Epilepsy is a diverse brain disorder, and the pathophysiology of its various forms and comorbidities is largely unknown. A recent machine learning method enables us to estimate an individual's ..."brain-age" from MRI; this brain-age prediction is expected as a novel individual biomarker of neuropsychiatric disorders. The aims of this study were to estimate the brain-age for various categories of epilepsy and to evaluate clinical discrimination by brain-age for (1) the effect of psychosis on temporal lobe epilepsy (TLE), (2) psychogenic nonepileptic seizures (PNESs) from MRI-negative epilepsies, and (3) progressive myoclonic epilepsy (PME) from juvenile myoclonic epilepsy (JME). In total, 1196 T1-weighted MRI scans from healthy controls (HCs) were used to build a brain-age prediction model with support vector regression. Using the model, we calculated the brain-predicted age difference (brain-PAD: predicted age-chronological age) of the HCs and 318 patients with epilepsy. We compared the brain-PAD values based on the research questions. As a result, all categories of patients except for extra-temporal lobe focal epilepsy showed a significant increase in brain-PAD. TLE with hippocampal sclerosis presented a significantly higher brain-PAD than several other categories. The mean brain-PAD in TLE with inter-ictal psychosis was 10.9 years, which was significantly higher than TLE without psychosis (5.3 years). PNES showed a comparable mean brain-PAD (10.6 years) to that of epilepsy patients. PME had a higher brain-PAD than JME (22.0 vs. 9.3 years). In conclusion, neuroimaging-based brain-age prediction can provide novel insight into or clinical usefulness for the diverse symptoms of epilepsy.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
This randomized, placebo-controlled, crossover, and double-blind trial aimed to examine the possible effects of four weeks L-theanine administration on stress-related symptoms and cognitive functions ...in healthy adults. Participants were 30 individuals (nine men and 21 women; age: 48.3 ± 11.9 years) who had no major psychiatric illness. L-theanine (200 mg/day) or placebo tablets were randomly and blindly assigned for four-week administration. For stress-related symptoms, Self-rating Depression Scale, State-Trait Anxiety Inventory-trait, and Pittsburgh Sleep Quality Index (PSQI) scores decreased after L-theanine administration (
= 0.019, 0.006, and 0.013, respectively). The PSQI subscale scores for sleep latency, sleep disturbance, and use of sleep medication reduced after L-theanine administration, compared to the placebo administration (all
< 0.05). For cognitive functions, verbal fluency and executive function scores improved after L-theanine administration (
= 0.001 and 0.031, respectively). Stratified analyses revealed that scores for verbal fluency (
= 0.002), especially letter fluency (
= 0.002), increased after L-theanine administration, compared to the placebo administration, in individuals who were sub-grouped into the lower half by the median split based on the mean pretreatment scores. Our findings suggest that L-theanine has the potential to promote mental health in the general population with stress-related ailments and cognitive impairments.
Rationale and objectives
The amino acid
l
-theanine (N-ethyl-
l
-glutamine) has historically been considered a relaxing agent. In the present study, we examined the effects of repeated
l
-theanine ...administration on behavior, levels of amino acids in the cerebrospinal fluid (CSF), and hippocampal activity in Wistar Kyoto (WKY) rats, an animal model of anxiety and depressive disorders.
Methods
Behavioral tests were performed after 7–10 days of
l
-theanine (0.4 mg kg
−1
day
−1
) or saline administration, followed by CSF sampling for high-performance liquid chromatography (HPLC) analysis. An independent set of animals was subjected to
18
Ffluorodeoxyglucose positron emission tomography (PET) scanning after the same dose of
l
-theanine or saline administration for 7 days.
Results
In the elevated plus maze test, the time spent in the open arms was significantly longer in the
l
-theanine group than in the saline group (
P
= 0.035). In addition, significantly lower CSF glutamate (
P
= 0.039) and higher methionine (
P
= 0.024) concentrations were observed in the
l
-theanine group than in the saline group. A significant increase in the standard uptake value ratio was observed in the hippocampus/cerebellum of the
l
-theanine group (
P
< 0.001).
Conclusions
These results suggest that
l
-theanine enhances hippocampal activity and exerts anxiolytic effects, which may be mediated by changes in glutamate and methionine levels in the brain. Further study is required to more fully elucidate the mechanisms underlying the effects of
l
-theanine.
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DOBA, EMUNI, FIS, FSPLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Rationale
Glucose is the principal energy substrate for the brain, although ketone bodies are an effective alternative. Evidence suggests that elevation of plasma ketone body levels through oral ...intake of medium chain triglycerides (MCTs) may improve cognitive function.
