BackgroundPost-traumatic stress symptoms （PTSS） is highly prevalent in adolescents who have experienced earthquake， which seriously threatens their physical and mental health， yet there is currently a lack of research on the effects of loneliness， social support and social media use on PTSS among post-earthquake adolescents.ObjectiveTo assess the PTSS among adolescents experiencing MS6.0 Luxian， Sichuan， earthquake on 16 September 2021， and to investigate the effects of loneliness， social support and social media use on PTSS， so as to provide references for the intervention of PTSS among post-earthquake adolescents.MethodsOn November 12， 2021， simple random sampling technique was used to select 2 522 post-earthquake adolescents in Luxian county of Luzhou city in Sichuan province. All subjects were assessed using Post-Traumatic Stress Disorder Checklist for DSM-5 （PCL-5）， Multidimensional Scale of Perceived Social Support （MSPSS）， Short-form UCLA Loneliness Scale （ULS-3） and Social Media Use Scale （SM-10）. Binary Logistic regression was used to determine the factors influencing PTSS among post-earthquake adolescents.ResultsPTSS was detected in 91 （3.61%） adolescents. Binary Logistic regression revealed that perceived social support from family members （OR=0.926， 95% CI： 0.879~0.976） was a protective factor for PTSS among post-earthquake adolescents. Lack of companionship （OR=1.764， 95% CI： 1.141~2.727）， feeling isolated （OR=2.037， 95% CI： 1.282~3.236）， and viewing negative emotional response of disaster victims through social media （OR=1.615， 95% CI： 1.291~2.020） were risk factors for PTSS among post-earthquake adolescents.ConclusionLack of companionship， feeling isolated， and viewing negative emotional response of disaster victims through social media pose a negative impact on PTSS among post-earthquake adolescents， while perceived social support from family members exert a positive impact on PTSS among post-earthquake adolescents. ［Funded by Humanity and Social Science Youth foundation of Ministry of Education of China （number， 22YJC190019）； Natural Science Foundation of Sichuan Province （number， 2023NSFSC1486）］
Martina Lucchesi, José Fernando Maya-Vetencourt, Dario Rusciano
Multisensory integration enables the brain to integrate information from different sensory modalities while enhancing perception. This principle relies on phenomena of neuroplasticity (i.e., the ability of neuronal networks in the brain to adapt to changing environmental conditions) and is crucial for visual rehabilitation, particularly in hemianopia and retinal degeneration. Here we review emerging experimental approaches and their translational potential for vision recovery in visually impaired patients. Rehabilitation strategies incorporating multisensory training, optogenetics, and pharmacological interventions have demonstrated to be instrumental in restoring visual function by leveraging plasticity of inputs from different sensory modalities. Emerging technologies such as virtual reality and auditory–visual stimulation further optimize neural reorganization. Future research should focus on refining these interventions to enhance sensory compensation and recovery. Understanding the role of multisensory ganglion cells and retinal circuits may unlock new strategies for improving visual function in visually impaired individuals.
Tatiane Muniz Barbosa, Brenda Cristina Albino, Luana Zytkoski Zanon
et al.
Introdução: A saúde compreendida por meio de um conceito ampliado contempla diferentes dimensões, dentre essas a saúde mental. Como a rotina dos estudantes de Medicina tende a ser marcada por estresse, ansiedade e outros sofrimentos emocionais, as escolas médicas oferecem serviço de apoio psicológico para assistir a saúde mental. Objetivo: Avaliar as percepções dos acadêmicos de medicina a respeito do serviço de apoio psicológico em uma Instituição de Ensino Superior do Sul do Brasil. Método: A pesquisa, quanti e qualitativa, deu-se pela aprovação do CEP, com aplicação de questionário para acadêmicos da 1ª a 8ª fase de um curso de medicina. Os dados foram organizados e tratados por meio de análise de conteúdo. Resultados: A maioria dos estudantes é do sexo feminino, jovens e solteiros. Entendem a saúde mental como um bom estado psicológico, sendo que boas relações interpessoais têm impactos positivos, enquanto que a sobrecarga nos estudos impacta negativamente. Dentre os que fizeram o uso do apoio psicológico, os principais motivos são dificuldades na vida acadêmica e relações pessoais. Não possuíam dificuldades de obter informações a respeito do serviço e se sentiram compreendidos. Porém, destacaram como obstáculos a fila de espera, a dificuldade na manutenção do atendimento e a falta de vínculo. Conclusão: A avaliação dos acadêmicos acerca do serviço de apoio psicológico foi positiva, mas levantam demandas para simplificação das etapas de acesso, o atendimento para além dos aspectos da vida acadêmica e o desenvolvimento de feedbacks que aumentem a satisfação dos resultados obtidos.
