Communications medicine最新文献

{"title":"Probiotic effects on brain health are both transient and sustained for several weeks after discontinuation: a randomised controlled trial.","authors":"Ashley N Hutchinson, Robert J Brummer, Julia Rode","doi":"10.1038/s43856-026-01800-6","DOIUrl":"10.1038/s43856-026-01800-6","url":null,"abstract":"<p><strong>Background: </strong>Modulating the gut-brain axis via probiotic supplementation has emerged as attractive strategy to promote brain health, but its long-term effects are largely unknown.</p><p><strong>Methods: </strong>This study with 32 community-dwelling self-reported healthy older adults (68.0 ± 5.4 years, 21 f/11 m, without contraindications for study examinations) assesses whether probiotic effects persist after intake cessation using brain imaging, targeting function (exploratory outcome of main study, primary outcome of report) and structure, and questionnaires for psychological assessments (exploratory). The 4-6 weeks discontinuation follow-up was performed after assessing immediate effects of a six-week randomised, blinded (investigators, nurses, participants), placebo-controlled parallel trial with two different formulations of Lacticaseibacillus rhamnosus HN001 of identical appearance/taste, in autumn 2023 in Örebro, Sweden.</p><p><strong>Results: </strong>Trial status: completed; participants analysed (of randomised) per group: n = 8(29) encapsulated probiotic, n = 12(31) non-encapsulated probiotic, n = 12(30) placebo; no related adverse events at discontinuation follow-up. Previously reported immediate intervention effects evoked alteration in anxiety symptom scores and distinct resting state functional connectivity patterns. While some changes persisted, others were not detectable any longer at discontinuation follow-up. Comparing both probiotic formulations, connectivity between left superior parietal lobule and right occipital/cuneal/intracalcarine/supracalcarine cortex differed significantly (seed-to-voxel analysis, T = + 7.38, cluster-size p = 0.0001 FDR-corrected, additionally correct for number of tests); levels for Hospital Anxiety and Depression Scale Total Score and its Anxiety Subscore differed significantly (time*group interaction effects); both between weeks 10-12 and week 6, but not baseline.</p><p><strong>Conclusions: </strong>These findings suggest that some brain-related probiotic effects may indeed persist 4-6 weeks post-intervention cessation, especially on the level of brain function as indicated by resting state functional connectivity, suggesting longer-lasting gut-brain axis effects than previously presumed.</p><p><strong>Registration: </strong>ClinicalTrials.gov NCT05801042.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13415881/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping genetic convergence across brain structure, mental health, and cardiometabolic disease.","authors":"Jakub Kopal, Alexey A Shadrin, Dennis van der Meer, Olav B Smeland, Sara E Stinson, Linn Rødevand, Nadine Parker, Kevin S O'Connell, Oleksandr Frei, Srdjan Djurovic, Anders M Dale, Ole A Andreassen","doi":"10.1038/s43856-026-01510-z","DOIUrl":"10.1038/s43856-026-01510-z","url":null,"abstract":"<p><strong>Background: </strong>Individuals with psychiatric disorders frequently experience comorbid cardiometabolic conditions, complicating treatment and worsening health outcomes. Both psychiatric and cardiometabolic disorders have been individually associated with alterations in brain structure. Yet, it remains unclear whether these associations stem from a shared genetic basis that underlies their frequent co-occurrence.</p><p><strong>Methods: </strong>We analyzed genome-wide association summary statistics from large international consortia of individuals of European ancestry, including psychiatric disorder GWAS with case-control sample sizes ranging from ~18,000 to ~158,000 cases, cardiometabolic disease GWAS with up to ~242,000 cases, and cortical morphology GWAS from UK Biobank comprising ~39,000 individuals. We applied complementary multivariate, causal, and mediation genetic analyses to disentangle genetic factors underlying brain alterations and comorbidity.</p><p><strong>Results: </strong>Here we show that patterns of genetic overlap differ across disorders. Schizophrenia exhibits substantial polygenic overlap with cortical thickness and type 2 diabetes, despite low genetic correlation. In contrast, attention-deficit/hyperactivity disorder (ADHD) is more strongly correlated with cardiometabolic disease but shows limited overlap with cortical morphology. Notably, cortical surface area partly mediates the genetic association between ADHD and type 2 diabetes. Pathway analyses highlight metabolic stress processes in ADHD as well as neurodevelopmental and immune processes in schizophrenia.