Neuropsychiatric Disease and Treatment最新文献

{"title":"Efficacy and Safety of Escitalopram for Major Depressive Disorder in Children and Adolescents: A Systematic Review and Meta-Analysis with Age-Specific Findings.","authors":"Benchalak Maneeton, Narong Maneeton, Pichaya Pojanapotha, Suwannee Putthisri, Awirut Oon-Arom, Nuntaporn Karawekpanyawong, Suttipong Kawilapat, Prapinpatch Maneeton, Kamolrawee Srichan","doi":"10.2147/NDT.S595606","DOIUrl":"10.2147/NDT.S595606","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy, acceptability, and safety of escitalopram for pediatric major depressive disorder (MDD) through a systematic review and meta-analysis.</p><p><strong>Methods: </strong>We searched Cochrane CENTRAL, CINAHL, PubMed, ClinicalTrials.gov, and Scopus (January 2001- October 2025) for randomized controlled trials comparing escitalopram with placebo in children and adolescents (ages 6-17) with MDD. The primary outcome was the change in the Children's Depression Rating Scale-Revised (CDRS-R). Secondary outcomes included Clinical Global Impressions scores, response rates, and discontinuation rates. Two reviewers independently assessed the risk of bias using Cochrane tools. Random-effects meta-analysis was performed; certainty was evaluated using GRADE.</p><p><strong>Results: </strong>Three RCTs (664 participants) were identified: two acute trials (Wagner 2006, n=268; Emslie 2009, n=316) and one continuation trial (Saito 2023, n=80). Meta-analysis of acute trials included 572 participants (completion rates 81-82%). Escitalopram demonstrated small and borderline statistically significant improvements versus placebo: CDRS-R (weighted mean difference [WMD]=-2.46, 95% CI: -4.83 to -0.09, I²=0%; low certainty); CGI-Severity (WMD=-0.35, 95% CI: -0.57 to -0.12); CGAS (WMD=2.56, 95% CI: 0.37 to 4.75); non-response rates (relative risk=0.84, 95% CI: 0.72 to 0.98; number needed to treat=11). Overall discontinuation (RR=1.37, 95% CI: 0.97 to 1.93) and discontinuation due to adverse events (RR=1.88, 95% CI: 0.44 to 8.03) did not differ significantly (low to very low certainty). Continuation treatment did not significantly prevent relapse (p=0.051).</p><p><strong>Limitations: </strong>Universal industry sponsorship, high placebo response (52-53% by CGI-I ≤2 in original publications), mixed trial results, limited evidence for children ages 6-11, and lack of independent replication.</p><p><strong>Conclusion: </strong>Escitalopram demonstrates small and borderline statistically significant efficacy for adolescent MDD (aged 12-17 years). Short-term tolerability is acceptable; however, no definitive conclusion on long-term safety can be drawn, and evidence is insufficient to support use in children aged 6-11 years. It may be considered when fluoxetine is unsuitable, combined with psychosocial interventions and close monitoring. Further independent studies are needed.</p><p><strong>Registration: </strong>PROSPERO CRD42019141268.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"595606"},"PeriodicalIF":3.2,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13157702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147875222","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":"Peripheral Blood Regulatory T Cells and IL-6 are Associated with Cognitive Impairment After Acute Ischemic Stroke.","authors":"Yueyue Chang, Xuke Zhang, Chuanqing Yu, Lei Zhu, Shiyu Sun, Zhongwu Sun","doi":"10.2147/NDT.S590109","DOIUrl":"10.2147/NDT.S590109","url":null,"abstract":"<p><strong>Background: </strong>Objective: Regulatory T cells (Tregs) and interleukin (IL)-6 are known to be involved in the progression of cognitive impairment but the association with post-stroke cognitive impairment remains little studied. Levels of Tregs and IL-6 in peripheral blood serum of patients with acute ischemic stroke (AIS) were investigated to assess the association with post-stroke cognitive impairment (PSCI).</p><p><strong>Methods: </strong>A total of 256 AIS patients were enrolled with 19 lost to follow-up after six months. Participants were divided into those without post-stroke cognitive impairment (PSNCI, n=129) and those with post-stroke cognitive impairment (PSCI, n=108). PSCI patients were subdivided into those with post-stroke cognitive impairment, no dementia (PSCIND, n=87) and those with post-stroke dementia (PSD, n=21). The percentage of peripheral blood CD4+ CD25+ CD127 (low) regulatory T cells (Tregs%) out of total CD4+ lymphocytes was evaluated by flow cytometry. IL-6 was measured by enzyme-linked immunosorbent assay (ELISA).</p><p><strong>Results: </strong>(1) Increased percentages of peripheral blood Tregs and IL-6 levels were found in PSCI, PSCIND and PSD patients relative to PSNCI and differences were particularly significant for PSCI and PSD groups. (2) Logistic regression analysis was performed after controlling for these risk factors and Tregs% (OR=1.122, 95% CI: 1.006-1.251, p=0.038) identified as an independent risk factor for cognitive impairment after AIS. ROC analysis gave an area under the curve (AUC) of 0.763 (95% CI: 0.653-0.873) for the combination of Tregs% and IL-6 levels in predicting cognitive impairment after AIS.