Brain and Behavior最新文献_第6页

Insulin Resistance and Cognitive Function in Nondiabetic Patients With Cerebral Small Vessel Disease: Role of Brain Glymphatic Function 非糖尿病性脑血管病患者的胰岛素抵抗与认知功能：脑淋巴功能的作用

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-22 DOI: 10.1002/brb3.71143

Xiao-Li Yang, Yu-Fan Luo, Tian-Yao Wang, Meng-Xiang Wang, Wen-Mei Lu, Hu-Lie Zeng, Dan-Hong Wu

Objective

Both insulin sensitivity and brain glymphatic function were linked to cognitive function in nondiabetic patients with cerebral small vessel disease (CSVD). This study aims to elucidate these complex associations through mediation analysis.

Methods

Patients who underwent multimodal magnetic resonance imaging (MRI) scans were recruited. Global cognitive assessment was performed by Mini-Mental State Examination (MMSE), four isolated cognitive domains were assessed simultaneously. Glymphatic function was assessed using the diffusion tensor imaging along the perivascular space (DTI-ALPS) index, insulin sensitivity was assessed by the homeostasis model assessment–estimated insulin resistance index (HOMA-IR), and HOMA-IR≥2.80 was defined as insulin resistance (IR). Mediation analysis was conducted to examine the effect of the DTI-ALPS on insulin sensitivity and cognitive function.

Results

110 CSVD patients were recruited, 40 patients were IR and 70 patients were non-IR. Both the HOMA-IR and DTI-ALPS index were significant predictors of cognitive function, with B = −0.592, 95%CI, −0.939 to −0.244, p = 0.001 and B = 9.378, 95% CI, 3.376 to 15.381, p = 0.003, respectively, after adjusting for age, sex, and other confounding factors. Mediation analysis revealed that the DTI-ALPS index served as a significant partial mediator in the relationship between HOMA-IR and cognitive function, with direct effect = −0.649 (95% CI, −1.015 to −0.282, p < 0.001), total effect = −0.743 (95% CI, −1.106 to −0.380, p < 0.001), and the indirect effect = −0.094 (95% CI, −0.236 to −0.006, p = 0.029), accounting for 12.66% of the total effect.

Conclusion

Both the HOMA-IR and the DTI-ALPS index are independent risk factors for cognitive function. Furthermore, the DTI-ALPS index significantly and partially mediates the relationship between the HOMA-IR and cognitive function.

目的：胰岛素敏感性和脑淋巴功能与非糖尿病性脑小血管疾病（CSVD）患者的认知功能相关。本研究旨在通过中介分析来阐明这些复杂的关联。方法：招募接受多模态磁共振成像（MRI）扫描的患者。采用Mini-Mental State Examination （MMSE）进行整体认知评估，同时评估4个孤立的认知领域。采用沿血管周围间隙扩散张量成像（DTI-ALPS）指数评估淋巴功能，采用稳态模型评估-估计胰岛素抵抗指数（HOMA-IR）评估胰岛素敏感性，HOMA-IR≥2.80定义为胰岛素抵抗（IR）。通过中介分析检验DTI-ALPS对胰岛素敏感性和认知功能的影响。结果：共纳入110例CSVD患者，其中IR组40例，非IR组70例。在校正年龄、性别等混杂因素后，HOMA-IR和DTI-ALPS指数均为认知功能的显著预测因子，B = -0.592, 95%CI为-0.939 ~ -0.244,p = 0.001; B = 9.378, 95%CI为3.376 ~ 15.381,p = 0.003。中介分析显示，DTI-ALPS指数在HOMA-IR与认知功能的关系中起着显著的部分中介作用，直接效应= -0.649 (95% CI, -1.015 ~ -0.282, p < 0.001)，总效应= -0.743 (95% CI, -1.106 ~ -0.380, p < 0.001)，间接效应= -0.094 (95% CI, -0.236 ~ -0.006, p = 0.029)，占总效应的12.66%。结论：HOMA-IR和DTI-ALPS指数均为认知功能的独立危险因素。此外，DTI-ALPS指数在HOMA-IR与认知功能之间具有显著和部分的中介作用。

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引用次数: 0

Efficacy of Different Combination Therapies for Mania in Bipolar Disorder: A Systematic Review and Meta-Analysis 双相情感障碍躁狂症不同联合治疗的疗效：一项系统综述和荟萃分析。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-22 DOI: 10.1002/brb3.71139

Peiling Yao, Pingan Ni, Liqin Yin

Objective

To systematically evaluate the efficacy and safety of different combination therapies in the treatment of mania in bipolar disorder, and to provide evidence-based support for individualized clinical treatment.

Methods

PubMed, Web of Science, Cochrane Library, CNKI, VIP, and Wanfang databases were systematically searched from inception to July 2025. Randomized controlled trials comparing ziprasidone or olanzapine combined with mood stabilizers (lithium carbonate or sodium valproate) for the treatment of manic episodes in bipolar disorder were included. Two reviewers independently performed literature screening, data extraction, and quality assessment. Meta-analysis was conducted using RevMan 5.4 software.

