Manli Huang

Association of Cerebral Networks in Resting State with Sexual Preference of Homosexual Men: A Study of Regional Homogeneity and Functional Connectivity

Recent imaging studies have shown that brain morphology and neural activity during sexual arousal differ between homosexual and heterosexual men. However, functional differences in neural networks at the resting state is unknown. The study is to characterize the association of homosexual preference with measures of regional homogeneity and functional connectivity in the resting state. Participants were 26 healthy homosexual men and 26 age-matched healthy heterosexual men in whom we collected echo planar magnetic resonance imaging data in the resting state. The sexual orientation was evaluated using the Kinsey Scale. We first assessed group differences in regional homogeneity and then, taking the identified differences as seed regions, we compared groups in measures of functional connectivity from those seeds. The behavioral significances of the differences in regional homogeneity and functional connectivity were assessed by examining their associations with Kinsey Scores. Homosexual participants showed significantly reduced regional homogeneity in the left inferior occipital gyrus, right middle occipital gyrus, right superior occipital gyrus, left cuneus, right precuneus, and increased regional homogeneity in rectal gyrus, bilateral midbrain, and left temporal lobe. Regional homogeneity correlated positively with Kinsey scores in the left inferior occipital gyrus. The homosexual group also showed reduced functional connectivity between left middle temporal gyrus, left supra-marginal gyrus, right cuneus and the seed region, i.e. left inferior occipital gyrus. Additionly, the connection between the left inferior occipital gyrus and right thalamus correlated positively with Kinsey scores. These differences in regional homogeneity and functional connectivity may contribute to a better understanding of the neural basis of male sexual orientation.

Patterns of Brain Activation during Visually Evoked Sexual Arousal Differ between Homosexual and Heterosexual Men

BACKGROUND AND PURPOSE: Nowadays the mechanism of homosexuality is little known. Few studies have been carried out to explore the brain functional changes of homosexual men during sexual arousal. We used functional MR imaging (fMRI) to determine whether the patterns of brain activation in homosexual and heterosexual men differed during visually evoked sexual arousal. MATERIALS AND METHODS: To all the subjects (10 homosexual and 10 heterosexual), real-time visual stimulation was provided by 3-minute exposure to 3 types of erotic film: heterosexual couples (F-M), male homosexual couples (M-M), and female homosexual couples (F-F) engaged in sexual activity, during which time fMRI was used to determine the patterns of brain activation. Self-reports of level of sexual arousal were collected immediately afterward. RESULTS: Statistical parametric mapping showed that viewing erotic film excerpts that induced sexual arousal was associated, in both groups, with activation of the middle prefrontal gyrus, bilateral temporal lobe and postcentral gyrus, thalamus, insula, vermis, left precuneus, occipital cortex, parietal cortex, and cerebellum. In homosexual men, the left angular gyrus, left caudate nucleus, and right pallidum were activated; in contrast, heterosexual men showed no activation in these regions. However, heterosexual men showed activation in the bilateral lingual gyrus, right hippocampus, and right parahippocampal gyrus, areas not activated in homosexual men. In both groups, region-of-interest analysis revealed no correlation between the magnitude of amygdala or thalamus activation and the reported level of sexual arousal. CONCLUSION: Our findings indicate that different neural circuits are active during sexual arousal in homosexual and heterosexual men and may contribute to a better understanding of the neural basis of male sexual orientation.

Cross-cultural difference and validation of the Chinese version of Montreal Cognitive Assessment in older adults residing in Eastern China: Preliminary findings

To evaluate the psychometric properties of the Chinese Montreal Cognitive Assessment (MoCA-C) and assess cross-cultural differences in a community-based cohort residing in the Eastern China. The study included 72 patients with Alzheimers disease (AD), 84 patients with mild cognitive impairment (MCI) and 146 cognitively normal controls. Sensitivities and specificities were calculated using the recommended cut-off scores. Receiver operator characteristic (ROC) curve analyses were performed to determine optimal sensitivity and specificity. Criterion validity, inter-rater, test-retest reliability and internal consistencies of the MoCA-C were examined, and clinical observations made. The influence of age, education level and gender on MoCA score was examined. Using the recommended cut-off score of 26, the area under the ROC (AUC) for predicting MCI groups using the MoCA-C was 0.930 (95%CI: 0.894; 0.965). The MoCA-C demonstrated 92% sensitivity and 85% specificity in screening for MCI. Cultural differences from the original MoCA affected the test response rate. The MoCA-C appears to have utility as a cognitive screen for early detection of AD and for MCI and warrants further investigation regarding its applicability in primary care settings in elderly Chinese people. It will be necessary to revise the contents of the questionnaire to account for by local characteristics.

