{"title":"Proteome-Wide and Immune Cell Phenotype Mendelian Randomization Highlights Immune Involvement in Genetic Generalized Epilepsy","authors":"Jianxiong Gui, Hongyuan Chu, Junjiao Zhang, Xiao Li, Wenwei Liu, Renqiuguo Li, Fan Zhang, Meiyu Dong, Kai Gao, Huaxia Luo, Yuwu Jiang","doi":"10.1002/brb3.70625","DOIUrl":"https://doi.org/10.1002/brb3.70625","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Genetic generalized epilepsy (GGE) involves polygenic inheritance, with emerging evidence implicating immune mechanisms in seizure pathogenesis. Unlike previous studies focusing on inflammation following seizures, we employed an integrative multi-omics approach to identify precipitating immune factors in GGE development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summary data on plasma protein levels were extracted from two large protein quantitative trait loci (pQTLs) studies, measuring 4907 and 2923 plasma proteins in 35,559 and 54,219 individuals, respectively. Immune cell trait data were derived from a genome-wide association study (GWAS) involving 3757 individuals. GGE data, comprising 7407 cases and 52,538 controls, were sourced from a GWAS meta-analysis by the International League Against Epilepsy (ILAE). Mendelian randomization (MR) analysis identified associations between plasma proteins, immune cell phenotypes, and GGE. Colocalization analysis assessed whether plasma proteins and GGE share a common causal variant. Transcriptome-wide association studies (TWAS) from GTEx v8 brain tissue and whole blood were conducted for validation. Drug target prediction and molecular docking identified potential therapeutic interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified 62 potential susceptibility proteins by integrating GWAS data for GGE and its subsyndromes with plasma proteomics data. Of these, eight proteins showed strong evidence of colocalization, primarily within immune-related pathways. The absolute count of TD CD4<sup>+</sup> cells was significantly associated with GGE (OR [95% CI]: 0.69 [0.59, 0.81]). Seven genes (<i>CD46</i>, <i>ITGAM</i>, <i>PRPSAP2</i>, <i>PYDC1</i>, <i>STX4</i>, <i>TMEM106A</i>, and <i>VAT1</i>) were significantly associated with GGE in at least one brain tissue in TWAS analysis. Drug target prediction and molecular docking identified several natural compounds (quercetin, cholecalciferol, resveratrol, curcumin, epigallocatechin gallate, and vitamin E) that may provide ideas for the intervention of GGE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings revealed causal associations between plasma proteins and GGE, prioritized immune-related biological pathways, and proposed potential therapeutic hypotheses targeting immunomodulatory mechanisms.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70625","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Francesca Bovis, Ludwig Kappos, Sophie Arnould, Goeril Karlsson, Maria Pia Sormani
{"title":"Personalized Treatment Response in Progressive MS: Can the Patient's Profile Influence the Outcome?","authors":"Francesca Bovis, Ludwig Kappos, Sophie Arnould, Goeril Karlsson, Maria Pia Sormani","doi":"10.1002/brb3.70459","DOIUrl":"https://doi.org/10.1002/brb3.70459","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Evidence from clinical trials providing average effects in populations is often used to forecast individualized patient outcomes similar to the trial patients. Multiple sclerosis (MS), known for notable heterogeneity in outcomes, makes the evaluation of potential heterogeneity of treatment effect (HTE) significant. Identifying factors that predict individual treatment response is crucial for optimizing patient care, and this study aimed to demonstrate the feasibility (proof of concept) of applying a statistical method to predict individual treatment response in MS trials.