Dialogues in Clinical Neuroscience最新文献

Objective: The aim of our study was to investigate neurobiological markers and gender difference for diagnosing anxious major depressive disorder (aMDD) through a meta-analysis.

Methods: We systematically searched multiple databases for whole-brain neuroimaging studies comparing anxious major depression disorder (aMDD), pure MDD, and healthy controls, with publication dates through December 2024. We extracted brain coordinates and their corresponding peaks, for further analysis using the Seed-based d Mapping software package.

Results: A total of 11 studies were included in this study, encompassing 829 aMDD patients, 681 MDD patients, and 865 healthy controls. The meta-analysis revealed that aMDD patients exhibited increased functional alteration in the left middle temporal gyrus compared to individuals diagnosed with MDD. In the comparison between individuals with aMDD and healthy controls, the meta-analysis revealed increased functional alteration in the anterior commissure and decreased functional alteration the right middle frontal gyrus. Furthermore, the meta-regression analysis revealed heightened neural activity of the left middle cingulate gyrus and right anterior thalamic regions, as well as weakened neural activity of the left rolandic operculum in females with aMDD compared to the control group.

Conclusions: We identified specific functional alterations in brain regions that may serve as potential neurobiological markers for aMDD and associated differences.

Background: Integrating electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) with naturalistic stimuli has advanced our understanding of the neural mechanisms underlying mental disorders. Naturalistic paradigms use dynamic, multimodal stimuli that capture complex emotional and cognitive processes more effectively than traditional experimental designs. Objective: This review synthesizes research from 2014 to 2024 exploring neural mechanisms of anxiety, depression, and schizophrenia within naturalistic paradigms. Methods: Recent EEG-fMRI studies employing naturalistic tasks were examined to identify common and disorder-specific neural alterations across affective and cognitive networks. Results: In anxiety, hyperactivity in the amygdala, prefrontal cortex, anterior cingulate cortex, and insula, together with changes in the dorsal attention, default mode, and frontoparietal networks, reflects excessive fear responses and impaired regulation. Depression is characterized by disruptions in default mode and frontoparietal connectivity and altered amygdala-prefrontal interactions, indicating maladaptive introspection and cognitive control. Schizophrenia shows abnormalities in motor and language processing, with aberrant activity in frontal, parietal, and temporal regions including the insula and temporoparietal junction. Conclusion: These findings highlight the shared involvement of the amygdala, prefrontal cortex, anterior cingulate cortex, and insula across disorders and demonstrate the potential of naturalistic paradigms for advancing personalized diagnostics and interventions in mental health.

Introduction: Evidence provides support for the therapeutic benefits of targeting avoidance in prolonged grief. However, it is not clear whether avoidance interferes with mourning through altered resilience to stress, as measured by heart rate variability (HRV).

Methods: Thirty-five adults (30 female; mean age: 39.2 years), who had been bereaved for more than one year, participated in this prospective, observational study. At each of the initial assessments and up to six-month follow-ups, grief symptoms were assessed using the Complicated Grief Questionnaire, and a resting electrocardiogram was recorded to extract the high-frequency component of HRV (HF-HRV). To differentiate avoidance from grief itself, principal component analysis was used.

Results: A nonlinear cross-sectional relationship was observed between avoidance and HF-HRV (coefficient = 0.29, p = .003); the lower the avoidance, the lower the HF-HRV in the low avoidance group. Grief improved only in the low avoidance group longitudinally. The observed relationship between increased HF-HRV and decreased grief was modified by the avoidance group, such that the low-avoidance group drove this association (estimate -0.53, 95% CI -0.86, -0.21, p = .001), while the high-avoidance group did not (estimate 0.44, 95% CI -0.32, 1.20, p = .26).

Conclusion: Despite its palliative gain, avoidance relates to the maintenance of grief longitudinally through attenuated autonomic resilience to stress.

Introduction: Alzheimer's disease (AD), Parkinson's disease (PD) and amyotrophic lateral sclerosis (ALS) are several common neurodegenerative diseases (NDs). At present, is the lack of effective diagnosis, progression, prognosis and therapeutic biomarkers. it is a urgent demand to search the relevant confident biomarkers.

