Connectivity differences between adult male and female patients with attention deficit hyperactivity disorder according to resting-state functional MRI

Attention deficit hyperactivity disorder（ADHD） is a pervasive psychiatric disorder that affects both children and adults. Adult male and female patients with ADHD are differentially affected, but few studies have explored the differences. The purpose of this study was to quantify differences between adult male and female patients with ADHD based on neuroimaging and connectivity analysis. Resting-state functional magnetic resonance imaging scans were obtained and preprocessed in 82 patients. Group-wise differences between male and female patients were quantified using degree centrality for different brain regions. The medial-, middle-, and inferior-frontal gyrus, superior parietal lobule, precuneus, supramarginal gyrus, superior- and middle-temporal gyrus, middle occipital gyrus, and cuneus were identified as regions with significant group-wise differences. The identified regions were correlated with clinical scores reflecting depression and anxiety and significant correlations were found. Adult ADHD patients exhibit different levels of depression and anxiety depending on sex, and our study provides insight into how changes in brain circuitry might differentially impact male and female ADHD patients.

Updated Review on the Clinical Use of Repetitive Transcranial Magnetic Stimulation in Psychiatric Disorders

With the ability to modulate cortical activity,repetitive transcranial magnetic stimulation（r TMS） is becoming increasingly important in clinical applications for psychiatric disorders. Previous studies have demonstrated its promising efficacy in depression and schizophrenia, and emerging evidence has also been found in patients with anxiety disorder, obsessive–compulsive disorder, and substance or food craving. However, the overall literature features some conflicting results, varied quality of studies,and a lack of consensus on optimal r TMS parameters.Besides, the efficacy of r TMS in patients with medicationresistant symptoms has drawn most attention from clinicians. Here we review multi-site studies and double-blind randomized controlled trials（RCTs） in single sites, as well as meta-analyses of RCTs in the last three years, in order to update evidence on efficacy and the optimal protocol of r TMS in psychiatric disorders, especially for medicationresistant symptoms.

The trade-off between COVID-19 and mental diseases burden during a lockdown: Mathematical modeling of control measures

Background:During the COVID-19 pandemic,many countries used lockdowns as a containment measure.While lockdowns successfully contributed to slowing down the contagion,the related mobility restrictions were reportedly associated with an increased risk of major depressive and anxiety disorders.We aimed to quantify the trade-off between the quality-adjusted life years(QALY)gain due to lower COVID-19 incidence as a result of a lockdown and QALY loss due to lockdown-induced mental disorders.Methods:We developed an agent-based model of COVID-19 epidemic and coupled mental disorder development in the population of a large city.We used data sources on the places of living,studying and working,public health and census surveys.Modeling of mental disorders was based on diathesis-stress concept.We quantified mental and physical health burden in terms of QALY taking into account major depressive and anxiety disorder episodes,lethal and non-lethal cases of COVID-19,and immunization.Findings:We evaluated the dynamics of new major depressive disorder(MDD)and anxiety disorder(AD)cases during the period between September 2020 and December 2021 in Moscow,Russia.We found that lockdown imposition increases the daily chances of getting MDD or ADD by a vulnerable person by 16.79%(95%CI[12.36%,21.23%]).The QALY loss associated with COVID-19-induced and lockdown-induced mental disorders was estimated to be 18.93%(95%CI[16.94%,19.73%])of the total QALY loss caused by COVID-19,immunization,and all kinds of mental disorders.For a synthetic“strong”lockdown,it had been shown that QALY loss is minimized when about 70%of the population are isolated.Interpretation:The burden associated with mental disorders amounts to a considerable part of COVID-19-related losses.Our findings demonstrate that cost-benefit analysis of mobility restriction should include a forecast of mental disorder development in the population.