Rates of firearm-related deaths from suicide and homicide have continued to rise during the last several years. This has prompted large-scale debate over the role of mental illness in gun violence and the need to investigate strategies for reducing harm. Many countries require either some form of mental health evaluation or a simple doctor's note on mental fitness before purchasing a firearm. This study focuses on practitioner attitudes toward this practice in South Carolina and looks to examine the primary factors that may interfere with implementing mandatory fitness evaluations before firearm purchase. Our specific aim was to assess the level of concern that practitioners had with 12 barriers that were identified by the research team as potentially problematic for conducting fitness screenings for gun ownership. Comfort with performing these evaluations also was assessed, including differences in attitudes and comfort level based on the specialty of the practitioner.

A survey was created and dispersed to regional providers in the fields of Family Medicine, Internal Medicine, and Psychiatry. The survey contained questions assessing provider beliefs on the capability and feasibility of fitness evaluations for firearm purchase, comfort in performing such evaluations, and the level of concern with 12 potential barriers to performing evaluations using a Likert scale.

A total of 794 individuals received the survey, with a response rate of 18.9% (150) and a completion rate of 17.4% (138). The majority of respondents (84.7%) believed that implementing mandatory fitness evaluations before firearm purchase is a good idea; however, fewer than half (48%) believed that it is feasible. The most concerning barriers were related to the unreliability of an applicant's self-reporting, concerns over liability, and a large abundance of firearm sales.

Findings from this study indicate that although most respondents viewed mandatory fitness evaluations as a good idea, the act of implementing them was viewed to be less feasible for a variety of factors. Most of the barriers presented were met with at least a moderate level of concern. Although a common practice in many other countries, the United States presents unique challenges when it comes to the potential for implementing mandatory fitness evaluations. This is the first known study to gather practitioners' perspectives on this process. More research is needed on investigating solutions for reducing gun violence and whether the use of fitness evaluations is a viable tool.

Emerging data support the benefits of creative arts interventions for addressing depression in adolescents, but the neural mechanisms are poorly understood. This study examined changes in connectivity among large-scale brain networks implicated in both depression and creativity, before and after an arts intervention for adolescents with depression. Thirty-nine adolescents with depression completed resting-state functional magnetic resonance imaging scans before and after completing a two-week arts intervention called Creativity Camp. To approximate a "waitlist" control, half the sample also completed scanning 2 weeks before camp. Using a graph theory approach, we calculated the strength of connectivity between four networks at the "nexus" of mood and creativity: Default, Control, Salience, and Limbic. For these between-network connection strength indices, we (1) measured pre- to post-camp changes across the whole sample; (2) compared changes during waitlist versus during camp for the rest of the sample; and (3) explored correlations between changes in connectivity and changes in depression. In the whole sample, the strength of connectivity between three network pairs increased significantly from pre- to post-camp: Default-Control, Limbic-Control, and Salience-Default (all p < 0.05, corrected). The waitlist control comparison revealed that pre-to-post camp changes were greater than those observed during the waitlist for two of these network pairs (uncorrected). Connectivity changes did not significantly correlate with changes in depressive symptoms. Intensive engagement in creative arts may contribute to increases in connections between large-scale neural networks that are implicated in both mood and creative thinking. Future research is needed with larger samples using randomized control trials to further understand how creative arts engagement confers its mental health benefits for adolescents.

Subacute sclerosing panencephalitis (SSPE) is a progressive, fatal encephalitis caused by persistent measles virus infection. Quantitative cortical imaging in SSPE remains poorly characterised, and the topology of the cortical structural covariance network (SCN) has not been examined.

To characterise whole-brain cortical structural alterations in SSPE using surface-based morphometry (SBM) and voxel-based morphometry (VBM), evaluate their clinical correlates, and describe the topology of the cortical SCN.

