Neuronal guidance signaling in neurodegenerative diseases: Key regulators that function at neuron-glia and neuroimmune interfaces

The nervous system processes a vast amount of information, performing computations that underlie perception, cognition, and behavior. During development, neuronal guidance genes, which encode extracellular cues, their receptors, and downstream signal transducers, organize neural wiring to generate the complex architecture of the nervous system. It is now evident that many of these neuroguidance cues and their receptors are active during development and are also expressed in the adult nervous system. This suggests that neuronal guidance pathways are critical not only for neural wiring but also for ongoing function and maintenance of the mature nervous system. Supporting this view, these pathways continue to regulate synaptic connectivity, plasticity, and remodeling, and overall brain homeostasis throughout adulthood. Genetic and transcriptomic analyses have further revealed many neuronal guidance genes to be associated with a wide range of neurodegenerative and neuropsychiatric disorders. Although the precise mechanisms by which aberrant neuronal guidance signaling drives the pathogenesis of these diseases remain to be clarified, emerging evidence points to several common themes, including dysfunction in neurons, microglia, astrocytes, and endothelial cells, along with dysregulation of neuron-microglia-astrocyte, neuroimmune, and neurovascular interactions. In this review, we explore recent advances in understanding the molecular and cellular mechanisms by which aberrant neuronal guidance signaling contributes to disease pathogenesis through altered cell-cell interactions. For instance, recent studies have unveiled two distinct semaphorin-plexin signaling pathways that affect microglial activation and neuroinflammation. We discuss the challenges ahead, along with the therapeutic potentials of targeting neuronal guidance pathways for treating neurodegenerative diseases. Particular focus is placed on how neuronal guidance mechanisms control neuron-glia and neuroimmune interactions and modulate microglial function under physiological and pathological conditions. Specifically, we examine the crosstalk between neuronal guidance signaling and TREM2, a master regulator of microglial function, in the context of pathogenic protein aggregates. It is well-established that age is a major risk factor for neurodegeneration. Future research should address how aging and neuronal guidance signaling interact to influence an individual's susceptibility to various late-onset neurological diseases and how the progression of these diseases could be therapeutically blocked by targeting neuronal guidance pathways.

Metabolic reprogramming of astrocytes: Emerging roles of lactate

Lactate serves as a key energy metabolite in the central nervous system, facilitating essential brain functions, including energy supply, signaling, and epigenetic modulation. Moreover, it links epigenetic modifications with metabolic reprogramming. Nonetheless, the specific mechanisms and roles of this connection in astrocytes remain unclear. Therefore, this review aims to explore the role and specific mechanisms of lactate in the metabolic reprogramming of astrocytes in the central nervous system. The close relationship between epigenetic modifications and metabolic reprogramming was discussed. Therapeutic strategies for targeting metabolic reprogramming in astrocytes in the central nervous system were also outlined to guide future research in central nervous system diseases. In the nervous system, lactate plays an essential role. However, its mechanism of action as a bridge between metabolic reprogramming and epigenetic modifications in the nervous system requires future investigation. The involvement of lactate in epigenetic modifications is currently a hot research topic, especially in lactylation modification, a key determinant in this process. Lactate also indirectly regulates various epigenetic modifications, such as N6-methyladenosine, acetylation, ubiquitination, and phosphorylation modifications, which are closely linked to several neurological disorders. In addition, exploring the clinical applications and potential therapeutic strategies of lactic acid provides new insights for future neurological disease treatments.

Is age-related myelinodegenerative change an initial risk factor of neurodegenerative diseases?

Myelination, the continuous ensheathment of neuronal axons, is a lifelong process in the nervous system that is essential for the precise, temporospatial conduction of action potentials between neurons. Myelin also provides intercellular metabolic support to axons. Even minor disruptions in the integrity of myelin can impair neural performance and increase susceptibility to neurological diseases. In fact, myelin degeneration is a well-known neuropathological condition that is associated with normal aging and several neurodegenerative diseases, including multiple sclerosis and Alzheimer's disease. In the central nervous system, compact myelin sheaths are formed by fully mature oligodendrocytes. However, the entire oligodendrocyte lineage is susceptible to changes in the biological microenvironment and other risk factors that arise as the brain ages. In addition to their well-known role in action potential propagation, oligodendrocytes also provide intercellular metabolic support to axons by transferring energy metabolites and delivering exosomes. Therefore, myelin degeneration in the aging central nervous system is a significant contributor to the development of neurodegenerative diseases. Interventions that mitigate age-related myelin degeneration can improve neurological function in aging individuals. In this review, we investigate the changes in myelin that are associated with aging and their underlying mechanisms. We also discuss recent advances in understanding how myelin degeneration in the aging brain contributes to neurodegenerative diseases and explore the factors that can prevent, slow down, or even reverse age-related myelin degeneration. Future research will enhance our understanding of how reducing age-related myelin degeneration can be used as a therapeutic target for delaying or preventing neurodegenerative diseases.

Optogenetic approaches for neural tissue regeneration: A review of basic optogenetic principles and target cells for therapy

Optogenetics has revolutionized the field of neuroscience by enabling precise control of neural activity through light-sensitive proteins known as opsins. This review article discusses the fundamental principles of optogenetics, including the activation of both excitatory and inhibitory opsins, as well as the development of optogenetic models that utilize recombinant viral vectors. A considerable portion of the article addresses the limitations of optogenetic tools and explores strategies to overcome these challenges. These strategies include the use of adeno-associated viruses, cell-specific promoters, modified opsins, and methodologies such as bioluminescent optogenetics. The application of viral recombinant vectors, particularly adeno-associated viruses, is emerging as a promising avenue for clinical use in delivering opsins to target cells. This trend indicates the potential for creating tools that offer greater flexibility and accuracy in opsin delivery. The adaptations of these viral vectors provide advantages in optogenetic studies by allowing for the restricted expression of opsins through cell-specific promoters and various viral serotypes. The article also examines different cellular targets for optogenetics, including neurons, astrocytes, microglia, and Schwann cells. Utilizing specific promoters for opsin expression in these cells is essential for achieving precise and efficient stimulation. Research has demonstrated that optogenetic stimulation of both neurons and glial cells-particularly the distinct phenotypes of microglia, astrocytes, and Schwann cells-can have therapeutic effects in neurological diseases. Glial cells are increasingly recognized as important targets for the treatment of these disorders. Furthermore, the article emphasizes the emerging field of bioluminescent optogenetics, which combines optogenetic principles with bioluminescent proteins to visualize and manipulate neural activity in real time. By integrating molecular genetics techniques with bioluminescence, researchers have developed methods to monitor neuronal activity efficiently and less invasively, enhancing our understanding of central nervous system function and the mechanisms of plasticity in neurological disorders beyond traditional neurobiological methods. Evidence has shown that optogenetic modulation can enhance motor axon regeneration, achieve complete sensory reinnervation, and accelerate the recovery of neuromuscular function. This approach also induces complex patterns of coordinated motor neuron activity and promotes neural reorganization. Optogenetic approaches hold immense potential for therapeutic interventions in the central nervous system. They enable precise control of neural circuits and may offer new treatments for neurological disorders, particularly spinal cord injuries, peripheral nerve injuries, and other neurodegenerative diseases.

Neural circuit mechanisms of epilepsy: Maintenance of homeostasis at the cellular, synaptic, and neurotransmitter levels

Epilepsy, a common neurological disorder, is characterized by recurrent seizures that can lead to cognitive, psychological, and neurobiological consequences. The pathogenesis of epilepsy involves neuronal dysfunction at the molecular, cellular, and neural circuit levels. Abnormal molecular signaling pathways or dysfunction of specific cell types can lead to epilepsy by disrupting the normal functioning of neural circuits. The continuous emergence of new technologies and the rapid advancement of existing ones have facilitated the discovery and comprehensive understanding of the neural circuit mechanisms underlying epilepsy. Therefore, this review aims to investigate the current understanding of the neural circuit mechanisms in epilepsy based on various technologies, including electroencephalography, magnetic resonance imaging, optogenetics, chemogenetics, deep brain stimulation, and brain-computer interfaces. Additionally, this review discusses these mechanisms from three perspectives: structural, synaptic, and transmitter circuits. The findings reveal that the neural circuit mechanisms of epilepsy encompass information transmission among different structures, interactions within the same structure, and the maintenance of homeostasis at the cellular, synaptic, and neurotransmitter levels. These findings offer new insights for investigating the pathophysiological mechanisms of epilepsy and enhancing its clinical diagnosis and treatment.

Tryptophan metabolism and ischemic stroke: An intricate balance

Ischemic stroke, which is characterized by hypoxia and ischemia, triggers a cascade of injury responses, including neurotoxicity, inflammation, oxidative stress, disruption of the blood-brain barrier, and neuronal death. In this context, tryptophan metabolites and enzymes, which are synthesized through the kynurenine and 5-hydroxytryptamine pathways, play dual roles. The delicate balance between neurotoxic and neuroprotective substances is a crucial factor influencing the progression of ischemic stroke. Neuroprotective metabolites, such as kynurenic acid, exert their effects through various mechanisms, including competitive blockade of N-methyl-D-aspartate receptors, modulation of α7 nicotinic acetylcholine receptors, and scavenging of reactive oxygen species. In contrast, neurotoxic substances such as quinolinic acid can hinder the development of vascular glucose transporter proteins, induce neurotoxicity mediated by reactive oxygen species, and disrupt mitochondrial function. Additionally, the enzymes involved in tryptophan metabolism play major roles in these processes. Indoleamine 2,3-dioxygenase in the kynurenine pathway and tryptophan hydroxylase in the 5-hydroxytryptamine pathway influence neuroinflammation and brain homeostasis. Consequently, the metabolites generated through tryptophan metabolism have substantial effects on the development and progression of ischemic stroke. Stroke treatment aims to restore the balance of various metabolite levels; however, precise regulation of tryptophan metabolism within the central nervous system remains a major challenge for the treatment of ischemic stroke. Therefore, this review aimed to elucidate the complex interactions between tryptophan metabolites and enzymes in ischemic stroke and develop targeted therapies that can restore the delicate balance between neurotoxicity and neuroprotection.

