IntroductionMammalian sleep is characterized by alternations between episodes of rapid-eye-movement sleep (REMS) and non-REM sleep (NREMS). The phenomenon of REMS pressure, namely a drive for REMS that builds up between REMS episodes, is thought to govern the timing of these ultradian NREMS-REMS cycles. Prior analyses of NREMS-REMS cycles in mice suggested that time in NREMS is a primary contributor to REMS pressure. We previously introduced a REMS propensity measure defined as the probability to enter REMS before the accumulation of an additional amount of NREMS. Analyzing mouse sleep data, we showed that REMS propensity at REMS onset was positively correlated with REMS bout duration and with the probability of the occurrence of a REMS bout followed by a short inter-REMS interval, called a sequential REMS cycle.MethodsHere, we extend the analysis of NREMS-REMS cycling to human and rat sleep behavior. We compare REMS propensity measures computed from sleep data recorded in humans, mice, and rats. As REMS in humans is influenced by the circadian rhythm, we also analyze circadian modulation of the expression of NREMS-REMS cycles across the human sleep episode.ResultsWe find that, as in mice, human and rat sleep contain both short sequential NREMS-REMS cycles and longer single NREMS-REMS cycles, with differences in the timescales of cycle durations. Although rodents exhibit polyphasic sleep in contrast with the consolidated sleep of humans, the calculated REMS propensity measures in all three species show similar profiles as functions of time spent in NREMS. Importantly, positive correlations of REMS propensity at REMS onset with REMS bout duration were present in both human and rat data as previously found in mouse data, suggesting that time spent in NREMS also influences REMS duration in these species. In the human data, we identified nuanced changes in the occurrence of single and sequential NREMS-REMS cycles suggesting that increased percent time spent in REMS as the sleep episode progresses is not solely due to increased REMS bout duration.ConclusionResults suggest that similarities in the regulation of NREMS-REMS alternation exist, despite temporal differences, in nocturnal polyphasic rodent sleep and diurnal monophasic human sleep.
Pulvinar and total thalamus volumes are preserved following early monocular enucleation
BackgroundMonocular enucleation, the surgical removal of one eye, occurs early in life and leads to changes in visual, auditory, and audiovisual processing in adulthood. These changes can be observed behaviorally, as well as through cortical structure and white matter connectivity of visual and auditory pathways. Subcortically, the thalamus is a critical sensory processing structure that modulates both unisensory and multisensory stimuli, which are later processed in the cortex. Previous studies have shown that following monocular enucleation, the lateral geniculate nucleus (LGN) is reduced in volume, although this reduction is less than predicted. In contrast, the medial geniculate body (MGB) is asymmetric but maintains its volume. Together, this may support the auditory and audiovisual enhancements observed following early monocular enucleation. Another key subcortical thalamic nucleus, the pulvinar, plays a broad role in human visual information processing and sensorimotor integration.MethodsThe current study used structural MRI to anatomically localize and measure the total pulvinar and its subnuclei, as well as total thalamus volume, in individuals who had undergone early monocular enucleation during postnatal maturation compared to binocularly intact controls.ResultsOverall, people with one eye demonstrated preserved pulvinar and total thalamus volumes compared to binocularly intact controls.ConclusionThe preserved structural volume of the pulvinar and total thalamus may support the intact lower-level auditory and audiovisual processing previously observed in individuals with one eye. The absence of pulvinar volume changes in this broad-function supporting, subcortical region builds on previous studies regarding thalamic plasticity after early monocular enucleation. These findings provide evidence that not all thalamic nuclei show measurable long-term volumetric alterations and that neural plasticity is both regionally and functionally dependent.
Trajectories and predictors of self-care from pre-discharge to 12 months after discharge in people with spinal cord injury: a longitudinal study using growth mixture modeling
IntroductionSelf-care is essential for preventing secondary complications and supporting community reintegration after spinal cord injury (SCI). However, evidence is limited on how self-care changes over time after discharge and whether distinct subgroups exhibit different trajectories.MethodsUsing convenience sampling, 220 patients with SCI were recruited from a tertiary hospital in northern China between August 2023 and December 2024. Self-care was measured with the Self-Care in Spinal Cord Injuries Inventory (SC-SCII) at pre-discharge baseline and at 1, 3, 6, and 12 months after discharge. Baseline mental health literacy and perceived social support were assessed using the Multicomponent Mental Health Literacy Scale (MMHL) and the Perceived Social Support Scale (PSSS). Repeated-measures ANOVA was used to describe the population-average time trend, and growth mixture modeling (GMM) was used as the primary person-centered analysis to identify latent trajectory classes. Multinomial logistic regression examined predictors of class membership.ResultsA total of 209 patients completed all assessments (attrition rate: 5.0%). Mean SC-SCII scores peaked at 1 month post-discharge and then declined gradually over 12 months (F = 25.965, p < 0.001). GMM identified three distinct self-care trajectories: low-level decreasing (31.1%), moderate-level stable (39.7%), and high-level increasing (29.2%), with high classification accuracy (entropy = 0.965). Sex, educational level, mental health literacy, and perceived social support were associated with trajectory membership.ConclusionSelf-care trajectories after SCI are heterogeneous, and early post-discharge improvements may be transient for many individuals. The identified trajectories provide preliminary evidence for developing future prediction tools and trajectory-informed transitional nursing interventions.
