Neuropsychiatric Disease and Treatment最新文献

{"title":"Effectiveness and Safety of Venlafaxine in Japanese Major Depressive Disorder Patients with or without Anxious Distress (EXPAND Study): A 12-Week Prospective Observational Study.","authors":"Hitoshi Sakurai, Keisuke Nomoto, Tomoki Ito, Yasuyuki Matsumoto, Shingo Higa","doi":"10.2147/NDT.S614460","DOIUrl":"https://doi.org/10.2147/NDT.S614460","url":null,"abstract":"<p><strong>Purpose: </strong>This study evaluated outcomes of venlafaxine treatment in Japanese patients with major depressive disorder (MDD) in routine clinical practice. Since anxiety is a common and clinically relevant feature of MDD, descriptive analyses were conducted based on the presence or absence of Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) anxious distress.</p><p><strong>Patients and methods: </strong>This 12-week, multicenter, single-arm, observational study consecutively enrolled adult patients with MDD initiating venlafaxine in Japan. DSM-5 anxious distress was assessed at baseline. The primary endpoint was change in Montgomery-Åsberg Depression Rating Scale (MADRS) total score from baseline to week 12 or discontinuation. Secondary endpoints included MADRS response and remission rates, patient-reported outcomes, and safety. Analyses were descriptive and conducted by anxious distress status.</p><p><strong>Results: </strong>Among enrolled patients, 407 received venlafaxine and comprised the safety analysis set; 198 (48.6%) had anxious distress. MADRS total score decreased from baseline to week 12 or discontinuation in the overall population and in patients with and without anxious distress. Patients with anxious distress had higher baseline symptom severity but showed improvement over time. Similar improvements were seen across secondary patient-reported outcomes in both subgroups. Drug-related adverse events and discontinuations due to adverse events were numerically more frequent in patients with anxious distress. The safety profile was in line with established findings.</p><p><strong>Conclusion: </strong>Venlafaxine treatment in clinical practice improved depressive symptoms, anxiety, functioning, quality of life, and cognitive complaints in patients with MDD. Improvements were seen in patients with and without anxious distress. These results provide descriptive real-world evidence on treatment outcomes; however, they should be interpreted with caution given the non-comparative study design and other limitations. The findings may inform clinical decision-making in patients with heterogeneous presentations encountered in routine psychiatric practice.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"614460"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897645","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":"Prevalence of Generalized Anxiety Disorder in Psychiatric Outpatients (PRADO Study): A Multicenter Cross-Sectional Study in Japan.","authors":"Keisuke Nomoto, Tempei Otsubo, Shingo Higa, Satoshi Matsuyama, Takeshi Inoue","doi":"10.2147/NDT.S607540","DOIUrl":"https://doi.org/10.2147/NDT.S607540","url":null,"abstract":"<p><strong>Purpose: </strong>Generalized anxiety disorder (GAD) impairs quality of life (QoL) and daily function; however, it remains under-recognized in Japan due to symptom overlap and a lack of approved treatments. This study estimated GAD prevalence among psychiatric outpatients using the Structured Clinical Interview for DSM (SCID), examined associated demographic and clinical factors, assessed health status and QoL, and evaluated the diagnostic validity of the Generalized Anxiety Disorder 7-item scale (GAD-7) and the Kessler 6-item Psychological Distress scale (K6) versus SCID.</p><p><strong>Methods: </strong>This multicenter, cross-sectional study analyzed 407 patients across 22 sites. Prevalence was determined through SCID-based structured interviews. Demographics were obtained from paper questionnaires and clinical characteristics from medical records. Patient-reported outcomes quantified burden and screening accuracy.