Behavioral Disorders Research Articles

Provider Perspectives: Feasibility, Acceptability, and Appropriateness of Online Parent Training With Therapist Coaching in a Community Practice Setting

A considerable body of evidence documents the detrimental impact of disruptive behavior disorders (DBDs) in childhood and their longstanding effects across development and into adulthood. While research has yielded evidence-based interventions for DBDs, such as parent management training, disparities in access to care persist. The growing ubiquity of consumer technologies underscores the potential to provide evidence-based treatments through online programs; however, structural barriers continue to impede dissemination in community settings. This paper examines clinic staff’s perspectives on the implementation of an online parent management program in a community mental health center (CMHC) to integrate novel programming with existing therapeutic care to maximize resource efficiency in treatment delivery and increase family adherence and engagement. Quantitative and qualitative data were collected from 16 staff members who were trained to deliver the intervention at a CMHC. Quantitative data indicated positive perceptions across various domains, while qualitative findings highlighted feasibility, acceptability, and appropriateness. Facilitators to feasibility included program ease, integration into sessions, and flexible access. Time constraints and technology access were barriers. Acceptability was high, with videos reinforcing therapy and promoting family connection. The program’s structure and psychoeducation were appreciated, while quiz format and time constraints were concerns. Appropriateness was positive, with broad relevance, insight-building impact, comprehensive coverage, evidence-based strategies, and support. Barriers existed for specific patient characteristics. Implications for implementation in practice and future directions of research are discussed.

PTPN2 dephosphorylates STAT3 to ameliorate anesthesia-induced cognitive decline in aged rats by altering the microglial phenotype and inhibiting inflammation

Perioperative neurocognitive disorders (PNDs) are common neurological complications after anesthesia in the elderly. Protein tyrosine phosphatase non-receptor type 2 (PTPN2) regulates signal transducer and activator of transcription protein 3 (STAT3) signaling to control inflammation in certain organs, but its role in PNDs remains unknown. Herein, we constructed a PND model in 18-month-old rats by treating them with sevoflurane. PND rats developed neuroinflammation, along with a significant decrease in PTPN2 expression and a rise in STAT3 phosphorylation in the hippocampus. Ptpn2 overexpression alleviated the behavioral disorders of PND rats, ameliorated neuronal injury, inhibited neuroinflammation, inflammasome activation, microglial activation, and microglial phenotype switching. Similar results were observed in sevoflurane-treated HMC3 microglia with PTPN2 overexpression, while PTPN2 silencing showed the opposite results. Additionally, PTPN2 seems to be a target of T-box transcription factor 2 (TBX2). These results contribute to the evidence supporting the idea that PTPN2 is a regulatory factor in PND progression.

Enhancing Autism Spectrum Disorder identification in multi-site MRI imaging: A multi-head cross-attention and multi-context approach for addressing variability in un-harmonized data

Multi-site MRI imaging poses a significant challenge due to the potential variations in images across different scanners at different sites. This variability can introduce ambiguity in further image analysis. Consequently, the image analysis techniques become site-dependent and scanner-dependent, implying that adjustments in the analysis methodologies are necessary for each scanner configuration. Further, implementing real-time modifications becomes intricate, particularly when incorporating a new type of scanner, as it requires adapting the analysis methods accordingly. Taking into account the aforementioned challenge, we have considered its implications for an Autism spectrum disorder (ASD) application. Our objective is to minimize the impact of site and scanner variability in the analysis, aiming to develop a model that remains effective across different scanners and sites.This entails devising a methodology that allows the same model to function seamlessly across multiple scanner configurations and sites. ASD, a behavioral disorder affecting child development, requires early detection. Clinical observation is time-consuming, prompting the use of fMRI with machine/deep learning for expedited diagnosis. Previous methods leverage fMRI’s functional connectivity but often rely on less generalized feature extractors and classifiers. Hence, there is significant room for improvement in the generalizability of detection methods across multi-site data, which is acquired from multiple scanners with different settings. In this study, we propose a Cross-Combination Multi-Scale Multi-Context Framework (CCMSMCF) capable of performing neuroimaging-based diagnostic classification of mental disorders for a multi-site dataset. Thus, this framework attains a degree of internal data harmonization, rendering it to some extent site and scanner-agnostic. Our proposed network, CCMSMCF, is constructed by integrating two sub-modules: the Multi-Head Attention Cross-Scale Module (MHACSM) and the Residual Multi-Context Module (RMCN). We also employ multiple loss functions in a novel manner for training the model, which includes Binary Cross Entropy, Dice loss, and Embedding Coupling loss. The model is validated on the Autism Brain Imaging Data Exchange I (ABIDE-I) dataset, which includes data from multiple scanners across different sites, and achieves promising results.

