Cognitive dysfunction in psychiatric disorders: characteristics, causes and the quest for improved therapy

The utility of the MMPI-3 in predicting substance use related problems in a clinical neuropsychology sample

Assessing for problematic substance use in neuropsychological assessments is crucial for differential diagnosis and attribution of symptom causes. The current investigation examines the utility of the Minnesota Multiphasic Personality Inventory-3 (MMPI-3 in predicting such substance use in a clinical neuropsychology sample. Participants included 208 outpatient neuropsychological examinees. Correlations and risk ratios were calculated for externalizing-psychopathology-related scales and external substance use criteria. Hierarchical regressions examined the incremental prediction of criteria by MMPI-3 externalizing scales above the Substance Abuse (SUB) scale. Results indicate that MMPI-3 externalizing scales are associated with substance-use-related criteria as conceptually expected. Additionally, we report significantly increased risk of experiencing substance-use-related problems at various T score elevations on multiple externalizing scales. Finally, SUB served as the primary predictor of substance-use-related criteria. These findings support the ability of the MMPI-3 to assess for past or current substance use and negative consequences of substance use in a clinical neuropsychology setting.

Schizophrenia-like phenotypes and long-term synaptic plasticity impairment in GluN2A-transgenic mice

While N-methyl-d-aspartate receptor (NMDAR) hypofunction has been suggested as a hallmark of schizophrenia, the role of subunit-specific dysregulation such as GluN2A overexpression remains poorly understood. The present study comprehensively investigated the impact of GluN2A overexpression on behavioral phenotypes, cognitive functions, and synaptic plasticity in transgenic mice with forebrain-specific overexpression of the GluN2A subunit (GluN2A-TG). Behavioral assessments revealed schizophrenia-like phenotypes, including prolonged stereotypic movement duration, impaired sensorimotor gating, reduced social interaction, and diminished nest-building activity in GluN2A-TG mice. Consistently, GluN2A-TG mice exhibited not only deficits in spatial working memory and olfactory working memory but also impaired associative learning. In addition, both long-term potentiation and long-term depression were significantly attenuated in the prefrontal cortex (PFC) of GluN2A-TG mice. Furthermore, electrophysiological analysis of NMDAR-mediated excitatory postsynaptic currents in PFC neurons revealed altered kinetics characterized by a faster decay time and significantly increased amplitude in GluN2A-TG mice. Collectively, these findings suggest that GluN2A overexpression may induce schizophrenia-like phenotypes via impairing NMDAR-dependent long-term synaptic plasticity in the PFC, likely due to altered NMDAR subunit composition leading to disrupted calcium signaling dynamics. These results provide critical insights into the pathological role of GluN2A in schizophrenia.

Prefrontal parvalbumin interneurons mediate CRHR1-dependent early-life stress-induced cognitive deficits in adolescent male mice

Cognitive impairment, a core symptom of psychiatric disorders, is frequently observed in adolescents exposed to early-life stress (ES). However, the underlying neural mechanisms are unclear, and therapeutic efficacy is limited. Targeting parvalbumin-expressing interneurons (PVIs) in the medial prefrontal cortex (mPFC), we report that ES reduces mPFC PVI activity, which causally mediated ES-induced cognitive deficits in adolescent male mice through chemogenetic and optogenetic experiments. To understand the possible causes of PVI activity reduction following ES, we then demonstrated that ES upregulated corticotropin-releasing hormone (CRH) receptor 1 [CRHR1, mainly expressed in pyramidal neurons (PNs)] and reduced activity of local pyramidal neurons (PNs) and their excitatory inputs to PVIs. The subsequent genetic manipulation experiments (CRHR1 knockout, CRH overexpression, and chemogenetics) highlight that ES-induced PVI activity reduction may result from CRHR1 upregulation and PN activity downregulation and that PVIs play indispensable roles in CRHR1- or PN-mediated cognitive deficits induced by ES. These results suggest that ES-induced cognitive deficits could be attributed to the prefrontal CRHR1-PN-PVI pathway. Finally, treatment with antalarmin (a CRHR1 antagonist) and environmental enrichment successfully restored the PVI activity and cognitive deficits induced by ES. These findings reveal the neurobiological mechanisms underlying ES-induced cognitive deficits in adolescent male mice and highlight the therapeutic potentials of PVIs in stress-related cognitive deficits in adolescent individuals.

Early postnatal NMDA receptor ablation in cortical interneurons impairs affective state discrimination and social functioning

Emotion recognition is fundamental for effective social interactions among conspecifics. Impairments in affective state processing underlie several neuropsychiatric disorders, including schizophrenia, although the neurobiological substrate of these deficits remains unknown. We investigated the impact of early NMDA receptor hypofunction on socio-affective behaviors. Male mice lacking NMDA receptors in GABAergic interneurons of cerebral and hippocampal cortices from an early postnatal age (interNMDAr-KO mutants) were evaluated in affective state discrimination, social preference and social novelty preference, hierarchy and dominance, aggression and territoriality, and long-term social interaction. We show that interNMDAr-KO mice failed to discriminate conspecifics based on their affective states, unlike control littermates, while exhibiting an intact preference for social stimuli over inanimate objects. This discrimination deficit was observed regardless of whether affective valences were manipulated positively or negatively, via a palatable reward or social defeat, respectively. Additionally, interNMDAr-KO mice failed to establish a normal social hierarchy, consistently assuming subordinate roles against control littermates, and presented an abnormal response to conspecifics in the resident-intruder test. Finally, mice lacking NMDA receptors in GABAergic interneurons exhibited social withdrawal following exposure to unfamiliar conspecifics in a custom setting designed to monitor social behavior over extended time periods. This deficit was reversed by subchronic clozapine treatment. Our study thoroughly assessed the impact of a pathophysiological manipulation relevant to schizophrenia on social behavior in mice. Overall, this study provides evidence demonstrating that altered NMDAr-dependent development of cortical and hippocampal interneurons impairs affective state discrimination and leads to deficits in social functioning and long-term sociality.

Self-Control Abilities in Specific Types of Problematic Usage of the Internet: Findings From Clinically Validated Samples With Neurocognitive Tasks

OBJECTIVE

Reduced cognitive functions are commonly associated with diminished self-control abilities. Research on cognitive functions in gaming disorder and other specific types of problematic usage of the Internet (PUI) remains rare. The aim of this study was to compare performance in different cognitive domains between clinically validated groups of individuals with and without specific PUI.

METHODS

The data, from a large-scale multicenter study in Germany, were collected between October 2021 and August 2024. The study compared three groups: Internet users with pathological use (N=284), risky use (N=305), and nonproblematic use (N=424). Grouping was based on structured interviews for four types of specific PUI (gaming, buying-shopping, pornography use, social network use). All participants underwent extensive laboratory testing, including self-report scales and standard cognitive tasks: Modified Card Sorting Test, Stroop test, a logical reasoning test, Game of Dice Task, a delay discounting task, and a go/no-go task with Internet-related stimuli.

RESULTS

The groups differed significantly regarding both behavioral (partial eta2 ≤0.06) and self-report measures (partial eta2 ≤0.14) of self-control abilities. The group with pathological use showed the weakest mean performance in all tasks. The groups with risky and nonproblematic use barely differed in behavioral measures but did differ in self-reported self-directedness and attentional impulsivity. Post hoc analyses revealed significant (interaction) effects of PUI type.

CONCLUSIONS

PUI is associated with deficits in general executive functions, decision making, and stimulus-specific inhibitory control that may evolve in later stages of addiction development. Potential PUI-specific differences should be considered when designing trainings and interventions that target improving self-control abilities.

Cholinesterase-based inhibitors as multitarget small molecules for the therapy of Alzheimer's disease

Herein, we have summarized the most significant results that we have communicated from our laboratories in the last thirty years, highlighting the most potent and attractive ChEIs based hit(lead)-Multitarget Small Molecules, such as (S)-p-methoxytacripyrine (1), ASS234 (2), Contilisant (3), and Contilistat (4), that we have identified in the search for new chemical entities for the therapy of Alzheimer's disease.

Targeting heterogeneous depression with trazodone prolonged release: from neuropharmacology to clinical application

AIM

This paper evaluates the clinical efficacy, safety, and practical implications of Trazodone Prolonged Release (PR) in managing depression, anxiety, and sleep disorders, with a focus on its multimodal mechanism of action and advantages over traditional therapies.

METHODOLOGY

A critical review of recent literature (2020-2024) [1-3] was conducted, analyzing data from clinical trials, real-world studies, and European treatment guidelines to assess the pharmacodynamics, pharmacokinetics, and therapeutic outcomes of Trazodone PR.

RESULTS

Trazodone PR demonstrates efficacy in addressing complex symptoms of depression, anxiety, and sleep disturbances, with a favorable safety profile and reduced risk of sexual dysfunction and weight gain compared to other antidepressants. Its ability to modulate serotonin, norepinephrine, dopamine, and histamine systems enhances mood, sleep quality, and cognitive recovery.

