This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at...This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at all stages of their life.We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population,along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems.We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID.The review is structured around the three generations of therapies:Applied behavior analysis(e.g.,positive behavior support),cognitive behavioral therapies(e.g.,mindfulness-based cognitive therapy),and contextual therapies(e.g.,dialectical behavior therapy).We conclude with some recommendations for professional practice in the fields of ID and psychiatry.展开更多
In the context of global aging,mild behavioral impairment(MBI)is present in 48.9%of patients with mild cognitive impairment(MCI).MBI,a neurobehavioral syndrome in the elderly,is an independent risk factor for cognitiv...In the context of global aging,mild behavioral impairment(MBI)is present in 48.9%of patients with mild cognitive impairment(MCI).MBI,a neurobehavioral syndrome in the elderly,is an independent risk factor for cognitive decline and is closely related to peripheral blood biomarkers associated with Alzheimer's disease,offering new diagnostic and interventional avenues for early MCI.To summarize evidence on peripheral blood biomarkers related to MBI and their underlying mechanisms involving neuroinflammation,tau pathology,and oxidative stress,a systematic review of studies published between 2015 and 2024 was conducted.MBI is closely associated with peripheral blood biomarker changes.Neuroinflammatory markers like glial fibrillary acidic protein and neurofilament light indicate astrocyte activation and neural circuit disruption,with glial fibrillary acidic protein levels correlating with impulse dyscontrol scores.Chitinase-3-like protein 1,a marker of blood-brain barrier integrity,exacerbates neuroinflammation and is linked to depressive symptoms and hippocampal atrophy.Elevated phosphorylated tau proteins in blood correlate with brain tau deposition,increasing the risk of MBI and impairing cognition.Oxidative stress markers damage neurons and disrupt neurotransmission,and concurrent alterations in malondialdehyde and superoxide dismutase levels significantly elevate the risk of MBI.The correlation between MBI and biomarkers offers new diagnostic and interventional directions for early MCI.Future research should standardize MBI assessment,conduct longitudinal studies,explore biomarker-MBI relationships,investigate psychosocial impacts,and develop advanced detection methods.展开更多
Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveil...Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.展开更多
To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionate...To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.展开更多
Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unc...Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unclear. Several prospective studies have reported that specific non-motor symptoms predict a conversion risk of developing a neurodegenerative disease, including olfactory dysfunction, abnormal color vision, autonomic dysfunction, excessive daytime sleepiness, depression, and cognitive impairment. Parkinson＇s disease （PD） with RBD exhibits clinical heterogeneity with respect to motor and non-motor symptoms compared with PD without RBD. In this review, we describe the main clinical and pathogenic features of RBD, focusing on its association with other non-motor symptoms of parkinsonism.展开更多
Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The...Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.展开更多
Emerging evidence suggests a link between alterations in the gut microbiome and adverse health outcomes in the hosts exposed to environmental pollutants.Yet,the causal relationships and underlying mechanisms remain la...Emerging evidence suggests a link between alterations in the gut microbiome and adverse health outcomes in the hosts exposed to environmental pollutants.Yet,the causal relationships and underlying mechanisms remain largely undefined.Here we show that exposure to biotoxins can affect gut pathobiome assembly in amphibians,which in turn triggers the toxicity of exogenous pollutants.We used Xenopus laevis as a model in this study.Tadpoles exposed to tropolone demonstrated notable developmental impairments and increased locomotor activity,with a reduction in total length by 4.37%e22.48%and an increase in swimming speed by 49.96%e84.83%.Fusobacterium and Cetobacterium are predominant taxa in the gut pathobiome of tropolone-exposed tadpoles.The tropolone-induced developmental and behavioral disorders in the host were mediated by assembly of the gut pathobiome,leading to transcriptome reprogramming.This study not only advances our understanding of the intricate interactions between environmental pollutants,the gut pathobiome,and host health but also emphasizes the potential of the gut pathobiome in mediating the toxicological effects of environmental contaminants.展开更多
Introduction:ADHD is one of the most common neurodevelopmental disorders in childhood and adolescence.Although the disorder starts to manifest early in childhood,a significant proportion of cases often persists into a...Introduction:ADHD is one of the most common neurodevelopmental disorders in childhood and adolescence.Although the disorder starts to manifest early in childhood,a significant proportion of cases often persists into adulthood.ADHD negatively and significantly impacts social and occupational functioning and academic performance.A number of extant theories and scientific evidence provide insight into the genesis and manifestations of ADHD and the attendant challenges of significant dysfunction that individuals may encounter at home,school,and the workplace.Method:This systematic review was conducted through a literature search for published peer-reviewed articles using standard PRISMA guidelines.The goal of the study was to explore current theories,models,concepts,and risk factors about ADHD published in peer-reviewed literature.We made use of use several online databases-including PsycINFO,PubMed,Web of Science,ScienceDirect,and Medline in the process of searching for