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Metformin for the treatment of antipsychotic-induced metabolic disturbances in people with intellectual and developmental disabilities. 二甲双胍治疗智力和发育障碍患者抗精神病药物引起的代谢紊乱。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-03-01 DOI: 10.1503/jpn.220200
Nicolette Stogios, Margaret K Hahn, Yona Lunsky, Pushpal Desarkar, Sri Mahavir Agarwal
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引用次数: 1
We're not in Kansas anymore: ectopic dopaminergic terminals as an explanation for the positive symptoms in psychiatric pathology. 我们不再是在堪萨斯州了:异位多巴胺能终端作为精神病病理阳性症状的一种解释。
IF 4.1 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-02-21 Print Date: 2023-01-01 DOI: 10.1503/jpn.230015
Radu Gabriel Avramescu, Cecilia Flores
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引用次数: 0
Sex-specific transcriptional signatures in the medial prefrontal cortex underlying sexually dimorphic behavioural responses to stress in rats. 内侧前额叶皮层的性别特异性转录特征是大鼠对压力的性二态行为反应的基础。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-02-16 Print Date: 2023-01-01 DOI: 10.1503/jpn.220147
Ying-Dan Zhang, Dong-Dong Shi, Sen Zhang, Zhen Wang

Background: Converging evidence suggests that stress alters behavioural responses in a sex-specific manner; however, the underlying molecular mechanisms of stress remain largely unknown.

Methods: We adapted unpredictable maternal separation (UMS) and adult restraint stress (RS) paradigms to mimic stress in rats in early life or adulthood, respectively. The sexual dimorphism of the prefrontal cortex was noted, and we performed RNA sequencing (RNA-Seq) to identify specific genes or pathways responsible for sexually dimorphic responses to stress. We then performed quantitative reverse transcription polymerase chain reaction (qRT-PCR) to verify the results of RNA-Seq.

Results: Female rats exposed to either UMS or RS showed no negative effects on anxiety-like behaviours, whereas the emotional functions of the PFC were impaired markedly in stressed male rats. Leveraging differentially expressed genes (DEG) analyses, we identified sex-specific transcriptional profiles associated with stress. There were many overlapping DEGs between UMS and RS transcriptional data sets, where 1406 DEGs were associated with both biological sex and stress, while only 117 DEGs were related to stress. Notably, Uba52 and Rpl34-ps1 were the first-ranked hub gene in 1406 and 117 DEGs respectively, and Uba52 was higher than Rp134-ps1, suggesting that stress may have led to a more pronounced effect on the set of 1406 DEGs. Pathway analysis revealed that 1406 DEGs were primarily enriched in ribosomal pathway. These results were confirmed by qRT-PCR.

Limitations: Sex-specific transcriptional profiles associated with stress were identified in this study, but more in-depth experiments, such as single-cell sequencing and manipulation of male and female gene networks in vivo, are needed to verify our findings.

Conclusion: Our findings show sex-specific behavioural responses to stress and highlight sexual dimorphism at the transcriptional level, shedding light on developing sex-specific therapeutic strategies for stress-related psychiatric disorders.

