Hasil untuk "Neurosciences. Biological psychiatry. Neuropsychiatry"

M. Notaras, M. van den Buuse

Giulia Binarelli, Florence Joly, François Christy et al.

Abstract Background This feasibility study evaluated adherence and effectiveness to a digital multimodal intervention (cognitive and physical training) for cancer-related cognitive impairment (CRCI) in patients with breast cancer. Methods Breast cancer patients undergoing radiotherapy and with significant cognitive complaints impacting quality of life participated in a 12-week intervention, combining non-simultaneous 20-min cognitive and 30-min physical sessions, twice weekly. Assessments included perceived cognitive impairment (PCI), objective cognition, fatigue, anxiety/depression, sleep and satisfaction. High level of adherence was defined as completing 9/12 weeks of the program. A week was complete when at least 70% of each of the planned sessions was completed. Physical activity intensity was defined by max age-related heart rate. Results Among 419 radiotherapy-treated patients with breast cancer, 170 had cognitive complaints (41%), 83 were eligible (49%), 29 were not included (35%) due to organizational issue and 20 among eligible contacted patients agreed to participate (37%). The majority of participants (48.3 ± 8 years of age) received chemotherapy (18/20) and 17 had I-II cancer stage. Eleven of twenty participants were highly adherent (higher adherence in physical (95%) than cognitive training (55%)). All expressed satisfaction. Post-intervention, overall objective cognition (p = 0.016), PCI (p = 0.004), fatigue (p = 0.011), and depression (p = 0.049) significantly improved. Post-intervention, high adherence was associated with significant improvements in PCI (p = 0.01) and fatigue (p = 0.03). High-intensity physical training was associated with significant improvements in PCI (p < 0.05), fatigue (p = 0.011) and depression (p = 0.037). Conclusions This intervention showed to be feasible and potentially efficient for the management of CRCI in patients with breast cancer. Trial registration NCT04213365, 27/12/2019.

Rachel L. Smith, Stephen J. Sawiak, L. Dorfschmidt et al.

Understanding how early life experiences shape brain network development is a key challenge in the neuroscience of mental health disorders. To address this, we used magnetic resonance imaging (MRI) similarity network analysis to study the effects of stress in the rat, an important animal model in neuropsychiatry. We measured magnetization transfer ratio (MTR) at each of 53 distinct cortical areas and estimated a cortical similarity network for each individual scan, in two independent experimental datasets. We first characterized normative network development in rats scanned repeatedly between postnatal days 20 (weanling) and 290 (mid-adulthood) (N=47), and then contrasted these findings with a cohort exposed to early life stress in the form of repeated maternal separation (RMS, N=40). The normative rat cortical similarity network exhibited biologically meaningful organization, aligning with prior cytoarchitectonic and tract-tracing data, and displayed complex topological features, including rich club organization. During postnatal and adolescent development, brain regions became more similar, including an early phase of fronto-hippocampal convergence. Early increases in inter-areal similarity were reversed in a later phase of fronto-hippocampal divergence in mid-adulthood. RMS exposure altered inter-areal similarity, especially between frontal and parahippocampal regions, that were also most active developmentally and in aging. Our results reveal how normative cortical network changes in the developing brain are influenced by early life stress. These findings suggest a new translational framework for elucidating how environmental risk factors lead to atypical development of cortical networks.

