The safety of antidepressants in bipolar disorder (BD) remains controversial, particularly regarding the risk of behavioral activation and worsening Non-Suicidal Self-Injury (NSSI). This multi-center retrospective cohort study included 575 patients with BD from 15 medical centers in China to evaluate the association between antidepressant use and NSSI frequency, suicidal ideation (SI), and suicidal behavior (SB) over a one-year period. Multivariable logistic regression revealed that antidepressant use was associated with higher odds of the worsening of NSSI (OR=1.90, p = 0.030), as well as the presence of SI (OR=1.70, p = 0.016) and SB (OR=1.80, p = 0.010). In exploratory subgroup analyses, point estimates were larger in patients with low household income (OR=2.74, p = 0.038) and non-depressive dominant polarity (OR=7.05, p < 0.001), and the association reached significance only in patients not receiving concurrent lithium (OR=2.29, p = 0.032) but not in lithium-treated patients (OR=1.38, p = 0.462); however, none of the formal interaction tests was statistically significant (all interaction p > 0.05). These findings indicate that antidepressant use in BD is associated with higher odds of worsening NSSI and suicidality. The observed subgroup differences did not reach statistical significance on interaction testing and should be regarded as hypothesis-generating.

BackgroundAdolescent depression exhibits distinct neurophysiological features, with marked age heterogeneity particularly in the resting motor threshold (RMT) measured during repetitive transcranial magnetic stimulation (rTMS), and substantial variability in clinical therapeutic efficacy. Functional near-infrared spectroscopy (fNIRS) enables the assessment of cortical excitability levels; however, research investigating the association between RMT and cortical activation in adolescent patients with depression remains limited. This study aims to elucidate the underlying neural mechanisms from the perspective of cortical hemodynamics, which is crucial for further optimizing neuromodulation strategies in patients with depression.MethodsWe collected data from 85 treatment-naive patients with depression who underwent rTMS therapy. All patients completed RMT measurement, fNIRS examination, and Hamilton Depression Rating Scale (HAMD) assessment prior to rTMS treatment. Participants were divided into three groups according to age: the adolescents group (n=31), the young adult group (n=26), and the middle-aged group (n=28). We compared the differences in RMT among the three groups and explored the relationships between RMT, cortical activation (reflected by prefrontal oxyhemoglobin level changes during the verbal fluency task via fNIRS), and depression severity (assessed by HAMD scores).ResultsThe results demonstrated that the adolescents group had a significantly higher RMT than the other age groups (58.00 ± 11.14, P < 0.001), accompanied by the lowest prefrontal Oxy-Hb activation level (0.095 ± 0.06, P < 0.001). A strong negative correlation was observed between RMT and cortical activation (Spearman’s rs= -0.929, P < 0.001), while a strong positive correlation was found between RMT and depression severity (Spearman’s rs = 0.837, P < 0.001). The distinct coupling phenomenon of high threshold-low activation-severe symptoms was most prominently manifested in this age group, which may theoretically reflect an underlying dysregulation in broader emotional networks, though the current direct findings strictly indicate localized alterations in prefrontal activation and motor cortical excitability.ConclusionsThe characteristics of high RMT and low cortical activation in adolescent depression serve as important neurobiological markers for depression severity. This finding provides a novel direction for developing individualized, developmentally tailored neuromodulation strategies (e.g., optimization of rTMS targets and dosages), indicating that interventions for adolescent depression should prioritize promoting the healthy integration of emotional circuits and the functional coordination between the cortex and subcortex.