Twenty-eight patients with SSPE and 48 age- and sex-matched healthy controls underwent 3.0 T volumetric T1-weighted MRI. SBM was performed in FreeSurfer using the Desikan-Killiany (DK) atlas, adjusted for age and sex; VBM used the FSL-VBM pipeline with threshold-free cluster enhancement, adjusted for age, sex and total intracranial volume. Clinical associations used Pearson correlation with false discovery rate (FDR) correction and Spearman sensitivity analyses; severity was quantified with the Neurological Disability Index. Group-level SCNs were constructed from age- and sex-adjusted regional thickness correlations; graph metrics were computed across 16 network densities and summarised as the area under the metric-versus-density curve, so that findings do not depend on a single arbitrary threshold. Group differences were assessed by subject-label permutation testing with bootstrap confidence intervals.

VBM identified widespread bilateral grey matter volume reduction extending from cortex into deep grey matter and cerebellum, with additional right-lateralised clusters in the planum temporale and frontal pole. Vertex-wise SBM demonstrated 35 bilateral cortical thickness clusters and 21 cortical volume clusters; in the covariate-adjusted regional analysis, 38 of 68 DK regions showed significant thinning after FDR correction, and 18 of 68 regions showed significant volume reduction, most prominently the bilateral frontal pole and posterior cortices. Cortical thickness and volume correlated negatively with disease duration across most regions, but not with clinical severity. SCN metrics differed consistently in direction across all densities - longer characteristic path length, higher modularity and local efficiency, and loss of degree assortativity in patients - but no metric difference survived subject-label permutation testing after FDR correction (smallest adjusted p = 0.24); SCN findings are therefore reported as descriptive.

SSPE produces widespread, duration-dependent cortical thinning and grey matter volume loss involving association, limbic and primary cortices. Group-level SCN topology showed a consistent directional pattern of network reorganisation that did not reach corrected statistical significance at this sample size. Prospective, longitudinal and multi-centre studies are required before any clinical application of these measures can be considered.

Today's young people (aged ∼10-24 y) are the first "digital natives" but have become the most sedentary generation on record. These trends have coincided with a widely recognized decline in youth mental health, prompting increasingly polarized debate: some attribute the crisis primarily to smartphones and social media, but large-scale analyses suggest more heterogeneous population-level effects. Therefore, this review examines the role of physical activity (PA) in mental health during the online era; considering how different forms of online engagement relate to youth mental health, with regard to both the emerging downsides (through increasing sedentariness) and the potential for harnessing such platforms to improve PA and mental health, together. As a narrative review of an emerging field, we drew on nonsystematic searches of PubMed and Google Scholar alongside author expertise to integrate key findings and identify new directions. Two conclusions emerged. First, whether online time helps or harms depends more on content, context, and user characteristics than screentime, although converging (though still-developing) causal evidence points to displacement of PA, alongside disrupted sleep as a leading mechanism. Second, digital adoption itself has become an opportunity for promoting PA/delivering exercise interventions, online, with growing evidence of benefits for depression, anxiety, and well-being. However, these tools also carry risks, including body surveillance, social comparison, and compulsive exercise. Furthermore, data on online PA interventions in clinical mental health populations is sparse but appear to favor blended approaches. Overall, we argue the coming decade's key challenge is embedding evidence-based PA promotion within young people's online lives.

Post-COVID-19 syndrome (PCS) is characterised by persistent cognitive, affective, and somatic symptoms that extend months beyond acute SARS-CoV-2 infection, frequently in the absence of overt systemic inflammation. While immune dysregulation is increasingly implicated, the mechanisms linking peripheral immune alterations to enduring brain-related symptoms remain poorly understood. The choroid plexus (CP), a specialised blood-cerebrospinal fluid barrier and neuroimmune interface, is well positioned to mediate such immune-brain communication.

In this pilot case-control study, we combined high-resolution structural MRI with peripheral immunophenotyping and a functional human neural progenitor model to investigate the neuroimmune relevance of CP morphology in PCS. Twenty individuals with PCS following mild acute COVID-19 and twenty recovered controls underwent MRI for manual CP segmentation, serum cytokine profiling, and serum exposure assays using human hippocampal progenitor cells.

