Brain disorders (Amsterdam, Netherlands)最新文献_第2页

Exploratory comparison of autoregulation indices in severe neurological injury using near-infrared spectroscopy and pressure reactivity index 近红外光谱法与压力反应性指数对重度神经损伤自调节指标的探索性比较

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-11-04 DOI: 10.1016/j.dscb.2025.100295

Jason J. Chang , David Kepplinger , Yongwoo Kim , Daniel R. Felbaum , Jeffrey C. Mai , Rocco A. Armonda , Edward F. Aulisi

Purpose

Cerebral autoregulation monitoring utilizes pressure reactivity index (PRx) but has limited use due to its reliance on invasive continuous intracranial pressure monitoring. Non-invasive forms of cerebral autoregulation monitoring may help evaluate secondary neurological injury. We compared temporal trends for tissue oxygen reactivity index (TOx)—a non-invasive cerebral autoregulation index that utilizes the moving correlation coefficient between tissue oxygen saturation and mean arterial pressure—and PRx.

Methods

A single-center, retrospective exploratory feasibility study in a Level-One Trauma and Tertiary Stroke center comparing PRx and TOx smoothed trajectories in patients with severe neurological injury and comatose exams.

Results

Eighteen patients who received TOx and PRx monitoring were analyzed. Individualized smoothed trajectories for TOx and PRx were created. Overall median correlations between TOx and PRx was 0.73. TOx and PRx were also analyzed for their association with poor clinical outcome. Matthew Correlation Coefficient (MCC) suggested that TOx had the strongest association with outcome, reaching a peak value of 0.71 that occurred after day 13 of monitoring. PRx achieved a peak MCC of 0.6 that was consistently reached after day 15 of monitoring.

Conclusion

Our findings suggest that TOx may correlate with PRx trajectories. In our cohort, TOx was more strongly associated with poor outcome than PRx. These preliminary results should be interpreted as exploratory, and further research is required to confirm and validate these findings.

脑自调节监测利用压力反应指数（PRx），但由于其依赖于有创性连续颅内压监测，其应用受到限制。无创形式的大脑自动调节监测可能有助于评估继发性神经损伤。我们比较了组织氧反应指数（TOx）（一种利用组织氧饱和度和平均动脉压之间的移动相关系数的非侵入性大脑自动调节指数）和PRx的时间趋势。方法采用单中心、回顾性、探索性可行性研究，比较PRx和TOx在重度神经损伤患者和昏迷检查中的平滑轨迹。结果对18例接受TOx和PRx监测的患者进行分析。为TOx和PRx创建了个性化的平滑轨迹。TOx和PRx的总体中位数相关性为0.73。还分析了TOx和PRx与不良临床结果的关系。马修相关系数（Matthew Correlation Coefficient， MCC）显示TOx与预后的相关性最强，在监测第13天达到峰值0.71。PRx的MCC峰值为0.6，在监测第15天后一直达到该峰值。结论我们的研究结果提示TOx可能与PRx轨迹相关。在我们的队列中，TOx与不良预后的相关性比PRx更强。这些初步结果应被解释为探索性的，需要进一步的研究来证实和验证这些发现。

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引用次数: 0

Genetic and metabolic diagnostic profile of children presented with spastic paraplegia/diplegia 痉挛性截瘫/双瘫儿童的遗传和代谢诊断概况

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-25 DOI: 10.1016/j.dscb.2025.100294

Nebal Waill Saadi , Basma Adel Ibrahim , Qusay Abed Fahad , Henry Houlden , Rahema Mohammad , Mina Zamani , Adel A. Kareem , Ali Kadhim Al-Husseinawi , Hayder Kadhim Jabbar , Saif Hamed Farhan , Omar A.Thu Noon , Mays Al-Tai

Background

Spastic paraplegia/diplegia in children may be an early manifestation of underlying neurogenetic disorders which are often underdiagnosed in clinical practice. The aim of the study is to investigate the genetic causes and clinical characteristics of neurogenetic disorders presenting with spastic diplegia/paraplegia in children.

