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Article: A review of critical brain oscillations in depression and the efficacy of transcranial magnetic stimulation treatment.

Tsai, Yi-Chun / Li, Cheng-Ta / Juan, Chi-Hung

2023 Volume 14, Page(s) 1073984

Abstract: Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do ... ...

Abstract	Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta burst stimulation (iTBS) have been proven effective non-invasive treatments for patients with drug-resistant major depressive disorder (MDD). However, some depressed patients do not respond to these treatments. Therefore, the investigation of reliable and valid brain oscillations as potential indices for facilitating the precision of diagnosis and treatment protocols has become a critical issue. The current review focuses on brain oscillations that, mostly based on EEG power analysis and connectivity, distinguish between MDD and controls, responders and non-responders, and potential depression severity indices, prognostic indicators, and potential biomarkers for rTMS or iTBS treatment. The possible roles of each biomarker and the potential reasons for heterogeneous results are discussed, and the directions of future studies are proposed.
Language	English
Publishing date	2023-05-16
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2023.1073984
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Article: Bevacizumab-Induced Thrombotic Microangiopathy (TMA) in Metastatic Lung Adenocarcinoma Patients Receiving Nivolumab Combined with Bevacizumab, Carboplatin and Paclitaxel: Two Case Reports.

Hsu, Ping-Chih / Chen, Tai-Di / Tsai, Tsung-Yu / Yang, Cheng-Ta

Clinics and practice

2023 Volume 13, Issue 1, Page(s) 200–205

Abstract: Anti-programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs), combined with bevacizumab and platinum-based chemotherapy, have shown promising efficacy in treating metastatic non-squamous cell lung cancer in phase 3 ...

Abstract	Anti-programmed death-1 (PD-1)/programmed death ligand 1 (PD-L1) immune checkpoint inhibitors (ICIs), combined with bevacizumab and platinum-based chemotherapy, have shown promising efficacy in treating metastatic non-squamous cell lung cancer in phase 3 clinical trials. However, drug-induced nephrotoxicity is an uncommon but threatening adverse effect when using this combination therapy, and should be evaluated and managed carefully. Here, we present two patients experiencing late-onset asymptomatic heavy proteinuria during the clinical trial. Kidney biopsies performed finally identified bevacizumab-induced thrombotic microangiopathy (TMA), and the proteinuria was decreased after discontinuing bevacizumab permanently. Our report suggests that a kidney biopsy is needed for those receiving ICIs in combination with bevacizumab and chemotherapy and experiencing nephrotoxicity such as heavy proteinuria.
Language	English
Publishing date	2023-01-30
Publishing country	Switzerland
Document type	Case Reports
ZDB-ID	2605724-4
ISSN	2039-7283 ; 2039-7275
ISSN (online)	2039-7283
ISSN	2039-7275
DOI	10.3390/clinpract13010018
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Article: Current Updates on Newer Forms of Transcranial Magnetic Stimulation in Major Depression.

Cheng, Chih-Ming / Li, Cheng-Ta / Tsai, Shih-Jen

Advances in experimental medicine and biology

2021 Volume 1305, Page(s) 333–349

Abstract: Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved technique for treating medication-resistant depression. Conventional rTMS includes high frequency (HF) to left dorsolateral prefrontal cortex (DLPFC) and low frequency to right DLPFC. ...

Abstract	Repetitive transcranial magnetic stimulation (rTMS) is an FDA-approved technique for treating medication-resistant depression. Conventional rTMS includes high frequency (HF) to left dorsolateral prefrontal cortex (DLPFC) and low frequency to right DLPFC. However, not all depressed patients could benefit from standard rTMS protocols. Meta-analytical evidence indicated that there was an average response rate of 29.3% for patients receiving the most commonly adopted HF rTMS to the left DLPFC. Hence, newer forms of rTMS paradigms are warranted to improve antidepressant response and remission rate in patients with depression, especially those who are refractory to adequate antidepressant trials. In the current chapter, we review newer forms of rTMS paradigms and the content will cover standard theta burst stimulation (TBS), prolonged iTBS (piTBS), accelerated rTMS (aTMS), deep TMS (dTMS), priming TMS (pTMS), synchronized TMS (sTMS), and magnetic seizure therapy (MST).
MeSH term(s)	Antidepressive Agents/therapeutic use ; Depression ; Depressive Disorder, Major/drug therapy ; Humans ; Prefrontal Cortex ; Transcranial Magnetic Stimulation ; Treatment Outcome
Chemical Substances	Antidepressive Agents
Language	English
Publishing date	2021-04-08
Publishing country	United States
Document type	Journal Article ; Meta-Analysis ; Review
ISSN	2214-8019 ; 0065-2598
ISSN (online)	2214-8019
ISSN	0065-2598
DOI	10.1007/978-981-33-6044-0_18
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Article ; Online: Optimal reimplantation timing in two-stage exchange for periprosthetic joint infection: an observative cohort study in Asian population.

