Cross disorder comparisons of brain structure in schizophrenia, bipolar disorder, major depressive disorder, and 22q11.2 deletion syndrome: A review of ENIGMA findings.

This review compares the main brain abnormalities in schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD), and 22q11.2 Deletion Syndrome (22q11DS) determined by ENIGMA (Enhancing Neuro Imaging Genetics through Meta Analysis) consortium investigations. We obtained ranked effect sizes for subcortical volumes, regional cortical thickness, cortical surface area, and diffusion tensor imaging abnormalities, comparing each of these disorders relative to healthy controls. In addition, the studies report on significant associations between brain imaging metrics and disorder-related factors such as symptom severity and treatments. Visual comparison of effect size profiles shows that effect sizes are generally in the same direction and scale in severity with the disorders (in the order SZ > BD > MDD). The effect sizes for 22q11DS, a rare genetic syndrome that increases the risk for psychiatric disorders, appear to be much larger than for either of the complex psychiatric disorders. This is consistent with the idea of generally larger effects on the brain of rare compared to common genetic variants. Cortical thickness and surface area effect sizes for 22q11DS with psychosis compared to 22q11DS without psychosis are more similar to those of SZ and BD than those of MDD; a pattern not observed for subcortical brain structures and fractional anisotropy effect sizes. The observed similarities in effect size profiles for cortical measures across the psychiatric disorders mimic those observed for shared genetic variance between these disorders reported based on family and genetic studies and are consistent with shared genetic risk for SZ and BD and structural brain phenotypes.

Neuropsychological predictors of cognitive deterioration in non-demented individuals.

Introduction: Previous studies performed neuropsychological tests in non-demented patients, especially those with mild cognitive impairment (MCI), to predict dementia. Few recent studies reported that subjective cognitive decline (SCD) itself predicts dementia conversion. We evaluated certain characteristics and neuropsychological tests to predict cognitive deterioration in non-demented individuals.Methods: This study included 106 participants with subjective cognitive complaints (SCCs) classified as non-demented (90 MCI and 16 SCD). Data were collected at baseline and follow-up, wherein participants completed a comprehensive neuropsychological assessment to assess their cognitive and daily functions.Results: During the follow-up of all participants, 52 converted to dementia, while 54 did not. There were significant differences in age and education years, as well as language, memory, frontal lobe function, and Barthel's Activities of Daily Living Index between the groups. Correlation analysis showed a significant correlation between the deterioration of the Clinical Dementia Rating scores and baseline language, memory, and frontal lobe function scores.Conclusion(s): SCDs consistently worrying about their SCCs and those identified with SCD by their caregivers were prone to cognitive function deterioration over time. Changes in language, memory, and frontal lobe function in neurocognitive tests were significantly different between the dementia converters and non dementia converters group. Particularly, SCD and MCI individuals with significantly poor initial executive function and memory abilities should be closely monitored for future cognitive decline.

Neurofeedback Treatment on Depressive Symptoms and Functional Recovery in Treatment-Resistant Patients with Major Depressive Disorder: an Open-Label Pilot Study.

BACKGROUND: We evaluated the effects of neurofeedback as an augmentation treatment on depressive symptoms and functional recovery in patients with treatment-resistant depression (TRD). METHODS: We included 24 adult patients with TRD and 12 healthy adults. 24 TRD patients were assigned to the neurofeedback augmentation group (n = 12) and the medication-only (treatment as usual [TAU]) group (n = 12). The neurofeedback augmentation group underwent combined therapy comprising medication and 12-24 sessions of neurofeedback training for 12 weeks. To assess the serum levels of brain-derived neurotrophic factor (BDNF) in both groups, pre- and post-treatment blood samples were obtained. Patients were evaluated using the Hamilton Depression Rating Scale (HAM-D), Beck Depression Inventory (BDI), Clinical Global Impression-Severity (CGI-S), 5-level version of European Quality of Life Questionnaire 5-Dimensional Classification (EQ-5D-5L), and Sheehan Disability Scale (SDS) at baseline, and at the 1-, 4-, and 12-week. RESULTS: From baseline to week 12, neurofeedback training reduced mean scores on HAM-D, BDI-II, CGI-S, and SDS, and increased mean EQ-5D-5L tariff score. In the neurofeedback augmentation group, the response and remission rates were 58.3% and 50.0%, respectively, at week 12. Changes in HAM-D, EQ-5D-5L tariff score, and SDS were significantly larger in the neurofeedback group than in the medication-only (TAU) group. No significant difference in BDNF level was found pre- vs. post-treatment in any of the groups. CONCLUSION: Despite the small sample size, these results suggest that neurofeedback treatment may be effective as an augmentation treatment, not only for depressive symptoms, but also for functional recovery, in patients with TRD. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0004183 ClinicalTrials.gov Identifier: NCT04078438.

