Protocol on transcranial alternating current stimulation for the treatment of major depressive disorder: a randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Transcranial alternating current stimulation (tACS) offers a new approach for adult patients with major depressive disorder (MDD). The study is to evaluate the efficacy and safety of tACS treating MDD.@*METHODS@#This is an 8-week, double-blind, randomized, placebo-controlled study. Ninety-two drug-naive patients with MDD aged 18 to 65 years will receive 20 daily 40-min, 77.5-Hz, 15-mA sessions of active or sham tACS targeting the forehead and both mastoid areas on weekdays for 4 consecutive weeks (week 4), following a 4-week observation period (week 8). The primary outcome is the remission rate defined as the 17-item Hamilton depression rating scale (HDRS-17) score ≤7 at week 8. Secondary outcomes are the rates of response at weeks 4 and 8 and rate of remission at week 4 based on HDRS-17, the proportion of participants having improvement in the clinical global impression-improvement, the change in HDRS-17 score (range, 0-52, with higher scores indicating more depression) over the study, and variations of brain imaging and neurocognition from baseline to week 4. Safety will be assessed by vital signs at weeks 4 and 8, and adverse events will be collected during the entire study.@*DISCUSSION@#The tACS applied in this trial may have treatment effects on MDD with minimal side effects.@*TRIAL REGISTRATION@#Chinese Clinical Trial Registry, ChiCTR1800016479; http://www.chictr.org.cn/showproj.aspx?proj=22048.

Association Study of a Proliferation-inducing Ligand, Spermatogenesis Associated 8, Platelet-derived Growth Factor Receptor-alpha, and POLB Polymorphisms with Systemic Lupus Erythematosus in Chinese Han Population / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Systemic lupus erythematosus (SLE) is a prototypic autoimmune disease with complex genetic inheritance. This study was conducted to examine whether the association of a proliferation-inducing ligand (APRIL), spermatogenesis associated 8 (SPATA8), platelet-derived growth factor receptor-alpha (PDGFRA), and DNA polymerase beta (POLB) with SLE can be replicated in a Chinese Han population.</p><p><b>METHODS</b>Chinese SLE patients (n = 1247) and ethnically and geographically matched healthy controls (n = 1440) were genotyped for the APRIL, SPATA8, PDGFRA, and POLB single-nucleotide polymorphisms (SNPs), rs3803800, rs8023715, rs1364989, and rs12678588 using the Sequenom MassARRAY System.</p><p><b>RESULTS</b>The Chinese Han SLE patients and controls had statistically similar frequencies of alleles and genotypes of four gene polymorphisms. Moreover, no association signal was detected on different genetic models (additive, dominant, and recessive, all, P> 0.05) or in SLE subgroups stratified by various clinical manifestations (all, P> 0.05).</p><p><b>CONCLUSIONS</b>Different genetic backgrounds from different ancestries and various populations may result in different genetic risk factors for SLE. We did not detect any significant association with SNPs of APRIL, SPATA8, PDGFRA, and POLB.</p>

Overlap between Headache, Depression, and Anxiety in General Neurological Clinics: A Cross-sectional Study / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Many studies have reported that depression and anxiety have bidirectional relationship with headache. However, few researches investigated the roles of depression or anxiety in patients with headache. We surveyed the prevalence of depression and anxiety as a complication or cause of headache among outpatients with a chief complaint of headache at neurology clinics in general hospitals. Additional risk factors for depression and anxiety were also analyzed.</p><p><b>METHODS</b>A cross-sectional study was conducted at 11 general neurological clinics. All consecutive patients with a chief complaint of headache were enrolled. Diagnoses of depression and anxiety were made using the Chinese version of the Mini International Neuropsychiatric Interview, and those for headache were made according to the International Classification of Headache Disorders, 2nd Edition. The headache impact test and an 11-point verbal rating scale were applied to assess headache severity and intensity. Logistic regression was used to analyze risk factors of patients with headache for depression or anxiety.</p><p><b>RESULTS</b>A total of 749 outpatients with headache were included. Among them, 148 (19.7%) were diagnosed with depression and 103 (13.7%) with anxiety. Further analysis showed that 114 (15.2%) patients complaining headache due to somatic symptoms of psychiatric disorders and 82 (10.9%) had a depression or anxiety comorbidity with headache. Most patients with depression or anxiety manifested mild to moderate headaches. Poor sleep and severe headache-related disabilities were predictors for either depression or anxiety.</p><p><b>CONCLUSION</b>Clinicians must identify the etiology of headache and recognize the effects of depression or anxiety on headache to develop specific treatments.</p>

Relationship between the thermography patterns and the clinical features of thalamus hemorrhage / 中国康复理论与实践

@#ObjectiveTo explore the relationship between thermography patterns and the clinical features of thalamus hemorrhage in the recovery period. MethodsTwo hands skin temperature of 32 patients with thalamus hemorrhage were measured with infrared heat radiation imaging 1 month after the stroke. Results21(66%) of 32 patients showed different imaging patterns between the affected limbs and the healthy sides. Of the 25 palsy patients, 18 (72%) showed abnormal images, just 3 of 7(42.6%) patients with normal muscle force showed abnormal images, and the difference was significanct(P<0.05). There was no relation between sensory disorder and imaging pattern. Patients with hematom lager than 10 millilitre showed more abnormal images than those with hematom under 10 millilitre(P<0.05). Patients with a course within 3 months had a tendency to show hot pattern, while those with a course beyond 3 month showed cold pattern. Conclusion There are certain relations between thermograpy patterns and the symptoms, signs of thalamus hemorrhage.

Sustained attention for the patients with mild cognitive impairment and mild Alzheimer's disease / 中国康复理论与实践

@#ObjectiveTo deter mine the sustained attention function of the patients with mild Alzheimer's disease(AD) and mild cognitive impairment(MCI).Methods10 patients with MCI, 10 with mild AD and other 10 healthy elderly controls were tested with Continuous Performance Task(CPT) aimed to assess sustained attention. ResultsCompared with the normal controls, the mild AD patients reacted very more slowly(P<0.001), missed more targets(P<0.05), while that the MCI patients did was as well as the control group. ConclusionThe mild AD patients shows impairment in sustained attention function, but the MCI patients shows a preserved ability of sustained attention function.