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IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-09-01 DOI: 10.1111/soc4.12812
No abstract is available for this article.
这篇文章没有摘要。
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引用次数: 0
Issue Information 问题信息
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-06-16 DOI: 10.1111/odi.13906
No abstract is available for this article.
这篇文章没有摘要。
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引用次数: 0
The roles of inactivated vaccines in older patients with infection of Delta variant in Nanjing, China. 灭活疫苗在中国南京感染德尔塔变种的老年患者中的作用。
4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-05-18 DOI: 10.18632/aging.204085
Xiao-Chun Song, Xue-Hui Zhou, Jing-Hui Cheng, Wen-Hao Zhang, Xiao Shen, Huan Xu, Shuai Nie, Ji-Lai Xiao, Fang Sun, Chang Shu, Jiu-Dong Chen, Yan Tang, Xiang Wang, Xin-Pei Sun, Jia-Kui Sun, Ping Feng, Qian-Kun Shi

Background: The coronavirus disease 2019 (COVID-19) is spreading around the world. The COVID-19 vaccines may improve concerns about the pandemic. However, the roles of inactivated vaccines in older patients (aged ≥60 years) with infection of Delta variant were less studied.

Methods: We classified the older patients with infection of Delta variant into three groups based on the vaccination status: no vaccination (group A, n = 113), one dose of vaccination (group B, n = 46), and two doses of vaccination (group C, n = 22). Two inactivated COVID-19 vaccines (BBIBP-CorV or CoronaVac) were evaluated in this study. The demographic data, laboratory parameters, and clinical severity were recorded.

Results: A total of 181 older patients with infection of Delta variant were enrolled. 111 (61.3%) patients had one or more co-morbidities. The days of "turn negative" and hospital stay in Group C were lower than those in the other groups (P < 0.05). The incidences of multiple organ dysfunction syndrome (MODS), septic shock, acute respiratory distress syndrome (ARDS), acute kidney injury, and cardiac injury in Group A were higher than those in the other groups (P < 0.05). The MV-free days and ICU-free days during 28 days in Group A were also lower than those in the other groups (P < 0.05). In patients with co-morbidities, vaccinated cases had lower incidences of MODS (P = 0.015), septic shock (P = 0.015), and ARDS (P = 0.008).

Conclusions: The inactivated COVID-19 vaccines were effective in improving the clinical severity of older patients with infection of Delta variant.

背景:冠状病毒病 2019(COVID-19)正在全球蔓延。COVID-19 疫苗可能会改善人们对这一流行病的担忧。然而,灭活疫苗在感染德尔塔变种的老年患者(年龄≥60 岁)中的作用研究较少:我们根据疫苗接种情况将感染德尔塔变异体的老年患者分为三组:未接种(A 组,113 人)、接种一剂(B 组,46 人)和接种两剂(C 组,22 人)。本研究评估了两种 COVID-19 灭活疫苗(BBIBP-CorV 或 CoronaVac)。研究记录了人口统计学数据、实验室参数和临床严重程度:结果:共招募了 181 名感染德尔塔变种的老年患者。111名患者(61.3%)患有一种或多种并发症。C 组的 "转阴 "天数和住院天数低于其他组(P < 0.05)。A 组的多器官功能障碍综合征(MODS)、脓毒性休克、急性呼吸窘迫综合征(ARDS)、急性肾损伤和心脏损伤的发生率高于其他组(P < 0.05)。A 组在 28 天内无 MV 天数和无 ICU 天数也低于其他组(P < 0.05)。在合并疾病的患者中,接种疫苗病例的 MODS(P = 0.015)、脓毒性休克(P = 0.015)和 ARDS(P = 0.008)发生率较低:结论:COVID-19灭活疫苗能有效改善感染Delta变种的老年患者的临床严重程度。
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引用次数: 0
Effects of Cannabis-Delivered THC on mood and negative attentional bias in the context of positive vs. neutral Alternatives—a pilot study 大麻四氢大麻酚对积极与中性选择下情绪和消极注意偏差的影响-一项初步研究
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-04-21 DOI: 10.1002/hup.2844
Matthew P. Gunn, Norka E. Rabinovich, Kris M. Martens, John D. Lindt, David G. Gilbert

Objective

To assess: (1) the acute effects of smoked marijuana (MJ) on negative attentional bias (NAB), (2) moderation of these effects by positive versus neutral alternatives, and (3) the associations of tetrahydrocannabinol (THC)-induced changes in NAB with changes in affect.