The Analysis of Electroencephalography Changes Before and After a Single Neurofeedback Alpha/Theta Training Session in University Students.

The underlying mechanisms of alpha/theta neurofeedback training have not been fully determined. Therefore, this study aimed to test the changes in the brain state feedback during the alpha/theta training. Twenty-seven healthy participants were trained during a single session of the alpha/theta protocol, and the resting quantitative electroencephalography (QEEG) was assessed before and after training. QEEG was recorded at eight scalp locations (F3, F4, C3, C4, T3, T4, O1, and O2), and the absolute power, relative power, ratio of sensory-motor rhythm beta (SMR) to theta (RST), ratio of SMR-mid beta to theta (RSMT), ratio of mid beta to theta (RMT), ratio of alpha to high beta (RAHB), and scaling exponent of detrended fluctuation analysis by each band were measured. The results indicated a significant increase of absolute alpha power, especially the slow alpha band, at all electrodes except T3 and T4. Moreover, the relative alpha power, especially the slow alpha band, showed a significant increase at all electrodes. The relative theta power showed a significant decrease at all electrodes, except T3. A significant decrease in relative beta power, relative lower beta power and relative mid beta power was observed at O1. RST (at C4, O1, and O2), RSMT and RMT (at F4, C4, O1 and O2), and RAHB (at all electrodes) showed significant increase. Scaling exponents at all electrodes except T3 showed a significant decrease. These findings indicate that a one-time session of alpha/theta training might have the possibility to enhance both vigilance and concentration, thus stabilizing the overall brain function.

Comparison of the Efficacy and Safety of Aripiprazole Versus Bupropion Augmentation in Patients With Major Depressive Disorder Unresponsive to Selective Serotonin Reuptake Inhibitors: A Randomized, Prospective, Open-Label Study.

PURPOSE: The purpose of this study was to compare the efficacy and safety of aripiprazole versus bupropion augmentation in patients with major depressive disorder (MDD) unresponsive to selective serotonin reuptake inhibitors (SSRIs). METHODS: This is the first randomized, prospective, open-label, direct comparison study between aripiprazole and bupropion augmentation. Participants had at least moderately severe depressive symptoms after 4 weeks or more of SSRI treatment. A total of 103 patients were randomized to either aripiprazole (n = 56) or bupropion (n = 47) augmentation for 6 weeks. Concomitant use of psychotropic agents was prohibited. Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale, Iowa Fatigue Scale, Drug-Induced Extrapyramidal Symptoms Scale, Psychotropic-Related Sexual Dysfunction Questionnaire scores were obtained at baseline and after 1, 2, 4, and 6 weeks of treatment. RESULTS: Overall, both treatments significantly improved depressive symptoms without causing serious adverse events. There were no significant differences in the Montgomery Asberg Depression Rating Scale, 17-item Hamilton Depression Rating scale, and Iowa Fatigue Scale scores, and response rates. However, significant differences in remission rates between the 2 groups were evident at week 6 (55.4% vs 34.0%, respectively; P = 0.031), favoring aripiprazole over bupropion. There were no significant differences in adverse sexual events, extrapyramidal symptoms, or akathisia between the 2 groups. CONCLUSIONS: The present study suggests that aripiprazole augmentation is at least comparable to bupropion augmentation in combination with SSRI in terms of efficacy and tolerability in patients with MDD. Both aripiprazole and bupropion could help reduce sexual dysfunction and fatigue in patients with MDD. Aripiprazole and bupropion may offer effective and safe augmentation strategies in patients with MDD who are unresponsive to SSRIs. Double-blinded trials are warranted to confirm the present findings.

