<![CDATA[Award-winning psychiatrist Steven Moffic, MD, urges psychiatry to elevate social, spiritual, and moral care, tackling burnout, tech, and ecological ethics.]]>

Mechanisms of action and advances in application of music therapy in improving cognitive impairment based on the theory of neuroplasticity

As global population aging accelerates, preventing and treating cognitive impairment has become a major public health priority. Music therapy is a safe, well-tolerated non-pharmacological intervention with substantial potential to improve cognitive function. This review synthesizes the neurologic music therapy (NMT) framework, encompassing techniques targeting attention, memory, and executive function, delivered through both active and receptive approaches. Clinical investigations indicate that music therapy may improve cognition and neuropsychiatric symptoms in Alzheimer’s disease (AD), vascular cognitive impairment (VCI), Parkinson’s disease–related cognitive impairment, mild cognitive impairment (MCI), and traumatic brain injury (TBI); however, effects appear to vary by intervention duration and disease stage. This narrative review aims to provide a theoretical foundation and practical guidance for the non-pharmacological intervention of cognitive impairment by collating evidence on the neuroplasticity theoretical foundations, technical systems, and clinical applications of music therapy.

Microglial regulation of synaptic plasticity in transsynaptic degeneration of glaucoma

Glaucoma is a heterogeneous group of irreversible and blinding optic neuropathies caused by multiple factors. It is clinically characterized by progressive loss of visual field and decline in visual acuity, ultimately culminating in complete blindness. Hallmark pathological features include progressive degeneration of retinal ganglion cells and atrophy of the optic nerve. Importantly, the pathological process of glaucoma extends far beyond the eyeball, involving transsynaptic degeneration across the entire visual pathway. Microglia, as the principal immune regulators of the central nervous system, serve as the earliest sensors and effectors in the pathogenesis of glaucoma. By modulating synaptic plasticity, microglia contribute to synaptic loss and the disruption of neural circuits. They also play essential roles in maintaining neural tissue homeostasis. This review summarizes current evidence and underlying mechanisms of bidirectional transsynaptic degeneration in glaucoma. It highlights that targeting microglial functional homeostasis, particularly their regulation of synaptic plasticity, may be a promising strategy to mitigate glaucoma-associated transsynaptic degeneration and promote central neuroprotection.

Transient multidomain functional improvement in advanced Alzheimer’s disease following high-dose psilocybin-containing mushroom administration: a case report

BackgroundAdvanced Alzheimer’s disease (AD) is generally regarded as a stage of irreversible functional decline. Psilocybin is known to transiently alter large-scale brain network dynamics and to induce plasticity-related mechanisms in preclinical models, yet clinical data in advanced dementia remain lacking.Case presentationWe report the case of an octogenarian Japanese-American woman with a 10-year history of Alzheimer’s disease, including 5 years of marked hypofunction and predominantly monosyllabic speech. Baseline features included chronic urinary incontinence, executive dysfunction, dysphagia, dependent mobility, flat affect, and severe reduction in spontaneous communication. The patient received 5 g of orally administered psilocybin-containing mushrooms (Enigma strain). The acute phase was marked by autonomic activation, clinically suspected hyperthermia, profuse sweating, and a prolonged deep sleep-like state. Approximately 19 h post-administration, spontaneous autobiographical speech emerged. Over subsequent days and weeks, functional improvements included restoration of urinary continence, improved ambulation, autonomous dressing, increased emotional responsiveness, sustained social interaction, contextual memory retrieval, preserved working memory for social context, and spontaneous conversational engagement.ConclusionThis case documents transient multidomain functional improvement in advanced Alzheimer’s disease following psilocybin administration. The findings do not imply disease reversal but suggest that residual functional capacity may persist in late-stage neurodegeneration and may become transiently accessible under specific neuromodulatory conditions.

