Pub Date : 2023-12-01DOI: 10.1136/gpsych-2023-101162
Gangliang Zhong, Hang Su, Di Zhao, Ji Hu, Xing Liu, Yonghui Li, Saeed Semnanian, Abbas Haghparast, Ti-Fei Yuan, Jiang Du
Addiction is a major global risk factor for disability and premature death1 and has become a public health and social problem worldwide. Despite substantial investments from governments and research institutions globally, current addiction medicine research remains centred in Western countries. However, theories, models and results from western-centric research may not be applicable to different cultures. Non-Western countries such as China and Iran, and Western countries are committed to establishing addiction prevention and treatment tailored to their unique histories and cultures. To foster a global addiction science, it is important to increase the diversity of evidence without preconceived biases. Studying addiction problems across different regions and cultural backgrounds and sharing successful prevention and treatment models can provide a more comprehensive perspective for global addiction science, potentially yielding innovative solutions that benefit all countries. China and Iran have their own unique addiction challenges and treatment experiences and have become important representatives of addiction research progress in countries outside the Western axis. Both China and Iran have rich traditional medicine experiences in addiction medicine, which have been developed over thousands of years of trial and error. These offer valuable insights for refining addiction treatment and preventing relapse. Traditional Chinese medicine has a history of over 2000 years in China and has been used to treat addiction, including substance and non-substance addiction, for the past two centuries. Traditional herbal therapy, which targets multiple systems and mechanisms, is considered effective in relieving withdrawal symptoms and preventing addiction relapse with minimal side effects.2 3 It also has a rehabilitative effect on physical issues caused by long-term drug use, including improvements in immune function and working memory and the prevention of neurological diseases.4 The continuous application of traditional medical therapies in China and Iran has preliminarily proven effective in addiction treatment in Western countries, …
{"title":"Cooperation between China and Iran in addiction medicine: opportunities, challenges and strategies","authors":"Gangliang Zhong, Hang Su, Di Zhao, Ji Hu, Xing Liu, Yonghui Li, Saeed Semnanian, Abbas Haghparast, Ti-Fei Yuan, Jiang Du","doi":"10.1136/gpsych-2023-101162","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101162","url":null,"abstract":"Addiction is a major global risk factor for disability and premature death1 and has become a public health and social problem worldwide. Despite substantial investments from governments and research institutions globally, current addiction medicine research remains centred in Western countries. However, theories, models and results from western-centric research may not be applicable to different cultures. Non-Western countries such as China and Iran, and Western countries are committed to establishing addiction prevention and treatment tailored to their unique histories and cultures. To foster a global addiction science, it is important to increase the diversity of evidence without preconceived biases. Studying addiction problems across different regions and cultural backgrounds and sharing successful prevention and treatment models can provide a more comprehensive perspective for global addiction science, potentially yielding innovative solutions that benefit all countries. China and Iran have their own unique addiction challenges and treatment experiences and have become important representatives of addiction research progress in countries outside the Western axis. Both China and Iran have rich traditional medicine experiences in addiction medicine, which have been developed over thousands of years of trial and error. These offer valuable insights for refining addiction treatment and preventing relapse. Traditional Chinese medicine has a history of over 2000 years in China and has been used to treat addiction, including substance and non-substance addiction, for the past two centuries. Traditional herbal therapy, which targets multiple systems and mechanisms, is considered effective in relieving withdrawal symptoms and preventing addiction relapse with minimal side effects.2 3 It also has a rehabilitative effect on physical issues caused by long-term drug use, including improvements in immune function and working memory and the prevention of neurological diseases.4 The continuous application of traditional medical therapies in China and Iran has preliminarily proven effective in addiction treatment in Western countries, …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"41 8 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139055901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The impact of the coronavirus disease 2019 (COVID-19) pandemic in 2020 on mental health was substantial in China1 2 and various other countries.3 4 Beyond the direct consequences of COVID-19, the pandemic created an environment in which many determinants of mental health were affected. Issues associated with the pandemic, such as loss of livelihood, limited access to medical services, reduced social interactions, and economic downturn, could potentially have adverse effects on the population’s mental well-being.5 In November 2021, the World Health Organization (WHO) designated the new variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), variant B.1.1.529, as a variant of concern and named it Omicron; its rapid mutation and spread raised a new global health concern.6 The first wave of the Omicron outbreak in