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Background: Neuroimaging suggests that white matter microstructure is severely affected in Alzheimer's disease (AD) progression. However, whether alterations in white matter microstructure are confined to specific regions and whether they can be used as potential biomarkers to distinguish normal control (NC) from AD are unknown. Methods: In this cross-sectional study, 33 cases of AD and 25 cases of NC were recruited for automatic fiber quantification (AFQ). A total of 20 fiber bundles were equally divided into 100 segments for quantitative assessment of fractional anisotropy (FA), mean diffusivity (MD), volume and curvature. In order to further evaluate the diagnostic value, the maximum redundancy minimum (mRMR) and LASSO algorithms were used to select features, calculate the Radscore of each subject, establish logistic regression models, and draw ROC curves, respectively, to assess the predictive power of four different models. Results: There was a significant increase in the MD values in AD patients compared with healthy subjects. The differences were mainly located in the left cingulum hippocampus (HCC), left uncinate fasciculus (UF) and superior longitudinal fasciculus (SLF). The point-wise level of 20 fiber bundles was used as a classification feature, and the MD index exhibited the best performance to distinguish NC from AD. Conclusion: These findings contribute to the understanding of the pathogenesis of AD and suggest that abnormal white matter based on DTI-based AFQ analysis is helpful to explore the pathogenesis of AD.

Background Treatment-resistant schizophrenia is a severe form of schizophrenia characterized by poor response to at least two antipsychotic drugs and is typically treated with clozapine. However, clozapine lowers the epileptic threshold, leading to seizures, which are severe side effects of antipsychotics that result in multiple complications. Clozapine-related seizures are generally considered to be dose-dependent and especially rare in the low-dose (150-300 mg/d) clozapine treated population. Due to clinical rarity, little is known about its clinical characteristics and treatment. Case summary A 62-year-old Chinese man with a 40-year history of treatment-resistant schizophrenia presented to the Emergency Department with symptoms of myoclonus, consciousness disturbance and vomiting after taking 125 mg clozapine. Upon admission, the patient had a suddenly generalized tonic-clonic seizure lasting for about half a minute with persistent disturbance of consciousness, fever, cough and bloody sputum, which was considered to be low-dose clozapine-related seizure. After antiepileptic and multiple anti-infection treatments, the patient was discharged without epileptic or psychotic symptoms. Conclusion Our aim is to highlight the early prevention and optimal treatment of clozapine-related seizure through case analysis and literature review.

