Depression is a heterogeneous condition characterized by affective symptoms, sleep disturbance, and altered physiological regulation, but the relative contribution of subjective and objective measures to depressive status remains unclear. In this cross-sectional study, 101 participants were categorized as healthy controls (HC, n = 47), subthreshold depression (SD, n = 30), and major depressive disorder (MDD, n = 24). Demographic characteristics, symptom questionnaires, polysomnographic variables, heart rate variability (HRV) indices, and eye-tracking measures were collected. Group differences were assessed across the three groups, and classification analyses were then performed by defining HC as the non-depressive group and combining SD and MDD as the depressive group. Univariate and multivariable logistic regression analyses were used to identify independent correlates of depressive status, and model discrimination was evaluated using the area under the receiver operating characteristic curve, accuracy, sensitivity, specificity, F1 score, and Brier score. Significant between-group differences were found for HAMD-17, PHQ-9, GAD-7, PSQI, ISI, NDQ, sleep latency, rapid eye movement latency, and RMSSD. After adjustment for age and sex, higher GAD-7 scores, greater NDQ scores, and longer rapid eye movement latency remained independently associated with depressive status. In model comparison analyses, the combined model showed the highest discriminative performance (AUC = 0.942), followed closely by the clinical model (AUC = 0.930), whereas the polysomnographic and HRV models showed lower performance. These findings indicate that depressive status in this cohort was primarily characterized by greater affective and sleep-related symptom burden, while rapid eye movement latency provided additional objective information beyond questionnaire-based assessment. However, these models should be interpreted as cohort-internal, screening-oriented discrimination models within a cross-sectional design rather than prospective, diagnostic, or etiological models.

Background and objectives Loberamisal, a novel agent that dissociates the post-synaptic density protein 95/neuronal nitric oxide synthase complex and potentiates the α2-containing γ-aminobutyric acid type A receptors, is a potential neuroprotectant that is effective in preclinical studies for acute ischaemic stroke. This trial aims to demonstrate the efficacy and safety of intravenous loberamisal in patients with acute ischaemic stroke (AIS) within 48 hours of onset.Methods and design The LAIS (Loberamisal for Acute Ischaemic Stroke) trial is a multicentre, prospective, randomised, double-blind, placebo-controlled phase 3 trial. A total of 998 eligible patients will be randomly assigned to receive either loberamisal or placebo in a 1:1 ratio.Outcomes The primary efficacy outcome is proportion of individuals achieving an excellent functional outcome, defined as modified Rankin Scale (mRS) 0–1 at 90 days. Secondary efficacy outcomes include favourable functional outcome (defined as an mRS score of 0 in patients with a baseline NIHSS score of 4 to 7; an mRS score of 0 to 1 in patients with a baseline NIHSS score of 8 to 14; and an mRS score of 0 to 2 in patients with a baseline NIHSS score of 15 to 25), distribution of mRS at 90 days, patients with ≥4 points reduction in National Institutes of Health Stroke Scale score from baseline at 10 days and 30 days, and Barthel Index ≥95 at 90 days. Safety outcomes were adverse events. Exploratory outcomes include the incidence of depressive and anxiety symptoms at 90 days.Discussion The LAIS trial will evaluate the potential of loberamisal as a novel neuroprotectant in acute ischaemic stroke.Trial registration number NCT06517173.