</p><p><strong>Results: </strong>Eighty-three of 407 patients (20.4%) met DSM-5 criteria for GAD using SCID. Prevalence was higher in females versus males (68.7% vs 31.3%) and more common among younger individuals. Comorbid depressive disorders were frequent (63.4%), with major depressive disorder being the most prevalent. Patients with GAD were more likely to have lower income, be students, and exhibit higher symptom severity on both the Quick Inventory of Depressive Symptomatology Self-Report (QIDS-SR) and the GAD-7. Patients with GAD (n=83) had higher QIDS-SR, GAD-7, and K6 scores than non-GAD patients, indicating greater depressive symptoms, anxiety, and psychological distress. Health-related QoL and functional impairment measured through EuroQol 5 Dimensions 5 Levels and the Sheehan Disability Scale indicated worse outcomes in GAD. GAD-7 and K6 demonstrated moderate diagnostic performance versus SCID.</p><p><strong>Conclusion: </strong>GAD was prevalent among Japanese psychiatric outpatients (20.4%), suggesting the potential under-recognition in clinical practice, with some patients receiving alternative diagnoses. The lack of approved treatments and recognized diagnostic procedures may exacerbate the patient's burden. Developing GAD-specific therapies and improving diagnostic awareness are critical to addressing this unmet need.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"607540"},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897648","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":"Heart-Brain Axis Dysregulation in Depression: Mechanisms and Implications for Neuromodulation.","authors":"Yilin Xiong, Ziyu Zhu, Caijie Shen, Wei Deng, Yuqi Cheng","doi":"10.2147/NDT.S623896","DOIUrl":"https://doi.org/10.2147/NDT.S623896","url":null,"abstract":"<p><p>Major depressive disorder (MDD) is increasingly recognized as a systemic disorder involving dysregulation of the heart-brain axis (HBA). Mounting evidence links impaired HBA signaling to the pathogenesis of major depressive disorder. Emerging data indicate that neuromodulation-mediated autonomic alterations correlate with depressive symptom remission. Although neuromodulatory therapies are widely deployed clinically, HBA-based biomarkers remain experimental, and no consistent physiological predictors of treatment response have been established to date. This review summarizes HBA dysfunction in depression across neural, biochemical, and mechanical pathways, integrating evidence from preclinical and clinical studies. We critically evaluate recent advances in leveraging these pathways to optimize neuromodulation strategies. Emerging evidence suggests that certain neuromodulation approaches-including transcranial magnetic stimulation (TMS), transcranial electrical stimulation (TES), vagus nerve stimulation (VNS), electroconvulsive therapy (ECT), and deep brain stimulation (DBS)-may modulate heart-brain axis function. It has been hypothesized that such modulation could represent a physiological pathway contributing to mood improvement, providing a rationale for a heart-oriented framework in neuromodulation research. However, the clinical utility of this framework and its underlying biomarkers remain to be established through rigorous long-term investigations. By bridging the conventional conceptual divide between psychiatric and cardiovascular diseases, this review offers a systems-level perspective on neuromodulation efficacy and highlights the potential of HBA-related biomarkers for assessing pathological states and guiding treatment strategies in depression and other psychosomatic conditions.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"623896"},"PeriodicalIF":3.2,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897690","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":"Electroacupuncture Attenuates Neuroinflammation in PCPA-Induced Insomnia Rats by Suppressing the TLR4/MyD88/NF-κB p65 Pathway and M1 Microglial Activation.","authors":"Meng Zhang, Lian Liu, Tian Tan, Lijuan He, Bingqing Hu, Sixian Li, Mengya Jiang, Peng Deng, Qingjia Ren","doi":"10.2147/NDT.S608945","DOIUrl":"10.2147/NDT.S608945","url":null,"abstract":"<p><strong>Background: </strong>Insomnia is closely associated with neuroinflammation, yet the therapeutic mechanism of electroacupuncture (EA) remains unclear. This animal study investigated whether EA attenuates hypothalamic neuroinflammation in para-chlorophenylalanine (PCPA)-induced insomnia rats by suppressing the TLR4/MyD88/NF-κB p65 pathway and M1 microglial activation, using TAK-242 (HY-11109), a selective TLR4 inhibitor, as a positive control.