Targeting the Labile Iron Pool with Engineered DFO Nanosheets to Inhibit Ferroptosis for Parkinson's Disease Therapy.

Ferroptosis in neurons is considered one of the key factors that induces Parkinson's disease (PD), which is caused by excessive iron accumulation in the intracellular labile iron pool (LIP). The iron ions released from the LIP lead to the aberrant generation of reactive oxygen species (ROS) to trigger ferroptosis and exacerbate PD progression. Herein, a pioneering design of multifunctional nanoregulator deferoxamine (DFO)-integrated nanosheets (BDPR NSs) is presented that target the LIP to restrict ferroptosis and protect against PD. The BDPR NSs are constructed by incorporating a brain-targeting peptide and DFO into polydopamine-modified black phosphorus nanosheets. These BDPR NSs can sequester free iron ions, thereby ameliorating LIP overload and regulating iron metabolism. Furthermore, the BDPR NSs can decrease lipid peroxidation generation by mitigating ROS accumulation. More importantly, BDPR NSs can specifically accumulate in the mitochondria to suppress ROS generation and decrease mitochondrial iron accumulation. In vivo experiments demonstrated that the BDPR NSs highly efficiently mitigated dopaminergic neuronloss and its associated behavioral disorders by modulating the LIP and inhibiting ferroptosis. Thus, the BDPR-based nanovectors holds promise as a potential avenue for advancing PD therapy.

Biofluid Markers and Tissue Biopsies Analyses for the Prodromal and Earliest Phase of Parkinson's Disease.

The recent development of new methods to detect misfolded α-synuclein (αSyn) aggregates in biofluids and tissue biopsies in the earliest Parkinson's disease (PD) phases is dramatically challenging the biological definition of PD. The αSyn seed amplification methods in cerebrospinal fluid (CSF) showed high sensitivity and specificity for early diagnosis of PD and Lewy bodies disorders. Several studies in isolated REM sleep behavior disorders and other at-risk populations also demonstrated a high prevalence of CSF αSyn positivity and its potential value in predicting the phenoconversion to clinically manifested diseases. Growing evidence exists for αSyn aggregates in olfactory mucosa, skin, and other tissues in subjects with PD or at-risk subjects. DOPA decarboxylase and numerous other candidates have been additionally proposed for either diagnostic or prognostic purposes in earliest PD phases. The newly described αSyn detection in blood, through its quantification in neuronally-derived exosome vesicles, represents a technical challenge that could open a new scenario for the biological diagnosis of PD. Despite this growing evidence in the field, most of method of αSyn detection and markers still need to be validated in ongoing longitudinal studies through an accurate assessment of different prodromal disease subtypes and scenarios before being definitively implemented in clinical settings.

