Structural and functional improvement of amygdala sub-regions in postpartum depression after acupuncture.

Objective: This study aimed to analyze the changes in structure and function in amygdala sub-regions in patients with postpartum depression (PPD) before and after acupuncture. Methods: A total of 52 patients with PPD (All-PPD group) were included in this trial, 22 of which completed 8 weeks of acupuncture treatment (Acu-PPD group). An age-matched control group of 24 healthy postpartum women (HPW) from the hospital and community were also included. Results from the 17-Hamilton Depression Scale (17-HAMD) and the Edinburgh Postnatal Depression Scale (EPDS) were evaluated, and resting-state functional magnetic resonance imaging (rs-fMRI) scans were performed at baseline and after the acupuncture treatment. Sub-regions of the amygdala were used as seed regions to measure gray matter volume (GMV) and analyzed for resting-state functional connectivity (RSFC) values separately. Finally, correlation analyses were performed on all patients with PPD to evaluate association values between the clinical scale scores, GMV, and RSFC values, while controlling for age and education. Pearson's correlation analyses were conducted to investigate the relevance between GMV and RSFC values of brain regions that differed before and after acupuncture treatment and clinical scale scores in Acu-PPD patients. Results: The HAMD scores for Acu-PPD were reduced after acupuncture treatment (P < 0.05), suggesting the positive effects of acupuncture on depression symptoms. Structurally, the All-PPD group showed significantly decreased GMV in the left lateral part of the amygdala (lAMG.L) and the right lateral part of the amygdala (lAMG.R) compared to the HPW group (P < 0.05). In addition, the GMV of lAMG.R was marginally increased in the Acu-PPD group after acupuncture (P < 0.05). Functionally, the Acu-PPD group showed a significantly enhanced RSFC between the left medial part of the amygdala (mAMG.L) and the left vermis_6, an increased RSFC between the right medial part of the amygdala (mAMG.R) and left vermis_6, and an increased RSFC between the lAMG.R and left cerebelum_crus1 (P < 0.05). Moreover, correlation studies revealed that the GMV in the lAMG.R was significantly related to the EPDS scores in the All-PPD group (P < 0.05). Conclusion: Our findings demonstrated that the structure of amygdala sub-regions is impaired in patients with PPD. Acupuncture may improve depressive symptoms in patients with PPD, and the mechanism may be attributed to changes in the amygdala sub-region structure and the functional connections of brain areas linked to the processing of negative emotions. The fMRI-based technique can provide comprehensive neuroimaging evidence to visualize the central mechanism of action of acupuncture in PPD.

Functional magnetic resonance imaging studies of acupuncture at ST36: a coordinate-based meta-analysis.

Background: Functional magnetic resonance imaging (fMRI) has been widely used to investigate the brain effect of acupuncture point Stomach 36 (ST36, Zusanli). However, inconsistent results have hindered our understanding of the neural mechanisms of acupuncture at ST36. Objective: To perform a meta-analysis of fMRI studies on acupuncture at ST36 to assess the brain atlas of acupuncture at ST36 from available studies. Method: Based on a preregistered protocol in PROSPERO (CRD42019119553), a large set of databases was searched up to August 9, 2021, without language restrictions. Peak coordinates were extracted from clusters that showed significant signal differences before and after acupuncture treatment. A meta-analysis was performed using seed-based d mapping with permutation of subject images (SDM-PSI), a newly improved meta-analytic method. Results: A total of 27 studies (27 ST36) were included. This meta-analysis found that ST36 could activate the left cerebellum, the bilateral Rolandic operculum, the right supramarginal gyrus, and the right cerebellum. Functional characterizations showed that acupuncture at ST36 was mainly associated with action and perception. Conclusion: Our results provide a brain atlas for acupuncture at ST36, which, besides offering a better understanding of the underlying neural mechanisms, also provides the possibility of future precision therapies.

Consistent functional abnormalities in patients with postpartum depression.

Postpartum depression (PPD) is a common public health concern. A wide range of functional abnormalities in various brain regions have been reported in fMRI studies on PPD, however, a consistent functional changing pattern is still lacking. Herein, we obtained functional Magnetic Resonance Imaging (fMRI) data from 52 patients with PPD and 24 healthy postpartum women (HPW). Functional indexes (low-frequency fluctuation, degree centrality, and regional homogeneity) were calculated and compared among these groups to explore the functional changing patterns of PPD. Then, correlation analyses were performed to investigate the relationship between changed functional indexes and clinical measurements in the PPD. Finally, support vector machine (SVM) was performed to test whether these abnormal features can be used to distinguish PPD from HPW. As a result, we identified significantly and consistently functional changing pattern characterizing by increased functional activity in the left inferior occipital gyrus and decreased functional activity right anterior cingulate cortex in the PPD as compared to HPW. These functional values in the right anterior cingulate cortex were significantly correlated with depression symptoms in the PPD, and can be used as features to distinguish PPD from HPW. In conclusion, our results suggested that the right anterior cingulate cortex could be served as a functional neuro-imaging biomarker for PPD, which might be used as a potential target for neuro-modulation.

Complete mechanochemical defluorination of perfluorooctanoic acid using Al2O3 and Al powders through matching electron-mediated reduction with decarboxylation.

