Daniel Solomons

Background and Objectives: Obstructive sleep apnea (OSA) is a heterogeneous disease with diverse clinical presentations and high global prevalence. Obesity is a common comorbidity in OSA, but its relationship with symptom subtypes remains unclear. This study aimed to evaluate the association between OSA symptom subtypes and obesity in a clinical cohort. Methods: This observational study analyzed data from the Santiago Obstructive Sleep Apnea (SantOSA) prospective clinical cohort, including adults with OSA confirmed by home sleep apnea testing. Symptom subtypes were identified using latent class analysis. Associations between obesity and symptom subtypes were evaluated using multivariable regression models adjusted for age, sex, tobacco use, RDI, T90%, TST, hypertension, and diabetes. Statistical significance was set at p < 0.05. Results: A total of 1167 patients were included (943 men). Latent class analysis identified three symptom subtypes: non-sleepy, disturbed sleep, and excessive daytime sleepiness. Among obese patients, 30.7%, 50.0%, and 19.3% were classified into these subtypes, respectively. Obesity prevalence was 50.2%, and compared with non-obese OSA patients, obese patients showed a higher prevalence of severe OSA (46.1% vs. 26.9%), hypertension (54.4% vs. 34.9%), and diabetes (37.2% vs. 19.4%), as well as higher ESS scores and higher RDI and T90% values (all p < 0.01). In adjusted analyses, obesity remained independently associated with the excessive daytime sleepiness subtype after controlling for age, sex, tobacco use, RDI, T90%, TST, and comorbidities. Conclusions: Obesity is highly prevalent in OSA and is associated with specific symptom-defined phenotypes, particularly excessive daytime sleepiness and disturbed sleep. These findings support the relevance of considering symptom profiles alongside traditional severity metrics.

Introduction. Autism spectrum disorder (ASD) is more frequently diagnosed in males; however, evidence suggests that this disparity may partly reflect sex-related biases in diagnostic criteria and assessment tools. Aim. To characterize core ASD symptoms in females across the two DSM-5 diagnostic domains (Social Communication and Interaction, and Restricted and Repetitive Behaviors) and to quantify sex-based differences in symptom severity using standardized diagnostic instruments. Methodology. This systematic review and meta-analysis was conducted in accordance with PRISMA guidelines. We included studies published between January 2013 and September 2025 that reported on diagnostic processes or symptom presentation and were identified through searches of PubMed/MEDLINE, Scopus, and Web of Science. Results. Forty-eight studies were included in the qualitative narrative synthesis and seven in the meta-analyses, covering a total of 54,060 participants. Qualitative findings suggested inconsistent sex differences in social communication (DSM-5 Criterion A), whereas more domain-specific patterns emerged for restricted and repetitive behaviors (DSM-5 Criterion B), especially in sensory reactivity and restricted interests. Meta-analyses showed small but significant differences in overall ADOS-2 scores (d = −0.18; 95% CI [−0.35, −0.01]; p = 0.043) and the Social Affect domain (d = −0.23; 95% CI [−0.45, −0.02]; p = 0.033), with lower severity in females. No significant differences (d = −0.12; 95% CI [−0.39, 0.15]; p = 0.393) were found in the Restricted and Repetitive Behavior domain, but we observed high heterogeneity (I2 = 64.7%). Publication bias analyses suggested some funnel-plot asymmetry, although the overall interpretation of the findings remained unchanged. Conclusion. These results highlight the need for sex-informed diagnostic approaches that incorporate comprehensive clinical assessments to enhance early detection and reduce diagnostic delays in females with ASD.

Introduction. Hearing loss (HL) rehabilitation involves using different hearing technologies, such as hearing aids or cochlear implants. The efficacy of HL rehabilitation strategies and their cognitive benefits has been reported for clinical populations, such as those with mild cognitive impairment or dementia. However, up to date, there is no clarity about the cognitive-linguistic implications of HL rehabilitation for healthy older adults. Therefore, increasing knowledge about its benefits in healthy older people is critical to generating early intervention strategies that could delay the progression to pathological stages. Aim. To profile cognitive-linguistic performance after HL rehabilitation in healthy older adults. Methodology. Systematic literature review following the PRISMA guidelines. We included randomized and non-randomized clinical trials from Medline by PubMed, Scopus, and Web of Science databases (January 2000 to May 2024). Results. We identified 410 titles, from which five papers were qualitatively analyzed. Results suggest that after HL rehabilitation, healthy older adults improve their performance in specific abilities such as working memory, delayed recall, attention, semantic and phonological fluency, and language comprehension. We highlight an association between working memory improvement and semantic skills' benefits, especially in subjects with mild to moderate HL. Conclusion. HL rehabilitation programs should consider cognitive-linguistic stimulation programs in healthy older adults to prevent cognitive dysfunction or neurodegenerative conditions. We only analyzed a few studies; thus, we suggest interpreting the information carefully. Indeed, promoting more follow-up studies to clarify the benefits of using hearing devices and their cognitive-linguistic implications in healthy people is still necessary.

Background/Objectives: Functional MRI (fMRI) is widely used to assess language lateralization, but its application in patients with brain tumors can be hindered by cognitive impairments, compensatory neuroplasticity, and artifacts due to patient movement or severe aphasia. Gray matter volume (GMV) analysis via voxel-based morphometry (VBM) in language-related brain regions may offer a stable complementary approach. This study investigates the relationship between GMV and fMRI-derived language lateralization in healthy individuals and patients with left-hemisphere brain tumors, aiming to enhance accuracy in complex cases. Methods: The MRI data from 22 healthy participants and 28 individuals with left-hemisphere brain tumors were analyzed. Structural T1-weighted and functional images were obtained during three language tasks. Language lateralization was assessed based on activation in predefined regions of interest (ROIs), categorized as typical (left) or atypical (right or bilateral). The GMV in these ROIs was measured using VBM. Linear regressions explored GMV-lateralization associations, and logistic regressions predicted the lateralization based on the GMV. Results: In the healthy participants, typical left-hemispheric language dominance correlated with higher GMV in the left pars opercularis of the inferior frontal gyrus. The brain tumor participants with atypical lateralization showed increased GMV in six right-hemisphere ROIs. The GMV in the language ROIs predicted the fMRI language lateralization, with AUCs from 80.1% to 94.2% in the healthy participants and 78.3% to 92.6% in the tumor patients. Conclusions: GMV analysis in language-related ROIs effectively complements fMRI for assessing language dominance, particularly when fMRI is challenging. It correlates with language lateralization in both healthy individuals and brain tumor patients, highlighting its potential in preoperative language mapping. Further research with larger samples is needed to refine its clinical utility.