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Clinical Insights Into the Mechanistic Crossroads of Lamotrigine and Therapeutic Ketosis in Bipolar Depression 拉莫三嗪与治疗酮症在双相抑郁症中的交叉作用机制的临床观察
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-09-22 DOI: 10.1016/j.bpsgos.2025.100616
Dina N. Ali , Iain H. Campbell , Jonathan G. Leung , Tamahara Gonzalez Campos , Duan Liu , Mete Ercis , Matej Markota , Deniz Ceylan , Kyla Lara-Breitinger , Francisco Lopez-Jimenez , Adam S. Anderson , Aysegul Ozerdem , Stacey J. Winham , Mark A. Frye
There are substantial care gaps in optimizing treatment response for bipolar depression given, at best, a modicum of benefit from antidepressant treatment and, in contrast, a substantial cardiometabolic burden associated with regulatory-approved antipsychotic treatment. Lamotrigine (LGT) is an anticonvulsant with an evidence base in both epilepsy and bipolar disorder (BD), in particular bipolar depression "stabilizing from down under." There is a well-established bidirectional relationship between BD and epilepsy. Recognizing the complex interplay between mood, diet, and energy metabolism, lifestyle interventions have emerged as an adjunctive therapeutic approach in BD. Among these, therapeutic ketosis, with century-old evidence base in epilepsy, has regained new interest as a promising adjunctive treatment for mood and metabolic comorbidities. LGT and therapeutic ketosis both target neurobiological pathways that regulate energy metabolism and promote neuronal stability—key processes implicated in mood regulation and neuronal protection. This alignment suggests the possibility of synergistic effects in BD. In this review, we explore the overlapping mechanisms of LGT and therapeutic ketosis and provide clinical insights into their combined use in BD, offering a comprehensive perspective on this innovative treatment strategy.
在优化双相抑郁症的治疗反应方面存在很大的护理差距,充其量只能从抗抑郁药物治疗中获得少量益处,相反,与监管部门批准的抗精神病药物治疗相关的心脏代谢负担很大。拉莫三嗪(LGT)是一种抗惊厥药,在癫痫和双相情感障碍(BD),特别是双相情感障碍抑郁症中都有证据表明其“从下到下稳定”。双相障碍与癫痫之间存在明确的双向关系。认识到情绪、饮食和能量代谢之间复杂的相互作用,生活方式干预已成为双相障碍的辅助治疗方法。其中,治疗酮症作为一种有希望的情绪和代谢合并症的辅助治疗方法,在癫痫中具有百年的证据基础,重新引起了人们的兴趣。LGT和治疗性酮症都针对调节能量代谢和促进神经元稳定性的神经生物学途径,这是涉及情绪调节和神经元保护的关键过程。在这篇综述中,我们探讨了LGT和治疗性酮症的重叠机制,并提供了它们在BD中的联合应用的临床见解,为这一创新的治疗策略提供了一个全面的视角。
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引用次数: 0
Altered Interpersonal Neural Synchronization During Social Interaction After Shared Excluded Experiences in Adolescents With Depression 青少年抑郁症患者分享排斥经历后社交互动中人际神经同步的改变
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-09-26 DOI: 10.1016/j.bpsgos.2025.100619
Yuwen He , Jieting Chen , Yong Lin , Natalia Chan , Fei Gao , Lulu Liu , Xiaoqing Yin , Yao Sun , Minghui Li , Sifan Zhang , Zihan Wei , Liangxuan Yu , Xinyi Huang , Zhihai Su , Zhen Yuan

Background

Major depressive disorder (MDD) is common in adolescents, and adolescents’ brains develop intensively but are still immature, making them more vulnerable during social interaction when exposed to public psychosocial stressors. Thus, it is essential to examine how a shared psychosocial stressor, i.e., shared excluded experiences, influences social interaction in adolescents with depression.

Methods

We designed a 4-player Cyberball game involving 2 virtual players and 2 real players and recruited 34 dyads of healthy adolescents and 34 dyads of adolescents with depression. This allowed us to investigate the responses of adolescents with depression to shared excluded experiences and explore the underlying interpersonal neural synchronization (INS), which can indicate mutual empathy, with functional near-infrared spectroscopy.

