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Repeated adenosine A1 receptor antagonism rewires ventral hippocampus-ventral tegmental area transmission and enhances stress-coping responses. 重复腺苷A1受体拮抗剂重新连接腹侧海马-腹侧被盖区传递并增强应激应对反应。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-14 DOI: 10.1016/j.pnpbp.2026.111609
Ornella Valenti, Karin Mueller, Jae-Won Yang, Hilal Bulut, Katarzyna Anna Rekawek, Stefan Boehm

Despite decades of research, antidepressant therapies are ineffective in many patients, and the rewiring of neuronal networks during depression has remained largely unexplored. Emerging evidence indicates that unbalanced inhibition/ excitation and dysregulations of ventral tegmental area (VTA) dopamine (DA) neuron activity are correlated with depression. Recently, caffeine and adenosine receptor antagonists were found to modulate VTA DA neuron activity, and investigations in both, humans and rodents, indicate that these receptors might serve as targets to treat depression. We employed a system-oriented approach and electrophysiology measurements to explore the impact of the adenosine A1 receptor antagonist DPCPX on the ventral hippocampus (vHPC)-VTA circuit and its ability to affect behavioral responses in forced swim and elevated plus maze tests. A single exposure to DPCPX reduced VTA DA neuron activity at doses known to elicit anxiety. With repeated exposure, a lower dose of DPCPX sufficed to stabilize DA neuron firing via vHPC and to prevent an influence of tetrahydrodeoxycorticosterone or forced swim task (FST), but not of elevated plus maze (EPM), on VTA DA neuron activity. Vice versa, repeated DPCPX enhanced active stress coping behavior in FST, but failed to exert an action in EPM. Our data indicate that repeated A1R antagonism in vHPC can rewire the vHPC - NAc - VTA circuitry to enhance stress resilience by orchestrating VTA DA neuron activity. As reinforced stress resilience may boost antidepressant therapy, A1 receptor antagonism may prove to be a promising strategy in the fight against major depressive disorder.

尽管经过数十年的研究,抗抑郁疗法对许多患者无效,而且抑郁症期间神经网络的重新布线在很大程度上仍未被探索。新的证据表明,腹侧被盖区(VTA)多巴胺(DA)神经元活动的抑制/兴奋不平衡和失调与抑郁症有关。最近,咖啡因和腺苷受体拮抗剂被发现可以调节VTA DA神经元的活动,在人类和啮齿动物中进行的研究表明,这些受体可能作为治疗抑郁症的靶点。我们采用系统导向的方法和电生理测量来探索腺苷A1受体拮抗剂DPCPX对腹侧海马(vHPC)-VTA回路的影响及其在强迫游泳和升高+迷宫测试中影响行为反应的能力。单次接触DPCPX会减少VTA DA神经元的活动,其剂量已知会引起焦虑。反复暴露后,低剂量的DPCPX足以通过vHPC稳定DA神经元的放电,并防止四氢脱氧皮质酮或强迫游泳任务(FST)的影响,但不影响升高的正迷宫(EPM)对VTA DA神经元活动的影响。反之,重复dcpx增强了FST的主动应激应对行为,但在EPM中不起作用。我们的数据表明,vHPC中重复的A1R拮抗可以通过协调VTA DA神经元的活动来重新连接vHPC - NAc - VTA回路,从而增强应激恢复能力。由于增强应激恢复能力可能促进抗抑郁治疗,A1受体拮抗剂可能被证明是对抗重度抑郁症的一种有前途的策略。
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引用次数: 0
Long-term impact of embryonic ethanol exposure on gene expression and executive functions in zebrafish. 胚胎乙醇暴露对斑马鱼基因表达和执行功能的长期影响。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-13 DOI: 10.1016/j.pnpbp.2026.111612
Romério de Oliveira Lima Filho, Ricardo Gabriel de Lima Bisneto, Beatriz Silva do Nascimento, Heloysa Araujo Silva, Silvia Regina Batistuzzo de Medeiros, Eduardo Pacheco Rico, Ana Carolina Luchiari