CONCLUSION

Trazodone PR is a versatile and well-tolerated treatment option for patients with comorbid conditions and treatment-resistant cases. Its multimodal action, combined with benefits like improved neuroplasticity through BDNF production, makes it a suitable choice for the long-term management of mood disorders and associated conditions [4-6].

The Deteriorated Center-Surround Suppression in Patients With First-Episode and Drug-Naïve Major Depressive Disorder

Background: Major depressive disorder (MDD) patients are often associated with inhibition deficits in the visual cortex. Most previous research has focused on visual inhibition in MDD patients during acute and remission phases, with little research on first-episode and drug-naïve (FEDN) patients. To fill this gap, we psychophysically investigated the inhibitory process of visual motion in patients with FEDN MDD. Methods: Two psychophysical tasks: Center-Surround Suppression (CSS) and Motion Repulsion (MR) were utilized to investigate the presence of visual perceptual inhibition deficits in patients with FEDN MDD. We collected data from 74 patients with FEDN MDD and 68 healthy controls (HCs) matched for age, years of education, and gender. We also measured the Hamilton Depression Rating Scale, 17-item (HAMD-17) for each patient to assess the severity of depressive symptoms. Results: The results showed that CSS was significantly deteriorated in FEDN MDD patients (p=0.001), but it did not correlate with the HAMD score (p > 0.05). In addition, no significant differences were observed between the two groups of subjects in terms of gender, age, and education level (all p > 0.05). Analysis of two previously published datasets using the same CSS task involving MDD patients in different illness stages revealed that the levels of CSS reduction in our FEDN patients were also significantly distinguishable from those in acute and recovered MDD patients (all p < 0.01). This quantitative comparison indicates that CSS impairments are dynamic over the course of illness development. Moreover, the magnitudes of MR showed no significant differences between MDD patients and HCs (all p > 0.05). Conclusions: Our study was the first to demonstrate the deteriorated CSS in patients with FEDN MDD. Notably, inhibitory deficits in MDD are also highly specific, as MDD affects only the CSS, but not the MR. Therefore, the discrepancy between these two psychophysical tasks suggests CSS may serve as a feasible early marker in MDD. These findings offer new insights into the specific visual cortical deficits in patients with FEDN MDD. Limitation: The current study lacks imaging data to support the perceptual phenomenon we observed.

Neurotransmitter modulation of human facial emotion recognition

Human facial emotion recognition (FER) is an evolutionarily preserved process that influences affiliative behaviours, approach/avoidance and fight-or-flight responses in the face of detecting threat cues, thus enhancing adaptation and survival in social groups. Here, we provide a narrative literature review on how human FER is modulated by neurotransmitters and pharmacological agents, classifying the documented effects by central neurotransmitter systems. Synthesising the findings from studies involving functional neuroimaging and FER tasks, we highlight several emerging themes; for example, noradrenaline promotes an overall positive bias in FER, while serotonin, dopamine and gamma-aminobutyric acid modulate emotions relating to self-preservation. Finally, other neurotransmitters including the cholinergic and glutamatergic systems are responsible for rather non-specific pro-cognitive effects in FER. With the ongoing accumulation of evidence further characterising the individual contributions of each neurotransmitter system, we argue that a sensible next step would be the integration of experimental neuropharmacology with computational models to infer further insights into the temporal dynamics of different neurotransmitter systems modulating FER.

Functional limitations and suicidal ideation: Independent, interactive, and cumulative associations in a nationally representative sample

BACKGROUND

Suicidal ideation is a critical public health issue, often linked to functional limitations that hinder daily activities. However, the independent, interactive, and cumulative effects of specific types and quantities of functional limitations on suicidal ideation remain underexplored.

METHODS

Data were analyzed from 12,263 U.S. adults in the National Health and Nutrition Examination Survey (NHANES, 2013-2018). Functional limitations were assessed across six domains: vision, hearing, cognitive, mobility, dressing/bathing, and errands. Multivariable logistic regression and interaction models were used to examine associations between functional limitations and suicidal ideation. Dose-response relationships were evaluated using restricted cubic spline regression.

RESULTS

Vision (OR = 1.77, 95 % CI = 1.00-3.13), cognitive (OR = 5.52, 95 % CI = 3.63-8.39), and errand limitations (OR = 1.75, 95 % CI = 1.09-2.79) were independently associated with suicidal ideation. A significant interaction effect was observed between hearing and cognitive limitations, with the co-occurrence amplifying suicidal ideation risk (OR = 5.80, 95 % CI = 3.84-8.78). Additionally, a dose-response relationship was found, with individuals experiencing ≥5 limitations having the highest risk.

CONCLUSIONS

Functional limitations, particularly cognitive and errand-related impairments, are strongly associated with suicidal ideation. Interaction effects and cumulative impacts underscore the need for integrated mental and physical healthcare approaches. Tailored interventions targeting specific limitations and addressing cumulative burdens may mitigate suicidal ideation in this vulnerable population.

Repetitive Transcranial Magnetic Stimulation (rTMS) Treatment Reduces Variability in Brain Function in Schizophrenia: Data From a Double-Blind, Randomized, Sham-Controlled Trial

BACKGROUND/HYPOTHESIS

There is increasing awareness of interindividual variability in brain function, with potentially major implications for repetitive transcranial magnetic stimulation (rTMS) efficacy. We perform a secondary analysis using data from a double-blind randomized controlled 4-week trial of 20 Hz active versus sham rTMS to dorsolateral prefrontal cortex (DLPFC) during a working memory task in participants with schizophrenia. We hypothesized that rTMS would change local functional activity and variability in the active group compared with sham.

STUDY DESIGN

83 participants were randomized in the original trial, and offered neuroimaging pre- and post-treatment. Of those who successfully completed both scans (n = 57), rigorous quality control left n = 42 (active/sham: n = 19/23), who were included in this analysis. Working memory-evoked activity during an N-Back (3-Back vs 1-Back) task was contrasted. Changes in local brain activity were examined from an 8 mm ROI around the rTMS coordinates. Individual variability was examined as the mean correlational distance (MCD) in brain activity pattern from each participant to others within the same group.

RESULTS

We observed an increase in task-evoked left DLPFC activity in the active group compared with sham (F1,36 = 5.83, False Discovery Rate (FDR))-corrected P = .04). Although whole-brain activation patterns were similar in both groups, active rTMS reduced the MCD in activation pattern compared with sham (F1,36 = 32.57, P < .0001). Reduction in MCD was associated with improvements in attention performance (F1,16 = 14.82, P = .0014, uncorrected).

CONCLUSIONS

Active rTMS to DLPFC reduces individual variability of brain function in people with schizophrenia. Given that individual variability is typically higher in schizophrenia patients compared with controls, such reduction may "normalize" brain function during higher-order cognitive processing.

A cross-sectional study of how high-frequency hearing loss impacts cognitive functions in middle-aged-to-older adults

Purpose

Research on the association between hearing loss and cognition has primarily focused on speech-range hearing frequencies (i.e., 0.5-4 kHz), as these frequencies are most relevant to everyday functioning. However, age-related hearing loss (ARHL) tends to impact higher-frequency hearing first, and more severely. Despite this, limited research has investigated the relationship between high-frequency (i.e., >4 kHz) hearing loss and cognitive impairment. In the current study, we aimed to assess whether high-frequency hearing loss predicts non-verbal cognitive functions (i.e., visuospatial executive function, learning, and memory tasks) above and beyond speech-frequency hearing loss.

Materials and methods

Participants were 241 English-speaking adults, aged 40-88 years, with hearing loss. Audiometrically assessed better-ear, speech-frequency (0.5, 1, 2 & 4 kHz; BE4PTA) and high-frequency (6 & 8 kHz; BE2PTA) hearing loss were compared to cognitive functions measured using non-verbal tests from the Cambridge Neuropsychological Test Automated Battery; covariates included hearing-loss asymmetry, age, sex, premorbid IQ, and mental health measured with the short-form Depression Anxiety Stress Scales.

Results

While correlation analyses demonstrated that all measured cognitive faculties were associated with both BE4PTA and BE2PTA, hierarchical linear regression analyses demonstrated that only BE4PTA predicted cognitive flexibility and working-memory ability after controlling for covariates; age primarily accounted for BE2PTA's cognitive effects.

Conclusion

While both speech and higher-frequency hearing loss were associated with poorer cognition, only the former demonstrated effects beyond those of ageing. However, the present study only investigated two frequencies in the higher range, encouraging broader investigation of higher-frequency hearing's cognitive effects in the future.

