Background: Bipolar disorder (BD) is characterized by persistent cognitive deficits. These deficits contribute to functional impairment and often respond poorly to pharmacotherapy. Although deep transcranial magnetic stimulation (dTMS) has demonstrated antidepressant efficacy, there is limited knowledge about its cognitive effects and comprehensive clinical performance in BD. In this study, we assessed the cognitive outcomes, clinical efficacy, and safety of H1-coil dTMS in BD patients. Methods: In this randomized, double-blind, sham-controlled trial, 100 inpatients with BD received 4 weeks of active or sham H1-coil dTMS. The MATRICS (Measurement and Treatment Research to Improve Cognition in Schizophrenia) Consensus Cognitive Battery (MCCB) was used to investigate the cognitive function, and the 17-item Hamilton Depression Rating Scale (HDRS-17) was used to assess depressive symptoms from baseline to week 4. Results: Both groups, active and sham dTMS, showed significant cognitive improvements across most domains (p < 0.05), with no statistically significant between-group differences (all p > 0.05). At the endpoint, the active dTMS group showed statistically significantly lower HDRS-17 scores and a higher response rate than the sham group (mean difference = 2.94, 95% CI [0.10, 5.78], p = 0.04); 50% vs. 24%; OR = 3.17, 95% CI [1.35, 7.44], p = 0.007). All treatments demonstrated a favorable safety profile, with only mild and transient adverse effects. Conclusions: In patients with BD, active dTMS was well-tolerated and was associated with a higher response rate and statistically significant (albeit modest) lower depressive symptom scores compared to sham stimulation, without inducing cognitive adverse effects. However, no specific cognitive benefit beyond its antidepressant effect was established. Overall, these results indicate that dTMS has potential as an adjunctive treatment option for bipolar depression, particularly when medications are limited or poorly tolerated. Clinical Trial Registration: NCT06524505. Registered 23 July, 2024, https://clinicaltrials.gov/study/NCT06524505.

The human brain is a dynamic neural system with time-varying functional connectivity (FC) strengths between brain regions. Evidence indicates that adolescents with major depressive disorder (MDD) exhibit decreased average FC strength in cognitive tasks. Nevertheless, research focused on dynamic FC analysis in this population remains limited. This study aims to identify cognitive task-related dynamic FC features as valuable biomarkers to characterize clinical symptoms in adolescents with MDD. A total of 83 adolescents with MDD and 78 age/sex-matched healthy controls (HCs) were recruited. We utilized functional near-infrared spectroscopy (fNIRS) to record brain functional data from participants while they performed the verbal fluency task (VFT). An analytical framework for fNIRS data was proposed, in which the average FC strength values over the entire VFT duration and the principal components (PCs) of dynamic (time-varying) FC strength values were extracted as static and dynamic FC features, respectively. A random forest model was built to distinguish adolescents with MDD from HCs. Statistical analyses of the FC features were conducted to identify between-group differences, as well as their relationships with clinical symptoms in adolescents with MDD. The random forest model achieved an accuracy of 86.32

Purpose: We aimed to verify the impact of functional remediation (FR) on serum brain-derived neurotrophic factor (BDNF) and tyrosine kinase receptor B (TrkB) levels, to explore the biomechanism of FR intervention in patients with euthymic bipolar disorder (BD). Patients and Methods: This is a randomized controlled, 12-week intervention study with participants randomized into the FR group (n=39) and the treatment as usual group (TAU, n=42) at the 11 ratio. 17-Hamilton Depression Rating Scale-17 (HDRS-17), Young Mania Rating Scale (YMRS), and Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) were used to assess affective symptoms and cognitive functioning both at baseline and week 12, respectively. Meanwhile, we collected blood samples (10 milliliters) from all participants for determination of serum BDNF/ TrkB levels both at baseline and week 12. After baseline assessment, all participants received FR or TAU treatments, respectively. Results: Our results showed significant decreasing in HDRS-17 and YMRS scores, increasing in serum BDNF and TrkB levels in both groups over 12 weeks (all p's< 0.05). There were no group differences in the HDRS-17 and YMRS scores (all p's> 0.05), but the FR group showed greater increasing in serum BDNF and TrkB levels than those in the TAU group (all p's< 0.05). In terms of cognition, the change in serum BDNF levels was negatively correlated with changes in Mazes test, and the improved TrKB levels were associated with improved Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT) in the FR group (all p's< 0.05). Conclusion: The changes in serum BDNF and TrkB levels may be implicated in the mechanisms underlying FR intervention in euthymic patients with BD. Limitation: A longer follow-up period than 12 weeks and set up healthy controls may make the results more convincing, and the sample size of this study is still insufficient.

