Serotonin receptor 4 in the hippocampus modulates mood and anxiety. Molecular psychiatry Serotonin receptor 4 (5-HTR) plays an important role in regulating mood, anxiety, and cognition, and drugs that activate this receptor have fast-acting antidepressant (AD)-like effects in preclinical models. However, 5-HTR is widely expressed throughout the central nervous system (CNS) and periphery, making it difficult to pinpoint the cell types and circuits underlying its effects. Therefore, we generated a Cre-dependent 5-HTR knockout mouse line to dissect the function of 5-HTR in specific brain regions and cell types. We show that the loss of functional 5-HTR specifically from excitatory neurons of hippocampus led to robust AD-like behavioral responses and an elevation in baseline anxiety. 5-HTR was necessary to maintain the proper excitability of dentate gyrus (DG) granule cells and cell type-specific molecular profiling revealed a dysregulation of genes necessary for normal neural function and plasticity in cells lacking 5-HTR. These adaptations were accompanied by an increase in the number of immature neurons in ventral, but not dorsal, dentate gyrus, indicating a broad impact of 5-HTR loss on the local cellular environment. This study is the first to use conditional genetic targeting to demonstrate a direct role for hippocampal 5-HTR signaling in modulating mood and anxiety. Our findings also underscore the need for cell type-based approaches to elucidate the complex action of neuromodulatory systems on distinct neural circuits. 10.1038/s41380-020-00994-y

Efficacy of acupuncture for dysphagia after stroke: a systematic review and meta-analysis. Lu Yanyan,Chen Ying,Huang Dongting,Li Ji Annals of palliative medicine BACKGROUND:The risk of dysphagia after stroke is extremely high. The efficacy of acupuncture in the treatment of dysphagia after stroke lacks high-level evidence-based medical support. This study aimed to systematically evaluate the clinical value of acupuncture therapy in patients with dysphagia after stroke. METHODS:A electronic search of six databases were used to screen for randomized controlled trials (RCTs) of acupuncture treatment of patients with dysphagia after stroke. The search time was from the establishment of the database to 18 October 2020, and the search languages were limited to Chinese and English. The literature was screened and the data extracted independently by two researchers. The Cochrane System Evaluation Manual was used to evaluate the quality of the included literature. RESULTS:A total of 39 RCTs were included, of which 36 studies reported the effective rate of acupuncture treatment for dysphagia. The effective rate of the experimental group was higher than that of the control group [relative risk (RR) =1.23, 95% confidence interval (CI): 1.19 to 1.27, P<0.00001]. The drinking test grading score of patients in the experimental group was lower than that of the control group [mean difference (MD) =-0.75, 95% CI: -1.11 to -0.41, P<0.0001] in 8 studies. The swallowing scores of patients in the experimental group were lower than those in the control group (MD =-4.63, 95% CI: -5.68 to -3.59, P<0.00001) in 8 studies. The Fujishima eating-swallowing rating score of the experimental group was higher than that of the control group [standardized mean difference (SMD) =1.92, 95% CI: 1.30 to 2.54, P<0.00001] in 3 studies. The score of the dysphagia-specific quality of life scale of the experimental group was higher than that of the control group (SMD =2.02, 95% CI: 0.82 to 3.22, P=0.0001) in 5 studies. The VFSS of the experimental group was higher than that of the control group (MD =2.53, 95% CI: 1.89 to 3.17, P<0.00001) in 5 studies. CONCLUSIONS:The existing evidence supports that acupuncture therapy can significantly improve the swallowing function of patients with dysphagia. 10.21037/apm-21-499

The effectiveness of acupuncture therapy in patients with post-stroke depression: An updated meta-analysis of randomized controlled trials. Medicine BACKGROUND:To assess the effectiveness of acupuncture in patients with post-stroke depression (PSD). METHODS:The Cochrane Library, CINAHL, EMBASE, PubMed, SCOPUS, Web of Science, and 4 Chinese databases were electronically searched for articles published between January 1, 2010 and May 31, 2018. Randomized controlled trials (RCTs) investigating the effects of acupuncture on PSD were included. The quality of all included trials was assessed according to guidelines published by the Cochrane Collaboration. RESULTS:Seven trials compared the effectiveness of acupuncture therapy with that of control in alleviating the symptoms of PSD. Pooled analysis demonstrated that patients in the acupuncture intervention group experienced a significantly higher treatment effect than controls (RR 1.16 [95% CI 1.08-1.24]; P < .0001), with low study heterogeneity (I = 4%). Based on intervention methods, further analysis revealed a statistically significant difference in effectiveness between the acupuncture alone and medicine groups (RR 1.25 [95% CI 1.11 1.41]; Z = 3.78; P = .0002). There was no statistically significant difference in efficacy between the acupuncture combined with medicine and medicine groups (RR 1.07 [95% CI 0.98-1.17]; P = .11). CONCLUSIONS:This meta-analysis provides evidence supporting the viewpoint that acupuncture is an effective and safe treatment for PSD. Subgroup analyses further revealed that acupuncture alone resulted in better outcomes than drug therapy in improving depressive symptoms. Further high-quality RCTs are needed to systematically evaluate the effectiveness of acupuncture for PSD and develop standardized acupuncture protocols. 10.1097/MD.0000000000015894