Inflammatory bowel diseases (IBDs) are characterized by chronic gastrointestinal inflammation due to abnormal immune responses to gut microflora. The gut–brain axis is disrupted in IBDs, leading to neurobiological imbalances and affective symptoms. Systemic inflammation in IBDs affects the brain’s inflammatory response system, hormonal axis, and blood–brain barrier integrity, influencing the gut microbiota. This review aims to explore the association between dysregulations in the gut–brain axis, serum biomarkers, and the development of cognitive disorders. Studies suggest a potential association between IBDs and the development of neurodegeneration. The mechanisms include systemic inflammation, nutritional deficiency, GBA dysfunction, and the effect of genetics and comorbidities. The objective is to identify potential correlations and propose future research directions to understand the impact of altered microbiomes and intestinal barrier functions on neurodegeneration. Serum levels of vitamins, inflammatory and neuronal damage biomarkers, and neuronal growth factors have been investigated for their potential to predict the development of neurodegenerative diseases, but current results are inconclusive and require more studies.

Background/Objectives: Inflammatory bowel diseases (IBD), including mainly ulcerative colitis (UC) and Crohn’s disease (CD), have been associated with cognitive and psychological changes, though the mechanisms remain unclear. Methods: This prospective case-control study aimed to evaluate cognitive performance and biomarkers (homocysteine, serum amyloid A, brain-derived neurotrophic factor, and S100B protein) in IBD patients. Results: A total of 90 individuals (34 UC, 21 CD, and 35 controls) were assessed using the Montreal Cognitive Assessment (MoCA), the Memory Impairment Index (MIS), and biomarker analysis. MoCA and MIS testing showed significant differences between UC, CD, and the controls, with lower scores observed in IBD groups (p = 0.003, p = 0.015). Regarding trail-making tests, digit symbol substitution tests, and forward and backward digit spans, no significant changes were observed. No functional deficits were observed in daily activities. Biomarker analysis revealed lower brain-derived neurotrophic factor and higher serum amyloid A levels in IBD patients, correlated to MOCA and MIS scores. There were no significant differences in psychological distress between IBD patients and the controls. Subtle cognitive declines were noted across all groups during the 1-year follow-up, without any statistical significance when groups were compared. Conclusions: In conclusion, IBD patients reported lower cognitive scores compared to the controls, while no differences in depression and anxiety scores were observed. Higher BDNF levels correlated with better cognitive functioning, while higher serum amyloid A correlated with lower cognitive functioning.

Multiple sclerosis (MS) is an immune-mediated disease characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. Brain plasticity, the brain’s ability to adapt its structure and function, plays a crucial role in mitigating MS’s impact. This paper explores the potential benefits of lifestyle changes and nutraceuticals on brain plasticity in the MS population. Lifestyle modifications, including physical activity and dietary adjustments, can enhance brain plasticity by upregulating neurotrophic factors, promoting synaptogenesis, and reducing oxidative stress. Nutraceuticals, such as vitamin D, omega-3 fatty acids, and antioxidants like alpha lipoic acid, have shown promise in supporting brain health through anti-inflammatory and neuroprotective mechanisms. Regular physical activity has been linked to increased levels of brain-derived neurotrophic factor and improved cognitive function. Dietary interventions, including caloric restriction and the intake of polyphenols, can also positively influence brain plasticity. Integrating these lifestyle changes and nutraceuticals into the management of MS can provide a complementary approach to traditional therapies, potentially improving neurological outcomes and enhancing the quality of life for the MS population.

