Brain and Behavior最新文献_第10页

Ketamine Combined With Psychotherapy as a Treatment for Resistant Depression in a Public European Hospital 氯胺酮联合心理疗法治疗欧洲公立医院难治性抑郁症

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-13 DOI: 10.1002/brb3.71164

Filipa Alves da Silva, Rita Avelar, Bernardo Peixoto, Leonor Bacelar-Nicolau, Francisco Santos, João Costa Ribeiro, Maria João Heitor

Purpose

Depression affects around 280 million people worldwide, and about 30% of patients have treatment-resistant depression. Ketamine has significant scientific evidence supporting its use as an antidepressant, making it a promising approach for treatment-resistant cases. Combining ketamine with psychotherapy may enhance therapeutic response and support longer-lasting cognitive and behavioral change. This pilot proof-of-concept study aims to evaluate the effect of treatment with ketamine infusion combined with psychological intervention in a sample of nine patients with treatment-resistant depression at a general hospital within the Portuguese National Health Service.

Methods

Clinical outcomes were measured through the clinical interview and the patient health questionnaire (PHQ-9) to assess complete or partial improvement.

Results

Following eight weeks of treatment, all showed a reduction in their PHQ-9 scores, with the median score transitioning from a baseline categorization of “severe” depression to a “moderate” level. It was found that 44.4% (4/9) of participants showed a response to treatment (≥ 50% reduction in the PHQ-9 score). Among the patients with suicidal ideation, slightly over half showed remission of these thoughts at the end of treatment. Among the participants subsequently monitored as outpatients, only 29% (2/7) experienced a deterioration in mood within three months post-treatment, requiring an adjustment of antidepressant therapy.

Conclusion

In our study, an improvement in depressive symptoms was observed, despite their severity, in a sample submitted to multiple previous pharmacological strategies.This retrospective study evaluated ketamine infusions combined with psychotherapy in nine patients with treatment-resistant depression at a general hospital. After eight weeks, all participants improved, with PHQ-9 scores shifting from severe to moderate. Overall, 44% responded to treatment, and among those with suicidal ideation, more than half showed remission.

目的：全世界约有2.8亿人患有抑郁症，其中约30%的患者患有难治性抑郁症。氯胺酮有重要的科学证据支持其作为抗抑郁药的使用，使其成为治疗耐药病例的一种有希望的方法。氯胺酮与心理治疗相结合可以增强治疗效果，并支持更持久的认知和行为改变。这项概念验证试验研究的目的是评估氯胺酮输注结合心理干预治疗在葡萄牙国家卫生服务总医院的9例难治性抑郁症患者中的效果。方法：通过临床访谈和患者健康问卷（PHQ-9）测量临床结果，评估完全或部分改善。结果：经过8周的治疗，所有人的PHQ-9得分都有所下降，中位数得分从“严重”抑郁的基线分类转变为“中度”抑郁水平。发现44.4%（4/9）的参与者对治疗有反应（PHQ-9评分降低≥50%）。在有自杀念头的患者中，略多于一半的患者在治疗结束时这些念头得到缓解。在随后作为门诊患者进行监测的参与者中，只有29%（2/7）在治疗后三个月内出现情绪恶化，需要调整抗抑郁治疗。结论：在我们的研究中，观察到抑郁症状的改善，尽管其严重程度，在一个提交了多种先前的药物策略的样本中。本回顾性研究评估了氯胺酮输注联合心理治疗在综合医院治疗的9例难治性抑郁症患者。八周后，所有参与者都有所改善，PHQ-9得分从严重变为中度。总体而言，44%的人对治疗有反应，在有自杀念头的人中，超过一半的人表现出缓解。

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引用次数: 0

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-13 DOI: 10.1002/brb3.71153

Filomeno Cortese, Pamela Hruska, Kevin J. McLaughlin, Sylvain P. Coderre, Andrea B. Protzner, Olave E. Krigolson, Kent G. Hecker

Purpose

This study investigated the behavioral and resting-state neural correlates of clinical decision-making among expert gastroenterologists and novice medical students, aiming to understand how diagnostic expertise is reflected in either pre-task and/or post-task brain activity.

Method

Participants completed a clinical decision-making task while behavioral measures (accuracy and response time) were recorded. Resting-state fMRI data were acquired immediately before and following the task. Group differences in brain connectivity were analyzed using seed-based connectivity and multivariate partial least squares (PLS) analyses, focusing on the frontopolar prefrontal cortex (FPPFC) and its associated networks.

