Brain and Behavior最新文献

Introduction: We aimed to explore the difference in choroidal vascular parameters using swept-source optical coherence tomography (SS-OCT) in patients with idiopathic intracranial hypertension (IIH) compared to controls. We also explored the ability of the choroidal parameters to reflect elevated intracranial pressure (ICP) in patients with IIH.

Methods: This observational study recruited patients diagnosed with IIH and healthy controls. A lumbar puncture was performed for ICP measurement. All the participants underwent OCT examinations. The choroid was automatically segmented and imaged by the OCT tool. The parafoveal choroidal vascular volume (CVV) and choroidal vascular index (CVI) were calculated in 3 mm annulus and 6 mm annulus.

Results: A total of 80 patients with IIH (34.67 ± 11.00 years; 37.50% males) and 92 controls (34.50 ± 12.08 years; 36.96% males) were included in the final analysis. Patients with IIH had higher BMI (< 0.001) and poor visual acuity (< 0.001) compared with controls. Patients with IIH demonstrated significantly lower parafovea CVI in both annuluses (p = 0.003 for 3 mm annulus, p = 0.001 for 6 mm annulus) compared to controls. Mean parafovea CVI in both annuluses was significantly correlated with ICP level (p = 0.014 for 3 mm annulus, p = 0.015 for 6 mm annulus). The combination of CVV and CVI in a 6 mm annulus demonstrated the highest diagnostic value with a mean AUC of 0.818.

Conclusion: CVI may serve as a potential marker for identifying IIH and reflecting ICP changes.

Background: Immune system modulation has been shown to have a significant impact on attention deficit hyperactivity disorder (ADHD). Mendelian randomization (MR) analysis was used in this study to investigate the potential role of different immune cells in the development of ADHD to provide therapy and preventative alternatives.

Methods: In this study, 731 immune cells and the risk of ADHD were examined using publicly accessible genetic data and a two-sample MR analysis. Included were four different types of immunological profiles: determinate cells (DC), proportional cells (PC), median brightness level (MBL), and morphological characteristics (MA). It was discovered that single-nucleotide polymorphisms (SNPs) are linked to ADHD. To evaluate the dependability of the results, we conducted sensitivity analysis (heterogeneity and pleiotropy) and employed supplementary MR techniques, such as the inverse variance weighted (IVW) and MR-Egger. Graphs are used to display the final findings of the pertinent analyses.

Results: Following MR analysis, immune cells associated with a few low p value phenotypes may influence ADHD, and these immune cells may serve as an inspiration for clinical treatment practices that aim to prevent and cure ADHD. Immune cell phenotypes that may both increase and worsen the likelihood of having ADHD were identified by IVW results. These included CD27 on memory B cells (OR = 1.066, 95% CI = 1.024-1.109, p = 2E-3) and CD27 on IgD^-CD38^- (OR = 1.059, 95% CI = 1.018-1.103, p = 5E-3), among others. Immune cell phenotypes that may act as a safeguard against ADHD included CD3 on resting Treg (OR = 0.925, 95% CI = 0.888-0.963, p = 1.5E-4) and SSC-A on monocytes (OR = 0.951, 95% CI = 0.924-0.980, p = 8.5E-4), among others. The primary findings and the outcomes of the sensitivity analysis matched.

Conclusions: This study provides a broad theoretical foundation for the development of immune-oriented therapeutic strategies in future clinical practice by demonstrating a potential genetic relationship between immune cells and ADHD. This study also advances our understanding of how to use the immune pathway to prevent and treat ADHD.

Background: While automated methods for differential diagnosis of parkinsonian syndromes based on MRI imaging have been introduced, their implementation in clinical practice still underlies considerable challenges.

Objective: To assess whether the performance of classifiers based on imaging derived biomarkers is improved with the addition of basic clinical information and to provide a practical solution to address the insecurity of classification results due to the uncertain clinical diagnosis they are based on.

Methods: Retro- and prospectively collected data from multimodal MRI and standardized clinical datasets of 229 patients with PD (n = 167), PSP (n = 44), or MSA (n = 18) underwent multinomial classification in a benchmark study comparing the performance of nine machine learning methods. A predictor space of imaging variables, either with or without clinical information, was investigated. Classification results were assessed using multiclass AUCs. Individual predicted probabilities were visualized to address diagnostic uncertainty.

Results: Clinical diagnosis was accurately confirmed using machine learning models with only small differences when using imaging and clinical signs versus imaging variables only (expected multiclass AUC of 0.95 vs. 0.92). Still, multinomial classification is hampered by imbalanced class frequencies. The most discriminatory variables were responsiveness to levodopa, vertical gaze palsy, and the volumes of subcortical structures, including the red nucleus.

