ObjectiveWhile tractography is used to determine the anatomical course of white matter tracts, it can often be imprecise and time-consuming, which can be a problem when comparing large groups of patients. The aim of this study is to compare the automated process of arcuate fasciculus determination using the TractSeg algorithm with manual AF determination in DSI studio software.MethodsThe process of importing the structured MPRAGE sequence and raw diffusion-weighted images from the PACS system, performing the TractSeg algorithm, superimposing the bilateral AFs obtained on the MPRAGE image and exporting this composite image to the PACS system was automated. This procedure was used to segment the arcuate fasciculus in 25 patients with hearing loss.ResultsThe automated algorithm was able to delineate the arcuate fasciculus bilaterally in all 25 patients, while the manual reference method and automated tractography based on DSI Studio software failed in three and one patient, respectively. TractSeg showed a mean distance of 2.0 ± 0.7 mm from manual segmentation, compared with 2.8 ± 1.0 mm for DSI Studio Auto-Tracking. In addition, TractSeg appeared to involve larger portions of the medial AF fibres than the other methods.ConclusionThe TractSeg algorithm has shown high efficacy in segmenting the arcuate fasciculus in patients with hearing loss. The algorithm is fast to run and has great potential to optimise and improve neural pathway delineation.
Altered perivascular-aligned diffusivity in postherpetic neuralgia assessed by the DTI-ALPS index
BackgroundThe glymphatic system has been proposed as a key pathway for interstitial fluid clearance in the brain, but its role in chronic neuropathic pain conditions such as postherpetic neuralgia (PHN) remains unclear. The diffusion tensor image analysis along the perivascular space (DTI-ALPS) index has been suggested as a noninvasive proxy of perivascular-aligned diffusivity related to glymphatic-associated processes.MethodsA total of 83 participants were recruited, comprising 42 patients with PHN and 41 age- and sex-matched healthy controls. All participants underwent DTI, and the DTI-ALPS index was calculated using DSI Studio. The primary group comparison was performed using analysis of covariance adjusted for age and white matter hypointensity volume. In the PHN group, neuropathic symptom severity was assessed using the Douleur Neuropathique en 4 questionnaire (DN4).ResultsIn the primary adjusted analysis, the DTI-ALPS index remained lower in patients with PHN than in healthy controls (estimated marginal means: 1.247 vs. 1.348; mean difference = −0.100, 95% CI: −0.172 to −0.029, p = 0.006). In an exploratory subgroup analysis, participants with higher DN4 scores (≥ 4) had a higher DTI-ALPS index than those with lower DN4 scores (<4) (1.270 vs. 1.108, p = 0.023). In patients with PHN, the DTI-ALPS index was negatively correlated with age (r = −0.397, p = 0.009) and positively correlated with DN4 score (r = 0.441, p = 0.003).ConclusionPatients with PHN demonstrate altered perivascular-aligned water diffusivity as reflected by the DTI-ALPS index. These findings may reflect alterations in perivascular-aligned diffusivity, an indirect proxy related to glymphatic-associated processes. Further studies are warranted to clarify the relationship between neuropathic pain and glymphatic-related processes.
Stronger associations of affectivity than social leisure activities with cognitive impairment: a 10-year trajectory study of Chinese older adults
BackgroundBoth positive and negative affectivity (PNA) and social leisure activities (SLA) are significantly associated with cognitive function, yet their relative strength of association with long-term cognitive decline remains unclear. Exploring this issue has significant implications for designing precise and effective cognitive health promotion programs in the future.MethodsThe data were derived from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Our analysis included 1,847 older adults (≥65 years) without diagnosed dementia at baseline, who were followed from 2008 to 2018. Using Group-Based Trajectory Models (GBTM), participants were classified based on their PNA and SLA trajectories to identify distinct subgroups. Binomial logistic regression analyzed associations between these groups and cognitive function, with Likelihood Ratio and Wald Tests comparing their relative strengths of association.ResultsThe “High-rapid-increasing PNA” group exhibited a 264% higher risk of cognitive impairment compared to the “Low-stable-increasing PNA” group (OR = 3.64, 95% CI: 2.92, 4.52). The “Low-stable SLA” group was associated with increased cognitive impairment risk (OR = 1.66, 95% CI: 1.32, 2.08). PNA demonstrated a stronger association with cognitive function than SLA [Likelihood Ratio Test: Δχ²(1) = 137.37, p < 0.001]. However, a formal test for multiplicative interaction was not statistically significant (OR = 0.88, 95% CI: 0.57, 1.35).ConclusionPNA demonstrated a stronger association with cognitive function in older adults than SLA. Affective factors may be a critical, and potentially underutilized, target for cognitive health interventions in aging populations.