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We developed an individualized response score (RS) to predict treatment response in patients with active secondary progressive MS (SPMS). The RS was a continuous combination of baseline clinical characteristics, including age, sex, previous relapses, EDSS, and disease duration. We used data from the EXPAND trial to train and validate the RS. A training dataset (70% of the data) was used to identify optimal response thresholds for four key outcomes: Expanded Disability Status Scale (EDSS), Timed 25 Foot Walk (T25FW), 9-Hole Peg Test (9HP), and the Symbol Digit Modalities Test (SDMT). The remaining 30% of the data served as a validation set to assess the RS's predictive performance. The continuous RS was binarized (into responder and non-responder) based on the threshold representing the top 25% versus the bottom 75% of the continuous score distribution.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Using baseline profiles, SPMS patients exhibiting varying benefits from Siponimod across different outcomes were successfully categorized as responders or non-responders. The overall effect of Siponimod on the EDSS was HR = 0.79 (95% CI: 0.65-0.95), while responders’ demonstrated a HR = 0.64 (95% CI: 0.49-0.84) versus a HR = 0.97 (95% CI: 0.74-1.27) for non-responders’, interaction p = 0.027. Siponimod's overall effect on SDMT progression was HR = 0.75 (95% CI: 0.63-0.88). Responders' demonstrated a HR = 0.59 (95% CI: 0.43-0.80) vs a HR = 1.00 (95% CI: 0.69-1.44) for non-responders, interaction p = 0.031. On the entire dataset, Siponimod exhibited a non-significant effect on 9HPT (HR = 0.86, 95% CI: 0.66-1.10) and on T25FW (HR = 0.95, 95% CI: 0.81-1.12), whereas responders’ demonstrated a HR = 0.68 (95% CI: 0.47-0.97) on 9HPT and a HR = 0.77 (95% CI: 0.60-0.98) for T25FW.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This analysis demonstrated the ability to define responders to a therapy based on t","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Junhao Li, Yuding Luo, Pingchuan Liu, Jiali Zhang, Chuanxi Duan, Hai Xiong, Maoxia Li, Binyang Zhang, Lu Li, Lulu Gong, Yupeng Niu, Bo Zheng, Jian Wang
{"title":"Development of a Diagnostic Prediction Model for Post-Stroke Cognitive Impairment in Acute Large Vessel Occlusion Stroke Using Multimodal MRI and PET/CT: A Study Protocol","authors":"Junhao Li, Yuding Luo, Pingchuan Liu, Jiali Zhang, Chuanxi Duan, Hai Xiong, Maoxia Li, Binyang Zhang, Lu Li, Lulu Gong, Yupeng Niu, Bo Zheng, Jian Wang","doi":"10.1002/brb3.70613","DOIUrl":"https://doi.org/10.1002/brb3.70613","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective:</h3>\u0000 \u0000 <p>Stroke is a leading cause of morbidity and disability worldwide. Post-stroke cognitive impairment (PSCI) significantly affects long-term prognosis in acute anterior circulation large-vessel occlusion stroke (LVO-AIS). This study aims to develop a PSCI prediction model integrating multimodal imaging, demographic, and clinical data collected during hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Design:</h3>\u0000 \u0000 <p>This single-center, prospective cohort study will enroll 379 anterior circulation LVO-AIS patients undergoing emergency endovascular treatment (EVT) within 24 h of symptom onset. Participants will be categorized into PSCI and non-PSCI groups and followed up at 90 and 180 days post-procedure. Primary outcomes include Montreal Cognitive Assessment scores at 3 and 6 months, with the modified Rankin Scale as a secondary outcome. Baseline imaging data will be processed using 3D Slicer for MRI and PET/CT standardization, registration, and feature extraction. Machine learning models will be developed using these imaging features combined with demographic and clinical data and evaluated via metrics such as the area under the receiver operating characteristic curve, precision, and recall. Analyses will be conducted in a blinded manner.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion:</h3>\u0000 \u0000 <p>This study will develop a PSCI prediction model based on multimodal imaging and clinical data in EVT-treated LVO-AIS patients, providing a tool for early diagnosis and personalized interventions. While limited to a single-center, future multicenter validation is necessary to establish its generalizability and clinical utility.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70613","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ruihan Wan, Haozhi Zhao, Xue Jiang, Beibei Feng, Yafei Wang, Chen Gong, Yangyang Lin, Wangwang Yan, Yixuan Ku, Yuling Wang
