Cell metabolism and epigenetic regulation play crucial roles in modulating cerebral ischemia/reperfusion (I/R) injury. How cell metabolism regulates cerebral I/R injury by regulating epigenetic modifications remains unclear. In this study, we utilized an in vivo injury model of transient middle cerebral artery occlusion (tMCAO) in C57BL/6 mice. The middle cerebral artery was occluded for 90 min, followed by reperfusion at different time points. We observed that the expression of ATP-citrate lyase (ACLY), an important enzyme involved in lipid synthesis, was significantly upregulated under cerebral I/R conditions. Inhibition of ACLY markedly exacerbated cerebral I/R injury in vivo. ACLY inhibition and knockdown in vitro also reduced cell viability in cultured neurons following oxygen-glucose deprivation/reoxygenation (OGD/R). Mechanistic studies revealed that ACLY enhances histone acetylation at the promoter regions of mitochondrial respiratory chain complexes by facilitating the accumulation of acetyl-CoA, thereby improving mitochondrial function and attenuating oxidative stress. Our findings reveal a novel metabolic-epigenetic axis mediated by ACLY in the regulation of cerebral I/R injury which may serve as a potential target for therapeutic intervention in ischemic stroke.
Subsequent to an intracerebral hemorrhage (ICH), a cascade of neuroinflammatory response drives the process of secondary brain injury. At present, no anti-inflammatory nor neuroprotective pharmacological interventions have been demonstrated to improve functional outcome after ICH. This Phase 2b study was designed to establish the safety and feasibility of CN-105, a neuroprotective and anti-inflammatory pentapeptide designed from the receptor binding region of apolipoprotein E, in patients with acute primary supratentorial ICH. The Singapore CN-105 in Participants with Acute Supratentorial ICH Trial (S-CATCH, NCT03711903) was a randomized, double-blind, placebo-controlled trial involving 60 patients (30 CN-105, 30 placebo) treated within 12 h of symptom onset. Safety was assessed through adverse events (AEs) and serious AEs (SAEs), while efficacy was evaluated using functional outcome measures, including the modified Rankin Scale (mRS) at 90 days. CN-105 was safe and well tolerated in patients with acute ICH, with no significant differences in incidence of SAEs between groups (30% SAEs in placebo vs. 26.7% in CN-105). Notably, fewer patients treated with CN-105 group experienced in-hospital neurological deterioration (0 vs. 10% in placebo). While treatment was not associated with a statistically significant improvement in 90-day mRS, higher proportion of patients treated with CN-105 achieved favorable mRS scores (≤ 3) compared with those in the placebo group (77.8 vs. 66.7%; p = 0.35). This Phase 2b trial confirmed the safety and feasibility of CN-105 administration in the acute setting of ICH. Although no statistically significant improvements in neurological outcomes were found, the observed trends warrant further investigation. Future Phase 3 trials should focus on refining patient selection and assessing the therapeutic efficacy of CN-105 in more targeted subgroups such as those with medium-sized subcortical ICH. Trial registration NCT03711903, https://clinicaltrials.gov/ https://clinicaltrials.gov/study/NCT03711903?term=NCT03711903&rank=1 . Registered 16 October 2018.