relevant studies.Relevant peer-reviewed publications since the 1980s when the term Attention-Deficit/Hyperactivity Disorder(ADHD)was introduced in DSM-III-R were included.Non-peer-reviewed publications,including dissertations,editorials,commentaries,and materials published in languages other than English were excluded.Results and Discussion:The results of the review indicated that ADHD is characterized by a behavioral reaction that interferes with personal and social functioning.The factors associated with ADHD fall into several major thematic areas,including genetic and hereditary factors;dietary and nutritional factors;parenting and behavioral factors;adverse early life events,and high-risk environmental factors,crystallized by a number of developmental and behavioral theories.The review also identified a number of extant models and theories that attempt to explain the diverse perspectives associated with ADHD.Conclusions:This study has attempted to identify the major risk factors and diverse models and theories associated with ADHD.The thematic risk factors include genetic and hereditary factors;dietary and nutritional factors;parenting and behavioral factors;adverse early life events,and high-risk environmental factors.The most prominent models identified include the biomedical model and the bio-psycho-social models,the latter being a more holistic approach which aims to treat both the patient and the disease.This review would provide an additional evidence base to individuals,families,and educators to make informed choices and decisions in the best interest of the affected children,including their personal growth,healthcare,and medical needs,academic performance,and social skills development.展开更多
Since children, as a rule, have more free time than adults, it is adults＇ responsibility to provide children with a chance to spend the time of relaxation, play, and fun in a beneficial way. Unfortunately, children＇...Since children, as a rule, have more free time than adults, it is adults＇ responsibility to provide children with a chance to spend the time of relaxation, play, and fun in a beneficial way. Unfortunately, children＇s spare time is nowadays very frequently organized for the sake of brushing up children＇s knowledge, skills, and competences, which is accomplished by means of escalating extra-curriculum activities. When expressed by teacher and parents, these ambition-related attitudes pave the way for the disappearance of children＇s personal interests and motivations to perform complicated tasks which are perceived as unwanted or obscure by the affected children themselves. This form of adults＇ behavior may lead to the feelings of frustration, stress, demotivation, or rebellion on behalf of their children. The said emotional states, especially in relation to the lack of spontaneous play, give rise to serious psychic dysfunctions, and the instability of children＇s psychic balance. It may also pave the way for various forms of destructive behavior that mostly characterize children of younger school age who are about to start schooling.展开更多
Typical Parkinsonian symptoms consist of bradykinesia plus rigidity and/or resting tremor. Some time later postural instability occurs. Pre-motor symptoms such as hyposmia, constipation, REM sleep behavior disorder an...Typical Parkinsonian symptoms consist of bradykinesia plus rigidity and/or resting tremor. Some time later postural instability occurs. Pre-motor symptoms such as hyposmia, constipation, REM sleep behavior disorder and depression may antecede these motor symp- toms for years. It would be ideal, if we had a biomarker which would allow to predict who with one or two of these pre-motor symptoms will develop the movement disorder Parkinson＇s disease （PD）. Thus, it is interesting to learn that biopsies of the submandibular gland or colon biopsies may be a means to predict PD, if there is a high amour of abnormally folded alpha-synuclein and phosphorylated alpha-synuclein. This would be of relevance if we would have available means to stop the propagation of abnormal alpha-synuclein which is otherwise one of the reasons of this spreading disease PD.展开更多
The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（A...The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.展开更多
Parkinson’s disease(PD)is the second most common neurodegenerative disease,which manifests with both motor and non-motor symptoms.Circadian rhythm dysregulation,as one of the most challenging non-motor features of PD...Parkinson’s disease(PD)is the second most common neurodegenerative disease,which manifests with both motor and non-motor symptoms.Circadian rhythm dysregulation,as one of the most challenging non-motor features of PD,usually appears long before obvious motor symptoms.Moreover,the dysregulated circadian rhythm has recently been reported to play pivotal roles in PD pathogenesis,and it has emerged as a hot topic in PD research.In this review,we briefly introduce the circadian rhythm and circadian rhythm-related genes,and then summarize recent research progress on the altered circadian rhythm in PD,ranging from clinical features to the possible causes of PD-related circadian disorders.We believe that future comprehensive studies on the topic may not only help us to explore the mechanisms of PD,but also shed light on the better management of PD.展开更多
BACKGROUND It is important to diagnose depression in Parkinson’s disease(DPD)as soon as possible and identify the predictors of depression to improve quality of life in Parkinson’s disease(PD)patients.AIM To develop...BACKGROUND It is important to diagnose depression in Parkinson’s disease(DPD)as soon as possible and identify the predictors of depression to improve quality of life in Parkinson’s disease(PD)patients.AIM To develop a model for predicting DPD based on the support vector machine,while considering sociodemographic factors,health habits,Parkinson's symptoms,sleep behavior disorders,and neuropsychiatric indicators as predictors and provide baseline data for identifying DPD.METHODS This study analyzed 223 of 335 patients who were 60 years or older with PD.Depression was measured using the 30 items of the Geriatric Depression Scale,and the explanatory variables included PD-related motor signs,rapid eye movement sleep behavior disorders,and neuropsychological tests.The support vector machine was used to develop a DPD prediction model.RESULTS When the effects of PD motor symptoms were compared using“functional weight”,late motor complications(occurrence of levodopa-induced dyskinesia)were the most influential risk factors for Parkinson's symptoms.CONCLUSION It is necessary to develop customized screening tests that can detect DPD in the early stage and continuously monitor high-risk groups based on the factors related to DPD derived from this predictive model in order to maintain the emotional health of PD patients.展开更多
