Neuropsychiatric Disease and Treatment最新文献

{"title":"Comparison of Neurocognitive Effects of Blonanserin, Olanzapine, Aripiprazole, and Risperidone in Drug-Naïve First-Episode Schizophrenia.","authors":"WanHeng Hu, BingJie Huang, XiaoDong Guo, XiaoLin Yin, XiangHe Wang, YunFei Ji, Yue Zheng, TianQi Gao, Chuan Shi, Xin Yu, Chengcheng Pu","doi":"10.2147/NDT.S603001","DOIUrl":"10.2147/NDT.S603001","url":null,"abstract":"<p><strong>Background: </strong>Neurocognitive deficits are a core feature of schizophrenia. The specific impact of antipsychotics on neurocognitive function in drug-naïve first-episode schizophrenia (FES) remains unclear, especially for newer agents like blonanserin. This study compared the neurocognitive effects of blonanserin, olanzapine, aripiprazole, and risperidone during the first 6 months of treatment in FES patients.</p><p><strong>Study design: </strong>Data were derived from two clinical trials in which FES patients received initial treatment with blonanserin, olanzapine, aripiprazole, or risperidone. Neurocognitive function was assessed at baseline and 6 months using multiple measures. Paired t-tests evaluated within-group changes, and repeated measures ANOVA examined differential effects across groups.</p><p><strong>Study results: </strong>Of 594 recruited patients, 294 completed follow-up. All four groups showed comparable improvements in processing speed and working memory. A significant group-by-time interaction was observed for verbal (<i>p</i> = 0.005) and visuospatial memory (<i>p</i> = 0.054). Notably, blonanserin-treated patients demonstrated greater improvements in verbal learning (<i>p</i> = 0.005) and visuospatial memory (<i>p</i> = 0.045) compared to risperidone.</p><p><strong>Conclusion: </strong>Initial antipsychotic treatment in drug-naïve FES patients is associated with neurocognitive benefits, particularly in processing speed and working memory. Furthermore, blonanserin may offer advantages in ameliorating learning and memory deficits compared to risperidone.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"603001"},"PeriodicalIF":3.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974483","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":"<i>Cistanche deserticola</i> Stem Extract Attenuates Depression Through NF-κB Pathway Modulation: Insights from Network Pharmacology and Experimental Validation.","authors":"Shijie Jiang, Zhiguo An, Qiang Hu, Yong Song, Xiaofeng Zhao, Shuaishuai Gao, Qiyu Jia, Bin Xu","doi":"10.2147/NDT.S586181","DOIUrl":"10.2147/NDT.S586181","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to elucidate the effects of <i>Cistanche deserticola</i> Y. C. Ma on depression and its mechanisms through a comprehensive approach involving network pharmacology evaluation, molecular docking, and animal experiments.</p><p><strong>Methods: </strong>By integrating network pharmacology, molecular docking, and animal testing, we systematically revealed the molecular mechanisms of the antidepressant effects of <i>Cistanche deserticola</i>. The main active components of <i>Cistanche deserticola</i> were selected from the TCMSP database, and depression-related targets were cross-verified using the OMIM/DisGeNET databases. Subsequently, a protein-protein interaction network was constructed using STRING, and the relationships between drug, target, and pathway were visualized using Cytoscape. GO function and KEGG pathway enrichment analyses were performed using DAVID and Metascape, molecular docking of core components with target proteins was completed using AutoDock Vina. The antidepressant effects and neuroprotective effects of <i>Cistanche deserticola</i> were further evaluated in a chronic unpredictable mild stress (CUMS) mouse model through behavioral tests and immunofluorescence, Nissl, and HE staining in the hippocampus.</p><p><strong>Results: </strong>Network pharmacology identified 6 key active components and 74 potential targets, focusing on 25 core targets. Molecular docking demonstrated that key components exhibited high affinity with core targets, with binding energies less than -5 kcal·mol^-1. KEGG enrichment analysis indicated that the NF-κB signaling pathway serves as a core regulatory axis (<i>FDR</i> < 0.001). Animal experiments confirmed that <i>Cistanche deserticola</i> significantly inhibited the activation of M1 microglia in the hippocampus of CUMS mice, reducing the expression of IL-1β, VCAM1, and NF-κB (<i>P</i> < 0.0001), while alleviating neuronal morphological damage and significantly improving depressive-like behaviors and cognitive impairments.