BACKGROUND:Inflammation and neurovascular dysfunction play a fundamental role in depression pathogenesis. We aim to investigate potential differences in neuroimmune interactions across disease stages (first-episode depression [FED] and recurrent depression [RED]) by simultaneously assessing peripheral inflammatory markers and task-related cerebral hemodynamics. METHODS:A total of 30 patients with FED, 35 with RED, and 30 demographically matched healthy controls (HC) were recruited. Symptom severity was assessed using the 24-item Hamilton Depression Rating Scale. Serum levels of pro-inflammatory cytokines, including interleukin-6 (IL-6), C-reactive protein (CRP), and tumor necrosis factor-alpha (TNF-α), and anti-inflammatory cytokines (IL-4, IL-10) were measured. Functional near-infrared spectroscopy during a verbal fluency task was used to record oxyhemoglobin (HbO2) dynamics in prefrontal and temporoparietal regions. Associations between cytokine levels and HbO2 responses were analyzed. RESULTS:Both FED and RED groups exhibited significantly higher IL-6, CRP, and TNF-α levels and lower anti-inflammatory cytokine levels than did HCs, with no significant differences between FED and RED. During task-related activation, both patient groups showed significantly reduced HbO2 responses in the left dorsolateral prefrontal cortex (DLPFC_L) and left somatosensory cortex compared to HC, with no significant difference between FED and RED. In the FED group, TNF-α levels positively correlated with HbO2 activation in DLPFC_L, while in the RED group, they negatively correlated with activation in the right dorsolateral prefrontal cortex, right frontal pole area, and right temporal cortex. CONCLUSIONS:Recurrent depression may involve a distinct neuroimmune interaction pattern, offering potential neuroimmune biomarkers for understanding mechanisms underlying relapse.

Depression is a highly prevalent mental disorder that remains difficult to assess and manage using traditional questionnaire- or interview-based approaches due to subjectivity and limited real-time adaptability. Existing support approaches further lack personalized interaction and adaptive feedback, limiting timely and individualized mental health support. To address these challenges, we propose MM-LLM, an augmented intelligent screening, assessment-support, and intervention-oriented response-generation framework by fusing multimodal data and Large Language Models (LLM). First, a cross-modal guidance module integrates EEG with speech and text representations using pretrained models to enhance neural discriminability. Second, a cross-domain knowledge transfer strategy aligns semantic spaces across subjects and task paradigms, enabling personalized yet generalizable modeling of depression-related features. Third, an LLM-based response-support module leverages state tracking, knowledge-graph retrieval, and retrieval-augmented generation to generate individualized supportive responses within a turn-level feedback cycle. Experimental results provide a proof-of-concept for MM-LLM's ability to enhance recognition accuracy and support response generation, while the small pilot pre-post evaluation provides only a preliminary short-term symptom-change signal that requires validation in larger controlled studies.

This study aims to differentiate between unipolar and bipolar depressive episodes through an integrated analysis of gut microbiome and serum metabolome. The study involved 82 patients experiencing depressive episodes, with 38 diagnosed with Major Depressive Disorder (MDD) and 44 with Bipolar Disorder (BD). The gut microbiome and serum metabolome were analyzed using 16S rRNA sequencing and ultra-high-performance liquid chromatography-mass spectrometry (UHPLC-MS), respectively. The results revealed distinct microbial compositions and metabolic pathways between the two groups. Seventeen microbial groups and fifty serum metabolites were found to be significantly different between the two groups. Four genera and eight serum metabolites demonstrated strong diagnostic potential for differentiating BD from MDD. The study also found correlations between certain differential genera and metabolites and the severity of clinical symptoms. This integrated multi-omics approach provides a promising direction for the differential diagnosis of unipolar and bipolar depression.

BACKGROUND:Lithium has long been associated with reduced suicide risk in bipolar disorder; however, evidence from real-world clinical populations remains susceptible to confounding, and the behavioral correlates related to this association are not well characterized. METHODS:In this multicenter cross-sectional study, 616 individuals aged 12-45 years with bipolar disorder were recruited from 14 psychiatric centers, of whom 585 had complete data for the present analyses. Lithium exposure within the past year was determined from clinical records. The primary outcome was a composite of suicide-related behaviors, including suicidal ideation, suicide attempts, and non-suicidal self-injury. A pre-specified analytical framework was applied, with multivariable logistic regression as the primary analysis and propensity score matching (PSM) as the principal approach to improve covariate balance. Regression-based decomposition analyses were conducted to examine whether aggression was statistically associated with the exposure-outcome relationship, and restricted cubic spline models were used to characterize the dose-response association between aggression and suicide-related behaviors. Robustness analyses included inverse probability of treatment weighting (IPTW), alternative matching specifications, E-value analyses, cluster-robust standard errors, and exploratory age-stratified analyses. RESULTS:Lithium exposure was associated with lower odds of suicide-related behaviors in both the fully adjusted model (OR = 0.55, 95% CI: 0.34-0.89) and the propensity score-matched sample (OR = 0.53, 95% CI: 0.33-0.86). Higher aggression scores were linearly associated with increased suicide-related risk. Exploratory regression-based decomposition analyses indicated that approximately 20.93% of the observed lithium-outcome association was statistically accounted for by aggression. Results from robustness analyses were directionally consistent with the primary findings. CONCLUSIONS:In this multicenter clinical sample, lithium exposure was consistently associated with lower odds of suicide-related behaviors across multiple analytic approaches. Aggression was independently associated with suicide-related risk and statistically accounted for part of the observed association between lithium exposure and suicide-related outcomes. However, causal inference is limited by the cross-sectional design, and residual confounding-particularly confounding by indication-remains a key concern. Prospective longitudinal studies are required to clarify temporal relationships and disentangle treatment effects from selection processes.

