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Women traversing menopause experience neuropsychological changes affecting cognitive domains such as memory, attention, and processing speed. However, the relationship between chronological age and cognitive performance across different climacteric stages remains poorly understood, particularly in Latin American populations. The menopausal transition is increasingly recognized as a critical period for women's cognitive health, characterized by profound neuroendocrine changes that may influence trajectories of cognitive aging. Chronological age was associated with better cognitive performance in early menopause, whereas in advanced postmenopause it was associated with lower performance. This pattern may reflect stage-specific differences related to reproductive aging, particularly across different phases of the climacteric. To examine whether chronological age differentially modulates cognitive performance according to climacteric stage in Chilean women from the Magallanes Region. Three hundred sixty women aged 50-81 years were recruited and classified by climacteric stage: early menopause (≤4 years since last menstrual period, n = 126), intermediate postmenopause (5-8 years, n = 123), and advanced postmenopause (>9 years, n = 111). Cognitive performance was assessed using the Addenbrooke's Cognitive Examination-Revised (ACE-R) and the Symbol Digit Modalities Test (SDMT). A Bayesian multivariate model with two-way interaction terms was fitted, simultaneously evaluating ACE-R and SDMT as response variables. More advanced climacteric stage was associated with lower ACE-R and SDMT scores. Although the main effect of age at assessment showed high uncertainty, a significant age × climacteric stage interaction revealed that the age-cognition slope differed by stage. Specifically, in early menopause, older age was associated with better cognitive performance, whereas in advanced postmenopause, older age was associated with lower cognitive performance. The association between chronological age and cognitive performance differed according to climacteric stage in Chilean women. These findings challenge the traditional view of age as a uniformly negative correlate of cognition and may have implications for cognitive screening strategies during the menopausal transition.
To compare the effects of different exercise modalities on multiple cognitive domains in cognitively healthy older adults and examine associations between exercise dose parameters and cognitive benefits. Randomized controlled trials (RCTs) of exercise interventions in cognitively healthy older adults were systematically searched. Outcomes were classified into five domains: executive function, memory, verbal fluency, processing speed, and working memory. Random-effects pairwise meta-analyses were performed using standardized mean differences (SMDs). Prespecified subgroup analyses were conducted by participant and intervention characteristics. Linear random-effects meta-regressions examined frequency, session duration, intervention length, weekly dose, and total dose as continuous moderators. Bayesian network meta-analysis (NMA) was applied to compare and rank exercise modalities, distinguishing active and PCs. Pairwise meta-analyses showed significant improvements in executive function (SMD = 0.31, 95% CI 0.18-0.44), memory (SMD = 0.26, 95% CI 0.14-0.38), and processing speed (SMD = 0.25, 95% CI 0.12-0.38), a borderline effect for working memory (SMD = 0.20, 95% CI 0.00-0.39), and no significant effect for verbal fluency. Meta-regression showed positive associations of training frequency and weekly dose with executive function, and of training frequency with processing speed. Bayesian NMA suggested aerobic exercise (AE) ranked higher for executive function and memory, while mind-body exercise (MBE) showed potential advantages for verbal fluency and working memory; however, most between-modality comparisons remained inconclusive. Exercise benefits multiple cognitive domains in cognitively healthy older adults, with more consistent effects on executive function and memory. AE appears promising, but further high-quality head-to-head trials with long-term follow-up are warranted. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261290474, CRD420261290474.
