PSD Group Research Articles

Intensity-dependence of auditory-evoked potentials might present an early surrogate marker for post-stroke depression

ObjectivePost-stroke depression (PSD) is a common stroke complication, associated with severe physical and cognitive impairment. Low central serotonergic tone, associated with depression, inversely correlates with the intensity-dependence of auditory-evoked potentials (IDAP). Aim of this study was to investigate IDAP’s usability as early surrogate marker for PSD development by assessing the correlation between IDAP early after stroke and the occurrence of PSD from 4 weeks after stroke. MethodsWe assessed auditory-evoked potentials (AEP) and depressive symptoms using the Montgomery-Åsberg Depression Rating Scale (MADRS) at day 1 – 3 and > 30 after stroke onset. IDAP was calculated as the linear slope of the N1-P2 amplitude/stimulus intensity function (ASF). Results37 patients completed the study. We diagnosed 7 patients with PSD, defined as MADRS-score≥ 7 at follow-up. The PSD group showed significantly steeper ASF slopes at admission compared with the non-depressed group (p = 0.007). We also found a positive correlation between ASF slopes on first and MADRS-scores on last measurement point for all stroke patients as a group (p = 0.007). ConclusionsThe study findings support the hypothesis that IDAP can predict the development of depressive symptoms following stroke and may therefore serve as an early surrogate marker for PSD. SignificanceThis is the first longitudinal study to assess the relationship between IDAP and PSD.

Effects of different anesthetic regimens on postoperative cognitive function of elderly patients undergoing thoracic surgery: a double-blinded randomized controlled trial

ObjectivePostoperative cognitive dysfunction (POCD) is a serious surgical complication. We assessed the different POCD incidences between anesthesia using sevoflurane and sevoflurane combined with dexmedetomidine, with propofol-based sedation in elderly patients who underwent a thoracic surgical procedure.MethodsA total of 90 patients aged 65 to 80 years old who underwent a thoracic surgical procedure at our hospital and 15 nonsurgical participants as controls, were enrolled in this study. Patients were divided in a randomized 1:1:1 ratio into 3 groups. All participants were randomized into a trial with three anesthesia groups (P, PS, PSD) or a control group (C) of healthy matches. All trial groups received distinct anesthetic combinations during surgery, while controls mirrored patient criteria.Group P (propofol and remifentanil were maintained during the surgery), Group PS (propofol, remifentanil, and sevoflurane were maintained during the surgery), and Group PSD (propofol, remifentanil, sevoflurane, and dexmedetomidine were maintained during the surgery).All participants were rated using a series of cognitive assessment scales before and three days after surgery. All participants were interviewed over the telephone, 7 days, 30 days, and 90 days postoperatively.ResultsPOCD incidences in the PSD (combined anesthetization with propofol, sevoflurane, and dexmedetomidine) group was significantly lower than that in the PS (combined anesthetization with propofol and sevoflurane) group, 1 day post-surgery (10.0% vs. 40.0%, P = 0.008), and the results were consistent at 3 days post-surgery. When the patients were assessed 7 days, 30 days, and 90 days postoperatively, there was no significant difference in POCD incidence among the three groups. Multivariate logistic regression analysis of POCD one day after surgery showed that education level was negatively correlated with incidence of POCD (P = 0.018) and single lung ventilation time was positively correlated with incidence of POCD (P = 0.001).ConclusionFor elderly patients who underwent a thoracic surgical procedure, dexmedetomidine sedation shows an obvious advantage on improving short-term POCD incidence, which is caused by sevoflurane.

Effect of high-frequency repetitive transcranial magnetic stimulation on swallowing function and pneumonia in poststroke dysphagia in rats

