Restorative Neurology and Neuroscience

Environmental changes in response to COVID-19 may negatively impact the development, behavior, and mental health of children with Autism spectrum disorder (ASD). Thus, it is necessary to investigate the changed behavioral goals provided.

This narrative review examined studies that investigated changes in intervention methods and behavioral goals for children with ASD during COVID-19. This study searched five databases and identified ten articles meeting the inclusion criteria. These articles were evaluated for risk of bias and quality of evidence level. Behavioral goals and intervention methods were reviewed.

The selected articles included two non-randomized single-group studies, six single-experiment studies, and two case studies. Behavioral goals included mask wearing, social participation and play, and behavioral regulation. Interventions included telehealth, social participation training, play-based sibling intervention, early intensive behavioral, differential reinforcement, and treatment extension for tolerating.

This review identifies the need to change in intervention methods and behavioral goals for children with ASD to adapt to environmental changes due to COVID-19.

This case-series piloted a novel cognitive rehabilitation approach, i.e., Constraint-Induced Cognitive Therapy (CICT), for improving Instrumental Activities of Daily Living (IADL) in stroke survivors with chronic, mild-to-moderate, cognitive impairment. Four consecutively sampled stroke survivors (mean chronicity=18 months, SD = 10) with mild (n = 3) or moderate (n = 1) cognitive impairment received 35 h of CICT. CICT combined two empirically supported approaches: Speed of Processing Training (SOPT) and behavior change techniques from Constraint-Induced Movement Therapy (CIMT) adapted to transfer gains from in-lab cognitive training to daily life. The latter featured IADL training following shaping principles and a suite of behavioral techniques, called the Transfer Package, to promote participation in cognitively-based functional activities outside of the lab. Outcome measures assessed cognitive processing speed (Useful Field of View, UFOV) and IADL performance outside the treatment setting (Canadian Occupational Performance Measure, COPM). All three participants with valid UFOV data displayed meaningful improvements after treatment in cognitive processing speed (M = 64%, SD = 40, d'=1.6). All three with COPM data reported meaningful improvements in satisfaction with IADL performance (M = 2.87, SD = 1.5, d'=1.9). Values of d’ ≥ 0.57 are large. Per structured interviews developed for this study, the IADL improvements present after treatment lasted for at least a year. These promising findings warrant further study.

Constipation is a common but often overlooked issue among stroke survivors, despite its adverse impact on recovery. Herein, we describe an unexpected improvement in constipation following aerobic exercise during the rehabilitation of a patient in the subacute stage of stroke. A man in his 70 s with moderate right-sided hemiparesis following a pontine infarction was admitted for inpatient rehabilitation. Despite maintaining a stable diet and fluid intake, as well as regular use of laxatives, he experienced persistent constipation (one to three bowel movements per week). After 4 weeks of standard rehabilitation, an aerobic exercise regimen was introduced, comprising 30-min sessions on a recumbent ergometer performed five times per week at 50% of the heart rate reserve. No changes were made to his medication, diet, or other therapies during the aerobic exercise period. After initiating aerobic exercise, the patient's bowel movement frequency increased rapidly to four to six times per week, with a marked reduction in constipation symptoms evident from the first week of intervention. To evaluate the effectiveness of aerobic exercise, the percentage of non-overlapping data (PND) was calculated. The PND was 75%, indicating that the intervention was effective. This improvement was sustained both during and after the aerobic exercise period. No other potential confounding factors were identified. This case highlights a temporal association between moderateintensity aerobic exercise and improved constipation in a patient with stroke, suggesting that exercise may warrant investigation as a potential adjunctive intervention. However, the retrospective, single-case design precludes causal inference, and the observed improvements could reflect natural variation or unmeasured confounders. A plausible mechanistic

Ischemic stroke, a leading cause of neurological disability and mortality, involves a multifactorial cascade of oxidative stress, mitochondrial dysfunction, and inflammation. Yet, conventional paradigms centered on apoptosis and necrosis fail to fully explain the inflammatory amplification that drives secondary brain injury—underscoring the emerging significance of pyroptosis as a distinct and targetable death program. This review delineates the mechanistic architecture of pyroptosis in ischemic stroke, integrating canonical (NLRP3–caspase-1–GSDMD) and noncanonical (caspase-4/5/11–GSDMD) inflammasome cascades with apoptosis-, necroptosis-, and ferroptosis-linked pathways within a unified PANoptotic continuum. Upstream regulators—such as mitochondrial ROS–TXNIP coupling, STING-mediated innate immune signaling, and astrocytic LCN2/24p3R activation—coordinate oxidative stress with neuroinflammatory propagation and blood–brain barrier disruption. Pharmacological inhibition of inflammasomes (MCC950, CY-09, OLT1177), caspases (VX-765, Ac-YVAD-CMK), or gasdermins (disulfiram, necrosulfonamide) markedly reduces IL-1β/IL-18 release and preserves neurovascular integrity in preclinical models, highlighting pyroptosis as a therapeutically tractable axis in ischemic stroke. Despite these advances, challenges remain in defining temporal–cellular specificity and achieving clinical translation. Integrating single-cell multi-omics, spatial imaging, and nanocarrier-based delivery systems may enable precise, phase-adaptive modulation of pyroptosis, transforming destructive inflammation into controlled neurovascular recovery.

