Impaired implicit emotion regulation in patients with panic disorder:An event-related potential study on affect labeling

BACKGROUND Panic disorder(PD)involves emotion dysregulation,but its underlying mechanisms remain poorly understood.Previous research suggests that implicit emotion regulation may play a central role in PD-related emotion dysregulation and symptom maintenance.However,there is a lack of studies exploring the neural mechanisms of implicit emotion regulation in PD using neurophysiological indicators.AIM To study the neural mechanisms of implicit emotion regulation in PD with eventrelated potentials(ERP).METHODS A total of 25 PD patients and 20 healthy controls(HC)underwent clinical evaluations.The study utilized a case-control design with random sampling,selecting participants for the case group from March to December 2018.Participants performed an affect labeling task,using affect labeling as the experimental condition and gender labeling as the control condition.ERP and behavioral data were recorded to compare the late positive potential(LPP)within and between the groups.RESULTS Both PD and HC groups showed longer reaction times and decreased accuracy under the affect labeling.In the HC group,late LPP amplitudes exhibited a dynamic pattern of initial increase followed by decrease.Importantly,a significant group×condition interaction effect was observed.Simple effect analysis revealed a reduction in the differences of late LPP amplitudes between the affect labeling and gender labeling conditions in the PD group compared to the HC group.Furthermore,among PD patients under the affect labeling,the late LPP was negatively correlated with disease severity,symptom frequency,and intensity.CONCLUSION PD patients demonstrate abnormalities in implicit emotion regulation,hampering their ability to mobilize cognitive resources for downregulating negative emotions.The late LPP amplitude in response to affect labeling may serve as a potentially valuable clinical indicator of PD severity.

Pt-Pd-Ni体系相图与热力学研究进展

铂基催化剂具有活性高、选择性好、电化学稳定性佳等优点,在工业催化和燃料电池领域具有非常重要的地位。然而,由于成本较高、可用性较低限制了其实际发展。因此,有必要优化铂基催化剂的利用率,设计低成本和高稳定性的铂基催化剂。本研究首先介绍了在燃料电池催化剂领域具有应用前景的Pt-Pd-Ni系合金电催化剂的发展和研究现状,然后详细介绍了Pt-Pd-Ni体系的三个二元系相图与热力学评估数据和研究进展,并对Pt-Pd-Ni三元系的一些实验研究进展和今后的研究工作提出展望,对不同相结构对催化性能的影响进行了分析和讨论。通过Pt-Pd-Ni系相图和相结构等的研究将为燃料电池用新型贵金属合金催化材料的设计及工业应用奠定理论和实验基础。

Pilot study of genome-wide DNA methylation and gene expression for treatment response to escitalopram in panic disorder

BACKGROUND Antidepressants,particularly selective serotonin reuptake inhibitors,are currently considered the first-line treatment for panic disorder(PD).However,little is known about the relationship between the biomarkers that may predict better treatment.AIM To compare genome-wide methylation and gene expression patterns between responsive and non-responsive patients with PD after 4 wk of escitalopram treatment.METHODS Thirty patients with PD were enrolled in this study(responders=13;nonresponders=17).All patients were assessed using the PD Severity Scale-Chinese version before and after treatment.The Illumina Infinium MethylationEPIC(850k)BeadChip for genome-wide methylation screening and mRNA sequencing was used in all patients with PD.RESULTS A total of 701 differentially methylated positions(DMPs)were found between responders and non-responders(|Δβ|≥0.06,q<0.05),and the hyper-and hypomethylated CpG sites were 511(72.9%)and 190(27.1%),respectively.Relative to non-responders,there were 59 differential transcripts,of which 20 were downregulated and 39 were upregulated(q<0.05).However,no differen tially expressed genes were identified by mRNA sequencing after correcting for multiple testing(|log2(FC)|>1,q>0.05).CONCLUSION This preliminary study showed that DMPs might be associated with the treatment response to escitalopram in PD;however,these DMPs need to be verified in large samples.

