Most recent paper
Individualized prediction of transition from subjective cognitive decline to mild cognitive impairment based on multimodal MRI: a 10-year follow-up study
J Prev Alzheimers Dis. 2026 Jan 1:100462. doi: 10.1016/j.tjpad.2025.100462. Online ahead of print.
ABSTRACT
BACKGROUND: Predicting the transition from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) is critical for dementia prevention.
OBJECTIVE: Comprehensive assessment of MRI-based macro-/micro-structural and functional brain changes in SCD to develop an individualized model predicting transition to MCI.
DESIGN, SETTING, AND PARTICIPANTS: Patients with SCD were screened from the ADNI, NACC, and OASIS-3 databases. 89 patients met the inclusion criteria and underwent structural magnetic resonance imaging (sMRI) and resting-state functional MRI (rs-fMRI). Over a 10-year follow-up, 49 patients progressed to MCI, while 40 remained stable.
MEASUREMENTS: The VB-net automated brain segmentation, extracting hippocampal radiomics and whole brain subregion volume features. Brain functional features were extracted based on rs-fMRI. Cox regression was used to develop predictive models, which were independently validated with the testing set. The nomogram was constructed to estimate the probability of transition to MCI at 5-/7-/10-year. The nomogram's accuracy was assessed using calibration curves and concordance index (C-index), and clinical utility was evaluated through decision curve analysis.
RESULTS: The model incorporating age, brain volume, functional, and radiomics features demonstrated the highest predictive performance for SCD progression in training (C-index: 0.962; 95 % CI: 0.95-0.98) and testing (C-index: 0.911; 95 % CI: 0.861-0.968) sets. A nomogram comprising 10 predictors was constructed to estimate individualized risk of progression to MCI at 5-/7-/10-year. The calibration curve showed good agreement between predicted and observed values. Decision curve analysis demonstrated the nomogram had substantial clinical value.
CONCLUSIONS: This multivariate model and nomogram could accurately predict the individual progression from SCD to MCI.
PMID:41478831 | DOI:10.1016/j.tjpad.2025.100462
Developmental differences in reward-learning and its connection to resting-state functional connectivity modeled using a hierarchical Bayesian model
Behav Brain Res. 2025 Dec 30;501:116008. doi: 10.1016/j.bbr.2025.116008. Online ahead of print.
ABSTRACT
Adolescence is a period of heightened sensation-seeking, risk-taking, and reward sensitivity, characterized by structural and functional changes in the brain. Developmental changes in functional connectivity between cortical and subcortical regions may refine communication within reward-related circuitry, influencing learning and decision-making. Here, we compared reinforcement learning behavior and its relationship to resting-state functional connectivity in reward-related circuits in adolescents and adults. Fifty-eight healthy participants (32 adolescents aged 13-16; 26 adults aged 30-40) completed a probabilistic two-armed bandit task and resting-state functional magnetic resonance imaging (fMRI). The learning-related parameters learning rate (α) and inverse temperature (β, an index of the randomness of choices) and their relationship to functional connectivity were modeled from behavioral data using Q learning in a hierarchical Bayesian framework. In the whole sample, learning rate was associated with functional connectivity in several cortico-subcortical pathways, particularly involving the anterior cingulate cortex. Adolescents exhibited lower learning rate and inverse temperature values than adults and had a stronger association between learning rate and fronto-striatal connectivity. Adolescents also showed less tendency to stay with winning options in the task, defined as the proportion of trials where participants repeated the previous choice after a reward. These findings highlight the involvement of the ACC in reward learning and indicate that behavior in a reinforcement learning context is characterized by reduced feedback-driven learning and more variable choice behavior or greater exploration in adolescents compared to adults, and suggest that adolescents rely more on fronto-striatal connectivity during learning.
PMID:41478440 | DOI:10.1016/j.bbr.2025.116008
Socio-Emotional Difficulties Observed in Alexithymia Reflect Altered Interactions of the Semantic and Monoaminergic Neuromodulatory Brain Networks
Psychophysiology. 2026 Jan;63(1):e70223. doi: 10.1111/psyp.70223.