{"title":"High-Definition Transcranial Direct Current Stimulation Enhances Exercise-Induced Hypoalgesia in Healthy Individuals: An fNIRS Study","authors":"Ruihan Wan, Haozhi Zhao, Xue Jiang, Beibei Feng, Yafei Wang, Chen Gong, Yangyang Lin, Wangwang Yan, Yixuan Ku, Yuling Wang","doi":"10.1002/brb3.70595","DOIUrl":"https://doi.org/10.1002/brb3.70595","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study investigates whether anodal high-definition transcranial direct current stimulation (HD-tDCS) enhances exercise-induced hypoalgesia (EIH) and explores brain plasticity changes using functional near-infrared spectroscopy (fNIRS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Thirty-nine participants were randomly assigned to either the active (<i>n</i> = 19) or sham HD-tDCS (<i>n</i> = 20) group. Both groups performed 25 min of moderate-intensity aerobic exercise followed by 20 min of either active or sham HD-tDCS applied to the left primary motor cortex (M1). Primary outcome: pressure pain threshold (PPT) at a local site. Secondary outcomes: PPT at a remote site, cold pain threshold (CPT), and brain activation changes via fNIRS during the cold pressor test.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Both groups showed significant increases in PPT<sub>leg</sub> (active: from 42.21 ± 11.77 N to 51.29 ± 12.75 N; sham: from 41.41 ± 9.73 N to 45.29 ± 12.05 N, <i>p</i> < 0.001) and PPT<sub>forearm</sub> (active: from 31.69 ± 6.06 N to 36.99 ± 6.35 N; sham: from 32.66 ± 7.34 N to 37.08 ± 10.56 N, <i>p</i> < 0.001). The active group showed a significantly greater increase in PPT<sub>leg</sub> compared to the sham group (9.08 ± 8.01 N vs. 3.69 ± 4.36 N, <i>p</i> < 0.012). fNIRS analysis revealed significant changes in specific cortical channels in the active group (<i>p</i> < 0.05), with a negative correlation between cortical activation in CH16 and PPTleg (<i>r</i> = −0.405, <i>p</i> = 0.011).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HD-tDCS over M1 enhances EIH and is associated with increased brain activation in sensory-motor processing areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Clinical trial registration: ChiCTR2100048146</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70595","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abdullah Bin Kamran, Ahmed Bazil Bin Khalil, Ayesha Muhammad, Hira Arshad, Fatima Nazir, Muhammad Mateen Ali, M. Mairaj Umar, Muhammad Farhan, Sudhair Alam, Javed Iqbal
{"title":"Tirofiban Combination Therapy for Acute Ischemic Stroke: A Systematic Review and Meta-Analysis","authors":"Abdullah Bin Kamran, Ahmed Bazil Bin Khalil, Ayesha Muhammad, Hira Arshad, Fatima Nazir, Muhammad Mateen Ali, M. Mairaj Umar, Muhammad Farhan, Sudhair Alam, Javed Iqbal","doi":"10.1002/brb3.70508","DOIUrl":"https://doi.org/10.1002/brb3.70508","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality globally. Standard antiplatelet therapies, while partially effective, do not fully inhibit all pathways of platelet aggregation, leaving patients at risk of recurrent thrombotic events. Tirofiban, a glycoprotein IIb/IIIa receptor inhibitor, has shown promise as an adjunctive treatment in AIS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was conducted in PubMed, ClinicalTrials.gov, and Cochrane library from inception to July 2024, following PRISMA guidelines. Inclusion criteria comprised randomized controlled trials (RCTs) and comparative observational studies where tirofiban was used as an adjunct to standard antiplatelet therapy. Primary outcomes included symptomatic intracranial hemorrhage (sICH) and favorable modified Rankin scale (mRS) scores at 90 days. Secondary outcomes included National Institute of Health Stroke Scale (NIHSS) scores and all-cause mortality. Data was analyzed using Review Manager v5.4.1, with random-effects models employed for all outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifteen studies, comprising 4,457 patients, were included. Tirofiban significantly improved the likelihood of achieving favorable mRS scores (OR 1.65, 95% CI [1.29, 2.11], p = 0.0001), with moderate heterogeneity (I<sup>2</sup> = 57%, p = 0.006). Tirofiban also significantly reduced NIHSS scores (MD -2.08, 95% CI [-2.77, -1.39], p < 0.00001). There was no significant difference in the incidence of sICH between the tirofiban and control groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tirofiban as an adjunct to standard antiplatelet therapy in AIS patients significantly improves functional outcomes and reduces neurological impairment without increasing the risk of sICH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Renata Rozovsky, Maria Wolfe, Halimah Abdul-waalee, Mariah Chobany, Greeshma Malgireddy, Jonathan A. Hart, Brianna Lepore, Farzan Vahedifard, Mary L. Phillips, Boris Birmaher, Alex Skeba, Rasim S. Diler, Michele A. Bertocci
{"title":"Gray Matter Differences in Adolescent Psychiatric Inpatients: A Machine Learning Study of Bipolar Disorder and Other Psychopathologies","authors":"Renata Rozovsky, Maria Wolfe, Halimah Abdul-waalee, Mariah Chobany, Greeshma Malgireddy, Jonathan A. Hart, Brianna Lepore, Farzan Vahedifard, Mary L. Phillips, Boris Birmaher, Alex Skeba, Rasim S. Diler, Michele A. Bertocci","doi":"10.1002/brb3.70589","DOIUrl":"https://doi.org/10.1002/brb3.70589","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bipolar disorder (BD) is among the psychiatric disorders most prone to misdiagnosis, with both false positives and false negatives resulting in treatment delay. We employed a whole-brain machine learning approach focusing on gray matter volumes (GMVs) to contribute to defining objective biomarkers of BD and discriminating it from other forms of psychopathology, including subthreshold manic presentations without a BD Type I/II diagnosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Five support vector machine (SVM) models were used to detect differences in GMVs between inpatient adolescents aged 13–17 with BD-I/II (<i>n</i> = 34), other specified BD (OSB) (<i>n</i> = 106), other non-bipolar psychopathology (OP) (<i>n</i> = 52), and healthy controls (HC) (<i>n</i> = 27). We examined the most discriminative GMVs and tested their associations with clinical symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Whole-brain classifiers in the model BD-I/II versus OSB achieved total accuracy of 79%, (AUC = 0.70, <i>p</i> = 0.002); BD versus OP 66%, (AUC = 0.61, <i>p</i> = 0.014); BD versus HC 66%, (AUC = 0.67, <i>p</i> = 0.011); OSB versus HC 77%, (AUC = 0.61, <i>p</i> = 0.01); OP versus HC 68%, (AUC = 0.70, <i>p</i> = 0.001). The most discriminative GMVs that contributed to the classification were in areas associated with movement, sensory processing, and cognitive control. Correlations between these GMVs and self-reported mania, negative affect, or anxiety were observed in all inpatient groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings indicate that pattern recognition models focusing on GMVs in regions associated with movement, sensory processing, and cognitive control can effectively distinguish well-characterized BD-I/II from other forms of psychopathology, including other specified BD, in a pediatric population. These results may contribute to enhancing diagnostic accuracy and guiding earlier, more targeted interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70589","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yagmur Sever Fidan, Ikbal Humay Arman, Sumeyye Yasemin Calli, Fusun Mayda Domac, Emine Nese Yeniceri, Bahar Tasdelen, Aynur Ozge
{"title":"Revisiting Late-Onset Bipolar Disorder Associated With Pituitary Adenoma: A Cross-Sectional, Multidisciplinary, Case-Based Analysis","authors":"Yagmur Sever Fidan, Ikbal Humay Arman, Sumeyye Yasemin Calli, Fusun Mayda Domac, Emine Nese Yeniceri, Bahar Tasdelen, Aynur Ozge","doi":"10.1002/brb3.70611","DOIUrl":"https://doi.org/10.1002/brb3.70611","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study explores the diagnostic, treatment, and follow-up approaches of neurologists, psychiatrists, and family physicians in managing late-onset bipolar disorder (BD) in elderly patients, emphasizing the role of interdisciplinary collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional survey involved 300 specialists (100 