Psychiatry and Clinical Neurosciences最新文献

{"title":"Metabolome Profiling of Yokukansan in Preventing Postoperative Delirium in Elderly Cancer Patients: A Reverse Translational Study.","authors":"Ryoichi Sadahiro, Katsuya Ohbuchi, Taiki Nakaya, Sei Manabe, Saho Wada, Takuhiro Yamaguchi, Masahiro Sugimoto, Ken Shimizu, Tetsufumi Sato, Minoru Esaki, Hiroyuki Daiko, Seiichi Yoshimoto, Yukihide Kanemitsu, Akira Kawai, Mitsuya Ishikawa, Yoshiyuki Matsui, Kazunori Aoki, Takao Ueno, Hiromichi Matsuoka, Yasuhito Uezono","doi":"10.1111/pcn.13875","DOIUrl":"10.1111/pcn.13875","url":null,"abstract":"<p><strong>Aims: </strong>Postoperative delirium (PD) is a common and severe complication in older adult patients undergoing invasive cancer resections. This study explored the plasma metabolome associated with PD and evaluated the efficacy of Yokukansan (YKS), a traditional Japanese Kampo medicine, in preventing PD.</p><p><strong>Methods: </strong>An ancillary study was conducted alongside a double-blind, placebo-controlled randomized clinical trial involving patients 65 years and older, focusing on patients older than 75 years as a primary analysis population. Plasma samples were analyzed using targeted and nontargeted metabolomics. An in vivo study using aged mice assessed the effects of YKS on plasma and brain metabolites.</p><p><strong>Results: </strong>A total of 83 patients, including 21 patients older than 75 years, were enrolled. Patients with PD had lower levels of several lipid mediators, free fatty acids, and phospholipids. YKS administration led to increased nine phospholipids and four hydrophilic metabolites in patients older than 75 years, including phosphatidylcholine (40:7) and phosphatidylcholine (42:8), which were also altered in delirium patients. In the patients older than 65 years, only two metabolites increased in the YKS administration group. In aged mice, YKS elevated plasma phospholipids, similar to findings in patients older than 75 years, and influenced brain citrulline and creatine, which related to oxidative stress and cognitive function. Correlation analyses revealed associations between plasma and brain metabolite changes.</p><p><strong>Conclusion: </strong>Our findings suggest that the plasma metabolome provides insight into the pathophysiology of PD and the potential mechanism underlying the preventive effect of YKS against PD.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"685-696"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789832","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":"Frailty subtypes and white matter alterations in older adults without dementia.","authors":"Chen-Hua Lin, Yah-Ting Wu, Jun-Ying Wei, Yao-Chia Shih, Yi-Ping Chao, Yen-Jun Lai, Yen-Ling Chiu, Yi-Fang Chuang","doi":"10.1111/pcn.13876","DOIUrl":"10.1111/pcn.13876","url":null,"abstract":"<p><strong>Aim: </strong>Frailty increases the risk of cognitive decline in older adults, yet the brain structural patterns associated with different frailty subtypes remain unclear. This study examined white matter (WM) alterations across frailty subtypes in community-dwelling older adults without dementia.</p><p><strong>Methods: </strong>This cross-sectional study included participants from the Taiwan Precision Medicine Initiative on Cognitive Impairment and Dementia (TPMIC) cohort. Frailty was assessed using Fried's phenotype and classified into mobility, non-mobility, and low physical activity subtypes. Cognitive function (attention, memory, and executive function) was evaluated using standardized neuropsychological tests. WM microstructure was measured using diffusion tensor imaging (DTI) metrics, including fractional anisotropy (FA) and mean diffusivity (MD).</p><p><strong>Results: </strong>Among 297 participants, 91 (30.6%) were pre-frail/frail. The pre-frail/frail group showed widespread WM alterations, with the internal capsule (IC) remaining significant after full adjustment and FDR correction (q < 0.05). The mobility subtype was associated with poorer cognitive performance across all domains (all P < 0.01) and showed lower FA and higher MD primarily in motor and cognitive-related tracts, such as the corpus callosum (all q < 0.05). In contrast, the non-mobility subtype was associated with poorer attention and executive function, with alterations primarily in emotion-regulation tracts, such as the cingulum and forceps major (all q < 0.05). No significant WM differences were found for the low physical activity subtype.</p><p><strong>Conclusion: </strong>Frailty subtypes are associated with distinct WM alteration patterns, reflecting potentially different mechanisms of brain aging. These findings highlight the importance of subtype-specific approaches to early detection and intervention.