ABSTRACT
Alexithymia is a multidimensional construct characterized by difficulties in identifying and describing feelings and reduced ability to engage in abstract thinking. Although often co-occurring with other psychological and neurodevelopmental conditions such as anxiety, depression and autism spectrum disorders, alexithymia is believed to be associated with unique alterations within the socio-emotional brain networks. With the semantic and neuromodulatory brainstem systems playing a key role in social and affective cognition, the current work aimed to study their contributions to alexithymia in unprecedented detail. First, we attempted to identify resting-state functional connectivity patterns of the social semantic hubs (superior anterior temporal lobe) and monoamine-producing regions (dorsal raphe, ventral tegmental area and locus coeruleus) linked to each alexithymia domain. Secondly, by deploying tractography and graph analysis of the associated structural network, we intended to identify their potential anatomical correlates. Alexithymia was strongly associated with dysconnectivity within the semantic network, and altered functional connectivity between the neuromodulatory brainstem regions and cortical areas crucial for social cognition and emotion regulation, including medial prefrontal cortex and inferior parietal lobule. On the anatomical level, these findings were paralleled by negative links with network modularity, suggestive of less specialized neural processing, and decreased clustering coefficient of the semantic node in the left posterior middle temporal gyrus. Despite observing associations with trait-anxiety and emotion suppression for some of the highlighted findings, these phenomena did not mediate the effects of alexithymia. Therefore, the current work highlights the existence of functional and structural alterations within socio-emotional networks as neural markers of alexithymia.
PMID:41476431 | DOI:10.1111/psyp.70223
Dysfunctional resting state network connectivity predicts postoperative delirium after major surgery
Br J Anaesth. 2025 Dec 30:S0007-0912(25)00844-X. doi: 10.1016/j.bja.2025.11.036. Online ahead of print.
ABSTRACT
BACKGROUND: Postoperative delirium is associated with increased morbidity, mortality, future cognitive decline, or dementia. Understanding the neural mechanisms that differentiate individual brain vulnerabilities is critical for future therapeutic development and prevention of postoperative delirium. We investigated the hypothesis that impaired resting state functional connectivity indicates predisposition to delirium.
METHODS: Preoperative blood oxygen level-dependent functional MRI data were collected from 120 participants (>65 yr, 52 female) undergoing major elective non-intracranial surgery. Denoised blood oxygen level-dependent signal time-series for 400 cortical regions were used to calculate resting state functional connectivity within and between canonical resting state networks. We used a support vector machine to determine whether resting state functional connectivity across higher-order cortical networks was predictive of postoperative delirium.
RESULTS: Group comparisons revealed significantly decreased within-network connectivity in salience-ventral attention, cognitive control, and default mode network in participants with postoperative delirium (n=31) compared with non-delirious participants (n=89; non-parametric permutation test, 1000 iterations, P<0.05). We found overall weaker connectivity within the default mode network and specific differences across the sub-networks of the default mode which overlap with higher-order cognitive processing. Supervised machine learning identified that the visual and salience-ventral attentional networks predicted postoperative delirium incidence with an accuracy of 68%.
CONCLUSIONS: Resting state functional connectivity is a neural correlate of vulnerability to postoperative delirium. Disrupted resting state connectivity within higher-order cognitive association areas, including the default mode network, salience attention, and cognitive control networks, was specifically correlated with delirium.
CLINICAL TRIAL REGISTRATION: NCT01980511 and NCT03124303.
PMID:41475933 | DOI:10.1016/j.bja.2025.11.036
Investigating the efficacy of electroacupuncture for postoperative ileus in patients with colorectal cancer: study protocol for a multicentre clinical trial with neuroimaging assessment
BMJ Open. 2025 Dec 31;15(12):e108722. doi: 10.1136/bmjopen-2025-108722.
ABSTRACT
INTRODUCTION: Postoperative ileus (POI) is a prevalent complication following abdominal surgeries, significantly compromising patients' quality of life and imposing a socioeconomic burden. Electroacupuncture (EA), a widely used therapeutic approach in China, has shown promise as an effective intervention for POI. However, the neural mechanism underlying its therapeutic effects remains unclear. Thus, this study aims to evaluate the efficacy of EA treatment for POI and investigate its central mechanism by functional MRI (fMRI).
METHODS AND ANALYSIS: This randomised controlled clinical trial will be conducted across three hospitals in China. A total of 50 eligible patients with colorectal cancer scheduled for elective laparoscopic surgery will be randomly assigned to either the EA or sham electroacupuncture (SA) group in a 1:1 ratio. All patients will undergo 5 sessions of 30 min EA or SA over 5 consecutive days post-surgery (once daily). Resting-state fMRI (rs-fMRI) scans will be performed at baseline and the end of treatment to examine brain functional changes related to EA treatment. The primary outcome is the time to first defecation. Secondary outcomes include the time to first flatus, ambulation, tolerability of semiliquid and solid food; length of postoperative hospital stay; severity of postoperative pain, abdominal distension and nausea; frequency of postoperative nausea and vomiting episodes; rate of readmission. Postoperative complications will be monitored and documented throughout the trial duration. Credibility and expectancy evaluation, along with blinding assessment, will be conducted after the first treatment session. Pearson/Spearman correlation analysis will be performed to determine the relationship between clinical variables and rs-fMRI metrics.