To examine the impact of BRD4 on hippocampus injury in a murine model of depression via altering signaling pathways inside hippocampal cells. Sixty-four male C57BL/6 mice were randomly assigned to either a vector control group or a model group. A depression model was created via the use of solitary living and chronic unexpected mild stress (CUMS). Behavioral investigations demonstrated depressive-like behaviors in mice. Western blotting (WB) was used to determine the expression levels of signaling pathway proteins and brain-derived neurotrophic factor (BDNF) in hippocampus tissue. We used the ELISA method to find out how much 5-HT, Ach, DA, MDA, and SOD there was. Additionally, single-cell transcriptome analysis (GSE308075) was performed to explore cellular heterogeneity and astrocyte-related signaling in depression. Compared with the Control group, the model group exhibited reduced open field central activity and elevated plus maze open arm activity, along with upregulated hippocampal BRD4 and downregulated Notch-1, p-PI3K, p-CREB, and p-TrkB. After JQ-1 treatment, these behavioral deficits were reversed; nuclear BRD4 and JMJD3 decreased, while EZH2, Notch-1, p-PI3K, p-CREB, BDNF, p-TrkB, 5-HT, Ach, DA, and SOD increased, and MDA decreased. Single-cell transcriptomic data revealed reduced oxidative stress scores and altered cell–cell communication networks in hippocampal astrocytes, supporting the involvement of BRD4-modulated pathways in glial dysfunction. This study demonstrates that BRD4 in the hippocampus serves as a key epigenetic regulator coupling oxidative stress with defective neurotrophic signaling. It drives depression progression by modulating the ROS/JMJD3/Notch-1/PI3K/BDNF/TrkB signaling network, suggesting that targeting BRD4 may represent a novel therapeutic strategy capable of simultaneously intervening in multiple pathological pathways.

Abnormal emotional processing characterizes major depressive disorder (MDD). This multimodal EEG study combines event-related potentials, functional connectivity analysis, and source localization to examine neural mechanisms of emotional face processing, identify neuromodulation targets, and evaluate whether functional connectivity predicts anxiety severity in MDD. Thirty-three participants (16MDD, 17controls) performed an emotional dot-probe task with happy-neutral and sad-neutral face pairs during a 128-channel EEG recording. Analyses encompassed temporal components, functional connectivity, eLORETA source localization, and regression models linking spatial covariance matrices to anxiety scores. Controls exhibited larger P100 amplitudes and longer latencies than MDD patients. Orthogonal envelope correlation analysis revealed significant differences in functional connectivity during emotional face processing between groups. Controls demonstrated stronger Left Middle Temporal Gyrus activation during happy conditions, whereas MDD showed excessive left superior frontal gyrus activation during sad conditions. Early-window functional connectivity optimally predicted anxiety under happy conditions, while mid-window connectivity predicted anxiety under sad conditions. Functional connectivity patterns may serve as biomarkers for anxious depression, with the left middle temporal gyrus and right superior frontal gyrus as potential neuromodulation targets.

