Journal of psychiatric research最新文献

Objectives: Childhood trauma (CT) increases risk for alcohol use disorder (AUD) and is linked to alterations in several brain regions. However, it remains unclear whether CT is associated with network-level resting-state functional connectivity (rs-FC) alterations in adults with AUD, and whether trauma subtypes show dissociable neural signatures. We examined associations between cumulative and subtype-specific CT exposure and amygdala- and insula-seeded rs-FC in adults with AUD versus healthy controls (HC).

Methods: The sample included 214 adults (120 with AUD; 94 HC) who underwent resting-state fMRI and comprehensive clinical assessment. CT exposure was retrospectively assessed using the Childhood Trauma Questionnaire (CTQ). Whole-brain seed-to-voxel rs-FC analyses were conducted using bilateral amygdala and insula seeds to probe connectivity with large-scale brain networks. Linear mixed-effects models tested interactions between diagnostic group (AUD vs. HC) and CT exposure (total CTQ score and exploratory subtype scores).

Results: Greater cumulative CT exposure was associated with weaker amygdala- and insula-centered rs-FC in AUD relative to HC. The most consistent effects involved reduced connectivity between these seeds-core nodes of the fronto-limbic and salience networks-and regions within the default mode network (DMN) and ventral visual stream. Exploratory CT subtype analyses (emotional abuse, emotional neglect, physical neglect) revealed largely overlapping rs-FC patterns.

Conclusions: CT is associated with a distinct pattern of network-level hypoconnectivity in adults with AUD, affecting circuits relevant to emotion regulation, memory, and socio-affective visual processing. The convergence of subtype-specific findings likely reflects high polytraumatization and widespread AUD-related network disruption and should be further investigated in future studies.

Background: Poor sleep quality is associated with adverse behavioural and brain-related outcomes, yet the neurobiological mechanisms remain incompletely understood. Because sleep is thought to support synaptic renormalization and network reorganization, structural-functional connectivity (SC-FC) coupling-indexing the correspondence between the brain's anatomical scaffold and resting-state functional interactions-may provide complementary sensitivity beyond structural or functional connectivity alone.

Methods: We analysed multimodal MRI data from 1037 adults in the Human Connectome Project. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI), and Mini-Mental State Examination (MMSE) total score was included as a coarse exploratory measure. Regional SC-FC coupling was quantified as the region-wise correspondence between diffusion-derived structural connectivity and resting-state functional connectivity profiles. We compared coupling between poor sleepers (PSQI>5) and good sleepers (PSQI≤5). We further used linear support vector regression (SVR) with leakage-controlled nested cross-validation to explore multivariate coupling patterns associated with PSQI. Finally, in secondary exploratory analyses, we tested whether regional coupling showed statistical indirect effects in the PSQI-MMSE association.

Results: Compared to good sleepers, poor sleepers exhibited reduced SC-FC coupling in frontoparietal and default-mode regions, alongside increased coupling in temporal subregions. SVR revealed a statistically significant but weak out-of-sample association between coupling features and PSQI, with negligible variance explained at the individual level. Additionally, coupling in frontal subregions showed small indirect effects in the PSQI-MMSE association.

Conclusion: Regional alterations in structure-function alignment were associated with subjective sleep quality, highlighting SC-FC coupling as a mechanistically interpretable marker of sleep-related brain differences. Further validation in clinical and longitudinal cohorts is needed.

Background: The benefits of acute physical exercise for substance use disorders have received extensive attention, but it is currently unclear whether adding repetitive transcranial magnetic stimulation (rTMS) based on exercise can achieve the superposition of benefits. This study aims to explore the acute effect and potential mechanism of rTMS combined with physical exercise on people with methamphetamine use disorders (MUD), and reveal the differences in effects among different models.

Methods: 64 men with MUD were randomly divided into the physical exercise group (PEG), low-frequency rTMS + physical exercise group (LF rTMS + PEG), high-frequency rTMS + physical exercise group (HF rTMS + PEG), and control group (CG) by an acute experimental study. The PEG was required to complete 35 min of moderate-intensity physical exercise, and the LF- and HF rTMS + PEG were required to complete the 1Hz and 10Hz rTMS tasks of 10 min based on the exercise group, respectively, while the CG only performed the reading task.

