1.The parallel mediating effects of anxiety and depression states between life events and behavior problems in adolescents
Zihao YANG ; Qingqing ZHANG ; Dan WANG ; Lei ZHANG ; Hua ZHENG ; Lijing SHI ; Nana WANG ; Yihan ZHANG ; Zhenyi LI ; Min SUN ; Huimin CHEN ; Huiping CHENG ; Ruiling ZHANG ; Chuansheng WANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(3):259-265
Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.
2.Effect and mechanism of retinoic acid-related orphan receptor alpha on cognitive impairment of mice induced by chronic alcohol use
Lina LIU ; Shuai LIU ; Dan WANG ; Zijun WANG ; Yanzhong BAI ; Zhong ZHANG ; Chuansheng WANG ; Ruiling ZHANG ; Yanjie ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(8):680-685
Objective:To explore the role of retinoic acid-related orphan receptor α (RORα) in cognitive impairment induced by chronic alcohol consumption in mice.Methods:(1)The SPF grade RORαflox/flox transgenic mice aged 8 weeks were generated, and 22 transgenic mice were evenly divided into two groups by the method of matching body mass, which were the control group (Con group) and the alcohol group (EtOH group), with 11 mice in each group.(2)Emx1-Cre transgenic mice were used to selectively knock out the RORα gene in the forebrain of RORαflox/flox transgenic mice, producing conditional knockout mice (cKO mice) with the genotype RORαflox/flox-Emx1-Cre+ /+. Fourteen cKO mice were further split into two groups by the method of matching body mass, which were the conditional knockout group (cKO group) and the conditional knockout + alcohol group (cKO + EtOH group), with 7 mice in each group. A chronic alcohol use cognitive impairment model was developed in the EtOH group and cKO + EtOH group through the two-bottle free-choice method, while the Con group and cKO group were given two bottles of water for the same period. Cognitive abilities of mice in all groups were evaluated using behavioral novel object recognition test and Y-maze test.RORα mRNA and protein expression levels in the hippocampus of the Con group and EtOH group were assessed by RT-qPCR and Western blot, respectively.The GraphPad Prism 9.0 software was used for data analysis.One-way ANOVA was used for the comparison of multiple groups and Tukey test was used for further pairwise comparisons.Results:(1) Comparison between Con group and EtOH group: the relative levels of ROR α protein (0.63±0.04) and mRNA (0.78±0.03) in the hippocampus of mice in the EtOH group were significantly lower than those in the Con group((1.00±0.06), (1.00±0.05), both P<0.05). The duration of the EtOH group in the Y maze was significantly lower than that of the Con group ((212.30±32.05) s, (129.30±21.50) s, P<0.05), and the new object recognition index of the EtOH group was lower than that of the Con group ((14.73±25.49)% vs (-15.55±27.88)%, P=0.08). (2)Comparison between Con group and cKO group: the frequency and duration of entering the Y maze of mice in the cKO group ((7.43±2.30) times, (124.10±13.95) s) were lower than those in the Con group ((14.90±3.65) times, (212.30±32.05) s, both P<0.05). There was no statistically significant difference in the new object recognition index between the cKO group and the Con group ( P>0.05). (3) Comparison between the cKO+ EtOH group and the cKO group: the frequency ((2.71±1.11)times) and duration ((161.70±17.95) s) of entering the new heteroarm of Y maze in the KO+ EtOH group were lower than those in the cKO group ((7.43±2.30) times, (124.10±13.95) s, both P<0.05), and there was no statistically significant difference in the new object recognition index ( P>0.05). (4) Comparison between the cKO+ EtOH group and the EtOH group: the frequency of entering new heteroarm of the Y maze in the cKO+ EtOH group ((2.71±1.11)times) was significantly lower than that in the EtOH group (12.18±4.49) ( P<0.05), while there was no statistically significant difference in other behavioral results between the two groups ( P>0.05). Conclusion:Chronic alcohol consumption leads to cognitive impairment through the downregulation of RORα in the hippocampus of mice. Specific knockout of RORα in the forebrain exacerbates cognitive impairment induced by chronic alcohol use. RORα may represent a potential therapeutic target for cognitive impairment resulting from chronic alcohol consumption.
