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Progress in Neuro-Psychopharmacology and Biological Psychiatry

Elsevier BV

Preprints posted in the last 7 days, ranked by how well they match Progress in Neuro-Psychopharmacology and Biological Psychiatry's content profile, based on 36 papers previously published here. The average preprint has a 0.03% match score for this journal, so anything above that is already an above-average fit.

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EEG responses to auditory stimuli are less context-dependent in preschoolers with autism spectrum disorder compared to typical development

Shao, M.; McNair, K. A.; Parra, G.; Tam, C.; Sullivan, N.; Senturk, D.; Gavornik, J. P.; Levin, A. R.

2026-04-25 neurology 10.64898/2026.04.17.26350631 medRxiv
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Individuals with autism spectrum disorder (ASD) often exhibit atypical auditory processing, yet it remains unclear whether and how the integration of simple acoustic features and contextual information is impacted in ASD. One real-world example of this integration is the auditory looming bias, the prioritized processing and perception of approaching auditory stimuli. We designed a paradigm that presents intensity-rising (looming) and intensity-falling (receding) auditory stimuli to 3-4-year-old children with ASD (n = 21), children with sensory processing concerns who do not have ASD (SPC; n = 16) and children with typical development (TD; n = 30). We recorded neural responses using electroencephalography (EEG) and found evidence of looming bias in the SPC and TD groups, as indexed by greater P1 peak amplitude during the looming than receding stimuli (TD: t(64) = 6.87, p < .001; SPC: t(64) = 4.07, p < .001). But this finding was not present in the ASD group (p = .194). Additionally, the ASD group showed reduced differentiation between looming and receding stimuli, as indicated by significantly lower Rise-Fall Difference Score (RFDS) in comparison to the TD group (Z = -3.00, padj = .008). These findings suggested altered context-dependent modulation of sensory input in ASD.

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Distinct Modulatory Effects on Affective Biases by Different Serotonergic Psychedelics and MDMA in Male Rats: Possible Implications for Antidepressant Effects

Hinchcliffe, J.; Bartlett, J.; Thomas, C.; Golden, C.; Bortolotto, Z.; Gilmour, G.; Robinson, E.

2026-04-22 neuroscience 10.64898/2026.04.20.719483 medRxiv
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Affective biases are important neuropsychological mechanisms by which emotions modulate cognition, behaviour and the subjective experience of mood. Previous studies have shown that the rapid-acting antidepressant, ketamine, and serotonergic psychedelic, psilocybin, modulate affective biases in a translational rat model. Both treatments differ from conventional, delayed onset antidepressants in being able to attenuate negatively biased memories and facilitate re-learning with a more positive affective valence. Psilocybin, but not ketamine, also positively biased new experiences, an effect similar to conventional antidepressants. This study used the different affective bias test protocols, in adult male rats, to investigate the effects of acute treatment with the serotonergic psychedelics N,N-DMT, LSD and 5-MeO-DMT, and MDMA. These drugs have different pharmacology in relation to their effects on serotonin receptor subtypes and we hypothesised this may influence their modulation of affective biases. When comparing the ability to attenuate a negatively biased memory, only MDMA had specific effects although for all drugs tested, retrieval of the FG7142-induced negative affective bias was more variable and less robust statistically. LSD attenuated the negative bias at higher doses but had non-specific effects on memory retrieval. At 24hrs post treatment only N,N-DMT had a sustained effect and none of the treatments facilitated re-learning with a more positive affective valence. However, like psilocybin and conventional antidepressants, N,N-DMT positively biased new experiences. These findings suggest there are divergent affective bias modulating effects associated with different psychedelics which may be relevant to their antidepressant effects.

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Regular cannabis use is associated with altered neural and behavioural responses during anticipation and feedback of monetary reward and loss

Lombardi, G.; Blest-Hopley, G.; Tarantini, M. M.; O'Neill, A.; Wilson, R.; O'Daly, O.; Giampietro, V.; Bhattacharyya, S.

2026-04-24 addiction medicine 10.64898/2026.04.23.26351366 medRxiv
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Regular cannabis use has been associated with alterations in reward-related neural processes, yet findings remain inconsistent and the relationship between neural activity and behavioural performance is not fully understood. The present study aimed to characterise neural and behavioural correlates of reward processing in regular cannabis users (CU) compared with matched non-users (NU) using the Monetary Incentive Delay Task (MIDT). Firstly, we assessed behavioural performance through reaction times, accuracy and monetary earnings to determine whether potential neural alterations were reflected in task performance. Secondly, focusing on reward-related brain regions, we examined group differences in BOLD functional MRI activity during anticipation and outcome phases separately for monetary win and loss conditions. Finally, we explored the association between behavioural performance and neural activation. Our findings indicate that regular cannabis use is associated with altered engagement of key nodes within the mesocorticolimbic circuit during both anticipatory and outcome phases of reward processing, accompanied by impaired behavioural performance. Particularly, compared with NU, CU showed (I) lower striatal activity during anticipation of monetary win and higher ventral striatum and frontal pole activity during anticipation of monetary loss; (II) greater VTA activation during outcome of successful monetary win and loss avoidance and lower frontal pole activity during outcome of unsuccessful loss avoidance; (III) impaired behavioural performance, reflected in lower monetary rewards and a trend towards slower reaction times and reduced accuracy; (IV) disrupted brain-behaviour coupling. Results from this study may help inform future research on the neurobiological mechanisms underlying changes in reward function and the resultant behavioural consequences of cannabis use.

