Childhood maltreatment and engaging in NSSI for automatic-negative reinforcement: The mediating role of alexithymia and moderating role of help-seeking attitudes.

BACKGROUND: There is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. METHODS: 3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. RESULTS: The findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. LIMITATION: The study's cross-sectional design hindered the inference of causality. CONCLUSION: The present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement.

Aberrant reward dynamics in depression with anticipatory anhedonia.

OBJECTIVE: Previous studies have shown that anticipatory anhedonia is linked to abnormal reward processing. The present study aimed to explore the underlying neural mechanism of the influence of anticipatory anhedonia symptoms on reward processing. METHODS: Electrophysiological activities in the anticipatory and consummatory phase were recorded during the Monetary Incentive Delay (MID) task in 24 depressed high anticipatory anhedonia (HAA) patients, 25 depressed low anticipatory anhedonia (LAA) patients, and 29 healthy controls (HC). RESULTS: We suggested a significant condition × group interaction effect on feedback-related negativity (FRN) amplitudes during the consummatory phase, a smaller FRN in reward cue trails compared with neutral cue trail was revealed in the HC and LAA group, but such reward-related effect was not found in the HAA group. In addition, we found significant correlations between FRN, fb-P3 and cue-N1, cue-N2 in the HC group, besides, significant correlations between FRN, fb-P3 and cue-P2 was also revealed in the HC and LAA group. However, no significant correlation was found in HAA patients. CONCLUSIONS: Our results suggest that the link between the anticipatory and consummatory phase was interrupted in depressed HAA patients, which may be driven by the aberrant consummatory reward processing. SIGNIFICANCE: The current study is the first one to demonstrate the influence of anticipatory anhedonia symptom on the association between anticipatory and consummatory phase of reward process.

Effects of high-definition transcranial direct current stimulation on implicit emotion regulation of social pain in healthy individuals.

BACKGROUND: Implicit emotion regulation (ER), a form of ER, is essential for protecting mental health in the process of social interaction. Both the ventrolateral prefrontal cortex (VLPFC) and the dorsolateral prefrontal cortex (DLPFC) have been shown to be involved in ER processes, including explicit ER of social pain, but whether they play a role in implicit ER is unclear. METHODS: We investigated whether anodal high-definition transcranial direct current stimulation (HD-tDCS) of the right VLPFC (rVLPFC) or the right DLPFC (rDLPFC) influences implicit ER. In total, 63 healthy participants completed an emotion priming task, which measures the implicit ER of social pain, before and after receiving active or sham HD-tDCS (2 mA for 20 min, 10 consecutive days). Event-related potentials (ERPs) were recorded during task performance. RESULTS: Combined with the results of the behavioral and electrophysiological indices indicated that stimulation of both the rVLPFC and the rDLPFC by anodic HD-tDCS could significantly reduce the affective responses caused by social exclusion. The further results also suggested that rDLPFC activation may contribute to promoting the involvement of early cognitive resources in the implicit ER process of social pain, thus helping to reduce the subjective negative experience of individuals. LIMITATIONS: There were no dynamic interactive emotional stimuli to induce social pain, and only static images of social exclusion were used. CONCLUSION: Our study provides cognitive and neurological evidence that expands our knowledge of the role of the rDLPFC and the rVLPFC in social ER. It can also serve as a reference for targeted intervention of implicit ER in social pain.

Psychosocial predictors of persistent suicidal ideation among Chinese adolescents: A longitudinal study.

BACKGROUND: Suicide is the fourth leading cause of death among adolescents. Studies have shown that persistent suicidal ideation has a more important effect on suicidal behavior. The objective of this study was to identify predictors of persistent suicidal ideation. METHODS: Data were collected from 4225 Chinese middle and high school students. These adolescents were assessed for suicidal ideation at baseline and the second year. We used multinomial logistic regression (n = 4171) for the predictive effect of these factors on persistent suicidal ideation. We controlled for gender, residence, clinical diagnosis, clinical diagnosis family, suicide planning, and suicide attempts. RESULTS: Depressive symptoms are essential in predicting persistent suicidal ideation (OR = 14.0; p < 0.001). Persistent suicidal ideation was predicted by sleep disorders, such as poor sleep quality (OR = 2.3; p = 0.008), difficulty falling asleep (OR = 2.4; p = 0.005), frequently midnight awakening (OR = 1.9; p = 0.044), and frequent nightmares (OR = 2.1; p = 0.040). There was a significant association between concern with persistent ideation and parental-peer alienation (OR for father, 1.9[p = 0.024]; OR for mother, 3.1[p < 0.001]; OR for peer, 2.3[p = 0.003]). LIMITATIONS: All measures are based on self-report rather than objective assessment or clinical diagnostic assessment. CONCLUSIONS: Persistent suicidal ideation had a more important role in influencing suicide planning and attempt. Interventions targeting sleep disorders and attention to attachments in the home and school are particularly important in preventing persistent suicidal ideation in adolescents.