3.The parallel mediating effects of anxiety and depression states between life events and behavior problems in adolescents
Zihao YANG ; Qingqing ZHANG ; Dan WANG ; Lei ZHANG ; Hua ZHENG ; Lijing SHI ; Nana WANG ; Yihan ZHANG ; Zhenyi LI ; Min SUN ; Huimin CHEN ; Huiping CHENG ; Ruiling ZHANG ; Chuansheng WANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(3):259-265
Objective:To explore the relationship between life events, anxiety, depression, and behavior problems in adolescents.Methods:From September to October 2022, the cluster sampling method was used to select 5 341 adolescents from 4 middle schools in Xinxiang urban area.The subjects and their parents were investigated by the adolescent self-rating life events check list (ASLEC), generalized anxiety disorder scale (GAD-7), patient health questionnaire (PHQ-9), and child behavior checklist (CBCL). SPSS 27.0 software was used for Spearman correlation analysis, and AMOS 28.0 software was used to construct the structural equation model.Results:The scores of anxiety, depression, and behavioral problems were 1 (0, 4), 1 (0, 4), and 3 (0, 10). The total score of life events was 5 (1, 13), and the dimensions scored as follows: interpersonal conflict 1 (0, 4), academic pressure 2 (0, 5), punishment 0 (0, 2), loss 0 (0, 0), health and adaptation problem 0 (0, 1), and others 0 (0, 2). There were positive correlations between life events and its dimensions, depression, anxiety and behavioral problems ( r=0.28-0.69, all P<0.01). In the overall population, anxiety and depression played parallel mediating roles in the impact of life events on behavior problems. Life events could positively predict anxiety ( β=0.68, P<0.01), and anxiety could positively predict behavior problems ( β=0.04, P=0.02). Life events could positively predict depression ( β=0.77, P<0.01), and depression could positively predict behavior problems ( β=0.18, P<0.01). The standardized total effect size of the impact of life events on behavioral problems was 0.622 (95% CI=0.564-0.675). The standardized direct effect size and indirect effect size were 0.460 (95% CI=0.374-0.539) and 0.162 (95% CI=0.108-0.218), accounting for 74.0% and 26.0%of the total effect, respectively. After stratification by gender, the results for male adolescents were consistent with the overall population, while the mediating effect of anxiety was not significant in the female adolescents. Conclusion:Life events can lead to anxiety and depression in adolescents, thereby increasing the risk of behavior problems.
4.Effect and mechanism of retinoic acid-related orphan receptor alpha on cognitive impairment of mice induced by chronic alcohol use
Lina LIU ; Shuai LIU ; Dan WANG ; Zijun WANG ; Yanzhong BAI ; Zhong ZHANG ; Chuansheng WANG ; Ruiling ZHANG ; Yanjie ZHANG
Chinese Journal of Behavioral Medicine and Brain Science 2025;34(8):680-685
Objective:To explore the role of retinoic acid-related orphan receptor α (RORα) in cognitive impairment induced by chronic alcohol consumption in mice.Methods:(1)The SPF grade RORαflox/flox transgenic mice aged 8 weeks were generated, and 22 transgenic mice were evenly divided into two groups by the method of matching body mass, which were the control group (Con group) and the alcohol group (EtOH group), with 11 mice in each group.(2)Emx1-Cre transgenic mice were used to selectively knock out the RORα gene in the forebrain of RORαflox/flox transgenic mice, producing conditional knockout mice (cKO mice) with the genotype RORαflox/flox-Emx1-Cre+ /+. Fourteen cKO mice were further split into two groups by the method of matching body mass, which were the conditional knockout group (cKO group) and the conditional knockout + alcohol group (cKO + EtOH group), with 7 mice in each group. A chronic alcohol use cognitive impairment model was developed in the EtOH group and cKO + EtOH group through the two-bottle free-choice method, while the Con group and cKO group were given two bottles of water for the same period. Cognitive abilities of mice in all groups were evaluated using behavioral novel object recognition test and Y-maze test.RORα mRNA and protein expression levels in the hippocampus of the Con group and EtOH group were assessed by RT-qPCR and Western blot, respectively.The GraphPad Prism 9.0 software was used for data analysis.One-way ANOVA was used for the comparison of