Clinical Psychopharmacology and Neuroscience最新文献

Objective: The association between panic disorder (PD) and heart rate variability (HRV) has long been studied with a focus on the imbalance of the autonomic nervous system. This study aims to demonstrate the predictive capability of HRV in determining PD severity using machine learning.

Methods: Psychometric scales and various HRV components were measured from 507 PD patients who were recruited. We designed three experiments with different sets of input features for comparison. The input features of each experiment were 1) both psychometric scales and HRV together (ExSH), or 2) only the scales (ExS), or 3) only the HRV components. In each experiment, nine machine learning models were used to predict the Panic Disorder Severity Scale. We compared the predictive capability of the three sets of input features by statistically analyzing the performance metrics of the models in the three experiments. SHapley Additive exPlanation (SHAP) was further employed to assess the importance of the input features.

Results: The Random Forest model in ExSH, which incorporated both psychometric scales and HRV, achieved the highest f1-score (76.50%) and sensitivity (75.35%). ExSH showed significantly higher sensitivity and f1-score compared to ExS. For the RF model of ExSH, the highest SHAP importance value was found for the Hamilton Rating Scale for Anxiety, followed by the Hamilton Depression Rating Scale, and the low-frequency power (LF).

Conclusion: Our findings demonstrate that integrating HRV with psychometric scales improves machine learning-based prediction of PD severity. We also highlighted LF as a promising variable among HRV components.

Objective: This systematic review explores the efficacy of fMRI-based neurofeedback as an alternative treatment for individuals with depression who do not respond well to traditional therapies.

Methods: A comprehensive literature search across several databases (PubMed, Web of Science, ProQuest, Cochrane Library, and Google Scholar) identified 649 articles related to neurofeedback and depression, ultimately including 26 studies after eligibility assessments.

Results: The majority of these studies, comprising both open-label and randomized controlled trials, reported significant reductions in depressive symptoms following neurofeedback interventions, which primarily targeted amygdala activity. Eighteen studies showed moderate to large effect sizes (Cohen's d values from 0.38 to 1.50) on validated depression measures. Notably, neurobiological changes were observed, including increased Blood Oxygenation Level Dependent (BOLD) activity and connectivity in emotion regulation regions such as the amygdala and prefrontal cortex. Some studies indicated sustained symptom improvements, with over 75% of patients applying learned strategies in daily life. However, methodological limitations and a moderate to high risk of bias were noted in several studies.

Conclusion: fMRI-based neurofeedback presents a promising adjunctive therapy for depression, especially for patients who are resistant to standard treatments. Although current evidence shows positive effects on neural function and clinical outcomes, addressing methodological issues and standardizing study designs is essential. Future research should emphasize larger sample sizes and long-term efficacy while enhancing accessibility and cost-effectiveness in diverse clinical environments.

Oxytocin, often called the "love hormone," is well-known for its roles in childbirth and lactation. Beyond these traditional functions, it plays a vital role in emotional and social behaviors, mood regulation, stress responses, and various physiological processes. Blood oxytocin levels are typically low under basal conditions but increase significantly during labor, breastfeeding, sexual activity, and positive social interactions. However, reported plasma oxytocin levels in humans and rodents vary widely across studies. In this study, we reviewed plasma oxytocin levels in rats from research conducted over the past decade, emphasizing the notable discrepancies observed between studies. Furthermore, we investigated the effects of two anesthetic protocols (inhaled isoflurane and a combination of three anesthetics) and the proteinase inhibitor aprotinin on plasma oxytocin levels in adult male rats. Our findings revealed that neither the anesthetics nor aprotinin significantly affected plasma oxytocin levels. We also discussed potential factors contributing to the marked differences in reported rat blood oxytocin levels.

Objective: To investigate relationships between diabetes, diabetes duration, and psychiatric difficulties using data from a nationwide survey and to examine associations between psychiatric difficulties and physician diagnosis, treatment status, and glycemic control in diabetes patients by performing subgroup analyses.

