<![CDATA[How do you pick an LAI antipsychotic? Molecule first, delivery system second, Jacob Hanaie, PharmD, shared at SoCal Psychiatry.]]>
<![CDATA[Why sleep checks matter in ADHD: spot apnea, executive dysfunction, and hidden ADHD behind treatment-resistant depression.]]>
<![CDATA[At the Southern California Psychiatry Conference, Jason Kellogg, MD, shares insights into the evolution of the MDD pipeline, with an eye on rapid-acting novel mechanisms. ]]>
<![CDATA[Gerald A. Maguire, MD, shares his experience and insights on the importance of trust and empathy. ]]>
<![CDATA[Explore newly FDA-approved ADHD treatments and late-stage contenders, plus practical guidance on managing sleep disorders with evidence-based behavioral strategies.]]>
Brain Scans Reveal Dopamine Damage in Long COVID, Pointing to New Treatments
New brain imaging research has provided the strongest evidence to date that long COVID is associated with injury to the brain’s dopamine system, offering a potential biological explanation for persistent symptoms such as fatigue, slowed movement, lack of motivation, and memory problems.
The study, published in eBioMedicine by researchers at the Centre for Addiction and Mental Health in Canada, used positron emission tomography (PET) imaging to examine dopamine-releasing neurons in people with long COVID. The findings suggest that reduced dopamine nerve terminal density in key brain regions may underlie many of the neurological symptoms experienced by patients and identify a potential therapeutic target for future treatments.
Long COVID is estimated to affect approximately nine million adults in the United States and about 5% of the global population, making it one of the most common chronic conditions to emerge from the COVID-19 pandemic. The condition is characterized by symptoms that persist for at least three months after the initial SARS-CoV-2 infection and commonly includes fatigue, brain fog, memory impairment, and mood changes. Despite its prevalence, there are currently no evidence-based treatments, largely because the biological mechanisms driving these symptoms remain poorly understood.
To investigate whether the brain’s dopamine system is involved, the researchers used PET imaging to measure a well-established marker of dopamine neuron integrity in individuals with long COVID and healthy control participants.
Compared with healthy volunteers, participants with long COVID had significantly lower levels of the dopamine neuron marker throughout the striatum, a brain region that plays a central role in motivation, movement, learning, and cognition. The reduced signal indicates a loss of dopamine nerve terminal density, providing direct evidence that dopamine-releasing neurons are injured in long COVID.
The imaging findings also closely matched patients’ clinical symptoms. Lower dopamine markers in the ventral striatum were associated with greater loss of motivation, reductions in the dorsal putamen correlated with slower movement, and lower marker levels in the caudate were linked to poorer memory performance. The pattern suggests that damage within specific regions of the dopamine system may contribute to distinct neurological symptoms experienced by people with long COVID.
The findings build on the research group’s earlier work demonstrating elevated inflammation in the brains of people with long COVID, particularly in regions rich in dopamine-producing neurons. Because inflammation is known to damage dopamine neurons in other neurological disorders, the new study provides direct evidence that this inflammatory process may be accompanied by measurable injury to the brain’s dopamine system. The close relationship between dopamine neuron loss and symptom severity further strengthens the case that dopamine dysfunction plays a central role in the condition.
The study also shifts attention beyond inflammation alone and suggests that long COVID should be considered, at least in part, a disorder affecting the brain’s dopamine system. That conclusion has important therapeutic implications because several medications already approved for other neurological disorders increase dopamine availability or enhance dopamine signaling. The researchers suggest that repurposing dopamine precursors or drugs that inhibit dopamine metabolism could represent a promising strategy for treating persistent cognitive and neurological symptoms associated with long COVID.
The findings also provide biological evidence supporting the experiences of people living with long COVID, many of whom have struggled for years with debilitating symptoms despite the absence of clear diagnostic markers. By demonstrating measurable injury to dopamine-releasing neurons, the study offers objective evidence that persistent neurological symptoms have a biological basis.
Building on these results, the investigators plan to launch a clinical trial in collaboration with University Health Network to evaluate whether therapies that improve dopamine function can reduce fatigue, improve motivation, and enhance memory in people with long COVID. If successful, the trial could pave the way for one of the first mechanism-based treatment approaches for the condition.