This study explores the long-term effects of embryonic ethanol exposure on cognitive functions and gene expression in zebrafish (Danio rerio). We hypothesized that ethanol exposure during a critical developmental stage would lead to deficits in executive functions, such as working memory and behavioral flexibility, as well as alterations in neurodevelopmental gene expression. Zebrafish embryos were exposed to ethanol for 2 h at 24 hpf, and behavior was assessed at the fry (15 days post-fertilization), juvenile (45 dpf), and adult (90 dpf) stages. The Y-FMP behavioral test revealed impairments in behavioral flexibility and working memory, indicated by increased repetitive strategy in the juvenile phase and reduced alternation strategy in adult individuals. Molecular analyses showed downregulation of genes responsible for neurodevelopment and also dopaminergic signaling, suggesting that ethanol exposure disrupts critical developmental pathways. Despite partial recovery of gene expression in the juvenile stage, cognitive deficits persisted, highlighting the long-term impact of embryonic ethanol exposure. This study underscores the need for early diagnostic and intervention strategies for individuals affected by Fetal Alcohol Spectrum Disorders (FASD) and calls for further research on biomarkers to distinguish FASD from other neurodevelopmental disorders. In conclusion, our findings demonstrate that embryonic ethanol exposure significantly impacts cognitive functions and gene expression pattern in zebrafish, mirroring the challenges faced by individuals with FASD. These results contribute to the understanding of the neurodevelopmental consequences of prenatal ethanol exposure and reinforce the importance of preventing ethanol consumption during pregnancy.

本研究探讨了胚胎乙醇暴露对斑马鱼(Danio rerio)认知功能和基因表达的长期影响。我们假设,在一个关键的发育阶段,乙醇暴露会导致执行功能的缺陷,如工作记忆和行为灵活性,以及神经发育基因表达的改变。将斑马鱼胚胎在24hpf下暴露于乙醇中2 h,并在鱼苗(受精后15 天)、幼鱼(45 dpf)和成鱼(90 dpf)阶段对其行为进行评估。Y-FMP行为测试显示行为灵活性和工作记忆的损害,表现为幼年期重复策略的增加和成年期交替策略的减少。分子分析显示,负责神经发育和多巴胺能信号传导的基因下调,表明乙醇暴露破坏了关键的发育途径。尽管在幼年阶段基因表达部分恢复,但认知缺陷仍然存在,这突出了胚胎乙醇暴露的长期影响。本研究强调了对胎儿酒精谱系障碍(FASD)患者早期诊断和干预策略的必要性,并呼吁进一步研究生物标志物,以区分FASD与其他神经发育障碍。总之,我们的研究结果表明,胚胎乙醇暴露显著影响斑马鱼的认知功能和基因表达模式,反映了FASD个体面临的挑战。这些结果有助于理解产前乙醇暴露对神经发育的影响,并加强了在怀孕期间预防乙醇消耗的重要性。
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引用次数: 0
Traumatic-like fear memory recall causes persistent morphine conditioned place preference in drug withdrawn male mice. 创伤样恐惧记忆唤起引起药物戒断雄性小鼠持续吗啡条件下的位置偏好。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-11 DOI: 10.1016/j.pnpbp.2026.111611
Claire Leconte, Virginie Beray-Berthat, Fanny Saulnier, Derin Reha Ulusoy, Amanda Patricia Sales, Matilde Donzelli, Laura Marques, Isabelle Nondier, Corinne Canestrelli, Florence Noble, Raymond Mongeau

Post-traumatic stress disorders (PTSD) can lead to substance use disorders (SUD), and in particular opioid dependence. Although preclinical models of the literature focused on traumatic stress-induced potentiation of opioid dependence acquisition, none studied the effect of fear memories during opioid withdrawal. The goal of this study was thus to develop and describe a preclinical model of the PTSD/SUD comorbidity during this critical period in adult male mice. Classically, the traumatic-like memory was acquired by fear conditioning and was followed by morphine-conditioned place preference (CPP) to acquire the associative memory linked to the drug-reinforcing effect. Departing from this approach, we evaluated the effect of a stress on drug-induced CPP using regular re-exposures to a conditioned fear stimulus recall (FR), immediately followed by CPP tests, several days after the last morphine injection (from the 5th to the 21st day). Our data indicated that FR sessions induce a persistent morphine CPP, that is absent in morphine withdrawn mice not subjected to FR. This effect was prevented when antalarmin, a corticotropin-releasing factor receptor 1 antagonist, was administered during morphine withdrawal before each FR. Persistent morphine-induced CPP was concomitant with a FR-induced kappa opioid receptor mRNA upregulation in the prefrontal cortex, while mu opioid receptor mRNA expression was enhanced in control morphine withdrawn mice, an effect absent, however, in withdrawn mice subjected to FR. Surprisingly, in the amygdala, endogenous opioid-related mRNA expression changes in relation with the long-term persistence of drug-induced CPP were few, but next generation sequencing revealed differential expression of numerous microRNAs in that brain area between morphine-control vs morphine-FR mice. The present study thus proposes an innovative behavioral model of the PTSD/SUD-like comorbidity with biological modulations in both the prefrontal cortex and the amygdala, paving the way to develop adapted treatments for this comorbidity in clinics.

