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Fluoxetine does not influence response to continuous theta burst stimulation in human motor cortex. 氟西汀不会影响人类运动皮层对连续θ脉冲刺激的反应。
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-07 DOI: 10.1002/npr2.12493
Duncan K Austin, Lourenço M D Amador, Lucia M Li, Simon J Little, John C Rothwell

Aim: Selective serotonin reuptake inhibitors are thought to exert a clinical effect through various mechanisms, including through alteration in synaptic plasticity. Repetitive transcranial magnetic stimulation can induce temporary changes in synaptic excitability in cerebral cortex that resemble long-term potentiation and long-term depression that serve as a measure of synaptic plasticity in vivo. A version of repetitive transcranial magnetic stimulation called continuous theta burst stimulation can induce inhibition of cortical excitability that can be measured through a motor evoked potential. Previous work has suggested that this response can be modulated by administration of selective serotonin reuptake inhibitors.

Method: Thirty-one healthy volunteers received both fluoxetine 20 mg and placebo in randomly ordered sessions, followed by spaced continuous theta burst stimulation to motor cortex. Changes in Motor Evoked Potentials were then recorded over 60 min.

Results: The response to spaced continuous theta burst stimulation did not differ significantly between fluoxetine and placebo sessions. Spaced continuous theta burst stimulation produced a paradoxical excitatory response in an unexpected number of participants.

Conclusion: A single dose of fluoxetine 20 mg does not influence the response to continuous theta burst stimulation. Previous results suggesting an effect of selective serotonin reuptake inhibitors on inhibitory non-invasive brain stimulation protocols may be due to insufficiently large sample sizes.

目的:选择性5-羟色胺再摄取抑制剂被认为通过各种机制产生临床效果,包括通过改变突触可塑性。重复经颅磁刺激可诱导大脑皮层突触兴奋性的暂时性变化,这种变化类似于长期延时和长期抑制,可作为体内突触可塑性的衡量标准。重复经颅磁刺激的一种形式称为连续θ脉冲刺激,可诱导抑制大脑皮层的兴奋性,这种抑制可通过运动诱发电位进行测量。以前的研究表明,这种反应可以通过服用选择性血清素再摄取抑制剂来调节:方法:31 名健康志愿者随机接受 20 毫克氟西汀和安慰剂治疗,然后对运动皮层进行间隔的连续θ脉冲刺激。然后记录 60 分钟内运动诱发电位的变化:结果:氟西汀和安慰剂对间隔连续θ脉冲刺激的反应没有显著差异。结果:氟西汀和安慰剂对间隔连续θ脉冲刺激的反应没有显著差异:结论:单剂量 20 毫克氟西汀不会影响对连续θ脉冲刺激的反应。之前的研究结果表明选择性血清素再摄取抑制剂对抑制性非侵入性脑刺激方案有影响,这可能是由于样本量不够大。
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引用次数: 0
Effects of repetitive transcranial magnetic stimulation therapy on weight and lipid metabolism in patients with treatment-resistant depression: A preliminary single-center retrospective cohort study. 重复经颅磁刺激疗法对耐药抑郁症患者体重和脂质代谢的影响:一项初步的单中心回顾性队列研究。
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-09 DOI: 10.1002/npr2.12494
Ami Nakazawa, Yuki Matsuda, Ryuichi Yamazaki, Nanase Taruishi, Shinsuke Kito

Aim: This study aimed to elucidate the effects of repetitive transcranial magnetic stimulation (rTMS) on weight, body mass index (BMI), and lipid metabolism in patients with treatment-resistant depression (TRD).

Methods: This retrospective observational study included patients with TRD who received rTMS treatment at the Jikei University Hospital from September 2018 to August 2021. The patients were diagnosed based on the DSM-5 and ICD-10 criteria and treated using the NeuroStar TMS System. For 3-6 weeks, 10-Hz rTMS was administered to the left dorsolateral prefrontal cortex at 120% motor threshold. The primary outcomes were changes in weight and BMI, whereas the secondary outcomes included changes in total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol levels, thyroid function indicators, as well as HAMD-17, HAMD-24, and Montgomery-Åsberg Depression Rating Scale (MADRS) scores. Statistical analysis was conducted using paired t-tests and repeated measures ANOVA.