(3) IL-6 level (OR=1.307, 95% CI: 1.058-1.614, p=0.013) was found to be an independent risk factor for dementia after AIS with an AUC of 0.805 (95% CI: 0.681-0.929).</p><p><strong>Conclusion: </strong>Elevated peripheral Tregs% and IL-6 levels are risk factors for cognitive impairment after AIS. Their combined predictive power is greater than individual predictive power, exposing new therapeutic targets for post-stroke cognitive impairment.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"590109"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147841033","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":"Optimizing Identification and Management of Depression in Neurological Diseases: A Narrative Review and Expert Perspective.","authors":"Lucie Bartova, Mara Lisa Beuster, Bruno Bonetti, Giuseppe Maina, Pedro Morgado, Johan Nyberg","doi":"10.2147/NDT.S575685","DOIUrl":"10.2147/NDT.S575685","url":null,"abstract":"<p><p>Comprehensive brain health is increasingly being recognized as critically important worldwide and incorporates elements of neurological and psychiatric health. This evolution in the view of cerebral wellbeing considers the many factors that can affect brain health and the interconnectedness of conditions affecting this organ. Such interplay between neurological and depressive diseases is highlighted by observations that these conditions share underlying pathophysiology and frequently co-occur in the same patient. A review of the literature on depression in post-stroke, Parkinson's disease, multiple sclerosis, and migraine, confirmed the high prevalence of depression in patients with neurological diseases, with approximately one third of patients with neurological diseases having depression. The search results also highlighted the importance of early detection of depression, and that appropriate treatment may substantially improve outcomes of both the depression and the neurological disease. However, there was a disparity in the amount of literature on depression in the different neurological diseases, with only three of the 80 retrieved articles discussing migraine and depression. Information on multidisciplinary care was also limited. Unmet needs with respect to management of depression in patients with neurological diseases include effective screening processes that can differentiate between overlapping symptoms. There is also a lack of clear, evidence-based treatment guidelines. Based on our clinical experience, we provide recommendations for best practice management of depression in patients with neurological diseases, including structured patient interviews to aid with diagnosis of depression, involvement of patient families and friends where relevant, multidisciplinary care that incorporates personalized treatment based on the specific symptoms, co-medications and needs of the patient, and continued follow up and monitoring. Antidepressant options are available with different mechanisms of action and adverse event profiles. Overall, evidence indicates that depression in neurological disorders is underdiagnosed and undertreated. We suggest that structured screening and tailored, multidisciplinary care can improve outcomes.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"575685"},"PeriodicalIF":3.2,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13142263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840962","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":"Insulin Resistance Across Cerebrovascular and Related Disorders: Mechanisms, Measurement, Genetics, and Clinical Implications.","authors":"Kai Chen, Yiqing Nong, Ying Liu, Ziming Ye","doi":"10.2147/NDT.S575306","DOIUrl":"10.2147/NDT.S575306","url":null,"abstract":"<p><p>Insulin resistance (IR) Insulin resistance (IR) is a central metabolic disturbance implicated in a broad range of cardiometabolic and neurological disorders. Increasing evidence suggests that IR plays a pivotal role in the initiation and progression of cerebrovascular diseases (CeVD) and contributes to neurodegeneration through shared molecular and vascular mechanisms. In the brain and its vasculature, impaired insulin signaling-particularly involving the IRS-PI3K-Akt-GSK-3β axis-interacts with inflammation, oxidative stress, endothelial dysfunction, and neurovascular unit impairment, thereby linking CeVD with Alzheimer's disease, Parkinson's disease, and cerebral small-vessel disease. Advances in the assessment of IR, ranging from traditional indices such as HOMA-IR to surrogate markers including the triglyceride-glucose (TyG) index and METS-IR, have enabled large-scale population studies and improved risk stratification for cardiometabolic disorders, with emerging relevance to cerebrovascular and cognitive outcomes. In parallel, genetic and Mendelian randomization studies support a causal contribution of IR-related traits to hypertension, atherosclerosis, and stroke risk, highlighting shared susceptibility pathways across metabolic and neurological phenotypes. This review synthesizes current evidence on the mechanisms, measurement, genetic architecture, and clinical implications of IR across cerebrovascular and related disorders. By integrating mechanistic insights with epidemiological and translational data, we propose IR as a tractable, cross-cutting therapeutic target. Future priorities include standardizing IR assessment, validating brain-relevant biomarkers, and linking mechanistic pathways to longitudinal cerebrovascular and neurodegenerative outcomes to advance precision prevention and individualized care.