ObjectiveThe objective of this study was to determine the implementation, clinical barriers, and unmet needs of repetitive transcranial magnetic stimulation (rTMS) and neuro-navigation systems for stroke rehabilitation.DesignWe employed a nationwide survey via Google Forms (web and mobile) consisting of 36 questions across rTMS and neuro-navigation systems, focusing on their implementation, perceptions, and unmet needs in stroke recovery. The survey targeted physiatrists registered in the Korean Society for Neuro-rehabilitation and in rehabilitation hospitals in South Korea.ResultsOf 1,129 surveys distributed, 122 responses were analyzed. Most respondents acknowledged the effectiveness of rTMS in treating post-stroke impairments; however, they highlighted significant unmet needs in standardized treatment protocols, guidelines, education, device usability, and insurance coverage. Unmet needs for neuro-navigation were also identified; only 7.4% of respondents currently used such systems, despite acknowledging their potential to enhance treatment accuracy. Seventy percent of respondents identified lack of prescription coverage, time and errors in preparation, and device cost as barriers to clinical adoption of neuro-navigation systems.ConclusionDespite recognition of the potential of rTMS in stroke rehabilitation, there is a considerable gap between research evidence and clinical practice. Addressing these challenges, establishing standardized protocols, and advancing accessible neuro-navigation systems could significantly enhance the clinical application of rTMS, offering a more personalized, effective treatment modality for stroke recovery.
Abstract
The field of psychosomatics has experienced many waves of “celebrity” since its origin. Its historical origin is impossible to precisely locate in time, one may argue that medicine since its very beginning has been psychosomatic in nature. In very recent times, many clinicians and researchers even from different backgrounds than psychosomatic medicine or psychiatry have expressed disappointment and worry about the excessive fragmentation of medical sciences, providing evidence in support and advocating towards the so-called holistic approach and integrated care. The old lesson of psychosomatic medicine, then, appears more contemporary than ever. This is also because it has been able to stay coherent but at the same time integrate the enormous progresses in the understanding of physiology and pathophysiology that medical sciences have witnessed in the last decades.
The presentation will focus on the most striking scientific production of 2023 in the field of psychosomatics, to show the contributions in its three souls of research, training and clinical activities and to outline the stimulating though sometimes difficult dialogue between this area of behavioural sciences and the rest of psychiatry.
Disclosure of Interest
None Declared
Md Dilshad Manzar, Ahmad H. Alghadir, Masood Khan
et al.
PurposePoor sleep and cognitive deficits are often associated with increased drug use. However, no study has addressed the relationship between poor sleep, substance dependence, and metacognitive deficit in polysubstance users.MethodsThis was a cross-sectional study with a simple random sampling involving community-dwelling polysubstance users (n = 326, age = 18–43 years) in Mizan, Ethiopia. Participants completed a brief sleep questionnaire, severity of dependence on khat (SDS-Khat), a brief meta-cognition questionnaire, and a socio-demographic survey.ResultsMajority (56.4%) of the polysubstance users had sleep disturbance. Chronic health conditions [adjusted odds ratio (AOR) = 2.52, 95% confidence interval (CI) 1.31–4.85], chronic conditions in the family (AOR = 2.69, 95% CI 1.40–5.20), illiterate-primary level of educational status (AOR = 2.40, 95% CI 1.30–4.04), higher SDS-Khat score (AOR = 1.39, 95% CI 1.13–1.72), and lower meta-cognition score (AOR = 0.90, 95% CI 0.84–0.97) predicted poor sleep in the polysubstance users. Moreover, low metacognition score and high SDS score also predicted additional sleep disturbances like chronic sleep insufficiency, lethargy and restlessness after nighttime sleep, socio-occupational dysfunctions, and daytime disturbances in polysubstance users.ConclusionPoor sleep, severe khat dependence, and metacognitive deficits are common in community polysubstance users. Moreover, poor sleep is associated with higher khat dependence, lower metacognitive ability, lower educational status, and the presence of chronic conditions in polysubstance users or their families.
