Cognitive Neuroscience Commons^™

Invisible Shipwrecks And Neurological Endangerment: The Trade-Off In Seeking Asylum - Reframing The Neurobiological Cost Of Forced Migration, Eisha Giran

CISLA Senior Integrative Projects

Forced migration along the Spain–Morocco route represents one of the most visible humanitarian crises of the twenty-first century, yet its neurological dimensions remain insufficiently examined. This paper investigates how prolonged displacement and trauma reshape neural systems involved in stress regulation, memory, and emotional processing. It introduces the concept of neurological endangerment, defined as a condition of prolonged and inescapable threat exposure during forced migration in which stress-response systems remain chronically activated, opportunities for recovery are structurally constrained, and cumulative neurobiological risk persists beyond the period of immediate danger.

To address the gap between biological measurement and lived experience, this paper …

Clinical And Demographic Characteristics Of Hospitalized Patients With Xylazine-Related Wounds, Elizabeth Novick, Nikhil Seval, Dagan Coppock, Mollie Tucker, Daniel Taupin, John Zurlo, Carolyn Kramer

Department of Medicine Faculty Papers

OBJECTIVES: Little is known about the demographic and clinical features of patients with xylazine-related wounds. We sought to characterize hospitalized patients with substance use disorder (SUD) and xylazine-related wounds seen for infectious diseases consultation.

METHODS: We retrospectively reviewed the medical records of 193 patients diagnosed with SUD at 3 Philadelphia hospitals between October 2023 and January 2024. Patients were identified as either being diagnosed with (n=73) or without (n=120) xylazine-related wounds. We compared the demographic and clinical features between the 2 groups.

RESULTS: Patients diagnosed with wounds were younger ( P < 0.001), more likely to be White or Hispanic and less likely to be Black/AA ( P < 0.001), more likely to have tested positive for fentanyl ( P < 0.001), amphetamines ( P < 0.001), and cocaine ( P 0.001), more likely to acknowledge injection ( P < 0.001), and more likely to leave the hospital by patient-directed discharge (PDD) ( P < 0.001). Most patients had multiple wounds (75%), and more than half (53%) had at least one wound greater than 10 cm at its widest dimension. Although most patients diagnosed with wounds received antibiotics, many did not have symptoms or signs of infection.

CONCLUSIONS: Xylazine-related wounds are highly associated with illicitly manufactured …

From Fog To Function: An Occupational Therapist's Guide To Evaluating And Treating Cancer-Related Cognitive Impairments, Lauren E. Toner

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

Cancer – related cognitive impairment (CRCI) is a common side effect of cancer treatment that interferes with cancer survivors’ occupational performance, independence, and quality of life. Despite its high prevalence, CRCI remains under recognized and inconsistently addressed within oncology care. About 70% of individuals diagnosed with cancer report cognitive changes during or after treatment, yet many do not receive treatment. Occupational therapists are clinically trained to evaluate and treat functional cognition, activities of daily activities, instrumental activities of daily living, and client centered goals, positioning them as key providers in addressing CRCI. However, limited occupational therapy specific resources have hindered …

The Complexities Of The Bilingual Advantage, Melisa Sierra

Behavioral Neuroscience Honors Papers

The bilingual advantage hypothesis, which proposes an enhancement of executive functions in bilinguals, remains heavily debated with inconsistent findings across studies. This study investigated working memory performance in bilingual and monolingual young adults using a modified n-back task with an interruption while recording EEG activity. Participants completed 1-back, 2-back, and 3-back conditions across the pre-interruption phase and a post-break 2-back condition. Behavioral measures (accuracy and response times) were analyzed alongside ERP, focusing on P300 and sustained activity components, were analyzed. Results showed a decrease in accuracy as task difficulty increased from 1-back to 3-back, indicating the expected effects of higher …

The Science Of Sound: Studying The Cognitive, Emotional, And Physiological Effects Of Frequency, Genre, And Music, Jett Yarborough

Senior Honors Theses

Music influences emotion, physiology, and cognition, yet little is known about how the frequency it is tuned to affects these influences. Prior research has shown that music tuned to 432 Hz can reduce stress, lower blood pressure, and improve sleep. My colleagues and I conducted two studies to investigate this. Our research found that music tuned to 432 Hz promotes a significant increase in memory retention and induces a state of focus and relaxation. These results suggest that shifting from the standard tuning frequency of 440 Hz to 432 Hz could have a profoundly positive impact on our daily lives. …