BackgroundPost-stroke dysphagia (PSD) is a common symptom of stroke. Clinical complications of PSD include malnutrition and pneumonia. Clinical studies have shown that high-frequency repetitive transcranial magnetic stimulation (HF-rTMS) can improve the swallowing function in stroke patients. However, few studies have elucidated the underlying molecular mechanisms. MethodsA PSD rat model was established using transient middle cerebral artery occlusion (tMCAO). Rats were randomly divided into sham-operated groups, PSD groups, PSD + sham-rTMS groups, PSD + 5 Hz-rTMS groups, PSD + 10 Hz-rTMS groups and PSD + 20 Hz-rTMS groups. Rats were weighed and videofluoroscopic swallowing studies were conducted. Pulmonary inflammation, levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the serum, lung, and nucleus tractus solitarius (NTS), brain-derived neurotrophic factor (BDNF) and 5-hydroxytryptamine (5HT) in NTS were evaluated. ResultsRats in the PSD group experienced weight loss, reduced bolus area and pharyngeal bolus speed, and increased pharyngeal transit time (PTT) and inter-swallow interval (ISI) on day 7 and day 14 after operation. Moreover, PSD rats showed pulmonary inflammation, reduced levels of SP in the lung and serum, increased levels of CGRP in the lung and NTS, reduced levels of BDNF and 5HT in the NTS. There was no significant difference between the PSD group and the PSD + sham-rTMS group in the results of weight and VFSS. Comparing with the PSD group, there significant increases in the bolus area, decreases in PTT of rats following 5 Hz rTMS intervention. HF-rTMS at 10 Hz significantly increased the weight, bolus area, pharyngeal bolus speed and decreased the PTT and ISI of rats. There were also significant increases in the bolus area (p < 0.01) and pharyngeal bolus speed, decreases in PTT and ISI of rats following 20 Hz rTMS intervention. Furthermore, compared with the PSD + 5 Hz-rTMS group, there were significant increases in the bolus area and pharyngeal bolus speed, decreases in ISI in the swallowing function of rats in the PSD + 10 Hz-rTMS group. Besides, compared with the PSD + 5 Hz-rTMS group, there were significant decreases in ISI in the swallowing function of rats in the PSD + 20 Hz-rTMS group. HF-rTMS at 10 Hz alleviated pulmonary inflammation, increased the levels of SP in the lung, serum, and NTS, CGRP in the serum and NTS, 5HT in the NTS of PSD rats. ConclusionCompared with 5 Hz and 20 Hz rTMS, 10 Hz rTMS more effectively improved the swallowing function of rats with PSD. HF-rTMS at 10 Hz improved the swallowing function and alleviated pneumonia in PSD rats. The mechanism may be related to increased levels of SP in the lung, serum and NTS, levels of CGRP in the serum and NTS, 5HT in the NTS after HF-rTMS treatment.

The predictive role of early inflammation and oxidative stress and the dynamics of cytokines networks in post-stroke depression

BackgroundsChronic inflammation and oxidative stress play an important role in the pathogenesis of PSD. The main purposes of this study were to examine the dynamic changes of cytokines networks in PSD and the predictive role of early inflammation and oxidative stress for 2-week PSD. MethodsPatients with ischemic stroke were recruited on day 3, and those with Hamilton Depression Rating Scale 24-Item (HAMD-24) ≥8 were classified as ischemic stroke patients with depressive symptoms and others as ischemic stroke patients without depressive symptoms. Subjects were then followed up at 2 weeks and 3 months, with those meeting diagnostic criteria for depressive symptoms on the HAMD ≥8 and the Statistical Manual of Mental Disorders-V (DSM-V) as the PSD group, and the others as the non-PSD group. ResultsAt 3 days, IFN-γ, IL-12(p70), IL-12(p40), IL-2, IL-28A/IFNλ2, and IL-19 were elevated in ischemic stroke patients with depressive symptoms. At 2 weeks, IL-12(p40), IL-19, IL-22, IFN-β and MMP-1 all were increased in PSD patients. At 3 months, IL-2, IFN-β and sCD163 increased in PSD group. Longitudinally, the inflammatory response decreased significantly in PSD group from 2 weeks to 3 months of follow-up, while it gradually decreased in non-PSD group from 3 days to 3 months of follow-up. SOD was positively related to IL-12(p70), IFN-γ and IL-20. Plasma IFN-γ at 3 days may be a potential predictive biomarker for 2-week PSD. ConclusionsPeripheral inflammation and oxidative stress are involved in the pathogenesis of PSD, providing new insights for its diagnosis and treatment.

The Croatian Primary Sjögren's Disease Oral Health Study: Oral Status and Oral Health-Related Quality of Life.

