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Acute inflammation induced by the Escherichia coli lipopolysaccharide considerably increases the systemic and brain exposure of olanzapine after oral administration in mice. 小鼠口服奥氮平后,大肠杆菌脂多糖引起的急性炎症显著增加了全身和脑暴露量。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf036
Jan Hubeňák, Martin Mžik, Hana Laštůvková, David Bayer, Lenka Jandová, Jolana Schreiberová, Ctirad Andrýs, Stanislav Mičuda, Jiří Masopust, Jaroslav Chládek

Background: A detailed understanding of alterations in olanzapine pharmacokinetics during acute inflammatory states, associated with infections, remains lacking. This study aimed to investigate the impact of endotoxemia on the pharmacokinetics of olanzapine and desmethylolanzapine (DMO) in mice.

Methods: C57BL/6N mice received an intraperitoneal injection of lipopolysaccharide (LPS, 5 mg/kg) or saline (controls), followed 24 hours later by single oral or intravenous doses of olanzapine or intravenous DMO. Concentrations and unbound fractions of olanzapine and DMO were measured in the plasma and brain homogenates.

Results: In LPS-injected mice, the area under the concentration-time curve (AUCs) for olanzapine increased 3.8-fold in the plasma and 5.2-fold in brain homogenates, in consequence of a higher absolute bioavailability of olanzapine (+200%), a lower plasma clearance (-34%), and a higher brain penetration ratio for the unbound drug relative to controls (Kp,uu,brain 6.2 vs. 4.1). LPS attenuated the hepatic mRNA expression of cytochrome P450 1A2 and the metabolism of olanzapine to DMO. However, the AUC of plasma DMO increased by 140% due to a 4.8-fold decrease in the plasma clearance of DMO. The brain penetration of DMO was minimal (Kp,uu,brain ≤ 0.051). The LPS-injected mice exhibited a downregulation of the hepatic and ileal mRNA expression of P-glycoprotein (Abcb1a), whereas the expression of Abcb1a and Abcb1b in the brain was upregulated.

Conclusions: Endotoxemia notably increases olanzapine concentrations in the plasma and brain following oral administration in mice. Further studies should clarify whether altered pharmacokinetics results in adverse effects in acutely infected patients taking oral olanzapine.

背景:对急性炎症状态下奥氮平药代动力学变化的详细了解,与感染相关,仍然缺乏。本研究旨在探讨内毒素血症对奥氮平和去甲基氮平(DMO)在小鼠体内药代动力学的影响。方法:C57BL/6N小鼠腹腔注射脂多糖(LPS, 5 mg/kg)或生理盐水(对照组),24小时后单次口服或静脉注射奥氮平或静脉注射DMO。测定血浆和脑匀浆中奥氮平和DMO的浓度和未结合组分。结果:在lps注射小鼠中,奥氮平在血浆中的浓度-时间曲线下面积(auc)增加了3.8倍,在脑匀浆中增加了5.2倍,这是因为奥氮平的绝对生物利用度更高(+ 200%),血浆清除率更低(- 34%),与对照组相比,未结合药物的脑渗透比更高(Kp,uu,脑6.2 vs. 4.1)。LPS降低了肝脏细胞色素P450 1A2 mRNA的表达,降低了奥氮平对DMO的代谢。然而,由于血浆DMO清除率降低了4.8倍,血浆DMO的AUC增加了140%。DMO的脑侵彻最小(Kp,uu,脑≤0.051)。lps注射小鼠肝脏和回肠p -糖蛋白(Abcb1a) mRNA表达下调,而脑内Abcb1a和Abcb1b表达上调。结论:内毒素血症显著增加小鼠口服奥氮平后血浆和脑内浓度。进一步的研究将阐明口服奥氮平的急性感染患者的药代动力学改变是否会导致不良反应。
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引用次数: 0
Activating group II metabotropic glutamate receptors in the basolateral amygdala inhibits increases in reward seeking triggered by discriminative stimuli in rats. 激活基底外侧杏仁核II组代谢性谷氨酸受体抑制大鼠鉴别刺激引发的奖赏寻求增加。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf030
Mandy Rita LeCocq, Amélie Mainville-Berthiaume, Isabel Laplante, Anne-Noël Samaha

Background: Reward-associated cues guide reward-seeking behaviors. These cues include conditioned stimuli (CSs), which occur following seeking actions and predict reward delivery, and discriminative stimuli (DSs), which occur response-independently and signal that a seeking action will produce reward. Metabotropic group II glutamate (mGlu2/3) receptors in the basolateral amygdala (BLA) modulate CS-guided reward seeking; however, their role in DS effects is unknown.