multiple groups and Tukey test was used for further pairwise comparisons.Results:(1) Comparison between Con group and EtOH group: the relative levels of ROR α protein (0.63±0.04) and mRNA (0.78±0.03) in the hippocampus of mice in the EtOH group were significantly lower than those in the Con group((1.00±0.06), (1.00±0.05), both P<0.05). The duration of the EtOH group in the Y maze was significantly lower than that of the Con group ((212.30±32.05) s, (129.30±21.50) s, P<0.05), and the new object recognition index of the EtOH group was lower than that of the Con group ((14.73±25.49)% vs (-15.55±27.88)%, P=0.08). (2)Comparison between Con group and cKO group: the frequency and duration of entering the Y maze of mice in the cKO group ((7.43±2.30) times, (124.10±13.95) s) were lower than those in the Con group ((14.90±3.65) times, (212.30±32.05) s, both P<0.05). There was no statistically significant difference in the new object recognition index between the cKO group and the Con group ( P>0.05). (3) Comparison between the cKO+ EtOH group and the cKO group: the frequency ((2.71±1.11)times) and duration ((161.70±17.95) s) of entering the new heteroarm of Y maze in the KO+ EtOH group were lower than those in the cKO group ((7.43±2.30) times, (124.10±13.95) s, both P<0.05), and there was no statistically significant difference in the new object recognition index ( P>0.05). (4) Comparison between the cKO+ EtOH group and the EtOH group: the frequency of entering new heteroarm of the Y maze in the cKO+ EtOH group ((2.71±1.11)times) was significantly lower than that in the EtOH group (12.18±4.49) ( P<0.05), while there was no statistically significant difference in other behavioral results between the two groups ( P>0.05). Conclusion:Chronic alcohol consumption leads to cognitive impairment through the downregulation of RORα in the hippocampus of mice. Specific knockout of RORα in the forebrain exacerbates cognitive impairment induced by chronic alcohol use. RORα may represent a potential therapeutic target for cognitive impairment resulting from chronic alcohol consumption.
5.Fingerprints,chemical pattern recognition analysis,and multi-index content determination of Jianpi hewei formula
Dongdong HE ; Hui ZONG ; Chongyang WANG ; Juanjuan WAN ; Xuepu MAO ; Chuansheng HUANG ; Xinchun WANG ; Liping WANG
China Pharmacy 2025;36(15):1876-1881
OBJECTIVE To establish HPLC fingerprint for Jianpi hewei formula(JPHWF),conduct chemical pattern recognition analysis,and determine the contents of seven components in the formula,aiming to provide a scientific basis for quality control and further research of JPHWF.METHODS Taking 15 batches of standard decoctions of JPHWF as samples,the HPLC fingerprint was established using the Similarity Evaluation System of TCM Chromatographic Fingerprint(2012 edition).Subsequently,similarity evaluation,as well as identification and attribution analysis of chromatographic peaks,were conducted.Using the common peak areas from the 15 batches of samples as variables,chemical pattern recognition analyses were performed on the samples through hierarchical cluster analysis,principal component analysis,and orthogonal partial least squares-discriminant analysis.The contents of adenine,5-hydroxymethylfurfural,tetrahydropalmatine,naringin,dehydrocorydaline,neohesperidin and glycyrrhizic acid in 15 batches of samples were determined by HPLC.RESULTS There were 19 common peaks in the characteristic chromatograms for 15 batches of samples with the similarities of more than 0.95.Results of chemical pattern recognition analysis showed that 15 batches of samples could be clustered into 3 categories,and 3 differential compounds were found[peak 7(5-hydroxymethylfurfural),peak 17(neohesperidin),and peak 15(naringin)].The 7 components were linearly good in the respective concentration ranges(R2≥0.999 4);RSDs of precision,stability and repeatability tests were less than 2%(n=6);the average recovery rate of 98.95%-103.81%,RSD of 0.61%-2.75%(n=6);the contents of them were 0.031-0.106,0.267-0.824,0.089-0.144,1.344-2.091,0.089-0.178,1.328-2.028,0.040-0.150 mg/g,respectively.CONCLUSIONS Established HPLC fingerprinting method coupled with multi-index content determination is validated to be accurate and reliable,and its combination with chemical pattern recognition analysis can be applied to the quality control of JPHWF.