Summary Background China has a large population of older people, but has not yet undertaken a comprehensive study on the prevalence, risk factors, and management of both dementia and mild cognitive impairment (MCI). Methods For this national cross-sectional study, 46 011 adults aged 60 years or older were recruited between March 10, 2015, and Dec 26, 2018, using a multistage, stratified, cluster-sampling method, which considered geographical region, degree of urbanisation, economic development status, and sex and age distribution. 96 sites were randomly selected in 12 provinces and municipalities representative of all socioeconomic and geographical regions in China. Participants were interviewed to obtain data on sociodemographic characteristics, lifestyle, medical history, current medications, and family history, and then completed a neuropsychological testing battery administered by a psychological evaluator. The prevalence of dementia (Alzheimer's disease, vascular dementia, and other dementias) and MCI were calculated and the risk factors for different groups were examined using multivariable-adjusted analyses. Findings Overall age-adjusted and sex-adjusted prevalence was estimated to be 6·0% (95% CI 5·8–6·3) for dementia, 3·9% (3·8–4·1) for Alzheimer's disease, 1·6% (1·5–1·7) for vascular dementia, and 0·5% (0·5–0·6) for other dementias. We estimated that 15·07 million (95% CI 14·53–15·62) people aged 60 years or older in China have dementia: 9·83 million (9·39–10·29) with Alzheimer's disease, 3·92 million (3·64–4·22) with vascular dementia, and 1·32 million (1·16–1·50) with other dementias. Overall MCI prevalence was estimated to be 15·5% (15·2–15·9), representing 38·77 million (37·95–39·62) people in China. Dementia and MCI shared similar risk factors including old age (dementia: odds ratios ranging from 2·69 [95% CI 2·43–2·98] to 6·60 [5·24–8·32]; MCI: from 1·89 [1·77–2·00] to 4·70 [3·77–5·87]); female sex (dementia: 1·43 [1·31–1·56]; MCI: 1·51 [1·43–1·59]); parental history of dementia (dementia: 7·20 [5·68–9·12]; MCI: 1·91 [1·48–2·46]); rural residence (dementia: 1·16 [1·06–1·27]; MCI: 1·45 [1·38–1·54]); fewer years of education (dementia: from 1·17 [1·06–1·29] to 1·55 [1·38–1·73]; MCI: from 1·48 [1·39–1·58] to 3·48 [3·25–3·73]); being widowed, divorced, or living alone (dementia: from 2·59 [2·30–2·90] to 2·66 [2·29–3·10]; MCI: from 1·58 [1·44–1·73] to 1·74 [1·56–1·95]); smoking (dementia: 1·85 [1·67–2·04]; MCI: 1·27 [1·19–1·36]), hypertension (dementia: 1·86 [1·70–2·03]; MCI: 1·62 [1·54–1·71] for MCI), hyperlipidaemia (dementia: 1·87 [1·71–2·05]; MCI: 1·29 [1·21–1·37]), diabetes (dementia: 2·14 [1·96–2·34]; MCI: 1·44 [1·35–1·53]), heart disease (dementia: 1·98 [1·73–2·26]; MCI: 1·17 [1·06–1·30]), and cerebrovascular disease (dementia: 5·44 [4·95–5·97]; MCI: 1·49 [1·36–1·62]). Nine of these risk factors are modifiable. Interpretation Dementia and MCI are highly prevalent in China and share similar risk factors. A prevention strategy should be developed to target the identified risk factors in the MCI population to thwart or slow down disease progression. It is also crucial to optimise the management of dementia and MCI as an important part of China's public health system. Funding Key Project of the National Natural Science Foundation of China, National Key Scientific Instrument and Equipment Development Project, Mission Program of Beijing Municipal Administration of Hospitals, Beijing Scholars Program, Beijing Brain Initiative from Beijing Municipal Science & Technology Commission, Project for Outstanding Doctor with Combined Ability of Western and Chinese Medicine, and Beijing Municipal Commission of Health and Family Planning.

Previous genome-wide association studies have identified dozens of susceptibility loci for sporadic Alzheimer’s disease, but few of these loci have been validated in longitudinal cohorts. Establishing predictive models of Alzheimer’s disease based on these novel variants is clinically important for verifying whether they have pathological functions and provide a useful tool for screening of disease risk. In the current study, we performed a two-stage genome-wide association study of 3913 patients with Alzheimer’s disease and 7593 controls and identified four novel variants (rs3777215, rs6859823, rs234434, and rs2255835; Pcombined = 3.07 × 10−19, 2.49 × 10−23, 1.35 × 10−67, and 4.81 × 10−9, respectively) as well as nine variants in the apolipoprotein E region with genome-wide significance (P, Jia et al. identify novel Alzheimer’s disease-related variants in a two-stage genome-wide association study in a Chinese population, and use the variants to build 11 predictive models. Validation of the models in a separate longitudinal cohort confirms that they can predict Alzheimer's disease risk.