Mental health is threatened every day by the stressors of life: frenetic work rhythms, stressful conditions can generate anxiety, depression, cognition, and sleep problems. Among natural products with properties to support mental health, Gingko biloba extract with phosphatidylserine (GBP) was exploited with the aim of evaluating its benefits in cognitive function, mood regulation, and overall quality of life. Gingko Biloba has been widely used to improve mental functions, while phosphatidylserine displayed neurotransmitter modulation in several studies. Two exploratory, registered RCT clinical studies were performed. In the first 480 mg/day of GBP, or placebo, was supplemented to healthy volunteers for 4 weeks. Mood states and cognitive performance were evaluated at 60 and 180 min (single dose), and after 4 weeks of supplementation. In the second trial adults experiencing moderate stress received GBP240 (240 mg/day) or GBP480 (480 mg/day) for 4 weeks, and perceived stress, anxiety, mood states, and cognitive performance were evaluated. Following both acute (single dose) and chronic (4-week) GBP480 supplementation, participants exhibited improvements in delayed verbal memory, and reaction time versus placebo, suggesting a possible beneficial impact on cognitive functions. The second study confirmed the GBP benefits on mood states and a visually consistent downward trend in reaction times across all four cognitive performance tests at both GBP dosages, suggesting improved processing speed in response to various stimuli. On the basis of the results obtained in the first study, the results on cognitive models on the second study were more modest than expected. However, the results described in the present research confirmed previous reported advantages of the unique association of Gingko Biloba and phosphatidylserine, so combining antioxidant, neuroprotective, and nootropic properties of both ingredients. Further research is needed to consolidate this preliminary evidence.
BackgroundCognitive functioning worsens during migraine attacks and in the interictal period, especially in chronic migraine. This study aims to evaluate whether preventive treatment with anti-CGRP monoclonal antibodies (mAbs) or botulinum toxin (BoNT) improves interictal cognitive performance in migraine patients, and to compare cognitive changes between treatment responders and non-responders, controlling for treatment type.MethodsA two-center prospective longitudinal comparative study of patients with Episodic (EM) or Chronic (CM) migraine receiving either mAbs or BoNT. Participants underwent two comprehensive cognitive evaluations targeting attention/processing speed, executive functions, episodic memory, and language, at baseline (visit 1) and after three to six months of treatment (visit 2). The primary end point was the degree of improvement measured by the z scores of each cognitive domain (adjusted for age and education), from baseline to follow-up, assessed using repeated-measures analysis with time as the within-subject factor and treatment response as the between-subject factor, controlling for treatment group. Treatment response was defined as a decrease in monthly moderate-to-severe headache days of ≥30% in CM or ≥50% in EM at follow-up.ResultsOne hundred patients were included, and 90 completed the study (median age = 42 years, 96.7% women, 58 (64.4%) with CM, 64 (71.1%) treated with mAbs, and 26 (28.8%) with BoNT. Forty-seven (52.2%) were responders (59.4% in the mAbs group and 34.6% in the BoNT group) after a mean follow-up time of 4.5 months. Improvement in a measure of executive functions (comprising tests of working memory, alternating attention, and phonological fluency) was significantly higher in responders than in non-responders, independently of treatment group. No significant differences between responders and non-responders were observed in episodic memory, language, or processing speed. Among responders, the change in executive function score was not associated with the reduction in monthly moderate-severe headache days or the final number of monthly headache-free days.ConclusionsPerformance on measures of executive capacities, may improve in migraine patients after a few months of effective migraine treatment with mAbs or BoNT, regardless of the treatment group. Further research is needed to determine whether this effect augments over time, is associated to the reduction of pre-ictal and post-ictal days and /or to brain networks reorganization.
