Neurobiological Basis Research Articles

Unraveling the distinct ambiguities of happiness and fear: neurodynamic and machine learning perspectives

ABSTRACT Using a public database, the research combined event-related potentials (ERP), time-frequency analysis (TFR) and machine learning to compare brain activities during Confusion and Unconfusion states. The findings revealed that processing ambiguous emotions decreased LPP amplitude compared to the Unconfusion state, supporting LPP as a biomarker for emotional ambiguity. Additionally, fear-related ambiguity showed greater beta wave power than happiness, indicating heightened brain sensitivity to threats. Machine learning analysis further demonstrated that fear-related features were more critical in distinguishing emotional ambiguity than happiness, corroborating non-phase-locked signal results. These results show that emotion types, particularly fear, significantly modulate brain activity in processing emotional ambiguity, highlighting increased sensitivity and adaptability to fear-related ambiguity. This research enhances our understanding of cognitive processing in emotional ambiguity and offers insights into the neurobiological basis and therapeutic strategies for emotional disorders.

Intrinsic functional brain connectivity in adolescent anxiety: Associations with behavioral phenotypes and cross-syndrome network features

BackgroundConsiderable research has mapped the human brain networks implicated in anxiety. Yet, less is known about the intrinsic features of the brain implicated in adolescent anxiety and its generalizability to affective and behavioral problems. To this end, we investigated the intrinsic functional connectomes associated with anxiety, their associations with behavioral phenotypes of clinical interest, and the cross-syndrome overlap between the anxiety network and other affective syndromes in an adolescent population. MethodsWe used the Boston Adolescent Neuroimaging of Depression and Anxiety (BANDA) dataset which comprises 203 clinical and healthy adolescents aged 14–17. Participants underwent a resting-state magnetic resonance imaging scan and completed the Child Behavior Checklist (CBCL) and Behavioral Inhibition/Activation System scale. Using network-based statistics, we identified functional networks associated with anxiety and other behavioral syndromes. The anxiety network strengths were then correlated with behavioral measures. ResultsA significant resting-state functional network associated with anxiety was identified, largely characterized by hyperconnectivity between the somatomotor and both the default mode network and subcortical regions. Network strengths derived from the anxiety network were significantly correlated to various behavioral syndromes, including internalizing and externalizing tendencies. Cross-syndrome overlapping edges were also observed in networks of internalizing disorders, more prominently post-traumatic stress syndromes. ConclusionsOur results revealed the functional connectomes characteristic of anxiety in adolescents. This resting-state functional network was also predictive of and shared similar features with behavioral syndromes typically associated with anxiety-related disorders, providing evidence that the high comorbidity of anxiety with other clinical conditions may have a neurobiological basis.

Cognitive engagement may slow clinical progression and brain atrophy in Huntington’s disease

Lifelong cognitive engagement conveys benefits in Huntington's disease (HD) and may positively affect non-cognitive domains in other populations. However, the effect of lifelong cognitive engagement on the progression of motor and psychiatric domains in HD remains unknown, as is its neurobiological basis. Forty-five HD individuals completed the Cognitive Reserve Questionnaire (CRQ) and longitudinal clinical evaluation (maximum total of six visits, mean inter-assessment duration of 13.53 ± 4.1 months). Of these, thirty-three underwent longitudinal neuroimaging (18 ± 6 months follow-up). Generalized linear mixed-effects models were executed to predict the effect of individual differences in lifelong cognitive engagement on HD clinical progression and voxel-based morphometry to explore the impact of lifelong cognitive engagement on whole-brain gray matter volume atrophy. Controlling for age, disease stage, and sex, higher CRQ scores were associated with reduced overall severity and longitudinal progression across cognitive, motor, and psychiatric domains. Those with higher CRQ scores demonstrated reduced gray matter volume loss in the middle frontal gyrus, supplementary motor area, and middle cingulate. This putative impact on HD clinical progression may be conferred by preservation of brain volume in neural hubs that integrate executive function with action initiation and behavioral regulation, providing support for early cognitive engagement, even prior to diagnosis.

Emerging Pharmacological Approaches for Psychosis and Agitation in Alzheimer's Disease.

