Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"Long-Term Neuropsychiatric Sequelae of COVID-19 in an Open Population: A Prospective Pilot Study.","authors":"Zeltzin González Rosas, Hanna Samara Martínez-Jiménez, Manuel Arroyo-Landín, Gladis Fragoso, María Chávez-Canales, Marisela Hernández, Marcos Francisco Rosetti, Juan Carlos López-Alvarenga, Edda Sciutto, Graciela Cárdenas","doi":"10.1176/appi.neuropsych.20240040","DOIUrl":"10.1176/appi.neuropsych.20240040","url":null,"abstract":"<p><strong>Objective: </strong>COVID-19 has been associated with a wide range of systemic and neurological complications, known as long COVID or postacute sequelae of COVID-19 (PASC). Such sequelae can be observed among all infected individuals, even among those with a mild disease course. Dysbiosis, a common condition associated with low-grade inflammation, has been proposed as a potential mechanism of PASC by altering levels of circulating lipopolysaccharide (LPS) and the tryptophan pathway metabolites kynurenine and quinolinic acid, known to affect neurocognitive function. The authors evaluated the evolution of neurological, neurocognitive, and neuropsychiatric COVID-19 sequelae and their relationship with circulating LPS and kynurenine and quinolinic acid levels.</p><p><strong>Methods: </strong>A prospective, longitudinal, and analytical study was conducted. Neurological, neurocognitive, and neuropsychiatric assessments of participants who had recovered from COVID-19 and did not require hospitalization during the acute stages of the infection were performed. Peripheral levels of LPS and tryptophan metabolites were measured 1, 3, 6, and 12 months after infection.</p><p><strong>Results: </strong>Of 95 participants recruited, 67 COVID-19-convalescent individuals and 20 COVID-19-free individuals were included. Significantly higher occurrences of asthenia, olfaction and taste alterations, headache, memory dysfunction, and systemic symptoms such as dyspnea, cough, and periodontal diseases were found among participants in the COVID-19-convalescent group compared with participants in the comparison group. A significant decrease in kynurenine levels, which correlated with cognitive impairment, was observed among PASC convalescents.</p><p><strong>Conclusions: </strong>Significant neurocognitive and neuropsychiatric impairments were observed among COVID-19-convalescent individuals, along with decreased kynurenine levels, which recovered during a 12-month follow-up period.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"68-75"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094081","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":"Longitudinal Relationships of Amygdalar and Hippocampal Volumes With Anxiety After Pediatric Traumatic Brain Injury.","authors":"Amaryllis Fernandes, Kelly Vaughn, Dana DeMaster, Linda Ewing-Cobbs","doi":"10.1176/appi.neuropsych.20240139","DOIUrl":"10.1176/appi.neuropsych.20240139","url":null,"abstract":"<p><strong>Objective: </strong>Traumatic brain injury (TBI) often involves injury to limbic structures that may be linked to posttraumatic psychological health difficulties. The authors investigated whether the relationship of amygdala and hippocampal volumes with anxiety differed among children with TBI versus children without a history of TBI over time since injury.</p><p><strong>Methods: </strong>Structural MRI scans were acquired for children ages 8-15 years at 7 weeks (time point 1) and 14 months (time point 2) after a TBI (N=51) as well as for age-matched healthy control (HC) children (N=36). The Screen for Child Anxiety Related Emotional Disorders (SCARED) was administered at both time points. Generalized linear models were used to evaluate the relationship of limbic volumes, experimental group, time of scan, and their interactions with SCARED scores. Pubertal status at time point 1, sex, and total gray matter volume were included as covariates.</p><p><strong>Results: </strong>The group × volume × time interaction was statistically significant for both structures bilaterally. Relative to the HC group, children with TBI showed altered directionality of the relationship of amygdala and hippocampal volumes with SCARED scores that changed between the two time points. During the subacute stage of recovery, higher self-reported anxiety was associated with larger amygdala and hippocampal volumes. During the chronic stage, higher anxiety was associated with lower volumes. SCARED scores were higher among girls than among boys when limbic volumes were controlled for.</p><p><strong>Conclusions: </strong>TBI significantly affected the typical relationship between amygdala and hippocampal volumes and anxiety scores, suggesting that limbic volumes may serve as markers of later developing psychological health.