Brain-first forms of Parkinson's disease are over-represented in patients with non-responsive resting tremor

Motor subtypes in Parkinson's Disease (PD) are unstable over time, limiting mechanistic insights and biomarker discovery. We focused on Rest Tremor (RT) as a symptom to test for phenotype stability and link it to specific circuits and disease mechanisms. Using the PPMI cohort data over 5 years we found that RT is more stable than classical Tremor-Dominant definitions, a stability also seen for RT response to therapy. At time of diagnosis, the population of therapy-resistant RT patients was enriched with a brain-first PD profile as predicted by a-Synuclein origin site and connectome (SOC) model. Resistant-RT patients have lower gastrointestinal and cardiovascular symptoms, lower prevalence of probable REM-Sleep behaviour disorder, and higher dopaminergic asymmetry compared to therapy-responsive or no tremor patients. Treating RT as a distinct phenomenon revealed a relative phenotypic stability with treatment response being linked to different patterns of disease progression.

Automatic quantification of REM sleep without atonia reliably identifies patients with REM sleep behavior disorder: a possible screening tool?

REM Sleep Behavior Disorder (RBD) is characterized by absence of physiological muscle atonia during REM sleep (REM sleep without atonia, RWA). Nigro-striatal dopaminergic impairment is a feature of Parkinson disease (PD) and can be identified in prodromal stages as well, such as idiopathic RBD (iRBD). Aims of this study are to explore the efficacy of an automatic RWA quantification in identifying RBD patients and the correlation between RWA and nigro-striatal dopaminergic function. Forty-five iRBD, 46 PD with RBD, 24 PD without RBD patients and 11 healthy controls were enrolled in the Genoa Center (group A) and 25 patients with iRBD (group B) were enrolled in the Danish Center. Group A underwent brain [123I]FP-CIT-SPECT and group B underwent brain [18F]PE2I-PET as measures of nigro-striatal dopaminergic function. Chin muscle activity was recorded in all subjects and analyzed by applying a published automatic algorithm. Correlations between RWA and nigro-striatal dopaminergic function were explored. The automatic quantification of RWA significantly differentiated RBD from non-RBD subjects (AUC = 0.86), although with lower accuracy compared with conventional visual scoring (AUC = 0.99). No significant correlation was found between RWA and nigro-striatal dopaminergic function. The automatic quantification of RWA is a reliable tool to identify subjects with RBD and may be used as a first-line screening tool, but without correlations with nigro-striatal dopaminergic functioning.

Daily Life Experiences of People with Dementia with Lewy Bodies: A Qualitative Study

Dementia with Lewy bodies (DLB) is the second most common cause of dementia and is associated with unique difficulties due to its characteristic symptoms. This study aimed to identify daily life changes experienced by people with DLB due to characteristic symptoms other than visual hallucinations. Semi-structured interviews and content analyses were conducted on 13 people with DLB and their 17 family members. Qualitative content analysis identified three categories of difficulties experienced by people with DLB in daily life: body discomfort, obstacles in daily life, and psychological pain. Participants experienced not only physical changes due to symptoms such as cognitive fluctuations, parkinsonism, and rapid eye movement sleep behavior disorder but also psychological pain related to daily life difficulties. This suggests the need for care that appreciates the unique experiences of people with DLB and includes psychological care to develop appropriate individual coping strategies, rather than focusing solely on alleviating physical symptoms.

SPECIFICITY OF CHILDREN'S SOCIALIZATION IN COMPLETE AND PARENT FAMILIES

The article describes the specifics of the socialization process of children in complete and incomplete families. The research is based on the use of various methods: parental surveys and psychological tests. The main goal was to determine the level of anxiety in children and their individual characteristics influencing the socialization process.The study showed that children from incomplete families are characterized by a higher level of anxiety than children from complete families. During the study of personality traits of children according to R. Kettell's questionnaire, it was found that most children living in incomplete families and for various reasons raised by one parent show significant differences in some traits and behaviour, which may result from the fact that they have an incomplete picture of the family environment, unlike children from complete families. Such traits as emotional stability, normative behaviour and self-control are not characteristic of this category of children.The projective technique "My Family" made it possible to assess the specifics of relations between children and members of complete and incomplete families. Analysis of the research results showed that children with behavioural disorders more often appear in the drawings of children who have experienced a divorce of their parents than children in harmonious interpersonal interaction with their parents. The questionnaire "Analysis of family relations" (Eidemiller, Yustyckis) allowed to diagnose dysfunctions in the system of mutual influence of family members on each other and to detect errors in the parenting style chosen by the parents. Analysis of the answers of complete and incomplete families surveyed using this method and their comparison with the description of parenting styles allows to state that in incomplete families the features of excessively dominant care, excessive protection and excessive indulgence, emotional alienation prevail. Parents who raise their children separately or alone most often choose an "indulgent" parenting style.

