Epidemiological studies revealed an unestablished association between neuroticism and posttraumatic stress disorder (PTSD) and we conducted mendelian randomization (MR) analyses to examine whether neuroticism clusters of worry, depressed affect, and sensitivity to environmental stress and adversity (SESA) were involved in the development of PTSD.
We obtained data on three neuroticism clusters, PTSD, and nine other psychiatric disorders from genome-wide association studies summary statistics and employed univariable, multivariable, and mediation MR analyses to explore causal associations among them.
Neuroticism clusters were linked with PTSD (depressed affect (odds ratio [OR]: 2.94 [95% confidence interval: 2.21–3.92]); SESA (2.69 [1.95–3.71]; worry (1.81 [1.37–2.99])). Neuroticism clusters were also associated with psychiatric disorders, with the depressed effect on panic disorder (PD) (2.60 [1.14–5.91]), SESA on anorexia nervosa (AN) (2.77 [1.95–3.94]) and schizophrenia (2.55 [1.99–3.25]), worry on major depressive disorder (MDD) (2.58 [2.19–3.05]). In multivariable MR, only the SESA-PTSD association remained (2.60 [2.096, 3.107]) while worry-PTSD and depressed affect-PTSD associations attenuated to nonsignificance. Mediation MR analyses suggested that PD mediated 3.76% of the effect of depressed effect on PTSD and AN mediated 10.33% of the effect of SESA on PTSD.
Delving deeper into neuroticism clusters, we comprehensively understand the role of neuroticism in PTSD.
The monocyte–lymphocyte ratio (MLR) is a hematological test parameter that reflects the status of both monocytes and lymphocytes as inflammatory cells. This study aims to investigate the relationship between MLR and carotid intraplaque neovascularization (IPN) in patients with asymptomatic carotid stenosis.
We performed the Angio Planewave Ultrasensitive (AngioPLUS) screening for patients with carotid plaques. The carotid plaque stability was evaluated by semiquantitative visual grading of carotid IPN. Binary logistic regression models were performed to determine the associations between different clinical and laboratory indicators and the presence of high IPN.
A total of 160 patients were eventually enrolled with 99 in the low IPN group (Scores 0–1) and 61 in the high IPN group (Score 2). Univariate logistic regression showed that age, monocytes, lymphocytes, glycated hemoglobin (HbA1c), fibrinogen, d-dimmer, and MLR were significantly associated with the presence of high IPN (all p < 0.05). Multivariate logistic regression models showed that MLR was significantly associated with the presence of high IPN after adjusting for other covariates. An MLR value of 32.9 was the optimal cutoff value to differentiate high and low IPN. High MLR was also significantly correlated with the presence of high IPN (odds ratio [OR] = 4.08, 95% confidence interval [CI]: 1.69–9.88, p = 0.002) when included in the above multivariate logistic regression model.
Elevated MLR is closely associated with the presence of high IPN and may serve as a surrogate biomarker for carotid IPN.
Post-traumatic stress disorder (PTSD) is a debilitating psychological disorder that occurs after exposure to catastrophic-level experiences. Although alterations in immune function have been identified in individuals with PTSD, the causal relationship between the two remains unclear.
To investigate the causal relationship between PTSD and immune function, we conducted the forward and backward two-sample Mendelian randomization (MR) analyses, based on summary-level genome-wide association studies (GWAS) data on PTSD and immune cell traits.
For the forward MR analysis, PTSD was found to reduce the levels of CD62L− dendritic cell (DC) (beta = −0.254, FDR = 0.01), CD86+ myeloid DC (beta = −0.238, FDR = 0.014), CD62L− myeloid DC (beta = −0.26, FDR = 0.01), CD62L− CD86+ myeloid DC absolute count (beta = −0.264, FDR = 0.024), and CD62L− CD86+ myeloid DC (beta = −0.328, FDR = 0.002). In contrast, PTSD was observed to increase the level of CD28− CD8dim T-cell absolute count (beta = 0.27, FDR = 0.029). For the backward MR analysis, the odds ratio (OR) for CD33 on CD33dim HLA DR+ CD11b− in relation to PTSD risk was found to be 1.045 (95% CI = 1.021–1.069, FDR = 0.008). The OR for FSC-A on HLA DR+ CD8br was 1.048 (95% CI = 1.018–1.079, FDR = 0.039) and for CCR2 on CD14− CD16+ monocyte was 1.059 (95% CI = 1.027–1.092, FDR = 0.008). No significant pleiotropy was detected in both forward and backward MR analyses.
The bidirectional MR study shed light on the intricate interplay between immune function and PTSD. The identification of a bidirectional causal relationship between T cells and PTSD opens new avenues for considering innovative approaches to the prevention and early intervention of PTSD.
We aimed to investigate the relationship between systemic immune-inflammation index (SII) and short-term mortality in acute ischemic stroke (AIS) with internal carotid artery (ICA) severe stenosis and stroke associated pneumonia (SAP) patients.
Information on general demographic, laboratory data, CT angiography, magnetic resonance angiography, or digital subtraction angiography were obtained. The predictive power was evaluated by assessing the area under the receiver operating characteristic (ROC) curve. The logistic regression was performed to assess the association of SII and short-term mortality in severe stenosis ICA-AIS and SAP patients.
Among 342 patients with severe stenosis ICA-AIS and SAP, death occurred in 66 patients during 120 days follow-up. Multivariate regression analyses indicated that increased SII predicts higher mortality in 120 days follow-up, and the risk of short-term mortality in SII > 666.31 × 109/L group is increased 4.671-fold. Patients with SII > 666.31 × 109/L had higher proportion of male, hypertension, smoking, higher admission NIHSS score, higher systolic blood pressure, and higher proportion of 120 days mortality. Higher SII predicted a worse 120 days mortality was worked out by Kaplan–Meier methods.