To determine salivary flow rate, oral and periodontal status, oral health-related quality of life (OHRQoL), objective and subjective indexes, and serum antibody reactivity in patients with primary Sjögren's disease (pSD). Thirty-one patients with pSD and 31 control subjects participated in this cross-sectional, single-center study. The unstimulated whole salivary flow rate (UWSFR) and stimulated whole salivary flow rate (SWSFR), salivary pH, DMFT index (DMFT = D-decayed, M-missing, F-filled tooth), periodontal pocket depth (PPD), clinical attachment level (CAL), interincisal distance, OHRQoL, objective European League Against Rheumatism (EULAR) SS Disease Activity Index (ESSDAI) and subjective (EULAR SS Patient Reported Index (ESSPRI), 6-items-VAS-SS (Visual Analog Scale), Profile of Fatigue) indexes were analyzed. The patients with pSD had a blood sample taken in the morning between 7 and 10 a.m. for comprehensive laboratory analysis. Patients with pSD had statistically significant lower UWSFR (0.20 vs. 0.90 mL/min) and SWSFR (0.56 vs. 1.64 mL/min) values compared with control subjects (p < 0.001, Mann-Withney U test). Salivary pH value of pSD patients was significantly lower compared with control subjects (6.00 vs. 7.00; p < 0.001, Mann-Whitney U test). The mean DMFT index of patients with pSD compared to control subjects was not statistically significant (23.74 ± 7.28 vs. 20.77 ± 5.73; p = 0.08, t-test). Interincisal distance was significantly decreased in the pSD group compared with control subjects (43.80 ± 0.38 vs. 47.60 ± 0.50; p = 0.003, t-test). The prevalence of periodontitis was similar in patients with pSD and control subjects (83.9% vs. 77.4%; p = 0.35, λ2 test). The mean Oral Health Impact Profile (OHIP-49) total score was statistically significantly higher in pSD patients compared with control subjects (32.00 vs. 8.00; p < 0.001, Mann-Whitney U test). Patients with pSD have decreased salivary flow and salivary pH, poor oral health, decreased interincisal distance, high prevalence of periodontitis, and worse OHRQoL. These findings highlight the need for a multidisciplinary approach to the management of patients with pSD that includes physical and psychological aspects of the disease.

Predictive microbial feature analysis in patients with depression after acute ischemic stroke.

Post-stroke depression (PSD) is the most common emotional problem following a stroke, which requires early diagnosis to improve the prognosis. Gut microbiota plays important role in the pathological mechanisms of acute ischemic stroke and influences the outcome of patients. However, the relationship between PSD and gut microbiota remains unknown. Here, we explored whether the microbial signatures of gut microbiota in the patients with stroke could be an appropriate predictor of PSD. Fecal samples were collected from 232 acute ischemic stroke patients and determined by 16s rRNA sequencing. All patients then received 17-Hamilton Depression Rating Scale (HAMD-17) assessment 3 months after discharge, and were further divided into PSD group and non-PSD group. We analyzed the differences of gut microbiota between these groups. To identify gut microbial biomarkers, we then established microbial biomarker model. Our results showed that the composition of gut microbiota in the PSD patients differed significantly from that in non-PSD patients. The genus Streptococcus, Akkermansia, and Barnesiella were significantly increased in PSD patients compared to non-PSD, while the genus Escherichia-Shigella, Butyricicoccus, and Holdemanella were significantly decreased. Correlation analyses displayed that Akkermansia, Barnesiella, and Pyramidobacter were positively correlated with HAMD score, while Holdemanella was negatively correlated with HAMD score. The optimal microbial markers were determined, and the combination achieved an area under the curve (AUC) value of 0.705 to distinguish PSD from non-PSD. Our findings suggest that PSD patients had distinct gut microbiota compared to non-PSD patients, and explore the potential of microbial markers, which might provide clinical decision-making in PSD.

Frequency-dependent and time-variant alterations of neural activity in post-stroke depression: A resting-state fMRI study

BackgroundPost-stroke depression (PSD) is one of the most frequent psychiatric disorders after stroke. However, the underlying brain mechanism of PSD remains unclarified. Using the amplitude of low-frequency fluctuation (ALFF) approach, we aimed to investigate the abnormalities of neural activity in PSD patients, and further explored the frequency and time properties of ALFF changes in PSD. MethodsResting-state fMRI data and clinical data were collected from 39 PSD patients (PSD), 82 S patients without depression (Stroke), and 74 age- and sex-matched healthy controls (HC). ALFF across three frequency bands (ALFF-Classic: 0.01–0.08 Hz; ALFF-Slow4: 0.027–0.073 Hz; ALFF-Slow5: 0.01–0.027 Hz) and dynamic ALFF (dALFF) were computed and compared among three groups. Ridge regression analyses and spearman’s correlation analyses were further applied to explore the relationship between PSD-specific alterations and depression severity in PSD. ResultsWe found that PSD-specific alterations of ALFF were frequency-dependent and time-variant. Specially, compared to both Stroke and HC groups, PSD exhibited increased ALFF in the contralesional dorsolateral prefrontal cortex (DLPFC) and insula in all three frequency bands. Increased ALFF in ipsilesional DLPFC were observed in both slow-4 and classic frequency bands which were positively correlated with depression scales in PSD, while increased ALFF in the bilateral hippocampus and contralesional rolandic operculum were only found in slow-5 frequency band. These PSD-specific alterations in different frequency bands could predict depression severity. Moreover, decreased dALFF in contralesional superior temporal gyrus were observed in PSD group. LimitationsLongitudinal studies are required to explore the alterations of ALFF in PSD as the disease progress. ConclusionsThe frequency-dependent and time-variant properties of ALFF could reflect the PSD-specific alterations in complementary ways, which may assist to elucidate underlying neural mechanisms and be helpful for early diagnosis and interventions for the disease.