背景:大量证据表明,压力会以特定性别的方式改变行为反应;然而,应激的潜在分子机制在很大程度上仍是未知的。方法:我们采用了不可预测的母体分离(UMS)和成人约束应激(RS)模式,分别模拟大鼠早期或成年期的应激。注意到前额叶皮层的两性异形,我们进行了RNA测序(RNA-Seq),以确定负责对压力的两性异形反应的特定基因或途径。然后,我们进行了定量逆转录聚合酶链式反应(qRT-PCR)来验证RNA-Seq的结果。结果:暴露于UMS或RS的雌性大鼠对焦虑样行为没有负面影响,而应激雄性大鼠的PFC情绪功能明显受损。利用差异表达基因(DEG)分析,我们确定了与应激相关的性别特异性转录谱。UMS和RS转录数据集之间存在许多重叠的DEG,其中1406个DEG与生物性别和应激均相关,而只有117个DEG和应激相关。值得注意的是,Uba52和Rpl34-ps1分别是1406个和117个DEG中排名第一的枢纽基因,并且Uba52高于Rp134-ps1,这表明应激可能对1406个DEG组产生了更显著的影响。途径分析显示,1406个DEG主要富集在核糖体途径中。这些结果得到了qRT-PCR的证实。模拟:本研究确定了与应激相关的性别特异性转录谱,但还需要更深入的实验,如单细胞测序和体内雄性和雌性基因网络的操作,来验证我们的发现。结论:我们的研究结果显示了对压力的性别特异性行为反应,并强调了转录水平上的性别二态性,为开发压力相关精神疾病的性别特异治疗策略提供了线索。
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引用次数: 1
Effect of short-term, high-dose probiotic supplementation on cognition, related brain functions and BDNF in patients with depression: a secondary analysis of a randomized controlled trial. 短期、高剂量补充益生菌对抑郁症患者认知、相关脑功能和 BDNF 的影响:随机对照试验的二次分析。
IF 4.1 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-18 Print Date: 2023-01-01 DOI: 10.1503/jpn.220117
Else Schneider, Jessica P K Doll, Nina Schweinfurth, Cedric Kettelhack, Anna-Chiara Schaub, Gulnara Yamanbaeva, Nimmy Varghese, Laura Mählmann, Serge Brand, Anne Eckert, Stefan Borgwardt, Undine E Lang, André Schmidt

Background: In major depressive disorder (MDD), cognitive dysfunctions strongly contribute to functional impairments but are barely addressed in current therapies. Novel treatment strategies addressing cognitive symptoms in depression are needed. As the gut microbiota-brain axis is linked to depression and cognition, we investigated the effect of a 4-week high-dose probiotic supplementation on cognitive symptoms in depression.

Methods: This randomized controlled trial included 60 patients with MDD, of whom 43 entered modified intention-to-treat analysis. A probiotic supplement or indistinguishable placebo containing maltose was administered over 31 days in addition to treatment as usual for depression. Participant scores on the Verbal Learning Memory Test (VLMT), Corsi Block Tapping Test, and both Trail Making Test versions as well as brain-derived neurotrophic factor levels were assessed at 3 different time points: before, immediately after and 4 weeks after intervention. Additionally, brain activation changes during working memory processing were investigated before and immediately after intervention.

Results: We found a significantly improved immediate recall in the VLMT in the probiotic group immediately after intervention, and a trend for a time × group interaction considering all time points. Furthermore, we found a time × group interaction in hippocampus activation during working memory processing, revealing a remediated hippocampus function in the probiotic group. Other measures did not reveal significant changes.

Limitations: The modest sample size resulting from our exclusion of low-compliant cases should be considered.

Conclusion: Additional probiotic supplementation enhances verbal episodic memory and affects neural mechanisms underlying impaired cognition in MDD. The present findings support the importance of the gut microbiota-brain axis in MDD and emphasize the potential of microbiota-related regimens to treat cognitive symptoms in depression.

Clinical trial registration: clinicaltrials.gov identifier NCT02957591.