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International Adaptation of a brief Problem-Solving Skills (the IAPPS trial) training for people in custody with severe mental illness in Poland: an open multicentred, parallel group, feasibility randomised controlled trial.

Perry, A. E.; Zawadzka, M.; Rychlik, J.; Hewitt, C.

2026-04-25 forensic medicine 10.64898/2026.04.24.26351654 medRxiv
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Objectives: The primary aim of this study was to assess the feasibility of delivering an adapted problem-solving skills (PSS) intervention by quantifying the recruitment, follow-up and completion rates using a brief problem-solving intervention for people with a mental health diagnosis in two Polish prisons. Design: IAPPS is an open, multi-centred, parallel group feasibility randomised controlled trial (RCT). Setting: Two prisons in Poland. Participants: Men in custody aged 18 years and older, having a mental illness and living within the prison therapeutic unit. Interventions: The intervention consisted of an adapted PSS skills intervention plus care as usual (CAU) or care as usual only. Delivered in groups of up to five people in 1.5-hour sessions over the course of two weeks. Main outcome measures: Primary outcomes - rate of recruitment, follow-up, and feasibility to deliver the intervention. Secondary outcomes included measures of depression, general mental health, and coping strategies. Results: 129 male prisoners were screened, 64 were randomly allocated, with a mean age of 53.5 years (SD 14, range 23-84). 59 (95%) prisoners were of Polish origin. Our recruitment rate was 48%. There was differential follow up with those in the intervention group less likely to complete the post-test battery versus those who received care as usual. Outcome measures were successfully collected at both time points. Conclusions We were able to recruit, retain and deliver the intervention within the prison setting; some logistical challenges limited our assessment of intervention engagement. Our data helps to demonstrate how use of the RCT study design can be implemented and delivered within the complex prison environment. Trial registration number ISRCTN 70138247, protocol registration date May 2021

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Striatal dopamine synthesis in schizophrenia decreases from psychosis to psychotic remission

Schulz, J.; Thalhammer, M.; Bonhoeffer, M.; Neumaier, V.; Knolle, F.; Sterner, E. F.; Yan, Q.; Hippen, R.; Leucht, S.; Priller, J.; Weber, W. A.; Mayr, Y.; Yakushev, I.; Sorg, C.; Brandl, F.

2026-04-21 psychiatry and clinical psychology 10.64898/2026.04.20.26351256 medRxiv
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Schizophrenia frequently follows a chronic relapsing-remitting course, comprising alternating episodes with and without psychotic symptoms (hereafter: psychosis and psychotic remission). One potential neurobiological correlate of this course is aberrant dopamine synthesis and storage (DSS) in the striatum, which can be estimated by 18F-DOPA positron emission tomography (PET). We hypothesised that striatal DSS in patients with schizophrenia decreases from psychosis to psychotic remission, with lower striatal DSS in patients during psychotic remission compared to healthy subjects. Additionally, we explored whether striatal DSS is associated with psychotic relapse after remission. 18F-DOPA PET scans and clinical assessments were conducted in 28 patients with schizophrenia at two timepoints, first during psychosis and second during early psychotic remission 6 weeks to 12 months after the first timepoint, as well as in 21 healthy controls, assessed twice in a comparable time interval. The averaged influx constant kicer as proxy for DSS was calculated for striatal subregions (i.e., nucleus accumbens, caudate, and putamen) using voxel-wise Patlak modelling with a cerebellar reference region. Mixed-effects models and post hoc analyses were used to test for longitudinal changes in kicer and cross-sectional group differences. An exploratory clinical follow-up 12 months after the second scan was conducted to assess psychotic relapse, and post hoc ANCOVAs were used to test for differences in kicer at each session between relapsing and non-relapsing patients. Kicer in both caudate and nucleus accumbens significantly changed from psychosis to psychotic remission compared to healthy controls, with a significant longitudinal decrease of caudate kicer in patients. Furthermore, kicer in both caudate and accumbens was significantly lower in patients during early psychotic remission compared to controls. At the exploratory clinical follow-up, 32% of patients had experienced a psychotic relapse; they showed higher caudate kicer compared to non-relapsing patients during psychosis, with no difference during psychotic remission. These findings provide evidence for the link between striatal, particularly caudate, DSS and the relapsing-remitting course of psychotic symptoms in schizophrenia, with lower caudate DSS during early psychotic remission. Data suggest altered striatal dopamine synthesis together with impaired DSS dynamics along the course of psychotic symptoms in schizophrenia.

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Virtual reality exposes fine-scale alterations in behaviour following loss of the ADHD-linked gene adgrl3.1 in zebrafish

Reynolds, P.; Read, E.; Daly-East, C.; Parker, M. O.; Hindges, R.

2026-04-21 neuroscience 10.64898/2026.04.20.719162 medRxiv
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Zebrafish have been used a prominent model for high-throughput phenotypic screens of candidate risk gene mutations for several disorders. This also includes models for attention deficit/hyperactivity disorder (ADHD). Traditional behavioural tests, such as the forced light/dark assay, concentrate on basic locomotion measures. However, recently developed visually-driven locomotion assays, for example closed-loop systems using virtual reality, have allowed extraction of richer data on animal locomotion and decision-making under different sensory stimuli. Here, we have used such a system to assess the behaviour in adgrl3.1 mutant fish, an established model for ADHD. Our results show that mutants exhibit a higher baseline excitability and a lower threshold for initiating motor events, demonstrating that collecting behavioural responses in an interactive environment enables a more precise characterisation of ADHD-relevant phenotypes associated with adgrl3.1 disruption. More generally, we establish a scalable translational platform to screen gene-function relationships and possible therapeutic interventions, not only for ADHD but multiple neurodevelopmental disorders.