The efficacy of intravenous thrombolysis is time-dependent. Reteplase has been shown to be superior to alteplase in certain acute ischemic stroke patients. The authors aimed to delineate the associations of stroke onset-to-treatment time (OTT) on the therapeutic benefits and clinical risks with reteplase in comparison to alteplase. This is a post hoc analysis of the RAISE (Reteplase versus Alteplase for Acute Ischemic Stroke) trial. Patients were divided into 3 groups based on their onset-to-treatment times: 0 to 90, 91 to 180, and 181 to 270 minutes. The primary efficacy outcome was the proportion of participants with a modified Rankin scale score of 0 to 1 at 90 days. The primary safety outcome was symptomatic intracranial hemorrhage within 36 hours post-thrombolytic treatment. A total of 1,399 patients (99.1%) with OTT (median 180 minutes; Q1-Q3: 135-222 minutes) were included. Adjusted risk ratios of primary efficacy outcome were 1.16 (95% CI: 0.70-1.91) for the 0 to 90 minutes group, 1.14 (95% CI: 0.97-1.35) for 91 to 180 minutes group, and 1.12 (95% CI: 0.93-1.18) for 181 to 270 minutes group. The primary safety outcome had no difference between reteplase and alteplase in the 3 OTT intervals. Among patients with ischemic stroke within 4.5 hours after symptom onset, there was no significant difference in the efficacy profile between reteplase and alteplase for achieving excellent functional outcomes at 3 different OTT intervals. (A Study of r-PA Treating Patients With Acute Ischemic Stroke [RAISE]; NCT05295173).

The intestinal microbiota has been implicated in depression, and patients with periodontal disease show particularly high rates of depressive symptoms. This study explored the relationship between oral microbiota, depression severity, and systemic inflammatory factors. Thirty-two patients with depression were enrolled and divided into mild (n = 13; PHQ-9 ≤ 14) and major (n = 19; PHQ-9 > 14) depression groups. Significant differences in oral microbial diversity were found between groups. Alpha-diversity was higher in mild depression (Shannon, P = 0.01; Simpson, P = 0.03), although richness did not differ significantly (Chao1, P = 0.06; ACE, P = 0.06). Beta-diversity analysis revealed distinct microbial community structures (Unweighted UniFrac, P < 0.01; Weighted UniFrac, P < 0.01). Several bacterial taxa (e.g., Actinobacteria, Micrococcales, Micrococcaceae, Peptostreptococcaceae, Flavobacteriaceae, Rothia, Paraclostridium, Capnocytophaga, Haemophilus_parainfluenzae, and Neisseria_elongata) showed positive correlations with depression severity. In contrast, Xanthomonadales was negatively associated. No significant intergroup differences were observed in inflammatory factors. These findings suggest that oral microbiota composition and diversity are closely linked to depression severity, though the role of inflammatory factors remains unclear.

Little is known about the association between catastrophic health expenditure (CHE) and mental health in elderly population and its potential moderators. This study examined the relationship between CHE and depressive symptoms in Chinese older persons and its difference between groups of different income level and social activity engagement. We employed data from the 4 waves (2011, 2013, 2015, and 2018, N = 15,406) of the China Health and Retirement Longitudinal Study (CHARLS). A linear mixed model was used to examine the association between depressive symptoms and CHE, and interaction terms were involved in the model to examine the moderating role of social activity and income levels. Significant correlations have been shown between CHE and depressive symptoms(coefficient = 0.363, P < 0.05), such association was more pronounced in socially inactive (P = 0.034, Difference = 0.37, interaction terms (social activity*CHE: -1.189) or low-income seniors (P < 0.001, Difference = 0.77, interaction terms (medium income*CHE: -0.594, P < 0.05, high income*CHE: -0.667, P < 0.01), and especially in socially inactive and low-income seniors (P < 0.001, Difference = 0.93, interaction terms (high income*CHE*social acitivity: 1.132, P < 0.05). Even after increasing the threshold of CHE to 20

[This corrects the article DOI: 10.3389/fnmol.2025.1617543.].

BACKGROUND AND PURPOSE:Ischemic stroke is the most common type of stroke and the second leading cause of global mortality. Prompt and accurate diagnosis is crucial for effective treatment. Non-contrast CT (NCCT) scans are commonly employed as the first-line imaging modality to identify the infarct lesion and affected brain areas, as well as to make prognostic predictions to guide the subsequent treatment planning. However, visual evaluation of infarct lesions in NCCT scans can be subjective and inconsistent due to reliance on expert experience. METHODS:In this study, we propose an automatic method using VB-Net with dual-channel inputs to segment acute infarct lesions (AIL) on NCCT scans and extract affected ASPECTS (Alberta Stroke Program Early CT Score) regions. Secondly, we establish a prediction model to distinguish reperfused patients from non-reperfused patients after treatment, based on multi-dimensional radiological features of baseline NCCT and stroke onset time. Thirdly, we create a prediction model estimating the infarct volume after a period of time, by combining NCCT infarct volume, radiological features, and surgical decision. RESULTS:The median Dice coefficient of the AIL segmentation network is 0.76. Based on this, the patient triage model has an AUC of 0.837 (95 % confidence interval [CI]: 0.734-0.941), sensitivity of 0.833 (95 % CI: 0.626-0.953). The predicted follow-up infarct volume correlates strongly with the DWI ground truth, with a Pearson correlation coefficient of 0.931. CONCLUSIONS:Our proposed pipeline offers qualitative and quantitative assessment of infarct lesions based on NCCT scans, facilitating physicians in patient triage and prognosis prediction.