Results

A total of 10 RCTs involving 842 patients were included. Meta-analysis showed no significant difference between the two groups in overall clinical efficacy (OR = 1.18, 95% CI: 0.80–1.75, p = 0.41). Ziprasidone was superior to olanzapine in reducing YMRS scores (MD = −1.47, 95% CI: −1.97–0.96, p < 0.00001). The incidence of adverse reactions was significantly lower in the ziprasidone group compared to the olanzapine group (OR = 0.16, 95% CI: 0.08–0.31, p < 0.00001). Furthermore, ziprasidone was associated with significantly greater increases in BDNF and T₃ levels after treatment.

Conclusion

Although the efficacy of ziprasidone plus mood stabilizers is comparable to that of olanzapine plus mood stabilizers in the treatment of manic episodes of bipolar disorder, ziprasidone offers advantages in improving manic symptoms (YMRS scores), reducing adverse events, and enhancing neuroendocrine indicators. It may serve as a favorable alternative in clinical practice. Further high-quality, multicenter, large-sample studies are needed to confirm its efficacy and safety.

目的：系统评价不同联合疗法治疗躁狂症双相障碍的疗效和安全性，为临床个体化治疗提供循证支持。方法：系统检索PubMed、Web of Science、Cochrane Library、CNKI、VIP、万方等数据库，检索时间为建库至2025年7月。比较齐拉西酮或奥氮平联合情绪稳定剂（碳酸锂或丙戊酸钠）治疗双相情感障碍躁狂发作的随机对照试验包括在内。两位审稿人独立进行文献筛选、数据提取和质量评估。采用RevMan 5.4软件进行meta分析。结果：共纳入10项rct，共842例患者。meta分析显示，两组患者总体临床疗效差异无统计学意义（OR = 1.18, 95% CI: 0.80 ~ 1.75, p = 0.41）。齐拉西酮在降低YMRS评分方面优于奥氮平（MD = -1.47, 95% CI: -1.97 ~ 0.96, p = 3）。结论：齐拉西酮加心境稳定剂治疗双相情感障碍躁狂发作的疗效与奥氮平加心境稳定剂相当，但齐拉西酮在改善躁狂症状（YMRS评分）、减少不良事件、增强神经内分泌指标等方面具有优势。在临床实践中可作为一种较好的替代方法。需要进一步的高质量、多中心、大样本研究来证实其有效性和安全性。

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引用次数: 0

Clinical Study on the Combined Therapy of Sinew Acupuncture and Low-Frequency Repetitive Transcranial Magnetic Stimulation for Hemiplegic Shoulder Pain 筋针联合低频重复经颅磁刺激治疗偏瘫肩痛的临床研究。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-22 DOI: 10.1002/brb3.70913

Lintong Zhu, Hongwei Zhai, Caixia Su, Lei Qin, Zhaoxue Li, Zunke Gong, Mi Wang

Objective

To observe the clinical efficacy of combining sinew acupuncture with low-frequency repetitive transcranial magnetic stimulation (rTMS) for treating hemiplegic shoulder pain.

Methods

A total of 90 patients with hemiplegic shoulder pain were randomly divided into three groups: the sinew acupuncture group, the rTMS group, and the combined group (30 patients each). All received conventional symptomatic medication and routine interventions. The sinew acupuncture group received subcutaneous shallow needling on the affected side; the rTMS group received 1 Hz rTMS stimulation on the contralateral M1 area of the cerebral cortex; and the combined group underwent both treatments. Pain severity, upper limb mobility, and activities of daily living were assessed using the Visual Analogue Scale (VAS), the Fugl-Meyer Assessment (FMA) of Upper Extremity, and the Modified Barthel Index (MBI) before and after 4 weeks of treatment.

Results

After treatment, all groups demonstrated substantial improvements in VAS, FMA, and MBI scores compared with baseline (p < 0.05). The combined therapy group exhibited superior improvements in pain reduction, upper limb function, and activities of daily living compared with the other two groups (p < 0.05).

Conclusion

Both sinew acupuncture and 1 Hz rTMS are effective in treating hemiplegic shoulder pain when used independently. Their combined application substantially reduces pain and enhances shoulder function and activities of daily living in patients, representing a valuable clinical approach.