There has been much evidence demonstrating the involvement of oxidative stress in the pathology of neurological disorders. Moreover, the vulnerability of the central nervous system to reactive oxygen species mediated injury is well established since neurons consume large amounts of oxygen, the brain has many areas containing high iron content, and neuronal mitochondria generate large amounts of hydrogen peroxide. Furthermore, neuronal membranes are rich in polyunsaturated fatty acids, which are particularly susceptible to oxidative stress. Recently, the biological roles of products produced by lipid peroxidation have received much attention, not only for their pathological mechanisms associated with neurological disorders, but also for their practical clinical applications as biomarkers. Here, we discuss the production mechanisms of reactive oxygen species in some neurological disorders, including Alzheimer’s disease, Down syndrome, Parkinson’s disease, and stroke. We also describe lipid peroxidation biomarkers for evaluating oxidative stress.
Ligamentum flavum hematoma (LFH) is an extremely rare compressive epidural lesion of the spine. The clinical manifestations of LFH are similar to that caused by other more common pathologies of nerve root compression like disc herniation. In the diagnosis, magnetic resonance imaging (MRI) is very important but challenging due to the changing intensities of the hematoma in relation to the stages of the aging blood. Herein, we report a case of LFH compressing the spinal canal in a 60-year-old man with pars interarticularis defect. He presented with low back pain radiating to the left leg. The neurological examination was consistent with left S1 nerve root compression. The MRI revealed a left posterior epidural mass compressing the thecal sac and S1 nerve root at the left L5–S1 level near the pars interarticularis defect. After surgical removal of the lesion, histopathological examination confirmed the diagnosis of LFH. Following surgery, he recovered rapidly. LFH due to spinal instability is important in terms of the understanding of the pathophysiological mechanisms related with LFH.
Surgery, Neurology. Diseases of the nervous system
Veronika Vasilevska, Veronika Vasilevska, Paul C. Guest
et al.
Based on current implications of the SARS-CoV-2 pandemic with regards to mental health, we show that biological links exist between inflammation and mental illness in addition to psychoreactive effects. We describe key principles of the biological interaction of the immune system and the mind, as well as the possible routes of viral entry into the brain. In addition, we provide a stepwise scheme for the diagnosis and therapy of autoimmune-encephalitis with schizophrenia-like symptomatology as a general guide for clinical practice and in the specialized scenario of infections, such as those caused by the SARS-CoV-2 virus.
Ruri Okubo, Toshiki Hasegawa, Kouji Fukuyama
et al.
Several mood-stabilizing atypical antipsychotics and antidepressants weakly block serotonin (5-HT) receptor type-7 (5-HT7R); however, the contributions of 5-HT7R antagonism to clinical efficacy and pathophysiology are yet to be clarified. A novel mood-stabilizing antipsychotic agent, lurasidone exhibits predominant binding affinity to 5-HT7R when compared with other monoamine receptors. To date, we have failed to discover the superior clinical efficacy of lurasidone on schizophrenia, mood, or anxiety disorders when compared with conventional mood-stabilizing atypical antipsychotics; however, numerous preclinical findings have indicated the possible potential of 5-HT7R antagonism against several neuropsychiatric disorders, as well as the generation of novel therapeutic options that could not be expected with conventional atypical antipsychotics. Traditional experimental techniques, electrophysiology, and microdialysis have demonstrated that the effects of 5-HT receptor type-1A (5-HT1AR) and 5-HT7R on neurotransmission are in contrast, but the effect of 5-HT1AR is more predominant than that of 5-HT7R, resulting in an insufficient understanding of the 5-HT7R function in the field of psychopharmacology. Accumulating knowledge regarding the pharmacodynamic profiles of 5-HT7R suggests that 5-HT7R is one of the key players in the establishment and remodeling of neural development and cytoarchitecture during the early developmental stage to the mature brain, and dysfunction or modulation of 5-HT7R is linked to the pathogenesis/pathophysiology of neuropsychiatric and neurodevelopmental disorders. In this review, to explore candidate novel applications for the treatment of several neuropsychiatric disorders, including mood disorders, schizophrenia, and other cognitive disturbance disorders, we discuss perspectives of psychopharmacology regarding the effects of 5-HT7R antagonism on transmission and intracellular signaling systems, based on preclinical findings.
