Anxiety and stress disorders are a major public health issue. However, their pathophysiology is still unclear. The gamma amino acid butyric acid(GABA) neurochemical system has been strongly implicated in their pathoge...Anxiety and stress disorders are a major public health issue. However, their pathophysiology is still unclear. The gamma amino acid butyric acid(GABA) neurochemical system has been strongly implicated in their pathogenesis and treatment by numerous preclinical and clinical studies, the most recent of which have been highlighted and critical review in this paper. Changes in cortical GABA appear related to normal personality styles and responses to stress. While there is accumulating animal and human neuroimaging evidence of cortical and subcortical GABA deficits across a number of anxiety conditions, a clear pattern of findings in specific brain regions for a given disorder is yet to emerge. Neuropsychiatric conditions with anxiety as a clinical feature may have GABA deficits as an underlying feature. Different classes of anxiolytic therapies support GABA function, and this may be an area in which newer GABA neuroimaging techniques could soon offer more personalized therapy. Novel GABAergic pharmacotherapies in development offer potential improvements over current therapies in reducing sedative and physiologic dependency effects, while offering rapid anxiolysis.展开更多
Controversy exists whether or not patient’s concerns regarding anesthetics can be reduced by face-to-face pre-assessment with an anesthetist. Thus we were looking at concerns patients had before and after such a cons...Controversy exists whether or not patient’s concerns regarding anesthetics can be reduced by face-to-face pre-assessment with an anesthetist. Thus we were looking at concerns patients had before and after such a consultation. Patient satisfaction was rated by a validated questionnaire. A four-staged Likert-scale was used to quantify the extent of patients concerns. The totaling 461 patients were overall highly satisfied. 448 patients had “nil” to “minimal” concerns. After the assessment, 106 patients stated their concerns had been lessened (p 0.001). Having gone through the anesthetic pre-assessment center, 99.1% of all patients reported no considerable concerns regarding anesthetics whatsoever. A high level of patient satisfaction does not constitute a low level of concerns patients may hold over anesthetics, although a pre-operative consultation mitigated these concerns by 23%, whilst for 9% of all patients this pre-assessment led to a higher level of concerns.展开更多
The nucleus accumbens(NAc)plays an important role in various emotional and motivational behaviors that rely on heightened wakefulness.However,the neural mechanisms underlying the relationship between arousal and emoti...The nucleus accumbens(NAc)plays an important role in various emotional and motivational behaviors that rely on heightened wakefulness.However,the neural mechanisms underlying the relationship between arousal and emotion regulation in NAc remain unclear.Here,we investigated the roles of a specific subset of inhibitory corticotropin-releasing hormone neurons in the NAc(NAcCRH)in regulating arousal and emotional behaviors in mice.We found an increased activity of NAcCRH neurons during wakefulness and rewarding stimulation.Activation of NAcCRH neurons converts NREM or REM sleep to wakefulness,while inhibition of these neurons attenuates wakefulness.Remarkably,activation of NAcCRH neurons induces a place preference response(PPR)and decreased basal anxiety level,whereas their inactivation induces a place aversion response and anxious state.NAcCRH neurons are identified as the major NAc projection neurons to the bed nucleus of the stria terminalis(BNST).Furthermore,activation of the NAcCRH-BNST pathway similarly induced wakefulness and positive emotional behaviors.Taken together,we identified a basal forebrain CRH pathway that promotes the arousal associated with positive affective states.展开更多
文摘Anxiety and stress disorders are a major public health issue. However, their pathophysiology is still unclear. The gamma amino acid butyric acid(GABA) neurochemical system has been strongly implicated in their pathogenesis and treatment by numerous preclinical and clinical studies, the most recent of which have been highlighted and critical review in this paper. Changes in cortical GABA appear related to normal personality styles and responses to stress. While there is accumulating animal and human neuroimaging evidence of cortical and subcortical GABA deficits across a number of anxiety conditions, a clear pattern of findings in specific brain regions for a given disorder is yet to emerge. Neuropsychiatric conditions with anxiety as a clinical feature may have GABA deficits as an underlying feature. Different classes of anxiolytic therapies support GABA function, and this may be an area in which newer GABA neuroimaging techniques could soon offer more personalized therapy. Novel GABAergic pharmacotherapies in development offer potential improvements over current therapies in reducing sedative and physiologic dependency effects, while offering rapid anxiolysis.
文摘Controversy exists whether or not patient’s concerns regarding anesthetics can be reduced by face-to-face pre-assessment with an anesthetist. Thus we were looking at concerns patients had before and after such a consultation. Patient satisfaction was rated by a validated questionnaire. A four-staged Likert-scale was used to quantify the extent of patients concerns. The totaling 461 patients were overall highly satisfied. 448 patients had “nil” to “minimal” concerns. After the assessment, 106 patients stated their concerns had been lessened (p 0.001). Having gone through the anesthetic pre-assessment center, 99.1% of all patients reported no considerable concerns regarding anesthetics whatsoever. A high level of patient satisfaction does not constitute a low level of concerns patients may hold over anesthetics, although a pre-operative consultation mitigated these concerns by 23%, whilst for 9% of all patients this pre-assessment led to a higher level of concerns.
基金supported by grants from the National Natural Science Foundation of China(82090033,82288101,U20A6005,32200801,and 32200967)China Postdoctoral Science Foundation(2021M700851,2023T160117,and 2023M740708).
文摘The nucleus accumbens(NAc)plays an important role in various emotional and motivational behaviors that rely on heightened wakefulness.However,the neural mechanisms underlying the relationship between arousal and emotion regulation in NAc remain unclear.Here,we investigated the roles of a specific subset of inhibitory corticotropin-releasing hormone neurons in the NAc(NAcCRH)in regulating arousal and emotional behaviors in mice.We found an increased activity of NAcCRH neurons during wakefulness and rewarding stimulation.Activation of NAcCRH neurons converts NREM or REM sleep to wakefulness,while inhibition of these neurons attenuates wakefulness.Remarkably,activation of NAcCRH neurons induces a place preference response(PPR)and decreased basal anxiety level,whereas their inactivation induces a place aversion response and anxious state.NAcCRH neurons are identified as the major NAc projection neurons to the bed nucleus of the stria terminalis(BNST).Furthermore,activation of the NAcCRH-BNST pathway similarly induced wakefulness and positive emotional behaviors.Taken together,we identified a basal forebrain CRH pathway that promotes the arousal associated with positive affective states.
