Journal of Applied Cognitive Neuroscience

Regulation on Neuronal Excitability and Epileptogenesis. Part I

Jorge URE — 2025-10-04

The intracellular pathways of potentially epileptogenic signals were described through the study of metabotropic glutamate receptors (mGluRs). A narrative review of the literature was conducted, based on evidence that G-protein-coupled receptors play critical roles in modulating neuronal excitability. The net effect is the potentiation of NMDAR currents. Three challenging findings are highlighted: 1) A reduction in the expression of GIPC1 (GAIP-interacting protein, C terminus) was observed in both patients with temporal lobe epilepsy (TLE) and in mice with kainic acid-induced epilepsy. Moreover, GIPC1 was found to colocalize with mGluR7, and its overexpression counteracted epileptogenesis through the upregulation of mGluR7; 2) Positive upregulation of postsynaptic Homer 1a may protect against neuronal damage by reducing levels of phosphorylated extracellular signal-regulated kinase (ERK), thereby controlling seizures and preventing epileptogenesis; and 3) In kindled rats, overexpression of neuropeptide Y (NPY) acted as a protective factor. NPY has been identified as being synthesized in GABAergic neurons and functions as a neurotransmitter expressed in interneurons during cellular communication. These findings point to three promising targets for the development of new antiepileptic drugs, whether as monotherapies or in synergistic combinations. In addition, downstream proteins of mGluRs, such as those involved in the ERK/MAPK, mTOR, PLC, PKC, and CaM pathways, may also represent valuable therapeutic targets.

Evidence-Based Medicine in Neuroscience: From Theory to Real Clinical Decisions

Andrea Elizabeth Siavichay León — 2025-12-30

Evidence-Based Medicine (EBM) is a cornerstone of contemporary clinical practice; however, its application in neuroscience remains challenged by the gap between available evidence and the complexity of real-world clinical decision-making. This narrative review provides a critical and practice-oriented analysis of how EBM principles must be reinterpreted and adapted to address the epistemological, methodological, and clinical particularities of neuroscience. Using an integrative framework, this review revisits the core concepts of EBM and examines the distinctive features of neuroscience evidence, including reliance on proxy outcomes, clinical heterogeneity, the chronic and progressive nature of many neurological conditions, and ethical and practical constraints on classical randomized trials. The transition from the traditional evidence hierarchy to next-generation EBM models is explored, emphasizing the integration of multiple layers of information such as real-world data, patient-centered outcomes, and longitudinal clinical trajectories. Common errors in translating evidence into clinical practice are identified, including the conflation of statistical significance with clinical relevance, uncritical extrapolation of population-level findings to individual patients, and rigid application of clinical guidelines. Finally, the manuscript outlines future research opportunities based on identified knowledge gaps, aimed at strengthening a more contextualized, realistic, and patient-centered EBM in neuroscience.

Meta-science in neuroscience: why we need to study how we research the brain

Wendy Dayanna Cuji Galarza — 2025-12-30

Neuroscience has undergone unprecedented growth driven by technological, methodological, and analytical advances that have substantially expanded our understanding of the brain. However, this rapid development has not always been accompanied by a proportional reflection on how neuroscientific knowledge is produced, evaluated, and interpreted. In this context, meta-science emerges as a critical framework for systematically examining research practices, epistemological assumptions, and the dynamics of scientific knowledge production. This article provides a narrative and reflective review of the role of meta-science in neuroscience, aiming to explain why this field requires a specific meta-scientific approach. Key structural challenges in neuroscientific research are discussed, including the intrinsic complexity of the brain as an object of study, the reliance on proxy variables, high interindividual variability, methodological and analytical biases, and persistent issues related to reproducibility and clinical translation. The implications of these challenges for evidence-based medicine and clinical decision-making are also examined, highlighting risks such as overinterpretation of findings, conflation of statistical significance with clinical relevance, and premature implementation of insufficiently validated results. Additionally, the article reflects on the roles of researchers, peer reviewers, editors, and scientific journals as central actors in shaping a more rigorous, transparent, and responsible neuroscientific ecosystem.

Is ocular salvage feasible in patients with high-risk intraocular retinoblastoma?

Keiny Maria Medina Pérez — 2025-11-02

N/A

Pharmacological management of infantile epileptic spasms syndrome: which agent provides the greatest benefits?

Lellys Patricia Rangel Gualdrón — 2025-11-02

N/A

Spanish Translation and Pilot Validation of the Scale for the Assessment and Rating of Ataxia (SARA)

Julian Matias Fernandez Boccazzi — 2025-10-04

Introduction: Ataxias are a heterogeneous group of disorders with multiple etiologies. Despite the existence of several rating scales, no validated Spanish version of the SARA scale has been available. Given that more than 480 million people worldwide are Spanish speakers, the absence of such a tool represents a gap in clinical practice and research. Methods: The SARA scale was translated and cross-culturally adapted following ITC guidelines. A pilot test was conducted in 13 patients with genetically confirmed (n=11) or immune-mediated (n=2) ataxia. Internal consistency was assessed using Cronbach’s alpha, and external validity was evaluated against Barthel index, disease stage, and disease duration. Results: The Spanish version of SARA showed good internal consistency (Cronbach’s alpha = 0.87). A significant negative correlation with Barthel index (r=-0.94, p<0.01) and a positive correlation with disease stage (r=0.921, p<0.01) were observed. Correlation with disease duration was weak and not significant (r=0.55, p=0.51). Discussion: This pilot study demonstrates the feasibility of a Spanish adaptation of SARA, aligning with results from international validations (Portuguese, Japanese, Chinese, French). Although preliminary, these findings suggest that this tool may provide a reliable measure for clinical and research purposes in Spanish-speaking populations. We generated a Spanish version of the SARA scale with promising preliminary results in terms of reliability and validity. Further multicenter studies with larger cohorts are warranted to confirm its definitive validation.