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Probing Neurophysiological Processes Related to Self-Referential Processing to Predict Improvement for Depressed Adolescents Receiving Cognitive Behavioral Therapy. 探究与自我暗示处理相关的神经生理过程,预测接受认知行为疗法的抑郁青少年的病情改善情况。
Pub Date : 2024-11-02 DOI: 10.1016/j.bpsc.2024.10.010
Nayoung Kim, Paul A Bloom, Anthony J Rosellini, Christian A Webb, Diego A Pizzagalli, Randy P Auerbach

Background: Cognitive Behavior Therapy (CBT) is a gold standard approach for treating major depressive disorder (MDD) among adolescents. However, nearly half of adolescents receiving CBT do not improve. In order to personalize treatment, it is essential to identify objective markers that predict treatment responsiveness. Toward addressing this aim, this study investigated neurophysiological processes related to self-referential processing that predicted CBT response among depressed, female adolescents.

Methods: At baseline, female adolescents ages 13-18-years-old (N=80) completed a comprehensive clinical assessment, and a self-referential encoding task was administered while electroencephalogram (EEG) data were recorded. Baseline EEG data were utilized to identify oscillatory differences between healthy (HC, n=38) and depressed (MDD, n=42) adolescents. Following the baseline assessment, depressed youth received up to 12-weeks of CBT. Baseline differences in EEG oscillations between healthy and depressed youth were used to guide CBT prediction analysis. Cluster-based event-related spectral perturbation analysis (ERSP) probed theta and alpha event-related synchronization/desynchronization (ERS/ERD) response to negative and positive words.

Results: Baseline analyses showed that, relative to the healthy adolescents, depressed youth exhibited higher levels of frontal theta ERS and a greater posterior alpha ERD. Multilevel modeling identified primary neural pre-treatment predictors of treatment response: greater theta ERS in the right prefrontal cortex (PFC) after the onset of negative words and lower alpha ERD in both the right PFC and posterior cingulate cortex (PCC). ERS and ERD associations with treatment response remained significant, with baseline depressive and anxiety symptoms included as covariates in all analyses.

Conclusions: Consistent with prior research, results highlighted that relative to healthy youth, depressed adolescents are characterized by prominent theta synchronization and alpha desynchronization over PFC and PCC, respectively. Cluster-based ERSP analysis also identified key mechanisms underlying depression-related self-referential processing that predicted improved symptoms during the CBT course. Ultimately, a better characterization of the neural underpinnings of adolescent depression and its treatment may lead to more personalized interventions.

背景:认知行为疗法(CBT)是治疗青少年重度抑郁障碍(MDD)的金标准方法。然而,近一半的青少年在接受 CBT 治疗后病情并未得到改善。为了实现个性化治疗,必须确定预测治疗反应的客观指标。为实现这一目标,本研究调查了与自我参照处理相关的神经生理过程,这些过程可预测抑郁女性青少年的 CBT 反应:基线时,13-18 岁的女性青少年(人数=80)完成了一项全面的临床评估,并在记录脑电图(EEG)数据的同时执行了一项自我参照编码任务。基线脑电图数据用于识别健康青少年(HC,38 人)和抑郁青少年(MDD,42 人)之间的振荡差异。基线评估后,抑郁青少年接受了长达 12 周的 CBT 治疗。健康和抑郁青少年脑电图振荡的基线差异被用来指导 CBT 预测分析。基于聚类的事件相关频谱扰动分析(ERSP)探测了θ和α事件相关同步/不同步(ERS/ERD)对消极和积极词语的反应:基线分析表明,与健康青少年相比,抑郁青少年表现出更高水平的额叶θ ERS和更高的后部α ERD。多层次建模确定了治疗前预测治疗反应的主要神经因素:在消极词语出现后,右侧前额叶皮层(PFC)的θ ERS更高,右侧前额叶皮层和后扣带回皮层(PCC)的α ERD更低。在将基线抑郁症状和焦虑症状作为协变量纳入所有分析的情况下,ERS和ERD与治疗反应的关系仍然显著:与之前的研究一致,研究结果表明,与健康青少年相比,抑郁青少年的前脑皮层(PFC)和后脑皮层(PCC)分别具有突出的θ同步性和α非同步性。基于ERSP的聚类分析还确定了与抑郁相关的自我参照处理的关键机制,这些机制可预测CBT治疗过程中症状的改善。最终,对青少年抑郁症及其治疗的神经基础进行更好的描述,可能会带来更多个性化的干预措施。
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引用次数: 0
Maternal Immune Activation and Child Brain Development: A Longitudinal Population-based Multimodal Neuroimaging study. 母亲免疫激活与儿童大脑发育:基于人群的多模态神经影像学纵向研究
Pub Date : 2024-11-02 DOI: 10.1016/j.bpsc.2024.10.013
Anna Suleri, Tonya White, Lot de Witte, Frederieke Gigase, Charlotte A M Cecil, Vincent W V Jaddoe, Michael Breen, Manon H J Hillegers, Ryan L Muetzel, Veerle Bergink

