Specialty Chief Editor
Murdoch Childrens Research Institute, Royal Children's Hospital
Na Liu, Qinying Ma, Moqing Zhou, Lin Yang, Wenyuan Wang, Yanyong Wang
Nemira Žilinskaitė-Tranas, Gytis Makarevičius, Aušra Liveikienė, Kristina Ryliškienė
Visual snow syndrome (VSS) is a chronic neurological condition marked by persistent, bilateral, pan-field visual static and a constellation of additional visual and non-visual symptoms. Affecting an estimate of 2% of the populations, VSS remains substantially underdiagnosed, as its symptoms overlap with migraine aura and structural ophthalmological disease, and no standardised diagnostic protocol currently exists. This structured narrative review synthesises evidence on the clinical features, pathophysiology, comorbidities, and differential diagnosis. It also proposes a stepwise diagnostic approach for routine practice, distinguished from the advanced, research-oriented evaluations used to investigate underlying mechanisms. Converging neuroimaging and electrophysiological evidence suggests cortical hyperexcitability and large-scale network dysfunction may underlie VSS, though the precise mechanisms remain incompletely understood. We recommend a multidisciplinary, patient-centred management approach and identify biomarker development, multicentre validation of the diagnostic approach, and large-scale interventional trials as research priorities.
Xiangyu Dai, Yujie Ji, Zheng Cai, Haixin Zeng, Yi Li, Haining Zhou, Xu Zhang, Bing Li
Glioblastoma (GBM) remains an aggressive adult primary brain tumor despite surgery, radiotherapy and temozolomide-based chemotherapy, partly because glioblastoma stem cells (GSCs) retain self-renewal capacity, lineage plasticity and therapeutic resistance. Cancer neuroscience has shown that glioma cells receive activity-dependent neuronal signals and exploit neural circuits to support tumor growth and invasion. Synaptic proteins may therefore regulate both neuron-glioma communication and tumor-cell state. Synapsin I, II, and III share conserved N-terminal domains but differ in C-terminal architecture, developmental expression and physiological function. An emerging model of functional divergence in GBM is supported by a recent preclinical study comparing Synapsin III with Synapsin I and II. In the tested GSC models, increasing Synapsin III promoted a neuronal-like differentiated phenotype through a neuregulin 3 (NRG3)-JAG1-NOTCH1 mechanism, with reduced stemness and proliferative growth. This review integrates structural, physiological and GBM-focused evidence to examine how the developmental functions of Synapsin III may be repurposed in malignant stem-like cells. Independent replication, durable loss of tumorigenicity and tumor-selective delivery are priorities for translation. Synapsin III is a candidate differentiation-restoring node whose clinical relevance remains to be established.
Joseph Russell, Jemma Inches, Camille B. Carroll, Jeroen H. M. Bergmann
Dongping Li, Jianhui Chen, Chunfa Weng, Jianhuang Huang
Venous thromboembolism (VTE) is a critical complication after traumatic brain injury (TBI) surgery. Conventional risk assessment tools were not developed for neurosurgical trauma populations, limiting their applicability. To develop and internally validate an interpretable clinical prediction model for postoperative VTE in TBI surgery patients. This retrospective cohort study enrolled 1,450 TBI patients who underwent surgery (2016–2024). Seven predictors were selected using Recursive Feature Elimination. Six machine learning algorithms were compared, with logistic regression (LR) selected as the final model. Performance was evaluated using AUC-ROC, calibration, and decision curve analysis. Among 1,450 patients, 205 (14.1%) developed postoperative VTE. The LR model achieved AUC-ROC of 0.868 (95% CI: 0.815–0.920) with good calibration (Brier score: 0.085). Seven predictors were identified: age, Barthel index, ASA classification, multiple surgeries, general anesthesia, limb AIS score, and serum magnesium. Compared with Caprini score (AUC: 0.686), the model showed improved discrimination (ΔAUC = 0.182; NRI: 0.559). An interpretable model based on seven routinely available variables demonstrated promising performance for postoperative VTE risk stratification in TBI surgery patients. A nomogram and web-based calculator are provided for clinical use.
