Adolescence is a sensitive period for the emergence of subclinical psychotic experiences, including paranoid ideation. Understanding their developmental course in relation to common mental health difficulties such as anxiety, is important for clarifying etiological processes and potential progression to clinical psychosis. This study longitudinally examined the possible bidirectional relationship between anxiety and paranoia assessed in a Virtual Reality setting in adolescents aged 12 to 18 and the role of childhood threat experiences, as part of the EMBRACE study. Data were collected in two waves, 18 months apart at baseline. State paranoia was assessed using the State Social Paranoia Scale (SSPS) in two distinct Virtual Reality (VR) environments. Anxiety was measured with the Revised Children’s Anxiety and Depression Scale (RCADS25), while childhood threat exposure was evaluated using the Juvenile Victimization Questionnaire (JVQ). Linear and multiple regression analyses were conducted to examine associations and moderation effects. At baseline, 120 adolescents participated, of whom 97 completed both waves. State paranoia in a school canteen VR environment at baseline significantly predicted state paranoia in a VR bar environment 18 months later (β = 0.45, SE = 0.10, p < 0.001). Similarly, anxiety at baseline strongly predicted anxiety at follow-up (β = 0.46, SE = 0.10, p < 0.001), but no associations were found between state paranoia and anxiety over time in either direction. Childhood threat exposure moderated the relationship between baseline state paranoia and anxiety at follow-up (β = -0.17, SE = 0.06, p = 0.009), with adolescents experiencing higher state paranoia and threat exposure at baseline showing lower anxiety at follow-up. In contrast, the interaction between Wave 1 anxiety and Wave 1 childhood threat exposure in predicting follow-up state paranoia was non-significant (β = –0.17, SE = 0.11, p = .117). VR can capture subtle paranoid ideation in ecologically valid, dynamic social interactions that are consistent over time and across different VR environments. The developmental trajectories of paranoia and anxiety may diverge depending on childhood threat exposure, highlighting the role of early adversity in shaping their interplay.

OBJECTIVE:We aimed to synthesize the evidence on confusional states and neurocognitive changes associated with the concurrent use of lithium and electroconvulsive therapy (ECT). METHODS:We conducted a systematic search of PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, CINAHL, PsycArticles, and clinical trials registries up to September 2025. Eligible studies compared the incidence of confusional states or changes in neurocognitive test scores in patients receiving lithium and ECT (Li-ECT) and those receiving ECT without lithium. We performed separate meta-analyses and calculated odds ratios (OR) with 95% confidence intervals (CI) for dichotomous outcomes and standardized mean differences (SMD) for continuous outcomes. Additionally, case reports describing cognitive effects of Li-ECT were synthesized. RESULTS:Sixteen studies were included: 11 studies (n = 66,156) assessed confusional states and five (n = 341) evaluated neurocognitive changes. The Restricted Maximum-Likelihood meta-analysis showed no significant association between lithium use and confusional states (OR 2.09; 95% CI: 0.94-4.66; p = 0.07), whereas a Paule-Mandel sensitivity analysis suggested a significant association (OR 2.38; 95% CI: 1.20-4.74; p = 0.01). No significant differences were observed in changes in global cognitive functioning, autobiographical memory or verbal fluency test scores ([SMD = 0.25; 95% CI: -0.98-1.49; p = 0.69], [SMD = 0.27; 95% CI: -1.37; 1.9; p = 0.75], [SMD = -0.89; 95% CI: -3.18; 1.39; p = 0.44]). CONCLUSION:Current evidence does not show a significant increase in cognitive side effects associated with lithium use during ECT. However, methodological limitations, sensitivity to meta-analytic assumptions and clinical heterogeneity preclude definitive conclusions. Large prospective studies using standardized cognitive assessments are needed to confirm the tolerability of concurrent lithium and ECT use. While our findings support the cautious continuation of lithium during ECT, individualized clinical decision-making remains crucial to maximize efficacy and minimize cognitive burden.