Methods: We developed a procedure to assess DS and CS effects on reward seeking in the same subjects within the same test session. Female and male rats self-administered sucrose where DSs signaled periods of sucrose availability (DS+) and unavailability (DS-). During DS+ trials, lever presses produced sucrose paired with a CS+. During DS- trials, lever presses produced a CS- and no sucrose. Across 14 sessions, rats learned to load up on sucrose during DS+ trials and inhibit responding during DS- trials. We then determined the effects of intra-BLA microinfusions of the mGlu2/3 receptor agonist LY379268 on cue-evoked sucrose seeking during a test where the DSs and CSs were presented response-independently, without sucrose. Before testing, rats received intra-BLA microinjections of artificial cerebrospinal fluid (aCSF) or LY379268.

Results: Under aCSF, only the DS+ and DS+CS+ combination triggered increases in reward-seeking behavior. The CS+ alone was ineffective. Intra-BLA LY379268 suppressed the increases in sucrose seeking triggered by the DS+ and DS+CS+ combination.

Conclusions: Using a new procedure to test reward seeking induced by DSs and CSs, we show that BLA mGlu2/3 receptor activity mediates the incentive motivational effects of reward-predictive DSs.

背景:奖励相关线索引导寻求奖励行为。这些线索包括条件刺激(CSs)和判别刺激(ds),前者发生在寻找行为之后,并预测奖励的传递;后者发生在反应独立的情况下,表明寻找行为将产生奖励。基底外侧杏仁核(BLA)代谢性II组谷氨酸(mGlu2/3)受体调节cs引导的奖赏寻求;然而,它们在DS效应中的作用尚不清楚。方法:我们开发了一个程序来评估DS和CS在同一测试阶段对同一受试者的奖励寻求的影响。雌性和雄性大鼠自我给予蔗糖,其中DSs表示蔗糖可用期(DS+)和不可用期(DS-)。在DS+试验中,活性杠杆压力机产生与CS+配对的蔗糖。在DS-试验中,主动杠杆压力机只产生CS-而不产生蔗糖。在14个实验中,大鼠在DS+试验中学会了大量摄入蔗糖,而在DS-试验中则学会了抑制反应。然后,我们比较了在bla内微量输注mGlu2/3受体激动剂LY379268对线索诱发的蔗糖寻求的影响,在没有蔗糖的情况下,DSs和CSs单独出现反应。实验前,大鼠接受bla内微注射人工脑脊液(aCSF)或LY379268。结果:在aCSF下,只有DS+和DS+CS+组合触发了寻求奖励行为的增加。单独使用CS+无效。Intra-BLA LY379268降低了DS+和DS+CS+组合引发的蔗糖寻找。结论:我们采用一种新的方法来测试由奖励预测性决策决策引起的奖励寻求,表明BLA mGlu2/3受体活性介导了奖励预测性决策决策的条件激励效应。
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引用次数: 0
Acute effects of intranasal esketamine application on thalamic structures in healthy individuals. 鼻内应用艾氯胺酮对健康人丘脑结构的急性影响。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf037
Benjamin Spurny-Dworak, Thomas Liebe, Samantha Graf, Gregor Dörl, Peter Stöhrmann, Elisa Briem, Manfred Klöbl, Clemens Schmidt, Marie Spies, Rupert Lanzenberger

Background: The N-methyl-D-aspartate receptor antagonist ketamine has found broad application in the field of psychiatry. Due to its rapid antidepressant and anti-suicidal properties, it is used as a treatment for major depressive disorder. Furthermore, ketamine evokes dissociative and psychotropic states, which allows the modeling of schizophrenic symptoms. The thalamus, a main target for ketamine's actions, consists of different nuclei responsible for sensory gating, attention, and consciousness. Thus, we here examine the effects of intranasally applied ketamine on thalamic structures in healthy individuals in a cross-over placebo-controlled study.

Methods: Twenty-six subjects (14 female, mean age ± SD = 24.3 ± 3 years) underwent two magnetic resonance imaging scans on a 3T system immediately after receiving a subanesthetic dose of 56 mg esketamine (2x Spravato 28mg nasal sprays) or placebo in a cross-over study design. FreeSurfer was used for morphological analysis of the thalamus and its distinct nuclei based on derived T1-weighted MPRAGE images. Repeated measure analyses of covariance across the whole group, regardless of measurement order, and the subgroup, receiving placebo in the first scan, were performed for the thalamus and all its nuclei, for each hemisphere, separately. Post hoc tests on thalamic nuclei were done in an exploratory manner.

Results: We found a significant volume increase in the right thalamus (pcorr. = .048), the pulvinar anterior nucleus (p = .048), and the right mediodorsal lateral parvocellular (p = .034) after esketamine in the subsample receiving placebo application in the first scan.

Conclusion: Our results suggest rapid structural adaptations in right thalamic structures which serve as relay stations for the visual cortex. This emphasizes the thalamus' role in visual perception after esketamine and its importance as a target to model schizophrenic symptoms.

