Weijuan Xu

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.

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.

Affective reactions differ between Chinese and American healthy young adults: a cross-cultural study using the international affective picture system

BackgroundSeveral cross-cultural studies have suggested that emotions are influenced by the cultural background. Emotional reactions to International Affective Picture System (IAPS) images were compared between Chinese and American young adults.Methods120 Chinese undergraduates (53 females, 67 males; aged 18-25 years) were enrolled at Zhejiang University, China, and the valence and arousal components of their emotional responses to IAPS images were rated using the Self-Assessment Manikin (SAM) system. Then, valence and arousal scores were compared to those of 100 American undergraduates (50 females, 50 males) of the same age group, enrolled at Florida University and surveyed by Prof. PJ Lang in 2001.ResultsValence scores assigned to 259/816 (31.74%) pictures differed significantly between Chinese and American female participants, while those assigned to 165/816 (20.22%) pictures differed significantly between Chinese and American males (P < 6 × 10-5). Of the 816 pictures, the arousal scores assigned to 101/816 (12.38%) pictures differed significantly between Chinese and American female participants; these scores significantly differed in 130/816 (15.93%) pictures between Chinese and American males (P < 6 × 10-5). Valence scores for pictures in the Erotic category differed significantly between Chinese and American females (P < 6 × 10-5). There were no significant differences in valence scores for the remaining eight categories studied between participants from the two countries, whether female or male.ConclusionsThe IAPS norms require a modification for their appropriate application in Asian cultures.

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.

Does amantadine induce acute psychosis? A case report and literature review.

Background Over-the-counter cold medicines, which contain amantadine, are widely used in the People’s Republic of China. Clinicians are familiar with the psychosis caused by long-term treatment with amantadine, especially in elderly patients; however, early-onset psychotic complications among healthy young individuals have rarely been reported. Case presentation This article reports the case of a 28-year-old patient who presented with hallucination–delusion syndrome soon after treatment with cold medicine containing amantadine hydrochloride and acetaminophen. The symptoms resolved completely after a 2-week course of paliperidone treatment. Conclusion Clinicians should be sensitive to the acute psychotic complications induced by an interaction between amantadine and acetaminophen.

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.

Relationships between dorsolateral prefrontal cortex metabolic change and cognitive impairment in first-episode neuroleptic-naive schizophrenia patients.

Abstract The present study aimed to explore the possible associations between the dorsolateral prefrontal cortex (DLPFC) metabolites and the cognitive function in first-episode schizophrenia (FES). This study included 58 patients with FES (29 males and 29 females; mean age, 22.66 ± 7.64 years) recruited from the First Affiliated Hospital, College of Medicine, Zhejiang University, and 43 locally recruited healthy controls (16 males and 27 females; mean age, 23.07 ± 7.49 years). The single-voxel proton magnetic resonance spectroscopy was used to measure the levels of N-acetylaspartate (NAA); complex of glutamate, glutamine, and &ggr;-aminobutyric acid (Glx); choline-containing compounds; and myo-inositol in the DLPFC. The ratios of metabolites to creatine (Cr) were calculated. The cognitive function was assessed by Measurement and Treatment Research to Improve Cognition in Schizophrenia Consensus Cognitive Battery (MCCB). Correlation analysis was used to assess the relationships between the DLPFC metabolites and the cognitive function.Compared with the healthy controls, the patients with FES showed significantly reduced scores in each part of the MCCB, significantly reduced NAA/Cr, and significantly increased Glx/Cr in the left DLPFC. Poor performance in verbal learning and visual learning was correlated to the reduced NAA/Cr ratio in the left DLPFC. These findings suggest that a lower NAA/Cr ratio in the left DLPFC is associated with the cognitive deficits in patients with FES, and may be an early biochemical marker for the cognitive impairment in schizophrenia.

Association of Genetic Polymorphisms with Age at Onset in Han Chinese Patients with Bipolar Disorder

Bipolar disorder (BD) is a chronic and disabling disorder characterized by manic, hypomanic, or depressive episodes, with an estimated lifetime prevalence ranging from 1% to 5%. Globally, it is a leading cause of disability and a socioeconomic burden. Gene-environment interactions are thought to be involved in the neurobiology of BD, with genetic factors contributing to 60%–85% of BD patients. Twin studies have shown a heritability of 59%, and an increased risk of BD has been found in first-degree relatives of probands [1]. Currently, many genes have been reported as possible risk factors for BD, including PBRM1, CACNA1C, ANK3, ODZ4, SYNE1, ITIH1, GABRB1, DAOA, NCAN, and TRANK1. Environmental factors such as maternal stress, prenatal malnutrition, preterm birth, childhood abuse, stressful life events, and cannabis use can also contribute to the development of BD. Early recognition and treatment of BD can improve treatment responses and the prognosis [2]. However, there is always a long delay from the onset of disease to a definite diagnosis. Nearly half of BD patients develop their first mood episode at puberty. Kataoka et al. have found a significant association of early disease onset in BD probands with de novo protein-altering mutations when compared with non-carriers [3]. Therefore, age at onset (AAO) may be a potential clinical marker for genetic susceptibility to BD. The relationship between risk genes for BD and AAO, however, has not been fully investigated. In this study, we aimed to explore the correlation between high-risk single-nucleotide polymorphism (SNP) loci and AAO in Chinese patients with BD. A total of 224 Han Chinese participants with BD were consecutively recruited from the First Affiliated Hospital of Zhejiang University School of Medicine from August 2011 to March 2016. The diagnosis was made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and further confirmed by the Structural Clinical Interview for DSM-IV. All patients were diagnosed with either type I or II BD. The exclusion criteria included prior or current comorbidity of other psychiatric diseases, alcohol or other psychoactive substance abuse, poisoning, or other physical conditions that could cause emotional lability. After a search of gene linkage analysis or genomewide association studies in databases (PubMed, EMBASE, and the Cochrane Library) up to February 2016, 35 SNP loci were screened as candidates. The genotypes were determined by the MassArray system (Agena iPLEX assay, San Diego, CA), with a 384-element SpectroCHIP gene array. Given our small sample size, the minor allele frequency of each SNP locus was required to be [ 0.05, and 26 SNP loci were finally included in the analysis. To determine the relationship between SNP loci and AAO of BD, Plink and Haploview statistical software was used and logistic regression analysis was performed. All study & Yi Xu xuyizju@zju.edu.cn

Memantine induces manic episode in a 73-year-old patient with vascular neurocognitive disorder: a case report

Memantine, an N-methyl-d-aspartate receptor antagonist, is a well-established treatment option for moderate-to-severe cognitive impairment related to Alzheimer disease. Recently, growing evidence has indicated memantine might also be effective in treatment of affective disorders. The common drug-induced adverse events of memantine include confusion, dizziness, drowsiness, headache, insomnia, and agitation. Herein, we presented a case of a 73-year-old female patient with vascular neurocognitive disorder, who developed a manic episode after taking memantine.