BackgroundSpinal cord injury (SCI) affects 15.4 million people worldwide, with a substantial proportion of incomplete SCI patients remaining non-ambulatory, highlighting the importance of motor function recovery and mobility in rehabilitation. While transcutaneous spinal cord stimulation (tSCS) has emerged as a promising non-invasive neuromodulation technique for enhancing motor recovery, the therapeutic potential of combining tSCS with transcranial magnetic stimulation (TMS) remains largely unexplored. This combination may leverage the complementary mechanisms of supraspinal and spinal neuromodulation to enhance corticospinal tract plasticity and functional motor outcomes.ObjectiveTo evaluate the efficacy and safety of combined TMS-tSCS intervention compared to tSCS alone for improving lower extremity motor function in individuals with chronic incomplete spinal cord injury.MethodsThis prospective, randomized, controlled, assessor-blinded clinical trial will enroll 60 participants with chronic (>12 months post-injury) incomplete spinal cord injury (AIS C or D) aged 18–65 years from Alexandra Hospital, Singapore. Participants will be randomized 1:1 to receive either combined TMS-tSCS (intervention group) or tSCS with sham TMS (control group) for 16 weeks (32 sessions). The primary outcome is change in Lower Extremity Motor Score (LEMS) from baseline to 16 weeks. Secondary outcomes include walking speed (10-Meter Walk Test), functional independence (Spinal Cord Independence Measure-III), spasticity (Modified Ashworth Scale), electromyography of the lower limb muscles and neurophysiological measures of corticospinal excitability.Expected outcomesWe hypothesize that combined TMS-tSCS will yield superior improvements in LEMS (≥2 points greater improvement) compared to tSCS alone, with enhanced corticospinal tract plasticity as evidenced by neurophysiological measures.Clinical trial registrationClinicalTrials.gov, identifier: NCT07595497.
A dual-branch network with brain region-constrained attention for EEG emotion recognition
IntroductionElectroencephalography (EEG)-based emotion recognition provides an objective avenue for affective computing. However, the complexity of EEG signals across temporal, frequency, and spatial domains makes any single dimension inadequate.MethodsTo overcome these limitations, we propose the Brain Region-Constrained Attention Dual-Branch Network (BRAD-Net). This network adopts a parallel Spatio-Temporal and Spectral-Spatial dual-branch architecture to achieve synergistic multi-domain EEG feature learning. Within the spatio-temporal branch, we introduce a novel Brain Region-Constrained Attention mechanism, which strictly confines self-attention computation to channels belonging to the same brain region. This design not only suppresses irrelevant cross-region interference but also incorporates neuroanatomical priors of brain parcellation, thereby enabling effective and interpretable representation learning.ResultsIn subject-dependent experiments using 10-fold cross-validation on DEAP and DREAMER datasets, BRAD-Net achieves high accuracies of 97.44%, 97.70%, and 97.97% for valence, arousal, and dominance on DEAP, and 99.66%, 99.78%, and 99.80% on DREAMER, respectively. Leave-one-subject-out validation on DREAMER dataset achieves accuracies of 72.80% and 75.66% for arousal and dominance, respectively. Additionally, the BRAD-Net demonstrates strong cross-paradigm adaptability, achieving 98.21% accuracy on a depression classification dataset.ConclusionsThese findings confirm that integrating neuroanatomical priors into a dual-branch multi-dimensional learning framework effectively extracts robust and interpretable neural representations. BRAD-Net not only advances high-performance EEG emotion recognition but also provides a novel, biologically-constrained design paradigm for developing more interpretable brain-computer interface models. By demonstrating that restricting attention to within-brain-region interactions suffices for accurate emotion recognition, our work offers a new theoretical perspective on the application of brain parcellation knowledge in classification models.