背景:n -甲基- d -天冬氨酸受体拮抗剂氯胺酮在精神病学领域有广泛的应用。由于其快速抗抑郁和抗自杀的特性,它被用作治疗重度抑郁症。此外,氯胺酮引起分离和精神状态,从而可以模拟精神分裂症症状。丘脑是氯胺酮作用的主要目标,它由负责感觉门控、注意力和意识的不同核组成。因此,我们在一项交叉安慰剂对照研究中研究了鼻内应用氯胺酮对健康人丘脑结构的影响。方法:在交叉研究设计中,26名受试者(14名女性,平均年龄±SD = 24.3±3岁)在接受亚麻醉剂量56mg艾氯胺酮(22x Spravato®28mg鼻喷雾剂)或安慰剂后立即在3T系统上进行了两次MRI扫描。使用FreeSurfer基于衍生的t1加权MPRAGE图像对丘脑及其不同核进行形态学分析。无论测量顺序如何,整个组和在第一次扫描中接受安慰剂的亚组分别对丘脑及其所有核进行了rmancova。采用探索性方法对丘脑核进行事后检测。结果:我们发现右丘脑(pcorr)体积显著增加。= 0.048),枕前核(p = 0.048)和右中背外侧旁细胞(p = 0.034),在第一次扫描中接受安慰剂应用的亚样本中使用艾氯胺酮后。结论:我们的研究结果表明,作为视觉皮层中继站的右丘脑结构具有快速的结构适应性。这强调了艾氯胺酮后丘脑在视觉感知中的作用,以及作为模拟精神分裂症症状的目标的重要性。
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引用次数: 0
Inhibition of hippocampal or thalamic inputs to the nucleus accumbens reverses stress-induced alterations in dopamine system function. 抑制海马或丘脑对伏隔核的输入可逆转应激诱导的多巴胺系统功能改变。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf034
Hannah B Elam, Alexandra M McCoy, Angela M Boley, Olivia J Yang, Natalie I Belle, Daniel J Lodge

Background: Symptoms of psychosis are often observed in patients with post-traumatic stress disorder (PTSD) and are driven by aberrant regulation of the mesolimbic dopamine system. We have previously shown that targeting upstream brain regions that regulate dopamine neuron activity, the ventral hippocampus (vHipp), and paraventricular nucleus of the thalamus (PVT) maybe a novel approach to restore dopamine system function. The vHipp and PVT work in concert to regulate ventral tegmental area (VTA) dopamine neuron activity through a multisynaptic circuit that begins with inputs to the nucleus accumbens (NAc). Therefore, we hypothesized that inhibition of projections from either the vHipp or PVT to the NAc would reverse stress-induced alterations in dopamine system function.

Methods: In this study, we induced stress-related pathophysiology in rats using a 2-day inescapable foot shock procedure. We then examined if foot shock stress altered the firing patterns and coordinated neuronal activity within vHipp and PVT circuits. Finally, we examined if chemogenetic inhibition of NAc afferents could reverse stress-induced alterations in dopamine system function.

Results: We observed a significant increase in coherence between the PVT and NAc up to 48 hours after foot shock stress. In addition, stress increased VTA dopamine neuron population activity, which was reversed following chemogenetic inhibition of either vHipp-NAc or PVT-NAc projections.

Conclusions: Taken together, these results suggest that increased coherence between the PVT and NAc, following stress, may contribute to psychosis-like symptoms but targeting either the PVT or vHipp may be viable options for the treatment of comorbid psychosis related to PTSD.