A Single Center Study Of The Symbol Digit Modalities Test As A Screening Tool For Cognitive Impairment In Parkinson’S Disease, Daniyell Thomason, Morganne Manuel, Shannin Moody, Jesus Lovera, Brain Copeland, Deidre Devier

School of Medicine Faculty Publications

Background: Parkinson’s Disease (PD) can include physical signs and possibly cognitive impairment, resulting from the convergence of pathologicalprocesses involving dopaminergic dysfunction, accumulation ofalpha-synuclein, cholinergic deficits, and disruption of otherneurotransmitter systems. We used screening tests to evaluate thecharacteristics of cognitive performance in patients with PD and to assess their validity compared tothe Montreal Cognitive Assessment (MoCA). Methods: This is a natural history study of participants with PD and controls screened for possible cognitive impairment using the MoCA, Symbol Digit Modalities Test (SDMT), and King-Devick (KD). The groups were compared on performance and then factors associated with cognitive performance (age, diagnosis, and …

Be Your Own Brain Advocate: Why Older People Should Request Routine Cognitive Testing, Josey M. Batura, Elizabeth B. Fauth

All Current Publications

Your primary care physician can conduct regular screenings and track cognitive changes; however, patients may need to advocate for and request testing. If there is noticeable loss in cognitive function, you may benefit from a more accurate diagnosis and a treatment plan or care plan from a medical specialist. Detecting cognitive changes early is better than knowing too late.

Integrating Neuroaesthetic Design Into Brain-On-Chip Research: Toward Enhanced Neural Engagement And Cognitive Accessibility, Piper Hutson, James Hutson

Faculty Scholarship

This study examines the potential for neuroaesthetic design and adaptive neurofeedback principles to enhance brain-on-chip (BoC) research, with an emphasis on optimizing neural engagement and cognitive accessibility for diverse populations. Existing BoC platforms have transformed neuroscience through high-fidelity modeling of neural circuits, yet cognitive accessibility and sensory inclusion remain comparatively underexplored. Drawing upon recent studies in neuroinclusion, multisensory interface design, and adaptive feedback, this work synthesizes findings from biophilic interface architecture, neurofeedback literature, and embodied cognition frameworks. The manuscript outlines a multidisciplinary research agenda that prioritizes sensory diversity and ethical considerations in the evolution of BoC systems. Instead of making …

Art, Play, And Neuroplasticity: Advancing Dementia Care Through Art-Enriched Environments, Piper Hutson, James Hutson

Faculty Scholarship

Dementia represents a global public health crisis, characterized not only by progressive memory loss but by a pervasive decline in cognitive flexibility, social functioning, and overall quality of life. Traditional therapeutic modalities, often limited to pharmacological management and cognitive training, have yielded only modest gains in symptom mitigation and patient well-being. Recent advances in neuroscience have illuminated the brain‘s capacity for neuroplasticity—its inherent ability to adapt, reorganize, and form new neural connections even in advanced age and the presence of neurodegenerative conditions. This emerging understanding invites a critical re-evaluation of dementia care strategies, highlighting the potential of non-pharmacological interventions to …

The Impact Of Insufficient Sleep On The Serial Reproduction Of Information, David L. Dickinson, Sean P. A. Drummond

ESI Publications

Story retelling is an important form of communication, cultural practice, and message transmission. Insufficient sleep is known to affect relevant cognitive skill areas necessary for story retelling or transmission fidelity. We conducted a preregistered randomized cross-over study on n = 155 young adults with exogenously assigned nightly sleep levels experienced in their at-home environments. A serial story reproduction task was administered online, and chains of up to three retells of a given story involved varied numbers of sleep restricted (SR) versus well-rested (WR) retellers. While story content decayed with each retell, group-level analysis showed that additional SR retellers in a …

Simulating Chill: Exploring The Cognitive And Therapeutic Potential Of Cold Vr Environments, Jessica Turner, Piper Hutson, James Hutson