Objective To identify an optimal lifestyle profile to protect against memory loss in older individuals. Design Population based, prospective cohort study. Setting Participants from areas representative of the north, south, and west of China. Participants Individuals aged 60 years or older who had normal cognition and underwent apolipoprotein E (APOE) genotyping at baseline in 2009. Main outcome measures Participants were followed up until death, discontinuation, or 26 December 2019. Six healthy lifestyle factors were assessed: a healthy diet (adherence to the recommended intake of at least 7 of 12 eligible food items), regular physical exercise (≥150 min of moderate intensity or ≥75 min of vigorous intensity, per week), active social contact (≥twice per week), active cognitive activity (≥twice per week), never or previously smoked, and never drinking alcohol. Participants were categorised into the favourable group if they had four to six healthy lifestyle factors, into the average group for two to three factors, and into the unfavourable group for zero to one factor. Memory function was assessed using the World Health Organization/University of California-Los Angeles Auditory Verbal Learning Test, and global cognition was assessed via the Mini-Mental State Examination. Linear mixed models were used to explore the impact of lifestyle factors on memory in the study sample. Results 29 072 participants were included (mean age of 72.23 years; 48.54% (n=14 113) were women; and 20.43% (n=5939) were APOE ε4 carriers). Over the 10 year follow-up period (2009-19), participants in the favourable group had slower memory decline than those in the unfavourable group (by 0.028 points/year, 95% confidence interval 0.023 to 0.032, P Conclusion A healthy lifestyle is associated with slower memory decline, even in the presence of the APOE ε4 allele. This study might offer important information to protect older adults against memory decline. Trial registration ClinicalTrials.gov NCT03653156 .

To compare effects of intensity-modulated radiotherapy (IMRT) with those of conventional radiotherapy on quality of life (QoL) and severity of xerostomia in patients with head and neck cancer. PubMed, Cochrane, and Embase databases were searched to July 1, 2019, to identify relevant studies, using the following terms: radiotherapy, head and neck cancer, quality of life, cognition, xerostomia, two-/three-dimensional conformal radiation therapy, IMRT, conformal proton beam radiation therapy, stereotactic radiosurgery, and volumetric modulated arc therapy. The outcomes of interest were QoL measured by global health status; emotional, social, and cognitive function; and severity of xerostomia. Seven studies with a total of 761 patients (n = 369 with IMRT; n = 392 with conventional RT) were included in this study. Median patient age was 18–65 years. IMRT group patients had better global health status (pooled standardized mean difference [SMD] = 0.80, 95% CI 0.26 to 1.35, P = 0.004) and cognitive function (pooled SMD = 0.30, 95% CI 0.06 to 0.54, P = 0.013) than the conventional RT group. Patients receiving IMRT also had significantly lower scores for xerostomia than those receiving conventional RT (pooled SMD = − 0.60, 95% CI − 0.97 to − 0.24, P = 0.001). No differences were found in emotional function (P = 0.531) and social function (P = 0.348) between the two groups. IMRT significantly improves QoL and reduces the severity of xerostomia in patients with head and neck cancer. Results of this study provide clinicians with guidelines for decisions on the use of IMRT versus conventional RT.

Background: The World Alzheimer Report has described and predicted the economic burden of Alzheimer’s disease (AD) patients in detail for four consecutive years. There was a large-scale national survey in China launched by Professor Jianping Jia in 2015, but it did not adequately represent the average economic burden of AD patients in Zhejiang Province. Objective: To investigate the economic burden and main factors influencing Alzheimer’s disease (AD) in Zhejiang Province. Methods: We recruited 830 patients from 10 cities in Zhejiang Province, evaluated their per capita and total cost related to AD treatment and care in 2017, and analyzed the main factors affecting economic burden from the perspective of demographic characteristics and disease severity. Results: In 2017, per capita cost of AD was 114,343.7 yuan, while the total cost was 27.53 billion yuan, accounting for 0.77% of Zhejiang Province’s GDP (5176.8 billion yuan). Total cost, direct medical cost, and indirect cost have different correlations with age, education level, type of work, marital status, comorbidity, and disease severity. Conclusion: The economic burden of AD in Zhejiang Province is heavy, similar to the national burden, and interventions based on demographic characteristics and disease severity can help reduce it.

