Hamilton Depression Rating Scale Research Articles

Serum Asprosin and Peptide Tyrosine Tyrosine (PYY) Levels in Bipolar Disorder

Objective: In our study, we aimed to investigate the differences in metabolic parameters, serum asprosin and peptide tyrosine tyrosine (PYY) levels in a bipolar disorder manic (BD-M) group, a euthymic group and in healthy controls; we also aimed to evaluate the relationship of asprosin and PYY levels with metabolic parameters and psychopathology in patients. Methods: The study included 54 manic patients, 40 euthymic patients and 39 healthy controls. The sociodemographic characteristics of the participants were recorded, and biochemical parameters and asprosin and PYY levels were measured. The Young Mania Rating Scale (YMRS) and the Hamilton Depression Rating Scale (HAM-D) were completed. Results: Body mass index (BMI) showed significant differences between the three groups (p < 0.001); the lowest was found in the control group and the highest in the euthymic group. Triglyceride levels were significantly higher in the euthymic group compared with the BD-M group and controls (p = 0.003). Glucose levels were significantly higher in the BD-M group compared with euthymic (pmanic-euthymic = 0.008) and controls (pmanic-control < 0.001). Asprosin (pmanic-control < 0.001, peuthymic-control = 0.046, pmanic-euthymic = 0.015) and PYY (pmanic-control < 0.001, peuthymic-control = 0.037, pmanic-euthymic = 0.002) levels were significantly different between the three groups, with the lowest levels in the BD-M group and the highest levels in the control group. The eta squared = 0.18 for asprosin and 0.21 for PYY. In the BD-M group, a moderate negative correlation was found between YMRS and asprosin (r = −0.345; p = 0.011) and PYY (r = −0.376; p = 0.005) levels. ROC analysis results showed that asprosin and PYY could be used to predict the manic period in BD-I (AUCasprosin:0.775; AUCPYY:0.760). After adjusting for asprosin as a covariate using ANCOVA, the difference in PYY between groups remained significant (manic–euthymic groups, p = 0.040; manic–control groups, p = 0.013). Conclusions: The study results revealed that asprosine and PYY levels were low, and metabolic parameters were impaired in the patients. Low asprosine and PYY levels may be indicators of impaired energy homeostasis in BD-I. PYY may be a state marker for manic episodes.

Effectiveness of Ginseng on the Symptoms of Depression and Anxiety in Patients Referred to Addiction Treatment Clinics in Ahvaz: A Randomized Clinical Trial

Background: Anxiety and depression are significant factors that can increase the likelihood of concurrent substance use in patients undergoing treatment. Objectives: This study aims to address the gap in knowledge regarding the treatment of anxiety and depression resulting from substance withdrawal by evaluating the effectiveness of ginseng on depression and anxiety symptoms in patients at addiction treatment clinics in Ahvaz. Methods: This research is categorized as applied research and falls under experimental designs for data collection. It was a randomized clinical trial with a pre-test and post-test design involving two groups. The statistical population included all patients visiting addiction treatment clinics in Ahvaz during 2023 - 2024. A total of 68 participants meeting the inclusion and exclusion criteria were randomly assigned to two groups: One receiving ginseng and the other a placebo (34 participants each). One group received 100 mg capsules of ginseng, while the other received a placebo for four weeks. All participants were assessed at the beginning of the study and after the intervention using the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS). Data analysis was conducted using descriptive statistics and analysis of covariance, utilizing SPSS-26 software. Results: The study involved 68 individuals aged 28 to 59 years, with a mean age of 43.22 ± 8.89. The mean ± standard deviation of depression and anxiety in the pre-test of the intervention group was 29.85 ± 6.19 and 25.00 ± 6.06, respectively, and in the placebo group was 27.79 ± 7.21 and 23.91 ± 4.82, respectively. The mean ± standard deviation of depression and anxiety in the post-test of the intervention group was 15.44 ± 11.37 and 12.26 ± 10.40, respectively, and in the placebo group was 11.91 ± 10.83 and 13.32 ± 10.10, respectively. The results indicate no significant difference between post-test and pre-test scores in the intervention group compared to the placebo group (P > 0.05). Conclusions: The results indicate that there was no significant difference in post-test means compared to pre-test means in the intervention group relative to the placebo group. However, further randomized trials with larger sample sizes are necessary for confirmation. Findings should be interpreted with caution.