Results: Among the 34 patients (20 men and 14 women) included, no significant changes were observed in weight or BMI after rTMS treatment (average weight reduction: -0.50 kg, 95% CI: -0.14 to 0.56, p = 0.24; average BMI reduction: -0.21, 95% CI: -0.10 to 0.61, p = 0.15). However, significant reductions in total, HDL, and LDL cholesterol levels and FT4 were observed. Furthermore, the HAMD-17, HAMD-24, and MADRS scores significantly increased post-treatment.

Conclusion: rTMS treatment did not affect weight or BMI in patients with TRD but is believed to improve lipid metabolism.

目的:本研究旨在阐明重复经颅磁刺激(rTMS)对治疗抵抗性抑郁症(TRD)患者的体重、体重指数(BMI)和脂质代谢的影响:这项回顾性观察研究纳入了2018年9月至2021年8月期间在慈惠大学医院接受经颅磁刺激治疗的TRD患者。患者根据DSM-5和ICD-10标准进行诊断,并使用NeuroStar TMS系统进行治疗。在3-6周的时间里,以120%的运动阈值对左侧背外侧前额叶皮层进行10赫兹经颅磁刺激。主要结果是体重和体重指数的变化,次要结果包括总胆固醇、高密度脂蛋白(HDL)和低密度脂蛋白(LDL)水平、甲状腺功能指标以及HAMD-17、HAMD-24和蒙哥马利-阿斯伯格抑郁量表(MADRS)评分的变化。统计分析采用配对 t 检验和重复测量方差分析:在接受经颅磁刺激治疗的 34 名患者(20 名男性和 14 名女性)中,体重或体重指数均未出现显著变化(平均体重减少:-0.50 千克,95% CI:-0.14 至 0.56,p = 0.24;平均体重指数减少:-0.21,95% CI:-0.10 至 0.61,p = 0.15)。不过,总胆固醇、高密度脂蛋白和低密度脂蛋白胆固醇水平以及 FT4 均有明显降低。此外,HAMD-17、HAMD-24 和 MADRS 评分在治疗后明显增加。
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引用次数: 0
Dysregulated HPA axis during postnatal developmental stages in the BTBR T+ Itpr3tf/J mouse: A model of autism spectrum disorder. BTBR T+ Itpr3tf/J小鼠出生后发育阶段HPA轴异常:自闭症谱系障碍模型
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-28 DOI: 10.1002/npr2.12508
Nozomi Endo, Atsuo Hiraishi, Sayaka Goto, Hitoshi Nozu, Takayo Mannari-Sasagawa, Noriko Horii-Hayashi, Michiko Kitsuki, Mamiko Okuda, Manabu Makinodan, Mayumi Nishi

Autism spectrum disorder (ASD) is a neurodevelopmental disorder. Some children with ASD show enhanced cortisol response to stress. BTBR T+ Itpr3tf/J (BTBR) mice, an ASD model, display behavior consistent with the three diagnostic categories of ASD and exhibit an exaggerated response to stress in adulthood. However, it remains unclear how basal corticosterone levels change and how the hypothalamic-pituitary-adrenal axis responds to stress during the early life stages in BTBR mice. In this study, we found that basal corticosterone levels showed characteristic changes, peaking at weaning during postnatal development in both BTBR and control C57BL/6J (B6J) mice. Furthermore, we observed higher corticosterone and corticotropin-releasing hormone levels in BTBR mice than in B6J mice following acute stress exposure during weaning; however, adrenocorticotropic hormone levels were lower in BTBR mice. Glucocorticoid receptor mRNA expression levels in the hippocampus and lateral septum after stress were higher in BTBR mice than in B6J mice. This study documented changes in corticosterone levels at baseline during postnatal development in mice and showed that BTBR mice exhibited disrupted stress responses at weaning.

