Decoding human emotion states from intracranial neural activity is key in developing affective brain–computer interfaces and new therapies for affective disorders. However, real-world application of decoding requires high performance that integrates neural activity from both gray and white matter, stable generalization across different contexts, sufficient neural encoding explainability and robust real-time implementation, all of which remain elusive. Here we simultaneously recorded intracranial electroencephalogram (iEEG) and abundant self-rated valence and arousal scores across two emotion-eliciting tasks in 18 individuals. We then developed personalized decoding models within a deep learning framework, achieving high-performance decoding of continuous valence and arousal states and improving on the performance of prior EEG and iEEG decoding. Critically, the models substantially improved performance by integrating gray and white matter signals and demonstrated cross-task generalization. The models further revealed shared and preferred mesolimbic–thalamo–cortical subnetworks encoding valence and arousal, showing neurophysiological explainability. Finally, the models realized robust real-time decoding in four new individuals. Our results have implications for advancing emotion decoding neurotechnology toward deployable affective brain–computer interfaces and closed-loop therapeutic systems for affective disorders. This study reports personalized models that decode human emotion states from intracranial brain recordings in real time, work across different tasks and uncover key brain networks that could guide future treatments for mental health conditions.

Objective: Deep brain stimulation (DBS) targeting the lateral habenula (LHb) is a promising therapy for treatment-resistant depression (TRD) but its clinical effect has been variable, which can be improved by adaptive DBS (aDBS) guided by a neural biomarker of depression symptoms. Existing neural biomarkers, however, cannot simultaneously track slow and fast symptom dynamics, do not sufficiently respond to stimulation parameters, and lack neurobiological interpretability, which hinder their use in developing aDBS. Methods: We conducted a study on one TRD patient who achieved remission following a 41-week LHb DBS treatment, during which we assessed slow symptom variations using weekly clinical ratings and fast variations using daily self-reports. We recorded daily LHb local field potentials (LFP) concurrently with the reports during the entire treatment process. We then used machine learning methods to identify a personalized depression neural biomarker from spectral and temporal LFP features. Results: The neural biomarker was identified from classification of high and low depression symptom states with a cross-validated accuracy of 0.97. It further simultaneously tracked both weekly (slow) and daily (fast) depression symptom variation dynamics, achieving test data explained variance of 0.74 and 0.63 respectively and responded to DBS frequency alterations. Finally, it can be neurobiologically interpreted as indicating LHb excitatory and inhibitory balance changes during DBS treatment. Conclusion: By collecting and analyzing a unique personalized dataset of weekly and daily LFP recordings and symptom evaluations, we identified a high-performance neural biomarker for depression during LHb DBS. Significance: Our results hold promise to facilitate future aDBS for treating TRD.