Finding

Experts outperformed novices in diagnostic accuracy and speed, especially on “easy” cases, suggesting enhanced cognitive efficiency. Experts also showed more pronounced response time variation with task difficulty, potentially reflecting strategic modulation. Resting-state fMRI revealed that experts had increased post-task connectivity between the FPPFC and the paracingulate gyrus (PaCG), a brain area associated with the executive control network. Novices, by contrast, showed stronger FPPFC connectivity with the posterior cingulate cortex (PCC), part of the default mode network (DMN), indicating a return to internally directed cognition. PLS analyses further revealed that experts engaged executive and attentional network regions post-task, while novices primarily activated DMN regions. Notably, for the expert group only, increased brain activity in attention-related regions was associated with gastroenterologists who had slower, deliberate responses on easy cases.

Conclusion

Clinical expertise is associated with sustained engagement of goal-directed neural networks after task completion, potentially reflecting ongoing cognitive evaluation or preparation. In contrast, novices appear to disengage more readily, reverting to self-referential thought. These findings highlight distinct neural mechanisms that may support the development of diagnostic expertise.

目的：本研究调查了胃肠病学专家和医学生新手临床决策的行为和静息状态神经相关因素，旨在了解诊断专长如何反映在任务前和/或任务后的大脑活动中。方法：参与者完成临床决策任务，同时记录行为测量（准确性和反应时间）。静息状态fMRI数据是在任务之前和之后立即获得的。使用基于种子的连通性和多元偏最小二乘（PLS）分析脑连通性的组差异，重点分析额极前额叶皮层（FPPFC）及其相关网络。发现：专家在诊断准确性和速度上优于新手，特别是在“简单”病例上，这表明他们的认知效率更高。专家们还发现，反应时间随任务难度的变化更为明显，这可能反映了策略调节。静息状态功能磁共振显示，专家们增加了FPPFC和副扣带回（PaCG）之间的任务后连接，PaCG是一个与执行控制网络相关的大脑区域。相比之下，新手的FPPFC与默认模式网络（DMN）的一部分后扣带皮层（PCC）的连通性更强，表明他们回到了内定向认知。PLS分析进一步揭示，专家在任务后参与执行和注意网络区域，而新手主要激活DMN区域。值得注意的是，仅就专家组而言，注意力相关区域的大脑活动增加与胃肠病学家有关，他们对简单病例的反应较慢，深思熟虑。结论：临床专业知识与任务完成后目标导向神经网络的持续参与有关，潜在地反映了正在进行的认知评估或准备。相比之下，新手似乎更容易脱离，回到自我参照思维。这些发现突出了不同的神经机制，可能支持诊断专业知识的发展。

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引用次数: 0

Risk Factors of Caregiver Burden in Patients With Cognitive Dysfunction: A Scoping Review 认知功能障碍患者照顾者负担的危险因素：范围综述。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71191

Liu Jinheng, Zhao Jingyi, Cui Shaomei, Ye Danjuan, Wang Liansheng, Chen Lixia

Introduction

To synthesize the risk factors of caregiver burden in patients with cognitive dysfunction and provide insights for clinical nursing practice and research.

Methods

A scoping review was conducted following the five-stage methodological framework proposed by Arksey and O'Malley. A systematic search was performed using a combination of subject terms and free terms across six databases: China National Knowledge Infrastructure, Wanfang Database, PubMed, Embase, Cochrane Library, and Web of Science Core Collection. The search period covered from the establishment of each database to July 22, 2025, with grey literature excluded. Two authors independently screened the literature based on predefined inclusion and exclusion criteria, and discrepancies were resolved by team consensus. Data from included studies were extracted into tables, and results were collated through descriptive overview and thematic synthesis.

Results

A total of 3313 records were retrieved, and 19 studies were finally included. Included studies covered regions such as China, the United States, Japan, Australia, and several European countries and involved 5233 patients with cognitive dysfunction and 5586 caregivers. Caregiver burden was influenced by three categories of risk factors: patient factors, caregiver factors, and environmental-social factors. The most commonly used tools to measure caregiver burden were the Zarit Burden Interview and Caregiver Burden Inventory.