Repetitive transcranial magnetic stimulation in combination with citalopram in young patients with first-episode major depressive disorder: A double-blind, randomized, sham-controlled trial

Objectives: To evaluate the effectiveness of repetitive transcranial magnetic stimulation (rTMS) started with citalopram in first-episode young major depressive patients. Methods: In a 2-week double-blind study with a 2-week extended antidepressant phase, 60 first-episode young major depressive patients were randomly assigned to citalopram in combination with 2 weeks of either active or sham rTMS treatment. During the following 2 weeks, the patients continued only the citalopram treatment. The 17-item Hamilton depression rating scale (HAMD-17) and Montgomery–Asberg depression rating scale (MADRS) were used to assess the severity of depression. Moreover, the Wisconsin Card Sorting Test (WCST), Trail-Making Test (TMT), and Stroop Color–Word Test (SCWT) were used to assess executive function. Results: (1) There was a significantly greater number of early improvers (a reduction of HAMD-17 score ≥20% within the first 2 weeks) observed in the active rTMS group compared to the sham group (57% vs. 29%, χ2=4.667, p=0.031). (2) There was no significant difference observed in responder rates (46% vs. 36%, χ2=0.295, p=0.586) or in remission rates (39% vs. 29%, χ2=0.319, p=0.572) between the two groups at 4 weeks. (3) There was a significant difference seen in both HAMD-17 and MADRS scores between the two groups at 2 and 4 weeks. The active rTMS group showed a significantly faster score reduction compared to the sham group at 2 weeks (HAMD-17, t=13.444, p=0.001; MADRS, t=30.123, p=0.000), which was maintained at 4 weeks on both scales (HAMD-17, t=46.915, p=0.000; MADRS, t=39.996, p=0.000). (4) The patients did not deteriorate in executive performance, and even improved in categories on WCST and completed TMT faster in the active group. Conclusions: rTMS accelerated the rapidity of the antidepressant response in first-episode young depressive patients. Our results call for future rTMS studies with larger sample sizes, high intensity of stimuli, and longer duration to draw more definitive conclusions.

Repetitive Transcranial Magnetic Stimulation-Induced Seizure of a Patient with Adolescent-Onset Depression: A Case Report and Literature Review

Repetitive transcranial magnetic stimulation (rTMS) has been used as an investigative and therapeutic tool in neuropsychiatry and is advocated as a therapy for the treatment of psychiatric disorders, particularly adult depression. The therapeutic efficacy of current antidepressants applied to children or adolescents is unsatisfactory; thus innovative treatments such as rTMS are in demand. Large-scale clinical studies are required to determine the safety of rTMS for this age group. The present case report describes a 15-year-old female with depression who had seizure and hypomania during the first session of rTMS concomitant to sertraline 100 mg/day orally. The patient continued on this regimen of sertraline therapy but rTMS was not repeated. Subsequent electroencephalogram (EEG) examination detected no abnormalities and no long-term complications were observed. We suggest that rTMS should be used cautiously to treat adolescents with depressive disorders, particularly when used concomitant to antidepressant treatment.

Combination of citalopram plus paliperidone is better than citalopram alone in the treatment of somatoform disorder: results of a 6-week randomized study.

The objective of this study was to evaluate the effectiveness and tolerability of citalopram versus citalopram plus paliperidone combination therapy in patients with somatoform disorders (SDs). In this 6-week, randomized, fixed-dose study, 60 patients with SD (ICD-10 F45.0), undifferentiated SD (F45.1), and somatoform autonomic dysfunction (F45.3) were randomly assigned to receive citalopram (20 mg/day) with or without paliperidone (3 mg/day). Four scales were used to evaluate effectiveness and tolerability at baseline and at the end of the second, fourth, and sixth week after treatment: Somatoform Disorders Screening Symptoms-7 (SOMS-7), Hamilton Anxiety Scale (HAMA), 17-item Hamilton Depression Scale (HAMD-17), and Treatment Emergent Symptom Scale (TESS). The rater was blinded to the kind of treatment patients received. (i) In the intention-to-treat population (N=51), the overall response ratio (50% reduction in SMOS-7 scores) was significantly higher in the citalopram–paliperidone group compared with the citalopram group after a 6-week treatment (71.4 vs. 38.10%, &khgr;2=4.71, P=0.03). (ii) The SOMS-7 and somatic subscore of the Hamilton Anxiety Scale (HAMA-SOM) total score of the citalopram plus paliperidone group decreased more significantly than that of the citalopram group, and a significant difference could be observed at the end of 4 weeks of treatment. (iii) There was no significant difference between the two groups in adverse effects, and no serious adverse event was reported in both groups. Our findings indicate that a combination with paliperidone is significantly better than monotherapy with citalopram whether synergistic or add-on for patients with SDs. Our results call for future studies with larger sample sizes and a longer duration to draw more definitive conclusions.