自闭症谱系障碍(ASD)是一种神经发育障碍。一些自闭症儿童对压力的皮质醇反应增强。BTBR T+ Itpr3tf/J (BTBR)小鼠是一种ASD模型,其表现出与ASD的三种诊断类别一致的行为,并且在成年期表现出对压力的夸张反应。然而,在BTBR小鼠的早期生活阶段,基底皮质酮水平如何变化以及下丘脑-垂体-肾上腺轴如何对压力作出反应尚不清楚。在这项研究中,我们发现BTBR和对照C57BL/6J (B6J)小鼠的基础皮质酮水平出现特征性变化,在产后发育期间断奶时达到峰值。此外,我们观察到在断奶期间急性应激暴露后,BTBR小鼠的皮质酮和促肾上腺皮质激素释放激素水平高于B6J小鼠;然而,BTBR小鼠的促肾上腺皮质激素水平较低。应激后BTBR小鼠海马和侧隔糖皮质激素受体mRNA表达水平高于B6J小鼠。本研究记录了小鼠出生后发育期间皮质酮水平的基线变化,并表明BTBR小鼠在断奶时表现出中断的应激反应。
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引用次数: 0
Initial psychotropic prescriptions and symptom associations in first-visit patients with major depressive disorder: A single-center cross-sectional study. 重度抑郁障碍初诊患者的初始精神药物处方和症状关联:单中心横断面研究。
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-20 DOI: 10.1002/npr2.12507
Yugo Ishihara, Norio Sugawara, Yasushi Kawamata, Norio Yasui-Furukori

Aim: There are limited reports regarding psychotropic prescriptions in first-visit patients with major depressive disorder (MDD). The objective of this study is to clarify the prescription patterns of psychotropics and their association with symptoms among first-visit patients with MDD in Japan.

Methods: In this cross-sectional analysis, we examined 376 first-visit patients diagnosed with MDD. Depressive symptoms were evaluated using the Quick Inventory of Depressive Symptomatology Japanese version (QIDS-J). To assess personality traits, we administered the Japanese version of the Ten Item Personality Inventory (TIPI-J), and psychotic symptoms were evaluated using the PRIME Screen-Revised (PS-J).

Results: Among the first-visit patients with MDD, 31.4% (118/376) were prescribed antidepressants, and 18.1% (68/376) received benzodiazepines. Overall, 40.2% (151/376) of the patients were prescribed at least one psychotropic medication. In a multivariate logistic regression model using the forced entry method, missing data on educational attainment and the view of myself domain of the QIDS-J were negatively associated, while the concentration/decision-making domain of the QIDS-J was positively associated with antidepressant prescription.

Conclusion: More than half of the first-visit patients did not receive any psychotropic medication. Psychiatrists appear to consider specific symptoms and personality traits when deciding whether to prescribe medications, which may also be influenced by patient preferences. Further studies, including longitudinal analyses, are needed to explore these associations in more detail.