Long-term blood pressure variability (BPV) has been proposed as a potential risk factor for dementia and cerebral small vessel disease progression. In this study, we investigate the association between BPV, brain injury, and cognitive decline in probable cerebral amyloid angiopathy (CAA). Using a prospective memory clinic cohort, we enrolled 102 participants, including 52 with probable CAA and mild cognitive symptoms. BPV was assessed using a coefficient of variation derived from outpatient BP measurements (median 12) over 5 years before imaging with 3-tesla research magnetic resonance imaging. We measured peak width of skeletonized mean diffusivity and neuroimaging markers of CAA, including lacunes and cortical cerebral microinfarcts. Using regression models, we evaluated the association of BPV with white matter integrity and whether CAA modified this association. We also examined the association of BPV with longitudinal cognitive decline. Systolic BPV had a dose-dependent association with peak width of skeletonized mean diffusivity (standardized β=0.22, 95% CI: 0.06-0.39, P=0.010), independent of age, sex, mean BP, common vascular risk factors, brain atrophy, and CAA severity. The presence of probable CAA strengthened the association between BPV and peak width of skeletonized mean diffusivity (β=9.33, 95% CI: 1.32-17.34, P for interaction=0.023). Higher BPV correlated with the presence of lobar lacunes, cortical cerebral microinfarcts, and a decline in global cognition and processing speed. Long-term BPV had a dose-dependent association with altered white matter integrity, ischemic brain injury, and cognitive decline. Controlling BPV might be a potential novel therapeutic target to prevent cognitive decline in memory clinic patients with probable CAA and mild cognitive symptoms.
Music engages brain regions involved in perceptual, socio-emotional and cognitive functions that may be relatively preserved in individuals with Alzheimer's disease but seem affected early in behavioural variant frontotemporal dementia. The effects of music in dementia are often assessed through observational studies, leaving the neurophysiological underpinnings of music processing in these dementia types unclear. Improved understanding of these mechanisms is relevant because the effectiveness of music therapy may depend on dementia types. In this study we investigated whether patients with behavioural variant frontotemporal dementia and Alzheimer's disease differ in music processing compared with healthy controls. We studied 60 participants (n = 35 female; aged 52-81), including 13 patients with behavioural variant frontotemporal dementia, 22 patients Alzheimer's disease, and 25 healthy controls. We designed a novel functional MRI paradigm based on passive listening to self-selected favourite music and experimenter-selected unfamiliar musical pieces using a sparse-sampling design. Activation patterns of favourite music listening (favourite > silence), unfamiliar music listening (unfamiliar > silence), and favourite music more than unfamiliar music (favourite > unfamiliar) were determined for each participant. Next, we compared activation patterns across groups for each contrast. Finally, associations between activation patterns and disease severity were investigated in behavioural variant frontotemporal dementia and Alzheimer's disease separately. The patient groups exhibited typical neuropsychological, socio-emotional and structural anatomical changes associated with Alzheimer's disease and behavioural variant frontotemporal dementia. Patients with behavioural variant frontotemporal dementia showed overall less activation during favourite music listening compared with Alzheimer's disease and healthy controls. When contrasting favourite and unfamiliar music, we found that patients with behavioural variant frontotemporal dementia showed reduced activation in the supplementary motor area, a region that has previously been implicated as an important region for semantic musical memory. Increased connectivity of the auditory cortices was observed in behavioural variant frontotemporal dementia compared with controls, potentially indicating network immaturity. Only patients with Alzheimer's disease exhibited activation in the caudate nucleus during unfamiliar music, a region associated with musical reward processing. Disease severity in Alzheimer's disease and behavioural variant frontotemporal dementia were associated with distinct patterns of functional activation. Our results confirm and expand the observation that music is processed differently in patients with behavioural variant frontotemporal dementia and Alzheimer's disease. The reduced activation in the supplementary motor area may explain altered music processing in behavioural variant frontotemporal dementia. These differences in music processing could have clinical implications in the selection of music therapy.
Empathy is fundamental for social functioning yet incurs significant mental costs. While contemporary theories emphasize that empathy is not automatic but regulated by resource availability, this cognitive cost hypothesis relies largely on indirect evidence. Few studies have causally manipulated effort to test its impact on neural empathetic processing. Addressing this gap, Study 1 examined the impact of prior cognitive effort exertion on event-related potential elicited by others' pain. Study 2 extended this investigation to the physical domain (Study 2a) and examined the specificity of these effects using nonpain negative stimuli (Study 2b). Across the three studies, participants consistently showed heightened neural responses for painful compared to neutral stimuli and successful machine classification between the two categories. Crucially, this neural pain empathic response was attenuated following cognitive effort exertion but amplified following physical effort exertion. Furthermore, this modulation was not observed for nonpainful negative stimuli. Collectively, these findings provide direct empirical support for the cognitive cost hypothesis of empathy while revealing that cognitive and physical effort do not simply deplete a shared pool of resources. Instead, they appear to engage distinct mechanisms that differentially shape the regulation of pain empathy. This work advances understanding of empathy as a dynamic process shaped by effort, with implications for theories of self-regulation and social behavior. (PsycInfo Database Record (c) 2026 APA, all rights reserved).