Neural circuits of disgust induced by sexual stimuli in homosexual and heterosexual men: An fMRI study

Few studies demonstrated neural circuits related to disgust were influenced by internal sexual orientation in male. Here we used fMRI to study the neural responses to disgust in homosexual and heterosexual men to investigate that issue. Thirty-two healthy male volunteers (sixteen homosexual and sixteen heterosexual) were scanned while viewing alternating blocks of three types of erotic film: heterosexual couples (F-M), male homosexual couples (M-M), and female homosexual couples (F-F) engaged in sexual activity. All the participants rated their level of disgust and sexual arousal as well. The F-F and M-M stimuli induced disgust in homosexual and heterosexual men, respectively. The common activations related to disgusting stimuli included: bilateral frontal gyrus and occipital gyrus, right middle temporal gyrus, left superior temporal gyrus, right cerebellum, and right thalamus. Homosexual men had greater neural responses in the left medial frontal gyrus than did heterosexual men to the sexual disgusting stimuli; in contrast, heterosexual men showed significantly greater activation than homosexual men in the left cuneus. ROI analysis showed that negative correlation were found between the magnitude of MRI signals in the left medial frontal gyrus and scores of disgust in homosexual subjects (p<0.05). This study indicated that there were regions in common as well as regions specific for each type of erotic stimuli during disgust of homosexual and heterosexual men.

Circulating T lymphocyte subsets, cytokines, and immune checkpoint inhibitors in patients with bipolar II or major depression: a preliminary study

This study aimed to investigate the less known activation pattern of T lymphocyte populations and immune checkpoint inhibitors on immunocytes in patients with bipolar II disorder depression (BD) or major depression (MD). A total of 23 patients with BD, 22 patients with MD, and 20 healthy controls (HCs) were recruited. The blood cell count of T lymphocyte subsets and the plasma level of cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were selectively investigated. The expression of T-cell immunoglobulin and mucin-domain containing-3 (TIM-3), programmed cell death protein 1 (PD-1) and its ligands, PD-L1 and PD-L2, on T lymphocytes and monocytes, was detected. In results, blood proportion of cytotoxic T cells significantly decreased in BD patients than in either MD patients or HCs. The plasma level of IL-6 increased in patients with BD and MD. The expression of TIM-3 on cytotoxic T cells significantly increased, whereas the expression of PD-L2 on monocytes significantly decreased in patients with BD than in HCs. These findings extended our knowledge of the immune dysfunction in patients with affective disorders.

Efficacy of repetitive transcranial magnetic stimulation with quetiapine in treating bipolar II depression: a randomized, double-blinded, control study

The clinical and cognitive responses to repetitive transcranial magnetic stimulation (rTMS) in bipolar II depressed patients remain unclear. In this study, thirty-eight bipolar II depressed patients were randomly assigned into three groups: (i) left high-frequency (n = 12), (ii) right low-frequency (n = 13), (iii) sham stimulation (n = 13), and underwent four-week rTMS with quetiapine concomitantly. Clinical efficacy was evaluated at baseline and weekly intervals using the 17-item Hamilton Depression Rating Scale (HDRS-17) and Montgomery-Asberg Depression Rating Scale (MADRS). Cognitive functioning was assessed before and after the study with the Wisconsin Card Sorting Test (WCST), Stroop Word-Color Interference Test (Stroop), and Trail Making Test (TMT). Thirty-five patients were included in the final analysis. Overall, the mean scores of both the HDRS-17 and the MADRS significantly decreased over the 4-week trial, which did not differ among the three groups. Exploratory analyses revealed no differences in factor scores of HDRS-17s, or in response or remission rates. Scores of WCST, Stroop, or TMT did not differ across the three groups. These findings indicated active rTMS combined with quetiapine was not superior to quetiapine monotherapy in improving depressive symptoms or cognitive performance in patients with bipolar II depression.

Relationship between negative symptoms and neurocognitive functions in adolescent and adult patients with first-episode schizophrenia.

BackgroundThis study aimed to explore differences in links between negative symptoms and neurocognitive deficits in adolescent and adult patients with first-episode schizophrenia. Schizophrenia is a mental disorder often characterized by positive and negative symptoms, reduced emotional expression, excitatory status, and poor cognitive ability. The severity of negative symptoms in patients with schizophrenia was reported to be more related to poor quality of life, weak functional ability, and heavy burden from families than with the severity of positive symptoms. Previous studies suggested correlations between the severity of negative symptoms in patients with schizophrenia and neurocognitive deficits.MethodsThis study included 92 patients (33 adolescents and 59 adults) with first-episode schizophrenia and 57 healthy people matched by age and education level. Neurocognitive functions and clinical symptoms were assessed using a standardized questionnaire.ResultsPatients with first-episode schizophrenia showed neurocognitive deficits in most neuropsychological assessments compared with healthy people. With the variable of education level controlled, the negative factor score of adolescent patients with first-episode schizophrenia was strongly correlated with more time spent in part 1 (r = .646) and part 2 (r = .663) of the trail making test, and moderately correlated to more perseverative errors (r = .425) of the Wisconsin card sorting test and fewer correct trials 2 (r = −.425) of the continuous performance test. However, no such correlations were found in adult patients.ConclusionsThis study indicated significant correlations between negative symptoms and most neurocognitive functions in patients with first-episode schizophrenia, with a stronger correlation in adolescent patients.Trial registrationThe trial registration number is ChiCTR-COC-14005302, while retrospectively registered on January 5, 2014.