Research Appraisals
Evidence-based critical appraisals of the latest medical research, systematically evaluated using Oxford CEBM methodology.
Showing 3 appraisals
Journal of affective disorders
Transcranial focused ultrasound for emotion regulation: A systematic review and quantitative summary of human studies.
BACKGROUND: Emotion regulation is a core transdiagnostic process in mood, anxiety, and stress-related disorders. While existing non-invasive brain stimulation approaches, such as transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), can modulate affective networks, their clinical use is limited by restricted spatial precision and depth penetration. Transcranial focused ultrasound stimulation (tFUS) offers submillimeter focality and access to both cortical and deep subcortical structures, making it a promising tool for affective neuromodulation. METHODS: We systematically searched PubMed, Embase, and PsycINFO for human studies using tFUS to modulate emotion regulation, affective processing, or related symptoms. Eligible studies included randomized controlled trials (RCTs), open-label, and within-subject designs. Data on stimulation parameters, target regions, outcomes, and safety were extracted. Effect sizes were calculated and pooled using a random-effects model, with subgroup analyses by clinical domain. RESULTS: Eleven studies met inclusion criteria, targeting the amygdala (n = 5), prefrontal cortex (n = 5), or subcallosal cingulate cortex (n = 1), with protocols varying in frequency (250-650 kHz), duty cycle (0.5-70%), and number of sessions (1-25). Across six studies reporting behavioral symptom outcomes, the pooled effect was moderate-to-large (Hedges' g = 0.88, 95% CI [0.47, 1.29]), with larger effects in depression-related measures (g = 1.31) than in anxiety-related measures (g = 0.67). Imaging outcomes were reported in a smaller subset of studies and were not included in the pooled estimates. No serious adverse events were reported. CONCLUSIONS: tFUS is a safe and well-tolerated intervention capable of engaging deep affective circuits; however, quantitative estimates remain preliminary given the small and heterogeneous evidence base. Future large-scale, harmonized, and mechanistically informed trials are warranted to refine protocols, establish durability, and optimize translation into clinical practice.
15 July 2026
Read appraisal →Biomedical physics & engineering express
Challenges and strategies in fusion of probes and imaging equipment for neural imaging
Recent years have seen significant progress in imaging technology, which has deepened our understanding of the brain. However, challenges remain in detecting nanoscale structures like the extracellular space and mapping complex neural networks. Various chemical probes have been developed to improve the imaging precision of microstructures and functional imaging. Yet, the integration of imaging technologies and probes stays underdeveloped. Differences in disciplinary paradigms, unclear quantitative and qualitative relationships, and a lack of optimized cross-functional orchestration are the main causes of this problem. In this paper, we propose potential strategies to achieve deep integration of probes and equipment for high-quality imaging. Specifically, we advocate for three main approaches: (1) designing imaging sequences driven by probe properties, (2) constructing quantitative dose-effect models, and (3) leveraging artificial intelligence for system optimization. Importantly, these strategies establish an adaptable framework that will facilitate the seamless integration of emerging probe and equipment technologies in future brain science research. Ultimately, this enhanced integration promises to advance our knowledge of brain function and structure.
29 June 2026
Read appraisal →The journal of headache and pain
The emerging role of the meningeal lymphatic and glymphatic systems in migraine pathophysiology: a systematic review
BACKGROUND/OBJECTIVE: Migraine is a common, debilitating neurological disorder of unclear pathophysiology. Recent evidence has implicated impaired meningeal lymphatic function and its interaction with the glymphatic system in the development of neuroinflammation and pain sensitization. This systematic review aimed to summarize existing evidence on the role of the meningeal lymphatic and glymphatic systems in migraine pathophysiology. METHODS: Following the PRISMA 2020 recommendations, we searched PubMed, Web of Science, and Scopus from inception to December 15, 2025. Inclusion criteria comprised human or animal studies examining meningeal lymphatic or glymphatic function in migraine or validated migraine animal models. SYRCLE's risk of bias tool for animal studies and the Joanna Briggs Institute (JBI) critical appraisal tools were used for quality assessment. RESULTS: The search yielded a total number of 457 records, out of which 10 articles fulfilled the eligibility criteria. These comprised six imaging studies conducted on human populations and four preclinical studies performed on animal models. Studies using dynamic contrast-enhanced (DCE)-MRI have shown changes in lymphatic enhancement characteristics in both episodic and chronic migraines. Diffusion tensor imaging along perivascular spaces (DTI-ALPS) yielded heterogeneous findings, with abnormalities more consistently observed in chronic and high-frequency migraine. Preclinical models demonstrated that cortical spreading depression, nitroglycerin exposure, and familial hemiplegic migraine mutations impaired glymphatic influx and reduced cerebrospinal fluid efflux through meningeal lymphatic vessels. DISCUSSION: Initial research has shown that altered lymphatic and glymphatic systems may be related to migraine. Nonetheless, there is no existing literature on whether these conditions can be considered causative agents for migraines. There is a need for longitudinal imaging studies in a larger population. REGISTRATION: PROSPERO ID: CRD420251266296.
20 June 2026
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