Methods

Fourteen MJ users (1–4 uses/wk) smoked a THC cigarette on 1 day and a placebo cigarette on the other counterbalanced day. After smoking, participants freely gazed back and forth at a series of two side-by-side pictures pairs presented for 3000 ms (one negative, while the other was either positive or neutral) while eye gaze was tracked.

Results

The effects of THC relative to placebo varied across time such that THC increased NAB during the early temporal component of threatening picture viewing, 333–858 ms after dual-picture onset, regardless of alternative picture valance. However, contrary to the attentional bias-causes affect hypothesis, during the early viewing phase THC-enhanced positive affect (PA) correlated positively with THC-induced NAB. In contrast, during the late phase (891–3000 ms) THC-enhanced PA did not correlate significantly with NAB, though THC-induced negative affect (NA) change did correlate positively with THC-induced change in NAB in the positive alternative condition.

Conclusions

We replicated findings of others showing that THC can enhance NAB during the early stages of threatening picture viewing. We extended previous results by demonstrating the THC-induced NAB is associated with increased PA during initial threat viewing, but with increased NA during later processing if positive alternatives are present.

目的探讨(1)吸食大麻(MJ)对负性注意偏倚(NAB)的急性影响,(2)正性和中性替代对负性注意偏倚的调节作用,以及(3)四氢大麻酚(THC)诱导的负性注意偏倚变化与情绪变化的关系。方法14例MJ使用者(1 ~ 4次/周)在1天抽四氢大麻酚香烟,在另一个平衡日抽安慰剂香烟。吸烟后,参与者在3000毫秒内自由地来回看两组并排的图片(一组是消极的,另一组是积极的或中性的),同时跟踪他们的目光。结果与安慰剂相比,四氢大麻酚的作用随时间的变化而变化,在双图像开始后333-858 ms,四氢大麻酚增加了NAB,而不考虑其他图像的价值。然而,与注意偏差导致影响假说相反,在观看早期,四氢大麻酚增强的积极影响(PA)与四氢大麻酚诱导的NAB呈正相关。相比之下,在后期(891-3000 ms), thc增强的PA与NAB没有显著相关,但在正向替代条件下,thc诱导的负影响(NA)变化与thc诱导的NAB变化呈正相关。结论我们重复了其他人的研究结果,表明四氢大麻酚可以在威胁性图片观看的早期阶段增强NAB。我们扩展了之前的结果,证明了thc诱导的NAB与初始威胁观察时PA的增加有关,但如果存在积极的替代方案,则在后期处理过程中NA增加。
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引用次数: 1
Evaluation of memantine's efficacy and safety in the treatment of children with autism spectrum disorder: A systematic review and meta-analysis 美金刚治疗儿童自闭症谱系障碍的有效性和安全性评价:系统回顾和荟萃分析
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-03-21 DOI: 10.1002/hup.2841
Walaa Elnaiem, Amira Yasmine Benmelouka, Ali Mohamed Naguib Elgendy, Mahmoud Shaban Abdelgalil, Muhamad Zakaria Brimo Alsaman, Aly Mogheeth, Mahmoud M. Ali, Shimaa Mohammad Yousof

Background

The United States Food and Drug Administration has approved drugs that address only autism-related symptoms rather than the underlying impairments. N-Methyl-D-Aspartate  receptor antagonists have recently emerged as a promising treatment option for a variety of neurologic and developmental problems, including autism.

Aims

To review (systematically), for the first time, the medical literature that explores the safety in and efficacy of memantine in autism.

Methods and procedures

A comprehensive electronic search for relevant randomized controlled trials was conducted in four databases. Using RevMan software, we extracted and pooled data as a risk ratio (RR) or normalized mean differences in an inverse variance strategy.