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"575306"},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840977","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":"Association Between Frontotemporal Atrophy and Cognitive Impairment in Patients with Schizophrenia Based on Computed Tomography Imaging.","authors":"Yueling Wang, Juntao Yang, Ying Ye, Lihua Lu, Haolei Wang, Peipei Guo, Na Hou, Xiaohan Huang, Cairui Li","doi":"10.2147/NDT.S602462","DOIUrl":"10.2147/NDT.S602462","url":null,"abstract":"<p><strong>Background: </strong>Patients with schizophrenia (SZ) exhibit frontotemporal atrophy accompanied by cognitive impairment. However, the relationship between CT-derived structural changes and cognitive deficits remains underexplored. This study aimed to evaluate the association between frontotemporal atrophy and cognitive performance using routine cranial CT.</p><p><strong>Methods: </strong>This retrospective cross-sectional case-control study included 120 patients with SZ and 100 healthy controls. Bifrontal ratio (BFR), frontal horn width (FHW), mean temporal horn width (THW_mean), sylvian fissure width (SFW), and frontotemporal atrophy index (FTAI) were measured. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and the Trail Making Test (TMT). Group comparisons, Spearman correlation, and multivariable regression analyses were performed.</p><p><strong>Results: </strong>Patients with SZ showed significantly increased atrophy indices and reduced cognitive performance. FTAI was negatively associated with global cognition, executive function, and attention. In multivariable models, FTAI remained significantly associated with cognitive outcomes and contributed to improved model fit (ΔR² = 0.319).</p><p><strong>Conclusion: </strong>CT-derived frontotemporal atrophy was significantly associated with cognitive impairment in SZ. These findings suggest that CT-based structural measures may provide a clinically accessible approach for characterizing brain changes related to cognitive dysfunction.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"602462"},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840982","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":"Sleep-Related Problems and Problematic Smartphone Use in Young Adult Males: Findings from a Short-Term Behavioral Restriction Study.","authors":"Özge Özen Gökmuharremoğlu, Aysel Çoban Taşkın","doi":"10.2147/NDT.S597802","DOIUrl":"10.2147/NDT.S597802","url":null,"abstract":"<p><strong>Purpose: </strong>Problematic smartphone use is a prevalent behavioral issue in the digital age and is frequently associated with sleep disturbances. However, evidence on how different sleep domains respond to short-term behavioral restriction under natural conditions remains limited. This study aimed to examine smartphone use patterns in young adult males, evaluate their relationship with problematic smartphone use risk, and assess changes in sleep-related outcomes following short-term, institutionally mandated smartphone restriction.</p><p><strong>Patients and methods: </strong>This prospective pre-post observational study was conducted at a male police college during a 10-day institution-mandated smartphone restriction. Participants (n = 254) were classified into low-risk and high-risk problematic smartphone use groups based on the Smartphone Addiction Scale-Short Version (SAS-SV). Sleep quality, sleep hygiene, insomnia severity, and daytime sleepiness were measured before and after the restriction period. Associations between smartphone use characteristics (daily duration, timing of use, and usage purposes) and sleep outcomes were examined using group comparisons and multivariate analyses.</p><p><strong>Results: </strong>At baseline, individuals classified as high-risk reported longer overall smartphone use, particularly during evening hours, together with poorer sleep hygiene, lower perceived sleep quality, and greater daytime sleepiness. After the restriction period, improvements were mainly observed in behaviorally related sleep measures, including sleep hygiene and subjective sleep quality. In contrast, insomnia severity and daytime sleepiness showed limited change and did not demonstrate a significant group-by-time interaction.