Background Alzheimer's disease (AD) is an age-progressive neurodegenerative disorder that affects cognitive function. There have been several functional connectivity (FC) strengths; however, FC density needs more development in AD. Therefore, this study wanted to determine the alternations in resting-state functional connectivity density (FCD) induced by Alzheimer's and mild cognitive impairment (MCI). Methods One hundred and eleven AD patients, 29 MCI patients, and 73 healthy controls (age- and sex-matched) were recruited and assessed using resting-state functional magnetic resonance imaging (MRI) scanning. The ultra-fast graph theory called FCD mapping was used to calculate the voxel-wise short- and long-range FCD values of the brain. We performed voxel-based between-group comparisons of FCD values to show the cerebral regions with significant FCD alterations. We performed Pearson's correlation analyses between aberrant functional connectivity densities and several clinical variables with adjustment for age and sex. Results Patients with cognition decline showed significantly abnormal long-range FCD in the cerebellum crus I, right insula, left inferior frontal gyrus, left superior frontal gyrus, left inferior frontal gyrus, and right middle frontal gyrus. The short-range FCD changed in the cerebellum crus I, left inferior frontal gyrus, left superior occipital gyrus, and right middle frontal gyrus. The long- and short-range functional connectivity in the left inferior frontal gyrus was positively correlated with Mini-mental State Examination (MMSE) scores. Conclusions FCD in the identified regions reflects mechanism and compensation for loss of cognitive function. These findings could improve the pathology of AD and MCI and supply a neuroimaging marker for AD and MCI.

Background Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory impairment. Previous studies have largely focused on alterations of static brain activity occurring in patients with AD. Few studies to date have explored the characteristics of dynamic brain activity in cognitive impairment, and their predictive ability in AD patients. Methods One hundred and eleven AD patients, 29 MCI patients, and 73 healthy controls (HC) were recruited. The dynamic amplitude of low-frequency fluctuation (dALFF) and the dynamic fraction amplitude of low-frequency fluctuation (dfALFF) were used to assess the temporal variability of local brain activity in patients with AD or mild cognitive impairment (MCI). Pearson's correlation coefficients were calculated between the metrics and subjects' behavioral scores. Results The results of analysis of variance indicated that the AD, MCI, and HC groups showed significant variability of dALFF in the cerebellar posterior and middle temporal lobes. In AD patients, these brain regions had high dALFF variability. Significant dfALFF variability was found between the three groups in the left calcarine cortex and white matter. The AD group showed lower dfALFF than the MCI group in the left calcarine cortex. Conclusions Compared to HC, AD patients were found to have increased dALFF variability in the cerebellar posterior and temporal lobes. This abnormal pattern may diminish the capacity of the cerebellum and temporal lobes to participate in the cerebrocerebellar circuits and default mode network (DMN), which regulate cognition and emotion in AD. The findings above indicate that the analysis of dALFF and dfALFF based on functional magnetic resonance imaging data may give a new insight into the neurophysiological mechanisms of AD.

To discuss the changes in cognitive function and related brain regions in patients with chronic benzene poisoning. Few studies have explored the damage to cognitive function that occurs in benzene toxic encephalopathy. It is important to identify early in the course of disease whether cognitive dysfunction is caused by benzene poisoning so that disease prognosis and appropriate treatment can be determined. We reported on the chronic benzene poisoning of a 41-year-old Han Chinese woman. The patient had graduated from primary school, and she had a cheerful and diligent personality. She had performed painting work for more than five years, and her primary work involved painting swivel chairs. The primary reasons she attended the psychiatric clinic were loss of appetite, she had experienced fatigue for more than 2 months, and she had had memory loss for a month. These symptoms seriously impacted the patient's daily life and ability to work. The patient's husband expressed concern that she could not recognize acquaintances, could not find her way home, and had lost approximately 5 kg per month over two months. We analyzed changes in this chronic benzene poisoning patient's cognitive function with cognitive function assessments and magnetic resonance imaging (MRI). Measurements were taken on presentation to hospital, during the patient's hospitalization, and three months following discharge. Long-term exposure to benzene can damage the central nervous system. However, it is difficult to recognize when cognitive impairment is caused by chronic benzene poisoning, as it rarely presents with a decline in cognitive function as the primary clinical manifestation. Atypical symptoms, such as decreased immune function and gastrointestinal issues, may be the first symptoms to appear, and these atypical symptoms are difficult to detect in the early stages of disease. Regular screening of high-risk groups is required to significantly reduce the incidence of systemic damage caused by benzene poisoning.