Cortical reactivity to transcranial magnetic stimulation predicts risk of post-stroke delirium

ObjectivePost-stroke delirium (PSD) is a frequent and with regard to outcome unfavorable complication in acute stroke. The neurobiological mechanisms predisposing to PSD remain poorly understood, and biomarkers predicting its risk have not been established. We tested the hypothesis that hypoexcitable or disconnected brain networks predispose to PSD by measuring brain reactivity to transcranial magnetic stimulation with electroencephalography (TMS-EEG). MethodsWe conducted a cross-sectional study in 33 acute stroke patients within 48 hours of stroke onset. Brain reactivity to single-pulse TMS of dorsolateral prefrontal cortex, primary motor cortex and superior parietal lobule of the right hemisphere was quantified by response intensity, effective connectivity, perturbational complexity index (PCIST), and natural frequency of the TMS-EEG response. PSD development was clinically tracked every 8 hours before and for 7 days following TMS-EEG. ResultsFourteen patients developed PSD while 19 patients did not. The PSD group showed lower excitability, effective connectivity, PCIST and natural frequency compared to the non-PSD group. The maximum PCIST over all three TMS sites demonstrated largest classification accuracy with a ROC-AUC of 0.943. This effect was independent of lesion size, affected hemisphere and stroke severity. Maximum PCIST and maximum natural frequency correlated inversely with delirium duration. ConclusionsBrain reactivity to TMS-EEG can unravel brain network states of reduced excitability, effective connectivity, perturbational complexity and natural frequency that identify acute stroke patients at high risk for development of delirium. SignificanceFindings provide novel insight into the pathophysiology of pre-delirium brain states and may promote effective delirium prevention strategies in those patients at high risk.

EFFECT OF DIFFERENT TYPES OF SLEEP DEPRIVATION AND SLEEP RECOVERY ON SALIVARY PH

Background: Salivary pH can rise or fall influenced by intrinsic and extrinsic factors. Sleep deprivation is one example of intrinsic factors. Sleep deprivation causes a reduction in sleep time at a certain time. Purpose: Analyze the effect of different types of sleep deprivations and sleep recovery on salivary pH. Method: This study was experimental research with a post-test only with a control group design. Thirty white Wistar strain rats were randomly divided into 5 groups: healthy control group (KI), partial sleep deprivation (PSD/KII), total sleep deprivation (TSD/KIII), partial sleep deprivation, and continued sleep recovery (PSD+SR/KIV) and total sleep deprivation and continued sleep recovery (TSD+SR/KV). The treatment is carried out on a single platform method. Salivary pH was measured with the help of color-coded pH strips that were given grading after the completion of sleep deprivation induction. Result: The mean decrease in salivary pH was highest in the TSD group. One Way ANOVA test showed significant differences (p &lt;0.05) in the control group with PSD and TSD, the PSD group with PSD+SR, TSD group with PSD+SR and TSD+SR. Conclusion: Sleep deprivation is proven to reduce the pH of Saliva. Total sleep deprivation is a chronic condition that has the most influence on decreasing salivary pH. The effect of decreasing salivary pH due to sleep deprivation is proven to be overcome by sleep recovery.

Genomic characteristics in neoadjuvant chemoradiotherapy for locally advanced esophageal squamous cell carcinoma.

The response to neoadjuvant chemoradiotherapy (nCRT) for locally advanced esophageal squamous cell carcinoma (ESCC) can vary, but there is still no biomarker that can identify the benefiting population. Therefore, biomarkers to predict the outcome of nCRT are needed, as well as elucidation of the mechanism of resistance therapy. We investigated differences of genomic characteristics between patients with a pathologic complete response (pCR) and those with little or no response (pathologic stable disease: pSD) before and after nCRT. Fourteen subjects with locally advanced ESCC (7 cases of pCR and 7 of pSD) who received nCRT before undergoing esophagectomy were enrolled. An analysis of whole-exome sequencing (WES) data from 27 ESCC tissue samples obtained from the subjects pre and post nCRT was performed. The number of pretherapy samples displaying loss of chromosome 19p13.11 was higher in the pCR group than in the pSD group (5/6) (P=0.0291, Fisher's exact test). Gain of 19q13.31 was observed significantly more often in the samples obtained following nCRT (5/14). KMT2A missense mutation was found more frequently in the pSD group's pre-nCRT samples than in those of the pCR group (3/6), and following nCRT, new genes such as NF1, KMT2D, NOTCH2, and NIPBL were detected new variations. C/G>G/C (P=0.003) and C/G>A/T (P=0.002) transitions were statistically significantly reduced in every patient after nCRT, with similar observations made in both groups (pCR group: C/G>G/C, P=0.027; C/G>A/T, P=0.004; and pSD group: C/G>G/C, P=0.032; C/G>A/T, P=0.017). Biomarkers to predict pCR might include 19p13.11 copy number loss and KMT2A missense mutation. Further validation in a prospective study of a larger sample is required.