Purpose:Major depressive disorder (MDD) is associated with worse cognitive functioning. We aim to examine the association between baseline cognitive functioning and the reduction rate in HDRS-17 total scores and to highlight the predictors of the reduction rate in HDRS-17 total scores in MDD with first-episode, drug-naïve (FED) patients.Patients and Methods:Ninety FED patients were recruited consecutively and evaluated using the 17-item Hamilton Depression Rating Scale (HDRS-17), the 14-item Hamilton Anxiety Scale (HAMA-14), the Functioning Assessment Short Test (FAST) and the MATRICS Consensus Cognitive Battery (MCCB) at baseline and again at week 8.Results:Eighty-four FED patients completed the study. Comparison showed that response group had significantly higher T scores in TMT-A, BACS-SC, WMS-III, BVMT-R, MSCEI and CPT-IP, but showed significantly lower scores in FAST total scores including autonomy, occupational functioning, cognitive functioning, interpersonal relationship than non- response group (all p's< 0.05). Partial correlation analysis also found that the reduction rate in HDRS-17 total scores could be negatively associated with autonomy, cognitive functioning and interpersonal relationship domains as well as total FAST scores, also was further positively associated with T-scores of BACS-SC, CPT-IP and MSCEI in MCCB, even when accounting for potential confounders. Furthermore, the levels of cognitive function domain, autonomy domain in FAST, and BACS-SC, CPT-IP in MCCB may predict the reduction rate in HDRS-17 total scores in FED patients (all p's< 0.05).Conclusion:Our findings underscore significant correlations between baseline functioning and the reduction rate in HDRS-17 total scores in FED patients. Moreover, better baseline cognitive function, autonomy, speed of processing and attention/vigilance are more likely to predict patients' response to antidepressant treatment, indicating pre-treatment better cognitive functioning may be predictors to treatment response in FED.

目的 探索惊恐障碍患者儿茶酚胺-O-甲基转移酶(catechol-O-methyltransferase,COMT)基因多态性(rs4680、rs740603)与艾司酞普兰疗效的关系.方法 纳入惊恐障碍患者69例,正常对照78名.患者组使用艾司西酞普兰固定剂量10 mg/d连续治疗8周,分别在基线及第2、4、8周使用汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)评估焦虑症状.采用基质辅助激光解吸飞行时间质谱(MALDI-TOF-MS)对所有被试COMT基因rs4680、rs740603位点进行基因分型.结果 患者组与对照组两位点基因型和等位基因分布无统计学差异(P>0.05).患者治疗第8周时,rs4680的G/G基因型患者HAMA减分率(72.52％±11.38％)大于A/G基因型患者(60.70％±16.25％),差异有统计学意义(P<0.05).在第2、8周时rs4680不同基因型患者焦虑症状治疗有效率差异有统计学意义(P<0.05).rs740603不同基因型患者HAMA减分率无统计学差异(P>0.05).结论 COMT基因多态性在艾司西酞普兰对惊恐障碍焦虑症状改善中可能有作用.

Introduction: The aims of our study are: i) to explore whether plasma levels of BDNF/GDNF are valuable in the diagnosis of first-episode depression; ii) to discuss whether there is an association between peripheral plasma levels of BDNF/GDNF and patients' depression severity and cognitive dysfunction; iii) to explore the association between plasma levels of BDNF/GDNF and the effectiveness of antidepressant treatment.Methods: Ninety patients with first-episode unmedicated MDD and healthy controls were recruited. MDD patients were treated with antidepressant medication for 8 weeks. Patients were assessed for clinical symptoms using HDRS-17 and HAMA-14. Social and neurocognitive functioning of all subjects was assessed at baseline using the Functional Assessment Test Short Form (FAST) and the MATRICS Consensus Cognitive Battery (MCCB). At the same time, peripheral venous blood was drawn from all subjects for BDNF/GDNF peripheral plasma level analysis at baseline and after 8 weeks of treatment.Results: The baseline BDNF/GDNF levels in MDD patients were significantly lower than that in healthy controls. The area under ROC curve (AUC) of baseline plasma BDNF and GDNF levels predicting MDD was 0.776 (95 % CI: 0.705-0.846, p < 0.001) and 0.864 (95 % CI: 0.808-0.920, p < 0.001), respectively. The baseline GDNF level (beta = 0.425, p = 0.001), the autonomy score of FAST (beta =-0.247, p = 0.037) and BACS-SC score of MCCB (beta = 0.323, p = 0.039) were predictors of HDRS-17 reduction rate after 8 weeks' antidepressant treatment.Limitations: A longer follow-up period than 8 weeks may make the results more convincing, and the sample size of this study is still insufficient.Conclusion: The decreased plasma levels of BDNF and GDNF are strong indicators for predicting the occurrence of MDD. This preliminary finding highlighted the value of GDNF plasma concentrations in the diagnosis of MDD and the prognosis of antidepressant treatment.

