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Genome-wide DNA methylation analysis in families with multiple individuals diagnosed with schizophrenia and intellectual disability. 诊断为精神分裂症和智力残疾的多个体家庭的全基因组DNA甲基化分析。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 Epub Date: 2023-04-18 DOI: 10.1080/15622975.2023.2198595
Shengmin Zhang, Kaiyu Shi, Nan Lyu, Yunshu Zhang, Guangming Liang, Wufang Zhang, Xijin Wang, Hong Wen, Liping Wen, Hong Ma, Jijun Wang, Xin Yu, Lili Guan

Objectives: Schizophrenia (SZ) and intellectual disability (ID) are both included in the continuum of neurodevelopmental disorders (NDDs). DNA methylation is known to be important in the occurrence of NDDs. The family study is conducive to eliminate the effects of relative epigenetic backgrounds, and to screen for differentially methylated positions (DMPs) and regions (DMRs) that are truly associated with NDDs.

Methods: Four monozygotic twin families were recruited, and both twin individuals suffered from NDDs (either SZ, ID, or SZ plus ID). Genome-wide methylation analysis was performed in all samples and each family. DMPs and DMRs between NDD patients and unaffected individuals were identified. Functional and pathway enrichment analyses were performed on the annotated genes.

Results: Two significant DMPs annotated to CYP2E1 were found in all samples. In Family One, 1476 DMPs mapped to 880 genes, and 162 DMRs overlapping with 153 unique genes were recognised. Our results suggested that the altered methylation levels of FYN, STAT3, RAC1, and NR4A2 were associated with the development of SZ and ID. Neurodevelopment and the immune system may participate in the occurrence of SZ and ID.

Conclusions: Our findings suggested that DNA methylation participated in the development of NDDs by affecting neurodevelopment and the immune system.

目的:精神分裂症(SZ)和智力残疾(ID)都属于神经发育障碍(NDDs)的连续体。众所周知,DNA甲基化在NDD的发生中起着重要作用。该家族研究有助于消除相对表观遗传背景的影响,并筛选真正与NDD相关的差异甲基化位置(DMP)和区域(DMR)。方法:招募四个单卵双胞胎家庭,两个双胞胎个体都患有NDD(SZ、ID或SZ加ID)。对所有样本和每个家族进行全基因组甲基化分析。确定了NDD患者和未受影响个体之间的DMP和DMRs。对注释基因进行功能和途径富集分析。结果:在所有样本中均发现两个CYP2E1注释的重要DMP。在第一家族中,1476个DMP被定位到880个基因,162个DMR与153个独特基因重叠。我们的研究结果表明,FYN、STAT3、RAC1和NR4A2甲基化水平的改变与SZ和ID的发生有关。神经发育和免疫系统可能参与SZ和D的发生。
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引用次数: 1
Red cell distribution width and depressive symptoms: A failed replication in female adolescents. 红细胞分布宽度与抑郁症状:女性青少年复制失败。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 Epub Date: 2023-05-15 DOI: 10.1080/15622975.2023.2203222
Valentin Kriegmair, Christine Sigrist, Jasper Vöckel, Michael Kaess, Julian Koenig

Objectives: Despite the increasingly high prevalence and serious consequences of depression in adolescents, there is a lack of economical and reliable biomarkers to aid the diagnostic process. Recent findings suggest that red blood cell distribution width (RDW) is an easily obtainable biomarker of depression in adults. Here, we aimed to replicate the finding of increased RDW in clinically depressed adolescents.

Methods: Data from depressed adolescent female patients (n = 93) and healthy controls (HC) (n = 43) aged 12-17 years from the AtR!Sk-bio cohort study were retrospectively analysed. We compared RDW between groups and tested whether there was an association between RDW and depression severity and global (psychiatric) symptom severity. We also examined the influence of age on RDW.

Results: There was no significant difference between depressed patients and healthy controls and no association between RDW and depression severity. However, higher RDW values were associated with greater global symptom severity. Regardless of group, there was a positive association between RDW and age.

Conclusions: RDW appears to be unfit as an aid for clinical diagnosis of depression in adolescents, but may be useful in assessing global psychiatric symptom burden.