</p><p><strong>Conclusion: </strong>The findings suggest that intensive evening smartphone use may be associated with sleep difficulties that are largely behaviorally mediated. Improvements in sleep-related behaviors accompanied short-term reductions in device exposure, whereas sleep parameters linked to more stable physiological regulation appeared less responsive over this brief interval. Addressing the timing and intensity of smartphone use is a relevant behavioral target in strategies to improve sleep health in young adults.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"597802"},"PeriodicalIF":3.2,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13138281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840972","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":"Long-Term Effectiveness and Safety of LCIG in Romania. 3-year Results from a Prospective, Observational Study (DUOGLOBE).","authors":"Jozsef Attila Szasz, Viorelia Adelina Constantin, Dragos Catalin Jianu, Traian Flavius Dan, Adriana Octaviana Dulamea, Monica Sabau, Mihai Titus Vasile, Lars Bergmann, Diana Popescu, Mihaela Adriana Simu","doi":"10.2147/NDT.S564900","DOIUrl":"10.2147/NDT.S564900","url":null,"abstract":"<p><strong>Background: </strong>Levodopa-carbidopa intestinal gel (LCIG) is an established treatment for patients with advanced Parkinson's disease (APD). Improvement of motor and non-motor symptoms, as well as the quality of life has been proven in clinical trials. Prospective long-term data in routine clinical practice are limited.</p><p><strong>Objective: </strong>To assess the effectiveness and safety of LCIG over a 36-month prospective follow-up in Romania, as part of the DUOGLOBE international non-interventional study.</p><p><strong>Methods: </strong>DUOGLOBE (DUOdopa/Duopa in Patients with APD - a GLobal OBservational Study Evaluating Long-Term Effectiveness; NCT02611713) was a long-term observational study in patients with APD receiving LCIG as part of their treatment strategy in routine clinical care. Prospective data up to 36 months from LCIG initiation were collected in the study. The primary objective assessed the change in OFF time from baseline to 36 months.</p><p><strong>Results: </strong>Of the total number of 195 patients enrolled worldwide, 51 patients were included in 6 movement disorder centers in Romania. In these patients, LCIG was initiated after a median disease duration of 8.1 years (1.6-19.7). The need for concomitant anti-PD medication decreased within one month after LCIG initiation and remained stable for up to 36 months. The OFF time was significantly reduced by LCIG treatment at all timepoints vs baseline (p<0.001) (mean change [standard deviation, SD] at final visit: -3.4 ± 2.8 hours). Improvement of dyskinesia was recorded at 36 months (mean change [SD] of the Unified Dyskinesia Rating Scale at final visit -9.0 [16.54], p=0.006). Improvements in non-motor symptoms and quality of life were consistent from Day 1 throughout the study. Safety was consistent with the well-established LCIG profile and with the global study results (serious adverse events [SAEs]): 49.0% of patients discontinued the therapy (27.5% due to SAEs).</p><p><strong>Conclusion: </strong>DUOGLOBE provides long-term data on routine practice in Romania and consistent LCIG benefits in patients with APD.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"564900"},"PeriodicalIF":3.2,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818211","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":"Clinical Efficacy of Integrated Acupuncture and Moxibustion Therapy Combined with Drugs in the Treatment of Acute Depressive Disorder: Protocol for a Pragmatic Randomized Controlled Trial.","authors":"Qian Wu, Yi Liu, Dehui Lin, Shanze Wang, Xuesong Liang, Bingxin Wu, Laisiqi Wan, Yuanyuan Liu, Taishun Wang, Huijun Liu, Leixin Lai, Lu Sun, Wenbin Fu","doi":"10.2147/NDT.S601078","DOIUrl":"10.2147/NDT.S601078","url":null,"abstract":"<p><strong>Purpose: </strong>Escitalopram oxalate is a first-line pharmacological treatment for acute-phase depressive disorder, but delayed onset and adverse effects may compromise adherence and early treatment response. Adjunctive non-pharmacological therapies are commonly used in clinical practice. This study aims to evaluate the efficacy and safety of integrative acupuncture and moxibustion combined with escitalopram oxalate in patients with moderate depressive disorder during the acute phase.</p><p><strong>Methods: </strong>This is a single-center, open-label, pragmatic, randomized clinical trial. A total of 300 participants with moderate depressive disorder will be randomly assigned in a 1:1:1 ratio to three groups: escitalopram oxalate alone, escitalopram oxalate plus repetitive transcranial magnetic stimulation (rTMS), or escitalopram oxalate plus integrative acupuncture and moxibustion (iAM) (100 participants per group). All participants will receive escitalopram oxalate, while adjunctive rTMS will be administered five times weekly for 3 weeks and iAM three times weekly for 6 weeks.</p><p><strong>Outcome measures: </strong>The primary outcome is the Hamilton Depression Rating Scale. Secondary outcomes include liver and kidney function, Stanford Expectations of Treatment Scale, Beck Depression Inventory-II, Generalized Anxiety Disorder-7, Hamilton Anxiety Scale, and Insomnia Severity Index.