Hasil untuk "Psychiatry"

Stéphane Potvin, Stéphane Potvin, Yasser Khazaal et al.

Syed Ameen Ahmad, Olivia Liu, Amy Feng et al.

Abstract Background There is an emerging understanding of the increased risk of stroke in patients with immune thrombocytopenic purpura (ITP) and immune thrombotic thrombocytopenic purpura (iTTP). We aimed to determine the prevalence and characteristics of acute ischemic stroke (AIS) and intracranial hemorrhage (ICH) in patients with ITP and iTTP in a systematic review and meta-analysis. Methods We used PubMed, Embase, Cochrane, Web of Science, and Scopus using text related to ITP, iTTP, stroke, AIS, and ICH from inception to 11/3/2023. Our primary outcome was to determine prevalence of AIS and/or ICH in a cohort of ITP or iTTP patients (age > 18). Our secondary outcomes were to determine stroke type associated with thrombopoietin receptor agonists (TPO-RAs) in ITP patients, as well as risk factors associated with stroke in ITP and iTTP patients. Results We included 42 studies with 118,019 patients (mean age = 50 years, 45% female). Of those, 27 studies (n = 116,334) investigated stroke in ITP patients, and 15 studies (n = 1,685) investigated stroke in iTTP patients. In all ITP patients, the prevalence of AIS and ICH was 2.1% [95% Confidence Interval (CI) 0.8-4.0%] and 1.5% (95% CI 0.9%-2.1%), respectively. ITP patients who experienced stroke as an adverse event (AE) from TPO-RAs had an AIS prevalence of 1.8% (95% CI 0.6%-3.4%) and an ICH prevalence of 2.0% (95% CI 0.2%-5.3%). Prevalence of stroke did not significantly differ between all ITP patients and those treated with TPO-RAs. iTTP patients had a prevalence of AIS and ICH of 13.9% (95% CI 10.2%-18.1%) and 3.9% (95% CI 0.2%-10.4%), respectively. Subgroup analysis revealed the prevalence of AIS and ICH was greater in iTTP patients vs. all ITP patients (p < 0.01 and p = 0.02, respectively). Meta-regression analysis revealed none of the collected variables (age, sex, history of diabetes or hypertension) were risk factors for stroke in all ITP patients, although there were high levels of data missingness. Conclusions Prevalence of different stroke types was lower in all ITP patients vs. iTTP patients. Additionally, ITP patients experienced a similar prevalence of stroke regardless of if they were specifically denoted to have been treated with TPO-RAs or not, supporting the continued use of TPO-RAs in management. Risk factors for stroke remain unclear, and future studies should continue to investigate this relationship.

Lalisa Saeaeh, Pornprom Sitthivethayanont, Theerawat Chalacheewa et al.

Abstract Background The 15-item Quality of Recovery scale (QoR-15), a short form of the QoR-40, is a widely used self-reported tool for measuring the postoperative quality of recovery. It has been translated into many languages. In this study, we aimed to validate a translated Thai version of the QoR-15 in patients undergoing elective abdominal surgery under general anesthesia. Methods This was a single-center observational cohort study. The QoR-15 was translated into Thai and culturally adapted, which led to the items on severe and moderate pain being merged, yielding a 14-item scale: the QoR-14-Thai. Next, the QoR-14-Thai, a checklist measuring the patients’ activities of daily living (ADL), and a 100-mm visual analog scale for assessing their global health (VAS-GH) were administered to the study patients before and 24 h after their abdominal surgery. The validity, reliability, responsiveness, and feasibility of the QoR-14-Thai were assessed. Results Among 166 patients, 140 completed the questionnaires, achieving a questionnaire completion rate of 100%. We observed moderate convergent validity between the postoperative QoR-14-Thai and the VAS-GH (r = 0.54, p < 0.001) and ADL checklist (r = 0.50, p < 0.001). The QoR-14-Thai was negatively correlated with the length of hospital stay (r = − 0.23, p < 0.006) and postoperative admission to the intensive care unit (r = − 0.85, p = 0.001). The QoR-14-Thai had excellent internal consistency (Cronbach’s alpha = 0.869), split-half reliability (0.913), test–retest reliability (0.94), and high responsiveness (Cohen’s effect size: 1.01, standardized response mean: 0.73). The median time to complete the questionnaire was 2 min (interquartile range: 1–2). Conclusions The QoR-14-Thai was deemed a valid, reliable, and convenient tool for evaluating the quality of recovery after elective abdominal surgery. Trial registration This study was registered prospectively on the Thai Clinical Trials Registry, identifier TCTR20210326009, on March 26, 2021.

