CNS Spectrums最新文献

{"title":"Choosing among the long-acting injectable antipsychotics: an evidence-based pragmatic guide - ERRATUM.","authors":"Leslie Citrome","doi":"10.1017/S109285292510059X","DOIUrl":"10.1017/S109285292510059X","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":"30 1","pages":"e84"},"PeriodicalIF":4.6,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145437659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moving beyond symptom subtypes: testing a common dimension of lifetime OCD symptoms.","authors":"Abel S Mathew, Sarah L Garnaat, David R Strong, Nicole C R McLaughlin, Kathleen D Askland, O Joseph Bienvenu, Janice Krasnow, Marco A Grados, Bernadette Cullen, Fernando S Goes, Steven Rasmussen, James A Knowles, James T McCracken, John Piacentini, Daniel Geller, Evelyn Stewart, Mark A Riddle, Paul Nestadt, Gerald Nestadt, Jack Samuels, Benjamin D Greenberg","doi":"10.1017/S1092852925100679","DOIUrl":"10.1017/S1092852925100679","url":null,"abstract":"<p><strong>Introduction: </strong>Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder characterized by recurrent intrusive thoughts and ritualized behaviors, often aimed at reducing distress. OCD is heterogeneous in its presentation and many patients with OCD experience a variety of different symptoms throughout their course of illness. Efforts to understand symptom domains in OCD have typically identified three to five symptom domains, such as the domains of doubt/checking, contamination, superstitions/rituals, symmetry/hoarding, and taboo thoughts. Recent studies in the genetics of OCD have suggested a common OCD dimension may provide additional information above and beyond the previously identified symptom domains. Thus, we sought to test a hierarchical model of lifetime OCD symptoms and evaluate the utility of the inclusion of a common OCD dimension.</p><p><strong>Methods: </strong>Participants included 999 individuals participating in the OCD Collaborative Genetics Study (OCGS) and an additional 2363 individuals participating in the OCD Genetic Association Study (OCGAS). We evaluated unidimensional, 5-factor, and hierarchical models of lifetime OCD symptom presentation using confirmatory factor analysis.</p><p><strong>Results: </strong>Results suggested that the hierarchical model best fit the data. Further evaluation of these models using a Bayesian testlet response model showed that lifetime presence of specific OCD symptoms was differentially associated with lifetime OCD severity. Moreover, symptoms associated with greater lifetime severity were generally reported less frequently than symptoms present at lower levels of lifetime severity. Implications of these findings and future directions are discussed.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e89"},"PeriodicalIF":4.6,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145430538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prescribing LAIs: from completing the first injection to going steady.","authors":"Andrew J Cutler, Meghan M Grady","doi":"10.1017/S1092852925100588","DOIUrl":"10.1017/S1092852925100588","url":null,"abstract":"<p><p>Non-adherence and even partial adherence to antipsychotic treatment can increase the risk of relapse in patients with schizophrenia. One strategy to improve adherence is through the use of long-acting injectable (LAI) antipsychotics. Multiple LAI antipsychotic options are available, which differ in terms of their formulation, administration, initiation, and maintenance dosing schedule. This article provides a practical guide to the conversion from oral to LAI antipsychotic treatment for the available LAI formulations as well as evidence-based principles for maintenance treatment.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"S30-S36"},"PeriodicalIF":4.6,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145387592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment and Treatment of Anosognosia in Schizophrenia.","authors":"Xavier Amador","doi":"10.1017/S1092852925100412","DOIUrl":"https://doi.org/10.1017/S1092852925100412","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"1-9"},"PeriodicalIF":4.1,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353933","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The repurposing of recreational drugs as medical treatments.","authors":"Seetal Dodd, Stephen M Stahl, Michael Berk","doi":"10.1017/S109285292510028X","DOIUrl":"10.1017/S109285292510028X","url":null,"abstract":"","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e88"},"PeriodicalIF":4.6,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354021","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin dose and timing: Do we have it right?","authors":"Shobha George, Anushree Sripathy, Aysha Rehman, Joseph George, Kanishk Chirayil, Emma Frost, Nalini Ramanathan, Simy Joseph, Karim Ghobrial-Sedky, Akshay Sripathy, Jose Maldonado, Jeff McCagh, Maju Mathew Koola","doi":"10.1017/S109285292510062X","DOIUrl":"10.1017/S109285292510062X","url":null,"abstract":"<p><p>Melatonin is an easily accessible, widely used drug for sleep issues, disrupted sleep-wake cycles, and jet lag, available in a variety of forms and dosages. Melatonin is also used in hospital settings to promote sleep onset, particularly in elderly patients, as a