Faculty Scholarship

This study investigates the cognitive and therapeutic potential of immersive virtual reality (VR) environments designed to simulate cold conditions. Through the engagement of participants through multisensory stimuli—including vivid visual representations of the Athabasca Glacier, auditory effects of icy winds, and corresponding haptic feedback—the research evaluates neurological and physiological responses associated with attention, emotional regulation, and stress modulation. Participants experienced virtual scenarios featuring icy winds and snow, activating specific neurological pathways involving the occipital lobe, primary visual cortex, superior colliculus, and insula, thus reinforcing sensory integration. Through predictive coding, the anterior insula and hypothalamus were engaged, prompting thermoregulatory simulations and subconscious …

Examining Physiological Responses To Misophonic Triggers, Christian O'Reilly, Xuan Yang, Sewon Oh, Doug Wedell, Svetlana Shinkareva

Faculty Publications

We collected and analyzed an array of biosignals (face electromyogram, skin electrodermal activity, peripheral temperature, and electrocardiogram) in 60 participants with and without misophonia, a condition characterized by decreased tolerance to innocuous sounds. Our goal was to objectively characterize the physiological response to misophonia triggering sounds. We found that misophonic responses can be objectively identified in some cases through atypical physiological reactions to triggering stimuli, though not all participants exhibited this response. Our analyses suggest a large interindividual variability in response to misophonic triggers and highlights the need for methodological adjustments in future experiments to increase the detectability of misophonic …

A Health Intervention Improves Cognition In Older Adults At Risk For Alzheimer’S Disease, Michelle Gray, Ray G. Urbina, Megan Jones, Anthony Campitelli, Joshua L. Gills, Sally Paulson, Jordan M. Glenn

Health, Human Performance and Recreation Faculty Publications and Presentations

Abstract Background: Alzheimer’s disease (AD) is the 7th leading cause of death and 6th most burdensome disease among US older adults. With pharmacological treatments for AD being predominantly ill-effective, alternative, non-pharmacological prevention and treatment strategies warrant exploration. Personal health coaching provides individualized strategies designed to improve physical, social, and emotional health leading to positive behavior changes that may improve cognitive ability. The purpose of the present investigation was to examine the effects of a health intervention on cognitive outcomes. Method: Adults (n = 184), 60+ years, completed a 24-month health intervention. All participants had their APOE4 status determined at baseline. …

Understanding How Hearing Works, Cecilia Zoutewelle

A. The Science of Sound

A 7-page introductory overview of the anatomical and neurological processes of hearing, with illustrations and bullet-point summaries. 

Cardiac Timing Effects On Response Speed Are Modulated By Blood Pressure But Not Heart Rate Variability In Healthy Young Adults, Xiao Yang, Catalina Roldan, Michael Gazzanigo, Yasmine Nabulsi, Fang Fang

Research and Infrastructure Service Enterprise (RISE) Faculty Publications

Cardiac timing effects reflect the dynamic interplay between interoceptive and exteroceptive processes. Human information processing tends to be facilitated during cardiac diastole and inhibited during systole, reflecting autonomic regulation and the neuromodulation by baroreceptor afferents. Thus, blood pressure (BP) and vagally-mediated heart rate variability (vmHRV) are potential modulators of those effects. Additionally, cognitive control appears to play a critical role in the processes. However, whether cardiac timing effects are influenced by those factors remains unclear. The present study aimed to clarify these relationships. Fifty-one healthy young adults completed three experimental sessions to assess BP, short-term HRV, and cardiac timing effects. …

Eeg Spectral Analysis Of Nighttime Sleep And Daytime Mslts And Neurocognitive Evaluations In Subjects With Co-Morbid Insomnia And Osa, Yuan Shi, Yuru Nie, Fengyi Hao, Xujun Feng, Ye Zhang, Larry D. Sanford, Rong Ren, Xiangdong Tang

Department of Biomedical and Translational Sciences Faculty Publications

Background

Chronic insomnia and obstructive sleep apnea commonly co-occur. Few studies have explored the neurophysiological and neurocognitive characteristics of COMISA, which could help guide improving treatment diagnostic tools and determining novel therapeutic targets. This study aims to explore the neurophysiological and neurocognitive characteristics of COMISA using electroencephalographic (EEG) spectral analysis and subjective and objective neurocognitive measurements.