Background:Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders(ASD).Although epidemiological studies have been conducted to clarify the association between restriction ...Background:Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders(ASD).Although epidemiological studies have been conducted to clarify the association between restriction diets and ASD,the conclusion remains unclear.This study was undertaken to investigate the effect of gluten free diet(GFD)on gastrointestinal symptoms and behavioral indices in children with ASD.Methods:In this randomized clinical trial,80 children diagnosed with ASD by the Autism Diagnostic Interview-Revised(ADI-R)were assigned into GFD(n=40)and regular diet(RD)(n=40)groups for 6 weeks.At the beginning and end of the intervention,the ROMEШquestionnaire for evaluating gastrointestinal symptoms and Gilliam Autism Rating Scale 2 questionnaire(GARS-2)for assessing psychometric properties were completed.Results:Of the 80 children,53.9%had gastrointestinal abnormalities.In the GFD group,the prevalence of gastrointestinal symptoms decreased significantly(P<0.05)after intake of GFD(40.57%vs.17.10%)but increased insignificantly in the RD group(42.45%vs.44.05%).GFD intervention resulted in a significant decrease in behavioral disorders(80.03±14.07 vs.75.82±15.37,P<0.05)but an insignificant increase in the RD group(79.92±15.49 vs.80.92±16.24).Conclusion:This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.展开更多
Celiac disease is a chronic, immune-mediated enteropathy caused by a permanent sensitivity to ingested gluten cereals that develops in genetically susceptible individuals. The classic presentation of celiac disease in...Celiac disease is a chronic, immune-mediated enteropathy caused by a permanent sensitivity to ingested gluten cereals that develops in genetically susceptible individuals. The classic presentation of celiac disease includes symptoms of malabsorption but has long been associated with cognitive, emotional, and behavioral disorders. We describe an 8-year-old patient with nonscarring alopecia and diagnosed with trichotillomania. Furthermore, she presented with a 3-year history of poor appetite and two or three annual episodes of mushy, fatty stools. Laboratory investigations showed a normal hemoglobin concentration and a low ferritin level. Serologic studies showed an elevated tissue immunoglobulin G anti-tissue transglutaminase level. A duodenal biopsy showed subtotal villous atrophy and crypt hyperplasia, and a large gastric trichobezoar was found in the stomach. Immediately after beginning a gluten-free diet, complete relief of trichotillomania and trichophagia was achieved. In this report, we describe a behavioral disorder as a primary phenomenon of celiac disease, irrespective of nutritional status.展开更多
An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodi...An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.展开更多
BACKGROUND Stroke is one of the major causes of disability and death worldwide.Some treatments for stroke exist,but existing treatment methods have limitations such as difficulty in the regeneration of damaged neurona...BACKGROUND Stroke is one of the major causes of disability and death worldwide.Some treatments for stroke exist,but existing treatment methods have limitations such as difficulty in the regeneration of damaged neuronal cells of the brain.Recently,mesenchymal stem cells(MSCs)have been studied as a therapeutic alternative for stroke,and various preclinical and case studies have been reported.CASE SUMMARY A 55-year-old man suffered an acute stroke,causing paralysis in the left upper and lower limbs.He intravenously transplanted the minimally manipulated human umbilical cord-derived MSCs(MM-UC-MSCs)twice with an 8-d interval.At 65 wk after transplantation,the patient returned to his previous occupation as a veterinarian with no adverse reactions.CONCLUSION MM-UC-MSCs transplantation potentially treats patients who suffer from acute ischemic stroke.展开更多
Autism spectrum disorder（ASD） is defined by impairments of social interaction and the presence of obsessive behaviors. The ＇＇twin＇＇ nonapeptides oxytocin（OXT） and arginine-vasopressin（AVP） are known to play ...Autism spectrum disorder（ASD） is defined by impairments of social interaction and the presence of obsessive behaviors. The ＇＇twin＇＇ nonapeptides oxytocin（OXT） and arginine-vasopressin（AVP） are known to play regulatory roles in social behaviors. However, the plasma levels and behavioral relevance of OXT and AVP in children with ASD have seldom been investigated. It is also unknown whether their mothers have abnormal plasma peptide levels. Here, using well-established methods of neuropeptide measurement and a relatively large sample size, we determined the plasma levels of the two neuropeptides in 85 normal children, 84 children with ASD, and 31 mothers from each group of children.As expected, children with ASD had lower plasma OXT levels than gender-matched controls（P = 0.028）. No such difference was found for plasma AVP concentrations. Correlation analysis showed that ASD children with higher plasma OXT concentrations tended to have less impairment of verbal communication（Rho =-0.22,P = 0.076）, while those with higher plasma AVP levels tended to have lower levels of repetitive use of objects（Rho =-0.231, P = 0.079）. Unlike the findings in children, maternal plasma OXT levels showed no group difference. However, plasma AVP levels in the mothers of ASD children tended to be lower than in the mothers of normal children（P = 0.072）. In conclusion, our results suggest that the OXT system is dysregulated in children with ASD, and that OXT and AVP levels in plasma seem to be associated with specific autistic symptoms. The plasma levels of OXT or AVP in mothers and their ASD children did not seem to change in the same direction.展开更多