创伤后应激障碍(PTSD)可导致物质使用障碍(SUD),特别是阿片类药物依赖。虽然文献的临床前模型侧重于创伤应激诱导的阿片类药物依赖获得的增强,但没有研究阿片类药物戒断期间恐惧记忆的影响。因此,本研究的目的是建立和描述成年雄性小鼠在这一关键时期PTSD/SUD合并症的临床前模型。典型的创伤样记忆是通过恐惧条件反射获得的,随后是吗啡条件下的位置偏好(CPP)获得与药物强化效应相关的联想记忆。在此基础上,我们评估了应激对药物性CPP的影响,方法是在最后一次吗啡注射后几天(从第5天到第21天),定期重新暴露于条件恐惧刺激回忆(FR),紧接着进行CPP测试。我们的数据表明,FR会诱导持续的吗啡CPP,而这在没有经历FR的吗啡戒断小鼠中是不存在的。在每次FR之前,在吗啡戒断期间给予抗肾上腺皮质激素释放因子受体1拮抗剂安他拉明,可以防止这种效应。持续的吗啡诱导的CPP伴随着FR诱导的前额皮质kappa阿片受体mRNA上调。虽然吗啡戒断小鼠的mu阿片受体mRNA表达增强,但在FR戒断小鼠中没有这种作用。令人惊讶的是,在杏仁核中,内源性阿片相关mRNA表达与药物诱导CPP长期持续相关的变化很少,但下一代测序显示吗啡戒断小鼠与吗啡戒断小鼠在该脑区有许多microrna的差异表达。因此,本研究提出了一种具有前额叶皮层和杏仁核生物调节的PTSD/ sud样共病的创新行为模型,为临床开发适应这种共病的治疗方法铺平了道路。
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引用次数: 0
Effects of intermittent theta- burst stimulation on emotion anticipation and processing in depression- investigating behavioral, electrodermal and neural activity 间歇性波爆发刺激对抑郁症情绪预期和加工的影响——行为、皮肤电和神经活动的研究。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2026.111606
Wiebke Struckmann , Magdalena Wlad , Jörgen Rosén , David Fällmar , Robert Bodén , Jonas Persson , Malin Gingnell

Background

Depression is characterized by disturbed emotion processing. Repetitive transcranial magnetic stimulation, and its development intermittent theta- burst stimulation (iTBS), induces brain network changes and is an emerging treatment alternative for depression. In this sham- controlled study, we aimed at studying the effects of iTBS on emotion anticipation and processing in depression.

Methods

42 patients with depression were allocated to receive active or sham iTBS treatment. Before treatment (baseline) and four weeks after baseline (follow- up), participants underwent functional magnetic resonance imaging (fMRI) scanning with simultaneous recordings of skin conductance responses (SCR). During scanning, participants were presented to an emotion anticipation and processing paradigm. Behavioral data (symptom ratings and ratings of emotional stimuli) were also collected.

Results

There were no differences in behavioral, skin conductance or neural activity after active, compared with sham, treatment. However, across groups, SCRs to positive anticipation increased and SCRs to negative processing decreased at follow- up. Additionally, amygdala and right insula reactivity to negative processing, and right amygdala reactivity to positive processing, decreased at follow- up. Increased ACC activity after active treatment to positive anticipation and processing was correlated with decreased anhedonia symptoms.