Psychosis and agitation are among the most distressing neuropsychiatric symptoms (NPSs) of Alzheimer's disease (AD), linked to faster disease progression and earlier admission to nursing homes. While nonpharmacological treatments may alleviate mild behavioral symptoms, more severe syndromes often require pharmacological intervention. Brexpiprazole is the only medication approved for agitation in AD, although its limited clinical efficacy has raised criticism. No drugs have been approved for treating psychosis in AD, highlighting the critical need for new, effective, and safe treatments. Recent studies have elucidated part of the neurobiological basis of NPSs in the AD brain, offering insights for testing repurposed and novel drugs. We conducted a comprehensive nonsystematic literature review, aiming to provide a critical overview of both current treatments and emerging pharmacological interventions under clinical development for treating psychosis and agitation in AD. Additionally, we present strategies to optimize the clinical development of new drug candidates. We identify three promising compounds that are currently in phase 3 trials: xanomeline-trospium for AD psychosis, and dextromethorphan-bupropion and dexmedetomidine for agitation in AD. We propose that biomarkers linked to the neuropsychiatric traits of AD patients should be identified in dedicated studies and then included in phase 2 dose-range-finding studies with novel compounds to establish biological engagement. Furthermore, phase 3 placebo-controlled studies should be carried out in AD biomarker-confirmed subjects with narrower cognitive impairment ranges and precise NPS severity at screening. Alternative study designs, such as sequential phase approaches, may also be adopted.

The Iatrogenic Consequences of Medicalising Grief: Resetting the Research Agenda.

When the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) was published in 2013, there was a firestorm of controversy about the elimination of the bereavement exclusion. Proponents of this change and of the proposed "complicated grief" designation believed that this change would help clinicians recognise major depression in the context of recent bereavement. Other researchers and clinicians have raised concerns about medicalising grief. In 2022 "prolonged grief disorder" (PGD) was officially included in the DSM-5-TR in the trauma- and stressor-related disorders section. Not surprisingly, there has been a push to identify biomarkers and to use neuroimaging to identify the neurobiological basis of PGD. Some researchers have even suggested that PGD is a 'reward circuit disorder' akin to addiction and that naltrexone, an opioid antagonist, may be a promising treatment. The purpose of this paper is to show how medicalising grief reinforces a research agenda dedicated to the search for pharmaceutical and psychological 'magic bullets.' Following George and Whitehouse (2021), we propose that an ecopsychosocial approach-one that incorporates environmental and contextual factors-is needed.

Social behavior in ASD males: The interplay between cognitive flexibility, working memory, and functional connectivity deviations

Autism spectrum disorder (ASD) is highly heterogeneous in presentation. While abnormalities in brain functional connectivity are consistently observed in autistic males, the neurobiological basis underlying the different domains of autism symptoms is unclear. In this study, we evaluated whether individual variations in functional connectivity deviations map to social behavior in ASD males. Using neuroimaging data from the Autism Brain Imaging Data Exchange (ABIDE), we modeled normative trajectories of between-network resting-state functional connectivity (rsFC) in non-ASD males across childhood (n = 321). These normative charts were then applied to ASD males (n = 418) to calculate individual deviation scores (z-scores) that reflect the degree of rsFC atypicality. Deviations in rsFC patterns among the default mode network (DMN), ventral attention network (VAN), frontoparietal network (FPN), and somatomotor network (SMN) were associated with distinct dimensions of social behavior. Cognitive flexibility and working memory mediated the association between VANxDMN z-scores and social behavioral problems. Our findings underscore the potential of normative models to identify atypical brain connectivity at an individual level, revealing the neurobiological patterns associated with social behavioral problems in ASD that are critical for precision diagnosis and intervention. Social outcomes in ASD males may be improved by targeting cognitive flexibility and working memory.

Regional homogeneity patterns reveal the genetic and neurobiological basis of State-Trait Anxiety

ObjectiveState anxiety and trait anxiety are differentially mapped in brain function. However, the genetic and neurobiological basis of anxiety-related functional changes remain largely unknown.MethodsParticipants aged 18–30 from the community underwent resting-state fMRI and were assessed with the State-Trait Anxiety Inventory. Using a general linear regression model, we analyzed the effects of state and trait anxiety, as well as their sum and difference (delta), on regional homogeneity (ReHo) in cortical areas. ReHo patterns denote the spatial distribution of ReHo associated with anxiety scores. We further explored the spatial correlations between ReHo patterns and neuromaps, including gene expression, neurotransmitter receptor density, myelination, and functional connectivity gradients, to elucidate the genetic and molecular substrates of these ReHo patterns.ResultsOur findings demonstrated robust spatial correlations between whole-brain ReHo patterns for state and trait anxiety, with trait anxiety and the delta value exhibiting stronger network correlations, notably in the dorsal attention, salience, visual, and sensorimotor networks. Genes highly correlated with ReHo patterns exhibited unique spatiotemporal expression patterns, involvement in oxidative stress, metabolism, and response to stimuli, and were expressed in specific cell types. Furthermore, ReHo patterns significantly correlated with neuromaps of neurotransmitter receptor density, myelination, and functional connectivity gradients.ConclusionsThe ReHo patterns associated with anxiety may be driven by genetic and neurobiological traits. Our findings contribute to a deeper understanding of the pathogenesis of anxiety from a genetic and molecular perspective.