The Efficacy of Neurofeedback in Patients with Major Depressive Disorder: An Open Labeled Prospective Study.

The purpose of this study was to evaluate the effect of neurofeedback on depressive symptoms and electrophysiological disturbances in patients with major depressive disorder. We recruited participants suffering from depression to evaluate efficacy of left prefrontal beta with alpha/theta training. An 8-week, prospective, open-label study was undertaken. Twenty participants were recruited. The treatment protocol was twice or three times a week training of beta at F3 with alpha/theta at Pz for 8 weeks. When every visit, patients were received beta training for 30 min, and then alpha/theta training for 30 min. Baseline, 4 and 8 week scores of; the Hamilton rating scale for Depression (HAM-D), the Hamilton rating scale for Anxiety (HAM-A), the Beck Depression Inventory (BDI)-II, the Beck Anxiety Inventory (BAI), Clinical global impression-severity (CGI-S), and pre- and post-treatment resting state EEGs were compared. Interhemispheric alpha power asymmetry (A score) was computed for homologous sites F3-F4. Pre- and post-training clinical assessments revealed significant improvements in HAM-D, HAM-A, BDI, and CGI-S scores. Cumulative response rates by HAM-D were 35.0 and 75.0 % at 4 and 8 weeks, respectively, corresponding cumulative remission rates by HAM-D were 15.0 and 55.0 %, respectively. No significant differences were found between pre- and post-treatment A score. Neurofeedback treatment could improve depressive symptoms significantly. In addition, anxiety symptoms and clinical illness severity decreased significantly after neurofeedback treatment. Despite its several limitations, such as, small sample size and lack of a control group, this study suggested neurofeedback has significant effects in patients with major depressive disorder.

Effects of neurofeedback on adult patients with psychiatric disorders in a naturalistic setting.

Few well-controlled studies have considered neurofeedback treatment in adult psychiatric patients. In this regard, the present study investigates the characteristics and effects of neurofeedback on adult psychiatric patients in a naturalistic setting. A total of 77 adult patients with psychiatric disorders participated in this study. Demographic data and neurofeedback states were retrospectively analyzed, and the effects of neurofeedback were evaluated using clinical global impression (CGI) and subjective self-rating scales. Depressive disorders were the most common psychiatric disorders (19; 24.7 %), followed by anxiety disorders (18; 23.4 %). A total of 69 patients (89.6 %) took medicine, and the average frequency of neurofeedback was 17.39 ± 16.64. Neurofeedback was applied to a total of 39 patients (50.6 %) more than 10 times, and 48 patients (62.3 %) received both ß/SMR and α/θ training. The discontinuation rate was 33.8 % (26 patients). There was significant difference between pretreatment and posttreatment CGI scores (<.001), and the self-rating scale also showed significant differences in depressive symptoms, anxiety, and inattention (<.001). This is a naturalistic study in a clinical setting, and has several limitations, including the absence of a control group and a heterogenous sample. Despite these limitations, the study demonstrates the potential of neurofeedback as an effective complimentary treatment for adult patients with psychiatric disorders.

Characteristics of esterified rice bran oil converted by enzymatic esterification.