Differential expression of miR-30a-5p in post stroke depression and bioinformatics analysis of the possible mechanism

To investigate the differential expression of miR-30a-5p in patients with poststroke depression and explore the possible mechanism. We obtained the target microRNAs through searching PubMed using the online software VENNY2.1. We collected the baseline demographic, clinical and radiographic data from consecutive patients with first-ever acute ischemic stroke on admission in our department from October, 2018 to March, 2019. From each patient, 5 mL peripheral venous blood was collected upon admission. Hamilton Depression Scale (HAMD-17) was used to evaluate the degree of depression at the end of the 3-month follow-up. The patients with a HAMD-17 score≥7 were diagnosed to have depression according to the diagnostic criteria of the Fourth Edition of the Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association (DSM-IV). The patients were divided into post-stroke depression group (PSD group, n=11) and non-post-stroke depression group (non-PSD group, n=25), and their plasma levels of miR-30a-5p were detected using qPCR. The STARBASE Database ENCORI miRNA-mRNA module and Comparative Toxicogenomics Database were used to predict and screen the possible target genes related to miR-30a-5p, and the possible mechanism of the target genes was further analyzed through bioinformatics. miR-30a-5p was identified by cross-screening as the target miRNA associated with stroke and depression and showed obvious differential expression between PSD and non-PSD patients (2.462±0.326 vs 1±0.126, P &lt; 0.0001). ROC curve analysis showed that the AUC of miR-30a-5p for predicting PSD was 0.869 (95%CI: 0.745-0.993, P=0.0005) at the cutoff value of 1.597, with a sensitivity and specificity of 0.727 and 0.840, respectively. The target proteins of miR-30a-5p involved a wide range of biological processes, including signal transduction, intercellular communication, regulation of nucleobase, nucleoside, nucleotide and nucleic acid metabolism. KEGG pathway enrichment analysis showed that the target proteins affected mainly the neural nutrient signaling pathway, axon guidance signaling pathway and insulin signaling system. We also identified the top 20 HUB genes that might be associated with post-stroke depression. Plasma miR-30a-5p is differentially expressed in PSD and can serve as a new blood marker for diagnosis and also a therapeutic target of PSD.

Amino acid metabolism, lipid metabolism, and oxidative stress are associated with post-stroke depression: a metabonomics study

BackgroundPost-stroke depression (PSD) is a mood disorder characterized by depression and anhedonia caused by stroke. Metabolomics identified metabolites associated with PSD, but previous studies are based on gas chromatography (GC)/mass spectrometry (MS). This study aimed to perform a liquid chromatography (LC)-MS-based metabolomics study of the plasma metabolite profiles between patients with PSD and controls.MethodsThis was a prospective study of patients with stroke enrolled between July and December 2017 at the Second Affiliated Hospital of Nanchang University. Patients were grouped as Hamilton Depression Rating Scale > 7 (PSD) or < 7 (controls). Metabonomics profiling of plasma sampled was conducted by LC-MS. By combining multivariable and univariable statistical analyses, significant differential metabolites between the two groups were screened. The threshold for significant differences was VIP ≥1 and P < 0.05. Log2FC is the logarithm of the mean ratio between the two groups.ResultsThere were no significant difference with respect to age, NIHSS score, and MMSE between the two groups (all P > 0.05). There were six differential metabolites between the PSD and stroke groups, of which three metabolites were increased and three were decreased. Compared with the control group, p-chlorophenylalanine (Log2FC = 1.37, P = 0.03), phenylacetyl glutamine (Log2FC = 0.21, P = 0.048), and DHA (Log2FC = 0.77, P = 0.01) levels were higher in the PSD group, while betaine (trimethylglycine) (Log2FC = − 0.79, P = 0.04), palmitic acid (Log2FC = − 0.51, P = 0.001), and MHPG-SO4 (Log2FC = − 2.37, P = 0.045) were decreased.ConclusionPlasma metabolomics showed that amino acid metabolism (phenylacetyl glutamine, p-chlorophenylalanine, trimethylglycine), lipid metabolism (DHA, palmitic acid, trimethylglycine), and oxidative stress (DHA, palmitic acid, trimethylglycine) were associated with PSD. These results could help to reveal the pathophysiological mechanism of PSD and eventually identify treatment targets.