Area covered: This review systematically analysed the potential biomarkers of blood, cerebrospinal fluid, neuroimaing and emerging non-invasive indicators, and synthesises current evidences on the biomarkers of AD, PD and ALS about diagnosis, progression, prognosis and therapeutic, especially diagnosis biomarkers.

Expert commentary: In this review, we focus on discussing relevant diagnosis, progression, prognosis and therapeutic biomarkers for AD, PD and ALS in recent years, and prospecting the possible future directions of relevant biomarkers.

Introduction: Sexual dysfunctions are prevalent public health issues with understudied neurobiological correlates. This study explores structural brain differences in individuals with DSM-5 sexual dysfunctions vs. matched controls.

Methods: This cross-sectional study employed voxel-based morphometry (VBM) to analyse structural brain scans from the Hamburg City Health Study. Participants with erectile disorder (ED; n = 20), premature ejaculation (PE; n = 20), genito-pelvic pain/penetration disorder (GPPPD; n = 8), and female sexual interest/arousal disorder (FSIAD; n = 32) were compared with matched controls (n = 40,40,24,32, respectively). Whole-brain VBM analyses used SPM12 and CAT12. Statistical parametric maps were thresholded at uncorrected voxel-level (p < .001) and false discovery rate (FDR) correction (p_FDR < .05).

Results: ED showed clusters in right putamen with reduced rGMV and left postcentral gyrus with higher rGMV. PE displayed lower rGMV in cerebellar lobe VI/Crus I and left superior/medial temporal gyrus. GPPPD exhibited higher rGMV in right middle frontal gyrus. FSIAD showed no differences. No clusters survived FDR correction, underscoring the exploratory and hypothesis-generating nature of the reported findings.

Conclusions: This study identifies potential associations between sexual dysfunctions and structural brain differences in regions related to sexual function, arousal, inhibition, motor coordination, and pain processing. Results require cautious interpretation due to small sample sizes, but provide hypothesis-generating evidence for future research .

Introduction: Psychedelics are gaining recognition for their therapeutic potential in mental health treatment, yet societal attitudes remain divided, influenced by both skepticism and curiosity. This study aimed to develop and validate a scale assessing attitudes toward psychedelics.

Methods: Study 1 (n = 1000, convenience sample) explored the factor structure, identifying two dimensions: Openness toward Psychedelics and Concerns toward Psychedelics. Study 2 (n = 843, representative Polish sample) confirmed the scale's validity.

Results: The Concerns factor negatively correlated with meaning in life, while the Openness factor was positively associated with openness to experience, agreeableness, conscientiousness, mindfulness, meaning in life, and nature-relatedness. These associations suggest that individuals with greater openness and psychological flexibility may hold more favorable views on psychedelics.

Discussion: The Concerns and Openness towards Psychedelics Scale (COPS) is a psychometrically sound tool for assessing attitudes toward psychedelics. Its meaningful correlations with established psychological constructs underscore its utility in research and public health. By providing insight into societal perceptions, COPS may help inform discussions on psychedelic therapy, policy, and education, ultimately fostering a more nuanced understanding of their potential benefits and risks.

Introduction: Insomnia, a widespread sleep disorder, affects a significant portion of the global population. This study is the first in Asia to evaluate the efficacy of electrical vestibular stimulation (VeNS) as a treatment for insomnia in Hong Kong adults, addressing a gap in non-pharmacological interventions.

Methods: A double-blind, randomized, sham-controlled trial was conducted with 101 adults exhibiting insomnia symptoms. Participants were randomized into active VeNS or sham groups (1:1 ratio) and underwent twenty 30-minute VeNS sessions over four weeks. Psychological outcomes, including insomnia severity, sleep quality, and quality of life were assessed at baseline (T1), post-intervention (T2). Follow-up assessments were conducted at one- (T3) and three-month (T4) to evaluate the sustainability of VeNS effects.

Results: Of 83 participants (40 VeNS and 43 sham-VeNS), the VeNS group showed significant reductions in insomnia severity at T2 (p = 0.03, d = -0.47) and T4 (p = 0.02, d = -0.32), alongside improved quality of life (i.e., role-physical) at T2.