In the present study, esterified rice bran oil (ERBO) was characterized using enzymatic esterification to improve stability, prevent acidification, enhance health-promoting biological activity and generate ω-3 PUFA-rich rice bran oil (RBO). Esterification reactions using RBO and ethanol were performed at 50°C under 200 bar with 3% lipozyme TL-IM (Thermomuces lanuginosa immobilized on silica gel) or RM-IM (Rhizomucor miehei immobilized on ion exchange resin) for 3 hr under supercritical CO2. The molar ratios of ethanol to RBO were 3, 6, 9 and 12, respectively. Total lipid contents and acid values decreased (maximum 83.75%),but γ-oryzanol content increased (maximum 41.33%) in esterified RBO (ERBO) prepared using TL-IM or RM-IM. In addition, DPPH radical scavenging activity of ERBO prepared by RM-IM atan ethanol to RBO molar ratio of 3 was 0.02 µg µl(-1), which was 63-fold higher than that of α-tocopherol (IC50 =1.25 µg µl(-1)). The anti-inflammatory effect of RM-IM 1:3 hydrolysate of RBO was verified showing its suppressive effect towards iNOS and Cox-2mRNA expression in a dose-dependent manner. Therefore, ERBO is a promising source of functional food, cosmetics and pharmaceuticals.

Genotoxicity of rice bran oil extracted by supercritical CO2 extraction.

Rice bran oil extracted by supercritical CO2 extraction (RB-SCE) reportedly exhibits pharmacological activities such as antioxidant and in vivo hair growth-inducing effects. Such activities raise the possibility of the development of novel hair growth-inducing agents using RB-SCE. The aim of this study was to investigate the potential genotoxic effects of RB-SCE in three short-term mutagenicity assays (bacterial reverse mutation assay, in vitro mammalian chromosomal aberration test, and in vivo micronucleus assay). RB-SCE showed no genotoxicity in the bacterial reverse mutation assay up to 5000 mg/plate and in the in vivo micronucleus test up to 600 mg/kg body weight. However, at 120 µg/mL with S9 mix and 200 µg/mL without S9 mix RB-SCE showed significantly different genotoxicity than the negative control in the in vitro chromosome aberration test. The induction of chromosomal aberrations under the present conditions may have no biological significance. We have herein demonstrated that RB-SCE can be regarded as a non-genotoxic material based on the available in vivo and in vitro results.

In vivo hair growth-promoting effect of rice bran extract prepared by supercritical carbon dioxide fluid.

The potential hair growth-promoting activity of rice bran supercritical CO2 extract (RB-SCE) and major components of RB-SCE, linoleic acid, policosanol, γ-oryzanol, and γ-tocotrienol, were evaluated with the histological morphology and mRNA expression levels of cell growth factors using real-time reverse transcriptase-polymerase chain reaction (PCR) in C57BL/6 mice. RB-SCE showed hair growth-promoting potential to a similar extent as 3% minoxidil, showing that the hair follicles were induced to be in the anagen stage. The numbers of the hair follicles were significantly increased. In addition, mRNA expression levels of vascular endothelial growth factor (VEGF), insulin-like growth factor-1 (IGF-1), and keratinocyte growth factor (KGF) were also significantly increased and that of transforming growth factor-ß (TGF-ß) decreased in RB-SCE-treated groups. Among the major components of RB-SCE, linoleic acid and γ-oryzanol induced the formation of hair follicles according to examination of histological morphology and mRNA expression levels of cell growth factors. In conclusion, our results demonstrate that RB-SCE, particularly linoleic acid and γ-oryzanol, promotes hair growth and suggests RB-SCE can be applied as hair loss treatment.

Solar retinopathy related to antidepressant use in a patient with major depressive disorder: a case report.

This case report is a unique case of solar retinopathy following antidepressant-induced mydriasis and highlights the need for comprehensive ophthalmic evaluation in patients treated with medications having mydriatic effects. A 49-year-old female patient who had received long-term antidepressant therapy presented with bilateral visual impairment after prolonged sun exposure. Fundoscopy confirmed solar retinopathy, which was attributed to drug-induced mydriasis. Medication adjustments and sun protection strategies led to full visual recovery, underscoring the importance of interdisciplinary awareness. This case emphasizes the challenges associated with the simultaneous management of psychiatric and ophthalmic conditions and highlights the need for routine ophthalmic evaluation of patients prescribed antidepressants with reported ocular side effects.