</p><p><strong>Methods: </strong>Forty Sprague-Dawley rats (20 male, 20 female, sex-balanced across groups) were randomly allocated to Control, Model, EA, and TAK-242 groups (n=10 per group). Insomnia was induced in the model, EA, and TAK-242 groups by intraperitoneal injection of PCPA (500mg/kg) for 2 consecutive days. The TAK-242 group received daily intraperitoneal injection of TAK-242 (3 mg/kg). The EA group received acupuncture at Baihui (GV20), bilateral Benshen (GB13), Shenmen (HT7) and Sanyinjiao (SP6), with ipsilateral Shenmen (HT7) and Sanyinjiao (SP6) connected to an electroacupuncture device using a 2 Hz continuous wavefor 20 minutes daily over 7 days. Sleep latency and total sleep duration were recorded via the pentobarbital sodium righting reflex test. Serum interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels were assessed via the enzyme-linked immunosorbent assay (ELISA); Hypothalamic microglial M1 polarization was assessed by Iba-1/CD86 immunofluorescence co-localization. Protein and mRNA levels of TLR4, MyD88, NF-κB p65, TNF-α, and IL-6 were quantified by Western blot and RT-qPCR, respectively. All outcome assessments were performed by investigators blinded to group allocation.</p><p><strong>Results: </strong>Compared with the model group, both electroacupuncture and TAK-242 significantly shortened sleep latency and prolonged total sleep time (P < 0.01), and reduced serum levels of TNF-α and IL-6 (P < 0.01). Both interventions also attenuated CD86 fluorescence intensity (P < 0.01) and Iba-1/CD86 co-expression (P < 0.05), and down-regulated the protein and mRNA expression of TNF-α, IL-6, TLR4, MyD88, and NF-κB p65 in the hypothalamus (P < 0.01). The effects of electroacupuncture and TAK-242 on sleep parameters, CD86 fluorescence intensity, and Iba-1/CD86 co-expression were comparable, whereas TAK-242 exerted a more pronounced inhibitory effect than electroacupuncture on the expression of inflammatory cytokines and pathway-related proteins in the serum and hypothalamus (P < 0.05, P < 0.01).</p><p><strong>Conclusion: </strong>Electroacupuncture effectively improved sleep disturbances in PCPA-induced insomnia rats. The underlying mechanism may be associated with inhibition of the TLR4/MyD88/NF-κB p65 signaling pathway, suppression of M1 microglial activation, and downregulation of pro-inflammatory cytokines, thereby partly alleviating hypothalamic neuroinflammation.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"608945"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888149","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":"Quality of Life Measurement Tools in Interventions for Anxiety and Depressive Disorders: A Systematic Literature Review in Global Settings.","authors":"Fredrick Dermawan Purba, Farah Fadilah Hasyim, Hari Setyowibowo, Ralph De Vries","doi":"10.2147/NDT.S614122","DOIUrl":"10.2147/NDT.S614122","url":null,"abstract":"<p><p>Anxiety and depression Disorders play a crucial role in the global disease burden and impose significant effects. Depression markedly impacts psychosocial functioning and quality of life. Nevertheless, the effectiveness of mental health interventions is generally assessed through symptom reduction, the use of QoL as a patient-centered outcome is still not standardized. This systematic review aims to identify QoL instruments used in anxiety and depression interventions and analyze variations in their application in various global contexts. A systematic literature review was conducted in accordance with PRISMA 2020 guidelines and prospectively registered in PROSPERO (CRD420251109799). Literature searches were performed in PubMed, Embase.com, Scopus, and APA PsycInfo. Following screening and eligibility assessment, 17 studies were included in the final review. Interventions included psychotherapy, mindfulness, and body-based therapy, digital interventions, pharmacotherapy, and combined approaches. The most frequently used QoL instruments were SF-36/SF-12, EQ-5D, and WHOQOL-BREF. In general, interventions showed that physical activity has a positive impact on QoL, particularly in the psychological and social domains. However, instrument heterogeneity, the dominance of self-reports, and cultural context limitations were major challenges. Standardization of culturally sensitive QoL measurements is needed to improve the validity and comparability of global findings.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"614122"},"PeriodicalIF":3.2,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13540574/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888145","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":"Serum Lithium Monitoring, Short-Term Outcomes, and Treatment Barriers in Bipolar Disorder: A Real-World Study.","authors":"Xin Xin, Guangyu Zhou","doi":"10.2147/NDT.S625299","DOIUrl":"10.2147/NDT.S625299","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize serum lithium monitoring, clinician-recorded short-term outcomes, and treatment barriers in a clinically selected outpatient cohort of patients with bipolar disorder that was enriched for suicide risk.