Intracerebral hemorrhage (ICH) remains associated with high mortality and treatment variability. Current workflows rely on fragmented imaging interpretation and operator-dependent surgical planning. The objective was to develop and validate an agentic artificial intelligence (AI) framework integrating automated imaging analysis, guideline-based reasoning, and trajectory optimization for ICH treatment. Fifty consecutive computed tomography (CT) and computed tomography angiography (CTA) datasets from patients with spontaneous ICH were retrospectively analyzed. The system performed multi-class anatomical segmentation of skin, skull, brain, ventricles, and hematoma, followed by volumetric quantification and JavaScript Object Notation (JSON) based structured encoding of imaging biomarkers. A knowledge-based module incorporating international ICH guidelines generated risk stratification and treatment recommendations. When evacuation was indicated, an automated trajectory modeling module proposed a patient-specific minimally invasive surgical corridor. Overall agreement between AI-generated and expert treatment recommendations was 82% (41/50 cases), with substantial agreement beyond chance (Cohen's κ = 0.71). Discrepancies occurred primarily in borderline surgical indication scenarios. In evacuation candidates, the automated planner generated feasible trajectories in all 50 cases. Median angular deviation between AI-generated and expert-defined trajectories was 7.6°, interquartile range (IQR) 5.1-9.8°. AI-generated trajectories demonstrated equal or greater safety margins relative to expert planning in the majority of cases. End-to-end processing has a potential to substantially reduce simulated decision-support time compared with manual workflow. The proposed agentic AI framework enables structured, explainable, and workflow-integrated decision support for ICH management. This system may reduce operator variability and enhance precision in minimally invasive evacuation planning.
The prevalence of brain tissue hypoxia (BTH; PbtO2 < 20 mm Hg) in patients with spontaneous ICH is not well established. In this study, we aimed to quantify the prevalence of BTH and to assess determinants of brain tissue normoxia (BTN; PbtO2 ≥ 20 mm Hg) and BTH resolution. This retrospective cohort study included 58 patients with ICH admitted to a neurological intensive care unit (ICU) between 2010 and 2020 with multimodal invasive neuromonitoring. BTN was sought by avoiding low cerebral perfusion pressure (CPP) and low blood hemoglobin levels, and by maintaining normocapnia, normoxemia, normothermia, and metabolic homeostasis. Hourly PbtO2, CPP, and temperature data were matched with intermittent variables (blood gases, hemoglobin, glucose, sodium, and microdialysis) over 10 days. Regression analyses were performed using generalized estimating equations to account for repeated measurements. Patients were 61 [interquartile range (IQR), 55-69] years old and presented with an ICH score of 2 (1-3). Of the patients, 52 (90%) underwent surgical evacuation via hemicraniectomy and/or craniotomy, while 6 (10%) received invasive neuromonitoring only. The median initial ICH volume was 40.2 (IQR 29.5-55.8) mL. Surgical evacuation achieved a median reduction of 86.6% (IQR 69.0-94.2), leaving a median residual volume of 5.5 (IQR 3.0-14.1) mL. The overall prevalence of BTH was 31%. In multivariable analysis, the following factors led to the highest percentage of BTN: CPP 80-89 mm Hg [odds ratio (OR) 1.88, 95% confidence interval (CI) 1.32-2.68, p < 0.001; reference: < 60 mm Hg], partial pressure of oxygen (PaO2) 90-99 mm Hg (OR 1.64, 95% CI 1.15-2.14, p = 0.001; reference: < 80 mm Hg), core body temperature 36.0-37.4 °C (OR 2.10, 95% CI 1.34-3.28, p = 0.001; reference: < 36.0 °C), PaO2/fraction of inspired oxygen (FIO2) 100-199 (OR 3.52, 95% CI 1.60-7.75, p = 0.002; reference: < 100) in a model corrected for probe position. Only CPP [74.6 (66.8-82.7) vs. 72.5 (64.9-80.2) mm Hg, p < 0.001)] was significantly higher after BTH resolution as compared with the time when PbtO2 was lowest during 229 BTH episodes. BTH was observed during 31% of the monitored time in patients with a large hematoma volume despite the use of a PbtO2-targeted therapy. These findings generate the hypothesis that physiological determinants, such as CPP, are significantly associated with the achievement of BTN in regions near to the ICH.
