Innovations in clinical neuroscience最新文献

{"title":"Cultural Concepts of Distress: A Dive into Presentation and Avenues for Management.","authors":"Rahi Patel, Amin Ashraf, Nicholas Myers, Nita Bhatt","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Cultural concepts of distress, previously referred to as culture-bound syndromes, are psychiatric conditions influenced by cultural beliefs, history, and social norms. In the <i>Diagnostic and Statistical Manual of Mental Disorders</i>, fifth edition, these syndromes manifest as culturally specific expressions of psychosocial distress, though there is a lack of formal diagnostic criteria. This article explores three cultural concepts of distress, koro, Dhat, and latah syndromes, through fictional case vignettes to illustrate their clinical presentation, underlying psychiatric associations, and potential management strategies. Each syndrome and case contain unique factors of psychosocial distress and highlights necessary considerations with avenues for improved patient care.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 7-9","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A First Seizure After 2,000mg Fluoxetine May or May Not Be Due to Intoxication.","authors":"Josef Finsterer","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 7-9","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Difficulty Concentrating, Remembering, or Making Decisions According to Chronic Medical Conditions and Cannabis Use Among US Adults in 2022.","authors":"Ray M Merrill","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>Cannabis use and chronic diseases have both been associated with impaired cognitive ability. The current study will explore their independent and co-occurring effects on cognitive difficulty concentrating, remembering, or making decisions on the population level.</p><p><strong>Methods: </strong>This study used a probability sample of United States (US) adults aged 18 years or older from the 2022 Behavioral Risk Factor Surveillance System (BRFSS), a telephone-administered survey. The cross-sectional survey collects data from a representative sample regarding health-related risk behaviors, chronic health conditions, and use of preventive services.</p><p><strong>Results: </strong>The study sample consisted of 94,918 participants in the BRFSS survey that completed the optional module on cannabis use. The prevalence of having difficulty concentrating, remembering, or making decisions was 12.7 percent (standard error [SE]: 0.21%), prevalence of monthly cannabis use was 14.9 percent (SE: 0.24%), that of daily cannabis use was 7.4 percent (SE: 0.18%), and prevalence of any chronic medical condition was 59.2 percent (SE: 0.32%). The prevalence of having difficulty concentrating, remembering, or making decisions was higher for those with a chronic medical condition (17.6% [SE: 0.31%] vs. 5.7% [SE: 0.25%], Rao-Scott <i>p</i><0.0001). Such difficulty was also higher for those who used cannabis monthly (24.4% [SE: 0.731%] vs. 10.7% [SE: 0.21%], Rao-Scott <i>p</i><0.0001) or daily (29.1% [SE: 1.12%] vs. 11.4% [SE: 0.21%], Rao-Scott <i>p</i><0.0001). Greater cognitive difficulty for those with a chronic medical condition was accentuated by cannabis use; daily cannabis (vs. nonuse) was associated with 145-percent higher prevalence of cognitive difficulty and monthly cannabis use (vs. nonuse) was associated with 76-percent higher prevalence of cognitive difficulty. For those without a chronic medical condition, the prevalence of cognitive difficulty was 183- and 97-percent higher in daily and monthly cannabis users (vs. nonusers), respectively.</p><p><strong>Conclusion: </strong>In the general population, having a chronic medical condition significantly increased cognitive difficulty concentrating, remembering, or making decisions. Cannabis use (particularly daily use) significantly increased cognitive difficulty for people with each chronic condition included in this study. The greater cognitive difficulty with cannabis use was less pronounced in individuals with chronic conditions with higher difficulty at the outset, such as depression.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 7-9","pages":"32-39"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724966/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can You Properly Manage Delusional Parasitosis?","authors":"Adil Tumbi, Amit Mistry, BreAnna-Anh Le, Steven Lippmann","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Delusional parasitosis is a psychiatric disorder in which one experiences persistent, false delusions of being infected by parasites or other organisms. Symptoms include formication, pruritis, and self-inflicted cutaneous manifestations. In this article, we discuss the complicated case of a 45-year-old male patient with history of Crohn's disease, opioid use disorder, and post-traumatic stress disorder to highlight key concepts of the disease. The clinical presentation often leads to a broad differential diagnosis, which can complicate and delay treatment.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 7-9","pages":"40-41"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724970/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Office-based Neurophysiological Assessments for Diagnosis and Prognosis of Concussion.","authors":"Robert G Bashuk, Stephen L Scranton, Robert S Allen, Marco Cecchi","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Patients with concussion often receive insufficient and/or ineffective diagnostic workups. A limiting factor for prompt and accurate diagnosis is the scarcity of practical and effective concussion diagnostics that can be used by private-practice physicians. This gap in the diagnostic process can delay the implementation of crucial interventions. The absence of an affirmative concussion diagnosis leaves patients with few options when follow-up treatment would otherwise be indicated, potentially leading to worsening symptoms, prolonged recovery, and a higher likelihood of developing long-term complications. Neurophysiological assessments