Inhibición y memoria de trabajo: marcadores diferenciales de las dificultades en cálculo y resolución de problemas en Educación Infantil

El objetivo del presente estudio consistió en determinar si las funciones ejecutivas de memoria de trabajo (MT) e inhibición se constituyen como marcadores diferenciales de las dificultades en los dominios de cálculo y resolución de problemas al inicio de la escolaridad. La muestra estuvo compuesta por 208 preescolares de 5 a 6 años (edad media = 70.17 meses; DT = 3.51; 47.6% niñas y 52.4% niños). Se administraron distintas tareas neuropsicológicas de funcionamiento ejecutivo para evaluar la inhibición (visual y auditiva) y la MT (verbal y viso-espacial). Los participantes se categorizaron en 4 grupos en función de su rendimiento en los subtest de cálculo y resolución de problemas de la batería TEDI-MATH (Grégoire, Noël, y Van Nieuwenhoven, 2005): dificultades iniciales en cálculo (DC, n = 17); dificultades iniciales en resolución de problemas (DRP, n = 13); dificultades iniciales en ambos dominios (DC+DRP = 20) y rendimiento medio (RM, n = 158). Los resultados revelaron un peor funcionamiento del grupo con DC+DRP en todas las tareas de inhibición y MT verbal en comparación con el grupo con RM. Se destaca una mayor afectación del grupo con DC en inhibición visual, y del grupo con DRP en MT verbal en comparación con los niños sin problemas. La tarea de inhibición auditiva es la única capaz de discriminar entre niños con DC+DRP y niños con dificultades en único dominio. No se encontraron diferencias en las tareas de MT viso-espacial en ninguno de los casos. Se comentan las implicaciones de estos hallazgos para la investigación y la práctica psicoeducativa.

Determinants of Greater Peak radiation skin dose in percutaneous coronary intervention for chronic total occlusion

BackgroundPeak skin dose (PSD) is closely associated with skin radiation injuries such as skin ulcers in percutaneous coronary intervention (PCI). Although PSD is greater in PCI for chronic total occlusion (CTO) lesions as compared with non-CTO lesions, the determinants of PSD in CTO-PCI are not fully understood. The purpose of this study was to investigate the clinical factors associated with excess PSD in PCI for CTO. MethodsThe study population included a total of 220 CTO-PCI cases that were divided into a standard PSD group (<2 Gy, n = 187) and an excess PSD group (≥2 Gy, n = 33). Clinical, lesion, and procedural characters were compared between the 2 groups. Multivariate logistic regression was performed to investigate the clinical factors associated with excess PSD. ResultsBody surface area (BSA) was significantly higher in the excess PSD group (1.85 ± 0.24 m2) than the standard PSD group (1.71 ± 0.18 m2) (p = 0.001). The J-CTO score was significantly higher in the excess PSD group (2.51 ± 1.28) than the standard PSD group (1.60 ± 1.13) (p < 0.001). Multivariate logistic regression analysis revealed that BSA (0.1 mm increase: OR 1.663, 95% CI 1.300–2.128, p < 0.001) and J-CTO score (1-point increase: OR 2.015, 95% CI 1.322–3.071, p = 0.001) were significantly associated with excess PSD. ConclusionsA large BSA and high J-CTO score were significantly associated with excess PSD. It is important to pay special attention to CTO patients who have a large BSA and/or high J-CTO score to reduce patient’s PSD.

Topological reorganization of the default mode network in patients with poststroke depressive symptoms: A resting-state fMRI study