BACKGROUND:Sleep quality may be a predictor of outcomes following ischemic stroke. This study aims to investigate the impact of pre-stroke subjective sleep quality on clinical outcomes in stroke patients. METHODS:Patients diagnosed with acute ischemic stroke (AIS) or transient ischemic attack (TIA) were recruited from China National Stroke Registry-III. The Pittsburgh Sleep Quality Index (PSQI) was used to evaluate pre-stroke subjective sleep quality. Cox regression was to explore the relationship between PSQI and recurrent stroke, mortality, and composite vascular events; logistic regression was used for poor functional outcome. RESULTS:A total of 2,266 patients were enrolled. After 1 year of follow-up, 44 (1.9 %) individuals died, 180 (7.9 %) individuals experienced stroke recurrence, 195 (8.6 %) individuals experienced composite vascular events, and 172 (7.6 %) individuals had poor functional outcome. Patients in the highest quartile of PSQI score (score range: 10-20) exhibited a significantly increased risk of mortality (HR = 3.73, 95 % CI = 1.24-11.22) and poor functional outcome (OR = 2.15 95 % CI = 1.27-3.63) when compared with patients in the lowest quartile (score range: 3-5). CONCLUSIONS:Pre-stroke poor subjective sleep quality independently predicts 1-year mortality and poor functional outcome in patients with AIS or TIA.

BACKGROUND:The efficacy of intravenous thrombolysis is time-dependent. Reteplase has been shown to be superior to alteplase in certain acute ischemic stroke patients. OBJECTIVES:The authors aimed to delineate the associations of stroke onset-to-treatment time (OTT) on the therapeutic benefits and clinical risks with reteplase in comparison to alteplase. METHODS:This is a post hoc analysis of the RAISE (Reteplase versus Alteplase for Acute Ischemic Stroke) trial. Patients were divided into 3 groups based on their onset-to-treatment times: 0 to 90, 91 to 180, and 181 to 270 minutes. The primary efficacy outcome was the proportion of participants with a modified Rankin scale score of 0 to 1 at 90 days. The primary safety outcome was symptomatic intracranial hemorrhage within 36 hours post-thrombolytic treatment. RESULTS:A total of 1,399 patients (99.1%) with OTT (median 180 minutes; Q1-Q3: 135-222 minutes) were included. Adjusted risk ratios of primary efficacy outcome were 1.16 (95% CI: 0.70-1.91) for the 0 to 90 minutes group, 1.14 (95% CI: 0.97-1.35) for 91 to 180 minutes group, and 1.12 (95% CI: 0.93-1.18) for 181 to 270 minutes group. The primary safety outcome had no difference between reteplase and alteplase in the 3 OTT intervals. CONCLUSIONS:Among patients with ischemic stroke within 4.5 hours after symptom onset, there was no significant difference in the efficacy profile between reteplase and alteplase for achieving excellent functional outcomes at 3 different OTT intervals. (A Study of r-PA Treating Patients With Acute Ischemic Stroke [RAISE]; NCT05295173).