The amygdala is an important part of the medial temporal lobe and plays a pivotal role in the emotional and cognitive function. The aim of this study was to build and validate comprehensive classification models based on amygdala radiomic features for Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI). For the amygdala, 3360 radiomic features were extracted from 97 AD patients, 53 aMCI patients and 45 normal controls (NCs) on the three-dimensional T1-weighted magnetization-prepared rapid gradient echo (MPRAGE) images. We used maximum relevance and minimum redundancy (mRMR) and least absolute shrinkage and selection operator (LASSO) to select the features. Multivariable logistic regression analysis was performed to build three classification models (AD-NC group, AD-aMCI group, and aMCI-NC group). Finally, internal validation was assessed. After two steps of feature selection, there were 5 radiomic features remained in the AD-NC group, 16 features remained in the AD-aMCI group and the aMCI-NC group, respectively. The proposed logistic classification analysis based on amygdala radiomic features achieves an accuracy of 0.90 and an area under the ROC curve (AUC) of 0.93 for AD vs. NC classification, an accuracy of 0.81 and an AUC of 0.84 for AD vs. aMCI classification, and an accuracy of 0.75 and an AUC of 0.80 for aMCI vs. NC classification. Amygdala radiomic features might be early biomarkers for detecting microstructural brain tissue changes during the AD and aMCI course. Logistic classification analysis demonstrated the promising classification performances for clinical applications among AD, aMCI and NC groups.

The purpose of this study was to explore the differences in interhemispheric functional connectivity in patients with Alzheimer’s disease (AD) and amnestic mild cognitive impairment (aMCI) based on a triple network model consisting of the default mode network (DMN), salience network (SN), and executive control network (ECN). The technique of voxel-mirrored homotopic connectivity (VMHC) analysis was applied to explore the aberrant connectivity of all patients. The results showed that: (1) the statistically significant connections of interhemispheric brain regions included DMN-related brain regions (i.e. precuneus, calcarine, fusiform, cuneus, lingual gyrus, temporal inferior gyrus, and hippocampus), SN-related brain regions (i.e. frontoinsular cortex), and ECN-related brain regions (i.e. frontal middle gyrus and frontal inferior); (2) the precuneus and frontal middle gyrus in the AD group exhibited lower VMHC values than those in the aMCI and healthy control (HC) groups, but no significant difference was observed between the aMCI and HC groups; and (3) significant correlations were found between peak VMHC results from the precuneus and Mini Mental State Examination (MMSE) and Montreal Cognitive Scale (MOCA) scores and their factor scores in the AD, aMCI, and AD plus aMCI groups, and between the results from the frontal middle gyrus and MOCA factor scores in the aMCI group. These findings indicated that impaired interhemispheric functional connectivity was observed in AD and could be a sensitive neuroimaging biomarker for AD. More specifically, the DMN was inhibited, while the SN and ECN were excited. VMHC results were correlated with MMSE and MOCA scores, highlighting that VMHC could be a sensitive neuroimaging biomarker for AD and the progression from aMCI to AD.

Alzheimer’s disease (AD) has become an issue of common concern. With the increasing numbers of people with dementia, the precaution and diagnosis of AD is more and more important. Many reports have pointed out that the AD is closely related to four metal ions within human body, including Zn2+, Fe3+, Al3+ and Cu2+. On the other hand, magnetic resonance imaging (MRI) plays a key role in the diagnosis of AD. Metal–organic frameworks (MOFs), as one of the well-known inorganic–organic hybrid material, have a promising potential in sensing of AD related ions, as well as MRI contrast agent. In this review, we summarized the recent progress in revealing pathogeny and diagnose of AD and discussed the potential of MOFs in this area. Specifically, MOFs as luminescent sensors for Zn2+, Fe3+, Al3+ and Cu2+ ions and MRI contrast agents are highlighted.