A. V. Kalueff, M. M. Kotova, D. Galstyan et al.

The zebrafish (Danio rerio) is a small freshwater teleost fish species that is increasingly utilized in biomedical research, particularly in neuroscience and biological psychiatry. Currently, zebrafish is the second-most utilized model organism in biomedicine globally, after mice, based on the number of animals tested each year. The model’s significance results from its experimental ease of use, affordability, conservation of fish physiology, relatively high genetic homology with humans (70%), rapid development, and potential for high-throughput bioscreening of drugs and genetic mutations. Over the past 15 years, our laboratory has conducted extensive experimental work to establish the principles behind using zebrafish to study various brain pathologies, including acute and chronic stress, anxiety, and depression, as well as probing their molecular mechanisms. In addition, existing behavioral models to study the central nervous system (CNS) development and new data on the zebrafish’s critical role in memory research were reviewed. Furthermore, this study will illustrate the effectiveness of integrating zebrafish models with advanced biological research techniques, such as molecular biology, bioinformatics, omics technologies, and chemical biology methods. For example, adult zebrafish experiencing chronic stress exhibit behavioral affective syndromes along with changes in neurochemistry, specifically in the metabolism of serotonin and dopamine in the telencephalon. Moreover, alterations in the expression of genes regulating neurotransmitter receptors, glial biomarkers, cytoskeleton, and pro- and anti-inflammatory cytokines, occur in the brain. In particular, we will focus on neuroimmune and epigenetic mechanisms of CNS pathogenesis in zebrafish models, including changes in the expression of apoptotic genes in the brain. Additionally, our own findings on using artificial intelligence (AI) systems to study zebrafish behavior after administering various neurotropic drugs, such as anxiolytics, antidepressants, psychostimulants, and hallucinogens will be presented. In general, zebrafish is a strategic and promising model organism for translational neuroscience research, creating new models of CNS pathogenesis and finding new drugs to treat various human brain diseases. Studies of CNS pathogenesis in zebrafish are critical because of their evolutionary conservatism and ease of laboratory application, revealing novel brain disease biomarkers and potential remediation targets. Meanwhile, certain distinctive aspects of the biology and neurophysiology of zebrafish facilitate the resolution of supplementary experimental issues, thereby enhancing data and discoveries attained in typical animal models using rodents.

M. Carmona-Abellan, R. Del Pino, A. Murueta-Goyena et al.

Background and objective: Multiple system atrophy is a rare and fatal neurodegenerative disorder, characterized by autonomic dysfunction in association with either parkinsonism or cerebellar signs. The pathologic hallmark is the presence of alpha-synuclein aggregates in oligodendrocytes, forming glial cytoplasmic inclusions. Clinically, it may be difficult to distinguish form other parkinsonisms or ataxias, particularly in the early stages of the disease. In this case series we aim to describe in detail the features of MSA patients. Material and methods: Unified MSA Rating Scale (UMSARS) score, structural and functional imaging and cardiovascular autonomic testing, are summarized since early stages of the disease. Results: UMSARS proved to be useful to perform a follow-up being longitudinal examination essential to stratify risk of poor outcome. Neuropathological diagnosis showed an overlap between parkinsonian and cerebellar subtypes, with some peculiarities that could help to distinguish from other subtypes. Conclusion: A better description of MSA features with standardized test confirmed by means of neuropathological studies could help to increase sensitivity. Resumen: Antecedentes y objetivo: La atrofia multisistémica es un trastorno neurodegenerativo raro y letal que se caracteriza por una disfunción autonómica en asociación con parkinsonismo o signos cerebelosos. La marca anatomopatológica es la presencia de agregados de α-sinucleína en los oligodendrocitos, que forman inclusiones citoplasmáticas gliales. Desde un punto de vista clínico, puede ser difícil de distinguir de otros parkinsonismos o ataxias, particularmente en las primeras etapas de la enfermedad. En esta serie de casos, nuestro objetivo es describir en detalle las características de los pacientes con atrofia multisistémica. Material y métodos: Se resumen los datos objetidos de la puntuación de la Escala de calificación unificada de la atrofia multisistémica (UMSARS), imágenes estructurales y funcionales y las pruebas autonómicas cardiovasculares realizadas desde las primeras etapas de la enfermedad. Resultados: La escala UMSAR demostró ser útil para hacer un seguimiento: el examen longitudinal esencial fue para estratificar el riesgo de peor evolución. El diagnóstico neuropatológico mostró un solapamiento entre los subtipos parkinsoniano y cerebeloso, con algunas peculiaridades que podrían ayudar a distinguir los subtipos. Conclusión: Una mejor descripción de las características de la atrofia multisistémica en casos confirmados mediante neuropatología podría ayudar a aumentar la sensibilidad del diagnóstico.

Michael Ortiz-Rios, Beshoy Agayby, Fabien Balezeau et al.