Purpose:Depression is a multifactorial disorder involving neurotransmitter dysregulation, gut microbiota imbalance, and metabolic disturbances. Low-intensity transcranial focused ultrasound stimulation (LIFUS) holds promise for treating depression. However, the effects of different LIFUS parameter settings on depression-like behaviors, and their potential associations with gut microbiota and fecal metabolite changes, remain largely unexplored. This study aims to investigate the parameter-specific effects of LIFUS on depression-like behaviors in a chronic unpredictable mild stress (CUMS) mouse model, and to explore potential associations with changes in gut microbiota and fecal metabolites. Methods:To establish a depression model, C57BL/6 mice were subjected to CUMS, while a separate cohort was kept as a control (CON) group. The CUMS-exposed mice were then randomly divided into four groups: CUMSpo, LIFUS1, LIFUS2 and SHAM. Depressive-like behaviors were evaluated using the sucrose preference test (SPT) and forced swim test (FST). The levels of neurotransmitters and Fecal concentrations of metabolites were quantified using liquid chromatography-tandem mass spectrometry (LC-MS/MS). Gut microbiota composition was analyzed by metagenomic sequencing, and α-diversity was assessed using the ACE, Chao1, and Shannon indices. Histopathology was assessed via HE staining. Results:LIFUS at 1.5 kHz PRF, but not 300 Hz, significantly attenuated CUMS-induced depressive-like behaviors, evidenced by increased sucrose preference and reduced immobility time, without affecting locomotor activity. This behavioral effect was accompanied by a significant increase in cortical glutamate. LIFUS2 protocol was associated with a significant increase in tryptamine, alongside a concurrent trend towards restoring the abundance of Clostridia and enhancing gut microbiota α-diversity. HE staining confirmed protocol safety. Conclusion:The antidepressant-like effects of LIFUS appear to be associated with multi-systemic alterations, including changes in cortical glutamate, modulation of the gut microbiota, and specific changes in tryptophan metabolism.

Individual variations in depressive disorder (DD) treatment responses highlight the need for early efficacy prediction to optimize regimens. The niacin skin flushing response (NSFR) is a potential DD biomarker, and elevated inflammatory cytokines are linked to DD. This study explored the association between blunted NSFR and DD symptom severity, and evaluated the predictive value of NSFR and inflammatory cytokines for early antidepressant efficacy. Fifty DD patients were grouped as responders (≥ 50

Objective: Bipolar disorder (BD) greatly increases the risk of suicide. While lithium is recognized for reducing suicide and suicidal behaviors, evidence regarding its association with suicidal ideation remains limited. This study evaluated lithium's association with reduced suicidal ideation and behaviors among adolescents and adults with BD in China. Method: This multicenter, retrospective cohort study included participants aged 12-45 years from 15 psychiatric centers across mainland China who met DSM-IV criteria for BD, recruited between April 19, 2024, and November 30, 2024. Patients receiving lithium for ≥80% of the first 6 months in the preceding year formed the lithium group; those without lithium exposure served as controls. The primary outcome was suicidal ideation assessed by the Columbia-Suicide Severity Rating Scale; secondary outcomes included suicidal behaviors, nonsuicidal self-injury (NSSI), and aggression. Results: Of 603 screened patients, 585 (290 lithium; 295 controls) met inclusion criteria. At 1-year follow-up, lithium use was significantly associated with a lower likelihood of suicidal ideation (adjusted odds ratio [aOR] = 0.57, 95% CI = 0.38-0.86, P = .008) and suicidal behaviors (aOR= 0.60, 95% CI = 0.39-0.90, P = .02). No difference was observed in NSSI, while lithium users reported lower hostility scores (P = .01). Subgroup analyses indicated more pronounced protective associations among females, adults, higher-income individuals, and those without comorbid anxiety, rapid cycling, or predominantly depressive episodes, regardless of psychotic symptoms. Conclusions: Lithium was associated with a 40% lower risk of suicidal ideation and reduced suicidal behaviors in BD. These findings reinforce lithium as a first-line treatment for suicide prevention and highlight its comprehensive antisuicidal role-from lower rates of ideation to fewer behaviors-supporting confident, evidence-based clinical use.