Background:Adjunctive therapy with a second-generation antipsychotic (SGA) represents a treatment option for major depressive disorder (MDD) patients with inadequate response to antidepressants. Evidence suggests that early initiation of adjunctive SGA treatment may yield greater benefits. This study aimed to investigate the efficacy, safety, and tolerability of adjunctive therapy with perospirone initiated after 4 weeks of antidepressant treatment in MDD patients with inadequate response. Methods:This phase IV, multi-center, randomized, double-blind, placebo-controlled trial assessed the efficacy, safety and tolerability of perospirone as an adjunct to serotonin norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs) in patients with MDD who showed inadequate response to SSRIs/SNRIs. Patients with moderate-to-severe depression (defined as a baseline Montgomery-Åsberg Depression Rating Scale [MADRS] score of ≥20) who exhibited a reduction of <50% in the total score of MADRS after receiving at least one antidepressant at an adequate dose for at least four weeks during the current episode were included in the study. The primary intervention timepoint was set at week 4, with treatment initiation permitted up to week 8. Eligible patients were randomized 1:1 to the perospirone group (perospirone + SSRIs/SNRIs) or the placebo group (placebo + SSRIs/SNRIs) and received treatment for 8 weeks. Perospirone was administered once or twice daily at an initial dose of 4-8 mg/day and a maintenance dose of 12-48 mg/day, based on symptom severity and patient tolerance. The study, conducted across 10 Chinese hospitals between December 16, 2021 and June 19, 2024, evaluated the primary efficacy endpoints of response (≥50% reduction in the MADRS score) and remission (MADRS score ≤10) rates at the end of the 8-week treatment. The study was registered at www.chictr.org.cn (ChiCTR2200063354). Findings:A total of 210 participants were randomized into the two groups (108 were assigned to the perospirone group and 102 to the placebo group). Compared to the placebo group, more patients in the perospirone group achieved remission at week 8 (55.2% vs. 38.9%, odds ratio [OR] = 1.944, 95% confidence interval [CI]: 1.060-3.564, p = 0.032), and the proportions of participants with clinical response were comparable between the two groups (67.8% vs. 60.0%, OR = 1.406, 95% CI: 0.759-2.605, p = 0.28). Most common adverse events (AEs) were mild arousal-related symptoms, autonomic dysfunction, and extrapyramidal symptoms. Treatment discontinuation rates due to AEs were low and comparable in both groups, with no significant safety concerns. Interpretation:Early adjunctive treatment with perospirone for 8 weeks may confer potential benefits, particularly in MDD patients who exhibit inadequate response to SSRIs/SNRIs and present with more severe symptoms requiring rapid improvement. While the treatment demonstrated acceptable tolerability and safety profiles, the observed efficacy should be interpreted with caution and regarded as hypothesis-generating due to the lack of multiplicity adjustment. Further confirmatory randomized controlled trials are warranted to validate these findings. Funding:The study was supported by the STI2030-Major Projects (grant 2021ZD0202000), National Natural Science Foundation of China (grant 82201693 and 82471555), Hunan Provincial Natural Science Outstanding Youth Foundation (grant 2025JJ20093), Science and Technology Innovation Program of Hunan Province (grant 2024RC3057), Sanming Project of Medicine in Shenzhen (grant SZSM202311025), and Reboscience (Zhuhai) Pharmaceutical Research Co., Ltd., and sponsored by Livzon Pharmaceutical Group Inc.

Background Neuroimaging-based connectome studies have indicated that major depressive disorder (MDD) is associated with disrupted topological organization of large-scale brain networks. However, the disruptions and their clinical and cognitive relevance are not well established for morphological brain networks in adolescent MDD. Objective To investigate the topological alterations of single-subject morphological brain networks in adolescent MDD. Methods Twenty-five first-episode, treatment-naive adolescents with MDD and 19 healthy controls (HCs) underwent T1-weighted magnetic resonance imaging and a battery of neuropsychological tests. Single-subject morphological brain networks were constructed separately based on cortical thickness, fractal dimension, gyrification index, and sulcus depth, and topologically characterized by graph-based approaches. Between-group differences were inferred by permutation testing. For significant alterations, partial correlations were used to examine their associations with clinical and neuropsychological variables in the patients. Finally, a support vector machine was used to classify the patients from controls. Results Compared with the HCs, the patients exhibited topological alterations only in cortical thickness-based networks characterized by higher nodal centralities in parietal (left primary sensory cortex) but lower nodal centralities in temporal (left parabelt complex, right perirhinal ectorhinal cortex, right area PHT and right ventral visual complex) regions. Moreover, decreased nodal centralities of some temporal regions were correlated with cognitive dysfunction and clinical characteristics of the patients. These results were largely reproducible for binary and weighted network analyses. Finally, topological properties of the cortical thickness-based networks were able to distinguish the MDD adolescents from HCs with 87.6% accuracy. Conclusion Adolescent MDD is associated with disrupted topological organization of morphological brain networks, and the disruptions provide potential biomarkers for diagnosing and monitoring the disease.

Abstract Purpose Paliperidone is an atypical antipsychotic as effective as other atypical antipsychotics for schizophrenia. However, few studies have explored the efficacy of paliperidone for treatment-resistant schizophrenia. This study aimed to compare the efficacy and safety of paliperidone extended release (ER) versus olanzapine in schizophrenia patients with either poor treatment response or intolerable adverse effects due to standardized antipsychotic therapy. Methods This 12-week randomized, double-blind, multicenter study compared the treatment efficacy on psychotic symptoms, cognitive functions, and tolerance between paliperidone ER (6–15 mg/d, n = 45) and olanzapine (10–30 mg/d, n = 41) in treatment-resistant or treatment-intolerant patients with schizophrenia. The severity of psychotic symptoms was evaluated by the Positive and Negative Syndrome Scale and the Clinical Global Impression Severity of Illness Scale. The cognitive functions were assessed by the MATRICS Consensus Cognitive Battery. In addition, the metabolic impacts were evaluated by weight gain and waist circumference. Results Patients with either paliperidone ER or olanzapine treatment showed apparent improvement in psychotic symptoms, without significant intergroup difference. Twelve-week paliperidone ER or olanzapine treatment did not improve the cognitive functions. Both paliperidone ER and olanzapine treatment caused significant increase in weight and waist circumference, and olanzapine had a greater impact on waist circumference than paliperidone ER. In addition, both drugs were well tolerated. Conclusions Paliperidone ER could be a safe alternative for treatment-resistant schizophrenia.

