Hasil untuk "Neurosciences. Biological psychiatry. Neuropsychiatry"

Rossella Rispoli, Barbara Cappelletto

Jinesh Mukesh Shah, Nijanth Manohararaj, Koh Yeow Hoay

We aim to report an extremely rare case of a primary thoracic intramedullary cavernoma with Brown-Sequard syndrome (BSS), its transcranial magnetic stimulation (TMS)/somatosensory evoked potential (SSEP) neurophysiology tests, and their localizing value. A 53-year-old Chinese male with a history of multiple arteriovenous malformations (AVMs) presented with an intermittent 3-year history of the left lower limb weakness with recent worsening and findings of dissociated sensory loss. Neurophysiological testing showed prolonged central motor conduction time to his left lower limb on TMS while tibial SSEP showed prolonged P37 latencies. Magnetic resonance imaging spine showed a T4-5 intramedullary expansile enhancing cord lesion, suggestive of a thoracic cavernoma, with surrounding acute hematomyelia and cord edema from C7 to T6. A spinal angiogram did not reveal any vascular malformation. He was conservatively treated for possible T4-5 cavernoma with hematomyelia. Repeat imaging showed complete resolution of edema with a T3-5 internal T2-weighted hyperintensity and residual susceptibility focus likely representing a cavernoma that had bled with no evidence of AVM. A repeat tibial SSEP still showed prolonged tibial SSEPs, but TMS was now normal. Primary thoracic intramedullary cavernomas may be a rare cause of BSS. TMS and SSEP may have a role in the diagnostic evaluation of BSS.

Narendra Javadekar, Archana Javadekar, Deepa Thakur

Mental illnesses have a significant impact on the lives of people not only because of their morbidity but also because of their noticeable impact on economic wellbeing. Out-of-pocket expenditure for mental healthcare services is significant in India and may even lead to impoverishment of the families. The present paper states that Health Technology Assessment (HTA) is necessary for mental healthcare primarily because of its rising cost and competing interests in government decisions and prioritization. HTA does a systematic evaluation of the consequences of using health technology. HTA will provide information to decision makers to develop and implement safer, cost-effective, and efficient policies at the individual and government levels. Appropriate guidance regarding the cost-effectiveness of mental health interventions will help to serve the purpose of providing transparent reports in the context of limited budgets.

Ethan R. Roy, Sanming Li, Sepideh Saroukhani et al.

Abstract Background Aging significantly elevates the risk of developing neurodegenerative diseases. Neuroinflammation is a universal hallmark of neurodegeneration as well as normal brain aging. Which branches of age-related neuroinflammation, and how they precondition the brain toward pathological progression, remain ill-understood. The presence of elevated type I interferon (IFN-I) has been documented in the aged brain, but its role in promoting degenerative processes, such as the loss of neurons in vulnerable regions, has not been studied in depth. Methods To comprehend the scope of IFN-I activity in the aging brain, we surveyed IFN-I-responsive reporter mice at multiple ages. We also examined 5- and 24-month-old mice harboring selective ablation of Ifnar1 in microglia to observe the effects of manipulating this pathway during the aging process using bulk RNA sequencing and histological parameters. Results We detected age-dependent IFN-I signal escalation in multiple brain cell types from various regions, especially in microglia. Selective ablation of Ifnar1 from microglia in aged mice significantly reduced overall brain IFN-I signature, dampened microglial reactivity, lessened neuronal loss, restored expression of key neuronal genes and pathways, and diminished the accumulation of lipofuscin, a core hallmark of cellular aging in the brain. Conclusions Overall, our study demonstrates pervasive IFN-I activity during normal mouse brain aging and reveals a pathogenic, pro-degenerative role played by microglial IFN-I signaling in perpetuating neuroinflammation, neuronal dysfunction, and molecular aggregation. These findings extend the understanding of a principal axis of age-related inflammation in the brain, one likely shared with multiple neurological disorders, and provide a rationale to modulate aberrant immune activation to mitigate neurodegenerative process at all stages.

Rei Otsuki, Rei Otsuki, Rei Otsuki et al.

Takumi Hirose, Toshiki Takayama , Nobuto Shibata et al.