Glutamate decarboxylase 1 gene polymorphisms are associated with respiratory symptoms in panic disorder

BACKGROUND Genetic factors play an important role in the pathogenesis of panic disorder(PD).However,the effect of genetic variants on PD remains controversial.AIM To evaluate the associations between glutamate decarboxylase 1(GAD1)gene polymorphisms and PD risk and assess the effect of GAD1 gene polymorphisms on the severity of clinical symptoms in PD.METHODS We recruited 230 PD patients and 224 healthy controls in this study.All participants were assessed for anxiety and panic symptom severity using the Hamilton Anxiety Rating Scale(HAM-A)and Panic Disorder Severity Scale(PDSS).GAD1 gene polymorphisms(rs1978340 and rs3749034)were genotyped and assessed for allele frequencies.RESULTS There were no significant differences between cases and controls in the genotype distributions or allele frequencies of GAD1(rs1978340 and rs3749034).In addition,the effect of GAD1(rs1978340 and rs3749034)on PD severity was not significant.However,regarding respiratory symptoms,patients with the GAD1 rs1978340 A/A genotype had significantly higher scores than those with the A/G or G/G genotype.CONCLUSION Here,we showed that the A/A genotype of GAD1 rs1978340 was associated with increased severity of respiratory symptoms in patients with PD.

Functional neuroanatomy in panic disorder:Status quo of the research

AIM To provide an overview of the current research in the functional neuroanatomy of panic disorder.METHODS Panic disorder(PD) is a frequent psychiatric disease. Gorman et al(1989; 2000) proposed a comprehensive neuroanatomical model of PD, which suggested that fear-and anxiety-related responses are mediated by a so-called "fear network" which is centered in the amygdala and includes the hippocampus, thalamus, hypothalamus, periaqueductal gray region, locus coeruleus and other brainstem sites. We performed a systematic search by the electronic database PubMed. Thereby, the main focus was laid on recent neurofunctional, neurostructural, and neurochemical studies(from the period between January 2012 and April 2016). Within this frame, special attention was given to the emerging field of imaging genetics. RESULTS We noted that many neuroimaging studies have reinforced the role of the "fear network" regions in the pathophysiology of panic disorder. However, recent functional studies suggest abnormal activation mainly in an extended fear network comprising brainstem, anterior and midcingulate cortex(ACC and MCC), insula, and lateral as well as medial parts of the prefrontal cortex. Interestingly, differences in the amygdala activation were not as consistently reported as one would predict from the hypothesis of Gorman et al(2000). Indeed, amygdala hyperactivation seems to strongly depend on stimuli and experimental paradigms, sample heterogeneity and size, as well as on limitations of neuroimaging techniques. Advanced neurochemical studies have substantiated the major role of serotonergic, noradrenergic and glutamatergic neurotransmission in the pathophysiology of PD. However, alterations of GABAergic function in PD are still a matter of debate and also their specificity remains questionable. A promising new research approach is "imaging genetics". Imaging genetic studies are designed to evaluate the impact of genetic variations(polymorphisms) on cerebral function in regions critical for PD. Most recently, imaging genetic studies have not only confirmed the importance of serotonergic and noradrenergic transmission in the etiology of PD but also indicated the significance of neuropeptide S receptor, CRH receptor, human TransM EMbrane protein(TMEM123D), and amiloride-sensitive cation channel 2(ACCN2) genes. CONCLUSION In light of these findings it is conceivable that in the near future this research will lead to the development of clinically useful tools like predictive biomarkers or novel treatment options.

The Effects of Low Dose Sertraline on Blood Pressure in Patients with Hypertension and Panic Disorder: A Pilot Study

Objective: In this pilot study, given the prevalence of hypertension and panic disorder as described in the literature, we proposed to fill the gaps in the literature on the possible utility of SSRI medication as an adjunct treatment in individuals with panic disorder and hypertension. Methods: We planned to only recruit patients with panic disorder who fit the criteria independently for treatment with SSRI;i.e. treatment would be given based on clinical need and currently accepted Pharmaceutical Benefits Scheme (PBS) criteria. Thereafter, we would monitor their BP at baseline, 14 days and 28 days to determine if there has been an effect on the individual’s BP. Results: Based on the observation above, there may be a trend of a reduction in systolic and diastolic BP after the commencement of sertraline. Conclusion: In order to confirm this observation, a larger sample size is required in the future. This pilot study proposed to meet the objectives as listed below;however due to difficulty with recruitment, only 2 out of 4 participants will be discussed in the analysis.