Genetic interaction of DISC1 and Neuroligin in regulation of glutamatergic synaptogenesis

Synaptic development and functionality have been considered as fundamental mechanisms underlying a range of neuropsychiatric disorders, including schizophrenia. Emerging evidence from biological and clinical studies implicates mutations in the Disrupted-in-Schizophrenia-1 (DISC1) gene in the pathogenesis of schizophrenia. In this study, genetic interactions among a select set of risk factor genes are examined using the unique model system: neuromuscular junctions (NMJs) in Drosophila. We found that dnlg1, the Drosophila homolog of the human Neuroligin-1, which encodes the NLGN1 protein, genetically interacts with DISC1 in synaptic development. We show that DISC1 overexpression in the dnlg1null heterozygous background causes synaptic alterations at the NMJs that are distinct from those in the wild-type background. Loss of dnlg1 enhanced the DISC1 overexpression phenotype in synaptic formation, strongly suppressing the formation of synaptic boutons. These results thus suggest an intriguing converging mechanism regulated by DISC1 and Neuroligin in the developing glutamatergic synapses.

Plant-derived bioactives, the gut–brain axis, and neurodegenerative diseases: mechanistic roles of diet–microbiota interactions

Diet is increasingly recognized as a potential upstream modulator of the gut-brain axis (GBA) through its effects on the microbiome, microbial metabolites, and host immune and endocrine responses. The GBA is a complex, bidirectional network connecting the gastrointestinal tract and central nervous system, with diet influencing microbial community structure and metabolic output. Plant-based diets, such as Mediterranean and MIND, have been associated with increased production of anti-inflammatory microbial metabolites and improved barrier function, while high calorie/low nutrient diets are often linked to increased immune activation and barrier dysfunction. However, while microbial metabolites, especially short-chain fatty acids, indoles, bile acids, and isothiocyanates, have been proposed as mediators of neuroprotective effects, their role in neurodegenerative diseases remains an area of active investigation, with evidence largely derived from preclinical and associative human studies. Cruciferous vegetables, especially broccoli sprouts, are an emerging focus of research for their bioactive compound sulforaphane, which activates Nrf2-centered cytoprotective pathways. Animal and early human studies suggest sulforaphane can improve cognitive and behavioral outcomes, though larger clinical trials are needed. Personalized, microbiota-targeted dietary interventions may offer scalable strategies for managing neuroinflammatory and neurodegenerative conditions, and we emphasize the need for integrated research across diet, microbiome, and brain health.

Perceived stress and depression among Chinese nurses: a cross-sectional mediation analysis of psychological flexibility and its components

BackgroundPerceived stress is a significant risk factor for depression among healthcare professionals. While this fundamental relationship is well-documented, the potential mediating mechanisms—specifically the role of psychological flexibility and its distinct components—in buffering the impact of perceived stress on depression within the nursing community remain poorly understood.MethodsThis cross-sectional study recruited 3,920 nurses from three tertiary Grade A public hospitals in Xi’an, China, using convenience sampling, of whom 3,611 were included in the final analysis. Data were collected online using the Chinese versions of Cohen’s Perceived Stress Scale and the Comprehensive Assessment of Acceptance and Commitment Therapy Processes, as well as the Patient Health Questionnaire-9. Pearson correlation analyzes and mediation analysis were conducted to examine the associations among perceived stress, psychological flexibility, and depression.ResultsDepression was positively correlated with perceived stress (r = 0.63, p < 0.01). Mediation analysis indicated that perceived stress was significantly associated with depression both directly (b = 0.47, 95% CI: 0.45 to 0.49) and indirectly via psychological flexibility (b = 0.12, 95% CI: 0.11 to 0.13) and its components, including acceptance and cognitive defusion (b = 0.14, 95% CI: 0.13 to 0.15), and values and committed action (b = 0.06, 95% CI: 0.04 to 0.08). The indirect association through mindfulness and self-as-context was not significant (b = 0.01, 95% CI: 0.00 to 0.02).ConclusionsPsychological flexibility and some of its components were involved in partial indirect associations between perceived stress and depression among Chinese nurses. These findings suggest that psychological flexibility may help understand how perceived stress is statistically associated with depression in this population. Given the cross-sectional design, however, the results should be interpreted as statistical associations rather than evidence of causal relationships.