Developing optogenetic methods for research in non-human primates (NHP) is important for translational neuroscience and for delineating brain function with unprecedented specificity. Here we assess, in macaque monkeys, the selectivity by which optogenetic stimulation of the primary visual cortex (V1) drives the local laminar and widespread cortical connectivity related to visual perception. Towards this end, we transfected neurons with light-sensitive channelrhodopsin in dorsal V1. fMRI revealed that optogenetic stimulation of V1 using blue light at 40 Hz increased functional activity in the visual association cortex, including areas V2/V3, V4, motion-sensitive area MT and frontal eye fields, although nonspecific heating and eye movement contributions to this effect could not be ruled out. Neurophysiology and immunohistochemistry analyses confirmed optogenetic modulation of spiking activity and opsin expression with the strongest expression in layer 4-B in V1. Stimulating this pathway during a perceptual decision task effectively elicited a phosphene percept in the receptive field of the stimulated neurons in one monkey. Taken together, our findings demonstrate the great potential of optogenetic methods to drive the large-scale cortical circuits of the primate brain with high functional and spatial specificity.

Yane Chaves, Fernanda Crunfli, Livea Godoy et al.

M. Minzenberg

“Who among us.” doesn’t mind rejection? Feeling social rejection or exclusion is painful and distressing, especially when it is dispatched by someone we depend on. In the current issue of Biological Psychiatry: Cognitive Neuroscience and Neuroimaging, Fertuck et al. (1) suggest that the psychological significance of social rejection can be situated in the wider context of Maslow’s Theory of the Hierarchy of Needs (2). This enduring psychological model posits 4 fundamental social needs that motivate the range of human behavior: belonging, self-esteem, control, and meaningful existence. Social exclusion is seen as a direct threat to these needs, often leading to the subjective experience of rejection distress. In moderation, this distress can be considered adaptive, as it signals to those important others that the social bond needs affirmation or repair. Indeed, overt expressions of distress and behavioral consequences in response to ruptures of the social bond are readily observed in most highly social mammals [dog lovers see (3)]. When humans experience this response in an unstable manner, however, as noted below, considerable hazardous behavior can ensue, in ways that can be hard to predict and even harder to mitigate, and this is one of our greatest concerns as clinicians. We have learned in the modern era of cognitive neuroscience that responses to social rejection relate to the brain’s sensitive detection that things are not right, that what we have received from our environment has not matched our goals. Thus, regions in the medial frontal cortex relating to social rejection light up (as revealed during functional magnetic resonance imaging) as they do when we make errors, have expectations violated, or feel somatic pain (4,5). Luckily, much of the time (surely not always) the brakes get applied automatically; the brain’s tendency for operating homeostasis kicks in, allowing us to subvocalize “I can deal with this,” and we (or our observers) experience that as emotion regulation. Unfortunately for some of us, the experience of rejection has a destabilizing, chaos-generating effect, and this can lead to trouble for both ourselves and those around us. And if rejection-related trouble is a regular feature of one’s psychological functioning, that individual may receive a psychiatric diagnosis of borderline personality disorder (BPD). As Fertuck et al. (1) note, for persons with BPD, this can often lead to high-risk urges and behaviors, including self-harm, suicide attempts, and completed suicide (7). These responses to rejection are a hallmark of BPD as much as any other clinical feature, and yet we have had only a foggy idea about how this happens in the brain.

Tim Nicholson

Tim Nicholson is a Reader in Neuropsychiatry at the Institute of Psychiatry Psychology & Neuroscience (IoPPN), King’s College London where he leads the Neuropsychiatry Research and Education Group. He is an Honorary Consultant Neuropsychiatrist at the South London and Maudsley NHS Foundation Trust and King’s College Hospital NHS Foundation Trust where he currently runs a Long COVID clinic focusing on neuropsychiatric complications. His clinical work and research covers the full spectrum of neuropsychiatry, but with a particular interest in Functional Neurological Disorder (FND) and immunopsychiatry. More recently he has focused on both the acute and chronic neuropsychiatric sequelae of COVID-19 including leading the psychiatry reporting system of the Coronerve surveillance study, the neuropsychiatry working group of the COVID-CNS project and the PC-COS study developing a Core Outcome Set for Long COVID. At the start of the pandemic he set up a weekly JNNP blog to rapidly collate and summarise the rapidly emerging data on the neuropsychiatric complications of COVID that has developed into Neuropsychiatry.net – a dynamic and expanding group of clinicians and scientists of all levels and backgrounds interested in neuropsychiatry research and education specialising in online distributed teamwork producing large and high impact systematic reviews and meta-analyses as well as increasing education activities such as a trainee led online journal club. He also has a particular interest in psychopharmacology and wrote 6 editions of the practical prescribing guide Pocket Prescriber. He co-edits the specialist version of this book (Pocket Prescriber Psychiatry, Rogers et al) produced in collaboration with the British Association of Psychopharmacology, the 2nd edition of which is scheduled to be published later this year. He is on the executive committee of the RCPsych Neuropsychiatry Faculty, the BNPA, Chair of the MSc in Clinical Neuropsychiatry at the IoPPN and a council member of the Fellowship of Postgraduate Medicine. Abstract A wide range of complex sensorimotor features are a common yet relatively overlooked aspect of autistic spectrum disorders (ASD). Most clinical and research attention is understandably on social and cognitive function in ASD. I will give an overview of what we know about these sensorimotor features in terms of the range of clinical features and the potential mechanisms underlying them. I will argue that these features deserve more research attention which could not only lead to a greater understanding and better management of the full range of distressing and disabling symptoms experienced by people with ASD, but also potentially provide insights into both broader brain function and dysfunction and the aetiology and management of disorders with which ASD may overlap and/or commonly co-occur with including functional as well as organic disorders.