Mobility impairments caused by cerebral palsy (CP) negatively impact the daily lives of those with this neurodevelopmental disorder. The primary treatment method is physical therapy, which requires an understanding of the musculoskeletal system. While previous studies focus on muscles, tendons are also critical to movement and ambulatory activities. Therefore, this study aims to understand and quantitatively compare the patellar tendons of children with CP and their typically developing (TD) peers to guide physical therapy treatment. The right patellar tendon of 20 children, 8 with CP and 12 TD, was imaged using a Clarius L7HD3 wireless ultrasound probe (Clarius Mobile Health, Vancouver, BC, Canada) in both the transverse and sagittal planes. The raw radiofrequency ultrasound data were analyzed to quantify differences in image quality, ultrasonic spectral parameters and envelope statistics between children with CP and their TD peers, both as a group and across age- and sex-matched pairings. Significant and consistent differences were observed in 6 of the 10 investigated metrics, including contrast, contrast-to-noise ratio, signal-to-noise ratio, mid-band fit, spectral slope and Nakagami-m. One notable difference was observed in contrast, where the mean ± standard deviation in the transverse plane for children with CP was lower than that of their TD peers (1.66±4.43 vs. 5.14±5.37, respectively), indicating a statistically significant difference in echogenicity between the two groups. The observed trends in children with CP correlate with previous studies in injured tendons. These results demonstrate the potential for point-of-care quantitative ultrasound-derived parameters to characterize patellar tendon microstructure and support personalized physical therapy assessment and treatment planning for children with CP.
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Cells release heterogeneous extracellular vesicles and particles (EVPs) into circulation, carrying RNA and proteins that reflect their origin. Recently, brain-derived EVs have gained significant attention as non-invasive biomarkers for Alzheimer's disease (AD). Here, we identified sub-50nm extracellular nanoparticles in human brain and blood that lack the hallmarks of small EVs, exosomes, exomeres, and supermeres but are enriched for brain-specific markers, hereafter termed small EPs or 'SECmeres'. We discovered that RNAs associated with SECmeres discriminated AD cases from controls with higher significance than small EVs, large EVs showed no differences. Discriminating RNAs were enriched in small EVs (Synaptotagmin, Alpha-synuclein, MAPT) or SECmeres (L1CAM, Syntaxin, Neurogranin), indicating distinct brain-derived signatures. Single-cell RNAseq deconvolution shows small EVs contain RNAs from diverse brain cells, whereas SECmeres enrich brain endothelial transcripts, lining cerebral blood vessels and forming the blood-brain barrier (BBB). These findings challenge the prevailing view that small EVs are the primary carriers of biomarkers. Collectively, our study shows that blood EVPs carry brain-specific information for liquid biopsy, pending validation in larger blinded clinical trials.
Miniaturized microscopes or 'miniscopes' for neuroimaging in freely behaving animals mostly operate over short durations (<2 h) and image either neuronal activity or cerebral hemodynamics. In contrast, central nervous system (CNS) disease models involving seizures, brain tumors etc. necessitate long-term (>24 h) imaging, remote operation and simultaneous characterization of multiple neurophysiological variables such as neuronal activity, blood flow, blood volume, oxygenation and cellular dynamics (a capability that we call 'neurosurveillance'). Thus, we developed the 'CloudScope', a cloud-based multicontrast miniscope for autonomous neurosurveillance in freely behaving animals. Its cloud-based architecture enables global remote operation and continuous acquisition of multicontrast images over CNS disease model life cycles. We demonstrate CloudScope's neurosurveillance capabilities in predicting behavior from 24-h neuroimaging data with deep learning (DL), characterizing neurovascular changes during natural behavior, seizure-induced neurovascular disruptions, and in vivo cellular and microvascular phenotyping of brain tumor microenvironments. Finally, CloudScope's architecture enables 'time-shared' imaging, which potentially reduces animal use. Collectively, CloudScope's neurosurveillance capabilities in conjunction with CNS disease models establish a new paradigm for characterizing their etiology and evolution.