Results

We found that shared excluded experiences enhanced adolescents’ social interaction but decreased INS between paired excluded adolescents. Such discrepancy suggested reduced mutual empathy between the excluded adolescents despite their increased interaction after shared exclusion. No significant between-group differences were observed in behavioral responses to shared excluded experiences. Subsequent analyses revealed that adolescents with MDD experienced more negative feelings compared with healthy control participants (HCs), and they demonstrated stronger INS than HCs after shared exclusion, which collectively indicate higher empathic stress in adolescents with depression. In addition, there were altered brain-behavioral association patterns in responses to shared excluded experiences in adolescents with depression.

Conclusions

Our study gives us deeper insights into how a shared psychosocial stressor impacts INS in adolescents with depression, and it suggests that INS could be more sensitive than behavioral responses at detecting social interaction deficits in adolescents with depression.
重度抑郁症(MDD)在青少年中很常见,青少年的大脑发育强烈,但仍不成熟,当暴露于公共社会心理压力源时,他们在社会交往中更容易受到伤害。因此,有必要研究共同的社会心理压力源,即共同的排斥经历,如何影响抑郁症青少年的社会互动。方法设计4人网球游戏,虚拟玩家2人,真实玩家2人,招募健康青少年34对,抑郁青少年34对。本研究利用近红外光谱技术研究了抑郁症青少年对共享排斥经历的反应,并探讨了潜在的人际神经同步(INS),这可以表明相互共情。结果我们发现,共享被排斥经历增强了青少年的社会互动,但降低了配对被排斥青少年的INS。这种差异表明,被排斥的青少年之间的相互同情减少了,尽管他们在共同排斥后的互动增加了。在对共同的排除经历的行为反应上,组间无显著差异。随后的分析显示,与健康对照组(hc)相比,MDD青少年经历了更多的负面情绪,并且在共同排斥后,他们比hc表现出更强的INS,这共同表明抑郁症青少年有更高的共情压力。此外,青少年抑郁症患者对共同排斥经历的反应中,大脑行为关联模式发生了改变。结论本研究进一步揭示了共同的社会心理应激源对青少年抑郁症患者INS的影响,表明INS在检测青少年抑郁症患者社交缺陷方面可能比行为反应更敏感。
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引用次数: 0
A Placebo-Controlled Randomized Trial of the Effects of Escitalopram on Depressive Symptoms and Immune Function in People With HIV 艾司西酞普兰对HIV感染者抑郁症状和免疫功能影响的安慰剂对照随机试验
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.bpsgos.2025.100627
Dwight L. Evans , Sergei Spitsin , Kevin G. Lynch , Chelsea D. Voytek , Menvekeh G. Daramay , Elizabeth A. Hembree , Danielle Fiore , Robert Gross , J. Cobb Scott , Steven D. Douglas , Michael E. Thase

Background

This study was a randomized controlled trial investigating the effects of a selective serotonin reuptake inhibitor (SSRI) and improvement in depressive symptoms on innate immunity and inflammation in people with HIV (PWH).

Methods

The mean 17-item Hamilton Depression Rating Scale (HAMD-17) score at baseline was 19.1 for the sample (N = 108). Eligible participants were randomized to 10 weeks of double-blind therapy with either SSRI (escitalopram) or placebo. All participants concurrently received computer-assisted cognitive behavioral therapy (CCBT). Peripheral blood was obtained from each participant at baseline and at weeks 2, 4, and 10, and intracellular interferon gamma (IFN-γ) in natural killer (NK) cells, lytic units per 107 NK cells (LUNKs), interleukin 6 (IL-6), and C-reactive protein (CRP) were measured.

Results

Participants showed substantial reduction in depressive symptoms during study with final HAMD-17 score of 8.00 (average decrease of 11.0 units). However, there was no statistically significant effect of treatment, whether viewed as a group × time interaction (F1,166 = 0.00, p = .976) or as a main effect for group (F1,667 = 0.50, p = .479). There were no statistically significant differences between the groups on the immune parameters over time. There was little evidence that the magnitude of symptom improvement was associated with changes in immune measures.