背景:在重度抑郁障碍(MDD)中,认知功能障碍是导致功能障碍的主要原因,但目前的疗法几乎没有解决这一问题。我们需要针对抑郁症认知症状的新型治疗策略。由于肠道微生物群-脑轴与抑郁症和认知功能有关,我们研究了为期 4 周的高剂量益生菌补充剂对抑郁症认知症状的影响:这项随机对照试验纳入了 60 名 MDD 患者,其中 43 人进入了修改后的意向治疗分析。除了按常规治疗抑郁症外,还在31天内服用益生菌补充剂或含有麦芽糖的无差别安慰剂。在3个不同的时间点(干预前、干预后和干预后4周)评估了参与者在言语学习记忆测试(VLMT)、科西块敲击测试和两个版本的路径制作测试中的得分以及脑源性神经营养因子水平。此外,还调查了干预前和干预后大脑在工作记忆处理过程中的激活变化:结果:我们发现,在干预后,益生菌组的 VLMT 即时记忆能力明显提高,而且在所有时间点上都出现了时间×组别的交互作用趋势。此外,我们还发现在工作记忆处理过程中海马激活存在时间×组别的交互作用,这表明益生菌组的海马功能得到了补救。其他指标未发现明显变化:局限性:由于我们排除了低依从性病例,因此样本量不大:结论:额外补充益生菌可增强言语外显记忆,并影响多发性硬化症患者认知功能受损的神经机制。本研究结果支持肠道微生物群-大脑轴在MDD中的重要性,并强调了微生物群相关疗法治疗抑郁症认知症状的潜力。临床试验注册:clinicaltrials.gov标识符NCT02957591。
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引用次数: 0
Action selection in early stages of psychosis: an active inference approach. 精神病早期阶段的行动选择:一种主动推理方法。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.220141
Franziska Knolle, Elisabeth Sterner, Michael Moutoussis, Rick A Adams, Juliet D Griffin, Joost Haarsma, Hilde Taverne, Ian M Goodyer, Paul C Fletcher, Graham K Murray

Background: To interact successfully with their environment, humans need to build a model to make sense of noisy and ambiguous inputs. An inaccurate model, as suggested to be the case for people with psychosis, disturbs optimal action selection. Recent computational models, such as active inference, have emphasized the importance of action selection, treating it as a key part of the inferential process. Based on an active inference framework, we sought to evaluate previous knowledge and belief precision in an action-based task, given that alterations in these parameters have been linked to the development of psychotic symptoms. We further sought to determine whether task performance and modelling parameters would be suitable for classification of patients and controls.

Methods: Twenty-three individuals with an at-risk mental state, 26 patients with first-episode psychosis and 31 controls completed a probabilistic task in which action choice (go/no-go) was dissociated from outcome valence (gain or loss). We evaluated group differences in performance and active inference model parameters and performed receiver operating characteristic (ROC) analyses to assess group classification.

Results: We found reduced overall performance in patients with psychosis. Active inference modelling revealed that patients showed increased forgetting, reduced confidence in policy selection and less optimal general choice behaviour, with poorer action-state associations. Importantly, ROC analysis showed fair-to-good classification performance for all groups, when combining modelling parameters and performance measures.

Limitations: The sample size is moderate.

Conclusion: Active inference modelling of this task provides further explanation for dysfunctional mechanisms underlying decision-making in psychosis and may be relevant for future research on the development of biomarkers for early identification of psychosis.

背景:为了成功地与环境互动,人类需要建立一个模型来理解嘈杂和模糊的输入。一个不准确的模型,就像精神病患者的情况一样,扰乱了最佳行动选择。最近的计算模型,如主动推理,强调了行动选择的重要性,将其视为推理过程的关键部分。基于一个主动推理框架,我们试图评估先前的知识和信念的准确性在一个基于行动的任务中,考虑到这些参数的改变与精神病症状的发展有关。我们进一步试图确定任务表现和建模参数是否适用于患者和对照组的分类。方法:23名精神状态有危险的个体、26名首发精神病患者和31名对照者完成了一项概率任务,在该任务中,行动选择(走/不走)与结果效价(得或失)分离。我们评估了各组在性能和主动推理模型参数方面的差异,并进行了受试者工作特征(ROC)分析来评估组分类。结果:我们发现精神病患者的整体表现下降。主动推理模型显示,患者表现出遗忘增加,对政策选择的信心降低,一般选择行为不太理想,行为状态关联较差。重要的是,当结合建模参数和性能测量时,ROC分析显示所有组的分类性能都很好。局限性:样本量适中。结论:该任务的主动推理建模为精神病决策机制的功能障碍提供了进一步的解释,并可能与未来开发用于早期识别精神病的生物标志物的研究相关。
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引用次数: 2
Altered regional homogeneity and its association with cognitive function in adolescents with borderline personality disorder. 边缘型人格障碍青少年的区域同质性改变及其与认知功能的关系。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.220144
Xiaoping Yi, Yan Fu, Zhejia Zhang, Furong Jiang, Qian Xiao, Bihong T Chen