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"677-684"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732973","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 a digital therapeutic for alcohol dependence: A multicenter, open-label, randomized controlled trial.","authors":"Ryuhei So, Kazuhiro Nouso, Sachio Matsushita, Hitoshi Yoshiji, Takefumi Yuzuriha, Eisuke Hida, Hiroki Nishimura, Yusuke Takagi, Yoshinori Horie","doi":"10.1111/pcn.13874","DOIUrl":"10.1111/pcn.13874","url":null,"abstract":"<p><strong>Aim: </strong>Digital therapeutics (DTx) is an emerging treatment modality for enhancing psychosocial interventions via software programs, such as smartphone applications (apps). We developed a DTx named ALM-003 to support treatment for people with alcohol dependence who are pursuing reduced drinking goals. ALM-003 was designed to promote behavioral change through daily self-monitoring with personalized feedback, interactive psychoeducational modules, and automated treatment support tools for both patients and physicians. In this multicenter, open-label, randomized controlled trial (RCT), we aimed to evaluate the efficacy and safety of ALM-003 in various clinical settings.</p><p><strong>Methods: </strong>In this RCT, participants with alcohol dependence without serious physical, mental, or social problems due to excessive drinking, and exhibiting high or very high drinking risk levels were randomized into an intervention group (psychosocial intervention enhanced by ALM-003) or a control group (psychosocial intervention with a basic drinking diary app) for 24 weeks. The primary outcome was the change in the number of heavy drinking days (HDDs) over 28 days (Week 0 to Week 12).</p><p><strong>Results: </strong>Data analysis of the primary outcome for 136 intervention and 142 control participants was performed. Baseline HDDs were 23.2 and 23.1 days/28 days in the intervention and control groups, respectively. [Correction added on 3 September 2025, after first online publication: The values of the baseline HDDs in the preceding sentence have been corrected from '19.4 and 19.1 days' to '23.2 and 23.1 days'.] At Week 12, the intervention and control groups showed a reduction in HDDs of -12.2 and -9.5 days from baseline, with a between-group difference of -2.79 days/28 days (95% confidence interval: -4.67 to -0.90; P = 0.004). Adverse events occurred in 32.9% of participants in the intervention group and 33.6% in the control group. No adverse events were attributed to app use.</p><p><strong>Conclusion: </strong>ALM-003 demonstrated efficacy in reducing heavy drinking days among people with alcohol dependence at a high or very high drinking risk.</p><p><strong>Clinical trial registration: </strong>The trial design was prospectively registered with the Japan Registry of Clinical Trials (jRCT) (https://jrct.niph.go.jp/). The trial identifier is jRCT2032220560.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"667-676"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12498122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732972","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":"Gastrointestinal obstruction due to the pica of plastic gloves in a long-term hospitalized patient with schizophrenia.","authors":"Shotaro Fujiwara, Hitomi Wake","doi":"10.1111/pcn.13896","DOIUrl":"https://doi.org/10.1111/pcn.13896","url":null,"abstract":"<p><p>An elderly inpatient with schizophrenia and pica developed bowel obstruction after ingesting plastic gloves; laparotomy removed eleven gloves. The case underscores the need to eliminate seemingly harmless plastic items from the environment of patients with pica, especially those with cognitive or communication impairments.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145200758","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bipolar disorder following reversible splenial lesion syndrome.","authors":"Yuri Kobayashi, Yuhei Mori, Akiko Sato, Yuya Itagaki, Yuhei Suzuki, Kazuko Kanno, Tetsuya Shiga, Shuntaro Itagaki, Kazuaki Kanai, Itaru Miura","doi":"10.1111/pcn.13879","DOIUrl":"10.1111/pcn.13879","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"708-710"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mental health consequences of visibility: How seeing others' situations influences well-being.","authors":"Akihiro Nishi, Michael Mengual","doi":"10.1111/pcn.13873","DOIUrl":"10.1111/pcn.13873","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"707-708"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute and long-term effects of repeated ketamine infusions in treatment-resistant depression and associated metabolite changes.","authors":"Hitoshi Sakurai, Daiki Setoyama, Takahiro A Kato, Hisateru Tachimori, Masami Murao, Yasuyuki Matsumoto, Teruo Tada, Yayoi Imamura, Hiroyuki Seki, Takashi Tsuboi, Hiroyuki Uchida, Koichiro Watanabe","doi":"10.1111/pcn.13870","DOIUrl":"10.1111/pcn.13870","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to investigate the acute and sustained antidepressant effects of repeated ketamine infusions in patients with treatment-resistant depression (TRD), and to identify early metabolomic changes predictive of treatment outcomes using metabolome analyses.