A protocol for a pooled analysis of cohort studies: The association between depression and anxiety in epileptic disorders.

BACKGROUND/INTRODUCTION: Depressive and anxiety disorders constitute major mental health challenges affecting adults of all ages globally. It has been reported that individuals with depressive or anxiety disorders face an elevated risk of developing neurological conditions, including seizures and epilepsy. Additionally, people with these disorders tend to exhibit distinct clinical outcomes compared to the general population. However, the associations between depressive or anxiety disorders and epilepsy remain contentious. Thus, this study aims to elucidate the associations between these neuropsychiatric disorders, including depressive and anxiety disorders, and epilepsy or seizures. METHODS: We will systematically search three electronic databases-PubMed, EMBASE, and the Cochrane Library-from inception through March 2023 to identify relevant cohort studies investigating the associations between depressive or anxiety disorders and epilepsy or seizures. Two independent reviewers will extract data from eligible studies using pre-designed standardized data extraction forms, and cross-check results. A third author will resolve any discrepancies. Quality assessment will be performed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Pooled risk estimates (Relative risks or hazard ratios with their 95% CI) will be calculated using the DerSimonian-Laird random-effects model. If between-study heterogeneity is identified, we will conduct subgroup analyses or meta-regressions to explore the possible sources of heterogeneity (participants, exposure, outcome, and study design) stratified by various study characteristics. Potential publication bias will be detected through the inspection of funnel plot asymmetry, complemented by the Egger linear regression approach (Egger's test) and the Begg rank correlation test (Begg's test). DISCUSSION: This pooled analysis will evaluate the association between depressive or anxiety disorders and epilepsy or seizures, providing high-level evidence to inform early identification and prevention strategies for epilepsy or seizures. ETHICS AND DISSEMINATION: Given that the data utilized for analysis in this pooled analysis does not involve human subjects or medical records, no ethical approval is required for this study. We intend to present the results of this study at national or international conferences or submit the findings to a peer-reviewed journal. OSF REGISTRATION NUMBER: DOI 10.17605/OSF.IO/WM2X8.

Resveratrol Treatment in Different Time-Attenuated Neuronal Apoptosis After Oxygen and Glucose Deprivation/Reoxygenation via Enhancing the Activation of Nrf-2 Signaling Pathway In Vitro.

Recent studies have indicated that resveratrol has protective effects against cerebral ischemia/reperfusion injury. However, the best therapeutic time for resveratrol treatment after acute ischemic stroke remains unknown. We aim to investigate whether resveratrol, administrated at different times after neuronal oxygen and glucose deprivation/reoxygenation (OGD/R) reduced neuronal injury in vitro. There were six experimental groups: normal, model, resveratrol pretreatment, resveratrol post-treatment, resveratrol OGD-treatment, and resveratrol whole-processing group. We found that resveratrol in a concentration-dependent manner decreased the activity of lactate dehydrogenase (LDH) and increased the activity of superoxide dismutase (SOD). Moreover, resveratrol, administrated at different times, increased neuronal viability, reduced neuronal apoptosis, upregulated the protein expressions of Nuclear factor erythroid 2-related factor 2 (Nrf-2), NAD(P)H: quinone oxidoreductase 1 (NQO-1), heme oxygenase 1 (HO-1), and Bcl-2, downregulated the protein expression of Caspase-3, and promoted Nrf-2 to transfer into the nuclei from the cytoplasm. The most effective treatment group was the whole-processing treatment group. These results suggest that resveratrol treatment at different times increased neuronal viability and inhibited neuronal apoptosis in vitro, at least in part, via enhancing the activation of the Nrf-2 signaling pathway.

Resveratrol pretreatment attenuates injury and promotes proliferation of neural stem cells following oxygen-glucose deprivation/reoxygenation by upregulating the expression of Nrf2, HO-1 and NQO1 in vitro.