目的:尽管青少年抑郁症的患病率越来越高,后果越来越严重,但缺乏经济可靠的生物标志物来帮助诊断过程。最近的研究结果表明,红细胞分布宽度(RDW)是成年人抑郁症的一个容易获得的生物标志物。在这里,我们的目的是复制临床抑郁症青少年RDW增加的发现。方法:来自抑郁症青少年女性患者(n = 93)和健康对照组(HC)(n = 43)12-17岁 距离AtR还有几年!对Sk生物队列研究进行回顾性分析。我们比较了各组之间的RDW,并测试了RDW与抑郁症严重程度和整体(精神)症状严重程度之间是否存在关联。我们还研究了年龄对RDW的影响。结果:抑郁症患者与健康对照组之间没有显著差异,RDW与抑郁症严重程度之间也没有关联。然而,RDW值越高,整体症状严重程度越高。不分年龄组,RDW与年龄呈正相关。结论:RDW似乎不适合作为青少年抑郁症的临床诊断辅助手段,但可能有助于评估全球精神症状负担。
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引用次数: 0
The potential of biomarkers for diagnosing insomnia: Consensus statement of the WFSBP Task Force on Sleep Disorders. 生物标志物诊断失眠的潜力:WFSBP睡眠障碍工作组的共识声明。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 Epub Date: 2023-03-07 DOI: 10.1080/15622975.2023.2171479
Dimitris Dikeos, Adam Wichniak, Periklis Y Ktonas, Thorsten Mikoteit, Tatjana Crönlein, Anne Eckert, Jana Kopřivová, Maria Ntafouli, Kai Spiegelhalder, Martin Hatzinger, Dieter Riemann, Constantin Soldatos

Objectives: Thus far, the diagnosis of insomnia is based on purely clinical criteria. Although a broad range of altered physiological parameters has been identified in insomniacs, the evidence to establish their diagnostic usefulness is very limited. Purpose of this WFSBP Task Force consensus paper is to systematically evaluate a series of biomarkers as potential diagnostic tools for insomnia.

Methods: A newly created grading system was used for assessing the validity of various measurements in establishing the diagnosis of insomnia; these measurements originated from relevant studies selected and reviewed by experts.

Results: The measurements with the highest diagnostic performance were those derived from psychometric instruments. Biological measurements which emerged as potentially useful diagnostic instruments were polysomnography-derived cyclic alternating pattern, actigraphy, and BDNF levels, followed by heart rate around sleep onset, deficient melatonin rhythm, and certain neuroimaging patterns (mainly for the activity of frontal and pre-frontal cortex, hippocampus and basal ganglia); yet, these findings need replication, as well as establishment of commonly accepted methodology and diagnostic cut-off points. Routine polysomnography, EEG spectral analysis, heart rate variability, skin conductance, thermoregulation, oxygen consumption, HPA axis, and inflammation indices were not shown to be of satisfactory diagnostic value.

Conclusions: Apart from psychometric instruments which are confirmed to be the gold standard in diagnosing insomnia, six biomarkers emerge as being potentially useful for this purpose.

目的:到目前为止,失眠的诊断是基于纯粹的临床标准。尽管已经在失眠症患者中发现了广泛的生理参数改变,但确定其诊断有用性的证据非常有限。这篇WFSBP工作组共识论文的目的是系统地评估一系列生物标志物作为失眠的潜在诊断工具。方法:使用新创建的评分系统来评估各种测量方法在失眠诊断中的有效性;这些测量结果来源于专家选择和审查的相关研究。结果:诊断性能最高的测量是来自心理测量仪器的测量。作为潜在有用的诊断工具的生物测量是多导睡眠图衍生的周期性交替模式、活动描记术和BDNF水平,然后是睡眠开始时的心率、褪黑激素缺乏节律和某些神经成像模式(主要是额叶和额前皮质、海马和基底神经节的活动);然而,这些发现需要复制,以及建立普遍接受的方法和诊断临界点。常规多导睡眠图、脑电图频谱分析、心率变异性、皮肤电导、体温调节、耗氧量、HPA轴和炎症指数均未显示出令人满意的诊断价值。结论:除了被证实是诊断失眠的金标准的心理测量仪器外,还有六种生物标志物可能对此有用。
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引用次数: 6
Electroacupuncture alleviates depression-like behaviours via a neural mechanism involving activation of Nucleus Accumbens Shell. 电针通过激活伏核壳的神经机制缓解抑郁样行为。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-10-01 Epub Date: 2023-08-02 DOI: 10.1080/15622975.2022.2155993
Hua-Min Zhang, Zhe-Yu Chen