Thiol-Disulfide Homeostasis in Patients with Panic Disorder

Objective: To determine serum thiol/disulfide homeostasis in panic disorder (PD). Methods: Serum native thiol, total thiol, and disulfide levels were measured in the patients with 40 PD patients and 40 healthy subjects. Serum native thiol, total thiol, and disulfide levels were measured with a novel colorimetric, automated method. The thiol-disulfide ratio was also calculated. Results: The native thiol (p Conclusion: This is the first study in the literature to evaluate thiol-disulfide homeostasis in patients with PD. Our results suggest that the disulfide/thiol ratio is significantly greater in panic disorder patients.

Psychological predictors of bipolarity in panic disorder

BACKGROUND Panic disorders frequently occur with affective disorders,particularly bipolar disorder.Patients with panic disorder and bipolar disorder are more likely to present with severe symptoms,such as high rates of suicidal behavior,poor symptomatic and functional recovery,and poor drug responses.AIM To investigate the psychological characteristics of panic disorder patients related to bipolarity.METHODS A total of 254 patients(136 men and 118 women,mean age=33.48±3.2 years)who were diagnosed with panic disorder were included in the study.Panic disorder with bipolarity(BP+)was defined as a score of≥7 on the Korean version of the Mood Disorder Questionnaire(K-MDQ),and a score lower than 7 was considered as a panic disorder without bipolarity(BP-).Self-report questionnaires were analyzed to examine their association with bipolarity.Psychological tests used in the study were the Mood Disorder Questionnaire(MDQ),Panic Disorder Severity Scale,Beck Depression Inventory,State-Trait Anxiety Inventory(STAI),Temperament and Character Inventory(TCI),and Minnesota Multiphasic Personality Inventory(MMPI).Statistical analyses were performed to evaluate the correlation between bipolarity of panic disorder patients and various psychological test results indicative of psychological characteristics.RESULTS Patients with a K-MDQ score of 7 or more were considered to have a history of manic or hypomanic episodes(BP+group,n=128),while patients with K-MDQ scores below 7 were defined as those without bipolarity(BP-group,n=126).The BP+group were more likely to be unmarried(single 56.2%vs 44.4%,P=0.008)and younger(30.78±0.59 vs 37.11±3.21,P<0.001).Additionally,the BP+group had significantly higher scores on psychological assessment scales,such as the hypochondriasis,psychopathic deviate,masculinity-femininity,psychasthenia,schizophrenia,and hypomania(Ma)in MMPI,and novelty seeking,harm avoidance and self-transcendence in TCI,and STAI(state and trait)compared to the BP-group.In logistic regression analysis,depression in MMPI,selfdirectedness in TCI,and age were negatively associated with MDQ score,meanwhile,Ma in MMPI and STAI(trait)were positively associated with MDQ score.CONCLUSION The result of this study suggests that almost 50%of patients with panic disorder are likely to have hypomanic or manic symptoms,and certain psychological factors are associated bipolarity in panic disorder.

帕罗西汀致持续性呃逆1例

惊恐障碍患者在使用抗抑郁药时,可能会出现持续性呃逆,给患者带来严重痛苦。本文报道1例患有惊恐障碍的成年患者,接受了帕罗西汀、劳拉西泮和普萘洛尔治疗。住院第3天,帕罗西汀增加至30 mg/d,5 d后增加至40 mg/d,次日患者开始呃逆。将帕罗西汀剂量降至30 mg/d,同时予以氯丙嗪改善呃逆表现,4 d后患者呃逆停止。根据病情需要,将帕罗西汀剂量增加至40 mg/d,患者再次出现呃逆,但与首次发作相比,持续时间较短,且严重程度较轻。再次给予氯丙嗪对症治疗,呃逆症状持续24 h后不再出现。帕罗西汀维持在40 mg/d,直至出院未再出现呃逆。帕罗西汀可引起成人惊恐障碍患者急性给药期持续性呃逆,应引起关注。