ETHICS AND DISSEMINATION: This protocol has been approved by the ethics committees of Beijing University of Chinese Medicine (number 2024BZYLL0113), Cancer Hospital Chinese Academy of Medical Sciences (number 24/323-4603), Beijing Friendship Hospital Affiliated to Capital Medical University (number 2024-P2-081-01) and Beijing Chaoyang Huanxing Cancer Hospital (number 2024-011-02). Participants will sign the paper-based informed consent form before enrolment. The results will be disseminated through peer-reviewed publications.
TRIAL REGISTRATION NUMBER: ITMCTR2024000504.
PMID:41475813 | PMC:PMC12766759 | DOI:10.1136/bmjopen-2025-108722
Orbitofrontal rTMS modulates inferior parietal lobule functional reorganization to alleviate negative symptoms in first-episode, drug-naïve patients with schizophrenia
Prog Neuropsychopharmacol Biol Psychiatry. 2025 Dec 29:111602. doi: 10.1016/j.pnpbp.2025.111602. Online ahead of print.
ABSTRACT
BACKGROUND: Recent studies have identified the orbitofrontal cortex (OFC) as a potential target for alleviating negative symptoms in schizophrenia. However, the neurobiological mechanisms underlying repetitive transcranial magnetic stimulation (rTMS) delivered to the OFC remain unclear.
METHODS: In this randomized controlled trial, seventy first-episode, drug-naïve patients with schizophrenia were assigned to receive either 20 sessions of active 1 Hz rTMS over the right lateral OFC (N = 36) or sham stimulation (N = 34). Clinical outcomes were measured using the Positive and Negative Syndrome Scale (PANSS). Resting-state functional MRI data were collected before and after treatment to assess changes in regional brain activity and functional connectivity, using fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and seed-based connectivity analyses.
RESULTS: Compared to sham stimulation, active OFC-rTMS led to significantly greater reductions in PANSS scores (total: 22.7 vs. 14.3, p = 0.003, Cohen's d = 0.733; negative: 6.2 vs. 4.0, p = 0.037, Cohen's d = 0.510). Neuroimaging analyses revealed increased spontaneous activity (fALFF and ReHo) in the right OFC and bilateral inferior parietal lobule (IPL), along with enhanced functional connectivity between the OFC and IPL in the active rTMS group. Importantly, IPL-related functional reorganization was significantly associated with symptom improvement, particularly in negative and general domains.
CONCLUSIONS: These findings suggest that rTMS targeting the OFC exerts therapeutic effects in schizophrenia by modulating IPL function and OFC-IPL connectivity. The IPL may serve as a critical downstream node mediating the clinical benefits of OFC-rTMS, offering novel insights into network-based neuromodulation strategies for negative symptoms.
PMID:41475556 | DOI:10.1016/j.pnpbp.2025.111602
Altered intrinsic brain connectivity in misophonia, with and without hyperacusis
Hear Res. 2025 Dec 26;471:109521. doi: 10.1016/j.heares.2025.109521. Online ahead of print.
ABSTRACT
Misophonia and loudness hyperacusis are debilitating sound intolerance conditions marked by extreme emotional and physiological responses to everyday sounds. Although frequently co-occurring, their distinct neural correlates remain poorly delineated. In an exploratory data-driven analysis, we identified neural-connectivity based markers of misophonia among cortical and subcortical networks in the brain using resting-state fMRI data. We leveraged an optimized and cross-validated machine learning framework to sift through >85 thousand functional connections and to evaluate detectability of misophonia, in isolation and when comorbid with hyperacusis. Participants were rigorously categorized using structured interviews into misophonia-only (MI), misophonia with hyperacusis (MH), and control (CTR) groups. Classifier models trained on individual functional connectivity distinguished both MI and MH from CTR, with 63 % and 67 % test prediction accuracy respectively. Core misophonia-related alterations consistently emerged across both groups, particularly in salience, somatomotor, and frontoparietal control networks, implying disruptions in emotion regulation, motor inhibition, and attentional control, respectively. Specific to misophonia-only were connectivity abnormalities in the basal ganglia and subcortex, suggesting a neural dissociation between MI and MH conditions. In contrast, connectivity trends unique to MH revealed networks implicated in higher-order visual processing, likely reflecting hyperacusis-linked processes. These findings offer a refined neurobiological dissociation between misophonia and hyperacusis and underscore the importance of careful diagnostic separation in both research and clinical contexts. By isolating misophonia-relevant brain networks, our results provide actionable insight into the development of precise neuroscience-informed interventions. In particular, they support psychology-based therapy to target dysfunctional connectivity in salience and control circuits for treating misophonia.
PMID:41475326 | DOI:10.1016/j.heares.2025.109521
Restoration of Normal Brain Connectivity With Deep Brain Stimulation for Drug-Resistant Epilepsy in a Pediatric Patient
Cureus. 2025 Nov 28;17(11):e98048. doi: 10.7759/cureus.98048. eCollection 2025 Nov.