Conclusions

Caregiver burden in patients with cognitive dysfunction is the result of multifactorial interactions, with neuropsychiatric symptoms and behaviors of patients as core risk factors and patient functional dependence and caregiver female gender as driving risk factors. These factors increase caregiver burden by enhancing care intensity, amplifying psychological pressure, and reducing coping resources. Future research should develop comprehensive intervention models based on cross-cultural comparisons and longitudinal designs to reduce caregiver burden.

前言：综合认知功能障碍患者照顾者负担的危险因素，为临床护理实践和研究提供参考。方法：根据Arksey和O'Malley提出的五阶段方法框架进行范围审查。在中国国家知识基础设施、万方数据库、PubMed、Embase、Cochrane图书馆和Web of Science核心馆藏6个数据库中使用主题词和免费词组合进行系统检索。检索时间为各数据库建立至2025年7月22日，不包括灰色文献。两位作者根据预先确定的纳入和排除标准独立筛选文献，并通过团队共识解决差异。纳入研究的数据被提取到表格中，并通过描述性概述和专题综合对结果进行整理。结果：共检索到3313条记录，最终纳入19项研究。纳入的研究覆盖了中国、美国、日本、澳大利亚和几个欧洲国家，涉及5233名认知功能障碍患者和5586名护理人员。照顾者负担受患者因素、照顾者因素和环境-社会因素三种危险因素的影响。测量照顾者负担最常用的工具是Zarit负担访谈和照顾者负担量表。结论：认知功能障碍患者的照顾者负担是多因素相互作用的结果，患者神经精神症状和行为是核心危险因素，患者功能依赖和照顾者女性性别是驱动危险因素。这些因素通过提高护理强度、放大心理压力和减少应对资源来增加照顾者负担。未来的研究应建立基于跨文化比较和纵向设计的综合干预模式，以减轻照顾者负担。

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引用次数: 0

Salivary Gland Uptake on 18F-Florbetaben PET Did Not Demonstrate Additional Diagnostic Value for Alzheimer's Disease 唾液腺摄取18F-Florbetaben PET对阿尔茨海默病没有额外的诊断价值。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71199

Hyun Woo Kwon, Saim Jung, Cheolmin Shin, Jong Hun Kim, Moon Ho Park

Objectives

Saliva, like other body fluids, has been investigated as a source of biomarkers for Alzheimer's disease (AD) due to its accessibility. Recently, decreased amyloid-PET uptake in the salivary glands of patients with AD was reported, prompting interest in the potential clinical relevance of that finding. This study evaluates the association between salivary gland uptake on ¹⁸F-florbetaben PET and cortical amyloid burden and assesses its diagnostic value.

Methods

We retrospectively analyzed 73 patients who underwent ¹⁸F-florbetaben PET imaging. Salivary gland uptake (SUVR_SG) was measured and compared with the cortical amyloid burden, severity of dementia, and clinical diagnoses (cognitively normal, mild cognitive impairment, and dementia). Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analyses.

Results

The mean SUVR_SG was 1.43 ± 0.29, with no significant differences based on the cortical amyloid burden, severity of dementia, or clinical diagnosis. SUVR_SG did not correlate with the cortical amyloid burden (ρ = −0.103, p > 0.05). The area under the ROC curve and volume under the ROC surface indicated that SUVR_SG had poor diagnostic performance.

Conclusions

Salivary gland uptake on ¹⁸F-florbetaben PET was not associated with the cortical amyloid burden or clinical stage of AD, and it did not demonstrate diagnostic value. Further research is needed to explore its biological significance and standardization methods.

目的：唾液，像其他体液一样，由于其可获得性，已被研究作为阿尔茨海默病（AD）生物标志物的来源。最近，有报道称AD患者唾液腺中淀粉样蛋白pet摄取减少，这引起了人们对该发现潜在临床相关性的兴趣。本研究评估唾液腺18f -florbetaben PET摄取与皮质淀粉样蛋白负荷的关系，并评估其诊断价值。方法：我们回顾性分析了73例接受18F-florbetaben PET显像的患者。测量唾液腺摄取（SUVRSG），并与皮质淀粉样蛋白负荷、痴呆严重程度和临床诊断（认知正常、轻度认知障碍和痴呆）进行比较。采用受试者工作特征（ROC）曲线分析评估诊断效果。结果：平均SUVRSG为1.43±0.29，在皮质淀粉样蛋白负荷、痴呆严重程度或临床诊断方面无显著差异。SUVRSG与皮质淀粉样蛋白负荷无关（ρ = -0.103, p < 0.05）。ROC曲线下面积和ROC曲面下体积显示SUVRSG的诊断效果较差。结论：唾液腺对18F-florbetaben PET的摄取与皮层淀粉样蛋白负荷或AD临床分期无关，不具有诊断价值。其生物学意义和标准化方法有待进一步研究。

