1) autobiographical memory and self-related processes, (2) neurobiological and emotional mechanisms relevant to memory updating and reconsolidation, and (3) narrative construction within empathically mediated social interaction contexts, with additional consideration of evidence from narrative-based and creative interventions. Results: The reviewed literature suggests that autobiographical memory functions as a plastic, socially embedded system supporting self-continuity, although the strength and consistency of evidence vary across studies and contexts. Narrativization within empathically responsive and psychologically safe contexts enhances narrative coherence, emotional integration, and perspective-taking, promoting psychological stability, although these effects are not uniformly observed across all populations and study designs. Creative narrative activities further facilitate retrieval and meaning reconstruction, extending memory updating beyond recall, while the underlying mechanisms and causal pathways remain to be fully established. Conclusions: We propose an empathy-mediated narrative reconstruction model in which creative activity, narration, empathic response, and retelling interact cyclically to support memory reconsolidation and self-narrative updating. By integrating cognitive, social, and creative dimensions, this model provides a theoretically grounded framework with implications for clinical, educational, gerontological, and creative applications.

Background: Upper-limb impairment is a major contributor to chronic disability after stroke. Conventional recovery protocols frequently suffer from poor adherence, limited accessibility, and insufficient intensity for prolonged rehabilitation. Methods: We performed a systematic analysis of randomized controlled trials (RCTs) and non-randomized designs published between 2019 and 2024, assessing virtual reality (VR) interventions for upper-limb stroke rehabilitation. Participant characteristics, VR intervention details, primary and secondary outcomes, and adherence rates were analyzed in accordance with PRISMA guidelines. The review is registered in PROSPERO (CRD420251150877). We searched PubMed, Embase, Wiley, Scopus, and Cochrane databases. Study quality was assessed using the RoB 2 and ROBINS-I tools. This review received no funding. Results: Forty-one trials met the inclusion criteria. High variability in study methodology, VR devices, intervention protocols, and outcome measures limited direct comparability. Dropout rates were low and were frequently attributed to factors unrelated to the VR intervention. Adverse events were uncommon, supporting the feasibility and safety of VR-based rehabilitation. Conclusions: While VR is a safe and feasible modality, large-scale, multicenter clinical trials with standardized protocols and long-term follow-up are essential to define the role of VR in routine stroke care.

Background: Health and social outcomes of previous opiate users (POUs) are not well-documented. We characterize the life situation, health status, and health-related quality of life (HRQoL) of POUs entering antiviral hepatitis C (HCV) treatment, compared with HCV patients without past illicit opiate use (NOU), and with HCV patients currently in opiate agonist treatment (OAT). Methods: Data are taken from the German Hepatitis C-Registry ("Deutsches Hepatitis C-Register", DHCR), a multi-centre registry study focussing on the course and outcome of HCV treatment with directly acting antivirals. At treatment entry, patients underwent a standardized clinical assessment, including the Short Form 36 (SF-36) for self-reported HRQoL. Results: POUs (n = 734) and OAT patients (n = 554) were similar with regard to age, sex, migrant background, and psychiatric comorbidity. Employment rate and cannabis, alcohol, and smoking abstinence rates were higher for POUs than for OAT patients, but still lower than for NOU (n = 4147) patients. Mental and physical HRQoL was better for POUs than for OAT patients, but worse than for NOU patients. Compared with SF-36 normative data, POUs showed decreased HRQoL, especially regarding mental health. Conclusions: Compared with opiate-dependent patients in OAT, POUs showed less psychotropic substance use and better HRQoL. Compared with NOU patients and the general population, mental health problems were especially increased. Challenges persist for POUs even during abstinence from opiates, highlighting the need for targeted interventions tailored to the specific needs of this population.