Disorganized thinking has been increasingly recognized as existing along a continuum in the general population. Cognitive flexibility has yielded inconsistent findings with respect to its relationship to disorganized thinking. Individual differences such as sex and self-esteem may account for this variability. This study aimed to assess the association between self-perceived, subjective cognitive flexibility and disorganized thinking in a general population sample, by exploring the moderating effects of sex and self-esteem. A cross-sectional study was performed between May and November 2025 among 553 general population adults (63.5% females) from Tunisia. The Disorganized Thoughts Scale, the Arabic Cognitive Flexibility Scale, and the self-report single-item self-esteem scale were administered to participants. Findings indicated that the relationship between cognitive flexibility and disorganized thinking was moderated by sex and self-esteem such that higher levels of cognitive flexibility were associated with lower levels of disorganized thinking among females (β=-0.62, p < 0.001) but not males, and this relationship was observed only at moderate to high levels of self-esteem. Findings suggest that the relationship between cognitive processes and disorganized thinking may be subject to the effect of other psychological factors. The identification of such factors may be essential for the development of effective prevention strategies and the promotion of mental health.
We evaluated whether the brain glymphatic drainage function estimated by the diffusion tensor imaging along the perivascular space (DTI-ALPS) index relates to white matter (WM) integrity, Alzheimer's disease (AD) neuropathology, resting-state electroencephalogram (rsEEG) alpha rhythms underpinning quiet vigilance, and cognitive decline in mild cognitive impairment (MCI). Clinical, neuroimaging, and rsEEG data were analyzed in matched mild cognitive impairment due to AD (ADMCI) and MCI not due to AD (noADMCI) participants. DTI-ALPS index and aperiodic and periodic components of the rsEEG power spectra were calculated following standard pipelines. Lower DTI-ALPS index was associated with higher AD neuropathology and WM lesions, lower periodic rsEEG alpha rhythms, and worse cognition in patients with ADMCI and noADMCI as a whole population, with the ADMCI (over noADMCI) group showing lower DTI-ALPS index, greater AD neuropathology, and lower periodic rsEEG alpha rhythms. The DTI-ALPS index may capture glymphatic system impairment linked to AD neuropathology, vigilance dysfunction, and cognitive decline in MCI.
To explore the impact of short-term online continuing education on gastroesophageal reflux disease (GERD) on the cognitive level, diagnostic and therapeutic behaviors of physicians in medical consortiums. Physicians of different levels, titles, and specialties from member units of the medical consortium were invited to receive an online GERD training program via the DingTalk platform and complete knowledge tests. The differences in knowledge test scores before and after training were analyzed, and the differences in physicians' choices of GERD examination methods and treatment plans before and after training were evaluated. A total of 232 physicians completed the study. The total score of the knowledge test after training was significantly higher than that before training (P < 0.05). The increase in knowledge test scores of physicians from primary and secondary hospitals, general practitioners and internal medicine physicians were significantly higher (P < 0.05). Data analysis using the GEE model showed that compared with before training, physicians were more likely to choose gastroscopy and gastrointestinal motility tests after training (P < 0.05). Gastroenterologists were more likely to choose gastrointestinal motility tests than general practitioners, and physicians from tertiary hospitals were more likely to choose gastrointestinal motility tests than those from primary hospitals (P < 0.05). Compared with before training, physicians were more likely to choose lifestyle modifications after training (P < 0.05). Short-term online continuing education on GERD can effectively improve the cognitive level of physicians in medical consortiums, especially for physicians in primary hospitals and general practitioners.