背景:创伤后应激障碍(PTSD)患者常出现精神病症状,并由中脑边缘多巴胺系统的异常调节驱动。我们之前已经表明,针对调节多巴胺神经元活动的上游大脑区域,腹侧海马(vHipp)和丘脑室旁核(PVT),可能是一种恢复多巴胺系统功能的新方法。vHipp和PVT通过从伏隔核(NAc)输入开始的多突触回路协同调节腹侧被盖区(VTA)多巴胺神经元的活动。因此,我们假设抑制从vHipp或PVT到NAc的投射可以逆转应激引起的多巴胺系统功能的改变。方法:在这项研究中,我们采用为期两天的不可避免的足部电击程序诱导大鼠的应激相关病理生理。然后,我们检查足部休克应激是否改变了vHipp和PVT回路中的放电模式和协调的神经元活动。最后,我们研究了NAc传入的化学发生抑制是否可以逆转应激诱导的多巴胺系统功能改变。结果:我们观察到足部休克应激后48小时PVT和NAc之间的一致性显著增加。此外,应激增加了VTA多巴胺神经元群的活性,而在化学发生抑制vhip - nac或PVT-NAc投射后,这一现象被逆转。结论:综合这些结果表明,应激后PVT和NAc之间的一致性增加可能导致类似精神病的症状,但针对PVT或vHipp可能是治疗与PTSD相关的共病精神病的可行选择。
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引用次数: 0
Safety and efficacy with esketamine in treatment-resistant depression: long-term extension study. 艾氯胺酮治疗难治性抑郁症的安全性和有效性:长期扩展研究。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf027
Naim Zaki, Li Nancy Chen, Rosanne Lane, Teodora Doherty, Wayne C Drevets, Randall L Morrison, Gerard Sanacora, Samuel T Wilkinson, Allan H Young, Acioly L T Lacerda, Jong-Woo Paik, Vanina Popova, Dong-Jing Fu
<p><strong>Importance: </strong>The rates of relapse and suicide risk are higher in treatment-resistant depression (TRD) vs non-treatment-resistant major depressive disorder. Even among patients with TRD who initially respond, the majority (70%) relapse within 6 months.</p><p><strong>Objective: </strong>To evaluate the long-term safety and efficacy of esketamine nasal spray, combined with an oral antidepressant, in patients with TRD.</p><p><strong>Design: </strong>Phase 3, open-label, single-arm long-term extension study (SUSTAIN-3) conducted from June 2016 to December 2022.</p><p><strong>Setting: </strong>Outpatient.</p><p><strong>Participants: </strong>Adults with TRD who participated in ≥1 of 6 phase 3 "parent" studies continued esketamine by either entering a 4-week induction phase followed by an optimization/maintenance phase of variable duration (n = 458) or directly entering the optimization/maintenance phase of SUSTAIN-3 (n = 690), based on their individual response to study drug at the endpoint of the parent study.</p><p><strong>Interventions: </strong>Intranasal esketamine dosing was flexible, twice-weekly during induction and individualized to depression severity during optimization/maintenance (weekly, every-other-week, or every-4-weeks), under direct supervision by site staff.</p><p><strong>Main outcomes and measures: </strong>To assess the long-term safety of esketamine. Efficacy endpoints included the change in depressive symptoms, assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS).</p><p><strong>Results: </strong>A total of 1148 patients were enrolled. Total exposure to esketamine was 3777 cumulative patient-years. Mean (median, range) exposure to esketamine in SUSTAIN-3 was 42.9 (45.8, range 0-79) months. The most common adverse events were headache (36.9%), dizziness (33.9%), nausea (33.6%), dissociation (25.5%), nasopharyngitis (23.8%), somnolence (23.1%), dysgeusia (20.2%), and back pain (20.0%). During the study, 5.3% and 6.4% of participants discontinued due to lack of efficacy or adverse event, respectively. Nine participants died: COVID-19-related (n = 3), pneumonia (n = 2), and completed suicide, myocardial infarction, multiple injuries, unknown cause (n = 1 each). The mean MADRS total score decreased during induction, and this reduction persisted during optimization/maintenance (mean [SD] change from baseline-to-phase endpoint of each phase: induction: -12.8 [9.73]; optimization/maintenance: + 0.2 [9.93]). A total of 35.6% of participants were in remission at the induction endpoint, and 48.5% and 49.6% at week 112 and optimization/maintenance endpoint, respectively.</p><p><strong>Conclusions and relevance: </strong>In the SUSTAIN-3 final dataset, no new safety signals were identified during long-term treatment with intermittently-dosed esketamine, combined with oral antidepressant, and improvement in depression generally persisted among participants who remained on maintenance treatment. These results add
重要性:难治性抑郁症(TRD)的复发率和自杀风险高于非难治性重度抑郁症。即使在最初有反应的TRD患者中,大多数(70%)在6个月内复发。目的:评价艾氯胺酮鼻腔喷雾剂联合口服抗抑郁药治疗TRD患者的长期安全性和有效性。设计:第三期,开放标签,单臂长期扩展研究(SUSTAIN-3),于2016年6月至2022年12月进行。设置:门诊。参与者:参加6个3期“父母”研究中≥1个的TRD成人通过进入4周诱导期,随后是可变持续时间的优化/维持期(n=458),或直接进入SUSTAIN-3的优化/维持期(n=690)继续使用艾氯胺酮,基于他们在父母研究终点对研究药物的个体反应。干预措施:鼻内艾氯胺酮剂量灵活,诱导期间每周两次,优化/维持期间根据抑郁严重程度进行个体化(每周、每隔一周或每4周),由现场工作人员直接监督。主要观察结果和措施:评价艾氯胺酮的长期安全性。疗效终点包括抑郁症状的改变,由Montgomery-Åsberg抑郁评定量表(MADRS)评估。结果:入组1148例患者。艾氯胺酮的总暴露量为3,777累计患者年。在SUSTAIN-3中,埃氯胺酮暴露的平均(中位数,范围)为42.9个月(45.8个月,范围0-79)。最常见的不良事件为头痛(36.9%)、头晕(33.9%)、恶心(33.6%)、精神分离(25.5%)、鼻咽炎(23.8%)、嗜睡(23.1%)、语言障碍(20.2%)和背痛(20.0%)。在研究期间,分别有5.3%和6.4%的参与者因缺乏疗效或不良事件而停止治疗。9名参与者死亡:与COVID-19相关(n=3),肺炎(n=2),完成自杀,心肌梗死,多重损伤,未知原因(各n=1)。平均MADRS总分在诱导过程中下降,并且在优化/维护过程中持续下降(从每个阶段的基线到阶段终点的平均[SD]变化:诱导:-12.8 [9.73];优化/维护:+0.2[9.93])。在诱导终点,35.6%的参与者缓解,在第112周和优化/维持终点,分别为48.5%和49.6%。结论和相关性:在SUSTAIN-3最终数据集中,间歇性给药艾氯胺酮联合口服抗抑郁药长期治疗期间没有发现新的安全性信号,并且在继续维持治疗的参与者中,抑郁症的改善通常持续存在。这些结果增加了用艾氯胺酮治疗TRD的累积证据。
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引用次数: 0
Exploring the risk of adverse drug events in combination with antiparkinsonics and antipsychotics-a two-decade real-world pharmacovigilance analysis based on the FAERS database. 探索与抗帕金森药和抗精神病药联合使用的药物不良事件的风险-基于FAERS数据库的二十年现实世界药物警戒分析。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf033
Junyi Wang, Sen Lin, Chen Bai, Huimin Zhang, Haoqi Liu, Min Wang, Rongjuan Guo