Background/Objectives: Multimodal data fusion is increasingly applied in neuroinformatics to integrate heterogeneous sources of information. However, the optimal strategies for combining modalities with markedly different dimensionality, scale, and noise characteristics remain unclear. To our knowledge, this is among the first systematic and controlled benchmarks explicitly disentangling the effects of fusion strategy and feature scaling within a unified deep learning framework. Methods: Using data from 747 healthy participants from the Human Connectome Project, we evaluated multiple fusion paradigms-including early fusion, attention-based fusion, subspace-based fusion, and graph-based fusion-within a unified and reproducible framework. Importantly, we assessed how different feature scaling techniques (Standard, Min-Max, and Robust scaling) interact with fusion strategies and influence model performance. Biological sex was used as a controlled benchmark task to focus on methodological insights rather than task-specific optimization. Results: Early feature-level fusion consistently achieved the highest classification performance across all evaluated configurations. In particular, direct concatenation of cognitive and neuroimaging features combined with Standard Scaling yielded the best results (AUC-ROC = 0.96 (0.95-0.96)), outperforming unimodal baselines as well as intermediate and late fusion strategies. Conclusions: This systematic benchmark demonstrates that multimodal deep learning performance in neuroscience is driven primarily by the interaction between fusion strategy and feature scaling rather than by architectural complexity alone. By explicitly disentangling the effects of fusion level and preprocessing within a unified framework, this study provides practical methodological guidance for the design, evaluation, and reproducible deployment of multimodal deep learning models in neuroscience.

Background/Objectives: This study aimed to examine how interpupillary distance (IPD) influences motor and sensory binocular vision functions at distance and near, and to examine associations between different motor and sensory binocular vision functions. Methods: A descriptive cross-sectional study was performed involving 100 random participants of both genders, aged 20 to 38 years. Optically corrected and non-strabismic participants were selected from King Saud University, Riyadh, Saudi Arabia between June 2024 and June 2025. Distance and near IPD were assessed with a pupillometer. Motor binocular functions included horizontal phoria using the von Graefe technique and near point of convergence (NPC). Sensory binocular vision was assessed using crossed and uncrossed TNO and Random-dot E stereopsis tests at near and distance respectively. Statistical analysis was conducted using SPSS version 26 (p ≤ 0.05). Results: IPD and phoria were not significantly associated at distance or near. However, moderate and significant correlations were found between IPD (distance and near) and NPC. Significant correlations were also found between IPD and both crossed and uncrossed stereopsis at distance, but correlations were weak or non-significant at near. A strong correlation was observed between NPC and stereopsis at distance. Conclusions: As interpupillary distance (IPD)increases, near point of convergence (NPC) receded, and stereopsis at distance declined, suggesting that anatomical variation influences binocular vision primarily at distance.

Objective: To investigate the integrated relationship between Cerebral Small Vessel Disease (CSVD) markers and quantitative facial soft-tissue measurements in Alzheimer's disease (AD) continuum, utilizing peripheral muscle health as a potential biomarker for systemic frailty and neurodegeneration. Methods: Retrospective analysis of 3T brain MRI data from 67 patients (AD, N = 45; Mild Cognitive Impairment [MCI], N = 22). CSVD markers were assessed using STRIVE and standardized scales (Fazekas, Potter). Facial soft-tissue metrics, including masseter and tongue volume, temporal muscle thickness (TMT), and fat infiltration (Mercuri Scale), were quantified via semi-automatic segmentation on T1-weighted sequences. Group comparisons (AD vs. MCI) used regression models adjusted for age and sex. The overall central-peripheral relationship was explored via Canonical Correlation Analysis (CCA). Results: The AD group showed a highly significant cognitive decline (MMSE: 23.2 ± 4.1 vs. 28.2 ± 1.4, p < 0.0001). Centrally, the presence of PVSs in the mesencephalic region was the most robust predictor for AD (p = 0.003). Peripherally, average masseter muscle volume was significantly lower in the AD group (p = 0.0273), and masseter fat infiltration was significantly higher (p = 0.025), supporting localized sarcopenia. The CCA demonstrated a statistically significant positive multivariate relationship (r = 0.51, Roy's Largest Root p = 0.015) between a higher combined CSVD burden and a worse soft tissue profile across the cohort. Conclusions: Quantitative indices of facial soft tissues, particularly masseter muscle volume and quality, reflect systemic frailty and cognitive deterioration along the AD continuum. The strong central-peripheral correlation suggests that sarcopenia and CSVD are interconnected manifestations of a shared pathobiological process. These easily measurable facial markers could serve as valuable, non-invasive peripheral biomarkers, complementing traditional neuroimaging risk stratification in AD.