Background: Adolescents with borderline personality disorder often have cognitive impairment, but the underlying mechanism for this is not clear. This study was aimed at assessing alterations in regional homogeneity using resting-state functional MRI (fMRI) in adolescents with borderline personality disorder, and evaluating the associations between regional homogeneity and cognitive testing scores.

Methods: We enrolled 50 adolescents with borderline personality disorder (age 12-17 years) and 21 age- and sex-matched healthy controls. We performed regional homogeneity and seed-based functional connectivity analysis for both groups. We also performed correlative analysis for regional homogeneity and cognitive testing scores.

Results: Compared with healthy controls, adolescents with borderline personality disorder had reduced regional homogeneity values in the frontal cortex (including the left inferior orbitofrontal cortex and the bilateral superior frontal cortex) as well as in the left precuneus in the default mode network. Adolescents with borderline personality disorder also had higher regional homogeneity values in several cortical regions: the right middle temporal gyrus, the right cuneus, the right precentral gyrus and the left middle occipital gyrus. Regional homogeneity values in the left middle occipital gyrus, left inferior orbitofrontal cortex and right superior frontal gyrus were associated with cognitive testing scores in adolescents with borderline personality disorder. We also found increased functional connectivity between the left middle occipital gyrus and right superior frontal gyrus in adolescents with borderline personality disorder.

Limitations: This study had a modest sample size, with a possible case selection bias for patients with more severe illness. This cohort also included patients with comorbidities or taking psychotropic medications, which may have confounded study results.

Conclusion: Alterations in regional homogeneity and functional connectivity in brain regions that involve the limbic-cortical circuit could be neural correlates for cognitive impairment in adolescents with borderline personality disorder.