D. Stoyanov, M. Maes

Psychiatry remains in a permanent state of crisis, which fragmented psychiatry from the field of medicine. The crisis in psychiatry is evidenced by the many different competing approaches to psychiatric illness including psychodynamic, biological, molecular, pan-omics, precision, cognitive and phenomenological psychiatry, folk psychology, mind-brain dualism, descriptive psychopathology, and postpsychiatry. The current “gold standard” Diagnostic and Statistical Manual of Mental Disorders/International Classification of Diseases taxonomies of mood disorders and schizophrenia are unreliable and preclude to employ a deductive reasoning approach. Therefore, it is not surprising that mood disorders and schizophrenia research was unable to revise the conventional classifications and did not provide more adequate therapeutic approaches. The aim of this paper is to explain the new nomothetic network psychiatry (NNP) approach, which uses machine learning methods to build data-driven causal models of mental illness by assembling risk-resilience, adverse outcome pathways (AOP), cognitome, brainome, staging, symptomatome, and phenomenome latent scores in a causal model. The latter may be trained, tested and validated with Partial Least Squares analysis. This approach not only allows to compute pathway-phenotypes or biosignatures, but also to construct reliable and replicable nomothetic networks, which are, therefore, generalizable as disease models. After integrating the validated feature vectors into a well-fitting nomothetic network, clustering analysis may be applied on the latent variable scores of the R/R, AOP, cognitome, brainome, and phenome latent vectors. This pattern recognition method may expose new (transdiagnostic) classes of patients which if cross-validated in independent samples may constitute new (transdiagnostic) nosological categories.

Sierra Carter, Y. Mekawi, Ifrah S. Sheikh et al.

Black women in the United States (U.S.) are faced with unrelenting chronic stressors that are often driven by racism and oppression to influence mental health inequities. Similar to common U.S. societal views of Black women, ideological values about Black women's lives also permeate psychiatry and neuroscience research to prevent likely impactful research that fully examines the role of social power structures in the biological embedding of racism. This article's overall aim is to highlight the most urgent areas to address in mental health inequities utilizing a Black feminist lens that include: (1) culturally grounded and contextually-relevant considerations for the biological embedding of racism on mental health outcomes for Black women across the lifespan; (2) intersectional frameworks that address mental health inequities ingrained in multiple marginalization. We conclude with a call to action informed by Black Feminist thought for the field of neuroscience to make a concerted effort to addresses mental health inequities among Black women and other disenfranchised groups from a frame of compassion, cultural humility, and a continuous pursuit of social justice.

M. Gillman

Medication dosages are crucial–no single dose fits all. My paper compares the safety, scientific and practical applicability of fixed 25–50% concentrations of nitrous oxide (N2O) with the variable titrated concentrations of Psychotropic Analgesic N2O (PAN), as used in dentistry, and neuropsychiatry. A crucial difference is that PAN is always titrated, via an open circuit (nasal mask), to the minimum concentration (dose), which ensures full consciousness, cooperation, comfort and relaxation. With PAN, the goal is subject comfort, not dose. In contrast, fixed goal concentrations are usually given via relatively closed circuits (full facial mask/similar) without account for individual patient's dose-response. Hence, fixed concentrations, in N2O sensitive subjects, could result in unconsciousness and other adverse effects (nausea, vomiting, anxiety, aspiration, might occur; requiring an anaesthesiologist for patient safety. PAN is titrated using each subject's subjective and objective responses as the guide to the ideal concentration. Thus, when PAN is used, there is no fixed concentration even for a single subject, nor is an anaesthesiologist required. Furthermore, there is a greater scientific rationale for using PAN, because the receptor systems involved are better known, whilst those for fixed concentrations are not. The PAN or dental titration method has been safely used in general dentistry for over 70 years and as an investigative, diagnostic and therapeutic tool for neuropsychiatry for over 40 years. Clinical applications include substance abuse detoxification, ameliorating depression, and investigations of schizophrenia, human orgasm, pain perception and basic neuroscience. By contrast, the experience with fixed doses in psychiatry is limited.

Fei Wang, Fei Wang, Min Fei et al.

