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Grief-Specific or Domain-General? Integrative Neuroimaging Perspectives for Understanding Long-Term Grief 特定悲伤还是一般领域?理解长期悲伤的综合神经影像学观点
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2025.10.008
Saren H. Seeley
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引用次数: 0
Auditory and Visual Thalamocortical Connectivity Alterations in Unmedicated People With Schizophrenia: An Individualized Sensory Thalamic Localization and Resting-State Functional Connectivity Study 未服药的精神分裂症患者的听觉和视觉丘脑皮质连通性改变:一项个性化的感觉丘脑定位和静息状态功能连通性研究。
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2025.05.016
John C. Williams , Philip N. Tubiolo , Roberto B. Gil , Zu Jie Zheng , Eilon B. Silver-Frankel , Natalka K. Haubold , Sameera K. Abeykoon , Dathy T. Pham , Najate Ojeil , Kelly Bobchin , Mark Slifstein , Jodi J. Weinstein , Greg Perlman , Guillermo Horga , Anissa Abi-Dargham , Jared X. Van Snellenberg

Background

Converging evidence from clinical neuroimaging and animal models has strongly implicated dysfunction of thalamocortical circuits in the pathophysiology of schizophrenia (SZ). Preclinical models of genetic risk for SZ have shown reduced synaptic transmission from the auditory thalamus to the primary auditory cortex, which may represent a correlate of auditory disturbances such as hallucinations. However, human neuroimaging studies have found a generalized increase in resting-state functional connectivity (RSFC) between whole thalamus and sensorimotor cortex in people with SZ (PSZ). We aimed to more directly translate preclinical findings by specifically localizing auditory and visual thalamic nuclei in unmedicated PSZ and measuring RSFC to primary sensory cortices.

Methods

In this case-control study, 82 unmedicated PSZ and 55 matched healthy control participants (HCs) completed RSFC functional magnetic resonance imaging (fMRI) (N = 137). Auditory and visual thalamic nuclei were localized for 55 unmedicated PSZ and 46 HCs who also completed a sensory thalamic nuclei localizer fMRI task (n = 101). Using localized nuclei as RSFC seeds, we assessed group differences in auditory and visual thalamocortical connectivity and associations with positive symptom severity.

Results

Auditory thalamocortical connectivity was not significantly different between PSZ and HCs, but hyperconnectivity was associated with greater positive symptom severity in the bilateral superior temporal gyrus. Visual thalamocortical connectivity was significantly greater in PSZ relative to HCs in the secondary and higher-order visual cortex but was not predictive of positive symptom severity.

Conclusions

These results indicate that visual thalamocortical hyperconnectivity is a generalized marker of SZ, while hyperconnectivity in auditory thalamocortical circuits relates more specifically to positive symptom severity.
背景:来自临床神经影像学和动物模型的越来越多的证据强烈地暗示了精神分裂症病理生理中丘脑皮质回路的功能障碍。精神分裂症遗传风险的临床前模型显示,从听觉丘脑到初级听觉皮层的突触传递减少,这可能与幻觉等听觉障碍有关。然而,人类神经影像学研究发现,在精神分裂症(PSZ)患者中,整个丘脑和感觉运动皮层之间的静息状态功能连接(RSFC)普遍增加。我们的目的是通过在未用药的PSZ中特异性定位听觉和视觉丘脑核,并测量初级感觉皮层的RSFC,更直接地转化临床前研究结果。方法:在本病例对照研究中,82名未服药的PSZ和55名匹配的健康对照(HC)完成了RSFC功能磁共振成像(fMRI)。55名未服药的PSZ和46名额外完成感觉丘脑核定位任务的HC被定位为听觉和视觉丘脑核(N = 101)。使用局部核作为RSFC种子,我们评估了听觉和视觉丘脑皮质连通性的组间差异以及与阳性症状严重程度的关联。结果:听觉丘脑皮质连通性在PSZ和HC之间无显著差异,但双侧颞上回的高连通性与更大的阳性症状严重程度相关。与HC相比,PSZ的视觉丘脑皮质连通性在二级和高阶视觉皮质中显著增加,但不能预测阳性症状的严重程度。结论:这些结果表明,视觉丘脑皮质超连通性是精神分裂症的一个普遍标志,而听觉丘脑皮质回路的超连通性与阳性症状的严重程度有更具体的关系。
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引用次数: 0
Guide for Authors 作者指南
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/S2451-9022(25)00343-X
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引用次数: 0
The Sensitivity of the Mini-Mental State Examination to Detect Objective Cognitive Side Effects Induced by Electroconvulsive Therapy: Results From the Dutch ECT Consortium 小型精神状态检查对检测电休克疗法引起的客观认知副作用的敏感性,荷兰电休克疗法联合会的研究结果。
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2024.08.002
Dore Loef , Philip F.P. van Eijndhoven , Sigfried N.T.M. Schouws , Arjen J.C. Slooter , Nikki Janssen , Rob M. Kok , Bart P.F. Rutten , Eric van Exel , Didi Rhebergen , Mardien L. Oudega , Roel J.T. Mocking , Indira Tendolkar , Annemiek Dols , Esmée Verwijk