背景:边缘型人格障碍青少年通常有认知障碍,但其潜在机制尚不清楚。本研究旨在利用静息状态功能MRI (fMRI)评估边缘型人格障碍青少年的区域同质性变化,并评估区域同质性与认知测试分数之间的关系。方法:我们招募了50名患有边缘型人格障碍的青少年(12-17岁)和21名年龄和性别匹配的健康对照。我们对两组进行了区域同质性和基于种子的功能连通性分析。我们还对区域同质性和认知测试分数进行了相关分析。结果:与健康对照组相比,边缘型人格障碍青少年额叶皮质(包括左侧下眶额叶皮质和双侧额叶上皮质)和左侧楔前叶默认模式网络的区域均匀性值降低。边缘型人格障碍青少年在几个皮质区域的区域同质性值也较高:右侧颞中回、右侧楔叶、右侧中央前回和左侧枕中回。青少年边缘型人格障碍患者左枕中回、左下眶额叶皮层和右额上回的区域均匀性值与认知测试成绩相关。我们还发现,在患有边缘型人格障碍的青少年中,左枕中回和右额上回之间的功能连通性增加。局限性:本研究样本量不大,对病情较严重的患者可能存在病例选择偏倚。该队列还包括患有合并症或服用精神药物的患者,这些患者可能会混淆研究结果。结论:边缘型人格障碍青少年认知功能障碍与边缘-皮层回路相关脑区同质性和功能连通性的改变有关。
{"title":"Altered regional homogeneity and its association with cognitive function in adolescents with borderline personality disorder.","authors":"Xiaoping Yi,&nbsp;Yan Fu,&nbsp;Zhejia Zhang,&nbsp;Furong Jiang,&nbsp;Qian Xiao,&nbsp;Bihong T Chen","doi":"10.1503/jpn.220144","DOIUrl":"https://doi.org/10.1503/jpn.220144","url":null,"abstract":"<p><strong>Background: </strong>Adolescents with borderline personality disorder often have cognitive impairment, but the underlying mechanism for this is not clear. This study was aimed at assessing alterations in regional homogeneity using resting-state functional MRI (fMRI) in adolescents with borderline personality disorder, and evaluating the associations between regional homogeneity and cognitive testing scores.</p><p><strong>Methods: </strong>We enrolled 50 adolescents with borderline personality disorder (age 12-17 years) and 21 age- and sex-matched healthy controls. We performed regional homogeneity and seed-based functional connectivity analysis for both groups. We also performed correlative analysis for regional homogeneity and cognitive testing scores.</p><p><strong>Results: </strong>Compared with healthy controls, adolescents with borderline personality disorder had reduced regional homogeneity values in the frontal cortex (including the left inferior orbitofrontal cortex and the bilateral superior frontal cortex) as well as in the left precuneus in the default mode network. Adolescents with borderline personality disorder also had higher regional homogeneity values in several cortical regions: the right middle temporal gyrus, the right cuneus, the right precentral gyrus and the left middle occipital gyrus. Regional homogeneity values in the left middle occipital gyrus, left inferior orbitofrontal cortex and right superior frontal gyrus were associated with cognitive testing scores in adolescents with borderline personality disorder. We also found increased functional connectivity between the left middle occipital gyrus and right superior frontal gyrus in adolescents with borderline personality disorder.</p><p><strong>Limitations: </strong>This study had a modest sample size, with a possible case selection bias for patients with more severe illness. This cohort also included patients with comorbidities or taking psychotropic medications, which may have confounded study results.</p><p><strong>Conclusion: </strong>Alterations in regional homogeneity and functional connectivity in brain regions that involve the limbic-cortical circuit could be neural correlates for cognitive impairment in adolescents with borderline personality disorder.</p>","PeriodicalId":50073,"journal":{"name":"Journal of Psychiatry & Neuroscience","volume":"48 1","pages":"E1-E10"},"PeriodicalIF":4.3,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/31/48-1-E1.PMC9829058.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10682249","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: 4
Thalamocortical functional connectivity in youth with attention-deficit/hyperactivity disorder. 青少年注意缺陷/多动障碍的丘脑皮质功能连通性。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.220109
Soon-Beom Hong

Background: Few studies have empirically tested the relationships between anatomically defined thalamic nuclei and functionally defined cortical networks, and little is known about their implications in attention-deficit/hyperactivity disorder (ADHD). This study aimed to investigate the functional connectivity of the thalamus in youth with ADHD, using both anatomically and functionally defined thalamic seed regions.

Methods: Resting-state functional MRIs obtained from the publicly available ADHD-200 database were analyzed. Thalamic seed regions were defined functionally and anatomically based on Yeo's 7 resting-state-network parcellation atlas and the AAL3 atlas, respectively. Functional connectivity maps of the thalamus were extracted, and thalamocortical functional connectivity was compared between youth with and without ADHD.

Results: Using the functionally defined seeds, significant group differences in thalamocortical functional connectivity and significant negative correlations between thalamocortical connectivity and ADHD symptom severity were observed within the boundaries of corresponding large-scale networks. However, in the analysis using the anatomically defined thalamic seeds, significant group differences in connectivity and significant positive correlations were observed outside the expected boundaries of major anatomic projections. The thalamocortical connectivity originating from the lateral geniculate nuclei of the thalamus was significantly correlated with age in youth with ADHD.

Limitations: The small sample size and smaller proportion of girls were limiting factors.

Conclusion: Thalamocortical functional connectivity based on the intrinsic network architecture of the brain appears to be clinically relevant in ADHD. The positive association between thalamocortical functional connectivity and ADHD symptom severity may represent a compensatory process recruiting an alternative neural network.