Emerging role of microglia in the developing dopaminergic system: Perturbation by early life stress

Early life stress correlates with a higher prevalence of neurological disorders, including autism, attention-deficit/hyperactivity disorder, schizophrenia, depression, and Parkinson's disease. These conditions, primarily involving abnormal development and damage of the dopaminergic system, pose significant public health challenges. Microglia, as the primary immune cells in the brain, are crucial in regulating neuronal circuit development and survival. From the embryonic stage to adulthood, microglia exhibit stage-specific gene expression profiles, transcriptome characteristics, and functional phenotypes, enhancing the susceptibility to early life stress. However, the role of microglia in mediating dopaminergic system disorders under early life stress conditions remains poorly understood. This review presents an up-to-date overview of preclinical studies elucidating the impact of early life stress on microglia, leading to dopaminergic system disorders, along with the underlying mechanisms and therapeutic potential for neurodegenerative and neurodevelopmental conditions. Impaired microglial activity damages dopaminergic neurons by diminishing neurotrophic support (e.g., insulin-like growth factor-1) and hinders dopaminergic axon growth through defective phagocytosis and synaptic pruning. Furthermore, blunted microglial immunoreactivity suppresses striatal dopaminergic circuit development and reduces neuronal transmission. Furthermore, inflammation and oxidative stress induced by activated microglia can directly damage dopaminergic neurons, inhibiting dopamine synthesis, reuptake, and receptor activity. Enhanced microglial phagocytosis inhibits dopamine axon extension. These long-lasting effects of microglial perturbations may be driven by early life stress-induced epigenetic reprogramming of microglia. Indirectly, early life stress may influence microglial function through various pathways, such as astrocytic activation, the hypothalamic-pituitary-adrenal axis, the gut-brain axis, and maternal immune signaling. Finally, various therapeutic strategies and molecular mechanisms for targeting microglia to restore the dopaminergic system were summarized and discussed. These strategies include classical antidepressants and antipsychotics, antibiotics and anti-inflammatory agents, and herbal-derived medicine. Further investigations combining pharmacological interventions and genetic strategies are essential to elucidate the causal role of microglial phenotypic and functional perturbations in the dopaminergic system disrupted by early life stress.

Current understanding and prospects for targeting neurogenesis in the treatment of cognitive impairment

Adult hippocampal neurogenesis is linked to memory formation in the adult brain, with new neurons in the hippocampus exhibiting greater plasticity during their immature stages compared to mature neurons. Abnormal adult hippocampal neurogenesis is closely associated with cognitive impairment in central nervous system diseases. Targeting and regulating adult hippocampal neurogenesis have been shown to improve cognitive deficits. This review aims to expand the current understanding and prospects of targeting neurogenesis in the treatment of cognitive impairment. Recent research indicates the presence of abnormalities in AHN in several diseases associated with cognitive impairment, including cerebrovascular diseases, Alzheimer's disease, aging-related conditions, and issues related to anesthesia and surgery. The role of these abnormalities in the cognitive deficits caused by these diseases has been widely recognized, and targeting AHN is considered a promising approach for treating cognitive impairment. However, the underlying mechanisms of this role are not yet fully understood, and the effectiveness of targeting abnormal adult hippocampal neurogenesis for treatment remains limited, with a need for further development of treatment methods and detection techniques. By reviewing recent studies, we classify the potential mechanisms of adult hippocampal neurogenesis abnormalities into four categories: immunity, energy metabolism, aging, and pathological states. In immunity-related mechanisms, abnormalities in meningeal, brain, and peripheral immunity can disrupt normal adult hippocampal neurogenesis. Lipid metabolism and mitochondrial function disorders are significant energy metabolism factors that lead to abnormal adult hippocampal neurogenesis. During aging, the inflammatory state of the neurogenic niche and the expression of aging-related microRNAs contribute to reduced adult hippocampal neurogenesis and cognitive impairment in older adult patients. Pathological states of the body and emotional disorders may also result in abnormal adult hippocampal neurogenesis. Among the current strategies used to enhance this form of neurogenesis, physical therapies such as exercise, transcutaneous electrical nerve stimulation, and enriched environments have proven effective. Dietary interventions, including energy intake restriction and nutrient optimization, have shown efficacy in both basic research and clinical trials. However, drug treatments, such as antidepressants and stem cell therapy, are primarily reported in basic research, with limited clinical application. The relationship between abnormal adult hippocampal neurogenesis and cognitive impairment has garnered widespread attention, and targeting the former may be an important strategy for treating the latter. However, the mechanisms underlying abnormal adult hippocampal neurogenesis remain unclear, and treatments are lacking. This highlights the need for greater focus on translating research findings into clinical practice.

Synaptic and synchronic impairments in subcortical brain regions associated with early non-cognitive dysfunction in Alzheimer's disease

For many decades, Alzheimer's disease research has primarily focused on impairments within cortical and hippocampal regions, which are thought to be related to cognitive dysfunctions such as memory and language deficits. The exact cause of Alzheimer's disease is still under debate, making it challenging to establish an effective therapy or early diagnosis. It is widely accepted that the accumulation of amyloid-beta peptide in the brain parenchyma leads to synaptic dysfunction, a critical step in Alzheimer's disease development. The traditional amyloid cascade model is initiated by accumulating extracellular amyloid-beta in brain areas essential for memory and language. However, while it is possible to reduce the presence of amyloid-beta plaques in the brain with newer immunotherapies, cognitive symptoms do not necessarily improve. Interestingly, recent studies support the notion that early alterations in subcortical brain regions also contribute to brain damage and precognitive decline in Alzheimer's disease. A body of recent evidence suggests that early Alzheimer's disease is associated with alterations (e.g., motivation, anxiety, and motor impairment) in subcortical areas, such as the striatum and amygdala, in both human and animal models. Also, recent data indicate that intracellular amyloid-beta appears early in subcortical regions such as the nucleus accumbens, locus coeruleus, and raphe nucleus, even without extracellular amyloid plaques. The reported effects are mainly excitatory, increasing glutamatergic transmission and neuronal excitability. In agreement, data in Alzheimer's disease patients and animal models show an increase in neuronal synchronization that leads to electroencephalogram disturbances and epilepsy. The data indicate that early subcortical brain dysfunctions might be associated with non-cognitive symptoms such as anxiety, irritability, and motivation deficits, which precede memory loss and language alterations. Overall, the evidence reviewed suggests that subcortical brain regions could explain early dysfunctions and perhaps be targets for therapies to slow disease progression. Future research should focus on these non-traditional brain regions to reveal early pathological alterations and underlying mechanisms to advance our understanding of Alzheimer's disease beyond the traditionally studied hippocampal and cortical circuits.

Dual effects of GABA A R agonist anesthetics in neurodevelopment and vulnerable brains: From neurotoxic to therapeutic effects

Debates regarding the specific effects of general anesthesia on developing brains have persisted for over 30 years. A consensus has been reached that prolonged, repeated, high-dose exposure to anesthetics is associated with a higher incidence of deficits in behavior and executive function, while single exposure has a relatively minor effect on long-term neurological function. In this review, we summarize the dose-dependent neuroprotective or neurotoxic effects of gamma-aminobutyric acid type A receptor agonists, a representative group of sedatives, on developing brains or central nervous system diseases. Most preclinical research indicates that anesthetics have neurotoxic effects on the developing brain through various signal pathways. However, recent studies on low-dose anesthetics suggest that they may promote neurodevelopment during this critical period. These findings are incomprehensible for the general "dose-effect" principles of pharmacological research, which has attracted researchers' interest and led to the following questions: What is the threshold for the dual effects exerted by anesthetics such as propofol and sevoflurane on the developing brain? To what extent can their protective effects be maximized? What are the underlying mechanisms involved in these effects? Consequently, this issue has essentially become a "mathematical problem." After summarizing the dose-dependent effects of gamma-aminobutyric acid type A receptor agonist sedatives in both the developing brain and the brains of patients with central nervous system diseases, we believe that all such anesthetics exhibit specific threshold effects unique to each drug. These effects range from neuroprotection to neurotoxicity, depending on different brain functional states. However, the exact values of the specific thresholds for different drugs in various brain states, as well as the underlying mechanisms explaining why these thresholds exist, remain unclear. Further in-depth exploration of these issues could significantly enhance the therapeutic translational value of these anesthetics.

Associations of anxiety and depression with prognosis in chronic obstructive pulmonary disease: A systematic review and meta-analysis

The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.

