Scalp Surface Research Articles

Monte Carlo simulations of a multisource transcranial photobiomodulation helmet device: application to young and aged brains

Transcranial photobiomodulation is an emerging non-invasive technique that uses near-infrared light to stimulate brain function and offer protection against damage. Although this method is safe, there is much uncertainty concerning the optimum dosage, in particular, the quantity of energy that, when applied transcranially from a multisource helmet device, reaches the brain parenchyma and produces a change in neural activity. In this study, we used the Monte Carlo method to simulate a typical session of transcranial photobiomodulation using an existing multisource helmet device and to quantify the energy deposition region by region in the brain. We simulated two commonly used wavelengths, 670 and 810 nm, and examined light propagation in young and aged brains. Our results showed that, from the multisource helmet device, light at both wavelengths could indeed reach superficial regions of the brain parenchyma, up to 3–4 cm beneath the scalp surface. Overall, the 810 nm light penetrated deeper than the 670 nm light. From approximately 1 cm beneath the scalp, the light distribution became almost uniform for both wavelengths. However, regional analysis revealed that light penetrated better into the frontal and parietal lobes than into other regions (e.g., the temporal lobe). Furthermore, the light from this multisource device did not reach deeper structures (e.g., subcortical). Finally, the Monte Carlo simulations from the device revealed only subtle differences between the young brain and the aged brain. In summary, our results contribute to a better understanding of the quantification of regional light deposition during a typical session of transcranial photobiomodulation using a multisource helmet device.

Deucravacitinib, an Oral Selective Tyrosine Kinase 2 (TYK2) Inhibitor, in Patients with Moderate to Severe Scalp Psoriasis: Efficacy and Safety Results of a Phase 3b/4, Multicenter, Randomized, Double-blinded, Placebo-controlled Trial (PSORIATYK SCALP)

Introduction: Deucravacitinib, an oral, selective, allosteric TYK2 inhibitor, is approved in multiple countries for treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. PSORIATYK SCALP, an ongoing, 52-week, phase 3b/4, multicenter, randomized, double-blinded, placebo-controlled trial, evaluated deucravacitinib efficacy/safety in patients with moderate to severe scalp psoriasis, including those with more limited overall psoriasis. Methods: Adults with moderate to severe scalp psoriasis defined by more focused and objective inclusion criteria (ss-PGA ≥3, scalp surface area involvement ≥20%, and PSSI ≥12 at baseline) and BSA involvement ≥3% were randomized 1:2 to oral placebo or deucravacitinib 6 mg once daily through Week 16. The primary efficacy outcome was ss-PGA 0/1; key secondary outcomes were PSSI 90, change from baseline in scalp-specific itch numeric rating scale (NRS), and sPGA 0/1 at Week 16. Efficacy outcomes were evaluated at Week 16 for the overall population and the subpopulation with global sPGA ≥3. Nonresponder imputation and modified baseline observation carried forward were used for patients who discontinued or had missing data for binary and continuous outcomes, respectively. Results: 154 patients were randomized (placebo, n=51; deucravacitinib, n=103). Baseline characteristics were similar in each group (placebo: mean BSA 10.0%, PASI 9.4, PSSI 32.2; deucravacitinib: mean BSA 10.5%, PASI 10.2, PSSI 33.5). In the overall population, a higher proportion of patients receiving deucravacitinib versus placebo achieved ss-PGA 0/1 at Week 16 (48.5% vs 13.7%; P<0.0001). Deucravacitinib was superior to placebo for PSSI 90 (38.8% vs 2.0%; P<0.0001) and mean change from baseline in scalp-specific itch NRS (−3.2 vs −0.7; P<0.0001). In the subpopulation (sPGA ≥3), a greater proportion achieved sPGA 0/1 with deucravacitinib versus placebo (51.0% vs 4.3%; P<0.0001). The most common adverse events (AEs) in the deucravacitinib group (≥5%) were nasopharyngitis (14.6%), upper respiratory tract infection (11.7%), acne (9.7%), headache (7.8%), COVID-19 (5.8%), and pustular acne (5.8%). Two serious AEs were reported (1/group); neither was considered treatment related or led to discontinuation. Conclusion: Deucravacitinib was efficacious and well tolerated in patients with moderate to severe scalp psoriasis, including those with less extensive overall psoriasis (BSA ≥3%). The overall psoriasis response rate (sPGA 0/1) was consistent with POETYK trial results, despite including patients with more limited BSA involvement. Safety findings were consistent with the known deucravacitinib safety profile.