Cognitive hierarchy in mood disorders and relations to daily functioning

Cognitive impairment affects approximately 50 % of patients with mood disorders during remission, which correlates with poorer daily-life functioning. The hierarchical organisation of cognitive processes may mean that some cognitive deficits, e.g., memory impairments, are secondary to impairments in suggested core processes, including executive functions, working memory, attention, and psychomotor speed. The exact structure of a cognitive hierarchy in mood disorders is unclear. In this study, we aimed to examine relationships between cognitive domains using network graphs. Further, we aimed to explore whether impairments in the proposed 'core cognitive domains' mediated patients' verbal memory impairment and functional disability using mediation and hierarchical regression analyses. We pooled data from patients with mood disorders and healthy controls (HC) from 10 original studies. In total, 1505 participants were included in the analyses (n = 900 patients; n = 605 HC). We found that cognitive domains were more intercorrelated in patients than in HC. Executive functions, working memory, and attention and psychomotor speed almost fully accounted for illness-associated verbal learning and memory impairments, indicating partial mediation. Of the core domains, working memory explained the largest amount of variance in memory impairments and functional disability. Our findings highlight the importance of targeting core cognitive domains in pro-cognitive interventions.

Enhanced sampling simulations to explore himalayan phytochemicals as potential phosphodiesterase-1 inhibitor for neurological disorders

The rising incidence of neurological and neuropsychiatric disorders underscores the urgent need for innovative and evidence based treatment strategies. Phosphodiesterase-1 (PDE1) is a dual-substrate (cAMP/cGMP) phosphodiesterase expressed in the central nervous system and peripheral areas, which modulates cyclic nucleotide signaling cascades. Inhibiting PDE1 enhances cAMP/cGMP levels, promoting neuronal plasticity and neuroprotection, making it a promising therapeutic strategy for neurological disorders. The pursuit of targeting this enzyme for treating neurological and neuropsychiatric disorders has faced obstacles due to the absence of potent, selective, and brain-penetrating inhibitors. This study aimed to identify potent PDE1 inhibitors by leveraging a diverse collection of bioactive molecules derived from Himalayan flora through computational screening methods. The four most promising hit molecules were chosen for further investigation and subjected to Molecular Dynamics (MD) simulations, binding free energy calculations, along with standard molecules. It was found that the hit molecules stigmast-7, corilagin and emblicanin-A had formed the most stable complexes, and also, the least binding free energy was observed for stigmast-7 among the hit molecules. Additionally, the pulling simulations indicated that stigmast-7 and corilagin were the most robust binders, and required the highest force to dissociate from the binding cavity completely. The umbrella sampling simulations also revealed the lowest binding free energy for corilagin and stigmast-7. The insights gained from this study provide a foundation for future research into PDE1-targeted therapies, highlighting the potential of Himalayan bioactive compounds in developing novel therapeutic interventions.

Enhancing Cognition, Self-Efficacy, and Postural Control Skills of Persons with Schizophrenia Spectrum Disorders Using Immersive Puzzle Video Games

Introduction: Players' engagement in video games is dependent on their level of immersion in the virtual gaming environment. Tabletop (TT) puzzle video games (PVGs), which are usually played in a sedentary posture and require upper limb motor skill, improve players' cognition and upper limb motor performance. Immersive PVGs, such as Angry Birds, have been created recently. These games are played in a standing mode and require the players to shift their center of gravity (COG) to achieve the gaming goals. Their task-oriented nature makes it possible for these video games to improve players' self-efficacy. However, there is a lack of research into the cognitive, upper and lower limb motor performance, capacity to shift the COG, that is, stability limit, and self-efficacy benefits of immersive PVGs played in standing mode. Objectives: This study examined the effects of an immersive physics-based PVG (PBPVG), the Angry Birds, on cognition, motor outcomes, and self-efficacy. Immersive video games were developed in order to enable a high level of immersion and engagement. We hypothesized that following three sessions per week for 12 weeks of training, players would demonstrate improvements in cognition, upper and lower limb motor performance, stability limit, and self-efficacy. Methods: A sample of 82 adults with schizophrenia spectrum disorders recruited from two psychiatric rehabilitation units were assigned by lottery randomization to an experimental group or a control group (n = 41 respectively). Participants in the experimental group played Angry Birds in standing mode for three 50-minute sessions per week for 12 weeks. Processing speed and cognitive flexibility (two critical components of integrated cognition), upper and lower limb motor performance, stability limit, and self-efficacy were evaluated at baseline and at 12 weeks. Results: A repeated measures two-way analysis of variance revealed significant interaction effects (P = 0.021-P < 0.001) with medium to large effect sizes (ηp2 = 0.064-0.241) for stability limit and self-efficacy. Significant main effects (P < 0.001) with medium to large effect sizes (ηp2 = 0.095-0.277) for processing speed and upper and lower limb motor performance were found. The following simple main effects examined with one-way analysis of covariance showed significant improvement (P < 0.001) with medium to large effect sizes (ηp2 = 0.151-0.249) for stability limit and self-efficacy. A near significant difference (P = 0.063) with a near medium effect size (ηp2 = 0.040) showed improvement in cognitive flexibility, but nonsignificant improvement (P > 0.05) with a trivial effect size (ηp2 = 0.001) for processing speed and a small effect size (ηp2 = 0.021-0.027) for upper and lower limb motor performance were found. Conclusion: PBPVGs could improve cognitive flexibility, stability limit, and self-efficacy. These effects might depend on the level of immersion, type of motor skill and body part involvement, and demands of cognitive components when playing, which might stem from the task-oriented nature of the chosen game and gaming mechanism.

Fear conditioning: Insights into learning, memory and extinction and its relevance to clinical disorders

Fear, whether innate or learned, is an essential emotion required for survival. The learning, and subsequent memory, of fearful events enhances our ability to recognise and respond to threats, aiding adaptation to new, ever-changing environments. Considerable research has leveraged associative learning protocols such as contextual or auditory forms of fear conditioning in rodents, to understand fear learning, memory consolidation and extinction phases of memory. Such assays have led to detailed characterisation of the underlying neurocircuitry and neurobiology supporting fear learning processes. Given fear processing is conserved across rodents and humans, fear conditioning experiments provide translational insights into fundamental memory processes and fear-related pathologies. This review examines associative learning protocols used to measure fear learning, memory and extinction, before providing an overview on the underlying complex neurocircuitry including the amygdala, hippocampus and medial prefrontal cortex. This is followed by an in-depth commentary on the neurobiology, particularly synaptic plasticity mechanisms, which regulate fear learning, memory and extinction. Next, we consider how fear conditioning assays in rodents can inform our understanding of disrupted fear memory in human disorders such as post-traumatic stress disorder (PTSD), anxiety and psychiatric disorders including schizophrenia. Lastly, we critically evaluate fear conditioning protocols, highlighting some of the experimental and theoretical limitations and the considerations required when conducting such assays, alongside recent methodological advancements in the field. Overall, rodent-based fear conditioning assays remain central to making progress in uncovering fundamental memory phenomena and understanding the aetiological mechanisms that underpin fear associated disorders, alongside the development of effective therapeutic strategies.

A novel role of the antidepressant paroxetine in inhibiting neuronal Kv7/M channels to enhance neuronal excitability

The voltage-gated Kv7/KCNQ/M potassium channels exert inhibitory control over neuronal membrane excitability. The reduction of Kv7 channel function can improve neuronal excitability that defines the fundamental mechanism of learning and memory. This suggests that pharmacological inhibition of Kv7 channels may present a therapeutic strategy for cognitive improvement. Paroxetine, a selective serotonin reuptake inhibitor, is widely used in the treatment of various types of depression with reported improvements in memory and attention. However, the exact mechanism underlying cognitive improvement by paroxetine remains poorly understood. In this study, we demonstrate that paroxetine inhibits whole-cell Kv7.2/Kv7.3 channel currents in a concentration-dependent manner with an IC50 of 3.6 ± 0.2 μΜ. In single-channel recording assay, paroxetine significantly reduces the open probability of Kv7.2/Kv7.3 channels. Moreover, paroxetine exhibits an inhibition of the native M-current and an increase in the firing of action potentials in hippocampal neurons. Taken together, our findings unveil a novel role of the antidepressant paroxetine in inhibiting M-current, providing insights into its pharmacological effects on cognition enhancement.

Anterior prefrontal EEG theta activities indicate memory and executive functions in patients with epilepsy

OBJECTIVE

Cognitive deficits are one of the most debilitating comorbidities in epilepsy and other neurodegenerative, neuropsychiatric, and neurodevelopmental brain disorders. Current diagnostic and therapeutic options are limited and lack objective measures of the underlying neural activities. In this study, electrophysiological biomarkers that reflect cognitive functions in clinically validated batteries were determined to aid diagnosis and treatment in specific brain regions.

METHODS

We employed the Cambridge Neuropsychological Test Automated Battery (CANTAB) tasks to probe memory and executive functions in 86 patients with epilepsy undergoing clinical electroencephalography (EEG) monitoring. EEG electrode signals during performance of particular battery tasks were decomposed to identify specific frequency bands and cortical areas that differentiated patients with impaired, normal, and good standardized performance according to their age and gender.

RESULTS

The anterior prefrontal cortical EEG power in the theta frequency band was consistently lower in patients with impaired memory and executive function performance (z-score < -1). This effect was evident in all four behavioral measures of executive, visual, spatial, and working memory functions and was confined to the cortical area of all four frontal pole electrodes (Nz, Fpz, Fp1, and Fp2).

