This week in BMC Medicine: Novel therapies, diagnosis and clinical management of neuropsychiatry

Common psychiatric and neurodegenerative disorders are mainly treated using medications that modify the activity of monoamine neurotransmitter systems. New lines of pharmacological therapeutics for some of these disorders are emerging that target pathophysiological pathways, including inflammation, circadian and sleep patterns. Interestingly, sleep disorders are frequently associated with mental health particularly depression, whereas motor symptoms characterize Parkinson’s disease, a progressive neurodegenerative disease showing loss of dopaminergic neurons. Other progressive diseases such as neuromuscular diseases are more difficult to diagnose and quantify. These topics are highlighted in some recently published articles in BMC Medicine that we discuss below.

On the topic of therapies, Ian Hickie and colleagues recommend that sleep-wake cycles and circadian systems are targets for mood disorders. Individual differences in circadian physiology are suggested to advance the personalized approach to patient treatment in clinical psychiatry based on behavioral and pharmacological interventions.

Furthermore, other aspects of sleep have been addressed in psychiatry by Yves Dauvilliers and colleagues who review studies that have examined symptoms of mood disorders in hypersomnia, a specific sleep disorder. The authors additionally describe hypersomnia assessment methods and suggest that further interventional studies are required to explore the bidirectional association of sleep symptoms and mood disorders.

Continuing on the theme of treatment options, Michael Berk and colleagues review the potential of aspirin as a therapeutic agent in neurological and psychiatric disorders including depression, schizophrenia, bipolar disorder and Alzheimer’s disease. This literature appraisal reveals a suggested role for aspirin in regulating inflammation, oxidative and nitrosative stress and mitochondrial dysfunction in the brain. Further research will be needed to fully elucidate the clinical potential of this drug in psychiatry and neurology.

Focusing on neurodegenerative diseases, dyskinesia is a major complication in the treatment of Parkinson’s disease with dopaminergic agents and is associated with motor dysfunction. Christian Duval and colleagues have recently proposed a new approach to manage the level and type of motor symptoms to help improve patients’ quality of life and reduce the burden on health care systems.

Other disorders that affect motor function include neuromuscular diseases and the current morphological assessment of them is subjective and non-quantifiable. A new diagnostic tool based on a network science analysis helps to diagnose muscular dystrophies and neurogenic atrophies in a quantifiable manner. This evaluation will help monitor disease progression in both clinical and pre-clinical settings.

Together, the latest evidence highlights the need for new drug treatments for patients with neuropsychiatric disorders. In the case of neurodegenerative diseases, improved diagnosis and better management of patients in the clinic will provide early treatment and benefit their care.

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