Abstract Background Previous studies have found that blood neuroflament light chain protein(NfL) is associated with the assessment of cognitive function, and decreased cognitive function is associated with higher levels of circulating inflammation. However, the intrinsic association between blood NfL levels and inflammatory cytokines and cognitive function is not clear. Aims & Objectives The purpose of this study is to explore the role of serum NfL and inflammatory cytokines in the early recognition of Alzheimer's disease(AD), and explore the relationship between serum NfL and inflammatory cytokines. Method A total of 157 subjects aged 55 years above were recruited from the community and divided by cognitive function into three groups. Cognitive assessment and serum samples were collected by trained psychiatrists, and concentrations of neurofilament light chains, inflammatory factors and other pathological markers of AD were measured by enzyme linked immunosorbent assay(ELISA). The correlation between cognitive function, NfL, inflammatory factors and other pathological markers of AD was analyzed, and the ability to recognize MCI was explored. Counting data were compared by Chi-square test. The receiver operating characteristic (ROC) was analyzed for the concentration of various cognitive scales and blood indicators of the subjects, and the area under the curve (AUC) was calculated to evaluate the diagnostic performance with sensitivity and specificity. Results 1. The level of serum NfL in MCI population and probably AD population was higher than that in healthy control group(F=7.582,P=0.023); 2. Serum NfL content was positively correlated with inflammatory cytokines IL-1β and IL-6 and Aβ40, and the correlation coefficients were 0.471,0.269 and 0.386, respectively;3. The combination of serum NfL with p-tau217 and Boston naming test significantly improved the accuracy of MCI prediction, the areas under the curve were 0.687 and 0.742, respectively. But the combination of serum NfL with inflammatory factors did not improve the accuracy of MCI prediction. Discussion & Conclusion This study found that serum NfL content is related to cognition and inflammatory factors, which can help early identification of MCI population, indicating that NfL can be an early identification of Alzheimer's disease peripheral blood biomarker, and hopefully provide a new concept for the treatment of Alzheimer's disease.

Background: Affective disorders are the leading cause of disability worldwide. Intermittent theta burst stimulation (iTBS) is a safe and effective brain stimulation therapy for reducing depressive symptoms in adolescents. The purpose of this study is to investigate the clinical efficacy of iTBS in treating adolescent patients with depressive disorders and the factors influencing clinical symptoms. Methods: Participants were randomized to receive left-sided dorsolateral prefrontal cortex(DLPFC) to navigate either active or sham iTBS treatment 5 sessions daily for 2 days. During 4 weeks of maintenance treatment, two sessions were administered weekly. The primary study outcome was the change in the Montgomery-Asberg Depression Rating Scale (MADRS) from baseline to the post-treatment follow-up period. We also explored relevant clinical factors that influence the efficacy of iTBS. Results: About 22 adolescents with affective disorders were in the active iTBS group and 18 patients were in the sham iTBS group. Compared to the sham group, patients in the active iTBS group showed significant improvement in depressive symptoms over the two days of treatment. In addition, in the active iTBS group, higher baseline SHAPS and BHS scores were associated with worse outcomes. Conclusions: The current study suggests that two days of active iTBS to the DLPFC region can rapidly, safely, and effectively improve depressive symptoms in adolescents with depression. We found that iTBS was less effective in baseline patients with greater feelings of hopelessness and anhedonia. Our data can provide valuable recommendations and directions for the clinical management of adolescent depression.

