Brain Sciences最新文献

Objective: Electroconvulsive therapy (ECT) is utilized for treating psychiatric disorders, such as schizophrenia (SCZ), major depressive disorder (MDD), and bipolar disorder (BD). We aimed to compare pre- and post-ECT treatment outcomes between patients with SCZ and a combined group of patients with MDD and BD (MDD+BD) to assess the distinction between the antipsychotic and antidepressant effects of ECT.

Methods: ECT was administered to patients with SCZ (n = 17) and those with MDD+BD (n = 7). Symptoms were evaluated using the brief psychiatric rating scale (BPRS), clinical global impression scale (CGI), and global assessment of functioning (GAF). Plasma brain-derived neurotrophic factor (BDNF) levels were also measured.

Results: The BPRS, CGI, and GAF scores significantly differed after ECT compared with those before ECT in each patient group. However, no significant differences were observed between the groups for each disorder. No significant differences were observed in plasma BDNF levels between the groups at baseline and during ECT. At baseline, only depression scores were more favorable in the SCZ group, whereas positive symptoms and disorganization scores were higher in the MDD+BD group. During treatment, positive symptoms, activation, and disorganization items were significantly more favorable in the MDD+BD group compared with the SCZ group. Total BPRS scores were not associated with plasma BDNF levels; however, rating scores of the several items related to activation, resistance, and disorganization were positively correlated with BDNF levels.

Conclusion: ECT effects on several clinical outcomes in the MDD+BD group were associated with plasma BDNF levels. These findings suggest that ECT may be more effective for treating MDD than SCZ.

Objectives: The purpose of this study was to assess the efficacy of a pain neuroscience education program completed by patients with shoulder pain. Methods: A randomized, controlled trial was performed. Fifty-five patients satisfied the eligibility criteria, agreed to participate, and were randomized into an experimental group (n = 27) or control group (n = 28). A manual therapy and exercises program was administered for both groups. The experimental group also received a 4-week pain neuroscience education protocol (1 session/week, 75 min per session). The measurements taken included the active range of motion, pain, disability, catastrophizing, kinesiophobia, and therapeutic alliance. The outcomes were assessed at baseline and 5 weeks after completion of treatment. The primary outcome analyzed was the group × time interaction. Results: The 2 × 2 analysis of variance revealed a significant group × time interaction for the active range of motion (F = 15.27; p = 0.011), disability (F = 6.14; p = 0.01), catastrophizing (F = 8.79; p = 0.01), kinesiophobia (F = 7.62; p = 0.008), and therapeutic alliance (p = 0.03) in favor of the experimental group. Conclusions: This study showed that the patients with shoulder pain who completed the pain neuroscience program achieved significantly better results in terms of their active range of motion, disability, catastrophizing, kinesiophobia, and therapeutic alliance compared to those achieved by the control group. Therefore, pain neuroscience education may be beneficial in the treatment of patients with shoulder pain.

Background/objectives: Guidelines for the diagnosis of children with disorder of consciousness (DoC) in pediatric age have not been defined yet. Assessment tools designed for adults have generally not been standardized for pediatrics, which could lead to misdiagnosis due to the limited behavioral repertoire of children. This study aims at examining the basic psychometric properties of the Italian Coma Recovery Scale for Pediatrics (CRS-P) in typically developing children.

Methods: A total of 64 typically developing children aged 3 months to 5:7 years were administered the CRS-P. Performance was examined across the age range, and for the two behaviors indicating emergence to a conscious state, namely functional object use (FOU) and functional communication (FC).

Results: Inter-rater reliability ranged from 0.95 to 1 for subscale and total scores. All children aged ≥34 months scored at the CRS-P ceiling. All children ≥ 14 months met the criteria for FOU and all children ≥ 34 months met those for FC. Children as early as 3 months of age displayed behaviors discriminating between vegetative state (VS) and minimally conscious state (MCS) in the Visual and Motor subscales. Language-based behaviors of MCS in other subscales were consistently displayed by older children.

Conclusions: Typically developing children met the criteria for all items of the Italian CRS-P by 34 months, which suggests caution in adopting the scale at a younger age. However, the features of the distinct stages of DoC could be captured earlier, based on the various subscales. Modifications should be made to some items to improve diagnostic accuracy.

Background: In current clinical practice, resources remain limited and are insufficient to address the needs of people with chronic post-stroke aphasia. To improve access to speech therapy, self-administered therapies using computers or smart tablets are increasingly recommended. In addition to enabling more intensive and prolonged treatment, computer- and smart-tablet-delivered therapies can be highly enjoyable and motivating for patients.

Aims: This systematic review aimed to identify computer- and smart-tablet-based self-administered treatments and analyze the proposed interventions in terms of treatment targets, effectiveness (considering specificity, generalization, transfer, and maintenance), and clinician involvement (during and/or prior self-administered therapies).