Methods: Data from the 2022 Korea National Health and Nutrition Examination Survey were analyzed. A representative sample of 4,475 adults aged 19 years or older was obtained using stratified, multistage, clustered sampling. Psychiatric difficulties were assessed using PHQ-9 for depression, GAD-7 for anxiety, and face-to-face interviews for suicidality. Diabetes patients were categorized by diabetes duration (< 5, 5-9, 10-14, and ≥ 15 years). Statistical models were adjusted for demographic and clinical covariates.

Results: Diabetes patients were significantly more likely to experience depression than controls (aOR = 1.818). Those with a diabetes duration of ≥ 15 years showed significant associations with depression (aOR = 2.830), suicidal ideation (aOR = 2.496), and suicidal plans (aOR = 4.604). Such associations were not found in shorter duration groups. Subgroup analyses revealed links between suicidal ideation and being diagnosed by a physician or receiving treatment. No significant associations were found between glycemic control and psychiatric difficulties.

Conclusion: Depression was more prevalent in diabetes patients than in controls. A diabetes duration of ≥ 15 years was significantly linked to higher rates of depression and suicidality. Routine psychiatric screenings after 15 years of diabetes duration could enhance public health strategies. Addressing societal stigma and alleviating burdens of diabetes management might improve mental health outcomes.

Objective: This study explores how maternal depressive symptoms during the second trimester, a critical phase for autonomic nervous system (ANS) development, affect maternal and fetal heart rate variability (HRV) in the third trimester, with implications for infant development.

Methods: We examined the effects of second trimester maternal depression on subsequent maternal and fetal HRV. A cohort of women in early or late second trimester completed depression assessments using the Edinburgh Postnatal Depression Scale (EPDS) and underwent HRV evaluations in the third trimester.

Results: Among 118 participants, 97 completed the EPDS at 14-20 weeks, with 12 showing depressive symptoms. At 21-28 weeks, 111 participants were assessed, and 24 were identified as possibly depressive. Depressive symptoms were linked to increased maternal pNN50% (percentage of successive NN intervals differing by more than 50 ms) and decreased detrended fluctuation analysis alpha, indicating hemodynamic shifts. Their fetuses showed reduced root mean square of successive differences, standard deviation of successive differences, and short-term and long-term variability indices, suggesting weakened parasympathetic activity.

Conclusion: Prenatal depression influences maternal physiological adaptation and fetal ANS development, highlighting HRV as a potential biomarker for predicting neurodevelopment. Early identification and treatment of mid-pregnancy depressive symptoms may help mitigate potential risks to infant neurodevelopment.

Cues, which induce craving, and may lead to relapse, are an important paradigm for addiction research. Visual cues related to addictive substances trigger powerful neurophysiological responses in the brains of addicts, leading to craving. However, the molecular mechanisms underlying these neurophysiological responses remain incompletely understood. While the role of dopamine in cue-induced phenomena has been extensively studied, the contribution of glutamate, a major excitatory neurotransmitter and a key player in cue-associated phenomena as proposed by animal studies, is less explored in humans. Functional magnetic resonance spectroscopy (fMRS) is a promising tool for investigating glutamatergic modulations in tasks. This review aims to evaluate the potential of fMRS in explaining the dynamics of glutamate during cue-induced phenomena in drug addiction. We discuss the clinical implications, strengths, and limitations of fMRS in this context and propose directions for future research.

Objective: To investigate the role of neuroinflammation in the etiopathogenesis of autism spectrum disorder (ASD), we investigated the role of fractalkine and tumour necrosis factor alpha (TNF-α), which may be potential biomarkers for ASD. This study aimed to evaluate the serum levels of interleukin-1beta (IL-1β), interleukin-6 (IL-6), and high-sensitivity CRP (hs-CRP) and to investigate the relationship between fractalkine, TNF-α, IL-1β, IL-6, and hs-CRP and the severity of symptoms in ASD.