目的:有关重度抑郁障碍(MDD)初诊患者的精神药物处方的报道十分有限。本研究旨在阐明日本初诊重度抑郁症患者的精神药物处方模式及其与症状的关联:在这项横断面分析中,我们对 376 名被诊断为 MDD 的初诊患者进行了调查。抑郁症状采用抑郁症症状快速量表日文版(QIDS-J)进行评估。为了评估人格特征,我们使用了日文版十项人格量表(TIPI-J),并使用 PRIME 筛选-修订版(PS-J)评估了精神病性症状:在首次就诊的 MDD 患者中,31.4%(118/376)服用了抗抑郁药,18.1%(68/376)服用了苯二氮卓类药物。总体而言,40.2%(151/376)的患者至少服用了一种精神药物。在使用强制输入法的多变量逻辑回归模型中,教育程度数据缺失与 QIDS-J 的 "我对自己的看法 "领域呈负相关,而 QIDS-J 的 "注意力集中/决策制定 "领域与抗抑郁药物处方呈正相关:结论:一半以上的初诊患者没有接受任何精神药物治疗。精神科医生在决定是否开药时似乎会考虑特定的症状和人格特质,这也可能受到患者偏好的影响。要更详细地探讨这些关联,还需要进一步的研究,包括纵向分析。
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引用次数: 0
Inhibitory effects of the selective μ-opioid receptor antagonist UD-030 on methamphetamine-induced conditioned place preference. 选择性μ-阿片受体拮抗剂UD-030对甲基苯丙胺诱导的条件性位置偏好的抑制作用
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-27 DOI: 10.1002/npr2.12503
Soichiro Ide, Noriaki Iwase, Kenichi Arai, Masahiro Kojima, Shigeru Ushiyama, Kazutaka Ikeda

Although methamphetamine (METH) and other addictive substance use disorders are a major social problem worldwide, appropriate pharmacotherapies have not yet been discovered. Subtype-nonselective opioid receptor antagonists, such as naltrexone (NTX), have been reported to suppress METH addiction, but unclear are the opioid receptor subtypes that are involved in this beneficial effect. To clarify the role of μ-opioid receptors (MOPs), we examined effects of the novel nonpeptidic MOP-selective antagonist UD-030 on the acquisition and expression of METH-induced conditioned place preference (CPP) using behavioral tests in C57BL/6J mice. UD-030 was found to inhibit both the acquisition and expression of METH-induced CPP in a dose-dependent manner, with effects comparable to those observed with NTX. These findings suggest that UD-030 has the potential to mitigate METH-related reward mechanisms and may serve as a promising candidate for MOP-selective pharmacotherapy targeting METH addiction.

尽管甲基苯丙胺(METH)和其他成瘾性药物使用障碍是全球范围内的一个主要社会问题,但适当的药物疗法尚未被发现。据报道,纳曲酮(NTX)等亚型非选择性阿片受体拮抗剂可抑制甲基苯丙胺成瘾,但参与这种有益作用的阿片受体亚型尚不清楚。为了明确μ-阿片受体(MOPs)的作用,我们在C57BL/6J小鼠中使用行为测试,研究了新型非肽类MOP选择性拮抗剂UD-030对METH诱导的条件性位置偏好(CPP)的获得和表达的影响。研究发现,UD-030 能以剂量依赖的方式抑制 METH 诱导的条件性位置偏好(CPP)的获得和表达,其效果与 NTX 的效果相当。这些研究结果表明,UD-030具有减轻与METH相关的奖赏机制的潜力,可作为针对METH成瘾的澳门巴黎人娱乐官网选择性药物疗法的候选药物。
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引用次数: 0
Development of cefepime-induced encephalopathy in a patient with depression and rectal cancer: A case report. 抑郁症和直肠癌患者发生头孢吡肟诱发脑病:病例报告。
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1002/npr2.12502
Junji Yamaguchi, Ryoichi Sadahiro, Saho Wada, Eri Nishikawa, Tatsuto Terada, Rika Nakahara, Hiromichi Matsuoka

Background: Cefepime, a fourth-generation cephalosporin, has neurotoxic side effects such as encephalopathy. Baseline conditions, including blood-brain barrier (BBB) impairment and renal dysfunction, are known to associate with elevated central nervous concentration of cefepime. Although BBB dysfunction occurs with depression or cancer, currently, neither is regarded as a risk factor for cefepime-induced encephalopathy.

Case presentation: A 79-year-old woman with a history of depression and rectal cancer was hospitalized for a bacterial liver abscess. Brain metastasis and other causes for delirium were excluded, and no renal dysfunction was observed. However, 11 days after cefepime and metronidazole administration, the patient suddenly developed confusion, disorientation, and myoclonus, with no apparent changes on brain magnetic resonance imaging. Electroencephalography revealed a consistent tri-phasic wave pattern. Clinical symptoms were well consistent with cefepime-induced encephalopathy; hence, cefepime and metronidazole were discontinued, followed by rapid physical and mental recovery, with no aftereffects.