</p><p><strong>Patients and methods: </strong>We retrospectively reviewed consecutive routine-care records from a specialist mood-disorders clinic between January 2024 and March 2025. The monitoring dataset comprised 188 patients and 562 valid serum lithium measurements. The outcome dataset comprised 124 patient-level records from initial or follow-up encounters, and a separate implementation dataset contained 13 patients with documented discontinuation or non-initiation. The serum lithium value closest to the clinical outcome assessment was used in exploratory analyses.</p><p><strong>Results: </strong>Among monitored patients, 124/188 (66.0%) had at least two measurements. Median serum lithium concentration was 0.62 mmol/L (interquartile range 0.50-0.84), and 18/562 measurements (3.2%) were >1.2 mmol/L. Clinician-recorded remission was documented in 72/124 outcome records (58.1%) and any improvement in 114/124 (91.9%). Any improvement was 90.0%, 96.1%, and 81.5% in the <0.4, 0.4-<0.8, and ≥0.8 mmol/L groups, respectively (exploratory unadjusted P=0.053). Remission did not differ across groups (P=0.952), and the continuous serum lithium value was not associated with remission (odds ratio per 0.1 mmol/L, 1.01; 95% confidence interval 0.86-1.18). Documented barriers included adverse effects, testing or logistical burden, toxicity concerns, and poor palatability.</p><p><strong>Conclusion: </strong>A single routine-care serum lithium concentration recorded near a clinical assessment was not associated with clinician-recorded remission. The analysis did not evaluate longitudinal exposure or confirmed steady-state trough concentrations, and improvement during comprehensive care cannot be attributed to lithium alone. These findings support an integrated lithium-care pathway that combines interpretable monitoring, accessible testing, early management of adverse effects, clear toxicity education, and suicide-specific safety planning.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"625299"},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13526148/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866195","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":"Physical Therapies and Neuromodulation for Treatment-Resistant Schizophrenia: A Review of Potential Mechanisms, Efficacy, and Safety.","authors":"Haiqiang Zhao, Yu Ding, Haoran Xing, Yingying Zhang, Mier Li, Luanmei Ding, Wanyong Ye, Lei Geng, Hong Ye, Tianhao Bao","doi":"10.2147/NDT.S621364","DOIUrl":"10.2147/NDT.S621364","url":null,"abstract":"<p><p>Antipsychotic medications remain the conventional treatment for treatment-resistant schizophrenia (TRS), yet some patients exhibit poor responses. Due to the limitations of pharmacological interventions, physical therapies are increasingly recognized as essential supplements in managing TRS. This article systematically examines the current clinical applications and research advances of physical therapeutic techniques for TRS. Existing evidence suggests that electroconvulsive therapy (ECT), particularly when administered as an adjunct to antipsychotic medication, may improve positive symptoms and overall clinical outcomes in a subset of patients with TRS. However, its potential cognitive adverse effects and related ethical considerations warrant careful evaluation. As a non-invasive neuromodulatory technique, transcranial magnetic stimulation (TMS) may exert therapeutic effects by modulating frontotemporal cortical excitability and activity within associated neural circuits, thereby contributing to improvements in auditory hallucinations, negative symptoms, and cognitive function. Transcranial electrical stimulation (tES), including transcranial direct current stimulation (tDCS), is characterized by procedural simplicity, favorable safety, and good tolerability. Its clinical effects may be mediated through modulation of cortical excitability, synaptic plasticity, and functional connectivity. However, current studies remain highly heterogeneous with respect to sample size, stimulation parameters, treatment duration, outcome measures, and follow-up periods. Moreover, no physical therapy has yet been approved by the US. Food and Drug Administration (FDA) for the treatment of TRS. This article aims to synthesize the therapeutic efficacy of various physical interventions for TRS and summarize the current clinical evidence, thereby broadening the range of potential treatment options for patients with TRS and promoting a more comprehensive clinical understanding and management of this condition.