Abstract:Traumatic brain injury is one of the leading causes of death and disability worldwide. Patients with moderate to severe traumatic brain injury often experience significant cognitive impairments， including multidimensional deficits in attention， memory， executive function， and information processing speed， which severely impact their quality of life and ability to reintegrate into society. Due to the complexity of its pathogenesis and the high heterogeneity of its clinical manifestations， there is currently no unified diagnostic and treatment protocol supported by high-level evidence. This paper reviews and summarizes the neural mechanisms， assessment methods， comprehensive intervention strategies， and individualized management of cognitive impairment after moderate to severe traumatic brain injury. The aim is to establish a clinical framework of "mechanism identification， precise assessment， stratified intervention and long-term management"， providing reference for optimizing patients' cognitive rehabilitation and improving long-term prognosis.

Abstract:Objective To explore the functional connectivity differences of amygdala subregions in unipolar depressive disorder（ UDD） and bipolar depressive disorder（ BDD） patients with insomnia of varying severity. Methods This study was a cross-sectional study. A total of 147 outpatients or inpatients at Beijing Anding Hospital， Capital Medical University， between March 2021 and June 2022 were recruited， including 60 patients with BDD and 87 patients with UDD. At the same time， 53 participants for the healthy control group were recruited through public advertisements. General information， clinical data， and resting state functional magnetic resonance imaging（ fMRI） data of all subjects were collected. Based on the insomnia subscale of the 17-item Hamilton Depression Rating Scale（ HAMD-17）， the two groups of patients were divided into a low insomnia group（ LI group， HAMD-17 insomnia subscale total score ≤ 3） and a high insomnia group （HI group， HAMD-17 insomnia subscale total score ≥ 4）. Using the 8 subregions of the amygdala as seed points， functional connectivity between these seed points and all other voxels in the whole brain was calculated， and one-way analysis of covariance was used for intergroup comparisons. After identifying significant results， Spearman correlation analysis was further used to calculate the correlations between functional connectivity of amygdala subregions and patients' symptoms of depression， anxiety， and mania. After screening， 28 patients were enrolled in the BDDHI group， 28 in the BDDLI group， 38 in the UDDHI group， and 41 in the UDDLI group. Results There were statistically significant differences in the adjusted HAMD-17 total scores and HAMA total scores between the BDDHI group， BDDLI group， UDDHI group， UDDLI group， and the healthy control group（ all P ＜ 0.05）. Post-analysis comparisons revealed that the total scores on the aforementioned scales were higher in all patient groups than those in the healthy control group， with statistically significant differences（ all P ＜ 0.05）. There were statistically significant differences in functional connectivity between the right amygdala-striatal region and the left anterior cerebellar lobe in the four groups（ PFWE=0.001）. Post-analysis comparisons revealed that functional connectivity was higher in the BDDHI， UDDHI， and UDDLI groups than in the healthy control group， and that functional connectivity in the UDDLI group was higher than in the BDDLI group， and these differences were statistically significant（ all P＜0.05）. The sensitivity analysis between non-medicated patients and healthy control group showed that the direction of functional connectivity differences among the four groups was consistent with the results of this analysis. Spearman correlation analysis showed that the functional connectivity between the right amygdala-striatal region and the left anterior cerebellar lobe was significantly negatively correlated with the adjusted HAMD-17 total score in the BDDHI group［ r= -0.539，P=0.003， 95%CI（ -0.792， -0.201）］. In the BDDLI group， there was a significant positive correlation with the total HAMA score［ r=0.515， P=0.005， 95%CI（ 0.141， 0.723）］. Conclusions There are significant differences in the functional connectivity between the right amygdala-striatal region and the left anterior cerebellar lobe in UDD and BDD patients with insomnia of varying severity， and the correlation between this functional connectivity and clinical symptoms varies across different subtypes of BDD.