mainland China started in Shanghai in late February 2022.5 Subsequently, it led to a few small eruptions in several cities in China,7 despite multifaceted public health interventions. After evaluating the pathogenicity, immunity evasion, transmission of the virus, and possible consequences of the Omicron wave, the State Council of China lifted the strict virus control measures on December 7, 2022.8 The official release from attempting to control the epidemic rapidly ushered in the first widespread wave of Omicron, peaking within a month. The number of infected people across the country increased explosively.9 10 The pandemic’s evident impact on netizens’ health emphasised the need for up-to-date information on the prevalence of infectious symptoms and mental health effects. Unfortunately, the threat of future pandemics exists.11 Investigating the impact of epidemics, such as Omicron, and incorporating the findings in ways that inform health system responses has never been more urgent. However, there are few large-scale studies containing significant evidence to explain the effects of recent pandemics in large, widespread …
{"title":"Exploring the psychological impact of the 2022 SARS-CoV-2 Omicron variant outbreak in China","authors":"Gangbin Han, Guirong Cheng, Feifei Hu, Chunli Li, Dan Liu, Juan Zhou, Jing Liu, Linya Huang, Xiaochang Liu, Qianqian Nie, Dan Song, Deyang Zeng, Lang Xu, Jinquan Li, Yushan Chen, Zhen Wei, Qiong Wu, Xiaoming He, Qingming Wu, Wei Tan, Yufei Mei, Xingxing Chen, Yangming Ou, Jingjing Zhang, Yafu Yu, Mengliu Yang, Pengfei Lian, Fukai Zhou, Renjia Fan, Hong Wan, Chenlu Hu, Yidi Fu, Shiyue Li, Junyi Wang, Cheng Cai, Mengdie Pei, Yuyang Cui, Wanying Cai, Yiqing Li, Shiyao Pan, Chang Chen, Yan He, Zhaoxia Wu, Liu Hu, Liang Tao, Hongyan Xiao, Xinyan Xie, Yan Zeng","doi":"10.1136/gpsych-2023-101088","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101088","url":null,"abstract":"The impact of the coronavirus disease 2019 (COVID-19) pandemic in 2020 on mental health was substantial in China1 2 and various other countries.3 4 Beyond the direct consequences of COVID-19, the pandemic created an environment in which many determinants of mental health were affected. Issues associated with the pandemic, such as loss of livelihood, limited access to medical services, reduced social interactions, and economic downturn, could potentially have adverse effects on the population’s mental well-being.5 In November 2021, the World Health Organization (WHO) designated the new variant of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), variant B.1.1.529, as a variant of concern and named it Omicron; its rapid mutation and spread raised a new global health concern.6 The first wave of the Omicron outbreak in mainland China started in Shanghai in late February 2022.5 Subsequently, it led to a few small eruptions in several cities in China,7 despite multifaceted public health interventions. After evaluating the pathogenicity, immunity evasion, transmission of the virus, and possible consequences of the Omicron wave, the State Council of China lifted the strict virus control measures on December 7, 2022.8 The official release from attempting to control the epidemic rapidly ushered in the first widespread wave of Omicron, peaking within a month. The number of infected people across the country increased explosively.9 10 The pandemic’s evident impact on netizens’ health emphasised the need for up-to-date information on the prevalence of infectious symptoms and mental health effects. Unfortunately, the threat of future pandemics exists.11 Investigating the impact of epidemics, such as Omicron, and incorporating the findings in ways that inform health system responses has never been more urgent. However, there are few large-scale studies containing significant evidence to explain the effects of recent pandemics in large, widespread …","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"13 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138512735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1136/gpsych-2023-101050
Yu Cheng, Hongmei Liu, Ruixue Yuan, Kai Yuan, Shunying Yu
Background Pharmacogenomics (PGx) is a promising tool to realise tailored drug therapy for depression. Aims To investigate the treatment efficacy of PGx for treatment-resistant depression (TRD) compared with treatment as usual. Methods A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science and PsycINFO to identify relevant studies published from inception to 15 April 2023. Two-arm randomised controlled trials (RCTs) exploring the efficacy of PGx-guided versus unguided treatment for TRD were included. The risk of bias in the included studies was evaluated using the Cochrane risk of bias assessment tool. The overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results Seven RCTs (n=3003) comparing PGx-guided (n=1492) and unguided (n=1511) groups were identified and analysed. PGx-guided treatment was superior to treatment as usual in response (relative risk (RR)=1.31; 95% confidence interval (95% CI): 1.15 to 1.49; p<0.001) and remission (RR=1.40; 95% CI: 1.09 to 1.80; p=0.009) improvements. Effect sizes for acceptability (RR=0.90; 95% CI: 0.80 to 1.02; p=0.100) and side effect burden (RR=0.58; 95% CI: 0.29 to 1.15; p=0.120) between the two groups were not statistically different. The overall quality of evidence was rated from ‘very low’ (25%) to ‘low’ (75%) based on the GRADE criteria. Conclusions PGx-guided treatment has shown a small overall effect in improving the response and remission rates for patients with TRD. However, these results should be interpreted cautiously because of the few included studies and the low quality of evidence. Further high-quality clinical trials are warranted to confirm the findings. PROSPERO registration number CRD42022340182.
