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OBJECTIVES@#Major depressive disorder (MDD) patients with anhedonia tend to have a poor prognosis. The underlying imaging basis for anhedonia in MDD remains largely unknown. The relationship between nodal properties and anhedonia in MDD patients need to be further investigated. Herein, this study aims to explore differences of cerebral functional node characteristics in MDD patients with severe anhedonia (MDD-SA) and MDD patients with mild anhedonia (MDD-MA) before and after the antidepressant treatment.@*METHODS@#Ninety participants with current MDD were recruited in this study. 24-Item Hamilton Depression Scale (HAMD-24) and Snaith-Hamilton Pleasure Scale (SHAPS) were used to assess the severity of depression and anhedonia at baseline and the end of 6-months treatment. The MDD patients who scored above the 25th percentile on the SHAPS were assigned to an MDD-SA group (n=19), while those who scored below the 25th percentile were assigned to an MDD-MA group (n=18). All patients in the 2 groups received antidepressant treatment. Functional magnetic resonance imaging (fMRI) images of all the patients were collected at baseline and the end of 6-months treatment. Graph theory was applied to analyze the patients' cerebral functional nodal characteristics, which were measured by efficiency (ei) and degree (ki).@*RESULTS@#Repeated measures 2-factor ANCOVA showed significant main effects on group on the ei and ki values of left superior frontal gyrus (LSFG) (P=0.003 and P=0.008, respectively), and on the ei and ki values of left medial orbital-frontal gyrus (LMOFG) (P=0.004 and P=0.008, respectively). Compared with the MDD-MA group, the significantly higher ei and ki values of the LSFG (P=0.015 and P=0.021, respectively), and the significantly higher ei and ki values of the LMOFG (P=0.015 and P=0.037, respectively) were observed in the MDD-SA group at baseline. Meanwhile, higher SHAPS scores could result in higher ei and ki values of LSFG (P=0.019 and P=0.026, respectively), and higher ei value of LMOFG (P=0.040) at baseline; higher SHAPS scores could result in higher ei values of LSFG (P=0.049) at the end of 6-months treatment. The multiple linear regression analysis revealed that sex were negatively correlated with the ei and ki values of LSFG (r= -0.014, P=0.004; r=-1.153, P=0.001, respectively). The onset age of MDD was negatively correlated with the ki value of LSFG (r=-0.420, P=0.034) at the end of 6-months treatment. We also found that SHAPS scores at baseline were positively correlated with the HAMD-24 scores (r=0.387, P=0.022) at the end of 6-months treatment.@*CONCLUSIONS@#There are obvious differences in nodal properties between the MDD-SA and the MDD-MA patients, such as the high ei of LSFG in the MDD-SA patients, which may be associated with the severity of anhedonia. These nodal properties could be potential biomarkers for the prognosis of MDD. The increased ei and ki values in the LSFG of MDD-SA patients may underlie a compensatory mechanism or protective mechanism. The mechanism may be an important component of the pathological mechanism of MDD-SA. The poor prognosis in the MDD-SA patients suggests that anhedonia may predict a worse prognosis in MDD patients. Sex and onset age of MDD may affect the nodal properties of LSFG at baseline and the end of 6-months treatment.
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Humans , Infant , Infant, Newborn , Anhedonia , Antidepressive Agents/therapeutic use , Depressive Disorder, Major/drug therapy , Magnetic Resonance Imaging , Prefrontal CortexABSTRACT
Objective To study the characteristic of cognitive function impaired and its relationship with the psychiatric symptoms in patients with first-episode schizophrenia.Methods 43 first-episode male schizophrenia patients diagnosed with DSM-Ⅳ were recruited in the study and received the atypical antipsychotics treatment 8weeks.The total score and sub-scores of Chinese Cognitive Ability Scale (CCAS)were obtained for all the patients pre-and post-treatments,and the patients were also assessed by the Positive and Negative Syndrome Scale (PANSS).Results The differences of the intelligence quotient(IQ) and its cognitive function factors between pre-and post-treatment of the patients were significant(P＜ 0.01).The total IQ score (85.7 ± 11.5),learning ability (17.9± 2.3),reasoning ability (16.1 ± 3.4),processing speed (16.9 ± 2.1),working memory (13.8 ± 2.6),space/calculate (17.5 ± 2.9),verbal IQ (86.8 ± 11.7),performance IQ (83.9 ± 12.4) before treatment and cognitive score (97.6 ± 14.3) as well as cognitive function factor (learning ability (20.1 ± 2.9),reasoning ability (18.9± 3.1),processing speed (19.7 ± 1.8),working memory (15.7 ± 2.5),space/calculate (20.8 ± 2.5),verbal IQ (98.3 ± 13.7),performance IQ (95.8 ± 14.6) after treatment,there were significant differences pre-and posttreatment (P ＜ 0.01).The difference of IQ pre-and post-treatment was significantly correlated with that of total score and positive score of PANSS(r =0.596 or 0.783).Conclusions (1) This finding supports that the cognitive function impairment exists in the early stage of schizophrenia.(2)The typical antipsychotic drugs can improve the cognitive function impairment and psychiatric symptoms of schizophrenia.(3) The cognitive function impairment of schizophrenia has significant relation to the positive symptoms,but no relation to the negative symptoms.
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The idea of establishing Shanghai Academy of Medical Sciences was brought forward in the background of great external changes.It was to meet the demand for resolving all kinds of conflicts about researches arised from the long time operation of Medical Institutes in Shanghai.This article mainly discusses about the necessity and plans for establishing Shanghai Academy of Medical Sciences.
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Medical research institutions in Shanghai have been developing in at a slow pace because of problems such as out of date institution structures, unreasonable resource allocation and distribution,shortage of research resources, insufficient creativity, and unfocused effort and investment. Hence reform is the only way out. This research discussed the possible strategies for development and proposed some suggestions on the institution categorization, structure change, allocation of resource and overall arrangement.
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Objective: To examine reliability and validity of Chinese Cognitive Ability Scale (CCAS).Methods:The CCAS was administered 321 children, 275 adults, 32 patients with brain damage, and 31 children with mental retardation.Out of them, 26 children were tested with WISC-CR and 26 adults with WAIS-RC.Results: The test-retest reliability coefficients of subtests and scales ranged from 0.732 to 0.894, 0.919 to 0.960 for children, 0.859 to 0.937, 0.968 to 0.981 for adults; The reliability coefficients for children (quick coding was omitted) ranged from 0.810-0.928 (Split-half), 0.737-0.923 (Cronbach's ?) and 0.737-0.945 (generalizability) for subtests, 0.939-0.976,0.898-0.965 and 0.898-0.965 for scales; Coefficients for adults ranged from 0.829-0.948, 0.747-0.941 and 0.747-0.941 for subtests, 0.945-0.979, 0.915-0.967 and 0.915-0.967 for scales; The CCAS IQs were high correlated with WAIS-RC IQs (VIQ=0.775,PIQ=0.621,FIQ=0.724) and WISC-CR IQs (VIQ=0.888,PIQ=0.779,FIQ=0.886) , the CCAS VIQ, PIQ, and FIQ were 5.3,9.2,and 7.8 points less than WAIS-RC, and 2.0,7.2,and 5.0 points less than WISC-CR; Comparing with normal groups, mean IQs of brain damaged adults(VIQ=80.50,PIQ=80.59,FIQ=78.91) and mental retardation children(VIQ=43.68,PIQ=49.77,FIQ=44.06)were much lower.Conclusion: The Chinese Cognitive Ability Scale has excellent retest stability, internal consistency reliability, convergent and discriminant validity.