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Exploring the Relationship Between Non-Suicidal Self-Injury and Problematic Sexual Behaviour

Jiang, S.; Foo, J. C.; Roper, L.; Yang, E.; Green, B.; Arnau, R.; Behavioral Addictions Studies and Insights Consortium, ; Lodhi, R. J.; Isenberg, R.; Wishart, D. S.; Fujiwara, E.; Carnes, P. J.; Aitchison, K. J.

2026-04-25 addiction medicine 10.64898/2026.04.17.26351044 medRxiv
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Objectives: Non-suicidal self-injury (NSSI) and self-harming sexual behaviours share functional and behavioural overlaps. However, the relationship between NSSI and problematic sexual behaviour (PSB) remains underexplored. This study aimed to investigate the association between NSSI and PSB in two cohorts - a non-clinical university cohort and a clinical PSB patient cohort. Methods: Data were collected from 2,189 university participants and 477 clinical PSB patients. NSSI was assessed via self-report, and PSB was measured with the Sexual Addiction Screening Test-Revised (SAST-R) Core. The four core addictive dimensions of PSB: relationship disturbance, loss of control, preoccupation, and affect disturbance, were also evaluated. Logistic regression analyses were conducted to examine the association between PSB (presence/absence and severity) and NSSI, looking at effects of gender and contributions of addictive dimensions of PSB. Results: Rates of NSSI were similar in the university (7.1%) and patient (5.7%) cohorts; stratified by gender, a higher proportion of women PSB patients had NSSI compared to in the university cohort (29.3% vs 9.3%). In the university group, who had milder PSB than patients, PSB was associated with NSSI (OR=2.11, p<0.001); a significant gender by PSB interaction was found showing that women with PSB were over four times more likely to have NSSI than men without PSB (OR=4.44, p=0.037). In contrast, PSB severity was not associated with NSSI in PSB patients (OR=1.10, p=0.25). Associations of the addictive dimensions of PSB with NSSI were observed only in the subgroup of university women, in the 'preoccupation' dimension (p<0.001). Conclusions: Our findings highlight gender-specific patterns in the association between PSB and NSSI, suggesting the need for further research and possibly targeted prevention and intervention strategies in women.

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Linguistic Validation of the Rett Syndrome Behavior Questionnaire Spanish Translation: a Two-Stage Caregiver Study Across Latin America

Polo Sanchez, M.; Lesmes, A. C.; Muni, N.; Vigneault, F.; Novak, R.

2026-04-23 neurology 10.64898/2026.04.16.26349544 medRxiv
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Background: Rett Syndrome (RTT) is a severe neurodevelopmental disorder affecting approximately 1 in 10,000 live female births worldwide. The Rett Syndrome Behaviour Questionnaire (RSBQ), remains one of the most widely used standardized behavioral assessment tools for RTT. However, the RSBQ was originally validated only in British English, limiting its applicability for Spanish-speaking caregivers and clinical centers across Latin America and Spain. Objective: The primary aim of this study was to develop and validate the comprehension of the Spanish translation of the RSBQ to ensure cultural and linguistic equivalence, enhance data reliability, and facilitate earlier, more accurate clinical assessments among Spanish-speaking RTT populations. Methods: Surveys were administered in two phases to Spanish-speaking caregivers between November 2023 and September 2025. Phase I consisted of 12 guided survey administrations with participants being able to ask clarifying questions and offer linguistic modifications of RSBQ questions. Phase II consisted of independent online administration of the refined Spanish RSBQ and a retest at least 7 days later. Participants were recruited through direct outreach and supported virtually during questionnaire completion. Results: Following data cleaning and quality control, a total of 51 caregivers successfully completed both surveys. The Spanish RSBQ demonstrated high caregiver comprehension and strong engagement across multiple Latin American countries, including Argentina, Mexico, and Peru. Responses were highly correlated between test and retest timepoints, and no question showed biased response distributions. A slight effect of response interval on test-retest correlation was observed, potentially indicating the impact of natural disease progression confounding retest evaluation for long (>80 day) intervals; however this effect did not impact the overall linguistic validation results as analysis of only <21 day test-retest responders confirmed the findings. Conclusions: This linguistic validation study represents the first formal step toward the clinical validation of the Spanish RSBQ, enabling broader inclusion of Spanish-speaking populations in RTT research. The collaborative, bilingual data collection strategy proved both feasible and effective, paving the way for multinational trials and expanding therapeutic accessibility through localized, patient-centered innovation.

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Family-supervised disulfiram as a culturally grounded model for alcohol use disorder treatment in Sri Lanka: a pilot randomized controlled trial

Rajasuriya, M.; Chulasiri, P.; Ratnayake, P.; Plevin, D.

