Psychiatric effects of cenobamate in adults with epilepsy: A retrospective study.

Efficacy of transcranial direct current stimulation in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis.

Peripubertal PTSD-like stress in rats induces transient behavioral but lasting metabolic and inflammatory alterations: Limited fluoxetine efficacy.

All types of dementia present with some form of communication impairment, due to a combination of linguistic and extralinguistic deficits. Whereas intervention strategies have been developed to address communication for individuals in the mild-moderate stages, fewer options exist for adults with moderate to severe dementia. Non-invasive and simple strategies that can be implemented by both formal and informal caregivers or rehabilitation staff, such as music-based interventions, can be leveraged to address communication concerns across the dementia trajectory. Individualized passive music listening (IPML) has been shown to have beneficial effects for adults with dementia with the additional advantages of affordability and relative ease of use. Most dementia-focused investigations of IPML, however, have explored the utility of IPML in the context of reducing problem behaviors (e.g., agitation) to the exclusion of measuring the full spectrum of possible benefits, including communication. In this exploratory study, we examined the potential of volunteer-implemented IPML to increase functional communication in the form of discourse productivity and informativeness for adults with dementia. A single-subject-across subjects, alternating treatment design (IPML vs. standard care) was utilized for three individuals diagnosed with moderate to severe dementia and residing in a long-term care facility. IPML was implemented for study participants by two trained volunteers, with a conversational discourse probe administered prior to and immediately following each session, for each condition, as the primary outcome variable. Discourse length and informativeness were examined in terms of level and overlap of data across conditions. Small but positive effects of IPML on conversational discourse were found for all participants, with an intervention effect consistently demonstrated for two of the three participants (moderate and moderate-severe dementia). These preliminary findings support further testing of IPML as a potentially cost-effective way to supplement other types of interventions designed to maximize functional communication for individuals with moderate to severe dementia residing in long-term care settings. What is already known on this subject Individualized Passive Music Listening (IPML), which can be implemented by both formal and informal caregivers, has been recommended as an effective non-pharmacological approach for improving quality of life in individuals with dementia, particularly by decreasing behavioral and psychological symptoms of dementia (BPSD). However, fewer studies have explored the ability of IPML to impact positive behaviors (e.g., engagement, socialization), and no studies have directly measured the immediate impact of IPML on functional communication. What this study adds to the existing knowledge IPML was found to have small but positive effects on functional communication (discourse amount and informativeness) for individuals with moderate to severe dementia as measured immediately following intervention. These preliminary results support the need for continuing to investigate the full spectrum of positive effects following passive music listening interventions, particularly for individuals living with moderate to severe dementia for whom fewer options to address communication have been explored. What are the potential or actual clinical implications of this study? Music interventions, particularly IPML, are non-invasive, simple strategies that can be leveraged to support the cognitive processes underlying language and communication. SLPs are encouraged to collaborate with other members of the care team to design environments that capitalize on these effects for adults with dementia, particularly those within residential care settings.

Clinical profile of idiopathic normal pressure hydrocephalus with reduced myocardial sympathetic nerve function.

Glioblastoma can rarely present with predominantly psychiatric, cognitive, and behavioral symptoms, complicating timely diagnosis. This case describes a woman in her late 50s who developed abrupt-onset paranoia, memory impairment, and rapid neurological decline, initially misdiagnosed as rapidly progressive dementia with behavioral and psychological symptoms. Later, neuroimaging revealed a massive left fronto-temporoparietal glioblastoma with significant mass effect. Surgical excision and histopathology confirmed epithelioid glioblastoma (World Health Organization Grade IV) with tumor protein 53 and isocitrate dehydrogenase-1 mutations. Post-surgical recovery showed some neurological improvement, and she was referred for radiotherapy. This case highlights the diagnostic challenge of atypical brain tumor presentations and underscores the need for neuroimaging in patients with new-onset behavioral or cognitive symptoms, especially when neurological signs are present. Early recognition and intervention are critical in such cases to enable effective treatment and improve outcomes in aggressive brain tumors like glioblastoma.

