BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration ...BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.展开更多
BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational c...BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.展开更多
This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s ex...This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.展开更多
Background:There is growing evidence that an acute bout of exercise positively influences executive function(EF).However,the existing evidence primarily originates from laboratory-based studies,and only a limited numb...Background:There is growing evidence that an acute bout of exercise positively influences executive function(EF).However,the existing evidence primarily originates from laboratory-based studies,and only a limited number of studies have extended this work to real-world classroom settings.Accordingly,in the present study,we aimed to employ a real classroom setting to determine whether acute exercise-induced effects on EF emerged.Methods:All 49 students who enrolled in a real-world course agreed to participate in the experimental protocol and the final sample was composed of 43 individuals(13 male and 30 female participants).Participants were asked to perform an acute bout of exercise(i.e,10 min at moderate intensity)before a real classroom,and on a separate day,complete a non-exercise control condition.EF was assessed via Naming,Inhibition,and Switching variants of the Stroop task.We used a paired-samples t-test to compare participants’cognitive load between two conditions and a repeated-measures ANOVA to investigate changes in RPE.What’s more,a repeated measures ANOVA was used to examine potential pre-to post-class changes in EF-related parameters(e.g.,inverse efficiency scores,reaction times,and error rates).Results:A pre-to post-class benefit in performance efficiency across all Stroop task variants was shown.In both exercise and control conditions,there was a significant main effect of time,with lower inverse efficiency scores(IES)(p=0.003)and shorter reaction times(RT)(p<0.001)observed from pre-to post-class.Moreover,performance gains varied by Stroop task-type,with the Switching task showing the longest RTs and largest IES,reflecting its greater cognitive demands.Importantly,a marginally significant three-way interaction among task-type,intervention,and time(p=0.052)indicated that the exercise intervention enhanced post-class performance on the Switching task.Post-hoc analyses revealed significantly lower IES and faster RTs at post-class for both the Naming and Switching tasks,particularly in the exercise group(e.g.,Switching IES:p<0.001;Switching RT:p<0.001).Conclusions:These findings suggest that pre-class acute exercise enhances EF and provides a benefit to cognitive flexibility.Accordingly,our results extend previous knowledge by indicating that the cognitive benefits of acute exercise observed primarily in laboratory settings can be translated to real-world educational contexts.展开更多
Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to ex...Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.展开更多
文摘BACKGROUND Treatment-resistant depression(TRD)has a poor response to clinical treatment.Patients with TRD do not respond adequately to standard antidepressants.Even after receiving a full dose and sufficient duration of combined antidepressant therapy,significant improvement is still difficult to achieve.At present,electroconvulsive therapy(ECT)remains a clinically effective method for treating refractory depression.A good anesthesia regimen can enhance its clinical efficacy.Actively exploring high-quality anesthesia regimens has become a current research hotspot.AIM To explore the effect of esketamine and etomidate anesthesia on the clinical efficacy of ECT for TRD.METHODS A total of 120 patients with TRD,treated at the Department of Psychiatry,The Second Affiliated Hospital of Shandong First Medical University,China between April 2020 and April 2024,were selected for the study.The patients were allocated at random into two groups using a random number table:The combination and control groups,with 60 patients in each group.Both groups underwent ECT;the combination group received esketamine and etomidate anesthesia,while the control group received etomidate anesthesia.The following parameters were compared between the two groups:Heart rate(HR);mean arterial pressure(MAP);peripheral capillary oxygen saturation(SpO2);initial and final threshold charges;and serum brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),5-hydroxytryptamine(5-HT),and interleukin-4(IL-4)levels.Neurological functions,basic executive function scores,and adverse reactions were compared during the treatment process.RESULTS During treatment,the maximum and minimum HR and MAP values in the combination group were markedly lower than those in the control group(P<0.05),whereas there was no significant difference in SpO2 between the two groups(P>0.05).During the treatment,there were no significant differences in the initial threshold charge and average duration of seizures during ECT between the two groups(P>0.05).However,the final threshold charge and total charge in the combination group were considerably lower than those in the control group(P<0.05).After treatment,the BDNF,NGF,5-HT,and IL-4 levels were evidently higher in the combination group than in the control group(P<0.05).During treatment,as the number of ECT sessions increased,both BRNAS and Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery(MCCB)scores increased,whereas Hamilton Depression Rating Scale(HAMD)-24 scores decreased in both groups.Starting from the third treatment session,the BRNAS and MCCB scores in the combination group were higher than in the control group,whereas the Hamilton Depression Scale-24 score was lower in the combination group than in the control group(P<0.05).After treatment,the Wisconsin Card Sorting Test scores and Tower of Hanoi test results in the combination group were significantly better than those in the control group(P<0.05).The occurrence of adverse reactions was compared between the two groups(P>0.05).CONCLUSION Esketamine and etomidate anesthesia during ECT for patients with TRD helps maintain stable vital signs during the treatment process,improves depressive symptoms,and enhances neurological and basic executive functions.
