Brain Research on Mental Disorders: A Criticism

Objective: To expose the problems and inherent limitations of neuroscience-based brain research on mental disorders. Method: Discussion of the theory underlying brain research on mental disorders, followed by a systematic evaluation of typical studies. Results: The fundamental problem is that brain researchers fail to differentiate between biological mental disorders in which brain processes cause the disorder (notably schizophrenia, bipolar disorder, and melancholic depression) and learned mental disorders in which brain processes mediate but do not cause the disorder (which is the case with reactive depression, reactive anxiety, OCD, and PTSD). Researchers have been unsuccessful in identifying mechanisms in the brain that cause biological mental disorders, and will never be able to locate the innumerable specific neural connections that mediate learned mental disorders. Moreover, the author’s review of typical studies in this field shows that they have serious problems with theory, measurement, and data analysis, and that their findings cannot be trusted. Conclusions: Neuroscience-based brain research on mental disorders, unlike other neurological research, has been an expensive failure and it is not worth continuing.

Transcranial magnetic stimulation: potential treatment for co-occurring alcohol, traumatic brain injury and posttraumatic stress disorders

Alcohol use disorder （AUD）, mild traumatic brain injury （mTBI）, and posttraumatic stress disorder （PTSD） commonly co-occur （AUD ＋ mTBI ＋ PTSD）. These conditions have overlapping symptoms which are, in part, reflective of overlapping neuropathology. These conditions become problematic because their co-occurrence can exacerbate symptoms. Therefore, treatments must be developed that are inclusive to all three conditions. Repetitive transcranial magnetic stimulation （rTMS） is non-invasive and may be an ideal treatment for co-occurring AUD ＋ mTBI ＋ PTSD. There is accumulating evidence on rTMS as a treatment for people with AUD, mTBI, and PTSD each alone. However, there are no published studies to date on rTMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. This review article advances the knowledge base for rTMS as a treatment for AUD ＋ mTBI ＋ PTSD. This review provides background information about these co-occurring conditions as well as rTMS. The existing literature on rTMS as a treatment for people with AUD, TBI, and PTSD each alone is reviewed. Finally, neurobiological findings in support of a theoretical model are discussed to inform TMS as a treatment for co-occurring AUD ＋ mTBI ＋ PTSD. The peer-reviewed literature was identified by targeted literature searches using PubMed and supplemented by cross-referencing the bibliographies of relevant review articles. The existing evidence on rTMS as a treatment for these conditions in isolation, coupled with the overlapping neuropathology and symptomology of these conditions, suggests that rTMS may be well suited for the treatment of these conditions together.

Correlative Factors for Organic Psychotic Symptoms in Pa- tients Following Traumatic Brain Injury

Objective To investigate the correlative factors for organic psychotic symptoms following traumatic brain injury(TBI). Methods In the current study, 391 subjects who had undergone forensic identification of the organic mental disorders due to TBI were included, both the demographic and post-traumatic information collected. The relevant data were statistically analyzed in those confirmed as organic psychotic syndrome according to Chinese Classification of Mental Disorders 3rd version(CCMD-3). Results Fifty-two subjects(13.3%) were identified as organic psychotic symptoms. The chi-square test showed that the detectable organic psychotic symptoms were associated with the marriage status, damage nature,injury severity and treatment, and the multivariate logistic regression analysis revealed good fitness of treatment and injury severity with the regression model(OR=0.044, 95% CI: 0.017-0.114; OR=2.145,95% CI: 1.201-3.832, respectively). Conclusion The risks of organic psychotic symptoms following TBI can be involved in the alternative of craniotomy for the cases with trauma and moderate brain injury.