The current study investigated the gender-specific relationship between cognitive thinking styles (CTS) and arithmetic fluency, controlling for working memory. It focuses on two specific CTS-Inchworm and Grasshopper (Bath et al. 1986). Grasshoppers are intuitive and holistic, often skipping steps for efficiency, while Inchworms take a methodical, step-by-step approach and document their processes (Chinn 2020). The sample included 290 students (143 males, 147 females) from grades IX and X in Dhaka, Bangladesh. Preliminary t-test analyses revealed significant gender differences. Specifically, male students (M = 19.69, SD = 5.68) displayed more Grasshopper-oriented thinking than females (M = 15.98, SD = 4.03), and also outperformed them in arithmetic fluency (M = 89.83, SD = 20.35 vs. M = 85.01, SD = 19.10). However, for the working memory test, females (M = 17.40, SD = 3.78) outperformed males (M = 16.27, SD = 3.38). Hierarchical regression analyses indicated that, for males, CTS significantly predicted arithmetic fluency, β = 0.36, 95% CI [0.74, 1.86], p < 0.001, even after controlling for working memory. For females, however, only working memory predicted arithmetic fluency, β = 0.41, 95% CI [1.38, 2.82], p< 0.001, with CTS showing no significant relationship. These findings highlight gender-specific pathways through which CTS and working memory influence arithmetic fluency, suggesting the need for differentiated learning strategies in learning mathematics.
Depression is frequently accompanied by emotional eating (EE). However, existing research has largely reduced EE to excessive food intake, overlooking the two opposing phenotypes within depressive populations: emotional overeating (EOE) and emotional undereating (EUE). Furthermore, self-report measures are limited in capturing the dynamic neural processes triggered by negative emotions. To address these issues, this narrative review integrated event-related potential (ERP) evidence from studies on depression, EE, and exercise interventions. The neural characteristics of the two EE phenotypes were compared across multiple processing stages, including attentional allocation, conflict monitoring, inhibitory control, and reward processing. The synthesized evidence suggests that EOE may be characterized by exaggerated reward responsiveness coupled with deficient inhibitory control, whereas EUE is marked by attenuated reward processing accompanied by excessive conflict monitoring. To mitigate inferential risks from cross-population and cross-task integration, the reviewed evidence was hierarchically stratified according to inferential distance, and model conclusions were explicitly bounded. Based on this framework, we propose a bidirectional regulatory model in which exercise is hypothesized to modulate neural homeostasis in a baseline-dependent manner. Within this hypothesis-generating framework, exercise may primarily affect putative EOE-related profiles by supporting cognitive control processes and attenuating the motivational salience of food cues, whereas it may affect putative EUE-related profiles by potentially supporting reward responsiveness and attenuating excessive monitoring. These proposed pathways remain to be tested in phenotype-stratified ERP intervention studies. Future research should implement phenotype-stratified randomized controlled exercise trials combined with emotion-induced food-related ERP tasks to test the model predictions and advance personalized intervention strategies.
Walking draws from a limited pool of attentional resources. Dual-task assessments, where individuals perform a cognitive task while walking, often reveal changes in gait and balance due to competing attentional demands. As cognitive task difficulty increases, the resources necessary to complete the task also increase, causing greater interference with gait and balance. However, these interactions are typically examined using contrived tasks, such as mental arithmetic, that do not often occur during walking. Therefore, it is unclear how the cognitive processes commonly engaged during walking interfere with gait and balance. In this study, we investigated whether increasing the attentional demand of spatial navigation, a cognitive process intrinsically linked to movement, interferes with gait and balance. Healthy adults completed an ambulatory virtual reality homing task in which they walked through a virtual environment and navigated to previously visited locations while wearing ankle and lumbar trackers. We increased the attentional demand of navigation by removing sensory cues during homing: full cues, body-based cues only, or visual cues only. Navigation performance declined as sensory cues were removed, but we observed no corresponding changes in spatiotemporal gait and balance metrics. These results show that, in healthy adults, increasing the attentional demand of spatial navigation did not interfere with gait and balance during real-world movement. These finding suggests that locomotor control may be robust to navigation-related cognitive demands. Further research is needed to determine why navigation did not interfere with mobility and to clarify the relationship between these processes.