SIGNIFICANCE

Theta EEG power in the anterior prefrontal cortex provides simple, accessible, and objective electrophysiological measure of memory and executive functions in epilepsy. Our results suggest a feasible clinical biomarker for diagnosis, monitoring, and treatment of cognitive deficits with emerging targeted neuromodulation approaches.

Reliability of online, remote neuropsychological assessment in people with and without subjective cognitive decline

Online, remote neuropsychological assessment paradigms may offer a cost-effective alternative to in-person assessment for people who experience subjective cognitive decline (SCD). However, it is vital to establish the psychometric properties of such paradigms. The present study (i) evaluates test-retest reliability of remote, online neuropsychological tests from the NeurOn software platform in people with and without SCD (Non-SCD) recruited from the general population; and (ii) investigates potential group differences in baseline performance and longitudinal change. Ninety-nine participants (SCD N = 44, Non-SCD N = 55) completed seven tests from the NeurOn battery, covering visual and verbal memory, working memory, attention and psychomotor speed. Sixty-nine participants (SCD N = 34, Non-SCD N = 35) repeated the assessment six (+/- one) months later. SCD was classified using the Cognitive Change Index questionnaire. Test-retest reliability of the NeurOn test outcome measures ranged from poor to good, with the strongest evidence of reliability shown for the Sustained Attention to Response Test and Picture Recognition. The SCD group was significantly older than the Non-SCD group so group differences were investigated using analysis of covariance whilst controlling for the effect of age. SCD scored significantly better than Non-SCD for Digit Span Backwards (maximum sequence length) and Picture Recognition (recall of object position) at baseline. However, these were not significant when using the Bonferroni-adjusted alpha level. There were no differences between SCD and Non-SCD in longitudinal change. The results suggest online, remote neuropsychological assessment is a promising option for assessing and monitoring SCD, however more research is needed to determine the most suitable tests in terms of reliability and sensitivity to SCD.

Antibody immunotherapies for personalized opioid addiction treatment

Approved therapies for managing opioid addiction involve intensive treatment regimens which remain both costly and ineffective. As pharmaceutical interventions have achieved variable success treating substance use disorders (SUD), alternative therapeutics must be considered. Antidrug antibodies induced by vaccination or introduced as monoclonal antibody formulations can neutralize or destroy opioids in circulation before they reach their central nervous system targets or act as enzymes to deactivate opioid receptors, preventing the physiologic and psychoactive effects of the substance. A lack of "reward" for those suffering from SUD has been shown to result in cessation of use and promote long-term abstinence. Decreased antibody production costs and the advent of novel gene therapies that stimulate in vivo production of monoclonal antibodies have renewed interest in this strategy. Furthermore, advances in understanding of SUD immunopathogenesis have revealed distinct mechanisms of neuroimmune dysregulation underlying the disorder. Beyond assisting with cessation of drug use, antibody therapies could treat or reverse pathophysiologic hallmarks that contribute to addiction and which could be the cause of chronic cognitive defects resulting from drug use. In this review, we synthesize key current literature regarding the efficacy of immunotherapies in managing opioid addiction and SUD. We will explore the neuropharmacology underlying these treatments by relating evidence from studies on the use of antibody therapeutics to counteract various drug behaviors and by drawing parallels to the similar immunopathology observed in neurodegenerative disorders. Finally, we will discuss the implications of novel immunization technologies and the application of computational methods in developing personalized addiction treatments. SIGNIFICANCE STATEMENT: Significant new evidence contributing to our understanding of substance use disorders has recently emerged leading to a paradigm shift concerning the role of immunology in the neuropathogenesis of opioid use disorder. Concurrently, immunotherapeutic technologies such as antibody therapeutics have advanced the capabilities regarding applications that take advantage of these key principles. This article reviews key antibody-based treatments being studied and highlights directions for further research that may contribute to the management of opioid use disorder.

Preface to the Special Issue "Touchscreen Testing to Investigate the Neurochemistry of Cognition"

Touchscreen-based methodologies have enabled significant advancements in cognitive neuroscience by providing standardized, translationally relevant assessments of advanced cognitive functions in rodent models. This special issue highlights the potential of these systems to bridge animal and human research, providing insights into the neurochemical and biological mechanisms underlying cognition. The included studies explore diverse applications, from understanding the cognitive impacts of chronic stress and maternal immune activation to evaluating the effectiveness of novel therapeutics and assessing cross-species cognitive testing approaches that enhance translational relevance. By combining touchscreen technologies with cutting-edge approaches like electrophysiology and open science databases, these contributions underscore the critical role of automated systems in advancing translational research. Together, they lay the foundation for novel therapeutic strategies to address cognitive deficits in brain disorders.

Mapping global evidence of caregiver experiences in bipolar disorder in low and middle-income countries: A scoping review

BACKGROUND

Bipolar disorder (BD) imposes significant social, psychological, and economic burdens on individuals and their caregivers. While developing treatments for BD patients is crucial, supportive interventions for caregivers in low- and middle-income countries (LMICs) are equally important, given the limited resources and healthcare infrastructure. Understanding caregiver experiences in these settings is essential for creating effective interventions. This scoping review synthesizes knowledge of caregiver experiences in assisting individuals with BD in LMICs.

METHODS

Following Arksey and O'Malley's scoping review framework, we examined quantitative and qualitative studies on caregiver experiences. A comprehensive literature search was conducted across five databases, with two authors independently screening studies, extracting data, and reviewing references for additional eligible studies. Findings are presented through narrative synthesis according to PRISMA-ScR guidelines.

RESULTS

Out of 3518 records, 104 studies met the eligibility criteria. Five main themes and eight subthemes were identified: (1) burden of caregiving (impaired quality of life), (2) caregiver challenges (lack of understanding, family/social disruptions, financial restraints, mental and physical fatigue), (3) caregiver needs (information access, involvement, social support, financial assistance), (4) coping mechanisms, and (5) the silver lining in caregiving.

CONCLUSIONS

This review highlights significant challenges faced by caregivers of individuals with BD in LMICs, emphasizing the need for better psychoeducation, healthcare communication, and supportive resources. Addressing financial constraints and stigma is also crucial. Future research should focus on culturally adapting evidence-based strategies to support caregivers in these settings.

Rare mutations implicate CGE interneurons as a vulnerable axis of cognitive deficits across psychiatric disorders

Neuropsychiatric disorders such as autism spectrum disorder (ASD) and schizophrenia (SCZ) share genetic risk factors, including rare high penetrance single nucleotide variants and copy number variants (CNVs), and exhibit both overlapping and distinct clinical phenotypes. Cognitive deficits and intellectual disability-critical predictors of long-term outcomes-are common to both conditions. To investigate shared and disorder-specific neurobiological impact of highly penetrant rare mutations in ASD and SCZ, we analyzed human single-nucleus whole-brain sequencing data to identify strongly affected brain cell types. Our analysis revealed Caudal Ganglionic Eminence (CGE)-derived GABAergic interneurons as a key nexus for cognitive deficits across these disorders. Notably, genes within 22q11.2 deletions, known to confer a high risk of SCZ, ASD, and cognitive impairment, showed a strong expression bias toward vasoactive intestinal peptide-expressing cells (VIP+) among CGE subtypes. To explore VIP+ GABAergic interneuron perturbations in the 22q11.2 deletion syndrome in vivo , we examined their activity in the Df(16)A +/- mouse model during a spatial navigation task and observed reduced activity along with altered responses to random rewards. At the population level, VIP+ interneurons exhibited impaired spatial encoding and diminished subtype-specific activity suggesting deficient disinhibition in CA1 microcircuits in the hippocampus, a region essential for learning and memory. Overall, these results demonstrate the crucial role of CGE-derived interneurons in mediating cognitive processes that are disrupted across a range of psychiatric and neurodevelopmental disorders.

Neurochemical and Circuit Heterogeneity of Cognition-Modulating Prefrontal Corticotropin-Releasing Factor Neurons

BACKGROUND

Impairment of prefrontal cortex (PFC)-dependent cognition is associated with multiple psychiatric disorders. Development of more effective treatments for this form of cognitive dysfunction is hindered by our limited understanding of the neurobiology underlying PFC-dependent cognition. We previously identified a robust population of corticotropin releasing factor (CRF) neurons in the caudal dorsomedial PFC (dmPFC) of rats that impair both working memory and sustained attention. Although the working memory actions of these neurons involved local CRF release, the sustained attention actions were not. These results suggest potential heterogeneity within this population of CRF neurons, including the potential existence of both GABAergic (CRFGABA) interneurons and glutamatergic (CRFGlu) CRF projection neurons.

METHODS

Immunohistochemical analyses first identified both CRFGABA and CRFGlu neurons in the caudal dmPFC. Intersectional viral vector chemogenetic approaches were then used to assess the effects of activating caudal dmPFC CRFGlu and CRFGABA neurons on working memory and sustained attention in males and females (tested outside of proestrus).