Abstract:Objective To explore the trajectory changes of depressive symptoms and social functioning outcomes based on a prospective cohort study of depressive disorder， analyze its potential influencing factors， so as to provide a scientific basis for early clinical identification of patients with poor social functioning outcomes， and thereby timely adjust treatment plans to promote the comprehensive recovery of patients' social functioning. Methods From November 9， 2016 to December 30， 2020， a prospective multicenter cohort study on depressive disorder was conducted involving 1 385 participants from 12 hospitals selected across 10 provinces in China. General demographic data were collected at baseline， and depressive symptoms and social functioning were assessed at baseline， weeks 4， 8， 12， 16， and 24 using the 17-item Hamilton Depression Rating Scale （HAMD-17） and Sheehan Disability Scale（ SDS）， respectively. SAS（ PROC TRAJ） was used to construct latent class mixed models（ LCMMs）. The optimal trajectory model was identified by comparing models with different numbers of classes， including statistical indicators such as Bayesian information criterion（ BIC）， substantive indicators（ entropy）， and empirical indicators［ each class containing at least a sufficient number of participants （＞ 5%）］. Subgroups were then divided based on the initial level and slope direction of the trajectory. The chi-square test and Shapiro-Wilk test were used to analyze the baseline differences between groups， and the distribution percentage of social functioning trajectories within each symptom trajectory group was calculated to evaluate the degree of "symptom-function" matching. Patients with "rapid improvement in symptoms but slow or moderate improvement in function"， "moderate improvement in symptoms but slow improvement in function"， and "slow improvement in both symptoms and function" were collectively defined as "delayed functional recovery". The baseline differences between this group and the "good functional recovery" group were analyzed， and multivariate binary Logistic regression was used to identify independent influencing factors. Results A total of 1 385 patients were included in the analysis. The trajectories of depressive symptoms were divided into three subgroups： the rapid improvement group（ n=139， 10.04%）， the moderate improvement group （n=948， 68.45%）， and the slow improvement group（ n=298， 21.52%）. A comparison of baseline data showed that the slow improvement group had the lowest age［ 30.0（ 24.0， 41.0） years］， the highest proportion of students （20.54%） and single/divorced individuals（ 51.52%）， and the most severe depression［ HAMD-17 total score of 26.0（ 23.0， 29.0）］. The rapid improvement group had the highest age［ 33.0（ 26.0， 47.0） years］， the highest proportion of unemployed individuals（ 38.13%）， and the highest proportion of married individuals（ 63.04%）. The moderate improvement group had the mildest baseline depression［ HAMD-17 total score of 20.0（ 17.0， 23.0）］. All differences among these three groups were statistically significant（ all P＜0.05）. In the rapid improvement group， 100.00% of patients achieved rapid recovery of social functioning. There were 194 patients（ 14.01%） in the "delayed functional recovery" group. Binary Logistic regression analysis revealed that， after controlling for confounding factors such as age， gender， medication type， family history， seizure type， educational level， place of residence， marital status， and employment status， only the baseline HAMD-17 total score was a risk factor for delayed functional recovery in patients with depressive disorder［ OR=0.942， 95%CI（ 0.914， 0.971）， P=0.000 1］. Conclusions The symptoms and social functioning recovery of patients with depressive disorder show a trend of synchronous improvement overall. Improvement of early symptoms is the prerequisite for rapid functional recovery， while residual symptoms may hinder the recovery of social functioning. At the same time， this study identify employment（ or study） status， marital status， and age as important factors influencing symptom outcomes. Therefore， early identification of high-risk individuals and the implementation of targeted， enhanced interventions are crucial for improving prognosis.

Abstract:Objective To compare the levels of 21 amino acids in the serum of patients with neuromyelitis optica spectrum disorder（ NMOSD） and myelin oligodendrocyte glycoprotein（ MOG） antibodyassociated disease（ MOGAD）， and explore the correlation between amino acid level differences and neurological disability. Methods From the China National Registry of Neuro-Inflammatory Diseases（ NCT05154370）， 137 patients who were admitted to the Department of Neurological Infection and Immunology of Beijing Tiantan Hospital， Capital Medical University and diagnosed with NMOSD or MOGAD from January 2024 to January 2025 were selected as study subjects， including 92 NMOSD patients and 45 MOGAD patients. The levels of 21 amino acids in the serum of two groups of patients were detected and compared using liquid chromatographymass spectrometry（ LC-MS/MS）. Pearson correlation was used to analyze the correlation between amino acids and the Expanded Disability Status Scale（ EDSS） scores in patients with NMOSD. Results The levels of eight essential amino acids（ leucine， methionine， tryptophan， phenylalanine， lysine， valine， isoleucine， and threonine） in the serum of patients in the NMOSD group were all lower than those in the MOGAD group， with statistically significant differences（ Z/t=3.116， 3.139， 2.683， 2.130， 2.060， 2.411， 2.225， 2.014； all P＜ 0.05）. The levels of four non-essential amino acids（ tyrosine， glutamine， asparagine， and proline） in the serum of patients in the NMOSD group were lower than those in the MOGAD group， and the differences were statistically significant（ t/Z=2.184， 2.463， 2.805， 2.351； all P ＜ 0.05）. The levels of serum tryptophan， valine， and tyrosine in patients with NMOSD were statistically negatively correlated with EDSS scores（ r=-0.318， -0.248， -0.242； all P＜ 0.05）. Conclusions Lower overall amino acid levels are one of the key reasons why patients with NMOSD experience more severe neurological disability than those with MOGAD. Paying attention to the metabolic and nutritional status of patients with NMOSD and supplementing them with essential amino acids play a positive role in improving their condition and halting disease progression.