{"title":"Salivary Gland Uptake on 18F-Florbetaben PET Did Not Demonstrate Additional Diagnostic Value for Alzheimer's Disease","authors":"Hyun Woo Kwon, Saim Jung, Cheolmin Shin, Jong Hun Kim, Moon Ho Park","doi":"10.1002/brb3.71199","DOIUrl":"10.1002/brb3.71199","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Saliva, like other body fluids, has been investigated as a source of biomarkers for Alzheimer's disease (AD) due to its accessibility. Recently, decreased amyloid-PET uptake in the salivary glands of patients with AD was reported, prompting interest in the potential clinical relevance of that finding. This study evaluates the association between salivary gland uptake on <sup>1</sup><sup>8</sup>F-florbetaben PET and cortical amyloid burden and assesses its diagnostic value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analyzed 73 patients who underwent <sup>18</sup>F-florbetaben PET imaging. Salivary gland uptake (SUVR<sub>SG</sub>) was measured and compared with the cortical amyloid burden, severity of dementia, and clinical diagnoses (cognitively normal, mild cognitive impairment, and dementia). Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean SUVR<sub>SG</sub> was 1.43 ± 0.29, with no significant differences based on the cortical amyloid burden, severity of dementia, or clinical diagnosis. SUVR<sub>SG</sub> did not correlate with the cortical amyloid burden (ρ = −0.103, p > 0.05). The area under the ROC curve and volume under the ROC surface indicated that SUVR<sub>SG</sub> had poor diagnostic performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Salivary gland uptake on <sup>18</sup>F-florbetaben PET was not associated with the cortical amyloid burden or clinical stage of AD, and it did not demonstrate diagnostic value. Further research is needed to explore its biological significance and standardization methods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"16 1","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12778438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145916755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Association of Remnant Cholesterol With Self‑Reported Trouble Sleeping and Mediation by Depression 残余胆固醇与自我报告的睡眠困难的关系和抑郁症的调解。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71201

Qichao Yang, Zhaoxiang Wang, Han Yan, Xuejing Shao

Purpose

Remnant cholesterol (RC) is an independent risk factor for cardiovascular diseases. The objective of this study is to assess the correlation between RC levels and trouble sleeping among U.S. adults.

Methods

This study analyzed data from 14,617 adults enrolled in the National Health and Nutrition Examination Survey (NHANES), calculating RC by subtracting both high-density and low-density lipoprotein cholesterol (HDL-c and LDL-c) from total cholesterol (TC). Trouble sleeping was identified through self-report history. The relationship between RC and trouble sleeping was explored through logistic regression, restricted cubic spline (RCS), and mediation analysis.

Results

The prevalence of trouble sleeping escalates with increasing RC levels. Adjusting for potential confounders, higher RC levels were significantly associated with an increased risk of trouble sleeping [OR (95% CI): 1.30 (1.13–1.49), p < 0.001]. A linear relationship was identified through RCS analysis. Moreover, depression was found to partially mediate the relationship between RC and trouble sleeping.

Conclusions

Trouble sleeping is associated with increased RC levels. The causal relationship requires additional investigation.

目的：残余胆固醇（RC）是心血管疾病的独立危险因素。这项研究的目的是评估RC水平与美国成年人睡眠问题之间的关系。方法：本研究分析了14,617名参加国家健康与营养调查（NHANES）的成年人的数据，通过从总胆固醇（TC）中减去高密度和低密度脂蛋白胆固醇（HDL-c和LDL-c）来计算RC。睡眠问题是通过自我报告的历史来确定的。通过logistic回归、限制性三次样条（RCS）和中介分析探讨睡眠障碍与睡眠障碍的关系。结果：睡眠障碍患病率随着RC水平的升高而升高。调整潜在混杂因素后，较高的RC水平与睡眠困难风险增加显著相关[OR (95% CI): 1.30 (1.13-1.49), p < 0.001]。通过RCS分析发现两者呈线性关系。此外，我们还发现抑郁在RC与睡眠困难的关系中起部分中介作用。结论：睡眠困难与RC水平升高有关。因果关系需要进一步调查。

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引用次数: 0

Translation and Validation of the Thai Version of the Telephone Interview for Cognitive Status and the Mini Montreal Cognitive Assessment in Older Adults 泰语版电话访谈对老年人认知状况及迷你蒙特利尔认知评估的翻译与验证。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71178

Pasa Sukson, Weerasak Muangpaisan, Supakorn Chansaengpetch, Angkana Jongsawadipatana, Pitiporn Siritipakorn, Ananya Treewisut, Jirawit Wong-ekkabut, Somboon Intalapaporn

Introduction

This study aimed to translate and validate the telephone interview for cognitive status (TICS) and the mini montreal cognitive assessment (Mini MoCA) for use in older Thai adults and to compare their diagnostic validity for mild cognitive impairment (MCI) and dementia.

