Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change During the Disease Course.","authors":"Christopher B Morrow, Chiadi Onyike, Alexander Pantelyat, Gwenn S Smith, Jeannie Leoutsakos, Andreia V Faria, Neill R Graff-Radford, R Ryan Darby, Nupur Ghoshal, Adam M Staffaroni, Katya Rascovsky, Toji Miyagawa, Akshata Balaji, Kyrana Tsapkini, Maria I Lapid, Mario F Mendez, Irene Litvan, Belen Pascual, Julio C Rojas, Zbigniew K Wszolek, Kimiko Domoto-Reilly, John Kornak, Vidyulata Kamath","doi":"10.1176/appi.neuropsych.20240134","DOIUrl":"10.1176/appi.neuropsych.20240134","url":null,"abstract":"<p><strong>Objective: </strong>Hyperorality is a core feature of behavioral variant frontotemporal dementia (bvFTD); however, the cognitive, psychiatric, and neuroanatomical correlates of hyperorality across the bvFTD stages remain unclear. The authors explored these associations in early- and advanced-stage bvFTD.</p><p><strong>Methods: </strong>Participants with sporadic or genetic bvFTD were enrolled in the ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) consortium study. Baseline cognitive and psychiatric symptoms of participants with or without hyperorality were compared after stratification by disease severity. Linear multivariable regressions adjusted for age and total intracranial volume were used to examine associations between regional gray matter volume (GMV) and hyperorality status. Five anatomical regions of interest were preselected for analysis on the basis of previously identified neuroanatomical correlates of hyperorality in bvFTD.</p><p><strong>Results: </strong>Hyperorality was present in 50% of early-stage bvFTD participants (N=136) and was associated with higher rates of ritualistic-compulsive behavior and difficulty detecting social-emotional expressions. Hyperorality was present in 63% of advanced-stage participants (N=208) and was associated with higher rates of apathy, ritualistic-compulsive behavior, and socially aberrant behavior. Regional GMV was similar for those with or without hyperorality among early-stage participants. Among advanced-stage participants, hyperorality was associated with lower GMV in the right dorsal and ventral striatum.</p><p><strong>Conclusions: </strong>Hyperorality emerged early in bvFTD and was accompanied by deficits in social cognition and complex-ritualistic behavior before clinically significant GMV loss. These findings suggest that early identification and management of hyperorality could improve neuropsychiatric trajectories in bvFTD.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"31-37"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143710284","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommendations for Refining the Diagnosis of Functional Cognitive Disorder.","authors":"Ryan Van Patten","doi":"10.1176/appi.neuropsych.20250279","DOIUrl":"10.1176/appi.neuropsych.20250279","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"416-418"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cutoff Points for Commonly Used Instruments to Assess Mental Health Problems Among Adults With Tourette's Syndrome.","authors":"Rachael Nicholls, Tamara Pringsheim, Davide Martino, Chenhui Hao, Julian Fletcher, Natalia Szejko","doi":"10.1176/appi.neuropsych.20240226","DOIUrl":"10.1176/appi.neuropsych.20240226","url":null,"abstract":"<p><strong>Objective: </strong>Attention-deficit hyperactivity disorder, obsessive-compulsive disorder, depression, and anxiety are highly comorbid in Tourette's syndrome. Cutoff points of screening instruments for these conditions have been validated in the general population. The authors assessed whether established cutoff points on the General Anxiety Disorder-7 (GAD-7) scale; Patient Health Questionnaire-9 (PHQ-9); PHQ-2; Adult ADHD Self-Report Scale, version 1.1 (ASRS v1.1); and Obsessive-Compulsive Inventory (OCI) need to be adjusted for adults with Tourette's syndrome.</p><p><strong>Methods: </strong>Thirty-six adults with Tourette's syndrome completed these instruments and a diagnostic psychiatric interview. Measures of diagnostic accuracy were calculated (area under the receiver operating characteristic curve [AUC], sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio) for each instrument at various cutoffs. Cutoffs for the sample of adults with Tourette's syndrome were suggested by the lowest value derived from a Euclidean distance method.</p><p><strong>Results: </strong>In this sample of adults with Tourette's syndrome, the optimal cutoff points were a GAD-7 score ≥13 (sensitivity, 67%; specificity, 91%; and AUC, 79%), a PHQ-9 score ≥15 (sensitivity, 67%; specificity, 73%; and AUC, 70%), a PHQ-2 score ≥3 (sensitivity, 67%; specificity, 67%; and AUC, 67%), an ASRS v1.1 score ≥14 (sensitivity, 83%; specificity, 77%; and AUC, 80%), and an OCI score ≥63 (sensitivity, 70%; specificity, 89%; and AUC, 79%). The best-performing instrument was the ASRS v1.1, followed by the GAD-7 and OCI; the PHQ-9 and PHQ-2 performed least well in this population.</p><p><strong>Conclusions: </strong>Further research is needed to adapt screening instruments for the assessment of comorbid conditions among patients with Tourette's syndrome.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"53-60"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of Positive Signs of Functional Neurological Disorder With Headache Severity: A Prospective Cross-Sectional Study.","authors":"Eric Morel, Antonia Klein, Adrian Scutelnic, Janine Bühler, Selma Aybek, Christoph Schankin","doi":"10.1176/appi.neuropsych.20250004","DOIUrl":"10.1176/appi.neuropsych.20250004","url":null,"abstract":"<p><strong>Objective: </strong>Positive signs are clinical signs that are not explained by a structural neurological lesion and are considered the hallmark of functional neurological disorder (FND). In the literature and in clinical experience, positive signs are observed among patients without FND. The aim of the study was to examine the significance of positive signs among headache patients.</p><p><strong>Methods: </strong>The authors of this prospective study recruited patients in headache consultation at the University Hospital Inselspital, Bern, Switzerland. Inclusion criteria were headache or facial pain in the past 3 months and age ≥18 years. The exclusion criterion was a known diagnosis of FND. All patients were examined for 14 validated positive signs: give-way weakness, co-contraction, sternocleidomastoid sign, trapezius elevation test, head flexion test, drift without pronation, Hoover I and II, spinal injury test, arm drop test, lip-pulling sign, midline splitting, splitting of vibration sign at the front, and expressive behavior sign.