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Modeling impulsivity and risk aversion in the subthalamic nucleus with deep brain stimulation 用深部脑刺激模拟丘脑下核的冲动性和风险规避性
Pub Date : 2024-07-19 DOI: 10.1038/s44220-024-00289-z
Valerie Voon, Luis Manssuer, Yi-Jie Zhao, Qiong Ding, Ying Zhao, Linbin Wang, Tao Wang, Peng Huang, Yixin Pan, Bomin Sun, Dianyou Li
Risk evaluation is ubiquitous in decisions. Deep brain stimulation of the subthalamic nucleus is effective for Parkinson’s disease and obsessive–compulsive disorder, and can be associated with impulsivity and hypomania. Subthalamic stimulation has seemingly contrasting effects on impulsivity enhancing conflict-induced impulsivity but decreasing risk taking. Here, using a card gambling task paired with intracranial recordings (n = 25) and within-subject case control acute stimulation (n = 15) of the right subthalamic nucleus, we dissociated objective risk and uncertainty and subjective physiological markers of risk. Acute stimulation decreased risk taking (P = 0.010, Cohen’s d = 0.72) and increased subthalamic theta activity (P < 0.001, Cohen’s d = 0.72). Critically, stimulation negatively shifted the relationship between subthalamic physiology and a measure of evidence accumulation similar to observations with stimulation-induced conflict processing. This highlights the phenotypic and physiological heterogeneity of impulsivity, yet linking mechanisms underlying stimulation-induced conflict and risk. Finally, stimulation-induced risk seeking implicates the ventral subthalamic nucleus and dissociating anatomical and functional connectivity with the mesial prefrontal cortex. Our findings have implications for conceptualizations of impulsivity, and clinical relevance for neuropsychiatric disorders. Using a card gambling task paired with intracranial recordings and deep brain stimulation of the right subthalamic nucleus, the authors dissociate objective and subjective markers of risk taking and demonstrate the role of stimulation localization on risk-related behavior.
风险评估在决策中无处不在。对丘脑下核的深部脑刺激对帕金森病和强迫症有效,但也可能与冲动和躁狂症有关。刺激丘脑下核对冲动性的影响似乎截然不同,它能增强冲突诱发的冲动性,但却会降低冒险性。在这里,我们使用了一项与颅内记录(n = 25)和对右丘下核急性刺激(n = 15)的受试者内病例对照相匹配的纸牌赌博任务,将客观风险和不确定性与风险的主观生理标记区分开来。急性刺激降低了风险承担(P = 0.010,Cohen's d = 0.72),增加了丘脑下θ活动(P < 0.001,Cohen's d = 0.72)。重要的是,刺激负向改变了丘脑下生理学与证据积累测量之间的关系,这与刺激诱发冲突处理的观察结果类似。这凸显了冲动的表型和生理异质性,同时也将刺激诱发冲突和风险的内在机制联系起来。最后,刺激诱发的风险寻求牵涉到腹侧丘脑下核以及与中侧前额叶皮层的解剖和功能连接。我们的研究结果对冲动的概念化和神经精神疾病的临床相关性都有影响。作者利用颅内记录和对右侧丘脑下核的深部脑刺激来完成一项纸牌赌博任务,将风险承担的客观和主观标记区分开来,并证明了刺激定位对风险相关行为的作用。
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引用次数: 0
Author Correction: The effect of environment on depressive symptoms in late adolescence and early adulthood: an exposome-wide association study and twin modeling 作者更正:环境对青春晚期和成年早期抑郁症状的影响:全暴露体关联研究和双生子建模
Pub Date : 2024-07-18 DOI: 10.1038/s44220-024-00295-1
Zhiyang Wang, Stephanie Zellers, Alyce M. Whipp, Marja Heinonen-Guzejev, Maria Foraster, Jordi Júlvez, Irene van Kamp, Jaakko Kaprio
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引用次数: 0
Childhood-onset type 1 diabetes and subsequent adult psychiatric disorders: a nationwide cohort and genome-wide Mendelian randomization study 儿童期发病的 1 型糖尿病与成年后的精神障碍:全国性队列和全基因组孟德尔随机研究
Pub Date : 2024-07-17 DOI: 10.1038/s44220-024-00280-8
Tomáš Formánek, Danni Chen, Zdeněk Šumník, Karolína Mladá, James Hughes, Stephen Burgess, Nicholas J. Wareham, Graham K. Murray, Peter B. Jones, Benjamin I. Perry