Methods

Participants were from our community recruited OSA-insomnia-COMISA cohort with 206 included for our current analysis including 74 chronic insomniacs (CIs), 55 OSA patients and 77 COMISA patients. Standard polysomnography (PSG) and multiple sleep latency tests (MSLTs) were recorded and used to obtain relative …

Die Wirkliche Gefahr Liegt In Der Erosion Der Autonomie: Ein E-Mail-Interview Über Kognitive Freiheit Und Die Problematische Nutzung Neuronaler Daten, Nita Farahany, James Kennaway, Bernd Bösel

Faculty Scholarship

In this interview, James Kennaway and Bernd Bösel talk to Nita Farahany about significant themes related to the idea of mind control, as discussed in her book "The Battle for Your Brain" (2023). The book outlines the risks that neurotechnology poses to "cognitive freedom". EEG and EMG data are increasingly used in consumer products, raising concerns about potential misuse. Companies and governments could exploit cognitive biometric data for manipulation or control. Farahany calls for clear legal protections and highlights differences between U.S. and European regulations. She warns of neurotechnological warfare and advocates for global bans. While full mind control remains …

Psychological Distress Among Family Caregivers Of Persons With Alzheimer’S Disease And Related Dementias In Uganda, Martha Sajatovic

Faculty Scholarship

Background: Alzheimer's disease and related dementias (ADRD) present growing global health challenges, especially in aging populations, such as Uganda. In Uganda, familial caregiving, predominantly undertaken by female relatives, is the primary form of support provided to patients with ADRD. Cultural stigma around dementia and limited access to support services amplify caregivers' challenges. This study examined psychological distress, depression, and quality of life (QoL) among family caregivers of patients with ADRD in Wakiso District, Uganda. Methods: This cross-sectional study involved 90 caregivers from three sub-counties in Wakiso, selected through purposive sampling to capture diverse experiences. Participants included caregivers aged 18 years …

Covid 19 Is A Hoax, Vidushi Sharma '28

Best First-Year Seminar Writing

When COVID-19 first swept across the globe, it brought more than just a viral contagion—it sparked an epidemic of misinformation. Among the various conspiracy theories, one stands out for its audacity: the claim that COVID-19 does not exist. This theory undermines public health efforts, sows mistrust, and complicates crisis management. But why do people believe it, and what makes such narratives so compelling? More importantly, how can we combat this damaging misinformation? This essay explores the origins of the "COVID-19 doesn't exist" conspiracy, examines its three main iterations—denial of the virus’s existence, claims of government overreach, and accusations of corporate …

Medial Prefrontal Cortex To Nucleus Reuniens Circuit Is Critical For Performance In An Operant Delayed Nonmatch To Position Task, Evan J Ciacciarelli, Scott D Dunn, Taqdees Gohar, T Joseph Sloand, Mark Niedringhaus, Elizabeth A West

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Working memory refers to the temporary retention of a small amount of information used in the execution of a cognitive task. The prefrontal cortex and its connections with thalamic subregions are thought to mediate specific aspects of working memory, including engaging with the hippocampus to mediate memory retrieval. We used an operant delayed-non match to position task, which does not require the hippocampus, to determine roles of the rodent medial prefrontal cortex (mPFC), the nucleus reuniens thalamic region (RE), and their connection. We found that transient inactivation of the mPFC and RE using the GABA-A agonist muscimol led to a …

An Investigation Of Frequency-Domain Pruning Algorithms For Accelerating Human Activity Recognition Tasks Based On Sensor Data, Jian Su, Haijian Shao, Xing Deng, Yingtao Jiang

Electrical & Computer Engineering Faculty Research

The rapidly advancing Convolutional Neural Networks (CNNs) have brought about a paradigm shift in various computer vision tasks, while also garnering increasing interest and application in sensor-based Human Activity Recognition (HAR) efforts. However, the significant computational demands and memory requirements hinder the practical deployment of deep networks in resource-constrained systems. This paper introduces a novel network pruning method based on the energy spectral density of data in the frequency domain, which reduces the model’s depth and accelerates activity inference. Unlike traditional pruning methods that focus on the spatial domain and the importance of filters, this method converts sensor data, such …

Structural Projections To The Nucleus Accumbens Link To Impulsive Components Of Human Risk Preference, Loreen Tisdall, Kelly H. Macniven, Josiah Leong, Renato Frey, Jörg Rieskamp, Ralph Hertwig, Brian Knutson, Rui Mata