目的：观察针刺配合低频重复经颅磁刺激（rTMS）治疗偏瘫肩痛的临床疗效。方法：将90例偏瘫肩痛患者随机分为肌腱针刺组、rTMS组和联合组（各30例）。所有患者均接受常规对症药物治疗和常规干预。筋针组在患侧皮下浅刺；rTMS组对侧大脑皮层M1区给予1 Hz rTMS刺激；联合组接受了两种治疗。采用视觉模拟量表（VAS）、Fugl-Meyer上肢评分（FMA）和改良Barthel指数（MBI）评估治疗前后4周患者的疼痛程度、上肢活动能力和日常生活活动能力。结果：治疗后，与基线相比，所有组的VAS、FMA和MBI评分均有显著改善(p)。结论：单独使用筋针和1hz rTMS均可有效治疗偏瘫肩痛。它们的联合应用大大减少了疼痛，增强了患者的肩部功能和日常生活活动，代表了一种有价值的临床方法。

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引用次数: 0

Social Support, Self-Management Behaviors, and Coping Styles of Patients With Wilson's Disease: A Quantitative Empirical Research Wilson病患者社会支持、自我管理行为与应对方式的定量实证研究

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-22 DOI: 10.1002/brb3.71138

TingTing Zhan, Xiang Li, Yan Wang, Lili Wang, Caijie Sun, Xiaohan Hu, Shutong Qiao, Xue Li, Wenjie Tu

<div> <section> <h3> Purpose</h3> <p>Based on Roy's Adaptation Model, this study explores the relationship between social support, coping styles, and self-management behaviors in patients with Wilson's disease (WD), as well as the underlying mechanisms.</p> </section> <section> <h3> Methods</h3> <p>A cross-sectional survey was conducted among 230 WD patients from a tertiary hospital using the Social Support Rating Scale, the Simplified Coping Style Questionnaire, and the Chronic Disease Self-Management Study Scale. Structural equation modeling was employed to analyze the pathways between variables.</p> </section> <section> <h3> Results</h3> <p>The total scores for social support, coping styles, and self-management behaviors were 36.03 ± 7.71, 50.44 ± 10.95, and 37.76 ± 12.05, respectively. Social support was positively correlated with self-management behaviors (<i>r</i> = 0.386) and positive coping (<i>r</i> = 0.578) and weakly correlated with negative coping (<i>r</i> = −0.170). Positive coping was positively correlated with self-management behaviors (<i>r</i> = 0.519), while negative coping was negatively correlated (<i>r</i> = −0.308). Structural equation modeling indicated that coping style partially mediates the relationship between social support and self-management (<i>β</i> = 0.199, <i>p</i> < 0.001).</p> </section> <section> <h3> Conclusion</h3> <p>Social support directly enhances self-management behaviors in patients with WD and indirectly promotes them by fostering positive coping styles, supporting Roy's adaptation model as a theoretical basis for intervention development.</p> </section> <section> <h3> Implications for Practice</h3> <p>Effective self-management in WD patients requires a combination of factors, including the use of social resources, reducing negative perceptions of the disease, and adopting positive coping strategies.</p> </section> <section> <h3> Impact</h3> <p>Based on Roy's adaptation model, to explore the self-management behaviors of patients with hepatolenticular degeneration and their influencing factors. We identified the correlation between self-management behaviors and social support and coping styles in patients with Wilson's disease. This study provides a theoretical basis for improving the self-management behaviors of patients with Wilson's disease and lays a foundation for further empirical research.</p>

目的：基于Roy's适应模型，探讨Wilson's disease （WD）患者社会支持、应对方式和自我管理行为之间的关系及其机制。方法：采用社会支持评定量表、简易应对方式问卷和慢性病自我管理研究量表对某三级医院230例WD患者进行横断面调查。采用结构方程模型分析变量之间的关系。结果：社会支持、应对方式和自我管理行为总分分别为36.03±7.71分、50.44±10.95分和37.76±12.05分。社会支持与自我管理行为（r = 0.386）、积极应对（r = 0.578）呈正相关，与消极应对（r = -0.170）呈弱相关。积极应对与自我管理行为呈正相关（r = 0.519），消极应对与自我管理行为呈负相关（r = -0.308）。结构方程模型显示，应对方式在社会支持与自我管理之间具有部分中介作用（β = 0.199, p < 0.001）。结论：社会支持直接增强了WD患者的自我管理行为，并通过培养积极的应对方式间接促进了WD患者的自我管理行为，支持Roy的适应模型作为干预发展的理论基础。对实践的启示：WD患者有效的自我管理需要多种因素的结合，包括利用社会资源，减少对疾病的负面看法，并采取积极的应对策略。影响：基于Roy的适应模型，探讨肝豆状核变性患者的自我管理行为及其影响因素。我们确定了威尔逊病患者自我管理行为与社会支持和应对方式之间的相关性。本研究为改善Wilson病患者的自我管理行为提供了理论依据，为进一步的实证研究奠定了基础。

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引用次数: 0

Prodromal Sleep Disturbances and Polysomnographic Findings in Patients With Creutzfeldt–Jakob Disease 克雅氏病患者的前驱睡眠障碍和多导睡眠图表现。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.70971

Ezgi Demirel, Gul Yalcin-Cakmakli, Ezgi Yetim, Serap Saygi, Fadime Irsel Tezer

Purpose

Prion diseases are fatal neurodegenerative disorders of the central nervous system. Sporadic Creutzfeldt–Jakob disease (sCJD) is the most encountered form of the disease. The mean survival time is less than a year after diagnosis. Sleep problems are common in CJD. However, only a few studies revealed sleep pathology of CJD.