Background: The combination of antiparkinsonics and antipsychotic drugs (AP) can improve the motor and mental symptoms of Parkinson's disease (PD) and reduce the actual burden of chronic disease care. To explore the adverse drug events (ADEs) worthy of attention in this treatment management process, we conducted a real-world pharmacovigilance analysis based on the FDA Adverse Event Reporting System (FAERS) database.

Methods: The Standard pharmacotherapy for PD includes Levodopa/Carbidopa, Entacapone, Rasagiline, Pramipexole, Ropinirole, Rotigotine, Apomorphine, Amantadine, etc. Antipsychotic drug includes Quetiapine, Clozapine, and Pimavanserin. We collected the ADEs reports of FAERS that conformed to the combination regimens of anti-Parkinson's drugs and AP during the 20-year period from the third quarter of 2004 to the second quarter of 2024. Disproportionate analysis and subgroup analysis were conducted through 5 algorithms, namely Ω shrinkage measure, additive model, multiplicative model, Combination risk ratio, and Chi-square. The time-to-onset (TTO) analysis was used to predict the variation of the risk size of ADEs occurrence over time. Finally, we explored the correlation between population characteristics and the occurrence of ADEs through Logistic regression.

Results: We collected a total of 6297 cases, including 38 316 ADEs records. The results of the disproportionate analysis show that the ADEs with the highest occurrence frequency include hallucination, general physical health deterioration, somnolence, stoma site discharge, urinary tract infection, memory impairment, etc. The TTO analysis results showed that the median TTO for all ADEs was 657.50 days, the median TTO for infection and inflammation was 716.00 days, and the median TTO for psychiatric symptoms was 823.00 days. All median TTOs conform to the early failure curve. The results of Logistic regression showed that gender was correlated with the occurrence of infection and inflammation, and the female population was more inclined to have important medical events related to infection and inflammation.

Conclusions: During the combined application of antiparkinsonics and AP, in addition to ADEs such as movement disorders and emerging mental symptoms, the risks of infection and inflammation should also be given key attention. Long-term follow-up should run through the entire process of disease diagnosis and treatment, and attention should be paid to the influence of drug dosage forms and dosages. The medication plan should be adjusted in a timely manner when ADEs occur.

背景:抗帕金森药物联合抗精神病药物(AP)可改善帕金森病(PD)的运动和精神症状,减轻慢性病护理的实际负担。为了探讨该治疗管理过程中值得关注的药物不良事件(ADEs),我们基于FDA不良事件报告系统(FAERS)数据库进行了现实世界的药物警戒分析。方法:PD的标准药物治疗包括左旋多巴/卡比多巴、恩他卡彭、雷沙吉兰、普拉克索、罗匹尼罗、罗替戈汀、阿波啡、金刚烷胺等。AP包括喹硫平、氯氮平和匹马万色林。我们收集了2004年第三季度至2024年第二季度20年间符合抗帕金森药物和AP联合方案的FAERS的ADEs报告。通过Ω收缩测度、加性模型、乘性模型、组合风险比、卡方五种算法进行不成比例分析和亚组分析。发作时间(TTO)分析用于预测ade发生的风险大小随时间的变化。最后,我们通过Logistic回归探讨了人群特征与ade发生的相关性。结果:共收集6297例,其中ade记录38316例。不成比例分析结果显示,发生率最高的不良事件包括幻觉、一般身体健康状况恶化、嗜睡、造口部位分泌物、尿路感染和记忆障碍等。TTO分析结果显示,所有不良事件的中位TTO为657.50天,感染和炎症的中位TTO为716.00天,精神症状的中位TTO为823.00天。所有中位tto均符合早期失效曲线。Logistic回归结果显示,性别与感染和炎症的发生相关,女性人群更倾向于发生与感染和炎症相关的IME。结论:抗帕金森药与AP联合应用时,除了运动障碍和新出现的精神症状等不良事件外,还应重点关注感染和炎症的风险。长期随访应贯穿疾病诊疗全过程,并注意药物剂型和剂量的影响。发生不良反应时应及时调整用药计划。
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引用次数: 0
Roluperidone monotherapy, a treatment for negative symptoms in schizophrenia. 鲁哌酮单药治疗精神分裂症阴性症状。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf032
Michael Davidson, Nadine Noel, Florent Schmitt, Remy Luthringer