Abstract:Objective To investigate the changes in amplitude of low-frequency fluctuations（ ALFF） and fractional amplitude of low-frequency fluctuations（ fALFF） in resting-state functional magnetic resonance imaging（ rs-fMRI） among depressive disorder adolescents with attempted suicide， and to explore their clinical significance. Methods This study was a cross-sectional study. A total of 65 depressive disorder adolescents admitted to Suzhou Guangji Hospital from October 2022 to July 2023 were selected as research subjects. According to whether there was a history of attempted suicide within the past year， patients were divided into an adolescent depressive disorder group with attempted suicide（ SD group，n=32） and an adolescent depressive disorder group without attempted suicide（ ND group，n=33）. At the same time， 31 healthy individuals were recruited from the community as a healthy control group（ HC group）. All participants underwent rs-fMRI， and ALFF and fALFF values were calculated based on the imaging data. The severity of depressive disorder was assessed using the Patient Health Questionnaire-9（ PHQ-9）， and suicide risk was evaluated using the suicide subscale of the Mini-International Neuropsychiatric Interview for Children and Adolescents（ MINIKid）. Analysis of variance was used to compare differences among the three groups and to conduct post-hoc tests. On this basis， Spearman correlation was used to analyze the correlation between ALFF and fALFF values in different brain regions and PHQ-9 scores and MINI-Kid suicide subscale scores. Results Compared with the HC group， patients in the SD group exhibited statistically significant increases in ALFF values in the right superior frontal gyrus and in fALFF values in the left superior frontal gyrus， bilateral middle frontal gyrus， and left supramarginal gyrus， while fALFF values in the left precentral gyrus were statistically reduced（ all voxellevel P＜ 0.001， cluster-level P＜ 0.05， GRF-corrected）. In the ND group， there were statistically significant increases in ALFF values in the left angular gyrus and in fALFF values in the right middle frontal gyrus， left supramarginal gyrus， left medial gyrus， and parahippocampal gyrus， as well as a statistically significant decrease in fALFF values in the bilateral supratemporal gyrus（ all voxel-level P＜0.001， cluster-level P＜0.05， GRF-corrected）. Compared with the ND group， the patients in the SD group showed elevated fALFF values in the left supratemporal gyrus and reduced fALFF values in the left insula and right postcentral gyrus， with all differences being statistically significant（ all voxel-level P＜ 0.001， cluster-level P＜ 0.05， GRF-corrected）. Correlation analysis revealed that the fALFF values in the left supramarginal gyrus of patients in the SD group were negatively correlated with the PHQ-9 scores， and this difference was statistically significant（ r=-0.469， P=0.007）. Conclusions Depressive disorder adolescents with attempted suicide exhibit abnormal brain activity in multiple regions， and the fALFF values in the left superior marginal gyrus are negatively correlated with the severity of adolescent depressive disorder.

Abstract:Objective To explore the current status of public attitudes towards schizophrenia and analyze its influencing factors. Methods This study was a cross-sectional survey. From July to September 2024， convenience sampling was used to select 712 healthy participants without a diagnosis of mental disorders in Beijing， Tianjin， and Hebei as research subjects. Based on the "bio-psycho-social" theory， schizophrenia was renamed as the drug-relate psychosis（ name 1）， anxiety-related psychosis（ name 2）， trauma-related psychosis（ name 3）， and stress sensitivity-related psychosis（ name 4）. The General Information Questionnaire was used to collect participants' general information. The Schizophrenia Attitudes Questionnaire was used to assess healthy participants' attitudes toward schizophrenia. Multiple linear regression was used to analyze the influence of general characteristics and naming conventions on attitudes toward the disease. Results A total of 712 questionnaires were distributed， and 680 valid questionnaires were obtained， resulting in a valid response rate of 95.6%. There were statistically significant differences in the total scores on the Schizophrenia Attitudes Questionnaire of the original name group among participants of different ages， levels of familiarity with schizophrenia patients， and grades of medical students（ Z=-2.22，-4.33，-2.52； all P＜0.05）. There were statistically significant differences in the total scores of the Schizophrenia Attitudes Questionnaire between the original name group and the name 2 group and the name 3 group（ Z=-6.62， -8.22； P＜0.05）. In the comparison of scores for different items of the Schizophrenia Attitudes Questionnaire among participants in the original name group and name groups 1， 2， 3， and 4， there were no statistically significant differences in the scores for item 8 between the groups（ all P＞0.05）. Similarly， there were no statistically significant differences in the scores for item 1 in the name 1 group， item 4 in the name 3 group， and item 3 in the name 4 group between the groups（ all P＞ 0.05）. However， there were statistically significant differences in the scores for the remaining items between the groups（ all P＜0.05）. After grouping the participants according to different population types， the inter-group comparisons of the total scores（ H=36.57） and item scores 1-8（ H=107.94，49.40，89.53，76.01，44.35，12.83， 38.59， 62.71） of the Schizophrenia Attitudes Questionnaire among the three groups were statistically significant （all P＜ 0.05）. Multiple linear regression analysis revealed that medical students， mental health professionals， emergency-sensitive related mental disorders， drug-related mental disorders， and trauma-related mental disorders were predictors of the total score on the Schizophrenia Attitudes Questionnaire， with statistically significant differences（ β=1.58， 2.07， 0.50， 0.12， 0.16； all P＜0.05）. Conclusions Public attitudes toward schizophrenia are not influenced by gender or educational attainment. Age， naming conventions based on "biopsycho- social"， different occupations and educational backgrounds， and whether or not one has contact with schizophrenia patients can all influence attitudes toward the illness to varying degrees.