Background: Mild cognitive impairment (MCI) and Alzheimer’s disease (AD) might be more frequent in patients with inflammatory bowel disease (IBD), but the relationship between these 2 entities is yet to be entirely established. Certain blood biomarkers (eg, serum amyloid A [SAA] and serum homocysteine [Hcy], which increase in IBD and MCI; brain-derived neurotrophic factor [BDNF], which decreases in MCI and AD but is not clearly modified in IBD; and S100 calcium-binding protein B [S100B], which increases in the blood-brain barrier and neuronal lesions) might predict the stage of MCI or dementia or progression to a further state. The gut–brain axis (GBA) might be the key to the development of MCI in patients with IBD, along with systemic inflammation and the possible and unknown adverse effects of disease-modifying medication. Objective: The aim of this study is to investigate whether GBA interactions play a role in MCI development in patients with IBD. Methods: A case-control study will be conducted on at least 100 patients diagnosed with IBD, matched with 100 healthy individual controls. The matching will include sex, age, and education. Patients will be fully examined, and a full interview and a neurological and cognitive examination will be performed. The primary clinical outcomes will be cognitive test scores (Montreal Cognitive Assessment, Trail Making Test, Digit Symbol Substitution Test, forward and backward digit span testing). Depression, stress, and anxiety screening will also be performed. Blood samples from all participants will be collected, and aliquots will be immediately stored in a biobank. Primary laboratory outcomes will include serum levels of presumed cognitive dysfunction blood biomarkers SAA, Hcy, S100B, and BDNF. Follow-up will be performed at 12, 24, 36, and 48 months. Results: Data collection started in December 2021 and is ongoing. So far, 53 patients with IBD have been recruited and 50 HC matched. Data collection should end in January 2030. Intermediary analysis will be performed in April 2024. We expect patients with IBD to have lower scores on cognitive testing and a positive correlation between disease length and cognitive impairment level. In addition, the levels of stress, anxiety, and depression should be higher in the IBD group. The serum levels of the 4 biomarkers could correlate or anticorrelate with cognitive scores and serve as predictive factors for MCI or dementia development. A higher level of education, a younger age, the absence of malabsorption, and good disease control might serve as protectors against MCI. Conclusions: GBA interactions, along with systemic inflammation and the adverse effects of medication, might be a cause of MCI and AD development in patients with IBD. Serum biomarkers could prove cheap and useful predictors of MCI development. Trial Registration: ClinicalTrials.gov NCT05760729; https://clinicaltrials.gov/study/NCT05760729 International Registered Report Identifier (IRRID): DERR1-10.2196/50546

Multiple sclerosis (MS) is an immune-mediated disease characterized by inflammation, demyelination, and neurodegeneration within the central nervous system. Brain plasticity, the brain's ability to adapt its structure and function, plays a crucial role in mitigating MS's impact. This paper explores the potential benefits of lifestyle changes and nutraceuticals on brain plasticity in MS population. Lifestyle modifications, including physical activity and dietary adjustments, can enhance brain plasticity by upregulating neurotrophic factors, promoting synaptogenesis, and reducing oxidative stress. Nutraceuticals, such as vitamin D, omega-3 fatty acids, and antioxidants like alpha-lipoic acid, have shown promise in supporting brain health through anti-inflammatory and neuroprotective mechanisms. Regular physical activity has been linked to increased levels of brain-derived neurotrophic factor and improved cognitive function. Dietary interventions, including caloric restriction and the intake of polyphenols, can also positively influence brain plasticity. Integrating these lifestyle changes and nutraceuticals into the management of MS could provide a complementary approach to traditional therapies, potentially improving neurological outcomes and enhancing the quality of life for MS population.

Background/Objectives: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy, often impairing daily function and quality of life. This study aimed to translate, cross-culturally adapt, and assess the validity of the Boston Carpal Tunnel Questionnaire (BCTQ) in a Romanian cohort. Methods: We conducted a cross-sectional study to translate, culturally adapt, and validate the Romanian version of the BCTQ. A total of 190 participants were recruited, representing 380 wrists, including 130 patients with suspected or confirmed CTS and 60 healthy controls. The adaptation process followed international standards, with forward and backward translation, expert committee review, and pilot testing. Participants completed the Romanian BCTQ and performed standardized nerve conduction studies. The internal consistency and validity, including convergent and discriminant validity, exploratory factor analysis, and test–retest assessments, were performed. Results: The Romanian BCTQ exhibited exceptional internal consistency (Cronbach’s α = 0.96), significant inter-item correlations, and robust factor loadings confirming a one-factor structure. Convergent validity was evidenced by strong correlations with electrodiagnostic measurements. The test–retest reliability was high, with intraclass correlation coefficients above 0,99. Conclusions: The Romanian adaptation of the BCTQ is a valid, reliable, and culturally appropriate patient-reported instrument to assess symptom severity and functional status in CTS, improving clinical decision-making and cross-cultural research.