Особенности личностно-смысловой сферы студентов с разным индексом склонности к когнитивным ошибкам

Introduction. Cognitive errors (distortions) are of a semantic nature; they are based on distortions in the semantic sphere of personality, first of all, at its deep levels related to beliefs, semantic attitudes, life orientations, and metacognitive characteristics. However, there is currently a shortage of studies that would set a goal to prove this statement. The purpose of the work: to identify the peculiarities of the personal and semantic sphere of students with different indexes of propensity to cognitive errors. The materials and methods. The study was conducted using the Google Forms platform for creating and administering surveys and online forms. The sample size was 485 respondents, including 433 men and 52 women aged 17-25 years. The Cognitive Mistakes Questionnaire (CMQ − CMQ) (A. Freeman, R. Devulf, adapted by A.E. Bobrov and E.V. Faizrakhmanova) was used to study the propensity of personality to cognitive errors. The following methods were used to study the personal and semantic sphere of the respondents: the method of diagnostics of socio-psychological adaptation (SPA) (C. Rogers, R. Diamond, adapted by A.K. Osnitsky), “Big Five” (BFI) (R. McCrae, P. Costa, adapted by A.B. Khromov), Irrational Attitudes Diagnostic Methodology (A. Ellis), Basic Beliefs Scale (WASWorld assumptions scale) (R. Janov-Bulman, adapted by O. Kravtsova), Biographical Questionnaire for the Diagnosis of Behavioural Disorders (BIVBiographisches Inventar zur Diagnose von Verhaltensstoerungen) (Bottscher, Jager, Lischer), Life Orientations Questionnaire (LOQ) (E. Yu. Kravtsova), The Questionnaire to determine the content of the system of life meanings (V.Y. Kotlyakov), the method of diagnostics of coping mechanisms (E. Heim). Kruskal-Wallis H-criterion was used as a method of statistical data processing. The results of the research. It was revealed that there are statistically significant differences in the following indicators of the personal and semantic sphere of students with different indexes of propensity to cognitive errors: in adaptability in interpersonal relations; in the indicators of extraversion, emotional instability and expressiveness; in the expression of irrational attitudes and such basic beliefs as the benevolence of the world, the kindness of people, the value of one's own self, the degree of luck, the conviction in one's own value; in the indicators of family deficit syndrome; in such life orientation as transsituational mobility; in communicative life meanings and dominant coping mechanisms. The conclusion. The study revealed differences in the indicators of the personal and semantic sphere in students with different indexes of propensity to cognitive errors.

Urodynamic study and its correlation with cardiac meta-iodobenzylguanidine (MIBG) in body-first and brain-first subtypes of Parkinson's disease.

