Abstract:Objective To explore the awakening efficacy of transcranial direct current stimulation(tDCS)combined with median nerve electrical stimulation(MNS)in patients with prolonged disorders of consciousness(pDOC).Methods From January to September 2024,45 patients with pDOC after brain injury in the Intensive Rehabilitation Unit of the Department of Neurological Rehabilitation,Xuzhou Rehabilitation Hospital,Xuzhou Medical University,were selected for the study.The patients were divided into control group,tDCS group and combined group according to the randomized numerical table method,with 15 cases in each group.Patients in control group received conventional rehabilitation therapy,patients in tDCS group were given conventional rehabilitation therapy and tDCS,and patients in combined group were treated with conventional rehabilitation therapy,tDCS and MNS for four weeks.The Revised Coma Recovery Scale(CRS-R),Glasgow Coma Scale(GCS),Full Outline Unresponsiveness Scale(FOUR),and quantitative electroencephalograms{including the power ratio index[α/(δ+θ)]and α-wave relative power(αRP)}were used to compare the level of consciousness and the brain electrophysiologic function of the patients with pDOC before and after four weeks of treatment,respectively.Results There was no statistically significant difference in CRS-R,GCS,FOUR scores,α/(δ+θ),and αRP among the three groups of patients before treatment(P＞0.05).The CRS-R score[(14.73±3.11)in combined group,(11.53±3.14)in tDCS group,(9.07±2.09)in control group],GCS score[12(11,13)in combined group,10(9,12)in tDCS group,9(9,10)in control group],and FOUR score[15(14,15)in combined group,13(10,14)in tDCS group,10(10,12)in control group],and α/(δ+θ)[0.18(0.16,0.24)in combined group,0.13(0.11,0.15)in tDCS group,0.08(0.06,0.12)in control group]were higher than the pre-treatment CRS-R score[(8.33±1.87)in combined group,(7.53±0.50)in tDCS group,(7.93±1.75)in control group],GCS score[9(9,9)in combined group,8(7,9)in tDCS group,9(8,9)in control group],FOUR score[9(9,12)in combined group,9(8,9)in tDCS group,9(9,11)in control group]and α/(δ+θ)[0.09(0.06,0.12)in combined group,0.08(0.05,0.12)in tDCS group,0.09(0.05,0.11)in control group],the differences were statistically significant(all P＜0.05).The differences in CRS-R,GCS,FOUR score differences and α/(δ+θ),αRP differences before and after treatment were statistically significant in all three groups(all P＜0.05).The CRS-R score difference(6.40±2.77),α/(δ+θ)difference 0.10(0.06,0.14),and αRP difference 0.08(0.06,0.11)before and after treatment in patients in combined group was higher than those in tDCS group[CRS-R score difference(4.00±2.17),α/(δ+θ)difference 0.05(0.03,0.06),αRP difference 0.04(0.03,0.06)]and control group[CRS-R score difference(1.10±0.88)points,α/(δ+θ)difference 0.01(0.00,0.02),αRP difference 0.01(0.00,0.02)],the differences were statistically significant(all P＜0.05).The difference in GCS score of 3(2,4)and the difference in FOUR score of 4(4,6)before and after the treatment of patients in combined group were higher than those of control group[difference in GCS score of 1(1,1)and difference in FOUR score of 1(1,1)],and the differences were statistically significant(all P＜0.05).Conclusions MNS combined with tDCS can effectively promote the improvement of the degree of consciousness and improve the awakening efficacy in pDOC patients.

Abstract:Anxiety disorders are among the most prevalent mental health conditions globally,and their underlying mechanisms remain incompletely understood.The general consensus is that the etiology of anxiety disorders is strongly related to the interaction of genetic variables,neurobiological alterations,environmental impacts,and psychosocial factors.The lateral septum,which is an important component of the limbic system,integrates diverse information related to emotion,motivation,and reward.Its role in the regulation of anxiety-like behaviors has long been a focus of research.This paper reviews the mechanisms of the lateral septum in the regulation of anxiety-like behaviors.The goal is to elucidate the neural mechanisms underlying anxiety disorders and identify potential therapeutic targets,thereby providing a theoretical basis for the prevention and treatment of anxiety disorders.