Rapid eye movement(REM)sleep behavior disorder(RBD)is a parasomnia that is featured by elevated motor behaviors and dream enactments during REM sleep.Clinical observations show that RBD bears significant relevance wit...Rapid eye movement(REM)sleep behavior disorder(RBD)is a parasomnia that is featured by elevated motor behaviors and dream enactments during REM sleep.Clinical observations show that RBD bears significant relevance with several synucleinopathies such as Lewy body dementia and Parkinson disease(PD),and often develops prior to their diagnosis.Being a potential biomarker of PD,investigating the relationship of RBD symptoms and their emergence in developing PD would provide insight intoits pathogenesis.Here,in a chronic model of PD,rats with daily rotenone treatment exhibited key RBD features,including elevated sleep muscle tone,sleep fragmentation and EEG slowing at different time points.Based on detectedearly alpha synuclein aggregation and neural apoptosis in the sublaterodorsal tegmental nucleus(SLD),an area known to promote REM sleep and maintain sleep muscle atonia,the possible involvement of SLD glutamatergic neurons was interrogated.Via chemogenetic activation of SLD glutamatergic neurons,key RBD symptoms and EEG slowing in REM sleep were alleviated.These results are consistent with a progressive degeneration in REM sleep promoting pathways.Our findings provide a foundation for further studies into RBD and its relationship to neurodegenerative diseases.展开更多
Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease more common in those over the age of 60. PD is classically characterized by motor features, although patients may also experience non-...Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease more common in those over the age of 60. PD is classically characterized by motor features, although patients may also experience non-motor symptoms. Sleep disturbances, such as rapid eye movement (REM) behavior disorder (RBD), are common in patients with PD and may precede onset of PD. Methods: Data was collected on patients with PD (358 subjects)in a movement disorders clinic at a safety net hospital. In this retrospective database analysis, the association of PD complications with age of onset was evaluated using chi-square tests and logistic regression. Results: Of the PD complications analyzed, there was a significant difference in sleep disturbances by age. Among the 358 PD patients, 120 individuals (33.5%) had information regarding the presence or absence of sleep disturbances. There was a significant difference between the early (onset < 50) and later onset (≥50) groups (p = 0.03) with the odds of having a sleep disorder for the early group 1.6 times that of the late group. Those subjects with siblings who also had PD had 2.0 times the odds of having a sleep disorder compared those without (p = 0.02). Conclusion: Non-motor symptoms such as sleep disorders are a useful predictor of early onset PD. Genetic components of PD impact both motor and non-motor aspects of the disease.展开更多
基金Supported by Ministry of Science,Innovation and Universities,and the State Research Agency,No.PID2019-105737RBI00/AEI/10.13039/501100011033。
文摘This paper reviews the current state of knowledge on psychological interventions with empirical evidence of efficacy in treating common psychiatric and behavioral disorders in people with intellectual disability(ID)at all stages of their life.We begin with a brief presentation of what is meant by psychiatric and behavioral disorders in this population,along with an explanation of some of the factors that contribute to the increased psychosocial vulnerability of this group to present with these problems.We then conduct a review of empirically supported psychological therapies used to treat psychiatric and behavioral disorders in people with ID.The review is structured around the three generations of therapies:Applied behavior analysis(e.g.,positive behavior support),cognitive behavioral therapies(e.g.,mindfulness-based cognitive therapy),and contextual therapies(e.g.,dialectical behavior therapy).We conclude with some recommendations for professional practice in the fields of ID and psychiatry.
文摘In the context of global aging,mild behavioral impairment(MBI)is present in 48.9%of patients with mild cognitive impairment(MCI).MBI,a neurobehavioral syndrome in the elderly,is an independent risk factor for cognitive decline and is closely related to peripheral blood biomarkers associated with Alzheimer's disease,offering new diagnostic and interventional avenues for early MCI.To summarize evidence on peripheral blood biomarkers related to MBI and their underlying mechanisms involving neuroinflammation,tau pathology,and oxidative stress,a systematic review of studies published between 2015 and 2024 was conducted.MBI is closely associated with peripheral blood biomarker changes.Neuroinflammatory markers like glial fibrillary acidic protein and neurofilament light indicate astrocyte activation and neural circuit disruption,with glial fibrillary acidic protein levels correlating with impulse dyscontrol scores.Chitinase-3-like protein 1,a marker of blood-brain barrier integrity,exacerbates neuroinflammation and is linked to depressive symptoms and hippocampal atrophy.Elevated phosphorylated tau proteins in blood correlate with brain tau deposition,increasing the risk of MBI and impairing cognition.Oxidative stress markers damage neurons and disrupt neurotransmission,and concurrent alterations in malondialdehyde and superoxide dismutase levels significantly elevate the risk of MBI.The correlation between MBI and biomarkers offers new diagnostic and interventional directions for early MCI.Future research should standardize MBI assessment,conduct longitudinal studies,explore biomarker-MBI relationships,investigate psychosocial impacts,and develop advanced detection methods.
基金This study was supported by Emergency Technology Research Project of Huazhong University of Science and Technology(No.2020kfyXGYJ020).
