肌电生物反馈联合康复训练对脊髓损伤患者运动功能及功能独立性的影响

目的:观察肌电生物反馈疗法联合康复训练对脊髓损伤(SCI)患者运动功能障碍的康复疗效。方法:60例胸腰段不完全性脊髓损伤患者随机分为观察组和对照组,每组30例。2组均进行常规康复治疗,观察组加用双下肢肌电生物反馈治疗。治疗前及治疗后8周、12周进行下肢肌肉最大收缩时表面肌电(sEMG)信号采集、运动功能评定及功能独立性(FIM)评定,比较临床疗效。结果:治疗8周后,2组患者股四头肌、胫前肌最大收缩时的sEMG信号均较治疗前明显提高(P0.05),治疗后12周继续提高(P0.01);观察组sEMG信号增幅高于对照组(P0.05)。治疗8周后,2组患者ASIA运动功能评分及FIM评分亦较治疗前提高(P0.05),组间比较差异无统计学意义;治疗12周后,2组ASIA运动功能及FIM评分较治疗8周后提高更明显(P0.01),观察组更高于对照组(P0.05)。结论:肌电生物反馈疗法联合康复训练对胸腰段不完全性脊髓损伤患者运动功能有促进作用,能明显提高患者的股四头肌、胫前肌表面肌电信号及肌力,并能提高功能独立水平,减少并发症。     

Brain activity in near-death experiencers during a meditative state

Aim

To measure brain activity in near-death experiencers during a meditative state.

Methods

In two separate experiments, brain activity was measured with functional magnetic resonance imaging (fMRI) and electroencephalography (EEG) during a Meditation condition and a Control condition. In the Meditation condition, participants were asked to mentally visualize and emotionally connect with the “being of light” allegedly encountered during their “near-death experience”. In the Control condition, participants were instructed to mentally visualize the light emitted by a lamp.

Results

In the fMRI experiment, significant loci of activation were found during the Meditation condition (compared to the Control condition) in the right brainstem, right lateral orbitofrontal cortex, right medial prefrontal cortex, right superior parietal lobule, left superior occipital gyrus, left anterior temporal pole, left inferior temporal gyrus, left anterior insula, left parahippocampal gyrus and left substantia nigra. In the EEG experiment, electrode sites showed greater theta power in the Meditation condition relative to the Control condition at FP1, F7, F3, T5, P3, O1, FP2, F4, F8, P4, Fz, Cz and Pz. In addition, higher alpha power was detected at FP1, F7, T3 and FP2, whereas higher gamma power was found at FP2, F7, T4 and T5.

Conclusions

The results indicate that the meditative state was associated with marked hemodynamic and neuroelectric changes in brain regions known to be involved either in positive emotions, visual mental imagery, attention or spiritual experiences.     

A Special Electroencephalography Pattern Might Help in the Diagnosis of Antibody-positive Encephalitis

Background:

Patterns observed with electroencephalography (EEG) for patients who have encephalitis are usually known as generalized nonspecific cerebral abnormalities. The aim of this study was to investigate the presence of a special EEG pattern for patients with encephalitis and to explore features related to this special and uncommon pattern.

Methods:

EEG monitoring was performed for every patient aged >15 years with encephalitis who was hospitalized between December 2011 and March 2014. Clinical characteristics and EEG recordings were collected and evaluated.

Results:

Fifty-two patients with encephalitis were enrolled in our study with a 2-h median EEG recording time, and extreme beta brushes (EBBs) occurred in 17 patients (32.7%). Its presence was not significant regarding gender, age, psychiatric medication use, EEG rhythmic disorganization (P > 0.05). Nevertheless, among the patients with EBBs, nine patients (52.9%) had epileptic seizures that had a significant detection rate (P < 0.05); moreover, the cerebrospinal fluid (CSF) or serum of 15 patients (88.2%) with EBBs was positive for antibodies (P < 0.05). Four patients (23.5%) who had EBB had corresponding regional distributions on neuroimaging scans. The EBBs completely correlated with the regional distributions of spike discharges for four patients.

Conclusion:

EBB is a special EEG pattern for patients with encephalitis, especially those with epileptic seizures or who have antibody-positive CSF/serum, and should be considered in clinical practice.     