Background

Monitoring cognitive side effects following electroconvulsive therapy (ECT) is crucial for balancing side effects and clinical effectiveness. Yet, evidence-based guidelines on cognitive testing following ECT are lacking. A frequently used test in global ECT practice is the Mini-Mental State Examination (MMSE). We examined the change of the MMSE score and its performance in identifying a decline in predefined neuropsychological measures sensitive to ECT-induced cognitive changes: verbal recall and verbal fluency.

Methods

Mean MMSE scores before and 1 week after ECT were compared using a Wilcoxon signed rank test. The Reliable Change Index was calculated for all cognitive measures to indicate whether a participant’s change in score from pre- to post-ECT was considered statistically significant. The sensitivity and specificity of the MMSE were calculated.

Results

A total of 426 patients with depression from 5 sites were included from the Dutch ECT Consortium. Mean (SD) MMSE score increased significantly from 26.2 (3.9) before ECT to 26.8 (3.8) after ECT (p = .002). After ECT, 36 patients (8.5%) showed a significant decline in MMSE score. The sensitivity of the MMSE in identifying patients who experienced a significant decline in verbal recall or verbal fluency ranged from 3.6% to 11.1%. The specificity of the MMSE in identifying patients who did not experience a significant decline in verbal recall or verbal fluency ranged from 95.6% to 96.6%.

Conclusions

Given the very low sensitivity of the MMSE, we propose reconsidering the prominence of the MMSE in ECT practice and cognitive monitoring guidelines, advocating for a more comprehensive approach to assess ECT-induced cognitive changes.
背景:监测电休克疗法(ECT)后的认知副作用对于平衡副作用和临床疗效至关重要。遗憾的是,目前还缺乏有关电休克疗法后认知测试的循证指南。全球 ECT 实践中经常使用的测试是迷你精神状态检查(MMSE)。我们研究了 MMSE 的变化及其在识别对 ECT 引起的认知变化敏感的预定义神经心理学指标(言语回忆和言语流畅性)下降方面的表现:采用Wilcoxon符号秩检验比较ECT前和ECT后一周的MMSE平均得分。计算所有认知指标的可靠变化指数,以表明个人从治疗前到治疗后的得分变化是否具有统计学意义。计算了 MMSE 的敏感性和特异性:结果:荷兰 ECT 联合会共纳入了来自五个地点的 426 名抑郁症患者。MMSE的平均值从ECT前的26.2(SD=3.9)显著增加到ECT后的26.8(SD=3.8)(P=0.002)。36名患者(8.5%)在ECT后的MMSE评分明显下降。MMSE 在识别言语回忆或言语流利性显著下降的患者方面的灵敏度为 3.6% 至 11.1%。MMSE在识别言语回忆能力或言语流畅性未显著下降的患者方面的特异性为95.6%至96.6%:鉴于MMSE的灵敏度非常低,我们建议重新考虑MMSE在ECT实践和认知监测指南中的重要性,提倡采用更全面的方法来评估ECT引起的认知变化。
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引用次数: 0
Obsessive-Compulsive Disorder Comorbid With or Without Obsessive-Compulsive Personality Disorder: Conceptual Implications, Clinical Correlates, and Brain Morphometries 强迫症合并或不合并强迫性人格障碍:概念含义、临床相关性和脑形态测量。
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2024.09.010
Chen Zhang , Zongfeng Zhang , Rui Gao , Yongjun Chen , Xuan Cao , Xianghan Yi , Qing Fan

Background

Obsessive-compulsive disorder (OCD) is often comorbid with obsessive-compulsive personality disorder (OCPD). The relationship between OCD and OCPD is complex, and the impact of comorbid OCPD on OCD remains underexplored, necessitating further research. In this study, we aimed to investigate the clinical correlates and brain morphometries associated with comorbid OCPD in a large sample of unmedicated patients with OCD.

