A review of gamma oscillations in healthy subjects and in cognitive impairment

This review describes a wide range of functional correlates of gamma oscillations in whole-brain work, in neuroethology, sensory–cognitive dynamics, emotion, and cognitive impairment. This survey opens a new window towards understanding the brain's gamma activity.     

Lurasidone adjunctive with lithium or valproate for bipolar depression: A placebo-controlled trial utilizing prospective and retrospective enrolment cohorts

In this study, designed to evaluate the efficacy of lurasidone as adjunctive therapy with lithium or valproate, patients with bipolar I depression were randomized to 6 weeks of double-blind treatment with lurasidone (N = 180) or placebo (N = 176), added to background treatment with lithium or valproate. All patients were treated with lithium or valproate for a minimum of 4 weeks prior to screening. This was confirmed either by prospective treatment after study enrolment (run-in cohort), or retrospectively, with blood levels of lithium and valproate at screening (non-run-in cohort). Primary and key secondary endpoints were change from baseline to week 6 on the Montgomery-Åsberg Depression Rating Scale (MADRS) and depression severity score on the Clinical Global Impressions scale for use in bipolar illness (CGI-BP-S), respectively. Treatment with lurasidone was associated with non-significant improvement at week 6 vs. placebo for the MADRS total score (−11.8 vs −10.4; P = 0.176), and the CGI-BP-S score (−1.36 vs −1.13; P = 0.095). Significant separation from placebo was observed from weeks 2–5 for the MADRS and weeks 3–5 for the CGI-BP-S. Improvement in the placebo-subtracted MADRS total score was notably larger at week 6 for the non-run-in cohort compared to the run-in cohort (LS mean difference in endpoint change scores, −4.6; P = 0.009). Adverse events most frequently reported for lurasidone were akathisia, somnolence, and extrapyramidal side effects. In conclusion, lurasidone adjunctive with lithium or valproate demonstrated significant improvement in depressive symptoms based on the MADRS from weeks 2–5 but not at the primary week 6 endpoint.     

Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder

ObjectiveSleep disturbances are prevalent, persistent, and impairing features of bipolar disorder. However, the near-term and cumulative impact of the severity and variability of sleep disturbances on symptoms and functioning remains unclear. We examined self-reported daily sleep duration and variability in relation to mood symptoms, medication adherence, cognitive functioning, and concurrent daily affect.MethodsForty-one outpatients diagnosed with bipolar disorder were asked to provide daily reports of sleep duration and affect collected via ecological momentary assessment with smartphones over eleven weeks. Measures of depressive and manic symptoms, medication adherence, and cognitive function were collected at baseline and concurrent assessment of affect were collected daily. Analyses examined whether sleep duration or variability were associated with baseline measures and changes in same-day or next-day affect.ResultsGreater sleep duration variability (but not average sleep duration) was associated with greater depressive and manic symptom severity, and lower medication adherence at baseline, and with lower and more variable ratings of positive affect and higher ratings of negative affect. Sleep durations shorter than 7–8 h were associated with lower same-day ratings of positive and higher same-day ratings of negative affect, however this did not extend to next-day affect.ConclusionsGreater cumulative day-to-day sleep duration variability, but not average sleep duration, was related to more severe mood symptoms, lower self-reported medication adherence and higher levels of negative affect. Bouts of short- or long-duration sleep had transient impact on affect. Day-to-day sleep variability may be important to incorporate into clinical assessment of sleep disturbances in bipolar disorder.     

腹腔镜下卵巢良性肿瘤剥除术中两种止血方法对卵巢储备功能的影响分析

目的探讨腹腔镜下卵巢良性肿瘤剥除术中采用双极电凝止血和缝合止血两种方法对卵巢储备功能的影响。方法50例行腹腔镜下单侧卵巢良性肿瘤剥除术患者,应用随机数表法分为A组和B组,每组25例。A组术中卵巢肿瘤剥离创面采用双极点状电凝止血,B组术中卵巢肿瘤剥离创面采用3-0可吸收线间断或连续缝合止血。比较两组患者手术前后雌二醇(E2)、卵泡刺激素(FSH)、窦卵泡数(AFC)水平。结果50例患者手术过程均顺利,无中转开腹,术后对症治疗,无术后感染及出血,按时换药,如期出院。术后1个月,两组E2、AFC水平均低于术前,FSH高于术前,且A组E2(30.33±7.28)pg/ml、AFC(4.48±1.53)个均低于B组的(34.67±7.72)pg/ml、(5.68±1.46)个,FSH(10.33±2.25)U/L高于B组的(8.82±2.40)U/L,差异均具有统计学意义(P<0.05)。术后6个月,两组的E2、FSH水平与本组术前及组间比较,差异均无统计学意义(P>0.05);B组的AFC与术前比较,差异无统计学意义(P>0.05);A组的AFC低于本组术前及B组,差异具有统计学意义(P<0.05)。结论腹腔镜下良性卵巢肿瘤剥除术中双极电凝止血法及缝合止血法均可对卵巢储备功能造成一定影响,相对电凝止血法,手术缝合止血能更好的保护卵巢功能。     

注射用甲磺酸齐拉西酮对双相Ⅰ型障碍躁狂发作急性激越症状的疗效和安全性

目的分析注射用甲磺酸齐拉西酮治疗双相Ⅰ型障碍躁狂发作急性激越症状的疗效和安全性。方法选取2019年4月至2020年4月本院收治的60例双相Ⅰ型障碍躁狂发作急性激越症状患者,按治疗方式的不同分为两组,各30例。对照组采用氟哌啶醇注射液治疗,研究组采用甲磺酸齐拉西酮注射液治疗。比较两组不良反应发生率、阳性与阴性症状量表兴奋因子(PANSS-EC)评分、临床疗效总评量表-病情程度(CGI-SI)评分等。结果治疗后,研究组CGI-SI评分略低于对照组,但差异无统计学意义;治疗前及治疗后2、6、24、48、72 h两组PANSSEC评分比较差异无统计学意义;研究组不良反应总发生率为6.67%,低于对照组的43.33%,差异有统计学意义(P<0.05)。结论与氟哌啶醇注射液比较,临床采用注射用甲磺酸齐拉西酮药物治疗双相Ⅰ型障碍躁狂发作急性激越症状,虽疗效基本相当,但给药安全性更高,对疾病治疗有利。