镜像视觉反馈和肌电生物反馈对脑卒中偏瘫患者上肢功能的影响

目的研究镜像视觉反馈(MVF)、任务导向训练和肌电生物反馈(EMGBF)对脑卒中偏瘫患者上肢功能的恢复的作用。方法 90例脑卒中偏瘫患者采用随机数字表法分为对照组(n=30)、EMGBF组(n=30)和MVF组(n=30)。所有患者均接受常规康复治疗和任务导向性训练,EMGBF组在此基础上加EMGBF,MVF组在EMGBF组的基础上加MVF,共8周。治疗前后进行Fugl-Meyer运动功能评定(FMA)、Carroll手功能评定(UEFT),并测定偏瘫上肢相关肌电积分。结果治疗后,所有患者上肢FMA评分,UEFT评级和上肢肌肉肌电积分均较治疗前改善(P0.05)。组间比较,EMGBF组各项指标均优于对照组(P0.05),MVF组优于其他两组(P0.05)。结论镜像视觉反馈结合肌电生物反馈可以更有效地促进脑卒中偏瘫患者上肢功能的改善。     

Non-pharmacological treatments in the irritable bowel syndrome

INTRODUCTION The irritable bowel syndrome (IBS) is a gastrointestinal disorder characteried by chronic lower abdominal pain and disordered defaecation associated with bloating ,tenesmus and extra-intestinal symptoms including and functional upper gastrointestinal symptoms .Currently there is nounifying hypothesis which adepuately explains the pathogenesis of the disorder although a number of physiological and psychological abmormalites have been described.     

Neural Network Based Response Prediction of rTMS in Major Depressive Disorder Using QEEG Cordance

Objective

The combination of repetitive transcranial magnetic stimulation (rTMS), a non-pharmacological form of therapy for treating major depressive disorder (MDD), and electroencephalogram (EEG) is a valuable tool for investigating the functional connectivity in the brain. This study aims to explore whether pre-treating frontal quantitative EEG (QEEG) cordance is associated with response to rTMS treatment among MDD patients by using an artificial intelligence approach, artificial neural network (ANN).

Methods

The artificial neural network using pre-treatment cordance of frontal QEEG classification was carried out to identify responder or non-responder to rTMS treatment among 55 MDD subjects. The classification performance was evaluated using k-fold cross-validation.

Results

The ANN classification identified responders to rTMS treatment with a sensitivity of 93.33%, and its overall accuracy reached to 89.09%. Area under Receiver Operating Characteristic (ROC) curve (AUC) value for responder detection using 6, 8 and 10 fold cross validation were 0.917, 0.823 and 0.894 respectively.

Conclusion

Potential utility of ANN approach method can be used as a clinical tool in administering rTMS therapy to a targeted group of subjects suffering from MDD. This methodology is more potentially useful to the clinician as prediction is possible using EEG data collected before this treatment process is initiated. It is worth using feature selection algorithms to raise the sensitivity and accuracy values.     

间期痫样发放对内侧颞叶癫痫脑网络的影响

目的探讨间期痫样发放对内侧颞叶癫痫患者脑静息态网络的影响,揭示间期癫痫活动发放对全脑功能的损害机制。材料与方法从45例行同步脑电f MRI数据采集单侧颞叶癫痫患者中,挑选35例(左侧颞叶癫痫患者18例、右侧颞叶癫痫患者17例),以同步脑电图监测,每一患者均采集间期痫样发放及无痫样发放状态静息态f MRI数据。采用独立成分分析方法,分别提取患者两种状态的核心网络、背侧注意网络、执行控制网络、默认网络及感觉运动网络等7套内在连接网络。采用配对t检验比较痫样发放及无痫样发放状态m TLE患者脑内在连接网络的差异。结果相比未发放状态,发放状态下颞叶癫痫患者核心网络的前扣带回功能连接增强,听觉网络的脑岛及颞上回功能连接减低。此外,背侧注意网络的顶上小叶在左侧颞叶癫痫患者表现为功能连接增强,而在右侧表现为连接减弱。前默认网络的额中回在右侧表现为功能连接减弱,而后默认网络颞中回及后扣带回在右侧表现为功能连接增强。执行控制网络的中扣带回和视觉网络枕叶皮层在左侧表现为功能连接增强。相关分析结果显示,左侧组视觉网络及右侧组听觉网络内连接强度的变化与发放状态下IEDs发放次数呈正相关。结论内侧颞叶癫痫发作间期痫样发放对脑高级认知网络及感知觉网络均产生了广泛影响,尤其是对参与脑高级认知功能网络的损害,这有助于进一步了解海马硬化这一特异性内侧颞叶癫痫在发作间期脑功能受损机制。     

急性毒鼠强中毒检测脑电图与转氨酶的临床意义

目的探讨急性毒鼠强中毒脑电图(EEG)与转氨酶的临床意义。方法48例急性毒鼠强中毒患者72h内行EEG、转氨酶检测。结果EEG异常43例,异常率为89·6%;转氨酶异常39例,异常率为81·2%。结论EEG异常和转氨酶升高与患者临床症状轻重呈平行关系,且EEG和转氨酶恢复正常比临床症状消失晚。