Materials and methods

A total of 149 participants—51 cognitively normal (CN), 49 with MCI, and 49 with dementia—were enrolled. Diagnoses were based on DSM-5 criteria and the Clinical Dementia Rating (CDR), determined by a senior geriatric neurologist. Participants also completed the MMSE-2, MoCA, NPI-Q, and ADL assessments, administered by certified psychologists and a geriatric nurse. The TICS and Mini MoCA were administered by two independent, blinded clinicians within four weeks of the initial evaluation. Test-retest reliability was assessed after two weeks. Validity and reliability analyses included content and construct validity, and inter-rater/test-retest reliability.

Results

Mean age and education were comparable across groups. Both TICS and Mini MoCA scores correlated significantly with standard cognitive and functional measures. Test-retest and inter-rater reliability were excellent (ICC = 0.933 and 0.995 for TICS; 0.918 and 0.998 for Mini MoCA). For discriminating CN from dementia, sensitivity/specificity were 81.3%/81.2% (AUC = 0.883) for TICS and 87.5%/89.6% (AUC = 0.958) for Mini MoCA. For CN vs. MCI, Mini MoCA (AUC = 0.755) performed slightly better than TICS (AUC = 0.693). Average administration times were 8.7 and 4.4 min, respectively.

Conclusions

TICS and Mini MoCA are valid, reliable tools for cognitive screening in older Thai adults, with Mini MoCA showing slightly superior performance.

本研究旨在翻译和验证泰国老年人的认知状态电话访谈（TICS）和迷你蒙特利尔认知评估（mini MoCA），并比较它们对轻度认知障碍（MCI）和痴呆的诊断有效性。材料和方法：共纳入149名参与者，其中51名认知正常（CN）， 49名轻度认知障碍（MCI）， 49名痴呆（dementia）。诊断基于DSM-5标准和临床痴呆评分（CDR），由资深老年神经学家确定。参与者还完成了MMSE-2、MoCA、NPI-Q和ADL评估，由注册心理学家和老年护士管理。TICS和Mini MoCA由两名独立的盲法临床医生在初始评估的四周内给予。两周后评估重测信度。效度和信度分析包括内容效度和构念效度，以及评量者/重测者的信度。结果：各组的平均年龄和教育程度具有可比性。TICS和Mini MoCA评分与标准认知和功能测量结果显著相关。重测信度和评估间信度极好（TICS的ICC值分别为0.933和0.995；Mini MoCA的ICC值分别为0.918和0.998）。对于鉴别CN和痴呆，TICS的敏感性和特异性分别为81.3%/81.2% （AUC = 0.883）和Mini MoCA的敏感性和特异性分别为87.5%/89.6% （AUC = 0.958）。对于CN与MCI， Mini MoCA （AUC = 0.755）的表现略好于TICS （AUC = 0.693）。平均给药时间分别为8.7 min和4.4 min。结论：TICS和Mini MoCA是有效、可靠的泰国老年人认知筛查工具，Mini MoCA表现出稍好的效果。

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引用次数: 0

Endovascular Therapy Versus Best Medical Treatment in Posterior Cerebral Artery Stroke: A Systematic Review and Meta-Analysis 脑后动脉卒中的血管内治疗与最佳药物治疗：系统回顾和荟萃分析

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71194

Umama Alam, Rabia Ahmed, Shree Rath, Fazia Khattak, Muhammad Asad Asif, Monsurah Bisola Alatise, Lubaba Yunas, Adil Khan, Mohd Sijad Uddin, Labannya Das Puja, Sayed Inamullah, Mahin Fatima, Sumia Fatima, Fazeela Bibi, Abdul Moiz, Raheel Ahmed

Introduction

Posterior cerebral artery (PCA) stroke, while comprising a smaller proportion of ischemic strokes, often results in significant neurological deficits and poses distinctive therapeutic challenges. This study aims to systematically review and meta-analyze the efficacy and safety of EVT compared with best medical management (BMM) in patients with PCA stroke.