from each discipline). The survey assessed diagnostic accuracy, treatment preferences, follow-up adherence, and barriers to interdisciplinary collaboration. A pairwise <i>z</i>-test with Bonferroni correction was applied for comparative analysis across specialties to evaluate differences in response proportions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Neurologists demonstrated high proficiency in imaging and treatment initiation (91% correct imaging responses) but faced challenges in holistic management and follow-up adherence (2%). Psychiatrists excelled in diagnosing organic causes of mood disorders (92%) and therapeutic decisions but struggled with non-priority diagnostic tests (44%) and long-term follow-up strategies (14%). Family physicians showed strong skills in pharmacological management (96%) and follow-up adherence (89%) but encountered barriers like stigma and referral timing for high-risk cases. Common interdisciplinary challenges included diagnostic communication, treatment coordination, and follow-up collaboration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Late-onset BD management requires a multidisciplinary approach to address specialty-specific gaps and foster effective interdisciplinary collaboration. Enhanced training, integrated care models, and shared guidelines are recommended to optimize outcomes for elderly patients with mood disorders. Future research should focus on developing standardized protocols and evaluating the long-term impact of interdisciplinary interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70611","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wi-Sun Ryu, Jae W. Song, Jae-Sung Lim, Ju Hyung Lee, Leonard Sunwoo, Dongmin Kim, Dong-Eog Kim, Hee-Joon Bae, Myungjae Lee, Beom Joon Kim
{"title":"Segmentation of Leukoaraiosis on Noncontrast Head CT Using CT-MRI Paired Data Without Human Annotation","authors":"Wi-Sun Ryu, Jae W. Song, Jae-Sung Lim, Ju Hyung Lee, Leonard Sunwoo, Dongmin Kim, Dong-Eog Kim, Hee-Joon Bae, Myungjae Lee, Beom Joon Kim","doi":"10.1002/brb3.70602","DOIUrl":"https://doi.org/10.1002/brb3.70602","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Evaluating leukoaraiosis (LA) on CT is challenging due to its low contrast and similarity to parenchymal gliosis. We developed and validated a deep learning algorithm for LA segmentation using CT-MRIFLAIR paired data from a multicenter Korean registry and tested it in a US dataset.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We constructed a large multicenter dataset of CT–FLAIR MRI pairs. Using validated software to segment white matter hyperintensity (WMH) on FLAIR, we generated pseudo-ground-truth LA labels on CT through deformable image registration. A 2D nnU-Net architecture was trained solely on CT images and registered masks. Performance was evaluated using the Dice similarity coefficient (DSC), concordance correlation coefficient (CCC), and Pearson correlation across internal, external, and US validation cohorts. Clinical associations of predicted LA volume with age, risk factors, and poststroke outcomes were also analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The external test set yielded a DSC of 0.527, with high volume correlations against registered LA (<i>r</i> = 0.953) and WMH (<i>r</i> = 0.951). In the external testing and US datasets, predicted LA volumes correlated with Fazekas grade (<i>r</i> = 0.832–0.891) and the correlations were consistent across CT vendors and infarct volumes. In an independent clinical cohort (<i>n</i> = 867), LA volume was independently associated with age, vascular risk factors, and 3-month functional outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Interpretation</h3>\u0000 \u0000 <p>Our deep learning algorithm offers a reproducible method for LA segmentation on CT, bridging the gap between CT and MRI assessments in patients with ischemic stroke.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Haitham Jahrami, Khaled Trabelsi, Achraf Ammar, Nicola Luigi Bragazzi, Hadeel Ghazzawi, Waqar Husain, Maha M. AlRasheed, Seithikurippu R. Pandi-Perumal, Amir Pakpour, Zahra Saif, Michael V. Vitiello