RESULTS

CRFGlu neurons comprised a majority (85%) of caudal dmPFC CRF neurons, while remaining were identified as CRFGABA neurons. For both females and males, activation of caudal dmPFC CRFGABA neurons impaired working memory but not sustained attention, while activation of CRFGlu neurons impaired both working memory and sustained attention. Interestingly, the working memory actions of both CRFGABA and CRFGlu neurons were dependent on local CRF receptors.

CONCLUSION

These results advance our understanding of the neurobiology of PFC-dependent cognition and potential mechanisms through which cognitive dysfunction could arise.

Unexpected mechanisms of sex-specific memory vulnerabilities to acute traumatic stress

It is increasingly recognized that severe acute traumatic events (e.g., mass shooting, natural disasters) can provoke enduring memory disturbances, and these problems are more common in women. We probed the fundamental sex differences underlying memory vulnerability to acute traumatic stress (ATS), focusing on the role of the sex hormone, estrogen (17β-estradiol) and its receptor signaling in hippocampus. Surprisingly, high physiological hippocampal estrogen levels were required for ATS-induced episodic memory disruption and the concurrent sensitization and generalization of fear memories in both male and female mice. Pharmacological and transgenic approaches demonstrated signaling via estrogen receptor (ER)α in males and, in contrast, ERβ in females, as the mechanisms for these memory problems. Finally, identify distinct hippocampal chromatin states governed by sex and estrogen levels, which may confer an enduring vulnerability to post-traumatic memory disturbances in females.

Cumulative stressor exposure and cognitive functioning in late childhood: The role of inflammation

This study examined whether the experience of stressors since infancy is related to executive function and social communication in late childhood via inflammation, using data from 4457 participants of the Avon Longitudinal Study of Parents and Children (ALSPAC). It explored whether the effect of stressful life events (from 6 months to 8.5 years) on working memory, response inhibition, selective attention, attentional control, communication problems and social cognition (at ages 10-11 years) was mediated by inflammation (interleukin 6 and C-reactive protein) at age 9 years. While the study did not find evidence for mediation, it showed that, in the general child population, inflammation was related to executive function impairments, and stressful life events were related to social communication difficulties. These associations were small but robust to confounder adjustment. If causal, they suggest that reducing inflammation could improve executive functioning, the prerequisite to any purposeful and goal-directed action.

Placebo treatment entails resource-dependent downregulation of negative inputs

Clinical trials with antidepressants reveal significant improvements in placebo groups, with effects of up to 80% compared to real treatment. While it has been suggested that treatment expectations rely on cognitive control, direct evidence for affective placebo effects is sparse. Here, we investigated how cognitive resources at both the behavioral and neural levels influence the effects of positive expectations on emotional processing. Forty-nine healthy volunteers participated in a cross-over fMRI study where positive expectations were induced through an alleged oxytocin nasal spray and verbal instruction. Participants completed a spatial cueing task that manipulated attention to emotional face distractors while being scanned and were characterized regarding their general attention control ability. Placebo treatment improved mood and reduced distractibility from fearful compared to happy faces, particularly when more attentional resources were available for processing face distractors. This aligned with changes in activation and functional coupling within prefrontal-limbic networks, suggesting that expectations induce top-down regulation of aversive inputs. Additionally, neurobehavioral effects correlated with individual control ability. Our findings highlight the critical role of cognitive resources in verbally instructed placebo effects. This may be particularly relevant in patients with major depressive disorder, who often demonstrate enhanced negativity processing but have limited cognitive control capacity.

Transcranial direct current stimulation and its effect on cognitive symptoms of schizophrenia: An updated review

Objective

Cognitive impairments in schizophrenia significantly affect functional outcomes and quality of life. This meta-analysis evaluates the effectiveness of transcranial direct current stimulation (tDCS) as an intervention for cognitive deficits in individuals with schizophrenia.

Methods

From May 20 to June 15, 2024, a systematic search of PubMed, Medline, Embase, and the Cochrane central register of controlled trials was conducted. After applying eligibility criteria, 13 randomized sham-controlled trials were included, involving 261 participants in the tDCS group and 247 in the sham group. Standardized mean difference (SMD) was computed to measure the effect size of cognitive outcomes. Statistical analyses were performed using a random-effects model to account for heterogeneity.

Results

The pooled analysis yielded an SMD of 0.09 (95 % CI: -0.17 to 0.35), indicating a non-significant difference between tDCS and sham on cognitive outcomes. Moderate heterogeneity (I2 = 44 %) was observed, attributed to variations in tDCS protocols, participant demographics, and cognitive assessment tools. Although certain studies showed improvements in specific domains like working memory, the overall impact of tDCS on cognitive symptoms was not statistically significant.

Conclusions

This meta-analysis underscores the lack of significant evidence for tDCS in improving cognitive deficits in schizophrenia. The findings highlight the urgent need for standardizing tDCS protocols and employing domain-specific cognitive assessments. This standardization, along with the collection of more domain-specific data, is crucial for future research and the improvement of current methodologies.

Humans actively reconfigure neural task states

The ability to switch between tasks is a core component of adaptive cognition, yet a mechanistic understanding of this capacity has remained elusive. In particular, there are longstanding debates over the extent to which task-switching is primarily influenced by interference from previous tasks or active preparation for upcoming tasks. We advance this debate by modeling the evolution of task representations in human electroencephalographic recordings as linear dynamical systems over a high-dimensional latent space. Using control theoretic analyses of dynamical systems fit to both brains and task-optimized neural networks, we reveal neural signatures of active preparation that reconcile the role of interference and control in task switching. These findings inform a core debate in cognitive control and offer a promising new paradigm for human neuroimaging analysis.

Trajectories of working memory and decision making abilities along juvenile development in mice

Rodents commonly serve as model organisms for the investigation of human mental disorders by capitalizing on behavioral commonalities. However, our understanding of the developmental dynamics of complex cognitive abilities in rodents remains incomplete. In this study, we examined spatial working memory as well as odor-and texture-based decision making in mice using a delayed non-match to sample task and a two-choice set-shifting task, respectively. Mice were investigated during different stages of development: pre-juvenile, juvenile, and young adult age. We show that, while working memory abilities in mice improve with age, decision making performance peaks during juvenile age by showing a sex-independent trajectory. Moreover, cFos expression, as a first proxy for neuronal activity, shows distinct age-and brain area-specific changes that relate to task-specific behavioral performance. The distinct developmental trajectories of working memory and decision making in rodents resemble those previously reported for humans.

Relationship between serum homocysteine, folate and vitamin B12 levels and cognitive function in patients with drug-naive obsessive-compulsive disorder

The study aimed to investigate the correlation between Homocysteine (HCY), folate and vitamin B12 (VB12) levels and cognitive function in patients with drug-naive obsessive-compulsive disorder (OCD).Fifty patients with drug-naive OCD and 50 matched healthy controls recruited were enrolled. Subjects were cognitively assessed using The MATRICS Consensus Cognitive Battery (MCCB) scales. Serum HCY, floate, and vitamin B12 levels were collected.There was impairment in memory, attention in drug-naive OCD patients compared to the control group (P < 0.05). There were significant differences in HCY and folate levels compared to the control group (P < 0.05). SPSS mediated effects model 4 analyses showed that HCY levels mediated the relationship between Y-BCOS scores and verbal learning ability (median effect value: -0.43, 95% CI [-0.58 ~ -0.28]). Folate levels also mediated the relationship between Y-BOCS scores and verbal learning ability (median effect value: -0.11,95% CI: [-0.21 ~-0.03]). HCY levels were positively correlated with symptom severity and verbal learning ability, speed of information processing, and impaired emotion management in patients with drug-naive OCD, and folate levels may be protective against cognitive changes in patients with drug-naive OCD. OCD symptom severity together with HCY and folate levels affect cognitive function.

Assessing cognitive flexibility in mice using a custom-built touchscreen chamber

Automated touchscreen systems have become increasingly prevalent in rodent model screening. This technology has significantly enhanced cognitive and behavioral assessments in mice and has bridged the translational gap between basic research using rodent models and human clinical research. Our study introduces a custom-built touchscreen operant conditioning chamber powered by a Raspberry Pi and a commercially available computer tablet, which effectively addresses the significant cost barriers traditionally associated with this technology. In order to test our prototype, we decided to train C57BL/6 mice on a visual discrimination serial-reversal task, and both C57BL/6 and AppNL-G-Fstrain - an Alzheimer's Disease (AD) mouse model - on a new location discrimination serial-reversal task. The results demonstrated a clear progression toward asymptotic performance, particularly in the location discrimination task, which also revealed potential genotype-specific deficits, with AppNL-G-F mice displaying an increase in the average number of errors in the first reversal as well as in perseverative errors, compared to wild-type mice. These results validate the practical utility of our touchscreen apparatus and underline its potential to provide insights into the behavioral and cognitive markers of neurobiological disorders.

Frontotemporal dementia. How to deal with its diagnostic complexity?