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"621364"},"PeriodicalIF":3.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857508","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":"Prevalence of Anxiety and Depression Among Patients in a Palliative Care Setting During the COVID-19 Pandemic: A Mixed-Methods Cross-Sectional Study.","authors":"Doreen Birungi Agasha, Germanus Natuhwera, Eve Namisango, Hanif Kasozi, Elizabeth Mbabazi, Stanley Wilson Acuda","doi":"10.2147/NDT.S575211","DOIUrl":"10.2147/NDT.S575211","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 is a new disease with high transmission and mortality rates and can cause or exacerbate a myriad of psychological sequelae, particularly in patients with underlying serious illness. Palliative care patients' experiences have been widely studied, but research on their experiences during COVID-19 pandemic is scanty.</p><p><strong>Aim: </strong>To determine the prevalence of and factors associated with anxiety and depression among palliative care patients and explore palliative care patients' experiences during the COVID-19 pandemic.</p><p><strong>Materials and methods: </strong>This cross-sectional mixed-methods study used the Hospital Anxiety and Depression Scale (HADS) and face-to-face audio-recorded interviews to collect data from participants between April and May, 2022. Quantitative data were analysed using STATA v.17. Chi-square test and multivariate logistic regression were performed to examine factors associated with depression and anxiety. Qualitative data were analysed using thematic analysis.</p><p><strong>Results: </strong>Of the 96 participants, 74% (n=71) were female. Patients who earned ≥100,000 Ugandan shillings (OR=0.18, p=0.026, CI 0.040-0.818) had lower odds of depression compared to patients who earned less, while patients who missed clinic appointment sometimes (OR=26.02, P=0.025, CI 1.503-450.226) and those who reported change in sleep pattern (OR=15.91, p=001, CI 3.030-83.567) had higher odds of depression. Male participants had lower odds of anxiety (OR=7.93, p=0.003, CI 2.004-31.370) while those who missed medicines very often (OR=6.79, p=0.024, CI 1.288-35.852) and those who reported change in sleep pattern (OR=10.21, p=0.000, CI 2.790-37.393) showed higher odds of anxiety. Three main themes emerged from the qualitative interviews: (1) Navigating multidimensional suffering before and during a pandemic, (2) the healthcare system as a precipitant of suffering, and (3) finding hope and meaning amidst uncertainty and suffering.</p><p><strong>Conclusion: </strong>Mental health morbidities were great in this cohort, occurring in a multifaceted manner, with disruptions to the psychological, social, financial, and physical dimensions of patients' quality of life. Palliative care continuity and mental health, psychosocial and spiritual support services should be integrated into humanitarian emergency health care package in future outbreaks.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"575211"},"PeriodicalIF":3.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796137","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":"Does the Microbiota-Gut-Brain Axis Mediate the Antidepressant Effects of Acupuncture? A Structured Review of Preclinical and Clinical Evidence.","authors":"Ling Wang, Ruping Shang, Chunping Zhang, Shengchun Wang, Jin Xian","doi":"10.2147/NDT.S625958","DOIUrl":"https://doi.org/10.2147/NDT.S625958","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture is used for depressive disorders, but the extent to which its effects are mediated by the microbiota-gut-brain axis (MGBA) remains uncertain.</p><p><strong>Objective: </strong>To determine whether current preclinical and clinical evidence supports gut microbiota as a mediator, amplifier, or biomarker of acupuncture-related antidepressant effects.</p><p><strong>Methods: </strong>Eight databases were searched from inception to 6 July 2026 for peer-reviewed studies of acupuncture in depressive disorders or validated depressive-like phenotypes that reported gut microbiota or microbiota-derived metabolite outcomes.