Conclusions

Active, compared with sham, iTBS treatment does not affect behavioral, skin conductance or neural activity to emotion anticipation and processing in depression. However, across treatment groups, changes occur with time, perhaps reflecting normalization processes or partial treatment effect of sham iTBS. The ACC seems to be involved in the treatment mechanism of iTBS.
背景:抑郁症以情绪加工障碍为特征。反复经颅磁刺激及其发展为间歇性θ波爆发刺激(iTBS),可诱导脑网络变化,是一种新兴的抑郁症治疗方法。在本实验中,我们旨在研究iTBS对抑郁症患者情绪预期和加工的影响。方法:将42例抑郁症患者分为主动iTBS和假iTBS两组。在治疗前(基线)和基线后4周(随访),参与者接受功能性磁共振成像(fMRI)扫描,同时记录皮肤电导反应(SCR)。在扫描过程中,参与者被呈现在情绪预期和处理范式中。行为数据(症状评分和情绪刺激评分)也被收集。结果:与假治疗相比,治疗后大鼠的行为、皮肤电导及神经活动均无明显差异。然而,在随访中,各组对积极预期的scr增加,对消极加工的scr减少。此外,杏仁核和右脑岛对消极加工的反应性,以及右杏仁核对积极加工的反应性在随访中有所下降。积极的预期和加工治疗后ACC活性的增加与快感缺乏症状的减少相关。结论:与假治疗相比,主动iTBS治疗不影响抑郁症患者的行为、皮肤电导或情绪预期和加工的神经活动。然而,在整个治疗组中,随着时间的推移会发生变化,这可能反映了假性iTBS的正常化过程或部分治疗效果。ACC似乎参与了iTBS的治疗机制。
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引用次数: 0
High-fat diet-induced obesity enhances stress vulnerability and promotes a PTSD-like phenotype in rats 高脂肪饮食引起的肥胖增加应激易感性,促进大鼠ptsd样表型。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2025.111596
Carmit Cohen , Joseph Zohar , Doron Todder , Hagit Cohen
The association between post-traumatic stress disorder (PTSD) and subsequent obesity is well-established in humans, however, whether obesity exacerbates vulnerability to PTSD remains underexplored. To investigate this, we employed a rat model fed either a high-fat diet (HFD; 60 % kcal from fat) or a control diet (CD). After confirming significant body mass index differences between HFD and CD groups, rats were exposed to predator scent stress (PSS) or a sham-PSS control. Behavioral phenotyping was conducted using the elevated plus maze (EPM) and acoustic startle response (ASR) to classify stress response profiles, supplemented by the forced swim test to assess depressive-like behavior and the Morris water maze to evaluate spatial learning and memory. Neural cytoarchitecture and molecular mechanisms were examined via Golgi-Cox staining and immunohistochemistry, targeting shared modulators of the orexigenic and anxiolytic systems in the hippocampus and hypothalamus. Our findings reveal that HFD-induced obesity promotes a PTSD-like phenotype, exacerbates depressive-like behavior, and impairs spatial learning and memory acquisition. Morphological alterations in the hippocampus and amygdala of HFD-fed rats resembled those in PSS-exposed CD-fed rats, regardless of stress exposure, suggesting common neurostructural changes. Furthermore, HFD-induced obesity modulated region-specific expression of neuropeptide Y (NPY), NPY-Y1 receptor, and glucocorticoid receptor immunoreactivity in hippocampal and hypothalamic nuclei. These results underscore a bidirectional interplay between diet-induced obesity and stress-related disorders, highlighting the critical role of the orexigenic and anxiolytic systems and their neurobiological underpinnings in mediating these effects.