Amnestic mild cognitive impairment (aMCI) represents a prodromal stage of Alzheimer’s disease and carries a high risk of progression to dementia. Disruptions in functional brain networks, synaptic degeneration, and tau pathology each serve as neural markers of cognitive decline in aMCI. In this study, we employed a multimodal neuroimaging approach to determine whether integrating these markers provides a more powerful explanation of cognitive deterioration than examining them individually. Twenty-eight aMCI patients and 24 healthy controls underwent cognitive assessment, resting-state fMRI, 11C-UCB–J PET (synaptic density), and 18F-MK-6240 PET (tau). Eighteen aMCI patients were reassessed after 2 years. Graph-theoretical measures of network topology were derived, and linear regression models were used to examine whether combining functional, synaptic, and tau markers improved prediction of cognitive decline in aMCI. Longitudinal changes in right hippocampal characteristic path length, synaptic density, and tau accumulation jointly predicted decline in delayed memory recall, achieving a higher predictive performance (adjusted R2 = 0.753) than unimodal models (adjusted R2 range: − 0.009–0.421), with reduced overfitting degree. Multimodal neuroimaging integrating functional network topology, synaptic density, and tau burden improves prediction of memory decline in aMCI. These findings highlight complementary neural processes underlying progression and support multimodal imaging as a valuable approach for monitoring in prodromal Alzheimer’s disease.

BACKGROUND:Reduced hippocampal volumes are frequently observed in psychiatric disorders and have been linked to childhood adversity. Conversely, physical activity is associated with increased hippocampal volumes. This study aimed to integrate these risk and protective factors in young people by examining both group-level differences and dimensional associations. METHODS:We investigated the associations between hippocampal subfield volumes, early-stage psychiatric symptoms, childhood adversity and cardiorespiratory fitness as a proxy measure for long-term physical activity (VO2max/kg), using multi-level models. The sample included 122 participants aged 16-24 years, categorized into a symptom and healthy control group. A transdiagnostic approach was employed to capture the heterogeneous and pluripotent nature of early-stage symptomatology. RESULTS:No significant group differences in overall or subfield hippocampal volumes were observed between participants with early-stage psychiatric symptoms and healthy controls. However, within the symptom group, reduced CA1 subfield volumes showed clear associations with more childhood adversity, depressive and PTSD symptoms. In contrast, cardiorespiratory fitness was associated with greater right CA1 volume. Moreover, the negative association between depressive symptoms and overall hippocampal volume was moderated by cardiorespiratory fitness, being significant only in individuals with low fitness levels. CONCLUSIONS:These findings indicate that the CA1 volumetric variation may be influenced by environmental risk and protective factors. Future research should explore these dynamics longitudinally, accounting for the type, severity and duration of both psychiatric symptoms and childhood adversity.

BACKGROUND: Digital self-monitoring tools, such as the Experience Sampling Methods (ESM), can be used to support mental health delivery and improve individuals’ self-management. However, like many digital health interventions, ESM tools struggle to achieve routine implementation into clinical practice and decision making. Existing habits are major predictors of the adoption of new technologies. Examining individuals’ technology and self-monitoring habits can therefore inform the implementation of digital self-monitoring tools in mental healthcare.OBJECTIVES: This study examines the adoption potential of digital self-monitoring tools among mental healthcare service users across four European countries, by (1) identifying and quantifying user type patterns in self-monitoring behavior and technology usage, and (2) examining whether user types differ in terms of demographic characteristics, attitudes towards technology, and psychiatric diagnosis. METHODS: A latent class analysis was performed on data from 435 mental healthcare service users participating in an anonymous online survey across Belgium, Germany, Scotland, and Slovakia. Multinomial logistic regression was used to examine how class membership was associated with different covariates. RESULTS: Findings showed that while only one-fourth of participants had experience with digital self-tracking, the majority of mental healthcare service users were interested in self-tracking. Based on self-tracking and technology use habits, four classes of users were identified; the ‘’digital trackers’’, the ‘’non-digital trackers’’, the ‘’interested non-trackers’’, and the ‘’non-interested non-trackers’’. Covariate analysis suggests that older and less educated individuals might require more support and guidance to utilize digital self-monitoring tools. Furthermore, lower preferences for task-switching and lower positive attitudes toward technology might explain why some individuals do not use digital self-monitoring tools. CONCLUSION: To enable better uptake, implementation approaches should be tailored to meet the needs and preferences of different types of users. Future research should aim to develop a more in-depth understanding of drivers and barriers experienced by members belonging to the different classes.