Objectives
We tried to examine the possible effects of a ketogenic meal serving on cognition in elderly non-demented subjects.
Methods
Subjects were 19 non-demented elderly adults over 60 years old (13 females; mean age: 66.1 ± 2.9 years) who underwent neurocognitive tests 90 and 180 min after oral intake of a ketogenic meal (Ketonformula®) containing 20 g of MCTs and an isocaloric placebo meal without MCTs on separate days.
Results
Elevation of plasma ketone concentration after intake of a single ketogenic meal containing 20 g of MCTs was confirmed (all
p
< 0.001). As for cognition, improvements were observed in the digit span test, Trail-Making Test B, and the global score (
Z
= −2.4,
p
= 0.017) following the ketogenic meal and the change in the executive functioning score was positively correlated with that of the plasma β-hydroxybutyrate level. The cognition-enhancing effect was observed predominantly for individuals who had a relatively low global score at baseline (
Z
= −2.8,
p
= 0.005), compared to individuals with a high global score (Z = −0.7,
p
= 0.51).
Conclusions
Plasma levels of ketone bodies were successfully increased after intake of the ketogenic meal. The ketogenic meal was suggested to have positive effects on working memory, visual attention, and task switching in non-demented elderly.
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DOBA, EMUNI, FIS, FSPLJ, FZAB, GEOZS, GIS, IJS, IMTLJ, IZUM, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UILJ, UKNU, UL, UM, UPUK, VKSCE, VSZLJ, ZAGLJ
Patients with Alzheimer’s disease (AD) and mild cognitive impairment (MCI) exhibit balance deficits. Although only a few studies have evaluated the relationship between the brain images and balance ...indices. In this study, we measured balance indices, including the index of postural stability (IPS) and assessed the relationship between the brain images and their clinical motor and cognitive functional features.
The study included patients with MCI (N = 14) and patients with AD (N = 19). The primary outcome was IPS under a visual block condition and/or a proprioception block condition. In addition, 9 MCI and 8 AD patients underwent a 1.5-Tesla (1.5-T) Magnetic Resonance Imaging (MRI) scan, and the relationships between the MRI parameters and the balance indices were evaluated.
The IPS score was significantly lower in the AD group than the MCI group, but only under the closed eyes/hard surface condition. In terms of MRI, there was a significant positive correlation between the IPS and the regional betweenness centrality in the left hippocampal region.
The finding of a significantly lower IPS score under the closed eyes/hard surface condition in AD than in MCI cases suggests that the vestibular and/or proprioceptive systems were more severely impaired in AD than MCI cases. The results suggest that a dynamic balance disturbance due to deficits of the vestibular hippocampal pathway may be a useful marker for the diagnosis of MCI and detection of disease progression from MCI to AD.
•We showed balance deficit in patients with Alzheimer's disease•There was a positive correlation between balance index and cognitive function•Balance index under closed eyes was associated with network in hippocampal region•Balance deficit may be an effect of impaired vestibular-hippocampal pathway
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Although the pathophysiology of bipolar disorder remains elusive, growing evidence suggests the beneficial effects of
and
in the gut microbiota on stress response and depressive symptoms. In the ...present study, we examined
and
counts for association with bipolar disorder and serum cortisol levels.
Bacterial counts in fecal samples were examined in 39 patients with bipolar disorder according to the Diagnostic and Statistical Manual of Mental Disorders, 4th edn. and 58 healthy controls using bacterial rRNA-targeted reverse transcription-quantitative polymerase chain reaction.
No significant difference was found in either bacterial counts between the two groups. However, we found a significantly negative correlation between
counts and sleep (ρ = -0.45,
= 0.01). Furthermore, a significant negative correlation was found between
counts and cortisol levels (ρ = -0.39,
= 0.02) in the patients, although such a correlation was not found for
counts.
Our results suggest that
or
counts may not play a major role in the pathophysiology of bipolar disorder in our sample. However, the observed negative correlation between
counts and sleep and that between
counts and serum cortisol levels point to the possible roles of these bacteria in sleep and stress response of the patients.