Methods: Terms encompassing three main concepts (rehabilitation, self-administration, and aphasia) were used to search three electronic databases (Scopus, PubMed, and PsycINFO). Two reviewers independently screened titles and abstracts against eligibility criteria. Data extraction of included studies was completed by three reviewers.

Results: Thirty-nine studies were included in this study. In terms of treatment targets, anomia is the most treated symptom in published studies (n = 24), but the existence of promising studies for other disorders means that the targets can be broadened. Therapies are effective for trained items, and gains are maintained. There is some evidence of transfer effects for treatments targeting the sentence level. Most studies offer training sessions, previous self-administered therapy, and/or observation and monitoring sessions during therapy; more rarely, self-administered therapy is supplemented with face-to-face therapy.

Conclusions: This systematic review is the first to focus specifically on self-administered technology-based therapies. It provides important evidence-based information for clinical practice in self-administered therapies via computer or smart tablet.

Background/objectives: The cortical auditory evoked potential P1 response is a biomarker of cortical auditory maturation for tracking longitudinal cortical maturation in children with hearing loss after treatment with hearing aids and/or cochlear implants. In conjunction with hearing treatments, children with hearing loss commonly receive language therapy services. However, the effect of language therapy on cortical maturation in hearing loss is less well studied.

Methods: This study explored auditory cortical maturation changes, using the P1 response, with coinciding language changes, utilizing the Preschool Language Scales test, following approximately six months of supplemental listening and spoken language therapy services in 39 children with hearing aids or cochlear implants.

Results: Following supplemental language therapy, P1 latencies significantly decreased in all children, at a rate found to be significantly faster than expected for typical maturation. Language scores also significantly improved beyond expected maturation effects and were correlated with P1 latencies following supplemental therapy. Overall, with approximately six months of therapy, the children in this study made significantly greater gains of 9 to 10 months in total language and expressive communication. A subgroup analysis revealed that children with cochlear implants showed significantly lower language scores than their chronological age following supplemental therapy, while children with hearing aids obtained language scores that were not significantly different to their chronological age at follow-up.

Conclusions: Overall, the results from this study showed that supplemental language therapy resulted in more typical auditory cortical maturation and improved language abilities and that the P1 CAEP response can objectively track neuroplastic changes in children as a function of language therapy provided in conjunction with hearing aids and CIs.

Background/Objectives: The incidence of mood disorders in adolescents is increasing. Bipolar disorder is often misdiagnosed in the early stages of the disease due to the prevalence of depressive symptoms, while manic episodes occur later. Identifying predictors of diagnosis conversion could facilitate timely and appropriate treatment. Our study aimed to find correlations of selected peripheral protein levels with temperament and character traits in adolescents diagnosed with major depressive disorder and bipolar disorder. Methods: A group of adolescents and young adults diagnosed with major depressive disorder (MDD, n = 50) or bipolar disorder (BD, n = 24) was enrolled in the study during the exacerbation of symptoms and followed up over two years. Diagnosis conversion from MDD to BD was monitored. The Temperament and Character Inventory was applied, and BDNF, proBDNF, EGF, MIF, SCF, S100B, TNF-alpha, and IL-8 serum levels were measured. Spearman's rank correlation analysis was conducted. Results: We found different patterns of correlations in MDD (TNF-alpha, IL-8, EGF, S100B with reward-dependence, self-directedness, and empathy) and BD (BDNF and EGF with persistence novelty-seeking and self-transcendence). Significant correlations were found in a group with diagnosis conversion. Conclusions: The findings of our study have the potential to significantly impact our understanding and treatment of mood disorders. Correlations obtained in the subgroup with diagnosis conversion may contribute to the development of prognostic markers in the future. Evaluating temperament and character traits alongside established biomarkers may offer a valuable method for predicting the conversion of mood disorders in adolescents, facilitating early and effective pharmacotherapy.

Background/objectives: Functional seizures (FSs) are paroxysmal, time-limited events with motor, sensory, autonomic, or cognitive manifestations related to pathophysiological processes other than abnormal electric discharges in the brain. However, these seizures are often followed by different psychiatric comorbidities. Their impact on the overall quality of life and the cofounding factors, especially the ones that can be treated, were the main investigation aims of this study.

Methods: This study comprised 76 patients who were diagnosed with FSs. This study included patients who were diagnosed with FSs via video-EEG telemetry. We used the "Likert scale" from the QOLIE 31 questionnaire to evaluate patients' subjective perception of their quality of life. We researched the association of various clinical factors with the subjective QoL score.

Results: A statistically significant marginal association was shown for seven variables, four of them with a positive association (subjective perception of disease severity, belief in treatments' positive effects, functional seizure cessation, and not being afraid of next seizure) and three of them with a negative association (age at FS onset, depression symptoms, and current age of life). After Bonferroni correction for multiple testing only symptoms of depression stayed statistically significantly associated with outcome. Multivariable logistic regression following variable selection identified that six variables (age at FS onset, absence of psychiatric testing, perceiving oneself as mentally changed due to the disease, seizure severity, depressive symptoms, and fear of therapy side effects) were statistically significantly negatively associated with the outcome.

