Release date: 2014-04-11
2013 is an outstanding year in the field of neuropsychology. Several breakthrough studies have opened up a new direction in the treatment of neuropsychiatric diseases, with milestone significance. This article will take stock of the major events in the neuropsychiatric field in 2013 from three aspects: advances in neuroscience, advances in clinical psychiatry, and important events in the spiritual field.
â– Progress in Neuroscience "The birth of the human brain in vitro" In September 2013, "Nature 2013, 501 (7467): 373] published a new research result, which was used by researchers in Austria, Germany, and the United Kingdom. Human pluripotent stem cells produce a tissue that mimics the human brain in a test tube (see above). It is a three-dimensional self-organizing model and the most complicated "in vitro human brain" to date.
The researchers first used stem cells to grow brain cells, which in turn allowed the brain cells to form brain tissue. Eventually, like the real human brain, there were signs of stratification.
"In vitro human brain" has a structure similar to choroidplexus, cerebral cortex, and retinaltissue. After staining, the researchers further found that after 16 days of development, the brain tissue has formed so-called forebrain (brain), midbrain and hindbrain structures. The researchers also found a number of molecular markers that are unique to the brain's specialized regions, including the outer subventricular zone (OSVZ), which is unique to the human brain.
Regardless of its structure or function, the "in vitro human brain" is similar to the shape of the human brain during its early development. Therefore, it can be used to study the developmental problems of the human brain and even to construct pathological models of neurodevelopmental disorders, for example, small heads. deformity. Knoblich's group has used the induced pluripotent stem cells of patients with microcephaly to simulate the development of microcephaly.
Although this kind of brain tissue has certain limitations, for example, it may not be suitable for studying more complicated neurological dysplasia diseases such as autism or schizophrenia (because these diseases involve higher cell maturity, The degree of contact between the involved cells is also more complicated), but researchers are also trying to study how to develop a more consistent brain-like tissue, and also hope to be able to add vascular system to make brain-like tissue grow bigger. , developed more mature and complete.
Diversity of brain genetics The scientific community generally believes that every cell in a human body has the same genetic information, and the special expression pattern of the genome makes different cells function differently. However, an article recently published in Science [Science 2013, 342 (6158): 632] has overturned this view.
The researchers used single-cell sequencing technology to perform genome analysis on more than 100 neurons. The results showed that 41% of neurons had unique DNA copy number variation (CNV). These genetic differences may affect the function of brain cells, and may even shape our personality and learning ability, causing certain types of people to be susceptible to certain neurological diseases.
The key to answering these questions is to find out if changes in the DNA copy number of neurons in the brain cause changes in gene expression and how they affect gene expression. The current technology allows dual analysis of gene copy number changes and gene expression changes at the single cell level.
Genetic associations between mental illnesses At present, little is known about the pathogenesis of mental illness, but it is certain that mental illness is associated with genetic risk factors.
In 2013, the Cross-Disorder Group of the Psychiatric Genomics Consortim first published bipolar disorder, depressive disorder, schizophrenia, autism spectrum disorder (ASD), attention deficit hyperactivity disorder ( ADHD) There is evidence of overlapping genetic risk between the five major mental illnesses.
A study published in the March 18 issue of The Lancet [Lancet 2013, 381 (9875): 1371] pointed out that two genes associated with neuronal calcium balance, namely CACNA1C and CACNB2 single nucleotide polymorphisms Related to the above mental disorders. Voltage-gated calcium channel signal transduction may be a promising therapeutic target for the treatment of mental disorders.
In August of the same year, the research team published a paper in the journal Nature Genetics [NatGenet 2013, 45 (9): 984], which will map the genome-wide data of thousands of patients suffering from one of the five mental disorders mentioned above. Healthy controls were compared to calculate the genetic overlap between the five mental disorders. The results showed that the degree of genetic overlap between schizophrenia and bipolar disorder was 15%, 9% between depression and 3%, and 3% between ASD; the degree of genetic overlap between bipolar disorder and depressive disorder was 10%. The study only looked at genetic variants shared by multiple diseases, and in fact, the genetic overlap between these mental disorders may be higher.
The findings of the Interdisciplinary Research Group of the Psychiatric Diseases Genomics Association will help to develop a more scientific diagnostic system, and will also provide a theoretical basis for further understanding of the mechanisms of individual disease and the development of new treatments for mental illness.
New breakthroughs in autism genomics research In recent years, autism has become a global public health problem. Autism is a developmental disorder caused by disorders of the nervous system. People often call autistic children a "star child". A new breakthrough in autism genomics research may allow "star children" to stay away from loneliness.