文摘Objective This study aimed to explore the clinical value of Children Neuropsychological and Behavioral Scale-Revision 2016(CNBS-R2016)for Autism Spectrum Disorder(ASD)screening in the presence of developmental surveillance.Methods All participants were evaluated by the CNBS-R2016 and Gesell Developmental Schedules(GDS).Spearman’s correlation coefficients and Kappa values were obtained.Taking GDS as a reference assessment,the performance of the CNBS-R2016 for detecting the developmental delays of children with ASD was analyzed with receiver operating characteristic(ROC)curves.The efficacy of the CNBS-R2016 to screen for ASD was explored by comparing Communication Warning Behavior with Autism Diagnostic Observation Schedule,Second Edition(ADOS-2).Results In total,150 children aged 12–42 months with ASD were enrolled.The developmental quotients of the CNBS-R2016 were correlated with those of the GDS(r=0.62–0.94).The CNBS-R2016 and GDS had good diagnostic agreement for developmental delays(Kappa=0.73–0.89),except for Fine Motor.There was a significant difference between the proportions of Fine Motor,delays detected by the CNBS-R2016 and GDS(86.0%vs.77.3%).With GDS as a standard,the areas under the ROC curves of the CNBS-R2016 were above 0.95 for all the domains except Fine Motor,which was 0.70.In addition,the positive rate of ASD was 100.0%and 93.5%when the cut-off points of 7 and 12 in the Communication Warning Behavior subscale were used,respectively.Conclusion The CNBS-R2016 performed well in developmental assessment and screening for children with ASD,especially by Communication Warning Behaviors subscale.Therefore,the CNBS-R2016 is worthy of clinical application in children with ASD in China.
基金supported by National Natural Science Foundation Youth Project (81901386)the Fundamental Research Funds for the Central Universities (YG2025ZD07)+5 种基金the National Science and Technology Innovation 2030 Major Project of China (2021ZD0203900)National Natural Science Foundation of China (NSFC) grant (82422029)the Science and Technology Commission of Shanghai Municipality (24Y22800200, 22QA1407900)NSFC grant (82271530)Innovation teams of high-level universities in Shanghaithe Scientific Research and Innovation Team of Liaoning Normal University (24TD004).
文摘To the editor:Adverse home environments(AHE),characterised by family conflict,parental separation or dysfunctional parenting,are linked to negative mental health outcomes in children and adults.12 AHE disproportionately affect children with neurodevelopmental disorders such as attention-deficit/hyperactivity disorder(ADHD),which is characterised by inattention,hyperactivity/impulsivity and functional impairments.3 Apart from core symptoms,including inattention and hyperactivity,disruptive behaviour disorders(DBD),such as oppositional defiant disorder(ODD)and conduct disorder(CD),may be associated with AHE.Conduct problems are risk factors for ODD.And CD has become a main concern for childhood mental health.
基金supported by the National Natural Science Foundation of China (91649114)the Jiangsu Provincial Special Program of Medical Science, China (BL2014042)+3 种基金a Jiangsu Provincial Medical Key Discipline Projectthe Suzhou Clinical Research Center of Neurological Disease (Szzx201503)Jiangsu Province Ordinary University Professional Degree Graduate Practice Innovation, China (SJZZ16-0242)the Priority Academic Program Development of Jiangsu Higher Education Institutions, China
文摘Rapid eye movement sleep behavior disorder （RBD） is one of the most common non-motor symptoms of parkinsonism, and it may serve as a prodromal marker of neurodegenerative disease. The mechanism underlying RBD is unclear. Several prospective studies have reported that specific non-motor symptoms predict a conversion risk of developing a neurodegenerative disease, including olfactory dysfunction, abnormal color vision, autonomic dysfunction, excessive daytime sleepiness, depression, and cognitive impairment. Parkinson＇s disease （PD） with RBD exhibits clinical heterogeneity with respect to motor and non-motor symptoms compared with PD without RBD. In this review, we describe the main clinical and pathogenic features of RBD, focusing on its association with other non-motor symptoms of parkinsonism.
文摘Purpose: Rapid eye movement sleep behavior disorder (RBD) and impulse control disorders (ICDs) are common in subjects with Parkinson’s disease. The association between these two conditions has been contradictory. The aim of this study is to analyze the association between these two non-motor symptoms. Methods: Consecutive subjects with Parkinson’s disease attending the Movement Disorders Outpatient Clinic were included. The presence of ICDs was assessed using the Questionnaire for Impulse Control Disorders Rating Scale. RBD was diagnosed by an overnight, single night polysomnography. Results: Fifty-five consecutive subjects with Parkinson’s disease were included. The prevalence of ICDs and related behaviors was 23.6% (ICD in 14.5% and related behaviors in 9.1%). RBD was diagnosed in 47.2% of the patients. No differences were found in the frequency of ICDs and related behaviors when comparing subjects with and without RBD (23% versus 24.1%, p = 0.926, respectively). Conclusion: No association between the presence of RBD and the frequency of ICDs in subjects with Parkinson’s disease was found.
基金supported by the National Natural Science Foundation of China(32122074)the National Key R&D Program of China(2023YFD1400901)the Zhejiang University Global Partnership Fund,and the Fundamental Research Funds for the Central Universities(2021FZZX001-31 and 226-2023-00070).
文摘Emerging evidence suggests a link between alterations in the gut microbiome and adverse health outcomes in the hosts exposed to environmental pollutants.Yet,the causal relationships and underlying mechanisms remain largely undefined.Here we show that exposure to biotoxins can affect gut pathobiome assembly in amphibians,which in turn triggers the toxicity of exogenous pollutants.We used Xenopus laevis as a model in this study.Tadpoles exposed to tropolone demonstrated notable developmental impairments and increased locomotor activity,with a reduction in total length by 4.37%e22.48%and an increase in swimming speed by 49.96%e84.83%.Fusobacterium and Cetobacterium are predominant taxa in the gut pathobiome of tropolone-exposed tadpoles.The tropolone-induced developmental and behavioral disorders in the host were mediated by assembly of the gut pathobiome,leading to transcriptome reprogramming.This study not only advances our understanding of the intricate interactions between environmental pollutants,the gut pathobiome,and host health but also emphasizes the potential of the gut pathobiome in mediating the toxicological effects of environmental contaminants.