Comparative meta-analysis of task-related functional brain abnormalities in nonsuicidal self-injury and suicide attempt
BackgroundNonsuicidal self-injury (NSSI) and suicide attempt (SA) are two major self-injurious behaviors causing substantial suffering and socioeconomic burden. However, it remains unclear whether NSSI and SA are characterized by common or distinct brain dysregulations. Here, we aimed to identify shared and separable neurofunctional alterations during task engagement between NSSI and SA.MethodA coordinate-based meta-analysis was employed using Seed-based d Mapping with Permutation of Subject Images (SDM-PSI) by capitalizing on task-based functional magnetic resonance imaging (fMRI) studies comparing the brain activation between NSSI/SA individuals and controls.ResultThe search identified 10 studies for NSSI (n = 200, mean age: 22.89 years) and 16 studies for SA (n = 343, mean age: 28.65 years). After threshold-free cluster enhancement correction, NSSI individuals exhibited increased right amygdala activation relative to both controls and the SA group, as well as heightened left middle frontal gyrus and reduced left paracentral lobule activation compared to the SA group. No significant activation differences were found between SA and controls, though a less conservative threshold revealed increased left postcentral gyrus activation in the SA group. No shared functional abnormalities were identified between NSSI and SA under either corrected or uncorrected thresholds. Importantly, subgroup analyses revealed that the neurofunctional abnormalities in NSSI were primarily driven by adolescent cohorts, whereas no significant clusters emerged for the SA group across age-stratified analyses.ConclusionThese results suggest that neurofunctional abnormalities are evident in adolescent NSSI, particularly in fronto−limbic regions, with no robust findings in adult NSSI or SA subgroups. This highlights a unique developmental trajectory that necessitates age-tailored risk assessment and interventions for self-injurious behaviors.
The reliability and diagnostic accuracy of the GAD-7 and GAD-2 for the most prevalent anxiety disorders in Latvian primary care
IntroductionAnxiety disorders are common but often under-recognized in primary care. Validation data for the GAD-7 and GAD-2 in Eastern European primary care settings remain limited. To determine the reliability and diagnostic performance of the GAD-7 and GAD-2 for the most prevalent anxiety disorders in Latvian primary care using the Mini International Neuropsychiatric Interview (MINI) as the reference standard.MethodsConsecutive adult patients from 24 primary care practices completed the GAD-7 and GAD-2 prior to consultation. Within two weeks, blinded psychiatrists conducted MINI interviews by telephone. Internal consistency was assessed using Cronbach’s alpha. Diagnostic accuracy was evaluated using receiver operating characteristic analyses, sensitivity, specificity, and likelihood ratios.ResultsThe final analytical sample comprised 1,467 participants. The most prevalent MINI-defined anxiety disorders were agoraphobia (8.0%), generalized anxiety disorder (6.1%), and social phobia (4.7%). Internal consistency was 0.86 for the GAD-7 and 0.72 for the GAD-2. For generalized anxiety disorder, optimal cut-offs were ≥6 (GAD-7; sensitivity 71.9%, specificity 76.3%, AUC = 0.799) and ≥2 (GAD-2; sensitivity 80.9%, specificity 65.8%, AUC = 0.772). GAD-7 and GAD-2 performance for social phobia, agoraphobia and any anxiety disorders was relatively weak. For any anxiety disorder, the optimal thresholds were identified as ≥4 (GAD-7; sensitivity 70.6%, specificity 61.6%, AUC = 0.718) and ≥2 (GAD-2; sensitivity 64.9%, specificity 68.1%, AUC = 0.691).ConclusionThe GAD-7 and GAD-2 demonstrate satisfactory reliability and the strongest diagnostic accuracy to screen for generalized anxiety disorder in Latvian primary care, whereas performance for other anxiety disorder subtypes was comparatively more limited. Subtypes of anxiety disorders should be considered and specific cut-offs calculated to improve the detection of different anxiety disorders in routine general practice.
Research progress on addictive features and reward circuit mechanisms in non-suicidal self-injury and the feasibility of precision neuromodulation
Non-Suicidal Self-Injury (NSSI) presents a significant public health challenge; however, its underlying neurobiological mechanisms remain insufficiently understood, limiting the development of targeted interventions. Emerging evidence suggests that NSSI exhibits core addictive features, such as compulsive urges and tolerance, which may be driven by dysfunctions in the brain’s reward circuitry. This review synthesizes current research on the neural overlaps between NSSI and addiction, specifically focusing on the dysregulation of the ventral striatum and prefrontal cortex. Based on this mechanistic framework, we propose the potential of Stanford Accelerated Intelligent Neuromodulation Therapy (SAINT)—a high-dose, functional connectivity-guided transcranial magnetic stimulation protocol—as a precision treatment for NSSI. By targeting specific reward network deficits, SAINT may offer a novel, rapid-acting therapeutic strategy for patients who do not respond to conventional pharmacological or psychological interventions.
