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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 Epub Date: 2025-12-23 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
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 Epub Date: 2026-01-03 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
Exogenous estradiol and progesterone administration in healthy women does not affect decision making in Iowa gambling task 健康女性外源性雌二醇和黄体酮不影响爱荷华赌博任务的决策。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 Epub Date: 2025-12-15 DOI: 10.1016/j.pnpbp.2025.111589
Christian Eric Deuter , Michael Kaczmarczyk , Hanna Deus , Anna Kallidou , Christian Otte , Katja Wingenfeld
Decision-making is based on the integration of various emotional and cognitive processes and is the precondition for planned, structured action. Earlier studies show an increased risk tolerance during fertile phases of the cycle, i.e. the days before ovulation with high estradiol and low progesterone levels. Various studies indicate an influence of the menstrual cycle on decision-making behavior, potentially due to cyclical fluctuations in hormone levels. Estradiol and progesterone in particular can be regarded as the key hormones in cycle regulation. Previous research in humans has primarily been based on self-reported cycle information and correlative relationships. In the described study, we have investigated the influence of an experimental administration of estradiol, progesterone and both hormones in combination in a placebo-controlled, randomized study with young, healthy women (N = 116, mean age 25.7 years). The established and widely used Iowa Gambling Task (IGT) served as the outcome measure. To assess decisions under ambiguity and risk, we separately analyzed task performance in early and late trials of the task. The treatment groups did not differ significantly in either outcome. We discuss the findings against the background of the existing research literature on menstrual cycle and hormone effects as well as specific characteristics of the task and conclude that the previously reported effects are either task or context specific or the hormonal fluctuations of the cycle were not reflected by our manipulation.
决策是基于各种情感和认知过程的整合,是有计划的、有组织的行动的先决条件。早期的研究表明,在周期的生育阶段,即排卵前雌二醇水平高、黄体酮水平低的日子,风险承受能力会增加。各种研究表明,月经周期对决策行为的影响,可能是由于激素水平的周期性波动。特别是雌二醇和黄体酮可以被认为是周期调节的关键激素。以前对人类的研究主要是基于自我报告的周期信息和相关关系。在上述研究中,我们在一项年轻健康女性(N = 116,平均年龄25.7 岁)的安慰剂对照随机研究中,研究了雌二醇、黄体酮和这两种激素联合使用的影响。建立并广泛使用的爱荷华赌博任务(IGT)作为结果测量。为了评估模糊和风险下的决策,我们分别分析了任务早期和后期试验的任务绩效。两组治疗结果均无显著差异。我们在现有的关于月经周期和激素影响的研究文献以及任务的具体特征的背景下讨论了这些发现,并得出结论,先前报道的影响要么是任务特定的,要么是环境特定的,或者周期的激素波动没有被我们的操作反映出来。
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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 Epub Date: 2025-12-26 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 Epub Date: 2026-01-12 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
Uncovering the female phenotype in the VPA autism model: Brain-region specific synaptic pattern, microglial priming and behavioral singularity 揭示VPA自闭症模型中的女性表型:脑区特异性突触模式、小胶质启动和行为奇异性。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 Epub Date: 2025-12-20 DOI: 10.1016/j.pnpbp.2025.111591
Marianela E. Traetta , Martin G. Codagnone , Einav Litvak , María José Maleville Corpa , Nonthué A. Uccelli , Sandra C. Zárate , Analía G. Reinés
Neurodevelopmental disorders, such as autism spectrum disorders (ASD), exhibit a poorly understood male bias. While sex differences may provide key insights into ASD etiology and treatment, the female side of animal models, such as prenatal valproic acid (VPA) exposure, remains incompletely characterized. Here, we evaluated the behavioral, synaptic, and microglial profiles of female VPA rats. Female VPA animals exhibited social deficits, including a decreased sociability index in the three-chamber test and reduced play and social-recognition behaviors in a peer-interaction test, while exploratory and repetitive activities were preserved. At the synaptic level, the medial prefrontal cortex (mPFC) showed increased synaptophysin (SYN) immunostaining, whereas the hippocampal subfield CA3, displayed reduced SYN. Additionally, CA3 neurons exhibited increased neuronal cell adhesion molecule (NCAM) immunostaining, while the mPFC showed increased levels of its polysialylated form (PSA-NCAM), resulting in distinct NCAM/PSA-NCAM ratio shifts in each region. In vitro, hippocampal and cortical neurons from female VPA animals exhibited preserved synaptic puncta number and dendritic tree length and responded to glutamate-induced remodeling similarly to controls, suggesting no intrinsic neuronal alterations. Microglia from the mPFC and the hippocampus exhibited a less ramified morphology, with increased cell numbers in the mPFC. Isolated and cultured microglia retained this reactive phenotype, yet they responded to the exposure to synaptic terminals similarly to controls. Our findings indicate that female VPA rats display a distinctive social deficit linked to brain-area-specific synaptic remodeling impairment and microglial reactivity. Sex-differences in the VPA model could provide valuable insights into neuron-glia interactions underlying autism.