Overlaps and differences in the core symptoms of patients with attention-deficit/hyperactivity disorder and patients with borderline personality disorder
BackgroundIndividuals with attention-deficit/hyperactivity disorder (ADHD) and individuals with borderline personality disorder (BPD) show symptomatic overlaps. They both suffer from deficits in emotional regulation, are impulsive and have problems with their self-concept. Therefore, a precise diagnostic differentiation is of great importance. The aim of this study was to find symptom overlaps and differences in patients with ADHD and BPD.Methods80 patients with ADHD, 55 patients with BPD and 55 healthy controls were examined regarding their ADHD and BPD symptoms and their degree of emotional dysregulation using self-report instruments.ResultsPatients with ADHD and patients with BPD did not differ significantly in their expression of emotional dysregulation. However, the ADHD patients showed higher scores in impulsivity, inattention, and hyperactivity, whereas the group with BPD showed higher scores in self-concept problems and suicidal behaviour. The two clinical groups showed significantly higher scores in emotional dysregulation and all other symptom domains compared to the control group.ConclusionThe symptom overlap in emotional dysregulation yields implications for both further research and diagnosis of ADHD. Further studies should define emotional dysregulation consistently to examine the same construct. Key Practitioner Message: This article yields implications that individuals with ADHD and BPD have several symptom overlaps and in fact have no difference in their emotional dysregulation. This has a vast importance for differential diagnosis and treatment of ADHD.
Beyond aesthetic outcomes: psychodermatological benefits of botulinum toxin treatment in the upper facial third. A narrative review
BackgroundBotulinum toxin type A (BoNT-A) is widely used in aesthetic dermatology, particularly for dynamic wrinkles in the upper facial third. Beyond cosmetic effects, BoNT-A may influence emotional processing through the skin-brain axis. This narrative review synthesizes evidence on psychological and psychiatric outcomes of upper facial BoNT-A treatment, with a focus on mechanisms extending beyond aesthetics.MethodsA structured search was conducted in PubMed, Scopus, and Web of Science through January 2026. Search terms included “botulinum toxin,” “upper facial third,” “psychodermatology,” “facial feedback,” “depression,” “anxiety,” and “psychiatric disorders.” Original studies, randomized controlled trials (RCTs), observational studies, systematic reviews, and meta-analyses assessing psychological, psychiatric, or neurobiological outcomes were included.ResultsUpper facial BoNT-A is associated with clinically meaningful reductions in depressive and anxiety symptoms, and improvements in self-perception and social functioning. Inhibition of corrugator and procerus muscles modulates afferent signaling to limbic structures, supporting the facial feedback hypothesis. Neuroimaging evidence demonstrates attenuated amygdala activation after BoNT-A treatment. Psychosocial improvements may reinforce these neurobiological effects. Evidence in bipolar disorder and personality disorders remains limited and methodologically heterogeneous. Caution is advised in patients with body dysmorphic disorder.ConclusionsBoNT-A in the upper facial third provides psychodermatological benefits beyond aesthetics, improving emotional regulation and affective symptoms. It should be considered a complementary intervention within a biopsychosocial framework. Future large-scale RCTs with standardized psychiatric and neurobiological endpoints are warranted.