Tsai, Meng-Lun / Herng-Shouh Hsu, Allen / Wu, Cheng-Ta / Lin, Po-Chun / Tan, Timothy L / Kuo, Feng-Chih

BMC musculoskeletal disorders

2024 Volume 25, Issue 1, Page(s) 28

Abstract: Background: The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and ... ...

Abstract	Background: The optimal timing for reimplantation for periprosthetic joint infection (PJI) has not been established and varies from a few weeks to several months. The aim of this study was to assess the commendable time between implant removal and reimplantation in patients who underwent two-stage exchange arthroplasty for PJI. Methods: We retrospectively reviewed 361 patients who were treated with two-stage exchange arthroplasty for hip and knee chronic PJI at our institution between January 2000 and December 2018. Patient characteristics, comorbidities, surgical variables, microbiology data, and time to reimplantation were recorded. All patients were followed for a minimum of one year. Treatment failure was defined by Delphi criteria. Logistic regression analyses were used to calculate survival rates and adjusted odds ratios (ORs) of treatment failure. Results: In final analysis, 27 (7.5%) had treatment failure. Factors related to treatment failure including interim spacer exchange (OR, 3.13; confidence interval (CI), 1.04-9.09, p = 0.036), higher ESR level at reimplantation (OR, 1.85; CI, 1.05-3.57; p = 0.04), and time to reimplantation (OR, 1.00; CI, 1.003-1.005, p = 0.04). Performing revision arthroplasty surgery from 16 to 20 weeks had highest successful rate. The reimplantation over 24 weeks had a lower successful rate. However, no statistical significance in comparing each interval group. Conclusion: Our study emphasized the importance of timely reimplantation in achieving successful outcomes. Factors such as ESR levels, spacer exchange, and the duration of time to reimplantation influenced the likelihood of treatment failure in two-stage exchange arthroplasty for hip and knee PJI.
MeSH term(s)	Humans ; Arthroplasty, Replacement, Hip/adverse effects ; Arthroplasty, Replacement, Knee/adverse effects ; Treatment Outcome ; Prosthesis-Related Infections/diagnosis ; Prosthesis-Related Infections/surgery ; Prosthesis-Related Infections/etiology ; Retrospective Studies ; Cohort Studies ; Time Factors ; Reoperation/adverse effects ; Replantation ; Arthritis, Infectious/surgery
Language	English
Publishing date	2024-01-02
Publishing country	England
Document type	Journal Article
ZDB-ID	2041355-5
ISSN	1471-2474 ; 1471-2474
ISSN (online)	1471-2474
ISSN	1471-2474
DOI	10.1186/s12891-023-07129-8
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Article ; Online: Susceptibility to Treatment-Resistant Depression Within Families.

Cheng, Chih-Ming / Chen, Mu-Hong / Tsai, Shih-Jen / Chang, Wen-Han / Tsai, Chia-Fen / Lin, Wei-Chen / Bai, Ya-Mei / Su, Tung-Ping / Chen, Tzeng-Ji / Li, Cheng-Ta

JAMA psychiatry

2024

Abstract: Importance: Antidepressant responses and the phenotype of treatment-resistant depression (TRD) are believed to have a genetic basis. Genetic susceptibility between the TRD phenotype and other psychiatric disorders has also been established in previous ... ...