Childhood-onset type 1 diabetes (T1D) is associated with substantial psychiatric morbidity in later life, but it remains unknown whether these associations are due to common underlying biological mechanisms or the impacts of living with the condition and its treatment. Here, using Czech national register data, we identified children with T1D aged ≤14 years between 1994 and 2007 and estimated the risk of psychiatric disorders up to 24 years later. We found that children diagnosed with T1D had an elevated risk of developing substance use, mood, anxiety and personality disorders, and behavioral syndromes. Conversely, we found that children with T1D had a lower risk of developing psychotic disorders. In Mendelian randomization analysis, we found an association with schizophrenia, which, however, did not persist following multiple testing adjustment. The combined observational and Mendelian randomization evidence suggests that T1D diagnosis in childhood predisposes to far-reaching, extensive psychiatric morbidity, which is unlikely to be explicable by common underlying biological mechanisms. The findings of this study highlight that monitoring and addressing the mental health needs of children with T1D is imperative, whereas glucose dysregulation and/or inflammation implicated in schizophrenia pathogenesis warrants future research. In this study, analyzing Czech national register-based data and using genome-wide Mendelian randomization, the authors report elevated risk for developing substance use, mood, anxiety and personality disorders in individuals with childhood-onset type 1 diabetes, and show that these associations are unlikely to be explicable by common underlying biological mechanisms.
儿童期发病的 1 型糖尿病(T1D)与日后生活中的大量精神病发病率有关,但这些关联是由于共同的潜在生物机制还是由于生活和治疗的影响,目前仍不得而知。在此,我们利用捷克全国登记数据,识别了 1994 年至 2007 年间年龄小于 14 岁的 T1D 患儿,并估算了 24 年后患精神疾病的风险。我们发现,确诊为 T1D 的儿童罹患药物使用、情绪、焦虑和人格障碍以及行为综合征的风险较高。相反,我们发现患有 T1D 的儿童患精神病的风险较低。在孟德尔随机分析中,我们发现了与精神分裂症的关联,但经过多重测试调整后,这种关联并未持续。观察和孟德尔随机分析的综合证据表明,在儿童期诊断出 T1D 易导致影响深远、范围广泛的精神病发病率,而这种发病率不太可能通过共同的潜在生物学机制来解释。本研究的结果突出表明,监测并满足 T1D 儿童的精神健康需求势在必行,而与精神分裂症发病机制有关的葡萄糖失调和/或炎症值得在未来进行研究。在这项研究中,作者分析了捷克的全国登记数据,并采用了全基因组孟德尔随机化方法,报告了儿童期发病的 1 型糖尿病患者患药物使用、情绪、焦虑和人格障碍的风险升高,并表明这些关联不太可能通过共同的潜在生物学机制来解释。
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引用次数: 0
Depressive symptoms and sex differences in the risk of post-COVID-19 persistent symptoms: a prospective population-based cohort study 抑郁症状与 COVID-19 后持续症状风险的性别差异:一项基于人群的前瞻性队列研究
Pub Date : 2024-07-17 DOI: 10.1038/s44220-024-00290-6
Joane Matta, Baptiste Pignon, Sofiane Kab, Emmanuel Wiernik, Olivier Robineau, Fabrice Carrat, Gianluca Severi, Mathilde Touvier, Hélène Blanché, Jean-François Deleuze, Clément Gouraud, Charles Ouazana Vedrines, Victor Pitron, Sarah Tebeka, Brigitte Ranque, Nicolas Hoertel, Marcel Goldberg, Marie Zins, Cédric Lemogne
Women are unexplainedly more affected than men by post-COVID-19 persistent symptoms. Depressive symptoms may partially explain these sex differences. In the French population-based CONSTANCES cohort, depressive symptoms were measured with the nine-item Patient Health Questionnaire between April 6 and May 4, 2020. Between December 2020 and January 2021, among 2,093 infected participants (mean (s.d.) age, 43.0 years (11.9); 55.3% women), 453 (21.6%) reported ≥1 new persistent symptom that emerged from March 