Cognitive and neuropsychological correlates of the attention training technique: a systematic review and evidence synthesis
IntroductionThe Attention Training Technique (ATT) is a brief metacognitive intervention recognised as a possibly efficacious standalone transdiagnostic treatment for emotional disorders. The cognitive and neuropsychological mechanisms underlying its clinical effects are of particular interest in understanding and developing the technique. The aim of the systematic review was to synthesise and evaluate the cognitive-attentional task performance and neurocognitive correlates of ATT in the context of theoretical mechanisms from which ATT is derived.MethodsFive electronic databases (PsycINFO, MEDLINE, PubMed, Web of Science and EMBASE) were searched from January 1990 to November 2025. Studies that used ATT as part of a metacognitive multi-component treatment package or combined with other therapy/technique(s) were excluded. Sample inclusion was diverse to capture effects on non-clinical and clinical individuals and across age groups for potential sub-group analyses.ResultsIn total, 20 studies with 1, 230 participants met the inclusion criteria. Four studies included clinical samples, four studies included non-clinical participants, two studies used experimental induction of pain or mind wandering, and 10 used healthy samples of which two used school children. Study quality varied from strong to weak with the majority receiving ‘moderate’ ratings. Across 14 cognitive-attentional tasks and three neural methodologies (EEG, fNIRS, fMRI), the review found small to large cognitive and neural effects associated with ATT. Nine cognitive tasks showed significant ATT-dependent effects in at least one study, with the most consistency shown on the emotional dot-probe. Neural findings across all methodologies converged, suggesting that ATT modulates cognitive control, frontoparietal, dorsal attention networks and reduces default mode network connectivity.DiscussionInterpretation and synthesis of findings based on the S-REF model are consistent with cognitive and neural effects involving reduced threat monitoring, improved executive control, and enhanced disengagement from self-referential processing; central theoretical mechanisms and design parameters of ATT. Where inconsistencies across study effects emerged, they may be due to heterogeneity in cognitive task and measurement factors and ATT protocol deviations. Future research on individual differences in neurocognitive effects associated with ATT across clinical and sub-clinical populations is needed. Studies must safeguard fidelity and adherence to the ATT protocol and improve reporting of these important factors.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024483053.
Editorial: Loneliness among youth and young adults
Gaming-based program for internet gaming disorder: feasibility and preliminary outcomes of a structured camp program
BackgroundAlthough controlled trials support several psychosocial interventions for adolescent internet gaming disorder (IGD), short, highly structured residential camp formats remain underreported, particularly regarding feasibility, safety, and process data from routine service settings.ObjectiveTo evaluate the feasibility, safety, and short-term entry-to-exit signals of a structured gaming-based camp program using retrospective, de-identified routinely collected service data, with a focus on implementation evidence for a brief, highly structured residential format.MethodsWe conducted a single-group entry-to-exit evaluation of a 7-day structured camp in 12 adolescents aged 11–16 years clinically diagnosed with IGD by psychiatrists using DSM-5 criteria. Entry and exit assessments were organized hierarchically, with the Gaming Disorder Screening Scale (GDSS), the Game Addiction Scale–7 (GAS-7), and the Visual Analog Scale (VAS) craving score as primary outcomes; the Barratt Impulsiveness Scale–11 (BIS-11), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Social Avoidance and Distress Scale (SADS), and Chinese version of the Interpersonal Reactivity Index (IRI-C) as supportive secondary outcomes; and camp residential counselor–rated Conners scores and the Stroop task as exploratory external-rating and objective complementary indicators, respectively. Wilcoxon signed-rank tests reported effect size r and Hodges–Lehmann (HL) median difference with 95% CI. Exploratory Spearman correlations examined baseline characteristics and change.ResultsCompletion was 100% (12/12) and attendance 98.6% (142/144), with no serious adverse events; two participants had a brief single-session interruption (coded as non-attendance for that session-person) but completed subsequent sessions and exit assessment. Primary outcomes decreased at exit: GDSS 50.00 (SD 8.32) to 28.67 (SD 8.98), p<0.001, r=0.88, HL −20.5 (95% CI −27.0 to −16.5); GAS-7 21.50 (SD 6.57) to 13.33 (SD 4.44), p=0.003, r=0.89, HL −8.5 (95% CI −12.5 to −6.0); VAS 4.25 (SD 2.63) to 2.75 (SD 2.05), p=0.012, r=0.85, HL −2.0 (95% CI −3.0 to −1.0). High-risk GDSS decreased from 66.7% to 0%, GAS-7 positivity from 58.3% to 8.3%, and moderate-to-severe craving from 58.3% to 25.0%. BIS-11, SDS, and IRI-C showed supportive short-term changes, and counselor-rated Conners scores showed exploratory external-rating changes, whereas SAS and SADS did not. Stroop reaction time decreased and accuracy increased in both conditions, while interference effects did not change significantly. Baseline PSQI correlated with change in VAS craving (ρ=0.767, p=0.004).ConclusionsThis pilot program evaluation suggests that a short, highly structured gaming-based residential camp can be delivered feasibly and safely and may be associated with short-term reductions in IGD symptom severity and craving. Its main value is to provide early implementation and short-term signal data for a service-based camp format that should be tested in subsequent controlled studies with follow-up.
Hybrid solid−liquid optics enable scalable, high-resolution light-sheet microscopy across diverse immersion media
Nature Biotechnology, Published online: 09 June 2026; doi:10.1038/s41587-026-03172-7
Hybrid solid–liquid optics improve light-sheet imaging of intact biological samples.
Bundibugyo Ebola without vaccines or therapeutics: why public health fundamentals matter more than border closures
Nature Medicine, Published online: 09 June 2026; doi:10.1038/s41591-026-04482-8
Bundibugyo Ebola without vaccines or therapeutics: why public health fundamentals matter more than border closures