Many institutions, such as Duke University School of Medicine, Toronto Children's Hospital and Shenzhen Huada Gene Research Institute, have successfully identified a series of genetic mutations and risk genes related to autism through genome-wide sequencing. American Journal of Human Genetics [AmJHumGenet 2013, 93(2): 249].
The researchers performed a genome-wide sequencing study of 32 autistic families and tested single-base mutations, copy number variations, and insertions/deletions across the genome to identify genes associated with autism. A newborn mutation or a rare genetic mutation that causes a deficiency or a missense change. In 32 families, the researchers identified new mutations in six families (19%) and identified X-linked or autosomal genetic variations in 10 families (31%). The proportion of pure line mutations identified was higher than previous studies, indicating that genome-wide sequencing can cover all sites more comprehensively. The researchers identified harmful mutations in nine previously known autism-associated genes, four newly discovered autism-associated genes, and eight candidate autism risk genes, for example, in association with the FMR1 gene. The CAPRIN1 and AFF2 genes of fragile X syndrome, the VIP gene associated with social cognitive deficits, can cause the CHD7 gene of CHARGE syndrome associated with autism, as well as the SCN2A, KCNQ2, and NRXN1 genes.
The study provides valuable genetic resources for autism research and may be a critical step in exploring the pathogenesis of autism and developing new treatments. In addition, the results of autism genome-wide sequencing will also contribute to the early diagnosis of autism.
Development of the genetics database The establishment of a database of mental disease genetics is of great importance for understanding the current state of research and guiding subsequent laboratory research.
The research team led by Wang Jing, a key laboratory of mental health of the Chinese Academy of Sciences, developed the "Diagnostic Attraction Hyperactivity Disorder Genetics Database" and the "Multidisciplinary Interdisciplinary Database of Major Depressive Disorders" in 2011 and 2012 respectively to fill the Chinese mental illness. A gap in the field of genetics databases. In 2013, Wang Jing research team again applied bioinformatics and genomics technology to the susceptibility genes and genetic mechanisms of mental illness, and developed a new cross-sectional study of bipolar disorder (BD) and schizophrenia and major depressive disorder. Genetics Database (BDgene Database).
The database integrates multiple types of BD genetic factors from more than 800 literatures, as well as findings from schizophrenia and major depressive disorder in disease crossover studies, to comprehensively understand the current state of genetic research in bipolar disorder, and to study biphasic The genetic basis of the disorder, its shared genetic mechanisms with schizophrenia and major depressive disorder, and further guidance for subsequent laboratory research provide a broad and reliable data set.
BDgene database website: http://bdgene.psych.ac.cn.
A new perspective on the cause of depressive disorder For the cause of depressive disorder, the scientific community has not been clearly aware of it. It is generally believed that depressive disorder is caused by insufficient serotonin (HT). A new study by Scott M. Thompson, a professor of physiology at the University of Maryland School of Medicine, found that depression is caused by a loss of communication between brain cells. The results were published in the journal Nature Neuroscience [NatNeurosci 2013, 16(4): 464].
The researchers compared the brain cell activity of normal and depressed rats and found that the 5-HT level in the brain of depressed rats did not change, but the excitatory interaction was abnormal. 5-HT tried to enhance the dialogue between neurons, but the signal Unable to pass.
This result indicates that people have a major change in the etiology and treatment of depressive disorder, that is, depression and other mental illnesses are not enough to improve the treatment of neurotransmitters. Finding new and more effective antidepressants should be improved. HT levels shift to enhance excitatory connections.
Biomarkers and Mental Disorders Diagnostics published in the Journal of Depression and Anxiety 2013 [DepressAnxiety 2013, 30(4): 307] showed that the level of inflammation in patients with severe depressive disorder (MDD) with high suicidal ideation (through blood) The test proved to be significantly higher than MDD patients with low suicidal ideation and healthy controls without MDD. Inflammatory cytokines such as interleukin (IL)-6 and tumor necrosis factor (TNF)-α, anti-inflammatory cytokines IL-10, and C-reactive protein (CRP) are used to detect suicide risk in patients with depressive disorder. .
A study published in Brain 2013, 136 (Pt9): 2825, first reported that brain abnormalities in infants are associated with autism. The researchers point out that children diagnosed with autism spectrum disorder (ASD) have excessive cerebrospinal fluid and enlarged brain during infancy, and these abnormalities may serve as potential biomarkers for early identification of this serious developmental disorder.