</p><p><strong>Conclusion: </strong>This trial will assess whether iAM combined with escitalopram oxalate is a feasible, safe, and potentially effective adjunctive treatment for moderate depressive disorder during the acute phase. The findings are expected to provide clinical evidence for the use of iAM in routine depression care.</p><p><strong>Trial registration: </strong>ITMCTR2024000380 (International Traditional Medicine Clinical Trial Registry; registered on 05 Sep 2024).</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"601078"},"PeriodicalIF":3.2,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147818014","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":"Mechanism-Driven Translation of Electroacupuncture for Depression: Bridging the Gap Between Preclinical and Clinical Research.","authors":"Jing Cao, Deguang Ding, Xiuhua Ming, Chuang Liu, Yangyang Xu","doi":"10.2147/NDT.S598864","DOIUrl":"10.2147/NDT.S598864","url":null,"abstract":"<p><p>Electroacupuncture (EA) has demonstrated multi‑level antidepressant effects, yet the strength of clinical evidence remains insufficient and its efficacy consistency is highly contested. The key bottlenecks include heterogeneous research designs, a lack of standardized stimulation parameters and acupoint selection, insufficient attention to disease biological subtyping, and a disconnect between mechanistic studies and clinical outcomes. To address these gaps, this review proposes a mechanism‑driven precision translation pathway centered on patient stratification. By integrating neural circuitry, immune‑inflammatory pathways, biomarkers, and multimodal assessment tools, we argue that the primary translational bottleneck is not a lack of mechanisms but the failure to systematically integrate them into a clinical decision‑oriented paradigm. Enhancing interpretability and clinical scalability through parameter optimization, targeted neural network modulation, and objective indicator integration may transform EA from a complementary therapy into a precision intervention with clear mechanisms and reliable evidence.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"598864"},"PeriodicalIF":3.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777212","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":"Parallel Single-Tissue Summary-Data Mendelian Randomization and Functional Validation Identify the ARRDC1 Promoter SNP rs4494021 as a Genetic Marker Associated with Anxiety Disorders.","authors":"Lesheng Wang, Zhipeng Xu, Gaomeng Luo, Wei Wei, Meimei Guo, Yunhe Yuan, Bei Shi, Haowen Guan, Sha Liu, Xiang Li","doi":"10.2147/NDT.S593689","DOIUrl":"10.2147/NDT.S593689","url":null,"abstract":"<p><strong>Purpose: </strong>Anxiety disorders are highly heritable, but their underlying genetic mechanisms remain poorly understood. This study aimed to identify and functionally characterize genes whose expression is causally linked to anxiety disorder risk by integrating the parallel single-tissue genetic data.</p><p><strong>Methods: </strong>We applied a parallel single-tissue summary-data-based Mendelian randomization (SMR) approach. This integrated large-scale anxiety disorder GWAS statistics with expression quantitative trait loci (eQTL) data from peripheral blood and 13 brain regions. The functional impact of a prioritized SNP (rs4494021) was tested via dual-luciferase reporter assay. The behavioral consequences were investigated by performing stereotaxic, lentivirus-mediated overexpression of ARRDC1 specifically in the mouse cerebellar hemisphere, followed by comprehensive behavioral testing.</p><p><strong>Results: </strong>The SMR analysis identified thirteen potential causal genes (ITIH3, ZKSCAN4, GNL3, SLC35C1, FNBP4, COPZ1, ATP5MC1, ITIH4, EHMT1, PTPMT1, ARRDC1, NEK4, and BTN3A2). Among them, ARRDC1 emerged as a significant gene, showing associations with anxiety disorders in blood, cerebellar hemisphere, and cerebellum. The risk allele of the promoter SNP rs4494021 significantly enhanced ARRDC1 transcriptional activity. Crucially, cerebellar overexpression of ARRDC1 in mice robustly induced anxiety-like behaviors, including reduced exploration in the open field test, decreased open-arm activity in the elevated plus maze, and increased avoidance in the light-dark box test.</p><p><strong>Conclusion: </strong>By bridging genetic epidemiology with molecular and behavioral validation, this study identifies ARRDC1 promoter SNP rs4494021 as a genetically associated marker for anxiety disorders and functionally validates that elevated cerebellar ARRDC1 expression contributes to anxiety pathogenesis. These findings establish ARRDC1 as a functionally supported risk gene and highlight a novel component of anxiety-related neurocircuitry.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"593689"},"PeriodicalIF":3.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147777350","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}