INTRODUCTION

Frontotemporal dementia (FTD) encompasses a group of heterogeneous neurodegenerative disorders. Aside from genetic cases, its diagnosis is challenging, particularly in the early stages when symptoms are ambiguous, and structural neuroimaging does not reveal characteristic patterns.

AREAS COVERED

The authors performed a comprehensive literature search through MEDLINE, Scopus, and Web of Science databases to gather evidence to aid the diagnostic process for suspected FTD patients, particularly in early phases, even in sporadic cases, ranging from established to promising tools. Blood-based biomarkers might help identify very early neuropathological stages and guide further evaluations. Subsequently, neurophysiological measures reflecting functional changes in cortical excitatory/inhibitory circuits, along with functional neuroimaging assessing brain network, connectivity, metabolism, and perfusion alterations, could detect specific changes associated to FTD even decades before symptom onset. As the neuropathological process advances, cognitive-behavioral profiles and atrophy patterns emerge, distinguishing specific FTD subtypes.

EXPERT OPINION

Emerging disease-modifying therapies require early patient enrollment. Therefore, a diagnostic paradigm shift is needed - from relying on typical cognitive and neuroimaging profiles of advanced cases to widely applicable biomarkers, primarily fluid biomarkers, and, subsequently, neurophysiological and functional neuroimaging biomarkers where appropriate. Additionally, exploring subjective complaints and behavioral changes detected by home-based technologies might be crucial for early diagnosis.

Endogenous retroviruses in neurodevelopmental, psychotic and cognitive disorders

Endogenous retroviruses (ERVs) are inherited retroviral genomic elements that integrated into the mammalian genome through germline infections and insertions during evolution. Human ERVs (HERVs) comprise approximately 8 % of the human genome and are increasingly recognized to be involved in the etiology and pathophysiology of numerous brain disorders. In this narrative review, we summarize the existing evidence linking abnormal HERV expression to neurodevelopmental and psychosis-related disorders and discuss how these retroviral elements may contribute to the heterogeneity in clinical outcomes. We also review the findings suggesting that aberrant HERV expression contribute to late-onset cognitive disorders with neurodegenerative components, such as Alzheimer's disease (AD) and other forms of dementia. The evidence implicating abnormal HERV expression in neurodevelopmental, psychotic, and cognitive disorders is manifold and stems from diverse research fields, including human post-mortem brain studies, serological investigations, gene expression analyses, and clinical trials with HERV-specific pharmacological compounds. The recent establishment and use of animal models offer a complementary experimental platform that will help establish causal relationships and identify specific disease pathways affected by abnormal HERV expression. Yet, significant gaps persist in understanding the role of HERVs in neurodevelopmental, psychotic, and cognitive disorders, particularly concerning the specificity and stability of abnormal HERV expression in these conditions. Addressing these questions appears crucial for optimizing the potential benefits of therapeutic interventions aimed at targeting abnormal HERV expression across the broad spectrum of HERV-associated disorders of the central nervous system.

Control adjustment costs limit goal flexibility: Empirical evidence and a computational account

A cornerstone of human intelligence is the ability to flexibly adjust our cognition and behavior as our goals change. For instance, achieving some goals requires efficiency, while others require caution. Different goals require us to engage different control processes, such as adjusting how attentive and cautious we are. Here, we show that performance incurs control adjustment costs when people adjust control to meet changing goals. Across four experiments, we provide evidence of these costs, and validate a dynamical systems model explaining the source of these costs. Participants performed a single cognitively demanding task under varying performance goals (e.g., being fast or accurate). We modeled control allocation to include a dynamic process of adjusting from one's current control state to a target state for a given performance goal. By incorporating inertia into this adjustment process, our model accounts for our empirical finding that people under-shoot their target control state more (i.e., exhibit larger adjustment costs) when goals switch rather than remain fixed (Study 1). Further validating our model, we show that the magnitude of this cost is increased when: distances between target states are larger (Study 2), there is less time to adjust to the new goal (Study 3), and goal switches are more frequent (Study 4). Our findings characterize the costs of adjusting control to meet changing goals, and show that these costs emerge directly from cognitive control dynamics. In so doing, they shed new light on the sources of and constraints on flexibility of goal-directed behavior.

The Tower of London task in children and adolescents with neuropsychiatric disorders

The Tower of London, Drexel Version, Second Edition (TOL-DX) is purported to measure multiple aspects of executive functions, although it also possesses inherent non-executive demands. Such complexity makes it useful in detecting impairment but difficult in interpreting the neurocognitive cause of impairment, particularly in children. This study investigated the developmental, neurocognitive, and symptom correlates of the TOL-DX in children and adolescents with neuropsychiatric disorders. Two-hundred and thirty-three children and adolescents (7-21 years old) completed the TOL-DX during a neuropsychological evaluation as part of clinical care within a children's psychiatric hospital. Pearson correlation, regression models, and receiver operating characteristic curve (ROC) analyses examined the association among variables. Visuospatial and executive functions (EF) were most consistently related to total moves, execution time, and violations. TOL-DX variables were associated with attention in younger participants and EF in older participants. No TOL-DX scores were related to parent-reported symptoms. The TOL-DX possesses inherent visuospatial and attention/executive demands in children and adolescents which are difficult to differentiate, differ by age group, and not associated to clinical symptoms. Taken together, the TOL-DX is complex to interpret, but psychometrically sound and sensitive to neurocognitive impairment in children and adolescents with transdiagnostic neuropsychiatric disorders.

Parsing the heterogeneity of depression: a data-driven subgroup derived from cognitive function

Background

Increasing evidences suggests that depression is a heterogeneous clinical syndrome. Cognitive deficits in depression are associated with poor psychosocial functioning and worse response to conventional antidepressants. However, a consistent profile of neurocognitive abnormalities in depression remains unclear.

Objective

We used data-driven parsing of cognitive performance to reveal subgroups present across depressed individuals and then investigate the change pattern of cognitive subgroups across the course in follow-up.

Method

We assessed cognition in 163 patients with depression using The Chinese Brief Cognitive Test(C-BCT) and the scores were compared with those of 196 healthy controls (HCs). 58 patients were reassessed after 8 weeks. We used K-means cluster analysis to identify cognitive subgroups, and compared clinical variables among these subgroups. A linear mixed-effects model, incorporating time and group (with interaction term: time × group) as fixed effects, was used to assess cognitive changes over time. Stepwise logistic regression analysis was conducted to identify risk factors associated with these subgroups.

Results

Two distinct neurocognitive subgroups were identified: (1) a cognitive-impaired subgroup with global impairment across all domains assessed by the C-BCT, and (2) a cognitive-preserved subgroup, exhibited intact cognitive function, with performance well within the healthy range. The cognitive-impaired subgroup presented with more severe baseline symptoms, including depressed mood, guilt, suicidality, and poorer work performance. Significant group × time interactions were observed in the Trail Making Test Part A (TMT-A) and Continuous Performance Test (CPT), but not in Symbol Coding or Digit Span tests. Despite partial improvement in TMT-A and CPT tests, the cognitive-impaired subgroup's scores remained lower than those of the cognitive-preserved subgroup across all tests at the study endpoint. Multiple regression analysis indicated that longer illness duration, lower educational levels, and antipsychotic medication use may be risk factors for cognitive impairment.

Conclusion

This study identifies distinguishable cognitive subgroups in acute depression, thereby confirming the presence of cognitive heterogeneity. The cognitive-impaired subgroup exhibits distinct symptoms and persistent cognitive deficits even after treatment. Screening for cognitive dysfunction may facilitate more targeted interventions.

Clinical Trial Registration

https://www.chictr.org, identifier ChiCTR2400092796.

Causal Impacts of Psychiatric Disorders on Cognition and the Mediating Effect of Oxidative Stress: A Mendelian Randomization Study

Many psychiatric disorders are associated with major cognitive deficits. However, it is uncertain whether these deficits develop as a result of psychiatric disorders and what shared risk factors might mediate this relationship. Here, we utilized the Mendelian randomization (MR) analysis to investigate the complex causal relationship between nine major psychiatric disorders and three cognitive phenotypes, while also examining the potential mediating role of oxidative stress as a shared biological underpinning. Schizophrenia (SZ), major depressive disorder (MDD), and attention deficit hyperactivity disorder (ADHD) showed a decreasing effect on cognitive performance, intelligence, and education, while bipolar disorder (BPD) increased educational attainment. MR-Clust results exhibit the shared genetic basis between SZ and other psychiatric disorders in relation to cognitive function. Furthermore, when oxidative stress was considered as a potential mediating factor, the associations between SZ and the three dimensions of cognition, as well as between MDD and intelligence and ADHD and intelligence, exhibited larger effect sizes than the overall. Mediation MR analysis also supported the causal effects between psychiatric disorders and cognition via oxidative stress traits, including carotene, vitamin E, bilirubin, and uric acid. Finally, summary-based MR identified 29 potential causal associations of oxidative stress genes with both cognitive performance and psychiatric disorders. Our findings highlight the importance of considering oxidative stress in understanding and potentially treating cognitive impairments associated with psychiatric conditions.