Roluperidone is a drug in development targeting primary negative symptoms in schizophrenia, which binds sigma-2, 5-HT2A, and alpha1a receptors. Roluperidone administered as monotherapy to patients suffering from mild to moderate negative symptoms and withdrawal from antipsychotic drugs, improved negative symptoms in 2 clinical trials. The patients who were symptomatically stable for 3 or 6 months before antipsychotic drug withdrawal showed a very low rate of psychotic symptoms worsening over 6 or 9-month trial duration. Focus: Treatment of primary negative symptoms in a subgroup of patients suffering from schizophrenia.

罗鲁哌酮是一种正在开发的药物,针对精神分裂症的原发性阴性症状,结合sigma- 2,5 - ht2a和alpha1a受体。在两项临床试验中,罗鲁哌酮作为单一疗法用于患有轻度至中度阴性症状并停用抗精神病药物的患者,改善了阴性症状。停用抗精神病药物前症状稳定3 - 6个月的患者,在6 - 9个月的试验期间精神病症状恶化的发生率极低。焦点:精神分裂症患者亚组原发性阴性症状的治疗
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引用次数: 0
Pharmacological modulation of directed network communication and neural hubs in action-effect integration. 定向网络通信和神经中枢在行动-效果整合中的药理调节。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf031
Jasmin Mayer, Anna Helin Koyun, Moritz Mückschel, Veit Roessner, Bernhard Hommel, Christian Beste

Background: Acting intentionally requires individuals to anticipate the effects of their actions. Recent work has revealed the neural oscillatory dynamics underlying the establishment of action-effect bindings, which are vital to anticipating action effects. However, the neurobiological basis of these processes is elusive.

Methods: Healthy adult participants (N = 54) engaged in a double-blind, counter-balanced, placebo-controlled experiment in which they worked in an experiment able to examine how action effects are planned, anticipated, and processed under placebo and methylphenidate conditions. Electroencephalogram data were analyzed to investigate the directed communication in cortical networks underlying action effect integration.

Results: We show that an increase in catecholaminergic system activity alters the strength of directed communication in a cortical theta frequency network constituted by the insular cortex, the anterior temporal lobe, and the inferior frontal cortex. Additionally, pharmacological modulation regulates which of the brain structures act as a hub in different phases of the action-effect binding process.

Conclusions: The findings highlight how the neural organization of processes supporting intentional action can be optimized neurobiologically through the catecholaminergic system.

背景:有意识的行为要求个体预测其行为的后果。最近的工作揭示了神经振荡动力学背后的建立动作-效果绑定,这是至关重要的预测动作效果。然而,这些过程的神经生物学基础是难以捉摸的。方法:健康成人参与者(N=54)参与了一个双盲、平衡、安慰剂对照的实验,在这个实验中,他们参与了一个能够检查在安慰剂和MPH条件下如何计划、预期和处理动作效果的实验。分析脑电数据,探讨动作效应整合下皮层网络的定向通讯。结果:我们发现,儿茶酚胺系统活性的增加改变了由岛叶皮层、前颞叶和额叶下皮层组成的皮层θ频率网络中定向通信的强度。此外,药理学调节哪一种脑结构在作用-效应结合过程的不同阶段起枢纽作用。结论:研究结果强调了支持有意行为的过程的神经组织如何通过儿茶酚胺能系统在神经生物学上得到优化。
{"title":"Pharmacological modulation of directed network communication and neural hubs in action-effect integration.","authors":"Jasmin Mayer, Anna Helin Koyun, Moritz Mückschel, Veit Roessner, Bernhard Hommel, Christian Beste","doi":"10.1093/ijnp/pyaf031","DOIUrl":"10.1093/ijnp/pyaf031","url":null,"abstract":"<p><strong>Background: </strong>Acting intentionally requires individuals to anticipate the effects of their actions. Recent work has revealed the neural oscillatory dynamics underlying the establishment of action-effect bindings, which are vital to anticipating action effects. However, the neurobiological basis of these processes is elusive.</p><p><strong>Methods: </strong>Healthy adult participants (N = 54) engaged in a double-blind, counter-balanced, placebo-controlled experiment in which they worked in an experiment able to examine how action effects are planned, anticipated, and processed under placebo and methylphenidate conditions. Electroencephalogram data were analyzed to investigate the directed communication in cortical networks underlying action effect integration.</p><p><strong>Results: </strong>We show that an increase in catecholaminergic system activity alters the strength of directed communication in a cortical theta frequency network constituted by the insular cortex, the anterior temporal lobe, and the inferior frontal cortex. Additionally, pharmacological modulation regulates which of the brain structures act as a hub in different phases of the action-effect binding process.</p><p><strong>Conclusions: </strong>The findings highlight how the neural organization of processes supporting intentional action can be optimized neurobiologically through the catecholaminergic system.</p>","PeriodicalId":14134,"journal":{"name":"International Journal of Neuropsychopharmacology","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12143126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Molecular targets of vortioxetine mediating glioblastoma suppression revealed by gene and protein network analyses and molecular docking simulations. 沃替西汀介导胶质母细胞瘤抑制的分子靶点通过基因和蛋白质网络分析和分子对接模拟揭示。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-06-06 DOI: 10.1093/ijnp/pyaf029
Chuanjun Zhuo, Chao Li, Qiuyu Zhang, Lei Yang, Ying Zhang, Ximing Chen, Xiaoyan Ma, Ranli Li, Lina Wang, Hongjun Tian