Results: Three acute interventions not only significantly reduce depression, anxiety, and psychological cravings in people with MUD but also enhance internal inhibition (particularly in the HF rTMS + PEG) and increase the levels of DA, β-EP, and 5-HT in the blood. Meanwhile, these acute effects persisted for up to 60 min post-intervention (except for anxiety), and the HF rTMS + PEG demonstrated relatively stronger sustainability of these effects. Moreover, electrophysiological data revealed that compared to neutral cues, people with MUD exhibited abnormal prefrontal activation (manifested as significantly lower Fz-alpha wave power) when exposed to drug-related cues at baseline. Then all three intervention groups showed significantly increased Fz-alpha wave power during drug-cue tasks immediately after intervention, and both the LF rTMS + PEG and HF rTMS + PEG maintained significantly higher values compared to the CG at 60 min post-intervention.

Conclusion: A single session of moderate-intensity physical exercise demonstrates acute benefits for both psychological and physiological withdrawal recovery in people with MUD. More importantly, it is essential to combine rTMS (particularly 10 Hz) with physical exercise, as this integrated approach can strengthen the sustainability of benefits and serve as an effective supplementary method to promote both physical and psychological recovery in this population.

Purpose: To examine differences in sociodemographic, clinical, and treatment-related variables between migrant and native patients with schizophrenia admitted to an acute psychiatric unit in Spain.

Methods: We conducted a retrospective cohort study including 689 patients with schizophrenia admitted to the Acute Psychiatric Unit of Santa María University Hospital (Lleida, Spain) between 2010 and 2020. Patients were classified as natives (n = 475) or migrants (n = 214). Group differences were examined using unadjusted comparisons. Multivariable logistic regression analyses were performed for a priori selected outcomes, adjusting for age, sex, and key social factors. Adherence was defined as pharmacological adherence prior to admission and attendance at a scheduled outpatient psychiatric visit one year after discharge.

Results: Migrant patients were younger and experienced greater social disadvantage. In adjusted analyses, migrant status remained independently associated with higher odds of hallucinations at admission (OR 1.33, 95% CI 1.12-1.59), lower odds of suicidal ideation (OR 0.78, 95% CI 0.65-0.94), and a higher likelihood of initiation of long-acting injectable antipsychotics during hospitalization (OR 1.30, 95% CI 1.09-1.53). Differences in first-episode presentation, other symptom profiles, and one-year follow-up adherence were attenuated after adjustment. Treatment differences at admission largely converged by discharge, and overall functioning at discharge was comparable between groups.

Conclusion: Migrant patients with schizophrenia experience social disadvantage and distinct care trajectories. Most differences were largely explained by social and structural factors rather than migrant status itself, although some clinically relevant differences persisted after adjustment, underscoring the importance of addressing social determinants of care.

Exposure to high levels of adversity, such as maltreatment or geopolitical conflict, is a robust risk factor for severe psychiatric illness and is often associated with reduced treatment efficacy. The glucocorticoid receptor co-chaperone FK506 Binding Protein 51 (FKBP51), encoded by FKBP5 (chromosome 6p21.31), is a key regulator of the cortisol-induced stress response and a potential therapeutic target for stress-related psychiatric disorders. FKBP5 induction is moderated by a complex interplay of clinically relevant features including age and genotype, however, little is known about the role of mRNA splicing and the resulting protein isoforms in the human brain. Here, we characterise the expression profiles of three minor FKBP5 transcript variants (variants 2-4) in a large cohort of postmortem human brain samples from the dorsolateral prefrontal cortex of individuals who lived with a major psychiatric disorder (schizophrenia/major depressive disorder/bipolar disorder; n = 329) and controls (n = 231). Overall, expression of variant 3 (encoding full-length FKBP51) and variant 4 (encoding truncated FKBP51) showed the same neurotypical ageing trajectory as variant 1, while the lowly expressed variant 2 (encoding full-length FKBP51) showed no association with ageing past adolescence. In individuals with schizophrenia and major depressive disorder, we found increased expression of the same variants which may be partly moderated by genotype, given rs1360780 risk allele carriers had increased abundance of variants 3 and 4, but not variant 2. These findings suggest that in the human dorsolateral prefrontal cortex, minor FKBP5 mRNA splice variants follow a similar pattern of expression as the predominant variant 1.