Chenchao Liu, Chenchao Liu, Chenchao Liu et al.

ObjectiveThis study aimed to analyze the cerebrospinal fluid (CSF) parameters affecting the outcomes of patients with tuberculous meningitis (TBM).MethodsThis is a multi-center, retrospective, cohort study involving 81 patients who were diagnosed with TBM and treated in Haihe Clinical College of Tianjin Medical University, Tianjin Medical University General Hospital, and General Hospital of Air Force PLA from January 2016 to December 2019. Baseline data, Glasgow Coma Scale (GCS) score, and clinical presentations of all patients were collected at admission. CSF samples were collected at 48 h, 1, 2, and 3 weeks after admission. CSF lactate, adenosine deaminase, chloride, protein, glucose levels and intracranial pressure were measured. After a follow-up of 16.14 ± 3.03 months, all patients were assessed using the modified Rankin Scale (mRS) and divided into good (mRS scores of 0–2 points) and poor outcome groups (mRS scores of 3–6 points). The differences in patients' baseline data, GCS score, clinical presentations, and levels of CSF parameters detected at 48 h, 1, 2, and 3 weeks after admission between two groups were compared. Statistically significant variables were added to the binary logistic regression model to identify the factors impacting the outcomes of patients with TBM. Receiver operating characteristic (ROC) curve was used to assess the predictive ability of the model.ResultsThe CSF lactate level exhibited a decreasing trend within 3 weeks of admission in the two groups. For the within-group comparison, statistically significant differences in the lactate level was found in both groups between four different time points. A binary logistic regression model revealed that CSF lactate level at 48 h after admission, age, and GSC score on admission were independently associated with the outcomes of patients with TBM. ROC curve analysis showed that the area under the ROC curve (AUC) was 0.786 for the CSF lactate level (48 h), 0.814 for GCS score, and 0.764 for age.ConclusionHigh CSF lactate level at 48 h after admission is one of the important factors for poor outcomes in patients with TBM.

S. Irani, A. Nath, F. Zipp

The study of neuroinflammation provides an exciting opportunity to rapidly understand therapeutically amenable components of many illnesses embedded within the core practices of neurology and psychiatry. In addition to crucial therapeutic benefits, advances in understanding the immune basis of primary autoimmune conditions can present key aetiological and diagnostic insights. Recent advances have led to the growing appreciation for a role of the immune system in the pathogenesis of many other conditions, considered likely to have non-immune primary drivers (Fig. 1). These clinical arenas span neurodegenerative and neuro-infectious conditions in addition to neuro-oncology, neuropsychiatry, stroke and traumatic brain injury. In all these, potential immune contributions offer therapeutically tractable approaches. From a biological perspective, a more comprehensive understanding of clinically relevant neuroimmune interactions naturally segues into important basic questions about the anatomy and function of connections between the periphery and the CNS (Fig. 1), and the relative roles of immune system components in mediating these effects. While these questions should be studied in both health and disease, many observations arise most starkly when applying mechanisms of homeostasis in the context of pertinent diseases. Herein, we highlight eight top neuroinflammation publications in Brain between 2020 and 2021 and use these as a focal point to offer a vision of how anticipated developments in neuroinflammation are likely to impact our understanding of key elements of neurology, and lead to new treatments. In addition, this vision will provide a framework for a series of review articles to stimulate ideas and highlight some of the most exciting areas within this rapidly expanding, clinically relevant and highly translational field.