2020. Accounting for several confounders, women were more likely than men to have ≥1 symptom (odds ratio (95% confidence interval), 1.45 (1.17–1.80)). Further adjusting for the nine-item Patient Health Questionnaire, participants in the highest (versus lowest) quartile were more likely to have ≥1 symptom (2.97 (2.09–4.23)), while the association with female sex substantially dropped (1.28 (1.02–1.60)). Depressive symptoms mediated 41.5–45.4% of this association. A biopsychosocial model, integrating gender and mental health, is warranted to understand long COVID and inform preventive and therapeutic strategies. In this cohort study, the authors find that depressive symptoms at the beginning of the pandemic may partially explain why women participants who had a COVID-19 episode were more likely than their male counterparts to report at least one post-COVID-19 persistent symptom seven to ten months later.
与男性相比,女性受到 COVID-19 后持续症状的影响更大,这一点无法解释。抑郁症状可能是造成这些性别差异的部分原因。在法国基于人群的 CONSTANCES 队列中,于 2020 年 4 月 6 日至 5 月 4 日期间使用九项患者健康问卷对抑郁症状进行了测量。2020 年 12 月至 2021 年 1 月期间,在 2093 名感染者(平均(s.d.)年龄为 43.0 岁(11.9);55.3% 为女性)中,有 453 人(21.6%)报告自 2020 年 3 月以来出现了≥1 种新的持续性症状。考虑到几种混杂因素,女性比男性更有可能出现≥1种症状(几率比(95% 置信区间),1.45(1.17-1.80))。再根据九项患者健康问卷进行调整后,最高四分位数(相对于最低四分位数)的参与者更有可能出现≥1种症状(2.97(2.09-4.23)),而与女性性别的相关性则大幅下降(1.28(1.02-1.60))。抑郁症状介导了这一关联的 41.5-45.4%。要了解长期 COVID,并为预防和治疗策略提供信息,就必须建立一个将性别和心理健康结合起来的生物心理社会模型。在这项队列研究中,作者发现,大流行初期的抑郁症状可能部分解释了为什么发生过 COVID-19 事件的女性参与者比男性参与者更有可能在七到十个月后报告至少一种 COVID-19 后的持续症状。
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引用次数: 0
Shared genetics of ADHD, cannabis use disorder and cannabis use and prediction of cannabis use disorder in ADHD 多动症、大麻使用障碍和大麻使用的共同遗传以及对多动症患者大麻使用障碍的预测
Pub Date : 2024-07-17 DOI: 10.1038/s44220-024-00277-3
Trine Tollerup Nielsen, Jinjie Duan, Daniel F. Levey, G. Bragi Walters, Emma C. Johnson, Thorgeir Thorgeirsson, VA Million Veteran Program, Thomas Werge, Preben Bo Mortensen, Hreinn Stefansson, Kari Stefansson, David M. Hougaard, Arpana Agrawal, Joel Gelernter, Jakob Grove, Anders D. Børglum, Ditte Demontis
Cannabis use disorder (CUD) and cannabis use (CU) are prevalent conditions co-occurring with attention-deficit hyperactivity disorder (ADHD). Here we report results from a cross-disorder genome-wide association study of ADHD and CUD or CU. We identified 36 concordant genome-wide significant loci for ADHD–CUD and ten loci for ADHD–CU. DRD2 was identified as an ADHD–CUD risk gene. ADHD–CUD risk genes showed high expression across brain tissues and brain developmental stages, which was not observed for ADHD–CU genes. ADHD–CUD and ADHD–CU showed similar genetic correlations with substance use, whereas they differed for substance-use disorders. Individuals with ADHD–CUD had increased polygenic scores (PGS) for psychiatric disorders compared with those with ADHD without CUD and increased burden of rare deleterious variants. Stratification of individuals with ADHD by their CUD PGS revealed an absolute risk of 22% for comorbid CUD in the highest CUD-PGS bin—much higher than 1.6% risk among controls. Sex-specific differences were substantial with an approximately 10% higher CUD risk among men in the highest CUD-PGS bin. In this study, the authors use a combination of genetic methodologies to investigate the genetic associations between attention-deficit/hyperactivity disorder, cannabis use disorder and cannabis use.