A study published by Dazzan et al. in the Journal of the American Medical Association, Psychiatry [JAMAPsychiatry 2013, 70(10): 1031] shows that the degree of cerebral cortex fold is related to the efficacy of antipsychotics, and the brain is back. Patients with less mental illness have a poorer drug treatment. Therefore, it is possible to predict whether the antipsychotic drugs are effective by observing the "pleats" of the brain by neuroimaging.
â– Clinical Psychiatry Brain atrophy: Is it caused by disease progression or long-term use of high-dose antipsychotics?
Nancy Andreasen published an article in the American Journal of Psychiatry [AmJPsychiatry 2013, 170 (6): 609], with an average follow-up of 72 patients with first-episode schizophrenia for 7 years, every 6 Follow-up was performed monthly and magnetic resonance imaging was performed.
The results showed that long-term re-ignition had an adverse effect on the brain integrity of patients with schizophrenia, and re-ignition time was associated with a significant reduction in the overall volume of the brain and the volume of the frontal lobe. In addition, long-term exposure to large doses of antipsychotic drugs is associated with decreased volume of the frontal lobe, temporal cortex, and parietal lobe. The results of this study suggest that the "minimum effective dose" should be used for maintenance therapy in patients with schizophrenia.
Ketamine may fill the depression in patients with depression. There will be a decrease in the number of synapses associated with mood-regulated brain regions. Although antidepressants can reverse or block this nerve defect, it takes several weeks to several effects. Month time.
Ketamine is an N-methyl-aspartate (NMDA) glutamate receptor antagonist, the largest in ketamine, published in the American Journal of Psychiatry [AmJPsychiatry 2013,
Studies in 170(10):1134 have demonstrated rapid antidepressant effects of ketamine, providing further evidence for the regulation of NMDA receptors to alleviate severe and chronic depression. Studies have shown that ketamine can rapidly promote synapse formation and reverse nerve damage caused by chronic stress. This mechanism of action is different from the mechanism of action of currently used antidepressants.
In addition, a study conducted by Yale University, published online in MolPsychiatry on October 15, 2013, showed that a new drug, lanicemine (AZD6765), which is under development in the NMDA pathway, has an antibiotic similar to ketamine. Depressive effects, and no ketamine is a dangerous side effect of drug abuse. At present, the clinical trial of the drug has entered Phase II.
Video Game Training Enhances Cognitive Ability of the Elderly One of the biggest challenges for the elderly is cognitive decline, which can develop into Alzheimer's. A video game called NeuroRacer designed for older people, such as Gazzaley, is unique in that it improves the cognitive abilities of older people not only for entertainment. The results were published in the September 2013 issue of Nature [Nature 2013, 501 (7465): 97].
The researchers conducted cognitive tests on the elderly before and after the game. The results showed that in addition to the multi-tasking ability, the cognitive indicators of memory and concentration of the elderly also improved significantly. Brainwave monitoring results also confirmed that the cognitive function of the brain's prefrontal cortex was improved.
Currently, Ghazari and his colleagues are developing electronic video games related to the treatment of mental illness. Although video games cannot completely eliminate the symptoms of people with mental illness, it is foreseeable that these games being developed are certainly helpful to patients.
The importance of sleep for brain health A study published in the journal Science (Science 2013, 342(6156):373) by the University of Rochester Medical Center showed that the system of removing waste from the brain is most active during sleep.
Researchers used a technique called iontophoresis to study fluid flow in the brains of sleep and awake mice. The results showed that the tissue gap in the brain of sleep mice was 60% larger than that in the brain of awake mice; the brain of the sleeping mice cleared the waste [eg, amyloid beta (Aβ), one with Alzheimer's) The ability of disease (AD)-associated proteins is stronger, and the rate of Aβ out of the brain in sleep mice is twice as fast. Therefore, sleep can promote the recovery and protection of brain cell function. This may change scientists' understanding of the biological purpose of sleep and point to new ways to treat neurological diseases.
A study published in the Journal of the American Medical Association Neurology [JAMANeurol 2013, 70 (12): 1537] showed that sleep disorders in the elderly (including short sleep time and poor sleep quality) are associated with increased Aβ in the brain. The researchers used the 11C-labeled Pittsburgh complex B-positron emission tomography (11CPiB-PET) imaging volumetric ratio (DVR) to assess Aβ deposition. The results showed that the patient's self-reported sleep duration was correlated with an increase in the Aβ burden measured by mean cortical DVR (P=0.005) and pre-cranial DVR (P=0.007) after correction for potential confounders.