AIM:The American Heart Association (AHA) proposed Life's Essential 8 score (LE8) in 2022 as a new metric for cardiovascular health (CVH). This study investigated the association between the LE8 score and the development of carotid artery plaque. METHODS:Data were drawn from the Asymptomatic Polyvascular Abnormalities Community (APAC) cohort study. In 2010, 1,938 participants without carotid plaques were recruited and followed-up until 2012. LE8 scores ranging from 0 to 100 were categorized as low (0-49), moderate (50-79), and high (80-100), whereas carotid plaques were measured using color Doppler ultrasound. A logistic analysis was used to analyze the association between the LE8 score and carotid plaque. RESULTS:During the 2-year follow up period, 350 (18.1%) patients developed new carotid plaques. The incidence of newly developed carotid plaques decreased from 27.0% in the low-LE8 group to 13.7% in the high-LE8 group (p＜0.001). Adjusted odds ratios (ORs) for plaque development were 0.65 (95% confidence interval [CI], 0.45-0.93) in the moderate-LE8 group and 0.55 (95% CI, 0.34-0.90) in the high-LE8 group compared to the low-LE8 group. Higher LE8 scores were associated with a lower risk of stable and multiple carotid plaques. CONCLUSIONS:An elevated LE8 score was associated with a lower risk of carotid plaque formation as well as plaque stability and quantity. Promoting adherence to optimal CVH levels may be beneficial in reducing the burden of carotid plaques and the risk of cardiovascular disease.

Excessive daytime sleepiness (EDS) is a prominent symptom of obstructive sleep apnea (OSA), negatively affecting patients’ quality of life. The objective of this study was to assess the efficacy and safety of solriamfetol in patients with OSA with EDS from China. This multicenter, randomized, double-blind, placebo-controlled phase 3 trial compared solriamfetol (75/150 mg once daily) with placebo for 12 weeks. Adults diagnosed with OSA, mean Maintenance of Wakefulness Test (MWT) sleep latency < 30 min, and Epworth Sleepiness Scale (ESS) score ≥ 10 were included. Patients with disorders causing EDS other than OSA were excluded. Co-primary endpoints were change from baseline to week 12 in MWT mean sleep latency and ESS score; a key secondary endpoint was improvement on Patient Global Impression of Change (PGI-C), assessed on a seven-point scale. MWT was performed at baseline and at weeks 2, 5, and 12, whereas the ESS and PGI-C were evaluated at weeks 2, 5, 8, and 12. Safety and tolerability were assessed on the basis of treatment-emergent adverse events (TEAEs), laboratory tests, vital signs, 24-h ambulatory blood pressure monitoring, 12-lead electrocardiogram, and physical examination. Statistical analyses of co-primary endpoints were performed on the full analysis set (FAS) using a mixed model for repeated measures (MMRM). Safety analyses were performed on the safety population. A hierarchical testing sequence was used to control multiplicity. Of the 204 patients randomized (1:1) into placebo and solriamfetol groups, 192 completed the study (96 in each group). Co-primary endpoints were met, with significantly increased mean MWT sleep latency (P < 0.0001) and decreased ESS score (P = 0.0017) in the solriamfetol group (MWT, n = 95; ESS, n = 97) versus placebo (MWT, n = 95; ESS, n = 96) at week 12. Higher proportion of participants receiving solriamfetol (n = 90; 89.1

This cross-sectional study investigated sleep quality differences between young-old (65-79 years) and old-old (80+ years) elderly individuals in Shanghai. Among 832 participants, 30.2 % exhibited sleep disorders (PSQI > 5), with the old-old group showing significantly poorer sleep quality (higher PSQI scores and incidence of sleep disorders, both P < 0.001). Key differences between the groups included sleep latency (P < 0.001), sleep efficiency (P = 0.011), medication use (P = 0.012), and daytime dysfunction (P < 0.001). Comorbidity count was negatively correlated with sleep quality in both groups (P < 0.001). For the young-old group, higher Instrumental Activities of Daily Living (IADL) scores were linked to worse sleep (OR = 1.049, 95 %CI: 1.008-1.092), while in the old-old group, lower educational attainment was associated with poorer sleep (OR = 0.688, 95 %CI: 0.483-0.981). These findings suggest that sleep characteristics and determinants vary by age group, highlighting the need for tailored health interventions, especially for less educated old-old individuals.