Haiping Huang, Xinyi Su, Yuqian Zhang et al.

Abstract Background Stroke survivors often experience residual motor dysfunction in their limbs. Additional physical rehabilitation therapies may further improve patients’ functional outcomes. By combining direct interventions targeting the cerebral cortex or subcortical structures with indirect approaches that promote central nervous system reorganization, a closed-loop regulatory system can be established. This integrated approach may generate synergistic effects, thereby enhancing functional recovery outcomes. Methods This 3-week single-center randomized, single-masked study involved participants randomly assigned to either the electroacupuncture (EA) combined with robot-assisted gait training (RAGT) group (n = 22) or the RAGT alone group (n = 23). EA treatment was administered once daily for 30 min, 5 days per week, while RAGT treatment received the same duration of daily sessions. Baseline and endpoint assessments included the Fugl-Meyer lower extremity (FMA-LE) motor function assessment, functional ambulation category (FAC) scale, Berg Balance Scale (BBS) and electroencephalogram. Results After a 3-week intervention period, participants in both groups showed significant improvements in FMA-LE, FAC, and BBS scores compared to baseline levels. The EA combined RAGT group exhibited a reduction in the brain symmetry index within the alpha frequency band, along with enhanced coherence between the CZ electrode and the FCZ, FC2, and C1 electrodes. Furthermore, in the theta frequency band, a shortened average path length and improved global efficiency were observed. Conclusion Both interventions can safely and effectively improve lower limb motor function, and EA combined with RAGT combination therapy may have an advantage in promoting neuroplasticity, which may involve reversing pathological frequency spectrum imbalance after stroke, enhancing functional connections between sensorimotor-related brain regions, and optimizing the topological properties of brain functional networks. Trial registration Chinese Clinical Trial Registry (Registration No.: ChiCTR2500102382)

P. Carrasco Espí, M. Pellicer Ancos, B. Navarro León et al.

Gellan K. Ahmed, Gellan K. Ahmed, Ahmed A. Karim et al.

BackgroundAvoidant Restrictive Food Intake Disorder (ARFID) is a newly classified eating disorder that requires further understanding of its presentation. There is no previous report of ARFID in a child post-tonsillectomy. ARFID may be a potential negative outcome for children following oropharyngeal surgery.Case presentationA female child aged 10 years and 2 months presented with ARFID associated with depression, anxiety and nutritional deficiency following tonsillectomy. She had more difficulty in swallowing solids than fluids and had repeated vomiting and spitting food after chewing it. She became dehydrated and malnourished with a BMI of 10.5 and was misdiagnosed with myasthenic gravis.ConclusionsTo our knowledge, this is the first case report of ARFID in a child post-tonsillectomy. We discuss the pathophysiology of ARFID, which remains elusive, and recommend psychiatric assessment when evaluating children post operative tonsillectomy.

Mao-Qiang Man, Mao-Qiang Man, Mao-Qiang Man et al.

Autism spectrum disorder (ASD) is a common neurological disorder. Although the etiologies of ASD have been widely speculated, evidence also supports the pathogenic role of cutaneous inflammation in autism. The prevalence of ASD is higher in individuals with inflammatory dermatoses than in those without inflammatory diseases. Anti-inflammation therapy alleviates symptoms of ASD. Recent studies suggest a link between epidermal dysfunction and ASD. In the murine model, mice with ASD display epidermal dysfunction, accompanied by increased expression levels of proinflammatory cytokines in both the skin and the brain. Children with ASD, which develops in their early lifetime, also exhibit altered epidermal function. Interestingly, improvement in epidermal function alleviates some symptoms of ASD. This line of evidence suggests a pathogenic role of cutaneous dysfunction in ASD. Either an improvement in epidermal function or effective treatment of inflammatory dermatoses can be an alternative approach to the management of ASD. We summarize here the current evidence of the association between the skin and ASD.

Sarah Elizabeth Rotschafer

Autism spectrum disorder (ASD) is increasingly common with 1 in 59 children in the United States currently meeting the diagnostic criteria. Altered sensory processing is typical in ASD, with auditory sensitivities being especially common; in particular, people with ASD frequently show heightened sensitivity to environmental sounds and a poor ability to tolerate loud sounds. These sensitivities may contribute to impairments in language comprehension and to a worsened ability to distinguish relevant sounds from background noise. Event-related potential tests have found that individuals with ASD show altered cortical activity to both simple and speech-like sounds, which likely contribute to the observed processing impairments. Our goal in this review is to provide a description of ASD-related changes to the auditory system and how those changes contribute to the impairments seen in sound discrimination, sound-in-noise performance, and language processing. In particular, we emphasize how differences in the degree of cortical activation and in temporal processing may contribute to errors in sound discrimination.