Lower urinary tract symptoms (LUTS) are frequently observed in patients with Parkinson's disease (PD), but the underlying mechanism remains elusive. The concept of "body-first" and "brain-first" subtypes in PD has been proposed, but the correlation of PD subtype with LUTS remains unclear. We aimed to investigate the disparities in urological dysfunctions between body-first and brain-first subtypes of PD using urodynamic studies (UDS). We reviewed patients with PD (disease duration <3 years) who had undergone UDS and completed urological questionnaires (Overactive Bladder Symptom Score [OABSS] and International Prostate Symptom Score [IPSS]) and a voiding diary. Patients were categorized as having body-first or brain-first PD based on cardiac sympathetic denervation (CSD) using cardiac meta-iodobenzylguanidine (MIBG) uptake and the presence of rapid eye movement sleep behavior disorder (RBD), assessed using a questionnaire (PD with CSD and RBD indicating the body-first subtype). A total of 55 patients with PD were categorized into body-first PD (n = 37) and brain-first PD (n = 18) groups. The body-first PD group exhibited smaller voiding volume and first desire volume (FDV) than the brain-first PD group (p < 0.05 in both). Also, the body-first PD group had higher OABSS and IPSS scores, and higher prevalence of overactive bladder diagnosed by OABSS, compared to the brain-first PD group. In multiple linear regression, cardiac MIBG uptake was positively correlated with FDV and voiding volume andnegatively correlated with OABSS and IPSS (p < 0.05 in all). Patients with the body-first PD subtype exhibited more pronounced overactive bladder symptoms and impaired storage function in the early stage of disease. Additionally, cardiac MIBG was significantly associated with urological dysfunction.

Interventions for Remarried Families

Remarried families become widespread as a type of family that differs from first marriages both developmentally and structurally. Due to its developmental and structural differences, both the quality and continuity of this families emerge as areas that need to be studied. To offer effective interventions to remarried families, researchers and practitioners in the field of mental health should have access to knowledge on this subject. The literature on remarried families emphasizes biological, non-biological and co-parenting related issues. The expectations, knowledge and perceptions of both the married couple, the children and the surrounding social environment of the remarried family is another important issue. Communication, problem solving, and conflict management can be an important tool in strengthening relationships and preventing negative experiences for families established through remarriage. It is seen that the interventions that deal with the mentioned characteristics of families formed through remarriage are given in the form of group practices, adopting a preventive approach, supported by practices that point to skill acquisition in addition to providing information. Programs offered for families formed through remarriage share commonalities such as remarried family development, parenting skills, communication and problem-solving skills. The effectiveness of interventions for remarriage has been tested by various studies conducted since the late 1970s. While testing the effectiveness of such interventions, it is seen that different outcome variables such as family integrity, dyadic satisfaction, relationship quality, marital continuity, conflict level, stress level and behavioral disorders experienced by family members are considered. Research findings show that interventions for remarriage are effective.

The paradoxical impact of periodic limb movements on isolated REM sleep behavior disorder patients.

Recently, the α-synuclein origin and connectome model described two types of Parkinson's disease: "brain-first" and "body-first" subtypes. We aimed to investigate the role of periodic limb movements during sleep (PLMS) in identifying these subtypes starting from a prodromal stage of α-synucleinopathies. 191 patients with isolated REM sleep behavior disorder (iRBD) underwent video-polysomnography (vPSG), questionnaires, clinical interview, and neuropsychological battery. Patients who presented PLMS index (PLMSi) > 15 were compared with patients presenting PLMSi ≤ 15 on clinical questionnaires, vPSG, and neuropsychological domains with age as a covariate. Correlations were performed between PLMSi and vPSG and neuropsychological domains in both groups of iRBD. 48.2% of patients presented PLMSi > 15. iRBD subgroup with PLMSi > 15 performed better than the iRBD subgroup with PLMSi ≤ 15 in the executive function domain. In patients with PLMSi > 15 negative correlations were observed between PLMSi and some neuropsychological domains (memory, language, and executive function). Moreover, this subgroup was older and their PLMSi was positively correlated with wake-after-sleep onset and inversely correlated with total sleep time and sleep efficiency, suggesting a detrimental effect of PLM on sleep also in this cohort. Patients with PLMSi > 15 are characterized by a more preserved cognitive status, despite a more disrupted sleep. PLMSi could be explored in longitudinal studies concerning the "brain-first" and "body-first" model.