Abstract	Importance: Antidepressant responses and the phenotype of treatment-resistant depression (TRD) are believed to have a genetic basis. Genetic susceptibility between the TRD phenotype and other psychiatric disorders has also been established in previous genetic studies, but population-based cohort studies have not yet provided evidence to support these outcomes. Objective: To estimate the TRD susceptibility and the susceptibility between TRD and other psychiatric disorders within families in a nationwide insurance cohort with extremely high coverage and comprehensive health care data. Design, setting, and participants: This cohort study assessed data from the Taiwan national health insurance database across entire population (N = 26 554 001) between January 2003 and December 2017. Data analysis was performed from August 2021 to April 2023. TRD was defined as having experienced at least 3 distinct antidepressant treatments in the current episode, each with adequate dose and duration, based on the prescribing records. Then, we identified the first-degree relatives of individuals with TRD (n = 34 467). A 1:4 comparison group (n = 137 868) of first-degree relatives of individuals without TRD was arranged for the comparison group, matched by birth year, sex, and kinship. Main outcomes and measures: Modified Poisson regression analyses were performed and adjusted relative risks (aRRs) and 95% CIs were calculated for the risk of TRD, the risk of other major psychiatric disorders, and different causes of mortality. Results: This study included 172 335 participants (88 330 male and 84 005 female; mean [SD] age at beginning of follow-up, 22.9 [18.1] years). First-degree relatives of individuals with TRD had lower incomes, more physical comorbidities, higher suicide mortality, and increased risk of developing TRD (aRR, 9.16; 95% CI, 7.21-11.63) and higher risk of other psychiatric disorders than matched control individuals, including schizophrenia (aRR, 2.36; 95% CI, 2.10-2.65), bipolar disorder (aRR, 3.74; 95% CI, 3.39-4.13), major depressive disorder (aRR, 3.65; 95% CI, 3.44-3.87), attention-deficit/hyperactivity disorders (aRR, 2.38; 95% CI, 2.20-2.58), autism spectrum disorder (aRR, 2.26; 95% CI, 1.86-2.74), anxiety disorder (aRR, 2.71; 95% CI, 2.59-2.84), and obsessive-compulsive disorder (aRR, 3.14; 95% CI, 2.70-3.66). Sensitivity and subgroup analyses validated the robustness of the findings. Conclusions and relevance: To our knowledge, this study is the largest and perhaps first nationwide cohort study to demonstrate TRD phenotype transmission across families and coaggregation with other major psychiatric disorders. Patients with a family history of TRD had an increased risk of suicide mortality and tendency toward antidepressant resistance; therefore, more intensive treatments for depressive symptoms might be considered earlier, rather than antidepressant monotherapy.
Language	English
Publishing date	2024-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2701203-7
ISSN	2168-6238 ; 2168-622X
ISSN (online)	2168-6238
ISSN	2168-622X
DOI	10.1001/jamapsychiatry.2024.0378
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Article ; Online: Prediction of antidepressant responses to non-invasive brain stimulation using frontal electroencephalogram signals: Cross-dataset comparisons and validation.

Li, Cheng-Ta / Chen, Chi-Sheng / Cheng, Chih-Ming / Chen, Chung-Ping / Chen, Jen-Ping / Chen, Mu-Hong / Bai, Ya-Mei / Tsai, Shih-Jen

Journal of affective disorders

2023 Volume 343, Page(s) 86–95

Abstract: Background: 10-Hz repetitive transcranial magnetic stimulation(rTMS) and intermittent theta-burst stimulation(iTBS) over left prefrontal cortex are FDA-approved, effective options for treatment-resistant depression (TRD). Optimal prediction models for ... ...

Abstract	Background: 10-Hz repetitive transcranial magnetic stimulation(rTMS) and intermittent theta-burst stimulation(iTBS) over left prefrontal cortex are FDA-approved, effective options for treatment-resistant depression (TRD). Optimal prediction models for iTBS and rTMS remain elusive. Therefore, our primary objective was to compare prediction accuracy between classification by frontal theta activity alone and machine learning(ML) models by linear and non-linear frontal signals. The second objective was to study an optimal ML model for predicting responses to rTMS and iTBS. Methods: Two rTMS and iTBS datasets (n = 163) were used: one randomized controlled trial dataset (RCTD; n = 96) and one outpatient dataset (OPD; n = 67). Frontal theta and non-linear EEG features that reflect trend, stability, and complexity were extracted. Pretreatment frontal EEG and ML algorithms, including classical support vector machine(SVM), random forest(RF), XGBoost, and CatBoost, were analyzed. Responses were defined as ≥50 % depression improvement after treatment. Response rates between those with and without pretreatment prediction in another independent outpatient cohort (n = 208) were compared. Results: Prediction accuracy using combined EEG features by SVM was better than frontal theta by logistic regression. The accuracy for OPD patients significantly dropped using the RCTD-trained SVM model. Modern ML models, especially RF (rTMS = 83.3 %, iTBS = 88.9 %, p-value(ACC > NIR) < 0.05 for iTBS), performed significantly above chance and had higher accuracy than SVM using both selected features (p < 0.05, FDR corrected for multiple comparisons) or all EEG features. Response rates among those receiving prediction before treatment were significantly higher than those without prediction (p = 0.035). Conclusion: The first study combining linear and non-linear EEG features could accurately predict responses to left PFC iTBS. The bootstraps-based ML model (i.e., RF) had the best predictive accuracy for rTMS and iTBS.
MeSH term(s)	Humans ; Theta Rhythm/physiology ; Depressive Disorder, Major/diagnosis ; Depressive Disorder, Major/therapy ; Electroencephalography ; Prefrontal Cortex/physiology ; Transcranial Magnetic Stimulation ; Antidepressive Agents/therapeutic use
Chemical Substances	Antidepressive Agents
Language	English
Publishing date	2023-08-12
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.08.059
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Article ; Online: Risk of All-Cause and Suicide Death in Patients With Schizophrenia: An Entire-Population Longitudinal Study in Taiwan.

