Prevalence and predictors of prenatal depression during the COVID-19 pandemic: A multistage observational study in Beijing, China.

OBJECTIVE: While growing psychological health issues among pregnant women during the COVID-19 pandemic have been clearly validated, most research was conducted in countries with relatively lax quarantine measures. This study aimed to compare the prevalence of prenatal depression among pre-, peak-, and post-COVID-19 in Beijing, the region with a stringent response policy in China. We also explore predictors of prenatal depression throughout the outbreak. METHODS: We investigated prenatal depression among 742 pregnant women who received antenatal checkups in Beijing from March 28, 2019 to May 07, 2021 using the Edinburgh Postnatal Depression Scale and associative demographic, pregnancy-related, and psychosocial characteristics were measured. The phase was divided into pre-, peak-, and post-COVID-19 in light of the trajectory of COVID-19. Pearson's Chi-square test was used after the examination of confounders homogeneity. The bivariable and multivariable logistic regression was conducted to explore predictors. RESULTS: The pooled prevalence of prenatal depression was 11.9% throughout the COVID-19 pandemic. Rates at different phases were 10.6%, 15.2%, and 11.1% respectively and no significant difference was observed. Multivariable logistic regression revealed that history of mental illness, number of boy-preference from both pregnant women and husband's family, social support, occupation, and living space were independent predictors of prenatal depression in Beijing. CONCLUSION: Our data suggested that the impact of this pandemic on prenatal depression in Beijing appears to be not significant, which will strengthen confidence in adhering to current policy for decision-makers and provide important guidance for the development of major outbreak control and management policies in the future. Our findings may also provide a more efficient measure to identify high-risk pregnant women for professionals and help raise gender equity awareness of pregnant women and their husbands' families. Future studies should focus on the value of targeted care and family relations on the mental health of pregnant women.

Altered Functional Connectivity in the Resting State Neostriatum After Complete Sleep Deprivation: Impairment of Motor Control and Regulatory Network.

Sleep loss not only compromises individual physiological functions but also induces a psychocognitive decline and even impairs the motor control and regulatory network. In this study, we analyzed whole-brain functional connectivity changes in the putamen and caudate nucleus as seed points in the neostriatum after 36 h of complete sleep deprivation in 30 healthy adult men by resting state functional magnetic resonance imaging to investigate the physiological mechanisms involved in impaired motor control and regulatory network in individuals in the sleep-deprived state. The functional connectivity between the putamen and the bilateral precentral, postcentral, superior temporal, and middle temporal gyrus, and the left caudate nucleus and the postcentral and inferior temporal gyrus were significantly reduced after 36 h of total sleep deprivation. This may contribute to impaired motor perception, fine motor control, and speech motor control in individuals. It may also provide some evidence for neurophysiological changes in the brain in the sleep-deprived state and shed new light on the study of the neostriatum in the basal ganglia.

Recovery Sleep Reverses Impaired Response Inhibition due to Sleep Restriction: Evidence from a Visual Event Related Potentials Study.

OBJECTIVE: To investigate response inhibition after total sleep deprivation (TSD) and the restorative effects of one night of recovery sleep (RS). METHODS: Fourteen healthy male participants performed a visual Go/NoGo task, and electroencephalogram recordings were conducted at five time points: (1) baseline, (2) after 12 h of TSD, (3) after 24 h of TSD, (4) after 36 h of TSD, and (5) following 8 h of RS. The dynamic changes in response inhibition during TSD and after 8 h of RS were investigated by examining the NoGo-N2 and NoGo-P3 event-related potential components. RESULTS: Compared with baseline, NoGo-P3 amplitudes were decreased, while the NoGo-N2 latency increased along with the awake time prolonged. NoGo anteriorization, which was minimized after 24 h of TSD, progressively decreased with increasing TSD. After 8 h of RS, recoveries of both the NoGo-P3 amplitude and NoGo-N2 latency in the prefrontal cortex were observed compared with the values after 36 h of TSD. CONCLUSION: TSD induced a dose-dependent functional decline in the response inhibition of NoGo-N2 and NoGo-P3 on prefrontal cortex activation, and 8 h of RS resulted in recovery or maintenance of the response inhibition. However, it was not restored to baseline levels. LIMITATIONS: Participants were chosen male college students only, thus the findings cannot be generalized to older people and women. Additionally, the sample size was small, and, thus, speculations on the meaning of the results of this study should be cautious. The EEG continuous recording should be employed to monitor the decline of alertness following TSD.

