European Archives of Psychiatry and Clinical Neuroscience最新文献

Research on anxiety faces challenges due to the wide range of symptoms, making it difficult to determine if different aspects of anxiety are linked to distinct neurobiological processes. Both alterations in functional brain connectivity (FC) and monoaminergic neurotransmitter systems are implicated as potential neural bases of anxiety. We aimed to investigate whole-brain FC involving monoaminergic nuclei and its association with anxiety dimensions in 178 non-clinical participants. Nine anxiety-related scales were used, encompassing trait and state anxiety scores, along with measures of cost-probability, hypervigilance, reward-punishment sensitivity, uncertainty, and trait worry. Resting-state functional magnetic resonance imaging data were acquired, focusing on seven brainstem regions representing serotonergic, dopaminergic, and noradrenergic nuclei, with their FC patterns voxel-wise correlated with the scales. All models underwent family-wise-error correction for multiple comparisons. We observed intriguing relationships: trait and state anxiety scores exhibited opposing correlations in FC between the dorsal raphe nucleus and the paracingulate gyrus. Additionally, we identified shared neural correlates, such as a negative correlation between the locus coeruleus and the frontal pole. This connection was significantly associated with scores on measures of probability, hypervigilance, reward sensitivity, and trait worry. These findings underscore the intricate interplay between anxiety dimensions and subcortico-cortical FC patterns, shedding light on the underlying neural mechanisms governing anxiety.

BACKGROUND: This study aimed to investigate the differential clinical characteristics and distinct risk factors for suicide attempts between patients with psychotic major depression (PMD) and non-psychotic major depression (NPMD). METHODS: A cross-sectional analysis was conducted on a cohort of major depressive disorder patients. Comprehensive demographic and clinical data were collected. Assessments included the Hamilton Depression Rating Scale (HAMD), Hamilton Anxiety Rating Scale (HAMA), Positive and Negative Syndrome Scale (PANSS) positive subscale, and Clinical Global Impression-Severity scale (CGI-S). Fasting blood samples were analyzed for thyroid function (TSH, TgAb, TPOAb, FT3, FT4), metabolic parameters (fasting blood glucose, lipid profiles), and other biomarkers. RESULTS: Patients with PMD demonstrated a more severe clinical profile, including significantly higher HAMD, HAMA, and CGI-S scores, alongside elevated thyroid antibodies (TgAb, TPOAb) compared to the NPMD group. A critical finding was the divergent set of predictors for suicide attempts between the diagnostic subgroups. For the overall MDD cohort and the NPMD subgroup specifically, the severity of anxiety (HAMA) and depression (HAMD) were the primary risk factors. In stark contrast, for patients with PMD, positive psychotic symptoms (PANSS) and elevated TSH levels emerged as the dominant and unique predictors of suicide attempts. ROC analysis confirmed the high discriminatory power of TSH for suicide in PMD (AUC = 0.863). CONCLUSIONS: The path to suicidal behavior differs significantly between PMD and NPMD. Suicide risk in NPMD is primarily driven by the severity of core mood and anxiety symptoms, whereas in PMD, it is predominantly associated with the presence of psychosis and significant HPT axis dysregulation.

Background: An efficient and accurate diagnosis of MDD in adult ADHD is highly significant. Central symptoms identified through network analysis are considered to play a key role in diagnosis, potentially contributing to the achievement of this goal.

Methods: ADHD and MDD symptoms were assessed using the ADHD Rating Scale and Zung Self-Rating Depression Scale (SDS) in a clinical cohort of 418 adults with ADHD, followed by network estimations. Symptoms with high expected influence (EI) in the network were identified as central symptoms and tested for diagnostic validity via ROC curve analysis. Imaging analyses were further adopted to verify the effectiveness of the identified central symptoms from the perspective of construct validity.

Results: A five-symptom model was identified, including: "Depressed affect," "Personal devaluation," "Emptiness," "Agitation," and "Interest loss." The model exhibited strong diagnostic validity for MDD in adult ADHD, showing no significant difference compared to using all 20 SDS items. Moreover, significant functional alterations were detected in the left anterior cingulate cortex between groups classified by this model.

Conclusion: A five-symptom model comprising "Depressed affect," "Personal devaluation," "Emptiness," "Agitation," and "Interest loss" showed strong diagnostic validity for MDD in adult ADHD, and proven effective in exploring its underlying neural mechanisms. These symptoms should be considered a priority in diagnosing MDD in adults with ADHD.

Background: Despite numerous studies of the anxiolytic effects of dexmedetomidine compared with those of other drugs or saline, the results have been inconsistent. Here we report a systematic review and meta-analysis to comprehensively evaluate the evidence of the anxiolytic effects of dexmedetomidine.

Methods: This research has been registered in the International Prospective Register of Systematic Reviews. The PubMed, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov database were searched for clinical trials that compared the anxiolytic effects of dexmedetomidine with those of a control group with valid anxiety scores from inception to December 29, 2024.