ABSTRACT
Epilepsy is recognized as a network disorder. For drug-resistant epilepsy (DRE) that is not amenable to focal resection, deep brain stimulation (DBS) can modulate large-scale networks and improve seizure control. A 16‑year‑old patient with long‑standing DRE underwent hippocampal DBS. Following posterior lead migration, the patient developed a sustained clinical benefit, with seizure frequency decreasing from 12 to 16 daily events to occasional, non-disabling episodes occurring less than once per month - an evolution from Engel Class IVA to Engel Class IC in the Engel Epilepsy Surgery Outcome Classification. After a generator replacement in 2019, resting‑state functional magnetic resonance imaging (rs‑fMRI) was acquired with the stimulator off at discharge, and subsequently at one week and one month, and compared with a healthy control. The rs‑fMRI off‑stimulation imaging showed noticeable hypoconnectivity within the default mode network (DMN). At one week of stimulation, DMN connectivity remained reduced. One month after reactivation, DMN connectivity resembled the control pattern, paralleling the improvement in seizure control. This single‑case observation suggests that DBS may reversibly modulate intrinsic brain networks in DRE, with a time-dependent restoration of DMN connectivity. Although preliminary and exploratory in nature, these findings motivate prospective studies to confirm mechanisms and the durability of network normalization with DBS.
PMID:41473616 | PMC:PMC12745650 | DOI:10.7759/cureus.98048
Early functional network alterations predict motor and cognitive decline in parkinson's disease
Sci Rep. 2025 Dec 30. doi: 10.1038/s41598-025-34136-7. Online ahead of print.
NO ABSTRACT
PMID:41469501 | DOI:10.1038/s41598-025-34136-7
Contralateral Brain Region Exhibits a Hemispheric Difference in Brain Dynamic Functional Connectivity in Patients with Chronic ICA Occlusion
AJNR Am J Neuroradiol. 2026 Jan 5;47(1):158-168. doi: 10.3174/ajnr.A8952.
ABSTRACT
BACKGROUND AND PURPOSE: Many imaging studies focused on the assessment of volume atrophy, structural damage, and abnormal functional connectivity (FC) in patients with carotid artery stenosis disease. Our purpose was to investigate the differences in dynamic functional connectivity within the contralateral brain in patients with chronic ICA occlusion using resting-state fMRI.
MATERIALS AND METHODS: In this trial, 21 patients with chronic occlusion of the ICA (17 men and 4 women) and 11 patients with chronic occlusion of the left ICA (10 men and 1 woman) underwent resting-state fMRI. The control group consisted of 10 healthy men and 6 healthy women. The Mini-Mental State Examination and the Montreal Cognitive Assessment Scale were used to evaluate cognitive function. Cluster analysis and dynamic graph theory were used to analyze the dynamic functional connectivity data obtained through the sliding window method.
RESULTS: The analysis of dynamic graph theory revealed that the regions affected in patients with occlusion of the right ICA primarily involved the primary motor sensory network (precentral gyrus and postcentral gyrus) and the anterior default network (orbital inferior frontal gyrus and anterior cingulate gyrus). The damaged regions of the contralateral hemisphere in patients with left ICA occlusion primarily encompassed the posterior default network (precuneus, inferior parietal lobe, angular gyrus, and amygdala), the salience network (Rolandic operculum, middle cingulate cortex, and amygdala), and the frontal parietal lobe network (angular gyrus, supramarginal gyrus, and inferior parietal lobe). Most of these brain regions are localized within the dominant hemispheric areas.
CONCLUSIONS: Cluster analysis and dynamic graph theory analysis of contralateral brain regions in patients with chronic ICA occlusion on different sides revealed significant variations.
PMID:41469206 | PMC:PMC12767723 | DOI:10.3174/ajnr.A8952
Comparative Evaluation of Resting-State and CO(2)-Induced Cerebrovascular Reactivity in Patients with Traumatic Brain Injury
J Neurotrauma. 2025 Dec 26. doi: 10.1177/08977151251407598. Online ahead of print.