基金Supported by the 2025 Undergraduate Research Project of the Shandong Society for Innovation and Development in Philosophy and Social Sciences,No.Z-DXS25007。
文摘BACKGROUND Physical activity(PA)is a key contributor to the neurocognitive and psychological development of children and adolescents.With the rapid integration of digital technologies in educational and recreational contexts,technology-enhanced PA(TEPA)interventions have emerged as promising tools for promoting mental and cognitive health.However,the effectiveness of various TEPA modalities—such as virtual reality(VR),mobile applications,and biofeedback systems—remains unclear.Prior findings are fragmented across systematic reviews with inconsistent methodologies.This umbrella review was conducted to synthesize current evidence and evaluate whether specific TEPA modalities yield differential benefits.We hypothesized that TEPA interventions with immersive and selfregulatory features provide greater enhancements in executive function(EF),cognitive function(CF),and mental health(MH)than passive or minimally interactive formats.AIM To determine the effects of TEPA interventions and modality-specific characteristics on EF,CF,and MH outcomes in children and adolescents.METHODS An umbrella review of systematic reviews and meta-analyses was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines.Five databases(PubMed,Web of Science,EMBASE,EBSCOhost,and Cochrane Library)were searched up to March 2025.Eligible reviews included participants aged≤18 years,assessed TEPA interventions,and reported EF,CF,or MH outcomes.Methodological quality was assessed using A Measurement Tool to Assess Systematic Reviews 2.Data synthesis was stratified by intervention modality,and heterogeneity was evaluated using the I^(2)statistic.RESULTS A total of 11 systematic reviews and meta-analyses were included.Interventions using VR(2/2),game-based formats(2/2),biofeedback(2/2),and multicomponent programs(1/1)showed consistent evidence of improvements in EF and MH(e.g.,EF:6.92±3.86 vs 3.61±1.67,P<0.001).App-based interventions(3/3)demonstrated mixed or modest effects,while augmented reality-based formats showed limited efficacy.MH outcomes were most frequently improved(9/11 reviews),followed by EF(6/11 reviews)and CF(5/11 reviews).Heterogeneity ranged from moderate to high(I^(2)=42%-78%)across modalities.CONCLUSION TEPA significantly improves MH and selectively enhances executive and CF in youth.Immersive,interactive,and biofeedback-driven modalities are particularly effective.
基金supported by the National Natural Science Foundation of China(CN)(Grant No.32071074).
文摘This longitudinal study examined the association between parental autonomy support and school-aged children’s adjustment across four major domains of school functioning,as well as the mediating role of children’s executive function.Participants were 476 school-aged children(girl:49.2%,M_(age)=10.49 years,SD=1.32 years),who completed the Psychological Autonomy Support Scale,the Behavior Rating Inventory of Executive Function–2,and the Primary School Students’Psychological Suzhi Scale at baseline and at two subsequent follow-up assessments.Results from unconditional latent growth curve models and structural equation modeling indicated that paternal autonomy support was a significant predictor of children’s adjustment across all four school domains.In contrast,maternal autonomy support was significantly associated only with interpersonal adjustment.Both the intercept(initial level)and slope(rate of change)of children’s executive function significantly predicted their adjustment in all four domains.Notably,the initial level of executive function fully mediated the association between paternal autonomy support and school adjustment,whereas the rate of change in executive function did not serve as a significant mediator.Thesefindings underscore the importance of promoting parental autonomy-supportive behaviors-particularly among fathers-as a means to enhance children’s executive functioning and,consequently,their school adjustment.
基金supported by the Shenzhen Educational Research Funding(grant number zdzb2014)Shenzhen Science and Technology Innovation Commission(grant number 202307313000096)+3 种基金Social Science Foundation from China’s Ministry of Education(grant number 23YJA880093)Post-doctoral Fellowship(grant number 2022M711174)National Center for Mental Health(grant number Z014)Research Excellence Scholarships of Shenzhen University(grant number ZYZD2305).