Peganum harmala L. is a plant rich in β-carboline alkaloids, especially harmine, which is widely used in folk medicine and has therapeutic and toxic effects depending on the dose. In order to determine the toxic properties of harmine, the experiment was carried out by perorally treating this substance to the animals at a dose of 20 mg/kg every day for 14 days. As a result, although the absolute liver weight was significantly increased in the harmine-treated group compared to the control rats (4.65 g vs. 4.25 g, p = 0.04), the relative liver weight was significantly decreased (2.96% vs. 3.55%, p = 0.0045), likely reflecting the disproportionate increase in total body mass observed in the harmine group (157.25 g vs. 119.5 g, p = 0.0002). Additionally, the relative weight of the cerebral hemispheres was significantly reduced, and a statistically significant increase in ALT levels was observed. In the rats treated with harmine, blood was observed in the urine in 85.72% on the first day, and nitrites and proteins were observed in 71.3%. Examination of the amounts of alkaloids in organs and samples, very high amounts of harmine were found, especially in the liver. The 97.78% decrease in harmine content when passing from the stomach to the small intestine indicates its absorption from the stomach. As the result of light and transmission electron microscopy pathological changes were detected due to harmine such as damage to the wall of the central venous vessels and sinusoids, increase in the amount of edema fluid as a result of increased vascular permeability, indistinguishability of boundaries between hepatocytes and steatosis in their cytoplasm, vacuolization, increase in the amount of lysosomes, dystrophy of some nuclei, destruction of the microvilles of bile capillaries.
Accurate reconstruction of neuronal morphology is a cornerstone for understanding the structure and function of neural circuits. Despite significant advances in imaging and reconstruction techniques that have greatly expanded the scale and quality of neuronal data, existing public datasets still lack large-scale, high-quality, and well-annotated resources, limiting their utility for training and evaluating modern AI models. In this study, we present an open, graded neuronal dataset covering the entire mouse brain. Leveraging high-resolution optical microscopy, we combined automated reconstruction with multi-user collaborative proofreading to generate high-precision neuronal annotations. Our dataset was derived from 10,547 neurons across 258 whole-brain samples, and approximately 8,092,547 standardized data units with graded difficulty levels were generated through an interactive collaborative reconstruction process. Moreover, the dataset supports both API access and bulk downloads, offering researchers convenient data acquisition methods. This work fills a critical gap in standardized, annotated whole-brain neuronal resources, provides a high-quality benchmark for AI-driven automated neuronal reconstruction, and lays a solid foundation for building large-scale neural circuit maps.
Nightmare disorder is historically conceptualised as a rapid eye movement (REM) sleep parasomnia, but evidence also points to altered non-rapid eye movement (NREM) sleep physiology. Here, in a retrospective case-control study, we analysed overnight polysomnography from 26 adults with nightmare disorder and 32 controls using a harmonised event-based EEG pipeline. Nightmare disorder showed reduced frontal slow-oscillation-spindle coupling, whereas delta-spindle coupling was preserved, yielding lower coupling dominance than in controls (0.137 ± 0.083 versus 0.238 ± 0.096; p = 6.8 × 10-5). Stage-adjusted K-complex density across the first 6 h from sleep onset was also lower in nightmare disorder (0.463 ± 0.345 versus 0.723 ± 0.475 events per minute of available N2/N3 sleep; p = 0.019), whereas peak-timing differences were not robust. These findings suggest altered NREM sleep microarchitecture in nightmare disorder rather than a phenotype confined to REM sleep, and warrant prospective confirmation in harmonised, clinically phenotyped cohorts.
Adolescent social stress can impair myelination and increase vulnerability to psychiatric symptoms. We investigated whether acetyl-L-carnitine (ALC), a metabolite linking energy and lipid metabolism, regulates oligodendrocyte (OL) myelination and rescues behavioral deficits in a post-weaning social isolation (PWSI) mouse model. In vitro, ALC uptake and conversion through the OCTN2/CrAT axis promoted myelin sheath expansion without affecting OL precursor proliferation or early differentiation. ALC activated ERK signaling, increased histone acetylation, promoted PPARγ nuclear translocation, and selectively enhanced mitochondrial respiration in mature OLs. In vivo, oral ALC supplementation restored social preference and medial prefrontal cortex MBP expression in PWSI mice, whereas cuprizone co-administration abolished these effects, suggesting that the therapeutic effects of ALC are closely associated with its impact on myelination. Lipidomic analysis of the corpus callosum showed that ALC restored PWSI-induced changes in fatty acid chain length and unsaturation. These findings identify ALC as a metabolic regulator that restores social isolation-induced myelin deficits by coordinating myelin protein synthesis, mitochondrial function, and myelin lipid remodeling. ALC may therefore provide a metabolic strategy for targeting myelin-related neurodevelopmental and psychiatric disorders.