Conclusions

Our study did not demonstrate superiority of treatment with SSRI+CCBT versus placebo+CCBT. Patients in both arms showed improvement of depression symptoms, which did not correlate with changes in immune markers. We found no evidence of decreased inflammation (IL-6, CRP) or immune restoration (LUNKs or intracellular IFN-γ) following treatment with CCBT with or without active escitalopram. While antidepressant treatment is indicated for PWH with depression, we observed no evidence of direct immunologic benefits.
本研究是一项随机对照试验,旨在研究选择性血清素再摄取抑制剂(SSRI)和抑郁症状的改善对HIV (PWH)患者先天免疫和炎症的影响。方法样本(108例)17项汉密尔顿抑郁评定量表(HAMD-17)基线平均得分为19.1分。符合条件的参与者被随机分配到SSRI(艾司西酞普兰)或安慰剂的10周双盲治疗。所有参与者同时接受计算机辅助认知行为治疗(CCBT)。在基线和第2周、第4周和第10周采集每位参与者的外周血,并测量自然杀伤(NK)细胞中的细胞内干扰素γ (IFN-γ)、每107个NK细胞(LUNKs)的溶解单位、白细胞介素6 (IL-6)和c反应蛋白(CRP)。结果受试者抑郁症状明显减轻,最终HAMD-17评分为8.00分(平均下降11.0分)。然而,无论是作为组间交互作用(f1166 = 0.00, p = .976)还是作为组内主要作用(f1667 = 0.50, p = .479),治疗均无统计学显著影响。各组间免疫参数随时间变化无统计学差异。几乎没有证据表明症状改善的程度与免疫措施的改变有关。结论我们的研究并未证明SSRI+CCBT治疗优于安慰剂+CCBT治疗。两组患者均表现出抑郁症状的改善,这与免疫标记物的变化无关。我们没有发现在CCBT治疗后炎症(IL-6, CRP)或免疫恢复(lunk或细胞内IFN-γ)减少的证据。虽然抗抑郁治疗适用于伴有抑郁症的PWH,但我们没有观察到直接免疫益处的证据。
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引用次数: 0
Subscribers Page 用户页面
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1016/S2667-1743(25)00226-5
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引用次数: 0
Investigating Links Between Prenatal Cannabis Exposure and Brain Development Using Magnetic Resonance Imaging Techniques: A Narrative Review 使用磁共振成像技术调查产前大麻暴露与大脑发育之间的联系:叙述性回顾
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-09-30 DOI: 10.1016/j.bpsgos.2025.100624
Priscila Dib Gonçalves , James O. Woodruff , Maria Olivia Pozzolo Pedro , Milenna T. van Dijk , Emilie Bruzelius , Silvia S. Martins , Gretchen Bandoli , Alexandra Potter , Leigh-Anne Cioffredi , Ardesheer Talati , Matthew D. Albaugh
Understanding the impact of prenatal cannabis exposure (PCE) on brain development is increasingly important given rising cannabis use during pregnancy. Many existing reviews on this topic are more than 5 years old and may not reflect recent social shifts that could impact cannabis use during pregnancy; they also have not utilized the recently available large longitudinal datasets for more robust and population-representative investigations. In this narrative review, we aim to provide an updated and expanded examination of the associations between PCE and magnetic resonance imaging (MRI)–based brain outcomes from in utero development to adolescence. We included studies published after 2019 that used at least one of the following measures: structural MRI, diffusion-weighted imaging, resting-state fMRI, and/or task-based fMRI. Across 9 studies that met criteria, 1 study focused on MRI outcomes in utero, 2 in infancy, and 6 in early adolescence, and only 3 studies included MRI and behavior outcomes. PCE was linked to differences in frontal, parietal, and temporal areas, spanning from in utero to adolescence across multiple MRI modalities. However, in the current state of the literature, detecting a consistent trend on PCE’s impact on MRI findings was not possible. Furthermore, we found several divergences in study design: varying approaches to assessment (e.g., self-report vs. urine toxicology); difficulties in accounting for prenatal exposure to multiple substances; limited information on timing, frequency, potency, or mode of consumption; and the influence of parental or postnatal factors. Future research should implement designs that can rigorously capture the abovementioned elements to permit replication and eventual meta-analyses on this critical topic.
鉴于怀孕期间大麻使用量的增加,了解产前大麻暴露(PCE)对大脑发育的影响越来越重要。关于这一主题的许多现有评论已经超过5年,可能无法反映最近可能影响怀孕期间大麻使用的社会变化;他们也没有利用最近可用的大型纵向数据集进行更有力和具有人口代表性的调查。在这篇叙述性综述中,我们的目标是提供一个更新和扩展的PCE和基于磁共振成像(MRI)的大脑结果之间的关系的研究,从子宫发育到青春期。我们纳入了2019年以后发表的研究,这些研究至少使用了以下一种测量方法:结构MRI、扩散加权成像、静息状态fMRI和/或基于任务的fMRI。在符合标准的9项研究中,1项研究关注子宫内的MRI结果,2项研究关注婴儿期,6项研究关注青春期早期,只有3项研究包括MRI和行为结果。PCE与额叶、顶叶和颞叶区域的差异有关,从子宫到青春期跨越多种MRI模式。然而,在目前的文献中,不可能发现PCE对MRI表现影响的一致趋势。此外,我们还发现了研究设计上的一些差异:不同的评估方法(例如,自我报告与尿液毒理学);难以解释产前暴露于多种物质;关于时间、频率、效力或消费方式的有限信息;以及父母或后天因素的影响。未来的研究应该实施能够严格捕获上述元素的设计,以便对这一关键主题进行复制和最终的荟萃分析。
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引用次数: 0
Using Genetics to Shed Light on the Scientific Gray Zone of Functional Seizures 利用遗传学揭示功能性癫痫的科学灰色地带
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-11-12 DOI: 10.1016/j.bpsgos.2025.100628
Christal N. Davis
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引用次数: 0
Emotional Blunting and Time Estimation in Depression 抑郁症的情绪钝化与时间估计
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-10-10 DOI: 10.1016/j.bpsgos.2025.100626
Francesca Mura , Vincenzo Catrambone , Gaetano Valenza , Virginie Van Wassenhove , Giovanna Mioni , Claudio Gentili