</p><p><strong>Results: </strong>Twenty-six independent studies were included: 22 preclinical and 4 clinical studies. Animal experiments consistently showed acupuncture-induced behavioral improvements accompanied by shifts in gut microbial composition, with several studies also documenting changes in intestinal barrier function, inflammatory signaling, microbial metabolites, neuroendocrine indicators, and synaptic plasticity. However, reported alterations at the phylum and taxon levels were inconsistent, and most work merely identified parallel changes instead of establishing microbiota mediation. One electroacupuncture donor fecal microbiota transplantation study offered the strongest evidence that acupuncture-remodeled microbiota can transfer behavioral benefits, while a second bidirectional transplantation confirmed microbiota participation in the disease model but could not establish acupuncture-specific microbiota mediation. Clinical evidence was limited to postpartum and post-stroke depression and was constrained by nonrandomized allocation, add-on designs, incomplete longitudinal microbiota sampling, and confounding.</p><p><strong>Conclusion: </strong>Current evidence supports a host-mediated ecological framework whereby acupuncture remodels the intestinal niche and modulates MGBA signaling. Nonetheless, microbiota-mediated effects have not been verified across most preclinical models and remain unconfirmed in clinical settings.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"625958"},"PeriodicalIF":3.2,"publicationDate":"2026-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13489047/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796202","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":"Role of NRF2 in Electroacupuncture's Effects on Postoperative Cognitive Impairment in Rats.","authors":"Zhi-Gang Wang, Dong-Ran Cui, Yi Gao, Jin-Ge Yuan, Qiu-Jun Wang, Yong-Xue Chen","doi":"10.2147/NDT.S612783","DOIUrl":"https://doi.org/10.2147/NDT.S612783","url":null,"abstract":"<p><strong>Objective: </strong>Postoperative cognitive dysfunction (POCD), characterized by cognitive and memory decline following anesthesia and surgery, is a common complication in elderly patients. Nuclear factor erythroid-derived 2-like 2 (NRF2), a key regulator of cellular redox balance, has been implicated in cognitive processes in various neurological disorders. Electroacupuncture (EA), with its controllable stimulation parameters, has shown preventive effects against cognitive dysfunction. This study aimed to investigate whether NRF2 mediates the beneficial effects of EA on cognitive function in POCD.</p><p><strong>Methods: </strong>A POCD model was established in 20-month-old male Sprague-Dawley rats undergoing tibial fracture surgery. Beginning on postoperative day 24, EA was administered at the Hegu (LI4), Neiguan (PC6), and Zusanli (ST36) acupoints once daily for five consecutive days. The specific NRF2 antagonist ML385 (30 mg/kg) was intraperitoneally administered 2 hours before each EA session over the same period. Behavioral tests, including the T-maze test, fear conditioning (FC), and novel object recognition (NOR), were conducted on postoperative day 30. Immunofluorescence staining was used to assess neuronal count, apoptosis, microglial activation, and the percentage of NRF2-positive microglia. Electrophysiological recordings of brain activity were also performed.</p><p><strong>Results: </strong>EA treatment significantly improved cognitive and memory performance in POCD rats. Immunofluorescence analysis revealed reduced neuronal apoptosis, increased synaptic density, suppressed microglial activation, and enhanced nuclear translocation of NRF2, indicating attenuated neuroinflammation and oxidative stress. Furthermore, EA strengthened the phase-amplitude coupling between theta and gamma oscillations. Notably, all these neuroprotective and cognitive-enhancing effects of EA were abolished by ML385.</p><p><strong>Conclusion: </strong>In a POCD rat model, our findings demonstrate that EA ameliorates cognitive impairment, and this effect is potentially mediated through NRF2 pathway activation.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"612783"},"PeriodicalIF":3.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13477860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148796177","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}