Psychological Science Faculty Publications and Presentations

Functional responses in the Nucleus Accumbens (NAcc) to risk- and reward-related cues can predict real-life risk-taking behavior. Since NAcc activity depends on neurotransmission from connected brain regions, projections to the NAcc may also predict risk preference. To quantify risk preference, we employed latent variables previously derived in a comprehensive, independent study examining the psychometric structure of risk preference, which yielded a general risk preference factor as well as several specific factors, including a factor capturing impulsivity. Informed by previous work, we preregistered a set of hypotheses concerning the association between different risk preference factors and fractional anisotropy (or FA, which …

Memory Modulation: Dominance Of Negative Visual Context Over Neutral Verbal Memory, Stas Kozak, Noa Herz, Maya Tocker, Yair Bar-Haim, Nitzan Censor

Department of Neurology Faculty Papers

Neutral memories can be modulated via intentional memory control paradigms such as directed forgetting. In addition, previous studies have shown that neutral visual memories can be modulated indirectly, via remember and forget instructions towards competing verbal memories. Here we show that direct modulation of neutral verbal memory strength is impaired by negative visual context, and that negative visual context is resistant to indirect memory modulation. Participants were directly instructed to intentionally remember or forget newly encoded neutral verbal information. Importantly, this verbal information was interleaved with embedded negative visual context. Results showed that negative visual context eliminated the well-documented effect …

The Relationship Between Amygdala And Orbitofrontal Cortex Volume In The Context Of Oppositional Defiant Disorder, Rahul Alla

Honors Scholar Theses

Disobedient and rebellious attitude in children is on the rise and this type of behavior is categorized as Oppositional Defiant Disorder (ODD). ODD in children can be identified as a persistent pattern of angry or irritable mood, argumentative or defiant behavior or vindictiveness toward others according to the Diagnostic and Statistical Manual (DSM-5, Fifth Edition) of Mental Disorders.1 Children with ODD typically have difficulty regulating and processing their emotions. Issues with regulating emotions is defined as the process by which individuals “influence which emotions they have, when they have them, and how they experience and express them”.2 Dysregulation of emotions …

Are Objects Oriented Towards Your Dominant Hand Easier To Recognize?, Lauren A. Miller

Honors Scholar Theses

Previous research demonstrated that conceptual knowledge of manipulable objects is partially grounded in the motor system. For instance, explicitly retrieving knowledge about how a manipulable object is interacted with (e.g. pinched or clenched?) is easier for right handed people if the object is oriented so that it more easily affords grasping with the right hand (Chrysikou et al., 2017). We tested if motor experience through handedness also influences participants’ abilities to name objects that are commonly grasped with their dominant hand. Participants were asked to name images of graspable objects whose handles were oriented toward either their left or right …

Brainlife.Io: A Decentralized And Open-Source Cloud Platform To Support Neuroscience Research, Soichi Hayashi, Bradley A. Caron, Anibal Solon Heinsfeld, Sophia Vinci-Booher, Brent Mcpherson, Daniel N. Bullock, Giulia Berto, Guiomar Niso, Sandra Hanekamp, Daniel Levitas, Kimberly Ray, Anne Mackenzie, Paolo Avesani, Lindsey Kitchell, Josiah K. Leong, Filipi Nascimento-Silva, Serge Koudoro, Hanna Willis, Jasleen K. Jolly, Derek Pisner, Taylor R. Zuidema, Jan W. Kurzawski, Kyriaki Mikellidou, Aurore Bussalb, Maximilien Chaumon, Nathalie George, Christopher Rorden, Conner Victory, Dheeraj Bhatia, Dogu Baran Aydogan, Fang-Chen F. Yeh, Franco Delogu, Javier Guaje, Jelle Veraart, Jeremy Fischer, Joshua Faskowitz, Ricardo Fabrega, David Hunt, Shawn Mckee, Shawn T. Brown, Stephanie Heyman, Vittorio Iacovella, Amanda F. Mejia, Daniele Marinazzo, R. Cameron Craddock, Emanuale Olivetti, Jamie L. Hanson, Eleftherios Garyfallidis, Dan Stanzione, James Carson, Robert Henschel, David Y. Hancock, Craig A. Stewart, David Schnyer, Damian O. Eke, Russell A. Poldrack, Steffen Bollmann, Ashley Stewart, Holly Bridge, Ilaria Sani, Winrich A. Freiwald, Aina Puce, Nicholas L. Port, Franco Pestilli

Psychological Science Faculty Publications and Presentations

Neuroscience is advancing standardization and tool development to support rigor and transparency. Consequently, data pipeline complexity has increased, hindering FAIR (findable, accessible, interoperable and reusable) access. brainlife.io was developed to democratize neuroimaging research. The platform provides data standardization, management, visualization and processing and automatically tracks the provenance history of thousands of data objects. Here, brainlife.io is described and evaluated for validity, reliability, reproducibility, replicability and scientific utility using four data modalities and 3,200 participants.