Unraveling cysteinyl leukotrienes and their receptors in inflammation through the brain-gut-lung axis

Cysteinyl leukotrienes (CysLTs), as potent lipid inflammatory mediators, play a pivotal role in systemic multi-organ inflammation and inter-organ communication through interactions with their receptors (CysLTRs). However, However, the function of CysLT3R is unclear and lacks a network of cross-organ metabolite interactions, and the clinical use of leukotriene receptor antagonists (LTRAs) has certain limitations. This review systematically synthesizes existing evidence and proposes future directions by clarifying receptor subtype specificity, optimizing targeted therapies, exploring CysLTs' applications in neuroimmunology, and elucidating the dual roles of CysLTs in chronic inflammation. It is indicated that CysLTs activate eosinophils, mast cells, and airway tuft cells, driving type 2 immune responses and mucus secretion in the lungs, thereby exacerbating respiratory diseases such as asthma. In the nervous system, CysLTs aggravate neurodegenerative disorders like cerebral ischemia and Alzheimer's disease by disrupting the blood-brain barrier, promoting glial activation, and inducing neuronal damage. In the gut, CysLTs regulate anti-helminth immunity via the tuft cell-ILC2 pathway and collaborate with prostaglandin D2 (PGD2) to modulate bile excretion and mucosal protection. Furthermore, CysLTs mediate communication through the gut-lung and gut-brain axes via metabolites such as succinate, contributing to cross-organ inflammatory regulation. In conclusion, this review highlights the complex roles of CysLTs in chronic inflammation, providing a theoretical foundation for precise intervention in multi-organ inflammatory diseases, which provides a theoretical framework for precision interventions in multi-organ inflammatory diseases and inspires interdisciplinary breakthroughs.

The impact of trauma and how to intervene: a narrative review of psychotraumatology over the past 15 years

To mark 15 years of the European Journal of Psychotraumatology, editors reviewed the past 15-year years of research on trauma exposure and its consequences, as well as developments in (early) psychological, pharmacological and complementary interventions. In all sections of this paper, we provide perspectives on sex/gender aspects, life course trends, and cross-cultural/global and systemic societal contexts. Globally, the majority of people experience stressful events that may be characterized as traumatic. However, definitions of what is traumatic are not necessarily straightforward or universal. Traumatic events may have a wide range of transdiagnostic mental and physical health consequences, not limited to posttraumatic stress disorder (PTSD). Research on genetic, molecular, and neurobiological influences show promise for further understanding underlying risk and resilience for trauma-related consequences. Symptom presentation, prevalence, and course, in response to traumatic experiences, differ depending on individuals' age and developmental phase, sex/gender, sociocultural and environmental contexts, and systemic socio-political forces. Early interventions have the potential to prevent acute posttraumatic stress reactions from escalating to a PTSD diagnosis whether delivered in the golden hours or weeks after trauma. However, research on prevention is still scarce compared to treatment research where several evidence-based psychological, pharmacological and complementary/ integrative interventions exist, and novel forms of delivery have become available. Here, we focus on how best to address the range of negative health outcomes following trauma, how to serve individuals across the age spectrum, including the very young and old, and include considerations of sex/gender, ethnicity, and culture in diverse contexts, beyond Western, Educated, Industrialized, Rich, and Democratic (WEIRD) countries. We conclude with providing directions for future research aimed at improving the well-being of all people impacted by trauma around the world. The 15 years EJPT webinar provides a 90-minute summary of this paper and can be downloaded here [http://bit.ly/4jdtx6k].

Self-compassion mediates treatment effects in MDMA-assisted therapy for posttraumatic stress disorder

Background: Posttraumatic stress disorder (PTSD) is a severe condition often complicated by co-occurring disorders, such as major depression, alcohol use disorder, and substance use disorders. A well-powered phase 3 randomized, placebo-controlled trial has shown that MDMA-assisted therapy (MDMA-AT) may be an effective treatment for severe PTSD. However, the psychological mechanisms driving the therapeutic effects of MDMA-AT remain unclear. One potential mechanism is self-compassion, which is commonly conceptualized as a balance between compassionate self-responding (CS) - encompassing self-kindness, common humanity, and mindfulness - and uncompassionate self-responding (UCS) - encompassing self-judgment, isolation, and over-identification.Objective: This secondary analysis aimed to explore whether MDMA-AT enhances aspects of self-compassion and if changes in self-compassion mediate the therapy's effectiveness in reducing PTSD severity, depressive, and alcohol and substance use symptoms.Method: Eighty-two adults diagnosed with severe PTSD participated in a double-blind trial comparing three sessions of either MDMA-AT or placebo combined with therapy. Measures of PTSD severity, depressive symptoms, alcohol and substance use, and self-compassion were collected at baseline and 18 weeks later.Results: MDMA-AT led to statistically significant improvements in both UCS and CS. Significant improvements were also observed across all six subscales of the Self-Compassion Scale, including self-kindness, self-judgment, common humanity, isolation, mindfulness, and over-identification, most with large effect sizes. Changes in UCS and CS significantly and fully mediated the effects of MDMA-AT compared to placebo plus therapy in reducing PTSD severity and depressive symptoms. Findings were not significant for alcohol and substance use outcomes.Conclusions: These findings suggest that self-compassion may play a critical role in the therapeutic effects of MDMA-AT. Further research is needed to investigate the role of self-compassion in MDMA-AT to refine and develop more targeted, effective interventions for individuals with PTSD and co-occurring depression.

Potential of ultrasound stimulation and sonogenetics in vision restoration: a narrative review

Vision restoration presents a considerable challenge in the realm of regenerative medicine, while recent progress in ultrasound stimulation has displayed potential as a non-invasive therapeutic approach. This narrative review offers a comprehensive overview of current research on ultrasound-stimulated neuromodulation, emphasizing its potential as a treatment modality for various nerve injuries. By examining of the efficacy of different types of ultrasound stimulation in modulating peripheral and optic nerves, we can delve into their underlying molecular mechanisms. Furthermore, the review underscores the potential of sonogenetics in vision restoration, which involves leveraging pharmacological and genetic manipulations to inhibit or enhance the expression of related mechanosensitive channels, thereby modulating the strength of the ultrasound response. We also address how methods such as viral transcription can be utilized to render specific neurons or organs highly responsive to ultrasound, leading to significantly improved therapeutic outcomes.

A stacking classifier for distinguishing stages of Alzheimer's disease from a subnetwork perspective

Accurately distinguishing stages of Alzheimer's disease (AD) is crucial for diagnosis and treatment. In this paper, we introduce a stacking classifier method that combines six single classifiers into a stacking classifier. Using brain network models and network metrics, we employ t-tests to identify abnormal brain regions, from which we construct a subnetwork and extract its features to form the training dataset. Our method is then applied to the ADNI (Alzheimer's Disease Neuroimaging Initiative) datasets, categorizing the stages into four categories: Alzheimer's disease, mild cognitive impairment (MCI), mixed Alzheimer's mild cognitive impairment (ADMCI), and healthy controls (HCs). We investigate four classification groups: AD-HCs, AD-MCI, HCs-ADMCI, and HCs-MCI. Finally, we compare the classification accuracy between a single classifier and our stacking classifier, demonstrating superior accuracy with our stacking classifier from a subnetwork-based viewpoint.

3T dilated inception network for enhanced autism spectrum disorder diagnosis using resting-state fMRI data

Autism spectrum disorder (ASD) is one of the complicated neurodevelopmental disorders that impacts the daily functioning and social interactions of individuals. It includes diverse symptoms and severity levels, making it challenging to diagnose and treat efficiently. Various deep learning (DL) based methods have been developed for diagnosing ASD, which rely heavily on behavioral assessment. However, existing techniques have suffered from poor diagnostic outcomes, higher computational complexity, and overfitting issues. To address these challenges, this research work introduces an innovative framework called 3T Dilated Inception Network (3T-DINet) for effective ASD diagnosis using resting-state functional Magnetic Resonance Imaging (rs-fMRI) images. The proposed 3T-DINet technique designs a 3T dilated inception module that incorporates dilated convolutions along with the inception module, allowing it to extract multi-scale features from brain connectivity patterns. The 3T dilated inception module uses three distinct dilation rates (low, medium, and high) in parallel to determine local, mid-level, and global features from the brain. In addition, the proposed approach implements Residual networks (ResNet) to avoid the vanishing gradient problem and enhance the feature extraction ability. The model is further optimized using a Crossover-based Black Widow Optimization (CBWO) algorithm that fine-tunes the hyperparameters thereby enhancing the overall performance of the model. Further, the performance of the 3T-DINet model is evaluated using the five ASD datasets with distinct evaluation parameters. The proposed 3T-DINet technique achieved superior diagnosis results compared to recent previous works. From this simulation validation, it's clear that the 3T-DINet provides an excellent contribution to early ASD diagnosis and enhances patient treatment outcomes.

Assessing neurocognitive outcomes in PTSD: a multilevel meta-analytical approach

Background: Evidence supporting the association between posttraumatic stress disorder (PTSD) and cognitive impairment is accumulating. However, less is known about which factors influence this association.Objective: The aims of this meta-analysis were to (1) elucidate the association between PTSD and a broad spectrum of cognitive impairment, including the risk of developing neurocognitive disorder (NCD) later in life, using a multilevel meta-analytic approach, and (2) identify potential moderating factors of this association by examining the effects of age (20-39, 40-59, 60+), study design (cross-sectional or longitudinal), study population (war-exposed populations/veterans or the general population), neurocognitive outcome assessed (i.e. a diagnosis of NCD or type of cognitive domain as classified according to A Compendium of Neuropsychological tests), gender (≥50% women or <50% women), study quality (high vs low), type of PTSD measure (self-report or clinical diagnosis), as well as the presence of comorbidities such as traumatic brain injury (TBI), depression, and substance use (all coded as either present or absent).Method: Peer-reviewed studies on this topic were extracted from PubMed and Web of Science with predetermined keywords and criteria. In total, 53 articles met the criteria. Hedge's g effect sizes were calculated for each study and a three-level random effect meta-analysis conducted.Results: After accounting for publication bias, the results suggested a significant association between PTSD and cognitive impairment, g = 0.13 (95% CI: 0.10-0.17), indicating a small effect. This association was consistent across all examined moderators, including various neurocognitive outcomes, age, gender, study design, study population, study quality, type of PTSD measure, and comorbidities such as depression, substance use, and TBI.Conclusions: These findings collectively suggest that PTSD is associated with both cognitive impairment and NCD. This emphasizes the need for early intervention (including prevention strategies) of PTSD, alongside monitoring cognitive function in affected individuals.International Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42021219189, date of registration: 02.01.2021.