ObjectiveThis study mapped the topological configuration of the default mode network (DMN) in patients with depressive symptoms after acute ischemic stroke. MethodsThe study sample comprised 63 patients: 36 with poststroke depressive symptoms (PSD) and 37 without PSD matched according to age, gender and the severity of stroke. PSD was defined by a cutoff of ≥ 7 on the 15-item Geriatric Depression Scale (GDS). Resting-state functional magnetic resonance imaging (fMRI) was used to examine functional connectivity (FC) to reconstruct the DMN. Network based statistics estimated the FC differences of the DMN between the PSD and non-PSD groups. Graph theoretical approaches were used to characterize the topological properties of this network. ResultsThe study sample mainly comprised patients with mild to moderate stroke. A widespread hyper-connected configuration of the functional DMN was characterized in PSD group. The orbital frontal, dorsolateral prefrontal, dorsal medial prefrontal and, ventromedial prefrontal corticis, the middle temporal gyrus and the inferior parietal lobule were the functional hubs related to PSD. The nodal topology in inferior parietal lobule and superior frontal gyrus, overlapping with dorsal medial prefrontal and, ventromedial prefrontal cortices, tended to be functionally integrated in patients with PSD. After False Discovery Rate correction, no significant difference between the PSD and non-PSD groups was found with respect to the global and nodal metrics of the DMN. However, the correlations between these altered network metrics and severity of PSD were lacking. LimitationsThe diagnosis of PSD was based on the GDS score rather than established with a structured clinical interview. ConclusionsThe DMN in PSD was functionally integrated and more specialized in some core hubs such as the inferior parietal lobule and dorsal prefrontal cortex. The configuration of the subnetwork like DMN may be more essential in the pathogenesis of PSD than single stroke lesions.

Effects of total saponins of panax notoginseng on depressive behavior and hippocampal nerve regeneration in rats with following global cerebral ischemia depression

Objective To explore the effect of the total saponins of panax notoginseng (TSPN) on depression-like behavior following global cerebral ischemia depression in rats and its mechanism. Methods Using four-vessel occlusion method to build the global cerebral ischemia model, then the cerebral ischemia rats were given solitary breeding with chronic unpredictable mild stress(CUMS) to prepare depression model.Seventy rats were divided into sham group (n=10), model group (n=20), PSD group (n=20) and TSPN group (n=20). The rats in the TSPN group were administered TSPN intraperitoneally 30 min post-brain ischemia.The dose of TSPN (75mg/kg) was suspended in 0.9% saline 10g/L, once per day for 30 days after reperfusion.While rats in the vehicle group and PSD group was treated with equal volume of 0.9% saline, one injection per day until the rats were sacrificed at 30 days after brain ischemia.The BrdU, doublecortin (DCX) expression in the hippocampus was assessed by immunohistochemistry. Results In comparison with the model group, the sucrose preference percentage in the PSD group was significantly lower ((46.2±9.2)%, (61.2±7.6)%; t=3.18, P<0.05), then the PSD rats were administered TSPN intraperitoneally, the sucrose preference percentage increased significantly ((62.4±3.4)%, (46.2±9.2)%; t=3.43, P<0.05). During the forced swimming test, the immobility time of PSD group was significantly increased compared with the model group ((119.4±9.7)s, (88.0±15.6)s ; t=4.30, P<0.01), while after PSD rats administering TSPN intraperitoneally, the immobility time was shorten remarkably ((97.4±6.7)s, (119.4±9.7)s; t=3.01, P<0.05). Compared with the Model group(BrdU+ : (12.6±2.2)/mm2, DCX+ : (38.6±4.2)/mm2), the number of BrdU+ and DCX+ cells in the SGZ of hippocampus in PSD group decreased (BrdU+ : (8.8±1.5)/mm2, DCX+ : (27.2±2.8)/mm2; t=3.25, 4.29, both P<0.01). And compared with PSD group, the number of BrdU+ and DCX+ cells in the SGZ of hippocampus in TSPN group increased significantly (BrdU+ : (14.8±2.8)/mm2, DCX+ : (37.0±3.3)/mm2; t=4.68, 3.69, both P<0.05). Conclusion TSPN can improve the depression-like behavior of rats following global cerebral ischemia, which may be related with promoting hippocampal nerve regeneration. Key words: Total saponins of panax notoginseng; Hippocampus; Nerve regeneration; Following global cerebral ischemia depression; Rats

Purwoceng Roots Ethanol Extract Make no Improvement in Leydig Cells Activity to Male White Rats (Rattus norvegicus) Exposed by Paradoxical Sleep Deprivation (Psd) Stress Models

To observe the improvement of Leydig cell activity after the administrations of Purwoceng roots ethanol extract in white male rats which is exposed by PSD stress model. Experimental research, pre and post with control group study design. White male rats (Rattus norvegiens) Wistar strain animals were divided into six groups, five rats each group, there are negative control group (KI), PSD control group without sleep recovery (KII), PSD control group with sleep recovery (KIII), and also PSD group with Purwoceng roots ethanol extract with the dose of 16,65-16,75 mg, 33,30-33,75 mg and also 50,25 mg/200 gramBW/day (KIV, KV, KVI). PSD stress model exposure was administrated in 96 hours, continued by sleep recovery and intervention method in the next seven days after it and then leydig cell number and serum testosterone level r is examined. Statistical analysis shown that in leydig cell number study (p value = 0,589) and serum testosterone level study (p value = 0,572) so the result is not significant. Administration of Purwoceng roots ethanol extract make no significant effect in leydig cell number and serum testosterone level (p>0,05) so there is no improvement of Leydig cell activity in white male rats which is inducted by PSD stress model.