The poor self-reported sleep quality was associated with an increase in the Aβ burden measured by the anterior wedge DVR (P=0.03).
â– The impact of lifestyle on mental health The impact of coffee on mental health Coffee and suicide seem to be irrelevant. In July 2013, a study published in the World Journal of Biopsychiatry (WorldJBiol Psychiatry) linked the two together. The study showed that drinking a few cups of coffee a day can reduce the risk of suicide by 50%, and both men and women apply.
In January, researchers at institutions such as Johns Hopkins published a study in the journal Nat Neurosci, which showed that testers taking caffeine tablets were compared with those who took only placebo. Better performance in memory testing.
Despite the excitement of the above findings, researchers do not recommend that adults with depression increase their coffee consumption. Because most individuals have the best coffee intake for their body, blindly increasing their intake may cause unpleasant results.
Effects of smoking and alcohol abuse on mental health A large-scale longitudinal study published by the University of London scholars in the British Journal of Psychiatry [BrJPsychiatry 2013, 203(2): 120] evaluated smoking, drinking and drinking among people aged 45-69. The relationship of cognitive ability. The results showed that those who smoked and who drank heavily had a rapid age-related cognitive decline compared with the control group who did not smoke and/or moderately consumed alcohol. In addition, the combined effects of smoking and heavy drinking are greater than the effects of single smoking or heavy drinking.
Therefore, from a public health perspective, researchers suggest that people change their lifestyles to slow down cognitive decline. People should smoke less or quit smoking, and try to avoid drinking a lot, especially for middle-aged people.
â– The development of brain “stimulation†technology Electrical stimulation helps the brain “brakeâ€
Brain stimulation techniques can be used to treat mental illness by altering the abnormalities of the neural pathways hidden under mental illness.
The brain has a loop of inhibition or braking reactions to control individual behavior and mood. A study published in the journal Neuroscience [J Neurosci 2013, 33 (50): 19611] showed that harmless electrical stimulation can improve self-control by stimulating the brake circuit.
In the study, the researchers asked participants to perform simple tasks in which they needed self-control to slow down their behavior. At the same time, the researchers used brain imaging techniques to identify areas of the prefrontal cortex (the “Command and Control Center†of the brain) that were associated with behavior, and to pinpoint the activation to make the participants “brake†more A valid specific area. They then placed the electrodes on the surface of the brain in specific areas of the prefrontal cortex associated with behavior. Through an imperceptible, computer-controlled discharge, the researchers were able to improve their self-control ability as needed by the participants. This may benefit patients with behavioral disorders such as obsessive-compulsive disorder and tic syndrome.
Application of deep brain stimulation (DBS) in the treatment of mental illness DBS was originally approved by the US Food and Drug Administration (FDA) for primary moderate to severe Parkinson's disease (1997), idiopathic tremor (1997) ) and treatment of primary dystonia (2003), to be treated for mental illness (severe obsessive-compulsive disorder) (2009), for a total of 12 years, the application of DBS in the clinical field of psychology Constantly being broadened.
Neurologist Helen Mayberg, who has been treating DBS for the first time 10 years ago, has treated more than 200 patients with depression, and 40%-60% have significantly improved symptoms. The paper was published in Science [Science 2013, 342 (6158): 548] magazine.
In 2013, the study published in the Lancet 2013, 381 (9875): 1361 magazine first explored the application of DBS in anorexia nervosa. The results showed that DBS improved the mood of half of the subjects and increased the body mass index (BMI) of the subjects.
Application of TMS in the treatment of mental illness Transcranial magnetic stimulation (TMS) is a new neuroelectrophysiological technique created by Barker of the University of Sheffield in 1985. It has functional uniqueness and non-invasiveness. Pain, easy to operate, safe and reliable. TMS can be divided into three types: single pulse stimulation, double pulse stimulation and continuous pulse stimulation. Currently, more commonly used is continuous pulse stimulation, ie repetitive transcranial magnetic stimulation (rTMS). rTMS has been shown to be effective for depressive disorders and language disorders associated with Alzheimer's disease (AD) by 2013. In 2013, research on the treatment of mental illness with rTMS was fruitful.
At the 2013 American Psychiatric Association (APA) annual meeting, TMS can induce statistically and clinically meaningful responses that contribute to the relief of acute symptoms in patients with refractory depression. This effect can last up to 1 year. .
A study published in the journal Bio Psychiatry 2013, 73(6): 510, and Journal of Psychiatry Research [JPsychiatrRes 2013, 47(8): 999] in 2013 showed that rTMS can improve the work of patients with schizophrenia. Symptoms associated with memory and obsessive-compulsive disorder (OCD).
