Al-Sharman, A. J. A. | Search bioRxiv

bioRxiv2026

Longitudinal Changes in Intracortical Excitability During Ramadan Fasting: A Paired-Pulse Transcranial Magnetic Stimulation Study

Ramadan fasting represents a natural model of prolonged daily intermittent fasting associated with metabolic and circadian alterations. This study investigated longitudinal changes in intracortical excitability across pre-, mid-, and post-Ramadan timepoints in healthy adults observing Ramadan fasting. Thirty fasting participants underwent paired-pulse transcranial magnetic stimulation at three timepoints (pre-, mid-, and post-Ramadan). A non-fasting control group (n = 11) was assessed at pre- and mid-Ramadan. Conditioned motor-evoked potentials were recorded at interstimulus intervals of 2-10 ms and normalized to unconditioned responses. A linear mixed-effects model assessed effects of Timepoint and interstimulus interval (ISI). Secondary outcomes included blood glucose, cognitive performance, sleep duration, and reaction time. A significant main effect of Timepoint (p < 0.001) indicated longitudinal modulation of intracortical excitability, with increased MEP ratios at mid-Ramadan and partial persistence post-Ramadan. The ISI effect confirmed the inhibition-facilitation gradient (p < 0.001). The Timepoint x ISI interaction was not significant (p = 0.566), indicating a global shift in excitability without ISI-specific modulation. Blood glucose and sleep duration decreased significantly at mid-Ramadan. Ramadan fasting is associated with a time-dependent increase in intracortical excitability, most appropriately interpreted as a generalized shift rather than selective modulation of inhibitory or facilitatory circuits. These changes occur in the context of concurrent metabolic and sleep alterations and may reflect combined influences of fasting-related metabolic state and reduced sleep duration; however, these factors cannot be disentangled within the present design.

neuroscience↗

bioRxiv2026

Association between chronotype and dual-task gait cost across distinct cognitive domains in healthy young adults

Chronotype reflects individual circadian preference for timing of sleep, wakefulness, and peak performance and has been linked to variability in prefrontal cognitive function across the day. Whether chronotype independently relates to dual-task gait cost (DTC) and whether this relationship differs by cognitive task domain is unclear. Sixty-nine healthy young adults (37 female; mean age 21.3 years) completed the Morningness-Eveningness Questionnaire (MEQ). Spatiotemporal gait parameters were recorded with three-dimensional motion capture during single-task walking and three dual-task conditions: backward word spelling (5LWB; phonological), serial subtraction by seven (SS7; arithmetic), and reverse month recitation (RMR; sequential). DTC was calculated for eight gait parameters. Condition differences were assessed with nonparametric tests and post-hoc comparisons. Multiple linear regression, adjusting for age, sex, BMI, and baseline gait velocity, tested the independent association between MEQ score and mean velocity DTC; exploratory Spearman correlations examined other parameters. SS7 produced the largest mean velocity DTC (-12.76%), significantly greater than 5LWB (-7.95%; p = 0.002) and RMR (-9.57%; p = 0.021). MEQ score independently predicted mean velocity DTC in 5LWB ({beta} = -0.51, p < 0.001, R{superscript 2} = 0.269) and RMR ({beta} = -0.55, p = 0.004, R{superscript 2} = 0.222), indicating greater morningness associated with better gait-speed preservation under cognitive load; the SS7 association was not significant ({beta} = -0.33, p = 0.071). Exploratory correlations showed MEQ-DTC associations across 7/8 parameters in 5LWB, 4/8 in RMR, and 3/8 in SS7. Chronotype is independently associated with dual-task gait cost in a task-domain-specific manner, with stronger effects for phonological and sequential tasks than for arithmetic processing. The SS7 condition yielded the largest interference but weakest chronotype modulation, suggesting arithmetic dual-task disruption may be less sensitive to circadian arousal. Fixed testing time and cross-sectional design warrant within-subject, multi-timepoint studies to confirm chronotype effects separate from time-of-day confounds.

neuroscience↗