Impulsivity in ADHD and Borderline Personality Disorder: A Systematic Review of Gray and White Matter Variations.

Introduction: Impulsivity is one of the overlapping symptoms common to borderline personality disorder (BPD) and attention deficit hyperactivity disorder (ADHD), but the neurobiological basis of these disorders remains uncertain. This systematic review aims to identify abnormalities in the gray and white matter associated with impulsivity in BPD and ADHD. Methods: We conducted a systematic search of the PubMed, Embase, and SCOPUS databases, adhering to PRISMA guidelines. Studies that investigated gray and white matter alterations in BPD or ADHD populations and their relationship with impulsivity were included. We reviewed information from 23 studies involving 992 participants, which included findings from structural MRI and DTI. Results: The review identified various nonhomogeneous changes associated with impulsivity in BPD and ADHD. BPD was mainly associated with abnormalities in the prefrontal cortex (PFC) and limbic areas, which correlated negatively with impulsivity. In contrast, impulsivity associated with ADHD was associated with structural changes in the caudate nucleus and frontal-striatal pathways. Despite the overlapping symptoms of impulsivity, the neurobiological mechanisms appeared to differ between the two disorders. Conclusions: These findings emphasize the distinct neurostructural correlates of impulsivity in BPD and ADHD. While both disorders show impulsivity as one of their main symptoms, the fundamental brain structures associated with this trait are different. BPD is primarily associated with abnormalities in the prefrontal cortex and limbic system, whereas the alterations seen in ADHD tend to focus on the caudate nucleus and frontostriatal pathways. Further research is needed to clarify these differences and their implications for treatment.

Computational diplomacy: how 'hackathons for good' feed a participatory future for multilateralism in the digital age.

This article explores the role of hackathons for good in building a community of software and hardware developers focused on addressing global sustainable development goal (SDG) challenges. We theorize this movement as computational diplomacy: a decentralized, participatory process for digital governance that leverages collective intelligence to tackle major global issues. Analysing Devpost and GitHub data reveals that 30% of hackathons since 2010 have addressed SDG topics, employing diverse technologies to create innovative solutions. Hackathons serve as crucial kairos moments, sparking innovation bursts that drive both immediate project outcomes and long-term production. We propose that these events harness the neurobiological basis of human cooperation and empathy, fostering a collective sense of purpose and reducing interpersonal prejudice. This bottom-up approach to digital governance integrates software development, human collective intelligence and collective action, creating a dynamic model for transformative change. By leveraging kairos moments, computational diplomacy promotes a more inclusive and effective model for digital multilateral governance of the future. This article is part of the theme issue 'Co-creating the future: participatory cities and digital governance'.

Novelty Seeking in Parkinson’s Disease: A Candidate Biomarker for Cognitive Changes

Background: Parkinson’s disease (PD) is a common neurodegenerative disorder characterized by motor impairments, cognitive decline, and affective changes. Beyond the well-described motor symptoms, neuropsychiatric symptoms play a crucial role in PD disability burden. Novelty seeking, a trait extensively studied within various models of personality, may influence the manifestation of these non-motor symptoms. Methods: A narrative review of articles determined relevant by the author(s) was undertaken. Results: The literature indicates that PD patients typically exhibit low novelty seeking initially. However, dopaminergic therapies can increase novelty-seeking behaviors, sometimes leading to impulse control disorders (ICD). Studies using the Temperament and Character Inventory (TCI) suggest a complex interplay between disease state, medication, and baseline personality, which is not fully elucidated. High novelty seeking scores predict a higher risk of ICDs, yet they also correlate with a more benign clinical phenotype and improved quality of life post-DBS surgery. Conclusions: Novelty seeking is a significant trait in PD, influencing non-motor symptoms and treatment responses. Understanding its neurobiological basis and clinical implications could lead to better diagnostic and therapeutic strategies through the use of objective, practical tools for disease monitoring, individualized therapy, and pharmacological development.