Efficacy of Deucravacitinib in Plaque Psoriasis Across a Range of Body Surface Area Involvement: Post hoc Analysis of the Randomized, Double-Blinded, Placebo-Controlled, Phase 3b/4 PSORIATYK SCALP Trial

Introduction: Deucravacitinib, an oral, selective, allosteric tyrosine kinase 2 inhibitor, is approved in the US, EU, and other countries for treatment of adults with moderate to severe plaque psoriasis who are candidates for systemic therapy. Scalp involvement affects approximately 80% of patients with plaque psoriasis. PSORIATYK SCALP (NCT05478499) is an ongoing, 52-week, multicenter, phase 3b/4 trial evaluating deucravacitinib in patients with moderate to severe scalp psoriasis, including those with a range of total body surface area (BSA) involvement (≥3%). These patients are candidates for systemic therapy, according to the AAD/NPF and IPC treatment guidelines. This post hoc analysis assessed efficacy in overall body psoriasis. Methods: Adults (age ≥18 years) with moderate to severe scalp psoriasis (scalp-specific Physician Global Assessment [PGA] ≥3, scalp surface area involvement ≥20%, and Psoriasis Scalp Severity Index ≥12 at baseline) and BSA involvement ≥3% were eligible for inclusion. Patients were randomized 1:2 to oral placebo (n=51) or deucravacitinib 6 mg once daily (n=103) through Week 16. Stratification factors included prior biologic use and body weight. Outcomes at Week 16 included static PGA score of 0 (clear) or 1 (almost clear) (sPGA 0/1), change from baseline in Psoriasis Area and Severity Index (PASI), and change from baseline in whole-body itch numeric rating scale (NRS). Nonresponder imputation (binary outcomes) and modified baseline observation carried forward (continuous outcomes) were used for patients with missing data. All P values are nominal. Results: Baseline characteristics were similar between groups (deucravacitinib: mean [SD], BSA 10.5% [9.6%], PASI 10.2 [6.7], whole-body itch NRS 5.8 [2.8]; placebo: mean [SD], BSA 10.0% [8.1%], PASI 9.4 [5.6], whole-body itch NRS 5.8 [2.4]). Baseline total BSA involvement was 3%-10% in most patients (deucravacitinib, 68.0%; placebo, 74.5%). At Week 16, a significantly higher proportion of patients receiving deucravacitinib versus placebo achieved sPGA 0/1 (47.6% [95% CI, 37.6%-57.6%] vs 3.9% [0.5%-13.5%], respectively; P<0.0001). Similarly, patients treated with deucravacitinib achieved greater decreases in adjusted mean change from baseline in PASI (−6.4 [95% CI, −7.3 to −5.5] vs −1.3 [−2.6 to −0.1]; P<0.0001) and whole-body itch NRS (−2.9 [−3.4 to −2.4] vs −0.4 [−1.1 to 0.3]; P<0.0001). Conclusion: In the phase 3b/4 PSORIATYK SCALP trial, deucravacitinib was efficacious in improving overall psoriasis. Efficacy was consistent with the results observed in the phase 3 POETYK PSO-1/PSO-2 trials, despite including patients with less extensive total BSA involvement.

Deucravacitinib, an Oral, Selective, Allosteric Tyrosine Kinase 2 (TYK2) Inhibitor, in Patients With Moderate to Severe Scalp Psoriasis: Improvement in Scalp-Related Quality of Life and Symptoms in the Phase 3b/4 Multicenter, Randomized, Double-Blinded, Placebo-Controlled PSORIATYK SCALP Trial