Ya Chai, José R. Chimelis-Santiago, Kristy A. Bixler et al.

Background: Sex-specific neurobiological underpinnings of impulsivity in youth with externalizing disorders have not been well studied. The only report of functional connectivity (FC) findings in this area demonstrated sex differences in fronto-subcortical connectivity in youth with attention-deficit/hyperactivity disorder (ADHD). Methods: The current study used functional magnetic resonance imaging (fMRI) to examine sex differences in resting-state seed-based FC, self-rated impulsivity, and their interactions in 11-12-year-old boys (n = 43) and girls (n = 43) with externalizing disorders. Generalized linear models controlling for pubertal development were used. Seeds were chosen in the ventral striatum, medial prefrontal cortex, middle frontal gyrus and amygdala. Results: Impulsivity scores were greater in boys than girls (p < 0.05). Boys showed greater positive connectivity within a ventromedial prefrontal-ventral striatal network. In addition, boys demonstrated weaker connectivity than girls within two medial–lateral prefrontal cortical networks. However, only boys showed greater medial–lateral prefrontal connectivity correlated with greater impulsivity. Conclusions: The findings provide evidence supporting sex differences in both ventral striatal-ventromedial prefrontal and medial–lateral prefrontal functional networks in youth with externalizing disorders. These important networks are thought to be implicated in impulse control. Medial-lateral prefrontal connectivity may represent a male-specific biomarker of impulsivity.

Yixiang Lu, Rui Wang, Qingwei Gao et al.

Multi-modal image fusion integrates different images of the same scene collected by different sensors into one image, making the fused image recognizable by the computer and perceived by human vision easily. The traditional tensor decomposition is an approximate decomposition method and has been applied to image fusion. In this way, the image details may be lost in the process of fusion image reconstruction. To preserve the fine information of the images, an image fusion method based on tensor matrix product decomposition is proposed to fuse multi-modal images in this article. First, each source image is initialized into a separate third-order tensor. Then, the tensor is decomposed into a matrix product form by using singular value decomposition (SVD), and the Sigmoid function is used to fuse the features extracted in the decomposition process. Finally, the fused image is reconstructed by multiplying all the fused tensor components. Since the algorithm is based on a series of singular value decomposition, a stable closed solution can be obtained and the calculation is also simple. The experimental results show that the fusion image quality obtained by this algorithm is superior to other algorithms in both objective evaluation metrics and subjective evaluation.

Mehmet Ak, Murat Gulsun

Trichotillomania (TM) is a rare psychiatric disorder, and recognized with its complications effecting functionality. A number of pharmacological agents and psychotherapy have been used in the treatment of TM. There are few publications of drug therapy for TM and no consensus has been established yet. This 16 year-old female patient with TM will be the second case in the literature treated by aripiprazole. Trikotilomani tedavisinde aripiprazol: Olgu sunumu Trikotilomani işlevselliği etkileyebilen nadir görülen psikiyatrik bozukluklardan biridir. Tedavisinde birçok farmakolojik ajan ve psikoterapi yöntemleri kullanılmaktadır. TM’nin ilaçla tedavisine ilişkin bir kaç yayın bulunmakla birlikte henüz görüş birliğine varılmamıştır. Bu makalede, 16 yaşında TM’li kadın olgu bir atipik antipsikotik olan aripiprazol ile tedavi edilmiş olup bu olgu, aripiprazole yanıt verdiği bildirilen literatürdeki ikinci TM olgusudur.

Suvi Häkkinen, Stephanie A. Chu, Suzee E. Lee

Frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) have a strong clinical, genetic and pathological overlap. This review focuses on the current understanding of structural, functional and molecular neuroimaging signatures of genetic FTD and ALS. We overview quantitative neuroimaging studies on the most common genes associated with FTD (MAPT, GRN), ALS (SOD1), and both (C9orf72), and summarize visual observations of images reported in the rarer genes (CHMP2B, TARDBP, FUS, OPTN, VCP, UBQLN2, SQSTM1, TREM2, CHCHD10, TBK1).

Matthias S. Treder

MVPA-Light is a MATLAB toolbox for multivariate pattern analysis (MVPA). It provides native implementations of a range of classifiers and regression models, using modern optimization algorithms. High-level functions allow for the multivariate analysis of multi-dimensional data, including generalization (e.g., time x time) and searchlight analysis. The toolbox performs cross-validation, hyperparameter tuning, and nested preprocessing. It computes various classification and regression metrics and establishes their statistical significance, is modular and easily extendable. Furthermore, it offers interfaces for LIBSVM and LIBLINEAR as well as an integration into the FieldTrip neuroimaging toolbox. After introducing MVPA-Light, example analyses of MEG and fMRI datasets, and benchmarking results on the classifiers and regression models are presented.