Cyanotic heart defects in children: neurological aspects of the problem

Background. The goal is to justify the need to monitor neurodevelopment in children with congenital heart defects (CHD) and to study neurological disorders in patients under 3 years of age with cyanotic heart defects. Materials and methods. Modern research on the neurodevelopment of children with CHD were analyzed. Sixty-two patients with cyanotic heart defects who underwent examination and surgical treatment at the Center for Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine were studied. They are divided into 2 groups: group 1 are children with critical cyanotic CHD and group 2 — with non-critical cyanotic CHD. The control group consisted of 35 healthy patients. A neurological examination was performed using standardized neurological scales. Data processing was carried out using the Stata 12.1 licensed statistical package. Results. Neurodevelopmental disorders were diagnosed in 33 (53 %) of 62 children with cyanotic CHD: in group 1 — in 29 % of cases and in group 2 — in 24 %. These groups were statistically homogeneous in terms of gestational age (p = 0.492) and body weight at birth, with no significant difference from the control group. Older age is characterized mainly by delays in the stages of motor development (16 % in group 1 and 15 % in group 2) and speech disorders (7 % in group 1 and 3 % in group 2). Acute disorders of cerebral circulation (6 % in group 2) and the presence of epileptic seizures (up to 3 %) were characteristic of children under 1 year. Apgar score was lower in patients with critical cyanotic CHD with neurodevelopmental delay and a longer duration of artificial circulation during surgical treatment. Conclusions. 1. Neurological disorders were diagnosed in 53 % of patients with cyanotic heart defects: in 29 % with critical heart defects and 24 % with non-critical heart defects. 2. Older children are characterized mainly by delays in the stages of motor development and speech disorders. Behavioral disorders are more typical for children with non-critical CHD. Acute disorders of cerebral circulation and the presence of epileptic seizures were characteristic of children under 1 year of age. 3. The influence of body weight and gestational age on neurodevelopmental disorders is excluded. The severe state of children with neurodevelopmental delay at birth and an increase in the duration of artificial circulation during surgical treatment were found. 4. Interdisciplinary examination of patients with cyanotic heart defects, including examination by a pediatric neurologist, as well as a follow-up is necessary for timely referral to the next stages of rehabilitation.

History of symptoms consistent with REM sleep behavior disorder in a population with Parkinson's Disease

REM Sleep Behavioral Disorder (RBD) is a parasomnia marked by the maintenance of muscle tone during REM sleep. Evidence has placed RBD as one of the possible prodromal stages of Parkinson's Disease (PD), but data on the proportion of people with PD who have had symptoms of RBD are limited. This study aimed to investigate the history of symptoms compatible with RBD in a population with PD. The sample was composed by 73 patients with clinically diagnosed PD being followed up at a reference outpatient setting, compared to 73 age- and sex-matched individuals with no PD. The evaluation of symptoms compatible with RBD was performed using the Brazilian version of the RBD Screening Questionnaire (RBDSQ). The prevalence of symptoms compatible with RBD was 65 % for PD and 10.09 % for controls. The RBDSQ score was significantly higher in the PD group (6.03 ± 0.35) in comparison to the control group (2.38 ± 0.23). The odds ratio for presenting previous RBD-compatible symptoms was 12.09 in favor of positive PD cases. PD diagnosis has the following diagnostic properties in relation to presenting RBD symptoms: sensitivity of 0.65, specificity of 0.86, positive predictive value of 0.82 and negative predictive value of 0.71. In conclusion, the proportion of PD patients showing RBD symptoms is high, corroborating the expected neuroprogression of the disease on a case-control design comprising outpatient PD cases. Clinical practitioners should include evaluations of RBD-compatible symptoms during the PD assessment and, if positive, forward to a sleep specialist.