Longitudinal changes in mental health among medical students in China during the COVID-19 epidemic: depression, anxiety and stress at 1-year follow -up.

This study aimed to evaluate the influence of COVID-19 on the mental health of Chinese medical students at 1-year of follow-up. From 2 February 2020 to 23 February 2021, we conducted three waves of research online (T1 = during outbreak, T2 = controlling period, T3 = 1 year after outbreak). The survey collected demographic data and several self reporting questionnaires to measure the depressive, anxiety and stress symptoms. A total of 4002 participants complete the whole research phases. The study major, grade level and gender were the main factors related to psychological distress caused by the COVID-19 crisis. Importantly, medical knowledge has a protective effect on medical students' psychological distress during the COVID-19 period.

Individualized prediction of consummatory anhedonia from functional connectome in major depressive disorder.

BACKGROUND: Anhedonia is a key symptom of major depressive disorder (MDD) and other psychiatric diseases. The neural basis of anhedonia has been widely examined, yet the interindividual variability in neuroimaging biomarkers underlying individual-specific symptom severity is not well understood. METHODS: To establish an individualized prediction model of anhedonia, we applied connectome-based predictive modeling (CPM) to whole-brain resting-state functional connectivity profiles of MDD patients. RESULTS: The CPM can successfully and reliably predict individual consummatory but not anticipatory anhedonia. The predictive model mainly included salience network (SN), frontoparietal network (FPN), default mode network (DMN), and motor network. Importantly, subsequent computational lesion prediction and consummatory-specific model prediction revealed that connectivity of the SN with DMN and FPN is essential and specific for the prediction of consummatory anhedonia. CONCLUSIONS: This study shows that brain functional connectivity, especially the connectivity of SN-FPN and SN-DMN, can specifically predict individualized consummatory anhedonia in MDD. These findings suggest the potential of functional connectomes for the diagnosis and prognosis of anhedonia in MDD and other disorders.

Comparison of three machine learning models to predict suicidal ideation and depression among Chinese adolescents: A cross-sectional study.

BACKGROUND: Machine learning (ML) algorithms based on various clinicodemographic, psychometric, and biographic factors have been used to predict depression, suicidal ideation, and suicide attempt in adolescents, but there is still a need for more accurate and efficient models for screening the general adolescent population. In this study, we compared various ML methods to identify a model that most accurately predicts suicidal ideation and level of depression in a large cohort of school-aged adolescents. METHODS: Ten psychological scale scores and 20 sociodemographic parameters were collected from 10,243 Chinese adolescents in the first or second year of middle school and high school. These variables were then included in a random forest (RF) model, support vector machine (SVM) model, and decision tree model for factor screening, dichotomous prediction of suicidal ideation (yes/no), and trichotomous prediction of depression (no depression, mild-moderate depression, or major depression). RESULTS: The RF model demonstrated greater accuracy for predicting suicidal ideation (mean accuracy (ACC) = 87.3 %, SD = 3.2 %, area under curve (AUC) = 92.4 %) and depressive status (ACC = 84.0 %, SD = 2.8 %, AUC = 90.1 %) than SVM and decision tree models. We have also used the RF model to predict adolescents with both depression and suicidal ideation with satisfactory results. Significant differences were found in several sociodemographic parameters and scale scores among classification groups and differences in six factors between sexes. CONCLUSIONS: This RF model may prove valuable for predicting suicidal ideation, depression, and non-suicidal self-injury among the general population of Chinese adolescents.

Electroconvulsive therapy changes temporal dynamics of intrinsic brain activity in depressed patients.