Background: Maternal Immune Activation (MIA) has been hypothesized to have an adverse effect on child neurodevelopment, but only a few neuroimaging studies have been performed to date, mostly in neonates. In this population-based cohort study, we investigated the association between MIA and multiple neuroimaging modalities depicting brain development from childhood to adolescence.

Methods: We used data of mother-child pairs from the Generation R Study. To define our exposure, we measured IL-1β, IL-6, IL-17a, IL-23 and IFN-γ, and CRP at two time points during pregnancy. Given that levels of these 5 cytokines were highly correlated, we were able to compute a Cytokine index. We used multiple brain imaging modalities as outcomes, encompassing global and regional measures of brain morphology (structural MRI, volume, n=3,295), white matter microstructure (diffusion MRI, FA and MD, n=3,267), and functional connectivity (functional MRI, graph theory measures and network-level connectivity, n=2,914) at child mean ages 10 and 14 years. We performed mixed-effects models using the child's age as continuous time variable.

Results: We found no significant association or time interaction between MIA and any neuroimaging outcomes in children over time. These associations were similar for the Cytokine index, CRP, and individual cytokines. We observed no evidence for differential effects of timing of prenatal MIA or child sex after multiple testing correction.

Conclusions: This longitudinal population-based study reports no evidence for an association between MIA and child brain development in the general population. Our findings differ from prior research in neonates showing structural and functional brain abnormalities after MIA.

背景:母体免疫激活(MIA)被认为会对儿童的神经发育产生不良影响,但迄今为止仅开展了少数几项神经影像学研究,其中大部分是针对新生儿的。在这项基于人群的队列研究中,我们调查了 MIA 与描述儿童至青少年时期大脑发育的多种神经影像模式之间的关联:我们使用了 R 世代研究中的母子对数据。为了确定我们的暴露,我们在怀孕期间的两个时间点测量了IL-1β、IL-6、IL-17a、IL-23和IFN-γ以及CRP。鉴于这五种细胞因子的水平高度相关,我们可以计算出细胞因子指数。我们使用了多种脑成像模式作为研究结果,包括在儿童平均 10 岁和 14 岁时对大脑形态(结构磁共振成像,体积,n=3,295)、白质微结构(扩散磁共振成像,FA 和 MD,n=3,267)和功能连接(功能磁共振成像,图论测量和网络级连接,n=2,914)的整体和区域测量。我们使用儿童年龄作为连续时间变量,建立了混合效应模型:结果:我们发现,随着时间的推移,MIA 与儿童的任何神经影像结果之间都没有明显的关联或时间交互作用。细胞因子指数、CRP 和单个细胞因子也存在类似的关联。经过多重检验校正后,我们没有观察到产前 MIA 时间或儿童性别的不同影响:这项以人群为基础的纵向研究没有发现 MIA 与普通人群中儿童大脑发育有关的证据。我们的研究结果与之前对新生儿进行的研究不同,这些新生儿在经历 MIA 后会出现大脑结构和功能异常。
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引用次数: 0
Challenges and Frontiers in Computational Metabolic Psychiatry. 计算代谢精神病学的挑战与前沿。
Pub Date : 2024-10-29 DOI: 10.1016/j.bpsc.2024.10.011
Anthony G Chesebro, Botond B Antal, Corey Weistuch, Lilianne R Mujica-Parodi

One of the primary challenges in metabolic psychiatry is that the disrupted brain functions that underlie psychiatric conditions arise from a complex set of downstream and feedback processes spanning across multiple spatiotemporal scales. Importantly, the same circuit can have multiple points of failure, each of which results in a different type of dysregulation, and thus elicits distinct cascades downstream that produce divergent signs and symptoms. Here, we illustrate this challenge by examining how subtle differences in circuit perturbations can lead to divergent clinical outcomes. We also discuss how computational models can perform the spatially heterogenous integration and bridge in vitro and in vivo paradigms. By leveraging recent methodological advances and tools, computational models can integrate relevant processes across scales (e.g., TCA-cycle, ion channel, neural microassembly, whole-brain macro-circuit) and across physiological systems (e.g., neural, endocrine, immune, vascular), providing a framework that can unite these mechanistic processes in a manner that goes beyond the conceptual and descriptive, to the quantitative and generative. These hold the potential to sharpen our intuitions towards circuit-based models for personalized diagnostics and treatment.

