Efficacy and Safety of Transcranial Direct Current Stimulation for Depression in Older Adults: A Systematic Review and Meta-Analysis of Mixed-Age Studies.

Objectives: Geriatric depression is a significant public health burden and is challenging to treat. The current study aimed to examine the effectiveness of transcranial direct current stimulation (tDCS) as a nonpharmacologic intervention approach for depression in older adults.

Methods: We performed a systematic review of 24 studies across 13 countries including a total of 1,277 participants.

Lucid episodes among people with Alzheimer's disease and related dementias and their impact on family caregiver stress and grief (LEAD): protocol for a longitudinal observational study.

Introduction: Alzheimer's disease and related dementias (ADRD) are conditions with progressive cognitive decline. Still, people living with late-stage ADRD (PLWD) have been reported to exhibit transient recovery of communication or behavioural abilities that had seemingly been lost. These lucid episodes (LEs) are underinvestigated and poorly understood.

Transcranial Electrical Stimulation in Treatment of Depression: A Systematic Review and Meta-Analysis.

Importance: The role and safety of transcranial electrical stimulation (tES) for treating depressive disorders remain under evaluation.

Objective: To evaluate tES treatment in patients with major depressive disorder (MDD) and comorbid depressive conditions.

Data Sources: A search of MEDLINE, Embase, Cochrane, APA PsycINFO, and Scopus databases was conducted from inception to September 17, 2024.

Spouse and Child Caregivers' Experiences of Lucid Episodes in Dementia: A Mixed Methods Approach.

Background And Objectives: Lucid episodes (LEs) in people living with late-stage dementia have been reported anecdotally. However, how this seemingly unexpected phenomenon is experienced by family caregivers is less known. Focusing on the two most common groups of informal caregivers, spouses and adult children, this study examined variability in family caregivers' experiences with LEs-whether they exhibit differential appraisals of and responses to LEs.

Transcranial direct current simulation as an adjunctive treatment for treatment-resistant depression in hospitalized patients: A feasibility study protocol.

Transcranial direct current stimulation (tDCS) is clinically effective in treating treatment-resistant depression (TRD), as measured by response, symptom improvement, and disease remission. However, the feasibility and underlying mechanism of tDCS treatment in individuals with TRD during acute psychiatric hospitalization remain poorly characterized. This paper outlines the protocol that aims to investigate the feasibility of implementing a 5-day tDCS treatment in hospitalized patients with TRD and secondarily explore the effects on depression and cognition, and neurophysiological mechanisms underlying tDCS.

Primary Mental Health Competencies for Hospice and Palliative Medicine Physicians: A Delphi Study.

Context: Psychiatric and psychological care in serious illness is a core domain of hospice and palliative medicine (HPM), encompassing both normative psychosocial responses and mental health comorbidities. While social workers serve as psychosocial leaders on HPM interdisciplinary teams, commitment to supporting whole-person care remains the responsibility of the entire team. However, training and scope of practice for HPM physicians in the mental health domain are poorly standardized.

Large-scale network analysis of the cerebrospinal fluid proteome identifies molecular signatures of frontotemporal lobar degeneration.

The pathophysiological mechanisms driving disease progression of frontotemporal lobar degeneration (FTLD) and corresponding biomarkers are not fully understood. Here we leveraged aptamer-based proteomics (>4,000 proteins) to identify dysregulated communities of co-expressed cerebrospinal fluid proteins in 116 adults carrying autosomal dominant FTLD mutations (C9orf72, GRN and MAPT) compared with 39 non-carrier controls. Network analysis identified 31 protein co-expression modules.

Three approaches to determining clinically meaningful benefit on the Cohen-Mansfield Agitation Inventory in dementia clinical trials for agitation.

Introduction: There is a need to understand the clinical meaningfulness of symptom score changes in treatment trials of dementia-related agitation. We estimated minimal clinically important differences (MCIDs) for commonly employed agitation scales and contextualized their clinical application.

Methods: We employed anchor- and distribution-based approaches to determine changes in scores corresponding to minimal symptom improvement.

Evaluating the effectiveness of psilocybin in alleviating distress among cancer patients: A systematic review.

Objectives: Psychological and existential distress is prevalent among patients with life-threatening cancer, significantly impacting their quality of life. Psilocybin-assisted therapy has shown promise in alleviating these symptoms. This systematic review aims to synthesize the evidence on the efficacy and safety of psilocybin in reducing cancer-related distress.

A pilot randomized controlled double-blind trial of intermittent theta burst stimulation (iTBS) repetitive transcranial magnetic stimulation (rTMS) to improve memory in mild cognitive impairment (MCI): a study protocol.

Background: Mild cognitive impairment (MCI), prevalent among older adults, often precedes Alzheimer's disease (AD) or Alzheimer's disease-related dementias (ADRD), emphasizing the need for effective interventions. Early intervention in MCI is crucial, not only to alleviate symptoms but to potentially delay the progression of cognitive decline. The lack of definitive treatments for MCI has prompted the exploration into alternative non-pharmacological therapeutic approaches.

Hyperorality in Frontotemporal Dementia: How Psychiatric and Neural Correlates Change During the Disease Course.

