Caffeine is one of the world’s most consumed drugs. According to the Washington Post (2015), two billion cups of coffee are consumed per day worldwide. Caffeine is classified as a central nervous system (CNS) stimulant and an organic molecule called methylxanthine. Caffeine has three notable mechanisms of action on the CNS that produce a psychostimulant effect. These effects are responsible for the effect that caffeine has on cognitive function. The effects of caffeine consumption on cognitive function have been demonstrated across several studies involving humans and animals. With the immense number of people consuming caffeine around the world, it is of vital importance to study the effects that this drug has on people’s cognitive function. This literature review provides useful insights on this question through the analysis of caffeine’s effects on cognitive function, along with information on caffeine’s three modes of action. The findings of recent studies show mixed results regarding the effects of caffeine on mood, attention, processing speed, and memory. Current research suggests that if caffeine does have an effect on mood, the most significant changes may be anxiety. Studies did not support caffeine as having any significant effect on attention, but that it did play a role in enhancing processing speed. The majority of the studies reviewed suggest caffeine as having a significant positive effect on both short and long-term memory in adults and the elderly. Current findings warrant continued research on the association of caffeine and the resultant effects on cognitive function.

The coronavirus disease 2019 (COVID-19) pandemic has triggered governments worldwide to implement severe restrictions on physical therapy protocols in order to better control the spread of the virus. One of the mechanisms of providing physical therapy patient care during this era is via telemedicine. Telerehabilitation or telerehab is a technological visual-audio system that serves patients, including those with a spine injury, ailment, or postoperatively, with neurological deficits. In this scoping review, we discuss the development of telerehab, the technological advances in the field, and the usage of telerehab specifically pertaining to spine patients, and comment on the advancement of telerehab in the time of COVID-19. There is preliminary evidence that suggests that the adoption of telerehab in lieu of face-to-face interventions is beneficial for reducing pain and improving physical function in patients afflicted with chronic nonmalignant musculoskeletal pain from low back pain, lumbar stenosis, neck pain, and osteoarthritis. Availability is important, as the necessary technology should be accessible to all participants. Safety and security should be addressed, as the passage of patient data over the Internet requires secure confidentiality. Ease-of-use is crucial to promote practicality, user-friendly operation, and adherence to therapy. The combination of evidence-based methodologies with cost-effective services will serve as a basis for the further expansion of vital telerehab services and increases reimbursement by health insurance providers.

Coronavirus 2019 (COVID-19) is currently the center of what has become a public health crisis. While the virus is well-known for its trademark effects on respiratory function, neurological damage has been reported to affect a considerable proportion of severe cases. To characterize the neuro-invasive potential of this disease, a contemporary review of COVID-19 and its neurological sequelae was conducted using the limited, but growing, literature that is available. These neurological squeal are based on the manifestations that the virus has on normal central and peripheral nervous system function. The authors present the virology of the SARS-CoV-2 agent by analyzing its classification as an enveloped, positive-stranded RNA virus. A comprehensive timeline is then presented, indicating the progression of the disease as a public health threat. Furthermore, underlying chronic neurological conditions potentially lead to more adverse cases of COVID-19. SARS-CoV-2 may reach ACE2 receptors on neuronal tissue through mode of the general circulation. The CNS may also be susceptible to an immune response where a “cytokine storm” can manifest into neural injury. Histological evidence is provided, while symptoms such as headache and vertigo are highlighted as CNS manifestations of COVID-19. Treatment of these symptoms is addressed with paracetamol being recommended as a possible, but not conclusive, treatment to some CNS symptoms. The authors then discuss the peripheral nervous system sequelae and COVID's impact on causing chemosensory dysfunction starting with viral attack on olfactory sensory neurons and cells types within the lining of the nose. Histological evidence is also provided while symptoms such as anosmia and ageusia are characterized as PNS manifestations. Possible treatment options for these symptoms are then addressed as a major limitation, as anecdotal, and not conclusive evidence can be made. Finally, preventive measures of the neurological sequelae are addressed using a multidirectional approach. Postmortem examinations of the brains of COVID-19 patients are suggested as being a possible key to formulating new understandings of its neuropathology. Lastly, the authors suggest a more comprehensive neurological follow-up of recovered patients, in order to better characterize the neurological sequelae of this illness.

The development of the three-dimensional (3D) exoscope is a marvel of technological innovation in modern surgical practice. While its predecessor, the operating microscope (OM), has long been the gold-standard surgical visualization modality, its particular limitations in terms of accessibility and ergonomic demand have led to the development of a more sophisticated, 3D model. Specifically, the 3D exoscope allows for an enhanced image quality of the surgical field, while also being more ergonomically favorable. Moreover, this device’s ability to handle delicate microsensitve procedures, along with its alleviation of surgeon fatigue, indicates great potential for neurosurgical application. For this narrative review, the authors queried PubMed database using the keyword “exoscope” to identify relevant studies involving the specialty of neurosurgery that were published in English language full text. The search yielded full-text English language-related articles regarding neurosurgical exoscope, its applications and limitations. The 3D exoscope uniquely allows for enhanced surgeon comfort and superior imaging of the patient’s real-time anatomy. However, the OM was described to having a slight image favorability with fusion and decompression surgery. Cost analysis is highlighted for its potential disparity. 3D exoscopes will potentially be incorporated with intelligent carriers and robotic surgical systems. Ultimately, with further studies highlighting its use, the 3D exoscope is expected to continue to imprint its status as one of the most efficient technological visualization tools in the future of neurosurgical practice.