BACKGROUND:Depression is a psychological disorder characterized by altered self-referential cognition and impaired emotional expression. Traditional diagnostic methods can be costly or intrusive, while Speech-based analysis offers an accessible alternative for early detection. METHOD:This study introduces the Auto-Masked Audio Spectrogram Transformer (AMAST), a deep learning framework that extracts depression-related features from speech spectrograms. AMAST incorporates sliding window segmentation, auto-masked training to enhance contextual learning, and a time-frequency attention mechanism to capture both time and frequency information. RESULT:AMAST achieved F1 scores of 0.92 on the Distress Analysis Interview Corpus-Wizard of Oz dataset and 0.91 on the Multi-modal Open Dataset for Mental disorder Analysis dataset, outperforming baseline models. Emotionally evocative tasks such as word reading and interviews significantly improved classification performance. The model demonstrated robustness in detecting subtle depressive speech markers across various speaking conditions. CONCLUSION:AMAST provides a promising tool for non-invasive depression screening. Its effectiveness across diverse tasks and datasets supports its potential use in clinical and remote mental health assessments. Our code is available at https://github.com/zmc314/AMAST.

Objective To analyze the cognitive function and sleep quality of the elderly in Shanghai community,and explore the related influencing factors.Methods A stratified cluster random sampling method was used to select 8 community health centers in Shanghai for a questionnaire survey,including 3 677 elderly individuals who completed the"Comprehensive Health Status Survey of Elderly Residents in Shanghai"from September 2023 to November 2023.Basic information of the elderly was collected,including age,gender,education level,smoking,drinking,mahjong playing behavior,and exercise habits.The Pittsburgh sleep quality index(PSQI)was used to assess the sleep quality of the elderly,subjective cognitive decline(SCD)self-assessment questionnaire and Mini-Mental State Examination(MMSE)were used to evaluate cognitive function,while the Hamilton Anxiety Scale(HAMA)and patient health questionnaire-9(PHQ-9)were used to assess anxiety and depression levels,and the mini nutritional assessment(MNA)was used to evaluate nutritional status.According to the MMSE scores,the elderly were divided into three groups:no cognitive impairment(MMSE≥27),mild cognitive impairment(MMSE 21-26),and moderate to severe cognitive impairment(MMSE≤20).The general data,lifestyle habits,and scale scores of the three groups were compared.Ordered logistic regression was used to analyze the influencing factors of sleep quality.Results There were statistically significant differences in age,gender,waist circumference,body mass index(BMI),education level,pet ownership,smoking,drinking,mahjong playing behavior,exercise habits,and scale scores among the three groups(P＜0.05).Logistic regression analysis showed that age,waist circumference,gender,drinking habits,mahjong playing behavior,and chronic comorbidities are influencing factors for the PSQI grading in the elderly(P＜0.05).The MMSE score(OR=1.037,P=0.001),SCD score(OR=1.123,P＜0.001),HAMA score(OR=1.183,P＜0.001),PHQ-9 score(OR=1.249,P＜0.001)are positive influencing factors for PSQI grading,while the MNA score is a negative influencing factor(OR=0.960,P=0.037).Conclusions Advanced age,female gender,low education level,no pet ownership,no mahjong playing behavior,no exercise habits,and poor sleep quality are risk factors for cognitive impairment in the elderly.Advanced age,female gender,no mahjong playing behavior and poor nutritional status are influencing factors for poor sleep quality in the elderly,and severe comorbidities,anxiety,depression,and subjective decline in cognitive function all affect sleep quality.