Purpose Paliperidone is an atypical antipsychotic as effective as other atypical antipsychotics for schizophrenia. However, few studies have explored the efficacy of paliperidone for treatment-resistant schizophrenia. This study aimed to compare the efficacy and safety of paliperidone extended release (ER) versus olanzapine in schizophrenia patients with either poor treatment response or intolerable adverse effects due to standardized antipsychotic therapy. Methods This 12-week randomized, double-blind, multicenter study compared the treatment efficacy on psychotic symptoms, cognitive functions, and tolerance between paliperidone ER (6-15 mg/d, n = 45) and olanzapine (10-30 mg/d, n = 41) in treatment-resistant or treatment-intolerant patients with schizophrenia. The severity of psychotic symptoms was evaluated by the Positive and Negative Syndrome Scale and the Clinical Global Impression Severity of Illness Scale. The cognitive functions were assessed by the MATRICS Consensus Cognitive Battery. In addition, the metabolic impacts were evaluated by weight gain and waist circumference. Results Patients with either paliperidone ER or olanzapine treatment showed apparent improvement in psychotic symptoms, without significant intergroup difference. Twelve-week paliperidone ER or olanzapine treatment did not improve the cognitive functions. Both paliperidone ER and olanzapine treatment caused significant increase in weight and waist circumference, and olanzapine had a greater impact on waist circumference than paliperidone ER. In addition, both drugs were well tolerated. Conclusions Paliperidone ER could be a safe alternative for treatment-resistant schizophrenia.

Aims: This intervention study evaluates the effect of a virtual reality cognition training system (VRCTS) on improving cognitive function and clinical symptoms in Han Chinese patients with schizophrenia in the remission stage. Methods: Sixty-eight patients with schizophrenia in the remission stage were recruited for this study and were randomly allocated to either the virtual reality training (VRT) group or the treatment-as-usual (TAU) group. For the VRT group, patients received training with the VRCTS for two weeks and antipsychotic treatment as usual, while the TAU group only received antipsychotic treatment as usual. Cognitive function and clinical symptoms before and after the two-week treatment were assessed by the MATRICS consensus cognitive battery (MCCB), positive and negative syndrome scale (PANSS), and personal and social performance scale (PSP). Results: The results showed that (1) VRCTS could improve MCCB composite scores and scores on 2 out of 7 cognitive domains: visual learning as well as reasoning and problem solving. It was also observed that (2) VRCTS could alleviate general psychopathology symptoms of PANSS, but did not exert effects on positive and negative symptoms among patients with schizophrenia in the remission stage. Conclusions: A therapeutic effect of VRCTS was observed in patients with schizophrenia in the remission stage. This may improve cognitive function and general psychopathological symptoms. Trial registration: China Clinical Trial Registry, ChiVTR1800016121.

This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age, gender-and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α ), inter- feron-γ (IFN-γ ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT ( P ¼ 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT ( P ¼ 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels ( r ¼ 0.557 and 0.410 , P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.

