While psychological and emotional changes have been reported in some cases of idiopathic central precocious puberty (CPP), definitive conclusions about these associations are still lacking. This study aimed to investigate the emotional and psychosocial dimensions of girls diagnosed with CPP compared to healthy controls. The study comprised 21 cases with CPP and their parents, as well as 22 healthy controls and their parents. All participants underwent the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime (KSADS-PL) during psychiatric evaluation. Additionally, patients completed the Revised Child Anxiety and Depression Scale -Child (RCADS-CV), and Pediatric Quality of Life Inventory (PedsQL) questionnaire. Parents completed the Attention Deficit Hyperactivity Disorder Scale (ADHD), Emotion Regulation Checklist (ERC), Children Empathy-Systemize Scale (EQ-SQ), Strengths and Difficulties Questionnaire (SDQ), Revised Child Anxiety and Depression Scales -Parent Version (RCADS-P), Pediatric Quality of Life Inventory (PedsQL) for their children, and the Beck Depression Inventory for themselves. The median ages in the CPP and control groups were 7.6 years (range: 6-8) and 7.2 years (range: 6.5-8), respectively. KSADS-PL revealed significantly higher rates of anxiety disorder in CPP cases compared to controls. Notable differences were found in the impulsivity subscale of the ADHD scale, physical and school functioning in PedsQL (child and parent forms), peer problems in the SDQ, emotion regulation (ERC), and social phobia and separation anxiety (RCADS-CV). Parental separation anxiety (RCADS-P) also showed significant differences between groups.  Our findings suggest that patients diagnosed with precocious puberty are at an increased risk for psychiatric comorbidities compared to the control group. It is crucial to consider children's psychiatric comorbidities at the time of diagnosis. Additionally, this study provides data for future investigations aimed at assessing stress levels following GnRHa treatment. • Early pubertal onset has been associated with increased vulnerability to anxiety, emotional distress, and  psychosocial difficulties in children. • Previous studies on idiopathic CPP have reported inconsistent findings regarding the extent of psychological and behavioral impairments. • This study demonstrates that girls with idiopathic CPP show significantly higher rates of DSM-based anxiety disorders and broader psychosocial difficulties at the time of diagnosis. • In addition to anxiety, impairments in emotional regulation, peer relationships, impulsivity, and quality of life were identified, highlighting a multidimensional psychosocial impact.
Millions of people struggle with compulsive/problematic pornography use (i.e., PPU) or self-perceived addiction (i.e., SPA) to pornography. Despite pornography's global availability and PPU's recent official recognition as a manifestation of compulsive sexual behavior disorder, these problems remain poorly understood, primarily due to a lack of rigorous research beyond small, homogeneous samples. To address this gap and provide evidence that is both robust and generalizable, we tested the applicability of the Moral Incongruence Model of Pornography Use across diverse populations. This model posits that individuals develop problems with their pornography use due to behavioral dysregulation (i.e., PPU) and/or when their use conflicts with their moral values (i.e., moral incongruence), often influenced by religious beliefs, resulting in SPA. Using data from the International Sex Survey (N = 66,994; 50.8% women), we examined the associations between religiosity, pornography use frequency, PPU, and SPA, considering moral incongruence as a moderator. We employed multi-group structural equation models across 34 countries, three genders, and seven religious affiliations. Results indicated that the model was invariant across all countries, genders, and religious affiliations, with weak and positive associations between religiosity and PPU/SPA, and moderate-to-strong associations between pornography use frequency and PPU/SPA. Moral incongruence moderated the relationship between pornography use frequency and PPU/SPA, with stronger associations at higher levels of moral disapproval. These findings suggest that, regardless of cultural background, gender, or religion, the same mechanisms may underlie PPU/SPA, supporting the generalizability of the Moral Incongruence Model and its relevance to current international diagnostic guidelines.