</p><p><strong>Conclusions: </strong>These findings indicate that psychiatric-cardiometabolic comorbidity arises through both shared and disorder-specific genetic pathways. This work clarifies the genetic architecture of multimorbidity and highlights opportunities for trait-targeted prevention strategies in psychiatry.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13407876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancing data protections for implantable brain-computer interfaces.","authors":"Julian D Sandbrink, Michael J Young","doi":"10.1038/s43856-026-01797-y","DOIUrl":"10.1038/s43856-026-01797-y","url":null,"abstract":"<p><p>Implantable brain-computer interfaces (iBCIs) are rapidly transitioning from proof-of-concept devices to early clinical application. The high-resolution neural signals they capture may yield insights beyond those derived from conventional health data. In this Review, we examine how clinical iBCI data remain insufficiently protected, despite existing privacy laws like the Health Insurance Portability and Accountability Act (HIPAA) and the General Data Protection Regulation (GDPR). Five core gaps are identified: overreliance on conventional de-identification, limited individual control and rights, conflated consent practices, limited guardrails against misuse, and underspecified ownership. We examine strategies to address these gaps, including protections for de-identified data, stronger iBCI data rights and control, separate data consent, limits on harmful secondary uses, and monetization guardrails. As iBCIs transition from research tools to real-world clinical practice, clinicians, researchers, developers, and regulators, in dialogue with prospective and current iBCI users, will play central roles in advancing patient autonomy and privacy.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408982/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"High-dimensional profiling following third MMR vaccination or mumps virus infection reveals individuals with suboptimal immunity.","authors":"René H M Raeven, Martijn Vos, Maarten E Emmelot, Petra Molenaar, Irina Tcherniaeva, Hinke I Ten Hulscher, Sara Suarez Hernandez, Patricia Kaaijk","doi":"10.1038/s43856-026-01801-5","DOIUrl":"10.1038/s43856-026-01801-5","url":null,"abstract":"<p><strong>Background: </strong>Interindividual variation in vaccine responsiveness can help to identify tailored vaccine strategies for groups with suboptimal responses and potentially higher risk.</p><p><strong>Methods: </strong>Here we assessed and compared such interindividual variation in humoral and cellular immune responses following a third Mumps-Measles-Rubella (MMR3) immunization and mumps virus infection in young adults with a multiparameter analysis.</p><p><strong>Results: </strong>We demonstrate that MMR3 boosts (neutralizing) antibody, IgG⁺ B cell and CD4⁺ T cell responses against mumps virus whereas a mumps virus infection induces similar but stronger immune responses, including robust mumps-specific CD8⁺ T cell immunity. Interindividual variation in pre-existing and vaccine-induced immunity unravels subpopulations with low and high mumps-specific responses that are distinct in magnitude, kinetics, longevity and correlation profiles. High-dimensional immunophenotyping subsequently reveals that circulating Th1/Th17 central memory T cells (CD127⁺CD25^-CD38^-) correlate with MMR3-induced mumps-specific activated (CD137⁺CD154⁺OX40⁺) CD4⁺ T cell responses, particularly in high-responder groups, while a minor IgG⁺ memory B cell subset (CD38⁺CD21⁺CD95⁺CD24^-CXCR5⁺CCR6⁺CXCR3⁺) modestly correlates with virus-neutralizing antibody titers. Notably, infected individuals are characterized by elevated frequencies of innate lymphocyte subsets.</p><p><strong>Conclusions: </strong>Overall, our results indicate that a third MMR immunization boosts humoral and cellular responses in young adults albeit with clear distinct immune response profiles. This may enable the identification and more effective targeting of groups with suboptimal immunity.