Objectives: This study investigated the effects of electroacupuncture (EA) on the depression-like behaviours in a mouse model of chronic restraint stress (CRS) and explored the underlying neural mechanisms.

Methods: Depression-like behaviours including sucrose preference test (SPT), open field test (OFT) and tail suspension test (TST) were carried out to evaluate the effects of CRS and EA treatment. Using immunohistochemistry to measure the expression of c-Fos. The Nucleus Accumbens Shell (NAc Shell) in C57BL/6J mice were activated or inhibited using Chemogenetics.

Results: All the CRS stimulated groups showed lower sucrose preference in the SPT and decreased centre times in the OFT, and increased immobility time in the TST when compared to the normal control. Interestingly, EA at LR3 or HT7 exerted anti-depressant effects, and LR3 EA exhibited a more significant restoration than HT7. Furthermore, EA at LR3 increased expression of c-Fos in the NAc Shell. Chemogenetic inhibition of NAc Shell blocked the effects of EA, whereas enhancement of NAc Shell activity profoundly reversed depressive phenotypes.

Conclusions: LR3 EA was effective in alleviating the depressive-like behaviours, and this therapeutic effect was associated with the activation of NAc Shell. Collectively, these findings revealed that EA may represent a promising therapeutic strategy for depression.

目的:研究电针对慢性约束应激(CRS)小鼠抑郁样行为的影响,并探讨其潜在的神经机制。方法:采用蔗糖偏好试验(SPT)、露地试验(OFT)和尾部悬吊试验(TST)等抑郁样行为来评价CRS和EA治疗的效果。应用免疫组织化学方法检测c-Fos的表达。结果:与正常对照组相比,CRS刺激组在SPT中表现出较低的蔗糖偏好,在OFT中的中心时间减少,在TST中的不动时间增加。有趣的是,LR3或HT7的EA具有抗抑郁作用,并且LR3-EA表现出比HT7更显著的恢复。此外,LR3处的EA增加了NAc外壳中c-Fos的表达。NAc-Shell的化学遗传学抑制阻断了EA的作用,而NAc-Shell活性的增强则深刻地逆转了抑郁表型。结论:LR3电针能有效缓解抑郁样行为,其疗效与NAc-Shell的激活有关。总之,这些发现表明,电针可能是一种很有前途的抑郁症治疗策略。
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引用次数: 2
Peripheral signature of altered synaptic integrity in young onset cannabis use disorder: A proteomic study of circulating extracellular vesicles. 年轻发作的大麻使用障碍中突触完整性改变的外周特征:循环细胞外小泡的蛋白质组学研究。
IF 3 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-04-13 DOI: 10.1080/15622975.2023.2197039
Suhas Ganesh, TuKiet T Lam, Rolando Garcia-Milian, Deepak Cyril D'Souza, Angus C Nairn, Katya Elgert, Erez Eitan, Mohini Ranganathan

Background: Rates of Cannabis Use Disorder (CUD) are highest amongst young adults. Paucity of brain tissue samples limits the ability to examine the molecular basis of cannabis related neuropathology. Proteomic studies of neuron-derived extracellular vesicles (NDEs) isolated from the biofluids may reveal markers of neuropathology in CUD.

Methods: NDEs were extracted using ExoSORT, an immunoaffinity method to enrich NDEs from plasma samples from patients with young onset CUD and matched controls. Differential proteomic profiles were explored with Label Free Quantification (LFQ) mass spectrometry. Selected proteins were validated using orthogonal methods.