Introduction: PSORIATYK SCALP (NCT05478499)—an ongoing 52-week, phase 3b/4, multicenter, randomized, double-blinded, placebo-controlled trial—assesses the efficacy and safety of deucravacitinib in patients aged ≥18 years with moderate to severe scalp psoriasis (Psoriasis Scalp Severity Index ≥12, scalp-specific Physician Global Assessment ≥3, scalp surface area involvement ≥20%, and body surface area [BSA] involvement ≥3%). We assessed Week 16 patient-reported outcomes using Scalpdex, a validated, scalp-specific quality-of-life instrument, and numeric rating scales (NRSs) for scalp-specific symptoms. Methods: Patients were randomized 1:2 to placebo or deucravacitinib 6 mg for 16 weeks, stratified by previous biologic use (yes or no) and body weight (<90 or ≥90 kg). Changes from baseline in Scalpdex total score and NRS scores for scalp-specific itch, pain, and flaking were assessed with an analysis of covariance (ANCOVA) model with treatment and randomization stratification factors as fixed effects and the baseline value as a covariate. Scalpdex total score change from baseline was further assessed in BSA subgroups (BSA 3–10%, BSA >10%), using an ANCOVA model with treatment as a fixed effect and the baseline value as a covariate. P values are nominal. Results: Mean baseline scores (placebo: n=51; deucravacitinib: n=103) indicated severe impact on quality of life (Scalpdex total score >44.0) and moderate to severe symptoms (NRS ≥4.0). At Week 16, adjusted mean change from baseline (95% CI) in Scalpdex total score was greater in patients receiving deucravacitinib versus placebo (−22.3 [−26.1, −18.6] vs −10.5 [−15.7, −5.2]; P=0.0003). Changes from baseline (95% CI) in scalp-specific NRS measures were greater in patients receiving deucravacitinib versus placebo (itch: −3.2 [−3.7, −2.7] vs −0.7 [−1.4, 0.0]; pain: −2.1 [−2.6, −1.6] vs −0.1 [−0.8, 0.5]; flaking: −3.9 [−4.5, −3.4] vs −1.0 [−1.8, −0.2]; all P<0.0001). In each BSA subgroup, patients receiving deucravacitinib versus placebo reported greater Week 16 change from baseline in Scalpdex total score (BSA 3–10%: −19.8 [−23.9, −15.6] vs −10.5 [−16.1, −4.9]; P=0.0096; BSA >10%: −26.2 [−33.2, −19.3] vs −11.2 [−22.3, 0.0]; P=0.0263). Conclusion: Deucravacitinib was efficacious in improving scalp-specific psoriasis symptoms and quality of life. Furthermore, scalp-related quality of life was improved in patients receiving deucravacitinib in both BSA subgroups.

Creating ionic current pathways: A non-implantation approach to achieving cortical electrical signals for brain-computer interface

This study introduces a novel method for acquiring brain electrical signals comparable to intracranial recordings without the health risks associated with implanted electrodes. We developed a technique using ultrasonic tools to create micro-holes in the skull and insert hollow implants, preventing natural healing. This approach establishes an artificial ionic current path (AICP) using tissue fluid, facilitating signal transmission from the cortex to the scalp surface. Experiments were conducted on pigs to validate the method's effectiveness. We synchronized our recordings with perforated electrocorticography (ECoG) for comparison. The AICP method yielded signal quality comparable to implanted ECoG in the low-frequency range, with a significant improvement in signal-to-noise ratio for evoked potentials. Our results demonstrate that this non-invasive technique can acquire high-quality brain signals, offering potential applications in neurophysiology, clinical research, and brain-computer interfaces. This innovative approach of utilizing tissue fluid as a natural conduction path opens new avenues for brain signal acquisition and analysis.

Scalp surface Laplacian potential monitoring system based on novel hydrogel active tri-polar concentric ring electrodes

Electroencephalography is valued in brain research for its high temporal resolution and user-friendly nature. However, limitations in spatial resolution and susceptibility to biological artifacts restrict its broader application. The surface Laplacian potential obtained through tri-polar concentric ring electrodes offers a solution by mitigating biological artifact interference and enhancing spatial resolution while preserving essential information. In this study, an active tri-polar concentric ring electrode based on conductive hydrogel and a 3-lead surface Laplacian potential monitoring system designed for use with the electrode were proposed. The part of the electrode that came into contact with the human body was the hydrogel with high electrical conductivity. The contact surface curvature was designed based on the real forehead curvature of 22 subjects, resulting in a normalized electrode-skin contact impedance of 30.95±16.76KΩ*cm2 at 10 Hz, which was lower than commercial disposable wet electrodes and remained stable over a 10-hour period of long-term wear. And the electrode still exhibited excellent performance after being left for 20 days. Additionally, the internal noise of the system was about 1.9μV, which was comparable to that of the FDA-approved equipment. The signal analysis results demonstrated that the surface Laplacian potential collected by the proposed electrode and system had better signal-to-noise ratio and spatial resolution, and had a good suppression effect on biological artifacts.

Whole-head high-density diffuse optical tomography to map infant audio-visual responses to social and non-social stimuli