In addition, in 2013, the FDA approved the transcranial magnetic stimulation system produced by Brainsway for the treatment of refractory major depressive disorder (see http://).
New members of the antidepressant family The launch of new antidepressants has brought good news to people with depression. On July 26, 2013, the FDA approved the new serotonin (5-HT) and norepinephrine reuptake inhibitor (SNRI) drug levomilnacipran in the Forest Laboratory for the treatment of severe depression in adults. obstacle. This is the fourth SNRI-approved drug approved by the FDA, which has a stronger inhibitory effect on norepinephrine than on 5-HT.
On September 30, 2013, the FDA approved vortioxetine jointly developed by Takeda Pharmaceutical and Lingbei Pharmaceutical for the treatment of major depressive disorder in adults. The drug is considered to be a novel multi-model antidepressant drug. In vitro studies have shown that it can antagonize 5-HT3, 5-HT7 and 5-HT1D receptors, activate 5-HT1A receptors, partially activate 5-HT1B receptors and inhibit 5-HT transport.
â– Important events in the spiritual field US “brain plan†and EU “human brain project†implementation In April 2013, Obama announced the implementation of a scientific project comparable to the Human Genome Project – the “brain planâ€. Similarly, the European Commission also in early 2013. Announced that "Human Brain Engineering" is the "emerging flagship technology project" for the next 10 years, and set up a special research and development plan for this purpose.
The entire US Brain Project will cost $1 billion to create a detailed picture of all brain activity, helping researchers find treatment, cure, and even prevent brain diseases such as Alzheimer's, Epilepsy, and Traumatic Brain Injury. new method.
The EU's "Human Brain Engineering" project is estimated to cost 1.19 billion euros to establish a complete computer model of brain work for simulating drug treatment. Although the EU “human brain project†is very different from the US “brain planâ€, the two can complement each other. The new data discovered by the US “brain plan†can support the EU “human brain projectâ€; the EU “human brain project†The new data discovered during the simulation can also bring some inspiration to the US “brain plan†research. There is no doubt that the two scientific research programs in Europe and the United States will promote the advancement of human neuropsychiatry. DSM-5 Released On May 18, 2013, the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (pdf download) was released, the first full update of DSM in 19 years.
Compared with the DSM-IV-TR, the DSM-5 has three major changes: removing the multi-axis diagnostic system, adding a dimensional diagnostic system, and reorganizing the disease chapter and categorization.
The five-axis diagnostic system was replaced by the “no†axis diagnostic system, which was designed to circumvent the artificial boundaries between mental disorders. Abandoning the five-axis diagnostic system is also intended to give the DSM-5 its own disease severity and damage scale to better help doctors assess and monitor the patient's condition, helping doctors choose the right treatment.
However, since the beginning of the revision of DSM-5, a lot of controversy has arisen. DSM is classified based on the symptoms of the disease. It is not comprehensive to understand mental illness from one aspect alone. This is why DSM is often criticized. Many experts and scholars believe that the DSM-5 diagnostic criteria are too broad, expanding the scope of mental illness diagnosis, and labeling patients with mental illness for some patients who may have daily problems. Prior to the publication of DSM-5, Thomas Insel, director of the National Institute of Mental Health (NIMH), publicly announced on his blog that NIMH would no longer use the manual to guide its research. To replace DSM-5, NIMH is currently working on a new project to develop a research field standard (RDoC) to develop new diagnostic criteria and treatments based on genetic, physiological and cognitive data rather than symptoms.
The implementation of the "People's Republic of China Mental Health Law" was initiated from the legislative work of the "People's Republic of China Mental Health Law" in 1985, and was passed at the end of 2012. The "People's Republic of China Mental Health Law" has gone through 27 years and finally It was officially implemented on May 1, 2013.
This law fills the legal gap in the field of mental health in China, which is conducive to raising the public's mental health, safeguarding the legitimate rights and interests of people with mental disorders, and ensuring and promoting the development of mental health.
Source: China Medical Tribune
If you aspire to start a commercial growing operation, we have designed the System as a beginning package especially for you to get hands-on experience. This unit is very well thought out, easy to assemble and operate, and includes virtually everything you need to get started (comes with a full year of growing supplies). In weeks, the system will be up to full speed, producing some of the best crops you and your customers will have ever seen.
Greenhouse A Hydroponics,Hydroponic Garden,Hydroponic System
JIANGSU SKYPLAN GREENHOUSE TECHNOLOGY CO.,LTD , https://www.alibabagreenhouse.com