Efficacy and Safety of Adjunctive Aripiprazole LAI or Paliperidone LAI for the Management of Patients Suffering from Bipolar I Disorder with Comorbid Obsessive-Compulsive Disorder

Background/Objectives: Bipolar disorder (BD) and obsessive-compulsive disorder (OCD) often coexist, presenting significant challenges in treatment. OCD comorbidity in BD is associated with severe clinical features such as increased suicidality and impaired functioning. While selective serotonin reuptake inhibitors (SSRIs) are effective for OCD, they may increase manic shifts in BD patients. The use of long-acting injectable (LAI) antipsychotics such as monthly aripiprazole (ARI-LAI) and monthly paliperidone (PP-LAI) has been proposed as a promising alternative for BD treatment, while their efficacy and safety in BD-OCD remain understudied. This study investigated the effectiveness and tolerability of ARI-LAI and PP-LAI as adjunctive therapies in this population. Methods: 27 BD-OCD patients were treated with ARI-LAI or PP-LAI, alongside mood stabilizers (MS) (lithium or sodium valproate), over a 24 week period. Clinical and psychopathological assessments were performed at baseline and regular intervals using the Yale-Brown Obsessive Compulsive Scale and the Hamilton Depression Rating Scale. Safety and tolerability were evaluated using the UKU Side Effect Rating Scale. Results: Both treatments led to significant reductions in obsessive-compulsive symptoms and mood stabilization without manic episodes. ARI-LAI showed superior tolerability in terms of body weight gain compared to PP-LAI, with no significant differences in overall efficacy between the groups. Conclusions: This study is the first that investigated the efficacy and safety of adjunctive PP-LAI and ARI-LAI in this population highlighting their potential as effective and well-tolerated options for managing BD-OCD. Further studies are needed to confirm these results and refine treatment strategies for this complex population.

Subthalamic nucleus versus globus pallidus internus deep brain stimulation in the treatment of dystonia: A systematic review and meta-analysis of safety and efficacy.

This systematic review and meta-analysis aimed to compare the efficacy and safety of deep brain stimulation (DBS) targeting subthalamic nucleus (STN) versus the globus pallidus internus (GPI) in the treatment of dystonia. A comprehensive search strategy was implemented up to July 2024, across five databases, identifying studies relevant to STN-DBS and GPI-DBS in dystonia. Eligibility criteria included randomized controlled trials (RCTs) and observational studies comparing the two interventions. Two independent reviewers conducted the screening and data extraction. The risk of bias was assessed using RoB-2 for RCTs and the Newcastle-Ottawa Scale for cohort studies. Statistical analysis involved meta-analysis using Review Manager, with heterogeneity assessed by I2 and Chi-square tests. Subgroup and sensitivity analyses were performed. Five studies, involving 154 patients, were included. No significant difference was found between STN-DBS and GPI-DBS in Burke-Fahn-Marsden Dystonia Rating Scale motor and disability (BFMDRS-M and BFMDRS-D) scores at 1months, 6 and 12months. STN-DBS showed significant improvement in mental health (SMD = 0.43, 95% CI: [0.05, 0.8], P = 0.03). STN-DBS also showed significant improvement in Hamilton Anxiety Rating Scale (HAMA) (SMD = -2.7, 95% CI: [-5.38, -0.02], P = 0.05). No significant difference was found in Hamilton Depression Rating Scale (HAMD) scores. Both STN-DBS and GPI-DBS can improve motor symptoms in dystonia, with STN-DBS potentially resulting in more superior mental health benefits. Future research should address long-term outcomes, and regional effectiveness, and include diverse populations to enhance generalizability.

Cerebellum abnormalities in vascular mild cognitive impairment with depression symptom patients: A multimodal magnetic resonance imaging study.

Subcortical vascular mild cognitive impairment (svMCI) frequently occurs alongside depression symptoms, significantly affecting patients' quality of life. While cognitive decline and depression symptoms are linked to cerebellar changes, the specific relationship between these changes and cognitive status in svMCI patients with depression symptoms remains unclear. This study aimed to investigates the gray matter volume and functional alterations in the cerebellum of svMCI patients, with and without depression symptoms, and their correlation with cognitive and depressive symptoms. We enrolled 16 svMCI patients with depression symptoms (svMCI+D), 15 without (svMCI-D), and 12 normal controls (NC). Multimodal MRI scans were conducted, assessing gray matter volume and resting-state functional connectivity (RSFC) in the cerebellum. Correlations between RSFC and clinical scores from the Montreal Cognitive Assessment (MoCA) and Hamilton Depression Scale (HAMD) were analyzed. Structural analysis indicated gray matter atrophy in left cerebellar lobules I_IV and VI (Cere6.L) in svMCI patients. svMCI+D patients showed reduced RSFC between Cere6.L and left cerebellar region IX and the left superior frontal gyrus (SFGdor.L). Both svMCI+D and svMCI-D groups showed increased RSFC between Cere6.L and the right caudate nucleus. RSFC between Cere6.L and SFGdor.L correlated negatively with HAMD scores in svMCI+D and positively with MoCA scores in svMCI-D. RSFC between Cere6.L and the right caudate nucleus also correlated positively with MoCA in the svMCI-D. Cerebellar abnormalities, including the gray matter atrophy and RSFC changes, are associated with svMCI, particularly when depression symptoms are present. These results suggest potential diagnostic and therapeutic implications for svMCI and emphasize the need for further research on the cerebellum's role in cognitive and emotional disorders.