Abstract:Objective To systematically evaluate the feasibility and effectiveness of internet-based cognitive behavioral therapy(ICBT)for children and adolescents with obsessive-compulsive disorder(OCD),so as to provide a specific and reliable evidence-based basis for clinical practice in children and adolescents with OCD.Methods The study on the efficacy of ICBT in children and adolescents with OCD was electronically searched in 7 databases,including PubMed,Embase,Cochrane Library,Web of Science,China National Knowledge Infrastructure,WanFang Data,and VIP.The search period was from database establishment to November 2024.Two investigators independently used EndNote to screen studies that met the inclusion criteria.Meta-analysis of the included literature was performed using RevMan 5.4.Results A total of 10 papers were included with a total of 307 patients.Four studies demonstrated the feasibility of ICBT for improving obsessive-compulsive symptoms in children and adolescents from different perspectives.Eight studies demonstrated the effectiveness of ICBT for children and adolescents with OCD.The results showed that compared with control group,ICBT significantly reduced post-intervention obsessive-compulsive symptom scores of children and adolescents,and the difference was statistically significant[MD=-5.81,95%CI(-11.11,-0.51),P＜0.05].When comparing between groups after long-term follow-up,the difference in obsessive-compulsive symptom scores before and after long-term follow-up was statistically significant for ICBT with exposure and response prevention(ERP)as the main component[MD=2.71,95%CI(0.88,4.54),P＜0.05].The difference in obsessive-compulsive symptom scores before and after long-term follow-up was not statistically significant for ICBT with non-ERP as the main component[MD=1.39,95%CI(0.12,2.65),P＞0.05].Conclusions ICBT is feasible and acceptable for improving obsessive-compulsive symptoms in children and adolescents,with significant efficacy and long duration of efficacy maintenance,and has good prospects for clinical application.

Abstract:Objective To investigate the expression level of plasma adiponectin(APN)in patients with depressive disorders and its clinical significance.Methods From August 20,2023 to May 19,2024,90 patients with first-episode depressive disorders attending the First Psychiatric Hospital of Harbin were selected as case group,and 90 healthy volunteers during the same period were selected as control group.General clinical data were collected and the 24-item Hamilton Depression Scale(HAMD-24)was used to assess the severity of depressive disorder in case group.Plasma APN levels were measured by enzyme-linked immunosorbent assay(ELISA)in both groups of subjects.Spearman correlation was used to analyze the correlation between plasma APN levels and HAMD-24 scores and the duration of depressive disorders,and multifactorial Logistic regression was used to predict the factors affecting the occurrence of depressive disorders.The diagnostic value of plasma APN levels for depressive disorders was analyzed using the receiver operating characteristic(ROC)curve.Results Plasma APN levels were 50.47(48.86,52.16)ng/mL in case group and 55.82(52.78,56.00)ng/mL in control group,and the difference between the two groups was statistically significant(Z=-6.387,P＜0.001).Spearman correlation analysis showed that plasma APN levels in case group did not correlate with the duration of depressive disorder(P＞0.05)and were negatively correlated with the HAMD-24 score with a statistical difference(r=-0.266,P＜0.001).Multifactorial Logistic regression analysis showed that plasma APN was an influencing factor in the occurrence of depressive disorders,and the difference was statistically significant[OR=3.500,95%CI(1.600,6.300),P＜0.05].The area under the ROC curve for plasma APN levels to diagnose depressive disorders was 0.766.Conclusions Plasma APN levels are reduced in patients with depressive disorders and correlated with the severity of depressive disorder.Plasma APN levels are effective in the diagnosis of depressive disorders.

Abstract:Microplastics(plastic particles＜5 mm in diameter),as a new class of environmental contaminants,have been detected in a variety of environmental media and food products.It has been shown that microplastics can cross the blood-cerebrospinal fluid barrier and act on the central nervous system of animals,and their effects and molecular mechanisms need to be elucidated.This paper systematically reviews the impact of microplastic exposure on neurological development,cognition and learning,emotion and behavior in animals,and explores the potential mechanisms of action,including oxidative stress,neuroinflammation and neurotransmitter dysregulation,with a view to further revealing the neurotoxic effects of microplastics and providing potential molecular intervention pathways.

Abstract:Traumatic brain injury(TBI)is the most common disease in neurosurgery,characterized by high rates of disability and mortality.Secondary brain injury after TBI is an important cause of patient prognosis.The nuclear factor-erythroid 2-related factor 2(Nrf2)is an important anti-oxidative stress transcription factor involved in the pathophysiological regulation of neurological disorders.A number of scholars have found that activation of Nrf2 can affect pathophysiological processes such as oxidative stress,cellular autophagy,apoptosis,and neuroinflammation after TBI,further demonstrating that Nrf2 can regulate the prognosis of TBI.This article provides a brief overview of the pathophysiology after TBI as well as a summary of the potential protective role of Nrf2 in TBI,providing new directions for the treatment of TBI.