Individuals with PCS exhibited significantly enlarged CP volume compared with recovered controls, independent of intracranial volume. CP enlargement showed minimal association with circulating cytokine concentrations, indicating limited correspondence with contemporaneous peripheral inflammatory markers. In contrast, CP volume was tentatively associated with serum-induced immune and astrocytic responses in vitro, including reduced IL-8 sretion and altered astrocytic marker expression (GFAP and AQP4), while no associations were observed with neuronal differentiation markers.

These findings highlight a dissociation between static peripheral cytokine levels and functional brain-relevant immune effects, and suggest that CP enlargement preferentially indexes brain-proximal neuroimmune signalling capacity rather than peripheral inflammatory load alone. By integrating neuroimaging with human cellular assays, this study positions the choroid plexus as a structural marker of persistent neuroimmune dysregulation in PCS and highlights immune-barrier interfaces as critical targets for understanding post-infectious brain symptoms.

Transcutaneous auricular vagus nerve stimulation (taVNS) is a non-invasive neuromodulation approach that may influence memory-related brain activity. Theta oscillations are closely related to episodic memory processing, but it remains unclear whether taVNS modulates memory-related theta activity in a frequency-specific manner and how these effects change after stimulation.

This study investigated the sustained effects of 20 Hz and 40 Hz taVNS on free recall and resting-state EEG theta oscillations in healthy young adults.

Forty-four participants were enrolled in this randomized, single-blind, sham-controlled, three-arm parallel-group study. They were randomly assigned to the sham stimulation group, the 20 Hz taVNS group, or the 40 Hz taVNS group. Free recall performance was assessed before and after stimulation, and resting-state EEG was recorded at baseline and multiple time points after stimulation.

The results showed that participants receiving 40 Hz taVNS exhibited better free recall performance than those receiving sham stimulation or 20 Hz stimulation. 40 Hz taVNS increased the relative power of theta waves, particularly in the frontal region. This enhancement was an immediate increase followed by a gradual decrease over time. Frontal theta activity and stimulation-induced theta changes were positively correlated with free recall performance. Furthermore, exploratory Bayesian mediation analysis supported a theta-dependent model.

This study suggests that 40 Hz taVNS may promote verbal free recall performance by inducing transient enhancement of frontal theta wave activity, providing preliminary evidence for the modulation of memory-related neural oscillations by frequency-specific taVNS.

The behavioural activity of freely moving animals is a confounding factor that affects the recording, analysis, and final results of animal EEG experiments. Along with the lack of standardisation in animal in vivo electrophysiology experiments, this could lead to huge inconsistencies, especially in the analysis of centrally acting drugs. Therefore, the main aim of this paper is to investigate the effects of behavioural activity versus inactivity on the multichannel EEG in freely moving rats. In a large sample (n = 116) of waking recordings from 12 cortical electrodes (ECoG) in Wistar rats, we evaluated behavioural activity-related changes in the power spectrum, current source density, and power-based global functional connectivity (GFC) in a 3D rat brain model, according to the TOHOKU Rat Brain Atlas. The main findings were that behavioural activity was associated with 1) a robust power increase in 6-8 Hz, peaking at 7 Hz with maximum changes over the parietal and temporal cortex, 2) an increase in gamma (30-40 Hz) and high-gamma (55-100 Hz) power across the whole brain, 3) a decrease in delta (1-4 Hz) and beta (12-25 Hz) and high-beta (25-30 Hz) power across the whole cortex. Changes were also localised in subcortical regions, particularly in the diencephalon/thalamus. The GFC analysis showed a similar pattern of changes across the 6-8 Hz, delta, and beta bands; however, GFC in the gamma band decreased, while high-gamma GFC increased. Again, the GFC analysis revealed changes in connectivity within subcortical structures, primarily in the thalamus. None of the measures was affected in the alpha band (8-12 Hz). These findings emphasise behavioural state as a critical factor influencing EEG outcomes, with important implications for the standardisation and translational validity of preclinical neurophysiological studies.