Ruiyu Yang, Qiongru Yu, Cassidy Elizabeth Owen et al.

Background: Childhood adverse experiences may come to bear particularly during adolescence, when neural reward systems are developing rapidly and psychopathology spikes. Despite prior work differentiating threat- (abuse) vs. deprivation- (neglect) related adversity, no research has yet identified their relative nor interactive contributions to reward neural substrates during adolescence. In the present study, we leveraged a diverse sample of adolescents with different childhood adversity profiles to examine neural responses to reward in relation to varying degrees of abuse vs. neglect. Methods: Adolescents (N = 45; 23 females; mean age = 14.9 years, SD = 1.9) completed a child-friendly monetary incentive delay task during fMRI acquisition. The self-report Childhood Trauma Questionnaire assessed childhood abuse and neglect. Whole brain ANCOVA analyses evaluated reward anticipation (reward vs. no reward expected) and feedback (hitting vs. missing the target with a reward vs. no reward) in relation to abuse and neglect dimensions. Results: Whole-brain analyses revealed that abuse, adjusted for neglect, is associated with greater differences between task conditions (reward vs. no reward, hit vs. miss) in regions associated with threat/emotion regulation (prefrontal and temporal cortices, as well as posterior regions including fusiform and posterior cingulate/precuneus). Additionally, level of neglect modulated neural response associated with abuse in prefrontal and temporoparietal regions, such that youths with high levels of both abuse and neglect showed qualitatively different, more exaggerated neural patterns compared to youths with elevated adversity in only one dimension. Conclusions: Our findings suggest that early experiences of abuse and neglect have a long developmental reach resulting in reward-related neural alterations in adolescence. Moreover, our results bolster theoretical conceptualizations of adversity along threat and deprivation dimensions and provide evidence that “adding up” adverse life events may not be sufficient to capture the qualitatively different neural profiles produced by differing combinations of types of adversity, which may in turn necessitate different treatment approaches.

O. Nikolaeva, E. Nikolaev, D. Hartfelder et al.

Introduction Depressive disorders are common for cardiac patients; however, a surgical intervention enhances their distress. How typical is suicidal ideation for cardiac surgery patients and with what clinical and psychological signs does it correlate? Objectives To estimate the frequency of suicidal ideation and correlations between suicidal ideation, clinical and psychological manifestations in cardiac surgery patients. Methods We examined 60 cardiac surgery patients, aged 25 – 65, prior to their operation. The Pierson correlation between manifestation of suicidal ideation, clinical and psychological signs was calculated with p<0.05. Results We revealed suicidal ideation in 3.33% of cardiac surgery patients. Its intensity credibly correlated with the frequency of taking alcohol (r=.32), as well as with manifestation of dysorexia (r=.59), dissatisfaction with life (r=.53), general level of depression (r=.49), sleeping disorders (r=.44), sense of guilt (r=.43), asthenia (r=.31), self-abhorrence (r=.29), and irritability(r=.29). A higher level of suicidal ideation correlated with a lower index of Positive-Past in their personal time perspective (r=-.27), which revealed itself in a patient having lack of positive impressions and recollections of their past life, which reduced a person’s adaptability in the present. Conclusions The frequency of suicidal ideation in preoperative cardiac surgery patients is not high. Nevertheless, we should bear in mind that high suicidal risk is characteristic for patients with not only depression, but also alcohol problems, as well as for those who have manifestations of negative attitude to their past. Disclosure No significant relationships.

Henna Haravuori, MD, PhD, Katinka Tuisku, MD, PhD, Katja Torkkola, RN et al.

Dissociative identity disorder’s origin is often traced back to early traumatization. This disorder is difficult to diagnose within a short appointment, and the patient may appear psychotic. We describe a patient case in which a threat of suicidal behaviour led to a further assessment in adolescent psychiatric services. A diagnosis of psychotic depression with traumatic experiences was suspected initially. The functioning of the patient remained relatively intact without treatment of psychosis. A thorough differential diagnostic study was performed due to unusual symptom presentation. The symptoms appearing psychotic were driven by communication between distinct personality states and by concerning memory gaps. Consequently, a diagnosis of dissociative identity disorder was made. The primary treatment recommendation for dissociative disorders that cause unexpected memory gaps or amnesia by expert consensus is psychotherapy. Amnesia can be frightening, and internal dialogue is difficult to explain to others. The goal of psychotherapeutic treatment is to integrate the distinct personality states or modes, to restore continuity in sense of self without memory gaps and to maintain functioning.