Electroconvulsive therapy (ECT) has been demonstrated to be effective in treating depressed patients. Previous neuroimaging studies have focused mainly on alterations in static brain activity and connectivity to study the effects of ECT in depressed patients. However, it remains unclear whether the temporal dynamics of brain activity are associated with mechanisms of ECT in depressed patients. We measured the dynamics of spontaneous brain activity using dynamic amplitude of low-frequency fluctuation (dALFF) in healthy controls (n = 40) and patients diagnosed with unipolar depression (UD, n = 36) or bipolar disorder (BD, n = 9) before and after ECT. Furthermore, the temporal variability of intrinsic brain activity (iBA) was quantified as the variance of dALFF across sliding window. In addition, correlation analysis was performed to investigate the relationships among dALFF, depressive symptoms, and cognitive function in depressed patients. We lack second resting-state functional magnetic resonance imaging (rs-fMRI) data for healthy controls. After ECT, patients showed decreased brain dynamics (less temporal variability) in the right dorsal anterior cingulate cortex (dACC) and the right precuneus, whereas they showed increased brain dynamics in the bilateral superior medial frontal cortex (mSFC). No significant correlation was found between the dALFF and clinical variables in depressed patients. Our findings suggest that right dACC, right precuneus, and bilateral mSFC play an important role in response to ECT depressed patients from the perspective of dynamic local brain activity, indicating that the dALFF variability may be useful in further understanding the mechanisms of ECT's antidepressant effects.

Contrasting Responses of Rhizosphere Fungi of Scutellaria tsinyunensis, an Endangered Plant in Southwestern China.

Scutellaria tsinyunensis is an endangered species in southwest China, distributed sporadically in mountainous areas at an elevation of approximately 200 to 900 m. Rhizosphere soil properties and fungal communities play critical roles in plant survival and expansion. Nevertheless, understanding of soil properties and fungal communities in the S. tsinyunensis distribution areas is extremely limited. The present study examined soil properties and fungal communities in nearly all extant S. tsinyunensis populations at two altitudinal gradients (low and high groups). Our findings indicated that soil characteristics (i.e., soil pH, water content, and available phosphorus) were affected distinctively by altitudes (P < 0.05). In addition, the low altitude group harbored higher fungal richness and diversity than the high altitude. Co-occurrence network analysis identified six key genera that proved densely connected interactions with many genera. Further analysis represented that the low altitude group harbored three beneficial genera belonging to Ascomycota (Archaeorhizomyces, Dactylella, and Helotiales), whereas the high altitude showed more pathogenic fungi (Apiosporaceae, Colletotrichum, and Fusarium). Correlation analysis found that soil water content was highly correlated with Hydnodontaceae and Lophiostoma. Besides, plants' canopy density was negatively correlated with four pathogenic fungi, indicating that the high abundance of the pathogen at high altitudes probably inhibited the survival of S. tsinyunensis. To sum up, this comprehensive analysis generates novel insights to explore the contrasting responses of S. tsinyunensis rhizosphere fungal communities and provides profound references for S. tsinyunensis habitat restoration and species conservation. IMPORTANCE Our study highlighted the importance of rhizosphere fungal communities in an endangered plant, S. tsinyunensis. Comparative analysis of soil samples in nearly all extant S. tsinyunensis populations identified that soil properties, especially soil water content, might play essential roles in the survival and expansion of S. tsinyunensis. Our findings proved that a series of fungal communities (e.g., Archaeorhizomyces, Dactylella, and Helotiales) could be essential indicators for S. tsinyunensis habitat restoration and protection for the first time. In addition, further functional and correlation analyses revealed that pathogenic fungi might limit the plant expansion into high altitudes. Collectively, our findings displayed a holistic picture of the rhizosphere microbiome and environmental factors associated with S. tsinyunensis.

Multi-modality connectome-based predictive modeling of individualized compulsions in obsessive-compulsive disorder.