Episodic memory deficits are frequently encountered following stroke. Rehabilitation of these deficits is often associated with short term effects that do not persist at follow up times. Neuromodulation tools acting on alterations of excitation/inhibition dynamics could be useful for rehabilitation of episodic memory. Prism adaptation with visual field deviation ipsilateral to the affected hemisphere can specifically modulate brain excitability and lead to improvement of cognitive deficits in post-stroke patients. Here we investigated whether prism adaptation followed by digital cognitive training could induce long term improvement of episodic memory deficits in stroke patients as compared with traditional rehabilitation.

Sixty stroke patients were recruited for the study. Thirty patients were treated with prism adaptation combined with serious games targeting executive processes, with a ten days protocol (experimental group); thirty patients were treated with conventional rehabilitation (control group). Patients were tested with a battery of neuropsychological tests, including verbal and visual episodic memory tasks at four times: at baseline (T0); immediately after the end of the rehab protocol (T1); after 3 months (T2); after six months (T3).

The main results showed a significant long term effect of the experimental treatment on both immediate and delayed recall phases of the visual episodic memory task. The effects were not linked to the affected hemisphere (right vs. left), nor to the hemorrhagic or ischemic type of stroke nor to the cortical or subcortical site of lesion.

These findings show for the first time an improvement of long term memory in stroke patients following the use of a medical device combining prism adaptation and digital cognitive training, paving the way to novel rehabilitation techniques for cognitive deficits in stroke.

In this open-label single-arm study, we tested the preliminary therapeutic effects of a four-week mindfullness-based intervention (MBI) tailored for fibromyalgia, including weekly online group meetings and daily mindfulness practices. Forty-six patients completed the intervention. The primary outcome was pain intensity scored on a numerical rating scale (NRS). Secondary outcomes included verbal fluency and self-reports of affective pain, quality of life, sleep quality, mood, emotion regulation, and psychological impairment. Transcranial magnetic stimulation was used to measure mindfulness-induced cortical excitability changes. Participants reported statistically reduced pain intensity post-training, with only 15.3% of the patients demonstrating clinically meaningful pain relief. A moderate improvement in quality of life, with only 45.6% clinical responders, were noted. Small-to-medium improvements in affective pain level, mindfulness level, and resilience as well as increase in long-interval intracortical inhibition—a measure of GABA_Bergic inhibition—were observed. The study introduces a novel MBI tailored for fibromyalgia. Nonetheless, given the current study design and the lack of clinical significance of the findings despite statistical significance, the results are insufficient to draw firm conclusions regarding its potential therapeutic efficacy. Future sham-controlled randomized clinical trials are necessary to validate and expand upon these results.

Individuals with severe neurological injuries often rely on assistive technologies, but current methods have limitations in accurately decoding multi-degree-of-freedom (DoF) movements. Intracortical brain-machine interfaces (iBMIs) use neural signals to provide a more natural control method but currently struggle with higher-DoF movements: something the brain handles effortlessly. It has been theorized that the brain simplifies high-DoF movement through muscle synergies, which link multiple muscles to function as a single unit. These synergies have been studied using dimensionality reduction techniques like principal component analysis (PCA), non-negative matrix factorization (NMF), and demixed PCA (dPCA) and successfully used to reduce noise and improve offline decoder stability in non-invasive applications. However, their effectiveness in improving decoding and generalizability for implanted recordings across varied tasks is unclear. Here, we evaluated whether brain and muscle synergies can enhance iBMI performance in non-human primates performing a two-DoF finger task. Specifically, we tested if PCA, dPCA, and NMF could compress and denoise brain and muscle data and improve decoder generalization across tasks. Our results showed that while all methods effectively compressed data with minimal loss in decoding accuracy, none improved performance through denoising in our datasets. Additionally, none of the methods enhanced generalization across tasks. These findings suggest that while dimensionality reduction can aid data compression, extracting synergies alone did not provide an advantageous or cleaner control space for linear decoding in our study. Further research with larger sample sizes and more channels in muscle recordings is required to determine whether synergies can be leveraged as an optimal control framework or if alternative approaches are required to enhance decoder robustness in iBMI applications.

This study sought to explore the neural and affective responses to exercise- and sedentary-related imagery among Latin Americans and Non-Hispanic Whites with overweight and obesity, aiming to understand the influence of cultural background on exercise behaviors. Using electroencephalography, the research investigates differences in directional brain connectivity patterns and emotional reactions between the two groups. Participants were shown images depicting exercise and sedentary behaviors, with affective responses recorded via the Self-Assessment Manikin and neural connectivity assessed using Granger Causality Analysis. Results indicate significant differences in brain connectivity between groups and conditions. Non-Hispanic Whites showed stronger connectivity within frontal-parietal networks during exercise imagery, while Latin Americans displayed more distributed connectivity during sedentary imagery, suggesting different neural engagement strategies. Affective data revealed that participants reported higher valence for exercise-related images, with Latin Americans exhibiting higher perceived activation for sedentary images. Qualitative analysis of semi-structured interviews identified key themes, including family support, motivation to exercise, and time constraints. Both groups emphasized the importance of social influences on physical activity; however, Latin Americans expressed more ambivalence toward exercise. Network analysis of interview data further highlighted the complex interplay between these psychosocial factors. This study provides novel insights into how cultural differences shape both neural and emotional responses to exercise, informing the development of culturally tailored interventions to promote physical activity in populations with higher obesity prevalence.