Patients and methods

A retrospective analysis of medical records of children aged 0 – 18 years who were reported to have spastic paraplegia/diplegia as a core clinical feature with confirmed genetic etiologies was conducted. Data on demographic and clinical features, neuroimaging, and available genetic testing results were analyzed.

Results

A total of 53 patients fulfilled the study eligibility criteria. The study comprises 27 males (50.9 %) with male:female ratio 1.04:1. Mean age of onset is approximately 3 years. Walking difficulty/gait disturbance/posturing of limbs were the commonest presenting features (29, 54.7 %). The two commonest neurological disorders identified were leukodystrophies/genetic leukoencephalopathies (20, 37.7 %) and hereditary spastic paraplegia (15, 28 %). The most frequent abnormalities found in neuroimaging were signal abnormalities in the white matter and thinning of corpus callosum. This study contributes with 23 novel mutations that were not reported in other non-Iraqi patients.

Conclusions

A comprehensive clinical approach to patients with spastic paraplegia/diplegia will aid in early diagnosis, targeted management, and improve counseling in pediatric neurology practice. We contribute to the regional and international data on the genetic spectrum of spastic paraplegia/diplegia.

背景：儿童痉挛性截瘫/双瘫可能是潜在神经遗传疾病的早期表现，但在临床实践中往往未被充分诊断。本研究的目的是探讨儿童痉挛性双瘫/截瘫的遗传原因和神经遗传疾病的临床特征。患者与方法回顾性分析0 ~ 18岁以痉挛性截瘫/双瘫为核心临床特征并确定遗传病因的患儿病历。分析了人口统计学和临床特征、神经影像学和现有基因检测结果的数据。结果53例患者符合研究资格标准。研究对象为男性27人（50.9%），男女比例为1.04:1。平均发病年龄约为3岁。行走困难/步态障碍/肢体姿势是最常见的表现（29,54.7%）。两种最常见的神经系统疾病是白质营养不良/遗传性白质脑病（20.37.7%）和遗传性痉挛性截瘫（15.28%）。神经影像学中最常见的异常是白质信号异常和胼胝体变薄。这项研究发现了23个在其他非伊拉克患者中未报道的新突变。结论对痉挛性截瘫/双瘫患者采取综合的临床治疗方法有助于小儿神经内科的早期诊断、针对性治疗和改善咨询。我们为痉挛性截瘫/双瘫的遗传谱提供区域和国际数据。

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引用次数: 0

Evaluating zuranolone: Discrepancies and insights from multiple systematic reviews and meta-analyses on major depression and postpartum depression treatment 评估祖拉诺酮：来自重性抑郁症和产后抑郁症治疗的多系统综述和荟萃分析的差异和见解

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-22 DOI: 10.1016/j.dscb.2025.100293

Abdulqadir J. Nashwan , Areesha Jawed

Zuranolone, a novel neuroactive steroid and positive allosteric modulator of γ-aminobutyric acid type A (GABA_A) receptors, has been explored for its potential in treating major depressive disorder (MDD) and postpartum depression (PPD). This review compiles findings from multiple systematic reviews and meta-analyses, emphasizing its rapid action and efficacy in alleviating depressive symptoms. Significant improvement is consistently observed by day 15 of treatment, positioning zuranolone as a promising option for rapid relief in depressive episodes. However, variability in research outcomes and methodology across different studies highlights the complexity of evaluating new treatments. Safety concerns, particularly at higher doses, and the increased incidence of side effects such as dizziness and somnolence, call for cautious dose management and close monitoring. Cultural and regional differences also influence treatment efficacy, suggesting the need for culturally sensitive clinical practices. This review underscores the therapeutic potential of zuranolone while also noting the necessity for further research to address safety concerns and optimize treatment protocols.