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"256-263"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145452268","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":"<i>Taking Control of Your Functional Cognitive Symptoms: Workbook</i>-A Novel Intervention.","authors":"Erica Cotton, Kristen Mordecai, Laura McWhirter, Veronica Cabreira, Ryan Van Patten, Noah Silverberg, Aaron Kaat, W Curt LaFrance","doi":"10.1176/appi.neuropsych.20240231","DOIUrl":"10.1176/appi.neuropsych.20240231","url":null,"abstract":"<p><strong>Objective: </strong>Functional cognitive disorder (FCD) is a subtype of functional neurological disorder (FND). FCD may include various cognitive symptoms, precipitants, and comorbid conditions (such as other FNDs, concussion, fatigue, or fibromyalgia). However, no widely available behavioral health interventions exist for FCD. The authors developed a therapist-guided and patient-led treatment for veterans and civilians with FCD.</p><p><strong>Methods: </strong>A well-known evidence-based treatment for functional seizures (an FCD-adjacent condition often with cognitive symptoms) was adapted to fit hypothesized mechanisms of FCD. The process used a health research format following the guidance for reporting intervention development studies. Key processes included determining the broad intervention framework, obtaining detailed FCD-specific content based on expert consensus, collecting evidence, developing theory, conducting target population-centered approaches, considering specialty subgroups, and gathering feedback from veteran and civilian stakeholders.</p><p><strong>Results: </strong>The authors created a comprehensive 14-chapter manualized therapist-guided neurobehavioral therapy protocol for FCD symptoms independent of etiology, the <i>Taking Control of Your Functional Cognitive Symptoms: Workbook.</i> Initial feasibility, tolerability, and utility were assessed with two target-population stakeholders with FCD (one civilian patient and one veteran patient), with both reporting a Patient Global Impression of Change scale rating of 1 (indicating that their condition had very much improved).</p><p><strong>Conclusions: </strong>This promising new multimodality behavioral health intervention can be considered to be in stage 1 (i.e., intervention generation, refinement, modification, adaptation, and pilot testing). Further pilot testing is being conducted and will need to be followed by traditional efficacy testing (in stage 2).</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"153-162"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12810142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212969","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":"Traumatic Brain Injury: State-of-the-Science Advances in the <i>Journal of Neuropsychiatry and Clinical Neurosciences</i>.","authors":"Erik Fraunberger, Margo D Lauterbach, Lindsey J Gurin, David B Arciniegas","doi":"10.1176/appi.neuropsych.20263804","DOIUrl":"10.1176/appi.neuropsych.20263804","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"424-428"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874263","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":"Sleep: State-of-the-Science Advances in the <i>Journal of Neuropsychiatry and Clinical Neurosciences</i>.","authors":"Melissa B Jones, Margo D Lauterbach, Taryn White, David B Arciniegas","doi":"10.1176/appi.neuropsych.20263801","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20263801","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 1","pages":"101-102"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030051","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":"Understanding the Role of Neuropsychiatric Symptoms in Functional Decline in Alzheimer's Disease.","authors":"Carolyn W Zhu, Lon S Schneider, Laili Soleimani, Judith Neugroschl, Hillel T Grossman, Corbett Schimming, Mary Sano","doi":"10.1176/appi.neuropsych.20250015","DOIUrl":"10.1176/appi.neuropsych.20250015","url":null,"abstract":"<p><strong>Objective: </strong>The authors explored classes of neuropsychiatric symptoms (NPSs) in Alzheimer's disease (AD), examined the relationship between NPS classes on rate of functional decline over time, and determined whether effects of individual symptoms on functional decline remained after controlling for NPS classes.</p><p><strong>Methods: </strong>The authors longitudinally analyzed 9,797 study participants with mild cognitive impairment or AD at baseline in the National Alzheimer's Coordinating Center Uniform Data Set. Function was measured with the Functional Assessment Questionnaire, and NPSs were assessed by using clinician judgment. Latent class analysis (LCA) was used to identify clusters of individuals who shared similar NPS profiles. Linear mixed models were used to estimate the relationship between NPS classes and individual symptom profiles in functional decline over time.