大麻使用障碍(CUD)和大麻使用(CU)是与注意力缺陷多动障碍(ADHD)并发的常见疾病。在此,我们报告了一项针对注意力缺陷多动障碍和 CUD 或 CU 的跨障碍全基因组关联研究的结果。我们发现了 36 个与 ADHD-CUD 相关的全基因组显著位点,以及 10 个与 ADHD-CU 相关的位点。DRD2被确定为ADHD-CUD的风险基因。ADHD-CUD风险基因在不同脑组织和脑发育阶段均有高表达,而ADHD-CU基因却没有这种表现。ADHD-CUD和ADHD-CU与药物使用表现出相似的遗传相关性,而在药物使用障碍方面则有所不同。与未患 CUD 的 ADHD 患者相比,ADHD-CUD 患者的精神障碍多基因评分(PGS)更高,罕见有害变异的负担也更重。按 CUD PGS 对 ADHD 患者进行分层后发现,CUD-PGS 最高的一组患者合并 CUD 的绝对风险为 22%,远高于对照组的 1.6%。性别特异性差异很大,CUD-PGS最高的人群中,男性的CUD风险高出约10%。在这项研究中,作者综合使用了多种遗传学方法来研究注意力缺陷/多动症、大麻使用障碍和大麻使用之间的遗传关联。
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引用次数: 0
Author Correction: Early detection of dementia with default-mode network effective connectivity 作者更正:利用默认模式网络有效连接早期发现痴呆症
Pub Date : 2024-07-16 DOI: 10.1038/s44220-024-00296-0
Sam Ereira, Sheena Waters, Adeel Razi, Charles R. Marshall
{"title":"Author Correction: Early detection of dementia with default-mode network effective connectivity","authors":"Sam Ereira,&nbsp;Sheena Waters,&nbsp;Adeel Razi,&nbsp;Charles R. Marshall","doi":"10.1038/s44220-024-00296-0","DOIUrl":"10.1038/s44220-024-00296-0","url":null,"abstract":"","PeriodicalId":74247,"journal":{"name":"Nature mental health","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s44220-024-00296-0.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141968563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deep brain stimulation of habenula reduces depressive symptoms and modulates brain activities in treatment-resistant depression 深部脑刺激可减轻耐药抑郁症患者的抑郁症状并调节大脑活动
Pub Date : 2024-07-12 DOI: 10.1038/s44220-024-00286-2
Zhiyan Wang, Chao Jiang, Lingxiao Guan, Lei Zhao, Tengteng Fan, Jian Wang, Xiaodong Cai, Yingli Zhang, Chen Yao, Bo Peng, Feixue Wang, Chunhua Hu, Zhiqiang Cui, Yiheng Tu, Luming Li
The habenula (Hb) is a phylogenetically old structure connecting forebrain and brainstem monoaminergic nuclei that has been implicated in the pathogenesis of depression. Here, to investigate the clinical efficacy and neural mechanisms of stimulating the Hb for alleviating depression symptoms in humans, we bilaterally implanted electrodes in six patients with treatment-resistant depression and delivered high-frequency stimulation. Compared to baseline, we observed a substantial reduction in Hamilton Depression Rating Scale scores: 62.1% at 1-month, 64.0% at 3-month and 66.2% at 6-month follow-up. Local field potential data showed that acute Hb stimulation increased theta-band power, especially in the right side, which was related to the following clinical remission. Moreover, functional magnetic resonance imaging data showed that acute Hb stimulation enhanced blood oxygen level-dependent responses of the medial orbitofrontal cortex, raphe and substantia nigra, which are important components of the dopaminergic and serotonergic systems. Our findings demonstrated that Hb stimulation can alleviate depressive symptoms and modulate the activity of the medial orbitofrontal cortex, raphe and substantia nigra in treatment-resistant depression patients. This trial was registered under the clinical trial numbers NCT03667872 and ChiCTR2100045363. Using deep brain stimulation of the habenula with implanted electrodes in patients with treatment-resistant depression, this study found a substantial reduction in depression scores at follow-up over multiple time points.