BACKGROUND:Depression is increasingly understood as a complex dynamic network of individual depressive symptoms that change over time and are causally related to each other. Directed dynamic time warping (DTW) is a novel method for examining the temporal pattern of symptom change, hereby identifying symptoms that tend to remit earlier and those that improve at later stages of treatment. We compared directed depressive symptom dynamics across psychotherapy, pharmacotherapy and electroconvulsive therapy (ECT). METHODS:Time series data from three observational studies (on ECT) and two randomized trials (one on pharmacotherapy and one on psychotherapy) were included, comprising a total of 549 patients. Across these cohorts, individual depressive symptoms were assessed using validated depressive symptom rating scales. Time series data were analyzed using DTW to calculate a directed symptom network yielding the temporal lead or temporal lag for each symptom. RESULTS:Patients were on average 62 years old and 60% were female. The dynamic symptom changes were largely similar across all treatment modalities. Somatic symptoms and suicidal ideation showed significant temporal lead, indicating that remission of these symptoms tended to precede remission of other symptoms. Mood symptoms showed the strongest temporal lag values, suggesting that remission of these symptoms tended to occur last during treatment. CONCLUSION:The current results suggest that improvements in depressive mood symptoms are preceded by improvements in somatic symptoms and suicidal ideation, irrespective of treatment modality. This may have some important clinical implications. Future research, however, should elucidate whether baseline symptom severity affects the directed DTW network.

OBJECTIVE:For decades, a persistent claim has been that autobiographical memory loss after electroconvulsive therapy (ECT) for depression might actually contribute to ECT efficacy by reducing or even eliminating autobiographical memories. To test this claim, the primary aim of this study is to examine the association between autobiographical memory loss and remission of depression. The hypothesis is that remitted patients have more autobiographical memory loss after ECT compared to non-remitted patients. METHODS:In 71 patients with major depressive disorder undergoing ECT, autobiographical memory consistency (Kopelman Autobiographical Memory Interview) and depression severity (Montgomery-Åsberg Depression Rating Scale) were assessed before and within 1 week after treatment. Logistic regression analyses were conducted to examine the association between both autobiographical memory loss (i.e., memory consistency) and remission (MADRS < 10), including age, episode duration, baseline MADRS score, and treatment condition as covariates. RESULTS:All logistic regression models were significant. The overall autobiographical memory consistency-score (OR = 1.072, 95% CI [1.018-1.130], p = 0.009) and the consistency-score for recent memories (OR = 1.043, 95% CI [1.006-1.082], p = 0.021) were significantly associated with the odds of remission but in the opposite direction of the hypothesis. A higher age and shorter episode duration further increased the likelihood of remission. Additionally, post hoc analyses showed that the trajectories of autobiographical memory performance over time differed between remitters and non-remitters, indicating a slight decrease in autobiographical memories for more recent events in non-remitters and no change in remitters. CONCLUSIONS:This study shows that, contrary to the hypothesis, remitted patients have less autobiographical memory loss, particularly for recent memories than non-remitters. This refutes the premise that the loss of autobiographical memories contributes to the therapeutic effectiveness of ECT.