Not All Antihistamines Are Created Equal: Alimemazine As A Cause Of Drug Induced Parkinsonism

Abstract Background A 67year old female presented to a Movement Disorder Service for assessment of tremor. She had a history of presbycusis, dermatitis herpetiformis, bronchiectasis, osteoporosis and stage A chronic lymphocytic leukaemia. History elucidated hypophonia, somniloquy, REM-sleep behaviour disorder, bruxism, presence hallucinosis, insidious bradykinesia and of titubation of increasing prevalence and amplitude over 20years. Examination demonstrated cognitive impairment (Montreal Cognitive Assessment 12+1/30) in the domains of visuospatial function, executive thinking, naming, attention, language, abstraction and anterograde recall. Luria test was 0/6. Also found was: micrographia, left exotropia, reduced left arm and leg swing, kinetic tremor asymmetry, decrement of amplitude and frequency of rapid repetitive movements asymmetrically, mandibular and lingual tremor, positive Kinnier-Wilson test and orthostatic deterioration in yes-yes titubation. Drg history identified use of Alimemazine 10mg for insomnia for approximately 20years. Methods Modified Simpson Angus Scale score was 6 indicating a clinically significant degree of extrapyramidal side effects. Unified Parkinson’s Disease Rating Scale part III was 17. Results Functional dopamine uptake imaging did not indicate a parkinsonian syndrome. Drg induced parkinsonism was diagnosed. 0.0097% of the Northern Ireland population were prescribed Alimemazine in 2022 for non-dermatological reasons, representing 73.49% of all dispensed preparations. In the first financial quarter of 2024 in Northern Ireland, all dispensed prescriptions cost £218,395. Conclusion Not all antihistamines are created equal. Alimemazine is an older phenothiazine derivative antihistamine with central sedative effects equivalent to Chlorpromazine but without anti-adrenaline action. It is rarely prescribed and easily overlooked as “just another antihistamine”. It is commonly prescribed by dermatologists for urticaria. It has substantial pharmacoeconomic implications given its cost disparity with other antihistamines. Extrapyramidal features of tremor, akinesia and hypertonicity are more common in older people; usually developing within weeks or months of commencement. Stopping the drug is the first-line intervention. Resolution of symptoms is not guaranteed.

Precision Medicine in Angelman Syndrome.

Angelman syndrome (AS) is a rare neurogenetic disorder caused by a loss of function of UBE3A on the maternal allele. Clinical features include severe neurodevelopmental delay, epilepsy, sleep disturbances, and behavioral disorders. Therapy currently evolves from conventional symptomatic, supportive, and antiseizure treatments toward alteration of mRNA expression, which is subject of several ongoing clinical trials.This article will provide an overview of clinical research and therapeutic approaches on AS.

Sleep and nighttime behavior disorders in older adults: associations with hypercholesterolemia and hypertriglyceridemia at baseline, and a predictive analysis of incident cases at 12 months follow-up.

Sleep disorders, particularly insomnia and obstructive sleep apnea, are associated with dyslipidemia in the general population. The study's aim was to explore the association between pathological Cholesterol and Triglyceride levels, and sleep and nighttime behavior disorders (SNBD) in older adults, whether they might predict SNBD onset, and to emphasize the role of body mass index (BMI) in this association. Alzheimer's Disease Neuroimaging Initiative (ADNI) population with complete Cholesterol, Triglyceride, SNBD, and neurocognitive data were included. Logistic regression was performed to study the association between hypercholesterolemia, hypertriglyceridemia, and SNBD at baseline and at12 months. Relevant confounders, particularly BMI, were adjusted for. Among the 2,216 included cases, 1,045 (47%) were females, and the median age was 73 years (IQR: 68, 78). At baseline, 357 (16%) had SNBD and 327 (18%) at 12 months; 187 of them were incident cases. There were more cases of baseline SNBD in the hypertriglyceridemia group than in those without (19% vs. 14%, P-value = 0.003). Similarly, more follow-up SNBD cases had hypertriglyceridemia at baseline (21% vs. 16%, P-value = 0.025). SNBD cases at baseline had significantly higher serum Triglyceride levels than those without (132 vs. 118mg/dL, P-value < 0.001). Only hypertriglyceridemia was significantly associated with baseline SNBD (crude OR = 1.43, 95%CI: 1.13,1.80, P-value = 0.003), even after adjustment for confounding factors (adj. OR = 1.36, 95%CI: 1.06,1.74, P-value = 0.016) and (BMI-adj. OR = 1.29, 95%CI: 1.00,1.66, P-value = 0.048). None of the dyslipidemia forms did predict incident cases at 12 months. Hypertriglyceridemia, but not hypercholesterolemia, was associated with higher odds of SNBD. The association was independent of BMI. None of the dyslipidemia forms did predict incident SNBD over 12 months. Sleep disorders should motivate a systematic screening of dyslipidemia in older adults and vice versa.