Conclusions: In terms of BBB dysfunction, depression and cancer might be possible occult risk factors for cefepime-induced encephalopathy. Doctors need to pay attention to encephalopathy risk when administering cefepime in patients with depression or cancer because the psychiatric symptoms of encephalopathy, depression, and delirium from other causes are often confusing, leading to misdiagnosis and a poor prognosis.

背景:头孢吡肟是第四代头孢菌素,具有神经毒性副作用,如脑病。已知包括血脑屏障(BBB)损伤和肾功能障碍在内的基线条件与头孢吡肟中枢神经浓度升高有关。虽然抑郁症或癌症也会导致血脑屏障(BBB)功能障碍,但目前这两种情况都不被视为头孢吡肟诱发脑病的危险因素:病例介绍:一名有抑郁症和直肠癌病史的 79 岁女性因细菌性肝脓肿住院治疗。排除了脑转移和其他导致谵妄的原因,也未观察到肾功能障碍。然而,在服用头孢吡肟和甲硝唑 11 天后,患者突然出现意识模糊、定向障碍和肌阵挛,脑磁共振成像无明显变化。脑电图显示出一致的三相波模式。临床症状与头孢吡肟诱发的脑病十分吻合,因此停用了头孢吡肟和甲硝唑,随后患者的身体和精神迅速恢复,没有出现后遗症:结论:就 BBB 功能障碍而言,抑郁症和癌症可能是头孢吡肟诱发脑病的隐性危险因素。医生在给抑郁症或癌症患者使用头孢吡肟时需要注意脑病风险,因为脑病、抑郁症和其他原因引起的谵妄等精神症状往往容易混淆,导致误诊和不良预后。
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引用次数: 0
Real-world predictors of severe psychological distress during the COVID-19 pandemic in Japan: Insights from a large-scale internet-based cohort study. 日本 COVID-19 大流行期间严重心理困扰的现实预测因素:基于互联网的大规模队列研究的启示。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-10-26 DOI: 10.1002/npr2.12495
Keita Tokumitsu, Norio Sugawara, Takahiro Tabuchi, Norio Yasui-Furukori

Aim: The COVID-19 pandemic has had negative physical and psychological impacts worldwide. However, there has been a lack of real-world evidence concerning the predictors of severe psychological distress (SPD) among the general population in Japan during the COVID-19 pandemic. The aim of this study was to examine predictors of SPD during the COVID-19 pandemic.

Methods: We investigated the predictors of new-onset SPD in the general Japanese population using data from a large-scale internet-based cohort study.

Results: We included 16 489 study participants (age range = 16-81, mean age = 52.7, percentage of male = 50%) in the analysis. Over the course of 1 year from baseline, the estimated proportion of participants who experienced SPD was 5.2% with inverse probability weighting. The predictors of SPD included younger age, being never married, being unemployed, having a higher education background, scoring higher on the Fear of Coronavirus-19 Scale, experiencing more adverse childhood experiences, reporting poorer subjective health status, and COVID-19 with oxygen therapy. Our internet-based survey of the Japanese population may have selection bias, limiting the generalizability to other countries and cultures.

Conclusion: This study revealed that being afflicted with COVID-19 requiring oxygen therapy is the most significant predictor of SPD. In addition, we found that vulnerability to social isolation, such as never being unmarried, anxiety toward COVID-19, and susceptibility to stress, are predictors of the emergence of SPD. Therefore, the implementation of online support systems and ensuring access to accurate information may protect against SPD during the COVID-19 pandemic in Japan.