{"title":"The Validation of the Nomophobia Questionnaire Using a Modern Psychometric Approach: An Item Response Theory Analysis of 5087 Participants","authors":"Haitham Jahrami, Khaled Trabelsi, Achraf Ammar, Nicola Luigi Bragazzi, Hadeel Ghazzawi, Waqar Husain, Maha M. AlRasheed, Seithikurippu R. Pandi-Perumal, Amir Pakpour, Zahra Saif, Michael V. Vitiello","doi":"10.1002/brb3.70622","DOIUrl":"https://doi.org/10.1002/brb3.70622","url":null,"abstract":"<p>Nomophobia, or the anxiety of being separated from one's mobile phone, is an emerging psychological condition in our digital age. The 20-item Nomophobia Questionnaire (NMP-Q) was developed to assess nomophobia symptoms. This study utilized item response theory (IRT) and classical test theory (CTT) methods to evaluate the NMP-Q's psychometric properties. Data were collected from 5087 adults who completed the NMP-Q. The CTT analyses included the computation of correlation coefficients, including McDonald's <i>ω</i>, Cronbach's <i>α</i>, Guttman's <i>λ</i>2, Guttman's <i>λ</i>6, greatest lower bound, average interitem correlation, Feldt–Gilmer coefficient, Feldt–Brennan coefficient, and Raju's <i>β</i>. IRT analyses included graded response modeling of items, test information function, differential item functioning, and reliability. CTT analysis revealed high reliability coefficients across nine metrics and a four-factor model with good fit indices. IRT analysis showed a strong item fit to the polytomous graded model, indicating the questionnaire's robustness. Based on IRT (both uni- and multidimensional IRT) analyses, we propose a 10-item short version (NMP-Q Short), demonstrating high correlation (<i>r</i> = 0.97) with the original NMP-Q. Our findings provide very good support for the NMP-Q's reliability and construct validity. The items displayed good discrimination and difficulty parameters. The second 10 items of the NMP-Q appeared to be the most informative. The proposed NMP-Q Short offers a valuable option for efficient/rapid and accurate screening. However, additional validation and sensitivity testing are warranted to further establish its usefulness.</p>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70622","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144256323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ke Zhongling, Chen Mengxin, Huang Yuxian, Chen Yanhui
{"title":"MCP-1 Is Elevated in the Cerebral Fluid of Children With Tourette Syndrome: Case Series and Literature Review","authors":"Ke Zhongling, Chen Mengxin, Huang Yuxian, Chen Yanhui","doi":"10.1002/brb3.70617","DOIUrl":"https://doi.org/10.1002/brb3.70617","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>This study aims to investigate cerebrospinal fluid (CSF) in patients with Tourette syndrome (TS) to identify the role of neuroinflammation in the pathophysiology of TS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively reported cerebrospinal fluid (CSF) examination in four male adolescents diagnosed with severe TS, as indicated by a high Yale Global Tic Severity Scale (YGTSS) score. The examination included routine and biochemical tests, oligoclonal band testing, and analysis of 14 neural autoantibodies. Furthermore, the levels of 34 cytokines were also measured.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>CSF examinations revealed that routine and biochemical tests were normal and that no oligoclonal bands were detected. The 14 neural autoantibodies tested were negative. Among the 34 cytokines analyzed, only monocyte chemoattractant protein-1 (MCP-1) levels were significantly elevated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to report elevated levels of MCP-1 in the CSF of patients with TS. Our findings suggest that MCP-1-associated neuroinflammation may play a crucial role in the pathogenesis of TS, indicating that targeting MCP-1 could be a promising therapeutic approach to managing symptoms of TS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9081,"journal":{"name":"Brain and Behavior","volume":"15 6","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/brb3.70617","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144255876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}