Hasil untuk "Psychiatry"

L. Duncan, M. Keller

S. Kapur, A. Phillips, T. Insel

T. Robbins, Claire M. Gillan, Dana G. Smith et al.

P. Montague, R. Dolan, Karl J. Friston et al.

J. Sarris, J. Sarris, A. Logan et al.

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.

Ying Xie, Dongmei Yang, Ting Jiang et al.

BackgroundChronic subdural hematoma (CSDH) has high postoperative recurrence rates. This study investigates the effects of hyperbaric oxygen therapy (HBOT) combined with Medical-Psychosocial-Nursing Functional Support (MPNFS) on functional recovery and recurrence prevention in CSDH patients, and establishes a recurrence prediction model.MethodsA total of 184 CSDH patients undergoing burr hole drainage were randomized into a control group and an observation group (HBOT + MPNFS). Neurological (NIHSS), motor (Fugl-Meyer Assessment), and quality-of-life (SF-36) outcomes were assessed preoperatively and at 1-month postoperatively. Complications and 6-month recurrence rates were recorded. Univariate/multivariate logistic regression identified recurrence risk factors, with ROC analysis evaluating predictive accuracy.ResultsThe observation group showed superior 1-month outcomes: lower NIHSS scores (t = 4.94, p < 0.001), higher FMA and SF-36 scores (p < 0.01). Complication and recurrence rates were significantly reduced (p < 0.05). Independent recurrence predictors included brain atrophy (OR = 2.877), poor brain reexpansion (OR = 3.165), preoperative hematoma width ≥ 20 mm (OR = 2.782), and absence of combined intervention (OR = 2.842). The multifactorial model achieved an AUC of 0.7862, indicating robust predictive efficacy.ConclusionHyperbaric oxygen therapy combined with MPNFS enhances neurological/motor recovery, improves quality of life, and reduces complications/recurrence in postoperative CSDH patients.

Melissa Blum, Donato DeIngeniis, Daniela K. Shill et al.

Introduction: Rising ambient temperatures threaten vulnerable populations such as pregnant women, with urban populations bearing a greater risk due to the urban heat island effect. Here, we assessed the independent effects of trimester-specific warm season exposure during pregnancy and neighborhood heat vulnerability on maternal outcomes, including gestational diabetes, hypertensive disorders of pregnancy, genitourinary infections, and operative delivery. Methods: This retrospective study analyzed 819 participants from the Stress in Pregnancy Study (2009–2014), a longitudinal birth cohort study in New York City. Generalized linear models examined associations between trimester-specific warm season exposure, New York City Heat Vulnerability Index (ranging 1-5), and adverse maternal outcomes, adjusting for demographics, parity, and substance use. Results: First trimester warm season exposure was associated with increased odds of gestational hypertension (adjusted odds ratio [AOR] 4.50, 95%CI 1.17-17.27), preeclampsia (AOR 4.38, 95%CI 1.51-12.75), and genitourinary infection (AOR 2.27, 95%CI 1.14-4.51). Each unit increase in heat vulnerability index was associated with increased odds of preeclampsia (AOR 1.38, 95%CI 1.05-1.81) and genitourinary infection (AOR 1.32, 95%CI 1.11-1.57). Conclusions: Both early pregnancy warm weather exposure and neighborhood vulnerability independently increased the risk of adverse maternal complications. Our findings provide evidence in support of targeted heat mitigation strategies to limit heat exposure in at-risk communities as climate change progresses.

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.

N. Stanton, E. Angova, K. Diamantopoulos

Introduction Sexual dysfunction (SD) is common in psychotic illness including schizophrenia, occurring in 30-82% of patients. It negatively impacts wellbeing and antipsychotic compliance, resulting in higher risk of relapse and hospitalisation. Due to over-reliance on spontaneous reports from patients, SD is typically under-identified which prevents investigation and treatment. Objectives To establish whether SD is under-identified in patients with psychosis in a general adult community mental health team; to elicit whether the Arizona Sexual Experience Scale (ASEX) improves identification; to investigate and manage identified cases of SD; to make recommendations about identification and monitoring of SD in this patient population. Methods A 12-month retrospective audit of patients with psychosis prescribed a long-acting injectable (LAI) antipsychotic (n=36) to identify sexual symptoms was completed. The ASEX was subsequently issued to screen for SD. Results Audit: 3/36 (8%) patients had documented sexual symptoms. Of the 18/36 patients that completed the ASEX: 10 (56%) exhibited SD. 4 consented to further investigation. 5 patients experienced significant difficulties with the language used in the ASEX. At the end of the project we revised the ASEX with simpler, colloquial language. Conclusions Implementation of the ASEX results in clear improvements in identification and monitoring of SD. Maudsley Practice Guidelines can inform investigation and management of SD. We suggest a review of NICE guidance to incorporate the above into clinical practice. Further work is needed to establish whether the revised ASEX can be developed and validated. Disclosure of Interest None Declared

S. Lui, Xiaohong Joe Zhou, J. Sweeney et al.

Rei Otsuki, Rei Otsuki, Rei Otsuki et al.

Takumi Hirose, Toshiki Takayama , Nobuto Shibata et al.

Ilker Şengül, Esra Candar, Ibrahim Demirçubuk et al.

Sónia Martins, Ana Rita Ferreira, Joana Fernandes et al.

N/a.

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.

I. Myin‐Germeys, Annelie Klippel, H. Steinhart et al.

A. Moreira-Almeida, Avdesh Sharma, Bernard Janse van Rensburg et al.

Yvonne Schröder, Daniela Michelle Hohmann, Tina Meller et al.

Abstract Background Previous case–control studies of autistic spectrum disorder (ASD) have identified altered brain structure such as altered frontal and temporal cortex volumes, or decreased fractional anisotropy (FA) within the inferior fronto-occipital fasciculus in patients. It remains unclear whether subclinical autistic-like traits might also be related to variation in these brain structures. Methods In this study, we analyzed magnetic resonance imaging (MRI) data of 250 psychiatrically healthy subjects phenotyped for subclinical autistic-like traits using the Autism Spectrum Quotient (AQ). For data analysis, we used voxel-based morphometry of T1-MRIs (Computational Anatomy Toolbox) and tract-based spatial statistics for diffusion tensor imaging data. Results AQ attention switching subscale correlated negatively with FA values in the bilateral uncinate fasciculus as well as the bilateral inferior fronto-occipital fasciculus. Higher AQ attention switching subscale scores were associated with increased mean diffusivity and radial diffusivity values in the uncinate fasciculus, while axial diffusivity values within this tract show a negative correlation. AQ attention to detail subscale correlated positively with gray matter volume in the right pre- and postcentral gyrus. Conclusions We demonstrate that individuals with higher levels of autism-spectrum-like features show decreased white matter integrity in tracts associated with higher-level visual processing and increased cortical volume in areas linked to movement sequencing and working memory. Our results resemble regional brain structure alterations found in individuals with ASD. This offers opportunities to further understand the etiology and pathogenesis of the disorder and shows a subclinical continuum perspective.