目的:COVID-19 大流行在全球范围内造成了负面的生理和心理影响。然而,关于 COVID-19 大流行期间日本普通人群严重心理困扰(SPD)的预测因素,一直缺乏实际证据。本研究旨在探讨 COVID-19 大流行期间严重心理压力(SPD)的预测因素:方法:我们利用一项基于互联网的大规模队列研究的数据,调查了日本普通人群中新发 SPD 的预测因素:我们将 16 489 名研究参与者(年龄范围 = 16-81,平均年龄 = 52.7,男性比例 = 50%)纳入分析。在从基线开始的一年时间里,经反向概率加权估计,经历过 SPD 的参与者比例为 5.2%。SPD的预测因素包括年龄较小、从未结过婚、失业、教育背景较高、对冠状病毒-19恐惧量表的评分较高、童年经历较多、报告的主观健康状况较差以及COVID-19与氧气治疗。我们对日本人口进行的基于互联网的调查可能存在选择偏差,从而限制了对其他国家和文化的普适性:本研究显示,患有需要氧疗的 COVID-19 是预测 SPD 的最重要因素。此外,我们还发现,未婚、对 COVID-19 的焦虑和易受压力影响等易受社会孤立的因素也是 SPD 出现的预测因素。因此,在日本 COVID-19 大流行期间,实施在线支持系统并确保获得准确的信息可预防 SPD。
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引用次数: 0
Qualitative analysis of blood from patients engaging in deliberate self-harm: Differences between prescribed and detected drugs. 对故意自残患者的血液进行定性分析:处方药和检测出的药物之间的差异。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-10-28 DOI: 10.1002/npr2.12492
Masato Masuda, Brian Waters, Leo Gotoh, Yoshihiko Nakamura, Yoshifumi Kato, Shigeki Nabeshima, Shin-Ichi Kubo, Nobuaki Eto, Hiroaki Kawasaki

Background: While drugs are sometimes taken during deliberate self-harm (DSH), no study has attempted to analyze drugs in the blood of DSH patients and compare them with prescribed medications or other drugs. In this study, drugs were analyzed from the blood of DSH patients, and the detected, prescribed, and suspected drugs were documented.

Methods: Patients who practiced DSH and were transferred to the emergency sites of Fukuoka University Hospital between April 2021 and September 2022 participated in the study. Psychiatrists assessed information such as the history of psychiatric treatment and recent methods of DSH, as well as prescribed drugs within 1 month of presenting to the hospital. Blood samples were analyzed using LC-MS/MS. Participants were divided into groups according to whether or not they were prescribed psychotropics within 1 month.

Results: Fifty-five patients were enrolled in the study. Forty had been prescribed psychotropics within 1 month of hospital admission. However, non-prescribed drugs (NPD) were detected in 42 of the 55 participants (76%). The detection of NPD was significantly high among patients with overdose of medications and OTC drugs (p = 0.036), but NPD were also detected in patients who engaged in other methods (n = 14), and in patients without prescribed medication (n = 10).

Discussion: This is the first study focused on the drug analysis of blood from patients engaging in DSH. Approximately 80% of the DSH patients in this study had taken NPD, revealing a large discrepancy between prescribed medications and those detected in the blood.