Influencing factors of the outcome of patients with haemophilia after knee replacement–a retrospective study

ObjectiveTo explore the factors that affect the efficacy of knee replacement surgery in hemophiliacs.MethodsA retrospective analysis was conducted on 87 patients with hemophilia (PWH) (117knees) who underwent knee arthroplasty in our hospital from January 2012 to December 2020 (mean follow-up 70.8 ± 22 months). General information, hemophilia information, surgical information, follow-up information and psychological assessment information were collected. The knee joint efficacy was evaluated using the Hospital for Special Surgery (HSS) knee score, the American Knee Society’s Clinical (KSC) and Functional (KSF) scores, flexion contracture degree (FC), range of motion (ROM), and wound healing. The excellent and poor groups were divided based on these factors. Logistic regression analysis was used to analyze factors that may affect the knee joint efficacy of patients.ResultsSeventy-four cases of excellent knee joints and 43 cases of poor knee joints were included. Single factor analysis: The pre-ROM, SF-12MCS, HSS, KSF, and KSC of the excellent group were significantly higher than those of the poor group (P < 0.05); the Hamilton Depression Scale (HAMD), Preoperative Visual Analogue Scale(Pre-VAS), pre-FC degree of the excellent group were significantly lower than those of the poor group (P < 0.05). The proportion of patients undergoing Simultaneous bilateral knee replacement, severe hemophilia, and quadricepsplasty during surgery in the excellent group was significantly lower than that in the poor group (P < 0.05). Logistic regression: Pre-ROM and Simultaneous bilateral knee replacement are independent risk factors affecting knee joint efficacy. Pre-ROM is positively correlated with knee joint efficacy, while Simultaneous bilateral knee replacement is negatively correlated.ConclusionIn PWH, the efficacy of knee replacement surgery is related to preoperative ROM and Simultaneous bilateral knee replacement. Better preoperative knee joint mobility is associated with improved outcomes, whereas Simultaneous bilateral knee replacement negatively impacts surgical efficacy.

Effectiveness and safety of transcutaneous auricular vagus nerve stimulation for depression in patients with epilepsy.

Our study aimed to evaluate the effectiveness and safety of transcutaneous auricular vagus nerve stimulation (taVNS) for treating mild to moderate depression in patients with epilepsy (PWE). A single-arm, prospective, multi-center, pre-post controlled study was conducted in Eastern China. After a four-week baseline period, PWE with mild to moderate depression began treatment with taVNS, administered for 30min, three times daily, over a 12-week period. The primary outcome measure was the change in 24-item Hamilton Depression Rating Scale (HAMD) scores from baseline to week 12. Secondary outcomes included the response and remission rates for depression at week 12, as well as changes in the 14-item Hamilton Anxiety Rating Scale (HAMA), the Pittsburgh Sleep Quality Index (PSQI), and the Quality of Life in Epilepsy Inventory-31 (QOLIE-31) scores, and seizure frequency at weeks 4 and 12 compared to baseline. Adverse events (AEs) were recorded to assess the safety of taVNS. Both modified Intention-To-Treat (mITT) and Per-Protocol (PP) analyses were employed. Sixty-nine participants were enrolled in this study. Of these, 61 (88.4%) completed the 4-week treatment phase, and 50 (72.5%) finished the 12-week treatment phase. In the mITT analysis, HAMD scores significantly decreased by 4.54±7.44 (p<0.001) from baseline to week 12, with clinical response in 16 (26.2%) and remission in 15 (24.6%) patients. HAMA scores also decreased significantly by week 4 (3.23±5.18, p<0.001) and week 12 (4.95±6.78, p<0.001). PSQI scores and seizure frequency showed non-significant changes at week 4, but seizure frequency decreased significantly by week 12 (0.03±10.47, p=0.038). In the PP analysis, similar improvements were observed. After 12weeks of taVNS compared to baseline, HAMD scores decreased significantly by 5.32±8.98 (p<0.001), with 32% of patients achieving a clinical response and 24% achieving clinical remission. And HAMA scores also decreased by 5.66±7.54 (p<0.001), seizure frequency by 0.14±11.03 (p=0.018), and PSQI scores by 1.06±4.14 (p=0.076).There was a significant increase in QOLIE-31 scores by 5.17±14.71 (p=0.020). Ten (14.5%) patients experienced non-serious adverse events, the most common of which was ear pain (n=4); one patient withdrew due to tinnitus enhancement; all resolved after reducing the stimulation intensity or stopping the treatment. Our study suggests that taVNS may effectively improve depressive symptoms in PWE. This may be an efficacious and safe treatment for mild to moderate depression in PWE.