Our brains dynamically adapt to a multisensory world by orchestrating diverse inputs across sensory streams. This process engages multiple brain regions, but it remains unclear how audiovisual stimuli are represented and evolve over time, especially in naturalistic scenarios. Here, we employed a movie-viewing paradigm to explore this question. We recorded intracranial electrocorticography (iEEG) to measure brain activity in 19 participants watching a short multilingual movie. Using unsupervised clustering and supervised encoding models, we identified a robust modality-specific gradient in the frontal cortex, wherein the ventral division primarily processes auditory information and the dorsal division processes visual inputs. Further, we found that this cortical organization dynamically changed, adapting to different movie contexts. This result potentially reflects flexible audiovisual-resource assignment to construct a coherent percept of the movie. Leveraging behavioral ratings, we found that the frontal cortex is the primary site in this modality assignment process. Together, our findings shed new light on the functional architecture of the frontal cortex underlying flexible multisensory representation and integration in natural contexts.
Children with severe self-injurious behaviour (SIB) are at risk of permanent injury and lack effective treatment options. Neuromodulation of the nucleus accumbens (NAc), a key node in reward and behavioural regulation circuits, may directly modulate the drivers of SIB. We report long-term outcomes from a first-in-human, single-centre trial of deep brain stimulation (DBS) targeting the NAc in children and adolescents with profound autism and treatment-refractory SIB (NCT03982888). Six participants (ages 7-14 years; mean 11.7) underwent bilateral implantation and were followed prospectively for at least 24 months (mean 32.5 months, range 25.8-56.0). One serious adverse event occurred: a device-related infection requiring hardware explantation, followed by relapse to baseline levels of self-injury. Subsequent re-implantation in this participant yielded rapid improvement in SIB, providing single-subject, causal withdrawal-rechallenge evidence of treatment-specific benefit. Across the cohort, NAc-DBS produced sustained reductions in SIB frequency and severity, repetitive and obsessive-compulsive behaviours, and clinically meaningful improvements in quality of life. The durability of these effects over multi-year follow-up suggests that circuit-targeted neuromodulation may modify the developmental course of severe behavioural pathology. These findings provide the first long-term evidence that modulation of reward circuitry can durably alter maladaptive behaviour in childhood neurodevelopmental disorders.
Type 2 diabetes mellitus and depression are mutually reinforcing, yet combined pharmacotherapy is limited by side effects and poor tolerability. Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulatory approach with emerging metabolic and antidepressant potential, although its central mechanisms remain unclear. Here, we investigated whether hypothalamic serotonergic signaling is involved in the dual effects of taVNS in a mouse model of type 2 diabetes with depression (T2DD). T2DD was induced in db/db mice by chronic unpredictable mild stress, followed by taVNS intervention (2/15 Hz, 1 mA, 30 min/day for 3 weeks). Behavioral performance, body weight, and fasting blood glucose were assessed, while brain-wide neuronal activity was mapped using fluorescence micro-optical sectioning tomography (fMOST). Hypothalamic 5-HT release was monitored by fiber photometry, and 5-HT content and 5-HT₁A receptor expression were quantified by ELISA and Western blotting. TaVNS significantly reduced body weight and fasting blood glucose, alleviated depression-like behaviors, and improved locomotor activity. Brain-wide mapping revealed state-dependent modulation of neuronal activity, characterized by widespread activation under physiological conditions and suppression of stress-induced hyperactivation in T2DD. Notably, taVNS induced robust hypothalamic 5-HT release, increased long-term 5-HT levels, and upregulated 5-HT₁A receptor expression. Correlation analyses further linked enhanced hypothalamic serotonergic signaling to improved glycemic control and behavioral outcomes. These findings suggest that hypothalamic 5-HT signaling may contribute to the dual metabolic and antidepressant effects of taVNS and highlight its potential as an integrative neuromodulatory intervention for metabolic-psychiatric comorbidity.