Epidemiological studies have demonstrated that the genetic factors partly influence the development of same-sex sexual behavior, but most genetic studies have focused on people of primarily European ancestry, potentially missing important biological insights. Here, we performed a two-stage genome-wide association study (GWAS) with a total sample of 1478 homosexual males and 3313 heterosexual males in Han Chinese populations and identified two genetic loci (rs17320865, Xq27.3, FMR1NB, Pmeta = 8.36 × 10−8, OR = 1.29; rs7259428, 19q12, ZNF536, Pmeta = 7.58 × 10−8, OR = 0.75) showing consistent association with male sexual orientation. A fixed-effect meta-analysis including individuals of Han Chinese (n = 4791) and European ancestries (n = 408,995) revealed 3 genome-wide significant loci of same-sex sexual behavior (rs9677294, 2p22.1, SLC8A1, Pmeta = 1.95 × 10−8; rs2414487, 15q21.3, LOC145783, Pmeta = 4.53 × 10−9; rs2106525, 7q31.1, MDFIC, Pmeta = 6.24 × 10−9). These findings may provide new insights into the genetic basis of male sexual orientation from a wider population scope. Furthermore, we defined the average ZNF536-immunoreactivity (ZNF536-ir) concentration in the suprachiasmatic nucleus (SCN) as lower in homosexual individuals than in heterosexual individuals (0.011 ± 0.001 vs 0.021 ± 0.004, P = 0.013) in a postmortem study. In addition, compared with heterosexuals, the percentage of ZNF536 stained area in the SCN was also smaller in the homosexuals (0.075 ± 0.040 vs 0.137 ± 0.103, P = 0.043). More homosexual preference was observed in FMR1NB-knockout mice and we also found significant differences in the expression of serotonin, dopamine, and inflammation pathways that were reported to be related to sexual orientation when comparing CRISPR-mediated FMR1NB knockout mice to matched wild-type target C57 male mice.

Importance:Health care workers exposed to coronavirus disease 2019 (COVID-19) could be psychologically stressed. Objective:To assess the magnitude of mental health outcomes and associated factors among health care workers treating patients exposed to COVID-19 in China. Design, Settings, and Participants:This cross-sectional, survey-based, region-stratified study collected demographic data and mental health measurements from 1257 health care workers in 34 hospitals from January 29, 2020, to February 3, 2020, in China. Health care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 were eligible. Main Outcomes and Measures:The degree of symptoms of depression, anxiety, insomnia, and distress was assessed by the Chinese versions of the 9-item Patient Health Questionnaire, the 7-item Generalized Anxiety Disorder scale, the 7-item Insomnia Severity Index, and the 22-item Impact of Event Scale-Revised, respectively. Multivariable logistic regression analysis was performed to identify factors associated with mental health outcomes. Results:A total of 1257 of 1830 contacted individuals completed the survey, with a participation rate of 68.7%. A total of 813 (64.7%) were aged 26 to 40 years, and 964 (76.7%) were women. Of all participants, 764 (60.8%) were nurses, and 493 (39.2%) were physicians; 760 (60.5%) worked in hospitals in Wuhan, and 522 (41.5%) were frontline health care workers. A considerable proportion of participants reported symptoms of depression (634 [50.4%]), anxiety (560 [44.6%]), insomnia (427 [34.0%]), and distress (899 [71.5%]). Nurses, women, frontline health care workers, and those working in Wuhan, China, reported more severe degrees of all measurements of mental health symptoms than other health care workers (eg, median [IQR] Patient Health Questionnaire scores among physicians vs nurses: 4.0 [1.0-7.0] vs 5.0 [2.0-8.0]; P = .007; median [interquartile range {IQR}] Generalized Anxiety Disorder scale scores among men vs women: 2.0 [0-6.0] vs 4.0 [1.0-7.0]; P < .001; median [IQR] Insomnia Severity Index scores among frontline vs second-line workers: 6.0 [2.0-11.0] vs 4.0 [1.0-8.0]; P < .001; median [IQR] Impact of Event Scale-Revised scores among those in Wuhan vs those in Hubei outside Wuhan and those outside Hubei: 21.0 [8.5-34.5] vs 18.0 [6.0-28.0] in Hubei outside Wuhan and 15.0 [4.0-26.0] outside Hubei; P < .001). Multivariable logistic regression analysis showed participants from outside Hubei province were associated with lower risk of experiencing symptoms of distress compared with those in Wuhan (odds ratio [OR], 0.62; 95% CI, 0.43-0.88; P = .008). Frontline health care workers engaged in direct diagnosis, treatment, and care of patients with COVID-19 were associated with a higher risk of symptoms of depression (OR, 1.52; 95% CI, 1.11-2.09; P = .01), anxiety (OR, 1.57; 95% CI, 1.22-2.02; P < .001), insomnia (OR, 2.97; 95% CI, 1.92-4.60; P < .001), and distress (OR, 1.60; 95% CI, 1.25-2.04; P < .001). Conclusions and Relevance:In this survey of heath care workers in hospitals equipped with fever clinics or wards for patients with COVID-19 in Wuhan and other regions in China, participants reported experiencing psychological burden, especially nurses, women, those in Wuhan, and frontline health care workers directly engaged in the diagnosis, treatment, and care for patients with COVID-19.

