青少年易激惹特征及其神经机制

青少年时期是一个身体迅速发育不断成熟的时期,而心理的发育成熟情况却是滞后于身体的发育速度,激惹心境（Irritable mood）（即易激惹性）的出现就是一个常见现象[1].     

Risperidone Improves Behavioral Symptoms in Children with Autism in a Randomized,Double-Blind,Placebo-Controlled Trial

Subgroup analysis of children (5–12 years) with autism enrolled in an 8-week, double-blind, placebo-controlled trial of risperidone for pervasive developmental disorders. The primary efficacy measure was the Aberrant Behavior Checklist-Irritability (ABC-I) subscale. Data were available for 55 children given risperidone (n = 27) or placebo (n = 28); mean baseline ABC-I ( ± SD) was 20.6 (8.1) and 21.6 (10.2). Risperidone [mean dose ( ± SD): 1.37 mg/day (0.7)] resulted in significantly greater reduction from baseline to endpoint in ABC-I versus placebo [mean change ( ± SD): −13.4 (1.5) vs. −7.2 (1.4), P < 0.05; ES = −0.7]. The most common adverse effect with risperidone was somnolence (74% vs. 7% with placebo). Risperidone treatment was well tolerated and significantly improved behavioral problems associated with autism.     

Atypical Kawasaki disease with remarkable paucity of signs and symptoms

We report on a 7-month-old infant with Kawasaki disease (KD) whose only manifestations were high-grade fever of 7 days duration, “non-toxic look” and “extreme irritability”, thereby not meeting the criteria for the classical or the atypical form of the disease. The diagnosis was confirmed by the demonstration of a solitary aneurysm in the proximal left anterior descending coronary artery. The present case raises the concern that the presently laid guidelines for the diagnosis of atypical KD may not be adequate.     

The effects of intrahypothalamic hemicholinium-3 on muricide, irritability and feeding

Male Long-Evans rats that consistently killed mice when food deprived were injected unilaterally in the lateral hypothalamus with 20 μg and 30 μg of the acetylcholine synthesis inhibitor hemicholinium-3 (HC-3) and saline in a counterbalanced order. Rats were evaluated 1,2,3,24,48 and 72 hours post-injection for effects on muricide, irritability and feeding. HC-3 suppressed muricide and feeding and produced a trend toward reduced irritability during the first three hours post-injection. These data indicate that modulation of cholinergic systems in the lateral hypothalamus influences several behaviors and not any one behavior specifically.     

Taming effects of p-chlorophenylalanine on the aggressive behavior of septal rats.

Septal irritability and shock-induced aggression were suppressed by the administration of p-chlorophenylalanine (PCPA) to septal rats. The levels of septal irritability and shock-induced fighting were significantly lower in septal, PCPC-treated rats than in nontreated septal rats. Since both parameters of septal aggression were reduced by PCPA, and while PCPA has no effect on shock-induced fighting of unlesioned rats under similar parameters, it appears that both forms of aggression may function through a common neural mechanism.     

行为改变教育策略对应激性消化不良患者的影响

目的分析、比较行为改变教育策略对肠易激综合征（IBS）的影响。方法采取问卷回顾性调查法调查行为改变教育策略对沈阳医学院奉天医院2008年3月～2012年5月100例应激性消化不良患者的影响,另选择我院同期收治人院的采用常规护理的应激性消化不良患者100例作为对照组,分析干预前、后简明健康状况问卷（SF-36）、生存质量评定量表（QLQ—C30）;观察两组临床症状改善情况。结果200例患者中a型行为者124例,占62．0％,非a型者（b型与混合型）76例,占38．0％。其中观察组总有效100例（100．0％）,对照组总有效75例（75．0％）,两组比较差异有统计学意义（x2=4．294,P〈0．05）;观察组QLQ—C30、SF-36总分与对照组相比差异有统计学意义（P〈0．05）。结论心理因素对IBS的发病有着重要影响,改变教育策略能显著改善IBS患者的生存质量。对该病的康复有确切的效果。     

Effects of rivastigmine on common symptomatology of Alzheimer’s disease (EXPLORE)

Abstract

Objective:

To evaluate, in a real-world clinical setting, the efficacy of rivastigmine in the management of six symptoms commonly associated with Alzheimer's disease (AD).     