代谢精神病学面临的主要挑战之一是,导致精神疾病的大脑功能紊乱源于一系列复杂的下游和反馈过程,这些过程跨越多个时空尺度。重要的是,同一回路可能存在多个故障点,每个故障点都会导致不同类型的失调,从而引发不同的下游级联,产生不同的体征和症状。在这里,我们通过研究电路扰动的细微差别如何导致不同的临床结果来说明这一挑战。我们还讨论了计算模型如何进行空间异质整合,并在体外和体内范例之间架起桥梁。通过利用最新的方法学进展和工具,计算模型可以整合跨尺度(如 TCA 循环、离子通道、神经微组装、全脑宏电路)和跨生理系统(如神经、内分泌、免疫、血管)的相关过程,提供一个框架,以超越概念和描述的方式将这些机理过程结合起来,并进行定量和生成。这些都有可能使我们的直觉更加敏锐,从而建立基于电路的个性化诊断和治疗模型。
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引用次数: 0
Closed-Loop Systems and Real-Time Neurofeedback in Mindfulness Meditation Research. 正念冥想研究中的闭环系统和实时神经反馈。
Pub Date : 2024-10-29 DOI: 10.1016/j.bpsc.2024.10.012
Joseph Cc Chen, David A Ziegler

Mindfulness meditation has numerous purported benefits to psychological wellbeing, however, problems such as adherence to mindfulness tasks, quality of mindfulness sessions, or dosage of mindfulness interventions may hinder individuals from accessing the purported benefits of mindfulness. Methodologies including closed-loop systems and real-time neurofeedback may provide tools to help bolster success in mindfulness task performance, titrate the exposure to mindfulness interventions, or improve engagement with mindfulness sessions. This review explores the use of closed-loop systems and real-time neurofeedback to influence, augment, or promote mindfulness interventions. Various closed-loop neurofeedback signals from functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) have been used to provide subjective correlates to mindfulness states including: fMRI region-of-interest based signals (e.g., posterior cingulate cortex), fMRI network-based signals (e.g., default mode network, central executive network, salience network), and EEG spectral-based signals (e.g., alpha, theta, and gamma bands). Past research has focused on how successful interventions has aligned with the subjective mindfulness meditation experience. Future research may pivot towards using appropriate control conditions (e.g., mindfulness-only or sham-neurofeedback) to quantify the effects of closed-loop systems and neurofeedback-guided mindfulness meditation in improving cognition and wellbeing.

正念冥想据称对心理健康有诸多益处,然而,正念任务的坚持性、正念课程的质量或正念干预的剂量等问题可能会阻碍人们获得正念所带来的益处。包括闭环系统和实时神经反馈在内的方法可以提供一些工具,帮助提高正念任务的成功率、调整正念干预的剂量或提高正念课程的参与度。本综述探讨了如何利用闭环系统和实时神经反馈来影响、增强或促进正念干预。来自功能磁共振成像(fMRI)和脑电图(EEG)的各种闭环神经反馈信号已被用于提供正念状态的主观相关性,包括:基于兴趣区域的fMRI信号(如后扣带回皮层)、基于fMRI网络的信号(如默认模式网络、中央执行网络、显著性网络)和基于频谱的EEG信号(如α、θ和γ波段)。过去的研究侧重于成功的干预措施如何与主观正念冥想体验相一致。未来的研究可能会转向使用适当的对照条件(例如,仅正念或假神经反馈)来量化闭环系统和神经反馈引导的正念冥想在改善认知和健康方面的效果。
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引用次数: 0
Preserved Spontaneous Mentalizing amid Reduced Intersubject Variability in Autism during a Movie Narrative. 自闭症患者在电影叙事过程中的自发心智化保持不变,同时降低了受试者间的变异性。
Pub Date : 2024-10-26 DOI: 10.1016/j.bpsc.2024.10.007
Margot Mangnus, Saskia B J Koch, Kexin Cai, Miriam Greidanus Romaneli, Peter Hagoort, Jana Bašnáková, Arjen Stolk

Background: While individuals with autism often face challenges in everyday social interactions, they may demonstrate proficiency in structured Theory of Mind (ToM) tasks that assess their ability to infer others' mental states. Using functional MRI and pupillometry, we investigated whether these discrepancies stem from diminished spontaneous mentalizing or broader difficulties in unstructured contexts.