BACKGROUND:In December 2019, the novel coronavirus (SARS-CoV-2) infection was first reported in Wuhan city, central China, which has spread rapidly. The common clinical features of patients with SARS-CoV-2 infection included fever, fatigue, and damage to the respiratory or digestive system. However, it is still unclear whether SARS-CoV-2 infection could cause damage to the central nervous system (CNS) inducing psychiatric symptoms.CASE REPORT:Herein, we present the first case of SARS-CoV-2 infection with manic-like symptoms and describe the diagnosis, clinical course, and treatment of the case, focusing on the identifications of SARS-CoV-2 in the specimen of cerebrospinal fluid (CSF). The patient developed manic-like symptoms when his vital signs recovered on illness day 17. After manic-like attack, the detection of SARS-CoV-2 specific IgG antibody in CSF was positive, while the reverse transcriptase-polymerase chain reaction (RT-PCR) on CSF for the SARS-CoV-2 was negative. The patient received Olanzapine for treatment and his mood problems concurrently improved as indicated by scores of Young Manic Rating Scale (YMRS).LIMITATION:This is a single case report only, and the RT-PCR test for SARS-CoV-2 in CSF was not performed simultaneously when SARS-CoV-2 was positive in samples of sputum and stool.CONCLUSION:This first case of COVID-19 patient with manic-like symptoms highlights the importance of evaluation of mental health status and may contribute to our understanding of potential risk of CNS impairments by SARS-CoV-2 infection.

BackgroundTestosterone is thought to play a crucial role in sexual differentiation of the brain, and sexual orientation is programmed into our brain structures even when we are still fetuses. Although gender and sexual orientation differences have been shown respectively in many brain structures, the mechanism underlying the sexual differentiation of the brain is still unknown. The study is to investigate the interactive effects of gender and sexual orientation on cerebral structures in homosexual and heterosexual people.MethodsSexual orientation was evaluated by the Kinsey scale. We collected structural magnetic resonance image (MRI) data of local cortical thickness, surface area, and gray matter volume in all the subjects (29 homosexual and 29 heterosexual men, 17 homosexual and 17 heterosexual women). Statistical maps were generated using a general linear model (GLM) using FreeSurfer's Query, Design, Estimate, Contrast (QDEC) interface. We had sexual orientation and gender as 2 discrete factors with 2 levels, allowing for the generation of the interaction between sexual orientation and gender: homosexual women and heterosexual men versus heterosexual women and homosexual men. Coordinates were in Talairach space. All the cluster sizes were calculated with a P value of 0.01.ResultsResults revealed interactions concerning the area and gray matter volume between the factors of sexual orientation and gender. Regarding the thickness, an interaction was not found in any regions of the clusters. Regarding the area, an interaction was found in region of left middle temporal lobe, inferior temporal lobe, lateral occipital lobe, fusiform [(-58.1, -38.6, -14.7), maximum vertex-wise (MV) log10(P) =3.30, cluster size (CS) =1,286.90 mm2], and left rostral middle frontal lobe, pars opercularis, caudal middle frontal lobe [(-37.3, 23.6, 24.8), MV log10(P) =2.92, CS =1,194.40 mm2]. Regarding the gray matter volume, an interaction was found in the region of the left pars opercularis (inferior frontal gyrus) [(-42.9, 6.3, 18.5), MV log10(P) =1.31, CS =526.79 mm2].ConclusionsThe present study extends our understandings of how structural features differ in homosexual men, heterosexual men, homosexual women, and heterosexual women. Furthermore, it highlights the interactions between sexual orientation and gender in the left inferior frontal gyrus, bilateral temporal lobe, and the right rostral anterior cingulate cortex, which are suggested to play a critical role in the sexual differentiation of the human brain.

