Orygen

To identify patient and intervention factors that moderate the effects of running on intervertebral disc health (IVD) in adults with non‑specific chronic low back pain. Pre‑planned secondary analysis of a 12-week parallel-group (1:1) randomised controlled trial of 40 adults with non-specific CLBP (mean [SD] age: 33 [6] years, female: 50%). Participants were allocated to a digitally-delivered progressive run-walk interval exercise training program (3 days/week, 30 min/session) or waitlist control. Magnetic resonance imaging at baseline, six, and 12 weeks quantified primary outcome IVD composition as whole-disc T2 (ms) from T11/T12 to L5/S1. Moderators included baseline degeneration (Pfirrmann grade; aggregated Pfirrmann score), sex, body mass index, and intervention factors (cumulative running volume, mean speed, and dominant surface). Linear mixed models were fitted at the IVD level to estimate group-by-time effects within each moderator-defined subgroup (α = 0.05). The highest aggregated Pfirrmann scores reflecting greater multi-level degeneration (estimated marginal mean net difference [95%CI]: 3.42 [0.22, 6.62] ms, P = 0.036), cumulative running volumes between 28.6 and 46.1 kms (4.80 [2.51, 7.10] ms, P < 0.001), mean running speeds between 10.5 and 11.7km/h (2.46 [0.14, 4.79] ms, P = 0.038), and running on grass (2.93 [0.10, 5.76] ms, P = 0.043) positively moderated between-group IVD T2 changes. In this pre-planned secondary analysis of a randomised control trial of a run-walk program, our data suggest running speed, volume and surface, as well as more multi-level IVD degeneration, may be associated with more favourable 12-week IVD T2 changes. Findings are hypothesis-generating and may inform future trials designed to optimise IVD health.

Brain network architecture is anticipated to influence future grey matter loss in individuals at Clinical High Risk (CHR) for psychosis. However, existing studies on grey matter structural network properties in CHR are scarce and constrained by small sample sizes. Here, we examined network topology differences comparing a) CHR versus healthy controls (HC); b) CHR who transitioned to psychosis (CHR-T) versus those who did not (CHR-NT); and c) different subsyndromes. We included structural scans from 1842 CHR individuals and 1417 HC individuals from 31 sites within the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) consortium. At the global level, CHR individuals exhibited lower structural covariance (q < 0.001; Cohen's d = 0.164) and less optimal structural network configuration than HC (lower global efficiency and clustering coefficient, d = 0.100,0.087, qs <= 0.027). Though no global difference between CHR-T and CHR-NT, network distinctiveness of the frontal and temporal surface area networks was higher in CHR-T than CHR-NT (d = 0.223,0.237) and HC (d = 0.208,0.219) (qs < 0.001). Network distinctiveness of the frontal cortical thickness network was lower in CHR-T (d = 0.218, q < 0.001) than CHR-NT and HC (d = 0.165, q < 0.001). Importantly, higher network distinctiveness was associated with worse positive symptoms in CHR-NT (frontal surface area, q = 0.008, R2 = 0.013) and at trend with worse negative symptoms in CHR-T (frontal thickness, q = 0.063, R2 = 0.049). Further, the brief intermittent psychotic syndrome subgroup showed more severe network alterations. Together, brain structural networks inform symptoms and the risk of transition to psychosis in CHR individuals.