BackgroundConstipation and dementia have similar epidemiological characteristics. Changes in intestinal flora and characteristics of the brain-gut axis play roles in the pathogeneses of the two diseases, suggesting that there may be a close connection between the two. Most of the studies on constipation in dementia patients have focused on the population with α-synucleinopathies [Parkinson’s disease dementia (PDD), dementia with Lewy bodies (DLB)]. Few studies have reported the prevalence of constipation in all-cause dementia and mild cognitive impairment (MCI) populations.ObjectiveTo assess the prevalence of constipation in patients with all-cause dementia and MCI subtypes and to explore the association between constipation with dementia and MCI subtypes.MethodsFrom May 2019 to December 2019, we conducted a population-based cross-sectional survey. A total of 11,743 participants aged 65 or older from nine cities in China were surveyed. Participants underwent a series of clinical examinations and neuropsychological measurements. Constipation, dementia, MCI and MCI subtype were diagnosed according to established criteria through standard diagnostic procedures.ResultsThe overall age- and sex-adjusted prevalence of constipation in individuals aged 65 years and older was 14.8% (95% CI, 14.6–15.0). The prevalence rates of constipation were19.2% (95% CI, 17.3–21.0), 19.1% (95% CI, 16.8–21.5), 14.4% (95% CI, 12.8–15.9), and 13.8% (95% CI, 13.0–14.6) in the dementia, non-amnestic (na)-MCI, amnestic (a)-MCI and normal cognition populations, respectively. Multivariate logistic regression analysis showed that higher prevalence of constipation was associated with dementia (p = 0.0.032, OR = 1.18, 95% CI: 1.02–1.38) and na-MCI (p = 0.003, OR = 1.30, 95% CI: 1.09–1.54).ConclusionThe present study found a high prevalence of constipation in elderly individuals in China, and higher in patients with dementia and na-MCI.

Yan Tao, Yusuke Murakami, Demetrios G. Vavvas et al.

Necroptosis mediates the chronic inflammatory phenotype in neurodegeneration. Receptor-interacting protein kinase (RIPK) plays a pivotal role in the induction of necroptosis in various cell types, including microglia, and it is implicated in diverse neurodegenerative diseases in the central nervous system and the retina. Targeting RIPK has been proven beneficial for alleviating both neuroinflammation and degeneration in basic/preclinical studies. In this review, we discuss the role of necroptosis in retinal degeneration, including (1) the molecular pathways involving RIPK, (2) RIPK-dependent microglial activation and necroptosis, and (3) the interactions between necroptosis and retinal neuroinflammation/degeneration. This review will contribute to a renewed focus on neuroinflammation induced by necroptosis and to the development of anti-RIPK drugs against retinal degeneration.

Diego Elgueda, Yaneri A. Ayala, Paul H. Delano et al.

Alexandre Simonin, Jean-Yves Fournier

莫名, 陈忠军, 范铁平, 赵旭生, 胡腾, 李迪

Dandan Wang, Chang Xu, Wenxiao Wang et al.

Allele 4 of the apolipoprotein E gene (APOE ε4) and hypertension are considered risk factors for Alzheimer’s Disease (AD). The detection of differences in cognitive function and brain networks between hypertensive patients who are APOE ε4 carriers and non-carriers may help in understanding how hypertension and risk genes cumulatively impair brain function, which could provide critical insights into the genetic mechanism by which hypertension serves as a potential risk factor for cognitive decline and even AD. Using behavioral data from 233 elderly hypertensive patients and neuroimaging data from 38 of them from Beijing, China; the study aimed to assess the effects of APOE ε4 on cognition and to explore related changes in functional connectivity. Cognitively, the patients with APOE ε4 showed decreased executive function, memory and language. In the MRI sub-cohort, the frontoparietal networks in the APOE ε4 carrier group exhibited an altered pattern, mainly in the left precentral regions, inferior frontal lobe and angular gyrus. More importantly, the decline of cognitive function was correlated with abnormal FC in the left precentral regions in APOE ε4 carriers. APOE ε4 aggravated the dysfunction in frontal and parietal regions in hypertensive patients. This highlights the importance of brain protection in hypertensive patients, especially those with a genetic risk of AD.