</p><p><strong>Results: </strong>LCA revealed four distinct NPS classes: an asymptomatic-mild group (48.2% of the sample, N=4,721), a second group predominantly having apathy and depression (36.4%, N=3,562), a third group with high rates of multiple symptoms except for hallucinations (12.8%, N=1,250), and a small group with high rates of all symptoms (complex class, 2.7%, N=264). NPS classes differed in baseline function but were not significantly associated with rate of functional decline. When NPS classes were controlled for, persistent apathy remained strongly associated with a faster rate of functional decline. Effects of apathy were observed across NPS classes and disease severity levels.</p><p><strong>Conclusions: </strong>Specific symptoms rather than classes of symptoms were associated with the trajectory of functional decline in AD. Apathy may be particularly useful for tracking longitudinal changes in function.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"144-152"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12320021/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144497343","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":"Treatments for Functional Neurological Disorder: A Practical Guide for Program Development.","authors":"Michael Martyna, Julie Muccini, Gisela Sandoval, Mark Fusunyan, Kim Bullock, Sepideh Bajestan, John J Barry, Juliana Lockman","doi":"10.1176/appi.neuropsych.20230213","DOIUrl":"10.1176/appi.neuropsych.20230213","url":null,"abstract":"<p><p>Functional neurological disorder (FND) is an often-disabling condition with a complex path to diagnosis, further challenged by limited availability of evidence-based treatment resources. Providers hoping to offer treatment resources face the challenge of identifying effective and sustainable implementation of interventions. The existing literature provides limited guidance on the logistics of creating specialized programs for FND outside of tertiary care centers or high-resource medical settings. Members of a multidisciplinary treatment team may find it challenging to identify program development resources that provide a unified perspective on each member's role and how they function together. The authors' FND program at the Stanford University School of Medicine has recently fielded a high number of requests by clinicians, health care staff, and administrators across the United States for collaboration to start new programs. Frequently asked questions include the criteria for patient selection, what personnel to include, how to ensure prompt staff responses to FND symptoms, when to hospitalize patients, how to obtain funding for services, and more. The intended audience for this review includes seasoned and new clinicians, allied health professionals, and nonclinicians, including administrators. The authors discuss diagnosis and evidence-based treatment strategies and provide guidance on practical issues, including work, disability, and driving. The authors' program experience is highlighted as an example, and alternative working models are discussed. The aim of this article is to improve providers' knowledge and confidence and remove frequently encountered barriers to program development. The authors seek to provide a resource that may help connect those in need of care to FND services.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"217-230"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145540558","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":"From Billing Codes to Breakthroughs: Filtering Signal From Noise in Electronic Medical Records-Based Research.","authors":"Erica B Baller","doi":"10.1176/appi.neuropsych.20250029","DOIUrl":"10.1176/appi.neuropsych.20250029","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"304-306"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086277","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":"In Memoriam: Robert G. Robinson, M.D., F.A.N.P.A.","authors":"Ricardo E Jorge, Sergio S Starkstein, David B Arciniegas","doi":"10.1176/appi.neuropsych.20250232","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250232","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 1","pages":"100"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146029998","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":"Klotho and Senescence: From Molecules to Brain Function.","authors":"Wilfredo López-Ojeda, Robin A Hurley","doi":"10.1176/appi.neuropsych.20250242","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250242","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 1","pages":"A4-4"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146030000","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}