Abstract:Objective To investigate the effects of high-definition transcranial direct current stimulation(HD-tDCS)on psychiatric symptoms and brain functional activity in patients with chronic schizophrenia.Methods This study used a randomized,sham-controlled,double-blind design.A total of 65 patients with chronic schizophrenia were recruited at the Third People's Hospital of Foshan between January and June 2021 and were randomly assigned to the HD-tDCS group(n=32)and the sham group(n=33)in a 1∶1 ratio using computer-generated randomization.After 10 days of intervention and the exclusion of those with detachment(n=9)or poor image quality(n=11),the subjects who finally completed the trial and were included in the analysis were 24 in HD-tDCS group and 21 in sham group.HD-tDCS group received HD-tDCS at 2 mA for 20 minutes,while sham group received only 30 seconds of sham stimulation.The patients'psychiatric symptoms were assessed by the Positive and Negative Syndrome Scale(PANSS),and their brain functional activity[amplitude of low frequency fluctuations(ALFF)and functional connectivity(FC)]was evaluated using resting-state functional magnetic resonance imaging(rs-fMRI).PANSS scores and imaging indicators were compared before and after intervention in each group,and the difference in PANSS scores and imaging indicators between the two groups before and after the intervention was compared.Partial correlation analysis was used to assess the correlation between post-intervention changes in psychiatric symptoms and changes in ALFF/FC.Results The positive symptom score[(13.5±6.44)vs.(16.04±7.51)],general psychiatric symptom score[(31.04±9.09)vs.(35.04±10.88)],and total symptom score[(59.96±16.07)vs.(68.79±23.51)]in HD-tDCS group decreased after intervention,and the differences were statistical(t=2.25,3.30,3.13;all P＜0.05).After intervention in HD-tDCS group,ALFF increased in the left posterior cerebellar lobe(CPL)[(-0.22±0.21)vs.(-0.37±0.14)],while FC enhancement was observed in the left CPL compared to itself[0.42(0.37,0.50)vs.0.21(0.17,0.27)],left posterior cingulate cortex(PCC)[0.23(0.19,0.27)vs.0.08(0.05,0.10)],and left hippocampus[0.21(0.17,0.25)vs.0.06(0.05,0.08)],and the differences were statistical(t=-5.27,-4.29,-4.29,-4.29;all P＜0.05).Correlation analysis showed that in HD-tDCS group,the rate of change in FC between left CPL and left PCC before and after the intervention was positively correlated with the rate of change in general psychiatric symptom scores and total symptom scores,and the difference was statistically significant(r=0.46,0.48;all P＜0.05).Conclusions HD-tDCS significantly improves psychiatric symptoms and cerebellar-related neural network activity in patients with chronic schizophrenia.

Abstract:Objectives? To anaLyze the correLation between Patient HeaLth Questionaire-9 (PHQ-9) and HamiLton Depression ScaLe-17 (HAMD-17) in assessing the severity of depression. Methods? A totaL of 115 patients with depression were seLected from the outpatient care of Bejing Anding HospitaL. HAMD-17 was used to assess the severity of depression, and aLL patients were aLso instructed to conduct PHQ-9 seLf-assessment. The internaL consistency of HAMD-17 totaL score and PHQ-9 totaL score was evaLuated by intracLass correLation efficient (ICC). The consistency of the ordered categoricaL variabLes of both scaLes was anaLyzed by weighted kappa coefficient. The correLation of the dimensions of both scaLes was assessed by Spearman rank correLation coefficient. ResuLts? PHQ-9 and HAMD-17 had a good consistency [ICC=0.657(0.504, 0.763), P＜ 0.01]. Kappa anaLysis showed that there was a correLation between the severity of the two groups at aLL LeveLs, but the consistency across two scaLes was poor [Kappa=0.313(0.197, 0.430), P＜ 0.01]. HAMD-17 and PHQ-9 showed correLation in the dimensions of suicide, sLeep, constitution, systemic symptoms, interest and seLf-bLame (P＜0.05). ParticuLarLy, there was a good correLation in suicide (r=0.62). However, there was no correLation in depressed mood (P＞0.05). ConcLusions? The PHQ-9 and HAMD scaLes have a high correLation in assessing the severity of depression. They can be used for earLy screening and suicide risk prediction of depression, providing a basis and reference for cLinicaL diagnosis and treatment.