ABSTRACT
Cerebrovascular reactivity (CVR) mapping is a promising biomarker for evaluating vascular dysfunction following traumatic brain injury (TBI). Traditional CVR assessment requires carbon dioxide (CO2) administration. Assessing CVR from resting-state blood-oxygen-level-dependent (BOLD) sequences (RS-CVR) offers a task-free alternative, but its validity in TBI has not yet been established. We aimed to evaluate whether RS-CVR can reliably detect cerebrovascular impairment in patients with TBI by comparing it with CO2-inhalation CVR (CO2-CVR). We enrolled 23 chronic moderate-to-severe TBI patients and 13 healthy controls (HC) who underwent both CO2-CVR and RS-CVR imaging using BOLD functional magnetic resonance imaging (BOLD fMRI). RS-CVR maps were computed using a voxel-wise general linear model (GLM) across 120 bandpass filters. Spatial correlations between RS-CVR and CO2-CVR were calculated to identify the optimal frequency bands. Z-score analyses and lesion-based comparisons were performed to assess CVR reductions in TBI. In the TBI cohort, lesion-based CVR was correlated with clinical outcomes using GLM adjusted for age and sex. The highest whole-brain spatial correlation between RS-CVR and CO2-CVR in HC occurred at [0-116.4 mHz] (r = 0.5239 ± 0.1107). In TBI, the peak correlation slightly shifted to [0-74.5 mHz] (r = 0.5217 ± 0.1108) but remained comparable at [0-116.4 mHz] (r = 0.5093 ± 0.1263). As expected, regions of encephalomalacia, fluid-attenuated inversion recovery hyperintensity, showed CVR reductions on RS-CVR and CO2-CVR maps, but low CVR was also identified through both methods in normal-appearing brain tissue. Across lesion areas, RS-CVR detected deficits consistent with CO2-CVR, with mean z-scores of -0.217 ± 0.334 and -0.391 ± 0.294 for encephalomalacia and hyperintensities, respectively. Lesion-based CVR values were associated with clinical outcomes, with both CO2-CVR and RS-CVR positively correlated with days in the intensive care unit (ICU; p < 0.05) and showing negative associations with Rivermead post-concussion symptoms questionnaire scores, statistically significant for CO2-CVR (p = 0.031) and trending for RS-CVR (p = 0.089). RS-CVR closely mirrors CO2-CVR in both global and lesion-specific analyses, validating its use as a noninvasive method for detecting vascular deficits in TBI. This task-free and scalable tool for cerebrovascular assessment offers a valuable approach for characterizing vascular health relevant to TBI prognosis and guiding neurorehabilitation efforts.
PMID:41468176 | DOI:10.1177/08977151251407598
Functional Connectivity to the Cerebellum and Resting-State Networks Predict Earlier Improvement of Dystonia Following Globus Pallidus Internus-Deep Brain Stimulation (GPi-DBS)
Mov Disord. 2025 Dec 30. doi: 10.1002/mds.70152. Online ahead of print.
ABSTRACT
BACKGROUND: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an established treatment for dystonia. However, the time from device activation to clinical improvement is typically prolonged, variable, and unpredictable. While most patients improve gradually over months, some show significant benefit within weeks. The neuroanatomical and network-level mechanisms underlying early response remain unknown.
OBJECTIVE: To investigate the structural and functional correlates of earlier symptom improvement in patients with isolated dystonia who responded to bilateral GPi-DBS.
METHODS: This retrospective study enrolled 46 patients. Early responders were defined as achieving ≥25% reduction in Unified Dystonia Rating Scale (UDRS) scores within 3 months post-surgery. Preoperative magnetic resonance imaging (MRI) and postoperative computed tomography data were processed to localize electrodes, model volume of activated tissue, and calculate electric fields. Functional connectivity was assessed using normative resting-state functional MRI (fMRI) data, while structural connectivity was estimated using fiber filtering of a histology-based atlas.
RESULTS: A stimulation 'sweet spot' at the ventral border of the lateral GPi and medial globus pallidus externus (GPe) was associated with early improvement. Early response correlated with neuromodulation of GPe-subthalamic nucleus fibers and lenticular fasciculus. Stimulation sites connected to cerebellar cortex (lobules IX, crus I, crus II), default mode, and limbic networks were associated with earlier benefit.
CONCLUSIONS: These findings support a broader network model integrating cerebellum, limbic system, and basal ganglia in dystonia. Stimulation of cerebellar-connected circuits may accelerate improvement independent of classical somatomotor networks. Results highlight novel targets and mechanisms for improving DBS effectiveness, suggesting multitarget, network-informed strategies could enhance therapeutic outcomes. © 2025 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
PMID:41467597 | DOI:10.1002/mds.70152
Neural Correlates of Personality Traits in Adolescents Exhibiting Excessive Smartphone Use: A Resting-State FMRI Study
Life (Basel). 2025 Dec 12;15(12):1899. doi: 10.3390/life15121899.
