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Higher cortisol levels due to a hyperactive hypothalamic–pituitary–adrenal axis have been reported in patients with major depressive disorder (MDD). Increased cortisol levels change both the brain morphology and function in MDD patients. The multivariate source-based morphometry (SBM) technique has been applied to investigate neuroanatomical changes in some neuropsychiatric diseases, but not MDD. We aimed to examine the alterations in gray matter (GM) networks and their relationship with serum cortisol levels in first-episode, drug-naïve MDD patients using SBM. Forty-two patients with MDD and 39 controls were recruited via interviews. Morning serum cortisol levels were measured, and high-resolution T1-weighted imaging followed by SBM analysis was performed in all participants. The patients had significantly higher serum cortisol levels than the controls. We found two GM sources, which were significantly different between patients with MDD and controls (prefrontal network, p < .01; insula-temporal network, p < .01). Serum cortisol levels showed a statistically significant negative correlation with the loading coefficients of the prefrontal network (r = − 0.354, p = 0.02). In conclusion, increased serum cortisol levels were associated with reductions in the prefrontal network in the early stage of MDD, and SBM may be a useful approach for analyzing structural MRI data.

The aim of the present study was to examine the association between miRNA levels in extracellular vesicles (EVs) from serum and the severity of Major Depression (MD). Patient sera from 16 MD cases were collected at our university hospital. The miRNAs contained in EVs were extracted using a nanofiltration method, and their expression levels were analyzed using miRNA microarrays. Intergroup comparisons were performed to validate the diagnostic performance of miRNAs in EVs. Furthermore, candidate miRNAs in EVs were added to neural progenitor cells, astrocytes, and microglial cells in vitro, and the predicted target genes of the candidate miRNAs were extracted. The predicted target genes underwent enrichment analysis. The expression levels of hsa-miR-6813-3p and hsa-miR-2277-3p were significantly downregulated with increasing depression severity of MD. The pathway enrichment analysis suggests that hsa-miR-6813-3p may be involved in glucocorticoid receptor and gamma-aminobutyric acid receptor signaling. Additionally, hsa-miR-2277-3p was found to be involved in the dopaminergic neural pathway. The analysis of serum miRNAs in EVs suggests that hsa-miR-6813-3p and hsa-miR-2277-3p could serve as novel biomarkers for MD, reflecting its severity. Moreover, these miRNAs in EVs could help understand MD pathophysiology.

Major depressive disorder (MDD) is a highly prevalent psychiatric condition with complex and heterogeneous biological underpinnings. Lipid dysregulation has emerged as a potential contributor to MDD pathophysiology. However, comprehensive lipidomic profiling studies in Japanese individuals remain limited. This study aimed to investigate serum lipidomic alterations in Japanese patients with MDD and explore the potential associations with depression severity. We conducted a real-world observational study including 30 Japanese patients with MDD and 30 healthy controls. Depression severity was assessed using the Montgomery-Asberg Depression Rating Scale. Lipidomic analysis identified 344 lipid peaks from serum samples. Multivariate and univariate statistical analyses were employed to identify differentially expressed lipids and their correlations with clinical symptoms. Thirty lipids were found to differ significantly between groups, with 7 elevated and 23 reduced in the MDD cohort. Pathway enrichment analysis highlighted disruptions in lysophosphatidylcholine (LPC), lysophosphatidylethanolamine (LPE), N-acylethanolamines, and fatty acylcarnitines. Notably, levels of LPC (20:3), platelet-activating factor (20:5), and platelet-activating factor (18:3) were negatively correlated with depression severity, suggesting a potential link to mood regulation. The pronounced enrichment changes observed in LPC and LPE-lipid species involved in membrane remodeling and cellular signal transduction-are consistent with previous findings. However, the observed negative correlations with psychiatric symptom severity were contrary to prior expectations. These results underscore the importance of interpreting lipidomic data in the context of specific population characteristics, methodological frameworks, and clinical settings. They suggest potentially meaningful metabolic alterations associated with MDD and provide a foundation for future longitudinal and mechanistic investigations.

We examined amygdala subregion volumes in patients with a first episode of major depression (MD) and in healthy subjects. Covariate-adjusted linear regression was performed to compare the MD and healthy groups, and adjustments for age, gender, and total estimated intracranial volume showed no differences in amygdala subregion volumes between the healthy and MD groups. Within the MD group, we examined the association between amygdala subregion volume and the 17-item Hamilton Rating Scale for Depression (HAMD) score and the HAMD subscale score, and found no association in the left amygdala. In the right amygdala, however, there was an inverse linear association between the HAMD total and the HAMD core and lateral nucleus and anterior-amygdaloid-regions. Furthermore, an inverse linear association was seen between the HAMD psychic and the lateral nucleus, anterior-amygdaloid-regions, transition, and whole amygdala. The findings of this study suggest that the severity of MD and some symptoms of MD are associated with right amygdala volume. There have been few reports on the relationship between MD and amygdala subregional volume, and further research is needed to accumulate more data for further validation.