BACKGROUND: While previous neuroimaging studies are mainly focused on dichotomous classification of obsessive-compulsive disorder (OCD) from controls, predicting continuous severity of specific symptom is also pivotal to clinical diagnosis and treatment. METHODS: We applied a machine-learning approach, connectome-based predictive modeling, on functional and structural brain networks constructed from resting-state functional magnetic resonance imaging and diffusion tensor imaging data to decode compulsions and obsessions of fifty-four patients with OCD. RESULTS: We successfully predicted individualized compulsions with a positive model of structural brain network and with a negative model of functional brain network. The structural predictive brain network comprises the motor cortex, cerebellum and limbic lobe, which are involved in basic motor control, motor execution and emotion processing, respectively. The functional predictive brain network is composed by the prefrontal and limbic systems which are related to cognitive and affective control. Computational lesion analysis shows that functional connectivity among the salience network (SN), the frontal parietal network and the default mode network, as well as structural connectivity within the SN are vital in the individualized prediction of compulsions in OCD. LIMITATIONS: There was no external validation of large samples to test the robustness of our predictive model. CONCLUSIONS: These findings provide the first evidence for the predictive role of the triple network model in individualized compulsions and have important implications in diagnosis, prognosis and treatment of patients with OCD.

Repetitive transcranial magnetic stimulation promotes response inhibition in patients with major depression during the stop-signal task.

BACKGROUND: Response inhibition (RI) deficit is an aspect of cognitive impairment in depressed individuals, but currently no effective treatment has been established. This study aimed to explore the effect of individualized repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (lDLPFC)-nucleus accumbens (NAcc) network on RI in patients with major depressive disorder (MDD). METHODS: Fourty-four patients diagnosed with MDD were randomized to receive 15 once-daily sessions of active (10 Hz, 100% of resting motor threshold) or sham rTMS within a double-blind, sham-controlled trial. We measured the efficacy of rTMS by the improvements in behavioral and neurological manifestations during the stop-signal task. The Hamilton Depression Rating Scale-17 items (HAMD-17) was used to assess depressive symptoms. We analyzed the differences in RI performance between MDD patients and 30 healthy controls (HCs) at baseline and assessed whether MDD patients who completed rTMS treatment had comparable RI ability to HCs. RESULTS: At baseline, the depressed patients showed longer stop-signal response time (SSRT), smaller P3 amplitudes, and weaker theta-band power in successful stop trials (SSTs) than HCs. The active group exhibited RI ability comparable to that of HCs after rTMS treatment, but the improvements were not significant in the sham group. The active group showed significant remission in depression symptoms post-treatment compared to the sham group, and the changes in P3 amplitudes and theta-band power during SSTs were negatively correlated with the decrease of HAMD-17 scores. CONCLUSION: The depressed patients have impaired RI and treatment with the individualized rTMS protocol may be an effective approach.

High-definition transcranial direct current stimulation modulates eye gaze on emotional faces in college students with alexithymia: An eye-tracking study.

BACKGROUND: Atypical eye gaze on emotional faces is a core feature of alexithymia. The inferior frontal gyrus (IFG) is considered to be the neurophysiological basis of alexithymia-related emotional face fixation. Our aim was to examine whether anodal high-definition transcranial direct current stimulation (HD-tDCS) administered to the right (r)IFG would facilitate eye gaze of emotional faces in alexithymia individuals. METHOD: Forty individuals with alexithymia were equally assigned to anodal or sham HD-tDCS of the rIFG according to the principle of randomization. The individuals then completed a free-viewing eye tracking task (including happy, sad, and neutral faces) before and after 5 consecutive days of stimulation (twice a day). RESULTS: The results showed that twice a day anodal HD-tDCS of the rIFG significantly increased the fixation time and fixation count of the eye area on happy and neutral faces, but there was no significant effect on sad faces. According to the temporal-course analysis, after the intervention, the fixation time on neutral faces increased significantly at almost all time points of the eye tracking task. For happy faces, the improvement was demonstrated between 500 and 1000 ms and between 2500 and 3500 ms. For sad faces, the fixation time improved but not significantly. CONCLUSIONS: Applying high-dose anodal HD-tDCS to the rIFG selectively facilitated eye gaze in the eye area of neutral and happy faces in individuals with alexithymia, which may improve their face processing patterns.

Selected rhizosphere bacteria are associated with endangered species - Scutellaria tsinyunensis via comparative microbiome analysis.