Results: A total of 231 (±10) proteins were identified in NDE preparations from CUD and controls of which 28 were differentially abundant between groups. The difference in abundance of properdin (CFP gene) was statistically significant. SHANK1 (SHANK1 gene), an adapter protein at the post-synaptic density, was nominally depleted in the CUD NDE preparations.

Conclusion: In this pilot study, we noted a decrease in SHANK1 protein, involved in the structural and functional integrity of glutamatergic post-synapse, a potential peripheral signature of CUD neuropathology. The study shows that LFQ mass spectrometry proteomic analysis of NDEs derived from plasma may yield important insights into the synaptic pathology associated with CUD.

背景:年轻人的大麻使用障碍(CUD)发生率最高。脑组织样本的缺乏限制了检查大麻相关神经病理学分子基础的能力。从生物流体中分离的神经元衍生的细胞外小泡(NDE)的蛋白质组学研究可能揭示CUD的神经病理学标志物。方法:使用免疫亲和法ExoSORT从年轻发作的CUD患者和匹配对照的血浆样本中提取NDEs。用无标记定量(LFQ)质谱法对差异蛋白质组学图谱进行了探索。使用正交方法对所选蛋白质进行验证。结果:CUD和对照组的NDE制剂中共鉴定出231(±10)种蛋白质,其中28种蛋白质在各组之间差异丰富。前肽(CFP基因)的丰度差异具有统计学意义。SHANK1(SHANK1基因)是突触后密度的一种衔接蛋白,在CUD NDE制剂中名义上是缺失的。结论:在这项初步研究中,我们注意到SHANK1蛋白的减少,该蛋白参与谷氨酸能后突触的结构和功能完整性,这是CUD神经病理学的潜在外周特征。该研究表明,对血浆NDE的LFQ质谱蛋白质组学分析可能会对与CUD相关的突触病理产生重要见解。
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引用次数: 0
Phase-and disorder-specific differences in peripheral metabolites of the kynurenine pathway in major depression, bipolar affective disorder and schizophrenia. 严重抑郁症、双相情感障碍和精神分裂症犬尿氨酸途径外周代谢产物的阶段和障碍特异性差异。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-01-30 DOI: 10.1080/15622975.2023.2169348
Murielle Brum, Matthias Nieberler, Christopher Kehrwald, Katrin Knopf, Nathalie Brunkhorst-Kanaan, Semra Etyemez, Kelly A Allers, Robert A Bittner, David A Slattery, Rhiannon V McNeill, Andreas Reif, Sarah Kittel-Schneider

Objectives: Kynurenine, kynurenic and quinolinic acid are important metabolites in tryptophan metabolism. Due to an involvement in glutamatergic neurotransmission and immune response, previous studies have investigated this pathway in mental disorders such as major depressive disorder (MDD), bipolar disorder (BD) or schizophrenia (SCZ). Tryptophan and kynurenine have been shown to be decreased across disorders, hinting at the missing link how inflammation causes neurotoxicity and psychiatric symptoms. The main aim of our study was to investigate if individual catabolites could serve as diagnostic biomarkers for MDD, BD and SCZ.

Methods: We measured plasma levels of tryptophan, kynurenine, kynurenic acid, quinolinic acid and ratio of quinolinic acid/kynurenic acid using mass spectrometry in n = 175 participants with acute episodes and after remission, compared with controls.

Results: Decreased levels of all tryptophan catabolites were found in the whole patient group, driven by the difference between BD and HC. Manic and mixed phase BD individuals displayed significantly lower kynurenine and kynurenic acid levels. We could not find significant differences between disorders. Upon reaching remission, changes in catabolite levels partially normalised.

Conclusions: Our data suggests an involvement of the kynurenine pathway in mental disorders, especially BD but disqualifying those metabolites as biomarkers for differential diagnosis.