2026-04-27 addiction medicine 10.64898/2026.04.25.26350029 medRxiv
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Objectives: To evaluate the effectiveness and cultural feasibility of family-supervised disulfiram as a first-line treatment for alcohol use disorder (AUD) in Sri Lanka, and to compare its clinical outcomes with standard therapy delivered at a tertiary psychiatric unit. Design: Single-blind Randomized Controlled Trial known as ETAT-RCT (Efficacy of Two Alcohol Treatments) was conducted under routine clinical setup with three parallel groups: family-supervised disulfiram, locally developed psychosocial intervention, and routine treatment. Allocation was independently concealed; assessors were blinded. Analyses followed an intention-to-treat approach using repeated-measures ANOVA (group x time). This paper reports the disulfiram (test) versus routine treatment (control) comparison; the psychosocial intervention will be reported separately. Setting: University Psychiatry Unit, National Hospital of Sri Lanka, Colombo (UPU, NHSLC). Participants: Patients aged [&ge;]14 years with AUD presenting to the unit were recruited consecutively without inducements. Planned allocation ratio was 1:1:1 with 31 participants per arm; key exclusions were lifetime psychotic disorder and current contraindication to disulfiram. Randomisation: Participants were randomised into each treatment arm using an independent concealed paper-based allocation system. Intervention: (1) family-supervised disulfiram, with psychoeducation/support only - DT arm, (2) a locally developed denormalization focused psychosocial programme - PT arm, and (3) standard therapy (motivational/cognitive/behavioural input; naltrexone permitted; no disulfiram/denormalisation) - ST arm. Outcome measures: Primary outcome was Alcohol Use Disorders Identification Test (AUDIT) score at 12 months. Key secondary outcomes were past 30 day alcohol use via Timeline Follow-Back (TLFB); alcohol biomarkers [ALT (alanine aminotransferase), {gamma}-GT (gamma-glutamyl transferase), MCV (mean corpuscular volume)]; locally developed measures of addiction-relevant cognitive, affective, behavioural factors [AARSU (Attitude Assessment Related to Substance Use), BARSU (Behaviour Assessment Related to Substance Use)]; and Quality of Life Enjoyment and Satisfaction Questionnaire Short Form (Q-LES-Q-SF). Outcomes were assessed at baseline, 6, and 12 months. Results: Participants in DT (n=33) and ST (n=38) were comparable at baseline. Both groups showed clinically and statistically significant improvement in AUDIT scores over 12 months (DT: F=39.90, p<0.001; ST: F=49.90, p<0.001), with no group x time interaction (F<0.001, p=0.98). Biomarkers and AARSU, and BARSU and Q-LES-Q-SF to a lesser degree, mirrored the AUDIT pattern. TLFB did not change significantly over time in either arm (p>0.05). In moderator analyses, improvement in AUDIT was not moderated by baseline motivation (F=0.20, p=0.89) but was moderated by baseline AUD severity (F=7.70, p=0.007). No serious adverse events were attributed to disulfiram. Adherence to supervised dosing was generally high during periods of supervision but intermittent overall. Conclusions: In this pilot RCT, family-supervised disulfiram achieved 12-month outcomes comparable to standard therapy in a tertiary Sri Lankan setting. Improvements were independent of baseline motivation and varied by baseline AUD severity. These findings may support family-supervised disulfiram as a culturally feasible first-line option in Sri Lanka; larger, adequately powered multicentre trials are warranted to confirm effectiveness and scalability. Trial registration: SLCTR/2014/021

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Anterior Cingulate Cortex Sulcal Patterns associated with Catatonia across Schizophrenia and Mood Disorders

Moyal, M.; Consoloni, T.; Haroche, A.; Sebille, S. B.; Belhabib, D.; Ramon, F.; Henensal, A.; Dadi, G.; Attali, D.; Le Berre, A.; Debacker, C.; Krebs, M.-O.; Oppenheim, C.; Chaumette, B.; Iftimovici, A.; Cachia, A.; Plaze, M.

2026-04-22 psychiatry and clinical psychology 10.64898/2026.04.20.26351285 medRxiv
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Catatonia is a severe psychomotor syndrome that occurs across psychiatric diagnoses and is increasingly conceptualized as reflecting neurodevelopmental vulnerability. The anterior cingulate cortex (ACC) plays a central role in motor initiation and cognitive-affective integration and displays substantial interindividual variability in its sulcal morphology, which is established prenatally and remains stable across life. In this MRI study, we examined whether ACC sulcal patterns represent a structural trait marker of catatonia. We analyzed high-resolution T1-weighted images from a hospital-based cohort comprising patients with catatonia (N = 109), psychiatric patients without catatonia (N = 323), and healthy controls (N = 91). The presence of the paracingulate sulcus (PCS) in each hemisphere was determined through blinded visual inspection, and regression analyses tested associations with diagnostic group, adjusting for age, sex, scanner type, intracranial volume, and benzodiazepine and antipsychotic exposure. Patients with catatonia exhibited a significantly reduced prevalence of the left PCS and diminished hemispheric asymmetry compared with both non-catatonic patients and healthy controls. These effects were independent of whether catatonia occurred within psychotic or mood disorders. PCS size did not differ across groups, and sulcal pattern did not correlate with catatonia severity among affected individuals. The findings demonstrate that ACC sulcal deviations are specifically associated with catatonia across diagnostic categories, supporting a neurodevelopmental etiology and reinforcing ACC involvement in its pathophysiology. Early-determined sulcal morphology may represent a trait-level marker contributing to vulnerability for catatonia, with implications for early identification, risk stratification, and targeted intervention strategies.