6.Clinical Observation on the Wenyang Huayin Prescription in the Treatment of Chronic Heart Failure in Elderly Patients with Fluid Retention due to Yang Deficiency
Jinchong YANG ; Chuansheng ZHANG ; Xiyan WANG ; Xiaona LIU ; Jin YU
Traditional Chinese Drug Research & Clinical Pharmacology 2024;35(5):749-755
Objective To observe the clinical efficacy of Wenyang Huayin Prescription(cooked Aconiti Lateralis Radix Praeparata,Cinnamomi Ramulus,Codonopsis Radix,Atractylodis Macrocephalae Rhizoma,Poria,Descurainiae Semen Lepidii Semen,etc.)combined with conventional western medicine in the treatment of elderly patients with chronic heart failure(CHF).Methods A total of 120 elderly CHF patients with fluid retention due to yang deficiency syndrome who were treated in People's Hospital of Chenghai District from December 2021 to December 2022 were selected as the research objects.They were randomly divided into control group and observation group,with 60 cases in each group.The control group was given conventional western medicine treatment,and the observation group was treated with Wenyang Huayin Prescription on the basis of the treatment of the control group.The course of treatment was four weeks.The indexes of the two groups were observed before and after treatment:(1)TCM syndrome scores;(2)serum levels of N-terminal pro-B-type natriuretic peptide(NT-proBNP),high-sensitivity C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6);(3)left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD);(4)6-minute walking distance.The clinical efficacy and safety of the two groups were compared.Results After treatment,(1)the scores of TCM syndromes in the two groups were significantly lower than those before treatment(P<0.05),and the scores in the observation group were significantly lower than those in the control group(P<0.05).(2)The levels of serum hs-CRP,TNF-α,IL-6 and NT-proBNP in the two groups were significantly lower than those before treatment(P<0.05),and the levels in the observation group were significantly lower than those in the control group(P<0.05).(3)The levels of LVEF in the two groups were significantly higher than those before treatment(P<0.05),and the levels of LVEDD were significantly lower than those before treatment(P<0.05).The level of LVEF in the observation group was significantly higher than that in the control group(P<0.05),and the level of LVEDD was significantly lower than that in the control group(P<0.05).(4)The 6-minute walking distance in the two groups was significantly increased when compared with that before treatment(P<0.05),and the increase in the observation group was significantly greater than that in the control group(P<0.05).(5)The total effective rate of the observation group(96.67%)was significantly higher than that of the control group(86.67%)(P<0.05);the total incidence of adverse reactions in the observation group(1.67%)was significantly lower than that in the control group(11.67%)(P<0.05).Conclusion Wenyang Huayin Prescription combined with conventional western medicine treatment can effectively reduce the TCM syndrome score of elderly CHF patients with fluid retention due to yang deficiency syndrome,improve clinical symptoms and cardiac function,and reduce the body's inflammatory response.The clinical efficacy is superior to that of western medicine alone,and the safety is relatively high.
7.Efficacy and safety of paliperidone palmitate versus other long-acting injectable antipsychotic drugs in the treatment of schizophrenia:a meta-analysis
Mingjun ZHAO ; Yage MAO ; Chuansheng WANG
Chinese Journal of Pharmacoepidemiology 2024;33(2):203-211
Objective To assess the safety of paliperidone palmitate(PP)injection versus other antipsychotic drugs long-acting injections(LAIs)in the treatment of schizophrenia.Methods PubMed,Web of Science,Embase,Cochrane Library,PsycINFO,CNKI,SinoMed,VIP and WanFang Data databases were searched to collect randomized controlled trials(RCTs)on PP injection versus other antipsychotic drugs LAIs in the treatment of schizophrenia from the inception to April 30,2023.Two reviewers independently screened literature,extracted data and assessed the risk of bias of included studies.Meta-analysis was then performed using RevMan 5.2 software.Results A total of 12 RCTs involving 4 368 patients were included.The results of Meta-analysis showed that there was no significant difference in clinical efficacy between PP injection treated group and risperidone LAIs treated group(P>0.05),no significant difference was found for positive and negative syndrome scale(PANSS)overall score changes between PP injection treated group and other antipsychotic drugs LAIs treated group(P>0.05).Compared with other antipsychotic LAIs treated groups,PP injection treated group had a significantly higher rate of total withdrawls(RR=1.14,95%CI 1.06 to 1.24,P<0.01)and the incidence of adverse reactions of abnormal injection site(RR=2.08,95%CI 1.03 to 4.22,P=0.04).Conclusion Current evidence indicates that PP injection didn't show significant difference in efficacy outcomes,while may increase the incidence of some adverse reactions when compared with other antipsychotic drugs LAIs for schizophrenic.However,due to the limitations of the quantity and quality of the included studies,the above conclusions still need to be validated by more high-quality studies.
8.Predictive value of foramen ovale size on pain recurrence after percutaneous balloon compression.