Methods: Fifty-two adults diagnosed with autism and 52 neurotypical controls viewed 'Partly Cloudy', a nonverbal animated film with a dynamic social narrative known to engage the ToM brain network during specific scenes. Analysis focused on comparing brain and pupil responses to these ToM events. Additionally, dynamic intersubject correlations explored the variability of these responses throughout the film.

Results: Both groups showed similar brain and pupil responses to ToM events and provided comparable descriptions of the characters' mental states. However, participants with autism exhibited significantly stronger correlations in their responses across the film's social narrative, indicating reduced inter-individual variability. This distinct pattern emerged well before any ToM events and involved brain regions beyond the ToM network.

Conclusions: Our findings provide functional evidence of spontaneous mentalizing in autism, demonstrating this capacity in a context affording but not requiring mentalizing. Rather than responses to ToM events, a novel neurocognitive signature - inter-individual variability in brain and pupil responses to evolving social narratives - differentiated neurotypical individuals from those with autism. These results suggest that idiosyncratic narrative processing in unstructured settings, a common element of everyday social interactions, may offer a more sensitive scenario for understanding the autistic mind.

背景:虽然自闭症患者在日常社会交往中经常面临挑战,但他们在评估其推断他人心理状态的能力的结构化心智理论(ToM)任务中却能表现得游刃有余。我们使用功能性核磁共振成像和瞳孔测量法研究了这些差异是源于自发心智化的减弱,还是源于非结构化情境中更广泛的困难:52名被诊断患有自闭症的成年人和52名神经典型对照者观看了《多云》(Partly Cloudy),这是一部非语言动画电影,具有动态的社会叙事,已知在特定场景中会调动ToM大脑网络。分析的重点是比较大脑和瞳孔对这些 ToM 事件的反应。此外,受试者之间的动态相关性还探讨了这些反应在整部影片中的可变性:结果:两组受试者对 ToM 事件的大脑和瞳孔反应相似,对人物精神状态的描述也相当。然而,自闭症参与者的反应在整个影片的社会叙事中表现出明显更强的相关性,这表明个体间的变异性降低了。这种独特的模式出现在任何ToM事件之前,并涉及ToM网络以外的大脑区域:我们的研究结果为自闭症患者的自发心智化提供了功能性证据,证明了自闭症患者在能够但不需要心智化的情境中具有这种能力。一种新的神经认知特征--大脑和瞳孔对不断演变的社会叙事的反应的个体间差异性--而不是对ToM事件的反应,将神经畸形个体与自闭症患者区分开来。这些结果表明,非结构化环境中的特异性叙事处理是日常社交互动的常见元素,它可能为理解自闭症患者的心理提供了一个更敏感的场景。
{"title":"Preserved Spontaneous Mentalizing amid Reduced Intersubject Variability in Autism during a Movie Narrative.","authors":"Margot Mangnus, Saskia B J Koch, Kexin Cai, Miriam Greidanus Romaneli, Peter Hagoort, Jana Bašnáková, Arjen Stolk","doi":"10.1016/j.bpsc.2024.10.007","DOIUrl":"https://doi.org/10.1016/j.bpsc.2024.10.007","url":null,"abstract":"<p><strong>Background: </strong>While individuals with autism often face challenges in everyday social interactions, they may demonstrate proficiency in structured Theory of Mind (ToM) tasks that assess their ability to infer others' mental states. Using functional MRI and pupillometry, we investigated whether these discrepancies stem from diminished spontaneous mentalizing or broader difficulties in unstructured contexts.</p><p><strong>Methods: </strong>Fifty-two adults diagnosed with autism and 52 neurotypical controls viewed 'Partly Cloudy', a nonverbal animated film with a dynamic social narrative known to engage the ToM brain network during specific scenes. Analysis focused on comparing brain and pupil responses to these ToM events. Additionally, dynamic intersubject correlations explored the variability of these responses throughout the film.</p><p><strong>Results: </strong>Both groups showed similar brain and pupil responses to ToM events and provided comparable descriptions of the characters' mental states. However, participants with autism exhibited significantly stronger correlations in their responses across the film's social narrative, indicating reduced inter-individual variability. This distinct pattern emerged well before any ToM events and involved brain regions beyond the ToM network.</p><p><strong>Conclusions: </strong>Our findings provide functional evidence of spontaneous mentalizing in autism, demonstrating this capacity in a context affording but not requiring mentalizing. Rather than responses to ToM events, a novel neurocognitive signature - inter-individual variability in brain and pupil responses to evolving social narratives - differentiated neurotypical individuals from those with autism. These results suggest that idiosyncratic narrative processing in unstructured settings, a common element of everyday social interactions, may offer a more sensitive scenario for understanding the autistic mind.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. Cognitive neuroscience and neuroimaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional brain connectivity predictors of prospective substance use initiation and their environmental correlates. 未来开始使用药物的大脑功能连接预测因素及其环境相关性。
Pub Date : 2024-10-25 DOI: 10.1016/j.bpsc.2024.10.002
Omid Kardan, Alexander Weigard, Lora Cope, Meghan Martz, Mike Angstadt, Katherine L McCurry, Cleanthis Michael, Jillian Hardee, Luke W Hyde, Chandra Sripada, Mary M Heitzeg