Cerebellar-Prefrontal Connectivity Predicts Negative Symptom Severity Across the Psychosis Spectrum.

Negative symptom severity predicts functional outcome and quality life in people with psychosis. However, negative symptoms are poorly responsive to antipsychotic medication and existing literature has not converged on their neurobiological basis. Previous work in small schizophrenia samples has observed that lower cerebellar-prefrontal connectivity is associated with higher negative symptom severity and demonstrated in a separate neuromodulation experiment that increasing cerebellar-prefrontal connectivity reduced negative symptom severity. We sought to expand this finding to test associations between cerebellar-prefrontal connectivity with negative symptom severity and cognitive performance in a large, transdiagnostic sample of individuals with psychotic disorders. In this study, 260 individuals with psychotic disorders underwent resting-state MRI and clinical characterization. Negative symptom severity was measured using the Positive and Negative Symptoms Scale, and cognitive performance was assessed with the Screen for Cognitive Impairment in Psychiatry. Using a previously identified cerebellar region as a seed, we performed seed to whole brain analyses and regressed connectivity against negative symptom severity, using age and sex as covariates. Consistent with prior work, we identified relationships between higher cerebellar-prefrontal connectivity and lower negative symptom severity (r=-0.17, p=.007). Higher cerebellar-prefrontal connectivity was also associated with better delayed verbal learning (r=.13, p=.034). Our results provide further evidence supporting the relationship between cerebellar-prefrontal connectivity and negative symptom severity and cognitive performance. Larger, randomized, sham-controlled neuromodulation studies should test if increasing cerebellar-prefrontal connectivity leads to reductions in negative symptoms in psychosis.

Chronic corticosterone exposure causes anxiety- and depression-related behaviors with altered gut microbial and brain metabolomic profiles in adult male C57BL/6J mice

Chronic exposure to glucocorticoids in response to long-term stress is thought to be a risk factor for major depression. Depression is associated with disturbances in the gut microbiota composition and peripheral and central energy metabolism. However, the relationship between chronic glucocorticoid exposure, the gut microbiota, and brain metabolism remains largely unknown. In this study, we first investigated the effects of chronic corticosterone exposure on various domains of behavior in adult male C57BL/6J mice treated with the glucocorticoid corticosterone to evaluate them as an animal model of depression. We then examined the gut microbial composition and brain and plasma metabolome in corticosterone-treated mice. Chronic corticosterone treatment resulted in reduced locomotor activity, increased anxiety-like and depression-related behaviors, decreased rotarod latency, reduced acoustic startle response, decreased social behavior, working memory deficits, impaired contextual fear memory, and enhanced cued fear memory. Chronic corticosterone treatment also altered the composition of gut microbiota, which has been reported to be associated with depression, such as increased abundance of Bifidobacterium, Turicibacter, and Corynebacterium and decreased abundance of Barnesiella. Metabolomic data revealed that long-term exposure to corticosterone led to a decrease in brain neurotransmitter metabolites, such as serotonin, 5-hydroxyindoleacetic acid, acetylcholine, and gamma-aminobutyric acid, as well as changes in betaine and methionine metabolism, as indicated by decreased levels of adenosine, dimethylglycine, choline, and methionine in the brain. These results indicate that mice treated with corticosterone have good face and construct validity as an animal model for studying anxiety and depression with altered gut microbial composition and brain metabolism, offering new insights into the neurobiological basis of depression arising from gut-brain axis dysfunction caused by prolonged exposure to excessive glucocorticoids.

Neuroanatomical correlates of subjective tinnitus: insights from advanced cortical morphology analysis.

Subjective tinnitus, characterized by the perception of phantom sounds in the absence of external stimuli, presents significant challenges in both audiology and neurology. Once thought to primarily involve aberrant neural activity within auditory pathways, it is now understood to engage a broader array of neuroanatomical structures. This study investigated the connections between auditory, cognitive, and sensory processing regions, which are crucial for unraveling the complex neurobiological basis of tinnitus. Using high-resolution T1-weighted magnetic resonance imaging, we compared 52 individuals with subjective tinnitus with 52 age-matched healthy controls, focusing on cerebral cortex features, including fractal dimensionality, gyrification, and sulcal depth. Covariate analyses were conducted to explore the relationships between tinnitus duration, Tinnitus Handicap Inventory scores, anxiety score, and neuroanatomical changes. We found significant alterations in key brain regions involved in sensory processing, cognition, and emotional regulation, including the insula, lateral occipital cortex, middle frontal gyrus, and superior parietal lobule. These neuroanatomical changes were strongly correlated with the severity and chronicity of tinnitus symptoms. Our findings reveal profound structural changes in the brain associated with subjective tinnitus, offering valuable insights into the condition's underlying mechanisms and providing a potential framework for guiding future research and therapeutic interventions.