Conclusion: Machine-learning-assisted classification of MR-imaging biomarkers gathered in routine care can assist in the diagnosis of parkinsonian syndromes as part of the diagnostic workup. We provide a visual method that aids the interpretation of neuroimaging-based classification results of the three main parkinsonian syndromes, improving clinical interpretability.

Background: Transcranial magnetic stimulation (TMS) is a promising neuromodulation technique that has been widely used in neuropsychiatric disorders, but there was no evidence on its effect on the improvement attention-deficit hyperactivity disorder (ADHD).

Objective: This systematic review and meta-analysis aimed to investigate the efficacy and safety of TMS in reducing ADHD symptoms.

Method: We systematically searched four databases (PubMed, Embase, Web of Science, and Cochrane Library databases) for randomized controlled/crossover trials on the efficacy and safety of TMS on ADHD symptom improvement compared to sham rTMS or non-TMS interventions, published until September 18, 2024. Extracted data from the included studies involved patient characteristics, intervention protocols, and main outcomes. The effect size of the TMS treatment was evaluated using the standardized mean difference (SMD) with a 95% confidence interval (CI), calculated with either a random effects model or fixed effects model depending on the level of heterogeneity.

Result: Eight studies (325 ADHD patients in total) were included in this systematic review and meta-analysis. According to the core symptoms, TMS significantly improved inattention (SMD = -0.94, 95% CI = -1.33 to -0.56, p < 0.001) and hyperactivity/impulsivity (SMD = -0.98, 95% CI = -1.27 to -0.69, p < 0.001) compared to non-TMS interventions after 3-6 weeks of intervention. During the 1-month follow-up, the TMS group still demonstrated a significant improvement in inattention symptoms compared to the non-TMS group (SMD = -0.67, 95% CI = -1.06 to 0.28, p < 0.001). The total symptoms in the TMS group only showed improvement in the 1-month follow-up compared to the non-TMS group. (SMD = -0.48, 95% CI = -0.82 to -0.14, p = 0.005). Only minor adverse events were reported in the included studies, comprising headache and scalp discomfort.

Conclusion: TMS significantly improved the inattention, hyperactivity/impulsivity, and total symptom scores in ADHD patients with minor adverse events. Future research should focus on the association between different brain regions and symptoms in ADHD patients, which is crucial for stimulation navigation in TMS interventions. The trial is registered in PROSPERO (PROSPERO registry number: CRD42023473853).

Background: Psychotherapeutic memory plays an important role in maintaining therapeutic effects; however, the neural mechanisms of therapeutic metaphor promoting long-term memory were still unknown.

Objective: This study used metaphorical micro-counseling dialog scenarios to investigate the memory effect of therapeutic metaphor and correlated neural mechanisms.

Methods: At first, 31 participants read a mental distress problem, followed by a metaphorical or a literal solution, while undergoing functional magnetic resonance imaging scanning during the encoding phase. One week later, a recognition memory test was performed outside the scanner.

Results: The results revealed that metaphorical solutions were associated with higher insight experiences and better memory performance than literal solutions. Greater activations were observed in the multiple memory systems, including episodic (parahippocampal gyrus, hippocampus, and thalamus), emotional (amygdala), and procedural/implicit (caudate, putamen, and cerebellum), in contrast to later remembered versus later forgotten based on the gap between metaphorical and literal solutions. Insightfulness and activities of the hippocampus, caudate, and cerebellum could predict memory performance.

Conclusions: These findings indicated that multiple memory systems are involved in successful memory encoding of therapeutic metaphors; this suggested that incorporating metaphors into psychotherapy practices could lead to better retention of therapeutic information and improve clinical outcomes compared to literal psychotherapy.

Introduction: Patients with bipolar disorder (BD) demonstrate episodic memory deficits, which may be hippocampal-dependent and may be attenuated in lithium responders. Induced pluripotent stem cell-derived CA3 pyramidal cell-like neurons show significant hyperexcitability in lithium-responsive BD patients, while lithium nonresponders show marked variance in hyperexcitability. We hypothesize that this variable excitability will impair episodic memory recall, as assessed by cued retrieval (pattern completion) within a computational model of the hippocampal CA3.

Methods: We simulated pattern completion tasks using a computational model of the CA3 with different degrees of pyramidal cell excitability variance. Since pyramidal cell excitability variance naturally leads to a mix of hyperexcitability and hypoexcitability, we also examined what fraction (hyper- vs. hypoexcitable) was predominantly responsible for pattern completion errors in our model.

Results: Pyramidal cell excitability variance impaired pattern completion (linear model β = -2.00, SE = 0.03, p < 0.001). The effect was invariant to all other parameter settings in the model. Excitability variance, specifically hyperexcitability, increased the number of spuriously active neurons, increasing false alarm rates and producing pattern completion deficits. Excessive inhibition also induces pattern completion deficits by limiting the number of correctly active neurons during pattern retrieval.