Animals undergo major behavioral adjustments during ontogeny, but how the underlying cognitive algorithms change during this process remains elusive. Here, we describe that zebrafish shift from light-seeking to dark-seeking as they grow from larval to juvenile stage. Combining complementary phototaxis assays in virtual reality and modeling, we dissect the computational basis of this transition. We identify three parallel pathways, one analyzing ambient whole-field luminance levels, one spatially comparing light levels across the eyes, and one computing luminance change in each eye. Larvae mostly use the latter two computations, whereas juveniles largely employ the first one. Using a library of agent-based models, we predict behavior in more complex environments. Model-based extraction of latent cognitive variables suggests potential neural correlates of this behavioral inversion. We suggest that zebrafish phototaxis is regulated via parallel processing streams, which could be a universal mechanism for adjusting behavior depending on developmental stage, context, or internal state.
This study investigated how stimulus material and effector specificity influence interference control (a form of inhibitory control) in adolescent players. Ninety-one males aged 15-18 years (28 handball players, 34 soccer players, 29 non-player controls) completed nine modified Flanker task versions varying in stimulus type (abstract, handball-specific, soccer-specific) and response modality (finger, hand, foot). Mixed-design ANOVAs revealed significant main effects of congruency, stimulus type, and response modality. Responses were slower, and interference effects were larger in incongruent than in congruent trials. In addition, sports-specific stimuli and more motorically demanding response modalities were associated with increased response times compared to abstract arrow stimuli and simple finger responses. A congruency × stimulus interaction revealed reduced flanker effects for sports-specific stimuli, indicating that domain-specificity shapes interference processing. However, no consistent group differences were found, suggesting adolescent players do not exhibit broad cognitive advantages, or such advantages are context-dependent. Overall, the findings suggest that performance was primarily shaped by perceptual and motor requirements of the task, i.e., bystimulus complexity and response modality rather than by differences between athlete and control groups. Longitudinal research is needed to clarify how training and development interact to shape cognitive-motor control.
The proposal that the human mind contains modular systems dedicated to processing distinct types of input has been influential for many decades. These systems are thought to function early in development; for example, infants recruit different brain areas and have different expectations about the behavior of physical objects versus social agents. Yet whether these specialized systems drive behavioral responses independently of one another early in life remains unknown. To find out, we examined individual differences in infants' responses to events involving physical objects versus social agents. Unlike previous studies, in which infants are tested with an event from a single domain, we showed 14- to 27-month-old children 16 different events that either accorded with or violated expectations about object physics or social behavior. We found that infants' increased visual interest in the surprising over expected events was better fit by a single latent factor than by separate factors for physical and social expectations. This similarity in surprise responses to physical and social expectancy violations increased with age. Finally, individual differences in infants' surprise across domains predicted later curiosity, highlighting the role these differences play outside the laboratory and across time. These findings suggest that although separate bodies of knowledge support infants' expectations about objects versus social entities, violations of those expectations also recruit domain general processing. SUMMARY: Infants' responses to expectancy violations across physical and social domains reflect a single, domain-general prediction error mechanism. Domain-generality of prediction error responses strengthens with age, suggesting growing generalization of error detection across knowledge systems. Early individual differences in prediction error responses predict later curiosity-driven exploration, but not other behavioral traits. Findings bridge core-knowledge and predictive-processing frameworks, identifying surprise as a developmental mechanism linking error-detection to curiosity.