The current study examined RNs' practical experiences in managing behavioral and psychological symptoms of dementia (BPSD) and delirium superimposed on dementia (DSD) in long-term care hospitals. In-depth, one-on-one interviews were conducted with 18 RNs-including charge nurses, head nurses, and general staff-at two long-term care hospitals. Nurses reported significant challenges in distinguishing and managing BPSD and/or DSD due to limited symptom-specific knowledge, overlapping clinical presentations in older adults, and resource constraints. Despite these barriers, they actively applied practical strategies to interpret symptoms and initiate appropriate interventions. Findings highlight the need for targeted education and structured clinical support to strengthen nurses' capacity to differentiate and manage BPSD and DSD. Enhancing institutional systems and interdisciplinary collaboration is essential to improving dementia care in long-term care hospitals.

BackgroundBehavioral and psychological symptoms of dementia (BPSD) in patients with Alzheimer's disease (AD) may seriously impact caregiver burden and, therefore, quality of care.ObjectiveTo clarify the association of BPSD and BPSD subtypes with caregiver burden and quality of life (QOL) among caregivers of patients with AD in Japan in a multidimensional manner.MethodsThis descriptive, cross-sectional, community-based survey involved administering a web-based questionnaire to live-in caregivers of patients with AD registered with Macromill Inc. BPSD prevalence was measured using the Japanese version of the Neuropsychiatric Inventory-Questionnaire Form. The Japanese version of the Zarit Caregiver Burden Scale (J-ZBI), EQ-5D-5L, and Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer) were used to assess caregiver burden, health-related QOL, and social care-related QOL, respectively.ResultsOf 705 survey responders, 639 (90.6%) and 66 (9.4%) cared for patients with and without BPSD, respectively. Mean caregiver age was 54.6 years, 56.9% were male, and 84.0% cared for parents or in-laws. In the "with BPSD" group, the J-ZBI score was higher (mean difference [95% confidence interval], 6.7 [4.5, 9.0]; p < 0.001), while EQ-5D-5L and ASCOT-Carer scores were lower (-0.076 [-0.134, -0.018; p = 0.010] and -0.101 [-0.168, -0.033]; p = 0.003, respectively) than in the "without BPSD" group.ConclusionsA significant association between increased caregiver burden and BPSD in patients with AD was demonstrated, which may be associated with decreased caregiver healthcare and social care-related QOL.

Background/Objectives: Smith–Magenis syndrome (SMS) is a rare neurogenetic disorder caused by a microdeletion in chromosome region 17p11.2 or by pathogenic variants in the RAI1 gene. The syndrome is characterized by a distinctive neurobehavioral profile, including cognitive deficits, sleep disturbances, self-injurious behavior, and typical dysmorphic features. A characteristic diagnostic hallmark is paradoxical melatonin secretion, with increased daytime levels instead of the normal nocturnal peak. This article aims to summarize current knowledge on the etiology, diagnostics, EEG findings, therapy, and prognosis of SMS from a neuropediatric perspective. Methods: A narrative review of the literature on Smith–Magenis syndrome was conducted, focusing on genetic background, clinical features, diagnostic approaches, EEG characteristics, therapeutic strategies, and prognosis. In addition, a detailed clinical case of a 16-year-old female patient with SMS is presented. Results: The reviewed data confirm that SMS is associated with characteristic neurobehavioral abnormalities and sleep–wake rhythm disturbances. EEG findings may include epileptiform activity without overt epilepsy. In the presented case, “Rolandic-type” spike–sharp wave complexes were observed on EEG and are interpreted as an expression of congenital disturbances in brain maturation processes. Therapeutic recommendations addressing behavioral symptoms and sleep regulation are discussed. Conclusions: Smith–Magenis syndrome represents a complex neurodevelopmental disorder with distinctive clinical, neurophysiological, and genetic features. Early recognition of characteristic signs, including sleep disturbances and EEG abnormalities, is essential for appropriate management. A multidisciplinary, individualized therapeutic approach may improve quality of life and long-term outcomes.