Zuranolone是一种新型的神经活性类固醇和γ-氨基丁酸a型（GABAA）受体的阳性变构调节剂，被认为具有治疗重度抑郁症（MDD）和产后抑郁症（PPD）的潜力。本综述汇编了来自多个系统综述和荟萃分析的发现，强调其在缓解抑郁症状方面的快速作用和疗效。在治疗的第15天观察到显著的改善，这使唑诺酮成为快速缓解抑郁发作的有希望的选择。然而，不同研究的研究结果和方法的可变性突出了评估新疗法的复杂性。安全问题，特别是在高剂量下，以及诸如头晕和嗜睡等副作用的发生率增加，要求谨慎的剂量管理和密切监测。文化和地区差异也会影响治疗效果，这表明需要对文化敏感的临床实践。本综述强调了祖拉诺酮的治疗潜力，同时也指出了进一步研究以解决安全性问题和优化治疗方案的必要性。

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引用次数: 0

A robust multi-criteria decision-making approach for selecting optimal drugs in epilepsy treatment using the analytic hierarchy process 一种基于层次分析法的癫痫治疗药物选择的稳健多准则决策方法

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-22 DOI: 10.1016/j.dscb.2025.100292

Hamzeh Ghorbani , Hrachuhi Papyan , Arsen Minasyan , David A. Wood , Parvin Ghorbani , Simin Ghorbani , Eduard Avagyan , Steve Badakian , Natali Minasian

Epilepsy, a neurological disorder characterized by recurrent seizures, poses significant challenges in selecting the most appropriate antiseizure medication (ASM) due to the complex interplay of clinical, pharmacological, and patient-specific factors. This study applies the Analytic Hierarchy Process (AHP), a structured multi-criteria decision-making (MCDM) method, to systematically evaluate and prioritize key criteria in ASM selection. The criteria analyzed include seizure control efficacy, safety and tolerability, pharmacokinetics, age and comorbidities, drug interactions, cost, patient compliance, risk of dependency, and impact on quality of life. Based on a comprehensive literature review and the judgments of a multidisciplinary panel of thirty experts, including neurologists, pharmacologists, biostatisticians, health economists, epilepsy nurses, and academic researchers, a pairwise comparison matrix was developed to determine the relative importance of each factor. The analysis identified seizure control as the most critical criterion (weight = 0.143), followed by safety (0.129), pharmacokinetics (0.123), and patient age (0.111). Factors such as cost, compliance, and drug dependency also played notable but comparatively secondary roles. The integration of AHP into the decision-making process provides clinicians with a transparent and rational framework that accommodates multiple, often competing, variables to inform a personalized treatment strategy. This approach enhances the precision of clinical choices, particularly in complex cases, by aligning medication selection with both evidence-based findings and collective expert insight. Overall, the findings support the adoption of AHP as a valuable tool in epilepsy management, promoting more effective and individualized treatment decisions through the quantitative assessment of critical therapeutic factors.

癫痫是一种以反复发作为特征的神经系统疾病，由于临床、药理学和患者特异性因素的复杂相互作用，在选择最合适的抗癫痫药物（ASM）方面提出了重大挑战。本研究应用层次分析法（AHP），一种结构化的多准则决策（MCDM）方法，对ASM选择中的关键准则进行系统评价和优先排序。分析的标准包括癫痫控制效果、安全性和耐受性、药代动力学、年龄和合并症、药物相互作用、成本、患者依从性、依赖风险和对生活质量的影响。基于全面的文献综述和一个由30位专家组成的多学科小组的判断，包括神经学家、药理学家、生物统计学家、卫生经济学家、癫痫护士和学术研究人员，我们开发了一个两两比较矩阵来确定每个因素的相对重要性。分析发现癫痫控制是最关键的标准（体重= 0.143），其次是安全性（0.129）、药代动力学（0.123）和患者年龄（0.111）。成本、依从性和药物依赖等因素也发挥了显著但相对次要的作用。将AHP整合到决策过程中，为临床医生提供了一个透明和合理的框架，该框架可容纳多个（通常是相互竞争的）变量，从而为个性化治疗策略提供信息。这种方法通过将药物选择与循证结果和专家集体见解结合起来，提高了临床选择的准确性，特别是在复杂病例中。总的来说，研究结果支持采用AHP作为癫痫管理的一种有价值的工具，通过对关键治疗因素的定量评估，促进更有效和个性化的治疗决策。