The Complexity of Borderline Personality Disorder: Network Analysis of Personality Factors and Defense Styles in the Context of Borderline Personality Organization.

OBJECTIVE: Borderline personality disorder (BPD) is known to share characteristics with a variety of personality disorders (PDs) and exhibits diverse patterns of defense mechanisms. To enhance our understanding of BPD, it's crucial to shift our focus from traditional categorical diagnostics to the dimensional traits shared with other PDs, as the borderline personality organization (BPO) model suggests. This approach illuminates the nuanced spectrum of BPD characteristics, offering deeper insights into its complexity. While studies have investigated the comorbidity of BPD with other PDs, research exploring the relationship between various personality factors and defense mechanisms within BPD itself has been scarce. The present study was undertaken to investigate the complex interrelationships between various personality factors and defense styles in individuals diagnosed with BPD. METHODS: Using a network analysis approach, data from 227 patients diagnosed with BPD were examined using the Defense Style Questionnaire and Personality Disorder Questionnaire-4+ for assessment. RESULTS: Intricate connections were observed between personality factors and defense styles. Significant associations were identified between various personality factors and defense styles, with immature defense styles, such as maladaptive and image-distorting being particularly prominent in BPD in the centrality analysis. The maladaptive defense style had the highest expected influence centrality. Furthermore, the schizotypal, dependent, and narcissistic personality factors demonstrated relatively high centrality within the network. CONCLUSION: Network analysis can effectively delineate the complexity of various PDs and defense styles. These findings are expected to facilitate a deeper understanding of why BPD exhibits various levels of organization and presents with heterogeneous characteristics, consistent with the perspectives proposed by the BPO.

Using Deep Learning Techniques as an Attempt to Create the Most Cost-Effective Screening Tool for Cognitive Decline.

OBJECTIVE: This study aimed to use deep learning (DL) to develop a cost-effective and accessible screening tool to improve the detection of cognitive decline, a precursor of Alzheimer's disease (AD). This study integrating a comprehensive battery of neuropsychological tests adjusted for individual demographic variables such as age, sex, and education level. METHODS: A total of 2,863 subjects with subjective cognitive complaints who underwent a comprehensive neuropsychological assessment were included. A random forest classifier was used to discern the most predictive test combinations to distinguish between dementia and nondementia cases. The model was trained and validated on this dataset, focusing on feature importance to determine the cognitive tests that were most indicative of decline. RESULTS: Subjects had a mean age of 72.68 years and an average education level of 7.62 years. The DL model achieved an accuracy of 82.42% and an area under the curve of 0.816, effectively classifying dementia. Feature importance analysis identified significant tests across cognitive domains: attention was gauged by the Trail Making Test Part B, language by the Boston Naming Test, memory by the Rey Complex Figure Test delayed recall, visuospatial skills by the Rey Complex Figure Test copy score, and frontal function by the Stroop Test Word reading time. CONCLUSION: This study showed the potential of DL to improve AD diagnostics, suggesting that a wide range of cognitive assessments could yield a more accurate diagnosis than traditional methods. This research establishes a foundation for future broader studies, which could substantiate the approach and further refine the screening tool.

The characteristics of elderly suicidal attempters in the emergency department in Korea: a retrospective study.