Neural dissociation between computational and perceived measures of curvature

There is substantial evidence to suggest that preference for visual curvature is a reliable phenomenon. Yet, little is known about the ways in which the encoding of curvature in the brain contributes to hedonic evaluation while participants are actively engaged in making choices about objects varying in curvature. To address this question, we reanalyzed fMRI data collected while participants made aesthetic judgments (beautiful vs. not beautiful) and approach-avoidance decisions (enter vs. exit) in relation to measures of (a) computational curvature, (b) perceived curvature, (c) perceived angularity, and (d) aesthetic pleasure in the domain of architecture. Our results show that a region in early visual cortex (BA 17) encompassing largely areas V2-V3 is sensitive to variation in computational curvature across both beauty judgments and approach-avoidance decisions, whereas a region encompassing the fusiform gyrus (BA 37) exhibits sensitivity to perceived curvature only when participants made beauty judgments. These results contribute to our understanding of the neurobiological basis of curvature preference by demonstrating that the sensitivity of the visual cortex to computational curvature is context invariant, whereas the sensitivity of the fusiform gyrus to perceived curvature varies by context.

Soft, precision engineered porous, hydrogel scaffolds mechanically tailored toward applications in the central nervous system

Diseases and traumatic injuries to the central nervous system (CNS) demand the development of new biomaterials to improve healing and treatment options. Matching material mechanical properties to specific tissues and optimizing material porous structures are central goals for improving biomaterials. However, biomaterials with both precision-controlled porous structures and brain-matched mechanical properties (low modulus) are still lacking. In this study, we developed soft hydrogel scaffolds with mechanical properties similar to that of CNS tissues, and a uniform 40 µm porous structure—40 µm pores have been shown to be optimal for healing in many tissues. The two characteristics were achieved by a new fabrication process combining phase separation and sphere templating. The resulting scaffolds are non-cytotoxic according to the ISO 10993-5 standard. In addition, the three-dimensional culture of microglial cells within the scaffolds demonstrates cell attachment and maintenance of a rounded, quiescent morphology, potentially due to spatial confinement. These results justify further in vivo studies and suggest broad potential in CNS applications, such as brain-computer interfaces, neural regeneration, and basic neurobiology. Subject classification codes: Neural Interfaces, soft hydrogel, synthetic biomaterials

New insights from gene expression patterns on the neurobiological basis of risky behavior

New insights from gene expression patterns on the neurobiological basis of risky behavior

Behavioral disorders in Parkinson disease: current view.

Patients with Parkinson disease (PD) frequently experience several behavioral symptoms, such as anxiety, apathy, irritability, agitation, impulsive control and obsessive-compulsive or REM sleep behavior disorders, which can cause severe psychosocial problems and impair quality of life. Occurring in 30-70% of PD patients, these symptoms can manifest at early stages of the disease, sometimes even before the appearance of classic motor symptoms, while others can develop later. Behavioral changes in PD show distinct patterns of brain atrophy, dopaminergic and serotonergic deterioration, altered neuronal connectivity in frontostriatal, corticolimbic, default mode and other networks due to a cascade linking molecular pathologies and deficits in multiple behavior domains. The changes suggest a multi-system neurodegenerative process in the context of a specific α-synucleinopathy inducing a variety of biochemical and functional changes, the neurobiological basis and clinical relevance of which await further elucidation. This paper is intended to review the recent literature with focus on the main behavioral disturbances in PD patients, their epidemiology, clinical features, risk factors, animal models, neuroimaging findings, pathophysiological backgrounds, and treatment options of these deleterious lesions.