Abstract Infancy is a time of rapid brain development. High-density diffuse optical tomography (HD-DOT) is an optical neuroimaging method that maps changes in cortical haemoglobin concentration, a marker of functional brain activation. Recent years have seen a huge advance in wearable hardware for HD-DOT, however previous headgear has only been capable of sampling specific areas of the cortex. In this work, we aimed to develop headgear capable of sampling across the whole infant scalp surface and to conduct a proof-of-concept demonstration of whole-head HD-DOT in infants aged 5 to 7 months. We developed a whole-head infant implementation of the high-density LUMO design developed by Gowerlabs Ltd. (UK). HD-DOT data were collected from a cohort of infants (N = 16) during the presentation of a screen-based paradigm assessing social processing. Using whole-head HD-DOT, we mapped activity across the entirety of the optically-accessible cortex which far exceeds coverage achieved by previous infant optical neuroimaging methods. We found activity in temporal regions which corroborates previous research. Further, we mapped activity in regions outside those typically sampled in infant research using social processing paradigms, finding activation in regions across the occipital, parietal, and frontal cortices as well as an apparent inverted response in sensorimotor regions. Following this proof-of-concept, we envisage that whole-head HD-DOT will be applied to map the interaction between different regions of the brain, opening new avenues to map activity in the awake infant brain to better understand the trajectory of typical and atypical neurodevelopment.

Predictors and Management of Inadequate Response to JAK Inhibitors in Alopecia Areata.

Alopecia areata is a common autoimmune disorder characterized by non-scarring hair loss on the scalp or other hair-bearing surface. In recent years, Janus kinase (JAK) inhibitors have shown promise in the treatment of alopecia areata by disrupting the signaling pathways involved in immune-mediated hair follicle damage. However, some patients with alopecia areata exhibit insufficient responses to JAK inhibitors. This review aims to explore the predictive factors for poor responses to JAK inhibitors in patients with alopecia areata and to discuss alternative treatment strategies in such cases. Patients with a longer duration of the current episode and higher baseline severity are at an increased risk of inadequate JAK inhibitor responses. Oral administration rather than topical application, and extended treatment durations, correlate with a favorable response. Notably, the poor response to JAK inhibitors in alopecia areata may be related to the amount and functional depletion of regulatory T cells resulting from an augmented T helper-2-type immune response. For patients with poor responses to JAK inhibitors, treatment adjustments may include increasing the dosage, extending the treatment duration, combination therapies, or switching to alternative JAK inhibitors. For patients with atopic comorbidities or psychological problems, it is important to select corresponding treatment options to optimize patient outcomes. Further research is needed to establish more reliable predictors and improve overall patient care.

Emotion Detection from EEG Signals Using Machine Deep Learning Models.

Detecting emotions is a growing field aiming to comprehend and interpret human emotions from various data sources, including text, voice, and physiological signals. Electroencephalogram (EEG) is a unique and promising approach among these sources. EEG is a non-invasive monitoring technique that records the brain's electrical activity through electrodes placed on the scalp's surface. It is used in clinical and research contexts to explore how the human brain responds to emotions and cognitive stimuli. Recently, its use has gained interest in real-time emotion detection, offering a direct approach independent of facial expressions or voice. This is particularly useful in resource-limited scenarios, such as brain-computer interfaces supporting mental health. The objective of this work is to evaluate the classification of emotions (positive, negative, and neutral) in EEG signals using machine learning and deep learning, focusing on Graph Convolutional Neural Networks (GCNN), based on the analysis of critical attributes of the EEG signal (Differential Entropy (DE), Power Spectral Density (PSD), Differential Asymmetry (DASM), Rational Asymmetry (RASM), Asymmetry (ASM), Differential Causality (DCAU)). The electroencephalography dataset used in the research was the public SEED dataset (SJTU Emotion EEG Dataset), obtained through auditory and visual stimuli in segments from Chinese emotional movies. The experiment employed to evaluate the model results was "subject-dependent". In this method, the Deep Neural Network (DNN) achieved an accuracy of 86.08%, surpassing SVM, albeit with significant processing time due to the optimization characteristics inherent to the algorithm. The GCNN algorithm achieved an average accuracy of 89.97% in the subject-dependent experiment. This work contributes to emotion detection in EEG, emphasizing the effectiveness of different models and underscoring the importance of selecting appropriate features and the ethical use of these technologies in practical applications. The GCNN emerges as the most promising methodology for future research.

The Effect of an Oral Probiotic Mixture on Clinical Evolution and the Gut and Skin Microbiome in Patients with Alopecia Areata: A Randomized Clinical Trial