Background: Vortioxetine is a serotonin reuptake inhibitor and serotonin receptor modulator used for the treatment of major depressive disorder, but recent studies have also reported anticancer effects in models of glioblastoma. Given the well-established benefits of drug repositioning, we examined the pharmacological mechanism for these anticancer actions using bioinformatics and molecular docking.

Methods: Putative molecular targets for vortioxetine were identified by searching DrugBank, GeneCards, SwissTargetPrediction, Comparative Toxicogenomics Database, and SuperPred databases, while glioblastoma-related proteins were identified using GeneCards, Online Mendelian Inheritance in Man; , and Therapeutic Target Database . A protein-protein interaction (PPI) network was constructed from vortioxetine targets also involved in glioblastoma to identify core (hub) targets, which were then characterized by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analyses using database for annotation, visualization, and integrated discovery. Cytoscape was utilized to generate a drug-pathway-target-disease network, and molecular docking simulations were performed to evaluate direct interactions between vortioxetine and core target proteins.

Results: A total of 234 unique vortioxetine protein targets were identified. Among 234 vortioxetine targets identified, 48 were also related to glioblastoma. Topological analysis of the PPI network revealed 5 core targets: the serine/threonine kinase AKT1, transcription factor hypoxia-inducible factor (HIF)-1, cell adhesion molecule cadherin-E, NF-κB subunit p105, and prostaglandin-endoperoxide synthase 2. According to GO and KEGG pathway analyses, the anticancer efficacy of vortioxetine may be mediated by effects on glucose metabolism, cell migration, phosphorylation, inflammatory responses, apoptosis, and signaling via Rap1, chemical carcinogenesis-reactive oxygen species, and HIF-1. Molecular docking revealed moderately strong affinities between vortioxetine and 4 core targets.

Conclusions: This study suggests that vortioxetine may inhibit glioblastoma development through direct effects on multiple targets and further emphasizes the value of bioinformatics analyses for drug repositioning.

背景:Vortioxetine是一种5 -羟色胺再摄取抑制剂和5 -羟色胺受体调节剂,用于治疗重度抑郁症,但最近的研究也报道了其在胶质母细胞瘤模型中的抗癌作用。鉴于药物重新定位的好处,我们利用生物信息学和分子对接研究了这些抗癌作用的药理学机制。方法:通过检索DrugBank、GeneCards、SwissTargetPrediction、CTD和SuperPred数据库确定vortioxetine的推测分子靶点,使用GeneCards、OMIM和TTD识别胶质母细胞瘤相关蛋白。利用vortioxetine靶点构建了一个蛋白-蛋白相互作用(PPI)网络,以确定核心(枢纽)靶点,然后使用DAVID对其进行GO和KEGG途径富集分析。利用Cytoscape生成药物通路-靶标-疾病网络,并进行分子对接模拟以评估沃替西汀与核心靶蛋白之间的直接相互作用。结果:共鉴定出234个独特的沃替西汀蛋白靶点。在确定的234个vortioxetine靶点中,48个也与胶质母细胞瘤有关。对PPI网络的拓扑分析揭示了5个核心靶点:丝氨酸/苏氨酸激酶AKT1、转录因子缺氧诱导因子(HIF)-1、细胞粘附分子cadherin-E、NF-κB亚基p105和前列腺素内过氧化物合成酶2。根据GO和KEGG通路分析,vortioxetine的抗癌作用可能是通过影响葡萄糖代谢、细胞迁移、磷酸化、炎症反应、细胞凋亡以及通过Rap1、化学致癌-活性氧和HIF-1信号传导介导的。分子对接显示vortioxetine与四个核心靶点之间有中等强的亲和力。结论:本研究提示vortioxetine可能通过对多个靶点的直接作用抑制胶质母细胞瘤的发展,进一步强调了生物信息学分析在药物重新定位中的价值。
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引用次数: 0
Premorbid characteristics of the SAPAP3 mouse model of obsessive-compulsive disorder: behavior, neuroplasticity, and psilocybin treatment. 强迫症小鼠SAPAP3模型的病前特征:行为、神经可塑性和裸盖菇素治疗。
IF 3.7 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2025-05-09 DOI: 10.1093/ijnp/pyaf022
Michal Lazar, Michal Brownstien, Alexander Botvinnik, Chloe Shevakh, Orr Shahar, Tzuri Lifschytz, Bernard Lerer