Youth depression disrupts the social and vocational transition into adulthood. Most depression burden is caused by recurring or chronic episodes. Identifying young people at risk for relapsing, recurring, or chronic depression is critical. We systematically reviewed and meta-analyzed the literature on prognostic factors for relapsing, recurrent, and chronic depression in young people. We searched the literature up (MEDLINE, PsycINFO, CINAHL, Embase, CENTRAL, WHO ICTRP, ClinicalTrials.gov, bioRxiv, MedRxiv) to March 6, 2024, and included cohort studies and randomized trials that assessed any prognostic factor for relapse, recurrence, or chronicity of depression in young people (aged 10-25 years at baseline) with a minimum of a 3-month follow-up. We assessed individual study risk of bias using the QUIPS tool and the certainty of evidence via the GRADE approach. We conducted random-effects meta-analyses with Hartung-Knapp-Sidik-Jonkman adjustment when 3 or more estimates on the same prognostic factor were available. Qualitative synthesis was conducted to identify promising prognostic factors that could not be meta-analyzed. A total of 76 reports of 46 studies (unique cohorts or trials) were included that tested 388 unique prognostic factors in 7,488 young people experiencing depression. The majority of the reports were at high risk of bias (87%). We conducted 22 meta-analyses on unadjusted, and 7 on adjusted, prognostic factors of a poor course trajectory (ie, combined relapse, recurrence, and chronicity). Female sex (adjusted; odds ratio [95% CI] = 1.49 [1.15, 1.93], p = .003), higher severity of depressive symptoms (unadjusted; standardized mean difference [95% CI] = 0.53 [0.33, 0.73], p < .001), lower global functioning (unadjusted; standardized mean difference [95% CI] = -0.35 [-0.60, -0.10], p = .005), more suicidal thoughts and behaviors (unadjusted; standardized mean difference [95% CI] = 0.52 [0.03, 1.01], p = .045), and longer sleep-onset latency (unadjusted; mean difference [95% CI] = 6.96 [1.48, 12.44] minutes, p = .013) at baseline predicted a poor course trajectory of depression. The certainty of the evidence was overall very low to moderate. Promising prognostic factors that could not be meta-analyzed included relational/interpersonal factors (friend relationships and family relationships/structure). Our findings demonstrate the prognostic value of demographic and clinical factors for poor course trajectories of depression in young people. More research is needed to confirm the potential value of relational/interpersonal factors in predicting poor depression course. Limitations of the literature include the high risk of bias of included studies, which indicates that future studies should include large sample sizes and wider diversity of prognostic markers (eg, genetic and neurobiological) in multivariable models. The critical next step is to combine the identified prognostic factors and to evaluate their clinical value in identifying individuals at risk for a poor course trajectory of depression during youth, a life stage in which most of the disability and burden attributable to depression can be averted. This systematic review and meta-analysis summarized the evidence for factors that can be used to identify relapsing, recurrent, and chronic depression in young people. Data from 76 reports of 46 unique cohorts, including a total of 7,488 young people experiencing depression, found that female sex, more severe depressive symptoms, suicidal thoughts and behaviors, lower global functioning, and longer sleep-onset latency were predictive of a poor course trajectory of depression. This information has the potential to identify youth at risk for a poor course of depression, a life stage in which most of the disability and burden attributable to depression can be averted. Prognostic factors for relapsing, recurrent or chronic depression in youth: a systematic review with meta-analysis; https://www.crd.york.ac.uk/PROSPERO/view/CRD42023458646.

Abstract Youth alcohol use is a significant global health concern. Despite the widespread nature of alcohol use-related problems, the longitudinal effects of alcohol on brain structure in youth remain unclear. This review aimed to systematically synthesise the findings from the longitudinal structural magnetic resonance imaging (sMRI) literature on how alcohol use is associated with changes in brain structure in youth. Following PRISMA guidelines, five databases were searched, and studies of youth alcohol use that measured brain structure using sMRI at more than one time-point were included. A label-based meta-analysis (i.e., ratio of number of significant effects for a specific brain region to total number of analyses for that brain region) approach was employed to synthesise the findings. Sixteen studies were included. There was preliminary evidence that youth alcohol use is associated with reduced cortical volume (particularly in temporal regions) and attenuated increases in white matter volume over time. The role of pre-existing structural differences, and other moderating factors remains unclear due to limited research. Future longitudinal studies are needed to clarify the clinical significance of neurodevelopmental changes associated with youth alcohol use. Significance statement This systematic review synthesises evidence from 16 longitudinal neuroimaging studies on youth alcohol use and brain structure. Preliminary findings suggest adolescent drinking may be associated with reduced grey and white matter volume over time, with heavier consumption amplifying these effects. While methodological limitations prevent definitive conclusions, these potential neurodevelopmental disruptions during a critical brain maturation window could influence cognitive and behavioural outcomes. The review highlights the need for rigorous future research to further clarify the impact of alcohol on developmental brain trajectories, which could support targeted prevention approaches for adolescent brain health.

BackgroundAn individual's life history and past trauma may have implications for their experience of dementia and dementia care relationships. However, an understanding of the social context and origins of trauma and how these may be present in dementia care is missing from the literature and could be useful when implementing trauma‐informed dementia care practices. The objective of this study was to explore the phenomenology of trauma documented in the psychosocial histories of individuals diagnosed with dementia, and to discuss how the social aspects of that trauma may impact dementia care.MethodWe screened and sampled 113 individuals with younger onset dementia diagnoses that were admitted to a specialist neuropsychiatric health service between 2017 and 2021 (inclusive), using clinical discharge summaries as a data source. Clinician's descriptions of psychiatric and life history were used to identify individuals with a history of trauma. Text descriptions of trauma were extracted and gathered using a data collection tool. The study used qualitative methods, with the extracted text subject to reflexive thematic analysis. This method was used to construct themes encompassing trauma experienced by individuals within the sample. To compliment the qualitative analysis, demographic and clinical data was collected to characterise the sample.ResultForty‐four individuals had a documented history of trauma. Ten themes were constructed using reflexive thematic analysis of the data set. The themes encompassed the social origins and context of the past trauma experienced by the sampled individuals. The themes related to dynamics that play out at a personal, interpersonal, familial, historical and societal level.ConclusionsThis study provides further understanding of the experiences of trauma in people living with dementia, and how they are embedded within an individual's social life history and world. The findings demonstrate the potential for trauma to influence current and future dementia care relationships and provide context for how these relationships may currently be playing out within healthcare systems that provide dementia care. The findings can directly inform what should be considered when researching, planning and implementing trauma‐informed care for individuals living with dementia.