Lavender improves sleep through olfactory perception and GABAergic neurons of the central amygdala

Ethnopharmacological relevanceThe use of lavender as sleep aid or hypnotic agent can be traced back as early as ancient Romans and Greeks. Yet, objective experimental data on whether and how lavender enhances sleep duration or/and sleep quality remain lacking. Aim of the studyWe aimed to characterize the sleep-wake regulating effects of lavender in the mouse and to demonstrate the brain targets and neural circuits involved. Materials and methodsA self-made precise odor delivery system combined with chronic polysomnographic recordings was employed to assess the sleep-wake effects of inhalation with lavender essential oil (LEO, extracted from lavender) and its different constituents during the light and dark phases in free-moving C57BL/6J mice. Neuroviral labeling, in situ hybridization and pharmacogenetics were combined to identify the neural circuits and targets involved. Finally, an insomniac model of DL-4-Chlorophenylalanine (PCPA)-treated mice was established to examine the sleep-inducing potential of LEO. ResultsWe found that inhalation of LEO with a concentration at 25.0% during the light (inactive) phase significantly shortened the latency to non-rapid eye movement (NREM) sleep, increased the total amount of NREM sleep at the expense of wakefulness (W), and enhanced cortical EEG slow wave activities, notably delta power spectra density. We further identified linalool, d-limonene, 1,8-cineole, linalyl acetate and terpinene-4-ol as the major effective sleep-promoting monomer components. Importantly, we found that LEO no longer produced any of the above sleep-promoting effect following either nasal injection of zinc sulfate which interrupts the olfactory pathway, or pharmacogenetics silencing of central amygdala GABAergic neurons. Finally, LEO reestablished NREM sleep with short latency in PCPA-treated insomniac mice, effects comparable with those induced by a potent sedative diazepam. ConclusionsWe have characterized the quantitative and qualitative sleep-promoting effects of LEO and its effective components via the olfactory pathway and central amygdala GABA neuronal targets. The hypnotic property of LEO is reinforced by its ability to restore sleep in insomnia. Our study thus establishes a neurobiological basis for aromatherapy of sleep disorders using lavender.

Brain-to-brain synchrony increased during interpersonal touch in romantic lovers: an EEG-based hyperscanning study

BackgroundInterpersonal touch is an essential element of human social life. It’s unclear whether the neural patterns of interpersonal touch are specific to intimate relationships or generally apply to other social relationships. Romantic lovers are typically intimate and have a high level of interpersonal touch. Currently, researchers focused on the neurobiological basis and neural processes of romantic love.Methods110 participants finished two resting-state blocks, no-handholding and handholding conditions, with Electroencephalogram (EEG). We aimed to explore the differences in the brain-brain synchrony pattern of interpersonal touch between romantic lovers and strangers by calculating dynamic interpersonal functional connectivity (dIFC) via EEG-based hyperscanning.ResultsOur results supported that the neural processing of interpersonal touch is a dynamic process. At first half, both groups tended to adapt, and then interpersonal touch increased the dIFC between romantic lovers and decreased the dIFC between strangers. Finally, we employed Support Vector Machine (SVM) to classify EEG signals into two different relationships. SVM recognized two relationships with an accuracy of 71% and 0.77 AUC of ROC at the first half, a 73% accuracy and 0.8 AUC of ROC at the second half.ConclusionsOur study indicates that interpersonal touch may have different meanings between romantic lovers and strangers. Specifically, interpersonal touch enhances the dIFC between romantic lovers while reducing the dIFC between strangers. The research has important implications for planning touch-based interventions in social and medical care.

Advancing Understanding of Dermatological Manifestations in Munchausen Syndrome by Proxy.

This comprehensive review critically examines the complex relationship between Munchausen Syndrome by Proxy (MSBP) and its dermatological manifestations, uncovering new insights into the relatively uncharted territory of this psychiatric disorder. By synthesizing existing literature, case studies, and clinical observations, this paper reveals the multifaceted spectrum of dermatological phenomena seen in individuals affected by MSBP, ranging from self-inflicted injuries to entirely fabricated skin conditions. Additionally, we explore the psychological and behavioral mechanisms driving caregivers to induce or stimulate dermatological symptoms, shedding light on underlying psychopathologies, the nuanced dynamics of the caregiver-patient relationship, and patterns of pathological attachment and dependency. This review confronts the significant obstacles healthcare providers encounter in accurately identifying dermatological symptoms related to MSBP amidst genuine dermatologic conditions, underscoring the indispensable role of a multidisciplinary strategy and heightened clinical vigilance in these complex cases. Future investigations call for the development of standardized assessment tools, the potential of biomarkers for early detection, the exploration of the neurobiological basis of MSBP, and the utilization of specific interventions to protect susceptible populations while improving the accuracy of MSBP diagnoses. This paper calls for a more informed, sensitive, and proactive approach to better understanding and treating the dermatological manifestations of MSBP.