文摘Introduction:ADHD is one of the most common neurodevelopmental disorders in childhood and adolescence.Although the disorder starts to manifest early in childhood,a significant proportion of cases often persists into adulthood.ADHD negatively and significantly impacts social and occupational functioning and academic performance.A number of extant theories and scientific evidence provide insight into the genesis and manifestations of ADHD and the attendant challenges of significant dysfunction that individuals may encounter at home,school,and the workplace.Method:This systematic review was conducted through a literature search for published peer-reviewed articles using standard PRISMA guidelines.The goal of the study was to explore current theories,models,concepts,and risk factors about ADHD published in peer-reviewed literature.We made use of use several online databases-including PsycINFO,PubMed,Web of Science,ScienceDirect,and Medline in the process of searching for relevant studies.Relevant peer-reviewed publications since the 1980s when the term Attention-Deficit/Hyperactivity Disorder(ADHD)was introduced in DSM-III-R were included.Non-peer-reviewed publications,including dissertations,editorials,commentaries,and materials published in languages other than English were excluded.Results and Discussion:The results of the review indicated that ADHD is characterized by a behavioral reaction that interferes with personal and social functioning.The factors associated with ADHD fall into several major thematic areas,including genetic and hereditary factors;dietary and nutritional factors;parenting and behavioral factors;adverse early life events,and high-risk environmental factors,crystallized by a number of developmental and behavioral theories.The review also identified a number of extant models and theories that attempt to explain the diverse perspectives associated with ADHD.Conclusions:This study has attempted to identify the major risk factors and diverse models and theories associated with ADHD.The thematic risk factors include genetic and hereditary factors;dietary and nutritional factors;parenting and behavioral factors;adverse early life events,and high-risk environmental factors.The most prominent models identified include the biomedical model and the bio-psycho-social models,the latter being a more holistic approach which aims to treat both the patient and the disease.This review would provide an additional evidence base to individuals,families,and educators to make informed choices and decisions in the best interest of the affected children,including their personal growth,healthcare,and medical needs,academic performance,and social skills development.
文摘Since children, as a rule, have more free time than adults, it is adults＇ responsibility to provide children with a chance to spend the time of relaxation, play, and fun in a beneficial way. Unfortunately, children＇s spare time is nowadays very frequently organized for the sake of brushing up children＇s knowledge, skills, and competences, which is accomplished by means of escalating extra-curriculum activities. When expressed by teacher and parents, these ambition-related attitudes pave the way for the disappearance of children＇s personal interests and motivations to perform complicated tasks which are perceived as unwanted or obscure by the affected children themselves. This form of adults＇ behavior may lead to the feelings of frustration, stress, demotivation, or rebellion on behalf of their children. The said emotional states, especially in relation to the lack of spontaneous play, give rise to serious psychic dysfunctions, and the instability of children＇s psychic balance. It may also pave the way for various forms of destructive behavior that mostly characterize children of younger school age who are about to start schooling.
文摘Typical Parkinsonian symptoms consist of bradykinesia plus rigidity and/or resting tremor. Some time later postural instability occurs. Pre-motor symptoms such as hyposmia, constipation, REM sleep behavior disorder and depression may antecede these motor symp- toms for years. It would be ideal, if we had a biomarker which would allow to predict who with one or two of these pre-motor symptoms will develop the movement disorder Parkinson＇s disease （PD）. Thus, it is interesting to learn that biopsies of the submandibular gland or colon biopsies may be a means to predict PD, if there is a high amour of abnormally folded alpha-synuclein and phosphorylated alpha-synuclein. This would be of relevance if we would have available means to stop the propagation of abnormal alpha-synuclein which is otherwise one of the reasons of this spreading disease PD.
基金supported by a Project of Shanghai Municipal Health and Family Planning Commission (201540114)a Key Specialty Project of Shanghai Municipal Health and Family Planning Commission grant for Child Psychiatry (ZK2015B01)a Research Project of the Shanghai Changning Health and Family Planning Commission grant (20164Y013)
文摘The neurocircuitries that constitute the corticostriato-thalamo-cortical（CSTC） circuit provide a framework for bridging gaps between neuroscience and executive function in attention deficit hyperactivity disorder（ADHD）, but it has been difficult to identify the mechanisms for regulating emotional problems from the understanding of ADHD comorbidity with disruptive behavior disorders（DBD）. Research based on ＂cool＇＇ and ＂hot＇＇executive functional theory and the dual pathway models,which are thought of as applied response inhibition and delay aversion, respectively, within the neuropsychological view of ADHD, has shed light on emotional responding before and after decontextualized stimuli, while CSTC circuit-related domains have been suggested to explain the different emotional symptoms of ADHD with or without comorbid DBD. This review discusses the role of abnormal connections in each CSTC circuit, especially in the emotion circuit, which may be responsible for targeted executive dysfunction at the neuroscience level. Thus, the two major domains – abstract thinking（cool） and emotional trait（hot） – trigger the mechanism of onset of ADHD.