Dissecting the shared molecular mechanisms underlying polycystic ovary syndrome and schizophrenia etiology: a translational integrative approach

Recent evidence suggests that individuals with polycystic ovary syndrome (PCOS) have an increased risk of developing mental health disorders and comorbidities linked to nervous system dysfunction. Interestingly, patients with schizophrenia (SCZ) often exhibit PCOS symptoms, indicating a possible connection between the two conditions. However, the underlying molecular links between these diseases remain poorly understood. We employed a comprehensive in-silico approach, utilizing publicly available datasets to investigate shared biomarkers candidates and key regulators involved in the development of PCOS and SCZ. We retrieved the datasets from the NCBI GEO database and differentially expressed genes (DEGs) were identified for each dataset. Common DEGs (cDEGs) were determined, and transcription factors (TFs) and miRNA targeting cDEGs were examined using the mirDIP portal and TRRUST database, respectively. We also assessed the TF-miRNA interactions by TransmiR database and constructed a regulatory network including TFs-microRNAs-cDEGs. Our analysis identified a total of 15 cDEGs that are regulated by 15 TFs and 8 mRNAs. Among our findings, we prioritized RELA as a potential TF regulator for both diseases, demonstrating synergistic interaction with four cDEGs (EGR1, CXCL8, IL1RN, IL1B) and seven microRNAs (hsa-miR-580, hsa-miR-5695, hsa-miR-936, hsa-miR-3675, hsa-miR-634, hsa-miR-603, hsa-miR-222) that target these genes. Our data highlights potential common biomarkers for PCOS and SCZ, presenting a novel regulatory network that elucidates the molecular mechanisms underlying both conditions. This emphasizes the importance of further research to explore new translational approaches, which may ultimately lead to improved diagnostic and therapeutic strategies for affected individuals.

The relationship between childhood trauma, rs1360780 genotypes, FKBP5 intron 7 methylation and posttraumatic stress disorder in women who have experienced rape

Background: Posttraumatic stress disorder (PTSD) is a common sequela of rape. Dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, a core regulator of the stress response, has been implicated in the aetiology and chronicity of PTSD. FK506 binding protein (FKBP5) is a co-chaperone and functional regulator of the glucocorticoid receptor and the HPA-axis.Objective: This study investigated main and interaction effects of childhood trauma and the FKBP5 rs1360780 genotype on longitudinal FKBP5 intron 7 methylation, and whether change in FKBP5 methylation over time was associated with PTSD symptom severity over time.Method: Women who experienced rape (n = 96) were recruited from post-rape care services in KwaZulu Natal, South Africa. Total PTSD symptom scores, derived from the Davidson Trauma Scale, were assessed at baseline, 3-months and 6-months post-rape. Methylation levels at five FKBP5 intron 7 CpG sites were determined using EpiTYPER Sequenom MassArray technology. Genotyping of rs1360980 was completed using the Agena MassArray genotyping system. Mixed linear regression models were used to analyse the data.Results: The interaction between rs1360780 genotype and childhood trauma was a significant predictor of FKBP5 methylation over time. There was a significant positive correlation between childhood trauma and methylation levels in participants with the CT and TT genotypes, while there was a significant negative correlation between childhood trauma and methylation in CC genotype carriers. FKBP5 methylation was not a predictor of PTSD scores over time.Conclusion: This is the first study to investigate longitudinal change in FKBP5 methylation in a demographically homogenous same-trauma sample. The findings implicate childhood trauma and FKBP5 rs1360980 genotype in the trajectory of FKBP5 methylation levels in the aftermath of rape. Further research is needed to investigate the longitudinal role of FKBP5 intron 7 methylation in relation to PTSD symptom trajectories post-rape.

Comparison of neurological and psychiatric profiles of people with epilepsy based on the presence and timing of potentially psychologically traumatic experiences

Objective: While psychological trauma in people with epilepsy (PWE) is a major issue, there is limited research on the interactions between such trauma and epilepsy. Therefore, our primary aim is to describe types and timing of potentially psychologically traumatic experiences (PPTE) in relation to epilepsy onset. Our secondary objective is to evaluate the impact of the timing of the PPTE on patients' psychiatric and neurological profiles.Methods: We conducted an observational study involving 182 PWE, excluding patients with comorbid functional/dissociative seizures. All participants underwent a comprehensive psychiatric evaluation, including biographical, neurological, psychiatric, and traumatic data collection through a semi-structured clinical interview and standardized scales. We compared the neurological and psychiatric characteristics of three groups of patients: those without PPTE, those with PPTE occurring before the onset of epilepsy, and those with PPTE occurring after the onset of their epilepsy.Results: Sixty-one patients (33.5%) reported having experienced PPTE before the onset of epilepsy, 65 patients (35.7%) reported having experienced PPTE after the onset of their epilepsy, and 56 patients (30.8%) had no history of PPTE neither before nor after the onset of epilepsy. The 'before' group had a significantly higher prevalence of epilepsy localized in the temporal lobe (p = .043). The 'after' group showed significantly more general psychiatric symptoms (p = .026), as well as more postictal mood and anxiety symptoms (p = .014). Additionally, the 'before' group reported a higher number of past traumatic experiences, with childhood traumatic experiences being more prevalent. According to our multinomial logistic regression model, higher temporal localization (p = .028) and fewer febrile seizures (p = .030) were significant predictors for the 'before' group.Significance: This study highlights the potential impact of the timing of PPTE on patients' psychiatric and neurological profiles. It underscores the importance of systematically assessing psychiatric and posttraumatic comorbidities in PWE. The role of trauma in temporal epilepsy requires further investigation.

A polyepigenetic glucocorticoid exposure score and HPA axis-related DNA methylation are associated with gestational epigenetic aging

Gestational epigenetic aging (GEA) is a novel approach for characterizing associations between prenatal exposures and postnatal risks. Psychosocial adversity in pregnancy may influence GEA, but the molecular mechanisms are not well understood. DNA methylation to glucocorticoid regulation and hypothalamic-pituitary-adrenal (HPA) axis genes are implicated but have not been fully examined in association with GEA. This study investigated whether a polyepigenetic glucocorticoid exposure score (PGES) and HPA axis gene (NR3C1, HSD11B2, FKBP5) methylation were associated with GEA, and whether associations were sex-specific. Participants were from a prospective cohort of racial/ethnic diverse and socially disadvantaged pregnant women and infants (n = 200). DNA methylation variables were estimated using umbilical cord blood. PGES was derived with CpGs shown to be sensitive to synthetic dexamethasone exposure. NR3C1, HSD11B2, and FKBP5 methylation was summarized via factor analysis. We found that PGES (β = -1.12, SE = 0.47, p = 0.02) and several NR3C1 and FKBP5 factor scores were associated with decelerated GEA (all p < 0.05). A significant sex interaction was observed for FKBP5 factor score 3 (β = -0.34, SE = 0.15, p = 0.02) suggesting decelerated GEA for males but not females. This study showed that glucocorticoid regulation-related DNA methylation was associated with a decelerated aging phenotype at birth that might indicate a neonatal risk.

Factors working against suicidal attempts in nursing home residents under COVID-19

This study examines the protective and risk factors for suicide among nursing home residents as well as strategies to prevent suicide. In this study, semi-structured interviews are used to interpret the experiences and perceptions of nursing home residents regarding suicide attempts. The research is conducted using the technique of content analysis with Nvivo. Researchers have assessed this study for clarity. The experiences of nursing home residents with suicidal ideation were divided into three categories, nine sub-themes, and relevant theme clusters. The three categories were: (a) protective factors for suicide prevention; (b) risk factors for suicide attempts; and (c) suicide prevention strategies. These factors and strategies were found to be associated with suicide ideation and attempts. Factors and strategies influencing suicidal ideation and attempts among nursing home residents revealed some new issues and problems during COVID-19, allowing healthcare providers to better understand nursing home residents and improve intervention strategies in practice.

Hippocampal connectivity changes after traumatic memory reactivation with propranolol for posttraumatic stress disorder: a randomized fMRI study

Background: Reactivation of traumatic memory under the influence of propranolol has shown encouraging clinical results in the treatment of posttraumatic stress disorder (PTSD), but the neural correlates remain unknown. To identify these correlates, we examined the changes in brain functional connectivity specifically associated with the influence of propranolol and their correlation with improvement in PTSD symptoms.Objectives: To identify resting-state functional connectivity (rs-FC) changes specifically associated with propranolol after a traumatic memory reactivation procedure (TMRP) in PTSD patients.Method: Thirty patients (50% of women) with PTSD were enrolled in a randomized controlled study comprised of six sessions of a traumatic memory reactivation procedure (TMRP) under the influence of propranolol (n = 16), compared to the same reactivation under a placebo (n = 14). Patients were scanned twice by functional magnetic resonance before and after treatment. Resting state functional connectivity (rs-FC) was compared across groups and over time.Results: Post versus pretreatment comparisons found an increase in rs-FC between the right hippocampus and the left parahippocampal gyrus in the propranolol group, but not in the placebo group. Symptom improvement in both groups were associated with an increase in rs-FC between the parahippocampal gyrus and both the supramarginal gyrus and the amygdala.Conclusions: During TMRP treatment, propranolol appears to constrain functional connectivity changes in the explicit memory brain system. These findings require further replication and exploration but could distinguish the effect of TMRP on the brain from other forms of PTSD psychotherapy.