{"title":"Effectiveness of pharmacogenomics on the response and remission of treatment-resistant depression: a meta-analysis of randomised controlled trials","authors":"Yu Cheng, Hongmei Liu, Ruixue Yuan, Kai Yuan, Shunying Yu","doi":"10.1136/gpsych-2023-101050","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101050","url":null,"abstract":"Background Pharmacogenomics (PGx) is a promising tool to realise tailored drug therapy for depression. Aims To investigate the treatment efficacy of PGx for treatment-resistant depression (TRD) compared with treatment as usual. Methods A systematic search was conducted in PubMed, Embase, the Cochrane Library, Web of Science and PsycINFO to identify relevant studies published from inception to 15 April 2023. Two-arm randomised controlled trials (RCTs) exploring the efficacy of PGx-guided versus unguided treatment for TRD were included. The risk of bias in the included studies was evaluated using the Cochrane risk of bias assessment tool. The overall quality of evidence was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Results Seven RCTs (n=3003) comparing PGx-guided (n=1492) and unguided (n=1511) groups were identified and analysed. PGx-guided treatment was superior to treatment as usual in response (relative risk (RR)=1.31; 95% confidence interval (95% CI): 1.15 to 1.49; p<0.001) and remission (RR=1.40; 95% CI: 1.09 to 1.80; p=0.009) improvements. Effect sizes for acceptability (RR=0.90; 95% CI: 0.80 to 1.02; p=0.100) and side effect burden (RR=0.58; 95% CI: 0.29 to 1.15; p=0.120) between the two groups were not statistically different. The overall quality of evidence was rated from ‘very low’ (25%) to ‘low’ (75%) based on the GRADE criteria. Conclusions PGx-guided treatment has shown a small overall effect in improving the response and remission rates for patients with TRD. However, these results should be interpreted cautiously because of the few included studies and the low quality of evidence. Further high-quality clinical trials are warranted to confirm the findings. PROSPERO registration number CRD42022340182.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"58 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139051078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-24eCollection Date: 2023-01-01DOI: 10.1136/gpsych-2021-100527corr1
[This corrects the article DOI: 10.1136/gpsych-2021-100527.].
[这更正了文章DOI: 10.1136/gpsych-2021-100527]。
{"title":"Correction: Development of a psychosocial functioning questionnaire for patients with major depressive disorder.","authors":"","doi":"10.1136/gpsych-2021-100527corr1","DOIUrl":"https://doi.org/10.1136/gpsych-2021-100527corr1","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1136/gpsych-2021-100527.].</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"36 6","pages":"e100527corr1"},"PeriodicalIF":11.9,"publicationDate":"2023-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10693680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138482211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-02eCollection Date: 2023-01-01DOI: 10.1136/gpsych-2023-101057
Kuan Zeng, Xuan Yu, Zhen Wei, Yong Wu, Jianzhi Wang, Rong Liu, Yi Li, Xiaochuan Wang
Background: Methamphetamine (METH) addiction causes a huge burden on society. The prefrontal cortex (PFC), associated with emotion and cognitive behaviours, is also involved in addiction neurocircuitry. Although bulk RNA sequencing has shown METH-induced gene alterations in the mouse PFC, the impact on different cell types remains unknown.