(1) Background: Given the autoimmune nature of Alopecia Areata (AA) and the immunomodulatory properties of probiotics, this trial was conducted to evaluate the efficacy of a probiotic mixture, consisting of Lactobacillus rhamnosus and Bifidobacterium longum strains, as an adjuvant treatment in a group of AA patients. (2) Method: This study was a 24-week, randomized, double-blind, placebo-controlled clinical trial. Twenty-six patients with AA were included in this study, and their clinical progression, along with changes in gut and skin microbiota, were analyzed. (3) Results: A higher proportion of AA patients treated with the probiotic formula showed improvement compared to the placebo group, based on both the reduction in the number of AA plaques (56% vs. 30%) and the affected scalp surface area (45% vs. 20%). For “activity”, “inactivity”, and “regrowth”, an improvement in 55%, 67%, and 55% of patients was, respectively, observed in the probiotic group, compared to 50%, 40%, and 30% in the placebo group. No changes were observed in the gut microbiota during the intervention period. Regarding skin microbiota, changes were detected in the probiotic group, with reductions in characteristic genera during the study. (4) Conclusions: To our knowledge, this is the first clinical trial assessing the efficacy of a probiotic product in patients with AA. This probiotic mixture in a routine clinical practice setting appears to improve the course of patients. In addition, the skin microbiota of scalp lesions was modified using the probiotic treatment.

Effect of a Hair Loss Management Concurrently Incorporating Aroma Scalp Massage on Hair and Scalp Conditions

This study is a similar experimental study aimed at analyzing the effects of a hair loss management program combined with aroma scalp massage on changes in hair and scalp conditions. The study included 8 participants each in the experimental and control groups, aged 20 to 50, who underwent the hair loss management program once a week for 8 weeks. Data collected were analyzed using the SPSS 26.0 program. The results showed that, firstly, both groups did not show significant differences in hair thickness and density based on the timing of management and between-group differences. Secondly, both groups showed significant increases in moisture and oiliness after 4 and 8 weeks, while stratum corneum amount, pore condition, and scalp surface significantly decreased. A significant decrease in stratum corneum amount was observed in the experimental group after 8 weeks. Thirdly, subjective satisfaction evaluations after management revealed significantly higher satisfaction ratings in the experimental group.

Scalp acupuncture targets for neurological disorders：evidence from neuroimaging studies (part 1).

Scalp acupuncture is a unique acupuncture method developed based on brain functional and pathophysiological knowledge. In past decades, there has been significant development in the understanding of the brain pathology of many neurological disorders through cutting-edge brain imaging techniques. Yet, these findings have not been incorporated into scalp acupuncture. In the present paper, we aimed to initiate an attempt to develop/identify scalp acupuncture targets based on neuroimaging findings. Based on the meta-analysis of neuroimaging studies in the Neurosynth database platform (http：//neurosynth.org/), the brain clusters related to neurological disorders were automatically identified according to the search terms "Parkinson's disease"(PD), "chronic pain"(CP), "aphasia"(APH), "dyslexia"(DYS), "mild cognitive impairment", "Alzheimer's disease" and "dementia". Subsequently, the discovered brain region clusters projected onto the brain surface and scalp surface were listed, and the peak points of the clusters projected to the scalp surface were proposed as the potential stimulation targets for the corresponding diseases. Further, by combining the traditional scalp acupoints (including the scalp acupuncture lines) with 10-20 EEG system sites, we made localization suggestions for scalp stimulation targets and made acupuncture operation suggestions by combining with the shape of the brain region clusters. The literature search was conducted on July 30, 2022. The localization and manipulation suggestions of neuroimage-based scalp acupuncture targets were introduced in two parts. This part (part 1) includes PD, CP, APH, and DYS. Here are 3 target examples of each of these 4 diseases simply introduced due to word limitation. 1) PD. Based on the 175 articles retrieved from Neurosynth, we identified 7 potential scalp acupuncture targets for PD, the locations of the acupuncture stimulation and the recommended acupuncture needle operation (RANO) as well as the corresponding brain regions (CBRs) respectively are as below. PD1：about 0.5 cun (1 cun≈33.3 mm) superior-posterior to the left Xuanlu (GB5)；puncturing subcutaneously and forward-upward；the left premotor area, subfrontal cortex of the island, inferior frontal gyrus and middle frontal gyrus. PD2：about 1 cun lateral-inferior to the left Chengling (GB18)；puncturing subcutaneously and backward-upward；the inferior parietal lobule and postcentral gyrus. PD3：about 0.5 cun lateral-anterior to the left GB18；puncturing subcutaneously and inward-backward；left anterior central gyrus and posterior central gyrus. 2) CP. Based on the retrieved 92 articles, we identified 8 potential scalp acupuncture targets, the location of the acupuncture stimulation and the RANO, and CBRs respectively are as below. CP1：about 1 cun anterior-inferior to the left Xuanli (GB8)；puncturing subcutaneously and backward-inwards；the left inferior frontal gyrus orbitalis and pars triangularis. CP2：about 0.5 cun posterior-superior to the left GB5；puncturing subcutaneously and forward-upward；the left anterior central gyrus and premotor area. CP3：about 0.5 cun posterior-superior to the left GB8；puncturing subcutaneously and forward；left inferior central area/central sulci operculum (second somatosensory area). 3) APH. Based on the retrieved 82 papers, we identified 7 potential scalp acupuncture targets for APH, their locations, RANO, and CBRs respectively are as below. APH1：close to the left GB5；puncturing subcutaneously and forward-downward；left subfrontal gyrus operculi/triangularis. APH2：about 0.5 cun posterior to the left Hanyan (GB4)；puncturing subcutaneously and backward-upward；the left anterior central gyrus and posterior central gyrus. APH3：about 0.5 cun anterior-inferior to the left Qubin (GB7)；puncturing subcutaneously and backward-downward；left medial/superior temporal gyrus. 4) DYS. Based on the retrieved 76 researches, we identified 8 potential scalp acupuncture targets for DYS, their locations, RANO and CBRs respectively are as below. DYS1：about 1 cun anterior-inferior to the left GB5；puncturing subcutaneously and forward-upward；the pars triangularis of the left inferior frontal gyrus. DYS2：about 0.5 cun posterior-superior to the left GB5；puncturing subcutaneously and forward-downward；the left subfrontal gyrus operculum, pars triangularis and anterior central gyrus. DYS3：the midpoint between the left GB5 and GB18；puncturing subcutaneously and forward；the left anterior central gyrus and posterior central gyrus. We identified scalp acupuncture targets for several common neurological disorders based on neuroimaging evidence for clinical application and research. The proposed targets may also be used for treating these disorders using brain stimulation methods.