Analysis of brain network effective connectivity in juvenile myoclonic epilepsy

Juvenile Myoclonic Epilepsy (JME) is a prevalent idiopathic generalized epilepsy whose neurophysiological mechanisms remain elusive. This study aims to elucidate the aberrant brain network patterns in JME through a multi-modal fMRI approach combining local consistency, functional connectivity, and causal interaction analysis. Resting-state fMRI data were acquired from 37 JME patients and 35 healthy controls. Regional homogeneity (ReHo) and amplitude of low-frequency fluctuations (ALFF) analyses identified eight brain regions with significant between-group differences (FDR-corrected p < 0.05), including the right middle frontal gyrus, right insula, right medial/paracingulate gyrus, bilateral superior frontal gyri, left postcentral gyrus, and left superior occipital gyrus. These regions served as regions of interest (ROIs) for subsequent functional and effective connectivity analyses. Functional connectivity analysis revealed increased connectivity strength between the right middle frontal gyrus and right medial or paracingulate gyrus, as well as between the right insula and right medial/paracingulate gyrus (two-sample t test, p < 0.01), despite decreased local synchrony in these regions. Dynamic causal modeling (DCM) demonstrated bidirectional enhancement of effective connectivity between the right insula and right medial or paracingulate gyrus in patients (Bayesian posterior probability > 0.95). These findings suggest that the observed decoupling of local neuronal synchronization and long-range connectivity may reflect compensatory neuroadaptive processes, particularly involving the salience network (insula) and cognitive control circuitry (cingulate regions).The integration of ReHo/ALFF mapping with DCM provides a novel framework for understanding the neurodevelopmental trajectory of JME, highlighting the critical role of cortico-subcortical dysregulation in its pathogenesis.

The role of long-term hair steroids as diagnostic and intervention-related biomarkers in a multimorbid inpatient sample with posttraumatic stress disorder

Background: Steroid hormone dysregulations have frequently been implicated in posttraumatic stress disorder (PTSD) pathogenesis. However, the translation into naturalistic clinical settings as markers of symptomatology and treatment success remains complex. Particularly, there is little longitudinal data on steroid secretion over the course of interventions.Objective: This study examined the potential of long-term steroid hormone secretion assessed in hair as diagnostic and intervention-related biomarkers among medicated, multimorbid inpatients with PTSD.Method: As part of a secondary analysis of a randomised controlled trial, 54 female inpatients with a primary diagnosis of PTSD received standardised treatment and provided hair samples at pre-treatment, post-treatment, and 3-month follow-up. Cortisol, cortisone, and dehydroepiandrosterone (DHEA) were determined, alongside clinical assessments.Results: Cross-sectional results showed a negative association of pre-treatment DHEA with anxiety symptoms and a trend-level association with lifetime trauma exposure. While inpatients improved in PTSD symptomatology during treatment, neither pre-treatment steroids, nor treatment-induced steroid changes predicted PTSD symptoms at post-treatment or 3-month follow-up.Conclusion: The study highlights the challenges of establishing biomarkers in naturalistic clinical populations. While the association of attenuated DHEA with anxiety symptoms warrants further exploration, our data points towards the potential necessity of patient sub-sample selection to understand, and in the long run clinically target, the endocrine mechanisms in PTSD.

Trauma exposure, prevalence and associated factors of complex PTSD in mainland China: a cross-sectional survey

Background: The ICD-11 distinguishes Complex Post-Traumatic Stress Disorder (CPTSD) as a separate trauma-related disorder from PTSD. While numerous studies have examined these conditions globally, no nationwide research has yet investigated their one-month prevalence and associated factors in the general population of China.Objective: This study aimed to determine the one-month prevalence of ICD-11 CPTSD and identify associated factors within a general adult sample in mainland China.Methods: A total of 2,115 adults living in mainland China participated in an online survey. PTSD and CPTSD were assessed using the International Trauma Questionnaire (ITQ) based on ICD-11 criteria. Trauma exposure was measured via the International Trauma Exposure Measure (ITEM). Multinomial logistic regression identified associated factors for PTSD and CPTSD.Results: Among participants, 88.2% reported at least one traumatic exposure. The prevalence of PTSD and CPTSD was 4.9% and 4.5%, respectively. Shared predictors for both conditions included a greater number of siblings, broader interpersonal trauma exposure during adolescence, and more frequent and recent index trauma events. Specific predictors for CPTSD included female gender, older age, being left behind by migrant parents, lower socioeconomic status, and broader trauma exposure in adulthood.Conclusion: This study provides the first estimates of ICD-11 PTSD and CPTSD prevalence in the general population of mainland China, revealing relatively high rates compared to other mental disorders. Findings highlight key associated factors and offer intervention recommendations for at-risk groups.

Akkermansia muciniphila reverses neuronal atrophy in Negr1 knockout mice with depression-like phenotypes

Genetic predispositions can shape the gut microbiome, which in turn modulates host gene expression and impacts host physiology. The complex interplay between host genetics and the gut microbiome likely contributes to the development of neuropsychiatric disorders, yet the mechanisms behind these interactions remain largely unexplored. In this study, we investigated the gut microbiota in Negr1 knockout (KO) mice, which exhibit anxiety- and depression-like behaviors, as NEGR1 (neuronal growth regulator 1) is a cell adhesion molecule linked to neuronal development and neuropsychiatric disorders. Our findings show significant early-life alterations in the gut microbiota composition of Negr1 KO mice, most notably a marked reduction in Akkermansia spp. along with reduced dendritic arborization and spine density in the nucleus accumbens (NAc) and the dentate gyrus (DG) of the hippocampus. Remarkably, daily administration of an Akkermansia strain isolated from wild-type mice reversed the neuronal structural abnormalities and ameliorated anxiety- and depression-like behaviors in Negr1 KO mice. Transcriptomic profiling revealed upregulation of mitochondrial genome-encoded genes in the NAc and hippocampus of Negr1 KO mice, along with a predisposition toward a pro-inflammatory state in the colon of Negr1 KO mice. The Akkermansia supplementation downregulated these mitochondrial genes in the NAc and hippocampus and upregulated genes involved in T cell activation and immune homeostasis in the colon. These findings demonstrate a novel gene-microbiome interaction in the pathophysiology of Negr1 KO mice, positioning Akkermansia spp. as a key mediator that improves neuronal atrophy and modulates anxiety- and depression-like behaviors. Our study provides compelling evidence for bidirectional interactions between host genetics and the gut microbiome in modulating neuropsychiatric phenotypes, offering new insights for addressing genetically influenced mental disorders.

Prevalence of war-related posttraumatic stress disorder in adolescents: a systematic review and meta-analysis

Background: Posttraumatic stress disorder is common in civilians who are currently experiencing, or who have experienced, war. Most previous studies have focused on adult populations and, despite the recognised detrimental effect of war trauma on adolescent mental health, there remains a paucity of evidence on the prevalence of war-related PTSD in adolescents.Objective: This pre-registered (https://osf.io/dqg2z) systematic review and meta-analysis aims to understand the prevalence of PTSD, as well as both risk and protective factors for developing PTSD, in adolescents aged 10-24 years from across the world who are experiencing, or have experienced, war-related traumatic events, described in papers published in a 10 year period (2013-2023). We also examine how the choice of PTSD diagnostic assessment tool influences prevalence rates.Method: Medline (PubMed), PsycINFO (EBSCOhost), and PTSDpubs (ProQuest) were searched, which resulted in 21 papers eligible for inclusion. Data was searched, extracted and synthesised using the software tool Covidence.Results: The age range of adolescents in the included papers was 11-19 years. The average prevalence of PTSD was 29.4% (95% CI [18.7%, 43.0%]), although prevalence rates across studies were highly inconsistent (I2 = 99.4%). Prevalence rates were significantly higher in studies conducted longer after war exposure, and the PTSD diagnostic assessment tool used influenced prevalence.Conclusions: There is high prevalence of PTSD in adolescents during and after war. The prevalence of war-related PTSD increases with time in the post-war period, highlighting the need for access to psychological services following war. This study underscores the importance of defining age ranges and using validated and culturally sensitive assessment tools when interpreting prevalence rates of PTSD in adolescents.

Mind at rest, mind at risk: A prospective population-based study of sleep and subsequent mental disorders

Background

Depression and anxiety disorders are highly prevalent among young adults, with evidence suggesting sleep problems as key risk factors.

Objective

This study aimed to examine the association between insomnia and sleep characteristics with major depressive episode (MDE) and anxiety disorders, and the association after accounting for baseline mental health symptoms.

Methods

We conducted a prospective cohort study using data from the Students' Health and Wellbeing Study (SHoT), surveying Norwegian higher education students aged 18 to 35 (N = 53,362). A diagnostic assessment of 10,460 participants was conducted in 2023. Self-reported insomnia, sleep duration, sleep onset latency, and wake after sleep onset were recorded in 2022. MDE and five types of anxiety disorders were assessed after one year using a self-administered CIDI 5.0. Analyses adjusted for age, sex, baseline mental health symptoms, and somatic conditions.

Results

Insomnia in young adults was associated with a significantly increased risk of MDE (adjusted RR = 3.50, 95 % CI = 3.18-3.84) and generalized anxiety disorder (GAD) (adjusted RR = 2.82, 95 % CI = 2.55-3.12) one year later. Sleep duration showed a reversed J-shaped association with mental disorders, with both short and, to a lesser extent, long sleep durations linked to elevated risks, even after adjusting for baseline mental health symptoms and somatic conditions. Although the associations were attenuated after adjustment, they remained statistically significant.