Methods

Electronic searches of PubMed, Embase, and Scopus up to July 2025 identified studies comparing EVT and BMM for PCA stroke. Eligible studies included patients with PCA stroke, compared EVT with BMM, and reported at least one outcome of interest. Statistical analyses employed random or fixed-effects models as appropriate; results are presented as odds ratios (OR) or mean differences (MD) with 95% confidence intervals (CI).

Results

A total of 12 studies were included, encompassing 39,525 patients (2,540 EVT; 37,075 BMM). EVT was associated with significantly increased odds of early neurological improvement (ENI) (OR 2.11, 95% CI 1.81–2.45), and greater reduction in NIHSS at 24 h (MD –1.30, 95% CI –1.89 to –0.71). There was no significant difference in visual field normalization and no difference in excellent functional outcome. EVT was associated with lower odds of achieving functional independence (mRS 0–2 at 90 days: OR 0.75, 95% CI 0.67–0.85), and significantly increased risks of symptomatic intracranial hemorrhage (OR 2.32, 95% CI 1.66–3.23) and mortality at 90 days (OR 1.86, 95% CI 1.47–2.35).

Conclusion

In PCA stroke, endovascular thrombectomy (EVT) confers early neurological recovery but does not improve long-term functional independence and is associated with higher risks of symptomatic hemorrhage and mortality compared with BMM. While EVT may benefit selected patients, these results underscore the need for individualized treatment decisions and prospective randomized trials focused on PCA stroke.

脑后动脉（PCA）卒中虽然在缺血性卒中中所占的比例较小，但往往导致严重的神经功能障碍，并给治疗带来独特的挑战。本研究旨在系统回顾和荟萃分析EVT与最佳医疗管理（BMM）在PCA卒中患者中的疗效和安全性。方法：电子检索PubMed， Embase和Scopus，直到2025年7月，确定了比较EVT和BMM对PCA卒中的研究。符合条件的研究包括PCA卒中患者，比较EVT和BMM，并报告至少一个感兴趣的结果。统计分析酌情采用随机或固定效应模型；结果以95%置信区间（CI）的优势比（OR）或平均差异（MD）表示。结果：共纳入12项研究，包括39,525例患者（2,540例EVT； 37,075例BMM）。EVT与早期神经系统改善（ENI）的几率显著增加（OR 2.11, 95% CI 1.81-2.45）和24小时NIHSS的更大降低（MD -1.30, 95% CI -1.89 -0.71）相关。两组在视野正常化和良好功能预后方面无显著差异。EVT与较低的实现功能独立的几率相关（90天时mRS 0-2: OR 0.75, 95% CI 0.67-0.85），并显著增加症状性颅内出血的风险（OR 2.32, 95% CI 1.66-3.23）和90天死亡率（OR 1.86, 95% CI 1.47-2.35）。结论：在PCA卒中中，血管内血栓切除术（EVT）可以早期恢复神经功能，但不能改善长期功能独立性，而且与BMM相比，EVT有更高的症状性出血和死亡率风险。虽然EVT可能有利于选定的患者，但这些结果强调了个体化治疗决策和前瞻性随机试验的必要性，这些试验主要集中在PCA卒中。

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引用次数: 0

Effects of Dexmedetomidine on the Behavioral Outcomes in Streptozotocin-Induced Alzheimer's Disease Rats 右美托咪定对链脲佐菌素诱导的阿尔茨海默病大鼠行为结局的影响。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71196

Mina Mohasel-Roodi, Masoumeh Nozari, Ali Shamsara, Mohsen Basiri, Vida Mirzaie, Masoumeh Baghalishahi

Introduction

Alzheimer's disease (AD) is a progressive and prevalent neurodegenerative disorder characterized by progressive cognitive decline and memory impairment. Intracerebroventricular (ICV) administration of streptozotocin (STZ) in rodents recapitulates key features of sporadic AD, including brain insulin resistance and oxidative stress. Dexmedetomidine (Dex), a highly selective α2-adrenergic receptor agonist, has demonstrated neuroprotective and anti-inflammatory properties, suggesting its potential utility as a therapeutic approach for AD.

