Journal of Neuropsychiatry and Clinical Neurosciences最新文献

{"title":"The Heart-Brain Circuit: Cardiac Neurons and the Amygdalar Neuraxis.","authors":"Wilfredo López-Ojeda, Robin A Hurley","doi":"10.1176/appi.neuropsych.20260067","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20260067","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"38 3","pages":"A4-216"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148447363","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":"Dimensional Apathy as a Predictor of Health-Related Quality of Life in Parkinson's Disease.","authors":"Hannah Darwazah, Hannah L Combs, Robert M Roth, Jared B Hammond, Nora S Vanegas-Arroyave","doi":"10.1176/appi.neuropsych.20250186","DOIUrl":"10.1176/appi.neuropsych.20250186","url":null,"abstract":"<p><strong>Objective: </strong>Apathy, defined as diminished self-initiated purposeful behavior, is common in Parkinson's disease (PD) and affects health-related quality of life (HRQoL). Although apathy is now recognized as a multidimensional syndrome, the contributions of total apathy and its dimensions to HRQoL, when mood and cognition are accounted for, remain unclear. The authors examined these relationships for individuals with PD.</p><p><strong>Methods: </strong>Twenty-eight adults with PD without dementia completed the Dimensional Apathy Scale (DAS), General Anxiety Disorder-7 (GAD-7), Beck Depression Inventory-II (BDI-II), Parkinson's Disease Questionnaire-39, and a neuropsychological battery. Motor severity was assessed via the Movement Disorders Society-Unified Parkinson's Disease Rating Scale part III (MDS-UPDRS III). A cognitive composite score reflected mean within-individual performance across cognitive tests. Hierarchical regression analyses were conducted to identify predictors of HRQoL.</p><p><strong>Results: </strong>GAD-7, BDI-II, MDS-UPDRS III, and cognitive composite scores explained 61% of the variance in HRQoL (R²=0.605, p<0.001). Adding the DAS total score to the analysis accounted for an additional 9% of the variance (ΔR²=0.088, p=0.026), with greater apathy being associated with lower HRQoL (β=0.369, p=0.026). Secondary analyses revealed that this effect was driven exclusively by the DAS executive subdomain.</p><p><strong>Conclusions: </strong>Total apathy and executive apathy have distinct negative effects on HRQoL in PD when mood and cognition are controlled for in analyses. These findings highlight the importance of assessing apathy subdomains in the setting of PD.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"389-394"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147355313","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":"Suicidal Ideation in Spinocerebellar Ataxia.","authors":"Levi Peppel, Ruo-Yah Lai, Christian Rummey, Puneet Opal, Jeremy D Schmahmann, Christopher M Gomez, Henry Paulson, Theresa A Zesiewicz, Susan Perlman, George Wilmot, Sarah H Ying, Chiadi U Onyike, Khalaf O Bushara, Michael D Geschwind, Karla P Figueroa, Stefan M Pulst, Sub H Subramony, Antoine Duquette, Tetsuo Ashizawa, Ali G Hamedani, Marie Y Davis, Sharan R Srinivasan, Matthew R Burns, Nadia Amokrane, Lauren R Moore, Vikram G Shakkottai, Liana S Rosenthal, Sheng-Han Kuo, Chi-Ying R Lin","doi":"10.1176/appi.neuropsych.20250006","DOIUrl":"10.1176/appi.neuropsych.20250006","url":null,"abstract":"<p><strong>Objective: </strong>Suicidal ideation has not been extensively studied in spinocerebellar ataxias (SCAs). The authors examined whether individuals with SCAs have increased suicidal ideation and related factors.</p><p><strong>Methods: </strong>The authors studied patients with genetically confirmed SCAs enrolled in the Clinical Research Consortium for the Study of Cerebellar Ataxia cohort, examining the percentages of patients with SCA subtypes 1, 2, 3, and 6 who reported suicidal ideation and comparing findings with nationally representative data from the National Survey on Drug Use and Health (NSDUH). Clinical characteristics that may contribute to suicidal ideation in SCAs, including age, disease duration, sex, ataxia severity, depression, and SCA subtype, were also studied.</p><p><strong>Results: </strong>Suicidal ideation was present among 12% of 769 patients with SCAs and 4.3% of individuals in the general population recorded in the NSDUH. Compared with individuals in the general population, SCA patients had higher odds of suicidal ideation (OR=2.72). Compared with patients with SCA without suicidal ideation, patients with SCA and suicidal ideation had a longer disease duration (mean±SD=13.1±8.2 years vs. 11.2±9.4 years), more severe ataxia (Scale for the Assessment and Rating of Ataxia mean score=15.9±8.6 vs. 12.9±7.6), and more severe depression. Having suicidal ideation at baseline significantly increased the odds of suicidality later in the disease course (OR=58.73, 95% CI=36.00-98.40).