Results: Overall, this systematic review and meta-analysis included 25 clinical studies with 2159 participants who underwent surgery. The primary outcome revealed that patients who were treated with dexmedetomidine had significantly lower anxiety scores than others did overall (MD = - 1.73, 95% CI = [ - 2.33, - 1.13], p < 0.00001, I² = 86.5%). Dexmedetomidine was found to be more effective than benzodiazepines in relieving anxiety (MD = - 1.34, 95% CI = [ - 2.08, - 0.60], p = 0.0004, I² = 83.3%). The secondary outcomes revealed no significant differences in satisfaction, pain level, sedation scores or the risk of postoperative nausea and vomiting between patients who were treated with dexmedetomidine and controls. However, the occurrence of bradycardia was more common in the dexmedetomidine groups.

Conclusions: Overall, this meta-analysis provided evidence of the potential of dexmedetomidine for relieving anxiety among patients who undergo surgery, with superior antianxiety effects compared with those of benzodiazepines.

Eating disorders (ED) are associated with a maladaptive body schema and several cognitive biases. This pilot study aimed to investigate the effect of visual stimulation by body images on maladaptive body schema and body dissatisfaction in patients with ED. The rubber hand illusion (RHI) was applied to a sample of 33 women with anorexia or bulimia nervosa and 27 control subjects. The RHI was administered in a novel way using a standard-sized hand that had been distorted in appearance (perceived as unsatisfactory), and it was used before and after an ad hoc priming effect (exposure to thin-body media images). In accordance with the maladaptive body schema, ED patients exhibited higher scores on the Body Shape and Body Perception Questionnaires (with a positive correlation between the scores) and there was a significant increase in scores for all items in the location-proprioception and agency domains. However, before the priming effect, the ED sample showed significantly lower scores on all proprioceptive drift items during the distorted RHI condition and the regression analysis demonstrated a significant association between reduced proprioceptive drift (recording a similar embodiment index to healthy subjects) and improved body dissatisfaction. Following the priming effect, the proprioceptive drift embodiment index increased, and no ANOVA interaction was recorded. The maladaptive body schema in patients with bulimia or anorexia nervosa is characterised by both distorted proprioception and high interoceptive awareness. The visual body images that are perceived as unsatisfactory play a role in preserving proprioception and consequently in reducing body dissatisfaction. Conversely, the exposure effect of thin-body ideal images is involved in the maladaptive body schema.

Background: Previous studies have suggested an association between tinnitus and various psychiatric phenotypes; however, the causal relationship and underlying pathways remain unclear.

Methods: We used univariable Mendelian randomization (MR) to investigate the bidirectional causality between tinnitus and 8 psychiatric phenotypes. Multivariable MR was employed to control for potential confounders. Extensive sensitivity analyses were conducted to validate our results. Additionally, two-step MR and genetic pleiotropy analyses were performed to explore potential pathways.

Results: Genetic susceptibility to tinnitus was significantly associated with an increased risk of major depressive disorder (MDD) (OR = 1.07, 95% CI = 1.03-1.11). Multivariable MR demonstrated that the impact of tinnitus on MDD was independent of potential confounders. No causal effects were observed from the eight psychiatric phenotypes on tinnitus; likewise, no causal effects were found from tinnitus on the remaining seven psychiatric phenotypes. Two-step MR analysis revealed that hearing difficulties with background noise and insomnia mediated the effect of tinnitus on MDD, with mediation proportions of 20.0% (0.0%-40.1%) and 31.4% (0.9%-61.9%), respectively. Genetic pleiotropy analysis identified a global genetic correlation between tinnitus and MDD (r_g = 0.36-0.48). PLACO analysis revealed 66 shared loci, primarily enriched in the cerebellum and cerebellar hemisphere. FUMA identified two independent genomic risk loci (rs58825580 and rs729437) and mapped 91 pleiotropic genes, which were mainly enriched in nucleosome and chromatin-remodeling processes, and immune response dysregulation.

Conclusions: This study provides genetic evidence that genetic susceptibility to tinnitus has a causal effect on the risk of MDD, partially mediated by hearing difficulties and insomnia. Our genetic pleiotropy analysis further highlights the shared genetic architecture between tinnitus and MDD.

Social behaviors are essential for both reproduction and survival. Human and animals exhibit distinct patterns of social interaction following trauma experienced during puberty, which are shaped by the complex interplay between environmental and biological factors. Although neuropeptides and early life stress (ELS) influence social behavior, it remains unclear whether the regulation of neuropeptides in response to ELS further modulates social behavior. Two sex neuropeptides, oxytocin (OT) and arginine vasopressin (AVP), exert profound effects on social behaviors. Therefore, we investigate the involvement of OT and AVP in modulating the alterations in social behavior resulting from ELS. The 89 adult men participants were divided into heterosexual (n=32) and gay/bisexual (n=57) groups. Mental health and the serum levels of OT and AVP were evaluated. Our clinical samples reveal significant variations in ELS exposure across sexual orientation groups, which correlate with neuroendocrine alterations, including altered OT and AVP levels. Animal study further substantiates the critical role of OT and AVP in mediating these changes, highlighting their involvement in shaping social behavior. These findings uncover potential underlying mechanisms through which the OT and AVP systems contribute to stress-induced alterations in social behavior.