Methods

Seventy adult male Wistar rats were randomly allocated to seven experimental groups: Control, Sham, STZ, Sham + Dex (25 µg/kg), and STZ + Dex (25, 50, 100 µg/kg). Cognitive performance and anxiety-like behaviors were evaluated using the open-field test (OFT), elevated plus maze (EPM), Y-maze test, and Morris water maze (MWM).

Results

In the Y-maze, STZ-treated rats exhibited significant reductions in spontaneous alternation behavior (p = 0.002), which were significantly reversed by Dex (25 µg/kg, p = 0.002). In the MWM, the STZ administration resulted in prolonged escape latencies and increased path lengths compared with Control animals (p < 0.05). Treatment with Dex (25 µg/kg) significantly improved spatial learning and memory retention (p < 0.05). No significant differences were observed in locomotor activity and anxiety-related behaviors in the OFT or EPM.

Conclusions

These findings indicate that Dex at 25 µg/kg attenuates STZ-induced cognitive deficits, likely through neuroprotective and anti-inflammatory mechanisms. The results highlight Dex as a promising candidate for AD therapy, though further research is required to elucidate its underlying molecular pathways. The study supports the potential repurposing of Dex for neurodegenerative disorders.

阿尔茨海默病（AD）是一种进行性和普遍的神经退行性疾病，其特征是进行性认知能力下降和记忆障碍。在啮齿类动物脑室内注射链脲佐菌素（STZ）可以重现散发性AD的关键特征，包括脑胰岛素抵抗和氧化应激。右美托咪定（Dexmedetomidine, Dex）是一种高选择性α2-肾上腺素能受体激动剂，具有神经保护和抗炎特性，提示其作为AD治疗方法的潜在效用。方法：将70只成年雄性Wistar大鼠随机分为对照组、Sham组、STZ组、Sham + Dex组（25µg/kg）和STZ + Dex组（25、50、100µg/kg）。采用开阔场测试（OFT）、高架迷宫（EPM）、y形迷宫测试和Morris水迷宫（MWM）评估认知表现和焦虑样行为。结果：在y型迷宫中，stz处理大鼠的自发交替行为显著减少（p = 0.002），而Dex（25µg/kg, p = 0.002）显著逆转了这一现象。在MWM中，与对照组相比，STZ使小鼠的逃避潜伏期延长，路径长度增加（p < 0.05）。使用25µg/kg的右美托咪定（Dex）可显著改善空间学习和记忆保持（p < 0.05）。在OFT或EPM的运动活动和焦虑相关行为方面未观察到显著差异。结论：这些研究结果表明，25µg/kg的Dex可能通过神经保护和抗炎机制减轻stz诱导的认知缺陷。尽管需要进一步的研究来阐明其潜在的分子途径，但这些结果突出了Dex作为阿尔茨海默病治疗的有希望的候选者。这项研究支持了替他咪唑治疗神经退行性疾病的潜在用途。

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引用次数: 0

Prediction Models for Acute Kidney Injury in Stroke Patients: A Systematic Review 脑卒中患者急性肾损伤的预测模型：系统综述。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2026-01-07 DOI: 10.1002/brb3.71188

Baihui Zhong, Yifan Du, Xinyi Wang, Xue Dong

Introduction

To systematically identify and synthesize the research on prediction models for acute kidney injury (AKI) in stroke patients. Methods: CNKI, Wanfang, VIP, CBM, PubMed, Cochrane Library, Embase, and Web of Science were searched from inception to April 26, 2025. The fundamental characteristics of the included studies were extracted, including model construction, predictors, model performance, and presentation methods. Results: A total of 35 prediction models were identified in this systematic review, with area under the curve (AUC) values ranging from 0.428 to 1.000. Seven studies performed external validation. Common predictors included hypertension, serum creatinine levels, age, diuretic use, mechanical ventilation, and the National Institutes of Health Stroke Scale score (NIHSS). Conclusions: The risk prediction model for AKI in stroke patients still needs to be developed. Despite demonstrating promising predictive capability, the models exhibited significant performance variability and an overall high risk of bias. Future research requires standardized development and validation of models to develop reliable prediction tools with minimal bias and enhanced applicability.