Conclusions: Excitability variance in CA3 pyramidal cell-like neurons observed in lithium nonresponders may predict pattern completion deficits in these patients. These cognitive deficits may not be fully corrected by medications that minimize excitability. Future studies should test our predictions by examining behavioral correlates of pattern completion in lithium-responsive and -nonresponsive BD patients.

Background: Duloxetine, a serotonin and norepinephrine reuptake inhibitor (SNRI), is used to treat various health conditions, including major depressive disorder, generalized anxiety disorder, fibromyalgia, and off-label for chemotherapy-induced pain. We conducted this systematic review and meta-analysis aiming to test the current evidence regarding effectiveness and safety of duloxetine for postspine surgeries pain.

Methods: We searched the Cochrane Central Register of Controlled Trials, PubMed, Scopus and Web of science databases for relevant articles up to March 2024. The following search terms were Used in combination using the Boolean operators ((Duloxetine Hydrochloride) AND ((Pain, Postoperative) OR (Postoperative Period) OR (Postoperative Cognitive Complications) OR (Delayed Emergence from Anesthesia) OR (Postoperative Care) OR (spine surgery)) without time constrain for the search. Meta-analysis was performed using Review Manager (RevMan version 5.4) on the extracted outcome data that present in at least 3 of the included studies. Mean difference (MD) was used as the effect size for continuous outcomes with a 95% confidence interval (CI) or standardized mean difference (SMD) in case of different outcome reporting scales.

Results: Pooled analysis showed that duloxetine significantly reduces pain intensity after 24 h from the operation compared to placebo (SMD = -1.11, 95% CI [-2.16 to -0.07], p = 0.04) with no significant difference in pain after 2 and 48 h. Meta-analysis revealed that duloxetine shows a significant reduction in the amount of analgesic consumption after 24 h postoperative; (MD = -3.33, 95% CI [-5.53 to -1.13], p = 0.003). The analysis did not show any statistically significant difference between duloxetine and placebo in patients experiencing nausea or vomiting (RR = 1.37, 95% CI [0.62 to 3.00] CONCLUSION: The findings of this study suggest that duloxetine may be effective in reducing pain 24 h after spine surgery. Furthermore, there is a promising effect of duloxetine in treating chronic postoperative pain. However, it is important to acknowledge that further research is warranted to thoroughly evaluate the efficacy and safety of duloxetine for relieving chronic postoperative pain.

Background: Previous studies on neuroimaging findings in Alzheimer's disease (AD) patients with hallucinations and delusions have yielded inconsistent results. We aimed to systematically review neuroimaging findings of delusions and hallucinations in AD patients to describe the most prominent neuroimaging features.

Methods: We performed a comprehensive search in three online databases, including PubMed, Scopus, and Web of Science in June 2023. We included studies that reported neuroimaging features of AD patients with delusion, hallucination, or psychosis.

Results: After the screening, 34 studies with 2241 AD patients were eligible to be included in our qualitative synthesis. On the basis of the included studies, there are significant changes in the volume and perfusion levels of broad brain areas, including the hippocampus, amygdala, insula, cingulate, occipital, frontal, prefrontal, orbitofrontal, temporal, and parietal cortices in these patients. Moreover, AD patients with psychosis, hallucinations, or delusions reflected different EEG waves compared to AD patients without these disorders.

Conclusion: The results of our review provided evidence about the neuroimaging alterations in AD patients suffering from psychosis, hallucinations, and delusions using different imaging methods. AD patients with psychosis, hallucinations, or delusions have significant differences in the volume and perfusion levels of various brain regions along with alterations in EEG waves and biological molecules compared to patients with only AD.

Purpose: Despite the increasing interest in positive psychology and the functional characteristics of one of its practical derivations, strength-based parenting, there is a paucity of information regarding the assessment tools for strength-based parenting and their psychometric properties. Thus, this study aimed to translate the Strength-Based Parenting Scale (SBPS) into Persian and investigate its validity and reliability among Iranian adolescents.

Method: Of the 645 adolescents who completed the Persian translation of the SBPS (349 females, M_age = 14.01 years, SD_age = 0.82, range = 13-15), 300 also answered the Mental Toughness Scale for Adolescents and the Connor-Davidson Resilience Scale.

Finding: Confirmatory factor analysis supported a two-factor structure comprising dimensions of "knowledge of strengths" and "use of strengths," the measurement invariance of which was established across sexes and school grades. The two dimensions were significantly and strongly correlated with the constructs of mental toughness and psychological resilience (r = 0.36-0.65, p < 0.01), corroborating the criterion-related validity of the SBPS. Furthermore, excellent internal consistency coefficients were observed for both subscales (0.96-0.97).

Conclusion: Our findings substantiate the positions derived from positive psychology, upon which the conceptual foundation of strength-based parenting is built, and provide preliminary support for the psychometric properties of the Persian version of the SBPS.