抑郁症的基础与认知激活脑SPECT显像

目的通过抑郁症患者基础和认知激活局部脑血流（ｒＣＢＦ）灌注显像的半定量分析，评估抑郁症患者的脑血流灌注异常。方法选择２７例未经抗抑郁治疗、ＩＣＤ１０分类为中度抑郁发作伴躯体症状的患者，１５例年龄匹配的健康人作正常对照。２７例患者中２１例、１５例健康人中１３例行双日法基础与认知激活脑ｒＣＢＦ显像；另６例患者及２例健康人仅行基础脑ＳＰＥＣＴ显像。认知激活采用Ｗｉｓｃｏｎｓｉｎ卡片分类试验。半定量分析在横断面图像７～１１帧上进行，将各ＲＯＩ的平均计数与同侧小脑的最高计数相除，得到各ＲＯＩ的ｒＣＢＦ比值。结果抑郁症左额叶和左颞叶的基础ｒＣＢＦ值均为０７２０，明显低于对照组（０７６４和０７５０，Ｐ＜００５）；左额、左颞、左顶叶的认知激活ｒＣＢＦ值分别为０７１９、０６９０及０７０１，明显低于对照组（０７８２、０７５２和０７６６，Ｐ＜００１和Ｐ＜００５）。结论①抑郁症患者存在左额叶、左颞叶的局部血流低灌注。②额叶、颞叶皮层低灌注可能是引起抑郁症认知障碍、心境低落的原因。③Ｗｉｓｃｏｎｓｉｎ卡片分类试验认知激活脑ＳＰＥＣＴ显像有助于提高抑郁症的诊断准确性     

核苷酸结合寡聚化结构域样受体蛋白3炎症小体在脑卒中后认知障碍中的研究进展

脑卒中后认知障碍(PSCI)是脑卒中患者常见的并发症,严重影响患者的生活质量。目前,PSCI在临床治疗中尚未发现有效的针对性治疗措施。大量研究证实核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症小体的活化在PSCI中起关键作用,且对其进行的许多抑制性治疗显示出了改善认知障碍的功效。为此,本文总结了NLRP3炎症小体的活化和影响因素及其与PSCI的关系,发现在PSCI的细胞和动物模型中,针对NLRP3或其炎症小体成分的抑制措施可以减轻炎性反应和相应的病理特征,从而促进其认知功能的恢复,因此,靶向NLRP3炎症小体可能是PSCI治疗的新趋势。然而到目前为止,尽管许多药物和治疗措施已成功鉴定出能够抑制NLRP3炎症小体的活化,但其在临床中的治疗效果和安全性仍有待进一步验证。     

The hemodynamics of oddball processing during single-tone and two-tone target detection tasks

Event-related potential (ERP) studies have shown that the neural systems engaged during performance of oddball tasks are sensitive to contextual manipulations, such as the number of stimulus classes. Some ERP components (i.e., N1) are modulated by the number of stimulus types, while others (i.e., P3) are not greatly affected. However, little is known about how these contextual manipulations affect the hemodynamics underlying oddball processing. The purpose of this study was to examine the hemodynamic correlates of target stimulus processing in single-tone (targets alone) and two-tone (targets and standard tones) auditory oddball tasks. The primary hypothesis was that processing of salient stimuli in both contextual conditions would engage the same spatially distributed cortical and subcortical networks observed in previous oddball fMRI studies. Results were consistent with this hypothesis and suggest that the brain engages many potentially useful brain regions during salient stimulus processing despite the low probability that said regions are necessary for task performance, which likely reflects a form of “adaptive reflexive processing”. Results were also consistent with ERP data that shows that the N1 is larger for single-tone tasks by showing greater amplitude of hemodynamic response for single-tone targets, relative to two-tone targets, in bilateral temporal cortex and bilateral inferior lateral frontal cortex. The results are discussed as they relate to the understanding of neurocognitive function pertaining to contextual manipulations in general, and orienting processes in particular.     