Results

This systematic review and meta-analysis includes five trials. There was no difference in enhancing social responsiveness when compared to placebo, though memantine lowered the likelihood of anxiety (RR = 0.25; 95% Confidence interval: [0.07; 0.87], p = 0.03). However, memantine aggravated impulsive behaviors. Additionally, in another trial that compared memantine added to risperidone versus risperidone added to placebo, memantine was found to be effective and safe.

Conclusion

Memantine showed safety in reducing acute symptoms of anxiety and other symptoms encountered in pediatric patients with autism spectrum disorders. However, memantine does not improve the core symptoms of autism. Nevertheless, further long-term trials are needed to explore its potential efficacy.

美国食品和药物管理局已经批准了仅针对自闭症相关症状而非潜在损害的药物。n -甲基- d -天冬氨酸受体拮抗剂最近作为一种有前途的治疗选择出现在各种神经和发育问题,包括自闭症。目的首次系统地回顾探讨美金刚治疗自闭症的安全性和有效性的医学文献。方法和步骤在4个数据库中对相关随机对照试验进行全面的电子检索。使用RevMan软件,我们提取并汇总数据作为风险比(RR)或在逆方差策略中归一化平均差异。本系统综述和荟萃分析包括5项试验。与安慰剂相比,在增强社会反应方面没有差异,尽管美金刚降低了焦虑的可能性(RR = 0.25;95%置信区间:[0.07;0.87], p = 0.03)。然而,美金刚加重了冲动行为。此外,在另一项试验中,将美金刚加利培酮与利培酮加安慰剂进行比较,发现美金刚有效且安全。结论美金刚在减轻儿童自闭症谱系障碍患者的急性焦虑等症状方面具有安全性。然而,美金刚并不能改善自闭症的核心症状。然而,需要进一步的长期试验来探索其潜在疗效。
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引用次数: 3
Efficacy of tiapride in the treatment of psychiatric disorders: A systematic review 噻必利治疗精神疾病的疗效:一项系统综述
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-03-21 DOI: 10.1002/hup.2842
Caroline Zangani, Barbara Giordano, Hans-Christian Stein, Stefano Bonora, Edoardo Giuseppe Ostinelli, Armando D'Agostino

Background

Tiapride is an atypical antipsychotic used to treat alcohol withdrawal, aggressiveness and agitation, headache, dyskinesias, tic and Tourette's disorder. More recently, it has been proposed for the treatment of delirium and agitation in hospitalised patients with COVID-19. Although its safety profile makes it suitable for use in vulnerable populations, the use of tiapride for psychiatric disorders is limited. This work aims to systematically review the available evidence on the efficacy and tolerability of tiapride in individuals with a psychiatric disorder.

Methods

We searched PubMed, Embase, PsycINFO, GreyLit, OpenGrey, and ProQuest up to March 2020 for randomised controlled trials focussing on the use of tiapride in the treatment of individuals with a psychiatric disorder (e.g., mood disorder, schizophrenia spectrum, substance use disorder). The Risk of Bias 2 was performed for the quality assessment of the included studies.

Results

We identified 579 records. Of them, six studies (published between 1982 and 2010) were included in the review. Four studies referred to alcohol withdrawal, and two to the management of agitation in elderly patients with dementia. None of the studies reported significant differences between tiapride and other active comparators in terms of efficacy and tolerability. The overall risk of bias was moderate to high.

Conclusion

Tiapride may be considered as a relatively safe treatment option for selected patients with alcohol withdrawal or agitation in dementia. However, solid evidence of its efficacy in the scientific literature is lacking. High-quality trials remain necessary to fully sustain its use in clinical practice.