创伤后应激障碍(PTSD)和随后的肥胖之间的联系在人类中是公认的,然而,肥胖是否会加剧创伤后应激障碍的易感性仍未得到充分研究。为了研究这一点,我们采用了高脂肪饮食(HFD; 60% %卡路里来自脂肪)或对照饮食(CD)的大鼠模型。在确认HFD组和CD组之间的显著体重指数差异后,将大鼠暴露于捕食者气味应激(PSS)或假PSS对照组。行为表型研究采用升高+迷宫(EPM)和声惊反应(ASR)对应激反应进行分类,辅以强迫游泳测试评估抑郁样行为,Morris水迷宫评估空间学习和记忆。通过高尔基-考克斯染色和免疫组织化学检测神经细胞结构和分子机制,以海马和下丘脑的促氧和抗焦虑系统的共同调节剂为目标。我们的研究结果表明,hfd诱导的肥胖促进了ptsd样表型,加剧了抑郁样行为,并损害了空间学习和记忆的获得。hfd喂养的大鼠海马和杏仁核的形态学改变与pss喂养的cd喂养的大鼠相似,无论应激暴露如何,都表明了共同的神经结构变化。此外,hfd诱导的肥胖调节了海马和下丘脑核中神经肽Y (NPY)、NPY- y1受体和糖皮质激素受体免疫反应性的区域特异性表达。这些结果强调了饮食引起的肥胖和压力相关疾病之间的双向相互作用,强调了产氧和抗焦虑系统及其神经生物学基础在介导这些影响中的关键作用。
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引用次数: 0
Cross-trial prediction of treatment response to transcranial direct current stimulation in patients with major depressive disorder 重度抑郁症患者经颅直流电刺激治疗反应的交叉试验预测。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2025.111600
Gerrit Burkhardt , Stephan Goerigk , Lucia Bulubas , Esther Dechantsreiter , Daniel Keeser , Ulrike Vogelmann , Katharina von Wartensleben , Johannes Wolf , Christian Plewnia , Andreas Fallgatter , Berthold Langguth , Claus Normann , Lukas Frase , Peter Zwanzger , Thomas Kammer , Carlos Schönfeldt-Lecuona , Daniel Kamp , Malek Bajbouj , Nikolaos Koutsouleris , Andre R. Brunoni , Frank Padberg
Machine-learning (ML) classification may offer a promising approach for treatment response prediction in patients with major depressive disorder (MDD) undergoing non-invasive brain stimulation. This analysis aims to develop and validate such classification models based on easily attainable sociodemographic and clinical information across two randomized controlled trials on transcranial direct-current stimulation (tDCS) in MDD. Using data from 246 patients with MDD from the randomized-controlled DepressionDC and ELECT-TDCS trials, we employed an ensemble machine learning strategy to predict treatment response to either active tDCS or sham tDCS/placebo, defined as ≥50 % reduction in the Montgomery-Åsberg Depression Rating Scale at 6 weeks. Separate models for active tDCS and sham/placebo were developed in each trial and evaluated for external validity across trials and for treatment specificity across modalities. In the DepressionDC trial, models achieved a balanced accuracy of 63.5 % for active tDCS and 62.5 % for sham tDCS in predicting treatment responders. Baseline self-rated depression was consistently ranked as the most informative feature. However, response prediction in the ELECT-TDCS trial and across trials was not successful. Our findings suggest that ML models based on easily attainable sociodemographic and clinical variables can yield modest improvements in predicting individual tDCS response, but performance remains insufficient for clinical application and will require refinement and external validation in larger, more comprehensively phenotyped cohorts.