Method

Between 2013 and 2023, patients diagnosed with probable CJD who had video electroencephalography (EEG) and polysomnography (PSG) studies were evaluated. Detailed examination of the first and last EEGs (if any) was based on background activity, slow wave paroxysms, epileptiform discharges, and additional findings. Macro- and microstructure of sleep and sleep disturbances were evaluated with PSG studies.

Results

Seven patients (two females, five males) at the mean age of 60 years were analyzed. Gait disturbances, difficulty in speech, and visual problems were common in addition to progressive cognitive impairment. Neurological examination revealed ataxia, dysarthria, myoclonus and/or aphasia, and loss of vision. Typical 1 Hz generalized periodic discharges and slow wave activity on the background were encountered in the advanced stage of the disease. Sleep-related problems were reported by three patients (42.8%); however, when we questioned carefully, we realized all patients had sleep disturbances such as simple or complex movements during sleep, sleep vocalizations, insomnia, and daytime sleepiness simultaneously with the main symptom. During PSG recording, sleep-related apnea and insomnia were frequently reported. Interestingly, one patient had an initial de novo finding of Cheyne–Stokes apnea.

Conclusion

Sleep problems such as insomnia or apnea could be the first sign of CJD. It should be carefully questioned of every patient and caregiver. PSG may help to specify prognostic and clinical differences.

目的：朊病毒病是一种致命的中枢神经系统退行性疾病。散发性克雅氏病（sCJD）是该病最常见的形式。确诊后平均生存时间不到一年。睡眠问题在克雅氏病中很常见。然而，只有少数研究揭示了克雅氏病的睡眠病理。方法：对2013年至2023年间诊断为疑似CJD的视频脑电图（EEG）和多导睡眠图（PSG）患者进行评估。第一次和最后一次脑电图（如果有的话）的详细检查是基于背景活动、慢波发作、癫痫样放电和其他发现。用PSG研究对睡眠和睡眠障碍的宏观和微观结构进行了评估。结果：7例患者（女2例，男5例），平均年龄60岁。除了进行性认知障碍外，步态障碍、言语困难和视觉问题也很常见。神经学检查显示共济失调，构音障碍，肌阵挛和/或失语，以及视力丧失。典型的1hz广义周期性放电和背景慢波活动在疾病晚期出现。睡眠相关问题3例（42.8%）；然而，当我们仔细询问时，我们发现所有患者都有睡眠障碍，如睡眠中简单或复杂的动作、睡眠发声、失眠、白天嗜睡等，同时伴有主要症状。在PSG记录期间，睡眠相关的呼吸暂停和失眠经常被报道。有趣的是，一名患者最初发现了Cheyne-Stokes呼吸暂停。结论：失眠或呼吸暂停等睡眠问题可能是CJD的第一个症状。应该仔细询问每一个病人和护理人员。PSG可能有助于明确预后和临床差异。

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引用次数: 0

Neuroprotective Effects of Tuina in CP Rats Are Associated With Gut Microbiota Remodeling and Intestinal Barrier Restoration 推拿对CP大鼠的神经保护作用与肠道菌群重塑和肠屏障修复有关。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.71136

Chenqin Si, Rui Qiao, Yu Liu, Ayipaxiaguli Kasimu, Danmei Chen, Lijian Xie, Ping-ping Sun, Bing Li

Introduction

Cerebral palsy (CP) is a neurodevelopmental disorder that has been linked to gut microbiota dysbiosis. Although Tuina has shown neuroprotective effects, it remains unclear whether these benefits involve regulation of the gut–brain axis. This study aimed to evaluate the therapeutic effects of Tuina in CP rats, with emphasis on its potential regulation of the gut–brain axis.

Methods

CP was induced in 7-day-old Sprague–Dawley rats through hypoxia–ischemia. Beginning on postnatal day 8 (P8), the Tuina group received daily Tuina therapy for 32 consecutive days. Motor function was assessed using the negative geotaxis test (P6–P12), the beam balance test (P36–P39), and the modified neurological severity score on P40. Gut microbiota composition was analyzed using 16S rRNA sequencing. Brain and intestinal histopathology were evaluated histologically via hematoxylin–eosin and Luxol fast blue staining. Protein expression of BDNF, Nrf2, GPX4, ZO-1, and occludin was assessed via western blotting and immunofluorescence. Serum short-chain fatty acids (SCFAs) were measured by mass spectrometry, whereas oxidative stress and intestinal barrier markers (superoxide dismutase, malondialdehyde, glutathione peroxidase, lipopolysaccharide [LPS], diamine oxidase [DAO], and D-lactate [D-LA]) were detected using enzyme-linked immunosorbent assay.

Results

In CP models induced by hypoxic–ischemic encephalopathy, significant brain injury and motor dysfunction were observed, accompanied by gut microbiota dysbiosis and impaired intestinal barrier function. Tuina intervention improved motor function and growth, regulated gut microbiota, and increased serum SCFA levels. It also enhanced intestinal barrier proteins (occludin, ZO-1), reduced serum levels of LPS, DAO, and D-LA, and increased the expression of brain-derived BDNF, Nrf2, and GPX4.