This work reports a mechanochemical (MC) method for complete defluorination of perfluorooctanoic acid (PFOA) by using Al and Al2O3 as milling agents. Both the Al/Al2O3 molar ratio ( [Formula: see text] ) and the pre-thermal treatment of Al2O3 strongly influenced the defluorination of PFOA. When commercial γ-Al2O3 was pre-treated at 1200 °C, the use of Al and heat-treated γ-Al2O3 with [Formula: see text] of 1: 1 led to PFOA defluorination of 100% after ball milling for 26 min at 350 rpm, being much higher than those (8.3%-58.1%) for using singlet milling agents or binary milling agents containing γ-Al2O3 pre-heated at temperatures lower than 700 °C. It was clarified that the carboxylate-mediated adsorption of PFOA on Al2O3 was essential for the MC decarboxylation as a degradation initiation step, and the in-situ generated electron on milled Al consequently caused the reductive dissociation of C-F bonds in the decarboxylation intermediate. A larger [Formula: see text] increased the in-situ electron generation rate (re), and a higher heat-treatment temperature decreased OH-/H2O adsorbed on Al2O3 to low the PFOA decarboxylation rate (rdec). The re/rdec ratio determined defluorination pathways, and the percentage of the defluorination of PFOA in its total degradation including the generation of any degradation intermediates increased linearly with increasing re/rdec.

Complete Defluorination and Mineralization of Perfluorooctanoic Acid by a Mechanochemical Method Using Alumina and Persulfate.

Perfluorooctanoic acid (PFOA) is a persistent organic pollutant that has received concerns worldwide due to its extreme resistance to conventional degradation. A mechanochemical (MC) method was developed for complete degradation of PFOA by using alumina (Al2O3) and potassium persulfate (PS) as comilling agents. After ball milling for 2 h, the MC treatment using Al2O3 or PS caused conversion of PFOA to either 1-H-1-perfluoroheptene or dimers with a defluorination efficiency lower than 20%, but that using both Al2O3 and PS caused degradation of PFOA with a defluorination of 100% and a mineralization of 98%. This method also caused complete defluorination of other C3∼C6 homologues of PFOA. The complete defluorination of PFOA attributes to Al2O3 and PS led to the weakening of the C-F bond in PFOA and the generation of hydroxyl radical (•OH), respectively. During the MC degradation, Al2O3 strongly anchors PFOA through COO--Al coordination and in situ formed from Lewis-base interaction and PS through hydrogen bond. Meanwhile, mechanical effects induce the homolytic cleavage of PS to produce SO4•-, which reacts with OH group of Al2O3 to generate •OH. The degradation of PFOA is initiated by decarboxylation as a result of weakened C-COO- due to Al3+ coordination. The subsequent addition of •OH, elimination of HF, and reaction with water induce the stepwise removal of all carboxyl groups and F atoms as CO2 and F-, respectively. Thus, complete defluorination and mineralization are achieved.

Roles of intrinsic Mn3+ sites and lattice oxygen in mechanochemical debromination and mineralization of decabromodiphenyl ether with manganese dioxide.

Commercial ß-MnO2 with a chemical formula of approximate Mn0.774+Mn0.233+O1.88 was used for mechanochemical (MC) oxidative degradation of decabromodiphenyl ether (BDE209). The ball milling process initiated the degradation of BDE209 on ß-MnO2, yielding a nearly complete degradation and debromination of BDE209 within 2 h. The use of ß-MnO2 exhibited much higher MC debromination efficiency than that by using birnessite (δ-MnO2, 40.2%), Bi2O3 (45.6%), CaO (65.3%), and persulfate (81.9%). It was demonstrated that the oxidative degradation of BDE209 was promoted by the redox half reactions of both Mn4+→ Mn3+ and Mn3+→ Mn2+, but naturally existed Mn3+ centers on the surface of ß-MnO2 functioned as dominant reactive species at the initial stage of the MC degradation (often before the degradation efficiency of BDE209 achieved 50%). Moreover, the surface lattice oxygen of MnO2, rather than O2, played a key role in the debromination and mineralization of BDE209. The Mn3+ sites on ß-MnO2 not only easily accepted the electron of BDE209, but also promoted the mobility of lattice oxygen from the bulk to the surface for mineralizing BDE209. These results firstly highlighted the importance of Mn3+ availability and oxygen mobility on the reactivity of manganese oxide for the MC oxidative degradation of organic pollutants.

Bipolar II disorder as the initial presentation of CADASIL: an underdiagnosed manifestation.

Mood disturbances have been documented in cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). The highly varied morbidity indicates that the affective symptoms in CADASIL have not been cataloged systematically, leading to ineffective treatment, affecting the patients' quality of life, and possibly resulting in suicide. We present a case of CADASIL with bipolar II disorder as the first manifestation. A middle-aged female reported recurrent depressive episodes and appeared treatment resistant to adequate dosages and durations of antidepressants. Following a structured psychiatric interview and neuropsychological assessment, a past episode of hypomania was identified. Added treatment with sodium valproate alleviated most symptoms. Considering late-onset bipolar disorder with unexplained decline in cognition, a medical history of migraine, and a suspected family history of stroke, further cranial magnetic resonance imaging scan was performed and revealed severe leukoencephalopathy, prompting further investigation. The diagnosis was revised to CADASIL after Arg587Cys NOTCH3 mutation was confirmed. This case highlights the evolving process of affective disorder diagnosis and underlying organic etiologies. Based on the overlap of white matter hyperintensities, NOTCH3 mutation, and valproate therapy in bipolar disorder and CADASIL, bipolar II depression may be a poorly recognized manifestation of CADASIL. Well-designed clinical trials are warranted to verify the current findings.