背景:很少有研究对解剖定义的丘脑核和功能定义的皮层网络之间的关系进行实证检验,并且对它们在注意缺陷/多动障碍(ADHD)中的意义知之甚少。本研究旨在利用解剖学和功能上定义的丘脑种子区来研究青少年多动症丘脑的功能连通性。方法:分析从公开的ADHD-200数据库中获得的静息状态功能核磁共振成像。基于Yeo's 7静息状态网络分割图谱和AAL3图谱,分别对丘脑种子区进行了功能和解剖上的定义。提取了丘脑的功能连接图,并比较了有和没有多动症的青少年的丘脑皮质功能连接。结果:使用功能定义的种子,在相应的大规模网络边界内,观察到丘脑皮质功能连通性的组间显著差异,以及丘脑皮质连通性与ADHD症状严重程度的显著负相关。然而,在使用解剖学定义的丘脑种子进行分析时,在主要解剖投影的预期边界之外观察到显著的组间连通性差异和显著的正相关性。来自丘脑外侧膝状核的丘脑皮质连通性与青少年ADHD患者的年龄显著相关。局限性:样本量小,女生比例小是限制因素。结论:基于大脑内在网络结构的丘脑皮质功能连通性似乎与ADHD临床相关。丘脑皮质功能连通性与ADHD症状严重程度之间的正相关可能代表了一个代偿过程,需要一个替代的神经网络。
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引用次数: 1
Utilizing pharmacogenetics when treating first episode psychosis. 利用药物遗传学治疗首发精神病。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.220154
Theo Korchia, Ridha Joober, Raphaelle Richieri, Priyadharshini Sabesan, Lena Palaniyappan
The parents of a 21-year-old man brought him to an emergency psychiatric clinic for disturbed behaviour. He displayed significant hallucinatory behaviour, prominent delusions of persecution involving “special forces” and notable disorganization of speech, and had experienced more than 8 months of sociooccupational dysfunction. Upon admission, neurologic examination was unremarkable and results of routine metabolic, endocrine, liver and renal screening were within normal limits. He met the diagnostic criteria for schizophrenia, with a first episode of untreated psychosis. He was prescribed 10 mg aripiprazole for 4 days, but quickly developed adverse effects with disabling extrapyramidal rigidity. He then was switched to 2 mg risperidone, but after 1 week, he presented hypersalivation and debilitating daytime sleepiness. Despite ongoing hallucinations and persecutory fears, he refused the options of clozapine, olanzapine and quetiapine owing to concerns about weight gain, but he accepted haloperidol. He was put on 5 mg haloperidol, but he soon reported tremors, stiffness and a notable anhedonia. At this stage, we sought a cytochrome P450 (CYP450) genotype assay for 2C19 and 2D6. The patient was found to be a normal (extensive) metaboliser for 2C19 but a poor metaboliser (PM) for CYP2D6. Haloperidol, aripiprazole and risperidone are likely to be degraded too slowly in patients who are CYP2D6 PM, leading to treatment failure, and risperidone is likely to be too slowly converted to its active metabolite, leading to a greater risk of adverse effects. The patient consented to be switched to paliperidone, and a rapid antipsychotic response followed over the next 10 days. The patient was discharged on 6 mg/d paliperidone and had a score of 2 on the Clinical Global Impressions Scale of Severity at 6 months. Most antipsychotics are hepatically metabolized by several CYP450 enzymes, but some, like paliperidone or amisulpride, are less metabolized than others.1 In clinical practice, pharmacogenomic testing of CYP2D6 and CYP2C19 is seldom done, likely because many prescribers do not consider genetic factors to be critical for treatment choice, dose titration or adverse effect reduction.2 The prevalence of PMs and ultra-rapid metabolizers (UM) is estimated to be less than 5% in Euro peans (with notable variations across other ethnicities4,5); preventive testing is deemed to have low yield in practice. Thus, the maximum daily doses recommended for antipsychotics are based on a genotype-weighted population equilibrium that ignores the clinical relevance of CYP2C19/CYP2D6 metab olizer categories. Nevertheless, several product labels offer dosing recommendations based on metabolizer status,2 and many commercial tests are now available to assist prescribers.5 Of relevance to the present case is a recent large retrospective observational study confirming the higher frequency of treatment failures in PMs.6 CYP2D6 PMs are 2–3 times more frequent than UMs among Euro pea
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引用次数: 2
Is history of abuse predictive of eating disorders with binge-eating episodes through an effect mediated by impulsivity? A French longitudinal study. 滥用史是否可以通过冲动介导的效应预测暴饮暴食的饮食失调?一项法国纵向研究。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.210218
Clémence Cabelguen, Anaïs Saillard, Antoine Vanier, Manuel Laslandes, Juliette Leboucher, Morgane Rousselet, Elsa Thiabaud, Marie Grall-Bronnec, Gaëlle Challet-Bouju

