Tag: News Approved

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Ketogenic therapy as a potential novel treatment approach for PTSD: an integrative review and proposed mechanistic model

BackgroundBrain and body metabolic disruptions have been suggested in several studies as a mechanism underlying posttraumatic stress disorder (PTSD). Therapies targeting metabolic pathways might provide new treatment options. This review explores the potential of ketogenic therapies, such as the ketogenic diet and ketone supplementation, as novel metabolic treatments for PTSD.MethodsAn integrative review was conducted. We searched PubMed, Scopus, PsycINFO, PsycArticles, PSYNDEX, MEDLINE, ClinicalTrials.gov, International Clinical Trials Registry Platform, and EU Clinical Trials Register for clinical, preclinical, observational, mechanistic, and review studies that reported outcomes or mechanisms on the intersection of ketogenic therapy and PTSD. Methodological quality of included studies was assessed independently by two reviewers based on predefined criteria.ResultsSixteen articles (9 human, 4 animal studies, 3 reviews) were eligible and included in the present review. Several metabolic and signaling pathways through which ketogenic therapies could impact PTSD pathophysiology were identified. Preclinical data suggestive of potential efficacy were identified, while only minimal reliable information is available from human studies.DiscussionImportantly, the absence of larger clinical trials and the reliance on low-level evidence substantially limit current interpretations. High-quality randomized and adequately powered clinical trials are required to examine the potential role of ketogenic therapies in treating PTSD.
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Investigating the DTI-ALPS index and its association with cognitive impairment in Alzheimer’s disease: a diffusion tensor imaging study

ObjectivesWith the global aging population, Alzheimer’s disease (AD) poses a major health challenge. The diffusion tensor image (DTI) analysis along the perivascular space (DTI-ALPS) index has emerged as a noninvasive imaging marker that indirectly reflects glymphatic function. However, its alterations in AD and their associations with cognitive impairment remain incompletely understood. This study primarily aimed to investigate changes in the bilateral ALPS index in patients with AD and to evaluate their associations with cognitive, functional, and emotional measures. Secondary analyses further explored white matter microstructural alterations and their relationships with the ALPS index.Materials and methodsIn total, 35 patients with AD and 21 cognitively normal healthy controls (HC) underwent 3.0T MRI and neuropsychological assessments. Tract-based spatial statistics (TBSS) analysis revealed areas of white matter damage and injured fibers in patients. Bilateral ALPS indices were compared between groups using analysis of covariance (ANCOVA) adjusted for age and gender. TBSS and ROI-based ANCOVA analyses of fractional anisotropy (FA) and mean kurtosis (MK) were performed as secondary analyses. Partial correlation analyses were used to examine associations between ALPS indices, white matter metrics, and neuropsychological scores.ResultsCompared with the HC group, the AD group showed significantly lower bilateral ALPS indices, and these differences remained significant after adjustment for age and gender (left: F = 14.404, P < 0.001; right: F = 28.513, P < 0.001). Bilateral ALPS indices were significantly correlated with cognitive and functional measures, including the Mini-Mental State Examination, Montreal Cognitive Assessment, and Activities of Daily Living (ADL), and were also significantly associated with emotional measures, including the Hamilton Anxiety Scale and Hamilton Depression Scale. Among these, the strongest associations were observed with ADL (left: r = 0.688; right: r = 0.701; both P_FDR < 1 × 10–7). Secondary analyses revealed widespread white matter microstructural alterations in AD. Region-of-interest-based analyses showed that the left hippocampal cingulum exhibited significant differences in both FA and MK, and these metrics were positively associated with the ALPS index as well as with cognitive and functional performance.ConclusionThe glymphatic system of AD patients has a reduced ability to clear waste. The ALPS index was closely associated with cognitive, functional, and emotional status, while white matter abnormalities, particularly in the left hippocampal cingulum, may represent a structural correlate of glymphatic dysfunction in AD.
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Multimodal network alterations in diagnosis-age-defined early- and late-onset Alzheimer’s disease

IntroductionEarly-onset Alzheimer’s disease (EOAD) and late-onset Alzheimer’s disease (LOAD) may differ in large-scale network organization. We compared multimodal MRI markers of diagnosis-age-defined Alzheimer’s phenotypes.MethodsAlzheimer’s Disease Neuroimaging Initiative participants were classified by age at first recorded mild cognitive impairment or Alzheimer’s disease diagnosis: <65 years for EOAD and ≥65 years for LOAD. Retrospective symptom-onset information was consistent with this grouping when available. We assessed resting-state functional measures, graph-theoretical nodal metrics, structural-functional coupling (SFC), structural decoupling, and DTI-derived measures. Primary models adjusted for age and sex; sensitivity analyses examined nonlinear age, covariate overlap, clinical severity, disease stage, atrophy, biomarkers, head motion, regional coverage, and control-group composition.ResultsThe functional cohort included 50 EOAD, 72 LOAD, and 113 healthy controls. Global mean SFC showed only a modest group effect. LOAD showed higher regional SFC than EOAD in four frontal regions after false discovery rate correction. Graph-theoretical effects were predominantly nominal: only the overall three-group effect in Vermis 9 nodal efficiency survived within-family correction, and no EOAD-versus-LOAD nodal contrast survived. DTI-derived regional measures and structural decoupling were less subtype-discriminative. All four frontal effects remained significant after mean Power framewise displacement adjustment and overlap weighting, with bootstrap confidence intervals excluding zero. However, corrected support narrowed to one region in the nonlinear-age model and disappeared in disease- stage-, APOE ε 4-, amyloid PET-, and centiloid-adjusted models; restriction to amyloid-negative controls also retained one region.ConclusionIn the primary model, diagnosis-age-defined LOAD showed higher frontal regional SFC than EOAD. The absence of corrected EOAD-versus-LOAD graph findings, variable sensitivity-analysis support, and lack of corrected SFC–clinical associations indicate a model-sensitive network phenotype rather than a definitive onset-age biomarker or clinically validated subtype marker.
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Usability, adherence and efficacy of coach-augmented dHealth cognitive behavioural therapy for insomnia in South African sexual assault survivors: a pilot study