Psychological Impact on the Patient With a History of Pregnancy Loss

Pregnancy loss is a traumatic event that deeply affects the mental health of women, predisposing them to the development of disorders such as perinatal grief, anxiety, post-traumatic stress and depression. This study aimed to evaluate the psychological impact on obstetric women with a history of pregnancy loss. An observational and prospective study was conducted at the UMAE Hospital de Gíneco-Obstetricia CMNO. Of the patients initially included, 51 completed the evaluation at the first and third month after the loss. Instruments such as the Perinatal Grief Scale, the Checklist for Post-Traumatic Stress Disorder and the Hamilton scales for depression and anxiety were applied. The results at the first month showed a high prevalence of active (98%) and complicated (94.1%) grief, along with anxiety (84.4%), post-traumatic stress (31.4%) and moderate depression (62.8%, according to the Hamilton scale). At three months, active grief persisted in 88.2% of patients, while depression remained in 60.8%, mostly at moderate levels. Anxiety was the most frequent disorder, presenting in 84.4% of patients with active grief. These findings highlight the need for an early and multidisciplinary psychological approach, especially for those women with active or complicated grief, given its strong association with other mental disorders.

Left prefrontal intermittent theta-burst stimulation therapy for major depressive disorder: A real-world, multisite observational study in Japan.

Although approved for treatment in 2018, the effectiveness of intermittent theta-burst stimulation (iTBS) in a real-world setting remains inadequately studied. This observational study investigated the real-world use of iTBS, a usual medical practice for depression, factors influencing its effectiveness, and differences in effectiveness between 600 and 1200 pulses. Data from patients who received iTBS therapy for depression at four private clinics between January 2021 and April 2024 were extracted. Patients were assessed using the 17-item Hamilton Depression Rating Scale at baseline and after treatment completion. Correlation and multiple regression analyses were performed to investigate clinico-demographic factors and stimulation parameters associated with iTBS effectiveness. Safety was assessed using all relevant data, and effectiveness was evaluated using eligible samples. Among 538 patients meeting eligibility criteria for effectiveness evaluation (mean age 40.8 ± 13.8 years, 44.1 % women), 63 completed iTBS with 600 pulses, and 475 completed iTBS with 1200 pulses. Overall response and remission rates were 69.1 % and 53.7 %, respectively, with no significant difference in effectiveness between iTBS-600 and iTBS-1200. Multiple regression analysis indicated fewer depressive episodes (β = -0.103, t = -2.080, p = 0.038) and more treatment sessions (β = 0.134, t = 3.155, p = 0.002) may have contributed to the positive effect of iTBS therapy. The most common adverse event was stimulation site pain. No severe adverse events, such as seizure induction or manic switch, were observed. The results suggest the highly favorable effectiveness of iTBS therapy for major depressive disorder in real-world settings.

Network structure of sleep quality and its bridging association with anhedonia in adolescent major depression disorder.