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149066511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The wider implications of dactylitis beyond psoriatic arthritis.","authors":"Niccolò Possemato, Marianna Oliva, Alessandra Rai, Nicolò Girolimetto, Francesco Caso, Carlo Salvarani, Antonio Marchesoni, Philip S Helliwell","doi":"10.1038/s43856-026-01730-3","DOIUrl":"10.1038/s43856-026-01730-3","url":null,"abstract":"<p><p>Dactylitis (from the Greek word dactylos, meaning \"digit\") is a medical condition commonly known as \"sausage digit\", referring to the diffuse swelling of a finger or toe. Dactylitis is most commonly associated with the spectrum of spondyloarthritis, particularly psoriatic arthritis (PsA), and more rarely with other inflammatory conditions such as sarcoidosis and gout. In PsA, dactylitis is associated with increased disease severity and radiographic progression, and its recognition may facilitate early diagnosis and timely treatment. In sarcoid disease, dactylitis is clinically relevant, reflecting granulomatous inflammation and potentially indicating multisystem involvement. Although most commonly linked to inflammatory disorders, it may also manifest in a variety of other conditions, such as trauma, congenital deformities, infectious diseases, and neoplastic processes, all of which can present with a clinically indistinguishable phenotype. This review provides a comprehensive, up-to-date overview of dactylitis, beginning with the origin of the term and its earliest historical and scientific references, and concluding with the latest insights into aetiopathogenesis, classification, anatomy, imaging, and therapeutic strategies. Through the integration of clinical knowledge with new developments in imaging, the paper explores how the study of dactylitis can extend beyond PsA.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13400733/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148586134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author Correction: Current status and future perspectives on the mechanistic and pathophysiological understanding of long COVID.","authors":"Mark A Faghy, Rob C I Wüst, Daniel M Altmann, Ruth Em Ashton, Sarah Barley McMullen, Rae Duncan, Andrew G Ewing, Elke Hausmann, Sanjay Gupta, Mady Hornig, David Joffe, Binita Kane, M Asad Khan, Micheal Natt, Rebecca Owen, David Putrino, Lindsay Skipper, Claire Taylor, Callum Thomas, David Tuller, Danielle Beckman, Arneaux Kruger, Etheresia Pretorius","doi":"10.1038/s43856-026-01806-0","DOIUrl":"10.1038/s43856-026-01806-0","url":null,"abstract":"","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":"6 1","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13396509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual atrophy patterns clarify latent neural subtypes in addiction.","authors":"Min Wang, Lei Guo, Ningning Zeng, Zhoukang Wu, Liangjiecheng Huang, Yijun Chen, Tianzhen Chen, Ziliang Wang, Qiang Hu, Guangheng Dong, Jun Yin, Hang Su, Hui Zheng","doi":"10.1038/s43856-026-01776-3","DOIUrl":"https://doi.org/10.1038/s43856-026-01776-3","url":null,"abstract":"<p><strong>Background: </strong>Addiction is a brain disorder marked by profound inter-individual heterogeneity, a factor that limits the clinical utility of group-level neuroimaging findings.</p><p><strong>Methods: </strong>To address this, we constructed a precision neuroimaging framework to capture individual variability. We quantified gray matter volume (GMV) deviations in 464 individuals with five substance-related and addictive disorders using a normative model derived from over 1000 healthy controls. Subsequently, we applied a dimensionality reduction technique to decompose these individual deviations into distinct spatial patterns.</p><p><strong>Results: </strong>We observe a shared pattern involving the insula and prefrontal cortex that reflects common underlying biology across different addictions. In contrast, a pattern centered on the basal ganglia captures the differences between specific addiction types. Importantly, only transdiagnostic factors correlated with clinical measures, whereas the heterogeneity factor did not.</p><p><strong>Conclusions: </strong>By resolving neurobiological heterogeneity into distinct, structural atrophy subtypes, this framework offers insights into understanding structural heterogeneity as a local effect of common networks.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating remote testing and machine learning to identify markers of cerebellar ataxia at home.","authors":"Penina Ponger, Yael De Picciotto, Daniela Maisel, Hanna Liandres, Sarah Brisman, William Saban","doi":"10.1038/s43856-026-01794-1","DOIUrl":"10.1038/s43856-026-01794-1","url":null,"abstract":"<p><strong>Background: </strong>In-person assessments face accessibility, scalability, and geographic diversity challenges, especially for rare diseases. Additionally, Cerebellar Ataxia (CA) non-motor symptoms(NMS) are often overlooked. We aimed to address these gaps by leveraging the Internet and machine-learning.