Neuropsychiatric symptoms (NPSs) are prevalent in Alzheimer's disease (AD), yet their neurobiological etiology remains elusive. We investigated relationships between NPS subsyndromes, plasma neurofilament light chain (NFL), AD-vulnerable brain atrophy, and cognition. We included 146 participants from a Chinese cohort. NPSs were assessed using the Neuropsychiatric Inventory Questionnaire and clustered into four subsyndromes (hyperactivity, psychosis, affective, apathy), each graded by severity (none, mild, severe). Sequential mediation analyses examined whether NPSs influence cognition through NFL and atrophy. Additionally, 1534 ADNI participants were enrolled to (1) replicate mediation effects; (2) examine longitudinal relationships of NPSs with incident cognitive decline; and (3) evaluate cognitive discrimination of NPSs and NFL and onset hazards of NPS subsyndromes. In the discovery cohort, global NPSs burden and three subsyndromes (hyperactivity, affective, apathy) were associated with elevated plasma NFL, poorer global cognition and memory, and reduced brain volumes (all P < 0.05). Sequential mediation revealed that plasma NFL and atrophy mediated the cross-sectional NPSs-cognition relationship, replicated in ADNI. Adding NPSs and NFL improved cognitive discrimination (AUC: 0.6754 to 0.8210, P < 0.001). Additionally, apathy and psychosis showed lower onset hazards than affective and hyperactivity (both P < 0.001). Baseline NPSs were cross-sectionally associated with elevated NFL, brain atrophy, and poorer cognition. Sequential mediation models supported a pathway linking NPSs to cognition via NFL and atrophy, though longitudinal evidence did not fully confirm temporal directionality. These hypothesis-generating findings require prospective validation.
One of the most influential attempts to characterize and explain the perceptual atypicalities of autism, as well as their relationship to the linguistic and social features of the condition, is the "enhanced perceptual functioning" (EPF) model. This model proposes stronger performance, an increased role, and greater autonomy of perception relative to other cognitive functions, and explains early language delay in autism as a temporary reliance on non-linguistic, perceptual processing of language. This paper presents an updated and reconceptualized version of the EPF framework, informed by accumulated knowledge of early language development and perceptual trajectories in autistic toddlers over the past two decades. The language-perception chimera model proposes that, due to a loss of the bias that typically prioritizes social information, the parental voice loses its unique status in triggering first-language acquisition. Consequently, the innate human drive to recognize, acquire, and master language becomes redirected toward its structural, non-communicative components. The selection, search, inspection, and manipulation of structural redundancies-characteristic of repetitive autistic behaviours-may therefore arise from the extension, to non-linguistic domains, of a mechanism through which children identify the language they will acquire. Seven arguments, based on cross-sectional and longitudinal observations of the early manifestations of prototypical autism, support this model. (1) Bayonet-shaped language trajectory: prototypical autism is preceded by reduced social interest and increased attention to non-social material. A plateau without communicative language follows the absence or regression of the few oral words typically acquired by 18 months. Later, language recovery, often including syntax, is delayed but common. (2) During this plateau, early interest in letters and occasional unexpected bilingualism indicate a spontaneous yet diverted orientation toward language. (3) Contemporaneous complex perception-based signs are highly specific to prototypical autism and contribute significantly to diagnostic certainty. (4) Early perception-based behaviours focus strongly on structural patterns. (5) Non-social language entry and complex perceptual behaviours arise when typically developing children experience a lexical and syntactic surge. (6) Veridical mapping phenomena and neuroimaging findings reveal enhanced pattern-language relationships. (7) The perception-language chimera can also account for certain savant abilities. When combined with a reconceptualization of autism as an asymmetric developmental bifurcation, the language-perception chimera model is the first to explain the occurrence, nature, idiosyncrasies, combinations, and developmental trajectories of the majority of social, language, and repetitive features observed in prototypical autism. This framework also clarifies the extent to which the innate mechanisms underlying language detection and acquisition in typical development are truly language-specific, as opposed to domain-general cognitive processes that converge to support language acquisition.