Major depressive disorder (MDD) is a leading cause of disease burden in adolescents, with persistently rising prevalence. Anhedonia, core symptom of adolescent MDD, is associated with suicidality and poor clinical outcomes. Impaired sleep quality is proven to be a significant risk factor for adolescent MDD and potentially influence anhedonia symptoms. Understanding the interplay between sleep quality and anhedonia is crucial for early intervention and treatment. This cross-sectional study recruited 200 drug-naïve adolescent MDD patients from Xijing Hospital. Depression, anhedonia and sleep quality were assessed during outpatient visits, using the Hamilton Depression Rating Scale, Snaith-Hamilton Pleasure Scale, and Pittsburgh Sleep Quality Index, respectively. Network analysis was applied to construct sleep quality network and its co-occurrence network with anhedonia. Centrality indices were computed to indicate central symptoms. Adolescent MDD patients exhibited moderate depression and anhedonia levels, and are heavily accompanied with sleep complaints. The sleep quality network identified "subjective sleep quality" as the most central factor, mainly due to prolonged "sleep latency" and shortened "sleep duration". In the co-occurrence network, "sleep disturbances" had prominent bridging connection with anhedonia, suggesting its critical role in activating anhedonia symptoms. Subjective sleep quality was the most central sleep complaints in adolescent MDD, while sleep disturbances were prominently associated with anhedonia. These findings underscore the importance of reducing sleep disturbances to alleviate anhedonia symptoms under clinical settings. Network analysis provides a nuanced understanding of the complex relationship of sleep quality and its association with anhedonia in adolescent MDD.

Improving hemodialysis patient depression outcomes with acupuncture: A randomized controlled trial.

To evaluate the efficacy and safety of acupuncture as a supplementary treatment for mild to moderate depression in hemodialysis patients. This multicenter, randomized, controlled, single-masked trial included 64 hemodialysis patients aged 18-75 divided into two groups. One group received genuine acupuncture, while the other received sham acupuncture over 12weeks. The primary outcome measure was Hamilton Depression Scale (HAMD) scores; an inclusion criterion was HAMD scores of 10-23. Secondary outcomes included life quality improvements and changes in biochemical markers, such as serum albumin and hemoglobin levels. To assess the predictive effects of acupuncture treatment and biochemical parameters on depressive symptoms, a multivariable linear regression analysis was conducted. Following acupuncture treatment, HAMD scores significantly decreased, quality of life scores improved, and biochemical indicators (serum albumin, hemoglobin, transferrin, and total protein levels) showed some improvement, indicating the effectiveness of acupuncture in alleviating depressive symptoms and enhancing overall health in hemodialysis patients. Multivariable regression analysis showed that acupuncture treatment (P=0.004) and serum albumin levels (P=0.03) were significant predictors of improvement in depressive symptoms, with an adjusted R2 of 0.45, indicating that the model explained 45% of the variance in symptom improvement. Other biochemical indicators, such as hemoglobin, transferrin, and total protein, did not show significant predictive effects (P>0.05). No serious adverse events were observed during the treatment. Acupuncture is a safe and effective adjunct therapy for alleviating mild to moderate depression in hemodialysis patients. Acupuncture treatment and certain biochemical indicators (such as serum albumin) have significant predictive value for improving depressive symptoms.

Spaced Transcranial Direct Current Stimulation for Major Depression.

This study investigated spaced transcranial direct current stimulation for major depressive disorder, focusing on feasibility. In a prospective open-label study, 30 participants with major depressive disorder were enrolled to receive a 50-session transcranial direct current stimulation (tDCS) treatment over 2 weeks. The feasibility, safety, tolerability, and preliminary therapeutic effects of this tDCS protocol were assessed using the 17-item Hamilton Depression Rating Scale (HAM-D-17) and the Montgomery-Åsberg Depression Rating Scale (MADRS) at baseline and 1-week and 4-week follow-ups, as well as with the 6-item HAM-D (HAM-D-6) daily during treatment. The protocol demonstrated good feasibility, with a retention rate of 93.3% and an adherence rate of 99.7%. There were no serious adverse events. The most common side effect was a mild tingling and itching sensation during stimulation (100%) and temporary skin redness following stimulation (100%). Additionally, 64.3% of participants presented with mild irritative contact dermatitis, which had disappeared by the 1-week follow-up for most participants and completely resolved by the 4-week follow-up for the remaining cases; this was not treatment limiting and did not require specific treatment. HAM-D-17 scores decreased from a mean of 21.3 (SD=3.0) at baseline to 15.3 (SD=6.3) at 1 week and 13.2 (SD=7.1) at 4 weeks. Depressive symptom severity, as measured by the HAM-D-17, showed significant reductions over time, with similar trends observed on the MADRS. HAM-D-6 scores highlighted important differences between response groups, particularly during the later stages of treatment, suggesting a potential for differential response patterns between the 1-week and 4-week follow-ups. The protocol was feasible, safe, and well-tolerated and led to significant reductions in depressive symptoms. These results will need to be validated in a sham-controlled randomized trial. The inclusion of neurophysiological measures in future trials for purposes of biological target engagement might also contribute to our understanding of underlying mechanisms and biomarker discovery.

Abnormal network homogeneity in patients with bipolar disorder in attention network.