基金the National Nature Science Foundation of China(81771521)Key Research and Development Plan of Liaoning Science and Technology Department(2018225051)+1 种基金Guangdong Provincial Key R&D Program(2018B030337001)the National Key Research and Development Program of China(2016YFC1306600).
文摘Parkinson’s disease(PD)is the second most common neurodegenerative disease,which manifests with both motor and non-motor symptoms.Circadian rhythm dysregulation,as one of the most challenging non-motor features of PD,usually appears long before obvious motor symptoms.Moreover,the dysregulated circadian rhythm has recently been reported to play pivotal roles in PD pathogenesis,and it has emerged as a hot topic in PD research.In this review,we briefly introduce the circadian rhythm and circadian rhythm-related genes,and then summarize recent research progress on the altered circadian rhythm in PD,ranging from clinical features to the possible causes of PD-related circadian disorders.We believe that future comprehensive studies on the topic may not only help us to explore the mechanisms of PD,but also shed light on the better management of PD.
基金the National Research Foundation of Korea,No.NRF-2019S1A5A8034211the National Research Foundation of Korea,No.NRF-2018R1D1A1B07041091.
文摘BACKGROUND It is important to diagnose depression in Parkinson’s disease(DPD)as soon as possible and identify the predictors of depression to improve quality of life in Parkinson’s disease(PD)patients.AIM To develop a model for predicting DPD based on the support vector machine,while considering sociodemographic factors,health habits,Parkinson's symptoms,sleep behavior disorders,and neuropsychiatric indicators as predictors and provide baseline data for identifying DPD.METHODS This study analyzed 223 of 335 patients who were 60 years or older with PD.Depression was measured using the 30 items of the Geriatric Depression Scale,and the explanatory variables included PD-related motor signs,rapid eye movement sleep behavior disorders,and neuropsychological tests.The support vector machine was used to develop a DPD prediction model.RESULTS When the effects of PD motor symptoms were compared using“functional weight”,late motor complications(occurrence of levodopa-induced dyskinesia)were the most influential risk factors for Parkinson's symptoms.CONCLUSION It is necessary to develop customized screening tests that can detect DPD in the early stage and continuously monitor high-risk groups based on the factors related to DPD derived from this predictive model in order to maintain the emotional health of PD patients.
基金Nutrition Research Center,Tabriz University of Medical Sciences
文摘Background:Genetic and environmental factors are both responsible for the etiology of autism spectrum disorders(ASD).Although epidemiological studies have been conducted to clarify the association between restriction diets and ASD,the conclusion remains unclear.This study was undertaken to investigate the effect of gluten free diet(GFD)on gastrointestinal symptoms and behavioral indices in children with ASD.Methods:In this randomized clinical trial,80 children diagnosed with ASD by the Autism Diagnostic Interview-Revised(ADI-R)were assigned into GFD(n=40)and regular diet(RD)(n=40)groups for 6 weeks.At the beginning and end of the intervention,the ROMEШquestionnaire for evaluating gastrointestinal symptoms and Gilliam Autism Rating Scale 2 questionnaire(GARS-2)for assessing psychometric properties were completed.Results:Of the 80 children,53.9%had gastrointestinal abnormalities.In the GFD group,the prevalence of gastrointestinal symptoms decreased significantly(P<0.05)after intake of GFD(40.57%vs.17.10%)but increased insignificantly in the RD group(42.45%vs.44.05%).GFD intervention resulted in a significant decrease in behavioral disorders(80.03±14.07 vs.75.82±15.37,P<0.05)but an insignificant increase in the RD group(79.92±15.49 vs.80.92±16.24).Conclusion:This study suggested that GFD may be effective in controlling gastrointestinal symptoms and ASD behaviors.
文摘Celiac disease is a chronic, immune-mediated enteropathy caused by a permanent sensitivity to ingested gluten cereals that develops in genetically susceptible individuals. The classic presentation of celiac disease includes symptoms of malabsorption but has long been associated with cognitive, emotional, and behavioral disorders. We describe an 8-year-old patient with nonscarring alopecia and diagnosed with trichotillomania. Furthermore, she presented with a 3-year history of poor appetite and two or three annual episodes of mushy, fatty stools. Laboratory investigations showed a normal hemoglobin concentration and a low ferritin level. Serologic studies showed an elevated tissue immunoglobulin G anti-tissue transglutaminase level. A duodenal biopsy showed subtotal villous atrophy and crypt hyperplasia, and a large gastric trichobezoar was found in the stomach. Immediately after beginning a gluten-free diet, complete relief of trichotillomania and trichophagia was achieved. In this report, we describe a behavioral disorder as a primary phenomenon of celiac disease, irrespective of nutritional status.
文摘An overview is presented of the literature dealing with sleep-like motility and concomitant neuronal activity patterns throughout the life cycle in vertebrates, ectothermic as well as endothermic. Spontaneous, periodically modulated, neurogenic bursts of non-purposive movements are a universal feature of larval and prenatal behavior, which in endothermic animals （i.e. birds and mammals） continue to occur periodically throughout life. Since the entire body musculature is involved in ever-shifting combinations, it is proposed that these spontaneously active periods be designated as ＇rapid-BODY-movement＇ （RBM） sleep. The term ＇rapid-EYE- movement （REM） sleep＇, characterized by attenuated muscle contractions and reduced tonus, can then be reserved for sleep at later stages of development. Mature stages of development in which sustained muscle atonia is combined with ＇paradoxical arousal＇ of cortical neuronal firing patterns indisputably represent the evolutionarily most recent aspect of REM sleep, but more research with ectothermic vertebrates, such as fish, amphibians and reptiles, is needed before it can be concluded （as many prematurely have） that RBM is absent in these species. Evidence suggests a link between RBM sleep in early development and the clinical condition known as ＇REM sleep behavior disorder （RBD）＇, which is characterized by the resurgence of periodic bouts of quasi-fetal motility that closely resemble RBM sleep. Early developmental neuromotor risk factors for RBD in humans also point to a relationship between RBM sleep and RBD.