A. David

Professor David is among Britain’s preeminent psychiatrists and academics. His research in recent times has focused on schizophrenia, neuropsychiatry, medically unexplained syndromes and neuroimaging. He has particular interest and expertise in the concept and nature of ‘insight’ in schizophrenia, and its relation to treatment compliance and an individual’s decision-making capacity. Professor David is Director of the UCL Institute of Mental Health. Professor David is a widely published author in influential peer-reviewed academic journals. He recently published his latest book, the acclaimed Into the Abyss: A Neuropsychiatrist’s Notes on Troubled Minds. Dr David has co-edited several books, including The Self in Neuroscience and Psychiatry and Insight and Psychosis. He is the co-editor of the journal Cognitive Neuropsychiatry. Professor David is a founding member of both the British Neuropsychological Society and the British Neuropsychiatry Association – he was Chair of the latter organization between 2004 and 2007. In 2018, he delivered the inaugural lecture as part of the Kings Lectures series. Abstract A maverick is an outsider who has rare qualities which may be highly valued in many areas of society. Empirical research has validated ‘maverickism’ as a recognisable personality type. Medicine and psychiatry have always attracted mavericks – neuropsychiatry in particular. Over the last 150 years there have been several notable examples who have a few key characteristics in common, but their contribution has been mostly negative, sometimes disastrously so. Modern mavericks continue to flourish perhaps aided by the loosening of bounds on science communication and governance but also because of the difficulty mainstream neuropsychiatry has in communicating the biopsychosocial approach in a way that satisfies some sufferers. The question is whether they can be a useful stimulus.

S. Garfinkel

Sarah Garfinkel is Professor at the Institute of Cognitive Neuroscience, University College London (UCL), where she leads the Clinical and Affective Neuroscience Group. She completed her PhD at the University of Sussex, a training fellowship in Psychiatry and Neuroscience at the University of Michigan and her first faculty position at the Brighton and Sussex Medical School. Her research focuses on brain-body interactions in different clinical conditions. In 2018, Sarah was named by the journal Nature as one of 11 ‘Rising Star’ researchers and in 2021 she was awarded the Mid-Career Prize in Cognitive Neuroscience by the British Association for Cognitive Neuroscience. Abstract Cognitive and emotional processes are shaped by the dynamic integration of brain and body. A major channel of interoceptive information comes from the heart, where phasic signals are conveyed to the brain to indicate how fast and strong the heart is beating. This talk will detail how cardiac afferent signals can interact with neuronal mechanisms to alter emotion processing. This interoceptive channel is disrupted in distinct ways in neuropsychiatric conditions; specific interoceptive disturbances may contribute to our understanding of symptoms in these clinical conditions, including changes in emotion, dissociation and anxiety. The discrete cardiac effects on emotion and cognition have broad relevance for clinical neuroscience, with implications for peripheral treatment targets and behavioural interventions focused on the heart.

J. Dukart, S. Weis, S. Genon et al.

V. Leong, D. Bzdok, F. Paulus et al.

Division of Psychology, Nanyang Technological University, Singapore, Singapore, Department of Psychology, University of Cambridge, Cambridge, United Kingdom, Mila Quebec Artificial Intelligence Institute, Montreal, QC, Canada, 4 Faculty of Medicine, Montreal Neurological Institute, McGill University, Montreal, QC, Canada, 5 Social Neuroscience Lab at the Translational Psychiatry Unit, Department of Psychiatry and Psychotherapy, Lübeck University, Lübeck, Germany, Department of Neurology, University of Virginia, Charlottesville, VA, United States, Department of Psychology, University of Maryland, College Park, MD, United States, Medical Faculty, Ludwig Maximilians University, Munich, Germany

Rachna Varma, Gauri Varma, Sudheer Dara et al.

Traumatic neuromas are sometimes formed in the surgical scars. Peripheral nerve injuries lead to complex clinical presentation. They are benign tumors which are formed by critical nerve tissue interaction and are extremely painful. They are formed by intraneural or extraneural scar formation affecting the nerve-gliding plane. Their main clinical presentation is neuropathic pain. This condition is also termed as “painful scar neuropathy.” There have been different approaches to treatment depending on the type of lesion whether it is perineural, endoneurial, or combined and type of pain due to traction or trauma, rest pain, and severity. Varying degrees of therapeutic success has been described in literature using different techniques. There is no consensus on the best therapeutic approach to treat neuropathic pain due to scar tethering. Patient counseling about the condition and the need for multiple interventions, if needed, is essential. Here, we report a case of a 16-year-old female with traumatic neuroma of superficial peroneal nerve formed in the surgical scar of chronic osteomyelitis presenting with severe pain and paresthesia treated by pulsed radio frequency (PRF). PRF is a novel therapeutic method to treat many conditions in pain medicine as it offers treatment without motor deficits and deafferentation syndrome.