Prefrontal modulation of frustration-related physiology in preschool children ranging from low to severe irritability

Limbic-prefrontal connectivity during negative emotional challenges underpins a wide range of psychiatric disorders, yet the early development of this system is largely unknown due to difficulties imaging young children. Functional Near-Infrared Spectroscopy (fNIRS) has advanced an understanding of early emotion-related prefrontal activation and psychopathology, but cannot detect activation below the outer cortex. Galvanic skin response (GSR) is a sensitive index of autonomic arousal strongly influenced by numerous limbic structures. We recorded simultaneous lateral prefrontal cortex (lPFC) activation via fNIRS and GSR in 73 3- to 5-year-old children, who ranged from low to severe levels of irritability, during a frustration task. The goal of the study was to test how frustration-related PFC activation modulated psychophysiology in preschool children, and whether associations were moderated by irritability severity. Results showed lPFC activation significantly increased, and GSR levels significantly decreased, as children moved from frustration to rest, such that preschoolers with the highest activation had the steepest recovery. Further, this relation was moderated by irritability such that children with severe irritability showed no association between lPFC activation and GSR. Results suggest functional connections between prefrontal and autonomic nervous systems are in place early in life, with evidence of lPFC down-regulation of frustration-based stress that is altered in early psychopathology. Combining fNIRS and GSR may be a promising novel approach for inferring limbic-PFC processes that drive early emotion regulation and psychopathology.     

中医“烦躁状态”概述及脉象探要

＂烦躁状态＂是人体的一种心理紊乱状态,这种状态持续不缓解,最终成为导致诸多疾病发生和维持的症结所在。在对＂烦躁状态＂内涵进行诠释和发病机制分析的基础上,对其相关脉象进行总结,以期为临床辨识和辨治提供重要的理论依据。     

Neuropsychiatric symptoms and Apolipoprotein E: Associations with eventual Alzheimer’s disease development

ObjectiveAlzheimer’s disease (AD) is the result of neurodegeneration, which manifests clinically as deficits in memory, thinking, and behavior. It was hypothesized that neuropsychiatric symptoms and the apolipoprotein E genotype increase the likelihood of Alzheimer’s disease development.MethodsUtilizing data from the National Alzheimer’s Coordinating Center, information from evaluations of 11,453 cognitively intact participants was analyzed. Survival analysis was used to explore relationships between individual neuropsychiatric symptoms as determined by the Neuropsychiatric Inventory Questionnaire, apolipoprotein E, and eventual AD diagnosis. Cox proportional hazard models were utilized to explore the main effects and synergistic (additive and multiplicative) interactions.ResultsThis study provided evidence for an increased hazard of developing AD among participants with any of the symptoms assessed by the NPI-Q. The hazard of developing AD was almost thirteen times higher for _ε4 carriers with delusions and eleven times greater for those with apathy and disinhibition. Statistically significant hazards (p > 0.001) were also realized by _ε4 carriers with hallucinations; agitation; depression; anxiety; elation; apathy; irritability; and motor, sleep, and appetite disturbances.ConclusionsFindings suggest that neuropsychiatric symptoms are associated with eventual AD diagnosis among a group of cognitively asymptomatic participants at baseline. Many studies begin with a group of participants already impacted by AD diagnosis. The longitudinal analysis of a group of participants who, at baseline, demonstrated no observable signs of AD was a strength of this study. This investigation contributes to the literature exploring an increased hazard of AD due to potential modifiable risk factors and genetic biomarkers such as apolipoprotein E.