such as electroencephalography (EEG) and event-related potentials (ERPs) offer an opportunity for an objective evaluation of brain deficits that can occur after a concussion. By detecting abnormalities in brain patterns that are often associated with concussive injuries, these tests can help provide timely diagnosis and treatment of the disorder, thus reducing the likelihood of chronification of post-concussive symptoms. We reviewed a battery of neurophysiological assessments that have been scientifically validated to detect the pathophysiological effects of concussion and can be performed in office settings by nonspecialist technicians. These assessments are designed to help with diagnosis and prognosis of concussion, while also being accessible and practical to administer for private-practice physicians who can incorporate them into routine evaluations of patients with traumatic brain injury (TBI). The implementation of neurophysiological tools in primary care and outpatient settings has the potential to bridge the gap between symptom presentation and definitive diagnosis, thus mitigating the risk for long-term adverse outcomes.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 7-9","pages":"18-23"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12724993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pranayama as a Monotherapy to Manage the Symptoms of Dissociative (Conversion) Disorders Among Girls and Women: A Case Series.","authors":"Devendra Kumar Singh Varshney, Manju Agrawal, Rakesh Kumar Tripathi, Satish Rasaily","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>This case series is an inaugural attempt to provide a feasible management plan for symptoms of dissociative (conversion) disorders among adolescent girls and women using pranayama, a systematic and rhythmic yogic breathing technique. Dissociative disorders are frequently reported among adolescent girls and women across different cultures and states in India. The neurobiology of dissociative disorders is not clearly understood. Hence, there is no effective medication available. There are no scientific reports available on the use of pranayama for dissociative disorders.</p><p><strong>Methods: </strong>This study presents three female patients (aged 17 years, 26 years, and 14 years) who underwent pranayama therapy instead of conventional management in outpatient settings for four weeks. A pranayama intervention module was designed based on their specific symptoms, using the Dissociative Experiences Measurement Oxford (DEMO) scale. After four weeks, the results were documented, and all three patients were advised to continue the daily practice of pranayama for 30 minutes in the morning and evening.</p><p><strong>Results: </strong>All three patients reported improvement in breathlessness, restlessness, sleep, focus and concentration, feeling numb and disconnected, memory blanks, and vivid internal world. A follow-up was done after four weeks of completion of the pranayama intervention. No adverse effects were noted during the four weeks of intervention and at follow-up.</p><p><strong>Conclusion: </strong>This case series testifies to the potential efficacy of pranayama intervention in managing the symptoms of dissociative disorders among adolescent girls and women. Further studies are required on a large sample size to validate the role of pranayama in the management of symptoms of dissociative disorders as an independent intervention.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 4-6","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement-based Care Training Curriculum in Psychiatry Residency Programs: Four-year Implementation Experience and Future Directions.","authors":"Ahmed Aboraya, Daniel Elswick, James Berry, Dilip Chandran, Cheryl Hill, Wanhong Zheng, Jeremy D Hustead, Dorothy Van Oppen, Vishal Patel, Sara Berzingi, Karen Wang, Daniel Grimes, Gerard Gallucci, Dolly Mishra, Ramita Shrestha, John Justice, Paramjit Chumber, Abid Rizvi, Deep Yadava, Issaiah Wallace, Joy Parks, Tina Spence, Morsi Abdallah, Jehad Albitar, Ryan Murphy, Olwy Aboelnour, Mohamed Sakr, Richard Cadenas, Amanda Durazo, Albaraa Badawood, Luke Stover, Richard Burd, Christopher Feghali, Sunanda Mattancheril, Triet Tran, Seth Moomaw, Salwa Nubani, Venkat Mokkapati, Talha Siddiqui, Naveed Shaikh, Uzma Ansari, Abby Chainani, Krystle Mishra, Krupa Patel, Sara Perez-Pujols, Khadija Siddiqui, Sona Xavier, Emeka Boka, Jonathan Hyacinthe","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Objective: </strong>In 2019, the authors began implementing a measurement-based care (MBC) curriculum into two residency programs at West Virginia University (WVU) and Delaware Psychiatric Center (DPC). The authors present findings from the four-year implementation period and describe a web-based MBC course that aims to train attendings and residents across the United States (US) and abroad.</p><p><strong>Methods: </strong>The web-based MBC course includes four readings (the MBC instruction manual, the Standard for Clinicians' Interview in Psychiatry [SCIP] glossary, clinician-administered [CA] scales, and self-administered [SA] scales), four didactic presentations (MBC basics, psychopathology assessment, epidemiological concepts, and psychiatric measures), and four video interviews. The web-based MBC course is accessible through the WVU online continuing medical education (CME) web courses. The modified MBC psychiatry residency training curriculum includes four didactic lectures taught by MBC-trained faculty members and attendings. Residents practice using the scales during their inpatient and outpatient rotations and complete the web-based MBC course before graduation.</p><p><strong>Results: </strong>The web-based MBC course was used to train most of the attendings in the WVU and DPC residency programs. Both programs now require residents to complete the web-based MBC course before graduation. Of the 52 residents in both programs, 26 residents (50%) had completed the training at the time of writing this article.