Large-Scale Brain Network Coupling Predicts Total Sleep Deprivation Effects on Cognitive Capacity.

Interactions between large-scale brain networks have received most attention in the study of cognitive dysfunction of human brain. In this paper, we aimed to test the hypothesis that the coupling strength of large-scale brain networks will reflect the pressure for sleep and will predict cognitive performance, referred to as sleep pressure index (SPI). Fourteen healthy subjects underwent this within-subject functional magnetic resonance imaging (fMRI) study during rested wakefulness (RW) and after 36 h of total sleep deprivation (TSD). Self-reported scores of sleepiness were higher for TSD than for RW. A subsequent working memory (WM) task showed that WM performance was lower after 36 h of TSD. Moreover, SPI was developed based on the coupling strength of salience network (SN) and default mode network (DMN). Significant increase of SPI was observed after 36 h of TSD, suggesting stronger pressure for sleep. In addition, SPI was significantly correlated with both the visual analogue scale score of sleepiness and the WM performance. These results showed that alterations in SN-DMN coupling might be critical in cognitive alterations that underlie the lapse after TSD. Further studies may validate the SPI as a potential clinical biomarker to assess the impact of sleep deprivation.

A visual ERP study of impulse inhibition following a zaleplon-induced nap after sleep deprivation.

The side effects of a zaleplon-induced nap as a countermeasure in the reduction of impulse inhibition function decline following 30 h of sleep deprivation (SD) were examined by event-related brain potentials. Sixteen adult participants performed a Go/NoGo task at five time points: (1) baseline; (2) after 30 h of SD; (3) upon sudden awakening, also called 2 h post-drug; (4) 4 h post-drug; and (5) 6 h post-drug. Behavior results show an increase in both reaction time and false alarm rates after SD and sudden awakening, and a marked decrease at 4 h and 6 h post-drug in zaleplon and placebo conditions. However, no difference was observed between the zaleplon condition and the placebo condition. In event-related potential (ERP) reults compared with results obtained under control conditions, NoGo-P3 latencies significantly increased, whereas the Nogo-P3 amplitude decreased after 30 h of SD and sudden awakening in both the zaleplon condition and the placebo condition. These results indicate that SD attenuates resource allocation and error monitoring for NoGo stimuli. In addition, NoGo-P3 latencies were longer in the zaleplon condition compared with the placebo condition at sudden awakening. Additionally, the NoGo-P3 latencies were shorter in the zaleplon condition than in the placebo condition at 4 h and 6 h post-drug. These results indicate that zaleplon at a dose of 10 mg/day may help subjects achieve a better recovery or maintain better impulse inhibition function, although the side effects of zaleplon last at least 2 h post-drug.

Medication of l-tetrahydropalmatine significantly ameliorates opiate craving and increases the abstinence rate in heroin users: a pilot study.

AIM: Drug addiction is a chronic brain disease with constant relapse requiring long-term treatment. New pharmacological strategies focus on the development of an effective antirelapse drug. This study examines the effects of levotetrahydropalmatine (l-THP) on reducing heroin craving and increasing the abstinence rate among heroin-dependent patients. METHODS: In total, 120 heroin-dependent patients participated in the randomized, double-blinded, and placebocontrolled study using l-THP treatment. The participants remained in a ward during a 4-week period of l-THP treatment, followed by 4 weeks of observation after treatment. The patients were followed for 3 months after discharge. Outcome measures are the measured severity of the protracted abstinence withdrawal syndrome (PAWS) and the abstinence rate. RESULTS: Four weeks of l-THP treatment significantly ameliorated the severity of PAWS, specifically, somatic syndrome, mood states, insomnia, and drug craving, in comparison to the placebo group. Based on the 3 month follow-up observation, participants who survived the initial 2 weeks of l-THP medication and remained in the trial program had a significantly higher abstinence rate of 47.8% (95% confidence interval [CI]: 33%- 67%) than the 15.2% in the placebo group (95% CI: 7%-25%), according to a log- rank test (P<0.0005). CONCLUSION: l-THP significantly ameliorated PAWS, especially reducing drug craving. Furthermore, it increased the abstinence rate among heroin users. These results support the potential use of l-THP for the treatment of heroin addiction.