Evidence suggests that oral intake of medium-chain triglycerides (MCTs), which promote the production of ketone bodies, may improve cognitive functions in elderly people; however, the underlying ...brain mechanisms remain elusive. We tested the hypothesis that cognitive improvement accompanies physiological changes in the brain and reflects the use of ketone bodies as an extra energy source. To this end, by using functional magnetic resonance imaging, cerebral blood oxygenation level-dependent (BOLD) signals were measured while 20 healthy elderly subjects (14 females and 6 males; mean age: 65.7 ± 3.9 years) were engaged in executive function tasks (N-back and Go-Nogo) after ingesting a single MCT meal (Ketonformula®) or placebo meal in a randomized, double-blind placebo-controlled design (UMIN000031539). Morphological characteristics of the brain were also examined in relation to the effects of an MCT meal. The MCT meal improved N-back task performance, and this was prominent in subjects who had reduced grey matter volume in the dorsolateral prefrontal cortex (DLPFC), a region known to promote executive functions. When the participants were dichotomized into high/low level groups of global cognitive function at baseline, the high group showed improved N-back task performance, while the low group showed improved Go-Nogo task performance. This was accompanied by decreased BOLD signals in the DLPFC, indicative of the consumption of ketone bodies as an extra energy source.
Alzheimer's disease (AD) and Lewy body disease (LBD), the two most common causes of neurodegenerative dementia with similar clinical manifestations, both show impaired visual attention and altered ...eye movements. However, prior studies have used structured tasks or restricted stimuli, limiting the insights into how eye movements alter and differ between AD and LBD in daily life.
We aimed to comprehensively characterize eye movements of AD and LBD patients on naturalistic complex scenes with broad categories of objects, which would provide a context closer to real-world free viewing, and to identify disease-specific patterns of altered eye movements.
We collected spontaneous viewing behaviors to 200 naturalistic complex scenes from patients with AD or LBD at the prodromal or dementia stage, as well as matched control participants. We then investigated eye movement patterns using a computational visual attention model with high-level image features of object properties and semantic information.
Compared with matched controls, we identified two disease-specific altered patterns of eye movements: diminished visual exploration, which differentially correlates with cognitive impairment in AD and with motor impairment in LBD; and reduced gaze allocation to objects, attributed to a weaker attention bias toward high-level image features in AD and attributed to a greater image-center bias in LBD.
Our findings may help differentiate AD and LBD patients and comprehend their real-world visual behaviors to mitigate the widespread impact of impaired visual attention on daily activities.
Introduction: There have been numerous reports of cluster outbreaks of coronavirus disease 2019 (COVID-19) in hospitals and nursing homes. Healthcare workers fighting COVID-19 experience mental ...health issues. Caregivers in nursing homes experienced increased psychological distress and concern about deterioration of their mental health. We conducted a large-scale web-based survey exploring mental health among caregivers working in nursing homes during the COVID-19 pandemic with the aim of identifying their support needs. Methods: Survey participants were caregivers working at 284 nursing homes in Ibaraki prefecture, Japan. The survey period was from September 2020 to March 2021. Participants responded to a questionnaire covering gender, age, occupation, infections at facilities, infection protection, changes in nursing home users, cooperation with other medical institutions, and prejudice/discrimination. The Hospital Anxiety and Depression Scale (HADS) was used to evaluate participants’ depression and anxiety. Results: In total, 676 participants completed the survey; 350 (52.5%) were with anxiety symptoms and 378 (56.7%) were with depressive symptoms (scores exceeding the HADS cut-off points). The risk for anxiety was associated with being care worker or social worker. The risk of anxiety or depression was high when family caregivers’ mental state changed. Discussion/Conclusion: This study found that caregivers working in nursing homes were exposed to high levels of stress during the COVID-19 pandemic and were at high risk for developing depression and anxiety.
Coronavirus disease 2019 (Covid-19) has caused numerous problems worldwide since 2020. The pandemic and subsequent quarantine policies have resulted in numerous psychological problems among students. ...The quarantine policy forced students to change their behavior and refrain from going out. To date, the relationship between behavioral and psychological changes following the implementation of the quarantine policy has not been investigated. We conducted a web-based survey to investigate the change in time spent out of the house between before and after the implementation of the quarantine policy and how this related to changes in depression. We collected data from 12,088 students, which included the Patients Health Questionnaire-9, frequency of going out, and demographics. We divided subjects into three categories based on the frequency of going out before and after the policy was put in place. Results showed that students who frequently went out before the pandemic and strictly followed the government policy were significantly more depressed than those who did not frequently go out. In contrast, students who had always been reluctant to go out did not have a tendency for depression to worsen. Our findings indicate that behavioral modification leads to depression in those who previously had active social lives.
•Covid-19 induced behavioral changes, which increased depression among students.•Students who went out frequently before the pandemic showed worsening of depression.•Students who tended to stay home did not experience worsening of depression.•Depression among students should be monitored according to their behavioral status.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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