Dialogues in Clinical Neuroscience最新文献

Introduction: Sleep disturbances and impaired bed mobility are common in Parkinson's disease (PD). We examined whether objectively measured sleep efficiency is associated with axial motor impairment and explored its potential relationship with cognitive and mood profiles.

Methods: Twenty-eight patients with PD underwent single-night EEG-based sleep monitoring and assessment of nocturnal turning. Partial correlations between sleep metrics and scores on motor, cognitive and mood outcomes were analysed, controlling for age, sex and the MDS-UPDRS 3. Family-wise error (FWE) correction was applied within each sleep predictor.

Results: Poor sleep efficiency correlated with higher MDS-UPDRS axial subscore (r_partial = -.615) and this association survived stringent correction for multiple comparisons (FWE-p = .018). However, its associations with PIGD and clinically rated freezing of gait did not remain significant after the correction. Exploratory analyses showed the relationships of N1 percentage with mood disturbances and REM latency with self-reported freezing of gait, of which only the relationship of N1 percentage with depression score showed a trend towards significance after the correction (r_partial =.551, FWE-p = .074).

Conclusion: Poor objective sleep quality was robustly associated with axial motor severity in PD, independent of overall motor burden. Sleep efficiency may represent a clinically accessible marker of shared brainstem-related pathology underlying axial dysfunction.

Introduction: Gender dysphoria (GD) causes distress from gender-sex incongruence with elevated suicide risk, yet its neuropathology remains unclear. The thalamic-cortical functional connectivity (FC) in transgender women (TW) is unexplored. We investigated thalamo-cortical FC and its mediating role in TW's symptom-cognition relationships.

Methods: We retrospectively analysed resting-state fMRI from 44 TW, 40 cisgender men (CM), and 42 cisgender women (CW), between October 2021 and January 2024. Clinical symptoms (GIDYQ-AA) and cognition (MCCB) were assessed. Seed-based thalamic subregion FC and mediation analyses were performed.

Results: Relative to CW, TW and CM exhibited increased FC in multiple thalamo-prefrontal circuits. Compared to CM, TW showed decreased left mPFtha-left DLPFC FC (p = 0.026), and right rTtha-left DLPFC FC (p = 0.025). Compared to CM, right PPtha-right MOG FC (p = 0.023; p < 0.001), and right cTtha-right SOG FC (p = 0.008; p < 0.001) were increased in TW and CW. In TW, left rTtha-bilateral MPFC FC correlated with GIDYQ-AA scores, attention/vigilance, and composite. This FC fully mediated relationships between GD symptoms and both attention/vigilance (bootstrapped 95% CI = 1.861-11.688) and composite (bootstrapped 95% CI = 1.025-12.283).

Conclusions: TW exhibit thalamo-cortical FC abnormalities and cognitive dysfunction. Critically, thalamus-MPFC dysconnectivity mediates GD symptom-related cognitive dysfunction, revealing a novel neural pathway. Validation in larger, diverse samples is needed.

Objective: Internet addiction (IA) is often associated with impaired attention control. Nevertheless, ways to improve this deficit are lacking, and so is the understanding of the mechanisms that such interventions might impact. To address this gap, this study seeks to examine the efficacy of Solution-Focused Group Counselling (SFGC) in enhancing attention networks among individuals with IA.

Methods: A total of 32 college students with high IA scores were recruited, with 26 participants (16 females and 10 males; mean age 19.42 ± 1.10) completing a five-week SFGC intervention. Assessments conducted pre- and post-intervention included the Attention Network Test (ANT) and electroencephalogram (EEG).

Results: Results demonstrated a significant reduction in executive network reaction times (RT) following the intervention. Neurophysiological analyses revealed an increase in P3 amplitude and a decrease in alpha-band event-related desynchronisation (ERD) in the central parietal lobe, suggesting altered executive control. Moreover, a novel event-related potential (ERP) component, termed the Executive Efficiency Difference Wave (EED), was identified. It negatively correlated with executive network RT post-intervention, but not pre-intervention.

Conclusions: Preliminary findings in a small sample suggest that SFGC effectively enhances both behavioural performance and neural indices associated with attention in individuals with IA. We call for future research to examine the broader applicability and long-term efficacy of SFGC.