Background/Objectives: Tinnitus and hyperacusis can occur together or in isolation, with hyperacusis being associated with tinnitus much more frequently than vice versa. This striking correlation between tinnitus and hyperacusis prevalence implies that there might be a common origin, such as (hidden) hearing loss, and possibly interrelated neural mechanisms in the pathological development of those two conditions. Here, we propose such interrelated pathological mechanisms. Methods: This is a theoretical work based solely on considerations and published data. Results: We propose a model localized in the dorsal cochlear nucleus (DCN) of the brainstem, based on classical mechanisms of Hebbian and associative plasticity known from classical conditioning. Specifically, our model proposes that hyperacusis results from the synaptic enhancement of cochlear input to the DCN, whereas chronic tinnitus results from the synaptic enhancement of somatosensory input to the DCN. Specific conditions leading to one or the other condition are discussed. Conclusions: Our model predicts that hearing loss leads to chronic tinnitus, while noise exposure (which may also cause hearing loss) leads to hyperacusis. We would like to emphasize that our aim with the proposed model is not to provide a self-contained theoretical construct, but to stimulate thought regarding possible pathological causes of tinnitus and hyperacusis that have not yet been investigated. Individual assumptions that cannot yet be substantiated by the existing literature are intended to provide impetus for future experimental studies.

Background/Objectives: Finasteride and dutasteride are 5α-reductase inhibitors that block the conversion of testosterone to dihydrotestosterone, reducing androgenic stimulation of tissues such as the prostate and hair follicles. Used mainly for benign prostatic hyperplasia and androgenic alopecia, finasteride selectively inhibits type-2 5α-reductase isoenzyme, while dutasteride inhibits both type-1 and type-2. Although sexual adverse effects like erectile dysfunction are well-documented, emerging evidence suggests possible neuropsychiatric reactions-including depression, suicidal ideation, and cognitive decline-potentially linked to reduced neurosteroid synthesis, such as that of allopregnanolone. Causality cannot be inferred from spontaneous reporting data. This study aimed to assess pharmacovigilance signals for psychopathological disorders associated with finasteride and dutasteride in the FAERS database. Methods: Cleaned FAERS data referring to years up to 2025 after deduplication were analyzed, excluding non-serious cases and those without the drug as the sole suspect (MedDra 29.0). Reporting Odds Ratios (RORs) with 95% CIs were calculated to compare psychiatric reactions between finasteride and dutasteride. Python 3.11 was used to screen and summarize relevant cases, accounting for differences in total case numbers. Results: This pharmacovigilance study analyzed FAERS data to assess the neuropsychiatric and sexual adverse reactions associated with finasteride and dutasteride. Depression, anxiety, suicidality, and libido-related issues were reported more frequently for finasteride, especially in younger men using low-dose therapy for alopecia. Potential mechanisms include reduced neurosteroid synthesis, androgen/sex-hormone axis disruption, altered hippocampal neurogenesis, and dopaminergic changes. Conclusions: A baseline psychiatric assessment and the regular monitoring of mood, sexual function, and suicidal ideation are recommended. Limitations include under-reporting, reporting bias, and a lack of incidence data. The findings underscore the need for ongoing surveillance and controlled studies to clarify the clinical significance of these signals.

Alterations in excitation/inhibition (E/I) balance, involving both inhibitory and excitatory signaling, have been implicated in the pathophysiology of autism spectrum disorder (ASD). Volatile anesthetics, including sevoflurane, act on multiple molecular and network targets, and anesthetic sensitivity may therefore differ in ASD. This study investigated whether sevoflurane sensitivity is altered in BTBR T+Itpr3tf/J (BTBR) mice, a widely used mouse model of ASD. Sevoflurane sensitivity was compared between BTBR mice and C57BL/6J (B6) control mice using behavioral and electroencephalographic (EEG) analyses. The minimum alveolar concentration required to abolish nociceptive responses (MACsevo) and the sevoflurane concentration associated with recovery of the righting reflex (RRsevo) were measured. Dose-dependent EEG changes, including burst suppression and theta power distribution, were also evaluated. MACsevo did not differ significantly between BTBR and B6 mice. However, RRsevo was significantly lower in BTBR mice (1.10 ± 0.10%) compared with B6 mice (1.65 ± 0.13%; p < 0.001). EEG analyses demonstrated that burst suppression occurred at lower sevoflurane concentrations in BTBR mice (2.0%) than in B6 mice (2.4%). In addition, topographical mapping revealed distinct theta power dynamics between the two strains during anesthesia. BTBR mice exhibit increased sensitivity to sevoflurane during emergence from anesthesia and show distinct EEG patterns compared with control mice. These findings suggest altered anesthetic responsiveness in a mouse model of ASD and support the possibility that network-level neurophysiological differences may influence anesthetic responses. Further studies are needed to clarify whether similar alterations are present across other ASD models and human ASD populations.