Bipolar disorder (BD) is a complex psychiatric condition marked by significant mood fluctuations that deeply affect quality of life. Understanding the neural mechanisms underlying BD is critical for improving diagnostic accuracy and developing more effective treatments. This study utilized resting-state functional magnetic resonance imaging (rs-fMRI) to investigate functional connectivity within the ventral and dorsal attention networks in 52 patients with BD and 51 healthy controls. Independent Component Analysis (ICA) was employed to establish network templates, while Network Homogeneity (NH) analysis facilitated the comparison of NH values across various brain regions. We examined the association of NH values with clinical measures, including the Hamilton Depression Scale, Perceptual Deficit Questionnaire, and Young Mania Scale. Results indicated that BD patients exhibited lower NH values in the right inferior temporal gyrus of the dorsal attention network and the right middle temporal gyrus of the ventral attention network compared to controls. Notably, NH values in the right superior marginal gyrus of the ventral network were higher in the BD group. Although no significant correlations were found between NH values and clinical symptoms, Support Vector Machine (SVM) analysis demonstrated over 60% accuracy in differentiating BD patients based on NH values. These findings highlight the potential of NH measures as biomarkers for BD, underscore the importance of advanced neuroimaging in uncovering the disorder's complex neural dynamics, and point to the challenges and need for further research to improve predictive accuracy.

The effect of transcranial direct current stimulation and inhibitory control training on depression and anxiety among post-stroke individuals

BackgroundRecent research has highlighted the role of fronto-parietal brain networks and cognitive control in mood disorders. Transcranial direct current stimulation (tDCS) and computer-based cognitive training are used in post-stroke rehabilitation. This study examined the combined effects ofof computer-based inhibitory control training (ICCT) and anodal tDCS on post-stroke depression and anxiety.MethodsThirty-five participants were randomly assigned to one of three groups: active tDCS treatment (A), sham tDCS treatment with ICCT (T), or active tDCS with ICCT (AT), for a duration of ten days. Primary outcome measures included the Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HAM-D), and Spielberger’s State-Trait Anxiety Inventory (STAI-S/T). Statistical analysis was performed using a Mixed-model Analysis of Variance, with supplementary Bayesian analysis.ResultsThe AT group showed a significant improvement in BDI scores (p < .001), whereas no significant effects were observed on the HAM-D, STAI-T, or STAI-S scales.ConclusionsThe combination of tDCS and ICCT reduced depressive symptoms as measured by the BDI; while no significant effects were found with either treatment alone. Further research is needed to explore the mechanisms behind the synergistic effects in the treatment of post-stroke mood disorders.

Serum Galectin-3 and IL-6 as Inflammatory Markers in Bipolar Disorder: Insights from Manic and Euthymic Episodes

Objectives: This study aimed to assess serum Galectin-3 (Gal-3) and IL-6 levels, along with other inflammatory markers, in type-1 bipolar disorder (BD) patients and explore their relationship with clinical features, metabolic parameters, and symptom severity. Background: The study included 38 manic, 35 euthymic BD patients, and 40 healthy controls. Sociodemographic data, such as age, gender, alcohol and smoking habits, and body mass index (BMI), were recorded. Methods: The Young Mania Rating Scale (YMRS) and Hamilton Depression Rating Scale (HAM-D) were administered to patients. Biochemical measurements included Gal-3, IL-6, CRP, neutrophil, lymphocyte, platelet counts, and inflammatory indices like NLR, PLR, SII, and SIRI. Results: Gal-3 levels significantly differed among the groups (F = 52.251, p &lt; 0.001), with the highest levels in euthymic patients. IL-6 levels were elevated in both manic and euthymic patients compared to controls (F = 7.379, p = 0.001). Manic patients had significantly higher levels of neutrophils, monocytes, CRP, NLR, PLR, SII, and SIRI. A positive correlation was found between Gal-3 levels, the total number of episodes, and YMRS scores in manic patients. In euthymic patients, Gal-3 levels correlated positively with disease duration and episode count. Conclusions: Elevated Gal-3 levels, particularly in the euthymic phase, may serve as a biomarker for BD and indicate ongoing inflammation. These findings suggest Gal-3 could help identify BD and differentiate the euthymic phase.

Repeated transcranial magnetic stimulation on the bilateral cerebellum to improve symptoms of ataxia with multiple system atrophy: a prospective, randomized, sham-controlled pilot study.