Psychotic-like experiences (PLEs) refer to hallucination-like (HLEs) or delusion-like (DLEs) experiences defined as subclinical phenomena located at the lower end of the psychosis continuum. PLEs etiology includes neurodevelopmental changes, maladaptive coping styles, exposure to negative emotions, and stress. These factors frequently co-occur in individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms, considered a risk factor for PLEs. A total of 188 participants from the general population completed the Adult ADHD Self-Report Scale (ASRS) questionnaire and participated in a seven-day ESM procedure. Participants were divided into High and Low ADHD groups based on self-report symptom severity scale. Saliva samples were collected to determine cortisol levels. A temporal network analysis was used to analyze targeted associations, and permutation testing to compare the differences between the groups. In the H_ADHD group, cortisol was a stronger predictor of threat anticipation (TA) than in the L_ADHD group, and DLEs were strongly associated with TA. In the L_ADHD group, HLEs had a stronger relationship with ruminations and TA than in the H_ADHD group. In both groups, negative affect (NA) was the strongest predictor of ruminations. Out-strength analysis revealed that in the H_ADHD group, DLEs exhibited the strongest predictive function on other variables, while in the L_ADHD group, it was NA. Cortisol level was associated with an increase in TA exclusively in the H_ADHD group, meanwhile in the L_ADHD with subsequent alcohol consumption. The study highlights the different temporal dynamics between factors in individuals with high/low ADHD symptomatology in a non-clinical sample. Interventions for individuals with ADHD should prioritize NA as a central element, focusing on adaptive emotion and stress regulation.

BACKGROUND: Borderline Personality Disorder (BPD) is characterized by unstable relationships, affective dysregulation, and impulsivity. A growing body of evidence suggests that deficits in socio-cognitive domains (i.e., mentalization, empathy, and emotion recognition) contribute to the core psychopathology of BPD. However, the neural circuits underlying these deficits remain inconclusive. METHODS: We conducted a review of studies retrieved from PubMed, Scopus, and PsycINFO. We included structural MRI (sMRI) and functional MRI (fMRI) studies that compared individuals with BPD or borderline traits to healthy or clinical control groups. Eligible studies assessed social cognition using task-based paradigms (i.e., emotion recognition, empathy, Theory of Mind) or resting-state protocols focused on connectivity within social brain networks. RESULTS: Twenty-nine studies met the inclusion criteria. Most employed task-based fMRI (k = 24), with fewer using resting-state fMRI (k = 2) or structural MRI (k = 3). Common findings indicate hyperactivation of the amygdala under emotionally salient conditions, altered anterior cingulate cortex (ACC) responses (either hyper- or hypoactivation depending on stimulus valence), and insular hyperresponsivity to social threat contexts. Frontal hypoactivation (i.e., IFG) commonly co-occurred with limbic imbalance. Temporal and temporoparietal areas (STS, TPJ) showed variable patterns, with emotional empathy linked to increased activity and cognitive empathy to reduced activation. CONCLUSIONS: Aberrant activation and connectivity in fronto-limbic and temporoparietal networks contribute to socio-cognitive dysfunction in BPD, underlying emotional dysregulation, impulsivity, interpersonal instability, and self-disturbance. Future standardized paradigms and longitudinal designs should clarify the progression of these neural disruptions and guide targeted psychotherapeutic and neuromodulatory interventions.

BACKGROUND: Patients suffering from alcohol dependence (AD) experience high relapse rates. Prior studies investigating the organization of resting-state functional connectivity networks in AD using graph theory typically focused on alterations of the whole network (macroscale) or on aberrations of single brain regions (microscale). However, little is known about the complex dynamics and interactions among different brain regions and neural systems, i.e. the network organization at mesoscale. METHODS: To investigate mesoscale network alterations, we applied a data-driven community detection algorithm to identify the modular structure of functional brain networks and assess its association with relapse over a 12-month follow-up period in alcohol-dependent patients (relapsers, REL, n = 59; abstainers, ABS, n = 28) and age- and sex-matched controls (CON, n = 83). RESULTS: Our results reveal differences in the modular organization in REL, marked by a fragmentation and reorganization of major functional modules. Across individuals, functional modules of REL exhibited higher modular variability, particularly in brain regions associated with behavioral and emotional regulatory processes. Conversely, prefrontal reward-related brain regions were more central for inter-module communication in REL, emerging as functional brain hubs. Furthermore, higher overall modular variability significantly predicted time to relapse during follow-up. CONCLUSION: Collectively, our results shed light on potential neural substrates of relapse risk in alcohol dependence, which may foster the development of targeted interventions to promote sustained abstinence.