</p><p><strong>Methods: </strong>In a bi-center study, we assessed 100 participants: 30 CA, 45 neurotypically healthy(NH), and 25 Parkinson's disease(PD), recruited from 57 geographical locations across two countries. We evaluated multiple domains-cognition, anxiety, depression, social support, and personality-using accessible online tools. We applied leave-one-out cross-validation and feature importance analysis to examine the machine-learning model's ability to distinguish between groups and identify the most sensitive and specific CA predictors.</p><p><strong>Results: </strong>Machine-learning models trained on these remote non-motor features alone, yield AUCs of 0.74/0.76(CA vs. NH) and 0.78/0.79 (CA vs. PD) using leave-one-out cross-validation, demonstrating classification power exceeding 20%.</p><p><strong>Conclusion: </strong>These findings highlight the value of integrating digital-health technologies and machine-learning models for CA NMS evaluation, potentially serving as scalable digital-markers.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating care across the life course supports goal-aligned end-of-life care.","authors":"M Courtney Hughes","doi":"10.1038/s43856-026-01807-z","DOIUrl":"10.1038/s43856-026-01807-z","url":null,"abstract":"<p><p>As global populations age and lifespan increases, health systems too often conceptualize \"healthy aging\" and \"end-of-life care\" as distinct phases. Yet emerging evidence from geroscience, palliative care, and health systems science suggests that aging and dying lie on a continuum of adaptation and care. This Perspective proposes a framework that treats system-supported, goal-aligned end-of-life care as a public health outcome of integrated life-course care and argues for system redesign to introduce earlier palliative approaches, align care models across the life-course, and reduce health disparities. This article outlines key mechanisms, evidence for integration, a conceptual model, and implications.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13408578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148537453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and diagnostic performance of vaginal squamous cell carcinoma after hysterectomy.","authors":"Fengyi Xiao, Min Xiao, Tingting Su, Long Sui","doi":"10.1038/s43856-026-01803-3","DOIUrl":"https://doi.org/10.1038/s43856-026-01803-3","url":null,"abstract":"<p><strong>Background: </strong>Vaginal squamous cell carcinoma (SCC) is a rare gynecological malignancy. Current guidelines do not recommend routine cancer screening after hysterectomy for non-cervical conditions based on the assumption of negligible risk. However, clinical characteristics of vaginal SCC in post-hysterectomy women remain inadequately defined, particularly for those with non-cervical indications.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of 227 patients with vaginal SCC diagnosed at a Chinese tertiary center between 2017 and 2025. Clinical characteristics, high-risk human papillomavirus (HPV) status, diagnostic yields of cytology, colposcopy, ultrasound and MRI, and latency from hysterectomy to cancer diagnosis were analyzed.</p><p><strong>Results: </strong>We found that 66.5% (151/227) of vaginal SCC cases occurred in women with prior hysterectomy; 86.1% had surgery for cervical lesions and 13.9% for non-cervical indications. The overall high-risk HPV positivity rate was 94.7%, with HPV16 predominating (74.9%). Regular post-hysterectomy surveillance was associated with earlier stage at diagnosis: 90.6% of surveilled patients presented with stage I disease versus 65.8% of non-surveilled patients. Latency to diagnosis was significantly shorter for women with prior cervical lesions (median 46.5 versus 120 months). Cytology and colposcopy demonstrated diagnostic yields exceeding 90%, while imaging showed lower detection rates.</p><p><strong>Conclusions: </strong>Vaginal SCC after hysterectomy is predominantly HPV-driven, including in women with non-cervical indications. Regular post-hysterectomy surveillance is strongly associated with earlier stage at diagnosis. While universal screening is not warranted due to disease rarity, these findings support individualized HPV-informed risk counseling for sexually active women after hysterectomy and reinforce current surveillance recommendations for those with prior cervical lesions.</p>","PeriodicalId":72646,"journal":{"name":"Communications medicine","volume":" ","pages":""},"PeriodicalIF":7.4,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148498458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}