Background:Adolescence and early adulthood represent critical periods for the emergence of psychiatric symptoms, often spanning multiple symptom dimensions. Alterations in fear learning and generalization are implicated in anxiety-related disorders, yet research on these processes in youth with early-stage transdiagnostic psychiatric symptoms remains limited. Methods:This study investigated fear learning and generalization in youth aged 16-24 years with transdiagnostic psychiatric symptoms (anxiety, depressive, and psychotic), as indexed by US expectancy ratings. Additionally, considering the modulatory impact of exercise on memory processes, we explored the effects of a 10-minute moderate-intensity exercise intervention using a randomized between-subject design. Results:Contrary to hypotheses, the symptom group did not show impaired threat-safety discrimination or overgeneralization of fear. However, they exhibited elevated overall threat expectancy during generalization, suggesting that a bias in threat expectancy could represent an early vulnerability in threat processing. Dimensional analyses point to subtle symptom-specific differences in generalization patterns, underscoring the importance of modeling continuous symptom severity alongside group-based comparisons. No significant effects of acute exercise on fear acquisition or generalization were observed. Conclusion:These findings highlight early alterations in threat processing in youth with early-stage psychiatric symptoms. Future research should investigate symptom-specific patterns in fear generalization, track their longitudinal development, and refine exercise interventions to effectively modulate fear processing.

Background Late-life depression (LLD) is characterized by medial temporal lobe (MTL) abnormalities. Although gray matter (GM) and white matter (WM) differences in LLD have been reported, few studies have investigated them concurrently. Moreover, the impact of aetiological factors, such as neurodegenerative and cerebrovascular burden, on tissue differences remains elusive. Methods This prospective cross-sectional study involved 72 participants, including 33 patients with LLD (mean age 72.2 years, 23 female) and 39 healthy controls (HCs) (mean age 70.6 years, 24 female), who underwent clinical and positron emission tomography (PET)-magnetic resonance imaging (MRI) assessments. High-resolution 3D T1-weighted and T2-weighted FLAIR images were used to assess MTL GM volumes and white matter hyperintensities (WMHs), a proxy for cerebrovascular burden. Diffusion kurtosis imaging metrics derived from multishell diffusion MRI data were analyzed to assess WM microstructure in the following MTL bundles reconstructed using constrained spherical deconvolution tractography: uncinate fasciculus, fornix, and cingulum. Standardized uptake value ratio of 18F-MK-6240 in the MTL was used to assess Alzheimer’s disease (AD) type tau accumulation as a proxy for neurodegenerative burden. Results Compared to HCs, patients with LLD showed significantly lower bilateral MTL volumes and WM microstructural differences primarily in the uncinate fasciculi bilaterally and right fornix. In patients with LLD, higher vascular burden, but not tau, was associated with lower MTL volume and more pronounced WM differences. Conclusions LLD was associated with both GM and WM differences in the MTL. Cerebrovascular disease, rather than AD type tau-mediated neurodegenerative processes, may contribute to brain tissue differences in LLD.

Introduction: Olfaction plays an important role in different aspects of our daily functioning and there is a positive correlation between olfactory dysfunction (OD) and depressive symptoms. Multiple parts of the brain are involved in both olfaction and the origin of depressive symptoms, e.g. amygdala and hippocampus. Olfactory training (OT) is one of the main therapeutic options in the management of OD. The objective of our study is to look at the prevalence of depressive symptoms in patients with olfactory disorders and to examine the effect of OT on mood in patients who present with OD. Methods: We included patients who presented at the Ears-Nose-Throat outpatient clinic with subjective OD and were eligible for OT. At baseline and follow-up (3 to 6 months) olfactory function and depression were assessed respectively by a Sniffin’ Sticks test and the Quick Inventory of Depressive Symptoms questionnaire. Results: Our study revealed that 57 % of participants had mild to severe depressive symptoms at baseline. There was no correlation between the depressive symptoms and OD at baseline. From baseline to follow-up, there was a significant decline in depressive symptoms, but no significant changes in the olfactory function. In addition, there was no correlation between change in depression and change in olfactory function. Limitations: These results should be interpreted with caution because this is an observational pilot study with no placebo-controlled group and a small sample size. Further investigation is warranted.