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引用次数: 0

Host and microbiota interaction in depression syndrome 宿主和微生物群在抑郁症中的相互作用

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-11 DOI: 10.1016/j.dscb.2025.100291

Zeinab Mohsenipour , Pariya Keshavarz , Zahra Shahpasand Moghanloo

Depression is a multifactorial mental disorder with genetic, environmental, and neurobiological influences. More recently, the role of the gut microbiota in the pathophysiology of depression has received growing interest, placing the gut-brain axis as a key mediator in this relationship. Dysbiosis, or an imbalance in the gut microbial community, may correlate with neurotransmitter synthesis alteration, immune demodulation, and increased inflammation—all of which contribute to depressive symptoms. The current review discusses the growing evidence that supports the involvement of the gut microbiota in depression by focusing on its mechanisms of action, including microbial-driven neuroinflammation, as well as alterations in the production of 5-HT and γ-aminobutyric acid (GABA) and the modulation of the immune system. We also discuss interventions, including Fecal microbiota transplant (FMT) and dietary supplements, in an attempt to bring the gut microbiota to a healthy state and improve depressive symptoms. However, several challenges remain in translating microbiome-based therapies into clinical practice. Future research should focus on elucidating the exact microbial species involved, identifying biomarkers for targeted therapies, and conducting large-scale clinical trials to assess the long-term efficacy and safety of microbiome modulation as a treatment for depression.

抑郁症是一种受遗传、环境和神经生物学影响的多因素精神障碍。最近，肠道微生物群在抑郁症病理生理中的作用受到越来越多的关注，将肠-脑轴作为这种关系的关键中介。生态失调，或肠道微生物群落失衡，可能与神经递质合成改变、免疫解调和炎症增加有关，所有这些都有助于抑郁症状。目前的综述讨论了越来越多的证据支持肠道微生物群参与抑郁症，重点关注其作用机制，包括微生物驱动的神经炎症，以及5-HT和γ-氨基丁酸（GABA）产生的改变和免疫系统的调节。我们还讨论了干预措施，包括粪便微生物群移植（FMT）和膳食补充剂，试图使肠道微生物群达到健康状态并改善抑郁症状。然而，在将基于微生物组的疗法转化为临床实践方面仍然存在一些挑战。未来的研究应该集中在阐明确切的微生物种类，确定靶向治疗的生物标志物，并进行大规模的临床试验，以评估微生物组调节作为抑郁症治疗的长期疗效和安全性。

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引用次数: 0

The Science of tomorrow: Unearthing hidden discoveries of cognitive enhancers 未来科学：发掘认知增强剂的隐藏发现

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-10 DOI: 10.1016/j.dscb.2025.100290

Meysam Mirzaei , Zahra Razi , Mohammad Hossein Morowvat

Recent advancements in cognitive enhancers have paved the way for a new era in neuropharmacology and Cognitive Science, offering significant potential to enhance human cognition. This article provides a concise overview of current research on cognitive enhancers, with a focus on their mechanisms of action and related ethical considerations.

认知增强剂的最新进展为神经药理学和认知科学的新时代铺平了道路，为增强人类认知提供了巨大的潜力。本文简要概述了当前认知增强剂的研究，重点介绍了其作用机制和相关的伦理考虑。

引用次数: 0

Five-Year Longitudinal Trajectories of Non-Motor Symptoms in Relation to Baseline Dopaminergic Decline in Parkinson’s Disease 帕金森病患者非运动症状与基线多巴胺能下降相关的五年纵向轨迹

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-09 DOI: 10.1016/j.dscb.2025.100288

Mehrdad Mozafar , Hanieh Mirhosseini , Setayesh Farahani , Hamid Harandi , Setareh Garousi , Fatemeh Samadian , Ali Rezaei , Hossein Hamidi , Melika Jameie , Samira Rezaei , Mehran Mottahedi , Mahsa Mayeli

Introduction

While Non-motor symptoms (NMS) in Parkinson’s disease (PD) substantially affect quality of life, their association with dopaminergic dysfunction remains unclear. This study examined longitudinal associations between NMS and striatal dopamine transporter single-photon emission computed tomography (DaT-SPECT) measures over five years in PD patients.