Sepsis-induced cardiac dysfunction is one of the most common complications of sepsis. It is also a major cause of death in pediatric intensive care units. The underlying mechanism of sepsis-induced cardiac dysfunction remains elusive. Cold-inducible RNA-binding protein (CIRP) is a damage-associated molecular pattern that is up-regulated during sepsis. Hydrogen sulfide (H2S) has been shown to play a protective role in sepsis-induced cardiac dysfunction in adult animals. The present study aimed to determine whether H2S ameliorates the cardiac function in infant rats by inhibiting CIRP-mediated sepsis-induced cardiac dysfunction. Rat pups aged 17-18 days were subjected to cecal ligation and puncture (CLP) to induce sepsis. Six hours after CLP, hemodynamic results demonstrated that there was a significant decrease in +dP/dtmax, -dP/dtmax, left ventricular ejection fraction, and left ventricular shortening fraction, indicating cardiac dysfunction. The plasma levels of myocardial injury markers such as creatine kinase-myocardial band and cardiac troponin I were significantly increased at 6 h after CLP. The inhibition of CIRP with C23 improved the cardiac function of the rats with CLP-induced sepsis, accompanied by a significant decrease in endoplasmic reticulum stress (ERS) activation. Moreover, treatment with sodium 4-phenylbutyrate (an inhibitor of ERS) ameliorated myocardial injury and dysfunction, accompanied by a significant decrease in ERS activation. Sodium hydrosulfide, a H2S donor, ameliorated CLP-induced cardiac dysfunction and decreased CIRP levels and ERS. In contrast, the inhibition of endogenous H2S production by propargylglycine (a cystathionine-γ-lyase inhibitor) aggravated CLP-induced cardiac dysfunction and increased CIRP levels. In conclusion, the present study demonstrated that H2S exerted cardioprotective effects by inhibiting the CIRP/ERS pathway in infant rats with sepsis. These findings might indicate a novel target in the treatment of sepsis in infants.

Background:Harmful drinking habits can have a profound effect on individual health. However, there is currently a lack of network analysis studies on clinical indicators related to drinking population. The aim of this study was to investigate the relationships among drinking characteristics, cognitive functions, liver and kidney functions, and glucose and lipid levels in alcohol drinkers through the application of network analysis. Method:We conducted a stratified random sampling survey of 1,432 male employees in Gaocheng District, Hebei Province, in 2016. The Alcohol Dependence Scale (ADS) and the Alcohol Use Disorders Identification Test (AUDIT) were utilized to evaluate alcohol-related behaviors. Cognitive functions were assessed via the Hopkins Verbal Learning Test (HVLT), the Brief Visuospatial Memory Test (BVMT), Digit Symbol Coding Test (DSCT), and Digit Span Test (DST). Additionally, biochemical indicators such as blood glucose and lipid levels and hepatic and renal functions were measured. Analyses were performed to identify central symptoms and bridge symptoms of this network. Results:In our network analysis, the nodes representing TC, AST, AST/ALT, and ALT had the highest strength centrality. TC and AST presented the highest expected influence centrality. The closeness centrality indices for all the indicators performed well. The node DSCT ranked highly in terms of betweenness centrality. Conclusion:Correlations may exist among cognitive function, glycemic and lipid profiles, and hepatic-renal function in individuals with varying alcohol consumption patterns. Lipid and liver function indicators were identified as the most central factors in the network model. In the clinic, practitioners may focus on these abnormal central indicators as potential intervention targets to enhance the quality of life in alcohol drinkers.

Mental health is crucial to older adults, especially in the context of the aging society and longevity era. To better address these challenges, it is necessary to delineate medical students’ knowledge, attitude, and practice (KAP) status from the first-year students to the junior before entering clinical practice. Thus, the study aimed to investigate medical undergraduate students’ KAP regarding the mental health of older adults. A cross-sectional online survey was conducted from December 7 to 26, 2023, among medical students at ten universities in China. We used a web-based questionnaire to collect information on demographic characteristics and KAP. 1,087 medical students (age: 19.02 ± 1.15 years; 463 male, 624 female; 471 first-year students, 207 sophomores, 409 junior) completed the survey. The average correct rate of knowledge was 63.6