Scalp surface estimation and head registration using sparse sampling and 3D statistical models

Registering the head and estimating the scalp surface are important for various biomedical procedures, including those using neuronavigation to localize brain stimulation or recording. However, neuronavigation systems rely on manually-identified fiducial head targets and often require a patient-specific MRI for accurate registration, limiting adoption. We propose a practical technique capable of inferring the scalp shape and use it to accurately register the subject’s head. Our method does not require anatomical landmark annotation or an individual MRI scan, yet achieves accurate registration of the subject’s head and estimation of its surface. The scalp shape is estimated from surface samples easily acquired using existing pointer tools, and registration exploits statistical head model priors. Our method allows for the acquisition of non-trivial shapes from a limited number of data points while leveraging their object class priors, surpassing the accuracy of common reconstruction and registration methods using the same tools. The proposed approach is evaluated in a virtual study with head MRI data from 1152 subjects, achieving an average reconstruction root-mean-square error of 2.95 mm, which outperforms a common neuronavigation technique by 2.70 mm. We also characterize the error under different conditions and provide guidelines for efficient sampling. Furthermore, we demonstrate and validate the proposed method on data from 50 subjects collected with conventional neuronavigation tools and setup, obtaining an average root-mean-square error of 2.89 mm; adding landmark-based registration improves this error to 2.63 mm. The simulation and experimental results support the proposed method’s effectiveness with or without landmark annotation, highlighting its broad applicability.

The Insight Meditation Enhanced Stress, Depression, and Anxiety Reduction in Working Professionals Like Medical Representatives Determined by Using Serum Cortisol Level and Electroencephalogram: A Qualitative Study

The Indian pharmaceutical industry is one of the fastest-growing sectors of the Indian economy and ranks among the top 15 drug-manufacturing countries globally. Among the fastest-growing industries in the world, the pharmaceutical industry has increased over the years. A pharmaceutical company appoints a medical representative to make their products easily reach healthcare specialists and then be used by the general public. The medical representatives construct a well- built network with doctors, clinical specialists, medical practitioners, paramedical experts, Dietitians and nutritionists, paediatricians, gynaecologists, psychiatrists, etc. The problem of stress is widespread in every job description, and it may affect directly or indirectly in the form of health issues and low productivity; the demands of achieving targets induced among medical representatives. Much of this credit goes to Medical Sales Representatives or Pharmaceutical Sales Representatives (also known as MR, PSR) who are solely responsible for the promotion of products among Physicians, Hospitals, and pharmacies and are accountable for sales results. They act as the face of the Pharma company contributing to a better quality of life for customers, building goodwill, and increasing the company’s market share. Pharmaceutical sales representatives (PSR) play a large role in helping an industry in a rapidly changing environment to achieve a new corporate vision and normally these medical representatives are in the highest stress position. Most pharmaceutical sales representatives experience significant job stress and unhappiness levels. Stress, depression, and anxiety are the most common psychiatric disorders all over the world. One of India's oldest meditation methods, vipassana also known as Insight meditation, helps a person become aware of things as they are. The goal of the Vipassana method, which aids in self-change via self-observation, is to finally arrive at a condition of inner and exterior peace and mental equilibrium. It is a process of "Self- exploration" to the normal base of the brain and body that removes mental smog and results in a healthier personality filled with love and empathy. Electroencephalography (EEG) is an efficient modality that helps to acquire brain signals corresponding to various states from the scalp surface area. These signals are generally categorized as delta, theta, alpha, beta, and gamma based on signal frequencies ranging from 0.1 Hz to more than 100 Hz. This paper primarily focuses on EEG signals and their characterization for various states of the human body. Beta wave induced the production of cortisol. Also, the beta wave is necessary for our everyday lives, such as thought, communicating, arguing, and problem-solving, during conscious mental work. This Beta wave can also lead to tension, anxiety, and restlessness as they enable us to think properly. Persistently elevated cortisol concentrations are associated with metabolic disorders. Cortisol is a vital hormone sometimes known as the stress hormone in humans, as it is involved in the body's natural response to physical or emotional stress. cortisol has effects on memory, mood, and neurological diseases. Cortisol is best known for mediating the body’s reaction to stress. This study aims to review the existing research and challenges of serum cortisol levels (cortisol is an indicator of stress) and EEG signals with the Insight meditation effect.