Conclusions: It seems that patients who have FSs coexisting with depressive symptoms and also those with worse disease perception have less chances to be satisfied with their overall quality of life.

Background: Ouabain is a steroid hormone that binds to the sodium pump (Na⁺, K⁺-ATPase) at physiological (nanomolar) concentrations, activating different signaling pathways. This interaction has been shown to prevent the axotomy-induced death of retinal ganglion cells (RGCs), although the underlying mechanisms remain unclear. Objective: In this study, we investigated potential mechanisms by which ouabain promotes RGC survival using primary cultures of rat neural retina. Results: Our findings indicate that ouabain regulates brain-derived neurotrophic factor (BDNF) signaling in retinal cells via matrix metalloproteinase-9-mediated processing of proBDNF to mature BDNF (mBDNF) and by increasing the phosphorylation of the mBDNF receptor, tropomyosin-related receptor kinase B. Ouabain also enhances the maturation of interleukin (IL)-1β through the increased activation of caspase-1, which mediates the processing of proIL-1β into IL-1β, and transiently upregulates both IL-1 receptor and IL-1 receptor antagonist (IL-1Ra). Treatment using either IL-1β or IL-1Ra alone is sufficient to enhance RGC survival similarly to that achieved with ouabain. Finally, we further show that ouabain prevents RGC death through a complex signaling mechanism shared by BDNF and IL-1β, which includes the activation of the Src and protein kinase C pathways. Conclusions: Collectively, these results suggest that ouabain stimulates the maturation and signaling of both BDNF and IL-1β, which act as key mediators of RGC survival.

Introduction: Parkinson's disease (PD) is characterized by motor and cognitive impairments that often manifest as distinct motor subtypes: Postural Instability Gait Difficulty (PIGD) and Tremor-Dominant (TD). Motor-cognitive interference, especially under dual-task (DT) walking conditions, may vary by subtype, providing insights into specific impairments. This study explored DT interference effects in PD subtypes, focusing on the potential impact of self-reported physical activity, which may help mitigate subtype-specific impairments and improve motor-cognitive function. Methods: PD patients classified as PIGD or TD and healthy controls completed single-task (ST) and DT walking assessments involving different cognitive tasks (Serial Subtraction, Auditory Stroop, and Clock Task). Physical activity levels were evaluated using the CHAMPS questionnaire, analyzing the self-reported frequency and duration of weekly exercise-related activities. Results: Interference effects were significantly different between PD patients and controls, with the PIGD group showing greater motor impairment under high cognitive load, primarily affecting gait, than the TD and control groups. Performance differences between groups diminished as cognitive load increased. Self-reported physical activity does not significantly moderate motor performance under DT conditions, suggesting that activity levels in this sample are insufficient to offset motor-cognitive interference. However, like group affiliation, physical activity directly influences motor performance during DT conditions, indicating that both factors independently impact motor-cognitive function in PD. Discussion: These findings suggest that DT assessments help differentiate PD motor subtypes, as group differences were minimal in ST conditions. While physical activity is associated with general improvements in motor ST and DT performance in PD and controls, the lack of a significant moderating effect from self-reported exercise-related physical activity indicates that current activity levels may not be high enough to counter motor-cognitive interference. More intensive or DT-specific exercise may be required to reduce interference effects. Future research should examine the role of structured physical activity programs, potentially incorporating DT training, to evaluate their impact on motor-cognitive interference in PD.

Background: Psychedelics are increasingly recognized as a promising and innovative treatment strategy for several mental disorders. However, there is still a lively controversy in the medical community as regards the rationale of their employment, specifically their indications and potential dangers. Methods: A comprehensive literature search on "MEDLINE/PubMed" and "Web of Science" was performed from inception to 26 June 2024, cross-checking the obtained references. We included all studies, i.e., both clinical and preclinical, that supplied original data. Results: We initially obtained a total of 1083 entries, 813 from MEDLINE/PubMed and 270 from Web of Science. After duplicate elimination, 903 underwent systematic literature selection. Primary abstract screening yielded a total of 572 candidates for eligibility assessment and excluded 331 entries on formal grounds. Eligibility assessment led to the exclusion of 501 titles. Finally, a total of 70 articles were included in this review. Discussion: Preclinical evidence from genetic expression, histology and behavioral studies is soundly consistent with psychedelics possessing neuroplasticity-inducing properties. Despite methodological difficulties, clinical evidence seems to be inferentially in agreement with preclinical findings. However, it is still unclear whether the "neuroplastic boost" induced by classic psychedelics might be dissociable from the psychodysleptic effects, thereby reducing the psychopathological hazards implied by these compounds. Moreover, the fact that the so-called "relaxation of priors" should be unconditionally beneficial appears debatable, and further research should clarify the possible indications and contraindications of psychedelic psychoplastogens within a precision medicine perspective.