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Initial presentations of psychosis require a thorough physical health assessment to identify comorbidities, establish treatment safety and exclude organic causes of psychosis. Despite clinical consensus that these assessments are essential, global guidelines are variable and outdated. This work aimed to synthesise current evidence to inform updated recommendations for physical assessments in psychosis, balancing thorough investigation with practical applicability. A scoping review of physical health disorders associated with psychosis was conducted using PubMed, Embase and CINAHL. Separately, a systematic review of international guidelines from 2000 to 2025 was performed, extracting physical health assessment recommendations for schizophrenia spectrum disorders. A narrative analysis evaluated the clinical utility of identified investigations. Eighty-four physical health disorders with potential psychotic presentations were identified, mostly rare and typically associated with other neurological or systemic features. There was significant heterogeneity in investigations advised by the 25 identified guidelines, outside of the common consideration for metabolic screening. The majority of guidelines considered investigations for both the exclusion of organic causes of psychosis and identifying a physical health baseline or comorbidity. There was limited consistency around recommendations for neuroimaging or autoimmune screening. Clinical assessment remains central to determining appropriate investigations. Global inconsistency in assessment recommendations reflects the complexity of distinguishing organic psychoses from primary psychiatric disorders. Structured yet individualised assessments, informed by symptomatology and risk factors, are essential. A staged, context-sensitive approach is proposed to optimise diagnostic accuracy and avoid unnecessary testing. Updated, evidence-informed guidelines are critical for improving care for people with psychosis.
Background Deliberate self-harm (DSH) represents intentional self-inflicted physical injury encompassing both non-suicidal self-injurious acts and suicide attempts, constituting a significant psychiatric emergency with profound morbidity implications. Individuals with personality disorders demonstrate substantially elevated suicide attempt rates compared to those without personality pathology. Comprehensive psychosocial assessment remains fundamental for evaluating DSH presentations. While research has investigated socioeconomic determinants and personality disorders among adolescent populations, investigations examining general adult populations remain limited. This study determined personality profiles among DSH patients and investigated relationships between sociodemographic factors and DSH behaviors. Methodology This analytical cross-sectional investigation enrolled 193 adults presenting with DSH to the RL Jalappa Hospital Psychiatry Department, Sri Devaraj Urs Medical College, Kolar, Karnataka, India, between September 2022 and December 2023. Comprehensive histories were obtained through patient interviews and reliable informant collateral and discussed with departmental psychiatrists. Personality diagnoses were established according to the International Classification of Diseases, 10th Revision (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria using the International Personality Disorder Examination screening questionnaire, with responses documented and scored. Results Among 193 participants, the mean age was 31 years (31.46±9.75), with 99 females (51.3%) and 94 males (48.7%). Lower socioeconomic status characterized 70% (n=136), while 132 were unmarried (68.4%). Ninety-three participants were unemployed (48.2%), with 164 from rural areas (84.9%). One hundred eleven participants (57.5%) attempted DSH without psychiatric illness, whereas 82 (42.5%) had psychiatric comorbidity: adjustment disorders, 33 cases (17.1%), depression, 22 cases (11.4%). One hundred and three participants (53.4%) reported previous suicide attempts. Family conflicts precipitated stress (n=60, 60.6%) and financial difficulties (n=22, 22.2%). Methods included liquid poison in 127 cases (65.8%), multiple tablets in 28 (14.5%), hanging in 24 (12.4%), and self-cutting in 15 (7.8%). Substance abuse affected 97 participants (50.25%). Borderline personality predominated in 48 cases (24.9%), dependent in 42 (21.8%), and impulsive in 27 (14%). Cluster B constituted 98 cases (50.8%), Cluster C 66 (34.2%), and Cluster A 29 (15%). Significant Cluster B associations included younger age, female gender, lower education, lower socioeconomic status, unmarried status, unemployment, recurrent attempts, stressors, substance abuse, and the liquid poison method (p<0.05). Conclusion Psychiatric disorders constitute established self-harm risk factors, with findings demonstrating literature consistency. Cluster B personality disorders, particularly borderline traits, predominate among DSH presentations. Multiple sociodemographic vulnerabilities, including younger age, female gender, socioeconomic disadvantage, unemployment, and substance abuse, are significantly associated with personality clustering. Larger investigations warrant a comprehensive personality profile evaluation among suicide attempters.