Cheng, Chih-Ming / Chang, Wen-Han / Tsai, Shih-Jen / Li, Cheng-Ta / Tsai, Chia-Fen / Bai, Ya-Mei / Lin, Wei-Chen / Su, Tung-Ping / Chen, Tzeng-Ji / Chen, Mu-Hong

The Journal of clinical psychiatry

2023 Volume 84, Issue 6

Abstract: Background:: Methods:: Results:: Conclusions: ...

Abstract	Background: Methods: Results: Conclusions:
MeSH term(s)	Humans ; Female ; Male ; Young Adult ; Adult ; Longitudinal Studies ; Schizophrenia ; Taiwan/epidemiology ; Retrospective Studies ; Research Design
Language	English
Publishing date	2023-09-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	716287-x
ISSN	1555-2101 ; 0160-6689
ISSN (online)	1555-2101
ISSN	0160-6689
DOI	10.4088/JCP.22m14747
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Article ; Online: Genetic sequence changes related to the attenuation of avian infectious bronchitis virus strain TW2575/98.

Tsai, Cheng-Ta / Wu, Hung-Yi / Wang, Ching-Ho

Virus genes

2020 Volume 56, Issue 3, Page(s) 369–379

Abstract: The attenuated avian infectious bronchitis virus (IBV), derived from a wild strain (TW2575/98w) in chicken embryos after 75 passages, is designed as a commercial vaccine strain (TW2575/98vac) to control the disease in Taiwan. The differences in viral ... ...

Abstract	The attenuated avian infectious bronchitis virus (IBV), derived from a wild strain (TW2575/98w) in chicken embryos after 75 passages, is designed as a commercial vaccine strain (TW2575/98vac) to control the disease in Taiwan. The differences in viral infectivity, replication efficiency, and genome sequences between TW2575/98w and TW2575/98vac were determined and compared. TW2575/98vac caused earlier death of chicken embryos and had higher viral replication efficiency. Thirty amino acid substitutions resulting from 44 mutated nucleotides in the viral genome were found in TW2575/98vac. All of the molecular variations lead to attenuation, found in TW2575/98, were not observed consistently in the other IBVs (TW2296/95, Ark/Ark-DPI/81, the Massachusetts strain, GA98/CWL0470/98, and CK/CH/LDL/97I) and vice versa. After further comparisons and evaluations from three aspects: (1) longitudinal analysis on the timing of variations appeared in specific homologous strain passages, (2) horizontal evaluations with the amino acid changes between wild and vaccine strains among the other 5 IBVs, and (3) inspection on alterations in the chemical characteristics of substituted amino acid residues in viral proteins, four amino acid substitutions [V342D in p87, S1493P and P2025S in HD1, as well as F2308Y in HD1(P41)] were selected as highly possible candidates for successful TW2575/98w attenuation. Our findings imply that molecular variations, which contribute to the successful attenuation of different IBVs, are diverse and not restricted to a fixed pattern or specific amino acid substitutions in viral proteins. In addition, four amino acid changes within the replicase gene-encoded proteins might be associated with TW2575/98 virus virulence.
MeSH term(s)	3' Untranslated Regions ; Base Sequence ; Coronavirus Infections/virology ; Genetic Variation ; Genome, Viral ; Genomics/methods ; Infectious bronchitis virus/genetics ; Virus Replication
Chemical Substances	3' Untranslated Regions
Keywords	covid19
Language	English
Publishing date	2020-03-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	639496-6
ISSN	1572-994X ; 0920-8569
ISSN (online)	1572-994X
ISSN	0920-8569
DOI	10.1007/s11262-020-01753-5
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Article ; Online: Baseline cognitive function predicts full remission of suicidal symptoms among patients with treatment-resistant depression and strong suicidal ideation after low-dose ketamine infusion.

Lin, Wei-Chen / Su, Tung-Ping / Li, Cheng-Ta / Wu, Hui-Ju / Tsai, Shih-Jen / Bai, Ya-Mei / Tu, Pei-Chi / Chen, Mu-Hong

Journal of psychopharmacology (Oxford, England)

2023 Volume 37, Issue 8, Page(s) 795–801

Abstract: Background: Whether pretreatment working memory and response inhibition function are associated with the rapid and sustained antisuicidal effect of low-dose ketamine among patients with treatment-resistant depression (TRD) and strong suicidal ideation ... ...