This study aims to evaluate the impacts of COVID-19 on cognitive functions in recovered patients and its relationship with inflammatory profiles. Twenty-nine patients recovered from COVID-19 as confirmed by negative nucleic tests for two consecutive times were recruited. A total of 29 age-, gender- and education-matched healthy controls were also recruited. The cognitive functions of all subjects were evaluated by the iPad-based online neuropsychological tests, including the Trail Making Test (TMT), Sign Coding Test (SCT), Continuous Performance Test (CPT), and Digital Span Test (DST). Blood samples from all patients were collected for examining inflammatory profiles, including interleukin-2 (IL-2), IL-4, IL-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and C-reactive protein (CRP). The relationship between cognitive functions and inflammatory profiles were analyzed by Pearson correlation. In results, although no significant differences were found in TMT, SCT, and DST between the two groups, patients with COVID-19 scored lower in the correct number of the second and third parts of CPT, they also scored higher in the missing number of the third part of CPT (all P < 0.05). In patients with COVID-19, there was a trend of significant difference for lower reaction time in the first and second parts of CPT (P = 0.050, and 0.051, respectively), as well as the lower correct number of the second part of CPT (P = 0.050). Correlation analysis showed that the reaction time for the first and second parts of CPT was positively correlated with the CRP levels (r = 0.557 and 0.410, P < 0.05). In conclusion, our findings indicated that cognitive impairments exist even in patients recovered from COVID-19, and might be possibly linked to the underlying inflammatory processes.

Abstract Background: This is an intervention study which explores the effect of using virtual reality supermarket training system (VRSTS) to improve cognitive function deficiency and clinical symptoms in Han Chinese patients with schizophrenia in the remission stage. Methods: 68 patients with schizophrenia in the remission stage were recruited for the interventional study and were randomly allocated to either virtual reality training (VRT) group or treatment-as-usual (TAU) group. For VRT group, patients received training with VRSTS for two weeks and antipsychotic treatment as usual while TAU group only received antipsychotic treatment as usual. Cognitive function and clinical symptoms before and after intervention were assessed by MATRICS Consensus Cognitive Battery (MCCB), Positive and Negative Syndrome Scale (PANSS), and the Personal and Social Performance Scale (PSP). Results: Results showed (1) VRSTS could improve MCCB composite scores and 4 out of 7 cognitive domains: speed of processing, working memory, visual learning, reasoning and problem solving, and (2) VRSTS could alleviate general psychopathology symptoms of PANSS but did not exert effects on positive and negative symptoms among patients with schizophrenia in the remission stage Conclusion: A therapeutic effect of VRSTS was observed in patients with schizophrenia in the remission stage. It may improve cognitive impairment and general psychopathology symptoms.

BACKGROUND:Novel coronavirus disease 2019 (COVID-19) was first found in Wuhan, China, and it has rapidly spread worldwide since the end of 2019. There is an urgent need to treat the physical and psychological aspects of COVID-19. Interpersonal psychotherapy (IPT)-based psychological intervention is an evidence-based therapy for depression and post-traumatic stress disorder.CASE SUMMARY:This report describes a case of COVID-19 in a patient who transmitted the disease to his entire family. The patient received four sessions of IPT-based psychological intervention. We used the Hamilton Rating Scale for Depression and Patient Health Questionnaire to measure depression level, and the Hamilton Anxiety Scale and Generalized Anxiety Disorder to measure anxiety among the patients.CONCLUSION:This case shows that IPT-based therapy can reduce COVID-19 patient depression and anxiety and the advantage of IPT-based therapy.

During the last decade, the problem of suicide has become more serious in individuals with depression. Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for major depressive disorder (MDD). This study aims to investigate the efficacy of magnetic resonance imaging (MRI)‐based neuronavigation‐guided daily high‐dose rTMS for rapidly improving suicidal ideation in treatment‐naive patients with MDD. In the present 1‐week double‐blind study, 42 treatment‐naive patients with MDD with suicidal ideation were randomly assigned to the treatment of escitalopram oxalate tablets (10 mg/d) in combination with either active (n = 21) or sham (n = 21) rTMS. The TMS coil was positioned over a specified target location (−44, 40, and 29) in left dorsolateral prefrontal cortex based on MRI data. The severity of suicidal ideation was measured by the Beck Scale for Suicide Ideation (BSI). The 24‐item Hamilton Depression Rating Scale (HAMD‐24) and Montgomery–Åsberg Depression Rating Scale (MADRS) were utilized to assess the severity of depression. The Wisconsin Card Sorting Test, Continuous Performance Test, and Stroop Color–Word Test were adopted to assess executive function. In contrast to the sham group, the active rTMS group showed a significantly greater BSI score reduction at the third day and the seventh day (P < 0.001). Moreover, the active rTMS group showed a significantly greater HAMD (P < 0.001) and MADRS (P < 0.001) score reduction at the seventh day in comparison to the sham group. The present findings suggested that the neuronavigation‐guided high‐dose rTMS may be a novel method to rapidly reduce suicidal ideation and mitigate depressive symptoms.