Exposure-associated physiologic reactions (EAPR) represent unexpected physiologic responses to medications, food additives, environmental exposures, and immunologic stimuli that are increasingly encountered in modern clinical practice. While most exposures are well-tolerated, a subset of individuals develops disproportionate, multisystem responses that do not conform to traditional models of hypersensitivity, toxicity, or pharmacologic effect. These reactions are frequently misattributed to primary disease processes due to their atypical and transient nature, leading to diagnostic uncertainty and unnecessary investigation. Emerging clinical observations suggest that such responses may represent a broader and previously underrecognized phenomenon. This review proposes the concept of EAPR as a unifying clinical framework describing non-classical, often non-IgE-mediated responses to pharmacologic, dietary, environmental, and immunologic exposures. Drawing upon case-based evidence involving cardiovascular, renal, neurologic, ophthalmologic, and autonomic manifestations, this article integrates diverse observations into a cohesive mechanistic and diagnostic model. Recognition of EAPR may improve diagnostic accuracy, reduce unnecessary investigations, and enhance pharmacovigilance by integrating fragmented clinical observations into a coherent and clinically actionable framework. This framework is intended as a conceptual and hypothesis-generating model and requires further validation through systematic investigation.
Traumatic brain injury (TBI) plays a major role in mortality rates and is often associated with investigations in forensic and neuropathological fields. New bioassays and data analysis techniques for use in TBI diagnostics applicable to both ante- and post-mortem individuals must constantly be investigated in light of scientific and clinical advancements. The multifunctional and evolutionarily conserved oncoprotein Y-box binding protein 1 (YB-1) has attracted significant attention in the oncology and neuroscience community, because of its versatile roles in gene transcription, DNA damage repair, RNA splicing, cell cycle progression, autophagy and immunity. The aim of this study sought to clarify whether increased levels of YB-1 in biofluids like serum and cerebrospinal fluid (CSF) are present in cases of TBI during a population-based autopsy screening. The comparative analysis of YB-1 protein expression in the collected brain tissue through immunohistochemical staining was additionally done. The research involved a total of 40 cases, divided evenly into two groups including individuals with severe head injuries (n = 20) suspected to be the cause of death and control cases of sudden death (n = 20) due to cardiopulmonary failure. Biofluids, including serum and CSF were collected approximately 24 h post-mortem and analyzed through ELISA testing. Additionally, brain specimens were obtained during forensic autopsies and subjected to immunohistochemical staining. In present study, we observed the elevated concentration level of YB-1 in serum and CSF. In anti-YB-1 staining of the frontal cortex, a significant, generalized homogenization of the reaction was observed both within the neuronal bodies and their axons among the head injury group. In the anti-YB-1 staining of the hippocampus, homogenization in some number of its projection cells was observed within head injury group. The coexistent altitude of YB-1 in biofluids with its generalized homogenization image in immunohistochemical staigings seems to confirm the recapitulation of developmental changes after TBI and its associated potential transcriptomic, methylomics and proteomic signatures resembling neurogenesis. The potential use of YB-1 assays offers an interesting and novel tool for investigation and research regarding TBI diagnosis and pathogenesis.
'Query encephalitis' is one of the most common reasons for inpatient neurology referral in the context of an acutely confused patient. Growing evidence suggests that time to treatment is a key determinant of outcome in both infectious and autoimmune encephalitis; hence, these two causes should be considered simultaneously at presentation. However, under-recognition and the existence of several mimics make a rapid diagnosis of encephalitis challenging. Appreciation of clinical syndromes can guide aetiological investigation and consequent treatment. In this article, we discuss clinical phenotypes associated with both infectious and autoimmune encephalitis, as well as a systematic approach to their investigation and up-to-date treatment strategies. We also highlight ongoing areas of research, such as metagenomics and therapeutic trials.
Empirical research on maladaptive daydreaming (MD), a clinically impairing form of compulsive immersive fantasy associated with attention dysregulation, emotional dysregulation and digital behavioural addictions, has expanded substantially over the past decade. Despite this growth, the intellectual structure, thematic evolution and collaborative networks of the MD literature indexed in the Web of Science Core Collection (WoSCC) remain unmapped. This bibliometric study aimed to characterise the intellectual landscape of WoSCC-indexed MD research between 2009 and 2025. A total of 141 publications were analysed using bibliometrix (R), VOSviewer and Python-based network analyses. The corpus accumulated 2187 citations with a mean of 15.5 citations per document and a field h-index of 26. Israel, the United States and Italy were the most productive countries. Four thematic clusters emerged: core MD phenomenology and dissociation; neurodevelopmental and attentional correlates; emotional dysregulation and pandemic-related psychopathology and digital behavioural addictions. Thematic evolution revealed a shift from phenomenological description toward multidimensional clinical investigation with increasing neurodevelopmental integration. Persistent gaps include longitudinal studies, randomized controlled trials and neurobiological investigations. These findings clarify the structure, thematic evolution and collaborative landscape of the Web of Science-indexed literature on MD and identify underdeveloped areas for future empirical work.