</p><p><strong>Conclusion: </strong><i>Cistanche deserticola</i> exerts antidepressant effects by regulating the NF-κB signaling pathway and inhibiting neuroinflammation. This study provides preliminary theoretical and experimental evidence supporting the potential of <i>Cistanche deserticola</i> stem as a safe and tolerable plant-derived antidepressant.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"586181"},"PeriodicalIF":3.2,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147974474","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":"Functional Impairment and Post-Stroke Depression: Potential Roles of Sleep Quality and Fatigue in a Cross-Sectional Structural Equation Analysis.","authors":"Qian-Ying Hu, Kai-Yue Yang, Yu-Fei Ming, Su-Juan Sun, Juan Liu","doi":"10.2147/NDT.S606661","DOIUrl":"10.2147/NDT.S606661","url":null,"abstract":"<p><strong>Objective: </strong>To examine the association between functional impairment and depressive symptoms in hospitalized patients undergoing post-stroke rehabilitation, and to explore whether sleep quality and fatigue were statistically linked to this association within a structural equation modeling framework. We also compared the relative contributions of the Barthel Index (BI) and modified Rankin Scale (mRS).</p><p><strong>Methods: </strong>In this single-center retrospective cross-sectional study, 137 patients with stroke admitted for rehabilitation were included. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), sleep quality using the Pittsburgh Sleep Quality Index (PSQI), and fatigue using the Fatigue Assessment Scale (FAS). Functional status was evaluated with the BI (reverse-transformed to Barthel_rev) and mRS. Structural equation modeling with maximum likelihood estimation and bootstrap resampling (2,000 samples) was used to estimate direct and indirect associations.</p><p><strong>Results: </strong>In the primary latent-variable model, greater functional impairment was associated with poorer sleep quality (β=0.407, p=0.012) and greater fatigue (β=0.692, p=0.010). Poorer sleep quality was associated with higher PHQ-9 scores (β=0.296, p=0.003), whereas fatigue was not. The indirect association through sleep quality was significant (b=0.068, 95% CI 0.018-0.131), but the indirect association through fatigue was not. In a supplementary mutually adjusted model, mRS showed significant indirect associations with depressive symptoms through both sleep quality and fatigue, whereas Barthel_rev was linked primarily through fatigue. Because the supplementary model showed suboptimal fit, these findings should be interpreted cautiously.</p><p><strong>Conclusion: </strong>These findings suggest that sleep quality may represent a more consistent statistical pathway linking functional impairment and depressive symptoms in post-stroke rehabilitation, whereas the role of fatigue appears to vary by functional measure and model specification. Early screening of sleep disturbance and fatigue may still be clinically relevant, but causal inferences cannot be drawn from this cross-sectional study.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"606661"},"PeriodicalIF":3.2,"publicationDate":"2026-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973993","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":"Psychomotor Rehabilitation for Pediatric Delirium: A Study Protocol for a Randomized Controlled Trial Investigating Efficacy and Brain Electrophysiological Mechanisms.","authors":"Xiao Zhang, Yu-Qian Ren, Yi-Jun Shan, Yi-Ping Zhou, Jia-Ying Dou, Ye Lu, Yun Cui, Li-Juan Ao","doi":"10.2147/NDT.S595008","DOIUrl":"10.2147/NDT.S595008","url":null,"abstract":"<p><strong>Purpose: </strong>Pediatric delirium is a serious complication in critically ill children with limited effective treatments. This study aims to evaluate the efficacy and safety of Psychomotor Therapy (PMT)-a comprehensive rehabilitation system integrating motor, cognitive, emotional, and psychological domains-in treating pediatric delirium, and to characterize its underlying mechanisms through electroencephalographic (EEG) and brain network analyses.