Glutamate and depression: Reflecting a deepening knowledge of the gut and brain effects of a ubiquitous molecule

The versatility of glutamate as the brain’s foremost excitatory neurotransmitter and modulator of neurotransmission and function is considered common knowledge.Years of research have continued to uncover glutamate’s effects and roles in several neurological and neuropsychiatric disorders,including depression.It had been considered that a deeper understanding of the roles of glutamate in depression might open a new door to understanding the pathological basis of the disorder,improve the approach to patient management,and lead to the development of newer drugs that may benefit more patients.This review examines our current understanding of the roles of endogenous and exogenous sources of glutamate and the glutamatergic system in the aetiology,progression and management of depression.It also examines the relationships that link the gut-brain axis,glutamate and depression;as it emphasizes how the gut-brain axis could impact depression pathogenesis and management via changes in glutamate homeostasis.Finally,we consider what the likely future of glutamate-based therapies and glutamate-based therapeutic manipulations in depression are,and if with them,we are now on the final chapter of understanding the neurochemical milieu of depressive disorders.

The Mental Protection System for Protective Behaviors: The Social Brain and the Mental Immune System

The physical protection system of the body consists of the protective organs for vulnerable body parts-functions and the protective countermeasures against invaders (pathogens), but to survive, the body also requires the protective social groups for vulnerable social members-functions and the protective instinctive mental countermeasures against adversities such as hardship, danger, and unfamiliarity-uncertainty. As a result, this paper proposes that the mental protection system of the body consists of the social brain to set up the protective social groups for vulnerable social members-functions and the mental immune system to produce the protective mental countermeasures against adversities. This paper proposes that from the social brain, the protective social groups include alliance group for vulnerable individuals, kinship-friendship group for vulnerable children, interdependent specialists group for vulnerable pregnant females, territorial group for social boundary, connective group for social connection, and competitive group for social competition. From the mental immune system, the mental protective countermeasures include comforter against hardship, hyperactivity against danger, phobia against unfamiliarity-uncertainty, and rationality against unfamiliarity-uncertainty. The overactive mental immune system causes mental allergies and auto immune diseases as personality-mental disorders against ubiquitous harmful and harmless perceived adversities, correlating to physical allergies and auto immune diseases against ubiquitous harmful and harmless detected invaders. The mental protection system also produces personality traits, social moralities, social organizations, social systems, religions, and cultures as described in this paper. The mental protective system is the source of protective behaviors.

BRAIN DYSFUNCTION OF PATIENTSWITH QIGONG INDUCED MENTAL DISORDERREVEALED BY EVOKED POTENTIALS RECORDING

Objective: In order to investigate the brain function of patients with Qigong induced mental disorder (QIMD), this study was carried out. Methods: Four kinds of evoked potentials, including contingent negative variation (CNV), auditory evoked potentials (AEP), visual evoked potentials (VEP), and somatosensory evoked potentials (SEP), were recorded from 12 patients with Qigong induced mental disorder.Comparison of their evoked potentials with the data from some normal controls was made. Results: The results revealed that there were 3 kinds of abnormal changes in evoked potentials of patients with QIMD that is latency prolongation, amplitude increase and amplitude decrease, as compared with normal controls. Conclusion: Brain dysfunction of patients with QIMD was confirmed. Its biological mechanism needs further studying.

脑外伤后睡眠障碍患者医患护三位一体实施的应用效果

目的:以脑外伤以后出现睡眠障碍的患者为研究对象,分析医患护三位一体的实施效果。方法:选取2023年1月至2023年12月福建省立医院南院收治的脑外伤且均伴有不同程度的睡眠障碍患者76例作为研究对象,按照系统随机化法分为对照组和观察组,每组38例。对照组采取常规护理,观察组应用医患护三位一体,对比干预效果,评估指标包含睡眠质量、心理状态、疾病不确定感。结果:护理前,2组患者睡眠质量、心理状态以及疾病不确定感评分比较,差异无统计学意义(P>0.05)。护理后,睡眠质量评分均降低,且观察组较对照组低(P<0.05);护理后,观察组HAMA、HAMD评分低于对照组(P<0.05),观察组疾病不确定感低于对照组(P<0.05)。结论:予以脑外伤后睡眠障碍患者医患护三位一体干预对于提高睡眠质量、改善心理状态具有突出效果,有利于减轻患者疾病不确定感,具有较高借鉴价值。