ABSTRACT
Background: Although smartphone usage is inevitable and convenient in recent days, numerous potential problems due to excessive smartphone use (ESU) have been highlighted. With the rising concern about ESU, the focus on exploring the relationship between ESU and personality traits and their neural correlations also increased; however, studies that explore these factors simultaneously are lacking. Objective: This study investigated whether altered resting state functional connectivity (rsFC) is related to personality traits in adolescents exhibiting ESU compared to healthy controls (HCs). Methods: Thirty-one adolescents exhibiting ESU and 31 HCs (62 adolescents) aged 12-18 years were included in this study. Seed-to-voxel connectivity analysis was used to examine group differences in rsFC in the middle cingulate cortex (MCC) and insula, key parts of the salience network, in relation to personality traits. Results: Adolescents exhibiting ESU showed trends toward low persistence and high harm avoidance in terms of personality traits. Additionally, they exhibited enhanced rsFC between the MCC and insula but reduced rsFC between the precentral and postcentral gyri compared with HCs. Notably, increased rsFC between the MCC and insula in the ESU group was negatively correlated with low persistence. Conclusions: ESU was associated with low persistence at the uncorrected threshold in terms of personality traits and involved in neuro-functional alterations between the key hubs of the salience network, MCC, insula, and several other brain regions. These findings may provide a neurobiological basis for intervention targeting behavioral addiction in youth. Accordingly, adolescents with low persistence may need tailored education on appropriate and controlled use of smartphones and internet-based technologies.
PMID:41465839 | PMC:PMC12734216 | DOI:10.3390/life15121899
Advances in Preoperative and Intraoperative Technologies for Safe Resection of Gliomas in Cognitive Regions
Cancers (Basel). 2025 Dec 5;17(24):3890. doi: 10.3390/cancers17243890.
ABSTRACT
Advances in neuroimaging and intraoperative mapping have transformed brain tumour surgery from anatomy-based resection to function-guided intervention. This review synthesises current evidence on multimodal strategies for maximising tumour removal while preserving cognitive and neurological function. Integrating task-based and resting-state functional MRI (fMRI), diffusion tensor imaging (DTI), tractography, and connectomic analysis enables personalised mapping of eloquent and cognitive networks. Intraoperatively, awake craniotomy with direct electrical stimulation (DES) remains the gold standard for real-time functional validation, while adjuncts such as intraoperative MRI (iMRI), 5-aminolevulinic acid (5-ALA) fluorescence, and ultrasound-based extended resection accuracy. However, these technologies present unique limitations, including neurovascular uncoupling in fMRI, tract distortion in DTI, and resource constraints in low-income settings. Our review differentiates their application across low-grade and high-grade gliomas, emphasising that tumour biology determines the balance between neuroplasticity-driven mapping and imaging-guided radicality. Key future priorities include validation of multimodal imaging protocols, integration of longitudinal neuropsychological outcomes, and development of interpretable connectomic models. Addressing the technological and ethical challenges of high-field MRI, data standardisation, and cost-effective implementation will be essential for equitable global adoption. Ultimately, the evolution of functional neurosurgery depends not only on new technologies but on integrating multimodal evidence and patient-centred outcome measures to achieve reproducible, safe, and personalised brain tumour surgery.
PMID:41463141 | PMC:PMC12731021 | DOI:10.3390/cancers17243890
Multimodal neuroimaging insights into central mechanisms of overactive bladder with an empty bladder: a cross-sectional study
Eur J Med Res. 2025 Dec 29;30(1):1262. doi: 10.1186/s40001-025-03542-y.
ABSTRACT
BACKGROUND AND OBJECTIVE: Overactive bladder (OAB) is a complex condition involving central nervous system (CNS) processes that are not fully understood. We conducted a detailed neuroimaging study to investigate the CNS role in OAB, focusing on the bladder emptying state.
METHODS: This cross-sectional study included 168 OAB patients and 133 matched controls. Participants underwent resting-state functional magnetic resonance imaging (rs-fMRI) and diffusion tensor imaging (DTI) during the bladder emptying state. Data were analyzed using tract-based spatial statistics (TBSS), graph theory, functional connectivity, and structure-function coupling. The Overactive Bladder Symptom Score (OABSS) and the Overactive Bladder Questionnaire Short Form (OAB-q SF) were also utilized.
KEY FINDINGS AND LIMITATIONS: TBSS revealed three white matter tracts with higher fractional anisotropy in OAB patients; the largest of these, including the body of the corpus callosum (bCC) and bilateral anterior corona radiata (ACR), correlated positively with OAB-q scores. Functional connectivity analysis indicated increased connectivity between the left dorsolateral superior frontal gyrus (SFGdor.L) and bilateral supplementary motor areas, and reduced connectivity between the left middle temporal gyrus (MTG.L) and the right inferior temporal gyrus (ITG.R). The left amygdala (AMYG.L) exhibited enhanced structure-function coupling, which was positively associated with OABSS and OAB-q scores. However, the study's cross-sectional design precludes determining causal relationships due to the lack of longitudinal data.