Methods

We studied 258 PD patients from the Parkinson’s Progression Markers Initiative (PPMI). The associations between the baseline DaT-SPECT-derived specific binding ratios (SBR) in the caudate, putamen, and striatum and longitudinal NMS, including rapid eye movement sleep behavior disorder (RBD), Epworth Sleepiness Scale, impulsivity, depression, anxiety, cognition, and olfaction were investigated.

Results

Greater caudate SBR asymmetry at baseline was associated with poorer visuospatial reasoning at year 2 (p < 0.001). Lower initial putamen and striatal SBR correlated with impaired verbal memory retention at year 3 (p < 0.001). Reduced baseline bilateral putamen SBR were linked to deficits in working memory and executive function at year 4 (p < 0.001). Decreased baseline putamen uptake was associated with higher anxiety five years after diagnosis (p < 0.001). Lower baseline caudate and striatal uptake was noted in PD patients who manifested depression 4–5 years later, whereas diminished baseline caudate, putamen, and striatal SBR was detected in those who exhibited RBD five years post-diagnosis (p < 0.05). Predictive modeling indicated modest diagnostic accuracy, with olfactory dysfunction best distinguished using the asymmetry index (AUC > 0.6).

Conclusion

Reduced striatal dopamine uptake, particularly in the caudate and putamen, was associated with progression of NMS including anxiety, depression, memory loss, visuospatial impairment, and RBD. Baseline DaT-SPECT may serve as a useful tool for anticipating NMS trajectories in PD.

虽然帕金森病（PD）的非运动症状（NMS）显著影响生活质量，但其与多巴胺能功能障碍的关系尚不清楚。本研究在PD患者中检测了NMS和纹状体多巴胺转运体单光子发射计算机断层扫描（DaT-SPECT）测量之间的纵向关联。方法我们研究了258名帕金森进展标志物计划（PPMI）的PD患者。研究了尾状核、壳核和纹状体的基线data - spec衍生特异性结合比（SBR）与纵向NMS（包括快速眼动睡眠行为障碍（RBD）、Epworth嗜睡量表、冲动、抑郁、焦虑、认知和嗅觉）之间的关系。结果基线时尾状核SBR不对称程度越高，第2年时视觉空间推理能力越差（p < 0.001）。较低的初始壳核和纹状体SBR与第3年的言语记忆保留受损相关（p < 0.001）。基线双侧壳核SBR降低与第4年的工作记忆和执行功能缺陷有关（p < 0.001）。基线壳核摄取降低与诊断后5年焦虑升高相关（p < 0.001）。4-5年后出现抑郁症状的PD患者尾状核和纹状体摄取基线降低，而在诊断后5年出现RBD的患者尾状核、壳核和纹状体SBR基线降低（p < 0.05）。预测模型显示诊断准确性不高，嗅觉功能障碍最好使用不对称指数（AUC > 0.6）来区分。结论纹状体多巴胺摄取减少，尤其是尾状核和壳核，与NMS的进展有关，包括焦虑、抑郁、记忆丧失、视觉空间障碍和RBD。基线DaT-SPECT可以作为预测PD中NMS轨迹的有用工具。

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引用次数: 0

Predicting blink rate and pupil diameter from ADHD symptoms: Effects of white noise stimulation in an experimental study 从ADHD症状预测眨眼频率和瞳孔直径：一项实验研究中白噪声刺激的影响

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-10-08 DOI: 10.1016/j.dscb.2025.100289

Erica Jostrup , Emma Claesdotter-Knutsson , Pia Tallberg , Göran Söderlund , Peik Gustafsson , Marcus Nyström

Background

Children with ADHD are reported to have lower dopamine (DA) and norepinephrine (NE) levels compared to typically developing children. We exploratively investigated how blink rate and pupil diameter, which are considered to be proxies for DA and NE signaling, were related to ADHD symptom severity. Moreover, we tested whether this relation is modulated by auditory white noise stimulation, which has been suggested as a non-pharmacological treatment for children with ADHD.