There is considerable interest in the use of drugs and other methods for protecting implanted neural stem cells (NSCs) from the adverse environment of injured tissue for successful cell therapy. Resveratrol can modify cardiac stem cells to enhance their survival and differentiation, however, its effect and the mechanism underlying its neuroprotective effect on NSCs following stroke remain to be fully elucidated. Nuclear factor erythroid 2­related factor 2 (Nrf­2) signaling is important in antioxidative stress, and the role of Nrf­2 signaling in the enhanced neuroprotection of NSCs by resveratrol following stroke also remains to be elucidated. In the present study, NSCs were pretreated with resveratrol prior to oxygen­glucose deprivation/reoxygenation (OGD/R) in vitro. The survival, apoptosis and proliferation of the NSCs were assessed using an MTT assay, Hoechst 33258 staining of nuclei and flow cytometry, respectively. In addition, the activity of superoxide dismutase (SOD), level of malondiadehyde (MDA) and content of glutathione (GSH) were determined. The protein expressions levels of Nrf­2, NAD(P)H:quinone oxidoreductase 1 (NQO­1), and heme oxygenase 1 (HO­1) were detected using western blot analysis. It was found that resveratrol markedly enhanced NSC survival and proliferation, decreased apoptosis and the levels of MDA, and increased the activity of SOD and content of GSH in a concentration­dependent manner following OGD/R injury in vitro. In addition, the protein expression levels of Nrf2, HO­1 and NQO1 were significantly upregulated. These findings suggested that resveratrol attenuated injury and promoted proliferation of the NSCs, at least in part, by upregulating the expression of Nrf2, HO­1 and NQO1 following OGD/R injury in vitro.

Sonic hedgehog signaling mediates resveratrol to increase proliferation of neural stem cells after oxygen-glucose deprivation/reoxygenation injury in vitro.

BACKGROUND/AIMS: There is interest in drugs and rehabilitation methods to enhance neurogenesis and improve neurological function after brain injury or degeneration. Resveratrol may enhance hippocampal neurogenesis and improve hippocampal atrophy in chronic fatigue mice and prenatally stressed rats. However, its effect and mechanism of neurogenesis after stroke is less well understood. Sonic hedgehog (Shh) signaling is crucial for neurogenesis in the embryonic and adult brain, but relatively little is known about the role of Shh signaling in resveratrol-enhanced neurogenesis after stroke. METHODS: Neural stem cells (NSCs) before oxygen-glucose deprivation/reoxygenation (OGD/R) in vitro were pretreated with resveratrol with or without cyclopamine. Survival and proliferation of NSCs was assessed by the CCK8 assay and BrdU immunocytochemical staining. The expressions and activity of signaling proteins and mRNAs were detected by immunocytochemistry, Western blotting, and RT-PCR analysis. RESULTS: Resveratrol significantly increased NSCs survival and proliferation in a concentration-dependent manner after OGD/R injury in vitro. At the same time, the expression of Patched-1, Smoothened (Smo), and Gli-1 proteins and mRNAs was upregulated, and Gli-1 entered the nucleus, which was inhibited by cyclopamine, a Smo inhibitor. CONCLUSION: Shh signaling mediates resveratrol to increase NSCs proliferation after OGD/R injury in vitro.

Primary cilia mediate sonic hedgehog signaling to regulate neuronal-like differentiation of bone mesenchymal stem cells for resveratrol induction in vitro.

Mesenchymal stem cells (MSCs) can differentiate into neuronal-like cell types under specific conditions. The classical antioxidant inducers such as ß-mercaptoethanol (BME), butylated hydroxyanisol (BHA), and dimethylsulfoxide (DMSO) are limited in clinical because of toxicity. Resveratrol, a safer, natural antioxidant, can stimulate osteoblastic differentiation of MSCs. However, its effect of inducing MSCs to differentiate into neuronal-like cells is less well studied, and its differentiated mechanisms are not well understood. Sonic hedgehog (Shh) signaling, mediated by the primary cilia, is crucial for embryonic development and tissue differentiation, but relatively little is known about the role of Shh signaling and primary cilia in neuronal-like differentiation of MSCs. Here we show that primary cilia, harboring patched 1 (Ptc1), are present in growth-arrested MSCs and that smoothened (Smo) and Gli1 are present in cytoplasm of MSCs, which are important components of the Shh signaling pathway. After resveratrol induction, MSCs acquire neuronal-like cell morphologies and phenotypes, Smo translocates to the primary cilia, Gli1 enters the nucleus, and expressions of Smo and Gli1 proteins increase, which can be inhibited by cyclopamine, a Smo antagonist. Meanwhile, Smo agonist (SAG) attains similar effects compared with the resveratrol group. These data indicate that resveratrol can induce MSCs to differentiate into neuronal-like cells and activate Shh signaling pathway in the primary cilia. Moreover, the primary cilia and Shh signaling are essential for resveratrol inducing neuronal-like differentiation of MSCs. Our finding is important for understanding the neuronal-like differentiation mechanism of MSCs for resveratrol and promoting its clinical therapeutic utility.