Electroconvulsive therapy (ECT) has been a cornerstone in treating Major Depressive Disorder (MDD), demonstrating high efficacy but often limited by cognitive side effects. As an alternative, magnetic seizure therapy (MST) has emerged, offering comparable antidepressant effects with potentially fewer cognitive adverse outcomes. This study aimed to compare the efficacy, safety, and cognitive impact of MST and ECT. This multicenter, double-blind, parallel, non-inferiority randomized clinical trial will be conducted at seven clinical centers. Participants diagnosed with MDD will be randomly allocated to either the ECT or MST group. Each center aims to recruit 30 participants, resulting in a total sample size of 210. The intervention includes 12 sessions over 4 weeks, followed by 12-week follow-up. Assessments (the 24-item Hamilton Depression Rating Scale (HDRS-24), Hamilton Anxiety Scale (HAMA), 8 cognitive tests, Electroencephalography, electrocardiography) occur at baseline, post-sessions 3/6/9/12 (3 hours after each session), and 4-/8-/12-week follow-ups. The primary outcome is the change in HDRS-24 total score from baseline to the 12-week follow-up, which is assessed after the completion of the 12-session acute treatment phase (conducted over 4 weeks) and a subsequent 12-week post-treatment observation period. Randomization and blinding protocols will be strictly followed to ensure unbiased treatment administration and assessment. This trial aims to provide robust evidence that MST is as effective as ECT in reducing depressive symptoms (assessed via HDRS-24) and to confirm its superior cognitive safety, with the Hopkins Verbal Learning Test-Revised as an additional primary outcome to evaluate verbal memory changes. Remaining cognitive measures will serve as secondary outcomes. Exploratory analyses will examine electroencephalography and electrocardiography data to identify potential neurophysiological biomarkers. If successful, this trial could significantly influence clinical practices and improve seizure treatment for patients with MDD.Clinical trial registrationClinicalTrials.gov, identifier NCT06409325.

ObjectiveStudies have shown associations between Body Mass Index (BMI), High-Sensitivity C-reactive protein (HSCRP), and depressive symptoms(DP). However, the complex relationship between them remains uncertain. The objective of this research is to examine the correlation between them in a substantial sample that is representative of the national level.MethodsOur analysis was based on the 2015-2016National Health and Nutrition Examination Survey (NHANES).DP was measured by the Patient Health Questionnaire-9 (PHQ-9). Using multivariable logistic regression analysis and stratified analysis, we examined the relationship between BMI, HSCRP, and DP. We applied generalized additive models to explore the non-linear relationships among variables.ResultsThis study included a total of 4834 participants. The results revealed that BMI (P=0.002) and HSCRP (P=0.008) were risk factors for DP. The relationship between BMI and DP (P=0.035), BMI and HSCRP (P<0.001) were non-linear. The nonlinear association between HSCRP and DP (P=0.031), BMI and DP (P=9e-04) is significant in females when stratified by gender. No nonlinear association was found between BMI and DP (P =0.677) and between HSCRP and DP (P =0.439) in males. The results of the interaction test reveal a significant interaction between HSCRP and gender.ConclusionsResearch has found both BMI and HSCRP are risk factors for DP and the relationship between them was non-linear. The nonlinear associations between BMI and DP, as well as between HSCRP and DP, are gender-dependent.

BackgroundDepression, a prevalent chronic mental disorder, presents complexities and treatment challenges that drive researchers to seek new, precise therapeutic targets. Additionally, the potential connection between depression and cancer has garnered significant attention.MethodsThis study analyzed depression-related gene expression data from the GEO database. Using data normalization, differential expression analysis, WGCNA, and machine learning, we identified core genes strongly associated with depression. These genes were validated in depression patients through q-PCR and examined for expression patterns and potential roles across various cancers.ResultsWe identified six core genes (GRB10, TDRD9, BCL7A, GPR18, KLRG1, and THEM4) significantly associated with depression and cancer. In depression, GRB10 and TDRD9, involved in cell growth and stress responses, exhibited elevated expression, while BCL7A, GPR18, KLRG1, and THEM4, linked to immune regulation and apoptosis, showed reduced expression, suggesting dysregulated cellular signaling and impaired immune function. In cancer, these genes displayed altered expression patterns across tumor types, influencing tumor progression, prognosis, and immune microenvironment modulation. Shared molecular pathways, such as immune dysregulation and apoptosis, highlight their potential as biomarkers and therapeutic targets for both depression and cancer.ConclusionThis study integrates bioinformatics and machine learning to uncover key molecular pathways and targets for depression, introducing innovative therapeutic prospects that may enhance precision treatment for depression. Furthermore, by revealing shared mechanisms between depression and cancer, we have identified six core genes with significant functional roles in immune regulation, apoptosis, and cellular signaling. These findings not only deepen our understanding of the molecular overlap between these conditions but also lay the groundwork for developing dual-targeted therapeutic strategies. This study uniquely contributes to bridging mental health and oncology research, offering new insights and hope for improving patient outcomes in both fields.