Introduction: Rapid symptom relief is crucial for individuals with emotional disorders. The current study aimed to determine whether facilitator-supported mindfulness-based self-help (MBSH) intervention as an adjunctive treatment could provide rapid improvement for individuals with emotional disorders. Methods: A practice-oriented randomized controlled trial was conducted on a sample of 302 patients with emotional disorders from four centers. Participants were randomly assigned to either MBSH+TAU (treatment as usual; n = 152) or TAU-only group (n = 150). Assessments were conducted at baseline, week 3, week 5, immediately after intervention and at a 3-month follow-up. Primary outcomes included self-reported and clinician-reported anxiety and depression symptoms. Secondary outcomes included mindfulness, physical symptoms, perceived stress, sleep quality, and inner peace. Results: The MBSH+TAU group achieved significantly greater improvements in all primary and secondary outcome measures as compared with TAU-only immediately after intervention (Cohen’s d = 0.19–0.51). In addition, relatively greater improvements were observed in self-reported depression, mindfulness, physical symptoms, perceived stress, and inner peace as early as week 3 or 5, which were sustained at the 3-month follow-up (Cohen’s d = 0.20–0.34). Conclusions: Facilitator-supported MBSH offers a scalable and effective adjunctive treatment option for patients with emotional disorders in clinical practice, facilitating rapid improvements.

Background Intra-arterial prourokinase has been shown to be a promising thrombolytic agent in patients with acute ischaemic stroke. Given the global shortage of thrombolytics, we aimed to assess the non-inferiority of intravenous recombinant human prourokinase compared with alteplase in patients with acute ischaemic stroke who were ineligible for or who refused endovascular thrombectomy. Methods PROST-2 was a phase 3, open-label, non-inferiority, randomised controlled trial conducted at 61 hospitals in China. Patients older than 18 years with acute ischaemic stroke, who were ineligible for or who refused endovascular thrombectomy, were randomly assigned in a 1:1 ratio within 45 h of stroke onset to receive intravenous recombinant human prourokinase (15 mg bolus followed by 20 mg infusion within 30 min) or intravenous alteplase (09 mg per kg, maximum dose 90 mg; 10% bolus followed by remainder as infusion over 60 min). The primary efficacy outcome was the proportion of patients with a modified Rankin Scale score of 0 or 1 at 90 days, assessed via masked review in the intention-to-treat population, with a non-inferiority margin for the risk ratio of 093. The primary safety outcome was the incidence of symptomatic intracranial haemorrhage within 36 h. This trial is registered with ClinicalTrials.gov (NCT05700591) and is now completed. Findings Between Jan 29, 2023, and March 14, 2024, 1552 patients were randomly assigned: 775 received recombinant human prourokinase and 777 received alteplase. The primary outcome of a modified Rankin Scale score of 0 or 1 at 90 days was reached by 558 (720%) of 775 patients in the recombinant human prourokinase group versus 534 (687%) of 777 in the alteplase group (risk ratio 104 [95% CI 098 to 110]; p<00001 for non-inferiority). The frequency of symptomatic intracranial haemorrhage within 36 h was lower in the recombinant human prourokinase group than in the alteplase group (two [03%] of 770 patients vs ten [13%] of 775, risk difference -10 percentage points [95% CI -21 to -01]; p=0021), as was the incidence of major bleeding at 7 days (four [05%] vs 16 [21%]; -15 percentage points (-28 to -04); p=00072). All-cause mortality within 7 days did not differ between groups (five [06%] deaths in the recombinant human prourokinase group vs 13 [17%] in the alteplase group; risk difference -10 percentage points; 95% CI -23 to 01]; p=0060). Interpretation In our trial, recombinant human prourokinase was shown to be non-inferior to alteplase for achieving excellent functional outcome, with no difference between groups in safety endpoints. These findings support the use of recombinant human prourokinase as a viable alternative to alteplase for patients with ischaemic stroke who are eligible for intravenous thrombolysis therapy but ineligible for or who have refused endovascular thrombectomy.

Previous studies have found the effect of ShuganJieyu capsule and St. John’s wort on the treatment of depression and explored their potential benefits for somatic symptoms, while the evidence of comparison of them for depression with somatic complaints is lacking. In this multicenter randomized controlled trial, 198 major depressive disorder (MDD) patients with somatic complaints were randomly allocated, 92 in the ShuganJieyu capsule group, and 91 in the St. John’s wort group completed 8 weeks treatment. Primary outcome was the change score of the 17-item Hamilton Depression Rating Scale (HDRS-17) at week 8. Secondary outcomes included other indices of depression, somatic symptoms, anxiety, insomnia, quality of life, and adverse events. The change scores of HDRS-17 were not significantly difference between the two groups, but the reduction in HDRS-17 was significantly improved in both the ShuganJieyu capsule (HDRS-17Δ = − 11.35 ± 5.38, p < 0.001) and St. John’s wort (HDRS-17Δ = − 11.20 ± 5.71, p < 0.001) groups. The other outcomes showed similar results. Compared with St. John’s wort, the ShuganJieyu capsule induced significantly greater HDRS-17 reductions in male (SMD, − 0.55; 95% CI, − 1.08 to − 0.02) but not in female. Overall, The ShuganJieyu capsule was comparable to St. John’s wort as a complementary and alternative intervention for MDD patients with somatic complaints in the acute treatment, especially for male patients.