精神障碍患者童年创伤经历及其与文化智力的关联研究

目的:探究精神障碍患者的童年创伤经历及与其文化智力水平的关联。方法:纳入就诊于昆明医科大学第二附属医院精神科的203例精神障碍患者(包括抑郁障碍、焦虑障碍、目前为抑郁发作的双相情感障碍患者),采用童年创伤问卷简化版(CTQ-SF)、文化智商问卷(CIQ)进行调查。根据童年创伤类型对患者进行分组,比较各组间童年创伤和文化智商的关联。结果:忽视组与忽视+虐待组患者的童年创伤经历、文化智商量表总分及各因子分均低于不伴童年创伤组的患者(P均<0.05)。情感忽视与文化智商量表总分、认知因子得分负向关联(β=-0.3、-0.3);躯体忽视与元认知因子得分、行为因子得分负向关联(β=-0.2、-0.2)。结论:与不伴有童年创伤经历的精神障碍患者相比,伴有童年创伤经历的患者的文化智力水平低。情感忽视和躯体忽视与此类患者的文化智力水平有较强的关联性。

乳腺术后三阴方干预三阴性乳腺癌化疗脑症状临床研究

目的:观察评价乳腺术后三阴方对三阴性乳腺癌化疗相关认知障碍临床症状的影响。方法:采用前瞻性队列研究设计,选取2020年12月至2021年6月上海龙华医院、上海肿瘤医院化疗患者130例作为研究对象,按照是否服用乳腺术后三阴方分为对照组(n=64)和观察组(n=66),对照组给予常规治疗,观察组给予中药乳腺术后三阴方,餐后温服,疗程3个月。治疗结束后,观察癌症患者功能评估-认知功能量表(FACT-cog)评分,神经心理学测验,中医症状及安全性指标。结果:随访结束后对照组认知异常为49例,占79.03%,观察组认知异常为47例,占75.81%,暴露因素相对危险度(RR)为0.93。观察组患者生命质量的提升与对照组比较,差异均有统计学意义(均P<0.05),对照组生命质量与治疗前比较有所提高,其余相关症状均逐渐加重。FACT-cog各维度症状与乳腺术后中医症状存在相关性。随访3个月后,观察组患者中医症状积分显著低于对照组(P<0.05)。结论:乳腺术后三阴方对认知能力的提升作用尚未明确,但其通过缓解化疗不适症状改善三阴性乳腺癌患者自我感知到的认知障碍相关症状,且对三阴性乳腺癌化疗相关认知能力的减退可能具有预防作用。

童年创伤影响社交焦虑障碍的心理与生物机制研究进展

社交焦虑障碍(social anxiety disorder,SAD)对个体的社会交往和正常生活具有显著负面影响,而童年创伤在SAD的发生发展中起着重要作用。童年创伤通过影响自我意识的发展,损害信息加工能力,阻碍前额叶-边缘系统环路和默认网络的正常发育,造成糖皮质激素和催产素的分泌异常等,导致个体在正确理解社交线索、合理调控情绪等方面存在困难,在社交情境中无法产生适应性情绪和行为反应,进而可能产生SAD。总之,童年创伤从心理和生理两个方面对社交功能产生持久的不良影响。