</p><p><strong>Results: </strong>In total, 101 patients were recruited (69% female; mean±SD age=40.8±16.3 years), of whom 43% showed positive signs. Splitting of vibration was the most common sign (27%); the other signs were less frequent (≤10%). Patients with positive signs were older than patients without such signs and had more monthly headache days and exacerbations as well as more intense headache at examination. Multivariable logistic regression revealed a significant association between positive signs and exacerbation days per month (OR=1.08, 95% CI=1.01-1.14, per exacerbation day; p=0.019).</p><p><strong>Conclusions: </strong>Positive signs are frequent among headache patients and point toward a more severe headache condition. This finding suggests overlapping mechanisms in headache and FND.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"84-92"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hunting for an Answer: Misdiagnosis of Huntington's Disease as Schizophrenia.","authors":"Anisha Narayan, Jennifer Wang, Lia DeRoin, Victor Valencia, Joseph J Cooper","doi":"10.1176/appi.neuropsych.20250045","DOIUrl":"10.1176/appi.neuropsych.20250045","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"205-208"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Nicotine Pouches: An Emerging Central Nervous System Toxicant.","authors":"Wilfredo López-Ojeda, Robin A Hurley","doi":"10.1176/appi.neuropsych.20250291","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250291","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 2","pages":"A4-106"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seeing Depression Through a Cultural Lens.","authors":"Alya Reeve","doi":"10.1176/appi.neuropsych.20250143","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250143","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 3","pages":"309"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Measurement of Multiple Dynamic Pupillary Variables in the Neuropsychiatric Assessment of TBI: A Case Report.","authors":"William V McCall, Brian J Miller, Michael M Zarreii, Steven E Brooks","doi":"10.1176/appi.neuropsych.20250036","DOIUrl":"10.1176/appi.neuropsych.20250036","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"300-303"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The American Psychiatric Association Practice Guideline for the Prevention and Treatment of Delirium: Updated Implications for Patient Care.","authors":"Mark A Oldham, Laura J Fochtmann, Catherine Crone","doi":"10.1176/appi.neuropsych.20250203","DOIUrl":"10.1176/appi.neuropsych.20250203","url":null,"abstract":"<p><p>Delirium occurs in a significant proportion of hospitalized and older patients, contributing to increased morbidity and mortality rates, lengthier hospitalizations, increased readmissions, higher health care costs, greater odds of persistent functional decline, and psychological distress for patients, their families, and clinicians. Given that the global population continues to age, the incidence of delirium is expected to rise. The recently updated American Psychiatric Association Practice Guideline for the Prevention and Treatment of Delirium includes 15 statements to help clinicians prevent delirium, improve its detection, and optimize treatment for delirium in adult patient populations. In this analysis and commentary, the authors review each of the guideline statements, providing context and discussion of their clinical implications.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"410-415"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146125154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Trajectories After Hospitalization for COVID-19: A 36-Month Longitudinal Study.","authors":"Maria Paula Maziero, Eunyoung A Lee, Gabriela D Colpo, Lucy Couture, Livia C Merrill, Lynae Baskin, Ana E Cahuiche, Ana Petway, Huihui Fan, Elizabeth Reese, Kendra M Anderson, Louise D McCullough, Paul E Schulz, Guadalupe Javier Ortiz","doi":"10.1176/appi.neuropsych.20250267","DOIUrl":"10.1176/appi.neuropsych.20250267","url":null,"abstract":"<p><strong>Objective: </strong>Neurological symptoms are commonly reported among individuals with postacute sequelae of COVID-19 (PASC), with cognitive impairment being the most common feature, but cognitive trajectories in PASC have not been clearly defined. The authors determined long-term cognitive changes in a cohort of individuals hospitalized with COVID-19, characterized their distinct cognitive trajectories, and identified factors associated with each trajectory at 36 months posthospitalization.</p><p><strong>Methods: </strong>The sample comprised 630 patients who were hospitalized with severe COVID-19 symptoms; 214 patients returned for at least one follow-up assessment over a 36-month period. Cognitive function, including attention, cognitive flexibility, processing speed, and memory, was evaluated by using BrainCheck, a validated digital platform, at 3-6, 12, 24, and 36 months posthospitalization. Longitudinal changes in cognitive performance and their associations with demographic factors, medical history, and neuropsychiatric symptoms were analyzed with linear mixed-effects models.</p><p><strong>Results: </strong>Four distinct cognitive trajectories over 36 months were identified and characterized. Group 1 (N=103, 48%) exhibited consistent normal cognitive function, group 2 (N=14, 7%) transitioned from unimpaired to impaired, group 3 (N=29, 14%) changed from impaired to unimpaired, and group 4 (N=68, 32%) showed persistent impairment across all domains. Poorer cognitive outcomes were associated with Hispanic ethnicity, although effects varied across domains.</p><p><strong>Conclusions: </strong>As with many viral encephalitides, some patients showed stable normal or abnormal cognition or improved cognition over time. Surprisingly, however, a fourth subset exhibited delayed cognitive decline. This observation suggests that PASC-associated mechanisms, perhaps including chronic cerebral inflammation, may cause progressive cognitive impairment well after the initial infection clears.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"350-359"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}