Sleep disturbances profoundly affect the quality of life in individuals with neurological disorders. Closed-loop deep brain stimulation (DBS) holds promise for alleviating sleep symptoms, however, this technique necessitates automated sleep stage decoding from intracranial signals. We leveraged overnight data from 121 patients with movement disorders (Parkinson's disease, Essential Tremor, Dystonia, Essential Tremor, Huntington's disease, and Tourette's syndrome) in whom synchronized polysomnograms and basal ganglia local field potentials were recorded, to develop a generalized, multi-class, sleep specific decoder - BGOOSE. This generalized model achieved 85% average accuracy across patients and across disease conditions, even in the presence of recordings from different basal ganglia targets. Furthermore, we also investigated the role of electrocorticography on decoding performances and proposed an optimal decoding map, which was shown to facilitate channel selection for optimal model performances. BGOOSE emerges as a powerful tool for generalized sleep decoding, offering exciting potentials for the precision stimulation delivery of DBS and better management of sleep disturbances in movement disorders.

Background Inflammatory factors are associated with depression. We seek to investigate the correlation between inflammatory cytokines and prognosis of depression or suicidal ideation and behavior at 3 months in depression patients. Methods Eighty-two depressed outpatients were recruited and treated as usual. Plasma cytokines were measured at baseline. Patients were followed up with Patient Health Questionnaire-9 and suicidal ideation and behavior according to the item 3 of Hamilton depression scale for 3 months. Results Compared to the depression patients with low level of interleukin-1β, the high one had severe depressive symptoms at month 2 and 3 (B 0.92, P < 0.01; B 0.86, P = 0.02; respectively). The incidence of suicidal ideation or behavior was 18.3% at 3 months. Depression patients with high levels of tumor necrosis factor-α showed high risk of suicidal ideation and behavior than the low one (OR 2.16, 95% CI 1.00-4.65, P = 0.04). Conclusions High levels of interleukin-1β and tumor necrosis factor-α were predictive of middle-term severe depressive symptoms and suicidal ideation and behavior respectively.

BackgroundRapid eye movement (REM) sleep behaviour disorder (RBD) is one of the most common sleep problems and represents a key prodromal marker in Parkinson’s disease (PD). It remains unclear whether and how basal ganglia nuclei, structures that are directly involved in the pathology of PD, are implicated in the occurrence of RBD.MethodHere, in parallel with whole-night video polysomnography, we recorded local field potentials from two major basal ganglia structures, the globus pallidus internus and subthalamic nucleus, in two cohorts of patients with PD who had varied severity of RBD. Basal ganglia oscillatory patterns during RBD and REM sleep without atonia were analysed and compared with another age-matched cohort of patients with dystonia that served as controls.ResultsWe found that beta power in both basal ganglia nuclei was specifically elevated during REM sleep without atonia in patients with PD, but not in dystonia. Basal ganglia beta power during REM sleep positively correlated with the extent of atonia loss, with beta elevation preceding the activation of chin electromyogram activities by ~200 ms. The connectivity between basal ganglia beta power and chin muscular activities during REM sleep was significantly correlated with the clinical severity of RBD in PD.ConclusionsThese findings support that basal ganglia activities are associated with if not directly contribute to the occurrence of RBD in PD. Our study expands the understanding of the role basal ganglia played in RBD and may foster improved therapies for RBD by interrupting the basal ganglia-muscular communication during REM sleep in PD.