Alcohol-related attentional bias (AB) is a central mechanism in alcohol use disorder (AUD), yet its temporal dynamics and measurement reliability remain debated. This study investigated the psychometric properties and temporal characteristics of AB in a clinical sample using a multimodal approach. Patients with AUD (N = 49) completed a visual-probe task at short (200 ms) and long (2000 ms) stimulus-onset asynchronies (SOAs). Reaction times (RT) and eye-tracking (ET) indices were evaluated, including dwell time, fixation count, and first fixation landing position, with internal reliability assessed specifically for AB indices (difference scores) and correlations across modalities. RT-based AB-indices showed moderate split-half reliability at short and good reliability at long SOAs. ET-base AB indices of dwell time and fixation count demonstrated good reliability. Contrary to some prior studies, multimodal measures were interrelated, with significant correlations between dwell time and RT-based AB indices at both SOAs. RTs revealed a biphasic pattern via a significant approach bias at 200 ms and avoidance at 2000 ms. However, ET indices showed no significant effects for dwell time or fixation count. AB correlated with momentary craving, which was generally low in this clinical sample, but not with AUD severity. No significant differences were observed based on alcohol type preference. Manual RTs captured the dynamic pattern of the approach-avoidance time course of AB. Findings support a state-dependent perspective, suggesting AB reflects a fluid motivational state rather than a stable trait. Overall, the results indicate that AB indices can be measured with acceptable reliability, supporting further investigation of attentional processes in AUD.
To validate the French version of the Menstrual Distress Questionnaire (MEDI-Q) for use in French-speaking populations. The study involved translation and cultural adaptation of the MEDI-Q from English to French, followed by a cross-sectional validation study. A sample of 266 French-speaking women aged 18-50 completed the French MEDI-Q, Brief Symptom Inventory (BSI), and Shortened Premenstrual Assessment Form (SPAF). Psychometric properties were assessed, including internal consistency, test-retest reliability, and convergent validity. The French MEDI-Q demonstrated good internal consistency (Cronbach's α = 0.84, McDonald's ω = 0.86) and excellent test-retest reliability (ICC = 0.94). Convergent validity was confirmed through significant correlations with age, psychological distress, and premenstrual symptoms. The French-speaking sample showed higher average MEDI-Q scores compared to previous Italian and English validations, particularly in items related to menstrual bleeding distress and feelings of being dirty. The French version of MEDI-Q exhibits robust psychometric properties, supporting its use in French-speaking populations. The observed differences in scores highlight potential cultural variations in menstrual experiences, warranting further investigation into cross-cultural perceptions of menstruation.
Postherpetic neuralgia (PHN) is often accompanied by depression, creating a vicious cycle that exacerbates symptoms and contributes to suboptimal treatment outcomes, even with interventional therapies. Repetitive transcranial magnetic stimulation (rTMS) has demonstrated potential in alleviating both pain and mood disturbances. However, its efficacy in enhancing prognosis when used alongside interventional neuromodulation therapy for PHN accompanied by depression remains inadequately explored and requires further investigation. This study aims to generate preliminary evidence on the efficacy and safety of rTMS in enhancing prognosis and alleviating pain in patients with PHN and mild to moderate depression undergoing interventional neuromodulation therapy. This study is a single-center, randomized, double-blind, placebo-controlled trial involving 174 adult patients with PHN. Participants will be randomly assigned, stratified by interventional neuromodulation therapy, to either the rTMS group (n=87) or the control group (n=87). Both groups will undergo either 10 Hz rTMS or sham stimulation for five consecutive days. The primary outcome is the incidence of poor prognosis at 3 months post-discharge. Secondary outcomes include the incidence of poor prognosis at 6 months post-discharge; Visual Analog Scale (VAS) sleep scores; short-form McGill Pain Questionnaire (SF-MPQ) scores; Self-Rating Depression Scale (SDS) scores; patient satisfaction; Pain Disability Index (PDI) scores; Multidimensional Fatigue Inventory-20 (MFI-20) scores; pregabalin oral doses; and the need for tramadol or antidepressants. Safety outcomes will include assessments of headache, pain at the stimulation site, neck pain, insomnia, muscle soreness, dizziness, nausea, tinnitus, irritability, tachycardia (heart rate > 100 bpm), and epilepsy. Data will be analyzed using a modified intention-to-treat approach. This study aims to provide preliminary evidence on the efficacy and safety of 10 Hz rTMS in improving prognosis and alleviating pain in PHN patients with mild to moderate depression undergoing interventional pain management. https://www.chictr.org.cn/bin/project/edit?pid=261070, identifier ChiCTR2500096978.