Comparing Cognitive Tests And Smartphone-Based Assessment In 2 Us Community-Based Cohorts., Ileana De Anda-Duran, Preeti Sunderaraman, Edward Searls, Shirine Moukaled, Xuanyi Jin, Zachary Popp, Cody Karjadi, Phillip H Hwang, Huitong Ding, Sherral Devine, Ludy C Shih, Spencer Low, Honghuang Lin, Vijaya B Kolachalama, Lydia Bazzano, David J Libon, Rhoda Au

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Smartphone-based cognitive assessments have emerged as promising tools, bridging gaps in accessibility and reducing bias in Alzheimer disease and related dementia research. However, their congruence with traditional neuropsychological tests and usefulness in diverse cohorts remain underexplored.

METHODS AND RESULTS: A total of 406 FHS (Framingham Heart Study) and 59 BHS (Bogalusa Heart Study) participants with traditional neuropsychological tests and digital assessments using the Defense Automated Neurocognitive Assessment (DANA) smartphone protocol were included. Regression models investigated associations between DANA task digital measures and a neuropsychological global cognitive

CONCLUSIONS: Our findings demonstrate that smartphone-based cognitive assessments exhibit concurrent validity with a …

Cancer Research Provides A Model For Advancing Clinical Trials In Dementia In The Era Of Disease-Modifying Alzheimer’S-Type Dementia Therapies, Gregory Jicha, Thomas Tucker, Susanne Arnold, Peter T. Nelson

Neurology Faculty Publications

Dementia and cancer are multifactorial, widely-feared, age-associated clinical syndromes that are increasing in prevalence. There have been major breakthroughs in clinical cancer research leading to some effective treatments, whereas the field of dementia has achieved comparatively limited success in clinical research. The lessons of cancer research may help those in the dementia research field in confronting some of the dilemmas faced when the clinical care regimen is not entirely safe or efficacious. Cancer clinical trials have assumed that untreated individuals with cancer are at high risk for morbidity and mortality after primary diagnoses. Thus, patients deserve a choice of clinical …

U.S. Public Perceptions Of The Sensitivity Of Brain Data, Shenyang Huang, Umika Paul, Shikhar Gupta, Karan Desai, Melinda Guo, Jennifer Jung, Beatrice Capestany, William D. Krenzer, Dylan Stonecipher, Nita A. Farahany

Faculty Scholarship

As we approach an era of potentially widespread consumer neurotechnology, scholars and organizations worldwide have started to raise concerns about the data privacy issues these devices will present. Notably absent in these discussions is empirical evidence about how the public perceives that same information. This article presents the results of a nationwide survey on public perceptions of brain data, to inform discussions of law and policy regarding brain data governance. The survey reveals that the public may perceive certain brain data as less sensitive than other ‘private’ information, like social security numbers, but more sensitive than some ‘public’ information, like …

Impact Of Amyloid And Cardiometabolic Risk Factors On Prognostic Capacity Of Plasma Neurofilament Light Chain For Neurodegeneration, Keun You Kim, Eosu Kim, Jun-Young Lee, Alzheimer’S Disease Neuroimaging Initiative

Neurology Faculty Publications

Background Plasma neurofilament light chain (NfL) is a blood biomarker of neurodegeneration, including Alzheimer’s disease. However, its usefulness may be influenced by common conditions in older adults, including amyloid‑β (Aβ) deposition and cardiometabolic risk factors like hypertension, diabetes mellitus (DM), impaired kidney function, and obesity. This longitudinal observational study using the Alzheimer’s Disease Neuroimaging Initiative cohort investigated how these conditions influence the prognostic capacity of plasma NfL. Methods Non‑demented participants (cognitively unimpaired or mild cognitive impairment) underwent repeated assessments including the Alzheimer’s Disease Assessment Scale‑Cognitive subscale (ADAS‑Cog) scores, hippocampal volumes, and white matter hyperintensity (WMH) volumes at 6‑ or 12‑month …