Children with autism spectrum disorder (ASD) often experience feeding difficulties, including extreme food selectivity (FS), disruptive eating behaviors, and in severe cases, avoidant/restrictive food intake disorder (ARFID). These issues can result in unbalanced nutrient intake, impaired growth and development, worsened gastrointestinal symptoms (GIS), and significant feeding burdens for families. This review aims to summarize the dietary characteristics of children with ASD, examine the underlying causes, and evaluate common treatments. The primary objective is to provide evidence-based guidance for child health physicians to implement scientific, individualized nutritional management strategies in clinical practice. We systematically reviewed journal articles published between 2010 and 2025. The analysis focused on dietary characteristics, related mechanisms, and corresponding dietary intervention strategies for children with ASD. This review summarizes the characteristic dietary profiles of children with ASD and discusses the underlying mechanisms from several perspectives: sensory processing dysfunction, microbiota-gut-brain axis dysregulation, food allergy or intolerance, and behavioral-cognitive abnormalities. It also systematically evaluates the effectiveness of mainstream nutritional and behavioral interventions. The main treatment is applied behavior analysis (ABA). It works best for improving eating behaviors. Other food-related treatments have mixed results: special diets [like gluten-free and casein-free (GFCF)] are not proven to help core autism symptoms for most children. They may be tried for a short period in certain cases. Probiotics/prebiotics can help with stomach problems, but their effect on autism symptoms is unclear. Omega-3 supplements do not clearly help autism symptoms. Vitamin/mineral supplements should only be used if blood tests show a lack of specific nutrients. We conclude that ABA constitutes the primary behavioral intervention. Nutritional approaches must be implemented following comprehensive evaluation, targeting specific comorbidities-such as GIS or allergies-or confirmed nutrient deficiencies through precise supplementation. This individualized strategy effectively avoids generalized dietary protocols.
Modern linguistic theories propose that language processing is supported by widely distributed large-scale modules that flexibly interact with domain-general networks. Progressive gliomas tend to reshape the language-associated systems causing dynamic reorganization that can be characterized by resting-state and task-based fMRI, thereby informing surgical decision-making. However, the interplay of neuropathological factors influencing reorganization patterns remains unclear, with ambiguity regarding the recruitment of cognitive resources across various levels of linguistic complexity. We included 100 patients with gliomas and 127 matched normal controls in this study. Activation analyses were performed on task fMRI data acquired during a picture-naming paradigm. Spectral DCM and connectome analyses were combined to examine state-dependent shifts between rest and task conditions. ANOVAs were used to assess relationships between clinicopathological factors and compensatory mechanisms. Mediation analyses were used to explore the mediated pathways among clinicopathological factors, topological indicators, and language performance. First, we observed widely distributed activations associated with glioma-induced perilesional and remote reorganization patterns, exhibiting predominantly right-hemispheric lateralization in domain-general networks. VLSM analyses further showed that the spatial distribution of these activation clusters was significantly associated with tumor location and grade. Second, spectral DCM analyses indicated that task demands were associated with a greater number of positive effective connections across the reorganized language network, interactions among which were inherently dynamic varying with exogenous linguistic complexity and endogenous functional integrity. Third, ANOVAs suggested that alterations in language network topology were accompanied by flexible engagement of domain-general network components, which were associated with a partial restoration of the balance between integration and segregation under task conditions. Finally, we identified associations and potential mediation pathways among clinicopathological factors, topological properties, and language performance, consistent with the concept of glioma-related network metaplasticity. Our findings highlight that the dynamics of language reorganization depend on clinicopathological factors of gliomas and may thus open new perspectives for personalized surgical strategies for functional protection in the era of network neurosurgery. These group-level findings provide a modeling framework that may guide future research toward individualized network assessment and surgical planning.