Conclusion

Sleep disturbances, including insomnia and abnormal sleep durations, predict mental health issues in young adults, even after accounting for baseline mental health and somatic health. Addressing sleep problems early may help prevent subsequent mental health conditions in this population.

Assessment of depression in patients admitted with acute coronary syndrome: a double-blind study

Depression commonly accompanies acute coronary syndrome (ACS), impacting up to 30% of patients and correlating with adverse outcomes. Our study aimed to assess the accuracy of clinical impression compared to the PHQ9 questionnaire for evaluating depression in ACS patients admitted to the cardiac intensive care unit. Screening for depression was conducted at least 48 hours from hospital admission and 24 hours following coronary angiography and PCI. The assessment was performed separately and in a blinded manner by the clinical assessment of the attending medical team and by the PHQ9 questionnaire. The study comprised 150 ACS patients with a mean age of 62 ± 13 years. Baseline clinical and demographic characteristics were typical for ACS patients. Based on the PHQ9 questionnaire, depressive symptoms were above the cutoff for clinical depression in 31 (20.7%) patients, with 10 (32.3%) of them experiencing moderate or severe depression (PHQ9 score >15). There were no significant differences in clinical baseline characteristics between the groups with and without clinical depression. Compared to the PHQ9 questionnaire, the medical team's assessment of depression demonstrated a reasonable specificity of 84% and low sensitivity of 32%. Negative and positive predictive values were 82.6% and 35.8%, respectively. Similar findings were observed in subgroup analyses according to gender, age, type of ACS, and history of cardiovascular disease. Depression is prevalent among ACS patients, highlighting the importance of an increased awareness of this condition. Our findings suggest that detecting clinically significant severity of depressive symptoms by the attending medical team alone may not suffice for depression assessment. Incorporating validated screening tools such as the PHQ9 questionnaire or involving psychological evaluations can enhance the accuracy of depression diagnosis in ACS patients. This multifaceted approach is crucial for ensuring comprehensive care and improving patient outcomes.

The impact of intimate partner violence on facial emotion recognition among Korean baby boomers

ABSTRACTBackground: Intimate partner violence (IPV) can have lasting psychological and cognitive effects, potentially impairing facial emotion recognition (FER). This study examines the accuracy of FER among IPV survivors compared to individuals without IPV experience within the Korean baby boomer generation, aged 60-69, exploring the relationship between IPV, post-traumatic stress disorder (PTSD) symptoms, and FER abilities.Objective: To assess whether IPV impacts FER accuracy and intensity and to investigate whether symptoms of PTSD moderate this relationship.Method: The study included 80 participants, with 31 % identified as IPV survivors. A self-administered survey collected information on lifetime experiences of physical, emotional, and sexual abuse, as well as assessments for PTSD symptoms. Participants completed the Korean Montreal Cognitive Assessment (K-MOCA) and performed 70 FER tasks to evaluate accuracy and intensity of facial emotions. Logistic regressions were used to analyse the relationship between IPV, PTSD symptoms, and FER performance.Results: IPV survivors demonstrated 0.64 times lower accuracy in recognizing overall facial emotions, including anger, sadness, surprise, and neutral expressions Additionally, IPV survivors exhibited significantly lower intensity scores for overall facial expressions. Significant interaction terms between IPV and PTSD symptoms indicate that PTSD symptoms moderate the effect of IPV on the FER, as well as neutral and sad facial expressions.Conclusions: IPV can disrupt one's ability to recognize facial emotions, and PTSD symptoms may moderate this impairment. This highlights the potential benefits of assisting IPV survivors with emotion recognition as part of their recovery process, which could enhance both social connections and their safety.

Sex- and ALDH2-dependent differences in alcohol metabolism and psychomotor performance: a study in Han Chinese adults after binge drinking

BACKGROUND

Psychomotor impairments due to alcohol consumption may lead to a series of negative consequences. However, the influence of sex and ALDH2 polymorphism on psychomotor dysfunction has not yet been investigated.

METHODS

One-hundred and three participants, genotyped for ALDH2 rs671, were administered a dose of 1.0 g/kg of white spirits. The blood ethanol concentration (BEC) and acetaldehyde concentration (BAAC) were measured at specific time intervals before and after alcohol consumption. Additionally, auditory simple reaction time (ASRT), visual choice reaction time (VCRT), pursuit tracking task (PTT) and digit-symbol substitution test (DSST) were used to evaluate psychomotor function. Linear mixed-effects model was used to analyze the effects of sex and the ALDH2 genotype on alcohol metabolism and psychomotor function..

RESULTS

Acetaldehyde metabolism depended on both ALDH2 genotype and sex. Women with ALDH2*1/*1 genotype exhibited 2.21 to 18.27 µmol/L higher BAAC levels than men with the same genotype. Conversely, among participants with ALDH2*1/*2 genotype, BAAC levels of women were 0.25 to 31.32 µmol/L lower than men. The impact of ALDH2 genotype on psychomotor function varied across the four tests. VCRT increased significantly in men with ALDH2*1/*2 genotype compared to those with ALDH2*1/*1 at 2-4 h post-consumption. In the PTT test, the percentage of time on target decreased by 3.83% and 3.11% in women relative to men at 1 and 2 h post-consumption, respectively. Notably, ASRT performance was significantly correlated with BAAC levels. No effects of ALDH2 genotype and sex were observed on DSST performance.

CONCLUSIONS

ALDH2 genotype and sex independently or interactively contribute to alcohol-related psychomotor impairment.

Glucocorticoid receptor epigenetic activity in the heart

The glucocorticoid receptor (GR) is a critical nuclear receptor that regulates gene expression in diverse tissues, including the heart, where it plays a key role in maintaining cardiovascular health. GR signaling influences essential processes within cardiomyocytes, including hypertrophy, calcium handling, and metabolic balance, all of which are vital for proper cardiac function. Dysregulation of GR activity has been implicated in various cardiovascular diseases (CVDs), highlighting the potential of GR as a therapeutic target. Remarkably, recent insights into GR's epigenetic regulation and its interaction with circadian rhythms reveal opportunities to optimize therapeutic strategies by aligning glucocorticoid administration with circadian timing. In this review, we provide an overview of the glucocorticoid receptor's role in cardiac physiology, detailing its genomic and non-genomic pathways, interactions with epigenetic and circadian regulatory mechanisms, and implications for cardiovascular disease. By dissecting these molecular interactions, this review outlines the potential of epigenetically informed and circadian-timed interventions that could change the current paradigms of CVD treatments in favor of precise and effective therapies.

Individual differences in behavioral responses to predator odor predict subsequent stress reactivity in female rats

Stress-induced neuropsychiatric disorders are among the most prevalent medical conditions and have widespread effects on both patients and society. Females experience over twice the rates of stress-related anxiety and depression when compared to males and often exhibit worse symptomatology and treatment outcomes. However, preclinical experiments exploring the neurobiological mechanisms of stress susceptibility in females have been traditionally understudied. Previous data from our lab has determined that females are selectively vulnerable to the consequences of vicarious witness stress, and these experiments were designed to determine specific behavioral and physiological factors that could predict which groups would be more susceptible to the effects of stress. Adult, female, Sprague-Dawley rats were first exposed to a ferret predator odor to determine baseline individual differences in behavioral responses. Rats were stratified by the duration of freezing behavior exhibited in response to the ferret odor and equally balanced into non-stressed controls and vicarious witness stress exposed groups. These female rats were then assessed on a battery of behavioral tasks including sucrose preference, elevated plus maze, acoustic startle, and the ferret odor and witness stress cue exposures to determine if baseline differences in stress responding can predict the behavioral response to future stress and stress cues. High freezing in response to the ferret odor was associated with behavioral sensitization to witness stress and hypervigilant responses to stress cues that was accompanied by exaggerated neuroimmune responses. These experiments establish a powerful behavioral predictor of stress susceptibility in females and begin to address neurobiological correlates that underlie this response.

Childhood maltreatment and mental health: causal links to depression, anxiety, non-fatal self-harm, suicide attempts, and PTSD

Background: This study aims to elucidate the causal relationship between childhood maltreatment (CM) and subsequent mental health outcomes, including major depressive disorder (MDD), anxiety (ANX), post-traumatic stress disorder (PTSD), suicide attempts, and non-fatal self-harm. Utilising Mendelian Randomisation (MR) and genome-wide association studies (GWAS) data from individuals of European descent, this research applies a rigorous analytical methodology to large-scale datasets, overcoming the confounding variables inherent in previous observational studies.Methods: Genetic data were obtained from publicly available GWAS on individuals of European ancestry, focusing on Childhood Maltreatment (CM), Major Depressive Disorder (MDD), Anxiety (ANX), Post-Traumatic Stress Disorder (PTSD), Age at First Episode of Depression, Number of Depression Episodes, Non-fatal self-harm, and Suicide Attempts. Mendelian Randomisation (MR) analyses were conducted to investigate the causal impact of CM on these outcomes. Sensitivity analyses included IVW, MR Egger, WM, and MR-PRESSO. FDR corrections were applied to account for multiple testing. Results were presented as odds ratios (ORs) with confidence intervals (CIs).Results: Significant associations were identified between CM and the likelihood of developing MDD (IVW: OR = 2.28, 95% CI = 1.66-3.14, PFDR < .001), ANX (IVW: OR = 1.01, 95% CI = 1.00-1.02, PFDR =.032), and PTSD (IVW: OR = 2.29, 95% CI = 1.43-3.67, PFDR =.001). CM was also linked to increased non-fatal self-harm (IVW: OR = 1.06, 95% CI = 1.04-1.08, PFDR <.001), higher frequency of depressive episodes (IVW: β=0.31, 95% CI = 0.17-0.46, PFDR <.001), and earlier onset of depression (IVW: β=-0.17, 95% CI = -0.32 to - 0.02, PFDR =.033). No significant association was found between CM and suicide attempts (IVW: OR = 1.09, 95% CI = 0.81-1.45, PFDR =.573).Conclusion: This study provides robust evidence that CM is a significant causal factor for MDD, ANX, PTSD, and non-fatal self-harming behaviours. It is associated with a higher frequency of depressive episodes and earlier onset of depression. These findings highlight the need for early intervention and targeted prevention strategies to address the long-lasting psychological impacts of CM.