Isabelle Hoang, Maud Ranchet, Romain Derollepot et al.

Background: Walking while performing a secondary task (dual-task (DT) walking) increases cognitive workload in young adults. To date, few studies have used neurophysiological measures in combination to subjective measures to assess cognitive workload during a walking task. This combined approach can provide more insights into the amount of cognitive resources in relation with the perceived mental effort involving in a walking task.Research Question: The objective was to examine cognitive workload in young adults during walking conditions varying in complexity.Methods: Twenty-five young adults (mean = 24.4 ± 5.4) performed four conditions: (1) usual walking, (2) simple DT walking, (3) complex DT walking and (4) standing while subtracting. During the walking task, mean speed, cadence, stride time, stride length, and their respective coefficient of variation (CV) were recorded. Cognitive workload will be measured through changes in oxy- and deoxy-hemoglobin (ΔHbO2 and ΔHbR) during walking in the dorsolateral prefrontal cortex (DLPFC) and perceived mental demand score from NASA-TLX questionnaire.Results: In young adults, ΔHbO2 in the DLPFC increased from usual walking to both DT walking conditions and standing while subtracting condition. ΔHbO2 did not differ between the simple and complex DT and between the complex DT and standing while subtracting condition. Perceived mental demand gradually increased with walking task complexity. As expected, all mean values of gait parameters were altered according to task complexity. CV of speed, cadence and stride time were significantly higher during DT walking conditions than during usual walking whereas CV of stride length was only higher during complex DT walking than during usual walking.Significance: Young adults had greater cognitive workload in the two DT walking conditions compared to usual walking. However, only the mental demand score from NASA-TLX questionnaire discriminated simple from complex DT walking. Subjective measure provides complementary information to objective one on changes in cognitive workload during challenging walking tasks in young adults. These results may be useful to improve our understanding of cognitive workload during walking.

Keisuke Kawata, Masato Mitsuhashi, Randy Aldret

The purpose of the study was to test the utility of unique panel of blood biomarkers as a means to reflect one’s recovery process after sport-related neurotrauma. We established a panel of biomarkers that reacted positive with CD81 (extracellular vesicle marker) and various neuron- and glia-specific antigens [e.g., neurofilament light polypeptide (NF-L), tau, synaptosome-associated protein 25 (SNAP25), glial fibrillary acidic protein, and myelin basic protein]. We first evaluated test–retest reliabilities of brain-derived exosome markers, followed by an application of these markers in eight professional ice hockey players to detect cumulative neuronal burden from a single ice hockey season. During the season, two players were diagnosed with concussions by team physician based on an exhibition of symptoms as well as abnormality in balance and ocular motor testing. One player reached symptom-free status 7 days after the concussion, while the other player required 36 days for symptoms to completely resolve. Blood samples and clinical assessments including balance error scoring system and near point of convergence throughout recovery process were obtained. Biomarkers indicative of axonal damage, neuronal inflammation, and glial activation showed excellent test–retest reliabilities (intraclass correlation coefficient: 0.713–0.998, p’s &lt; 0.01). There was a statistically significant increase in the NF-L marker at post-season follow-up compared to pre-season baseline (Z = −2.100, P = 0.036); however the statistical significance did not withstand Bonferroni correction for multiple comparisons. In concussion cases, neuronal and microglia markers notably increased after concussions, with the unique expression patterns being similar to that of concussion recovery process. These longitudinal data coupled with excellent test–retest reliabilities of novel array of blood biomarkers potentially reflect the damage in neural cell structures and metabolic crisis due to concussion. However, future studies with larger sample size and appropriate control groups to evaluate sensitivity and specificity of these markers are needed. This preliminary case report suggests the potential utility of multimodal blood biomarkers for concussion prognosis and recovery assessment.

Li Lin, Rakhi Desai, Xiaoying Wang et al.