The clinical benefit of intracranial pressure (ICP) monitoring in severe traumatic brain injury (TBI) remains controversial. This study compared functional outcomes between ICP guided therapy and conventional management in routine trauma practice and explored whether treatment effects differed across clinically relevant patient subgroups. We conducted a retrospective cohort study of 1112 patients with severe TBI (Glasgow coma scale (GCS) score 3 - 8) admitted to a tertiary trauma center between January 1, 2004 and December 31, 2024. Patients were managed either with ICP monitoring and targeted therapy (n = 408) or conventional management guided by clinical assessment and neuroimaging (n = 704). Functional outcomes were assessed using the Glasgow outcome scale-extended at 7 days, 3 months, and 6 months. Multivariate logistic regression was used to identify independent predictors of favorable outcome at 6 months. Prespecified subgroup analyses were performed according to injury type, initial GCS score, and neurosurgical emergency status. Baseline characteristics differed between groups, with the ICP monitoring group demonstrating a higher frequency of diffuse brain injury (58.8% vs. 27.3%, p < 0.001), chest injury (25.5% vs. 9.1%, p = 0.009), hypoxia at admission (7.8% vs. 0%, p = 0.017), and anemia at admission (7.8% vs. 0%, p = 0.017). Despite receiving more intensive therapies, including sedation, vasopressors, osmotherapy, and induced hypothermia, functional outcomes did not differ significantly between treatment strategies at any time point. At 6 months, favorable outcomes were observed in 78.9% of patients in the ICP monitoring group and 78.7% in the conventional management group (p = 0.973). In multivariable logistic regression analysis, increasing age (adjusted odds ratio (OR): 0.93, 95% confidence interval (CI): 0.89 - 0.98, p = 0.010), initial GCS score 6 - 8 (adjusted OR: 10.71, 95% CI: 2.48 - 46.28, p = 0.001), absence of diffuse brain injury (adjusted OR: 11.57, 95% CI: 1.14 - 117.20, p = 0.038), absence of subdural hematoma (adjusted OR: 2.60, 95% CI: 2.74 - 11.29, p = 0.009), and absence of neurosurgical emergency conditions (adjusted OR: 23.65, 95% CI: 1.91 - 292.91, p = 0.014) were independently associated with favorable outcome. ICP monitoring was not independently associated with favorable outcome (adjusted OR: 2.42, 95% CI: 0.40 - 14.49, p = 0.334). No significant interactions were observed in prespecified subgroup analyses. In this real-world cohort of patients with severe TBI, ICP-guided therapy was not associated with improved functional outcomes compared with structured conventional management.
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Shaken Baby Syndrome and Abusive Head Trauma are significant traumatic brain injuries observed in infants and represent a critical public health issue. Although there is a vast literature on this subject, conducting a descriptive bibliometric analysis is essential to map the topic's quantitative development over time and to reveal its current geographical and conceptual distribution objectively. This study systematically analyzes 3,571 articles published between 1977 and 2025 in the Web of Science Core Collection database, examining the distribution of publications by year and country, leading journals, citation rates, and keyword networks. Our findings indicate a linear increase in the volume of SBS/AHT research publications since the 2000s. The analysis highlights two significant strengths and shifts in the literature. First, the emergence of countries from diverse regions-such as Romania, the United Arab Emirates, Malaysia, and Russia-in the literature network, alongside traditional research hubs, objectively confirms the subject's expanding global scope. Second, the fact that the highest citation rates and publication density are not limited to clinical medicine journals (e.g., Pediatrics) but are simultaneously concentrated in pioneering journals with social and legal content (e.g., Child Abuse & Neglect) highlights the field's multidimensional and interdisciplinary nature. In conclusion, this study provides an objective resource for all stakeholders-including physicians, forensic scientists, and legal professionals-by visualizing the current geographic diversity of scientific output, key terms, and journal dynamics.