Background Musical obsession has been reported as the “stuck song syndrome” and can be accompanied by obsessive compulsive disorder (OCD). Musical obsession is the phenomenon where a particular set of known musical notes are perceived repeatedly. We present a case of major depression with musical obsession. In this case, vortioxetine improved both depressive symptoms and musical obsession. Case presentation A female, 34-year-old, high school teacher presented with a depressed mood, anergia, difficulty in concentration, poor motivation, restlessness, anxiety, insomnia, and loss of appetite. She was diagnosed with major depression by her family physician and prescribed escitalopram (20 mg/day). Her depressive state partially responded to escitalopram. When she had been depressed, she also experienced musical obsessions as repetitive commercial tunes or instrumental notes inside her head that were not under conscious voluntary control and lasting several hours, causing a high level of distress in her daily life. After switching from escitalopram to vortioxetine (20 mg/day), her depressive symptoms and musical obsession symptoms were ameliorated. Conclusions This case report endorses the utility of vortioxetine for major depression with musical obsession, and further studies should be conducted to establish the optimal treatment.

Brain-derived neurotrophic factor (BDNF) is a growth factor synthesized in the cell bodies of neurons and glia, which affects neuronal maturation, the survival of nervous system, and synaptic plasticity. BDNF play an important role in the pathophysiology of major depression (MD). The serum BDNF levels changed over time, or with the improvement in depressive symptoms. However, the change of serum BDNF during pharmacotherapy remains obscure in MDD. In particular, the changes in serum BDNF associated with pharmacotherapy have not yet been fully elucidated. The present study aimed to compare the changes in serum BDNF concentrations in first-episode, drug-naive patients with MD treated with antidepressants between treatment-response and treatment-nonresponse groups. The study included 35 inpatients and outpatients composed of 15 males and 20 females aged 36.7 ± 6.8 years at the Department of Psychiatry of our University Hospital. All patients met the DSM-5 diagnostic criteria for MD. The antidepressants administered included paroxetine, duloxetine, and escitalopram. Severity of depressive state was assessed using the 17-item HAMD before and 8 weeks after drug administration. Responders were defined as those whose total HAMD scores at 8 weeks had decreased by 50% or more compared to those before drug administration, while non-responders were those whose total HAMD scores had decreased by less than 50%. Here we showed that serum BDNF levels were not significantly different at any point between the two groups. The responder group, but not the non-responder group, showed statistically significant changes in serum BDNF 0 and serum BDNF 8. The results suggest that the changes of serum BDNF might differ between the two groups. The measurement of serum BDNF has the potential to be a useful predictor of pharmacotherapy in patients with first-episode, drug-naïve MD.

Objective This study aimed to determine whether telecommuting's impact on psychological distress differed depending on the status of workers' cohabiting family members during the COVID‐19 pandemic. Methods We collected data from 33 302 workers in Japan through an Internet survey, and included 27 036 valid responses in the analysis. The survey included items on family cohabitation and telecommuting status during the COVID‐19 pandemic. We assessed workers' psychological distress using the Kessler 6. Results The psychological distress odds ratios (ORs) were higher for participants who lived with family members requiring care (OR = 1.38, P < .001), and lower for participants living with preschool children (OR = 0.77, P < .001) or a spouse (OR = 0.80, P < .001). Furthermore, odds ratios were higher for participants who worked from home and lived with family members requiring care or preschool children (OR = 1.52, P = .002; OR = 1.28, P = .028). Stratified by the presence or absence of family members living with them, psychological distress was higher for telecommuters with family members requiring care, preschool children, or elementary school children. Conclusion The association between telecommuting and psychological distress varies, depending on workers' living situation with family members.

Legionnaires' disease is a form of atypical pneumonia that can present with neurological symptoms, such as headaches, seizures, and focal neurological abnormalities. We report the case of a male patient who developed impaired consciousness and recurrent seizures following pneumonia caused by . The patient received antibiotics and antiepileptic treatment and was discharged on hospital day 56. He was diagnosed with hippocampal sclerosis 10 months later. To our knowledge, this is the first reported case of hippocampal sclerosis following Legionnaires' disease globally. Clinicians should be aware of the risk of hippocampal sclerosis after Legionnaires' disease.