The post Brain Scans Reveal Dopamine Damage in Long COVID, Pointing to New Treatments appeared first on Inside Precision Medicine.
Symptom-Specific Factors Associated With Chronic Constipation in Older Adults: Cross-Sectional Survey of Patient-Reported Outcomes
Background: In older adults with chronic constipation, symptoms of defecation difficulty often persist despite improvements in bowel movement frequency. However, constipation-related symptoms have rarely been examined as independent outcomes. Objective: The objective of this study is to explore factors associated with constipation-related symptoms, less than 3 spontaneous bowel movements per week, straining during bowel movements, a sensation of incomplete evacuation, and a sensation of anorectal obstruction or blockage. Methods: A cross-sectional web-based survey was conducted to collect patient-reported data. Constipation-related symptoms were defined according to the Rome IV criteria. Each symptom was treated as a binary variable in the analyses. Multivariable logistic regression analyses were used to examine associations between stool characteristics and medication, treatment processes, and lifestyle-related factors. Stool characteristics were classified using the Bristol Stool Form Scale, with hard stools defined as types 1 and 2. Results: We enrolled 546 participants and investigated the following constipation symptoms: less than 3 spontaneous bowel movements per week (n=226, 41.4%), straining (n=330, 60.4%), sensation of incomplete evacuation (n=344, 63.0%), and sensation of anorectal obstruction or blockage (n=242, 44.3%). Multivariable logistic regression analyses for these outcome variables showed that hard stool was consistently and independently associated with all constipation-related symptoms (odds ratio [OR] 1.86‐4.66). Symptom-specific associations that remained significant after false discovery rate adjustment included lower physical activity with less than 3 spontaneous bowel movements per week (OR 0.86, 95% CI 0.77‐0.96), stimulant laxative use with the sensation of incomplete evacuation (OR 2.01, 95% CI 1.22‐3.31), and lower adherence to the prescribed dosage with the sensation of anorectal obstruction or blockage (OR 0.87, 95% CI 0.78‐0.97). In contrast, the experience of adverse effects was associated with a higher probability of less than 3 spontaneous bowel movements per week and the sensation of anorectal obstruction or blockage. Conclusions: In older adults with chronic constipation, different constipation-related symptoms showed distinct patterns of association, while hard stool consistency emerged as a common factor across symptoms. These exploratory findings may support symptom-oriented assessment and help inform individualized management approaches using electronically collected patient-reported outcomes.
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Digital Mental Health Research Priorities, Revisited for the AI and Large Language Model Era
Digital mental health has become an established part of mental health care, but the rapid arrival of large language models and other artificial intelligence tools has refocused attention on the evidence needed to guide the field. This editorial updates the research priorities articulated by JMIR Mental Health in 2023, while reaffirming their emphasis on equity, replicability, privacy, efficacy, and engagement. What has changed is not the importance of these priorities, but the urgency with which they must now be applied. As digital tools become more clinically consequential, research must move beyond demonstrating that a technology is feasible, usable, or novel. The field needs studies that clarify how these tools work, for whom they are beneficial, under what conditions they may cause harm, and how they can be responsibly integrated into care. We call for research that is transparent about the technologies being studied, grounded in meaningful clinical questions, attentive to safety and accountability, and designed to produce knowledge that remains useful as specific products and models change. The promise of digital mental health will depend less on the sophistication of emerging tools than on the quality of the evidence used to shape their role in care.
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<![CDATA[Explore rapid TRD breakthroughs: accelerated TMS like SAINT, emerging neuromodulation tools, near-term psychedelic therapies, and why sharper diagnosis improves outcomes.]]>
Nominee for key federal health role has a history of questioning vaccines
WASHINGTON — The Trump administration’s pick to oversee preparedness and response to public health emergencies and disasters has questioned the use of the hepatitis B vaccine in infants and raised the disproven link between vaccines and autism in past comments reviewed by STAT.
Those comments by Sean Kaufman, nominated to be Assistant Secretary for Preparedness and Response, are part of an undercurrent of vaccine skepticism among some high-ranking Department of Health and Human Services officials under Secretary Robert F. Kennedy Jr. — despite efforts from White House officials to steer the conversation away from vaccines.