Objective This study aimed to identify misdiagnosed or undiagnosed psychiatric disorders and the factors associated with these disorders in patients with sleep problems who are referred to a consultation-liaison service. Method Records of all inpatients receiving a consultation from the Psychiatry Department between January and December 2016 were retrospectively reviewed. Psychiatric diagnoses were analyzed using descriptive statistics, and the factors associated with the risk of these disorders in patients with sleep problems were determined by multiple logistic regression analysis. Results Of the 331 referral patients whose referral reason was simply having trouble in sleeping, only 97 patients were diagnosed with primary sleep disorder after consultation. The recognition rate of psychiatric disorders in inpatients with sleep problems among nonpsychiatric physicians was 29.3%. Anxiety (107, 45.7%) was the most common psychiatric diagnosis in patients with sleep problems followed by organic mental disorder (83, 35.5%), depression (37, 15.8%), and other mental disorders (8, 3.4%). Multiple logistic regression analysis revealed that a course >1 month (OR = 3.656, 95% CI = 2.171–6.156, p = 0.000) and sleep–wake rhythm disturbances (OR = 25.008, 95% CI = 5.826–107.341, p = 0.000) were associated with increased risks of psychiatric disorders. Conclusions The study showed that recognition rate of psychiatric disorders in inpatients with sleep problems was very low. A course >1 month and sleep–wake rhythm disturbances were associated with increased risks of disorders and could be used as indicators by nonpsychiatric physicians to improve diagnoses.

Background: Impaired functional connectivity in the default mode network (DMN) is supposedly involved in Alzheimer’s disease (AD) progression. The posterior cingulate cortex (PCC) might be an imaging marker for monitoring AD progression. Objective: To investigate the alterations in the directed functional connectivity between the PCC and whole brain in patients with AD, patients with mild cognitive impairment (MCI), and healthy controls. Methods: A total of 116 enrolled participants were divided into three groups: AD (n=32), MCI (n=26), and controls (n=58). Using resting-state functional magnetic resonance imaging (rs-fMRI), the directed functional connectivity was studied using Granger causality analysis (GCA). Results: Almost all of the directed functional connections with significant differences were unidirectional. Compared with the NC group, the AD group showed enhanced directed connectivity from the whole brain to the PCC mainly for regions outside the DMN, and reduced connectivity from the PCC to the whole brain mainly for regions inside the DMN. Compared with the NC group, the MCI group showed enhanced directed connectivity from the PCC to the whole brain for the bilateral precuneus and postcentralgyrus, and reduced connectivity from the whole brain to the PCC for regions outside the DMN. Compared with the MCI group, the abnormal directed connectivity in the AD group was predominantly in the left hemisphere, possibly suggesting asymmetric characteristics. Conclusion: In patients with AD, the PCC in the DMN shows disorders in receiving and transmitting information, and these abnormalities are directional.

Alzheimer’s disease (AD) is a neurodegenerative disease with main symptoms of chronic primary memory loss and cognitive impairment. The study aim was to investigate the correlation between intrahippocampal functional connectivity (FC) and MRI radiomic features in AD. A total of 67 AD patients and 44 normal controls (NCs) were enrolled in this study. Using the seed-based method of resting-state functional MRI (rs-fMRI), the whole-brain FC with bilateral hippocampus as seed was performed, and the FC values were extracted from the bilateral hippocampus. We observed that AD patients demonstrated disruptive FC in some brain regions in the left hippocampal functional network, including right gyrus rectus, right anterior cingulate and paracingulate gyri, bilateral precuneus, bilateral angular gyrus, and bilateral middle occipital gyrus. In addition, decreased FC was detected in some brain regions in the right hippocampal functional network, including bilateral anterior cingulate and paracingulate gyri, right dorsolateral superior frontal gyrus, and right precentral gyrus. Bilateral hippocampal radiomics features were calculated and selected using the A.K. software. Finally, Pearson’s correlation analyses were conducted between these selected features and the bilateral hippocampal FC values. The results suggested that two gray level run-length matrix (RLM) radiomic features and one gray level co-occurrence matrix (GLCM) radiomic feature weakly associated with FC values in the left hippocampus. However, there were no significant correlations between radiomic features and FC values in the right hippocampus. These findings present that the AD group showed abnormalities in the bilateral hippocampal functional network. This is a prospective study that revealed the weak correlation between the MRI radiomic features and the intrahippocampal FC in AD patients.