Conclusion

Tuina significantly alleviated brain injury and improved motor function in CP rats. These effects were associated with modulation of the gut microbiota and restoration of intestinal barrier integrity, suggesting that the gut–brain axis may mediate the neuroprotective effects of Tuina.

脑瘫（CP）是一种神经发育障碍，与肠道菌群失调有关。尽管推拿已显示出神经保护作用，但尚不清楚这些益处是否涉及肠脑轴的调节。本研究旨在评价推拿对CP大鼠的治疗作用，重点探讨其对肠脑轴的潜在调节作用。方法：采用低氧缺血诱导7日龄sd大鼠CP。从出生后第8天（P8）开始，推拿组给予每日推拿治疗，连续32天。采用负地向性测试（P6-P12）、平衡木测试（P36-P39）和修正神经系统严重程度评分（P40）评估运动功能。采用16S rRNA测序分析肠道菌群组成。采用苏木精-伊红染色和Luxol快蓝染色对大鼠脑组织和肠道组织病理进行组织学观察。western blotting和免疫荧光法检测BDNF、Nrf2、GPX4、ZO-1和occludin的蛋白表达。采用质谱法检测血清短链脂肪酸（SCFAs），采用酶联免疫吸附法检测氧化应激和肠道屏障标志物（超氧化物歧化酶、丙二醛、谷胱甘肽过氧化物酶、脂多糖（LPS）、二胺氧化酶（DAO）和d -乳酸（D-LA））。结果：缺氧缺血性脑病诱导的CP模型出现明显的脑损伤和运动功能障碍，并伴有肠道菌群失调和肠屏障功能受损。推拿干预改善了运动功能和生长，调节了肠道微生物群，增加了血清SCFA水平。它还增强了肠道屏障蛋白（occludin, ZO-1），降低了血清LPS， DAO和D-LA的水平，并增加了脑源性BDNF， Nrf2和GPX4的表达。结论：推拿可明显减轻CP大鼠脑损伤，改善运动功能。这些作用与肠道微生物群的调节和肠道屏障完整性的恢复有关，表明肠-脑轴可能介导了推拿的神经保护作用。

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引用次数: 0

Association Between Self-Reported Sleep Quality and Conversion From Mild Cognitive Impairment to Dementia: A Retrospective Cohort Study Using the English Longitudinal Study of Ageing 自我报告的睡眠质量与从轻度认知障碍到痴呆的转化之间的关系：一项使用英国老龄化纵向研究的回顾性队列研究。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.71120

Johannes Schurr, Hilary Davies-Kershaw, Helen Strongman

Purpose:

Poor sleep quality is common in people diagnosed with mild cognitive impairment (MCI) and dementia and may be associated with conversion to dementia.

Method

This retrospective cohort study investigated the association of self-reported sleep quality and duration with dementia incidence in a cohort of people aged ≥ 50 with MCI from the English Longitudinal Study of Ageing (ELSA) panel study. We identified the MCI cohort using three waves (2008/2009, 2012/2013, 2016/2017) based on absence of diagnosed dementia, self-reported memory problems, preserved ability for daily activities, and reduced cognitive function in neuropsychological assessments. Exposures were self-reported poor sleep quality and sleep duration in the month before the baseline interview. The outcome was self-reported physician-diagnosed dementia from later waves. We modeled associations with Cox proportional hazards regression adjusted for multiple confounders.

Finding

Among 1885 patients with MCI at baseline, 24.7% reported poor sleep quality, 17.6% reported average sleep duration per night to be < 6 h, 74.6% reported average sleep duration per night to be 6–< 9 h, and 7.5% reported average sleep duration per night to be ≥ 9 h. Note that 176 (9.3%) developed dementia during follow-up (median 5.8 years, interquartile range [IQR] 2.1–6.3). Age-adjusted hazard for all-cause dementia, compared to 6–< 9 h sleep duration, was increased with sleep duration ≥ 9 h (hazard ratio [HR] 2.57, 95% confidence interval [CI] 1.62–4.02) but not short sleep duration (HR 0.94, 95% CI 0.55–1.61); there was weak evidence of reduced risk in persons with poor sleep quality, compared to good sleep quality (HR 0.68, 95% CI 0.41–1.12).

Conclusion

We found evidence for an association between long sleep duration and dementia risk in patients with MCI and limited evidence of an association between poor sleep quality and dementia.