BackgroundAlthough some studies have suggested that homelike care environments can have beneficial effects on people living with dementia (PlwDs) and people living with mild cognitive impairment (PlwMCIs), studies on effects of a non-pharmacological, psychosocial intervention on behavioral and psychological symptoms of dementia (BPSDs) in the setting of shared-housing arrangements (SHAs) are still lacking.MethodsIn the prospective, multicenter, mixed-methods, cluster-randomized controlled DemWG study, 97 SHAs comprising 341 PlwDs or PlwMCIs were randomly assigned to either the intervention group (IG) or control group (CG). The complex intervention consisted of the education of nursing staff in SHAs (Component A), the education of general practitioners (Component B), and the multicomponent, psychosocial group intervention MAKS-mk+ (Component C). BPSDs (secondary outcome of the DemWG study) were assessed with the Cohen-Mansfield Agitation Inventory-Short Form (CMAI-SF) and the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH) at baseline (t0), 6 months after baseline (t1) and 12 months after baseline (t2). Unadjusted and adjusted generalized estimating equations (GEE) models were computed to investigate possible effects of the complex intervention on the outcome variables at t1 or t2.ResultsIn the intention-to-treat (ITT) sample, the adjusted GEE models showed that participants in the IG had a significantly lower CMAI-SF score at t1 and at t2 than participants in the CG with a small- to medium-sized effect (RESI = 0.26 [t1] & RESI = 0.26 [t2]). Regarding the NPI-NH, the adjusted GEE models showed no significant differences between the IG and CG at t1 and t2. Sensitivity analyses on individuals’ actual average weekly frequency of participating in the MAKS-mk + intervention (“as treated”) showed results comparable to the ITT analysis.DiscussionThe results of the study show that the complex intervention had a positive effect on agitation and aggression in PlwDs or PlwMCIs with a small- to medium-sized effect. Overall, these findings should also contribute to improvement in the caregiving situation and living conditions of relatives and professional caregivers. As the intervention has demonstrated feasibility in the SHA setting, more consideration should be given to implementing it in everyday SHA care.Trial registrationISRCTN89825211 (Registered prospectively, July 16, 2019).Supplementary InformationThe online version contains supplementary material available at 10.1186/s12888-026-07810-x.

As the number of people living with dementia continues to rise, acute hospitals must explore innovative, person-centred strategies to support their needs. Hospital environments can be disorientating and distressing for people with dementia, contributing to increased agitation, anxiety and poorer outcomes. Music, a widely accessible and low-cost intervention, is increasingly recognised for its therapeutic potential in this context. This article explores the use of music as a non-pharmacological intervention in acute hospital settings, highlighting its potential to support cognitive function, psychosocial wellbeing, motor activity, and behavioural symptoms. Drawing on current evidence and practical examples, it outlines how tailored music activities, such as listening, singing, lyric writing, and movement, can enhance person-centred care, improve the patient experience, and reduce reliance on medication. The article also discusses implementation challenges, ethical considerations, and the need for further research to embed music more effectively within routine dementia care in hospitals.

Nature-based approaches to dementia, cognitive impairment, and caregiver well-being: A scoping review of gardening and therapeutic strategies.

Facial emotion recognition (FER) deficits in Alzheimer disease (AD) are associated with atypical eye-gaze strategies and exacerbated behavioral and psychological symptoms of dementia (BPSD). This results in increased caregiver burden and impacts social interactions and quality of life. To evaluate the effects of Training of Affect Recognition (TAR), a targeted cognitive remediation program, on FER, eye-gaze patterns, and BPSD in individuals with AD, as well as caregiver burden. We hypothesized improvements in emotional processing and associated clinical outcomes. Twenty-four patient-caregiver dyads participated in this single-blind randomized controlled pilot study. Each patient was assigned to participate in the TAR program (ie, the AD-TAR group; n = 12) or to receive cognitive stimulation intervention twice weekly for 6 weeks (ie, the AD-CS group; n = 12). We assessed FER using static (n = 24) and dynamic (n = 16) stimuli with eye-tracking. We used the Neuropsychiatric Inventory to assess BPSD and the Zarit Burden Interview to assess caregiver burden. Each assessment was completed at baseline, post-intervention, and 1-month follow-up. The AD-TAR group showed improvements in static FER accuracy and recognition speed, as well as increased dynamic FER speed. There were concomitant beneficial changes in eye-gaze strategies in static FER and reinforced observation strategies for dynamic FER. Reductions in BPSD and caregiver burden persisted at the 1-month follow-up. Targeted FER remediation is a promising intervention for improving emotional processing in AD, with potential clinical implications for managing BPSD and enhancing quality of life for individuals with AD and their caregivers.