The temporal evolution of schizophrenia symptoms is inherently complex and non-linear. Clinical states fluctuate between relatively stable and highly disorganised phases. These dynamics are only partially captured by conventional diagnostic frameworks. This limitation has motivated the development of models that explicitly account for temporal structure and state transitions. Dynamical systems theory provides a rigorous framework for describing non-linear interactions and evolving symptom trajectories. Recent advances in longitudinal data acquisition and computational analysis have enabled the identification of informative dynamical features and the characterisation of patient-specific trajectories. This narrative review synthesises the growing body of work applying dynamical systems theory to schizophrenia spectrum disorders. It distinguishes theoretical models, data-driven approaches, and frameworks empirically evaluated against real patient data. It also examines methodological limitations, translational challenges, and the need for further longitudinal validation. The aim is to provide a coherent conceptual framework for understanding schizophrenia as a dynamic process, to promote cross-disciplinary dialogue, and to guide future research in translational computational psychiatry.

Background: Integrating electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) with naturalistic stimuli has advanced our understanding of the neural mechanisms underlying mental disorders. Naturalistic paradigms use dynamic, multimodal stimuli that capture complex emotional and cognitive processes more effectively than traditional experimental designs. Objective: This review synthesizes research from 2014 to 2024 exploring neural mechanisms of anxiety, depression, and schizophrenia within naturalistic paradigms. Methods: Recent EEG-fMRI studies employing naturalistic tasks were examined to identify common and disorder-specific neural alterations across affective and cognitive networks. Results: In anxiety, hyperactivity in the amygdala, prefrontal cortex, anterior cingulate cortex, and insula, together with changes in the dorsal attention, default mode, and frontoparietal networks, reflects excessive fear responses and impaired regulation. Depression is characterized by disruptions in default mode and frontoparietal connectivity and altered amygdala-prefrontal interactions, indicating maladaptive introspection and cognitive control. Schizophrenia shows abnormalities in motor and language processing, with aberrant activity in frontal, parietal, and temporal regions including the insula and temporoparietal junction. Conclusion: These findings highlight the shared involvement of the amygdala, prefrontal cortex, anterior cingulate cortex, and insula across disorders and demonstrate the potential of naturalistic paradigms for advancing personalized diagnostics and interventions in mental health.

Introduction: Depression is a highly heterogeneous disorder with a similarly heterogeneous neurobiological background. Understanding separate depressive phenotypes, driven by distinct aetiological pathways like early trauma and neurobiological contributors, can improve treatment. Furthermore, sex differences must be considered, as both the development and treatment of depression may be sex-specific. We aimed to investigate the sex-dependent association between polygenic risk for chronotypes, childhood traumas, and depression.

Methods: In a discovery sample of 273,033 participants GWASs were ran and polygenic risk scores (PRS) were calculated in a target sample of 25,476 participants, separately for morning and evening chronotypes. Effects of chronotype-PRS in interaction with childhood adversities were analysed.

Results: We identified 39 significant lead-SPNs (single nucleotide polymorphisms) and 44 genes associated with morning chronotype, and 69 significant lead-SNPs and 76 genes for evening chronotype. Heritability was comparable, at 12.1% for morning and 11.8% for evening chronotypes. No significant main effect of either chronotype-PRS was found on depressive symptom scores, however, in interaction with childhood traumas, morningness-PRS showed a significant effect on depressive symptom scores in women.

Discussion: Our findings highlight important sex differences in the aetiological role of known risk factors for depression, such as chronotype or early trauma, and may have implications in the prevention of mood disorders in those genetically vulnerable and exposed to early risk factors.

Introduction: Gratitude plays a crucial role in promoting affective well-being, yet the neural mechanisms underlying their relationship remains unclear. Given the central role of the nucleus accumbens (NAcc) and amygdala in emotion and reward processing, this study investigated whether resting-state functional connectivity (RSFC) of these subcortical regions correlates with trait gratitude and mediates its association with affective well-being.

Methods: Resting-state fMRI data were collected from 363 young adults. Seed-based connectivity analyses identified NAcc and amygdala connectivity patterns associated with trait gratitude. Mediation analyses tested whether these patterns explained the association between gratitude and affective well-being.

Results: Trait gratitude was linked to stronger connectivity between the left NAcc and dorsomedial prefrontal cortex and left posterior superior temporal sulcus; between the right NAcc and left dorsolateral prefrontal cortex (DLPFC), right inferior temporal gyrus and bilateral fusiform; and between the right amygdala and right DLPFC, superior temporal gyrus, cerebellum, and putamen. Critically, the right amygdala-putamen connectivity mediated the relationship between gratitude and positive affective well-being.