Methods

A total of 248 unmedicated patients diagnosed with OCD (45 comorbid with OCPD) were included in this study. All participants were assessed for OCD symptoms, OCPD traits, obsessive beliefs, depression, and anxiety. Among them, 145 patients (23 comorbid with OCPD) volunteered to receive magnetic resonance imaging brain scans.

Results

Approximately 18% (45/248) of patients with OCD were comorbid for OCPD (OCD+OCPD). Patients with OCD+OCPD exhibited more severe OCD symptoms, obsessive beliefs, depression, and anxiety than OCD patients without OCPD. Additionally, the severity of OCPD was positively correlated with OCD symptoms and obsessive beliefs. Furthermore, patients with OCD+OCPD exhibited increased cortical complexity in the left superior parietal lobule and left precuneus, which mediated the relationship between OCPD and OCD symptoms only in OCD patients without OCPD.

Conclusions

The co-occurrence of OCPD may contribute to the heightened severity of psychopathological symptoms and associated brain morphological alterations in patients with OCD, indicating distinct but interrelated constructs between these 2 disorders.
背景:强迫症(OCD)通常与强迫性人格障碍(OCPD)并发。强迫症与强迫性人格障碍之间的关系十分复杂,而合并强迫性人格障碍对强迫症的影响仍未得到充分探讨,因此有必要开展进一步研究。本研究旨在调查大量未服药强迫症患者的临床相关性以及与合并 OCPD 相关的大脑形态:本研究共纳入了 248 名未经治疗的强迫症患者(其中 45 人合并有 OCPD)。所有参与者均接受了强迫症症状、强迫症特质、强迫观念、抑郁和焦虑的评估。其中,145 名患者(23 名合并有 OCPD)自愿接受磁共振成像(MRI)脑部扫描:结果:约 18% 的强迫症患者(45/248)合并有 OCPD。与未合并 OCPD 的强迫症患者相比,合并 OCPD 的强迫症患者(OCD+OCPD)表现出更严重的强迫症症状、强迫观念、抑郁和焦虑。此外,OCPD 的严重程度与强迫症症状和强迫观念呈正相关。此外,强迫症+强迫症患者左侧顶叶上部和左侧楔前叶的皮层复杂性增加,只有合并无强迫症的强迫症患者的皮层复杂性才会介导强迫症与强迫症症状之间的关系:结论:OCPD的并发可能会导致强迫症患者精神病理症状的严重程度和相关的大脑形态学改变,这表明这两种疾病之间存在不同但相互关联的结构。
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引用次数: 0
Neuroimaging and Glutamatergic Trials in Psychosis: Where Are We Standing, and Where Do We Go Now? 精神疾病的神经影像学和谷氨酸能试验:我们现在站在哪里,我们现在要去哪里?
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2025.10.003
Camilo de la Fuente-Sandoval
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引用次数: 0
Accelerated Aging of White Matter in Late-Life Depression: Evidence From 18F-Flutemetamol Positron Emission Tomography Imaging 老年抑郁症患者白质加速老化:来自18f氟替他莫PET成像的证据
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2025.03.013
Akihiro Takamiya , Thomas Vande Casteele , Filip Bouckaert , Margot G.A. Van Cauwenberge , Maarten Laroy , François-Laurent De Winter , Patrick Dupont , Jan Van den Stock , Michel Koole , Koen Van Laere , Louise Emsell , Mathieu Vandenbulcke

Background

Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates that amyloid positron emission tomography (PET) tracers are sensitive and reliable markers for evaluating normal-appearing WM (NAWM) on magnetic resonance imaging (MRI), showing an association between lower uptake and Alzheimer’s disease pathology and higher uptake with age-related changes. Utilizing this novel and reliable technique, we aimed to distinguish between 2 hypothetical models for neurobiology of LLD, the pathological neurodegenerative model and the accelerated aging model.