Abstract Background Microglial cultures comprise a critically important model system for investigating inflammatory mechanisms in almost all CNS disorders. Mild trypsinization and shaking are the two most commonly used methods to isolate primary microglia from mixed glial cultures. In this study, we characterized and compared microglia obtained using these two methods. Methods Primary rat microglia cultures were prepared from cerebral cortices of 1–2-day-old neonatal Sprague-Dawley rats. After achieving confluency at about 14 days in vitro, microglia were isolated from mixed glial cultures via either mild trypsinization or shaking. The purity of microglia was estimated by flow cytometry. Quantitative real-time PCR was used to measure mRNA expression. TNFα, IL-1β, IL-10, and IGF-1 in cell culture supernatant were measured using ELISA kits. Phagocytic function was assessed using fluorescein-labeled Escherichia coli K-12 BioParticles. Results Mild trypsinization generated a higher yield and purity than shaking. Microglia isolated by mild trypsinization appeared to be in a quiescent state with ramified morphology. Microglia isolated by shaking showed a more heterogenous morphology, including cells with rounded shapes suggestive of activation. Compared with shaking, microglia isolated by trypsinization also had lower baseline phenotype markers (iNOS, CD86, CD206, and arginase 1) and lower levels of cytokines (TNFα, IL-1β, IL-10, and IGF-1) as well as reduced phagocytic capability. Both methods yielded microglia that were responsive to various stimuli such as IL-4, lipopolysaccharide (LPS), or interferon-γ (IFNγ). Although stimulated patterns of gene expression and cytokine release were generally similar, there were also significant differences in terms of absolute response. LPS treatment induced significantly higher levels of TNFα and IL-10 in microglia isolated by mild trypsinization versus shaking. IFNγ induced a lower response in TNFα in microglia obtained by mild trypsinization versus shaking. Conclusions Our results suggest that isolating microglia with the shaking method may induce slight activation even at baseline, and this may affect stimulus responses in subsequent experiments. Caution and attention should be warranted when choosing isolation protocols for primary microglia cultures.

G. Olivito, M. Cercignani, M. Lupo et al.

Spinocerebellar ataxia type 2 (SCA2) is an autosomal dominant neurodegenerative disease characterized by a progressive cerebellar syndrome, which can be isolated or associated with extracerebellar signs. It has been shown that patients affected by SCA2 present also cognitive impairments and psychiatric symptoms. The cerebellum is known to modulate cortical activity and to contribute to distinct functional networks related to higher-level functions beyond motor control. It is therefore conceivable that one or more networks, rather than isolated regions, may be dysfunctional in cerebellar degenerative diseases and that an abnormal connectivity within specific cerebello-cortical regions might explain the widespread deficits typically observed in patients. In the present study, the network-based statistics (NBS) approach was used to assess differences in functional connectivity between specific cerebellar and cerebral “nodes” in SCA2 patients. Altered inter-nodal connectivity was found between more posterior regions in the cerebellum and regions in the cerebral cortex clearly related to cognition and emotion. Furthermore, more anterior cerebellar lobules showed altered inter-nodal connectivity with motor and somatosensory cerebral regions. The present data suggest that in SCA2 a cerebellar dysfunction affects long-distance cerebral regions and that the clinical symptoms may be specifically related with connectivity changes between motor and non-motor cerebello-cortical nodes.

TÊMIS MARIA FÉLIX, JOÃO MONTEIRO DE PINA-NETO

Three families with the fragile X syndrome were studied with the aim to establish the most frequent clinical signs in the affected individuals and heterozygous women. The clinical evaluation, IQ level measurements and cytogenetic studies were performed in 40 subjects, 20 males and 20 females. The fragile X diagnosis was confirmed in all the male individuals with mental retardation. In the postpubertal subjects the most frequent clinical signs were inner canthal distance < 3.5 cm, macro-orchidism, long and narrow face and high arched palate while in the prepubertal subjects the behavioral characteristics as hyperactivity and poor eye contact were the most frequent and were observed in all patients. Twenty six percent of the heterozygous women presented with mental retardation and showed clinical signs rather than behavioral ones. All male individuals with mental retardation were observed as having fragile X [fra(X)] in lymphocytes culture. Sixty three percent of women showed fra(X). There was a positive correlation between the frequency of fra(X) and the clinical characteristics. We emphasize the importance of the clinical evaluation in the study of familial mental retardation and in the screening of isolated cases with suspect of having the fragile X syndrome.

Paulo E. Marchiori, Alberto J. Duarte, M. Izabel A. M. Birolli et al.

Os autores avaliam os linfócitos T (CD3, CD4, CD8, CD4/8) por anticorpos monoclonais e rosácea em 20 pacientes e linfócitos B por Fab' por imunofluorescência em 9 pacientes com miastenia grave. Observam elevação significante na população de linfócito B e redução nos linfócitos T totais CD3+ por rosáceas. Não foram observadas modificações nas subpopulações celulares com timectomia e corticosteróides.

Joy Arruda