</p><p><strong>Conclusion: </strong>The web-based MBC course was successfully implemented in two US residency programs and is now available for clinicians around the world to access. Free access to the SCIP scales will be granted to psychiatry residency programs implementing the MBC curriculum.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 4-6","pages":"20-26"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intranasal Esketamine in Patients with Treatment-resistant Depression Who Have Previously Failed Transcranial Magnetic Stimulation: A Case Series.","authors":"Rabeel Ahmad, Samantha Shor, Genesy Aickareth, Roselyn Chiyezhan, Meghna Mathews, Isabel Chacko, Brett Pontelandolfo, Joanne Mathews","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Treatment-resistant depression (TRD) is major depression that has not responded to at least two trials of antidepressants. The STAR-D study highlighted the necessity of multiple treatment steps to achieve remission, with each step decreasing the likelihood of success and increasing relapse risk, underscoring the complexity of TRD treatment and the need for personalized approaches. Transcranial magnetic stimulation (TMS) is a noninvasive technique using magnetic fields to stimulate brain nerve cells, targeting the dorsolateral prefrontal cortex, that is effective in many patients with depression. However, for patients with TRD who fail TMS, no standard of care exists. Intranasal esketamine, a noncompetitive N-methyl-D-aspartic acid (NMDA) receptor antagonist, is approved for adults with TRD or major depressive disorder with suicidal thoughts. We present a case series of five patients with TRD who failed TMS and subsequently responded to intranasal esketamine. Response, defined as a 50-percent symptom reduction, was monitored using Patient Health Questionnaire (PHQ-9), Beck Depression Inventory (BDI), and Generalized Anxiety Disorder-7 (GAD-7) scores. After 16 treatment sessions, all patients achieved a treatment response per PHQ-9 and BDI scores; 80 percent achieved complete remission per PHQ-9, and 60 percent per BDI. Additionally, 80 percent of patients showed a treatment response on GAD-7 scores. This case series supports further investigation into esketamine for patients with TRD who are unresponsive to TMS.</p>","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 4-6","pages":"27-28"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of a Clinical Decision Support Tool for Quantifying Risk of Torsades de Pointes in a Psychiatric Inpatient Population.","authors":"Samara White, Tammie Lee Demler, Eileen Trigoboff","doi":"","DOIUrl":"","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Psychiatric inpatients often require complex medication regimens due to the refractory nature of their serious mental illness (SMI) and the high prevalence of medical comorbidities. Among the many inherent issues associated with these regimens are the potential pharmacodynamic drug interactions resulting in an increased risk of QTc prolongation and the potential sequelae, Torsades de Pointes (TdP). This study builds on previous research that demonstrated the utility of the MedSafety Scan (MSS) clinical decision support (CDS) tool by establishing theoretical evidence from patients with SMI but did not provide objective data to validate its use in this population. This has left prescribers questioning whether the MSS CDS tool is capable of accurately guiding prescribing decisions in this vulnerable patient population. Therefore, the objective of this study was to assess the degree of correlation between psychiatric patients' QTc intervals and their MSS-calculated TdP risk scores to objectively validate the predictive impact and clinical value of the MSS tool in psychiatric inpatients for the purpose of informing safe prescribing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted to assess the relationship between participants' MSS TdP risk scores and their QTc Δ, defined as the difference between participants' measured QTc intervals and sex-specific QTc prolongation thresholds (female individuals: 470ms; male individuals: 450ms). The MSS TdP risk score is calculated based on patient demographic data, medical diagnoses, serum electrolyte values, and medications. Data from 251 subjects were extracted from an adult inpatient psychiatric facility's electronic medical record system from February 1, 2018, through November 30, 2023. Inpatients with a documented electrocardiogram during the study period were eligible for inclusion, and the exclusion criterion was having a Criminal Procedure Law (CPL) designation. Data were analyzed using a one-way analysis of variance (ANOVA) with alpha set to 0.01.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The data from the ANOVA that compared participants' QTc Δ to MSS TdP risk score were found to be significant (&lt;i&gt;p&lt;/i&gt;&lt;0.01).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This study showed that the MSS CDS tool accurately reflected the relationship between our psychiatric inpatients' measured QTc intervals and their predicted MSS TdP risk scores, which objectively validated the predictive impact and clinical utility of this tool in our psychiatric population. Prescribers can use this tool to mitigate QTc prolongation risk for patients without underlying, unknown congenital risk; therefore, this can be an important course of action in treating psychiatric patients, given their predisposition to decreased lifespans and their increased risk of QTc prolongation due to SMI-related proarrhythmic factors. The MSS tool is an open-source, web-based CDS tool that provides comprehensive analyses of ","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 4-6","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333500/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges of Psychiatric Diagnostic Support Using Functional Near-infrared Spectroscopy.","authors":"Takahiko Nagamine","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":13635,"journal":{"name":"Innovations in clinical neuroscience","volume":"22 4-6","pages":"12-13"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}