Impairments in lumbar sensory perception, including reduced tactile acuity, occur in patients with nonspecific low back pain (LBP). Tactile acuity is linked to primary somatosensory cortex (S1) activity and structure, but neural markers of lumbar-specific tactile acuity tests remain unvalidated. This cross-sectional study investigated associations between lumbar two-point discrimination (TPD) and estimation (TPE) with functional and structural properties of S1, as well as S1-thalamic connectivity. Resting-state functional MRI and diffusion-weighted MRI assessed S1-thalamic functional connectivity (FC) and structural connectivity, as well as regional homogeneity (ReHo) and mean diffusivity (MD) of S1 grey matter in 78 LBP patients and 39 pain-free controls. Participants with LBP were subdivided into 2 groups: 1 with pain (LBP+, n = 39) and 1 without pain (LBP-, n = 39) on the day of assessment. Higher TPD (ie, worse tactile acuity) was associated with higher contralateral S1-thalamic FC (β = 19.97 mm, 95% CI = 8.47-31.46 mm) and lower contralateral S1-MD (β = -76.98 mm, 95% CI = -142.83 to -11.13 mm). Higher TPE was associated with higher S1-ReHo (β = 19.67 mm, 95% CI = 0.35-39 mm). Two-point discrimination and two-point estimation were positively correlated (r = 0.25, P < 0.001). No between-group differences were found for the MRI variables or TPE, but the LBP+ group showed higher TPD thresholds than pain-free controls (MDiff. = 6.05 mm, Padj . = 0.023). Our findings question the validity of TPE as a measure of tactile acuity. Both neural markers of TPD may not explain tactile acuity impairments in LBP but instead reflect a baseline indicator of tactile performance capability, suggesting poor validity as an LBP-specific marker of neuroplasticity.

ABSTRACTIntroductionBody image dissatisfaction is a risk and maintenance factor for disordered eating. Parents may contribute to offspring body image dissatisfaction through weight‐related criticism (direct influence), as well as expressed parental body image dissatisfaction and dieting (indirect influence). This study retrospectively investigated the contribution of parental influence towards adult offspring's body image dissatisfaction.MethodsOne hundred and fifty six participants from a general community sample completed a survey recording their experience of direct and indirect parental influence throughout adolescence, in addition to their current body image satisfaction.ResultsWhile controlling for peer and media influences, hierarchical linear regression determined that parental influence was a significant contributor to offspring body image dissatisfaction (p < 0.001), and this effect was driven by direct influence (p < 0.001). Indirect parental influence was non‐significant (p = 0.899).ConclusionsThe observed strength of direct influence supports the need for parents to reinforce positive weight‐related behaviours at home as a method of reducing and managing body image dissatisfaction levels in their offspring.

Behavioral change studies mostly focus on external reinforcements to modify preferences. Cue-approach training (CAT) is a paradigm that influences preferences by the mere association of stimuli, sensory cues, and a rapid motor response, without external reinforcements. The behavioral effect has been shown to last for months after less than 1 h of training. Here, we used a modified version of CAT by changing the neutral-cue to a number that represented a monetary amount of reward that the participants accumulate (i.e., incentive-cue). After a single training session, we compared behavioral performance and functional connectivity (FC), as measured by resting-state scans using functional magnetic resonance imaging, between two groups (total of 107 males and females in both groups), one receiving a neutral-cue and the other receiving an incentive-cue, at five time points across 1 year. We replicated the maintenance of behavioral changes after 6 months for the nonexternally reinforced neutral-cue participants, but not for the reinforced group. The reinforced training group showed higher FC within the limbic system, whereas the nonexternally reinforced group showed higher functional connectivity within and between default mode and dorsal attention networks. Our findings offer putative neural correlates for both reinforced and nonexternally reinforced preference changes that are maintained over time and which could be implemented in future behavioral change interventions.

ABSTRACT An alarming progression of human-centred and environmental concerns has marked the Anthropocene, including climatic changes and the inextricably linked deterioration of human mental health. Expanding on the 2015 Rockefeller Foundation-Lancet Commission on Planetary Health, we propose that mental health be explicitly included within the planetary health approach. This inclusion acknowledges the importance of population mental health as part of planetary health and addresses the symbiotic deterioration of global mental health and environmental health. As part of this approach, we conceptualise several types of interventions, including symbiocentric and transformative mental health interventions, with the latter combining active environmentalism with the aim of simultaneously improving mental health and wellbeing. We further identify several areas of opportunity in which transformative interventions could be translated to practice and implemented across a range of settings, including workplaces, educational contexts, and organised sport. Making a call to action, we highlight the urgency of shifting from individualised to collective environmental responsibility, including collective transformative reflection, with different stakeholders coming together to scale up transformative interventions and working towards true planetary (mental) health. Finally, we give recommendations to promote symbiocentric and transformative interventions in policy and reform.