Music-Based Cognitive Training for Adults with Major Depressive Disorder and Suicide Risk: A Pilot Study

Background/Objectives: Cognitive challenges in attention and executive function worsen over time in individuals with major depressive disorder (MDD) and suicidal risk. These difficulties persist beyond acute episodes, with limited targeted treatments available. Neurologic music therapy (NMT) is effective for cognitive rehabilitation in brain injuries and developmental disabilities, suggesting potential benefits for adults with MDD and suicide risk. This pilot study evaluated the feasibility, acceptability, and preliminary effectiveness of short-term NMT on cognitive function in adults with MDD. Methods: Adults aged 18+ with MDD and suicidal ideations participated in an 8-week single-arm open label study with 45-min individual in-person NMT sessions using musical attention control training (MACT) and musical executive function training (MEFT). Participants provided feedback on feasibility and acceptability, and pre- and post-intervention assessments included neurocognitive tasks and questionnaires on suicidal ideation, depressive symptoms, and quality of life. Results: A total of 18 individuals enrolled, and 10 participants completed the study protocol. Of the participants, 100% were satisfied with their experience with NMT, with 100% noting improvements in attention and 80% in executive function. Participants experienced some improvements in short-term memory (Digit Span Forward Test), cognitive flexibility (Trail Making Test B), and inhibitory control (Stroop Task). Significant reduction in suicidal ideation intensity (Beck Suicidal Scale of Ideation) was observed, as well as significant improvements in quality of life. Conclusions: This is the first study using NMT to demonstrate feasibility, acceptability, and effectiveness with respect to cognitive function in adults with MDD and suicide risk, providing preliminary data for future randomized controlled trials.

Neurocognitive impairments in rat offspring after maternal exposure to vortioxetine: Involvement of BDNF, apoptosis and cholinergic mediated signaling pathways

Depression in pregnant women raises concerns about the safety of antidepressants use, particularly its impact on offspring's neurocognition. This study investigates the effects of maternal exposure to vortioxetine (VOX) on the neurocognitive development of rat offspring. Pregnant Wistar rats were administered clinically pertinent doses of VOX, 1 mg/kg/day or 2 mg/kg/day from gestational day 6-21. The dams delivered their offspring naturally and reared until postnatal day (PND) 70. Offspring of both sexes were assessed for postnatal growth by measuring body weight from PND 1-70 weekly and cognitive function using Morris water maze (MWM) test and passive avoidance learning test from PND 49-70. After behavioral assessments, adult rat offspring were sacrificed, and their brains were dissected out for assessment of brain morphology as well as biochemical analysis. The results demonstrated that VOX exposure potentially impaired cognitive performance, evidenced by increased latency in MWM and passive avoidance learning tests. Additionally, it led to decreased body weight, altered brain morphology, and disrupted neurobiochemical profiles. Specifically, VOX 2 mg/kg exposure significantly reduced brain-derived neurotrophic factor (BDNF) expression, increased pro-apoptotic BAX expression, decreased anti-apoptotic Bcl-2 expression, and elevated acetylcholinesterase (AChE) activity in the hippocampus. Lower dose of VOX (1 mg/kg) did not show significant adverse effects on neurocognition, suggesting a dose-dependent impact. No sex specific neurocognitive deficits were observed in current study. These findings indicate that while VOX may offer a safer profile compared to SSRIs, high doses during pregnancy can still result in neurocognitive impairments in offspring.

Navigating Risk: A Comprehensive Study on Pedestrian-Vehicle Collision Factors

INTRODUCTION

While older adults, young children, and individuals with psychiatric illnesses are commonly believed to be most susceptible to becoming pedestrians struck by motor vehicles (PSMV), substantial empirical evidence is lacking. This study aimed to discern the risk factors predisposing trauma patients requiring hospital evaluation to being struck by a vehicle.

METHODS

The 2017-2021 Trauma Quality Improvement Program database was queried for all blunt trauma patients. Two groups were compared: PSMV and those presenting with other blunt trauma mechanisms. A multivariable logistic regression analysis was performed to identify predictors for PSMV and to analyze the risk difference between children (age <12 y), adolescents (12-17 y), and elderly patients (≥65 y) compared to adults (18-64 y).

RESULTS

Of 4,769,055 blunt trauma patients, 174,314 (3.7%) were PSMV. The pedestrian struck cohort had increased rates of lung injuries (20.8% versus 10.6%, P < 0.001) and rib fractures (24.0% versus 16.4%, P < 0.001), as well as overall complications (8.3% versus 4.3%, P < 0.001). On multivariable analysis, children (odds ratio [OR] 0.87, confidence interval [CI] 0.85-0.88, P < 0.001) and elderly patients (OR 0.36, CI 0.36-0.37, P < 0.001) were less likely to present as a pedestrian struck compared to adult patients. The strongest independent associated risk factor for PSMV was substance use disorder (OR 2.13, CI 2.09-2.16, P < 0.001), followed by alcohol use disorder (OR 1.21, CI 1.19-1.23, P < 0.001) and psychiatric illness (OR 1.12, CI 1.11-1.14, P < 0.001).

CONCLUSIONS

This study found that substance use disorders and psychiatric illness were the strongest predictor of PSMV among trauma patients. Surprisingly, children and the elderly were less likely to present as a PSMV compared to other blunt mechanisms, challenging prevailing beliefs. A 2-fold increase in complications and nearly 3-fold increase in mortality after PSMV highlights the need for both pedestrians and drivers to exercise caution in shared spaces and increased efforts for primary prevention.

A retrospective, observational study of real-world clinical data from the Cognitive Function Development Therapy program

Introduction

Cognitive deficits are common in psychiatric and mental health disorders, making the assessment of cognitive function in mental health treatment an important area of research. Cognitive Function Development Therapy (CFDT) is a novel therapeutic modality designed to enhance cognitive function and regulate the autonomic nervous system through targeted exercises and activities focused on attention networks and memory systems. The therapy is tracked and based on Primary Cognitive Function (PCF) scores.

Methods

This retrospective, observational study analyzed real world data from 183 children and adults undergoing CFDT to evaluate changes in cognition over time, incorporating both cognitive performance measures and an exploratory analysis of neurophysiological function. Objective neurophysiological measures in the form of the brain vital signs framework, based in event-related potentials (ERPs), were measured in a small subset of clients to explore the frameworks use in CFDT.

Results

Our findings indicate that CFDT holds promise for improving cognitive performance, as evidenced by increased PCF scores at the group level compared to pre-treatment levels [F (5, 173) = 7.087, p < 0.001, ηp 2 = 0.170]. Additionally, a weak effect of age [Spearman's Rho range: -0.301 to -0.340, p < 0.001] was found to influence the degree of cognitive improvement, suggesting the importance of early intervention for maximizing cognitive gains. The exploratory analysis suggested that CFDT may affect neurophysiological measures of information processing, particularly in basic attention, as reflected in increased amplitude in P300 measures.

Discussion

While these initial findings are encouraging, caution is warranted due to the retrospective nature of the study, though overall, the results suggest a positive impact of CFDT on cognitive function.

A study of long-term GABA and high-energy phosphate alterations in the primary motor cortex using anodal tDCS and 1H/31P MR spectroscopy

Introduction

Anodal transcranial direct current stimulation (tDCS) has been reported to modulate gamma-aminobutyric acid levels and cerebral energy consumption in the brain. This study aims to investigate long-term GABA and cerebral energy modulation following anodal tDCS over the primary motor cortex.

Method

To assess GABA and energy level changes, proton and phosphorus magnetic resonance spectroscopy data were acquired before and after anodal or sham tDCS. In anodal stimulation, a 1 mA current was applied for 20 min, and the duration of ramping the current up/down at the start and end of the intervention was 10 s. In the sham-stimulation condition, the current was first ramped up over a period of 10 s, then immediately ramped down, and the condition was maintained for the next 20 min.

Results

The GABA concentration increased significantly following anodal stimulation in the first and second post-stimulation measurements. Likewise, both ATP/Pi and PCr/Pi ratios increased after anodal stimulation in the first and second post-stimulation measurements.

Conclusion

The approach employed in this study shows the feasibility of measuring long-term modulation of GABA and high-energy phosphates following anodal tDCS targeting the left M1, offering valuable insights into the mechanisms of neuroplasticity and energy metabolism, which may have implications for applications of this intervention in clinical populations.

Major depression symptom severity associations with willingness to exert effort and patch foraging strategy

BACKGROUND

Individuals with major depressive disorder (MDD) can experience reduced motivation and cognitive function, leading to challenges with goal-directed behavior. When selecting goals, people maximize 'expected value' by selecting actions that maximize potential reward while minimizing associated costs, including effort 'costs' and the opportunity cost of time. In MDD, differential weighing of costs and benefits are theorized mechanisms underlying changes in goal-directed cognition and may contribute to symptom heterogeneity.