前言：系统识别和综合脑卒中患者急性肾损伤（AKI）预测模型的研究。方法：检索中国知网、万方、维普、CBM、PubMed、Cochrane Library、Embase、Web of Science自创刊至2025年4月26日。提取纳入研究的基本特征，包括模型构建、预测因子、模型性能和呈现方法。结果：共建立了35个预测模型，曲线下面积（AUC）为0.428 ~ 1.000。7项研究进行了外部验证。常见的预测因素包括高血压、血清肌酐水平、年龄、利尿剂使用、机械通气和美国国立卫生研究院卒中量表评分（NIHSS）。结论：脑卒中患者AKI风险预测模型有待进一步完善。尽管显示出有希望的预测能力，但模型表现出显著的性能可变性和总体上的高偏倚风险。未来的研究需要标准化开发和验证模型，以开发具有最小偏差和增强适用性的可靠预测工具。

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引用次数: 0

Distinct Gut Microbiota Profiles Reflect Severity in Chronic Insomnia Disorder 不同的肠道菌群反映慢性失眠症的严重程度。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-31 DOI: 10.1002/brb3.71155

Yaxi Liu, Yixian Cai, Xian Shi, Mei Fan, Xiaotao Zhang, Jingjing Lin, Xiaoxuan Fan, Bingdong Liu, Jiyang Pan

Introduction

Severe insomnia symptoms increase the risk of persistent sleep disorders, underscoring the need for timely identification to optimize therapeutic interventions. Given the established association between chronic insomnia disorder (CID) and gut microbiota, this study aimed to evaluate the utility of gut microbiota characteristics for stratifying CID severity.

Methods

A total of 65 patients with CID were categorized into two groups based on Pittsburgh Sleep Quality Index (PSQI) scores: S-CID (more severe poor sleep quality; median age: 36, IQR: 30–47; M/F: 12/22) and M-CID (milder poor sleep quality; median age: 33, IQR: 25–43; M/F: 11/20). Thirty healthy controls (HC; median age: 32, IQR: 26–48; M/F: 8/22) were also included. All participants underwent polysomnography and clinical assessments. Fecal samples were collected and analyzed via 16S rRNA gene sequencing. We compared microbial structure across severity groups, identified key bacterial genera using LASSO regression and the Boruta algorithm, and examined their correlations with sleep parameters via Spearman analysis. Functional pathway predictions were performed with PICRUSt2. A random forest model was constructed to evaluate severity-stratified discriminative capacity.

Results

Significant alterations in gut microbial diversity and composition were observed in S-CID patients compared to HC, whereas M-CID patients showed less pronounced differences. Seven key bacterial genera were identified and consistently correlated with sleep parameters. Functional perturbations in glutamate/butanoate metabolism and branched-chain amino acid degradation pathways differed by severity. The random forest model demonstrated moderate efficacy (AUC = 0.711–0.730) in distinguishing S-CID patients based on microbial signatures.

Conclusion

This study reveals distinct gut microbial signatures associated with varying severity levels of CID, providing insights that may support the development of microbiota-based diagnostic and therapeutic interventions.

严重的失眠症状增加了持续性睡眠障碍的风险，强调了及时识别以优化治疗干预的必要性。鉴于慢性失眠症（CID）与肠道微生物群之间的关联，本研究旨在评估肠道微生物群特征对CID严重程度分层的效用。方法：根据匹兹堡睡眠质量指数（PSQI）评分将65例CID患者分为两组：S-CID（较重度睡眠质量差，年龄中位数：36岁，IQR: 30-47; M/F: 12/22）和M-CID（较轻度睡眠质量差，年龄中位数：33岁，IQR: 25-43; M/F: 11/20）。同时纳入健康对照30例（HC，中位年龄32岁，IQR: 26-48, M/F: 8/22）。所有参与者都进行了多导睡眠描记和临床评估。收集粪便样本，通过16S rRNA基因测序进行分析。我们比较了不同严重程度组的微生物结构，使用LASSO回归和Boruta算法确定了关键细菌属，并通过Spearman分析检查了它们与睡眠参数的相关性。用PICRUSt2进行功能通路预测。建立了随机森林模型来评价严重分层判别能力。结果：与HC相比，S-CID患者的肠道微生物多样性和组成发生了显著变化，而M-CID患者的差异不太明显。七个关键的细菌属被确定并与睡眠参数一致相关。谷氨酸/丁酸代谢和支链氨基酸降解途径的功能扰动因严重程度而异。随机森林模型在根据微生物特征区分S-CID患者方面表现出中等疗效（AUC = 0.711-0.730）。结论：本研究揭示了与不同严重程度的CID相关的不同肠道微生物特征，为基于微生物群的诊断和治疗干预的发展提供了见解。

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引用次数: 0