Aims: To clarify the effects of METH treatment on different cell types of the PFC and the potential pathways involved in METH-related disorders.
Methods: We performed single-nucleus RNA sequencing (snRNA-seq) to examine the transcriptomes of 20 465 nuclei isolated from the PFC of chronic METH-treated and control mice. Main cell types and differentially expressed genes (DEGs) were identified and confirmed by RNA fluorescence in situ hybridization(FISH).
Results: Six main cell types were identified depending on the single-cell nucleus sequencing; of particular interest were the mature oligodendrocytes in the PFC. The DEGs of mature oligodendrocytes were enriched in the myelin sheath, adenosine triphosphate (ATP) metabolic process, mitochondrial function and components, and so on. The messenger RNA levels of Aldoc and Atp5l (FISH) and the protein level of the mitochondrial membrane pore subunit TOM40 (immunofluorescence) decreased in the mature oligodendrocytes. Fast blue staining and transmission electron microscopy image indicated myelin damage, and the myelin thickness decreased in METH brains.
Conclusions: snRNA-seq reveals altered transcriptomes of different cell types in mouse PFC induced by chronic METH treatment, underscoring potential relationships with psychiatric disorders.
{"title":"Single-nucleus transcriptome profiling of prefrontal cortex induced by chronic methamphetamine treatment.","authors":"Kuan Zeng, Xuan Yu, Zhen Wei, Yong Wu, Jianzhi Wang, Rong Liu, Yi Li, Xiaochuan Wang","doi":"10.1136/gpsych-2023-101057","DOIUrl":"10.1136/gpsych-2023-101057","url":null,"abstract":"<p><strong>Background: </strong>Methamphetamine (METH) addiction causes a huge burden on society. The prefrontal cortex (PFC), associated with emotion and cognitive behaviours, is also involved in addiction neurocircuitry. Although bulk RNA sequencing has shown METH-induced gene alterations in the mouse PFC, the impact on different cell types remains unknown.</p><p><strong>Aims: </strong>To clarify the effects of METH treatment on different cell types of the PFC and the potential pathways involved in METH-related disorders.</p><p><strong>Methods: </strong>We performed single-nucleus RNA sequencing (snRNA-seq) to examine the transcriptomes of 20 465 nuclei isolated from the PFC of chronic METH-treated and control mice. Main cell types and differentially expressed genes (DEGs) were identified and confirmed by RNA fluorescence in situ hybridization(FISH).</p><p><strong>Results: </strong>Six main cell types were identified depending on the single-cell nucleus sequencing; of particular interest were the mature oligodendrocytes in the PFC. The DEGs of mature oligodendrocytes were enriched in the myelin sheath, adenosine triphosphate (ATP) metabolic process, mitochondrial function and components, and so on. The messenger RNA levels of <i>Aldoc</i> and <i>Atp5l</i> (FISH) and the protein level of the mitochondrial membrane pore subunit TOM40 (immunofluorescence) decreased in the mature oligodendrocytes. Fast blue staining and transmission electron microscopy image indicated myelin damage, and the myelin thickness decreased in METH brains.</p><p><strong>Conclusions: </strong>snRNA-seq reveals altered transcriptomes of different cell types in mouse PFC induced by chronic METH treatment, underscoring potential relationships with psychiatric disorders.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"36 5","pages":"e101057"},"PeriodicalIF":11.9,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10626793/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71480481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Music therapy is a promising complementary intervention for addressing various mental health conditions. Despite evidence of the beneficial effects of music, the acoustic features that make music effective in therapeutic contexts remain elusive. Aims This study aimed to identify and validate distinctive acoustic features of healing music. Methods We constructed a healing music dataset (HMD) based on nominations from related professionals and extracted 370 acoustic features. Healing-distinctive acoustic features were identified as those that were (1) independent from genre within the HMD, (2) significantly different from music pieces in a classical music dataset (CMD) and (3) similar to pieces in a five-element music dataset (FEMD). We validated the identified features by comparing jazz pieces in the HMD with a jazz music dataset (JMD). We also examined the emotional properties of the features in a Chinese affective music system (CAMS). Results The HMD comprised 165 pieces. Among all the acoustic features, 74.59% shared commonalities across genres, and 26.22% significantly differed between the HMD classical pieces and the CMD. The equivalence test showed that the HMD and FEMD did not differ significantly in 9.46% of the features. The potential healing-distinctive acoustic features were identified as the standard deviation of the roughness, mean and period entropy of the third coefficient of the mel-frequency cepstral coefficients. In a three-dimensional space defined by these features, HMD’s jazz pieces could be distinguished from those of the JMD. These three features could significantly predict both subjective valence and arousal ratings in the CAMS. Conclusions The distinctive acoustic features of healing music that have been identified and validated in this study have implications for the development of artificial intelligence models for identifying therapeutic music, particularly in contexts where access to professional expertise may be limited. This study contributes to the growing body of research exploring the potential of digital technologies for healthcare interventions. All data relevant to the study are included in the article or uploaded as supplementary information.