文摘Background:There is growing evidence that an acute bout of exercise positively influences executive function(EF).However,the existing evidence primarily originates from laboratory-based studies,and only a limited number of studies have extended this work to real-world classroom settings.Accordingly,in the present study,we aimed to employ a real classroom setting to determine whether acute exercise-induced effects on EF emerged.Methods:All 49 students who enrolled in a real-world course agreed to participate in the experimental protocol and the final sample was composed of 43 individuals(13 male and 30 female participants).Participants were asked to perform an acute bout of exercise(i.e,10 min at moderate intensity)before a real classroom,and on a separate day,complete a non-exercise control condition.EF was assessed via Naming,Inhibition,and Switching variants of the Stroop task.We used a paired-samples t-test to compare participants’cognitive load between two conditions and a repeated-measures ANOVA to investigate changes in RPE.What’s more,a repeated measures ANOVA was used to examine potential pre-to post-class changes in EF-related parameters(e.g.,inverse efficiency scores,reaction times,and error rates).Results:A pre-to post-class benefit in performance efficiency across all Stroop task variants was shown.In both exercise and control conditions,there was a significant main effect of time,with lower inverse efficiency scores(IES)(p=0.003)and shorter reaction times(RT)(p<0.001)observed from pre-to post-class.Moreover,performance gains varied by Stroop task-type,with the Switching task showing the longest RTs and largest IES,reflecting its greater cognitive demands.Importantly,a marginally significant three-way interaction among task-type,intervention,and time(p=0.052)indicated that the exercise intervention enhanced post-class performance on the Switching task.Post-hoc analyses revealed significantly lower IES and faster RTs at post-class for both the Naming and Switching tasks,particularly in the exercise group(e.g.,Switching IES:p<0.001;Switching RT:p<0.001).Conclusions:These findings suggest that pre-class acute exercise enhances EF and provides a benefit to cognitive flexibility.Accordingly,our results extend previous knowledge by indicating that the cognitive benefits of acute exercise observed primarily in laboratory settings can be translated to real-world educational contexts.
基金supported by the STI 2030-Major Projects(2021ZD0200500).
文摘Background:Adverse childhood experiences(ACEs)are a significant issue in adolescent health due to their robust correlation with deficits in executive functions(EF)and health risk behaviors(HRBs).This study aimed to examine the association between ACEs and a range of HRBs,including substance use,sexual risk behavior,suicidal ideation,physical inactivity,and violence.Methods:This cross-sectional study used self-administered questionnaire and cluster sampling in seven junior high schools in Samarinda,Indonesia,with a sample size of 534 students.Data analysis using descriptive statistics,the Chi-square test,the independent t-test,ANOVA,binary logistic regression,and mediation analysis with macro-PROCESS.Results:The most common ACEs were community violence(68.0%),physical neglect(52.8%),psychological/emotional abuse(52.6%),physical abuse(50.4%),and peer bullying(45.9%).Adolescents with more than five ACEs showed significantly higher involvement in smoking/vaping(67.9%),suicidal ideation(75.2%),sexual risk behavior(57.7%),bullying(64.3%),and physical fighting(59.7%)(p<0.001).ACEs were significantly correlated with EF deficits(r=0.471,p<0.01)and HRB(r=0.578,p<0.01).Regression analysis confirmed that ACEs predicted EF deficits(β=0.466,p<0.001)and HRB(β=0.469,p<0.001),with EF deficits partially mediating this relationship(β=0.107,95%CI[0.045,0.094]).In addition,two subdomains of EF deficits,self-motivation(β=0.042)and self-regulation of emotion(β=0.032),significantlymediated the relationship between ACEs and HRBs.Conclusion:These findings suggest an important role for EF deficits in linking childhood adversity to engagement in risky behaviors.Addressing ACEs and EF deficits(self-motivation and self-regulation of emotion)through early intervention may be important in reducing long-term health risks among Indonesian adolescents.
文摘近年来,抑郁症(major depressive disorder,MDD)与注意缺陷多动障碍(attention deficit hyperactivity disorder,ADHD)共病的现象愈发受到关注。在成人患者中,MDD共病ADHD通常意味着治疗费用高昂、药物反应欠佳以及疾病预后不良,且现有药物治疗存在一定局限性。考虑到执行功能障碍作为MDD和ADHD的关键共同特征,从执行功能层面出发,探讨共病在脑影像学方面的潜在机制,并寻求更为有效的治疗方法,显得尤为重要。近年来的研究表明,经颅直流电刺激(transcranial direct current stimulation,tDCS)作为一种能够调节特定脑区活动的非侵入性物理治疗方法,可有效改善MDD及成人ADHD的相关症状。该文回顾成人MDD共病ADHD所面临的治疗困境,从与执行功能相关的脑结构、脑功能网络等多个维度,综述成人MDD共病ADHD的可能机制,同时探讨了tDCS在治疗成人MDD共病ADHD的应用前景。