BACKGROUND: Although Korea ranks first in the suicide rate of elderly individuals, there is limited research on those who attempt suicide, with preventive measures largely based on population-based studies. We compared the demographic and clinical characteristics of elderly individuals who attempted suicide with those of younger adults who visited the emergency department after suicide attempts and identified the factors associated with lethality in the former group. METHODS: Individuals who visited the emergency department after a suicide attempt from April 1, 2017, to January 31, 2020, were included. Participants were classified into two groups according to age (elderly, ≥65 years; adult, 18-64 years). Among the 779 adult patients, 123 were elderly. We conducted a chi-square test to compare the demographic and clinical features between these groups and a logistic regression analysis to identify the risk factors for lethality in the elderly group. RESULTS: Most elderly participants were men, with no prior psychiatric history or suicide attempts, and had a higher prevalence of underlying medical conditions and attributed their attempts to physical illnesses. Being sober and planning suicide occurred more frequently in this group. In the elderly group, factors that increased the mortality rate were biological male sex (p<0.05), being accompanied by family members (p<0.05), and poisoning as a suicide method (p<0.01). CONCLUSION: Suicide attempts in elderly individuals have different characteristics from those in younger adults and are associated with physical illness. Suicides in the former group are unpredictable, deliberate, and fatal. Therefore, tailored prevention and intervention strategies addressing the characteristics of those who are elderly and attempt suicide are required.

Efficacy and Safety of Lurasidone vs. Quetiapine XR in Acutely Psychotic Patients With Schizophrenia in Korea: A Randomized, Double-Blind, Active-Controlled Trial.

OBJECTIVE: This study was performed to evaluate the efficacy and safety of lurasidone (160 mg/day) compared to quetiapine XR (QXR; 600 mg/day) in the treatment of acutely psychotic patients with schizophrenia. METHODS: Patients were randomly assigned to 6 weeks of double-blind treatment with lurasidone 160 mg/day (n=105) or QXR 600 mg/day (n=105). Primary efficacy measure was the change from baseline to week 6 in Positive and Negative Syndrome Scale (PANSS) total score and Clinical Global Impressions severity (CGI-S) score. Adverse events, body measurements, and laboratory parameters were assessed. RESULTS: Lurasidone demonstrated non-inferiority to QXR on the PANSS total score. Adjusted mean±standard error change at week 6 on the PANSS total score was -26.42±2.02 and -27.33±2.01 in the lurasidone and QXR group, respectively. The mean difference score was -0.91 (95% confidence interval -6.35-4.53). The lurasidone group showed a greater reduction in PANSS total and negative subscale on week 1 and a greater reduction in end-point CGI-S score compared to the QXR group. Body weight, body mass index, and waist circumference in the lurasidone group were reduced, with significantly lower mean change compared to QXR. Endpoint changes in glucose, cholesterol, triglycerides, and low-density lipoprotein levels were also significantly lower. The most common adverse drug reactions with lurasidone were akathisia and nausea. CONCLUSION: Lurasidone 160 mg/day was found to be non-inferior to QXR 600 mg/day in the treatment of schizophrenia with comparable efficacy and tolerability. Adverse effects of lurasidone were generally tolerable, and beneficial effects on metabolic parameters can be expected.

Hypertension and cognitive dysfunction: a narrative review.

Cognitive dysfunction is relatively less considered a complication of hypertension. However, there is sufficient evidence to show that high blood pressure in middle age increases the risk of cognitive decline and dementia in old age. The greatest impact on cognitive function in those with hypertension is on executive or frontal lobe function, similar to the area most damaged in vascular dementia. Possible cognitive disorders associated with hypertension are vascular dementia, Alzheimer disease, and Lewy body dementia, listed in decreasing strength of association. The pathophysiology of cognitive dysfunction in individuals with hypertension includes brain atrophy, microinfarcts, microbleeds, neuronal loss, white matter lesions, network disruption, neurovascular unit damage, reduced cerebral blood flow, blood-brain barrier damage, enlarged perivascular damage, and proteinopathy. Antihypertensive drugs may reduce the risk of cognitive decline and dementia. Given the high prevalence of dementia and its impact on quality of life, treatment of hypertension to reduce cognitive decline may be a clinically relevant intervention.

Effectiveness of Switching to Long-acting Injectable Aripiprazole in Patients with Recent-onset and Chronic Schizophrenia.