circadian rhythm regulator. Despite the popularity of melatonin, it is not approved by the US Food and Drug Administration (FDA). This creates ambiguity surrounding its proper usage for optimum results, including dosage and time of administration. The objective of this article is to shed light on the best timing to administer melatonin. Melatonin is a hormone that our body naturally produces to regulate our biological clock. Even though our body has a built-in \"sleep system,\" many people still suffer from chronic sleep disorders such as insomnia. Melatonin has also proved to help prevent delirium in hospitalized patients due to its circadian rhythm regulatory effects. The elderly are at risk of developing insomnia because as one ages, melatonin production decreases. The most convenient solution for insomnia is to take melatonin supplements. To optimize the effects of melatonin supplements, proper dosage and timing must be considered. Additionally, patients who are oppositional to bedtime, which is known as bedtime resistance, are typically more willing to go to bed following melatonin administration. Melatonin administration at around 6 PM (1-2 hours before bedtime) is optimal to regulate sleep cycles of patients, and it can help with bedtime resistance. This should be the standard of care in all hospitals, nursing homes, and at home.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e86"},"PeriodicalIF":4.6,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064696/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VMAT2 inhibitors for the treatment of tardive dyskinesia: a narrative review.","authors":"Amita R Patel, Robert A Hauser, Leslie Citrome, Laxman Bahroo, Tracy Hicks, Alta Maness, Khodayar Farahmand, Kira Aldrich, Dawn Vanderhoef, Andrew J Cutler","doi":"10.1017/S1092852925100643","DOIUrl":"10.1017/S1092852925100643","url":null,"abstract":"<p><p>Two vesicular monoamine transporter 2 (VMAT2) inhibitors, valbenazine and deutetrabenazine, are approved for the treatment of tardive dyskinesia (TD), a persistent and potentially disabling movement disorder associated with prolonged exposure to antipsychotics and other dopamine receptor blocking agents. Since their initial approval in 2017, new formulations and doses for both medications have become available, including a sprinkle capsule for valbenazine and a once-daily tablet for deutetrabenazine. In light of these new therapeutic options, a comprehensive scoping review was conducted to consolidate the current knowledge about these medications. Both valbenazine and deutetrabenazine are safe and effective in treating TD. However, as they are different drugs, one objective of this review is to describe their pharmacology and pharmacokinetics. Another objective is to summarize the similarities and differences as to how these medications are prescribed, specifically in terms of their warnings and precautions, their use in special populations, and recommendations for dosing when taken with concomitant medications. Results from double-blind, placebo-controlled clinical trials are presented, along with post hoc analyses that provide benchmarks for clinical relevance (eg, effect size, number needed to treat, minimal clinically important difference). As most patients with TD will require ongoing treatment, findings from long-term studies provide evidence for the safety and effectiveness of these medications.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e90"},"PeriodicalIF":4.6,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145343904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rebuilding the atrophied brain: 6-month nasal esketamine therapy expands key frontal and hippocampal regions and reduces serum neurofilament levels in patients with major depressive disorder. A proof-of-concept study of the depTesk (DEPression treatment with ESKetamine) study.","authors":"Ana Rodríguez Lorente, María Pilar Campos-Navarro, Ángela Gil Montoya, Celia Marín Pérez, María Luisa Maso Navarro, Tomás Orgaz Morales, Nuria López Ramirez, Juan Antonio García-Carmona","doi":"10.1017/S1092852925100631","DOIUrl":"10.1017/S1092852925100631","url":null,"abstract":"<p><strong>Objectives: </strong>This proof-of-concept study aimed to assess the impact of intranasal esketamine (ESK-IN) in brain volume and neurofilament light chain (sNfL) over 6-months in patients with treatment resistant depression (TDR).</p><p><strong>Methods: </strong>Seven TRD patients received ESK-IN while continuing oral antidepressants. Clinical evaluations were conducted at baseline, 1, 3, and 6 months, with MRI scans and blood samples taken at baseline and 6 months. Brain volume was assessed using VolBrain2 and DSI studio.</p><p><strong>Results: </strong>Compared to controls, TRD patients initially showed lower volumes (mm³) in key cortical regions such as the insula (p = 0.0156), the frontal lobe (p = 0.0228) the superior parietal lobe (p = 0.0402), both superior (p = 0.0216) and inferior (p = 0.0437) temporal lobes and subcortical regions such as the nucleus accumbens (p = 0.0056), putamen (p = 0.0083), thalamus (p = 0.0102) and the hippocampus (p = 0.0001). Brain volume increased in the frontal cortex (p = 0.0295), the anterior cingulate (p = 0.0496), and hippocampus (p = 0.0015), as well as in the volume and fiber tracts associated with emotional regulation, such as the frontoparahippocampal (p = 0.0156 and p = 0.0313, respectively), the frontoparietal (p = 0.0496 and p = 0.0156, respectively) and the frontal aslant tract after 6 months on treatment with ESK-IN. In parallel, sNfL levels decreased post-treatment, indicating potential neuroprotective effects.