不同剂量奥氮平治疗脑器质性和躯体疾病致精神障碍患者的效果

目的探讨不同剂量奥氮平治疗脑器质性和躯体疾病所致精神障碍患者的效果。方法以收治的108例脑器质性和躯体疾病致精神障碍患者为研究对象,用随机数字表法分为对照组和观察组,每组54例。对照组予以大剂量奥氮平片治疗,观察组予以小剂量奥氮平片治疗。2组均治疗8周。比较2组治疗后的效果,治疗前后阳性与阴性症状量表(positive and negative symptom scale,PANSS)评分、神经功能缺损评分量表(national institute of health strokescale,NIHSS)评分、日常生活能力量表(activity of daily living,ADL)评分、简明精神病评定量表(brief psychiatric rating scale,BPRS)评分和糖脂代谢指标。结果治疗后,观察组的临床总有效率高于对照组;2组阳性症状评分、阴性症状评分、一般精神病理评分、总评分、NIHSS评分及BPRS评分均降低,且观察组低于对照组(P<0.05),ADL评分升高,且观察组高于对照组(P<0.05);2组血清总胆固醇(total cholesterol,TC)、低密度脂蛋白-胆固醇(low-density lipoprotein cholesterol,LDL-C)、三酰甘油(triglycerides,TG)、空腹血糖(fasting blood glucose,FBG)、空腹胰岛素(fasting insulin,FINS)、稳态胰岛素评价指数(homeostasis model assessment of insulin resistance,HOMA-IR)及餐后2 h血糖(2 hours postprandial blood glucose,2 h PBG)水平均升高,且观察组低于对照组,血清高密度脂蛋白-胆固醇(high-density lipoprotein cholesterol,HDL-C)水平均降低,且观察组高于对照组(P<0.05)。结论脑器质性和躯体疾病所致精神障碍患者应用小剂量奥氮平能够有效提高其临床治疗效果及日常生活能力,改善其精神状况、临床症状及神经功能,同时对患者糖脂代谢的影响较小。

神经调控技术在脑科学研究中的应用研究进展

通过药物和物理刺激(如光、电、磁、超声)的方法可实现对脑神经元功能的操控。其中,化学遗传和光遗传技术由于可精确操控目标脑区特定类型的神经元,在脑环路功能研究中应用最为广泛。近年来开发的磁遗传技术可在磁场条件下利用磁感应元件激活神经元,实现了对大脑特定脑区神经元的非侵入且瞬时的调控。本文主要对脑科学研究中最常用的化学遗传和光遗传技术的发展进程和存在问题,以及正处于探索阶段的磁遗传技术的最新进展进行综述,同时也讨论了经颅电刺激、经颅磁刺激、深部脑刺激和经颅超声刺激技术在脑疾病的治疗中发挥的作用。期望通过不断的调整和改善,这些技术能更好地应用于脑科学研究和脑疾病治疗。

从“三心二意”到“一心一意”——再论心主神志

从中医藏象心的生理功能看,心主神志是强调心的功能脏腑属性;而心主血脉则是强调其解剖脏腑的属性,即中医的心是功能脏腑和解剖脏腑整合起来的脏腑系统。从解剖脏腑来看,“心”其实涵盖了“三心”,即心、胃(包含消化道的其他脏腑)和脑,为神之器;从功能脏腑来看,“心”涵盖了“二意”,即脑和胃(胆等其他消化道脏腑)藏神,为神之用。而最终作为元神之府的脑则是五脏六腑和奇恒之府藏神功能的最终主导者,是真正意义上的“心主神志”,此为“一心一意”。

粪菌移植治疗炎症性肠病躯体心理症状的研究进展

炎症性肠病是一种由免疫介导的慢性非特异性肠道炎性疾病。近年来,其发病率在中国呈显著上升趋势。目前诸多研究发现炎症性肠病不仅影响消化系统的正常功能,还会通过微生物群肠脑轴影响患者的情绪和行为功能。其中,焦虑和抑郁等心理合并症对患者的影响更为突出。同时肠道心理的交互作用还会影响患者的自然病程,增加疾病出现不良结局的风险。因此在治疗炎症性肠病躯体症状的同时,心理干预及治疗已逐渐引起研究者的重视。目前,粪菌移植治疗作为依赖于该轴的新兴治疗策略逐渐受到关注。本文就炎症性肠病躯体心理症状的相互作用以及粪菌移植治疗在炎症性肠病躯体心理症状治疗中的应用前景予以综述。

精神障碍类疾病神经调控新进展

精神障碍类疾病是一类涉及认知、情感、思维和行为的疾病,其临床表现各异,致病机制复杂,病因尚未被彻底阐明,目前仍无有效的针对性治疗方案,是当前医学领域的难点之一。近年研究结果表明,以电、磁、光、声为基础开发的新型神经调控手段可以有效的治疗或缓解各类药物难治性精神类疾病的临床症状。因此本文将聚焦于总结和回顾各类新型神经调控手段的研发与应用进展,为精神障碍类疾病治疗方案的更新提供新思路。