Objective: This study investigated the effectiveness of switching to once-monthly long-acting injectable (LAI) aripiprazole from other second-generation antipsychotics including LAI paliperidone palmitate in both recent-onset and chronic schizophrenia patients. Methods: This was a 24-week prospective, open-label, flexible dose-switching study in patients with schizophrenia. Scores on the Positive and Negative Syndrome Scale (PANSS), Personal and Social Performance (PSP) scale, Clinical Global Impression (CGI), Subjective Well-being Under Neuroleptics-Short Form (SWN-K), and a computerized emotional recognition test (ERT) were evaluated. Subjects were divided into two groups (recent onset and chronic) based on 5 years' duration of the illness. Results: Among the 82 patients participating, 67 (81.7%) completed the 24-week study. The discontinuation rate after switching to LAI aripiprazole did not differ according to clinical characteristics including type of previous antipsychotics. Scores on the PANSS, PSP, SWN-K, CGI, and ERT were significantly improved after a switch to LAI aripiprazole without exacerbation of metabolic parameters and bodyweight. The improvements in the PANSS, PSP, and CGI scores were significantly greater in patients with recent-onset than in those with chronic schizophrenia; the improvement in metabolic parameters was significantly greater in the latter group. Conclusion: High rates of successful switching to LAI aripiprazole from other antipsychotics suggest its good tolerability and effectiveness. Improvements in psychopathology and social functioning were more evident in patients with recent- onset schizophrenia, and improvements in metabolic abnormalities were more prominent in patients with chronic schizophrenia.

Characteristics of Cognitive Function Changes and Related Factors in Individuals With Cognitive Impairment During the Pandemic of COVID-19: A Retrospective Chart Review Study.

OBJECTIVE: This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment during the coronavirus disease 2019 (COVID-19) pandemic. METHODS: Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID-19 and tested regularly at least three times within the last 5 years were included (1st, the initial screening; 2nd, the test immediately before the COVID-19 pandemic; 3rd, the most recent test after the pandemic). Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID-19. RESULTS: When comparing CDR changes before and after COVID-19, there was no significant difference between the two groups (p=0.317). Alternatively, the main effect of the time when the test was conducted was significant (p<0.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/ improved group significantly decreased before COVID-19 (1st-2nd) (p=0.045). After COVID-19 (2nd-3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<0.001). Mini-Mental State Examination recall memory and changes in activity during COVID-19 were significantly associated with CDR deterioration. CONCLUSION: Memory dysfunction and decreased activity during the COVID-19 pandemic are strongly related to the deterioration of cognitive impairment.

Five negative symptom domains are differentially associated with resting state amplitude of low frequency fluctuations in Schizophrenia.

This study examined associations between resting-state amplitude of low frequency fluctuations (ALFF) and negative symptoms represented by total scores, second-order dimension (motivation and pleasure, expressivity), and first-order domain (anhedonia, avolition, asociality, alogia, blunted affect) factor scores in schizophrenia (n = 57). Total negative symptom scores showed positive associations with ALFF in temporal and frontal brain regions. Negative symptom domain scores showed predominantly stronger associations with regional ALFF compared to total scores, suggesting domain scores may better map to neural signatures than total scores. Improving our understanding of the neuropathology underlying negative symptoms may aid in addressing this unmet therapeutic need in schizophrenia.

Management of Panic Disorder with Neurofeedback in Patients with Muscular Dystrophy: A Case Report.

Duchenne muscular dystrophy (DMD) is the most common hereditary progressive muscular disease. It was recently reported that symptoms of anxiety and depression are frequent in patients with DMD, and psychosocial support is important for their quality of life. We reported 3 patients (2 patients with DMD and 1 patient with muscular dystrophy of an unknown etiology) with panic disorder and treated them successfully with neurofeedback (NFB). The NFB protocols were slow motor rhythm at T4 for 2 patients, beta training at F3 for 1 patient, and alpha/theta training at Pz for all patients. All patients had significantly improved anxiety symptoms, including panic attacks, after NFB therapy. NFB can be considered a safe therapeutic alternative without causing even minor side effects and without drug interactions for DMD patients with panic or anxiety disorders.