METHODS

We used the Effort Foraging Task to quantify cognitive and physical effort costs, and patch leaving thresholds in low effort conditions (reflecting perceived opportunity cost of time) and investigated their shared versus distinct relationships to clinical features in participants with MDD (N = 52, 43 in-episode) and comparisons (N = 27).

RESULTS

Contrary to our predictions, none of the decision-making measures differed with MDD diagnosis. However, each of the measures was related to symptom severity, over and above effects of ability (i.e. performance). Greater anxiety symptoms were selectively associated with lower cognitive effort cost (i.e. greater willingness to exert effort). Anhedonia and behavioral apathy were associated with increased physical effort costs. Finally, greater overall depression was related to decreased patch leaving thresholds.

CONCLUSIONS

Markers of effort-based decision-making may inform understanding of MDD heterogeneity. Increased willingness to exert cognitive effort may contribute to anxiety symptoms such as worry. Decreased leaving threshold associations with symptom severity are consistent with reward rate-based accounts of reduced vigor in MDD. Future research should address subtypes of depression with or without anxiety, which may relate differentially to cognitive effort decisions.

Clinical and Psychological Factors Associated with Frailty in Patients with Heart Failure

Background/Objectives: Heart failure (HF) is a significant public health issue with high morbidity and mortality rates. This study aims to investigate the interrelationships between frailty, cognitive impairment, and depression in older adults with HF, specifically focusing on how the physical and neuropsychiatric dimensions of frailty contribute to cognitive decline. Methods: This study included 250 patients aged 60 years or older, diagnosed with HF and hospitalized for acute decompensated HF. The patients were assessed using standardized protocols for frailty, cognitive function, and depression. The frailty was evaluated using Fried's phenotype criteria, cognitive function with MMSE and MoCA, and depression and anxiety with HADS and PHQ-9. Statistical analyses included univariable and multivariable linear regression to identify the predictors of frailty. Results: Of the 250 patients, 151 (60.4%) were identified as frail. The frail patients were older (mean age 73.58 ± 6.80 years) compared to the non-frail patients (mean age 70.39 ± 6.16 years, p = 0.0002). Significant differences were observed in the NYHA class, length of the hospital stay, and prevalence of diabetes mellitus. The frail patients had worse cognitive (MMSE: 27.39 ± 2.12 vs. 28.13 ± 1.72, p = 0.004; MoCA: 24.68 ± 3.65 vs. 25.64 ± 3.98, p = 0.050) and psychological outcomes (higher prevalence of marked depression based on HADS categories: 8.61% vs. 1.01%, p = 0.021; and PHQ-9 categories: severe depression: 2.65% vs. 1.01%, p < 0.001). Conclusions: Age, C-reactive protein (CRP) levels, and anxiety were identified as independent predictors of frailty in the patients with heart failure. Depression, cognitive dysfunction, and the length of the hospital stay showed significant differences between the frail and non-frail patients in the group comparisons but were not independent predictors.

Aerobic exercise prevents and improves cognitive dysfunction caused by morphine withdrawal via regulating endogenous opioid peptides in the brain

BACKGROUND

Morphine withdrawal leads to serious cognitive deficits in which dynorphins are directly involved. Recently, exercise has been shown to prevent and improve cognition dysfunction in a variety of ways. Meanwhile, exercise can regulate the endogenous opioid peptides including dynorphins. However, it remains unclear whether exercise influences cognitive dysfunction caused by morphine withdrawal via dynorphins. In the current study, we investigate the physiological mechanism of exercise prevention and improvement aganist cognition dysfunction caused by morphine withdrawal.

METHODS

Male, adult C57BL/6 mice were randomly divided into 5 groups : Saline control (WT), exercise (EXE), morphine withdrawl (MW), exercise + morphine withdrawl (EMW), morphine withdrawl + exercise (MWE). We established aerobic exercise prevention/improvement models, and conducted behavioral tests including Open field test (OFT), Temporal order memory test (TOM) and Y-maze. Through Western Blotting and immunofluorescence staining, we detected endogenous opioid peptides in hippocampus and mPFC.

RESULTS

Compared with MW group, EMW group and MWE group showed the same performance as WT group in TOM and Y-maze, with correct object recognition and memory ability. In Western Blotting and immunofluorescence staining experiments, it indicated that EMW group reduced the expression of PDYN and its fluorescence intensity in hippocampus; MWE group reduced the expression of OPRK1 and its fluorescence intensity in mPFC.

CONCLUSION

Our data suggest that aerobic exercise can both prevent and improve cognitive dysfunction caused by acute morphine withdrawal via respectively down-regulating PDYN in the hippocampus and down-regulating OPRK1 in the mPFC. They may become new targets for drugs development in the future.

Brain-phenotype predictions of language and executive function can survive across diverse real-world data: Dataset shifts in developmental populations

Predictive modeling potentially increases the reproducibility and generalizability of neuroimaging brain-phenotype associations. Yet, the evaluation of a model in another dataset is underutilized. Among studies that undertake external validation, there is a notable lack of attention to generalization across dataset-specific idiosyncrasies (i.e., dataset shifts). Research settings, by design, remove the between-site variations that real-world and, eventually, clinical applications demand. Here, we rigorously test the ability of a range of predictive models to generalize across three diverse, unharmonized developmental samples: the Philadelphia Neurodevelopmental Cohort (n=1291), the Healthy Brain Network (n=1110), and the Human Connectome Project in Development (n=428). These datasets have high inter-dataset heterogeneity, encompassing substantial variations in age distribution, sex, racial and ethnic minority representation, recruitment geography, clinical symptom burdens, fMRI tasks, sequences, and behavioral measures. Through advanced methodological approaches, we demonstrate that reproducible and generalizable brain-behavior associations can be realized across diverse dataset features. Results indicate the potential of functional connectome-based predictive models to be robust despite substantial inter-dataset variability. Notably, for the HCPD and HBN datasets, the best predictions were not from training and testing in the same dataset (i.e., cross-validation) but across datasets. This result suggests that training on diverse data may improve prediction in specific cases. Overall, this work provides a critical foundation for future work evaluating the generalizability of brain-phenotype associations in real-world scenarios and clinical settings.

Two hub genes of bipolar disorder, a bioinformatics study based on the GEO database

Bipolar disorder is a mood illness that affects many people. It has a high recurrence frequency and will cause significant damage to the patient's social function. At present, the pathogenesis of BD is not clear. The National Center for Biotechnology Information (NCBI) established and maintained the Gene Expression Omnibus (GEO) database, a gene expression database. For bioinformatics analysis, researchers can obtain expression data from the internet. At present, the samples of the dataset used in the research of BD are mostly from brain tissue, and the data containing blood samples are rarely used. GEO databases (GSE46416, GSE5388, and GSE5389) were used to retrieve public data, and utilizing the online tool GEO2R, differentially expressed genes (DEGs) were retrieved. The common DEGs between the samples of patients with BD and the samples of the normal population were screened by Venn diagrams. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses were used to perform functional annotation and pathway enrichment analysis of DEGs. A protein-protein interaction network (PPI) was built to investigate hub genes on this basis. There were 117 up-regulated DEGs and 38 down-regulated DEGs discovered, with two hub genes [SRC, CDKN1A] among the up-regulated DEGs. These two hub genes were also highly enriched in the oxytocin signaling pathway, proteoglycans in cancer and bladder cancer, according to KEGG analysis. The results of the receiver operating characteristic curve (ROC) of SRC and CDKN1A in the three datasets strongly suggested that SRC and CDKN1A were potential diagnostic markers of BD. The results strongly suggest that SRC and CDKN1A are related to the pathogenesis of BD.

Associations between major depressive disorder and performance-based and self-reported music cognition

Background

There is evidence that major depressive disorder (MDD) comes with multiple cognitive impairments including deficits in perception and memory. Music cognition is one of the least explored cognitive functions in relation to MDD, with some studies pointing to mild amusic deficits. These findings, however, are derived only from performance-based tests. Our objectives were to explore differences in music perception and memory between individuals with MDD and a control group, in both performance test and self-report of amusic dysfunction, and to assess the correlation between these measures.

Method

We recruited 62 participants, including MDD individuals (n = 34) diagnosed with the Mini International Neuropsychiatric Interview and controls (n = 18). All the participants were evaluated with the Montreal Battery for Evaluation of Amusia (MBEA) and the Amusic Dysfunction Inventory (ADI).

Results

None of the assessed dimensions from the MBEA or the ADI showed statistical differences between groups. Some significant associations were found between ADI's Vocal Production and the MBEA's three tests of the melodic dimension (Scale, Contour and Interval) and between MBEA's Scale and Memory, Meter and ADI's Melodic Perception, and tests of Memory from each respective instrument.

Conclusion

Results suggest that perception and memory of basic music stimuli are not among the cognitive deficits within MDD, however, they may be indirectly affected by other cognitive phenomena common to this psychopathology, such as poor sustained concentration due to mental fatigue.