BACKGROUND: To study the efficacy of tandospirone citrate in treating Alzheimer’s disease (AD) patients with anxiety. METHODS: Thirty mild-to-moderate AD patients with anxiety symptoms were randomly divided into a monotherapy group (donepezil) and a combination therapy group (donepezil and tandospirone). The treatment lasted for 12 weeks. Drug efficacy was regularly assessed using psychological assessment scales and quantitative pharmaco-electroencephalogram (QPEEG) power spectral analysis. RESULTS: After 12 weeks of treatment, the mean Hamilton Anxiety Scale (HAMA) score and mean Neuropsychiatric Inventory (NPI) score of the combination therapy group were 5.13±4.18 and 4.2±5.0, respectively, which was significantly lower compared to baseline and the monotherapy group (all P

Enyan Yu,1,2 Junpeng Zhu,1,2 Yunfei Tan,1,2 Zhengluan Liao,1,2 Yaju Qiu,1,2 Bingren Zhang,3 Chu Wang,3 Wei Wang3 1Department of Psychiatry, Zhejiang Provincial People’s Hospital, Hangzhou, People’s Republic of China; 2Department of Psychiatry, People’s Hospital of Hangzhou Medical College, Hangzhou, People’s Republic of China; 3Department of Clinical Psychology and Psychiatry/School of Public health, Zhejiang University College of Medicine, Hangzhou, People’s Republic of China Purpose: Color preferences vary among normal individuals and psychiatric patients, and this might be related to their different levels of hypnotic susceptibility. We hypothesized that individuals with higher hypnotic susceptibility prefer more arousing colors such as red.Patients and methods: Out of 440 participants, we selected 70 with higher (HIGH) and 66 with lower (LOW) hypnotic susceptibilities, and asked them to undergo the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC) test, then to order their preferences of 11 colors.Results: The HIGH group preferred red more and scored higher on the total SHSSC. The preference order of black was negatively predicted by the SHSSC Taste hallucination but positively by Arm rigidity, and the preference of yellow was positively predicted by Posthypnotic amnesia and Taste hallucination in the HIGH group.Conclusion: The red preference and the SHSSC associations with black and yellow preferences in participants with high hypnotic susceptibility help to clarify the individual difference of color preference and provide research hints for behavioral studies in normal individuals and psychiatric patients. Keywords: color perception, healthy people, the Stanford Hypnotic Susceptibility Scale: Form C (SHSSC)

Impaired functional connectivity in the Default Mode Network (DMN) may be involved in the progression of Alzheimer's Disease (AD). The Posterior Cingulate Cortex (PCC) is a potential imaging marker for monitoring the progression of AD. Previous studies did not focus on the functional connectivity between the PCC and nodes in regions outside the DMN, but our study is an effort to explore these overlooked functional connections. For collecting data, we used functional Magnetic Resonance Imaging (fMRI) and Granger Causality Analysis (GCA). fMRI provides a non-invasive method for studying the dynamic interactions between the different brain regions. GCA is a statistical hypothesis test for determining whether one-time series is useful in forecasting another. In simple terms, it is judged by comparing the "Known all the information on the last moment, the distribution of the probability of X at this time" and the "Known all the information on the last moment except Y, the distribution of the probability of X at this time", to determine whether there is a causal relationship between Y and X. This definition is based on the complete information source and stationary chronological sequence. The main step of this analysis is to use X and Y to establish the regression equation and draw a causal relationship by a hypothetical test. Since GCA can measure causal effects, we used it to investigate the anisotropy of the functional connectivity and explore the hub function of the PCC. Here, we screened 116 participants for MRI scanning, and after preprocessing the data obtained from neuroimaging, we used GCA to derive the causal relationship of each node. Finally, we concluded that the directed connection is significantly different between the Mild Cognitive Impairment (MCI) and AD groups, both from the PCC to the whole brain and from the whole brain to the PCC.