目的：睡眠质量差在轻度认知障碍（MCI）和痴呆症患者中很常见，并可能与转化为痴呆症有关。方法：本回顾性队列研究调查了来自英国老龄化纵向研究（ELSA）小组研究的年龄≥50岁MCI患者自我报告的睡眠质量和持续时间与痴呆发病率的关系。在神经心理学评估中，我们使用三波（2008/2009年、2012/2013年、2016/2017年）来确定MCI队列，基于没有诊断出痴呆、自我报告的记忆问题、保持日常活动能力和认知功能下降。在基线访谈前一个月，暴露者自我报告睡眠质量和睡眠时间较差。结果是自我报告的医生诊断的老年痴呆症。我们用Cox比例风险回归模型对多个混杂因素进行了校正。研究发现：在1885名轻度认知障碍患者中，24.7%的患者报告睡眠质量差，17.6%的患者报告每晚平均睡眠时间短。结论：我们发现了轻度认知障碍患者睡眠时间长与痴呆风险相关的证据，而睡眠质量差与痴呆风险相关的证据有限。

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引用次数: 0

Exploring the Animal Models of Gastrointestinal and Emotional Comorbidity 探索胃肠道和情绪共病的动物模型。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.71135

Yan-hui Wang, Xiang-rui Kong, Xin-zhu Ye, Su Pu, Xin-xin Ren, Qing-yang Huang, Ya-qing Lu, Hao Wang

Background

With the comorbid anxiety/depression in gastrointestinal diseases occur at a high rate worldwide, it is particularly important to discover and optimize the protocols of comorbidity models, thus further to reveal the mechanism and develop the treatment strategies of comorbidity.

Methods

Using “functional dyspepsia (FD), animal model, anxiety, depression” as search terms, this search is conducted in PubMed, Web of Science, and SpringerLink databases, with the search period from 2020 to 2025.

Results

We find that both iodoacetamide (IA) gavage and tail clamping (TC) are classical methods for establishing FD model; physical stress such as “ice water gavage” or “irregular feeding (IF)” also used. We propose that IA + TC + IF or TC + IF + ice water gavage can be used to prepare comorbidity models in future. Maternal separation (MS) may also potentially become one of the effective models for studying comorbidities. In anxiety/depression model, we show that both chronic restraint stress (CRS) and chronic unpredictable mild stress (CUMS) are classical models for emotional disorders. We suggest CRS/CUMS combines with IA/IF/TC can better to establish gastrointestinal-emotional comorbidity model which through brain–gut cross talk. Then the review also develops a comprehensive and standardized evaluation system for comorbidity models, with recording behavioral indicators related to gastrointestinal/emotional disorders, while including multidimensional parameters such as the microbiota, neuroinflammation, metabolomics, brain–gut peptide, and neurotransmitters.

Conclusion

This study is the first comprehensive comparison of FD and anxiety–depression modeling protocols to propose effective protocols of comorbidity models and develop a comprehensive and standardized evaluation system for comorbidity models.

背景：在世界范围内，焦虑/抑郁共病在胃肠道疾病中的发生率很高，发现并优化共病模型的方案，从而进一步揭示共病的机制和制定治疗策略显得尤为重要。方法：以“功能性消化不良（FD）、动物模型、焦虑、抑郁”为检索词，在PubMed、Web of Science和SpringerLink数据库中进行检索，检索期为2020 ~ 2025年。结果：碘乙酰胺（IA）灌胃和夹尾（TC）是建立FD模型的经典方法；物理压力，如“冰水灌胃”或“不规律喂养（IF）”也被使用。我们建议未来可采用IA + TC + IF或TC + IF +冰水灌胃的方法制备共病模型。产妇分离（MS）也可能成为研究合并症的有效模型之一。在焦虑/抑郁模型中，我们发现慢性约束应激（CRS）和慢性不可预测的轻度应激（CUMS）都是情绪障碍的经典模型。我们认为CRS/CUMS联合IA/IF/TC能更好地通过脑肠串扰建立胃肠-情绪共病模型。在此基础上，建立了综合、标准化的共病模型评价体系，记录胃肠道/情绪障碍相关行为指标，同时纳入微生物群、神经炎症、代谢组学、脑肠肽、神经递质等多维参数。结论：本研究首次对FD与焦虑抑郁建模方案进行综合比较，提出了有效的共病模型方案，并建立了综合、规范的共病模型评价体系。

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引用次数: 0

Electroacupuncture Potentiates Astragaloside IV Cerebral Delivery via P-Glycoprotein-Mediated Transcellular Transport: A Novel Blood–Brain Barrier Penetration Strategy for Ischemic Stroke Therapy 电针通过p -糖蛋白介导的跨细胞转运增强黄芪甲苷脑传递：缺血性卒中治疗的一种新的血脑屏障穿透策略。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.71134

Ling Ouyang, Xinyi Yang, Jiayue Wu, Bufan Wu, Qidong Huang, Yonglin Chen, Xiaolong Zhang, Yi Cao, Ying Chen, Yirong Yang, Jingjing Zhang, Xiaobei Hao, Shengfeng Lu, Xinyue Jing, Shuping Fu

Background

Astragaloside IV (AS-IV) exhibits therapeutic potential in central nervous system (CNS) disorders. However, its brain bioavailability is restricted by P-glycoprotein (P-gp)-mediated efflux at the blood–brain barrier (BBB). This study aims to investigate whether electroacupuncture (EA) can enhance the cerebral delivery of AS-IV by inhibiting nuclear factor-kappa B (NF-κB) nuclear translocation to downregulate P-gp expression.