躯体形式障碍的治疗分析

目的探讨躯体形式障碍的治疗方法。方法用钟友彬的认识领悟疗法对躯体形式障碍3案例治疗通程予以报告和分析。结果认识领悟疗法对躯体形式障碍有一定的临床治疗效果。结论认识领悟疗法治疗躯体形式障碍是有效的和可行的。     

心理健康对精神分裂症患者认知功能的影响

目的观察心理健康对精神分裂症患者认知功能的影响。方法采用入院顺序分层随机法，将120例慢性精神分裂症患者分为研究组（心理健康＋奋乃静）和对照组（单用奋乃静）治疗。在治疗前，治疗后4、8、12周末分别以阳性症状和阴性症状量表（PNASS？评定疗效，用韦氏成人智力量表（WAIS—R）、韦氏记忆量表（WMS）和威斯康星卡片分类测验（wCST）评定治疗前后患者认知功能的改变。结果治疗12周后，研究组的言语量表、操作量表、全量表和记忆量表分分别为84．97±3．73、80．41±5．93、83．37±5．81、77．26±13．31；对照组分别为75．41±3．95、72．43±5．56、75．87±5．34、72．15±13．19，两组有显著差异（P〈0．01）。PANSS总分、阴性因子分比治疗前明显降低。结论心理健康治疗对精神分裂症患者认知功能有明显改善。     

The Topography of Non-Linear Cortical Dynamics at Rest, in Mental Calculation and Moving Shape Perception

Differential cortical activation by cognitive processing was studied using dimensional complexity, a measure derived from nonlinear dynamics that indicates the degrees of freedom (complexity) of a dynamic system. We examined the EEG of 32 healthy subjects at rest, during a visually presented calculation task, and during a moving shape perception task. As a nonlinear measure of connectivity, the mutual dimension of selected electrode pairs was used. The first Lyapunov coefficient was also calculated. Data were tested for non-linearity using a surrogate data method and compared to spectral EEG measures (power, coherence). Surrogate data testing confirmed the presence of nonlinear structure in the data. Cognitive activation led to a highly significant rise in dimensional complexity. While both tasks activated central, parietal and temporal areas, mental arithmetic showed frontal activation and an activity maximum at T3, while the moving shape task led to occipital activation and a right parietal activity maximum. Analysis of mutual dimension showed activation of a bilateral temporal-right frontal network in calculation. The Lyapunov coefficent showed clear topographic variation, but was not significantly changed by mental tasks (p<.09). While dimensional complexity was almost unrelated to power values, nonlinear (mutual dimension) and linear (coherence) measures of connectivity shared up to 37% of variance. Data are interpreted in terms of increased cortical complexity as a result of recruitment of asynchronously active, distributed neuronal assemblies in cognition. The topography of nonlinear dynamics are related to neuropsychological and neuroimaging findings on mental calculation and moving shape perception.     

The relationship of age and cardiovascular fitness to cognitive and motor processes

Older and younger aerobically trained and sedentary adults participated in an S1-S2-S3 paradigm designed to elicit event-related potential (ERP) and behavioral responses to determine the influence of cardiovascular fitness on cognitive and motor processes. The paradigm provided warning (S1) as to the difficulty level of an upcoming decision task (S2). Participants had to decide the taller of two bars on presentation of S2 but hold their response until S3, to which they indicated their choice motorically. Results revealed age-related differences for ERP measures as older participants showed increased amplitude of the stimulus preceding negativity (SPN) prior to S2, and longer latencies and equipotentiality of P3 in response to S2. Fitness effects were also observed for the contingent negative variation (CNV) with decreased amplitude for fit relative to sedentary individuals. Age interacted with fitness for P3 latency to S2 as older sedentary individuals showed the longest latency followed by older fit and both younger groups. No significant group differences were observed for reaction time (RT) to S3. Therefore, physical fitness is associated with attenuation of cognitive decline in older individuals and greater economy of motor preparation for both young and older participants.     