背景:虽然在故意自残(DSH)过程中有时会服用药物,但还没有研究尝试分析DSH患者血液中的药物,并将其与处方药或其他药物进行比较。本研究分析了自残患者血液中的药物,并记录了检测到的药物、处方药物和可疑药物:方法:在 2021 年 4 月至 2022 年 9 月期间,患有 DSH 并转入福冈大学医院急诊室的患者参与研究。精神科医生对患者的信息进行了评估,如精神科治疗史和最近的DSH方法,以及入院后1个月内的处方药物。血液样本采用 LC-MS/MS 进行分析。根据患者是否在一个月内服用过精神药物将其分为几组:55名患者参加了研究。其中 40 人在入院后 1 个月内服用过精神药物。然而,在 55 名参与者中,有 42 人(76%)被检测出服用了非处方药物(NPD)。在药物和非处方药过量的患者中,非处方药物的检出率明显较高(p = 0.036),但在使用其他方法的患者(n = 14)和没有处方药物的患者(n = 10)中也检出了非处方药物:讨论:这是第一项重点针对从事 DSH 的患者血液进行药物分析的研究。本研究中约有 80% 的 DSH 患者服用过 NPD,这表明处方药物与血液中检测到的药物之间存在很大差异。
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引用次数: 0
Effects of frequently prescribed antiseizure medications on motor vehicle driving performance: Narrative review based on a tiered approach for the assessment of clinically meaningful driving impairment in the Ministry of Health, Labour, and Welfare guideline. 常用抗癫痫药物对机动车驾驶性能的影响:根据卫生、劳动和福利部指南中对有临床意义的驾驶损伤进行分级评估的叙述性综述。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-11-04 DOI: 10.1002/npr2.12469
Kunihiro Iwamoto, Tetsuo Nakabayashi, Akiko Yamaguchi, Yuki Konishi, Momoe Saji, Reiji Yoshimura, Kousuke Kanemoto, Hirofumi Aoki, Masahiko Ando, Norio Ozaki

Patients with epilepsy often require long-term treatment with antiseizure medications, and their impact on daily activities, particularly driving, is of significant concern. The recently published "Guideline for Evaluating Effects of Psychotropic Drugs on the Performance to Drive a Motor Vehicle" in Japan provides a framework that can be referred to for not only the evaluation of new drugs but also the reevaluation of approved drugs. This study conducted a literature review regarding the effects of carbamazepine, valproate, lamotrigine, lacosamide, and levetiracetam, which are frequently prescribed for epilepsy, on driving performance following the guideline's tiered evaluation approach. Analyses of pharmacological, pharmacodynamic, and adverse events suggested that these drugs primarily affect arousal function. Driving studies showed that acute administration of carbamazepine, but not chronic monotherapy with carbamazepine, valproate, lamotrigine, and levetiracetam, significantly impairs driving performance. Epidemiological studies have not identified a definitive association between these drugs and traffic accidents. Initial administration of these five antiseizure medications may affect driving performance, warranting special attention, but the influence appears to diminish with continued use. Nevertheless, while long-term administration of these five drugs may not have a clinically meaningful effect on driving performance, safe driving is not guaranteed for each individual patient, and appropriate individualized guidance is important in clinical practice.

癫痫患者通常需要长期接受抗癫痫药物治疗,而这些药物对日常活动,尤其是驾驶的影响令人十分担忧。日本最近发布的《精神药物对驾驶机动车性能影响的评估指南》提供了一个框架,不仅可用于评估新药,还可用于重新评估已批准的药物。本研究按照该指南的分级评估方法,对卡马西平、丙戊酸钠、拉莫三嗪、拉考沙胺和左乙拉西坦等治疗癫痫的常用处方药对驾驶性能的影响进行了文献综述。对药理学、药效学和不良事件的分析表明,这些药物主要影响唤醒功能。驾驶研究表明,急性服用卡马西平会显著影响驾驶表现,但长期单一服用卡马西平、丙戊酸钠、拉莫三嗪和左乙拉西坦不会。流行病学研究并未发现这些药物与交通事故之间存在明确的联系。初次服用这五种抗癫痫药物可能会影响驾驶性能,因此需要特别注意,但持续服用后影响似乎会减弱。不过,虽然长期服用这五种药物可能不会对驾驶性能产生有临床意义的影响,但并不能保证每个患者都能安全驾驶,因此在临床实践中提供适当的个体化指导非常重要。
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引用次数: 0
Correction to "Brexpiprazole: A new option in treating agitation in Alzheimer's dementia-Insights from transgenic mouse models". 更正 "布雷克吡唑:治疗阿尔茨海默氏症痴呆症躁动的新选择--转基因小鼠模型的启示"。
IF 2 Q3 NEUROSCIENCES Pub Date : 2024-12-01 Epub Date: 2024-11-12 DOI: 10.1002/npr2.12496
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引用次数: 0
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Neuropsychopharmacology Reports
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