At the end of 2019, a new form of pneumonia disease known as the corona virus disease 2019 (COVID-19) rapidly spread throughout most provinces of China, and the total global number of COVID-19 cases has surpassed 500 000 by Mar. 27, 2020 (WHO, 2020). On Jan. 30, 2020, the World Health Organization (WHO) declared COVID-19 a global health emergency (WHO, 2020). COVID-19 causes most damage to the respiratory system, leading to pneumonia or breathing difficulties. The confirmed case fatality risk (cCFR) was estimated to be 5% to 8% (Jung et al., 2020). Besides physical pain, COVID-19 also induces psychological distress, with depression, anxiety, and stress affecting the general population, quarantined population, medical staff, and patients at different levels (Kang et al., 2020; Xiang et al., 2020). Previous research on patients in isolation wards highlighted the risk of depressed mood, fear, loneliness, frustration, excessive worries, and insomnia (Abad et al., 2010).

BackgroundSexual orientation has been suggested to affect executive function, of which the neurobiological basis is still largely unknown. In this study, we explored the interrelationship between neuropsychological characteristics in homosexual and heterosexual men and their anatomical connectome by graph theoretical analysis.MethodsFifty-three homosexual and 47 heterosexual males underwent diffusion tensor magnetic resonance imaging (MRI) and neuropsychological assessments. Whole-brain anatomical networks were constructed using white matter tractography, performed on the diffusion tensor imaging data. Neuropsychological tests included the Wisconsin Card Sorting Test (WCST), the Continuous Performance Test (CPT) and the Trail-Making Test (TMT).ResultsThe cognitive performance of homosexual men was significantly poorer than their heterosexual counterparts in terms of WCST total correct responses. Anatomical connectome analysis revealed a lower (P=0.001) anatomical connectivity between left PoCG and left SMG (P=0.003) in homosexual men as compared to heterosexual men. Linear regression analyses showed that the WCST total correct responses score was significantly linked with sexual orientation (P=0.001). The anatomical connectivity strength between left PoCG and left SMG was also shown to be significantly correlated with sexual orientation (P=0.039) and education (P=0.047).ConclusionsOur study demonstrated the differences in the performance of WCST and anatomical connectome of large-scale brain networks between homosexual and heterosexual men, extending our understanding of the brain's circuitry and the characteristics of executive function in men of different sexual orientation.

This study aims to characterize the gut microbiota in depressed patients with bipolar disorder (BD) compared with healthy controls (HCs), to examine the effects of quetiapine treatment on the microbiota, and to explore the potential of microbiota as a biomarker for BD diagnosis and treatment outcome. Analysis of 16S-ribosomal RNA gene sequences reveals that gut microbial composition and diversity are significantly different between BD patients and HCs. Phylum Bacteroidetes and Firmicutes are the predominant bacterial communities in BD patients and HCs, respectively. Lower levels of butyrate-producing bacteria are observed in untreated patients. Microbial composition changes following quetiapine treatment in BD patients. Notably, 30 microbial markers are identified on a random forest model and achieve an area under the curve (AUC) of 0.81 between untreated patients and HCs. Ten microbial markers are identified with the AUC of 0.93 between responder and nonresponder patients. This study characterizes the gut microbiota in BD and is the first to evaluate microbial changes following quetiapine monotherapy. Gut microbiota-based biomarkers may be helpful in BD diagnosis and predicting treatment outcome, which need further validations.

产妇分娩后的盆底肌康复一直是临床关注焦点,而产妇在产后极易表现出盆腔底部肌力异常,应针对性开展预防及康复措施.盆腔底部肌肉功能训练的最佳时间应在产妇完成分娩后6周内进行,若未及时开展康复训练,盆底肌肉功能障碍可演变为中重度盆腔底部功能异常.本文对盆腔底部功能障碍产妇开展了盆腔底部肌肉康复锻炼辅以生物反馈性电刺激疗法,并对效果进行总结.