老年人脑电图与认知功能的关系研究

目的:探讨老年人脑电图(EEG)与认知功能的关系。方法:对569名老年人进行EEG 检查及认知功能测验,用选自韦氏成人智力量表(WAIS-R)的算术、数字广度、填图、木块图以及简易智能状态检查表(MMSE)等五项测验逐个测量老年人的认知水平。在第一次测查一年后,对其中373 名老年人重复进行认知功能测查。结果:MMSE及数字广度测验的得分变化与各位点EEG θ、δ波功率值有关,MMSE:得分下降组基线θ、δ波功率值高于MMSE得分不变组,差异有统计学意义,主要以头后部各区(T3、T5,P3、O1,O2,T4、T6)为明显。T6处θ波功率为9．25μV2,对MMSE得分下降诊断的灵敏度为0．73,特异度为0．64。T3处θ波功率的增加为8．75μV2,对数字广度得分下降诊断的灵敏度为 0．75,特异度为0．56。结论:EEG θ波功率的增加对了解认知功能下降有重要的参考价值。     

Modern Mind-Brain Reading: Psychophysiology, Physiology, and Cognition

This paper reviews the actual and potential benefits of a marriage between cognitive psychology and psychophysiology. Psychophysiological measures, particularly those of the event-related brain potential, can be used as markers for psychological events and physiological events. Thus, they can serve as "windows" on the mind and as "windows" on the brain. These ideas are illustrated in the context of a series of studies utilizing the lateralized readiness potential, a measure of electrical brain activity that is related to preparation for movement. This measure has been used to illuminate presetting processes that prepare the motor system for action, to demonstrate the presence of the transmission of partial information in the cognitive system, and to identify processes responsible for the inhibition of responses. The lateralized readiness potential appears to reflect activity in motor areas of cortex. Thus, this measure, along with other psychophysiological measures, can be used to understand how the functions of the mind are implemented in the brain.     

Nucleus basalis lesions in neonate rats induce a selective cortical cholinergic hypofunction and cognitive deficits during adulthood

Summary Ibotenic acid was infused into the nucleus basalis magnocellularis (nBM) of 2-day old rats to eliminate immature cholinergic neurons before they develop functional synaptic connections in the neocortex. For bilaterally lesioned neonates, cognitive testing was initiated 2 months after lesioning and animals were sacrificed at 8 or 12 months of age. Lesioned animals exhibited a marked deficit in the retention of passive avoidance behavior, as well as in the acquisition of 2-way active avoidance behavior. Lesioned animals also made significantly more alternation errors than control animals in the Lashley III spatial maze and showed severe impairments in general learning, reference memory and working memory during 17-arm radial maze testing. For all 4 tasks, neonatally lesioned animals did not show any recovery to the performance level of control animals. Histological analysis of the subcortex from lesioned animals during adulthood revealed: (1) a substantial reduction in acetylcholinesterase-positive cells (presumably cholinergic) within the nucleus basalis, (2) decreased acetylcholinesterase staining in neocortex and (3) a gliosis essentially restricted to the globus pallidus. Surrounding brain regions were apparently not damaged as a direct result of excitotoxin infusion. Neurochemically, neonate nBM lesioning produced a long term cholinergic hypofunction as evidenced by significant reductions of 25% and 18% in frontal cortex chorine acetyltransferase (CAT) activity at 12 and 8 months of age, respectively. By contrast, prefrontal cortical concentrations of biogenic amines and their metabolites were unaffected, thus indicating a degree of neurochemical specificity for these neonatal nBM lesions. The persistant cortical cholinergic hypofunction in lesioned animals may be related to the long term deficits in learning/memory abilities that were also observed. It is suggested that neonatal nBM lesioning could provide a useful animal model for elucidating the plasticity of the developing brain after cortical anervation.