</p><p><strong>Conclusions: </strong>ESK-IN may promote structural changes in regions associated with mood regulation and neuroplasticity, while also reducing neuronal damage in TRD patients.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e83"},"PeriodicalIF":4.6,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of electroconvulsive therapy on cognition: an exploratory retrospective study.","authors":"Susanna Riessland, Pia Baldinger-Melich, Nicoletta Margreiter-Neuwirth, Ursula Kainzmayer, Ina Bozic, Rupert Lanzenberger, Richard Frey, Dan Rujescu, Vincent Millischer","doi":"10.1017/S1092852925100606","DOIUrl":"10.1017/S1092852925100606","url":null,"abstract":"<p><strong>Objectives: </strong>Electroconvulsive therapy (ECT) is one of the most effective treatments for depression, but worries about cognitive side effects remain. This retrospective study evaluated cognitive outcomes and the antidepressant efficacy of ECT in a real-life sample of patients with treatment-resistant uni- or bipolar depression.</p><p><strong>Methods: </strong>We included 90 depressed inpatients aged 49 ± 13.8 (SD) years who underwent 10 ± 2.1 (SD) unilateral or bitemporal ECT treatments and completed an extensive pre- and post-treatment psychological test battery. The Hamilton Depression Rating Scale (HAMD) and the Mini-Mental State Examination (MMSE) were evaluated as main outcomes pre-/post-ECT treatment.</p><p><strong>Results: </strong>There was no significant change in MMSE scores between pre-/post-treatment assessments (<i>β</i> = 0.10, 95% confidence interval [CI] [-0.44, 0.25], <i>p</i> = 0.58), indicating no negative effect on global cognition. A minority of patients (<i>N</i> = 3) experienced a reduction of ≥5 points in the MMSE. Most cognitive tests showed no difference; however, some domains revealed statistically significant improvements (visual learning and motoric reaction time), whereas one domain showed a significant decline (verbal learning). Higher age and higher stimulus doses predicted worse outcomes in some cognitive domains. While ECT significantly reduced depressive symptoms measured by HAMD (<i>β</i> = -5.51, 95% CI [-7.08, -3.94], <i>p</i> < 0.001), depressive symptoms were not associated with cognitive outcomes.</p><p><strong>Conclusions: </strong>No major cognitive changes were observed. While test results indicated deterioration in verbal learning and improvement in visual learning and motoric reaction time, effect sizes were small, and other cognitive tests showed no significant changes. The main limitation is the absence of retrograde memory assessment.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e87"},"PeriodicalIF":4.6,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of transcranial direct current stimulation combined with gait training in patients with Parkinson's disease: Systematic review and meta-analysis.","authors":"Ignacio Domínguez-Pera, David Lucena-Anton, Maria-José Estebanez-Perez, Jose-Manuel Pastora-Bernal, Rocío Martín-Valero","doi":"10.1017/S1092852925100618","DOIUrl":"10.1017/S1092852925100618","url":null,"abstract":"<p><p>Parkinson's disease, the second most prevalent neurological disorder, is a multisystem neurodegenerative disease characterized by both motor and non-motor symptoms. Transcranial direct current stimulation (tDCS) is a non-invasive brain neuromodulation technique that has been shown to be effective in some neurological conditions and for some clinical outcomes. To evaluate the efficacy of tDCS combined with gait training in Parkinson's disease, compared to placebo, absence of treatment, conventional therapy, or other therapies. A systematic review and meta-analysis were performed in accordance with the PRISMA guidelines and registered in PROSPERO CRD42024542552. The literature search was conducted in PubMed, CINAHL, SPORT Discus, Web of Science, Scopus, MEDLINE, and Academic Search Ultimate (EBSCO) databases up to May 2024, limited to trials from the last 10 years. A total of 600 articles were identified; 9 were included in the systematic review and 8 in the meta-analysis. Significant intra-group changes were observed, but in the meta-analysis, no significant differences were seen between tDCS + gait training and tDCS placebo + gait training, although variables such as motor function slightly favored the combination (MD = -0.49; 95% CI [-1.55; 0.57], I² = 0%). The combination of tDCS and gait training could provide significant motor benefits in terms of gait speed, functional mobility, cadence, motor function, quality of life, 6MWT, coordination and dynamic balance, flexibility, and stretch resistance in patients with Parkinson's disease, but not in a more effective way than the same training without stimulation.</p>","PeriodicalId":10505,"journal":{"name":"CNS Spectrums","volume":" ","pages":"e79"},"PeriodicalIF":4.6,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13064760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}