</p><p><strong>Methods: </strong>This open-label study investigated the effects of four intravenous ketamine infusions (0.5 mg/kg) administered over 2 weeks in 30 patients with TRD. Clinical outcomes, including the Montgomery-Åsberg Depression Rating Scale (MADRS), were evaluated at baseline, 1-2 h after each infusion, and monthly during a 12-month follow-up. Plasma levels of 11 depression-associated metabolites were measured at baseline and 1.5-2 h after the first infusion. A general linear model was employed to analyze the association between metabolite changes after the first infusion and the MADRS score percent improvements after the fourth infusion and at 12 months. Remission was defined as a MADRS score of ≤10.</p><p><strong>Results: </strong>All participants completed the four infusions. The MADRS score decreased from 30.6 ± 6.1 at baseline to 20.3 ± 11.5 after the fourth infusion, with a remission rate of 26.7%. At 12 months, 13.3% of participants remained in remission. Changes in 3-hydroxybutyrate levels after the first infusion predicted the MADRS score percent improvements after the fourth infusion (β = 1.35, 95% CI: 0.41-2.30, P = 0.005) and at 12 months (β = 1.38, 95% CI: 0.37-2.39, P = 0.007).</p><p><strong>Conclusion: </strong>While repeated ketamine infusions demonstrated rapid antidepressant effects, sustained remission was achieved in a minority of patients with TRD. 3-Hydroxybutyrate may serve as a biomarker for predicting treatment response. These findings underscore the potential for individualized strategies using ketamine infusions.</p><p><strong>Clinical trial registration: </strong>jRCTs031210648 (Japan Registry of Clinical Trials).</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":"645-652"},"PeriodicalIF":6.2,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in determining motor threshold for therapeutic repetitive transcranial magnetic stimulation: A paradigmatic case report of radiculopathy.","authors":"Joshua Tritsch, Amelie Völkel, Alkomiet Hasan, Frank Padberg, Wolfgang Strube","doi":"10.1111/pcn.13900","DOIUrl":"https://doi.org/10.1111/pcn.13900","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145177884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mendelian randomization analyses uncover causal relationships between brain structural connectome and risk of psychiatric disorders.","authors":"Kanwei Xiao, Xinle Chang, Chenfei Ye, Zhiguo Zhang, Ting Ma, Jingyong Su","doi":"10.1111/pcn.13897","DOIUrl":"10.1111/pcn.13897","url":null,"abstract":"<p><strong>Aims: </strong>Growing evidence suggests abnormalities of brain structural connectome in psychiatric disorders, but the causal relationships remain underexplored. Therefore, elucidating the causality is critical for deciphering the neurobiological underpinnings of mental illnesses.</p><p><strong>Methods: </strong>We conducted bidirectional two-sample Mendelian randomization (MR) analyses to investigate the causal links between 206 white-matter connectivity phenotypes (n = 26,333, UK Biobank) and 13 major psychiatric disorders (n = 14,307 to 1,222,882).</p><p><strong>Results: </strong>Forward MR analyses identified causal effects of five genetically predicted white-matter structural connectivity phenotypes on six psychiatric disorders, with associations being significant or suggestive. For instance, the increase in structural connectivity between the left-hemisphere frontoparietal control network and right-hemisphere default mode network was significantly causally associated with decreased autism spectrum disorder risk, while elevated structural connectivity between the right-hemisphere frontoparietal control network and hippocampus was significantly causally linked to lower risk of both anorexia nervosa and cannabis use disorder. Reverse MR analyses revealed significantly or suggestively causal relationships between the risk of two psychiatric disorders and four different white-matter structural connectivity phenotypes. For example, the heightened susceptibility to anorexia nervosa was found to be significantly causally associated with diminished structural connectivity between the left-hemisphere visual network and pallidum.</p><p><strong>Conclusions: </strong>These findings offer new insights into the cause of psychiatric disorders and highlight potential biomarkers for early detection and prevention at the brain structural connectome level.</p>","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next steps of predictive models using biological measurements in psychiatry.","authors":"Shinsuke Koike","doi":"10.1111/pcn.13898","DOIUrl":"https://doi.org/10.1111/pcn.13898","url":null,"abstract":"","PeriodicalId":20938,"journal":{"name":"Psychiatry and Clinical Neurosciences","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145150431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}