噻必利是一种非典型抗精神病药物,用于治疗酒精戒断、攻击性和躁动、头痛、运动障碍、抽动和图雷特病。最近,它被提议用于治疗COVID-19住院患者的谵妄和躁动。虽然它的安全性使它适合于易受伤害的人群使用,但对精神疾病的使用是有限的。这项工作的目的是系统地审查现有证据的有效性和耐受性对个体的精神障碍。方法:我们检索PubMed、Embase、PsycINFO、GreyLit、OpenGrey和ProQuest,检索截至2020年3月的随机对照试验,重点研究使用tiapride治疗精神障碍(如情绪障碍、精神分裂症谱系、物质使用障碍)的个体。对纳入的研究进行2级偏倚风险评价。结果共鉴定出579条记录。其中,6项研究(发表于1982年至2010年之间)被纳入综述。四项研究涉及酒精戒断,两项研究涉及老年痴呆患者的躁动管理。没有研究报告在疗效和耐受性方面,噻必利和其他活性比较物有显著差异。偏倚的总体风险为中等至高。结论对于有酒精戒断或躁动的痴呆患者,噻必利可作为一种相对安全的治疗方案。然而,在科学文献中缺乏其有效性的确凿证据。高质量的试验仍然是必要的,以充分维持其在临床实践中的使用。
{"title":"Efficacy of tiapride in the treatment of psychiatric disorders: A systematic review","authors":"Caroline Zangani,&nbsp;Barbara Giordano,&nbsp;Hans-Christian Stein,&nbsp;Stefano Bonora,&nbsp;Edoardo Giuseppe Ostinelli,&nbsp;Armando D'Agostino","doi":"10.1002/hup.2842","DOIUrl":"10.1002/hup.2842","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Tiapride is an atypical antipsychotic used to treat alcohol withdrawal, aggressiveness and agitation, headache, dyskinesias, tic and Tourette's disorder. More recently, it has been proposed for the treatment of delirium and agitation in hospitalised patients with COVID-19. Although its safety profile makes it suitable for use in vulnerable populations, the use of tiapride for psychiatric disorders is limited. This work aims to systematically review the available evidence on the efficacy and tolerability of tiapride in individuals with a psychiatric disorder.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We searched PubMed, Embase, PsycINFO, GreyLit, OpenGrey, and ProQuest up to March 2020 for randomised controlled trials focussing on the use of tiapride in the treatment of individuals with a psychiatric disorder (e.g., mood disorder, schizophrenia spectrum, substance use disorder). The Risk of Bias 2 was performed for the quality assessment of the included studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 579 records. Of them, six studies (published between 1982 and 2010) were included in the review. Four studies referred to alcohol withdrawal, and two to the management of agitation in elderly patients with dementia. None of the studies reported significant differences between tiapride and other active comparators in terms of efficacy and tolerability. The overall risk of bias was moderate to high.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tiapride may be considered as a relatively safe treatment option for selected patients with alcohol withdrawal or agitation in dementia. However, solid evidence of its efficacy in the scientific literature is lacking. High-quality trials remain necessary to fully sustain its use in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13030,"journal":{"name":"Human Psychopharmacology: Clinical and Experimental","volume":"37 5","pages":""},"PeriodicalIF":1.7,"publicationDate":"2022-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40310648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 3
5-MeO-DMT has not been found in traditional ayahuasca preparations and the combination of 5-MeO-DMT with MAOIs is dangerous 在传统的死藤水制剂中未发现5‐MeO‐DMT,并且5‐MeO‐DMT与MAOIs的组合是危险的
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-03-17 DOI: 10.1002/hup.2839
Rafael Lancelotta
I was concerned to read the section about 5‐MeO‐DMT in the published article entitled “N,N‐dimethyltryptamine and Amazonian ayahuasca plant medicine” (James et al., 2022). In particular, the mention of 5‐MeO‐DMT as being part of ayahuasca brews. There is no significant chemical evidence of 5‐MeO‐DMT being present in ayahuasca admixture plants. One of the plants that is commonly cited as containing 5‐MeO‐DMT is chaliponga or Diplopterys cabernara, but recent chemical analyses have shown that it instead contains high concentrations of N,N‐dimethyltryptamine (DMT) and N‐methyltryptamine (Diplopterys Cabrerana ‐ DMT‐Nexus Wiki, n.d.). The misinformation that 5‐MeO‐DMT is present in ayahuasca brews is dangerous, because there is a toxic interaction between 5‐MeO‐DMT and harmala alkaloids, such as those found in the B. Caapi vine (Shen et al., 2010). James et al., 2022 cite a paper by Riga et al., 2014 which, in its title, names 5‐MeO‐DMT as a component of ayahuasca brews. Although Riga et al., 2014 makes this claim in the title and in the introductory