Background: SAPAP3-knockout (SAPAP3-KO) mice develop excessive self-grooming behavior at 4-6 months of age, serving as a model for obsessive-compulsive disorder (OCD). Given that anxiety often precedes OCD diagnosis in humans, this study investigated whether juvenile SAPAP3-KO mice exhibit anxiety-like behaviors before developing the self-grooming phenotype, and whether such behaviors respond to psilocybin (PSIL) treatment. The study also examined 4 key neuroplasticity-related synaptic proteins-GAP43, PSD95, synaptophysin, and SV2A-as SAPAP3 is a postsynaptic scaffold protein that interacts with PSD95 and may affect synaptic function.

Methods: Two studies were conducted using male and female juvenile (10-13 weeks) SAPAP3-KO mice. Study 1 compared behavioral phenotypes between homozygous (HOM), heterozygous, and wild-type (WT) mice. Study 2 evaluated a different sample of HOM and WT mice and assessed the effect of PSIL (4.4 mg/kg) on identified behavioral differences. Both studies included comprehensive behavioral testing focused on anxiety-like behavior, social interaction, and cognitive function. Additionally, levels of 4 synaptic proteins were measured by western blots in the frontal cortex, hippocampus, amygdala, and striatum of juvenile and adult SAPAP3-KO mice.

Results: In both studies, juvenile HOM SAPAP3-KO mice showed significant anxiety-like behaviors compared to WT mice, spending less time in open field center, and elevated plus maze open arms. They also buried fewer marbles and found fewer buried Oreos than WT mice. Psilocybin treatment did not improve these behavioral manifestations. Analysis of synaptic proteins revealed significant increases in GAP43, synaptophysin, and SV2A across multiple brain regions in adult male HOM mice and of SV2A in the frontal cortex of HOM females compared to WT, but not in juvenile mice of either sex.

Conclusions: Juvenile SAPAP3-KO mice exhibit anxiety-like behaviors before developing the characteristic excessive self-grooming phenotype, paralleling the prodromal anxiety often seen in human OCD. Unlike in adult SAPAP3-KO mice, these manifestations were not responsive to PSIL treatment. The age-dependent increases in synaptic proteins observed in adult (but not juvenile) male SAPAP3-KO mice HOM for the deletion and to a lesser extent in female homozygotes, may represent compensatory plasticity changes in response to the phenotype. These results provide insights into the developmental trajectory of OCD-like behaviors and associated neuroplastic adaptations.

背景:sapap3基因敲除(SAPAP3-KO)小鼠在4-6月龄时出现过度的自我梳理行为,可作为强迫症(OCD)的模型。考虑到焦虑通常先于人类的强迫症诊断,本研究调查了幼年SAPAP3-KO小鼠在发展自我梳理表型之前是否表现出焦虑样行为,以及这种行为是否对裸盖菇素治疗有反应。该研究还检测了四种关键的神经可塑性相关突触蛋白- gap43, PSD95, synaptophysin和SV2A -因为SAPAP3是一种与PSD95相互作用并可能影响突触功能的突触后支架蛋白。方法:采用雄性和雌性幼年(10-13周龄)SAPAP3-KO小鼠进行两项研究。研究1比较了纯合子(homs)、杂合子(HET)和野生型(WT)小鼠的行为表型。研究2评估了不同的HOM和WT小鼠样本,并评估了裸盖菇素(4.4 mg/kg)对确定的行为差异的影响。两项研究都包括全面的行为测试,侧重于焦虑类行为、社会互动和认知功能。此外,通过western blots检测幼年和成年SAPAP3-KO小鼠额叶皮质、海马、杏仁核和纹状体中四种突触蛋白的水平。结果:在两项研究中,幼鼠HOM SAPAP3-KO与WT小鼠相比,表现出显著的焦虑样行为,在空地中心停留的时间较少,升高+迷宫张开双臂。它们埋下的弹珠和奥利奥也比WT小鼠少。裸盖菇素治疗并没有改善这些行为表现。突触蛋白分析显示,与WT相比,成年雄性HOM小鼠的多个脑区中GAP43、synaptophysin和SV2A以及雌性HOM小鼠额叶皮层中SV2A的表达均显著增加,但在雌雄幼鼠中均没有。结论:幼年SAPAP3-KO小鼠在出现特征性的过度自我梳理表型之前表现出焦虑样行为,与人类强迫症常见的前驱焦虑相似。与成年SAPAP3-KO小鼠不同,这些表现对裸盖菇素治疗没有反应。在成年(而非幼年)雄性SAPAP3-KO小鼠纯合子中观察到突触蛋白的年龄依赖性增加,在雌性纯合子中也有较小程度的增加,这可能代表了对表型的代偿性可塑性变化。这些结果为强迫症样行为的发展轨迹和相关的神经可塑性适应提供了见解。
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引用次数: 0
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International Journal of Neuropsychopharmacology
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