Informal carers' needs and challenges towards managing behavioural and psychological symptoms of dementia and accepting mHealth applications: A qualitative study.

Frontotemporal dementia is the most common dementia in people under age 60. Although FTD is often characterized by behavioral symptoms, few national interventions address management of these symptoms. Here we describe our protocol for STELLA-FTD, an intervention for FTD care partners. STELLA-FTD is an NIH Stage 1B randomized controlled trial that tests the efficacy of the intervention and will isolate the hypothesized mechanism of action. Two groups (test and control) receive information and peer support over eight weekly sessions. The test group will receive the behavioral management intervention, the control group will not. Prior to implementation, the advisory board (STAR Council) tested the website and participated in mock sessions. Revisions were completed and recruitment started in June 2025. STELLA-FTD addresses the needs of an under-studied group, FTD care partners. The study will provide evidence of intervention efficacy and identify the mechanism of action.

Huntington's disease (HD) is a fatal neurodegenerative disorder characterized by a triad of behavioral symptoms: involuntary movement, emotional change, and cognitive dysfunction. Although alterations in WNT signaling have been reported in HD, its precise role in pathogenesis remains unclear. In this study, we found that astrocytic WNT5B mRNA and protein levels are elevated in the striatum of both HD patients and HD model mice. The noncanonical WNT5B signaling pathway induced sustained expression of matrix metallopeptidase 14 (MMP14), an extracellular matrix (ECM)-degrading enzyme, via activation of the NFATc2 transcription factor in both human and primary mouse astrocytes. Robust upregulation of MMP14 led to ECM degradation, medium spiny neuron (MSN) damage, and increased mutant huntingtin aggregation in N171-82Q HD transgenic mice. Furthermore, WNT5B gain-of-function exacerbated neuropathology, impaired motor coordination, and shortened the lifespan of N171-82Q mice. We further demonstrated that the overexpression of the estrogen receptor α (ERα) suppresses NFATc2 transcriptional activity in vitro. A targeted therapy for the WNT5B-NFATc2-MMP14 signaling pathway by genistein, a phytoestrogen, reduced MMP14 transcription by antagonizing NFATc2 activity and preventing ECM degradation in N171-82Q mice. Genistein treatment also ameliorated neuropathology and motor deficits and prolonged the lifespan of HD mice. Together, these findings define a molecular pathological mechanism in which astrocytic MMP14 transcription, driven by the noncanonical WNT5B signaling pathway, promotes ECM degradation and MSN damage and accelerates neurodegeneration in HD. Modulation of the noncell-autonomous WNT5B-NFATc2-MMP14 signaling pathway by genistein may serve as a potential therapeutic strategy for mitigating HD pathogenesis.

Autism spectrum disorder (ASD; autism) is a prevalent and heterogeneous neurodevelopmental disorder characterised by social communication difficulties, repetitive behaviour, and restricted interests. For individuals with autism, in particular those who require substantial care-giver support, irritability, heightened sensitivity and aggressive behaviours in response to sensory, social, or environmental triggers can limit access to health, education and community services and impact quality of life. Although gastrointestinal (GI) symptom severity is associated with irritable behaviours in autism, there are few approved medications to address challenging behaviour or comorbid psychiatric disorders, or gut dysfunction in autism. Here, we review the mode of action of drugs undergoing clinical trials for treating irritable behaviour and improving social communication as well as potentially gastrointestinal symptoms in individuals with autism. Repurposed medications such as pimavanserin (an atypical antipsychotic) and the antiparasitic suramin are being trialled for treating irritable behaviours and impaired social interaction, respectively, in autism. NTI164 is a medicinal cannabis-derived biopharmaceutical undergoing clinical safety and efficacy trials for improving social communication and similarly, ML-004 is an investigational drug being assessed for treating social communication deficits. Two other repurposed medications previously utilised for schizophrenia; brexpiprazole and lumateperone, as well as AB-2004, a microbial metabolite sequestering agent (with proposed actions on gut function), are undergoing clinical trials to assess impacts on irritability associated with autism. We also outline emerging findings from clinical studies on the use of gut-targeted small molecules and bacteriophage therapy, prebiotics, probiotic supplementation and faecal microbiota transplantation (FMT), and their potential impact on behavioural symptoms in autism.