Chuansheng LI ; Jie YANG ; Fengwei HAN ; Tiemin HU ; Jiwei ZHANG ; Bing LIU ; Lina YAN ; Wenxia LIU ; Kunpeng WANG
Journal of Central South University(Medical Sciences) 2023;48(5):682-690
OBJECTIVES:
Primary trigeminal neuralgia (PTN) is a common cranial nerve disease in neurosurgery, which seriously endangers the physical and mental health of patients. Percutaneous balloon compression (PBC) has become an effective procedure for the treatment of PTN by blocking pain conduction through minimally invasive puncture. However, the recurrence of facial pain after PBC is still a major problem for PTN patients. Intraoperative balloon shape, pressure and compression time can affect the prognosis of patients with PBC after surgery. The foramen ovale size has an effect on the balloon pressure in Meckel's lumen. This study aims to analyse the predictive value of foramen ovale size for postoperative pain recurrence of PBC by exploring the relationship between foramen ovale size and postoperative pain recurrence of PBC.
METHODS:
A retrospectively analysis was conducted on the clinical data of 60 patients with PTN who were treated with PBC in Department of Neurosurgery, Affiliated Hospital of Chengde Medical College from November 2018 to December 2021. We followed-up and recorded the Barrow Neurological Institute (BNI) pain score at 1, 3, 6 and 12 months after operation. According to the BNI pain score at 12 months after surgery, the patients were divided into a cure group (BNI pain score I to Ⅱ) and a recurrence group (BNI pain score Ⅲ to Ⅴ). The long diameter, transverse diameter and area of foramen ovale on the affected side and the healthy side of the 2 groups were measured. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used for analysis the relationship between the recurrence of pain and the long diameter, transverse diameter, area of foramen ovale on the affected side, and aspect ratio, transverse diameter ratio, area ratio of foramen ovale on the affected side to healthy side in the 2 groups.
RESULTS:
At the end of 12 months of follow-up, 50 (83.3%) patients had pain relief (the cured group), 10 (16.7%) patients had different degrees of pain recurrence (the recurrence group), and the total effective rate was 83.3%. There were no significant differences in preoperative baseline data between the 2 groups (all P>0.05). The long diameter of foramen ovale on the affected side, the long diameter ratio and area ratio of foramen ovale on the affected/healthy side in the cured group were significantly higher than those in the recurrence group (all P<0.05), and there were no significant differences in the transverse diameter and area of foramen ovale on the affected side and the transverse diameter ratio of foramen ovale on the affected/healthy side between the 2 groups (all P>0.05). The ROC curve analysis showed that the AUC of the long diameter of foramen ovale on the affected side was 0.290 (95% CI 0.131 to 0.449, P=0.073), and the AUC of aspect ratio of foramen ovale on the affected side to healthy side was 0.792 (95% CI 0.628 to 0.956, P=0.004). The AUC of area ratio of foramen ovale on the affected side to healthy side was 0.766 (95% CI 0.591 to 0.941, P=0.008), indicating that aspect ratio and area ratio of foramen ovale on the affected side to healthy side had a good predictive effect on postoperative pain recurrence of PBC. When aspect ratio of foramen ovale on the affected side to healthy side was less than 0.886 3 or area ratio of foramen ovale on the affected side to healthy side was less than 0.869 4, postoperative pain recurrence was common.
CONCLUSIONS
Accurate evaluation of the foramen ovale size of skull base before operation is of great significance in predicting pain recurrence after PBC.
Humans
;
Retrospective Studies
;
Foramen Ovale
;
Treatment Outcome
;
Trigeminal Neuralgia/surgery*
;
Pain, Postoperative/etiology*
;
Recurrence
9.MANF brakes TLR4 signaling by competitively binding S100A8 with S100A9 to regulate macrophage phenotypes in hepatic fibrosis.