{"title":"Uncovering potential distinctive acoustic features of healing music","authors":"Yue Ding, Jiaqi Jing, Qihui Guo, Jiajia Zhou, Xinyao Cheng, Xiaoya Chen, Lihui Wang, Yingying Tang, Qing Fan","doi":"10.1136/gpsych-2023-101145","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101145","url":null,"abstract":"Background Music therapy is a promising complementary intervention for addressing various mental health conditions. Despite evidence of the beneficial effects of music, the acoustic features that make music effective in therapeutic contexts remain elusive. Aims This study aimed to identify and validate distinctive acoustic features of healing music. Methods We constructed a healing music dataset (HMD) based on nominations from related professionals and extracted 370 acoustic features. Healing-distinctive acoustic features were identified as those that were (1) independent from genre within the HMD, (2) significantly different from music pieces in a classical music dataset (CMD) and (3) similar to pieces in a five-element music dataset (FEMD). We validated the identified features by comparing jazz pieces in the HMD with a jazz music dataset (JMD). We also examined the emotional properties of the features in a Chinese affective music system (CAMS). Results The HMD comprised 165 pieces. Among all the acoustic features, 74.59% shared commonalities across genres, and 26.22% significantly differed between the HMD classical pieces and the CMD. The equivalence test showed that the HMD and FEMD did not differ significantly in 9.46% of the features. The potential healing-distinctive acoustic features were identified as the standard deviation of the roughness, mean and period entropy of the third coefficient of the mel-frequency cepstral coefficients. In a three-dimensional space defined by these features, HMD’s jazz pieces could be distinguished from those of the JMD. These three features could significantly predict both subjective valence and arousal ratings in the CAMS. Conclusions The distinctive acoustic features of healing music that have been identified and validated in this study have implications for the development of artificial intelligence models for identifying therapeutic music, particularly in contexts where access to professional expertise may be limited. This study contributes to the growing body of research exploring the potential of digital technologies for healthcare interventions. All data relevant to the study are included in the article or uploaded as supplementary information.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"1 1","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138819564","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-11-01DOI: 10.1136/gpsych-2023-101278
Wenfeng Zhao, Huang Wang, Haixia Leng, Qing Xue, Mao Peng, Xiukun Jin, Liucen Tan, Na Pan, Xuedi Wang, Jie Wang, Keming Gao, Xiangyang Zhang, Hongxing Wang
{"title":"Acute effect of twice-daily 15 mA transcranial alternating current stimulation on treatment-resistant depression: a case series study","authors":"Wenfeng Zhao, Huang Wang, Haixia Leng, Qing Xue, Mao Peng, Xiukun Jin, Liucen Tan, Na Pan, Xuedi Wang, Jie Wang, Keming Gao, Xiangyang Zhang, Hongxing Wang","doi":"10.1136/gpsych-2023-101278","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101278","url":null,"abstract":"","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135615528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer’s disease (AD), and some studies suggest a close relationship between cognition and plasticity. However, the clinical benefits of transcranial direct current stimulation (tDCS) in patients still need to be evaluated. Aims This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity. Methods 124 patients with AD were randomly assigned to active tDCS (n=63) or sham tDCS (n=61). The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks (5 days per week, 2 days off). The Mini-Mental State Examination and the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) were used for cognition evaluation at baseline, week 2 and week 6. The cortical plasticity was represented by motor-evoked potential (MEP) measured with an electromyogram. Results The results showed that multiple courses of active tDCS can improve the cognitive functions of patients with AD, especially in the memory domain (word recall, recall of test instructions and word recognition). In addition, the damaged MEP level was enhanced following active treatment. In the active tDCS group, the improvements in ADAS-Cog total and subitem (word recall and word recognition) scores were negatively correlated with the enhancement of MEP. Conclusions Our research indicates for the first time that twice-a-day tDCS may improve the cognitive function of patients with AD. This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity, which warrants mechanistic investigations of the relationship between cognition and plasticity in the future. Trial registration number ChiCTR1900021067. Data are available upon reasonable request.