Background: Early substance use initiation (SUI) places youth at substantially higher risk for later substance use disorders. Furthermore, adolescence is a critical period for the maturation of brain networks, the pace and magnitude of which are susceptible to environmental influences and may shape risk for SUI.

Methods: We examined whether patterns of functional brain connectivity during rest (rsFC), measured longitudinally in pre-and-early adolescence, can predict future SUI. Next, in an independent sub-sample, we tested whether these patterns are associated with earlier environmental exposures, specifically neighborhood pollution and socioeconomic dimensions. We utilized data from the Adolescent Brain Cognitive Development (ABCD) Study®. SUI was defined as first-time use of at least one full dose of alcohol, nicotine, cannabis, or other drugs. We created a control group (N = 228) of participants without SUI who were matched with the SUI group (N = 233) on age, sex, race/ethnicity, and parental income and education.

Results: Multivariate analysis showed that whole-brain rsFC from 9-10 to 11-12 years of age (prior to SUI) prospectively differentiated the SUI and control groups. The SUI-related rsFC pattern was also related to aging in both groups, suggesting a pattern of accelerated maturation in the years prior to SUI. This same pattern of rsFC was predicted by higher pollution, but not neighborhood disadvantage (adjusted for family socioeconomic factors) in an independent sub-sample (N = 2,854).

Conclusion: Brain functional connectivity patterns in early adolescence that are linked to accelerated maturation can predict SUI in youth and are associated with exposure to pollution.