BackgroundBrain-derived neurotrophic factor (BDNF) is a candidate for susceptibility locus of Panic disorder (PD). However, the findings about the role of the BDNF Val66Met variant in PD were not consistent. Till now, the relationship between BDNF Val66Met polymorphism and anxiety-related traits in PD patients has been rarely explored. This study aimed to explore the relationship among BDNF Val66Met polymorphism, plasma BDNF level and anxiety-related trait in Chinese PD patients.MethodThis multi-center study included 116 PD patients and 99 health controls. We detected single-nucleotide polymorphism (SNP) of BDNF rs6265 (Val66Met) and BDNF plasma level in the two groups. In addition, PD patients were administered the State-Trait Anxiety Inventory (STAI), Panic Disorder Severity Scale-Chinese Version (PDSS-CV) and Hamilton Anxiety Rating Scale (HAMA-14). Quantitative comparison of the differences of BDNF concentration among subjects with different genotypes and association between BDNF Val66Met genotype and trait anxiety were performed.ResultsThere were no significant differences in the genotype frequency (p = 0.79) or allele frequency (p = 0.88) between PD patients and health controls. BDNF plasma levels of PD patients were significantly lower than those in control group (p = 0.003). BDNF plasma levels of the Met/Met genotype were significantly lower than those of Val/Met genotype in PD patients (p = 0.033). PD patients carried Met/Met genotype showed significantly higher scores in STAI trait compared to those carried Val/Val genotype (p = 0.045) and Val/Met genotype (p = 0.018). STAI trait scores of PD patients with agoraphobia were significantly higher than those of patients without agoraphobia (p < 0.05). The ANCOVA showed that the dependent variable STAI trait score was significantly affected by factor “genotype” (Val/Val, Val/Met, Met/Met, p = 0.029), and covariate “agoraphobia” (p = 0.008). In this model, 11.5% of the variance of the STAI trait score was explained by the BDNF genotype. Contrast analysis showed STAI trait scores of Met/Met subjects were significantly higher than those of Val/Met (p = 0.018) and Val/Val individuals (p = 0.045).ConclusionWe found that anxiety trait was associated with the BDNF polymorphism in PD patients. BDNF Met/Met genotype may decrease plasma BDNF level and increase trait anxiety in panic disorder.

Background The aim was to explore the associations between clinical symptoms, demographic variables, social and neurocognitive functioning in euthymic patients with bipolar disorder (BD) stratified by subgroups of DSM-IV BD (type I (BD-I) and type II (BD-II)) and occupational status (employed/unemployed), and to highlight the significance of occupational status when assessing social and neurocognitive functioning in euthymic BD patients. Methods A total of 81 euthymic BD patients were participated in the study. The severity of the depressive and manic/hypomanic symptoms was measured using the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Young Mania Rating Scale (YMRS), respectively. Social functioning and neurocognitive functioning were evaluated by the Functioning Assessment Short Test (FAST) and neurocognitive measures, respectively. Results Employed BD patients displayed greater social functioning (autonomy, occupational functioning, interpersonal relationship domain) and better verbal learning performance and speed of processing than unemployed BD patients. The correlation between neurocognitive functioning and social functioning was stronger in the employed group than in the unemployed group. There were no significant differences in neurocognitive and social functioning between the BD-I and BD-II groups, and the correlation between neurocognitive functioning and social functioning was similar between the BD-I and BD-II groups. Conclusion Employed BD patients may present greater occupational functioning and interpersonal relationships, as well as better verbal learning performance and speed of processing.

Major depressive disorder (MDD) is characterized by heterogeneous clinical performance and neurocognitive impairment. It is important to explore the correlation between global functioning and regional homogeneity (ReHo)/amplitude of low-frequency fluctuation (ALFF) values in MDD patients. 67 first-episode, drug naïve MDD patients and 69 healthy subjects were enrolled in the study. The MATRICS Consensus Cognitive Battery (MCCB) and the Functioning Assessment Short Test (FAST) were used to assess functional impairment in patients. Brain activity was assessed using ReHo and ALFF measurements. The relationship between the clinical features and altered brain function was evaluated using correlation analysis. There were significant differences in the ReHo and ALFF values between MDD patients and healthy subjects. The reduction in ReHo in the left calcarine/lingual gyrus/cuneus was negatively correlated with occupational functioning and the total FAST scores. The reduction in ALFF in the right calcarine/lingual gyrus was positively correlated with the verbal learning aspects of the MCCB. These findings suggest that the altered brain function in the default mode network (DMN) may be related to functional impairments in patients with first-episode, drug naïve major depressive disorder.