目的:犬尿蛋白、犬尿蛋白和喹啉酸是色氨酸代谢中的重要代谢产物。由于参与谷氨酸能神经传递和免疫反应,先前的研究已经在精神障碍中研究了这一途径,如重度抑郁障碍(MDD)、双相情感障碍(BD)或精神分裂症(SCZ)。色氨酸和犬尿氨酸已被证明在各种疾病中都会减少,这暗示了炎症如何导致神经毒性和精神症状的缺失环节。我们研究的主要目的是研究个体分解代谢物是否可以作为MDD、BD和SCZ的诊断生物标志物。方法:采用质谱法测定大鼠血浆色氨酸、犬尿氨酸、狗尿烯酸、喹啉酸及喹啉酸/犬尿烯酸比值 = 与对照组相比,175名急性发作和缓解后的参与者。结果:由于BD和HC之间的差异,在整个患者组中发现所有色氨酸分解代谢产物的水平降低。躁狂期和混合期BD个体表现出显著较低的犬尿氨酸和犬尿烯酸水平。我们找不到不同疾病之间的显著差异。病情缓解后,分解代谢水平的变化部分正常化。结论:我们的数据表明犬尿氨酸途径参与了精神障碍,尤其是BD,但不符合这些代谢产物作为鉴别诊断的生物标志物的资格。
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引用次数: 3
Promoter methylation of the glucocorticoid receptor following trauma may be associated with subsequent development of PTSD. 创伤后糖皮质激素受体启动子甲基化可能与PTSD的后续发展有关。
IF 3 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-03-13 DOI: 10.1080/15622975.2023.2177342
Lior Carmi, Joseph Zohar, Alzbeta Juven-Wetzler, Frank Desarnaud, Louri Makotkine, Linda M Bierer, Hagit Cohen, Rachel Yehuda

Objectives: The ability to identify persons at elevated risk for post-traumatic stress disorder (PTSD) soon after exposure to trauma, could aid clinical decision-making and treatment. In this study, we explored whether cytosine methylation of the 1 F promoter of the NR3C1 (glucocorticoid receptor [GR]) gene obtained immediately following a trauma could predict PTSD.

Methods: Our sample comprised 52 trauma survivors (28 women, 24 men), presenting to the Emergency Department (ED) within six hours of a traumatic event and followed for 13 months. Blood samples were taken at intake (n = 42) and again at the end of the study (13 months later, n = 27) to determine NR3C1-1F promoter methylation as well as plasma levels of cortisol, adrenocorticotropic-hormone (ACTH), and neuropeptide-Y (NPY).

Results: At the 13-month follow-up, participants who met the PTSD criteria (n = 4) showed significantly lower NR3C1-1F promoter sum percent methylation compared to the non-PTSD group (n = 38). Further, NR3C1-1F methylation at ED intake was inversely correlated with PTSD severity 13 months later, indicating that lower NR3C1-1F promoter methylation in the immediate aftermath of trauma was associated with the development of PTSD.

Conclusion: To the extent that reduced promoter methylation is associated with greater GR expression and responsivity, this finding is consistent with the hypothalamic-pituitary-adrenal dysregulation previously described for PTSD.

目的:在暴露于创伤后不久识别创伤后应激障碍(PTSD)高危人群的能力,可以帮助临床决策和治疗。在这项研究中,我们探讨了1 创伤后立即获得的NR3C1(糖皮质激素受体[GR])基因的F启动子可以预测PTSD。方法:我们的样本包括52名创伤幸存者(28名女性,24名男性),他们在创伤事件发生后6小时内到急诊科就诊,并随访13年 月。取血时取血样(n = 42),并且在研究结束时再次(13 几个月后,n = 27)测定NR3C1-1F启动子甲基化以及皮质醇、促肾上腺皮质激素(ACTH)和神经肽Y(NPY)的血浆水平。结果:在13个月的随访中,符合PTSD标准的参与者(n = 4) 与非PTSD组相比,NR3C1-1F启动子总甲基化百分比显著降低(n = 38)。此外,ED摄入时NR3C1-1F甲基化与PTSD严重程度呈负相关13 几个月后,表明创伤后即刻NR3C1-1F启动子甲基化水平较低与PTSD的发展有关。结论:在某种程度上,启动子甲基化减少与GR表达和反应性增加有关,这一发现与先前描述的PTSD的下丘脑-垂体-肾上腺失调一致。
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引用次数: 0
Treatment of depression and borderline personality disorder with 1 Hz repetitive transcranial magnetic stimulation of the orbitofrontal cortex - A pilot study. 1治疗抑郁症和边缘型人格障碍 Hz重复经颅磁刺激眶额皮质——一项初步研究。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-03-15 DOI: 10.1080/15622975.2023.2186484
C Reinsberg, M Schecklmann, M A Abdelnaim, F C Weber, B Langguth, T Hebel