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Common Substrates of Early Illness Severity: Clinical, Genetic, and Brain Evidence

Ye, R. R.; Vetter, C.; Chopra, S.; Wood, S.; Ratheesh, A.; Cross, S.; Meijer, J.; Tahanabalasingam, A.; Lalousis, P.; Penzel, N.; Antonucci, L. A.; Haas, S. S.; Buciuman, M.-O.; Sanfelici, R.; Neuner, L.-M.; Urquijo-Castro, M. F.; Popovic, D.; Lichtenstein, T.; Rosen, M.; Chisholm, K.; Korda, A.; Romer, G.; Maj, C.; Theodoridou, A.; Ricecher-Rossler, A.; Pantelis, C.; Hietala, J.; Lencer, R.; Bertolino, A.; Borgwardt, S.; Noethen, M.; Brambilla, P.; Ruhrmann, S.; Meisenzahl, E.; Salonkangas, R. K. R.; Kambeitz, J.; Kambeitz-Ilankovic, L.; Falkai, P.; Upthegrove, R.; Schultze-Lutter, F.; Koutso

2026-04-22 psychiatry and clinical psychology 10.64898/2026.04.21.26350991 medRxiv
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BackgroundThe severity of positive psychotic symptoms largely defines emerging psychosis syndromes. However, depressive and negative symptoms are strongly psychologically and biologically interlinked. A transdiagnostic exploration of symptom severity across early illness syndromes could enhance the understanding of shared common factors and future trajectories of mental illness. We aimed to identify subgroups based on the severity of positive, negative, and depressive symptoms and assess relationships with: 1) premorbid functioning, 2) longitudinal illness course, 3) genetic risk, and 4) brain volume differences. MethodsWe analysed 749 participants from a multisite, naturalistic, longitudinal (18 months) cohort study of: clinical high risk for psychosis (n=147), recent onset psychosis (n=161), and healthy controls (n=286), and recent onset depression (n=155). Participants were stratified into subgroups based on severity of baseline positive, negative, and depression symptoms. Baseline and longitudinal differences between groups for clinical, functioning, and polygenic risk scores (schizophrenia, depression, cross-disorder) were assessed with ANOVAs and linear mixed models. Voxel-based morphometry was used to examine whole-brain grey matter volume differences. Discovery findings were replicated in a held-out sample (n=610). ResultsParticipants were stratified into no (n=241), mild (n=50), moderate (n=182), and severe symptom (n=254) subgroups. The mean (SD) age was 25.3 (6.0) and 344 (47.3%) were male. Symptom severity was associated with poorer premorbid functioning and illness trajectory, greater genetic risk, and lower brain volume. Findings were not confounded by the original study groups or symptoms and were largely replicated. Conclusions and relevanceTransdiagnostic symptom severity is linked to shared aetiologies, prognoses, and biological markers across diagnoses and illness stages. Such commonalities could guide therapeutic selection and future research aiming to detect unique contributions to specific psychopathologies.

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Lateral hypothalamic melanin-concentrating hormone neuron dynamics in rats during sensory stimulation and sugar sweetened alcoholic cocktail drinking

Kuebler, I. R. K.; Vollan, J. D.; Chin, J. Y.; Suarez, M.; Bass, C. E.; Hubbard, N. A.; Wakabayashi, K. T.

2026-04-21 neuroscience 10.64898/2026.04.17.719280 medRxiv
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There is a dearth of information on how different cocktails sweetened with different sugars impact brain activity. Glucose enters the brain faster and in greater concentration than fructose and directly affects neuronal activity of melanin-concentrating hormone (MCH) neurons. MCH signaling promotes both glucose drinking and alcohol intake by integrating central and sensory inputs, but it is currently unknown how MCH neuronal activity relates to sweetened cocktail drinking. This study sought to investigate the relationship between MCH activity and sugar-sweetened alcoholic cocktail drinking. We also sought to compare MCH neuronal responses to the sugar solutions without alcohol as well as their response to sensory stimuli. In female and male rats, we used fiber photometry to monitor MCH neurons in response to sensory stimuli and during drinking of 10% glucose, 10% fructose, and glucose or fructose cocktails with 1.25% or 10% alcohol. We found that MCH activity rises in response to a variety of sensory stimuli and peaks before the start of drinking for all cocktails, before returning to baseline near the start of drinking. The cocktail type impacted the dynamics of MCH activity, where increased alcohol concentration resulted in earlier MCH activity for fructose but not glucose cocktails. Finally, we found that peak MCH activity during drinking is correlated with approach behavior for all sugar and cocktail types. These findings suggest that glucose and alcohol may interact to directly influence MCH activity. Further, MCH neurons may regulate cocktail drinking in response to sugar type and alcohol concentration. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=118 SRC="FIGDIR/small/719280v1_ufig1.gif" ALT="Figure 1"> View larger version (17K): org.highwire.dtl.DTLVardef@b992c3org.highwire.dtl.DTLVardef@1526895org.highwire.dtl.DTLVardef@1504c6dorg.highwire.dtl.DTLVardef@c990fc_HPS_FORMAT_FIGEXP M_FIG C_FIG New and noteworthyFiber photometry was used to monitor lateral hypothalamic melanin-concentrating hormone (MCH) neurons in male and female rats during sensory stimuli and drinking of glucose, fructose, or glucose- or fructose-sweetened alcoholic cocktails. Subsecond-scale changes in MCH activity occurred after stimuli. Peak MCH activity during drinking was correlated with approach behavior. Alcohol concentration only impacted MCH activity with fructose cocktails. We discuss the implications of MCH dynamics towards brain function, associative learning, and alcohol use disorder.

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Subtypes of Internalizing and Externalizing Problems in Autistic Preschool Children: Participation in Daily Life and Family Outcomes

Nakamura, T.; Koshio, I.; Nagayama, H.