Self-esteem and inner strengths: a network study in Thai university students with borderline personality disorder symptoms
IntroductionSelf-esteem is widely regarded as an important construct in the psychological functioning of individuals with borderline personality disorder (BPD) symptoms. During emerging adulthood, fluctuations in self-esteem are often linked to emotional dysregulation and maladaptive adjustment; however, self-esteem has rarely been examined within a broader system of culturally relevant psychological resources. Drawing on the Theravāda Buddhist framework of the Ten Pāramīs, inner strengths may represent protective resources that can be examined alongside self-esteem to clarify how these strengths co-occur among students experiencing BPD symptoms.MethodsThe present study employed a regularized psychological network approach to investigate partial associations between self-esteem and Ten Pāramī–based inner strengths among Thai university students screening positive for BPD symptoms. Participants were 346 Thai university students (25.4% male, 74.6% female; mean age = 21.60 ± 2.24 years) identified using a standardized BPD screening instrument. Inner strengths included Truthfulness, Perseverance, Wisdom, Generosity, adherence to the Five Precepts, Meditation, Tolerance, Equanimity, Determination, and Loving-kindness.ResultThe estimated network showed a predominantly positive pattern of partial associations among strengths. The strongest edge was observed between Generosity and Loving-kindness, and links between self-esteem and Determination (and Equanimity) were among the most consistently estimated associations (based on bootstrap confidence intervals). Centrality indices were examined descriptively; however, case-dropping bootstrap results indicated very limited stability of centrality estimates (CS(cor = 0.7) = 0.13 for strength and expected influence), and centrality rankings were therefore treated as strictly exploratory. Discussion: Although some negative partial associations were estimated (e.g., involving Truthfulness, Perseverance, and Equanimity), their precision was limited and such patterns should be treated as exploratory. Exploratory gender-stratified analyses suggested that the strongest edges were similar in the female subsample, whereas the male subsample yielded a sparse/near-empty regularized network, limiting inference regarding gender differences. Given the cross-sectional design, all associations are interpreted as conditional co-occurrence rather than directional or causal effects.ConclusionOverall, these findings highlight a small set of robust co-occurring inner strengths linked to self-esteem in Thai university students with BPD symptoms and provide a culturally informed basis for hypothesis generation regarding strengths-based skills cultivation and supportive interventions in university settings.
Hair cortisol as psychotherapy process parameter – an inpatient pediatric psychosomatic study
IntroductionPediatric-psychosomatic inpatient therapy is an essential part of the German health care system for the treatment of mental disorders in children and adolescents. However, empirical research in this field remains scarce and limited to psychological parameters. This longitudinal naturalistic study aimed to evaluate the efficacy and sustainability of inpatient psychosomatic therapy in children and adolescents by examining both psychological outcomes and biological markers.MethodsA total of 58 patients were assessed at seven time points before, during, and after treatment. Hair cortisol concentration (HCC) was measured as a neuroendocrine parameter of long-term stress regulation. Psychometric data were collected using five validated questionnaires.ResultsFindings indicated significant improvements in perceived stress, depressive and anxiety symptoms, family functioning and internalizing symptoms in the course of inpatient treatment. Overall, these effects remained stable at three- and six-month follow-ups, with only transient increases in depressive symptoms and family problems. HCC showed a significant decrease from admission to discharge and remained stable across follow-ups.DiscussionThese results support the efficacy of inpatient pediatric psychosomatic interventions on both psychological outcomes and neuroendocrine stress regulation and highlight the value of integrating biological markers into psychotherapy research.
Frontier AI companies as biotech acquirers
Nature Biotechnology, Published online: 07 July 2026; doi:10.1038/s41587-026-03214-0
A new class of biotech buyer is emerging, as frontier AI and big tech companies acquire early-stage biology foundational platforms. How do big tech acquisitions differ from traditional pharma exits, and what are the potential implications for founders, investors and the pharmaceutical industry?
Bispecific 10E8.4/iMab broadly neutralizing antibody in people with or without HIV-1: a partially randomized phase 1 trial
Nature Medicine, Published online: 07 July 2026; doi:10.1038/s41591-026-04472-w
A first-in-human, partially randomized and placebo-controlled phase I trial examined the safety, tolerability, pharmacokinetics and antiviral activity of the bispecific 10E8.4/iMab broadly neutralizing monoclonal antibody in people living with or without HIV, and found it was safe and well tolerated at different dose levels and routes of administration.
Longitudinal multiomics profiling of extracorporeal cross-circulation with pig liver xenografts in human decedents
Nature Medicine, Published online: 07 July 2026; doi:10.1038/s41591-026-04511-6
Multiomics profiling of extracorporeal cross-circulation with gene-edited pig liver xenografts in four human decedents provides comprehensive information on immune, coagulation and metabolic parameters that will help in the clinical development of this strategy for delivering hepatic support to patients with liver failure.