Correlation of non-suicidal self-injury with SLC6A4 promoter DNA methylation in children and adolescents with bipolar depression
PurposeTo investigate the association between non-suicidal self-injury (NSSI) and DNA methylation of the SLC6A4 promoter region in individuals diagnosed with bipolar depression.Patients and methodsA total of 48 children and adolescent patients meeting ICD-10 criteria for bipolar disorder with current depressive episodes (Hamilton Depression Rating Scale-24 score >20) were recruited, and stratified into two groups according to the presence or absence of non-suicidal self-injurious (NSSI) behavior(NSSI group and non-NSSI group). Negative life events were evaluated using the Adolescent Self-Rating Life Events Checklist (ASLEC). The methylation levels of five CpG sites within the SLC6A4 promoter region were determined by pyrosequencing, and mRNA expression was assessed by quantitative reverse transcription polymerase chain reaction (qRT-PCR).ResultsIn 48 adolescents with bipolar depression, the two groups were comparable in age, gender, education, only-child status, family history of mental illness, and disease course (all p > 0.05). Compared with the non-NSSI group, the NSSI group showed significantly lower CpG2 methylation at the SLC6A4 promoter, higher SLC6A4 mRNA expression, and higher ASLEC scores. The other four CpG sites showed no significant differences. Spearman’s correlation revealed a strong negative association between CpG2 methylation and mRNA expression (ρ = -0.547, p < 0.001). Two logistic regression models both fit the data well. Higher CpG2 methylation was a protective factor against NSSI (OR = 0.131, p = 0.021), while higher mRNA expression was a risk factor (OR = 10.957, p = 0.015). ASLEC scores and interaction terms were not significant.ConclusionThese preliminary findings suggest that lower CpG2 methylation and higher SLC6A4 mRNA expression are each independently associated with NSSI in adolescents with bipolar depression. Stressful life events were higher in the NSSI group, but did not significantly moderate these associations in the current sample. Given the small sample size and cross-sectional design, the results should be viewed as exploratory and require replication in larger studies.
Determinants of antipsychotic prescription in women detainees admitted to an acute forensic psychiatric unit
BackgroundWomen represent a small proportion of the global prison population but carry a disproportionate burden of mental illness. Evidence indicates high rates of psychotropic medication use among women in prison, often independently of the clinical diagnosis. Antipsychotics, particularly second-generation (SGAs) are widely prescribed in forensic settings. Data focusing on the prescription of these agents to women detainees are still scarce.ObjectivesThis study aimed to investigate whether socio-demographic, clinical and forensic characteristics determine SGA prescription to women admitted in an acute forensic psychiatric ward located in prison.MethodsWe conducted a retrospective study of 166 women admitted between 2014 and 2023 to the sole acute forensic psychiatric unit for detainees in French-speaking Switzerland. Among them, 128 cases received second generation antipsychotic medication during their hospital stay. Sociodemographic data included age, nationality, educational attainment and primary spoken language. Criminological variables included types of offense and detention. Clinical variables included psychiatric outpatient and inpatient history prior to conviction, total number of stays during the study period, main diagnosis, presence of substance use disorder and personality disorders. Psychotropic prescriptions were analyzed with conversion of antipsychotic doses into chlorpromazine equivalents. Regression analyses, including LASSO models were used to identify variables associated with antipsychotic dosage.ResultsPsychotropic use was very high with more than two-thirds receiving two or more psychotropic agents. SGAs were prescribed in 77.1% of cases (128 out of 166 cases), while psychotic disorders were diagnosed in only 28.3% indicating frequent off-label use. Regression analyses showed that higher antipsychotic doses were associated with previous psychiatric history, more inpatient stays and court-ordered treatments. Cluster A personality disorders were associated with lower antipsychotic doses.ConclusionsOur findings reveal an extremely high rate of psychotropic use with very frequent off-label prescription for antipsychotics in acute forensic psychiatry wards. Moreover, they show that clinical variables and not demographic and criminological factors determine the use of antipsychotics in this setting.
Editorial: The role of self-perception in mental health: current insights on self-esteem and self-schemas
Editorial: Social interaction in cyberspace: online gaming, social media, and mental health
Zero-shot de novo peptide sequencing with open posttranslational modification discovery
Nature Biotechnology, Published online: 19 May 2026; doi:10.1038/s41587-026-03116-1
RNovA is an open-search de novo peptide sequencing model.
A multimodal biomarker strategy to enhance diagnostic precision in neurodegenerative parkinsonism
Nature Medicine, Published online: 19 May 2026; doi:10.1038/s41591-026-04398-3
In a prospective cohort of 166 participants (and in a 63-participant validation cohort), dermal α-synuclein and 4-repeat tau seed amplification, combined with serum neurofilament light chain assays, were able to identify parkinsonian syndromes.
STAT+: Eli Lilly tops prominent rankings on pharma R&D performance
Here’s one more sign of Eli Lilly’s dominance in the drug industry: It took both top spots in a prominent ranking of pharmaceutical innovators and investors.
The index, produced by U.K.-based IDEA Pharma, ranks drug company laboratories on two different sets of criteria: innovation, which takes into account revenue from new products, new drug approvals, and major drug development events; and invention, which looks at the number of drugs a company has in development, its clinical trials, and its R&D investment, among other factors. IDEA is part of SAI MedPartners, a larger consultancy.
This is the first time that one company — in this case, Lilly — has ranked No. 1 in both categories.