哈伯脑(Habenula,Hb)是连接前脑和脑干单胺类神经核的系统发育古老的结构,与抑郁症的发病机制有关。在此,为了研究刺激 Hb 对缓解人类抑郁症状的临床疗效和神经机制,我们为六名耐药抑郁症患者双侧植入电极,并给予高频刺激。与基线相比,我们观察到汉密尔顿抑郁量表评分大幅下降:随访 1 个月时为 62.1%,3 个月时为 64.0%,6 个月时为 66.2%。局部场电位数据显示,急性 Hb 刺激增加了θ波段功率,尤其是在右侧,这与随后的临床缓解有关。此外,功能磁共振成像数据显示,急性 Hb 刺激增强了内侧眶额叶皮层、剑突和黑质的血氧水平依赖性反应,而这些部位是多巴胺能和血清素能系统的重要组成部分。我们的研究结果表明,刺激血红蛋白可减轻耐药抑郁症患者的抑郁症状,并调节内侧眶额皮层、剑突和黑质的活动。该试验的临床试验注册号为 NCT03667872 和 ChiCTR2100045363。这项研究利用植入电极对耐药抑郁症患者的哈氏神经节进行深部脑刺激,发现在多个时间点的随访中,患者的抑郁评分大幅下降。
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引用次数: 0
Circadian disruptions and brain clock dysregulation in mood disorders 情绪障碍中的昼夜节律紊乱和大脑时钟失调
Pub Date : 2024-07-11 DOI: 10.1038/s44220-024-00260-y
Jorge Mendoza
The circadian system, composed of a network of brain and peripheral 24-hour clocks and oscillators, allows organisms to anticipate and synchronize to natural daily events. The day–night cycle is the dominant timing signal to align circadian clocks to the external time. Thereby, exposure to aberrant light–dark cycles leads to disruptions of the circadian system, evoking different health issues, including mental or affective ones. Humans with circadian misalignments, such as those observed in jet-lag-exposed people or shift workers, and animal models of clock disturbances show mood alterations such as anxiety and depressive-like behaviors. The mechanisms underlying the physiopathology of mood disorders in circadian disruption may imply an altered functioning of the main clock in the suprachiasmatic nucleus, from other central oscillators, or a loss of internal synchrony between them. This Review outlines the current knowledge on the link between circadian perturbations and mood disorders in humans and animal models, and the possible neurobiological mechanisms involved. This Review explores the link between mood disorders and circadian disruptions, including social jet lag and shift work, and offers new perspectives for therapeutic development in future chronobiology research.