Ataxia is a common symptom in patients with Cerebellar subtype of Multiple system atrophy (MSA-C), but effective treatments remain elusive. The present study aims to investigate whether repetitive transcranial magnetic stimulation (rTMS) over the bilateral cerebellum could relieve ataxia in patients with MSA-C. This is a single-center, randomized and double-blind trial. 26 patients with MSA-C were randomly divided into experimental group and control group. The experimental group underwent (rTMS) in both cerebellum for 10 consecutive days, while the control group was given sham rTMS. The participants underwent clinical assessments at baseline (T0), and three follow-up timepoints, that is, immediately after the tenth treatment session (T1), 2weeks (T2), and 4weeks (T3) after T1. The Scale for the Assessment and Rating of Ataxia scores (SARA) was used as the primary outcome measure, with the Fatigue Severity Scale-9 (FSS-9), the Hamilton Anxiety Scale (HAMA) and the Hamilton Depression Rating Scale-24 (HAMD-24) as secondary outcomes. Two-way repeated ANOVAs showed significant group × time interactions among SARA (p < 0.001), FSS-9 (p < 0.001), HAMA (p < 0.001) and HAMD-24 (p < 0.001). Post-hoc analyses showed that compared with T0, the activity group showed significant improvement in SARA, HAMA and HAMD-24 scores at T1, T2 and T3, and significant improvement in FSS-9 scores at T1 and T2, but no significant improvement in T3. rTMS over bilateral cerebellum could provide short-term improvements for alleviating ataxia and the symptoms of fatigue, depression anxiety, but the beneficial effects last no more than 4weeks.

Exploration of neurometabolic alterations in adolescent patients with bipolar depression and non-suicidal self-injury based on proton magnetic resonance spectroscopy

BackgroundAdolescent bipolar depression (ABD) refers to depressive episodes that arise in adolescent patients with bipolar disorder. Its identification and diagnosis are challenging, and it is characterized by a high rate of misdiagnosis and disability. Studies have revealed that patients with ABD are more prone to non-suicidal self-injury (NSSI) compared to those with unipolar depression. However, the neuropathophysiological mechanisms behind NSSI in ABD remain unclear. Therefore, this study employed proton magnetic resonance spectroscopy (1H-MRS) technology to investigate the potential relationship between NSSI and neurometabolism in the ventromedial prefrontal cortex (vmPFC) of patients with ABD.MethodsThis study compared brain biochemical metabolism between ABD with and without NSSI. Forty ABD were recruited and divided into groups with (n=21) and without NSSI (n=19). Proton magnetic resonance spectroscopy (1H-MRS) was used to detect the ratio of biochemical metabolites in the ventromedial prefrontal cortex (vmPFC) of all patients.ResultsThere was no statistically significant difference (P&amp;gt;0.05) in the age, gender, only child status, residential status, education level, age of onset, disease course, family history, and 24-item Hamilton Depression Scale (HAMD) score between patients in the NSSI group and those without NSSI group. The N-acetylaspartate (NAA)/creatine (Cr) of patients with NSSI was lower than that of patients without NSSI, and the difference was statistically significant (Z=-4.347,P&amp;lt;0.001). There was no statistically significant difference in choline (Cho)/Cr and myo-inositol (mI)/Cr between the group with NSSI and the group without NSSI (P&amp;gt;0.05).There is a positive correlation (r=0.703,P&amp;lt;0.00625) between Cho/Cr and HAMD scores in patients with NSSI, while there is a varying degree of negative correlation (r=-0.605,P=0.006;r=0.624,P=0.004) between mI/Cr and age and onset age in patients without NSSI. There is no correlation (P&amp;gt;0.05) between other indicators.ConclusionCompared with ABD without NSSI, ABD with NSSI have reduced NAA/Cr metabolism in the vmPFC brain area. The level of membrane phospholipid breakdown metabolism in the vmPFC brain area of ABD with NSSI may be related to the severity of depression. The level of phosphoinositol cycle in the vmPFC brain area of ABD without NSSI may be related to age or onset age. Therefore, further validation was required.

Association of inflammation cytokines with cognitive function in first-episode major depressive disorder.