CONCLUSIONS AND CLINICAL IMPLICATIONS: This study identified distinct functional and structural brain alterations in OAB patients during the bladder emptying state. These findings offer new perspectives for investigating innovative treatment strategies. Trial registration This study was registered on the UK's Clinical Study Registry (ISRCTN11583354).
PMID:41462487 | PMC:PMC12752313 | DOI:10.1186/s40001-025-03542-y
Functional neuroimaging features for predicting the transition from benign paroxysmal positional vertigo to persistent postural-perceptual dizziness
J Vestib Res. 2025 Dec 29:9574271251407403. doi: 10.1177/09574271251407403. Online ahead of print.
ABSTRACT
ObjectivesBenign paroxysmal positional vertigo (BPPV) is a prevalent triggers of persistent postural-perceptual dizziness (PPPD). The maladaptation of brain function may be one of the pathophysiology in PPPD. This study aims to identify brain functional neuroimaging features and establish prediction models to predict PPPD after BPPV.MethodsThe diagnosis of BPPV and PPPD was based on the criteria established by the Bárány Society. Patients with posterior semicircular canal BPPV were treated using the Epley maneuver. Patients with geotropic lateral canal BPPV were treated with the barbecue rotation maneuver, while those with apogeotropic lateral canal BPPV were treated using the Gufoni maneuver. After successful canalith repositioning maneuver treatment, the patient underwent resting-state functional magnetic resonance imaging (fMRI) scan. Using feature selection and extraction techniques, six machine learning algorithms were implemented to predict PPPD. The models were trained with 5-fold cross-validation, and performance was evaluated using the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1 score (F1).ResultsA total of 101 patients were included in the final analysis, comprising 64 patients without PPPD (non-PPPD) and 37 patients with PPPD (PPPD). A total of 22 functional neuroimaging features were identified to be closely associated with PPPD after BPPV. Among the six machine learning algorithms, the Multilayer Perceptron model exhibited superior performance, with an AUC of 0.93, a recall of 0.82, a precision of 0.83, an accuracy of 0.82, and an F1 score of 0.82. SHAP analysis identified the most influential resting-state fMRI features in this model. For the top 10 important resting-state fMRI features, 3 features overlapped in all six machine learning algorithms. These features include FC between the vermis 3 and the superior frontal gyrus, orbital part, DC in the cerebellum 7b, left, and FC between the Heschl gyrus, left, and the caudate, right.ConclusionsThese findings provide brain functional neuroimaging features which may be closely associated with the transition from BPPV to PPPD, thereby offering a valuable tool for the early detection of PPPD.
PMID:41460105 | DOI:10.1177/09574271251407403
Does learning a second or third language affect the adaptation of cognitive control in multilinguals? A longitudinal fMRI study
Cogn Neurodyn. 2026 Dec;20(1):24. doi: 10.1007/s11571-025-10397-w. Epub 2025 Dec 26.
ABSTRACT
Numerous studies in the bilingual literature have shown that cognitive control adapts to several factors related to second language (L2) learning. However, whether third language (L3) learning influences cognitive control remains underexplored. In this longitudinal study, we analyzed behavioral performance and functional magnetic resonance imaging (fMRI) data among Chinese-English bilinguals at resting-state and during a flanker task both prior to English (L2) or Japanese (L3) learning and one year later. During brain resting-states for these same learners, we conducted a correlation analysis between language exam scores and functional connectivity strength of resting-state data after one year of study. The connectivity between the left anterior cingulate cortex (ACC) and the left precuneus was positively correlated with English listening performance, while the connectivity between the right supramarginal gyrus (SMG) and the right inferior parietal lobe (IPL) was negatively correlated with English oral performance. The behavioral results from the flanker task showed that after one year of L2 learning in a classroom setting, a significantly smaller flanker effect emerged among Chinese-English bilinguals. Moreover, brain imaging revealed that incongruent flanker trials elicited greater activation of the left superior frontal gyrus (SFG) than congruent trials. These behavioral and neural patterns were not found among Chinese-English bilinguals who had studied Japanese for one year. Taken together, these findings suggest that cognitive control adapts to L2 learning, but appears to be unaffected by L3 learning.
SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11571-025-10397-w.
PMID:41458475 | PMC:PMC12743047 | DOI:10.1007/s11571-025-10397-w
Global signal regression reduces connectivity patterns related to physiological signals and does not alter EEG-derived connectivity
Front Neuroimaging. 2025 Dec 12;4:1653206. doi: 10.3389/fnimg.2025.1653206. eCollection 2025.
ABSTRACT
INTRODUCTION: Functional brain connectivity measures extracted from resting-state functional magnetic resonance imaging (fMRI) scans have generated wide interest as potential noninvasive biomarkers. In this context, performing global signal regression (GSR) as a preprocessing step remains controversial. Specifically, while it has been shown that a considerable fraction of global signal variations is associated with physiological and motion sources, GSR may also result in removing neural activity.