Background

Various cognitive and emotional factors shape our perception of time. Notably, individuals experiencing depressive symptoms often report changes in their time perception, characterized by a phenomenon termed depressive time dilation, or a subjective slowing of temporal flow. However, research on this topic has yielded conflicting and inconclusive findings, leaving the mechanisms behind altered time perception in depression largely unknown. In this study, we aim to explore the neural dynamics underlying the influence of emotional experiences on time perception in relation to depressive symptomatology.

Methods

A total of 120 university students participated in a retrospective time estimation task after watching either sad or neutral emotion-eliciting videos. Moreover, participants’ electroencephalographic (EEG) activity was recorded for the whole duration of the experiment by means of a high-density EEG cap. The severity of depressive symptoms was assessed using the Patient Health Questionnaire-9.

Results

Our findings revealed notable differences between individuals with depressive symptoms and healthy control individuals. Specifically, emotional modulation influenced time estimations exclusively in healthy control individuals. Moreover, individuals with depressive symptoms exhibited a significant relationship between beta band power and retrospective time estimations, specifically after watching the neutral video.

Conclusions

These results suggest that cognitive processes related to depression may disrupt the link between emotions and time perception. Overall, our study contributes to a deeper understanding of the interplay between emotional experience, cognitive processes, and time perception in individuals with depressive symptoms.
各种认知和情感因素塑造了我们对时间的感知。值得注意的是,经历抑郁症状的个体经常报告他们的时间感知发生了变化,其特征是一种称为抑郁时间扩张的现象,或主观的时间流减慢。然而,关于这一主题的研究产生了相互矛盾和不确定的发现,使得抑郁症改变时间感知的机制在很大程度上未知。在本研究中,我们旨在探讨情绪体验对抑郁症状的时间感知影响的神经动力学。方法120名大学生在观看了悲伤或中性的视频后,参与了一项回顾性的时间估计任务。此外,通过高密度脑电图帽记录参与者在整个实验过程中的脑电图(EEG)活动。使用患者健康问卷-9评估抑郁症状的严重程度。结果抑郁症状个体与健康对照组之间存在显著差异。具体来说,情绪调节仅在健康对照个体中影响时间估计。此外,有抑郁症状的个体表现出β波段功率与回顾性时间估计之间的显著关系,特别是在观看中性视频后。这些结果表明,与抑郁相关的认知过程可能会破坏情绪和时间感知之间的联系。总的来说,我们的研究有助于更深入地了解抑郁症状个体的情绪体验、认知过程和时间感知之间的相互作用。
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引用次数: 0
Guide for Authors 作者指南
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1016/S2667-1743(25)00228-9
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引用次数: 0
Editorial Board Page 编委会页面
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2026-01-15 DOI: 10.1016/S2667-1743(25)00225-3
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引用次数: 0
Bipolar Disorder VII: Family History and Its Relationship With Suicide Attempts, Severity, and the Prophylactic Effect of Lithium Treatment in a Long-Term Follow-Up Study of Bipolar Disorder 双相情感障碍VII:家族史及其与自杀企图、严重程度的关系,以及锂治疗在双相情感障碍长期随访研究中的预防作用
IF 3.7 Q2 NEUROSCIENCES Pub Date : 2026-01-01 Epub Date: 2025-09-06 DOI: 10.1016/j.bpsgos.2025.100608
Per-Olof Nylander , Erik Lexne , Christer Lehman , Lars Brudin , Finn Bengtsson