神经发育障碍,如自闭症谱系障碍(ASD),表现出一种鲜为人知的男性偏见。虽然性别差异可能为ASD的病因和治疗提供了关键的见解,但动物模型的女性方面,如产前丙戊酸(VPA)暴露,仍然没有完全表征。在这里,我们评估了雌性VPA大鼠的行为、突触和小胶质特征。雌性VPA动物表现出社会缺陷,包括在三室测试中社交指数下降,在同伴互动测试中玩耍和社会识别行为减少,而探索性和重复性活动保留下来。在突触水平上,内侧前额叶皮层(mPFC)突触素(SYN)免疫染色增加,而海马亚区CA3显示SYN减少。此外,CA3神经元表现出神经元细胞粘附分子(NCAM)免疫染色增加,而mPFC显示其多口化形式(PSA-NCAM)水平增加,导致每个区域的NCAM/PSA-NCAM比值明显变化。体外实验显示,雌性VPA动物的海马和皮质神经元突触点数量和树突状树长度保持不变,并对谷氨酸诱导的重塑做出反应,与对照组相似,表明没有内在的神经元改变。来自mPFC和海马的小胶质细胞表现出较少的分枝形态,mPFC的细胞数量增加。分离和培养的小胶质细胞保留了这种反应性表型,但它们对暴露于突触终端的反应与对照组相似。我们的研究结果表明,雌性VPA大鼠表现出与脑区域特异性突触重塑损伤和小胶质细胞反应性相关的独特的社交缺陷。VPA模型中的性别差异可以为自闭症背后的神经元-神经胶质相互作用提供有价值的见解。
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引用次数: 0
Broad transcriptomic effects of Egr1 knockdown in the mouse nucleus accumbens core and its role in cocaine locomotor sensitization 小鼠伏隔核Egr1敲低的广泛转录组效应及其在可卡因运动致敏中的作用。
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 Epub Date: 2025-12-06 DOI: 10.1016/j.pnpbp.2025.111574
Yuki Nakamura , Mélody Labarchède , Tiago Mendes , Yukari Nakamura , Sophie Longueville , Giulia Albertini , Lucile Marion-Poll , Louise-Laure Mariani , Denis Hervé , Anne Roumier , Jean-Antoine Girault
Immediate early genes are widely used markers of neuronal activation, but their function in neurons is not well understood. We focused on the role of Egr1 in the nucleus accumbens core (NAc-c) in the long-lasting behavioral effects of cocaine, using an AAV expressing short hairpin RNA (Egr1-shRNA). Egr1 knockdown did not alter acute cocaine locomotor effects or conditioned place preference. In contrast, shEgr1 markedly decreased the locomotor sensitization induced by repeated cocaine administration. Because EGR1 is a transcription factor, we explored the transcriptomic alterations using RNAseq completed by RT-qPCR and protein studies. Egr1 knockdown modified the expression of numerous genes. Analysis of the upregulated genes revealed indirect activation of astrocytes and microglia evidenced by immunohistofluorescence, but shEgr1-induced dampening of cocaine sensitization was unaffected by minocycline, a microglia inhibitor. Proteasome genes were upregulated by shEgr1, possibly contributing to its functional consequences. Downregulated genes included potential EGR1 targets and comprised many genes characteristic of striatal neurons, including those coding signaling proteins (DARPP-32, CDK5 activator p35), glutamate ionotropic (NMDA NR1/2B, AMPA GluA1–3) and metabotropic (mGluR1/5) receptors, and postsynaptic proteins (PSD-95). We confirmed these alterations at the protein level and found decreased cocaine-induced phospho-Ser845-GluA1. Thus our study shows the broad transcriptional consequences of silencing Egr1 in neurons. It provides a mechanism by which Egr1 knockdown in the NAc-c can alter cocaine-induced locomotor sensitization, through downregulation of many genes including key components of glutamate neurotransmission. This broad role of EGR1 in regulating transcription provides clues about its function and role in learning, memory, and synaptic plasticity.