Non-stochastic reassembly of a metabolically cohesive gut consortium shaped by N-acetyl-lactosamine-enriched fibers

Diet is one of the main factors shaping the human microbiome, yet our understanding of how specific dietary components influence microbial consortia assembly and subsequent stability in response to press disturbances - such as increasing resource availability (feeding rate) - is still incomplete. This study explores the reproducible re-assembly, metabolic interplay, and compositional stability within microbial consortia derived from pooled stool samples of three healthy infants. Using a single-step packed-bed reactor (PBR) system, we assessed the reassembly and metabolic output of consortia exposed to lactose, glucose, galacto-oligosaccharides (GOS), and humanized GOS (hGOS). Our findings reveal that complex carbohydrates, especially those containing low inclusion (~1.25 gL-1) components present in human milk, such as N-acetyl-lactosamine (LacNAc), promote taxonomic, and metabolic stability under varying feeding rates, as shown by diversity metrics and network analysis. Targeted metabolomics highlighted distinct metabolic responses to different carbohydrates: GOS was linked to increased lactate, lactose to propionate, sucrose to butyrate, and CO2, and the introduction of bile salts with GOS or hGOS resulted in butyrate reduction and increased hydrogen production. This study validates the use of single-step PBRs for reliably studying microbial consortium stability and functionality in response to nutritional press disturbances, offering insights into the dietary modulation of microbial consortia and their ecological dynamics.

Therapists perspectives on the Early Intervention after Rape study: a qualitative process evaluation of a randomized controlled trial

ABSTRACTBackground: Early interventions using trauma-focused cognitive behavioural therapy have the potential to alleviate post-traumatic stress symptoms in individuals who have experienced recent sexual assault. Specialized Sexual Assault Centers (SACs) in Norway offers psychosocial support, however, this support varies across SACs and its efficacy has not been researched. The Early Intervention after Rape (EIR) study is a multisite randomized controlled trial designed to assess the efficacy and effectiveness of training SAC nurses and social workers to deliver a modified version of prolonged exposure therapy shortly after rape.Objective: This article aims to present a qualitative process evaluation of the implementation of the EIR study across three SACs in Norway, from the perspective of nurses and social workers.Method: We conducted semi-structured interviews with fifteen nurses and social workers, ten of whom received training in prolonged exposure therapy (mPE). We used Thematic Analysis to identify themes and subthemes.Results: Thematic analysis yielded four significant themes for process evaluation: (1) The quality of the new intervention modified prolonged exposure was considered satisfactory through training and supervision and delivered with good adherence to the manual, although some therapists perceived the manual as too rigid; (2) Adoption dynamics within the SACs are complex and include both enthusiasm for clinical research as well as resistance to change; (3) Narrow inclusion criteria and burden with participation for patients may limit reach and representativeness of the RCT; (4) Unintended consequences were identified, such as delayed start, conflicting advices and cross-contamination, underscoring the ongoing necessity for process evaluation alongside RCTs.Conclusion: This qualitative process evaluation offers insight into real-world clinical challenges with implementing a new intervention and conducting a multisite RCT within SACs in Norway. This study may inform opportunities to advance evidence-based practices for rape survivors seeking help.Trial registration: ClinicalTrials.gov identifier: NCT05489133..

Unraveling the functional complexity of the locus coeruleus-norepinephrine system: insights from molecular anatomy to neurodynamic modeling

The locus coeruleus (LC), as the primary source of norepinephrine (NE) in the brain, is central to modulating cognitive and behavioral processes. This review synthesizes recent findings to provide a comprehensive understanding of the LC-NE system, highlighting its molecular diversity, neurophysiological properties, and role in various brain functions. We discuss the heterogeneity of LC neurons, their differential responses to sensory stimuli, and the impact of NE on cognitive processes such as attention and memory. Furthermore, we explore the system's involvement in stress responses and pain modulation, as well as its developmental changes and susceptibility to stressors. By integrating molecular, electrophysiological, and theoretical modeling approaches, we shed light on the LC-NE system's complex role in the brain's adaptability and its potential relevance to neurological and psychiatric disorders.

Event-related potentials associated with cognitive control in adolescents exposed to complex childhood trauma

ABSTRACTBackground: Complex childhood trauma (CCT), characterized by repeated and prolonged exposure to adverse experiences, disrupts cognitive, emotional, and neural development. Adolescence, a critical developmental period, is particularly vulnerable to these effects, with CCT increasing the risk of psychopathologies, including post-traumatic stress disorder (PTSD). Despite this, the neurophysiological underpinnings of trauma-related deficits in cognitive control remain insufficiently explored, particularly in the developing brains of children and adolescents. This study aimed to investigate the neurophysiological markers of cognitive control in adolescents with CCT using event-related potential (ERP) components to propose an electrophysiological phenotype associated with CCT, as a vulnerability for PTSD.Methods: Twenty adolescents with CCT and 40 age- and gender-matched healthy controls performed a cued GO/NOGO task. ERP components - contingent negative variation (CNV), NoGo-N2, and NoGo-P3 - were analysed alongside behavioural measures such as omission and commission errors and reaction time, using a preregistered protocol. Statistical analysis included Mann-Whitney tests and cluster-based permutation tests for ERP comparisons.Results: Adolescents with CCT showed significant impairments in both proactive (reduced CNV amplitudes) and reactive (diminished NoGo-N2 and NoGo-P3 amplitudes) control mechanisms. Behaviourally, the CCT group exhibited higher omission errors and shorter reaction times than controls. Exploratory analysis revealed reduced amplitudes in the visual negativity (VN) component, suggesting disruptions in predictive processing. Latent component analysis identified ERP markers with potential diagnostic utility, linking deficits to key neural circuits associated with cognitive control and predictive processing.Conclusion: Study findings highlight significant impairments in cognitive control mechanisms and disrupted predictive processing in adolescents with CCT, emphasizing the importance of addressing trauma-related neural deficits during adolescence. Given that CCT is a significant risk factor for PTSD, the study provides insights into shared neurobiological pathways, supporting the development of targeted interventions. ERP markers like CNV, NoGo-N2, NoGo-P3, and VN show promise for improving diagnostic precision and monitoring therapeutic outcomes in trauma-exposed youth.

Exploring novel therapeutic strategies: Could psychedelic perspectives offer promising solutions for Alzheimer's disease comorbidities?

The increasing prevalence of dementia within an ageing global population, combined with prolonged life expectancy, accentuates Alzheimer's disease (AD) as a multifaceted healthcare challenge. This challenge is further compounded by the limited therapeutic options currently available. Addressing the intricacies of AD management, the mitigation of comorbidities has emerged as a pivotal facet of treatment. Comorbid conditions, such as neurobehavioral symptoms, play a role in shaping the clinical course, management, and outcomes of this pathology; highlighting the importance of comprehensive care approaches for affected individuals. Exploration of psychedelic compounds in psychiatric and palliative care settings has recently uncovered promising therapeutic potential, enhancing neuroplasticity, emotional processing and connection. These effects are particularly relevant in the context of AD, where psychedelic therapy offers hope not only for mitigating core symptoms but also for addressing the array of comorbidities associated with this condition. The integration of this comprehensive method offers a chance to significantly enhance the care provided to those navigating the intricate landscape of AD. Therefore, the current paper reviews the intricate link between more frequent additional health conditions that may coexist with dementia, particularly in the context of AD, and explores the therapeutic potential of psychedelic compounds in addressing these concurrent conditions.

Astrocyte-derived exosomes regulate sperm miR-34c levels to mediate the transgenerational effects of paternal chronic social instability stress

The effects of chronically stressing male mice can be transmitted across generations by stress-specific changes in their sperm miRNA content, which induce stress-specific phenotypes in their offspring. However, how each stress paradigm alters the levels of distinct sets of sperm miRNAs is not known. We showed previously that exposure of male mice to chronic social instability (CSI) stress results in elevated anxiety and reduced sociability specifically in their female offspring across multiple generations because it reduces miR-34c levels in sperm of stressed males and their unstressed male offspring. Here, we describe evidence that astrocyte-derived exosomes (A-Exos) carrying miR-34c mediate how CSI stress has this transgenerational effect on sperm. We found that CSI stress decreases miR-34c carried by A-Exos in the prefrontal cortex and amygdala, as well as in the blood of males. Importantly, miR-34c A-Exos levels are also reduced in these tissues in their F1 male offspring, who despite not being exposed to stress, exhibit reduced sperm miR-34c levels and transmit the same stress-associated traits to their male and female offspring. Furthermore, restoring A-Exos miR-34c content in the blood of CSI-stressed males by intravenous injection of miR-34c-containing A-Exos restores miR-34c levels in their sperm. These findings reveal an unexpected role for A-Exos in maintaining sperm miR-34c levels by a process that when suppressed by CSI stress mediates this example of transgenerational epigenetic inheritance.