An elevated SII was remarkably associated with 120 days mortality in severe stenosis ICA-AIS and SAP patients.
The aim of our study was to elucidate differences in brain activity patterns among obstructive sleep apnea (OSA) patients, OSA patients with depressive symptoms, and healthy controls (HCs). We also investigated the relationship between brain function and depression in OSA patients.
A total of 95 subjects were included in the study, including 34 OSA patients without depressive symptoms, 31 OSA patients with depressive symptoms, and 30 HCs. The 53-channel functional near-infrared spectroscopy (fNIRS) was used to monitor the concentration of oxy-hemoglobin (Oxy-Hb) in the brain, whereas the participants performed the verbal fluency task, and the degree of depression was scored using the 17-item Hamilton Rating Scale for Depression (HAMD-17). Hierarchical regression models were conducted to analyze the association of fNIRS features with depressive symptom.
The Oxy-Hb changes of the three groups were significantly different in Channels 25 (H = 9.878, p = .007) and 43 (H = 6.957, p = .031). Inter-group comparisons showed that the Oxy-Hb change of Channel 25 (located in the dorsolateral prefrontal cortex [DLPFC]) in OSA group was less than that in HC group (p = .006), and the Oxy-Hb change of Channel 43 (located in the right frontal polar region) in OSA group with depression was less than that in OSA group (p = .025). Spearman's test showed that there was a significant negative correlation between HAMD-17 scores and mean Oxy-Hb changes in Channel 43 (r = −.319, p < .05) in the OSA patients. Using hierarchical regression, Oxy-Hb changes in Channel 43 accounted for a significant proportion of the variation in outcome variables, even when accounting for other polysomnography features.
Changes in the hemodynamic response of DLPFC may be a potential mechanism of executive dysfunction in OSA patients. And the right frontal polar region may be significant in assessing depressive symptoms in patients with OSA.
We developed a proxy questionnaire for parents of children with Developmental Delay (DD) to provide comprehensive information for instructors about the child's functioning before participating in aquatic activities. This dedicated information will enable a high-quality treatment plan to promote the child's functioning in everyday life.
Based on the International Classification of Functioning, Disability, and Health (ICF) Coreset development and linking rules method, a set of questions was constructed in a preliminary process. A draft version was sent to instructors and parents in Israel. Seventy-five questionnaires from instructors and 25 from parents returned to the statistical analysis procedure. Reliability and face validity were analyzed by experts.
The questionnaire showed high validity and reliability for its purposes and allowed self-completion by the parents.
Epilepsy and amyotrophic lateral sclerosis (ALS) are common neurological disorders. The association between the two disorders has been raised in observational studies. However, it is uncertain to what extent they have mutual causal effects. In this study, we aimed to investigate their causal association using a two-sample Mendelian randomization (MR) method.
We performed a two-sample bidirectional MR analysis to evaluate the causal association of epilepsy with the risk of ALS. Publicly published genome-wide association study statistics for epilepsy and ALS were used in the study. The primary analysis included genetic variants with a p value of less than 1 × 10–5 as instrumental variables. We applied several alternative methods, including inverse variance weighting, weighted median, simple mode, weighted mode, MR-Egger regression and MR pleiotropy residual sum and outlier, and statistical graphs to assess the associations of epilepsy and its subtype with the risk of ALS. Reverse MR analyses were also performed to examine the association of ALS with the risk of epilepsy.
The primary MR analysis found no causal effect of epilepsy on risk of ALS (odds ration [OR]: 1.133, 95% confidence interval [CI]: 0.964–1.332, p = .130). Among subtypes of epilepsy, it also failed to observe any causal association between general epilepsy and ALS (OR: 1.036, 95% CI: 0.969–1.108, P = .300). However, focal epilepsy contributed to an increase in the risk of ALS (OR: 1.177, 95% CI: 1.027–1.348, p = .019). Moreover, the investigation of reverse causalities did not reveal significant results.
The current study supports a causal influence of focal epilepsy on ALS risk. Future studies are needed to explore its potential role in ALS.
In the aftermath of natural disasters, understanding the intricate links between mental health and physiological responses, such as menstrual cycle patterns, becomes crucial. This study explores the relationship between post-traumatic stress and menstrual irregularities among women of reproductive age residing in regions affected by the 2023 earthquake in Turkey.
309 women of reproductive age living in 11 provinces affected by the earthquake centered in Kahramanmaraş on February 6, 2023 and declared as disaster areas constituted the study sample. Data were collected online using Google forms nine months after the earthquake. The collected data were obtained using the Participant Information Form, Impact of Events Scale and Post-traumatic Stress Disorder-Short Form. In the data analysis, descriptive statistics such as count, percentage, median, minimum, and maximum were used, along with statistical tests including the Mann–Whitney U test, chi-squared test, multiple logistic regression analysis, and ROC analysis.
In the study, an increase in menstrual irregularities among women was observed following the earthquake (%14.3 to %44.8, p < .001). Risk factors for menstrual irregularities included post-traumatic stress symptoms, comorbid chronic diseases, and smoking. The prevalence of PTSD was found to be 22.7% and this was associated with women with menstrual irregularities. Setting the cut-off score of the IES-R scale at 45.50 resulted in higher sensitivity for detecting irregular menstrual cycles.
Women's menstrual cycles are affected after an earthquake. Therefore, post-earthquake mental health recovery programs should specifically address the protection of women's physical and mental health. This comprehensive approach can reduce the effects of earthquake-induced stress and trauma.
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