Chao Li, Chao Li, Ying Hou et al.

Background: Non-motor symptoms in PD usually arise at very early stage and vary during the whole disease progression. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD's motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown.Objective: The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with or without constipation and find potential factors which might influence the efficacy.Methods: A retrospective analysis of 65 PD patients accepted STN-DBS operation in Qilu Hospital during 2019–2020 were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses about the relationship between hyposmia and constipation were carried out. Analysis of flora in nasal mucosa was also conducted to evaluate the abundance and variety in different PD groups.Results: Our study showed that DBS had clearly improved olfactory function in Parkinson patients (P = 0.012) and subgroup analysis found that PD patients with constipation have lower olfactory function scores (25.27 ± 3.44 vs. 33.90 ± 6.633, p = 0.014) and worse improvement after DBS operation (ΔTDI 12.11 ± 3.2 vs. 8.78 ± 2.91, p = 0.0072). Analysis of flora indicated the obvious discrepancy on olfactory function scores and degree of improvement might be related to the abundance and dysbiosis of microbiota.Conclusion: In summary, this article presents a study on PD with hyposmia and constipation after DBS operation, explored the relationship between different NMS and offer a potential explanation on why PD patients with constipation usually have worse olfactory function for the less abundance and variety of microbiota.

M. Winz, O. Söderström

Epidemiological research in psychiatry has established robust evidence of the link between urban living and psychosis, but the situated experience of the city, as well as the precise ecology of psychosis remain largely unexplored. In this context, the aim of this paper is to discuss the productive potential of a ‘re-vitalized’ biosocial geographical thinking and researching on urban mental health. We do so through a methodological proposition. First, we discuss the need for a biosocial approach to the city/psychosis nexus and argue that a broader biological view, beyond epigenetics and neurosciences and a more precise investigation of ‘the social’ need to be developed. Second, a telling and recurring motto of recent reflections on biosocial processes is to understand how the environment or the social ‘gets under the skin’. We suggest examining a specific place in this pathway, the skin itself. This leads us to expose a methodology using electrodermal activity (EDA), combined with ethnographic observations and interviews, as a strategy for analysing ecological processes in psychosis. In doing so, we discuss the potential of ‘biosensory ethnographies’ in studies of urban mental health and more broadly as a biosocial approach to the geography of health.

Xin-yu WU, Xiao-chuan HOU, Yue BAO et al.

Objective To evaluate the value of Knosp classification and cavernous sinus zoning in the diagnosis of pituitary adenoma invasiveness and the significance of endoscopic transnasal surgery for pituitary adenomas. Methods There were 75 cases with pituitary adenomas of Knosp grade 3-4 (44 cases of Knosp grade 3 and 31 cases of Knosp grade 4) who were performed endoscopic transnasal surgery from July 2015 to June 2017 in our hospital. Based on coronal MRI of sellar region in patients with Knosp 3 pituitary adenomas, the ratio R of distance from the middle point of internal carotid artery (ICA) cavernous sinus segment to the upper part of anterior clinoid process segment and vertical distance from the furthest point of tumor invasion to the line was calculated and analyzed statistically. According to cavernous sinus zoning under endoscope and involvement of medial wall of cavernous sinus, patients with Knosp grade 3 pituitary adenomas were further divided into Knosp grade 3A (invasive and non-invasive) and 3B by invading different cavernous spaces. The total removal rate of tumor was reviewed by MRI in sellar region after operation. Results Among 75 cases, 36 were classified as Knosp grade 3A in 44 cases of Knosp grade 3 pituitary adenomas, including 12 cases of invasive pituitary adenomas (mainly involving posterior superior space of cavernous sinus and affecting oculomotor nerve) and 24 cases of non-invasive pituitary adenomas (the tumor pushed against the medial wall of cavernous sinus, presenting "pseudoinvasion"). The ratio R of invasive pituitary adenomas was significantly smaller than non-invasive pituitary adenomas (1.28 ± 0.18 vs. 1.74 ± 0.27; t = 5.275, P = 0.000). The Knosp grade 3A was divided into 2 groups according to the median value of ratio R: ≤ 1.59 group (17 cases) and > 1.59 group (19 cases). The invasion rate of ratio R ≤ 1.59 group was higher than that of > 1.59 group (12/17 vs. 0/19; Fisher's exact probability, P = 0.000). The total resection rate of 75 cases was 72% (54/75), among which the total resection rate of Knosp grade 3 was 84.09% (37/44), and rate of Knosp grade 4 was 54.84% (17/31). The average follow-up period was (14.84 ± 5.66) months, and no one case relapsed. Conclusions The calculation of ratio R in preoperative coronal MRI helps to evaluate the invasion degree of Knosp grade 3A pituitary adenomas. Combined with artificial division of cavernous sinus, it has guiding significance in endoscopic transnasal surgery for pituitary adenoma removal. DOI: 10.3969/j.issn.1672-6731.2019.03.006