Introduction Validated assessment tools for agitation in dementia are often time-consuming and require long-term caregiver observation, limiting use in acute settings. Quick and simple evaluations based on direct observation are sometimes needed. This study assessed the Richmond Agitation-Sedation Scale (RASS), a rapid, observation-based behavioral assessment tool in an acute setting, by comparing it to the Pittsburgh Agitation Scale (PAS). Methods This observational study included 37 patients admitted to an acute psychogeriatric unit. Nurses assessed behavior using RASS and PAS in an ecological momentary assessment protocol, completing 1486 paired observations. Correlations between scales and their responsiveness to sedative interventions were evaluated. Results Both scales correlated significantly (p <0.001), particularly for motor agitation, and effectively captured the effects of sedative interventions. Discussion The RASS shows promise as a complementary tool for behavioral assessment in acute dementia care. Its quick evaluation of arousal and sedation may complement the PAS's detailed focus on specific agitation types.

BACKGROUND:The premanifest stage in carriers of hexanucleotide repeat expansions in the C9orf72 gene (C9RE) is associated with memory impairment. The present study examines whether the impairment is general across domains or disproportionately affects specific stimulus categories such as socioemotional events, and its underlying functional neuroanatomy. METHODS:This task-based fMRI-study included 21 premanifest C9RE (preC9RE) carriers and 24 controls. Participants encoded stimuli of (emotional and neutral) faces and houses, followed by a recognition task. Using univariate and multivoxel pattern analyses at whole-brain level and region-of-interest level, we investigated the neural change during encoding and retrieval processes, as well as the neural pattern similarity between encoding and retrieval. RESULTS:Compared with controls, the preC9RE group demonstrated poorer performance in memorising faces (U=104, p=0.002), while their ability to memorise houses remained intact. The preC9RE group exhibited distinct neural patterns in the anterior insula during face encoding compared with the controls (accuracy>0.765, p<0.05). During face retrieval, the preC9RE group showed an increased neural response to encoded faces versus new faces in the right anterior insula (U=394, p=0.015). Individuals with preC9RE exhibited reduced encoding-retrieval neural similarity in the salience network specifically related to face stimuli (U=120, p=0.023). CONCLUSIONS:The findings reveal functional changes in the salience network related to impaired social memory at the premanifest stage of C9RE. The findings further underscore the high potential of multidimensional neural response patterns as a sensitive biomarker for neurodegenerative functional changes, and the salience network as biomarker for C9RE disease staging.

Motor signs are common in patients with a major depressive disorder (MDD) and associated with functional disability and falls. They appear to be more pronounced in patients with late life depression, but it is unclear whether this is caused by global brain aging or by a specific pathology associated with depression. We therefore sought to investigate associations between motor signs in late life depression and aging related changes in synapses, gray and white matter. From the monocentric Leuven Late Life depression study, we included 75 participants (41 healthy controls, 34 currently depressed MDD patients) aged ≥ 60 years. Motor assessment included the MDS-Unified Parkinson’s Disease Rating Scale part III (MDS-UPDRSIII), Scale for Assessment and Rating of Ataxia (SARA), gait analysis and digitized drawing. Brain synaptic vesicle glycoprotein 2A binding as a proxy for synaptic density was determined in predefined cortico-subcortical volumes of interest (VOI) using 11C-UCB-J PET in 62 participants (25 patients). Brain T1 and FLAIR MR images were used to quantify gray matter volume and white matter hyperintensity volume in 69 participants (32 patients). Multiple linear regression analyses were performed with motor outcome as the dependent variable, diagnosis and VOI 11C-UCB-J SUVR and their interaction, age, whole brain white matter hyperintensity volume and gray matter VOI as independent variables. The study demonstrated that patients had significant impairments on all motor assessments, compared to healthy controls. Specifically in patients, right globus pallidus synaptic density was associated with MDS-UPDRSIII score and drawing speed; thalamic gray matter volume predicted SARA score, gait and drawing speed; and white matter hyperintensity volume predicted MDS-UPDRSIII score. We conclude that motor signs in late life depression are associated with specific synaptic density and gray matter volume differences in basal ganglia-thalamic structures.