2026-04-21 psychiatry and clinical psychology 10.64898/2026.04.14.26350723 medRxiv
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AimAutistic children have a high but varied prevalence of internalizing and externalizing problems. This study aimed to identify the subtypes of internalizing and externalizing problems among autistic preschool children in Japan, examine their temporal stability, and investigate differences in participation in daily life and family outcomes across these subtypes. MethodsA prospective cohort study was conducted with 275 caregivers of autistic children aged 51-75 months. Internalizing and externalizing problems were assessed using the Strengths and Difficulties Questionnaire. ResultsLatent transition analysis identified five subtypes: Low-symptom, High-emotional, Externalizing, Comorbid, and Peer-difficulty groups. Membership in the High-emotional and Externalizing groups was relatively stable over time, whereas the Peer-difficulty group showed frequent transitions to subtypes with higher levels of internalizing or externalizing problems. Significant differences in participation in daily life and family outcomes were observed across subtypes, but these patterns were inconsistent with a simple gradient of symptom levels. ConclusionsThe novel findings that the temporal stability of subtype membership varied and that differences in participation in daily life and family outcomes were observed across the subtypes suggest that the heterogeneity of internalizing and externalizing problems may be associated with variations in childrens participation in daily life and family outcomes over time. Plain Language SummaryAutistic preschool children often experience emotional and behavioral difficulties, but the way these difficulties manifest varies widely across individuals. This study aimed to identify the patterns of these difficulties, examine how they change over time, and investigate how participation in daily life and family outcomes differ across autistic preschool children. We conducted a study with 275 caregivers of autistic children aged 4-6 years in Japan. From caregiver reports of childrens emotional and behavioral difficulties, five distinct patterns were identified: a group with mainly emotional difficulties, a group with mainly behavioral difficulties, a group with both types of difficulties, a group with relatively low levels of difficulties, and a group characterized primarily by peer-related difficulties. Our findings suggest that different patterns of emotional and behavioral difficulties are associated with differences in childrens participation in daily life and family outcomes. These differences could not be explained simply by the overall severity of difficulties but rather reflect distinct patterns based on the type of difficulty. The results indicate that autistic children face diverse difficulties that change over time.

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Physics-Guided Deep Neural Networks: Correcting Physical Distortions in Protein Phase Separation Prediction

Wang, M.; Lu, T.; Song, Y.-h.; Li, y.

2026-04-21 cell biology 10.64898/2026.04.18.719364 medRxiv
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BackgroundIn computational biology, embedding known physical laws into deep learning models to construct "Physics-Informed Neural Networks" (PINNs) is a mainstream paradigm for enhancing model interpretability and extrapolation capability. However, in complex multi-physics coupling problems, there is a risk of competitive imbalance between the physical term and the flexible artificial intelligence (AI) residual term, causing the model to degenerate into a "black-box" fit and lose the original purpose of being physics-driven. MethodsIn this study, targeting the problem of predicting protein liquid-liquid phase separation (LLPS) behavior in response to environmental factors (temperature, salt concentration), we identified physical distortions, gradient vanishing, and numerical instability in the initial physics-AI hybrid model. Three core correction strategies were proposed: (1) Weight Allocation Logic Reconstruction: Force the physical trunk weight to 1.0 at the output layer, suppressing the AI residual term to the perturbation level of 0.05~0.1, ensuring physics dominance; (2) Robust Physics Formula Construction: Abandon the unstable power function and introduce a combination of Softplus and logarithmic functions to stably simulate the nonlinear effects of charge shielding; (3) Gain Compensation Alignment: Apply gain compensation to the weak signal branch (temperature) to ensure its effective participation in optimization. ResultsThe optimized model maintained a fitting accuracy of R2{approx}0.62 on the test set, while physical consistency was significantly enhanced. The model successfully restored the monotonic increase in solubility with temperature characteristic of UCST-type phase diagrams and correctly captured the nonlinear charge shielding features in the salt concentration response. The weights of key physical parameters (e.g., hydrophobic contribution w_h, net charge contribution w_ncpr) increased from <10-3 to the 10-2 magnitude, demonstrating the reactivation of the physical branch. ConclusionsThe weight control, formula stabilization, and signal gain alignment strategies proposed in this study effectively address the classic problem of "AI hijacking" physics in physics-AI hybrid models. This work provides a universal solution for constructing biophysical predictive models that combine high fitting accuracy with strong physical interpretability.

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Effects of transcranial direct current stimulation (tDCS) combined with cognitive therapy in individuals with cognitive impairment: a systematic review and meta-analysis.

Soto-Ferndandez, P.; Toledo-Rodriguez, L.; Figueroa-Vargas, A.; Figueroa-Taiba, P.; Billeke, P.

2026-04-27 neurology 10.64898/2026.04.26.26351755 medRxiv
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Background: Cognitive impairment poses a significant challenge to healthcare systems worldwide, impacting patient autonomy, social participation, and quality of life, while placing a considerable burden on caregivers. Non pharmacological interventions, particularly cognitive training and non invasive brain stimulation, have emerged as promising therapeutic strategies. Objective: This study aims to quantify the synergistic effects of transcranial direct current stimulation (tDCS) with cognitive training on cognitive function across a spectrum of pathologies that induce cognitive impairment. Methods: We conducted a systematic review and metaanalysis following PRISMA guidelines. We searched PubMed for randomized controlled trials that investigated the effect of combined tDCS and cognitive training compared with cognitive training alone. The analysis was based on the GRADE framework for systematic reviews and metaanalyses. Results: Across 27 studies including 1,012 participants, tDCS combined with cognitive training showed a small effect compared with cognitive training alone (SMD = 0.36, 95% CI: 0.15 0.56). The effect was found only immediately after the intervention and declined during follow-up. Conclusion: tDCS combined with cognitive training may provide a small, short term benefit for cognitive function, but high heterogeneity across studies and loss of effect at follow up underscore the need for larger, better standardized trials to clarify its clinical value.