Objective: Hyperorality is a core feature of behavioral variant frontotemporal dementia (bvFTD); however, the cognitive, psychiatric, and neuroanatomical correlates of hyperorality across the bvFTD stages remain unclear. The authors explored these associations in early- and advanced-stage bvFTD.

Methods: Participants with sporadic or genetic bvFTD were enrolled in the ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration (ALLFTD) consortium study.

Resilient living program for patients with advanced cancer and their caregivers.

Objectives: Patients with advanced cancer and their caregivers experience a substantial amount of anxiety and distress. The purpose of this study was to assess the feasibility, acceptability, and preliminary effects of an 8-week, remotely delivered Resilient Living Program (RLP) for adult patients with advanced cancer and their caregivers.

Methods: Eligible patients included adults (≥18 years) with advanced cancer.

Neuropsychiatric symptoms cluster and fluctuate over time in behavioral variant frontotemporal dementia.

Aim: Cognitive and behavioral phenomena define behavioral variant frontotemporal dementia (bvFTD), but neuropsychiatric symptoms (NPS) outside the core criteria are common throughout the illness. Identifying how NPS cluster in bvFTD may guide development of future therapies.

Methods: Participants (n = 354) with sporadic and genetic bvFTD were enrolled in the ARTFL LEFFTDS Longitudinal Frontotemporal Lobar Degeneration Consortium.

Weighted Blankets for Agitation in Hospitalized Patients with Dementia: Protocol for a Randomized Controlled Trial.

Background: There are limited therapies approved for the treatment of aggression and agitation in patients with dementia. While antipsychotics and benzodiazepines are commonly used, these medications have been associated with significant side effects and US Food and Drug Administration (FDA) boxed warnings. Weighted blankets have been associated with decreased anxiety and improved sleep.

Optimizing Electroconvulsive Therapy With E-Field Modeling: A Narrative Review.

Electroconvulsive therapy (ECT) is an effective treatment for severe depression, especially in treatment-resistant cases. However, its potential cognitive side effects necessitate careful dosing to balance therapeutic benefits and cognitive stability. Recent advances in electric field (E-field) modeling offer promising avenues to optimize ECT dosing.

Motor threshold parameters do not predict repetitive Transcranial Magnetic Stimulation and intermittent Theta Burst Stimulation outcomes in major depressive disorder.

Background: Repetitive Transcranial Magnetic Stimulation (rTMS) and intermittent Theta Burst Stimulation (iTBS) are non-invasive treatments for major depressive disorder (MDD). While effective, variability in outcomes necessitates identifying predictors of therapeutic response. This study examined whether motor threshold (MT), percentage of motor threshold (%MT), and treatment intensity could predict clinical outcomes in MDD patients undergoing rTMS and iTBS.

Self-Rated ECT Outcomes in Patients With Depression: A Naturalistic Single-Site Study.

Objectives: Electroconvulsive therapy (ECT) is considered to be the most effective treatment for severe depression. This study investigated recent ECT outcomes for depression at a large tertiary center, which also provides community care.

Methods: Data were obtained from Mayo Clinic Rochester patients ages 18 and older who received an acute course of ECT between August 1, 2017 and April 30, 2024.

Evaluating Repetitive Transcranial Magnetic Stimulation for Neuropsychiatric Symptoms in Long COVID: A Case Series.

Objective: To describe the immediate clinical outcomes of repetitive transcranial magnetic stimulation (rTMS) in treating long COVID symptoms. Long COVID currently impacts approximately 5.3% of US adults, presenting with persistent fatigue, depression, anxiety, cognitive impairments, and social function decline.

Real-time TMS-EEG for brain state-controlled research and precision treatment: a narrative review and guide.

Transcranial magnetic stimulation (TMS) modulates neuronal activity, but the efficacy of an open-loop approach is limited due to the brain state's dynamic nature. Real-time integration with electroencephalography (EEG) increases experimental reliability and offers personalized neuromodulation therapy by using immediate brain states as biomarkers. Here, we review brain state-controlled TMS-EEG studies since the first publication several years ago.

Navigating Gender Identity and Dementia in Transgender Older Adults: Ethical Challenges and Patient-Centered Care.

Objectives: As transgender individuals age, they are at risk for neurocognitive disorders which pose not only medical but also bioethical questions. We present a case study of a transgender older adult with dementia who experienced changes in gender identity and explore the bioethical implications of identity over time, including end-of-life care.

Methods: We reviewed clinical notes and relevant medical history to describe the transition and detransition process and examined ethical frameworks related to autonomy, psychological continuity, and transgender care.

Medical Decision Making in Correctional Facilities: Highlighting Gaps and Advocating for Policy Change.

In the United States, a disproportionately high number of incarcerated individuals suffer from serious mental illnesses, substance use disorders, chronic medical conditions, infectious diseases, and traumatic brain injuries. Correctional facilities are often ill-equipped to address the incarcerated community's physical and mental health needs. Current laws and policies remain outdated and do not adequately address the complex health issues faced by incarcerated individuals, particularly the aging and terminally ill patients in correctional settings.