sentence, the article is not about the analysis of ayahuasca but rather is a study about the effects of 5‐MeO‐DMT on cortical function. In the introduction of the paper, they provide some references which supposedly provide evidence of 5‐MeO‐DMT being a constituent in ayahuasca brews. However, none of the articles that they provide as references do so. In turn, the references that Riga et al., 2014 provide as primary sources for that assertion are the following: McKenna, D. J., Towers, G. H. N., & Abbott, F. (1984). Monoamine oxidase inhibitors in South American hallucinogenic plants: Tryptamine and β‐carboline constituents of Ayahuasca. Journal of Ethnopharmacology, 10(2), 195–223. https://doi.org/10.1016/0378‐8741 (84)90003‐5 and McKenna, D. J. (2004). Clinical investigations of the therapeutic potential of ayahuasca: Rationale and regulatory challenges. Pharmacology & Therapeutics, 102(2), 111–129. https://doi.org/10.1016/j. pharmthera.2004.03.002 McKenna et al., 1984 make no mention of 5‐MeO‐DMT as being a constituent of any of the brews they analyzed. The only possibly similar mention in that article is the statement “A single sample of Diplopterys cabrerana (Plowman 6040), the Malpighiaceous admixture, was available for analysis and this also contained DMT together with an extremely trace amount of 5‐hydroxy‐DMT” (McKenna et al., 1984). Note that they write “extremely trace amount”, and in addition notice that they are describing 5‐HO‐ DMT, which is also known as bufotenine, which is not 5‐MeO‐ DMT. McKenna, 2004 is an article about the regulatory challenges of studying ayahuasca for clinical applications. It does not describe 5‐MeO‐DMT as a constituent of ayahuasca brews. Riga et al., 2014 provide Schultes & Hofmann, 1991 as another reference for 5‐MeO‐DMT being found in ayahuasca brews, but that reference is a book entitled “The botany and chemistry of hallucinogens” that is a general overview of
在发表的题为“N,N -二甲基色胺和亚马逊死藤水植物药”的文章中,我读到了关于5 - MeO - DMT的部分(James et al., 2022)。特别是,提到5 - MeO - DMT作为死藤水酿造的一部分。没有明显的化学证据表明死藤水混合物中存在5 - MeO - DMT。一种通常被认为含有5‐MeO‐DMT的植物是chaliponga或cabernara,但最近的化学分析表明,它含有高浓度的N,N‐二甲基色胺(DMT)和N‐甲基色胺(Diplopterys Cabrerana‐DMT‐Nexus Wiki, n.d)。死藤水中存在5‐MeO‐DMT的错误信息是危险的,因为5‐MeO‐DMT与苦藤生物碱之间存在毒性相互作用,例如在B. Caapi藤中发现的生物碱(Shen et al., 2010)。James et al., 2022引用了Riga et al., 2014年的一篇论文,该论文在标题中将5 - MeO - DMT命名为死藤水冲泡的一种成分。尽管Riga et al., 2014在标题和引言中提出了这一说法,但这篇文章并不是关于死藤水的分析,而是关于5 - MeO - DMT对皮质功能影响的研究。在论文的引言中,他们提供了一些参考文献,这些文献据称提供了死藤水冲泡中含有5 - MeO - DMT的证据。然而,他们提供的作为参考的文章都没有这样做。反过来,Riga et al., 2014提供的作为该断言主要来源的参考文献如下:McKenna, d.j., Towers, g.h.n., & Abbott, F.(1984)。南美致幻植物中的单胺氧化酶抑制剂:死藤水的色胺和β -碳碱成分。民族药理学杂志,10(2),195-223。https://doi.org/10.1016/0378‐8741(84)90003‐5和McKenna D. J.(2004)。死藤水治疗潜力的临床研究:基本原理和监管挑战。中国药理学杂志,2011(2),111-129。https://doi.org/10.1016/j。McKenna et al., 1984没有提到5 - MeO - DMT是他们分析的任何一种啤酒的成分。在那篇文章中,唯一可能类似的提到是这样的陈述:“有一个单一的双龙骨样本(Plowman 6040), malpiighiaceous混合物,可用于分析,其中也含有DMT以及极微量的5 -羟基- DMT”(McKenna et al., 1984)。请注意,他们写的是“极微量”,另外请注意,他们描述的是5‐HO‐DMT,也被称为丁fotenine,而不是5‐MeO‐DMT。McKenna, 2004是一篇关于研究死藤水临床应用的监管挑战的文章。它没有将5 - MeO - DMT描述为死藤水冲泡的成分。Riga et al., 2014提供了Schultes & Hofmann, 1991作为死藤水酿造中发现5 - MeO - DMT的另一个参考资料,但该参考资料是一本名为“致幻剂的植物学和化学”的书,该书概述了自然产生的致幻剂,有了这本书,我可以肯定地说,书中没有任何地方提到死藤水制剂中存在5 - MeO - DMT。很明显,这些文章都没有提供死藤水冲泡中含有5 - MeO - DMT的证据。此外,传播5 - MeO - DMT通常与哈拉马拉生物碱结合使用的信息在文化上是不准确的,并且可能有害。
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引用次数: 1
Reply to: 5-MeO-DMT has not been found in traditional ayahuasca preparations and the combination of 5-MeO-DMT with MAOIs is dangerous 在传统的死藤水制剂中未发现5‐MeO‐DMT,并且5‐MeO‐DMT与MAOIs的组合是危险的
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-03-17 DOI: 10.1002/hup.2840
Edward James, Joachim Keppler, Thomas L. Robertshaw, Ben Sessa
‐ ‐ disrupts
‐‐干扰
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引用次数: 1
Nx4 attenuated stress-induced activity of the anterior cingulate cortex—A post-hoc analysis of a randomized placebo-controlled crossover trial Nx4可减弱应激诱导的前扣带皮层活动——一项随机安慰剂对照交叉试验的事后分析
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-02-25 DOI: 10.1002/hup.2837
Luisa Herrmann, Vanessa Kasties, Cindy Boden, Meng Li, Yan Fan, Johan Van der Meer, Johannes C. Vester, Bernd Seilheimer, Myron Schultz, Sarah Alizadeh, Martin Walter