Brain Mechanisms Underlying Panic Attack and Panic Disorder

Panic disorder is a psychiatric disorder characterized by recurrent panic attacks,with a prevalence of~4%in the general population,causing heavy personal and socioeconomic burdens.The similarities of animal defense responses to clinical panic attack symptoms in humans make it possible to translate neuroanatomical pathways identified in animal studies to panic disorder in humans.Therefore,in this review we first present a basic overview of panic disorder in humans including the main subtypes,models commonly used to trigger panic attacks,related hypotheses,the neurotransmitter systems that may be involved,and the current clinical treatments to give the reader a comprehensive understanding of panic disorder.The animal section introduces the models that trigger panic-like behavior in animals and the brain regions that may be involved,providing insights for future elucidation of the neural circuit mechanisms behind panic attacks.

穴位针刺结合艾司西酞普兰治疗惊恐障碍的临床疗效

目的探讨穴位针刺结合艾司西酞普兰治疗惊恐障碍的临床疗效。方法对象选自2021年6月至2023年6月就诊于漳州市福康医院及漳州市第四医院诊断为惊恐障碍的60例患者。通过随机数字表法将这60例惊恐障碍患者分为两组,即治疗组30例,对照组30例。对照组予口服艾司西酞普兰治疗,治疗组在对照组的基础上联合穴位针刺疗法,两组均治疗8周。比较两组患者汉密尔顿焦虑量表(HAMA)、惊恐障碍严重程度量表(PDSS)评分情况,以HAMA的减分率来评定疗效。结果治疗后两组的HAMA量表评分、PDSS量表评分随治疗时间延长逐渐降低。通过8周的治疗后,治疗组的HAMA评分、PDSS评分低于对照组(P<0.05)。在HAMA的减分率方面,治疗组痊愈5例,显效21例,有效2例,无效2例,总有效率93.33%。对照组痊愈2例,显效14例,有效10例,无效4例,总有效率86.67%,治疗组的疗效优于对照组,差异有统计学意义(P<0.01)。结论穴位针刺结合艾司西酞普兰可以较快有效缓解患者惊恐障碍症状,其治疗惊恐障碍效果优于单纯的艾司西酞普兰的治疗。

Effects of a Cocktail Supplement of Ginkgo Biloba and Acai Extract on Cognitive Symptoms of Parkinson’s Disease

Parkinson’s Disease (PD) is a neurodegenerative disorder characterized by motor and non-motor symptoms, including cognitive impairment. Current treatments often involve synthetic drugs with significant side effects and potential for dependency. This study investigates the effects of a natural supplement combination of Ginkgo Biloba and Acai Extract on cognitive symptoms in a 77-year-old male with PD. The participant underwent a three-month supplementation regimen, with cognitive function assessed using the Montreal Cognitive Assessment (MoCA) test before and after the intervention. The results indicated an improvement in cognitive scores, suggesting that the combination of Ginkgo Biloba and Acai Extract may offer a promising alternative or adjunct to conventional PD treatments. This study highlights the potential of natural supplements in managing PD symptoms and calls for further research with larger sample sizes to confirm these findings. Human data was performed in accordance with the Declaration of Helsinki by the Roxbury District IRB Board (IRB Number: IRB00011767).