文摘BACKGROUND Stroke is one of the major causes of disability and death worldwide.Some treatments for stroke exist,but existing treatment methods have limitations such as difficulty in the regeneration of damaged neuronal cells of the brain.Recently,mesenchymal stem cells(MSCs)have been studied as a therapeutic alternative for stroke,and various preclinical and case studies have been reported.CASE SUMMARY A 55-year-old man suffered an acute stroke,causing paralysis in the left upper and lower limbs.He intravenously transplanted the minimally manipulated human umbilical cord-derived MSCs(MM-UC-MSCs)twice with an 8-d interval.At 65 wk after transplantation,the patient returned to his previous occupation as a veterinarian with no adverse reactions.CONCLUSION MM-UC-MSCs transplantation potentially treats patients who suffer from acute ischemic stroke.
基金supported by grants from the Research Special Fund for Public Welfare Industry of Health of China (201302002-11)the National Natural Science Foundation of China (81271507)
文摘Autism spectrum disorder（ASD） is defined by impairments of social interaction and the presence of obsessive behaviors. The ＇＇twin＇＇ nonapeptides oxytocin（OXT） and arginine-vasopressin（AVP） are known to play regulatory roles in social behaviors. However, the plasma levels and behavioral relevance of OXT and AVP in children with ASD have seldom been investigated. It is also unknown whether their mothers have abnormal plasma peptide levels. Here, using well-established methods of neuropeptide measurement and a relatively large sample size, we determined the plasma levels of the two neuropeptides in 85 normal children, 84 children with ASD, and 31 mothers from each group of children.As expected, children with ASD had lower plasma OXT levels than gender-matched controls（P = 0.028）. No such difference was found for plasma AVP concentrations. Correlation analysis showed that ASD children with higher plasma OXT concentrations tended to have less impairment of verbal communication（Rho =-0.22,P = 0.076）, while those with higher plasma AVP levels tended to have lower levels of repetitive use of objects（Rho =-0.231, P = 0.079）. Unlike the findings in children, maternal plasma OXT levels showed no group difference. However, plasma AVP levels in the mothers of ASD children tended to be lower than in the mothers of normal children（P = 0.072）. In conclusion, our results suggest that the OXT system is dysregulated in children with ASD, and that OXT and AVP levels in plasma seem to be associated with specific autistic symptoms. The plasma levels of OXT or AVP in mothers and their ASD children did not seem to change in the same direction.
基金The project supported by the HKGRCGRF gran(t14111715)
文摘Rapid eye movement(REM)sleep behavior disorder(RBD)is a parasomnia that is featured by elevated motor behaviors and dream enactments during REM sleep.Clinical observations show that RBD bears significant relevance with several synucleinopathies such as Lewy body dementia and Parkinson disease(PD),and often develops prior to their diagnosis.Being a potential biomarker of PD,investigating the relationship of RBD symptoms and their emergence in developing PD would provide insight intoits pathogenesis.Here,in a chronic model of PD,rats with daily rotenone treatment exhibited key RBD features,including elevated sleep muscle tone,sleep fragmentation and EEG slowing at different time points.Based on detectedearly alpha synuclein aggregation and neural apoptosis in the sublaterodorsal tegmental nucleus(SLD),an area known to promote REM sleep and maintain sleep muscle atonia,the possible involvement of SLD glutamatergic neurons was interrogated.Via chemogenetic activation of SLD glutamatergic neurons,key RBD symptoms and EEG slowing in REM sleep were alleviated.These results are consistent with a progressive degeneration in REM sleep promoting pathways.Our findings provide a foundation for further studies into RBD and its relationship to neurodegenerative diseases.
文摘Introduction: Parkinson’s disease (PD) is a progressive neurodegenerative disease more common in those over the age of 60. PD is classically characterized by motor features, although patients may also experience non-motor symptoms. Sleep disturbances, such as rapid eye movement (REM) behavior disorder (RBD), are common in patients with PD and may precede onset of PD. Methods: Data was collected on patients with PD (358 subjects)in a movement disorders clinic at a safety net hospital. In this retrospective database analysis, the association of PD complications with age of onset was evaluated using chi-square tests and logistic regression. Results: Of the PD complications analyzed, there was a significant difference in sleep disturbances by age. Among the 358 PD patients, 120 individuals (33.5%) had information regarding the presence or absence of sleep disturbances. There was a significant difference between the early (onset < 50) and later onset (≥50) groups (p = 0.03) with the odds of having a sleep disorder for the early group 1.6 times that of the late group. Those subjects with siblings who also had PD had 2.0 times the odds of having a sleep disorder compared those without (p = 0.02). Conclusion: Non-motor symptoms such as sleep disorders are a useful predictor of early onset PD. Genetic components of PD impact both motor and non-motor aspects of the disease.