机器学习(ML)分类可能为重度抑郁症(MDD)患者接受非侵入性脑刺激的治疗反应预测提供了一种有希望的方法。本分析旨在通过两项经颅直流电刺激(tDCS)治疗重度抑郁症的随机对照试验,基于易于获得的社会人口学和临床信息,开发和验证这种分类模型。使用来自随机对照Depression dc和ELECT-TDCS试验的246例重度抑郁症患者的数据,我们采用集成机器学习策略来预测对活性tDCS或假tDCS/安慰剂的治疗反应,定义为6 周时Montgomery-Åsberg抑郁评定量表降低≥50% %。在每个试验中分别开发了活动性tDCS和假药/安慰剂模型,并评估了不同试验的外部有效性和不同模式的治疗特异性。在DepressionDC试验中,模型在预测治疗反应方面达到了63.5 %活跃tDCS和62.5 %假tDCS的平衡准确性。基线自评抑郁一直被列为最具信息性的特征。然而,在ELECT-TDCS试验和跨试验中的反应预测并不成功。我们的研究结果表明,基于易于获得的社会人口学和临床变量的ML模型可以在预测个体tDCS反应方面产生适度的改进,但对于临床应用来说,性能仍然不足,需要在更大、更全面的表型队列中进行改进和外部验证。
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引用次数: 0
Complex relationship between endocannabinoids, fatty acid amide hydrolase, and stress reactivity in human intrusive memories of analogue trauma 内源性大麻素、脂肪酸酰胺水解酶和应激反应在人类模拟创伤侵入性记忆中的复杂关系
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2026.111610
Madeline A. Jarvis , Allison Matthews , Ken Chia Min Hsu , Emma Nicholson , Khalisa Amir Hamzah , Natalie Turner , Daniel V. Zuj , David Nichols , Kim Felmingham , Luke J. Ney
The endocannabinoid system has been shown to be involved in posttraumatic stress disorder-like behaviours in animal and human subjects. However, to date no studies have tested the relationship between blood markers of endocannabinoid signalling and intrusive memory development in humans. Across two studies, we tested the relationship between endocannabinoid genotypes, blood markers of endocannabinoids AEA and 2-AG, and intrusive memories of violent imagery and film clips. In study 1, we found a significant effect of rs324420 genotype on explicit memory recall, with A allele carriers (indicative of higher AEA) recalling fewer negative memories. Post-task AEA was negatively associated with explicit recall but not intrusive memories, though post-task AEA and 2-AG did interact with rs324420 to predict intrusive memory frequency. In study 2, stress induced changes in AEA but not 2-AG were negatively associated with intrusive memory frequency. In summary, we found evidence that AEA is involved in explicit and intrusive memories of negative stimuli. Evidence from both studies suggests that lower AEA is associated with higher explicit and intrusive memories. These findings support animal literature and have implications for targeted treatments for negative memory symptomology in posttraumatic stress disorder.
内源性大麻素系统已被证明与动物和人类的创伤后应激障碍行为有关。然而,到目前为止,还没有研究测试内源性大麻素信号的血液标记物与人类侵入性记忆发展之间的关系。在两项研究中,我们测试了内源性大麻素基因型、内源性大麻素AEA和2-AG的血液标记物与暴力图像和电影片段的侵入性记忆之间的关系。在研究1中,我们发现rs324420基因型对外显记忆回忆有显著影响,a等位基因携带者(表明AEA较高)回忆的负面记忆较少。任务后AEA与外显记忆呈负相关,但与侵入性记忆无关,但任务后AEA和2-AG与rs324420确实相互作用,预测侵入性记忆频率。在研究2中,应激引起的AEA变化与侵入记忆频率呈负相关,但与2- ag无关。总之,我们发现的证据表明,AEA与负面刺激的外显记忆和侵入性记忆有关。两项研究的证据都表明,较低的AEA与较高的外显记忆和侵入性记忆有关。这些发现支持动物文献,并对创伤后应激障碍负记忆症状的靶向治疗具有启示意义。
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引用次数: 0
The association between long-term opioid use and dementia risk: A systematic review and meta-analysis 长期阿片类药物使用与痴呆风险之间的关系:一项系统综述和荟萃分析。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2025.111595
Diana Marisol Abrego-Guandique , Saverio Nucera , Sara Ilari , Lucia Carmela Passacatini , Rosamaria Caminiti , Valeria Mazza , Jessica Maiuolo , Erika Cione , Vincenzo Mollace , Maria Cristina Caroleo , Carolina Muscoli