Borderline personality disorder (BPD) is characterised by impairments in emotional regulation, impulse control and interpersonal interaction. Comorbid depression is common. The orbitofrontal cortex (OFC) plays a crucial role in the biological substrate of BPD. We investigated the effects of 1 Hz repetitive transcranial magnetic stimulation (rTMS) targeting the OFC on depressive symptoms and symptoms of BPD in 15 patients suffering from both conditions to assess feasibility and effectiveness. Target treatment intensity was 120% of resting motor threshold (RMT) and intended duration four weeks. Treatment improved both symptoms of depression as measured by the Hamilton Depression Rating Scale and of BPD as measured by Borderline Symptom List-23 and Barratt Impulsivity Scale. Drop-out rates were high with 7/15 patients not completing the full course of rTMS, but only two drop-outs were related to treatment. Only a minority of patients tolerated target treatment intensity. Despite the limitations, the results suggest efficacy of treatment and welcome further research.

边缘型人格障碍(BPD)的特点是情绪调节、冲动控制和人际交往障碍。合并抑郁症很常见。眶额皮质(OFC)在BPD的生物基质中起着至关重要的作用。我们研究了1 Hz重复经颅磁刺激(rTMS)靶向OFC对15名患有这两种疾病的患者的抑郁症状和BPD症状进行治疗,以评估可行性和有效性。目标治疗强度为静息运动阈值(RMT)的120%,预期持续时间为四周。治疗改善了汉密尔顿抑郁评定量表测量的抑郁症状和Borderline症状列表-23和Barratt冲动量表测得的BPD症状。退出率很高,7/15名患者没有完成rTMS的全部疗程,但只有两名退出与治疗有关。只有少数患者能耐受目标治疗强度。尽管存在局限性,但研究结果表明治疗有效,欢迎进一步研究。
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引用次数: 0
Psychiatric onset of prodromal dementia with Lewy bodies: Current insights into neuroimaging tools. 路易体前驱性痴呆的精神病发作:神经成像工具的最新见解。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-04-12 DOI: 10.1080/15622975.2023.2191008
Niels Hansen, Sebastian Johannes Müller, Eya Khadhraoui, Marielle Ernst, Christian Heiner Riedel, Jens Wiltfang, Claudia Lange, Carolin Bouter

Purpose: Our article is dedicated to describing the state-of-the-art in imaging techniques for assessing prodromal dementia with Lewy bodies (pro-DLB) with a psychiatric-onset.

Materials and methods: Imaging biomarker techniques are discussed.

Results: (123)-I-2-ß-carbomethoxy-3ß-(4-iodophenyl)-N-(3-fluoropropyl) nortropane single photon emission computed tomography (123I-FP-CIT SPECT) seems to be a promising method as it reveals abnormalities in pro-DLB with a psychiatric-onset. New potential biomarkers can be revealed via novel techniques, such as manual segmentation in magnetic resonance imaging (MRI), which helps detect atrophy of the substantia innominata in pro-DLB with a psychiatric-onset as opposed to an onset with mild cognitive impairment (MCI). FDG-PET can also help us distinguish patients with mixed pro-DLB from those pro-DLB patients with a psychiatric-onset or MCI-onset. Changes in large-scale networks in the posterior standard mode and in attentional networks could be early signs in resting-state functional MRI to characterise pro-DLB.

Conclusions: In conclusion, there is a wide range of techniques that need to be explored in large-scale studies and are of promising value in understanding pro-DLB with a psychiatric-onset.