ObjectiveThere is ongoing concern about the possible negative impact of ECT on neuropsychological functioning, especially on autobiographical memory. In this study we aimed to identify the short- and long-term neuropsychological effects of ECT in the domain of memory.MethodsTwenty-eight patients aged 18 years and older with a unipolar or bipolar depression, referred for ECT, were eventually included. The neuropsychological test battery assessed verbal memory, verbal fluency, and autobiographical memory. The battery was administered prior to ECT, 1 week, and 3 months after the last ECT session. We compared the neuropsychological performances of our sample with normative data from a healthy population.ResultsAfter adjusting for covariates, performance on tasks assessing verbal memory, verbal fluency, and autobiographical memory showed a significant decline during ECT. However, test scores significantly improved following the completion of ECT. Additionally, patients with higher QIDS-CR scores consistently demonstrated lower performance on the verbal fluency task across all time points. No significant association was found between the total number of ECT sessions and changes in test scores during or after treatment. 3 months after ending ECT, cognitive functioning returned to pretreatment levels of performance. We found that patients with a depressive episode performed significantly worse on task measuring verbal memory and fluency at every time point as compared to a healthy population.ConclusionOur results show that a course of ECT in patients with a depressive episode influences verbal memory, autobiographical memory and verbal fluency. Neuropsychological performances significantly declined during ECT. Following ECT, neuropsychological performances, as compared to during ECT, were significantly improved and were equivalent to baseline. However, neuropsychological performance remains poor as compared to a healthy population.

AIMS:motor dysfunction, presenting as an altered quantity or quality of movements, is common in late life depression (LLD) but poorly understood. We characterized motor dysfunction with a multimodal clinical-experimental assessment and investigated associations with depressive symptoms, psychotropic medication and falls. METHODS:75 participants ≥60 yr., 34 patients with LLD and 41 healthy controls, from the Leuven LLD study completed affective, cognitive and motor assessments including the Montgomery-Åsberg Depression Rating Scale (MADRS), Apathy Evaluation Scale, mini-mental state examination, neuropsychological battery, parkinsonism scale (MDS-UPDRS part III), ataxia scale (SARA), speech and gait analysis. A digital tablet drawing task tracked how fast patients initiated and executed movements with variable complexity and cueing. Past year fall history was collected. Multiple linear regression analyses evaluated associations of motor outcome with assessments scores, depending on diagnostic group, with age, exercise frequency, education duration as covariates. Movement initiation and execution were investigated with linear mixed models including the same covariates. Psychotropic medication effects and statistical predictors of falls were analyzed in patients. RESULTS:patients (mean age 73.3 ± SD6.0 yr., MADRS 27.9 ± 11.1, 42 % fall incidence) performed worse than controls on all motor assessments which was overall not significantly associated with depression severity, apathy, cognitive dysfunction, antipsychotic or benzodiazepine use. Patients executed movements slower than controls, but movement initiation was similar if cueing was provided. Patients' SARA and gait outcome related to past year fall incidence. CONCLUSION:motor dysfunction in LLD patients was not clearly related to core depressive symptoms or cognitive dysfunction. Cueing may facilitate movement initiation in LLD. STUDY REGISTRATION:NCT03849417.