Many functional magnetic resonance imaging (fMRI) studies have indicated that Granger causality analysis (GCA) is a suitable method for revealing causal effects between brain regions. The purpose of the present study was to identify neuroimaging biomarkers with a high sensitivity to amnestic mild cognitive impairment (aMCI). The resting-state fMRI data of 30 patients with Alzheimer’s disease (AD), 14 patients with aMCI, and 18 healthy controls (HC) were evaluated using GCA. This study focused on the “triple networks” concept, a recently proposed higher-order functioning-related brain network model that includes the default-mode network (DMN), salience network (SN), and executive control network (ECN). As expected, GCA techniques were able to reveal differences in connectivity in the three core networks among the three patient groups. The fMRI data were pre-processed using DPARSFA v2.3 and REST v1.8. Voxel-wise GCA was performed using the REST-GCA in the REST toolbox. The directed (excitatory and inhibitory) connectivity obtained from GCA could differentiate among the AD, aMCI and HC groups. This result suggests that analysing the directed connectivity of inter-hemisphere connections represents a sensitive method for revealing connectivity changes observed in patients with aMCI. Specifically, inhibitory within-DMN connectivity from the posterior cingulate cortex (PCC) to the hippocampal formation and from the thalamus to the PCC as well as excitatory within-SN connectivity from the dorsal anterior cingulate cortex (dACC) to the striatum, from the ECN to the DMN, and from the SN to the ECN demonstrated that changes in connectivity likely reflect compensatory effects in aMCI. These findings suggest that changes observed in the triple networks may be used as sensitive neuroimaging biomarkers for the early detection of aMCI.

Wuling mycelia powder is the dry powder of rare a fungi Xyla ria sp., Carbon species, with a long history of medicinal use in Chinese medicine. Recently it has shown a powerful antidepressant activity in clinic.The present study explores the antidepressant activity of Wuling mycelia powder in chronic unpredictable mild stress (CUMS) rats and its possible involvement of l-arginine-nitric oxide (NO)-cyclic guanosine monophosphate (cGMP) signaling pathway.Experiments were performed in the rat CUMS model. CUMS rats were treated with Wuling mycelia powder (0.5, 1.0 or 2.0 g/kg, i.g.) to test behavioral changes including the sucrose preference, the crossing number and food consumption. Further, L-arginine (substrate for nitric oxide) (750 mg/kg), 7-nitroindazole (a specific neuronal nitric oxide synthase inhibitor) (25 mg/kg), sildenafil (phosphodiesterase 5 inhibitor) (5 mg/kg) and methylene blue (direct inhibitor of both nitric oxide synthase and soluble guanylate cyclase) (10 mg/kg) were treated for 60 min before each test to detect the possible mechanism of antidepressant-like effect of Wuling mycelia powder.After 4 weeks of administration, both 1.0 or 2.0 g/kg Wuling mycelia powder suppressed the behavioral changes including the sucrose preference [F(3, 31)=50.87, p0.001], the crossing number [F(3, 31)=68.98, p0.05], and food consumption [F(3, 31)=19.04, p0.05] in the CUMS rats. The antidepressant-like effect of Wuling mycelia powder was prevented by pretreatment with l-arginine and sildenafil. Pretreatment of rats with 7-nitroindazole and methylene blue potentiated the effect of Wulin mycelia powder.Our findings demonstrate that Wuling mycelia powder has an antidepressant-like effect in the CUMS rats, and possible involvement of L-arginine-nitric oxide-cyclic GMP signaling pathway in its antidepressant effect.