无创脑刺激可改善阿尔茨海默病(AD)患者的认知功能，一些研究表明认知与可塑性之间存在密切关系。然而，经颅直流电刺激(tDCS)对患者的临床益处仍需评估。目的探讨tDCS在认知改善中的作用，以及认知改善是否与大脑皮层可塑性改变有关。方法124例AD患者随机分为活动性tDCS组(63例)和假性tDCS组(61例)。tDCS应用于背外侧前额皮质，共30次治疗，为期6周(每周5天，休息2天)。在基线、第2周和第6周使用认知能力评估量表(ADAS-Cog)和简易精神状态检查(Mini-Mental State Examination)。用肌电图测量运动诱发电位(MEP)表征皮层可塑性。结果表明，多疗程的tDCS活动可改善AD患者的认知功能，特别是在记忆领域(单词回忆、测试说明回忆和单词识别)。此外，在积极治疗后，受损的MEP水平有所提高。在活跃tDCS组，ADAS-Cog总分和子项(单词回忆和单词识别)得分的改善与MEP的增强呈负相关。我们的研究首次表明，每天两次的tDCS可以改善AD患者的认知功能。该研究还表明认知功能障碍可能与大脑皮层可塑性受损有关，这为未来认知和可塑性之间关系的机制研究提供了依据。试验注册号ChiCTR1900021067。如有合理要求，可提供资料。
{"title":"Impact of twice-a-day transcranial direct current stimulation intervention on cognitive function and motor cortex plasticity in patients with Alzheimer’s disease","authors":"Xingxing Li, Lei Chen, Kunqiang Yu, Wenhao Zhuang, Hui Zhu, Wenqiang Xu, Hui Yan, Gangqiao Qi, Dongsheng Zhou, Shaochang Wu","doi":"10.1136/gpsych-2023-101166","DOIUrl":"https://doi.org/10.1136/gpsych-2023-101166","url":null,"abstract":"Background Non-invasive brain stimulation has improved cognitive functions in patients with Alzheimer’s disease (AD), and some studies suggest a close relationship between cognition and plasticity. However, the clinical benefits of transcranial direct current stimulation (tDCS) in patients still need to be evaluated. Aims This study examined the role of tDCS in improving cognition and whether the improved cognition is related to altered cortical plasticity. Methods 124 patients with AD were randomly assigned to active tDCS (n=63) or sham tDCS (n=61). The tDCS was applied at the dorsolateral prefrontal cortex for 30 treatment sessions across 6 weeks (5 days per week, 2 days off). The Mini-Mental State Examination and the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) were used for cognition evaluation at baseline, week 2 and week 6. The cortical plasticity was represented by motor-evoked potential (MEP) measured with an electromyogram. Results The results showed that multiple courses of active tDCS can improve the cognitive functions of patients with AD, especially in the memory domain (word recall, recall of test instructions and word recognition). In addition, the damaged MEP level was enhanced following active treatment. In the active tDCS group, the improvements in ADAS-Cog total and subitem (word recall and word recognition) scores were negatively correlated with the enhancement of MEP. Conclusions Our research indicates for the first time that twice-a-day tDCS may improve the cognitive function of patients with AD. This study also suggests that cognitive dysfunction may be related to impaired cortical plasticity, which warrants mechanistic investigations of the relationship between cognition and plasticity in the future. Trial registration number ChiCTR1900021067. Data are available upon reasonable request.","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"13 6","pages":""},"PeriodicalIF":11.9,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138512733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-31eCollection Date: 2023-01-01DOI: 10.1136/gpsych-2023-101127
Wenlei Zhang, Jiahui Zhou, Hang Su, Xiaocheng Zhang, Weichen Song, Zijing Wang, Chengjie Tang, Kadir Uludağ, Min Zhao, Zhi-Qi Xiong, Rongwei Zhai, Haifeng Jiang
Background: Brain-derived neurotrophic factor (BDNF) is known to prevent methamphetamine (METH)-induced neurotoxicity and plays a role in various stages of METH addiction. However, there is a lack of research with longitudinal design on changes in plasma BDNF levels in active METH-dependent individuals.