Methods

The permeability of the BBB was assessed using Evans blue (EB) staining and transmission electron microscopy. The intracerebral concentration of AS-IV was quantified by liquid chromatography–tandem mass spectrometry (LC–MS/MS). The therapeutic efficacy of AS-IV in combination with EA was evaluated using triphenyltetrazolium chloride (TTC) staining and neurological function assessments. mRNA and protein expression levels of relevant factors were analyzed through real-time quantitative polymerase chain reaction (RT-qPCR), western blot, and immunofluorescence.

Results

In normal mice, EA effectively increases the levels of EB and AS-IV in brain tissue. The combination of EA and AS-IV significantly activates the Wnt/β-catenin signaling pathway and promotes the expression of zonula occludens protein (ZO)-1 and Claudin-5. Furthermore, EA inhibits NF-κB nuclear translocation and mitigates AS-IV-induced upregulation of P-gp expression. Notably, EA significantly elevates the AS-IV content in ischemic brain tissue. The combination therapy demonstrates enhanced therapeutic effects in ischemic rats, including reductions in neurological function scores, infarct size, and pro-inflammatory factor levels, along with increased expression of anti-inflammatory factors. Additionally, this combination significantly inhibits NF-κB nuclear translocation and reduces P-gp expression in the brain tissue of ischemic stroke rats.

Conclusion

These findings indicate that EA enhances the brain uptake and neuroprotective effects of AS-IV, irrespective of BBB integrity. The underlying mechanism involves P-gp-mediated transcellular transport rather than the paracellular pathway.

背景：黄芪甲苷（AS-IV）显示出治疗中枢神经系统（CNS）疾病的潜力。然而，其脑生物利用度受到p -糖蛋白（P-gp）介导的血脑屏障外排的限制。本研究旨在探讨电针（EA）是否通过抑制核因子κB （NF-κB）核易位下调P-gp表达，从而增强AS-IV的脑传递。方法：采用Evans蓝染色和透射电镜观察血脑屏障的通透性。采用液相色谱-串联质谱法（LC-MS/MS）定量测定AS-IV脑内浓度。采用氯化三苯四唑（TTC）染色及神经功能评估评价AS-IV联合EA的治疗效果。通过实时定量聚合酶链反应（RT-qPCR）、western blot和免疫荧光分析相关因子的mRNA和蛋白表达水平。结果：EA能有效提高正常小鼠脑组织EB和AS-IV水平。EA和AS-IV联合使用可显著激活Wnt/β-catenin信号通路，促进occludens蛋白(ZO)-1和Claudin-5的表达。此外，EA抑制NF-κB核易位，减轻as - iv诱导的P-gp表达上调。值得注意的是，EA显著提高缺血脑组织AS-IV含量。联合治疗在缺血性大鼠中显示出增强的治疗效果，包括神经功能评分、梗死面积和促炎因子水平的降低，以及抗炎因子表达的增加。此外，联合用药可显著抑制缺血性脑卒中大鼠脑组织NF-κB核易位，降低P-gp表达。结论：这些发现表明，与血脑屏障完整性无关，EA可增强AS-IV的脑摄取和神经保护作用。潜在的机制涉及p- gp介导的跨细胞转运而不是细胞旁途径。

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引用次数: 0

Association Between Free Triiodothyronine to Free Thyroxine Ratio and Hemorrhagic Transformation After Intravenous Thrombolysis in Acute Ischemic Stroke Patients 急性缺血性脑卒中患者静脉溶栓后游离三碘甲状腺原氨酸与游离甲状腺素比值与出血转化的关系。

IF 2.7 3区心理学 Q2 BEHAVIORAL SCIENCES

Brain and Behavior

Pub Date : 2025-12-17 DOI: 10.1002/brb3.71140

Haoran Ma, Hong Li, Xinyi Fu, Chenchen Wei, Aijun Ma

Background

Hemorrhagic transformation (HT) is a critical complication following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Emerging evidence indicates thyroid homeostasis’ potential role in cerebrovascular outcomes, with the free triiodothyronine to free thyroxine (FT3/FT4) ratio demonstrating superior predictive value over isolated thyroid hormone measurements. This observational study works on elucidating the relation between pre-treatment FT3/FT4 ratios and post-thrombolytic HT occurrence in AIS populations.

Method

The research consecutively enrolled AIS patients receiving IVT therapy between January 2020 and August 2024. Clinical information from patients was gathered, and to examine the link between the FT3/FT4 ratio and post-IVT HT, we performed both multivariate and univariate logistic regression analyses. The optimal cutoff value was identified through the ROC curve analysis. The relation between clinical outcomes in HT patients and the FT3/FT4 ratio was further assessed using correlation analysis.