</p><p><strong>Patients and methods: </strong>This is a single-center, assessor-blinded, randomized controlled trial. A total of 34 participants (22 children with delirium aged 2 months to 14 years, meeting Richmond Agitation-Sedation Scale [RASS] and Cornell Assessment of Pediatric Delirium [CAPD] criteria, plus 6 children without any neurological disorders, managed within the same clinical environment) will be enrolled. Participants will be randomized to receive either PMT plus routine care or routine care alone. The PMT intervention will be administered once daily for 3 days. Primary outcome is the change in CAPD score. Secondary outcomes include delirium duration, EEG parameters, length of PICU stay, and safety. Assessments will be conducted at multiple time points before and after intervention.</p><p><strong>Results: </strong>This is a study protocol; as data collection is currently ongoing (January 2023-July 2026), final results are not yet available for analysis or reporting.</p><p><strong>Conclusion: </strong>The study has been approved by the ethics boards of Shanghai Yangzhi Rehabilitation Hospital and Shanghai Children's Hospital and will adhere to the Declaration of Helsinki. Findings will be disseminated via scientific conferences and publications. Key strengths include the first investigation of brain functional networks in pediatric delirium, incorporation of an environmental control group to mitigate confounding, and pioneering application of PMT. Limitations include single-center design and geographical restriction to Shanghai, necessitating future multi-center studies with larger samples.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"595008"},"PeriodicalIF":3.2,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13178487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963821","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 Electroencephalographic Biomarkers as Predictors of Post-Stroke Cognitive Outcomes in Patients with Cerebral Infarction: Literature Review.","authors":"Di Pu, Yan Xiong","doi":"10.2147/NDT.S566481","DOIUrl":"10.2147/NDT.S566481","url":null,"abstract":"<p><p>Cerebral infarction (ischemic stroke) is a leading cause of long-term disability. It is often associated with cognitive impairment that has a significant impact on quality of life. Predicting biomarkers is necessary, and electroencephalographic (EEG) biomarkers have emerged as promising tools to predict cognitive outcomes in these patients. To conduct this literature review, a comprehensive search was performed in different databases, including PubMed, Scopus, Web of Science, ScienceDirect, and Google Scholar from inception to 2025, focusing on biomarkers and the role of ECG in predicting cognitive outcomes. In addition, recent clinical trials were also reviewed and assessed for the role of biomarkers in predicting cognitive outcomes. This literature review suggests that specific EEG abnormalities, including generalized slowing or altered power in alpha, delta, beta, gamma, and theta bands, as well as disrupted functional connectivity, consistently correlate with deficits in memory, attention, and executive functioning. In addition, the ability to assess the effectiveness of cognitive rehabilitation interventions has also been demonstrated. It provides non-invasive, cost-effective, and accessible insights into brain function and event-related ability to assess cognitive prognosis after stroke. EEG biomarkers can be used as a predictor for cognitive impairments in patients with cerebral infarction (ischemic stroke).</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"566481"},"PeriodicalIF":3.2,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13179147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963771","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 Benefit and Risk Profile of TV-46000 for Patients with Schizophrenia as Assessed by Number Needed to Treat and Number Needed to Harm.","authors":"Leslie Citrome, Kelli R Franzenburg, Mark Suett, Orna Tohami, Nir Sharon, Ayellet Jehassi, Eran Harary, Daisy Yu, Christoph U Correll","doi":"10.2147/NDT.S534730","DOIUrl":"10.2147/NDT.S534730","url":null,"abstract":"<p><strong>Purpose: </strong>Long-acting injectable antipsychotics (LAIs) are underused, despite advantages in terms of patient outcomes. The Phase 3 RIsperidone Subcutaneous Extended-release (RISE) study evaluated the efficacy and safety of TV-46000, a subcutaneously administered long-acting formulation of risperidone, administered monthly (q1m) and once every 2 months (q2m), in patients with schizophrenia. During the relapse-prevention phase, TV-46000 significantly prolonged time to impending relapse versus placebo, with a safety profile comparable to other risperidone formulations. This post hoc study examined the number needed to treat (NNT) and the number needed to harm (NNH) using RISE data.