Aims: The aim of the study was to investigate changes in BDNF levels during METH self-administration in monkeys.
Methods: This study measured plasma BDNF levels in three male rhesus monkeys with continuous METH exposure and four male control rhesus monkeys without METH exposure. Changes in plasma BDNF levels were then assessed longitudinally during 40 sessions of METH self-administration in the three monkeys.
Results: Repeated METH exposure decreased plasma BDNF levels. Additionally, plasma BDNF decreased with long-term rather than short-term accumulation of METH during METH self-administration.
Conclusions: These findings may indicate that the changes in peripheral BDNF may reflect the quantity of accumulative METH intake during a frequent drug use period.
{"title":"Repeated methamphetamine exposure decreases plasma brain-derived neurotrophic factor levels in rhesus monkeys.","authors":"Wenlei Zhang, Jiahui Zhou, Hang Su, Xiaocheng Zhang, Weichen Song, Zijing Wang, Chengjie Tang, Kadir Uludağ, Min Zhao, Zhi-Qi Xiong, Rongwei Zhai, Haifeng Jiang","doi":"10.1136/gpsych-2023-101127","DOIUrl":"10.1136/gpsych-2023-101127","url":null,"abstract":"<p><strong>Background: </strong>Brain-derived neurotrophic factor (BDNF) is known to prevent methamphetamine (METH)-induced neurotoxicity and plays a role in various stages of METH addiction. However, there is a lack of research with longitudinal design on changes in plasma BDNF levels in active METH-dependent individuals.</p><p><strong>Aims: </strong>The aim of the study was to investigate changes in BDNF levels during METH self-administration in monkeys.</p><p><strong>Methods: </strong>This study measured plasma BDNF levels in three male rhesus monkeys with continuous METH exposure and four male control rhesus monkeys without METH exposure. Changes in plasma BDNF levels were then assessed longitudinally during 40 sessions of METH self-administration in the three monkeys.</p><p><strong>Results: </strong>Repeated METH exposure decreased plasma BDNF levels. Additionally, plasma BDNF decreased with long-term rather than short-term accumulation of METH during METH self-administration.</p><p><strong>Conclusions: </strong>These findings may indicate that the changes in peripheral BDNF may reflect the quantity of accumulative METH intake during a frequent drug use period.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"36 5","pages":"e101127"},"PeriodicalIF":11.9,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71432288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30eCollection Date: 2023-01-01DOI: 10.1136/gpsych-2023-101049
Ting Pang, Binte Xia, Xuhao Zhao, Yaping Zhang, Cheuk Ni Kan, Saima Hilal, Christopher Chen, Narayanaswamy Venketasubramanian, Wong Tien Yin, Ching-Yu Cheng, Changzheng Yuan, Xin Xu
Background: Case-finding is a recommended approach for dementia early detection in the community.
Aims: To investigate the discriminant validity and cost-effectiveness of a stepwise dementia case-finding approach in a Singaporean older adult community.
Methods: The two-phase study was conducted in the community from 2009 to 2015 in Singapore. A total of 3780 participants (age ≥60 years) completed phase I (a brief cognitive screening); 918 completed phase II and were included in the final analysis. In phase I, all participants were administered the Abbreviated Mental Test (AMT) and the Progressive Forgetfulness Question (PFQ). Those who screened positive on either test were invited to phase II, whereby the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery were administered, followed by the research diagnosis of no cognitive impairment, cognitive impairment no dementia (CIND)-Mild (≤2 impaired cognitive domains), CIND-Moderate (>2 impaired domains) or dementia. Receiver operating characteristic curve analyses were conducted for the different cognitive instruments. All discriminant indices were calculated, including sensitivity, specificity, positive and negative predictive values (NPV) and accuracy. Cost-effectiveness analysis was conducted by estimating the amount of screening time needed and the number of older adults requiring re-evaluation in two case-finding scenarios, ie, with or without preselection by the PFQ.