Sex differences in the murine HPA axis after acute and repeated restraint stress

Chronic stress and stress-related mental illnesses such as major depressive disorder (MDD) constitute some of the leading causes of disability worldwide with a higher prevalence in women compared to men. However, preclinical research into stress and MDD is heavily biased toward using male animals only. Aberrant activity of the hypothalamic-pituitary-adrenal (HPA) axis has been linked to the development of MDD and several animal models of MDD have been established based on HPA axis dysregulation. In the present study, we compared stress biomarkers and behavior of male and female mice after acute and chronic restraint stress to investigate potential effects of sex differences in the stress response. Further, the validity of the interrupted repeated restraint stress (IRRS) model as an animal model for the HPA axis disturbances seen in MDD was assessed. After acute stress, female mice showed increased corticosterone secretion and changes in molecular markers suggesting increased HPA axis feedback sensitivity. Acute stress-induced signs of anxiety-like behavior were observed in male mice only suggesting that female mice may be more resilient to the anxiogenic effects of acute stress. Males and females responded similarly to IRRS with no sustained perturbations in HPA axis biomarkers. The IRRS model did not adequately translate to the changes reported in MDD with HPA axis overactivity and more severe perturbation models are likely needed. However, in alignment with previous studies, these data support that there are important sex differences in the HPA axis and that these may contribute to the etiology of stress-related psychiatric disorders.

The GluN3-containing NMDA receptors

N-methyl-D-aspartate receptors (NMDARs) are heterotetrameric ion channels that play crucial roles in brain function. Among all the NMDAR subtypes, GluN1-N3 receptors exhibit unique agonist binding and gating properties. Unlike "conventional" GluN1-N2 receptors, which require both glycine and glutamate for activation, GluN1-N3 receptors are activated solely by glycine. Furthermore, GluN1-N3 receptors display faster desensitization, reduced Ca2+ permeability, and lower sensitivity to Mg2+ blockage compared to GluN1-N2 receptors. Due to these characteristics, GluN1-N3 receptors are thought to play critical roles in eliminating redundant synapses and pruning spines in early stages of brain development. Recent studies have advanced pharmacological tools for specifically targeting GluN1-N3 receptors and provided direct evidence of these glycine-activated excitatory receptors in native brain tissue. The structural basis of GluN1-N3 receptors has also been elucidated through cryo-EM and artificial intelligence. These findings highlight that GluN1-N3 receptors are not only involved in essential brain functions but also present potential targets for drug development.

Recall bias secondary to major trauma: results from a prospective study of the Beirut Port Blast

Background: Traumatic events are often perceived as unforgettable, yet scientific evidence highlights the complexity of memory recall in the aftermath of traumatic experiences. While some studies observed amplification of traumatic memory, others reveal rapid forgetfulness and falsification of details.Objective: The primary objective of this study is to investigate how initial memories of the Beirut Port Blast in 2020 fluctuate over time. Going beyond full-threshold self-reported post-traumatic stress disorder (PTSD) and self-reported acute stress disorder (ASD), the research aims to explore subthreshold self-reported PTSD and individual self-reported ASD symptoms as potential predictors of recall bias among healthcare workers.Method: This study draws on data from four waves of the ongoing B.L.A.S.T. (Beirut Longitudinal Assessment Study of Trauma) study which spans so far over a period of two years.Results: Being a clinical professional and having higher self-reported ASD symptoms in wave 1, specifically intrusion symptoms, were associated with recall diminishment. Higher self-reported PTSD, subthreshold self-reported PTSD diagnoses (six plus or majority) and higher anxiety scores were significantly associated with exaggeration of recall.Conclusion: The study underscores the importance of assessing a broad range of symptoms, beyond conventional diagnoses, to gain a comprehensive understanding of how traumatic memories are recalled and potentially altered over time.

Interventions targeting the gut microbiota and their possible effect on gastrointestinal and neurobehavioral symptoms in autism spectrum disorder

Autism spectrum disorder (ASD) is a developmental disorder that is characterized by deficits in social communication and restricted, repetitive, and stereotyped behaviors. In addition to neurobehavioral symptoms, children with ASD often have gastrointestinal symptoms (e.g. constipation, diarrhea, gas, abdominal pain, reflux). Several studies have proposed the role of gut microbiota and metabolic disorders in gastrointestinal symptoms and neurodevelopmental dysfunction in ASD patients; these results offer promising avenues for novel treatments of this disorder. Interventions targeting the gut microbiota - such as fecal microbiota transplant (FMT), microbiota transplant therapy (MTT), probiotics, prebiotics, synbiotics, antibiotics, antifungals, and diet - promise to improve gut health and can potentially improve neurological symptoms. The modulation of the gut microbiota using MTT in ASD has shown beneficial and long-term effects on GI symptoms and core symptoms of autism. Also, the modulation of the gut microbiota to resemble that of typically developing individuals seems to be the most promising intervention. As most of the studies carried out with MTT are open-label studies, more extensive double-blinded randomized control trials are needed to confirm the efficacy of MTT as a therapeutic option for ASD. This review examines the current clinical research evidence for the use of interventions that target the microbiome - such as antibiotics, antifungals, probiotics/prebiotics, synbiotics, and MTT - and their effectiveness in changing the gut microbiota and improving gastrointestinal and neurobehavioral symptoms in ASD.

Mouse strain-specific responses along the gut-brain axis upon fecal microbiota transplantation from children with autism

Several factors are linked to the pathophysiology of autism spectrum disorders (ASD); however, the molecular mechanisms of the condition remain unknown. As intestinal problems and gut microbiota dysbiosis are associated with ASD development and severity, recent studies have focused on elucidating the microbiota-gut-brain axis' involvement. This study aims to explore mechanisms through which gut microbiota might influence ASD. Briefly, we depleted the microbiota of conventional male BALB/cAnNCrl (Balb/c) and C57BL/6J (BL/6) mice prior to human fecal microbiota transplantation (hFMT) with samples from children with ASD or their neurotypical siblings. We found mouse strain-specific responses to ASD hFMT. Notably, Balb/c mice exhibit decreased exploratory and social behavior, and show evidence of intestinal, systemic, and central inflammation accompanied with metabolic shifts. BL/6 mice show less changes after hFMT. Our results reveal that gut microbiota alone induce changes in ASD-like behavior, and highlight the importance of mouse strain selection when investigating multifactorial conditions like ASD.

Interactive effect of sleep duration and trouble sleeping on frailty in chronic kidney disease: findings from NHANES, 2005-2018

BACKGROUND

Both sleep disorders and chronic kidney disease (CKD) are recognized as significant public health concerns. In the general population, sleep disorders have been shown to be associated with frailty in the elderly. This study aims to evaluate the association between sleep duration and trouble sleeping with frailty in CKD patients, as well as the potential interactive effect between these two factors.

METHODS

This cross-sectional study analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2005-2018. Sleep duration and trouble sleeping was self-reported. Frailty was assessed using a 49-item frailty index. The associations between sleep duration, trouble sleeping, and frailty were analyzed using weighted multivariate logistic regression and restricted cubic splines. Subgroup analysis was conducted to determine the consistency of the study's conclusions across various subgroups.

RESULTS

A total of 5,211 adult CKD patients were included in this analysis. Regression analysis results indicated that short sleep duration (OR = 1.364, 95% CI: 1.152-1.616), long sleep duration (OR = 1.648, 95% CI: 1.259-2.157), and trouble sleeping (OR = 2.572, 95% CI: 2.102-3.147) were significantly associated with an increased risk of frailty in CKD patients, with an interaction between sleep duration and trouble sleeping. Subgroup analysis revealed that the effects of trouble sleeping and sleep duration on frailty symptoms in CKD patients exhibit significant variation across age groups (p < 0.05 for interaction), with no notable differences observed in other subgroups. RCS results demonstrated a U-shaped relationship between frailty and sleep duration, with the lowest risk of frailty at 7.12 h of sleep.

CONCLUSION

Our findings indicated that both sleep duration and trouble sleeping were significantly associated with frailty in CKD patients, with a notable interaction between these two factors. Therefore, prevention and intervention strategies for frailty in CKD patients should address multiple aspects of sleep health.

Corticosterone rapidly modulates dorsomedial hypothalamus serotonin and behavior in an estrogen- and progesterone-dependent manner in adult female rats: potential role of organic cation transporter 3 (OCT3)

Previous studies have shown that corticosterone rapidly alters extracellular serotonin (5-hydroxytryptamine; 5-HT) concentrations in the dorsomedial hypothalamus (DMH) of adult male rats, suggesting a role for corticosterone actions in the DMH in regulation of physiological and behavioral responses. Whether or not corticosterone also rapidly alters extracellular serotonin concentrations in the DMH of female rats, and the dependence of this effect on ovarian hormones, is not known. To determine the effects of 17β-estradiol (E2), progesterone (P), and corticosterone on extracellular concentrations of serotonin in the DMH, corticosterone and/or P were delivered into the DMH of ovariectomized rats via reverse microdialysis in E2-primed rats. Combined, but not separate, delivery of corticosterone and P into the DMH rapidly and transiently increased extracellular 5-HT concentrations, a result that was dependent upon circulating E2. This effect of corticosterone on DMH 5-HT was replicated by local perfusion of the organic cation transporter 3 (OCT3) competitive inhibitor normetanephrine. Intra-DMH infusions of either corticosterone or normetanephrine also reversibly suppressed lordosis responses in E2 + P-primed females. These results suggest that ovarian hormones in combination with corticosterone modulate OCT3-mediated 5-HT clearance in the DMH, potentially representing an adaptive mechanism that allows sexually receptive females to respond rapidly to acute stressors.