Methods

In this monocentric cross-sectional study, a total of 103 participants, including 61 patients with LLD (age 73.8 ± 7.0 years; 41 female) and 42 healthy control (HC) participants (age 72.5 ± 7.6 years; 28 female), underwent PET imaging with 18F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery images were segmented into WM hyperintensities (WMHs) and NAWM.

Results

The 18F-flutemetamol standardized uptake value ratio (SUVR) in WMHs was significantly lower than that in NAWM (t102 = 7.8, p < .001). Compared with HC participants, patients with LLD exhibited higher 18F-flutemetamol SUVR in both NAWM (p < .001, Cohen’s d = 0.91) and WMHs (p = .005, d = 0.56), even after controlling for age and 18F-flutemetamol SUVR in cortical gray matter.

Conclusions

Our result of elevated 18F-flutemetamol uptake in NAWM is not consistent with the pathological neurodegenerative aging pattern observed in Alzheimer’s disease but is consistent with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.
背景:老年抑郁症(LLD)与白质(WM)改变有关。目前的证据表明,淀粉样蛋白PET示踪剂是在磁共振成像(MRI)上评估正常表现的WM (NAWM)的敏感和可靠的标志物,显示低摄取与阿尔茨海默病病理之间的关联,以及高摄取与年龄相关变化之间的关联。利用这种新颖可靠的技术,我们旨在区分两种假设的LLD神经生物学模型:病理性神经退行性模型和加速衰老模型。方法:在这项单中心横剖面研究中,共有103名参与者,包括61名LLD患者(年龄73.8±7.0岁,41名女性)和42名健康对照者(年龄72.5±7.6岁,28名女性),接受了18f氟替他莫PET成像、MRI和临床评估。将t2加权流体衰减反演恢复(FLAIR)图像分割为WM高强度(WMH)和NAWM。结果:WMH组的18f -氟替他莫标准化摄取值比(SUVR)显著低于NAWM组(t=7.8, df=102), NAWM组的p18f -氟替他莫标准化摄取值比(SUVR)显著低于NAWM组(p18f -氟替他莫皮质灰质SUVR)。结论:NAWM中18f -氟替他莫摄入量升高的结果与阿尔茨海默病中观察到的病理性神经退行性衰老模式不一致,但与年龄相关的变化模式一致。这种区别对于未来靶向治疗的发展至关重要。
{"title":"Accelerated Aging of White Matter in Late-Life Depression: Evidence From 18F-Flutemetamol Positron Emission Tomography Imaging","authors":"Akihiro Takamiya ,&nbsp;Thomas Vande Casteele ,&nbsp;Filip Bouckaert ,&nbsp;Margot G.A. Van Cauwenberge ,&nbsp;Maarten Laroy ,&nbsp;François-Laurent De Winter ,&nbsp;Patrick Dupont ,&nbsp;Jan Van den Stock ,&nbsp;Michel Koole ,&nbsp;Koen Van Laere ,&nbsp;Louise Emsell ,&nbsp;Mathieu Vandenbulcke","doi":"10.1016/j.bpsc.2025.03.013","DOIUrl":"10.1016/j.bpsc.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div><span>Late-life depression (LLD) is associated with white matter (WM) alterations. Current evidence indicates that amyloid positron emission tomography (PET) </span>tracers are sensitive and reliable markers for evaluating normal-appearing WM (NAWM) on magnetic resonance imaging (MRI), showing an association between lower uptake and Alzheimer’s disease pathology and higher uptake with age-related changes. Utilizing this novel and reliable technique, we aimed to distinguish between 2 hypothetical models for neurobiology of LLD, the pathological neurodegenerative model and the accelerated aging model.</div></div><div><h3>Methods</h3><div>In this monocentric cross-sectional study, a total of 103 participants, including 61 patients with LLD (age 73.8 ± 7.0 years; 41 female) and 42 healthy control (HC) participants (age 72.5 ± 7.6 years; 28 female), underwent PET imaging with <sup>18</sup>F-flutemetamol, MRI, and clinical assessment. T2-weighted fluid-attenuated inversion recovery images were segmented into WM hyperintensities (WMHs) and NAWM.</div></div><div><h3>Results</h3><div>The <sup>18</sup><span>F-flutemetamol standardized uptake value ratio (SUVR) in WMHs was significantly lower than that in NAWM (</span><em>t</em><sub>102</sub> = 7.8, <em>p</em> &lt; .001). Compared with HC participants, patients with LLD exhibited higher <sup>18</sup>F-flutemetamol SUVR in both NAWM (<em>p</em> &lt; .001, Cohen’s <em>d</em> = 0.91) and WMHs (<em>p</em> = .005, <em>d</em> = 0.56), even after controlling for age and <sup>18</sup>F-flutemetamol SUVR in cortical gray matter.</div></div><div><h3>Conclusions</h3><div>Our result of elevated <sup>18</sup><span>F-flutemetamol uptake in NAWM is not consistent with the pathological neurodegenerative aging pattern observed in Alzheimer’s disease but is consistent with patterns of age-related changes. This distinction is crucial for the development of future targeted treatments.</span></div></div>","PeriodicalId":54231,"journal":{"name":"Biological Psychiatry-Cognitive Neuroscience and Neuroimaging","volume":"10 12","pages":"Pages 1294-1301"},"PeriodicalIF":4.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Influence of Maternal and Paternal Parenting on Adolescent Brain Structure 母亲和父亲的养育方式对青少年大脑结构的影响。
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2024.06.013
Qingwen Ding , Xinying Li , Divyangana Rakesh , Siya Peng , Jiahua Xu , Jie Chen , Nengzhi Jiang , Yu Luo , Xuebing Li , Shaozheng Qin , Sarah Whittle