Background: In recent years, many studies have explored the associations among impulsivity, history of abuse, the emergence of eating disorders with episodes of binge eating (EDBE) and their severity. Nevertheless, factors associated with successful clinical outcomes of EDBE are still unknown. Our study aimed to test the hypothesis that a history of abuse is associated with unsuccessful clinical outcomes of EDBE through an effect mediated by impulsivity.

Methods: We assessed patients older than 15 years, 3 months with EDBE at inclusion and at 1 year. Recovery was defined as the absence of eating disorders at 1 year. A mediation analysis was performed by means of structural equation modelling.

Results: We included 186 patients in our analyses (54% bulimia nervosa, 29% anorexia nervosa binge eating/purging type and 17% binge-eating disorder); 179 (96%) were female. One-third (n = 63) of patients reported a history of abuse, and recovery was observed for 20% of the sample (n = 38). Contrary to our assumption, a history of abuse was not associated with the absence of recovery of EDBE at 1 year. Factors unfavourable for achieving recovery were anxiety disorders (odds ratio [OR] 0.41), vomiting (OR 0.39), physical hyperactivity (OR 0.29), negative urgency and a lack of perseverance (OR 0.85 for both). Only positive urgency was positively associated with recovery (OR 1.25).

Limitations: We excluded 219 patients lost to the 1-year follow-up.

Conclusion: Our findings may help to deconstruct the empirical belief that traumatic events may interfere with the successful course of treatment for eating disorders. A high level of positive urgency may be associated with more receptivity to care.

背景:近年来,许多研究探讨了冲动、虐待史、饮食失调与暴食发作(EDBE)及其严重程度之间的关系。然而,与EDBE成功临床结果相关的因素仍然未知。我们的研究旨在通过冲动介导的效应来验证滥用史与EDBE不成功的临床结果相关的假设。方法:我们评估了年龄大于15岁3个月的EDBE患者在纳入和1年时的情况。康复的定义是1年内没有饮食失调。通过结构方程模型进行中介分析。结果:我们纳入186例患者(54%为神经性贪食症,29%为神经性厌食症暴食/泻型,17%为暴食症);179例(96%)为女性。三分之一(n = 63)的患者报告有虐待史,20%的患者(n = 38)康复。与我们的假设相反,滥用史与1年内未恢复EDBE无关。对康复不利的因素有焦虑障碍(比值比[OR] 0.41)、呕吐(OR 0.39)、身体多动(OR 0.29)、消极急迫感和缺乏毅力(两者比值比均为0.85)。只有积极的紧迫感与恢复呈正相关(OR 1.25)。局限性:我们排除了219例1年随访失败的患者。结论:我们的研究结果可能有助于解构创伤性事件可能影响饮食失调成功治疗过程的经验信念。高度的积极紧迫感可能与更容易接受护理有关。
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引用次数: 2
Hippocampal subfield alterations in schizophrenia and major depressive disorder: a systematic review and network meta-analysis of anatomic MRI studies. 精神分裂症和重度抑郁症的海马亚区改变:解剖MRI研究的系统回顾和网络荟萃分析。
IF 4.3 2区 医学 Q2 NEUROSCIENCES Pub Date : 2023-01-01 DOI: 10.1503/jpn.220086
Yuan Sun, Na Hu, Mingqi Wang, Lu Lu, Chunyan Luo, Biqiu Tang, Chenyang Yao, John A Sweeney, Qiyong Gong, Changjian Qiu, Su Lui