Proton Magnetic Resonance Spectroscopy Study on the Metabolism Changes of Cerebellum in Patients with Post-Stroke Depression

Objective: To study the metabolic changes of cerebellum by proton magnetic resonance Spectroscopy (¹H-MRS) and discuss the relationships between the cerebellar changes and depression severity in patients with post-stroke depression. Methods and Results: Data of demographic characteristics, individual history and life style of all subjects were collected. 40 patients with stroke and 20 controls were enrolled. All groups received T1WI, T2WI, DWI and ¹H-MRS examination. The cerebral infarction volume and the distribution and severity of leukoaraiosis were evaluated. The ratios of NAA/Cr, Cho/Cr and Cho/NAA in the cerebellum were calculated. There were no statistical significant difference in the NAA/Cr, Cho/Cr and Cho/NAA ratios in bilateral cerebellum between CONT group and NORM group. The Cho/Cr and Cho/NAA ratios in the cerebellum contralateral to the stroke region were higher in PSD group than those in NORM and CONT groups, and the Cho/Cr and Cho/NAA ratios in the cerebellum ipsilateral to the stroke region were similar with those in NORM and CONT groups. However, there were no statistical significant difference in the NAA/Cr ratios in bilateral cerebellum among three groups. Conclusion: The result shows preliminarily that the cerebellum involves in the development of post-stroke depression.

Pretransplant paranasal sinus disease is associated with a high incidence of transplant-related mortality in hematopoietic stem cell transplantation for children and adolescents.

To determine whether pretransplant PSD affects the clinical outcomes in HSCT, a retrospective cohort analysis of 73 pediatric and adolescent patients who underwent HSCT was performed. Pretransplant PSD was defined as the presence of a fluid level or mucosal swelling or total opacity on sinus X-ray or CT examination performed before HSCT. Pretransplant PSD was observed in 21 (29%) patients. The probability of 2-year OS after HSCT was 42% in patients with pretransplant PSD (PSD group), and 64% in those without (non-PSD group) (P=.012). The cumulative incidence of 2-year TRM was 48% in the PSD group, and 17% in the non-PSD group (P=.005). The cumulative incidences of pulmonary complications and respiratory failure at 2years after HSCT were significantly higher in the PSD group (41% vs 15%, P=.022; 44% vs 14%, P=.009, respectively). PSD at the time of HSCT should be recognized as an additional potential risk factor for mortality. Further investigation is required to clarify the reasons for the present findings to improve the outcomes of patients with pretransplant PSD.

A qualititative study of neurological soft signs in obsessive compulsive disorder and effect of comorbid psychotic spectrum disorders and familiality on its expression in Indian population.

Obsessive Compulsive Disorder (OCD) is one of the most common psychiatric disorders, with lifetime prevalence of 2%-3% and is known to lie on a spectrum continuous with Schizophrenia and other affective psychosis. Neurological Soft Signs (NSS) have been reported to be higher in both Schizophrenia and affective psychosis, like bipolar disorder, and their first degree relatives but in OCD, the results have been inconsistent. It remains unclear if NSS occur at even higher rates in individuals who have a co-morbidity for OCD and either schizophrenia or bipolar disorder, as it might be expected if a broader neurodevelopmental hit underlies the pathophysiology of both OCD and these disorders. To assess and compare NSS in patients of OCD, OCD with Psychotic spectrum disorders (OCD-PSD), first degree relatives of OCD (FDR of OCD) and healthy controls. 90 subjects each were recruited in four groups- OCD, OCD-PSD, FDR of OCD and healthy controls, as per the pre-defined inclusion and exclusion criteria for each group. Diagnosis was made as per ICD-10 criteria and Cambridge Neurological Inventory, Part-2 was applied. This study found statistically significant difference between the severity of NSS among these groups. There was also a significant difference in presence of NSS in OCD with PSD group and OCD group. A greater abnormality of NSS in FDR of OCD compared to healthy controls was found. This difference in proportions and severity of NSS between groups points towards an underlying common neurobiological and etiopathological underpinning between OCD with and without comorbid PSDs and their first degree relatives.