Anja Goertz-Dorten, Anja Goertz-Dorten, Anja Goertz-Dorten et al.

Group-based child-centered cognitive behavioral therapy (CBT) for children with aggressive behavior has been found to significantly reduce child behavior problems. Nevertheless, most children suffer from residual symptoms at the end of treatment. Therefore, individualized interventions that treat the specific problem-maintaining factors and that use digital support may enhance treatment effects. However, enhanced computer-facilitated interventions have not been examined in clinical samples. Therefore, we tested the efficacy of an individualized computer-facilitated social skills training for children with clinically referred aggressive behavior problems. Fifty children aged 6–12 years with peer-related aggressive behavior problems were included in a within-subject design with two phases (waiting, treatment). The course of the outcome measures during an 8-week waiting phase was compared with that in the subsequent treatment phase (16 weekly child sessions and 2 parent psychoeducation contacts at the beginning of the treatment) using multilevel modeling. The primary outcome was peer-related aggressive behavior rated by parents. Further outcome measures included parent ratings and patient self-reports of aggressive and prosocial behavior. No significant changes occurred for any of the outcome variables during the waiting phase. During treatment, most parent-rated outcome measures (including the primary outcome measure) showed a significant decrease, which was stronger than changes in the waiting phase. Most self-rated outcome measures also showed significant decreases during treatment, but a stronger decrease than in the waiting phase was only found for peer-related aggressive behavior. The computer-facilitated social skills training appears to be an effective CBT intervention for children with peer-related aggressive behavior.

M. Keck, N. Kappelmann, J. Kopf-Beck

Mainak J. Patel

Two important stimulus features represented within the rodent barrel cortex are velocity and angular direction of whisker deflection. Each cortical barrel receives information from thalamocortical (TC) cells that relay information from a single whisker, and TC input is decoded by barrel regular-spiking (RS) cells through a feedforward inhibitory architecture (with inhibition delivered by cortical fast-spiking or FS cells). TC cells encode deflection velocity through population synchrony, while deflection direction is encoded through the distribution of spike counts across the TC population. Barrel RS cells encode both deflection direction and velocity with spike rate, and are divided into functional domains by direction preference. Following repetitive whisker stimulation, system adaptation causes a weakening of synaptic inputs to RS cells and diminishes RS cell spike responses, though evidence suggests that stimulus discrimination may improve following adaptation. In this work, I construct a model of the TC, FS, and RS cells comprising a single barrel system—the model incorporates realistic synaptic connectivity and dynamics and simulates both angular direction (through the spatial pattern of TC activation) and velocity (through synchrony of the TC population spikes) of a deflection of the primary whisker, and I use the model to examine direction and velocity selectivity of barrel RS cells before and after adaptation. I find that velocity and direction selectivity of individual RS cells (measured over multiple trials) sharpens following adaptation, but stimulus discrimination using a simple linear classifier by the RS population response during a single trial (a more biologically meaningful measure than single cell discrimination over multiple trials) exhibits strikingly different behavior—velocity discrimination is similar both before and after adaptation, while direction classification improves substantially following adaptation. This is the first model, to my knowledge, that simulates both whisker deflection velocity and angular direction and examines the ability of the RS population response to pinpoint both stimulus features within the context of adaptation.