Efficacy and safety of tildrakizumab for the treatment of moderate-to-severe plaque psoriasis of the scalp: A multicenter, randomized, double-blind, placebo-controlled, Phase 3b study

Scalp psoriasis is common and difficult to treat. To evaluate efficacy and safety of tildrakizumab for the treatment of scalp psoriasis. In this Phase 3b, randomized, double-blind, placebo (PBO)-controlled study (NCT03897088), patients with moderate-to-severe plaque psoriasis affecting the scalp (Investigator Global Assessment modified [IGA mod] 2011 [scalp] ≥3, Psoriasis Scalp Severity Index [PSSI] ≥12, ≥30% scalp surface area affected) received tildrakizumab 100mg or PBO at W0 and W4. The primary endpoint was IGA mod 2011(scalp) score of "clear" or "almost clear" with ≥2-point reduction from baseline at W16 (IGA mod2011 [scalp] response). Key secondary endpoints were PSSI 90 response at W12 and W16 and IGA mod 2011 (scalp) response at W12. Safety was assessed from adverse events. Of patients treated with tildrakizumab (n=89) vs PBO (n=82), 49.4% vs 7.3% achieved IGA mod 2011 (scalp) response at W16 (primary endpoint) and 46.1% vs 4.9% at W12; 60.7% vs 4.9% achieved PSSI 90 response at W16 and 48.3% vs 2.4% at W12 (all P<.00001). No serious treatment-related adverse events occurred. Only short-term data are presented. Tildrakizumab was efficacious for the treatment of scalp psoriasis with no new safety signals.

THE CHALLENGING SCALP–ELECTRODE INTERFACE AND THE EVOLUTION OF MATERIALS AND ELECTRODE INTEGRATED ICTs FOR ELECTROENCEPHALOGRAPHY

Electroencephalography (EEG) is a non-invasive technique used to measure the electrical activity of the brain. The use of EEG is very important for the diagnosis of traumatic brain events and mental states such as injury, stroke, depression and many others including the COVID-19 brain fog syndrome. The quality of EEG signals largely depends on the nature of the interface between the surface of the electrode material and the surface of the scalp from where the electrical brain signals are acquired. The scalp surface is composed of an epidermic substrate with hair, grease, dirt, dandruff, skin peels and eventually many different hair products. The electrodes must combine several properties including electrical conductivity, mechanical strength, biocompatibility and corrosion resistance. They also must be manufactured with shapes designed to overcome the inherently complex nature of the scalp–electrode interface. This review reports the latest advances in the design of materials, surface coatings, conductive gels and information and communication technologies being developed to increase the quality of measurement of brain electrical signals in EEG protocols.

Effective Signal Extraction Algorithm for Cerebral Blood Oxygen Based on Dual Detectors.

Functional near-infrared spectroscopy (fNIRS) can dynamically respond to the relevant state of brain activity based on the hemodynamic information of brain tissue. The cerebral cortex and gray matter are the main regions reflecting brain activity. As they are far from the scalp surface, the accuracy of brain activity detection will be significantly affected by a series of physiological activities. In this paper, an effective algorithm for extracting brain activity information is designed based on the measurement method of dual detectors so as to obtain real brain activity information. The principle of this algorithm is to take the measurement results of short-distance channels as reference signals to eliminate the physiological interference information in the measurement results of long-distance channels. In this paper, the performance of the proposed method is tested using both simulated and measured signals and compared with the extraction results of EEMD-RLS, RLS and fast-ICA, and their extraction effects are quantified by correlation coefficient (R), root-mean-square error (RMSE), and mean absolute error (MAE). The test results show that even under low SNR conditions, the proposed method can still effectively suppress physiological interference and improve the detection accuracy of brain activity signals.

