BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes o...BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.展开更多
Major Depressive Disorder(MDD)is often associated with high levels of stress and disturbances in the hypothalamic-pituitaryadrenal(HPA)system,yielding high levels of cortisol in addition to cognitive dysfunction.The a...Major Depressive Disorder(MDD)is often associated with high levels of stress and disturbances in the hypothalamic-pituitaryadrenal(HPA)system,yielding high levels of cortisol in addition to cognitive dysfunction.The aim of the present study was to examine the relation between cortisol levels after the dexamethasone suppression test and cognitive function in recurrent unipolar MDD patients.Twenty-four patients meeting the Diagnostic and Statistical Manual of Mental Disorders(4th ed.,text rev.)criteria for a recurrent MDD diagnosis were included in the study.The control group was matched for age,sex,and education level.Cortisol was measured in saliva collected with Salivette sampling devices.Saliva samples were collected four times during a 24-hr period over two consecutive days:at awakening,after 45 min,after 7 hr,and at 11:00 p.m.One milligram of dexamethasone was given on Day 1 at 11:00 p.m.The neuropsychological test battery consisted of standardized tests measuring cognitive functioning within verbal and visual memory,as well as executive functioning.Cortisol levels did not differ between patients and controls on Day 1.Cortisol levels in patients were higher than in controls at awakening on Day 2(D2S1),after dexamethasone administration the previous evening.All significant correlations between cognitive measures and cortisol at D2S1 were negative,indicating that low suppression after intake of dexamethasone is related to poor cognitive functioning.Significant relations were found in three of the cognitive tests measuring verbal memory,semantic fluency,and inhibition.The present findings indicate that dysregulation of the HPA-axis is related to poor verbal memory functioning.There was no firm evidence that abnormal cortisol levels were associated with inhibition difficulties.展开更多
文摘BACKGROUND The characteristics of cerebral hemodynamic indexes of patients with different types of auditory verbal hallucinations(AVHs)was not clear.AIM To explore the characteristics of cerebral hemodynamic indexes of patients with different types of AVHs and construct the risk nomogram prediction model of patients with different types of AVHs.METHODS Patients with different types of verbal hallucinations who visited Wenzhou Seventh People’s Hospital were retrospectively selected from March 2021 to March 2023,and these patients were classified into 117 cases of schizophrenia(SCZ)with AVHs,108 cases of post-traumatic stress disorder(PTSD)with AVHs,and 105 cases of recurrent depressive disorder with AVHs according to type.Transcranial doppler was performed to measure the hemodynamic parameters of the anterior cerebral artery(ACA),middle cerebral artery(MCA),posterior cerebral artery(PCA),basilar artery(BA)and vertebral artery(VA).Logistic regression modelling was used to explore the factors affecting patients with different types of AVHs and odds ratio,95%confidence interval(CI).A clinical prediction model was constructed,and the efficacy of the clinical prediction model was evaluated by using receiver operating characteristic,Hosmer-Lemeshow Goodness-of-Fit test,calibration curves and decision curve analysis.RESULTS The differences between the three groups of patients in mean velocity(Vm)-MCA,end-diastolic velocity(Vd)-MCA,Vm-ACA,pulsatility index(PI)-ACA,Vm-PCA,peak systolic velocity(Vs)-PCA,Vd-PCA,Vm-BA,Vs-BA,Vd-BA,PI-BA,resistance index(RI)-BA,Vm-VA,Vs-VA,Vd-VA,PI-VA,and RI-VA indexes were statistically significant.Rising Vm-ACA is an independent risk factor for SCZ with AVHs,and falling Vm-VA,Vd-MCA,and Vd-VA are independent risk factors for SCZ with AVHs.Rising Vm-ACA,Vm-PCA,Vs-PCA,Vd-PCA,Vm-BA,and Vs-BA are independent risk factors for PTSD with AVHs,and Vm-MCA,Vs-MCA,Vd-MCA,PI-PCA,and RIBA are independent protective factors for PTSD with AVHs.Elevated Vm-MCA,Vd-MCA,RI-BA,Vm-VA,and Vd-VA were independent risk factors,and elevated Vm-ACA,Vs-ACA,Vm-PCA,Vs-PCA,and Vd-PCA were independent protective factors.The areas under the curve of the three models were 0.82(95%CI:0.76-0.87),0.88(95%CI:0.83-0.92),and 0.81(95%CI:0.77-0.86),respectively;the Hosmer-Lemeshow Goodness-of-Fit test of the calibration curves of the three models suggests that P>0.05.CONCLUSION Monitoring the cerebral hemodynamic indexes of patients with AVHs is of practical significance in determining the type of mental disorder,which helps clinicians identify the type of AVHs and adopt more efficient treatment strategies to help patients recover.
文摘Major Depressive Disorder(MDD)is often associated with high levels of stress and disturbances in the hypothalamic-pituitaryadrenal(HPA)system,yielding high levels of cortisol in addition to cognitive dysfunction.The aim of the present study was to examine the relation between cortisol levels after the dexamethasone suppression test and cognitive function in recurrent unipolar MDD patients.Twenty-four patients meeting the Diagnostic and Statistical Manual of Mental Disorders(4th ed.,text rev.)criteria for a recurrent MDD diagnosis were included in the study.The control group was matched for age,sex,and education level.Cortisol was measured in saliva collected with Salivette sampling devices.Saliva samples were collected four times during a 24-hr period over two consecutive days:at awakening,after 45 min,after 7 hr,and at 11:00 p.m.One milligram of dexamethasone was given on Day 1 at 11:00 p.m.The neuropsychological test battery consisted of standardized tests measuring cognitive functioning within verbal and visual memory,as well as executive functioning.Cortisol levels did not differ between patients and controls on Day 1.Cortisol levels in patients were higher than in controls at awakening on Day 2(D2S1),after dexamethasone administration the previous evening.All significant correlations between cognitive measures and cortisol at D2S1 were negative,indicating that low suppression after intake of dexamethasone is related to poor cognitive functioning.Significant relations were found in three of the cognitive tests measuring verbal memory,semantic fluency,and inhibition.The present findings indicate that dysregulation of the HPA-axis is related to poor verbal memory functioning.There was no firm evidence that abnormal cortisol levels were associated with inhibition difficulties.