Early intervention efforts can be transformative for young children with autism, and parent involvement is an increasingly common component of many contemporary treatment models linked to enhanced long-term social communication and developmental outcomes. However, Spanish-speaking families face language barriers that limit opportunities to be trained in these strategies, directly contributing to disparities in their children's developmental outcomes. This study aims to address this barrier by exploring the feasibility, acceptability, and preliminary efficacy of a Spanish-translated and adapted pivotal response treatment (PRT) early intervention model. Using a multiple baseline across participant experimental design, the primary objective of this investigation was to evaluate the impact of ongoing participation in a Spanish PRT workshop on parent fidelity (mastery) of treatment implementation and child verbal responses using behavioral coding and parent-report measures. The study included three children with autism aged 18-60 months and their caregiver(s). Parents completed questionnaires, four PRT instructional lessons, and six in-person coaching sessions. Parent-child interaction videos were recorded at intake and after each in-person session to monitor participant process. All participants met fidelity of implementation criteria (>80%) for the PRT strategies, demonstrating the ability to successfully implement the core intervention components. Parents also reported improvements in their self-perceived (a) comprehension of the PRT principles and (b) confidence in applying them effectively. Lastly, children demonstrated improvements in the frequency of their verbal responses. These results suggest that the Spanish adaptation of PRT can effectively teach parents to understand and implement basic PRT components and facilitate language development in their autistic children.
Isolated rapid eye movement (REM) sleep behavior disorder (iRBD) involves dream enactment behaviors (DEBs) during REM sleep, accompanied by REM sleep without atonia (RWA). While most DEBs are bed-confined, a minority engage in ambulatory behaviors. This study investigated clinical, behavioral, and physiological characteristics of iRBD patients exhibiting ambulatory behaviors. We retrospectively reviewed electronic medical records of 361 patients with video-polysomnography (v-PSG)-confirmed iRBD (mean age: 66.9 years; 59.0% males). Patients reporting at least one DEB episode involving ambulation out of the bedroom were classified as RBD-walkers; those without any ambulatory episodes as non-walkers. Clinical assessments, dream contents, behaviors, and PSG metrics were compared between groups. 31 patients (8.6%) were categorized as RBD-walkers, none with prior history of sleepwalking. RBD-walkers were more frequently female (64.5% vs. 38.0%, p = 0.006) and showed higher RBDQ-KR Factor 1 scores (15.7 vs. 12.6, p = 0.005). Combined clonazepam-melatonin use was more common among RBD-walkers (38.7% vs. 19.8%, adjusted residual = +2.443). Behaviorally, they frequently exhibited escape-related motor behaviors and object-interactive behaviors. PSG findings revealed preserved sleep architecture, along with elevated RWA and REM EMG amplitude (6.7 μV vs. 3.6 μV, p = 0.009) in RBD-walkers. RBD-walkers represent a clinically and physiologically distinct iRBD subgroup, marked by complex ambulatory behaviors, increased treatment demands, and elevated RWA and REM EMG amplitude despite preserved sleep structure. These findings suggest that ambulatory DEB may arise from multifactorial mechanisms beyond simple REM-atonia loss, warranting further investigation for pathophysiology and clinical implications.