Conclusion: VeNS is a novel, non-invasive and safe neuromodulation device that may serve as an adjunct treatment for primary insomnia. The present findings provide a foundation for future multisite comparison studies to further evaluate VeNS efficacy.

Trial registration: ClinicalTrials.gov Identifier: NCT04452981.

The International Society for Bipolar Disorders (ISBD) Chronobiology and Chronotherapy Task Force conducted a comprehensive review to deliver concise evidence-based recommendations on the use of bright light therapy (BLT) for bipolar disorder (BD). Adjunctive BLT is likely an efficacious acute treatment for bipolar depression as implicated by higher quality evidence. The position of maintenance BLT for relapse prevention awaits further investigation. Protocols of effective BLT in BD are similar to parameters indicated for treatment of seasonal and non-seasonal major depressive disorder. Anti-manic prophylaxis (especially for BD-I) and clinical monitoring are recommended with initiation of and ongoing light treatment. Administer BLT daily, preferably in the morning or at mid-day. If mornings are prohibitive, then mid-day exposure, implemented to avoid excessively early wake times, is an acceptable alternative. Informed by the literature, target 30 min/day of BLT exposure. Patients wary of emergent hypomania or partial responders, can initiate 15 min/day and increase by 15 min each week to full response (or 30-60 min/day by the fourth week). Consider patient centred outcome assessments to evaluate mood response, safety and side effects. Clinical improvement is typically observed within 1-2 weeks, with response/remission expected by 4-6 weeks. Integration of BLT with other chronotherapeutic strategies may enhance long-term efficacy.

Background: Depression, including Bipolar and Unipolar types, is a widespread mental health issue. Conventional diagnostic methods rely on subjective assessments, leading to possible underreporting and bias. Machine learning (ML) and deep learning (DL) offer automated approaches to detect depression using behavioral and demographic data.

Methods: This study proposes a hybrid AI framework combining structured demographic features with synthetic actigraph time-series data. Demographic data is modeled using an XGBoost ensemble, while temporal data is analyzed through a deep convolutional neural network (CNN). The training pipeline includes stratified k-fold cross-validation, hyperparameter tuning, and statistical testing. Model explainability is enhanced using SHAP (XGBoost) and Grad-CAM (CNN).

Results: The hybrid model demonstrated strong classification performance across metrics like accuracy, sensitivity, and specificity. Integrating temporal and static features improved prediction of Bipolar and Unipolar Depression. Interpretability tools revealed key features and time patterns influencing predictions.

Conclusions: This work introduces a robust and interpretable framework for depression classification using synthetic multimodal data. While not clinically validated, the model serves as a methodological foundation for future research with real-world datasets.

Despite the relatively limited number of serotonergic neurons in humans, serotonin plays a key role in neurophysiological functions, including sleep, pain perception, learning, memory, cognition, emotion, reward, and mood regulation. Altered serotonergic neurotransmission is linked to conditions such as anxiety, depression, anorexia, migraine, insomnia, schizophrenia, Alzheimer's disease (AD), and cognitive impairments. The 5-HT6 receptor (5-HT6R), mainly found in brain regions involved in cognition, is a promising therapeutic target for cognitive deficits in neuropsychiatric disorders, particularly AD and schizophrenia. Preclinical studies have shown that 5-HT6R antagonists improve cognitive function. 5-HT6R interacts dynamically with an extensive intracellular protein network, regulating the localisation, trafficking, and signalling of these proteins. Proteomic and genetic studies have revealed interactions with mTOR kinase and neurofibromin, both of which are crucial for synaptic plasticity, learning, and memory. Fyn kinase is also associated with 5-HT6Rs, reinforcing receptor expression and G-protein coupling. Notably, the G protein-regulated inducer of neurite outgrowth 1 (GPRIN1) interacts with 5-HT6Rs independently of agonists, enhancing receptor activity. This review highlights the clinical testing of 5-HT6R ligands as regulators of these complex signalling properties, underscoring their therapeutic potential in addressing cognitive impairments associated with neuropsychiatric disorders.