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Estimating direct and indirect genetic effects on variation in depressive symptoms in early adolescence: a trio PGS analysis in the MoBa cohort

Bazezew, M. M.; Glaser, B.; Hegemann, L. E.; Askelund, A. D.; Pingault, J.-B.; Wootton, R. E.; Davies, N. M.; Ask, H.; Havdahl, A.; Hannigan, L.

2026-04-25 psychiatry and clinical psychology 10.64898/2026.04.17.26350751 medRxiv
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Background: Early adolescence is a common period of onset for depressive symptoms. In part, this may reflect a developmental manifestation of individual's genetic propensities as they undergo physiological and hormonal changes and interact with new environments. Many commonly proposed mechanisms assume direct effects of an individual's own genes on emerging variation in their depressive symptomatology. However, estimates of genetic influence based on analyses in unrelated individuals capture not only direct genetic effects but also genetic effects from parents and other biologically related family members. Aim: In data from the Norwegian Mother, Father and Child Cohort (MoBa), we used linear mixed models to distinguish developmentally-stable and adolescence-specific direct and parental indirect genetic effects. We examined effects of polygenic scores for major depressive disorder (MDD), ADHD, anxiety disorders, and educational attainment (EA) on depressive symptoms, which were assessed by maternal reports at ages 8 and 14. Results: Children's own MDD polygenic scores showed adolescence-specific effects on depressive symptoms ( b_PGS*wave=0.041, [95% CI: 0.017, 0.065]). Developmentally-stable direct effects from children's polygenic scores for MDD (b=0.016, [0.006, 0.039]), ADHD (b=0.024, [0.008, 0.041]) and EA (b=-0.02, [ -0.038, -0.002]) were also evident. The only evidence of indirect genetic effects was a stable effect of maternal EA polygenic scores (b=0.04, [0.024, 0.054]). Conclusion: Direct genetic effects linked to genetic liability to MDD accounted for emerging variation in depressive symptoms in adolescence. These results imply that specific etiological mechanisms related to MDD may become particularly relevant for depressive symptoms during early adolescence compared to at earlier ages.

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Loss of autism-associated gene wac alters social behavior and identifies cho-1 as a modulator of cholinergic signaling in C. elegans

Kim, D.-W.; Boonpraman, N.; Kuhn, N. C.; Sammi, S. R.

2026-04-21 neuroscience 10.64898/2026.04.17.719318 medRxiv
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WAC is an autism-associated gene involved in neurodevelopment. However, the effects of reduced WAC function on behavior and synaptic regulation in vivo remain unclear. Taking cues from the previous studies on the wac gene and the C. elegans model of ASD, we elucidated the effects of wac gene deletion on food-leaving behavior, a known parameter linked to ASD associated genes along with the cholinergic pathway. wac-deficient worms exhibited curtailed food-leaving behavior. Notably, observed phenotype was similar to that exhibited by nematodes with mutation in ASD related gene, neuroligin. In addition, wac-deficient worms showed impaired growth, reduced pharyngeal pumping, and lifespan. To examine potential synaptic mechanisms, we analyzed expression of genes related to cholinergic signaling across all developmental stages (L1-L4) through young adult (YA). Stage-specific transcriptional changes were observed, with increased expression of ace-1 and acr-3 at L1, acr-3 at L3, and acr-3, cha-1, lev-1, and lev-10 at L4. The transcriptomic alteration was most prominent at YA stage, exhibiting upregulation of ace-1, cha-1, cho-1, lev-1, lev-10, unc-17, unc-29, unc-38, and unc-50. To identify specific suppressor of upmodulated Ach signaling, RNAi of the upregulated genes was performed. cho-1 was identified as a specific suppressor of elevated Ach signaling. cho-1 encodes a high-affinity choline transporter responsible for choline uptake in the pre-synapse. These studies identify the molecular mechanisms pertaining to up-modulation of cholinergic signaling in wac mutant worms. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=112 SRC="FIGDIR/small/719318v1_ufig1.gif" ALT="Figure 1"> View larger version (24K): org.highwire.dtl.DTLVardef@1bdf8a9org.highwire.dtl.DTLVardef@1104825org.highwire.dtl.DTLVardef@1f09682org.highwire.dtl.DTLVardef@293b08_HPS_FORMAT_FIGEXP M_FIG C_FIG

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Causal Dissociation of Frontoparietal Control Mechanisms in Automatic Alcohol Approach Tendencies Using Continuous Theta Burst Stimulation

Verma, A. K.; Kumar, A. D.; Chivukula, U.; Kumar, N.