^(18)F-FDG PET/CT摄取值及血清载脂蛋白A1、谷胱甘肽对不同运动障碍亚型帕金森病的预测价值

目的:探讨^(18)F-脱氧葡萄糖(^(18)F-FDG)正电子发射断层扫描-计算机断层扫描(PET/CT)摄取值及血清载脂蛋白A1(Apo A1)、谷胱甘肽(GSH)用于不同运动障碍亚型帕金森病的预测价值。方法:选取2020年12月至2022年12月在临沂市人民医院就诊的84例帕金森病患者,根据国际运动障碍协会统一帕金森病评定量表(MDS-UPDRS)将患者分为震颤为主型(TD)组(50例)和姿势不稳或步态障碍型(PIGD)组(34例)。比较不同运动障碍亚型帕金森病患者^(18)F-FDGPET/CT的^(18)F-FDG摄取值、血清Apo A1及GSH水平,并通过受试者工作特征(ROC)曲线分析上述3项指标联合预测不同运动障碍亚型帕金森病的价值;验证^(18)F-FDG摄取值、血清Apo A1及GSH联合检测对不同运动障碍亚型帕金森病患者预测结果与患者实际亚型的一致性。结果:TD组丘脑的^(18)F-FDG摄取值显著低于PIGD组;TD组血清Apo A1水平显著高于PIGD组、TD组血清GSH水平显著高于PIGD组,差异有统计学意义(t=3.669、2.758、2.824,P<0.05);ROC曲线下面积(AUC)分析显示,丘脑^(18)F-FDG摄取值、Apo A1及GSH联合预测不同运动障碍亚型帕金森病的AUC为0.858;^(18)F-FDG摄取值、血清Apo A1及GSH联合对不同运动障碍亚型帕金森病患者预测结果与患者实际亚型的一致性较高(Kappa=0.804)。结论:^(18)F-FDG PET/CT摄取值、血清Apo A1及GSH联合应用对不同运动障碍亚型帕金森病有较好的的预测价值。

成人原发性PD患者发生强迫性精神障碍的影响因素

目的 探讨成人原发性帕金森氏病患者发生强迫性精神障碍的影响因素。方法 将462例成人原发性帕金森氏病患者采用冲动控制障碍问卷筛查强迫性精神障碍发生状况,对入组患者发生强迫性精神障碍的影响因素进行单因素分析及多元Logistic回归分析。结果 462例患者中确诊强迫性精神障碍26例,其中存在刻板行为16例,占比61.54%。成人原发性帕金森氏病患者发生强迫性精神障碍情况在多巴胺受体激动剂左旋多巴等效剂量及其使用情况、喝茶方面存在显著差异(P<0.05),在性别、年龄等方面差异无统计学意义(P>0.05)。Logistic回归显示,帕金森氏病发病年龄<65岁是入组患者发生强迫性精神障碍的独立保护因素(OR=0.27,P<0.05),多巴胺受体激动剂左旋多巴等效剂量≥100 mg·d是其独立危险因素(OR=4.26,P<0.05)。结论 成人原发性帕金森氏病患者强迫性精神障碍主要临床表现为刻板行为,多巴胺受体激动剂左旋多巴等效剂量超过≥100 mg·d者更易发生强迫性精神障碍,帕金森氏病发病年龄<65岁的患者发生强迫性精神障碍的风险降低。

远程医疗在神经病学中的应用以及研究进展

远程医疗是指用于在无身体接触的情况下为患者提供护理和服务的电子和电信技术和医疗服务。在神经病学领域中,许多慢性疾病的诊断、评估都可以借助远程医疗实施,远程医疗作为辅助就诊方法可以减轻患者就医的经济和医疗负担,提高诊治的效率和患者的依从性。综述癫痫、重症肌无力、睡眠呼吸通气障碍、帕金森病(PD)中远程医疗的最新研究以及应用进展,以期为临床诊疗提供借鉴。

PD-1/PD-L1抑制剂相关的内分泌紊乱及其治疗的研究进展

免疫检查点治疗是肿瘤治疗的新模式,目前国内外已有多种免疫检查点单抗药物即程序性细胞死亡蛋白-1(PD-1)及其配体(PD-L1)抑制剂获批进入临床,在恶性黑色素瘤、肺癌、膀胱癌、淋巴瘤等多种肿瘤中得到了广泛应用,但随着PD-1/PD-L1抑制剂在临床上的逐步推广应用,其引起的各种免疫相关不良反应引起了广泛关注,特别是近年来国内外均有多个内分泌腺体受损的相关不良反应报道。本文对PD-1/PD-L1抑制剂治疗引起的各内分泌腺体相关不良反应研究现状以及对应临床处理方法作一综述。