Objective

Stress-related symptoms are associated with significant health and economic burden. Several studies suggest Nx4 for the pharmacological management of the stress response and investigated the underlying neural processes. Here we hypothesized that Nx4 can directly affect the stress response in a predefined stress network, including the anterior cingulate cortex (ACC), which is linked to various stress-related symptoms in patients.

Methods

In a randomized, placebo-controlled, double-blind, crossover trial, 39 healthy males took a single dose of placebo or Nx4. Psychosocial stress was induced by the ScanSTRESS paradigm inside an MRI scanner, and stress network activation was analyzed in brain regions defined a priori.

Results

Using the placebo data only, we could validate the activation of a distinct neural stress pattern by the ScanSTRESS paradigm. For Nx4, we provide evidence of an attenuating effect on this stress response. A statistically significant reduction in differential stress-induced activation in the right supracallosal ACC was observed for the rotation stress task of the ScanSTRESS paradigm. The results add to previously published results of Nx4 effects on emotion regulation.

Conclusions

Our results strengthen the hypothesis that Nx4 modulates the stress response by reducing the activation in parts of the neural stress network, particularly in the ACC.

Trial registration: NCT02602275; ClinicalTrials.gov

目的应激相关症状与重大的健康和经济负担相关。一些研究表明Nx4可用于应激反应的药理学管理,并研究了潜在的神经过程。在这里,我们假设Nx4可以直接影响预定义的压力网络中的压力反应,包括与患者各种压力相关症状相关的前扣带皮层(ACC)。方法在一项随机、安慰剂对照、双盲、交叉试验中,39名健康男性服用单剂量安慰剂或Nx4。在MRI扫描仪内通过ScanSTRESS范式诱导心理社会压力,并在先验定义的大脑区域分析应激网络激活。结果仅使用安慰剂数据,我们可以通过ScanSTRESS范式验证不同神经应激模式的激活。对于Nx4,我们提供了对这种应力响应的衰减效应的证据。在ScanSTRESS范式的旋转应激任务中,观察到右胼胝体上ACC差异应激诱导激活的统计学显著减少。该结果补充了先前发表的Nx4对情绪调节的影响的结果。我们的研究结果加强了Nx4通过减少部分神经应激网络的激活来调节应激反应的假设,特别是在ACC中。试验注册:NCT02602275;ClinicalTrials.gov
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引用次数: 3
Estradiol treatment in young postmenopausal women with self-reported cognitive complaints: Effects on cholinergic-mediated cognitive performance 雌二醇治疗自我报告认知疾病的年轻绝经后妇女:对胆碱能介导的认知表现的影响
IF 1.7 4区 医学 Q3 CLINICAL NEUROLOGY Pub Date : 2022-02-24 DOI: 10.1002/hup.2838
Alexander C. Conley, Kimberly M. Albert, Brenna C. McDonald, Andrew J. Saykin, Julie A. Dumas, Paul A. Newhouse