Result

A cohort of 251 patients with AIS was recruited; among them, 46 patients experienced HT following IVT. Multivariate regression analysis presented a notable correlation between the FT3/FT4 ratio and the occurrence of HT, with an OR of 0.444 [95% CI 0.209−0.946, p = 0.035]. The area under the ROC curve (AUC) of the FT3/FT4 ratio for discriminating HT from non-HT was 0.774 (95% CI 0.695−0.853, p < 0.001), with an optimal cutoff value of 0.211. Correlation analysis demonstrated that FT3/FT4 levels were negatively related to baseline NIHSS score (r = −0.317, p = 0.032), In patients with HT, the NIHSS score at 24 h following thrombolysis (r = −0.367, p = 0.012) and the mRS score at 3 months post-onset (r = −0.394, p = 0.007) demonstrated significant correlations.

Conclusion

In patients with AIS, lower FT3/FT4 levels were found to be a potential predictive marker for HT. Nevertheless, no association was observed between FT3/FT4 levels and HT types. Moreover, lower FT3/FT4 levels were indicative of poorer clinical outcomes in HT patients.

背景：出血性转化（HT）是急性缺血性卒中（AIS）静脉溶栓（IVT）后的一个关键并发症。新出现的证据表明，甲状腺稳态在脑血管预后中的潜在作用，游离三碘甲状腺原氨酸与游离甲状腺素（FT3/FT4）比值比单独的甲状腺激素测量显示出更高的预测价值。这项观察性研究旨在阐明治疗前FT3/FT4比率与AIS人群溶栓后HT发生之间的关系。方法：本研究连续纳入2020年1月至2024年8月接受IVT治疗的AIS患者。收集了患者的临床信息，并检查FT3/FT4比率与ivt后HT之间的联系，我们进行了多变量和单变量logistic回归分析。通过ROC曲线分析确定最佳截止值。采用相关分析进一步评估HT患者临床结局与FT3/FT4比值的关系。结果：招募了251例AIS患者；其中，46例患者在IVT后出现HT。多因素回归分析显示，FT3/FT4比值与HT的发生有显著相关性，OR为0.444 [95% CI 0.209 ~ 0.946, p = 0.035]。FT3/FT4比值鉴别HT与非HT的ROC曲线下面积（AUC）为0.774 (95% CI 0.695-0.853, p < 0.001)，最佳截断值为0.211。相关分析显示FT3/FT4水平与基线NIHSS评分呈负相关（r = -0.317, p = 0.032）， HT患者溶栓后24 h的NIHSS评分（r = -0.367, p = 0.012）与发病后3个月的mRS评分（r = -0.394, p = 0.007）呈显著相关。结论：在AIS患者中，较低的FT3/FT4水平被发现是HT的潜在预测指标。然而，没有观察到FT3/FT4水平与HT类型之间的关联。此外，较低的FT3/FT4水平表明HT患者的临床预后较差。

{"title":"Association Between Free Triiodothyronine to Free Thyroxine Ratio and Hemorrhagic Transformation After Intravenous Thrombolysis in Acute Ischemic Stroke Patients","authors":"Haoran Ma, Hong Li, Xinyi Fu, Chenchen Wei, Aijun Ma","doi":"10.1002/brb3.71140","DOIUrl":"10.1002/brb3.71140","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hemorrhagic transformation (HT) is a critical complication following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS). Emerging evidence indicates thyroid homeostasis’ potential role in cerebrovascular outcomes, with the free triiodothyronine to free thyroxine (FT3/FT4) ratio demonstrating superior predictive value over isolated thyroid hormone measurements. This observational study works on elucidating the relation between pre-treatment FT3/FT4 ratios and post-thrombolytic HT occurrence in AIS populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>The research consecutively enrolled AIS patients receiving IVT therapy between January 2020 and August 2024. Clinical information from patients was gathered, and to examine the link between the FT3/FT4 ratio and post-IVT HT, we performed both multivariate and univariate logistic regression analyses. The optimal cutoff value was identified through the ROC curve analysis. The relation between clinical outcomes in HT patients and the FT3/FT4 ratio was further assessed using correlation analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>A cohort of 251 patients with AIS was recruited; among them, 46 patients experienced HT following IVT. Multivariate regression analysis presented a notable correlation between the FT3/FT4 ratio and the occurrence of HT, with an OR of 0.444 [95% CI 0.209−0.946, <i>p</i> = 0.035]. The area under the ROC curve (AUC) of the FT3/FT4 ratio for discriminating HT from non-HT was 0.774 (95% CI 0.695−0.853, <i>p</i> < 0.001), with an optimal cutoff value of 0.211. Correlation analysis demonstrated that FT3/FT4 levels were negatively related to baseline NIHSS score (<i>r</i> = −0.317, <i>p</i> = 0.032), In patients with HT, the NIHSS score at 24 h following thrombolysis (<i>r</i> = −0.367, <i>p</i> = 0.012) and the mRS score at 3 months post-onset (<i>r</i> = −0.394, <i>p</i> = 0.007) demonstrated significant correlations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>In patients with AIS, lower FT3/FT4 levels were found to be a potential predictive marker for HT. Nevertheless, no association was observed between FT3/FT4 levels and HT types. Moreover, lower FT3/FT4 levels were indicative of poorer clinical outcomes in HT patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 12","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12710526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145766627","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}

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