目的:我们的文章致力于描述最先进的成像技术,用于评估有精神病发作的路易体前驱痴呆(前DLB)。材料和方法:讨论了成像生物标志物技术。结果:(123)I-2-ß-甲氧基-3-(4-碘苯基)-N-(3-氟丙基)nortropane单光子发射计算机断层扫描(123I-FP-CIT SPECT)似乎是一种很有前途的方法,因为它可以揭示精神病发作前DLB的异常。新的潜在生物标志物可以通过新的技术来揭示,例如磁共振成像(MRI)中的手动分割,这有助于检测精神病发作的前DLB患者的无名质萎缩,而不是轻度认知障碍(MCI)的发作。FDG-PET还可以帮助我们区分混合性DLB前病变患者和精神病发作或MCI发作的DLB前患者。后验标准模式和注意网络中大规模网络的变化可能是静息状态功能MRI中表征前DLB的早期迹象。结论:总之,在大规模研究中需要探索广泛的技术,这些技术在理解精神病发作的前DLB方面具有很好的价值。
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引用次数: 1
Oral ketamine for depression: An updated systematic review. 口服氯胺酮治疗抑郁症:最新系统综述。
IF 3.1 4区 医学 Q2 PSYCHIATRY Pub Date : 2023-09-01 Epub Date: 2023-01-31 DOI: 10.1080/15622975.2023.2169349
Shakila Meshkat, Sipan Haikazian, Joshua D Di Vincenzo, Farhan Fancy, Danica Johnson, David Chen-Li, Roger S McIntyre, Rodrigo Mansur, Joshua D Rosenblat

Objectives: Ketamine is a glutamate N-methyl-D-aspartate receptor antagonist that can be used to treat major depressive disorder by single or repeated infusions. However, the accessibility and scalability of oral ketamine make it preferred over intravenous ketamine. In this systematic review, we aim to evaluate the efficacy, tolerability, and safety of oral ketamine, esketamine and r-ketamine for unipolar and bipolar depression. Materials and methods: Electronic databases were searched from inception to September 2022 to identify relevant articles. Results: Twenty-two studies, including four randomized clinical trials (RCTs), one case series, six case reports, five open-label trials and six retrospective chart review studies involving 2336 patients with depression were included. All included studies reported significant improvement following ketamine administration. Ketamine was well tolerated without serious adverse events. However, RCTs had a high risk of bias due to analysis methods and adverse events monitoring. Ketamine dosage varied from 0.5 to 1.25 mg/kg. The frequency of administration was daily to monthly. Several important limitations were identified, most notably the small number of RCTs. Conclusions: Taken together, preliminary evidence suggests the potential for antidepressant effect of oral ketamine. However, further research with large sample size and long follow-up period is needed to better determine the antisuicidal effect and efficacy in treatment-resistant depression.

目的:氯胺酮是一种谷氨酸N-甲基-D-天冬氨酸受体拮抗剂,可通过单次或多次输注治疗重度抑郁症。然而,口服氯胺酮的可及性和可扩展性使其优于静脉注射氯胺酮。在这篇系统综述中,我们旨在评估口服氯胺酮、氯胺酮和r-氯胺酮治疗单极和双相抑郁症的疗效、耐受性和安全性。材料和方法:检索从成立到2022年9月的电子数据库,以识别相关文章。结果:纳入了22项研究,包括4项随机临床试验(RCT)、1个病例系列、6份病例报告、5项开放标签试验和6项回顾性图表审查研究,涉及2336名抑郁症患者。所有纳入的研究都报告了氯胺酮给药后的显著改善。氯胺酮耐受性良好,无严重不良事件。然而,由于分析方法和不良事件监测,随机对照试验具有较高的偏倚风险。氯胺酮的剂量从0.5到1.25毫克/公斤不等。给药频率为每日至每月。发现了几个重要的局限性,最显著的是随机对照试验的数量很少。结论:综合来看,初步证据表明口服氯胺酮具有潜在的抗抑郁作用。然而,还需要进一步的大样本量和长随访期的研究,以更好地确定抗水作用和治疗难治性抑郁症的疗效。
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引用次数: 8
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World Journal of Biological Psychiatry
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