童年期创伤对精神障碍影响的研究进展

现如今,童年期创伤是一个普遍又严重的社会问题,主要表现为情感的忽视和虐待,对今后人格、情感和认知功能等都存在很大的影响,更容易引起一系列精神障碍。童年期经历过的创伤在大脑发育的关键时期会引起大脑的个别脑区结构和功能产生改变,并与其后期精神障碍的发生存在密切关联。本综述通过文献检索回顾性分析童年期创伤对精神障碍的影响,旨在为有童年创伤经历者在预防和干预精神障碍问题上提供科学依据,进而为儿童心理健康的发展提供有力支持。

针刺联合经颅直流电刺激治疗脑外伤后意识障碍的疗效观察

目的探讨针刺联合经颅直流电刺激(tDCS)治疗脑外伤(TBI)后意识障碍的疗效。方法符合纳入标准及排除标准的TBI后意识障碍患者40例,随机分为针刺组、电刺激组(经颅直流电刺激)、联合组(针刺联合经颅直流电)与对照组,每组各10例。针刺组采用针刺和药物治疗,电刺激组行经颅直流电刺激和药物治疗,联合组行针刺结合经颅直流电刺激及药物治疗,对照组仅行常规药物治疗。比较治疗前后四组患者意识障碍恢复量表修订版(CRS-R)评分、格拉斯哥意识障碍量表(GCS)评分、上肢体感诱发电位(USEP)。结果治疗后针刺组、电刺激组及联合组GCS、CRS-R、USEP均优于对照组,差异有统计学意义(P<0.05)。联合组治疗后GCS、CRS-R、USEP均高于针刺组及电刺激组,差异有统计学意义(P<0.05)。结论针刺联合经颅直流电刺激治疗能明显缩短昏迷时间,改善患者认知功能,对TBI后意识障碍有促进苏醒作用,有助于患者疾病康复。

脑外伤所致精神障碍患者的心理理论及相关因素

目的:探讨脑外伤所致精神障碍患者的心理理论功能及其相关因素。方法:以2008年在我所鉴定的脑外伤所致精神障碍患者131例为病例组,以我单位职工20名为正常对照组。根据脑损伤的部位将病例组分为额叶组(n=28)、颞叶组(n=31)、顶叶组(n=6)、枕叶组(n=6)、联合组(n=53)和脑震荡组(n=7),根据病史中昏迷指数将病例组分为轻型组(n=83)、中型组(n=28)和重型组(n=20),根据后遗精神症状将病例组分为精神病组(n=14)、神经症组(n=63)、智力缺损组(n=22)和人格改变组(n=32)。应用错误信念、解释性心理理论、失言任务来评估被试的心理理论。结果:病例组的三项心理理论任务得分及总分均低于对照组[如,总分(15.04±3.10)vs.(18.30±1.75),P<0.05]。额叶组、颞叶组、联合组的心理理论任务总分均低于对照组[(14.75±3.08),(15.13±3.17),(14.72±3.37)vs.(18.30±1.75);P<0.05],额叶组、颞叶组、联合组之间差异无统计学意义。轻、中、重型组患者心理理论任务总分均低于对照组[(15.45±2.80),(14.68±3.86),(13.85±2.91)vs.(18.30±1.75);P<0.05],轻、中、重型组之间的差异无统计学意义。以精神病性症状、神经症样综合征、智力缺损、人格改变症状为主的患者的心理理论任务总分均低于对照组[(13.71±3.41),(16.89±1.97),(13.77±2.89)vs.(12.84±2.86);P<0.05],其中精神病性症状、智力缺损、人格改变症状者总分低于神经症样综合征患者(P<0.05)。多元方差分析显示,不同精神症状、精神症状与损伤部位的交互作用的差异具有统计学意义,以人格改变组、额叶损伤合并人格改变患者的得分为最低(P<0.05)。结论:脑外伤所致精神障碍患者心理理论低于正常人,这种降低主要与后遗精神症状以及精神症状与损伤部位的交互作用有关。