Results: The stepwise case-finding approach (preselection by the PFQ, then MMSE or MoCA or AMT) showed an excellent NPV (>99%) and accuracy (>86%) for excluding dementia-free cases. Without preselection by the PFQ, screening time for the three cognitive tools were 317.5, 317.5 and 254 hours, with 159, 302 and 175 screen-positive older adults involved in further evaluation. By adopting the stepwise case-finding approach, total screening time were 156.5, 156.5 and 126.2 hours, which decreased by 50.7%, 50.7% and 50.3% as compared with those without preselection. Furthermore, after preselection, only 98, 167 and 145 screen-positive older adults required further evaluation, corresponding to a reduction of 38.4%, 44.7% and 17.1% in the numbers compared with those without preselection.
Conclusions: A stepwise approach for dementia case-finding should be implemented in the community to minimise the time and resources needed for large-scale early detection of dementia.
{"title":"Cost-benefit and discriminant validity of a stepwise dementia case-finding approach in an Asian older adult community.","authors":"Ting Pang, Binte Xia, Xuhao Zhao, Yaping Zhang, Cheuk Ni Kan, Saima Hilal, Christopher Chen, Narayanaswamy Venketasubramanian, Wong Tien Yin, Ching-Yu Cheng, Changzheng Yuan, Xin Xu","doi":"10.1136/gpsych-2023-101049","DOIUrl":"10.1136/gpsych-2023-101049","url":null,"abstract":"<p><strong>Background: </strong>Case-finding is a recommended approach for dementia early detection in the community.</p><p><strong>Aims: </strong>To investigate the discriminant validity and cost-effectiveness of a stepwise dementia case-finding approach in a Singaporean older adult community.</p><p><strong>Methods: </strong>The two-phase study was conducted in the community from 2009 to 2015 in Singapore. A total of 3780 participants (age ≥60 years) completed phase I (a brief cognitive screening); 918 completed phase II and were included in the final analysis. In phase I, all participants were administered the Abbreviated Mental Test (AMT) and the Progressive Forgetfulness Question (PFQ). Those who screened positive on either test were invited to phase II, whereby the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and a formal neuropsychological battery were administered, followed by the research diagnosis of no cognitive impairment, cognitive impairment no dementia (CIND)-Mild (≤2 impaired cognitive domains), CIND-Moderate (>2 impaired domains) or dementia. Receiver operating characteristic curve analyses were conducted for the different cognitive instruments. All discriminant indices were calculated, including sensitivity, specificity, positive and negative predictive values (NPV) and accuracy. Cost-effectiveness analysis was conducted by estimating the amount of screening time needed and the number of older adults requiring re-evaluation in two case-finding scenarios, ie, with or without preselection by the PFQ.</p><p><strong>Results: </strong>The stepwise case-finding approach (preselection by the PFQ, then MMSE or MoCA or AMT) showed an excellent NPV (>99%) and accuracy (>86%) for excluding dementia-free cases. Without preselection by the PFQ, screening time for the three cognitive tools were 317.5, 317.5 and 254 hours, with 159, 302 and 175 screen-positive older adults involved in further evaluation. By adopting the stepwise case-finding approach, total screening time were 156.5, 156.5 and 126.2 hours, which decreased by 50.7%, 50.7% and 50.3% as compared with those without preselection. Furthermore, after preselection, only 98, 167 and 145 screen-positive older adults required further evaluation, corresponding to a reduction of 38.4%, 44.7% and 17.1% in the numbers compared with those without preselection.</p><p><strong>Conclusions: </strong>A stepwise approach for dementia case-finding should be implemented in the community to minimise the time and resources needed for large-scale early detection of dementia.</p>","PeriodicalId":12549,"journal":{"name":"General Psychiatry","volume":"36 5","pages":"e101049"},"PeriodicalIF":11.9,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10618984/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71422711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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