This study aims to explore whether psychological detachment mediates the relationship between job stress and presenteeism among clinical nurses, and to determine the extent of the interaction between job stress, psychological detachment, and presenteeism. This study employed a convenience sampling method to select clinical nurses from five hospitals in Sichuan Province as the subjects of the investigation. A questionnaire survey was conducted using a general information survey form, the Chinese Nurses Stressor Scale (CNSS), the Psychological Detachment Questionnaire (PDQ), and the Stanford Presenteeism Scale-6 (SPS-6). A total of 325 valid questionnaires were collected. The mean scores for the CNSS, PDQ, and SPS-6 were (94.64 ± 15.89), (9.76 ± 3.60), and (21.01 ± 5.42), respectively. A positive correlation was observed between clinical nurses' presenteeism and job stress, while a significant negative correlation was found with psychological detachment (all p < 0.05). Job stress positively predicted presenteeism, whereas psychological detachment negatively influences presenteeism. Furthermore, psychological detachment partially mediates the relationship between job stress and presenteeism among clinical nurses, with an indirect effect of 0.06, accounting for 30% of the total effect. The findings indicate that job stress exerts both direct and indirect effects on the presenteeism of clinical nurses, with psychological detachment serving as a partial mediating factor that attenuates nurses' levels of presenteeism.
Severe mental illness (SMI) is associated with substantial barriers to competitive employment, including stigma, cognitive impairments, and limited social support. The Individual Placement and Support (IPS) model is an evidence-based intervention that provides individualized assistance for job search, placement, and retention. Although IPS has shown effectiveness in high-income countries, there is limited evidence regarding its feasibility and preliminary outcomes in low- and middle-income settings, particularly in Latin America. This pilot randomized controlled trial will assess the feasibility of implementing the IPS model for adults with SMI in Jalisco, Mexico. We will recruit 120 participants who are actively seeking employment and randomly assign them to either the IPS intervention or a control group receiving standard employment services. The intervention includes tailored support from trained IPS Employment Specialists in resume building, interview preparation, job search, and follow-up after job placement. Primary feasibility outcomes include recruitment and retention rates, participant acceptance, implementation fidelity, and identification of contextual barriers and facilitators. Secondary outcomes will explore employment status at 12 months, financial well-being, and health-related outcomes. Findings from this pilot study will contribute to addressing the current gap in implementation research on IPS in Latin America. Findings will offer preliminary insights into the feasibility, acceptability, and contextual adaptability of the model in a public mental health setting. These results are expected to guide the refinement of study procedures and support planning for a future definitive trial. Additionally, exploratory data on employment and quality of life outcomes may help identify relevant domains for further investigation. ClinicalTrials.gov NCT06019247. Registered on August 31, 2023.
Stress engages coordinated psychological, neuroendocrine, autonomic, and neural processes that enable adaptation to environmental demands but may contribute to vulnerability when stress is prolonged, uncontrollable, or socially evaluative. Functional neuroimaging has become central to psychoneuroendocrinology by enabling direct investigation of how acute stress shapes brain activation and connectivity and how these neural responses interact with hypothalamic-pituitary-adrenal axis regulation. This editorial introduces the Special Issue "Effects of stress on brain activation changes: Recent developments" and outlines key conceptual and methodological advances in the field. We highlight progress from endocrine-marker-based stress research toward brain-based models of stress, emphasizing evidence from scanner-based paradigms such as the Montreal Imaging Stress Task and ScanSTRESS, as well as emerging multimodal approaches including fNIRS, PET, EEG, and harmonized large-scale analyses. We discuss recent developments concerning exposure-time effects, network-level models of stress processing, and the importance of functional connectivity. We further emphasize the need to account for individual and contextual variability, including sex, gender, developmental stage, clinical vulnerability, and real-world stress relevance. This Special Issue invites contributions that use neuroimaging to advance mechanistic, translational, and reproducible models of stress-related brain function.