IntroductionTreating sleep difficulties – a core symptom of posttraumatic stress disorder (PTSD) – can improve both sleep and broader psychiatric outcomes. Digital health (dHealth) applications offer a scalable way to deliver cognitive behavioural therapy for insomnia (CBT-i), particularly for trauma survivors facing barriers to care. However, adherence to these interventions is often poor and may be improved through human support, especially for more demanding components such as sleep rescheduling. This study evaluated the usability, adherence, and preliminary efficacy of a dHealth application delivering sleep rescheduling both with and without coach support, alongside self-guided stimulus control and sleep hygiene components.MethodsFemale sexual assault survivors were assigned to one of two groups comparing the sleep rescheduling component of the dHealth application: either coach-assisted (n = 27) or self-guided (n = 27). All participants received stimulus control and sleep hygiene information embedded in the application, in the form of a newsletter, including a third comparator group (n = 25), which received this information only. Usability and negative effects were self-reported. Adherence was assessed via dropout rates, application engagement, newsletter openings, and compliance with sleep prescriptions. Efficacy was measured by changes in insomnia, depressive, and PTSD symptoms.ResultsThe self-guided group reported lower satisfaction and more negative effects than controls. Compared to the self-guided group, coach-assisted participants showed better adherence to sleep prescriptions. Across groups, insomnia and depressive symptoms decreased significantly. Preliminary evaluation of efficacy showed that PTSD symptoms improved substantially in the coach-assisted and comparator groups, while improvements in the self-guided group plateaued after initial gains.DiscussionUnguided application use was associated with poorer usability, greater negative effects, lower adherence, and some potential weaker outcomes. Preliminary findings suggest that sleep rescheduling may benefit from human support to be effective. Where coaching is unavailable, simple stimulus control and sleep hygiene education may be preferable.
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Pseudo-professional mechanism of collaborative mental health support in low-resource county-level contexts in China

China has made school-family-community collaboration a central policy direction for adolescent mental health, yet low-resource counties often lack the professional workforce, stable interorganizational arrangements, and non-stigmatizing pathways needed to reproduce an institutionalized service model. Existing research on task sharing shows that trained non-specialists can perform selected forms of basic psychological support, but it says less about how such tasks are incorporated into everyday school relationships and linked to professional referral. This community case study examines Suining County, Jiangsu Province, as an information-rich instrumental case. The core evidence consists of semi-structured interviews with 52 principals, school mental health teachers, homeroom teachers, subject teachers, parents, and students, together with non-participant observations conducted in 10 schools between September 2023 and June 2024. County policy documents, training records, and de-identified aggregate administrative screening data were used only to describe the case context. The analysis identifies a pseudo-professional mechanism organized through three related processes. Daily relational embeddedness enables risk signals to be noticed in classrooms, class management, and home-school communication. Bounded task sharing converts listening, basic reassurance, risk inquiry, and referral into limited front-end tasks that existing school actors can perform without assuming diagnostic or therapeutic authority. Tiered networking transfers responsibility from the class to the school and, when necessary, to medical services, while reconnecting students to everyday support after their return to school. This arrangement widens the reach of front-end support but remains constrained by teacher workload, parental refusal, discontinuities across school transitions, uneven supervision, and privacy risks. Pseudo-professionalization therefore does not mean replacing clinical professionals. It denotes a bounded reorganization of support functions whose safety depends on professional gatekeeping, sustained supervision, stable referral channels, informed participation, and disciplined information governance.
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From facing fears to experimental frontiers: immersive cinematic virtual reality environments as a catalyst for innovation in behavioral neuroscience

Virtual reality (VR) has gained traction in psychiatric research in exposure-based interventions for phobias, simulations of hallucinations in psychosis, and adaptations of cognitive-behavioral therapy. These applications demonstrate that emotionally immersive digital environments can meaningfully engage pathological processes in controlled settings. Yet VR’s potential in psychiatry goes beyond providing new contexts for well-established therapeutic interventions. Here, we argue that while emotionally rich, interactive VR scenarios can be leveraged to radically improve translational experimental design in behavioral neuroscience, there are not yet clear conceptual frameworks for the incorporation of these elements. Traditional lab tasks with theoretical implications for therapeutic interventions often rely on abstract procedures that fail to capture the immersive, affective dynamics of real-world maladaptive behaviors. Here, we discuss how high-fidelity VR scenarios simulate complex emotional naturalistic contexts while retaining precise experimental control. We illustrate this drawing on our recent work using high-fidelity, game-engine-based VR scenarios and consider how these environments offer a scalable and accessible platform for large-sample studies, as VR hardware becomes more common in the household. We propose a set of dimensions called the Immersive Behavioral Translation Framework (IBTF) that suggest conceptual considerations for VR in neuroscientific research: (i) The controllability of immersive environments; (ii) features of immersive environments that bridge ecological validity gaps; and (iii) the relatability of these emotionally immersive experiments to clinical conditions in translational research. We illustrate this framework with reference to emerging findings in associative learning and threat sensitivity, while emphasizing the broader implications for rethinking how we study cognition, emotion, and psychopathology.