Neuropsychiatric symptoms such as depression and apathy are frequently reported in all subgroups of frontotemporal dementia (FTD) or frontotemporal lobe degeneration (FTLD) and represent a substantial burden for both patients and caregivers. Both symptoms are most common in its behavioral variant (bvFTD) with a prevalence of up to 90%. Their severity is particularly high in bvFTD and the semantic variant of primary progressive aphasia (svPPA). Due to its clinical heterogeneity, bvFTD can mimic depression, especially in its initial stages, making their differentiation a major clinical challenge. The relationship between depression and the even more often presenting apathy is unclear, although they frequently co-occur and overlap. Depression in FTD is associated with atrophy in the left prefrontal/orbitofrontal cortex, supramarginal and postcentral gyrus, connected with dysfunction of neuronal networks involved in the pathogenesis of major depressive disorder and frontotemporal hypometabolism. Apathy, a core behavioral symptom in bvFTD, is associated with similar cortical atrophies on the right side and disordered networks between prefronto-striatal and other circuits. Since currently no curative treatment for FTD is available, the management of the basic disease and associated depression and apathy is mostly symptomatic. Most pharmacological interventions are without convincing effect; for depression, electroconvulsive therapy is a beneficial option, as is transcranial magnetic stimulation for apathy, but there is an impetus to develop general guidelines for the diagnosis and effective treatment of FTD and associated depression and apathy.

The bidirectional relationship between hikikomori behavioral tendencies and depressive symptoms: A three-wave longitudinal study.

HighlightsWhat is the main findings?•Term-born SGA children show a slightly reduced overall IQ with specific weaknesses in visuospatial abilities, attention, and processing speed, while verbal and memory skills remain relatively preserved.What is the implication of the main finding?•Early identification of deficits in perceptual reasoning and processing speed may guide timely cognitive and educational interventions, potentially improving long-term academic and social outcomes.Background/Objectives: Children born small for gestational age (SGA) are at increased risk for impaired growth, metabolic disturbances, and neurodevelopmental difficulties. Although previous research has examined cognitive and behavioral outcomes in this population, findings remain inconsistent. Moreover, limited evidence is available regarding the potential effects of recombinant human growth hormone (rhGH) therapy on cognitive development. We aimed to assess cognitive performance, emotional–behavioral functioning, and neonatal predictors of neurocognitive outcomes in term SGA children compared with age- and sex-matched peers born appropriate for gestational age (AGA). We also explored potential differences in cognitive outcomes between rhGH-treated and untreated SGA children. Methods: A total of 18 term SGA children and 23 AGA controls underwent anthropometric measurements, biochemical evaluation, cognitive testing using the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV), and behavioral assessment through the Child Behavior Checklist (CBCL). Birth weight, length, and head circumference were analyzed as potential predictors of cognitive performance. Results: SGA children demonstrated significantly lower Intelligence Quotient (IQ) scores than AGA peers, with marked weaknesses in Perceptual Reasoning index (PRI) and Processing Speed index (PSI), while Verbal Comprehension and Working Memory were preserved. They also exhibited higher internalizing behavioral symptoms, whereas externalizing behaviors did not differ between groups. Birth head circumference emerged as a strong predictor of PRI and a modest predictor of PSI. No associations were found between rhGH treatment parameters and cognitive outcomes. Larger longitudinal studies are needed to clarify how early growth restriction affects brain development and cognition and whether GH therapy influences these processes.