Scutellaria tsinyunensis is an endangered plant under extremely critical condition. Soil microbiome is important for plants growth. To better understand the endangered mechanism of S. tsinyunensis from the perspective of rhizosphere bacteria, we examined soil bacteria community in nearly all extant S. tsinyunensis populations at two altitude levels through high-throughput sequencing. Our co-occurrence network analysis manifested six key genera had active interactions with many genera. Moreover, we found that deterministic processes dominate rhizosphere bacterial community assembly. By constructing structural equation model, we found that pH as a key factor shaping the bacterial community, suggesting canopy density - pH - bacterial diversity regulatory model may contribute to the endangerment of S. tsinyunensis. Further, we revealed that Haliangium and Candidatus Koribacter act as essential genera for the protection of S. tsinyunensis through controlling multi combination of covariates. Together, our study revealed a holistic picture of rhizosphere microbiome and environmental factors associated with S. tsinyunensis, and provided direction for future protection of this endangered plant.

Prevalence and influencing factors of anxiety and depression symptoms among surgical nurses during COVID-19 pandemic: A large-scale cross-sectional study.

AIM: To evaluate the prevalence and influencing factors of anxiety and depression symptoms in surgical nurses during the COVID-19 epidemic in Anhui, China. METHODS: A cross-sectional, multic'entre quantitative study was conducted among surgical nurses in Anhui province. SAS, SDS and SSRS scales were used for the investigation. Data were collected between 3 March 2020 to 19 March 2020. RESULTS: A total of 3,492 surgical nurses completed the survey. The average level of anxiety and depression of surgical nurses were higher than that of the Chinese norm. Levels of social support for surgical nurses were significantly negatively associated with the degree of anxiety and depression. Fertility status, participation in care for COVID-19 patients, likelihood of being infected with COVID-19 and social support were significantly influencing surgical nurses' anxiety degree. Similarly, these characteristics were significantly associated with the odds of depression symptoms in surgical nurses. CONCLUSION: These findings suggest that targeted psychological interventions to promote mental health of surgical nurses need to be immediately implemented.

Electroencephalography-demonstrated mechanisms of dexmedetomidine-mediated deepening of propofol anesthesia: an observational study.

BACKGROUND: Although dexmedetomidine (Dex) is known to reduce bispectral index (BIS) values and propofol dosage, there is little information regarding raw electroencephalography (EEG) changes related to Dex deepening of propofol general anesthesia (GA). This study investigated the Dex effects on propofol GA via analysis of EEG changes. METHODS: A study cohort of 21 surgical patients (age range, 20-60 years) categorized as American Society of Anesthesiologists (ASA) class I or II was enrolled. We used time-varying spectral and bicoherence methods to compare electroencephalogram signatures 5 min before versus 10 min after intravenous Dex injection under propofol GA. The means and medians are reported with 95% confidence intervals (CIs) and inter-quartile ranges (IQRs), respectively. RESULTS: Dex augmented the slow waves power and theta (θ) oscillation bicoherence peak from a mean (95% CI) of 22.1% (19.0, 25.2) to 25.2% (21.8, 28.6). Meanwhile, Dex reduced alpha (α) peak power and bicoherence from 3.5 dB (1.0, 6.0) and 41.5% (34.0, 49.0) to 1.7 dB (- 0.6, 4.0) and 35.4% (29.0, 41.8), respectively, while diminishing the median frequency of α oscillation peak values and the mean frequency of α peaks in bicoherence spectra from 12.0 Hz (IQR 11.2, 12.6) and 11.7 Hz (11.3, 12.2) to 11.1 Hz (IQR 10.3, 11.8) and 11.2 Hz (10.9, 11.6), respectively. CONCLUSIONS: Profound EEG changes support the supposition that Dex enhances propofol-induced GA from a moderate to a deeper state. The present findings provide a theoretical basis and reference regarding protocols aimed at reducing anesthetic/sedative dosage while maintaining sufficient depth of GA. CLINICAL TRIAL REGISTRATION: ChiCTR, ChiCTR1900026955 . Registered on 27 October 2019.

The Relationship Between Suicidal Ideation and Parental Attachment Among Adolescents: The Mediator of Anhedonia and Peer Attachment.