目的 评估中文版Bell-Lysaker情绪识别任务(Bell-Lysaker emotion recognition task,BLERT)在中国成年重性抑郁障碍(major depressive disorder,MDD)患者中的信度和效度.方法 招募MDD患者125例,稳定期双相障碍(bipolar disorder,BD)患者69例,健康对照(healthy controls,HC)66名,使用中文版BLERT、中国面部表情图片系统(Chinese affective facial picture system,CAFPS)进行测评,其中83例MDD患者(66.4％)2周后完成重测.结果 中文版BLERT的内部一致性信度Cronbach'sα为0.78,重测信度组内相关系数为0.72(P<0.01);关联效度r为0.55(P<0.01),BLERT在MDD组与HC组间区分效度较高,最佳划界分为15分(此时敏感性为0.79,特异性为0.60);验证性因子分析显示7种基本情绪拟合良好(RMSEA=0.03,IFI=0.95,TLI=0.93,CFI=0.94).结论 中文版BLERT在中国成年MDD患者中具有可接受的信度和效度.

BACKGROUND:Major depression disorder (MDD) is often associated with cognitive impairment. The development of an accurate and effective battery to measure cognitive deficit is necessary for both research and clinical practice in MDD. Our study was designed to test the psychometric properties of the MATRICS Consensus Cognitive Battery (MCCB) in patients with MDD.METHOD:Forty-eight patients with MDD, forty-three euthymic patients with bipolar disorder (BD) and thirty-two remitted patients with schizophrenia (SCH) were recruited from Tianjin Anding Hospital in Tianjin, China. The MCCB, the Montreal Cognitive Assessment (MoCA) and the Hamilton Depression Rating Scale-17 (HDRS-17) were administered to assess cognitive impairment and depressive symptoms at both baseline and one month later.RESULT:Our findings showed that the MCCB had good internal consistency and acceptable reliability in Chinese MDD patients. Our findings revealed a high correlation between the MCCB and the MoCA, indicating good concurrent validity of the MCCB. Furthermore, the MCCB showed high discriminant ability between MDD patients and healthy controls, and a principal component analysis of the MCCB in MDD patients revealed four domains with acceptable internal structure.LIMITATIONS:We did not consider confounding factors, such as the course, severity of symptoms and medication treatments, which might bias the cognitive assessment. In addition, the use of the MoCA as a reference scale for mild cognitive impairment could weaken the concurrent validity of the MCCB in MDD patients.CONCLUSION:Our findings demonstrated that the MCCB may be clinically useful as a cognitive impairment rating battery in Chinese patients with MDD.

Objectives: Bipolar disorder (BD) is often associated with significant functional impairment. However, there is currently no valid and reliable instrument for this variable that is both brief and easy to administer in China. We thus aimed to evaluate the psychometric properties of the Chinese version of the Functioning Assessment Short Test (FAST) in Chinese adults with BD. Methods: In this sample of adult subjects, 176 with BD and 53 healthy controls were included. The Chinese version of the FAST, the Young Mania Rating Scale (YMRS), the 17-item Hamilton Depression Rating Scale (HDRS-17) and the Global Assessment Functioning (GAF) were administered, and the psychometric analysis of the FAST was conducted. Results: The internal consistency (Cronbach's alpha) was 0.89 and 0.88 for the FAST at the baseline and week 1, respectively. Four domains (occupational functioning, cognitive functioning, interpersonal relationship and financial issues) at baseline had high item-total correlations. The FAST assessments at baseline and week 1 were highly correlated, indicating high test-retest reliability. The FAST total score was strongly associated with GAF total scores at week 0 (r = -0.952, p<0.001), HDRS (r = 0.575, p<0.001) and YRMS (r = 0.394, p<0.001) and at week 1 (r = -0.945, p<0.001; r = 0.582, p<0.001; r = 0.363, p<0.001), respectively, suggesting high concurrent validity. The FAST showed four dimensional measurement properties in exploratory factor analysis at baseline. Conclusions: The Chinese version of the FAST has satisfactory psychometric properties in terms of validity and reliability in Chinese adults with BD.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">灾难后的心理救援工作需要心理咨询师、志愿者、精神科医师等多种角色。其中,精神科医师以其自身的身份优势、有医学背景、组织结构统一性好等特点,适合充当灾难后心理救援工作的领导角色。</span>