Patterns of Child and Adolescent Psychiatric Admissions Before and After the Onset of the COVID-19 Pandemic: Take Home Messages from a Clinical Population.

: This study from Istanbul aimed to compare the child and adolescent psychiatric admissions and diagnosis rates between the first 3 months of the pandemic, the previous 3 months in the same year, and the same months in the previous year. : Children and adolescents were grouped according to the admission dates. Group A, between March 11 and June 1, 2020; Group B, between January 1 and March 11, 2020; and Group C, between March 11 and June 1, 2019. Only clinical interviews and diagnoses according to Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version (K-SADS-PL) interview were included. : Autism spectrum disorder (ASD), obsessive-compulsive disorder (OCD)/tic disorder, and intellectual disability (ID) diagnoses were higher in group A than in groups B and C (for ASD, 6.4%, 4.3%, and 3.6%; for OCD/tic disorder, 2.9%, 1.8%, 1.7%; for ID, 3.7%, 2.5%, and 2.1%, respectively) (P < .001). Attention-deficit hyperactivity disorder (ADHD) diagnosis was higher in group A than in only group B (59.8% and 49.7%, respectively) (P < 0.001). Depression was higher in group A than in only group C (4.1% and 2.2%, respectively) (P < .001). Conduct disorder (CD) diagnosis was lower in group A than in only group B (3.6% and 6.4%, respectively) (P < .05). : Child psychiatry diagnosis rates were found to change significantly during the initial phase of the pandemic period. Among the referrals, ASD, OCD, Tic disorder, ID, ADHD, and depression admissions were significantly higher. The rate of pediatric neurodevelopmental disorders, particularly ASD, increased during the initial phase of the COVID-19 pandemic.

Assessment of modifiable risk factors and vascular wall stiffness in young people

Objective: to study the characteristics of vascular stiffness in young people, taking into account the presence of the main modifiable risk factors (FR) for the development of cardiovascular diseases (CVD). Materials and methods: a survey was conducted of 38 practically healthy young people (18 boys, 20 girls) — university students, whose average age was 19.8±1.45 years. By filling in the modified diagnostic charts, the subjects assessed the presence of the main behavioral CVD disorders. Volumetric sphygmography on the VaSera-1000 device (Fukuda Denschi, Japan) was used to assess the stiffness of the main vessels and blood pressure (BP) levels in the basins of the upper and lower extremities. Results: in the examined individuals, despite their young age and the documented absence of cardio-vascular pathology, all the main cardiovascular diseases were revealed: an increased body mass index (BMI≥25 kg/m2), smoking, psychosocial factors, sedentary lifestyle, unbalanced diet, alcohol consumption, which were present in various combinations. Vascular stiffness indices — the cardio-ankle index and the biological age of the vessels — were within the normal range, while the ankle-shoulder index was reduced in 24% of the students. Conclusion: the results obtained indicate the need for primary prevention of CVD by lifestyle modification, even in young people, since the FR detected in them and the tendency to change vascular stiffness indicators can subsequently act as triggers for the early onset of diseases of the circulatory system