Background: Previous studies had shown that poor quality of early parental attachment is a risk factor for suicide, but few have focus on the mechanism between suicidal ideation and parental attachment. The aim of this study was to explore how parental attachment, anhedonia, and peer attachment were associated with suicidal ideation in adolescents. Method: Participants were enrolled in middle schools, in Hefei, Anhui, China. All participants completed socio-demographic characteristic and standard assessments on parental attachment, peer attachment, anhedonia, and suicidal ideation by paper surveys. The effect of parental attachment on suicidal ideation mediated by anhedonia and peer attachment was analyzed by a structural equation model (SEM) using SPSS AMOS 23.0. Results: The SEM analysis revealed that the standard total effect of parental attachment on suicidal ideation was -0.137 (Z=-27.00, 95% confidence interval [CI; -0.147, -0.127], p<0.001), with a direct effect of parental attachment on suicidal ideation of -0.107 (Z=-21.40, 95% CI [-0.117, -0.098], p<0.001), while the indirect effects were-0.002 (Z=-3.33, 95% CI [-0.003, -0.002], p<0.001) in the pathway of parental attachment-anhedonia-peer attachment-suicidal ideation, -0.019 (Z=-19.00, 95%CI [-0.022, -0.017], p<0.001) in the pathway of parental attachment-anhedonia-suicidal ideation, and-0.008 (Z=-7.00, 95% CI [-0.010, -0.007], p<0.001) in the pathway of parental attachment-peer attachment-suicidal ideation. Conclusion: The study suggested that parental attachment could directly influence suicidal ideation and indirectly influence suicidal ideation via anhedonia and peer attachment. The results emphasized the importance of attachment in infancy and verified the feasibility of intervention on anhedonia and peer attachment to prevent suicidal ideation.

Therapeutic efficacy of connectivity-directed transcranial magnetic stimulation on anticipatory anhedonia.

BACKGROUND: There are currently no effective treatments specifically targeting anticipatory anhedonia, a major symptom of severe depression which is associated with poor outcomes. The present study investigated the efficacy of individualized repetitive transcranial magnetic stimulation (rTMS) targeting the left dorsolateral prefrontal cortex (lDLPFC)-nucleus accumbens (NAcc) network on anticipatory anhedonia in depression. METHODS: This randomized, double-blind, sham-controlled clinical trial (NCT03991572) enrolled 56 depression patients with anhedonia symptoms. Each participant received 15 once-daily sessions of rTMS at 10 Hz and 100% motor threshold. Stimulation was localized to the site of strongest IDLPFC-NAcc connectivity by functional magnetic resonance imaging. The Hamilton depression rating scale (HAMD) was used to measure depression severity, the temporal experience pleasure scale (TEPS) to measure anticipatory and consummatory anhedonia to specifically measure anticipatory/motivational anhedonia. Event-related potentials during the monetary incentive delay (MID) task were recorded to evaluate the electrophysiological correlates of reward anticipation and response. RESULTS: Patients in the Real group showed significant improvements in anticipatory anhedonia and general depression symptoms posttreatment compared to the Sham group. The Real group also demonstrated more positive going cue-N2 and cue-P3 amplitude during MID reward trials after treatment. The change in cue-P3 posttreatment was positive correlated with improved TEPS-anti score. CONCLUSION: Individualized rTMS of the lDLPFC-NAcc network can effectively alleviate anticipatory anhedonia and improved the reward seeking as evidenced by enhanced MID behavioral performance and more positive going cue-N2 and cue-P3. The lDLPFC-NAcc network plays a critical role in anticipatory reward and motivation processing.

Intermittent Theta Burst Stimulation (iTBS) as an Optimal Treatment for Schizophrenia Risk Decision: an ERSP Study.

Objective: People with schizophrenia have serious impairments in social function, especially in decision-making ability. Transcranial magnetic stimulation modified intermittent theta burst transcranial magnetic stimulation (iTBS) has been shown to regulate the functional connection of brain networks. Our study explored the therapeutic effect of iTBS on decision-making disorders in schizophrenia. Methods: Participants were pseudorandomized and assigned to iTBS (n = 16) or sham (n = 16) group. iTBS group was administered 1,800 pulses on the target of the left dorsol lateral prefrontal cortex (L-DLPFC) per day for 14 consecutive days. We compared Iowa gambling task performance and associated event-related spectral perturbation results (ERSP) among two groups. Results: The results show that participants' performance in the high-lose in the iTBS group had stronger stimulation of theta spectral power than those in the sham group. Specifically, we found that under high-risk conditions, compared with the control group, the iTBS group showed significant activation of the theta spectrum power in the FPZ, FZ, FCZ, and CZ regions after treatment. Conclusions: Our results provide evidence that long-term iTBS stimulation effectively improves the decision-making ability of schizophrenia. After receiving negative feedback, patients can turn to safety options. These findings support that iTBS may be a potential treatment for clinical decision-making disorders.