</p><p><strong>Patients and methods: </strong>NNT estimates versus placebo were calculated for patients who were free of impending relapse (ie, worsening symptom scores, psychiatric hospitalization, aggressive/violent behavior, suicidality), maintained stability, and achieved remission as well as all-cause discontinuation (an acceptability proxy). NNH estimates were calculated for safety and tolerability outcomes.</p><p><strong>Results: </strong>TV-46000 NNT estimates (95% CI) versus placebo were 5 (4-7) for q1m and 7 (5-13) for q2m for avoidance of impending relapse, and 4 (3-6) and 6 (4-11) for maintenance of stability. Remission rates ranged from 16.6-23.5% and did not differ between TV-46000 and placebo (TV-46000 NNT estimates: q1m, 22; q2m, 15). For all groups, adverse event (AE)-related discontinuation rates were low (1.7-3.9%), and NNH estimates for TV-46000 q1m and q2m versus placebo were 190 and 45, respectively, and not statistically significant. For AEs common to many second-generation antipsychotics (eg, akathisia, restlessness, somnolence, sedation) and ≥7% weight increase from baseline, NNH estimates for TV-46000 versus placebo were ≥10 and not statistically significant, indicating favorable safety and tolerability.</p><p><strong>Conclusion: </strong>Robust, single-digit NNT estimates for avoiding impending relapse and maintaining symptomatic stability support TV-46000 q1m and q2m efficacy, and high NNH estimates for safety and tolerability endpoints suggest TV-46000 is well tolerated regardless of dosing frequency. These findings provide clinically intuitive data supporting a favorable benefit-risk profile of TV-46000 for relapse prevention.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"534730"},"PeriodicalIF":3.2,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13165495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932049","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":"Central Neurobiological Mechanisms of Acupuncture in Post-Stroke Depression: Multi-Target and Network-Based Regulation.","authors":"Jing Cao, Yangyang Xu, Huifang Mao, Jianbei Chen, Deguang Ding, Xinyin Xu","doi":"10.2147/NDT.S596862","DOIUrl":"10.2147/NDT.S596862","url":null,"abstract":"<p><p>Post-stroke depression (PSD) is a common post-stroke complication with limited treatment options and significant adverse effects from conventional drugs. Acupuncture, a multi-target holistic non-pharmacological intervention, shows unique clinical advantages. This review provides the first systematic synthesis of the central neurobiological mechanisms underlying acupuncture's therapeutic effects on PSD. The identified mechanisms include promoting neuroplasticity via the BDNF/TrkB pathway and rebalancing neurotransmitter systems (monoamines and glutamate/GABA). Additionally, acupuncture inhibits microglial activation and TLR4/NF-κB/NLRP3-driven neuroinflammation, restores mitochondrial homeostasis through AMPK-dependent autophagy, and modulates the gut microbiota-brain axis. Together, these findings elucidate the \"multi-target, network-based\" characteristics of acupuncture from a modern scientific perspective, providing a scientific basis for traditional Chinese acupuncture principles. By integrating recent mechanistic advances, this review addresses literature gaps and offers a theoretical foundation for optimizing clinical strategies, promoting mechanism-driven personalized interventions, and bridging traditional Chinese medicine with contemporary neuroscience.</p>","PeriodicalId":19378,"journal":{"name":"Neuropsychiatric Disease and Treatment","volume":"22 ","pages":"596862"},"PeriodicalIF":3.2,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13159009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147932031","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":"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}