Method

We measured blink rate and pupil diameter in 97 children with varying levels of ADHD symptoms during a 60 s fixation task. The task was performed with and without auditory white noise stimulation. The effect of white noise stimulation was evaluated in relation to symptom severity and task duration.

Results

We found no relationship between the level of ADHD symptom severity and blink rate or pupil diameter, nor did symptom severity interact with auditory white noise stimulation. However, pupil diameter was consistently larger throughout the entire task as a result of the noise stimulation, an effect driven by boys.

Conclusions

Blink rate and pupil diameter do not seem to be reliably associated with ADHD symptom severity. This association also did not change when applying white noise stimulation. However, given the larger pupil diameter of boys, sex should be considered in future studies using white noise stimulation.

据报道，与正常发育的儿童相比，ADHD儿童的多巴胺（DA）和去甲肾上腺素（NE）水平较低。我们探索性地研究了眨眼频率和瞳孔直径（被认为是DA和NE信号的代理）与ADHD症状严重程度的关系。此外，我们测试了听觉白噪声刺激是否调节了这种关系，听觉白噪声刺激已被建议作为ADHD儿童的非药物治疗方法。方法对97例患有不同程度ADHD症状的儿童进行60秒注视任务时眨眼率和瞳孔直径的测量。这项任务在有和没有听觉白噪音刺激的情况下进行。白噪声刺激的效果与症状严重程度和任务持续时间有关。结果ADHD症状严重程度与眨眼频率或瞳孔直径无相关性，症状严重程度与听觉白噪声刺激无交互作用。然而，在整个任务过程中，由于噪音刺激，瞳孔直径一直都更大，这是由男孩引起的。结论眨眼频率和瞳孔直径似乎与ADHD症状严重程度没有可靠的关系。这种关联在施加白噪声刺激时也没有改变。然而，考虑到男孩的瞳孔直径更大，在未来使用白噪音刺激的研究中应该考虑到性别。

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引用次数: 0

Transcranial magnetic stimulation alleviates cognitive dysfunction after stroke by inhibiting microglial transformation 经颅磁刺激通过抑制小胶质细胞转化减轻脑卒中后认知功能障碍

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-25 DOI: 10.1016/j.dscb.2025.100287

Yi-ning Zhao , Zhen-Kun Gao , Xing-yu Zhang , Ping-ping Han , Xia Bi

Intermittent theta burst stimulation (iTBS) has been demonstrated to be a efficacious intervention for mitigating neurological deficits following a stroke. Nevertheless, there remains a paucity of animal studies that investigate the neurobiological mechanisms contributing to its therapeutic effects. Accordingly, the present experiments focused on the effects of iTBS on behavioral and neuropathology in ischemia/reperfusion (I/R)-injured rats and explored the underlying mechanisms. A rat model of I/R injury was established through middle cerebral artery occlusion (MCAO). Sprague-Dawley (SD) rats were randomly assigned to three groups: a sham group, an MCAO group, and an iTBS + MCAO group (administered once daily for ten consecutive days). There were 18 rats in each group, and cognitive function, myelin regeneration, microglia, inflammation, and MAPK signaling pathway expression were evaluated in each group.

The findings revealed that iTBS enhanced the performance of animals in Y-maze and Open Field Test and facilitated the recuperation of cognitive functions following I/R injury. Furthermore, iTBS mitigated myelin damage, facilitated myelin regeneration, simultaneously induced the conversion of microglia to a neuroprotective M2 phenotype and significantly reduced the intensity of pro-inflammatory factor storm. Subsequent studies demonstrated that iTBS enhanced cognitive function in rats subjected to I/R injury, which was partially attributed to the suppression of the ERK1/2 and JNK signaling cascades. This inhibition promoted the transformation of M2 microglia, suppressed inflammation, and created a conducive microenvironment for myelin regeneration.