Abstract:The biological clock， also known as the circadian rhythm， is a rhythmic activity in living organisms that operates on a cycle of approximately 24 hours. It participates in nearly all major physiological and metabolic processes within the body， playing a crucial role in physiological processes such as sleep， mood， attention， cognition， and learning. An increasing number of studies show that sleep disorders caused by disrupted circadian rhythms can lead to various mood disorders， such as depressive disorder and anxiety. This paper explores the molecular mechanisms related to the changes in circadian rhythm and the occurrence of mood disorders， aiming to provide a theoretical basis for advancing research into the physiological mechanisms of the biological clock and for the prevention and treatment of related mood disorders.

Abstract:Spinocerebellar ataxia type 3（ SCA3）， also known as Machado-Joseph disease， is a neurodegenerative disorder caused by an amplification of the polyglutamine repeat sequence in exon 10 of the ataxin-3 gene（ ATXN3）. It is a rare disease of autosomal dominant spinocerebellar ataxia. Its clinical manifestations primarily include ataxia， abnormal eye movements， dysarthria， and pyramidal and extrapyramidal symptoms， accompanied by psychological disorders. In recent years， with the advancement and improvement of in genetic testing technology， the number of confirmed cases of SCA3 has been steadily increasing. However， current treatment for this disease mainly focuses on alleviating clinical symptoms. This paper briefly reviews the pathophysiological mechanisms， pathogenesis， and clinical characteristics of SCA3 in recent years， with a focus on the latest advances in gene therapy， with the aim of providing a theoretical foundation for further research on gene therapy. With ongoing research into the clustered regularly interspaced short palindromic repeats and associated protein 9（ CRISPR/Cas9） system， antisense oligonucleotides（ ASOs）， and RNA interference（ RNAi） therapies， gene editing therapy is expected to emerge as a highly effective therapeutic strategy.

Abstract:Akkermansia muciniphila can alleviate symptoms of depressive disorder， anxiety， and neurodegenerative diseases through the gut-brain axis by regulating immunity and metabolism. However， its role in neuropsychiatric disorders is still controversial： clinical data show that this bacterium is specifically enriched in patients with autism and Parkinson's disease， suggesting that its abundance may be related to the stage of disease progression or host compensation mechanism. This paper systematically reviews the bidirectional role of this bacterium in neuropsychiatric disorders diseases such as depressive disorder and Alzheimer disease， integrates experimental and clinical evidence， explores key influencing factors including strain heterogeneity， host genetics， and intervention timing. This paper provides a basis for precise neural regulation based on the microbiome， and points out that in the future， multi-omics and clinical trials are needed to promote clinical translational research in this field.

Abstract:Common types of mental disorders include depressive disorder， anxiety， post-traumatic stress disorder， and schizophrenia. The pathogenesis of mental disorders has not yet been fully elucidated， but it is believed to be associated with abnormalities in neural circuits and imbalances in molecular mechanisms. The medial prefrontal cortex（ mPFC） is a key brain region that regulates emotions and cognition， divided into three major subregions： dorsomedial prefrontal cortex， anterior medial prefrontal cortex， and ventromedial prefrontal cortex. These three major subregions collectively comprise four smaller subregions： anterior cingulate cortex， infralimbic cortex， prelimbic cortex， and dorsal peduncular cortex. In recent years， technologies such as optogenetics and chemogenetics have revealed functional differences among subregions of the mPFC in the regulation of mental disorders. To provide a theoretical foundation for precise intervention strategies specific to brain regions. This paper systematically reviews the regulatory mechanisms of the four smaller subregions in common mental disorders， so as to advance the development of targeted neuromodulation and personalized treatments.