</p><p><strong>Conclusions: </strong>Suicidal ideation was more prevalent among patients with SCAs than in the general population. The findings of this study underscore the importance of continuous suicidal risk screening among individuals with SCAs and the need for effective depression management.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"38-44"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12990893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987942","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":"Rehabilitation Therapies for Functional Neurological Disorder: A Systematic Review and Meta-Analysis of Clinical Trials.","authors":"Eva S Keatley, Molly Cairncross, Shreya Raman, Ivan R Molton, Esther Choi, Kiarah O'Kane, Alison S Buchholz, Kathrin LaFaver, Rachel V Aaron","doi":"10.1176/appi.neuropsych.20250222","DOIUrl":"10.1176/appi.neuropsych.20250222","url":null,"abstract":"<p><strong>Objective: </strong>The authors conducted a systematic review and meta-analysis of clinical trials testing rehabilitation therapies for treating functional neurological disorder (FND).</p><p><strong>Methods: </strong>The authors searched databases for clinical trials of patients with FND who received rehabilitation therapies. Some trials included a mental health intervention, but psychotherapy-only trials were excluded. Study quality was assessed by using a modified version of the NIH quality assessment tool for a before-after (pre-post) study with no control group.</p><p><strong>Results: </strong>In total, 8,162 studies were screened for eligibility. Among these, 30 articles (N=1,581 participants) were included. Results of a meta-analysis of proportions revealed that 74% of the participants in FND rehabilitation trials had clinical improvement, but effect sizes varied significantly across studies. Twenty-three studies provided sufficient data to calculate pre-post rehabilitation effect sizes, which were uniformly positive for FND symptoms and physical function. Meta-analysis of seven available randomized controlled trials (RCTs) indicated a significant treatment effect on FND symptoms and that effects on physical function, fatigue, and mental health were not statistically significant. The generalizability of these findings was limited by heterogeneity across studies, attributed to differences in populations, treatment protocols, study designs, and outcome measures.</p><p><strong>Conclusions: </strong>Rehabilitation therapies are a promising approach for improving FND symptoms, and calculated estimates indicate that >70% of patients experience clinical improvement after rehabilitative treatment. However, additional high-quality RCTs are needed to clarify the overall efficacy of rehabilitation for FND and to identify which aspects of clinical improvement are most responsive to rehabilitation interventions.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"318-328"},"PeriodicalIF":3.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147627797","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 Frith Prescribing Guidelines for People With Intellectual Disability, 4th Edition.","authors":"Jay A Salpekar","doi":"10.1176/appi.neuropsych.20250064","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20250064","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"appineuropsych20250064"},"PeriodicalIF":2.9,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145212892","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":"Characterizing the Effects of Concussion and Head Impact Exposure: Design, Methods, and Participant Traits of the CARE 2.0 Study.","authors":"Thomas W McAllister, Steven P Broglio, Susan M Perkins, Barry P Katz, Paul F Pasquina, Michael A McCrea","doi":"10.1176/appi.neuropsych.20240022","DOIUrl":"10.1176/appi.neuropsych.20240022","url":null,"abstract":"<p><strong>Objective: </strong>This article describes the design, methods, and participant characteristics of the second phase of the Concussion Assessment, Research, and Education (CARE) Consortium study (\"CARE 2.0\") of the effects of concussion and repetitive head impact exposure on neuropsychiatric health.</p><p><strong>Methods: </strong>The authors conducted a prospective multisite observational study of male and female collegiate athletes and military service academy cadets and midshipmen participating in the CARE study. Participants were assessed at three time points: undergraduate baseline (UB), before departure from university or service academy (exit), and up to 6 years following graduation (postgrad) via an online battery of brain health assessments. Participant characteristics were compared across the three time points and four levels of head impact exposure.