Abstract	Background: Whether pretreatment working memory and response inhibition function are associated with the rapid and sustained antisuicidal effect of low-dose ketamine among patients with treatment-resistant depression (TRD) and strong suicidal ideation is unclear. Methods: We enrolled 65 patients with TRD, comprising 33 who received a single infusion of 0.5 mg/kg ketamine and 32 who received a placebo infusion. The participants performed working memory and go/no-go tasks prior to infusion. We assessed suicidal symptoms at baseline and on postinfusion Days 2, 3, 5, and 7. Results: The full remission of suicidal symptoms persisted for 3 days after a single ketamine infusion and the ketamine-related antisuicidal effect persisted for 1 week. Lower cognitive impairment at baseline (indicated by a higher rate of correct responses on a working memory task) was associated with the rapid and sustained antisuicidal effect of low-dose ketamine in patients with TRD and strong suicidal ideation. Discussion: Patients with TRD and strong suicidal ideation but low cognitive impairment may benefit the most from the antisuicidal effect of low-dose ketamine.
MeSH term(s)	Humans ; Antidepressive Agents/pharmacology ; Cognition ; Depression ; Depressive Disorder, Major/psychology ; Depressive Disorder, Treatment-Resistant/drug therapy ; Depressive Disorder, Treatment-Resistant/psychology ; Ketamine/adverse effects ; Suicidal Ideation
Chemical Substances	Antidepressive Agents ; Ketamine (690G0D6V8H)
Language	English
Publishing date	2023-06-18
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	639313-5
ISSN	1461-7285 ; 0269-8811
ISSN (online)	1461-7285
ISSN	0269-8811
DOI	10.1177/02698811231182107
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Article ; Online: Role of klotho on antidepressant and antisuicidal effects of low-dose ketamine infusion among patients with treatment-resistant depression and suicidal ideation.

Chen, Mu-Hong / Bai, Ya-Mei / Wu, Hui-Ju / Li, Cheng-Ta / Lin, Wei-Chen / Tsai, Shih-Jen / Su, Tung-Ping / Tu, Pei-Chi

Journal of affective disorders

2023 Volume 340, Page(s) 471–475

Abstract: Objective: Previous studies have found an association between klotho, an anti-aging hormone, and major depressive disorder. However, whether low-dose ketamine infusion alters klotho levels among patients with treatment-resistant depression (TRD) remains ...

Abstract	Objective: Previous studies have found an association between klotho, an anti-aging hormone, and major depressive disorder. However, whether low-dose ketamine infusion alters klotho levels among patients with treatment-resistant depression (TRD) remains unknown. Methods: In total, 48 patients with TRD and strong suicidal ideation were randomly assigned to a single 0.5 mg/kg ketamine or 0.045 mg/kg midazolam regimen and were subjected to a 2-week follow-up. Depressive and suicidal symptoms were assessed before the infusion and during the follow-up. The serum levels of klotho were assessed at baseline and 3 days postinfusion. Results: A generalized linear model with adjustment of baseline klotho levels showed that, despite the fact that ketamine did not significantly increase levels of klotho, patients in the ketamine group had higher levels of klotho at Day 3 postinfusion than patients in the midazolam group (p = 0.043). However, we found no association between changes in klotho levels and changes in depressive and suicidal symptoms (all p > 0.05). Higher klotho levels at baseline were associated with poorer antidepressant effect of low-dose ketamine during postinfusion follow-up. Discussion: Klotho may play a role in the antidepressant effect of low-dose ketamine. Additional molecular studies are necessary to elucidate the neuromechanisms of TRD, ketamine, and klotho.
MeSH term(s)	Humans ; Suicidal Ideation ; Ketamine/adverse effects ; Depressive Disorder, Major/diagnosis ; Depression ; Midazolam/adverse effects ; Antidepressive Agents/therapeutic use ; Depressive Disorder, Treatment-Resistant/drug therapy ; Depressive Disorder, Treatment-Resistant/complications ; Treatment Outcome
Chemical Substances	Ketamine (690G0D6V8H) ; Midazolam (R60L0SM5BC) ; Antidepressive Agents
Language	English
Publishing date	2023-08-12
Publishing country	Netherlands
Document type	Randomized Controlled Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	135449-8
ISSN	1573-2517 ; 0165-0327
ISSN (online)	1573-2517
ISSN	0165-0327
DOI	10.1016/j.jad.2023.08.061
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