Background

Adolescents raised in families with different maternal and paternal parenting combinations exhibit variations in neurocognition and psychopathology; however, whether neural differences exist remains unexplored. This study used a longitudinal twin sample to delineate how different parenting combinations influence adolescent brain structure and to elucidate the genetic contribution.

Methods

A cohort of 216 twins participated in parenting assessments during early adolescence and underwent magnetic resonance imaging scanning during middle adolescence. We utilized latent profile analysis to distinguish between various maternal and paternal parenting profiles and subsequently investigated their influences on brain anatomy. Biometric analysis was applied to assess genetic influences on brain structure, and associations with internalizing symptoms were explored.

Results

In early adolescence, 4 parenting profiles emerged, which were characterized by levels of harshness and hostility in one or both parents. Compared with adolescents in “catparent” families (low harshness/hostility in both parents), those raised in “tigermom” families (harsh/hostile mother only) exhibited a smaller nucleus accumbens volume and larger temporal cortex surface area; those in “tigerdad” families demonstrated larger thalamus volumes; and those in “tigerparent” families displayed smaller volumes in the midanterior corpus callosum. Genetic risk factors contributed significantly to the observed brain structural heterogeneity and internalizing symptoms. However, the influences of parenting profiles and brain structure on internalizing symptoms were not significant.