</p><p><strong>Results: </strong>A total of 4,643 participants completed the exit assessment, and 3,981 completed the postgrad assessment. Relative to the UB assessment cohort, the exit and postgrad assessment cohorts differed with respect to the percentage of women, baseline Wechsler Test of Adult Reading scores, National Collegiate Athletic Association division category, sport contact level, and number of previous concussions. The median standardized difference across balancing variables, assessment time points, and degree of head impact exposure was 0.12 (with 90% of effect sizes ≤0.29).</p><p><strong>Conclusions: </strong>Although there were some statistically significant differences between participants across assessments, the effect sizes were modest, and overall the data suggest that the exit and postgrad cohorts reflect the characteristics of the baseline cohort. The CARE study design and its large, richly characterized sample provide an opportunity to answer important questions about cumulative and persistent effects of concussion and repetitive head impact exposure on neuropsychiatric health.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"137-148"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142391159","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":"Case Study 9: A 64-Year-Old Man With Rapidly Progressive Cognitive Impairment and Behavioral Changes.","authors":"Syed N Kamal, Maria S Kryatova, Seth A Gale, Kirk R Daffner, David A Silbersweig, Scott M McGinnis, Barbara Schildkrout","doi":"10.1176/appi.neuropsych.20240198","DOIUrl":"10.1176/appi.neuropsych.20240198","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"170-178"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441108","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":"Posttraumatic Headache: A Possible Therapeutic Target of Transcranial Magnetic Stimulation.","authors":"Anika Balse, Christine N Smith, William Drew, Shahrokh Golshan, Hossein Ansari, Ameer Chaudry, Ananth Karanam, Mohammed Ahmed","doi":"10.1176/appi.neuropsych.20240030","DOIUrl":"10.1176/appi.neuropsych.20240030","url":null,"abstract":"<p><strong>Objective: </strong>Persistent headache is the most common and debilitating chronic condition after traumatic brain injury (TBI), affecting mood and reducing quality of life. The investigators examined in a community-based setting whether repetitive transcranial magnetic stimulation (rTMS) for management of major depression among outpatients with TBI histories was associated with improvement in the functional impact of headache (FH) and whether improvements were related to treatment at a specific site in the dorsolateral prefrontal cortex (DLPFC).</p><p><strong>Methods: </strong>In the discovery phase (posttraumatic headache 1 [PTH-1] group, N=21), the association of rTMS treatment at DLPFC targets and improvement in headache and depression and anxiety were studied. Associations between functional connectivity of the patient-specific TMS treatment sites and changes in patients' FH were used to identify a target for simultaneous treatment of behavioral and headache symptoms. Patients in the translational phase (PTH-2 group, N=7) received TMS treatment at this target.</p><p><strong>Results: </strong>The patients in the PTH-1 group had significant improvements in depression and anxiety but not FH, and more than half had a reduction in FH and reported an improvement in headache severity and duration. Increased functional connectivity between TMS sites and a subregion in the left DLPFC and bilateral precuneus was related to improved FH. Unlike the PTH-1 group, the PTH-2 group exhibited significant reductions in FH after 4 weeks of treatment and in anxiety and depression after 1-2 weeks of treatment.</p><p><strong>Conclusions: </strong>TMS treatment targeting the left DLPFC coordinate identified in this study may help improve treatment for both FH and anxiety and depression among PTH patients.</p>","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"333-341"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143795725","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":"Case Study 8: A 70-Year-Old Man With Memory Loss, Wandering, and Inappropriate Behaviors.","authors":"Lakeshia C Gibson, Katherine A Krause, Seth A Gale, Barbara Schildkrout, Michael B Miller, Mel B Feany, David A Silbersweig, Kirk R Daffner, Hyun-Sik Yang, Scott M McGinnis","doi":"10.1176/appi.neuropsych.20240125","DOIUrl":"10.1176/appi.neuropsych.20240125","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":" ","pages":"222-229"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12213165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066371","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":"Myokines and the Brain: A Novel Neuromuscular Endocrine Loop.","authors":"Wilfredo López-Ojeda, Robin A Hurley","doi":"10.1176/appi.neuropsych.20240173","DOIUrl":"https://doi.org/10.1176/appi.neuropsych.20240173","url":null,"abstract":"","PeriodicalId":16559,"journal":{"name":"Journal of Neuropsychiatry and Clinical Neurosciences","volume":"37 1","pages":"A4-4"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983781","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}