Abnormal cognitive functioning is a core symptom of Major Depressive Disorder (MDD) and is strongly correlated with MDD prognosis. Current studies suggest that the occurrence of MDD may be related to oxidative stress-induced inflammation, hypothalamic-pituitary-adrenal axis disorders, diminished monoamine function and microbe-brain-gut axis, among other pathways. In recent years, the relationship between the immune-inflammatory response and MDD has been a hot topic of research, but how the relationship between immunoinflammation and cognitive function is manifested in MDD is still unclear. In this study, we examined cognitive function characteristics, serum inflammatory factors, brain-derived neurotrophic factor, and their correlations before and after pharmacological treatment(paroxetine hydrochloride tablets) in patients with first-episode major depressive disorder, aiming to identify objective biomarkers for cognitive function assessment. We included 22 patients with first-episode major depressive disorder and 27 healthy volunteers from the community during the same period. The Hamilton Depression Scale-17 (HAMD-17) assessed the severity of depressive symptoms at baseline and after 8 weeks of treatment. The Repeatable Battery for the Assessment of Neuropsychological Status(RBANS) evaluated cognitive function, and serum samples were collected to determine levels of inflammatory and neurotrophic factors at these two time points. For healthy volunteers, only HAMD-17 scale scores, RBANS scale scores, and serum samples were taken at baseline. Spearman's correlation analyzed the relationship between inflammatory factors, neurotrophic factors, and cognitive function. Multiple linear regression determined factors affecting cognitive function in first-time patients. Baseline findings indicated that patients' IL-6 and TNF-α levels exceeded those of healthy individuals, while their IFN-α levels were below; their scores in language, attention, delayed memory, and the RBANS scale were also lower than healthy counterparts. Post-treatment, patients' BDNF, IL-6, and TNF-α levels remained higher than those of healthy subjects, and their IFN-α levels were still lower; their language and attention scores were also inferior. Association analyses revealed an association between BDNF and visuospatial/constructional ability scores and language scores in patients with MDD at baseline, and a positive relationship between TNF-α and attention score. Multiple regression analysis indicated an association between TNF-α levels and attention scores in MDD patients at baseline. Our study concludes that TNF-α and BDNF correlate with cognitive function in MDD at baseline, and furthermore, TNF-α could potentially serve as an objective biomarker to support the assessment of attentional function at baseline.

Oral Esketamine as Alternative for Maintenance Electroconvulsive Therapy in Patients With Treatment-Resistant Depression: A Case Series.

This study investigates repeated oral esketamine as a substitution strategy for maintenance electroconvulsive therapy (M-ECT) in eight patients with treatment-resistant depression (TRD). In a 6-week dosing phase, esketamine was titrated from 0.5 or 1.0 mg/kg to a maximum of 3.0 mg/kg twice weekly. Outcomes included 6-week change in Inventory of Depressive Symptomatology - Self-rated (IDS-SR), Hamilton Depression Rating Scale - 17 items (HDRS17), and Outcome Questionnaire 45 (OQ-45), along with esketamine treatmentcontinuation. Depression severity remained stable or improved in five patients, whereas three experienced worsening symptoms and resumed M-ECT. OQ-45 scores were available for five patients, all of whom showed improvement. Currently, four patients are still receiving oral esketamine. Repeated oral esketamine may be a suitable and patient-friendly alternative to M-ECT. We recommend controlled trials to compare long-term safety and efficacy.

Sex differences in prevalence and clinical correlates of subclinical hypothyroidism in Chinese patients with first-episode untreated major depressive disorder

BackgroundPrevious studies showed sex differences in the prevalences of both major depressive disorder (MDD) and subclinical hypothyroidism (SCH). This study aimed to further compare the prevalence and correlates of moderate-to-severe SCH between male and female Chinese MDD patients.MethodsA total of 1706 first-episode drug naïve Chinese patients with MDD were recruited. Depressive symptoms were assessed by the 17-item Hamilton Depression Rating Scale, psychotic symptoms by the Positive and Negative Syndrome Scale and anxiety symptoms by the Hamilton Anxiety Rating Scale. Serum thyroid stimulating hormone (TSH), free triiodothyronine (fT3) and free thyroxine (fT4) concentrations were measured by chemiluminescence immunoassay. Moderate-to-severe SCH was defined as serum TSH > 8 mIU/L with normal fT4.ResultsThe prevalence of moderate-to-severe SCH was 10.4% in male patients and 15.1% in female patients (χ2 = 7.22, p < 0.01). In female patients, binary logistic regression showed that systolic blood pressure (SBP), suicide attempts and psychotic symptoms (all p < 0.001) were associated with moderate-to-severe SCH. In male patients, SBP and psychotic symptoms were associated with moderate-to-severe SCH (both p < 0.001), while suicide attempts and severe anxiety were not (p > 0.05).ConclusionsOur findings reveal a higher prevalence rate of moderate-to-severe SCH in female untreated first-episode MDD patients compared with males. Moreover, there is a positive association between suicide attempts and moderate-to-severe SCH only in female MDD patients.