Chao HOU ; Dong WANG ; Mingxia ZHAO ; Petek BALLAR ; Xinru ZHANG ; Qiong MEI ; Wei WANG ; Xiang LI ; Qiang SHENG ; Jun LIU ; Chuansheng WEI ; Yujun SHEN ; Yi YANG ; Peng WANG ; Juntang SHAO ; Sa XU ; Fuyan WANG ; Yang SUN ; Yuxian SHEN
Acta Pharmaceutica Sinica B 2023;13(10):4234-4252
The mesencephalic astrocyte-derived neurotrophic factor (MANF) has been recently identified as a neurotrophic factor, but its role in hepatic fibrosis is unknown. Here, we found that MANF was upregulated in the fibrotic liver tissues of the patients with chronic liver diseases and of mice treated with CCl4. MANF deficiency in either hepatocytes or hepatic mono-macrophages, particularly in hepatic mono-macrophages, clearly exacerbated hepatic fibrosis. Myeloid-specific MANF knockout increased the population of hepatic Ly6Chigh macrophages and promoted HSCs activation. Furthermore, MANF-sufficient macrophages (from WT mice) transfusion ameliorated CCl4-induced hepatic fibrosis in myeloid cells-specific MANF knockout (MKO) mice. Mechanistically, MANF interacted with S100A8 to competitively block S100A8/A9 heterodimer formation and inhibited S100A8/A9-mediated TLR4-NF-κB signal activation. Pharmacologically, systemic administration of recombinant human MANF significantly alleviated CCl4-induced hepatic fibrosis in both WT and hepatocytes-specific MANF knockout (HKO) mice. This study reveals a mechanism by which MANF targets S100A8/A9-TLR4 as a "brake" on the upstream of NF-κB pathway, which exerts an impact on macrophage differentiation and shed light on hepatic fibrosis treatment.
10.Propranolol combined with memory retrieval reconsolidation procedure for the intervention of alcohol craving in patients with alcohol dependence
Pengjiao XU ; Shuai YU ; Han WANG ; Chuansheng WANG ; Ruiling ZHANG ; Yahui XU
Chinese Journal of Psychiatry 2023;56(2):106-113
Objective:This study aims to explore the effect of propranolol combined with memory retrieval reconsolidation procedure on alcohol craving.Methods:A total of 54 patients with alcohol dependence who met the diagnostic criteria for alcohol dependence in DSM-Ⅳ were enrolled. The patients were randomly located into the alcohol retrieval-propranolol group (study group, n=28) and the alcohol retrieval-placebo group (control group, n=26) using the random number table. The study group used propranolol combined with a memory retrieval reconsolidation procedure, while the control group used a placebo combined with a memory retrieval reconsolidation procedure. The Visual Analog Scale (VAS) was used to evaluate the degree of alcohol craving induced by images such as wine bottle, pouring wine, and drinking (alcohol-related cue images, previous cue images) and neutral images (new cue) at stages of baseline measures, relevance learning, and memory test. The systolic blood pressure, diastolic blood pressure, and heart rate were applied to evaluate cue responsiveness. Repeated measures analysis of variance was used to compare the craving degree, systolic blood pressure, diastolic blood pressure, and heart rate between the two groups. The correlation between cue responsiveness and craving degree was analyzed. Results:Relevance learning stage: Compared with before learning, the levels of systolic blood pressure, diastolic blood pressure, and heart rate of the two groups increased in varying degrees after learning conditional stimulation-relevance learning+(CS+, namely neutral images paired learning with alcohol) ( F=52.79, 42.44, 49.53, P<0.05). Compared with the baseline measures, the VAS of neutral images in relevancy learning increased ( F=99.88, 68.69, both P<0.01). Memory test stage: (1) Compared with the control group, the VAS scores of cravings induced by wine bottles, pouring wine, drinking images, and neutral images were lower in the study group ( F=7.38, 13.27, 11.34, 4.62, P<0.05). Compared with the VAS scores of cravings induced by wine bottles, pouring wine, drinking images, and neutral images in the relevance learning stage, the VAS scores of the study group in the memory test stage were significantly lower ( F=43.89, 23.53, 15.93, 31.01, P<0.05). For the control group, VAS scores induced by pouring wine and drinking images were significantly increased ( F=13.40, 63.65, P<0.05). (2) After the memory test stage, compared with the control group, the levels of diastolic blood pressure and heart rate in the study group decreased ( F=20.99, 15.42, P<0.05). Compared with before the test, the levels of diastolic blood pressure and heart rate in the study group decreased after the test ( F=4.11, 8.05, P<0.05), while those in the control group increased ( F=81.86, 41.13, P<0.05). (3) The difference in diastolic blood pressure before and after the memory test stage was positively correlated with the difference in neutral VAS score between the memory test and association learning ( r=0.394, P=0.038). Heart rate difference before and after the memory test stage positively correlated with the VAS score difference between the memory test and associated learning drinking images ( r=0.389, P=0.041). Conclusion:Propranolol combined with memory retrieval reconsolidation procedure can reduce alcohol cravings induced by previous and new cues in patients with alcohol dependence.

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