Introduction

In recent years, the increasing use of opioids has raised significant concerns about their potential long-term effects on cognitive health, particularly in elderly and vulnerable populations. While opioids are widely prescribed for chronic pain management, evidence suggests that prolonged use may accelerate cognitive decline.

Objective

This systematic review and meta-analysis aimed to investigate the association between opioid use and the risk of dementia.

Methods

To identify relevant studies published, a comprehensive search was conducted across multiple databases, including PubMed, Scopus, and the Web of Science. Studies examining opioid exposure and subsequent dementia diagnosis were included. Two independent reviewers performed data extraction and quality assessment. Meta-analyses were conducted to assess pooled risk estimates.

Results

Nine observational cohort studies were included. The random-effects model was applied. The pooled analysis showed a significant association between opioid use and an increased risk of dementia (HR = 1.35, 95 % CI = 1.21–1.50, P = ≤0.0001). Subgroup analyses by geographical region showed consistent associations, with no significant differences between regions (P = 0.70). The P-value for Egger's test was 0.11, indicating no publication bias.

Conclusion

These findings suggest that regular opioid use may be associated with a higher risk of dementia across the included studies; however, this finding should not be interpreted as evidence of causality. Clinicians should be aware of these potential risks when prescribing opioids, especially for older adults or those at higher risk of cognitive decline. Further research is needed to clarify underlying mechanisms and establish safe prescribing guidelines.
近年来,阿片类药物使用的增加引起了人们对其对认知健康,特别是老年人和弱势群体的潜在长期影响的严重关切。虽然阿片类药物被广泛用于慢性疼痛治疗,但有证据表明,长期使用阿片类药物可能会加速认知能力下降。目的:本系统综述和荟萃分析旨在调查阿片类药物使用与痴呆风险之间的关系。方法:在PubMed、Scopus和Web of Science等多个数据库中进行综合检索,以确定已发表的相关研究。研究包括阿片类药物暴露和随后的痴呆诊断。两名独立审稿人进行数据提取和质量评估。进行荟萃分析以评估综合风险估计。结果:纳入9项观察性队列研究。采用随机效应模型。合并分析显示阿片类药物使用与痴呆风险增加之间存在显著关联(HR = 1.35,95% % CI = 1.21-1.50,P ≤0.0001)。按地理区域进行的亚组分析显示出一致的相关性,区域间无显著差异(P = 0.70)。Egger检验的p值为0.11,无发表偏倚。结论:这些发现表明,在纳入的研究中,经常使用阿片类药物可能与痴呆的高风险相关;然而,这一发现不应被解释为因果关系的证据。临床医生在开阿片类药物处方时应该意识到这些潜在的风险,尤其是对老年人或认知能力下降风险较高的人。需要进一步的研究来阐明潜在的机制并建立安全的处方指南。
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引用次数: 0
Orbitofrontal rTMS modulates inferior parietal lobule functional reorganization to alleviate negative symptoms in first-episode, drug-naïve patients with schizophrenia 眼窝额部rTMS调节下顶叶功能重组以减轻首发drug-naïve精神分裂症患者的阴性症状。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2025.111602
Kexu Zhang , Xiong Jiao , Yanli Zhang , Ningning Zeng , Min Wang , Kun Li , Ziliang Wang , Junfeng Sun , Jijun Wang , Qiang Hu

Background

Recent studies have identified the orbitofrontal cortex (OFC) as a potential target for alleviating negative symptoms in schizophrenia. However, the neurobiological mechanisms underlying repetitive transcranial magnetic stimulation (rTMS) delivered to the OFC remain unclear.

Methods

In this randomized controlled trial, seventy first-episode, drug-naïve patients with schizophrenia were assigned to receive either 20 sessions of active 1 Hz rTMS over the right lateral OFC (N = 36) or sham stimulation (N = 34). Clinical outcomes were measured using the Positive and Negative Syndrome Scale (PANSS). Resting-state functional MRI data were collected before and after treatment to assess changes in regional brain activity and functional connectivity, using fractional amplitude of low-frequency fluctuations (fALFF), regional homogeneity (ReHo), and seed-based connectivity analyses.

Results

Compared to sham stimulation, active OFC-rTMS led to significantly greater reductions in PANSS scores (total: 22.7 vs. 14.3, p = 0.003, Cohen's d = 0.733; negative: 6.2 vs. 4.0, p = 0.037, Cohen's d = 0.510). Neuroimaging analyses revealed increased spontaneous activity (fALFF and ReHo) in the right OFC and bilateral inferior parietal lobule (IPL), along with enhanced functional connectivity between the OFC and IPL in the active rTMS group. Importantly, IPL-related functional reorganization was significantly associated with symptom improvement, particularly in negative and general domains.

Conclusions

These findings suggest that rTMS targeting the OFC exerts therapeutic effects in schizophrenia by modulating IPL function and OFC–IPL connectivity. The IPL may serve as a critical downstream node mediating the clinical benefits of OFC-rTMS, offering novel insights into network-based neuromodulation strategies for negative symptoms.
背景:最近的研究已经确定眶额皮质(OFC)是缓解精神分裂症阴性症状的潜在靶点。然而,OFC重复性经颅磁刺激(rTMS)的神经生物学机制尚不清楚。方法:在这项随机对照试验中,70名首发drug-naïve精神分裂症患者被分配到接受20次活动1 Hz rTMS的右侧OFC (N = 36)或假刺激(N = 34)。临床结果采用阳性和阴性综合征量表(PANSS)进行测量。在治疗前后收集静息状态功能MRI数据,使用低频波动分数幅值(fALFF)、区域均匀性(ReHo)和基于种子的连通性分析来评估区域大脑活动和功能连通性的变化。结果:与假性刺激相比,活跃OFC-rTMS导致PANSS评分显著降低(total: 22.7 vs. 14.3, p = 0.003,Cohen's d = 0.733;阴性:6.2 vs. 4.0, p = 0.037,Cohen's d = 0.510)。神经影像学分析显示,在活跃的rTMS组中,右侧OFC和双侧下顶叶(IPL)的自发活动(fALFF和ReHo)增加,同时OFC和IPL之间的功能连接增强。重要的是,ipl相关的功能重组与症状改善显著相关,特别是在阴性和一般领域。结论:这些研究结果表明,针对OFC的rTMS通过调节IPL功能和OFC-IPL连通性来治疗精神分裂症。IPL可能是介导OFC-rTMS临床益处的关键下游节点,为阴性症状的基于网络的神经调节策略提供了新的见解。
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引用次数: 0
Topologic but not volumetric differences diversify sex effects on thalamic nuclei in drug-naive patients with major depressive disorder 未用药的重性抑郁症患者丘脑核的拓扑而非体积差异使性别效应多样化。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 DOI: 10.1016/j.pnpbp.2025.111594
Yidan Wang , Xinyue Hu , Lianqing Zhang , Hailong Li , Yingxue Gao , Mengyue Tang , Zilin Zhou , Shuangwei Chai , Liqiong Liu , Weihong Kuang , Qiyong Gong , Xiaoqi Huang