Conclusions

The findings underscore distinct brain structural features linked to maternal and paternal parenting combinations, particularly in terms of subcortical volume and cortical surface area. This study suggests an interdependent role of maternal and paternal parenting in shaping adolescent neurodevelopment.
背景:在母亲和父亲不同养育组合的家庭中长大的青少年在神经认知和心理病理学方面表现出差异;然而,神经差异是否存在仍有待探索。本研究使用纵向双胞胎样本来描述不同的养育组合如何影响青少年的大脑结构,并阐明其中的遗传因素:方法:216对双胞胎在青春期早期参加了养育评估,并在青春期中期接受了核磁共振成像扫描。我们利用潜在特征分析来区分母亲和父亲的各种养育特征,随后研究了它们对大脑解剖的影响。我们还运用生物计量分析评估了遗传对大脑结构的影响,并探讨了与内化症状的关联:在青春期早期,出现了四种以父母一方或双方的严厉和敌意程度为特征的养育方式。与 "猫父母 "家庭(父母双方的严厉/敌意程度低)中的青少年相比,"虎妈妈 "家庭(只有母亲严厉/敌意)中的青少年表现出较小的伏隔核体积和较大的颞叶皮层表面积;"虎爸爸 "家庭中的青少年表现出较大的丘脑体积;"虎父母 "家庭中的青少年表现出较小的胼胝体中前部体积。遗传风险因素在很大程度上导致了所观察到的大脑结构异质性和内化症状。然而,养育方式和大脑结构对内化症状的影响并不显著:研究结果强调了与母亲和父亲的养育组合相关的不同大脑结构特征,尤其是在皮层下体积和皮层表面积方面。这项研究表明,母亲和父亲的养育方式在青少年神经发育过程中起着相互依存的作用。
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引用次数: 0
Glutamatergic Modulation of Brain Function in Psychosis: A Systematic Review of Neuroimaging Studies 精神疾病中脑功能的谷氨酸能调节:神经影像学研究的系统综述。
IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/j.bpsc.2025.07.004
Ioana Varvari , Lara Bolte , Chiara Colli , Valentina Mancini , Matthew M. Nour , Philip McGuire , Robert A. McCutcheon
Aberrant dopamine and glutamate signaling are implicated in the pathophysiology of schizophrenia. Existing treatments primarily target dopamine pathways underlying positive symptoms but have relatively little effect on cognitive and negative symptoms. Glutamatergic modulators may treat the latter symptom domains, and neuroimaging studies have the potential to identify therapeutic mechanisms. We conducted a systematic review to examine functional neuroimaging studies of glutamatergic modulators in psychosis and determine whether these agents alter brain activity, chemistry, or functional connectivity and whether such changes map onto clinical outcomes. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO: CRD42024549120), MEDLINE, Embase, and PsycInfo were searched from inception to June 2024 for studies administering pharmacologic glutamate modulators to individuals with psychosis, using functional neuroimaging (proton magnetic resonance spectroscopy [1H-MRS], functional magnetic resonance imaging [fMRI], arterial spin labeling, positron emission tomography, electroencephalography [EEG], or magnetoencephalography). Twenty-seven articles met inclusion criteria, encompassing 841 participants. Evidence from 1H-MRS suggests that sarcosine, N-acetylcysteine, and riluzole reduce glutamate concentrations in frontal and hippocampal regions, but clinical outcomes have not been investigated. Resting-state and task-based fMRI studies suggest that NMDA receptor modulators may normalize measures of functional dysconnectivity, although effects were often short-lived and did not always correspond to sustained symptom improvements. Similarly, EEG studies consistently identified normalization of mismatch negativity and gamma oscillations, but correlations with symptom or cognitive outcomes were inconsistent. While glutamatergic modulators show measurable effects on brain chemistry and electrophysiology, the relationship to robust, durable clinical benefits remains elusive. Future work should use larger, longer-duration, and multimodal imaging studies to clarify the precise mechanisms, optimal dosing, and the patient subgroups most likely to benefit from glutamatergic interventions in psychosis.
背景:异常的多巴胺和谷氨酸信号与精神分裂症的病理生理有关。现有的治疗主要针对潜在阳性症状的多巴胺通路,但对认知和阴性症状的影响相对较小。谷氨酸能调节剂可以治疗后一种症状域,神经影像学研究有可能确定治疗机制。我们进行了一项系统综述,以检查谷氨酸能调节剂在精神病中的功能神经影像学研究,并确定这些药物是否会改变大脑活动、化学或功能连接,以及这些变化是否与临床结果相关。方法:遵循PRISMA指南(PROSPERO: CRD42024549120),检索Medline、Embase和PsycINFO,从成立到2024年6月,使用功能神经影像学(1H-MRS、fMRI、ASL、PET、EEG或MEG)对精神病患者使用谷氨酸调剂的研究。27篇文章符合纳入标准,共841名受试者。结果:1H-MRS证据表明,肌氨酸、n -乙酰半胱氨酸和利鲁唑可降低额叶和海马区的谷氨酸浓度,但未研究临床结果。静息状态和基于任务的fMRI研究表明,NMDAR调节剂可能使功能连接障碍的测量正常化,尽管效果通常是短暂的,并不总是与持续的症状改善相对应。同样,脑电图研究一致地确定了错配负性和伽马振荡的正常化,但与症状或认知结果的相关性不一致。结论:虽然谷氨酸能调节剂对脑化学和电生理有可测量的影响,但与持久的临床益处的关系仍然难以捉摸。未来的工作应该采用更大、更长的持续时间和多模态成像研究,以阐明确切的机制、最佳剂量和最有可能从精神疾病的谷氨酸能干预中受益的患者亚组。
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引用次数: 0
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IF 4.8 2区 医学 Q1 NEUROSCIENCES Pub Date : 2025-12-01 DOI: 10.1016/S2451-9022(25)00340-4
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期刊
Biological Psychiatry-Cognitive Neuroscience and Neuroimaging
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