Methods: In this cross-sectional study, 44 children between the ages of 24-72 months diagnosed with ASD constituted the research group, and 44 healthy children of similar age and sex constituted the control group. Detailed mental status examinations were performed in both groups. Symptom severity of children diagnosed with ASD was evaluated using the Childhood Autism Rating Scale, Autism Behaviour Checklist and Repetitive Behaviours Scale-Revised Turkish Version. Peripheral venous blood samples were obtained from children in both groups and serum fractalkine, TNF-α, IL-1β, IL-6 and hs-CRP levels were measured by ELISA method.

Results: Serum fractalkine and IL-1β levels of children in the ASD group were significantly lower than those in the control group. No significant difference was found between the groups in serum TNF-α, IL-6 and hs-CRP levels. There was no correlation between ASD severity and fractalkine, TNF-α, IL-1β, and IL-6 levels.

Conclusion: Our study is the first to evaluate serum fractalkine levels in ASD in early childhood. Our findings suggest that fractalkine may play a role in the etiopathogenesis of ASD in early life and may be a potential biomarker for ASD.

Objective: This study aims to explore the relationship between symptom severity and cytokine levels in patients with tic disorders by evaluating these parameters at baseline and after a one-year follow-up.

Methods: A total of 44 tic disorder patients were recruited, 35 completed baseline assessments, and 20 completed endpoint assessments after one year. Based on changes in Yale Global Tic Severity Scale scores, patients were categorized into 'improved' and 'persistent' groups. Cytokine levels were measured using a Luminex^Ⓡ human cytokine multiplex assay at both time points.

Results: Significant increases were found in interferon (IFN)-α2, IFN-γ, interleukin (IL)-1β, IL-6, IL-10, IL-12 p40, IL-12 p70, and IL-13, while IL-1ra and IL-4 levels decreased. Changes in IFN-γ levels showed significant correlations with tic severity, with higher endpoint levels being linked to symptom worsening. Baseline IL-5 levels were significantly higher in the improved group compared to the persistent group.

Conclusion: This study underscores the potential of IFN-γ and IL-5 as biomarkers and therapeutic targets in tic disorders. The findings suggest that these cytokines could be instrumental in assessing tic disorder severity and developing targeted therapies. Further research involving larger cohorts is needed to validate these findings and explore cytokine-targeted therapies for tic disorders.

Objective: Intranasal (IN) esketamine represents a novel add-on treatment for treatment-resistant depression (TRD) with reported favourable effects on insomnia. IN esketamine treatment might similarly reduce the incidence of insomnia as an adverse event (AE). The present meta-analysis therefore investigated whether IN esketamine relative to placebo is associated with a lower incidence of insomnia as an AE in adults with TRD.

Methods: Data were retrieved from seven randomised placebo-controlled trials evaluating the safety and efficacy of IN esketamine combined with a monoaminergic antidepressant in the treatment of TRD that reported data on insomnia as an AE. The study population (n = 1,311) comprised adult patients (aged ≥ 18 years) with a primary diagnosis of major depressive disorder. A mixed-effects logistic regression model was employed to compare the incidence of insomnia as an AE between the IN esketamine and placebo group.

Results: Insomnia as an AE was reported by 52 patients (7.3%) in the IN esketamine group relative to 40 (6.7%) in the placebo group. IN esketamine compared to placebo was not associated with the odds of insomnia as an AE (OR = 1.07; 95% CI = 0.68-1.69; p = 0.76). There was no evidence for heterogeneity between the included trials.

Conclusion: IN esketamine does not affect the occurrence of insomnia as an AE in the treatment of TRD. This contrasts previous findings demonstrating beneficial effects of esketamine on insomnia severity relative to placebo, although AE reporting may not capture insomnia improvements in a population with frequent baseline insomnia.