背景:过早开始使用药物(SUI)会大大增加青少年日后出现药物使用障碍的风险。此外,青春期是大脑网络成熟的关键时期,而大脑网络成熟的速度和程度很容易受到环境的影响,并可能决定青少年罹患药物滥用症的风险:我们研究了在青春期前期和早期纵向测量的静息时大脑功能连接(rsFC)模式是否能预测未来的 SUI。接下来,我们在一个独立的子样本中测试了这些模式是否与早期的环境暴露有关,特别是邻里污染和社会经济因素。我们利用了青少年脑认知发展研究(ABCD)® 的数据。SUI 被定义为首次使用至少一次全剂量酒精、尼古丁、大麻或其他药物。我们设立了一个对照组(N = 228),由没有 SUI 的参与者组成,他们与 SUI 组(N = 233)在年龄、性别、种族/民族、父母收入和教育程度方面相匹配:多变量分析表明,从 9-10 岁到 11-12 岁(SUI 之前)的全脑 rsFC 可对 SUI 组和对照组进行前瞻性区分。与 SUI 相关的 rsFC 模式也与两组人的年龄增长有关,这表明在 SUI 之前的几年中,人的成熟速度加快。在一个独立的子样本(N = 2,854)中,污染程度越高,但邻里关系越差(根据家庭社会经济因素调整),也能预测出同样的rsFC模式:结论:与加速成熟有关的青春期早期大脑功能连接模式可以预测青少年的 SUI,并且与暴露于污染有关。
{"title":"Functional brain connectivity predictors of prospective substance use initiation and their environmental correlates.","authors":"Omid Kardan, Alexander Weigard, Lora Cope, Meghan Martz, Mike Angstadt, Katherine L McCurry, Cleanthis Michael, Jillian Hardee, Luke W Hyde, Chandra Sripada, Mary M Heitzeg","doi":"10.1016/j.bpsc.2024.10.002","DOIUrl":"10.1016/j.bpsc.2024.10.002","url":null,"abstract":"<p><strong>Background: </strong>Early substance use initiation (SUI) places youth at substantially higher risk for later substance use disorders. Furthermore, adolescence is a critical period for the maturation of brain networks, the pace and magnitude of which are susceptible to environmental influences and may shape risk for SUI.</p><p><strong>Methods: </strong>We examined whether patterns of functional brain connectivity during rest (rsFC), measured longitudinally in pre-and-early adolescence, can predict future SUI. Next, in an independent sub-sample, we tested whether these patterns are associated with earlier environmental exposures, specifically neighborhood pollution and socioeconomic dimensions. We utilized data from the Adolescent Brain Cognitive Development (ABCD) Study®. SUI was defined as first-time use of at least one full dose of alcohol, nicotine, cannabis, or other drugs. We created a control group (N = 228) of participants without SUI who were matched with the SUI group (N = 233) on age, sex, race/ethnicity, and parental income and education.</p><p><strong>Results: </strong>Multivariate analysis showed that whole-brain rsFC from 9-10 to 11-12 years of age (prior to SUI) prospectively differentiated the SUI and control groups. The SUI-related rsFC pattern was also related to aging in both groups, suggesting a pattern of accelerated maturation in the years prior to SUI. This same pattern of rsFC was predicted by higher pollution, but not neighborhood disadvantage (adjusted for family socioeconomic factors) in an independent sub-sample (N = 2,854).</p><p><strong>Conclusion: </strong>Brain functional connectivity patterns in early adolescence that are linked to accelerated maturation can predict SUI in youth and are associated with exposure to pollution.</p>","PeriodicalId":93900,"journal":{"name":"Biological psychiatry. Cognitive neuroscience and neuroimaging","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Functional Connectivity Between Glutamate Receptor Antagonism and Insulin Pathways: Implications for Modeling Mechanism of Action of Ketamine/Esketamine and Dextromethorphan in Depression Treatment. 谷氨酸受体拮抗与胰岛素通路之间的功能连接:氯胺酮/艾司他敏和右美沙芬在抑郁症治疗中的作用机制建模意义。
Pub Date : 2024-10-24 DOI: 10.1016/j.bpsc.2024.10.004
Sabrina Wong, Gia Han Le, Rodrigo B Mansur, Joshua D Rosenblat, Roger S McIntyre
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引用次数: 0
Antipsychotic-induced dysregulation of glucose metabolism through the central nervous system: a scoping review of animal models. 抗精神病药物通过中枢神经系统诱发的葡萄糖代谢失调:动物模型范围综述。
Pub Date : 2024-10-24 DOI: 10.1016/j.bpsc.2024.10.001
Emily Au, Kristoffer J Panganiban, Sally Wu, Kira Sun, Bailey Humber, Gary Remington, Sri Mahavir Agarwal, Adria Giacca, Sandra Pereira, Margaret Hahn

The use of antipsychotic drugs is associated with adverse metabolic effects. Disruptions in glucose metabolism such as hyperglycemia and insulin resistance have been shown to occur with antipsychotic use, independent of changes in body weight or adiposity. The regulation of whole-body glucose metabolism is partly mediated by the central nervous system (CNS). In particular, the hypothalamus and brainstem are responsive to peripheral energy signals and subsequently mediate feedback mechanisms to maintain peripheral glucose homeostasis. In this scoping review of preclinical in vivo studies, we aimed to explore central mechanisms through which antipsychotics dysregulate glucose metabolism. A systematic search for animal studies identified 29 studies that met our eligibility criteria for qualitative synthesis. The studies suggest that antipsychotic-induced changes in autonomic nervous system activity, certain neurotransmitter systems, expression of neuropeptides, and central insulin action mediate impairments in glucose metabolism. These findings provide insight into potential targets for the mitigation of the adverse effects of antipsychotics on glucose metabolism.