Background

Family history (FH) of affective disorders (ADs) is important for the course of bipolar disorder (BD).

Methods

In a long-term study (mean 25 years), 192 patients with BD diagnosed by DSM-IV criteria were recruited from lithium dispensaries. Differences between patients with and without an FH of ADs were studied.

Results

Patients with an FH of AD had poorer lithium response (p = .027), earlier age of onset (AOO) (p < .001), were younger (p = .009), made suicide attempts (SAs) earlier after onset (p = .012), and had more episodes/year (p = .017) and depressive episodes/year (p = .010) before SA. SAs were more common (p = .028) in patients with an FH of AD. SAs were more common (p = .001) before lithium treatment, and SAs (p < .001) were only present in patients with an FH of AD within the first 5 years after AOO. Patients with an FH of AD had more episodes (p = .009), episodes/year (p = .002), depressive episodes (p < .001), and depressive episodes/year (p < .001) during their lifetime. Before lithium, episodes (p = .009), depressive episodes (p = .006), and depressive episodes/year (p = .010) were more common in patients with an FH of AD. Manic episodes (p = .020) were more common in patients with no FH of AD. On lithium, episodes (p = .010), episodes/year (p = .001), depressive episodes (p < .001), and depressive episodes/year (p < .001) were more common in patients with an FH of AD. FH of suicide was present only among patients with an FH of AD (p < .001).

Conclusions

BD patients with an FH of AD have a more severe form of BD with a special effect on SAs, AOO, episodes, and lithium response in BD.
情感性障碍家族史(FH)对双相情感障碍(BD)的病程具有重要意义。方法在一项长期研究中(平均25年),从锂药房招募192例符合DSM-IV标准的BD患者。研究了有和没有ad FH的患者之间的差异。结果AD FH患者锂离子反应较差(p = 0.027),发病年龄较早(p < 0.001),年龄较小(p = 0.009),发病后自杀未遂(p = 0.012)早(p = 0.012), SA前每年发作次数较多(p = 0.017),抑郁发作次数较多(p = 0.010)。sa在AD的FH患者中更为常见(p = 0.028)。锂治疗前SAs更为常见(p = 0.001),而SAs仅存在于AOO后前5年内的AD FH患者中(p < 0.001)。AD的FH患者在其一生中有更多的发作(p = 0.009)、发作/年(p = 0.002)、抑郁发作(p < 0.001)和抑郁发作/年(p < 0.001)。在使用锂离子治疗前,发作(p = 0.009)、抑郁发作(p = 0.006)和抑郁发作/年(p = 0.010)在AD的FH患者中更为常见。躁狂症发作(p = 0.020)在无FH或AD患者中更为常见。在锂治疗中,发作(p = 0.010)、发作/年(p = 0.001)、抑郁发作(p < 0.001)和抑郁发作/年(p < 0.001)在FH / AD患者中更为常见。自杀念头仅存在于阿尔茨海默病患者中(p < .001)。结论伴有AD的FH的BD患者具有更严重的BD形式,对BD的sa、AOO、发作和锂反应有特殊影响。
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引用次数: 0
期刊
Biological psychiatry global open science
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