Background: Hippocampal disturbances are important in the pathophysiology of both schizophrenia and major depressive disorder (MDD). Imaging studies have shown selective volume deficits across hippocampal subfields in both disorders. We aimed to investigate whether these volumetric alterations in hippocampal subfields are shared or divergent across disorders.

Methods: We searched PubMed and Embase from database inception to May 8, 2021. We identified MRI studies in patients with schizophrenia, MDD or both, in which hippocampal subfield volumes were measured. We excluded nonoriginal, animal or postmortem studies, and studies that used other imaging modalities or overlapping data. We conducted a network meta-analysis to estimate and contrast alterations in subfield volumes in the 2 disorders.

Results: We identified 45 studies that met the initial criteria for systematic review, of which 15 were eligible for network metaanalysis. Compared to healthy controls, patients with schizophrenia had reduced volumes in the bilateral cornu ammonis (CA) 1, granule cell layer of the dentate gyrus, subiculum, parasubiculum, molecular layer, hippocampal tail and hippocampus-amygdala transition area (HATA); in the left CA4 and presubiculum; and in the right fimbria. Patients with MDD had decreased volumes in the left CA3 and CA4 and increased volumes in the right HATA compared to healthy controls. The bilateral parasubiculum and right HATA were smaller in patients with schizophrenia than in patients with MDD.

Limitations: We did not investigate medication effects because of limited information. Study heterogeneity was noteworthy in direct comparisons between patients with MDD and healthy controls.

Conclusion: The volumes of multiple hippocampal subfields are selectively altered in patients with schizophrenia and MDD, with overlap and differentiation in subfield alterations across disorders. Rigorous head-to-head studies are needed to validate our findings.

背景:海马紊乱在精神分裂症和重度抑郁症(MDD)的病理生理中都很重要。影像学研究显示,这两种疾病的海马亚区都存在选择性体积缺陷。我们的目的是研究海马体亚区的这些体积变化是否在不同的疾病中是共同的还是不同的。方法:检索PubMed和Embase数据库自建库至2021年5月8日。我们确定了对精神分裂症、重度抑郁症或两者兼而有之的患者进行MRI研究,在这些研究中测量了海马体亚区体积。我们排除了非原始、动物或死后的研究,以及使用其他成像方式或重叠数据的研究。我们进行了一项网络荟萃分析,以估计和对比两种疾病的子场体积的变化。结果:我们确定了45项符合系统评价初始标准的研究,其中15项符合网络荟萃分析的条件。与健康对照组相比,精神分裂症患者双侧锥体(CA) 1、齿状回颗粒细胞层、枕下、副枕骨、分子层、海马尾和海马-杏仁核过渡区(HATA)体积减小;左侧CA4和下骨前;在右边的肠膜里。与健康对照相比,MDD患者左侧CA3和CA4的容量减少,右侧HATA的容量增加。精神分裂症患者的双侧耻骨旁和右侧HATA小于重度抑郁症患者。局限性:由于信息有限,我们没有调查药物效应。研究异质性在重度抑郁症患者和健康对照之间的直接比较中值得注意。结论:在精神分裂症和重度抑郁症患者中,多个海马体亚区体积存在选择性改变,且在不同疾病的亚区改变中存在重叠和分化。需要严格的面对面研究来验证我们的发现。
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引用次数: 6
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Journal of Psychiatry & Neuroscience
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