Rosa Molina, Alejandro Porras-Segovia, Marta Ruiz
et al.
Objective: Psychomotor abnormalities are relevant symptoms in the clinical presentation of schizophrenia, and assessing them could facilitate monitoring. New technologies can measure psychomotor activity objectively and continuously, but evidence on the topic is scarce. Our aim is to systematically review the existing evidence about eHealth tools for assessing psychomotor activity in patients diagnosed with schizophrenia. Method: We performed a systematic search of the PubMed and Embase databases and identified 15 relevant articles on eHealth tools for assessing psychomotor activity in schizophrenia. Results: eHealth devices accurately assessed psychomotor activity and were well accepted. Abnormalities in psychomotor activity helped differentiate between different subtypes of schizophrenia. Abnormal increases in psychomotor activity were correlated with acute presentations, while lower activity was associated with relapses, deterioration, and negative symptoms. Conclusion: Actigraphy is still the preferred eHealth device in research settings, but mobile applications have great potential. Further studies are needed to explore the possibilities of psychomotor monitoring and mobile health applications for preventing relapses in schizophrenia. eHealth could be useful for monitoring psychomotor activity, which might help prevent relapses.
El llamado posacuerdo y la búsqueda de la paz han generado una situación nacional conflictiva pero urgente, en la que es necesario pensar en formas, metodologías y políticas que permitan la inclusión social. Sin embargo, tales procesos, que no son decretados por mandato presidencial, hacen preciso que la sociedad reconozca a ese otro que emerge bajo el significante “excombatiente”, tarea harto difícil porque en su historia, de manera sistemática, se le ha denominado “terrorista”. El texto presenta una ruta para reflexionar sobre algunos aspectos que intervienen en la construcción del otro y su tránsito al lugar de enemigo.
Lisa A. Ostrin, Christianne E. Strang, Kevin Chang
et al.
Purpose: Intrinsically photosensitive retinal ganglion cells (ipRGCs) contain the photopigment melanopsin, and are primarily involved in non-image forming functions, such as the pupillary light reflex and circadian rhythm entrainment. The goal of this study was to develop and validate a targeted ipRGC immunotoxin to ultimately examine the role of ipRGCs in macaque monkeys.Methods: An immunotoxin for the macaque melanopsin gene (OPN4), consisting of a saporin-conjugated antibody directed at the N-terminus, was prepared in solutions of 0.316, 1, 3.16, 10, and 50 μg in vehicle, and delivered intravitreally to the right eye of six rhesus monkeys, respectively. Left eyes were injected with vehicle only. The pupillary light reflex (PLR), the ipRGC-driven post illumination pupil response (PIPR), and electroretinograms (ERGs) were recorded before and after injection. For pupil measurements, 1 and 5 s pulses of light were presented to the dilated right eye while the left pupil was imaged. Stimulation included 651 nm (133 cd/m2), and 4 intensities of 456 nm (16–500 cd/m2) light. Maximum pupil constriction and the 6 s PIPR were calculated. Retinal imaging was performed with optical coherence tomography (OCT), and eyes underwent OPN4 immunohistochemistry to evaluate immunotoxin specificity and ipRGC loss.Results: Before injection, animals showed robust pupil responses to 1 and 5 s blue light. After injection, baseline pupil size increased 12 ± 17%, maximum pupil constriction decreased, and the PIPR, a marker of ipRGC activity, was eliminated in all but the lowest immunotoxin concentration. For the highest concentrations, some inflammation and structural changes were observed with OCT, while eyes injected with lower concentrations appeared normal. ERG responses showed better preserved retinal function with lower concentrations. Immunohistochemistry showed 80–100% ipRGC elimination with the higher doses being more effective; however this could be partly due to inflammation that occurred at the higher concentrations.Conclusion: Findings demonstrated that the OPN4 macaque immunotoxin was specific for ipRGCs, and induced a graded reduction in the PLR, as well as, in ipRGC-driven pupil response with concentration. Further investigation of the effects of ipRGC ablation on ocular and systemic circadian rhythms and the pupil in rhesus monkeys will provide a better understanding of the role of ipRGCs in primates.