Reward brain circuitry dysfunction is a hypothesized mechanism of bipolar disorder and alcohol use disorder co-occurrence (BD + AUD) that remains largely untested. This neuroimaging study represents the first investigation of functional connectivity in BD + AUD. Following a two-by-two factorial design (N = 90), individuals with BD + AUD (n = 22), AUD alone (n = 20), BD alone (n = 23), and healthy control participants (n = 25) were administered a fMRI alcohol-cue reactivity paradigm. Generalized psychophysiological interaction (PPI) modeling (p < 0.001; p-FDR < 0.05) was performed for regions of interest, including the right dorsal anterior insula, inferior frontal gyrus, and bilateral amygdala and dorsal striatum (i.e., caudate body). Extracted beta weights were explored for bivariate associations with key behavioral correlates (AUD age of onset, alcohol craving and dependence severity, abstinence duration, and impulsivity) (p < 0.05). BD + AUD individuals exhibited cue-modulated hyperconnectivity between the left dorsal striatum and right posterior cingulate cortex (p-FDR = 0.045) versus the AUD and BD groups, who both exhibited hypoconnectivity between these regions versus healthy participants. Additionally, there were main effects of AUD and BD (p-FDR ≤ 0.040) on cue-modulated functional connectivity of the right dAI (↓ middle frontal gyrus [MFG]) and left amygdala (↑ right superior temporal gyrus, anterior cingulate cortex, and MFG), respectively. Select functional connectivity data were associated with trait characteristics of AUD in BD + AUD (r ≥±0.50, p ≤ 0.026) but not AUD. A distinct pattern of cortico-striato-limbic functional connectivity and brain-behavior relationships was found to characterize BD + AUD with implications for treatment development. Namely, leveraging neuromodulation techniques that can effectively normalize the identified circuitry disruptions could represent a novel path for treatment advances in BD + AUD.
This study aimed to evaluate serum levels of the microglia-regulating cytokines IL-34 and CSF-1, as well as T-helper cytokines IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23, in individuals with autism and healthy controls, and to investigate the relationships between these parameters and the severity of autism symptoms. The study sample consisted of 42 children diagnosed with autism spectrum disorder (ASD) and 40 healthy participants. The severity of autism in the patient group was assessed using the Childhood Autism Rating Scale (CARS). Serum levels of IL-34, CSF-1, IL-12, IFN-γ, IL-4, IL-10, TGF-β, IL-17 and IL-23 were measured using the ELISA method. Serum levels of IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 were significantly higher in the ASD group compared to the control group. IL-34, CSF-1, IFN-γ, IL-4, IL-10 and IL-17 showed significant discriminative power in distinguishing ASD (p < 0.05). ROC analysis indicated that IL-10 had the highest area under the curve (AUC = 0.743; p < 0.001), and Delong test results demonstrated that its discriminative ability was statistically stronger than that of the other parameters. No significant correlations were observed between the examined cytokine levels and autism severity. Our findings indicate that IL-34 and CSF-1, along with T-helper-related cytokines (IFN-γ, IL-4, IL-10 and IL-17), were elevated in the ASD group. These alterations may reflect underlying pathophysiological processes. However, due to the cross-sectional design and limited sample size, the findings should be interpreted with caution, and their clinical utility requires further investigation in larger, longitudinal studies.
Intraindividual cognitive variability (IICV) is a promising measure for early identification of dementia risk. Fewer studies have assessed IICV using high-frequency digital cognitive assessment or in populations with medical conditions. We aimed to characterize associations between IICV for reaction time and accuracy with plasma biomarkers of neurodegeneration (phosphorylated tau 181, phosphorylated tau 217, β-amyloid 42/40 ratio, glial fibrillary acidic protein, and neurofilament light chain) in individuals with Type 1 diabetes. We analyzed data from 114 participants from the Glycemic Variability and Fluctuations in Cognitive Status in Adults With Type 1 Diabetes study who provided blood samples (M = 48.9 years, range = 19-84). Cognition was assessed digitally at baseline and three times daily for 15 days via ecological momentary assessment. Hierarchical linear regression models examined associations between biomarkers and IICV, adjusting for demographics, glycemic variability, mean cognition, and nephropathy. Multiple testing correction used Benjamini-Hochberg. IICVs for reaction time at baseline and across repeated assessments were correlated and associated with β-amyloid 42/40, glial fibrillary acidic protein, neurofilament light chain, and phosphorylated tau 217 (small to moderate effect size, p < .05), but associations did not remain significant after adjustment. Exploratory analyses indicated interactions with age and sex. IICV for accuracy was not associated with any biomarker. Although associations between IICV and plasma biomarkers were not robust after full adjustment, exploratory analyses suggested potential interactions with age and sex. The sample was predominantly non-Hispanic White, limiting the generalizability of our findings. These findings support continued investigation of digital IICV as a dynamic marker of early cognitive vulnerability. (PsycInfo Database Record (c) 2026 APA, all rights reserved).