METHODS: Here, we address this question by examining the fundamental sources of resting global signal fluctuations using simultaneous electroencephalography (EEG)-fMRI data combined with cardiac and breathing recordings.
RESULTS: Our results suggest that systemic physiological fluctuations account for a significantly larger fraction of global signal variability compared to electrophysiological fluctuations. Furthermore, we show that GSR reduces artifactual connectivity due to heart rate and breathing fluctuations, but preserves connectivity patterns associated with electrophysiological activity within the alpha and beta frequency ranges.
DISCUSSION: Overall, these results provide evidence that the neural component of resting-state fMRI-based connectivity is preserved after the global signal is regressed out.
PMID:41458206 | PMC:PMC12740878 | DOI:10.3389/fnimg.2025.1653206
Right Hemispheric Neuronal Dysfunction in Cancer Pain: A Resting-State fMRI Exploratory Study
J Pain Res. 2025 Dec 22;18:6993-7003. doi: 10.2147/JPR.S553431. eCollection 2025.
ABSTRACT
BACKGROUND: This exploratory study investigated the neurobiological mechanisms of cancer pain by examining functional brain alterations using resting-state functional magnetic resonance imaging (fMRI), aiming to characterize neural network changes and identify potential neuroimaging biomarkers.
METHODS: A cross-sectional study was conducted from October 2021 to October 2022, involving 20 cancer pain patients and 20 age-, sex-, and education-matched healthy controls. Participants underwent comprehensive clinical assessments and 3.0T resting-state fMRI scanning. Inclusion criteria were patients aged ≥18 years with pathologically confirmed malignant neoplasms experiencing moderate to severe pain (NRS ≥ 4). Functional connectivity and low-frequency amplitude analyses were performed using the right nucleus accumbens as a seed region.
RESULTS: Significant neuroplastic changes were observed in cancer pain patients, primarily in the right hemisphere. Low-frequency amplitude analysis revealed reduced spontaneous neural activity in critical brain regions, including the right medial prefrontal cortex (T = -4.36), right superior/middle frontal gyrus (T = -5.21), and right precuneus (T = -4.15). Functional connectivity analysis showed substantially decreased connectivity between the right nucleus accumbens and bilateral medial prefrontal cortex (T = -4.86), left temporal pole (T = -5.62), and right superior temporal gyrus (T = -5.05).
CONCLUSION: The study provides preliminary evidence of right hemispheric neuronal dysfunction in cancer pain, highlighting altered functional connectivity in emotion regulation and pain processing neural circuits. These findings offer insights into the neurobiological mechanisms of cancer pain and potential objective assessment approaches.
PMID:41458190 | PMC:PMC12742303 | DOI:10.2147/JPR.S553431
Relationship between intrahemispheric and interhemispheric connectivity of the language network and language improvement in subacute post-stroke aphasia
Front Neurol. 2025 Dec 12;16:1634902. doi: 10.3389/fneur.2025.1634902. eCollection 2025.
ABSTRACT
Speech production and comprehension are coordinated by a large-scale language network. The dynamic balance of intrahemispheric and interhemispheric connectivity within this network is essential for normal language processing. Stroke often significantly disrupts both the functional integrity and dynamic balance of the language network, leading to language deficits (aphasia). However, the brain's adaptive potential to compensate for lesions in post-stroke aphasia (PSA) remains incompletely understood. A key unresolved question is whether recovery of language function in PSA is primarily facilitated by compensatory mechanisms within the left hemisphere, increased recruitment ("upregulation") in the right hemisphere, or both. Building on prior research, we defined a language network encompassing canonical language areas. We employed resting-state functional magnetic resonance imaging (rs-fMRI) to quantify functional connectivity (FC) and investigated differences in intrahemispheric and interhemispheric connectivity within this network between 32 patients with PSA and 70 healthy controls (HCs). Furthermore, we examined the association between altered connectivity patterns at baseline and subsequent improvement in language function in the PSA group. Compared to the HCs, the patients with PSA exhibited increased intrahemispheric FC at baseline. Crucially, this increased intrahemispheric FC was positively correlated with the magnitude of language function improvement from baseline to follow-up. In addition, intrahemispheric FC was significantly higher than interhemispheric FC in the PSA group at baseline. These findings suggest that aberrant connectivity within the language network represents a neural substrate of language impairment in PSA and that heightened intrahemispheric connectivity within the residual left hemisphere language network may predict better recovery of language function in patients with subacute PSA. Collectively, network-based pathology analysis enhances our understanding of the neural mechanisms underlying both lesion effects and functional recovery in PSA.
PMID:41458121 | PMC:PMC12740746 | DOI:10.3389/fneur.2025.1634902