即时早期基因是广泛使用的神经元激活标记,但其在神经元中的功能尚不清楚。我们利用表达短发夹RNA (Egr1- shrna)的AAV,研究了伏隔核(nac -)中Egr1在可卡因长期行为效应中的作用。Egr1敲除不改变急性可卡因运动效应或条件位置偏好。相反,shEgr1显著降低了重复给药引起的运动致敏。由于EGR1是一种转录因子,我们利用RT-qPCR和蛋白质研究完成的RNAseq来探索转录组学改变。Egr1敲低修饰了许多基因的表达。对上调基因的分析显示,免疫组织荧光证实了星形胶质细胞和小胶质细胞的间接激活,但小胶质细胞抑制剂米诺环素不影响shegr1诱导的可卡因致敏抑制。蛋白酶体基因被shEgr1上调,可能有助于其功能后果。下调的基因包括潜在的EGR1靶点,包括纹状体神经元的许多特征基因,包括编码信号蛋白(DARPP-32, CDK5激活因子p35),谷氨酸嗜离子性(NMDA n1 / 2b, AMPA GluA1-3)和代谢(mGluR1/5)受体和突触后蛋白(PSD-95)。我们在蛋白水平上证实了这些改变,并发现可卡因诱导的磷酸化ser845 - glua1减少。因此,我们的研究显示了在神经元中沉默Egr1的广泛转录后果。它提供了一种机制,通过下调包括谷氨酸神经传递关键成分在内的许多基因,nac中的Egr1敲低可以改变可卡因诱导的运动敏化。EGR1在调节转录中的广泛作用为其在学习、记忆和突触可塑性中的功能和作用提供了线索。
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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 Epub Date: 2025-12-24 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
Norepinephrine and inhibitory transmission: Regional diversity and mechanisms of modulation 去甲肾上腺素与抑制传递:区域多样性和调节机制
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 Epub Date: 2025-12-24 DOI: 10.1016/j.pnpbp.2025.111592
Prabhjeet Singh , Tak Pan Wong
Norepinephrine, a stress-related neuromodulator, is a key regulator of synaptic transmission and neuronal activity. While the impact of norepinephrine on excitatory transmission has been frequently discussed, how norepinephrine regulates inhibitory transmission remains poorly understood. Norepinephrine modulates inhibitory synaptic function and the firing property of inhibitory neurons. These norepinephrine effects on inhibitory transmission are complex and often region- and inhibitory neuron subtype-specific. Malfunctioning of the norepinephrine-induced modulation of inhibitory transmission could underlie various brain diseases, especially norepinephrine-related psychiatric and neurodegenerative disorders. In this review, we examine findings on the expression of norepinephrine receptors in inhibitory neurons and norepinephrine-induced modulation of inhibitory transmission across different regions of the central nervous system. Furthermore, we discuss the role of adrenergic receptors, norepinephrine concentrations, signaling and inhibitory neuron subtypes in norepinephrine-induced modulation of inhibitory transmission. Overall, this review highlights inhibitory transmission as a major target of norepinephrine for influencing circuit functions and shaping behavioral outcomes.