PD-1/PD-L1通路在自身免疫性眼病中作用的研究进展

自身免疫性眼病是一类由自身免疫反应引起的炎症性眼病,主要包括自身免疫性葡萄膜炎、甲状腺相关眼病、干燥综合征相关型干眼症、视神经脊髓炎谱系障碍等。这类疾病发病机制复杂,可累及眼表、眼内和眼眶。传统治疗方法主要包括糖皮质激素治疗和免疫抑制剂治疗,其有效率低且不良反应较大,因此需要对自身免疫性眼病发病机制做更加深入的研究以期寻找到治疗靶点进行对因治疗。程序性死亡蛋白-1 (programmed death 1,PD-1)已被证实与许多自身免疫性疾病相关,它与程序性死亡蛋白配体1 (programmed death ligand 1,PD-L1)组成的信号通路对于调节免疫反应起关键作用。PD-1/PD-L1通路的失活可能导致自身免疫性T细胞的异常活化,从而导致自身免疫性疾病的发生发展。该综述系统总结了现阶段已研究发现的PD-1/PD-L1通路的免疫调节机制,以及其在自身免疫性眼病中的作用,并对未来靶向治疗的潜在可能提出展望。

Bioelemental patterns in the cerebrospinal fluid as potential biomarkers for neurodegenerative disorders

Neurodegenerative disorders like Parkinson＇s disease （PD） or atypi- cal Parkinsonian syndromes including the different synucleinopa- thies and tauopathies are an important burden for patients, rela- tives, care providers and incur mounting costs for the health care system in our aging society.

Deviation of congruent composition in Fe-Pd system

The first-principles calculation of the disordered Ll0 phase boundary for the Fe-Pd system is attempted by combining the FLAPW electronic structure total energy calculations and the cluster variation method via the cluster expansion method. The lattice vibration effects are taken into account based on the Debye-Gruneisen model within quasi-harmonic approximation. The transition temperature is reproduced with very high accuracy. However, the experimental congruent composition of disordered L10 phase that significantly deviates from 1.＂ 1 stoichiometry is not reproduced. Fulther calculations are attempted based on the phenomenological Lennard-Jones type pair potential, which is capable of introducing both tetragonality of the Ll0 ordered phase and additional configurational freedom because of the magnetic spins. The prelimi- nary calculations indicate that the tetragonality enhances the stability of the L10 ordered phase and the magnetic contributions also change the transition temperature. Despite these findings, the shift of the congruent composition still remains as a subject that needs further research. The electronic origin of the shifting of the congruent composition is briefly discussed.

Increased P wave duration in patients with depression or anxiety disorder

BACKGROUND： Activation of the sympathetic nervous system plays an important role in regulating cardiovascular actions. P wave parameters can provide general information on central cardiovascular autonomic regulatory responses, which are altered in patients with anxiety disorders and depression. In particular, there are no reports addressing changes in P wave duration and dispersion. OBJECTIVE： To compare the differences in P wave duration and P wave dispersion between patients with anxiety disorders and depression, because patients with anxiety disorders and depression develop abnormal electrocardiograms. DESIGN, TIME AND SETTING： A non-randomized concurrent controlled study was performed. Patients with depression and general anxiety disorders were admitted at the psychiatry outpatient clinics of the Medical Faculty of Duezce University of Turkey between May 2005 and October 2006. PARTICIPANTS： A total of 71 consecutive patients with depression and anxiety disorders, as well as 50 physically and mentally healthy age- and gender-matched controls were selected. METHODS： Electrocardiogram records were obtained at the time of admission to the outpatient clinics. MAIN OUTCOME MEASURES： P wave duration and P wave dispersion were measured. RESULTS： Both the maximum （Prnax） and minimum （Pmin） P wave duration were greater in patients with psychiatric disorders than in healthy controls. Pmax was significantly greater in patients with depression or anxiety disorders （Bonferroni test, P 〈 0.017）. The P wave dispersion was similar between patients and controls （P 〉 0.017）. P waves were similar between panic patients and other anxiety patients. Beck depression results were positively correlated with Prawn and Prnax （r= 0.374, 0.302, P = 0.013, 0.049, respectively）, and not associated with P wave dispersion （P 〉 0.05）. CONCLUSION： Psychiatric disorders are associated with increases in Prnax, but not with P wave dispersion. The P wave changes were associated with the degree of depression.