INTRODUCTION:Cognitive side effects, such as memory loss, associated with electroconvulsive therapy (ECT) have been extensively studied. However, knowledge about (sub)acute confusional states during ECT is limited, particularly in older adults with depression. Their incidence, recurrence, and co-occurrence remain unclear. This study aimed to describe the incidence, recurrence, co-occurrence, and clinical course of various subtypes of confusional states during ECT. METHODS:Data were derived from the 'Rivastigmine for ECT-induced Cognitive Adverse effects in Late-Life depression' (RECALL) prospective cohort study, involving 145 older adults (≥ 55 years) with a major depressive episode receiving ECT. We assessed different subtypes of confusional states: postictal and interictal delirium (PID and IID), postictal agitation (PIA), prolonged time to reorientation (TRO), and subacute general cognitive decline (Mini Mental State Examination decline ≥ 4 points) throughout the ECT course. RESULTS:Over half of the older adults (55.9%) experienced at least one subtype of confusional state during their ECT course. The most prevalent subtypes were PIA (29.5%) and prolonged TRO (28.3%), while postictal (5.9%) and interictal delirium (4.2%) were less common. Recurrence rates varied, with interictal delirium (66.7%) and prolonged TRO (50.0%) showing the highest rates compared to postictal delirium (12.5%). Notably, 18.0% of older adults experienced more than one subtype of confusional state during their ECT course, and these states could emerge at any time during the ECT course. CONCLUSION:This is the first study to comprehensively examine the clinical course of various subtypes of confusional states during ECT in older adults with depression Our findings reveal that confusional states are highly prevalent, heterogeneous, and may emerge at any time during the ECT course. Notably, since the instruments used were not designed to measure (subtypes of) confusional states during ECT, further research into the differentiation of (sub)acute confusional states is warranted. TRIAL REGISTRATION:EudraCT 2014-003385-24.

OBJECTIVE:To investigate whether tau accumulation is higher in late life depression (LLD) compared to non-depressed cognitively unimpaired (CU) older adults. To situate these findings in the neurodegeneration model of LLD by assessing group differences in tau and grey matter volume (GMV) between LLD, non-depressed CU and mild cognitive impairment due to Alzheimer's Disease (MCI). DESIGN:Monocentric, cross-sectional study. SETTING:University Psychiatric hospital, memory clinic and outpatient neurology practice. PARTICIPANTS:A total of 102 adults over age 60, of whom 19 currently depressed participants with LLD, 19 with MCI and 36 non-depressed CU participants completed neuropsychological testing and tau PET-MR imaging. MEASUREMENTS:PET-MRI: 18F-MK-6240 tracer SUVR for tau assessment; 3D T1-weighted structural MRI derived GMV in seven brain regions (temporal, cingulate, prefrontal and parietal regions); amyloid PET to assess amyloid positivity; Neuropsychological test scores: MMSE, RAVLT, GDS, MADRS. ANCOVA and Spearman's rank correlations to investigate group differences in tau and GMV, and correlations with neuropsychological test scores respectively. RESULTS:Compared to non-depressed CU participants, LLD patients showed lower GMV in temporal and anterior cingulate regions but similar tau accumulation and amyloid positivity rate. In contrast, MCI patients had significantly higher tau accumulation in all regions. Tau did not correlate with any neuropsychological test scores in LLD. CONCLUSION:Our findings suggest AD-type tau is not higher in LLD compared to non-depressed, cognitively unimpaired older adults and appears unlikely to contribute to lower gray matter volume in LLD, further underscoring the need to distinguish major depressive disorder from depressive symptoms occurring in early AD.

This pilot study aimed to test a comprehensive experience sampling method (ESM) protocol for investigating the relationship between stress and personality functioning (PF) in the daily lives of outpatients diagnosed with borderline personality disorder (BPD). Participants (N = 22) responded to a 32-item ESM questionnaire 10 times a day for 1 week while wearing two stress detection devices. Results showed that the protocol was feasible. There was a high level of compliance (i.e. average of 85%), and no serious adverse events. The main indices, that is, Stress and PF, demonstrated acceptable to excellent internal consistency and provisional evidence for their validity. We found that 64% of the variability in PF was due to within-subject differences. Mixed modelling showed that the momentary changes in stress (p < .001) and body position (i.e. active vs passive; p < .001) explained an estimated 46% of this within-subject variance. We found no significant within-subject effects when we used parameters of autonomic nervous system (ANS)-activity as predictors. Data loss during recording and artefact detection of electrophysiological data were substantial but not related to momentary changes in PF. The preliminary findings suggest that PF is a volatile aspect of personality pathology and that there is a strong, concurrent relationship between stress and PF in daily life. This pilot study constitutes the first demonstration of PF fluctuations within a clinical sample and initiates an examination of their association with ANS activity.