昼夜节律系统由大脑和外周 24 小时时钟和振荡器网络组成,使生物能够预测和同步自然界的日常事件。昼夜周期是使昼夜节律钟与外界时间保持一致的主要时间信号。因此,暴露于异常的光暗周期会导致昼夜节律系统紊乱,引发不同的健康问题,包括精神或情感问题。昼夜节律失调的人类,如时差暴露者或轮班工人,以及时钟紊乱的动物模型都会出现情绪改变,如焦虑和类似抑郁的行为。昼夜节律紊乱导致情绪失调的生理病理机制可能意味着嗜铬细胞上核的主时钟、其他中枢振荡器的功能发生了改变,或者它们之间失去了内部同步性。本综述概述了目前关于人类和动物模型中昼夜节律紊乱与情绪失调之间联系的知识,以及可能涉及的神经生物学机制。本综述探讨了情绪失调与昼夜节律紊乱(包括社会时差和轮班工作)之间的联系,并为未来时间生物学研究中的治疗发展提供了新的视角。
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引用次数: 0
Diffuse glioma location is associated with extremes of depressive symptoms 弥漫性胶质瘤位置与极端抑郁症状有关
Pub Date : 2024-07-11 DOI: 10.1038/s44220-024-00276-4
Mood dysfunction is more common in people with brain tumors than in those with other tumor types, but the reasons for this association are unclear. Using various methods for lesion–symptom mapping, we identified brain locations in patients with diffuse glioma that are related to severe depressive symptoms or an absence of depressive symptoms.
与其他类型的肿瘤相比,情绪功能障碍在脑肿瘤患者中更为常见,但这种关联的原因尚不清楚。我们利用各种病灶-症状映射方法,确定了弥漫性胶质瘤患者大脑中与严重抑郁症状或无抑郁症状相关的位置。
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引用次数: 0
Tumor location is associated with mood dysfunction in patients with diffuse glioma 肿瘤位置与弥漫性胶质瘤患者的情绪功能障碍有关
Pub Date : 2024-07-11 DOI: 10.1038/s44220-024-00275-5
Maisa N. G. van Genderen, Vera Belgers, Johanna M. Niers, Linda Douw, Jantine G. Röttgering, Maxine Gorter, Marieke E. C. Blom, Frederik Barkhof, Martin Klein, Roelant S. Eijgelaar, Philip C. De Witt Hamer
Gliomas are primary brain tumors that can cause neuropsychiatric symptoms, including severe depressive symptoms (SDS; in 14%) and an absence of depressive symptoms (ADS; in 29%), determined by Center for Epidemiologic Studies Depression (CES-D) scores. We examined the association between both SDS and ADS and brain tumor location in 201 patients with diffuse glioma before surgery. Tumors and white matter disconnectomes did not relate to CES-D using sparse canonical correlation analysis. SDS were associated with tumors in the right corticospinal tract, fornix, and inferior fronto-occipital fasciculus and the left uncinate fasciculus, whereas ADS was associated with tumors in the left uncinate fasciculus and first segment of the superior longitudinal fasciculus and the right temporal cingulum and thalamus using Bayesian regression analyses. ADS occurs even more frequently in patients with diffuse glioma than does SDS, which is explained partly by tumor location. This research aids the understanding of gliomas and mood dysfunction in general. The authors report how the anatomical location of diffuse gliomas is related to the occurrence of severe depressive symptoms or the absence of depressive symptoms.
胶质瘤是一种原发性脑肿瘤,可引起神经精神症状,包括严重抑郁症状(SDS,占 14%)和无抑郁症状(ADS,占 29%),以流行病学研究中心抑郁(CES-D)评分为准。我们研究了 201 名弥漫性胶质瘤患者手术前 SDS 和 ADS 与脑肿瘤位置之间的关系。通过稀疏典型相关性分析,肿瘤和白质断节与 CES-D 无关。通过贝叶斯回归分析,SDS 与右侧皮质脊髓束、穹窿、下前枕筋膜和左侧钩状筋膜的肿瘤有关,而 ADS 则与左侧钩状筋膜和上纵筋膜第一段以及右侧颞丘脑和丘脑的肿瘤有关。与 SDS 相比,ADS 在弥漫性胶质瘤患者中的发生率更高,这在一定程度上可以用肿瘤位置来解释。这项研究有助于人们了解胶质瘤和情绪功能障碍的总体情况。作者报告了弥漫性胶质瘤的解剖位置与出现或不出现严重抑郁症状的关系。
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引用次数: 0
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Nature mental health
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