使用抗精神病药物会对新陈代谢产生不良影响。事实证明,使用抗精神病药物会导致糖代谢紊乱,如高血糖和胰岛素抵抗,与体重或脂肪的变化无关。全身葡萄糖代谢的调节部分由中枢神经系统(CNS)介导。特别是,下丘脑和脑干对外周能量信号做出反应,随后介导反馈机制以维持外周葡萄糖平衡。在这项临床前体内研究的范围综述中,我们旨在探索抗精神病药物导致葡萄糖代谢失调的中枢机制。通过对动物研究的系统检索,我们发现有 29 项研究符合定性综述的资格标准。这些研究表明,抗精神病药物诱导的自律神经系统活动、某些神经递质系统、神经肽表达和中枢胰岛素作用的变化介导了葡萄糖代谢障碍。这些发现为减轻抗精神病药物对糖代谢的不良影响提供了潜在的靶点。
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引用次数: 0
Reward neurocircuitry predicts longitudinal changes in alcohol use following trauma exposure. 奖赏神经回路可预测遭受创伤后酒精使用的纵向变化。
Pub Date : 2024-10-08 DOI: 10.1016/j.bpsc.2024.09.015
Cecilia A Hinojosa, Sanne J H van Rooij, Negar Fani, Robyn A Ellis, Nathaniel G Harnett, Lauren A M Lebois, Timothy D Ely, Tanja Jovanovic, Vishnu P Murty, Stacey L House, Francesca L Beaudoin, Xinming An, Thomas C Neylan, Gari D Clifford, Sarah D Linnstaedt, Laura T Germine, Scott L Rauch, John P Haran, Alan B Storrow, Christopher Lewandowski, Paul I Musey, Phyllis L Hendry, Sophia Sheikh, Christopher W Jones, Brittany E Punches, Lauren A Hudak, Jose L Pascual, Mark J Seamon, Erica Harris, Claire Pearson, David A Peak, Roland C Merchant, Robert M Domeier, Niels K Rathlev, Brian J O'Neil, Paulina Sergot, Steven E Bruce, Diego A Pizzagalli, John F Sheridan, Steven E Harte, Karestan C Koenen, Ronald C Kessler, Samuel A McLean, Kerry J Ressler, Jennifer S Stevens

Background: Trauma is a risk factor for developing maladaptive alcohol use. Preclinical research has shown that stress alters the processing of midbrain and striatal reward and incentive signals. However, little research has been conducted on alterations in reward-related neurocircuitry post-trauma in humans. Neuroimaging markers may be particularly useful as they can provide insight into the mechanisms that may make an individual vulnerable to developing trauma-related psychopathologies. This study aimed to identify reward-related neural correlates associated with changes in alcohol use after trauma exposure.

Methods: Participants were recruited from U.S. emergency departments for the AURORA study (N=286, 178 female). Trauma-related change in alcohol use at 8 weeks post-trauma relative to pre-trauma was quantified as a change in 30-day total drinking per the PhenX Toolkit Alcohol 30-Day Quantity and Frequency Measure. Reward-related neurocircuitry activation and functional connectivity (FC) were assessed 2 weeks post-trauma using fMRI during a monetary reward task using region of interest and whole-brain voxelwise analyses.

Results: Greater increase in alcohol use from pre-trauma to 8 weeks post-trauma was predicted by (1) greater ventral tegmental area (VTA) and (2) greater cerebellum activation during Gain>Loss trials measured 2 weeks post-trauma and (3) greater seed-based FC between the VTA and lateral occipital cortex and precuneus.

Conclusions: Altered VTA activation and FC early post-trauma may be associated with reward-seeking and processing, contributing to greater alcohol use post-trauma. These data provide novel evidence of neural correlates that underlie increased alcohol use early post-trauma that may be targeted via early interventions to prevent the development of maladaptive alcohol use.