To analyze the factors influencing the return of spontaneous circulation (ROSC) in adult patients with cardiac arrest (CA) in the emergency department and to explore the value of end-tidal carbon dioxide (PETCO₂) in predicting cardiopulmonary resuscitation (CPR) outcomes. A prospective study was conducted, enrolling 133 adult patients who experienced cardiac arrest and underwent CPR from January 2023 to January 2024. Based on outcome indicators, patients were categorized into the ROSC group (n = 69) and the non-ROSC group (n = 64). The differences in demographic characteristics, resuscitation measures, and PETCO₂ levels at different time points between the 2 groups were compared. Additionally, the 72-hour survival status and brain function prognosis of ROSC group patients were evaluated to analyze the relationship between PETCO₂ levels and patient outcomes. Cardiac arrest etiology, defibrillation, CPR duration ≤30 minutes, lower doses of epinephrine, and lower doses of 5% sodium bicarbonate were significantly associated with ROSC occurrence (P < 0.01). PETCO₂ levels at 0-minute, 5-minute, 10-minute, 15-minute, and 20-minute time points, as well as initial, terminal, and average PETCO₂ levels, were significantly higher in the ROSC group compared to the non-ROSC group (P < 0.001). Furthermore, within the ROSC group, the survival group had significantly higher PETCO₂ levels at 10, 15, and 20 minutes than the nonsurvival group (P < 0.001). Similarly, the favorable brain function outcome group had significantly higher PETCO₂ levels at 10, 15, and 20 minutes than the poor brain function outcome group (P < 0.01). PETCO₂ levels may be associated with the occurrence of ROSC, survival prognosis, and brain function outcomes in CA patients, suggesting a potential adjunctive role in resuscitation assessment. PETCO₂ monitoring during CPR-particularly sustained levels at 10 to 20 minutes-may serve as a valuable adjunctive tool for predicting ROSC, short-term survival, and neurological prognosis in adult CA patients. These findings support integrating real-time PETCO₂ trends into resuscitation protocols.
The forward modeling of electroencephalogram (EEG) plays a crucial role in solving source localization and, consequently, in the detection of EEG connectivity networks in the rat brain. We investigated the impact of skull tissue properties-inhomogeneities, anisotropy, and thickness-on measured skull potentials. Five cuboid head phantoms with identical geometry, differing in skull material parameters, and a realistic head phantom with varying skull anisotropy ratios were tested. Simulations were verified by four electromagnetic solvers and an EEG measurement on a physical phantom. The cuboid phantom with sutures yields similar electric potentials as the isotropic one, but noticeable differences appear at electrodes near sutures, particularly in real brain sensing of somatosensory, motor, and visual cortices, as well as the retrosplenial dysgranular cortex, for a dipole located close to the surface. Skull thickness reduces potentials at the top electrodes but increases them at side electrodes, in real brain sensing somatosensory, auditory, association, and entorhinal cortices. Skull anisotropy alters electric potentials with differences up to 60% for dipoles near electrodes at the limiting anisotropy ratio of 10:1, and its effect decreases with increasing distance. Varying anisotropy ratios (10:1 to 1.3:1) show that nearby dipoles are the most affected, while the impact is reduced for lower, more realistic ratios (1.3:1 to 1.8:1) and for more distant sources. This trend was consistently observed in realistic head phantoms as well. Tangential dipoles are most strongly affected in the vicinity of the electrodes and gradually become radial at more distant positions near the inner skull surface.