Objective

Older women are at increased risk of developing Alzheimer's disease compared to men. One proposed reason is that following menopause there is a decline in estrogens. Estrogens are important for cholinergic functioning and attenuate the impact of cholinergic antagonists on cognitive performance in postmenopausal women. Self-reported or subjective cognitive complaints in middle or older age may represent a harbinger of cognitive decline and those who endorse cognitive complaints appear more likely to develop future cognitive impairment. However, the response of individuals with cognitive complaints after menopause to estrogen and the relationship to cholinergic functioning has not been investigated. This study investigated the effect of estrogen treatment using 17β-estradiol on cognitive performance following anticholinergic blockade in postmenopausal women and the relationship of this interaction with the level of self-reported (subjective) postmenopausal cognitive complaints.

Methods

Forty postmenopausal women (aged 50–60 years) completed a 3-month treatment regimen of either 1 mg oral estradiol or placebo. Participants then completed four challenge days in which they completed cognitive and behavioral tasks after one of four cholinergic antagonist drug conditions (oral mecamylamine (MECA), intravenous scopolamine, combined MECA and scopolamine, or PLC).

Results

Compared to PLC, the estradiol treated group performed worse on attention tasks under cholinergic challenge including the choice reaction time task and the critical flicker fusion task. In addition, participants who endorsed greater cognitive complaints showed reduced performance on the N-back working memory task, regardless of whether they received estradiol treatment.

Conclusions

The findings of this study indicate that estradiol treatment was unable to mitigate anticholinergic blockade in postmenopausal women with subjective cognitive complaints, and worsened performance on attention tasks. Moreover, the present study suggests that greater levels of cognitive complaints following menopause may be associated with an underlying decline in cholinergic function that may manifest as an inability to compensate during working memory tasks.

与男性相比,老年女性患阿尔茨海默病的风险增加。一个被提出的原因是绝经后雌激素会下降。雌激素对绝经后妇女的胆碱能功能起重要作用,并减弱胆碱能拮抗剂对认知能力的影响。中老年自我报告的或主观的认知抱怨可能是认知能力下降的先兆,那些认可认知抱怨的人似乎更有可能发展为未来的认知障碍。然而,绝经后有认知障碍的个体对雌激素的反应及其与胆碱能功能的关系尚未被调查。本研究探讨了17β-雌二醇雌激素治疗对绝经后妇女抗胆碱能阻断后认知表现的影响,以及这种相互作用与自我报告(主观)绝经后认知抱怨水平的关系。方法40例绝经后妇女(年龄50 ~ 60岁),分别口服雌二醇1 mg或安慰剂3个月。然后,参与者完成了为期四天的挑战,在四种胆碱能拮抗剂药物条件(口服美甲胺(MECA),静脉注射东莨菪碱,MECA和东莨菪碱联合或PLC)之一后,他们完成了认知和行为任务。结果雌二醇治疗组在选择反应时间任务和关键闪烁融合任务等胆碱能挑战下的注意任务上表现较差。此外,无论是否接受雌二醇治疗,认知抱怨更严重的参与者在N-back工作记忆任务中的表现都有所下降。结论本研究结果表明,雌二醇治疗不能缓解有主观认知障碍的绝经后妇女的抗胆碱能阻滞,并使注意力任务的表现恶化。此外,目前的研究表明,绝经后更严重的认知抱怨可能与潜在的胆碱能功能下降有关,胆碱能功能下降可能表现为在工作记忆任务中无法补偿。
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引用次数: 1
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Human Psychopharmacology: Clinical and Experimental
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