Conclusions: The right amygdala-putamen RSFC links gratitude to greater affective well-being. This finding identifies a specific subcortical pathway through which grateful dispositions translate into emotional benefit and suggests a potential target for interventions aimed at improving mental health.

Background: Current pharmacological treatments offer only limited benefits in altering the course of Alzheimer's disease (AD). Given these limitations, nonpharmacological interventions have emerged as potential therapeutic strategies. This study investigates the therapeutic effects of 40 Hz light stimulation in AD and analyzes blood biomarkers to explore its potential disease-modifying effects.

Methods: This longitudinal study examined the effects of 40 Hz light stimulation on clinical symptoms and blood biomarkers in AD patients. Fourteen individuals were enrolled, with 11 completing the 3-month light stimulation, and 6 continuing to 6 months for the final blood biomarker analysis, including amyloid beta (Aβ) oligomers, Aβ-40, Aβ-42, tau phosphorylated at threonine 181 (p-tau181) and 217 (p-tau217), and neurofilament light chain.

Results: At 3 months, cognitive function remained stable or improved in 63.6% of participants, depressive symptoms improved in 54.5%, caregiver burden decreased in 72.7%, and sleep quality improved in 90.9% (p = .014). At 6 months, cognitive function and neuropsychiatric symptoms remained stable or improved in 33.3% and 66.7% of participants, respectively. Biomarker analysis showed decreased Aβ oligomers, increased Aβ-42 and reduced p-tau, suggesting potential disease-modifying effects.

Conclusions: 40 Hz light stimulation demonstrated short-term benefits in cognitive stability, caregiver burden relief, and sleep improvement, with biomarker findings indicating possible neuroprotective effects.

Introduction: Evidence provides support for the therapeutic benefits of targeting avoidance in prolonged grief. However, it is not clear whether avoidance interferes with mourning through altered resilience to stress, as measured by heart rate variability (HRV).

Methods: Thirty-five adults (30 female; mean age: 39.2 years), who had been bereaved for more than one year, participated in this prospective, observational study. At each of the initial assessments and up to six-month follow-ups, grief symptoms were assessed using the Complicated Grief Questionnaire, and a resting electrocardiogram was recorded to extract the high-frequency component of HRV (HF-HRV). To differentiate avoidance from grief itself, principal component analysis was used.

Results: A nonlinear cross-sectional relationship was observed between avoidance and HF-HRV (coefficient = 0.29, p = .003); the lower the avoidance, the lower the HF-HRV in the low avoidance group. Grief improved only in the low avoidance group longitudinally. The observed relationship between increased HF-HRV and decreased grief was modified by the avoidance group, such that the low-avoidance group drove this association (estimate -0.53, 95% CI -0.86, -0.21, p = .001), while the high-avoidance group did not (estimate 0.44, 95% CI -0.32, 1.20, p = .26).

Conclusion: Despite its palliative gain, avoidance relates to the maintenance of grief longitudinally through attenuated autonomic resilience to stress.

Introduction: Brain fog (i.e., subjective cognitive deficits) is one of the most common long-lasting symptoms post-COVID-19. Cognitive deficits and psychological factors (such as depression) are possible causes of brain fog. This study is to determine whether brain fog post-COVID-19 results from cognitive deficits or depression induced by COVID-19 infection.

Methods: We implemented psychological (depression scale) and behavioural measures (dual task: subtraction while walking) with simultaneous functional near-infrared spectroscopy (fNIRS) recording in 25 healthy young adults pre-, 3, 7 and 14 weeks post-COVID-19. Depression level, dual task performance and fNIRS results were compared among sessions. The relationships between brain fog severity, depression and dual task performance were assessed.

Results: Depression level and dual task performance remained unchanged post-COVID-19. Brain fog severity was positively correlated depression at all sessions (p's < 0.05). Brain activation was significantly reduced at all sessions post-COVID-19 (p's < 0.001), while global efficiency was significantly reduced at 7 weeks post-COVID-19 (p = 0.003). Changes in left somatosensory and motor cortices activation were inversely correlated with changes in walking cost (p's = 0.005 and 0.007, respectively), while changes in global efficiency were associated with changes in walking cost (p = 0.006) from pre- to 7 weeks post-COVID-19.

Conclusions: Mild COVID-19 infection does not lead to apparent cognitive deficits or depression, although brain activation and global efficiency are reduced post-COVID-19. Brain fog is likely to result from depression rather than cognitive deficits induced by COVID-19. People should pay attention to their psychological states during COVID-19 pandemic.