Adaptive multipole models of optically pumped magnetometer data.

Multipole expansions have been used extensively in the Magnetoencephalography (MEG) literature for mitigating environmental interference and modelling brain signal. However, their application to Optically Pumped Magnetometer (OPM) data is challenging due to the wide variety of existing OPM sensor and array designs. We therefore explore how such multipole models can be adapted to provide stable models of brain signal and interference across OPM systems. Firstly, we demonstrate how prolate spheroidal (rather than spherical) harmonics can provide a compact representation of brain signal when sampling on the scalp surface with as few as 100 channels. We then introduce a type of orthogonal projection incorporating this basis set. The Adaptive Multipole Models (AMM), which provides robust interference rejection across systems, even in the presence of spatially structured nonlinearity errors (shielding factor is the reciprocal of the maximum fractional nonlinearity error). Furthermore, this projection is always stable, as it is an orthogonal projection, and will only ever decrease the white noise in the data. However, for array designs that are suboptimal for spatially separating brain signal and interference, this method can remove brain signal components. We contrast these properties with the more typically used multipole expansion, Signal Space Separation (SSS), which never reduces brain signal amplitude but is less robust to the effect of sensor nonlinearity errors on interference rejection and can increase noise in the data if the system is sub-optimally designed (as it is an oblique projection). We conclude with an empirical example utilizing AMM to maximize signal to noise ratio (SNR) for the stimulus locked neuronal response to a flickering visual checkerboard in a 128-channel OPM system and demonstrate up to 40 dB software shielding in real data.

Subject-specific information enhances spatial accuracy of high-density diffuse optical tomography.

Functional near-infrared spectroscopy (fNIRS) is a widely used imaging method for mapping brain activation based on cerebral hemodynamics. The accurate quantification of cortical activation using fNIRS data is highly dependent on the ability to correctly localize the positions of light sources and photodetectors on the scalp surface. Variations in head size and shape across participants greatly impact the precise locations of these optodes and consequently, the regions of the cortical surface being reached. Such variations can therefore influence the conclusions drawn in NIRS studies that attempt to explore specific cortical regions. In order to preserve the spatial identity of each NIRS channel, subject-specific differences in NIRS array registration must be considered. Using high-density diffuse optical tomography (HD-DOT), we have demonstrated the inter-subject variability of the same HD-DOT array applied to ten participants recorded in the resting state. We have also compared three-dimensional image reconstruction results obtained using subject-specific positioning information to those obtained using generic optode locations. To mitigate the error introduced by using generic information for all participants, photogrammetry was used to identify specific optode locations per-participant. The present work demonstrates the large variation between subjects in terms of which cortical parcels are sampled by equivalent channels in the HD-DOT array. In particular, motor cortex recordings suffered from the largest optode localization errors, with a median localization error of 27.4 mm between generic and subject-specific optodes, leading to large differences in parcel sensitivity. These results illustrate the importance of collecting subject-specific optode locations for all wearable NIRS experiments, in order to perform accurate group-level analysis using cortical parcellation.

Age as a predictive factor for reduced intracranial compliance in patients with headache.

Increased intracranial pressure (ICP) consists of a set of signs and symptoms related to changes in intracranial compliance (ICC) and ICP. This study presents a retrospective analysis of patients who underwent non-invasive monitoring of ICC based on complaints of headache, correlating decreased brain compliance and increased intracranial pressure. Noninvasive ICC monitoring was performed using a Brain4care device, which contains a strain gauge and a recorder connected to a mechanical device that touches the scalp surface in the frontoparietal area lateral to the sagittal suture. This tool monitors the ICP by identifying small changes in skull measurements that are caused by pressure variations, i.e., skull deformation is associated with the detection of changes in mean ICP. A clinical evaluation of 32 patients with complaints of headache occurred from the analysis of their medical records. Of the 32 patients initially chosen, it was possible to complete the analysis of 18 due to the availability of data in the medical records. From the non-invasive monitoring of the ICC, the following data were collected: time-to-peak, P2/P1 ratio, age, and gender. From the statistical analysis of age and P2/P1 ratio, it was noted that as age increases, ICC tends to decrease regardless of sex (p < 0.05). This study concluded that there is a correlation between changes in intracranial compliance and headache complaints in outpatients. There was also a relationship between age and decreased intracranial compliance but without a specific pain pattern.