2026-04-22 neuroscience 10.64898/2026.04.19.719365 medRxiv
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BackgroundPersistent automatic approach tendencies toward alcohol cues that resist goal-directed control are a key feature of harmful alcohol use, yet the causal neural mechanisms underlying this imbalance remain poorly understood. Converging evidence implicates the frontoparietal network (FPN) in actively regulating alcohol approach-avoidance behavior, but whether its constituent nodes make dissociable causal contributions has not been established. MethodsIn a within-subject, active-sham counterbalanced design, inhibitory continuous theta burst stimulation (cTBS) was applied to right dorsolateral prefrontal cortex (rDLPFC) and right posterior parietal cortex (rPPC) in separate groups of non-clinical alcohol users (rDLPFC: n = 29; rPPC: n = 28), followed by an Alcohol Approach-Avoidance Task. ResultsActive rDLPFC cTBS selectively slowed down alcohol push responses, whereas rPPC suppression produced a bidirectional action-specific shift in response to alcohol cues, where pull responses accelerated, and push slowed simultaneously. Suppression of either node shifted automatic tendencies toward greater alcohol approach through mechanistically distinct routes. ConclusionThese dissociable profiles indicate that rDLPFC is causally necessary for effortful top-down avoidance control, while rPPC supports the priority-based selection of alcohol cue-driven actions. These findings provide the first node-specific causal evidence for functional specialization within the FPN in the context of automatic tendencies towards alcohol. Alcohol avoidance emerges as an active, prefrontal-dependent process, whereas priority-based regulation emerges as a parietal-dependent process, together indicating rDLPFC and rPPC as mechanistically independent targets for intervention in maladaptive alcohol approach behavior.

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Rare protein-disrupting variants in NPY5R, DLGAP1 and MAPK8IP3 segregate with OCD in two multiplex pedigrees potentially implicating energy homeostasis and post-synaptic signalling in molecular etiology.

Ormond, C.; Cap, M.; Chang, Y.-C.; Ryan, N.; Chavira, D.; Williams, K.; Grant, J. E.; Mathews, C.; Heron, E. A.; Corvin, A.

2026-04-22 psychiatry and clinical psychology 10.64898/2026.04.21.26350600 medRxiv
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Obsessive compulsive disorder (OCD) is significantly heritable, but only a fraction of the contributory genetic variation has been identified, and the molecular etiology involved remains obscure. Identifying rare contributory variants of large effect would be an important milestone in helping to elucidate the mechanisms involved. Analysis of densely affected pedigrees is a potentially useful strategy to bypass the sample size challenges of standard case-control approaches. Here we performed whole genome sequencing (WGS) of 25 individuals across two multiplex OCD pedigrees. We prioritised rare variants using a Bayesian inference approach which incorporates variant pathogenicity and co-segregation with OCD. In the first pedigree, we identified a highly deleterious missense variant in NPY5R, carried by the majority of affected individuals. This gene is brain-expressed and has previously been implicated in panic disorder and internet addiction GWAS studies. In the second pedigree, we identified a large deletion of DLGAP1 and a missense variant in MAPK8IP3, that perfectly co-segregated in a specific branch of the family: both genes have previously been implicated in OCD and autism. Both genes contribute to a protein interaction network including ERBB4 and RAPGEF1 which we had previously identified in a large Tourette Syndrome pedigree. Our analysis suggests that both energy homeostasis and downstream signalling from the post-synaptic density may both be important avenues for future research.

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Embryonic depletion of D-aspartate perturbs NMDA receptor-dependent long-term potentiation in the hippocampus of juvenile mice

Mango, D.; Errico, F.; Motta, Z.; Dashtiani, S.; Di Maio, A.; Nistico, R.; De Stefano, M. E.; Pollegioni, L.; Usiello, A.

2026-04-23 neuroscience 10.64898/2026.04.22.720120 medRxiv
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D-Aspartate (D-Asp) is an endogenous D-amino acid that exhibits a pronounced developmental peak in the mammalian brain, suggesting a potential regulatory role in glutamatergic signaling and neurodevelopment. Disruption of D-Asp homeostasis has been associated with neuropsychiatric disorders characterized by early-life circuit vulnerability, including schizophrenia and autism spectrum disorders. However, its functional impact to hippocampal physiology remains incompletely defined. Here, we investigated how constitutive D-Asp depletion affects synaptic function in the hippocampal CA1 region of Ddo-knock-in (Ddo-KI) mice, in which zygotic overexpression of the D-Asp-degrading enzyme, D-aspartate oxidase (DASPO), results in embryonic and persistent D-Asp deficiency. Electrophysiological recordings were performed in acute hippocampal slices from male and female mice at postnatal day 30 (P30) and day 60 (P60). Basal synaptic transmission, assessed through paired-pulse ratio and spontaneous excitatory/inhibitory events, was unaltered between genotypes, indicating preserved presynaptic release probability and overall excitation/inhibition balance. In contrast, NMDA receptor (NMDAR)-dependent synaptic plasticity was selectively altered, as theta-burst stimulation induced significantly greater long-term potentiation (LTP) in juvenile P30 Ddo-KI mice, whereas this difference was no longer observed at P60. Consistently, patch-clamp recordings revealed a reduced AMPAR/NMDAR ratio in P30 Ddo-KI males, suggesting an increased relative contribution of NMDAR-mediated currents. Importantly, acute bath application of exogenous D-Asp restored LTP to wild-type levels, demonstrating rapid reversibility and supporting a model of homeostatic receptor rebalancing rather than irreversible circuit alterations. Biochemical assays confirmed significantly increased DASPO activity and reduced D-Asp levels in Ddo-KI mice. However, these parameters remained stable between P30 and P60, indicating that the age-dependent plasticity phenotype is unlikely to arise from progressive biochemical changes. Together, these findings indicate that developmental D-Asp deficiency induces a transient, juvenile-specific alteration characterized by enhanced NMDAR-dependent synaptic plasticity, which can be rapidly normalized upon D-Asp re-exposure.