Background

The thalamus is a crucial subcortical structure in etiological models of major depressive disorder (MDD). Given the well-documented sex differences in MDD prevalence and clinical manifestations, it remains unclear whether these differences are linked to structural characteristics of thalamus. This study aimed to investigate the divergent sex effects on thalamus nuclei in drug-naive patients with MDD.

Methods

High-resolution 3D T1-weighted and diffusion tensor imaging images were obtained for 174 drug-naive patients with MDD and 118 age-, sex-, education years- and handedness-matched healthy controls (HCs). The thalamus was segmented into 22 nuclei using FreeSurfer. A general linear model (GLM) was used to test sex-by-diagnosis interactions for volumes of whole thalamus and individual nuclei between groups. We also performed a graph theory analysis of the structural covariance network (SCN) of thalamic nuclei in females and males with MDD, compared to their sex-matched HCs, respectively.

Results

There were no significant sex-by-diagnosis interactions in whole thalamus or nuclei volumes. The disruptions of SCN were observed in females with MDD, including lower nodal degree in left lateral posterior (LP) nucleus, lower betweenness centrality across several nuclei in the left intralaminar and bilateral antero-lateral nuclei group, and higher betweenness and closeness centrality in right pulvinar lateral nucleus, compared to female HCs. Males with MDD displayed lower nodal degree in left ventral anterior magnocellular and right medial ventral reuniens nuclei and higher betweenness centrality in left mediodorsal lateral parvocellular nucleus relative to male HCs. Moreover, male HCs exhibited higher closeness centrality in the right LP nucleus than female HCs.

Conclusion

These findings represent the first evidence of sex-specific alterations in the topological properties rather than the volumes of thalamic nuclei in early untreated patients with MDD, indicating the structural reorganization of SCN of thalamic nuclei may represent a potential neuro-mechanism underlying sex differences in MDD.
背景:在重度抑郁症(MDD)的病因模型中,丘脑是一个至关重要的皮质下结构。鉴于重度抑郁症患病率和临床表现的性别差异,这些差异是否与丘脑的结构特征有关尚不清楚。本研究旨在探讨不同性别对MDD患者丘脑核的影响。方法:对174例初治MDD患者和118例年龄、性别、受教育程度和手性匹配的健康对照(hc)进行高分辨率3D t1加权和弥散张量成像。使用FreeSurfer将丘脑分割成22个核。使用一般线性模型(GLM)来测试各组间整个丘脑和单个核体积的性别诊断相互作用。我们还对女性和男性重度抑郁症患者丘脑核的结构协方差网络(SCN)进行了图论分析,并分别与性别匹配的hc进行了比较。结果:在整个丘脑或核体积中没有明显的性别诊断相互作用。在MDD女性患者中观察到SCN的破坏,包括与女性hcc相比,左侧外侧后核(LP)的结度较低,左侧板内核组和双侧前外侧核组几个核的中间中心性较低,右侧枕侧外侧核的中间中心性和紧密中心性较高。与男性hcc相比,男性MDD表现为左侧腹侧前大细胞核和右侧内侧腹侧团聚核结度较低,左侧中背侧旁细胞核间性中心性较高。此外,男性hcc在右侧LP核中表现出比女性hcc更高的紧密中心性。结论:这些发现首次证明了早期未经治疗的MDD患者丘脑核的拓扑特性而非体积发生了性别特异性改变,表明丘脑核SCN的结构重组可能是MDD性别差异背后的潜在神经机制。
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引用次数: 0
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Progress in Neuro-Psychopharmacology & Biological Psychiatry
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