间歇性θ波爆发刺激（iTBS）已被证明是一种有效的干预措施，以减轻中风后的神经功能障碍。然而，研究其治疗效果的神经生物学机制的动物研究仍然缺乏。因此，本实验将重点研究iTBS对缺血再灌注（I/R）损伤大鼠行为和神经病理学的影响，并探讨其潜在机制。采用大脑中动脉闭塞法（MCAO）建立大鼠I/R损伤模型。SD大鼠随机分为假手术组、MCAO组和iTBS + MCAO组（每天1次，连续10天）。每组18只大鼠，观察各组认知功能、髓磷脂再生、小胶质细胞、炎症、MAPK信号通路表达。结果表明，iTBS可提高I/R损伤后动物的y迷宫和开放场测试的表现，促进认知功能的恢复。此外，iTBS减轻髓磷脂损伤，促进髓磷脂再生，同时诱导小胶质细胞向神经保护性M2表型转化，并显著降低促炎因子风暴的强度。随后的研究表明，iTBS增强了I/R损伤大鼠的认知功能，部分原因是抑制了ERK1/2和JNK信号级联。这种抑制促进了M2小胶质细胞的转化，抑制了炎症，并为髓鞘再生创造了有利的微环境。

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引用次数: 0

With great power comes great responsibility: Promise and caution in the new psychedelic renaissance 强大的力量带来巨大的责任：新的迷幻文艺复兴中的承诺和谨慎

Brain disorders (Amsterdam, Netherlands)

Pub Date : 2025-09-18 DOI: 10.1016/j.dscb.2025.100286

Matthew Halma , Rakeem Levy , Joseph Varon

Clinicians and researchers are showing increased interest in psychedelic-assisted therapy for patients who don't show improvement from using conventional antidepressants. This updated review integrates recent developments, including data on lesser-studied compounds like DMT and 5-MeO-DMT, findings from large clinical trials, and evolving regulatory landscapes. In treatment-resistant depression, Ketamine stands out for its fast-acting effects; however, these benefits are often short-lived. Psilocybin and Ayahuasca have shown meaningful symptom reduction in both randomized trials and real-world settings. Emerging data on LSD and MDMA-assisted psychotherapy further suggest potential in mood disorder treatment. Several policy changes have created new frameworks for legal therapeutic use. Oregon legalized supervised psilocybin therapy in November 2020, Colorado passed Proposition 122 in November 2022, and Australia approved the prescription use of psilocybin and MDMA in February 2023. These milestones reflect a growing international shift toward integrating psychedelics into regulated mental health care. Although the mentioned outcomes are encouraging, these treatments must occur under professional supervision and local regulations to reduce the risk of adverse events. These therapies generally take place in a controlled setting with trained facilitators who help guide these introspective experiences and altered levels of consciousness.

临床医生和研究人员对使用传统抗抑郁药后没有好转的患者的迷幻辅助疗法表现出越来越大的兴趣。这篇更新的综述整合了最近的发展，包括对DMT和5-MeO-DMT等较少研究的化合物的数据，大型临床试验的发现，以及不断发展的监管格局。在难治性抑郁症中，氯胺酮因其快速起效而引人注目；然而，这些好处往往是短暂的。裸盖菇素和死藤水在随机试验和现实环境中都显示出有意义的症状减轻。关于LSD和mdma辅助心理治疗的新数据进一步表明了情绪障碍治疗的潜力。几项政策变化为法律治疗用途创造了新的框架。俄勒冈州于2020年11月将监管下的裸盖菇素疗法合法化，科罗拉多州于2022年11月通过了122号提案，澳大利亚于2023年2月批准了裸盖菇素和摇头丸的处方使用。这些里程碑反映了国际上越来越倾向于将致幻剂纳入规范的精神卫生保健。尽管上述结果令人鼓舞，但这些治疗必须在专业监督和当地法规下进行，以减少不良事件的风险。这些治疗通常在一个受控的环境中进行，由训练有素的辅导员帮助指导这些内省经验和改变的意识水平。

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