背景:精神创伤是酗酒的一个危险因素。临床前研究表明,压力会改变中脑和纹状体奖赏和激励信号的处理。然而,有关人类创伤后奖赏相关神经回路改变的研究却很少。神经影像标记可能特别有用,因为它们可以让人们深入了解可能使人容易患上创伤相关精神病理学的机制。本研究旨在确定与创伤后饮酒变化相关的奖赏相关神经相关性:AURORA研究从美国急诊科招募参与者(286人,178名女性)。根据PhenX工具包酒精30天数量和频率测量法,创伤后8周与创伤前相比,与创伤相关的饮酒变化被量化为30天总饮酒量的变化。利用感兴趣区和全脑体素分析,在金钱奖励任务中使用fMRI对创伤后2周与奖励相关的神经回路激活和功能连接(FC)进行评估:结果:从创伤前到创伤后8周,酒精使用量的增加主要是通过以下因素预测的:(1)创伤后2周测量的腹侧被盖区(VTA)增加;(2)在 "得">"失 "试验中小脑激活增加;(3)VTA与外侧枕叶皮层和楔前皮层之间基于种子的FC增加:结论:创伤后早期VTA激活和FC的改变可能与奖赏寻求和处理有关,从而导致创伤后更多的酒精使用。这些数据为创伤后早期酒精使用增加的神经相关性提供了新的证据,可以通过早期干预来预防适应不良的酒精使用。
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引用次数: 0
Elevated extracellular free water in the brain predicts clinical improvement in first-episode psychosis. 大脑细胞外游离水的升高可预测首发精神病的临床改善。
Pub Date : 2024-10-07 DOI: 10.1016/j.bpsc.2024.09.014
Tyler A Lesh, Daniel Bergé, Jason Smucny, Joyce Guo, Cameron S Carter

Background: Despite the diverse nature of clinical trajectories after a first-episode of psychosis, few baseline characteristics have been predictive of clinical improvement, and the neurobiological underpinnings of this heterogeneity remain largely unknown. Elevated extracellular free water (FW) in the brain is a diffusion imaging measure that has been consistently reported in different phases of psychosis that may indicate a neuroinflammatory state. Its predictive capacity in terms of clinical outcomes, however, is unknown.

Methods: We used diffusion imaging to determine FW and tissue-specific fractional anisotropy (FA-t) in first-episode psychosis. Forty-seven participants were categorized as clinical "Improvers" (n=26) if they achieved a 20% decrease in total Brief Psychiatric Rating Scale (BPRS) score at 12 months. To determine the predictive capacity of FW and FA-t, these measures were introduced in a stepwise logistic regression model to predict clinical improvement. For those measures surviving the model, regional between-group differences were also investigated in cortical surface or white matter tracts as applicable.

Results: Higher gray matter (GM) FW (OR-CI 1.134 - 2.543) and FA-t (OR-CI: 0.905 - 2.038) both predicted Improver status. FW in GM also linearly correlated with BPRS total score at 12 months follow-up. Examining regional specificity, Improvers showed greater FW predominantly in temporal regions and higher FA-t values in several white matter tracts, including bilateral longitudinal superior fasciculus.

Conclusions: Our results show that elevated FW in GM and FA-t predict further clinical improvement during the initial phases of psychosis. The potential roles of brain inflammatory processes in predicting clinical improvement are discussed.

背景:尽管精神病首次发作后的临床轨迹多种多样,但很少有基线特征能预测临床症状的改善,而且这种异质性的神经生物学基础在很大程度上仍不为人所知。大脑中细胞外自由水(FW)的升高是一种弥散成像测量指标,在精神病的不同阶段均有报道,可能预示着神经炎症状态。然而,它对临床结果的预测能力尚不清楚:我们使用弥散成像技术测定了首发精神病患者的FW和组织特异性分数各向异性(FA-t)。如果47名参与者在12个月时简明精神病评定量表(BPRS)总分下降了20%,则被归类为临床 "改善者"(26人)。为了确定 FW 和 FA-t 的预测能力,在逐步逻辑回归模型中引入了这些指标来预测临床改善情况。对于那些在模型中存活的指标,还根据情况调查了皮质表面或白质束的区域组间差异:较高的灰质(GM)FW(OR-CI:1.134 - 2.543)和FA-t(OR-CI:0.905 - 2.038)均可预测病情改善情况。在 12 个月的随访中,GM 的 FW 与 BPRS 总分也呈线性相关。从区域特异性来看,改善者主要在颞区显示出更高的FW,而在包括双侧纵上筋束在内的多个白质束中显示出更高的FA-t值:我们的研究结果表明,在精神病的初始阶段,GM 和 FA-t 的 FW 值升高可预测临床症状的进一步改善。我们还讨论了脑部炎症过程在预测临床改善方面的潜在作用。
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Biological psychiatry. Cognitive neuroscience and neuroimaging
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