去甲肾上腺素是一种与压力相关的神经调节剂,是突触传递和神经元活动的关键调节剂。虽然去甲肾上腺素对兴奋性传递的影响经常被讨论,但去甲肾上腺素如何调节抑制性传递仍然知之甚少。去甲肾上腺素调节抑制性突触功能和抑制性神经元的放电特性。这些去甲肾上腺素对抑制性传递的影响是复杂的,通常是区域和抑制性神经元亚型特异性的。去甲肾上腺素诱导的抑制性传递调节功能障碍可能是多种脑部疾病的基础,特别是与去甲肾上腺素相关的精神和神经退行性疾病。在这篇综述中,我们研究了去甲肾上腺素受体在抑制性神经元中的表达,以及去甲肾上腺素诱导的跨中枢神经系统不同区域的抑制性传递的调节。此外,我们还讨论了肾上腺素能受体、去甲肾上腺素浓度、信号传导和抑制性神经元亚型在去甲肾上腺素诱导的抑制性传递调节中的作用。总的来说,这篇综述强调了抑制传递是去甲肾上腺素影响电路功能和塑造行为结果的主要目标。
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引用次数: 0
Hyperlearning Hypothesis: Network disruption and maladaptive learning in schizophrenia 超学习假说:精神分裂症的网络中断和不适应学习
IF 3.9 2区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2026-01-02 Epub Date: 2025-12-24 DOI: 10.1016/j.pnpbp.2025.111599
Yuichi Takei , Masakazu Sunaga , Kazuyuki Fujihara , Takefumi Ohki , Yutaka Kato , Seiichiro Jinde
Schizophrenia unfolds through a dynamic course in which perceptual instability, aberrant salience, negative symptoms, and cognitive impairment emerge and interact over time. Existing models have not fully explained how acute disturbances in perceptual inference develop into persistent dysfunction across large-scale neural systems. Here, we advance the Hyperlearning Hypothesis, a mechanistic account proposing that schizophrenia arises from a two-stage disruption in neural learning. First, NMDA/GABA abnormalities impair the precision of prediction-error signaling, leading to unstable perceptual inferences. Second, excessive hippocampal ripple activity drives maladaptive overlearning, which reinforces and stabilizes inaccurate internal models. This cascade links acute perceptual instability to long-term network disorganization and the emergence of chronic negative and cognitive symptoms. Importantly, this framework highlights how aberrant learning signals—rather than static structural deficits—shape the evolution of psychopathology over time.
Electrophysiological evidence supports this framework, as individuals with schizophrenia exhibit elevated ripple frequency and power, delayed ripple-initiated network transitions, and reduced clustering and local efficiency within beta-band cortical networks. Together, these abnormalities suggest a progressive disintegration of large-scale templates that normally support stable cognitive function.
By integrating computational psychiatry, electrophysiology, and network neuroscience, the Hyperlearning Hypothesis offers a coherent mechanistic account of schizophrenia's evolution and outlines potential avenues for clarifying how learning-related and network-level processes contribute to illness progression.
精神分裂症是一个动态的过程,在这个过程中,知觉不稳定、异常突出、阴性症状和认知障碍随着时间的推移而出现并相互作用。现有的模型并没有完全解释知觉推理中的急性干扰如何发展成大规模神经系统的持续功能障碍。在这里,我们提出了“超级学习假说”,这是一种机械性的解释,提出精神分裂症是由神经学习的两阶段中断引起的。首先,NMDA/GABA异常损害了预测错误信号的准确性,导致不稳定的感知推断。其次,过度的海马纹波活动会导致不适应的过度学习,从而加强和稳定不准确的内部模型。这种级联将急性知觉不稳定与长期网络紊乱以及慢性阴性和认知症状的出现联系起来。重要的是,这个框架强调了异常的学习信号——而不是静态的结构缺陷——如何随着时间的推移塑造精神病理学的演变。电生理学证据支持这一框架,因为精神分裂症患者表现出波纹频率和功率升高,波纹引发的网络转换延迟,β波段皮质网络的聚类和局部效率降低。总之,这些异常表明,通常支持稳定认知功能的大规模模板正在逐步瓦解。通过整合计算精神病学、电生理学和网络神经科学,超学习假说为精神分裂症的进化提供了连贯的机制解释,并概述了阐明学习相关过程和网络水平过程如何促进疾病进展的潜在途径。
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引用次数: 0
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Progress in Neuro-Psychopharmacology & Biological Psychiatry
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