Major depressive disorder (MDD) is a complex psychiatric disorder lacking objective clinical diagnostic biomarkers. Platelets express a variety of neuroactive proteins, including serotonin transporters and receptors, and are easily accessible in peripheral blood, making them a valuable surrogate tool for exploring molecular alterations underlying central nervous system diseases. This study aimed to screen proteins from platelet-enriched preparations as candidate biomarkers for distinguishing patients with MDD from healthy controls (HCs) and to preliminarily explore the potential biological mechanisms of platelets in MDD pathogenesis. A total of 20 patients with MDD and 20 age- and gender-matched HCs were enrolled. Data-independent acquisition (DIA)-based proteomic analysis identified 299 differentially expressed proteins in the platelet-enriched fraction between the two groups. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were performed to characterize the functional profiles and signaling pathways of these altered proteins. Multiple machine-learning algorithms, including PLS-DA, LASSO regression, and SVM-RFE, were applied to screen optimal biomarker combinations. Finally, a four-protein panel consisting of C1QBP, DDX60, WDR81, and VPS37A showed favorable discriminatory potential for MDD, with consistent expression trends further examined in the validation cohort. The expression levels of this biomarker panel were correlated with HAMD scores in the pooled sample, which primarily reflected case-control differences. Within the MDD group, only C1QBP was significantly correlated with HAMD scores, whereas no significant correlations were observed for the other candidate proteins. Exploratory gender-stratified analysis further suggested potential gender-based heterogeneity in protein profiles of the platelet-enriched fraction among MDD individuals. In conclusion, this exploratory proteomic study identifies C1QBP, DDX60, WDR81, and VPS37A as potential candidate biomarkers from platelet-enriched preparations for MDD discrimination.

This study investigated the antisuicidal effects of repeated intravenous ketamine in patients with treatment-resistant depression and explored associations between suicidal ideation and temporal changes in selected plasma biomarkers to identify potential biomarkers.

This secondary analysis of an open-label trial included outpatients with treatment-resistant depression who received four intravenous ketamine infusions (0.5 mg/kg) over 2 weeks. Suicidal ideation was assessed at baseline and post-intervention using the Montgomery-Åsberg Depression Rating Scale (item 10), Quick Inventory of Depressive Symptomatology-Self Report (item 12), and Columbia Suicide Severity Rating Scale. Eleven targeted plasma biomarkers were quantified via liquid chromatography-mass spectrometry. Associations between suicidal ideation scores and biomarker changes were evaluated using Pearson's and Spearman's correlation coefficients, with p-values adjusted for multiple comparisons using the false discovery rate procedure.

Repeated ketamine infusions were associated with modest reductions in suicide-related item scores on the Montgomery-Åsberg Depression Rating Scale item 10 (1.5±1.5 to 1.0±1.3, p=0.01) and Quick Inventory of Depressive Symptomatology-Self Report item 12 (1.3±0.9 to 0.8±0.9, p=0.01). Columbia Suicide Severity Rating Scale scores numerically decreased (1.1±1.3 to 0.8±1.2, p=0.17) without reaching statistical significance. In unadjusted analyses, improved Columbia Suicide Severity Rating Scale scores showed nominal associations with increased levels of citric acid (r=- 0.40, p=0.03) and kynurenic acid (ρ=- 0.37, p=0.04), although these did not survive false discovery rate correction.

Repeated ketamine infusions were associated with modest reductions in suicide-related item scores on the Montgomery-Åsberg Depression Rating Scale and Quick Inventory of Depressive Symptomatology-Self Report. While no definitive biomarkers were identified after false discovery rate correction, these nominal associations are purely hypothesis-generating and require larger validation trials.