特发性快动眼期睡眠行为异常非运动障碍的特点

目的 通过分析快动眼期睡眠行为异常(idiopathic REM sleep disorder,iRBD)患者是否存在嗅觉减退、睡眠障碍、焦虑抑郁,来探讨iRBD患者的非运动障碍特点.方法 收集我院2014年1月至2016年1月iRBD患者48例及健康对照组53例,分别对两组人群进行睡眠指标、嗅觉功能、焦虑抑郁量表以及血清中IL-6、TNF-α浓度的检测.结果 iRBD组与健康对照组比较,其总睡眠时间、睡眠效率明显降低(P＜0.05);睡眠潜伏期、觉醒指数、快动眼睡眠潜伏期明显增高(P＜0.05);嗅觉减退明显增多(P＜0.01);焦虑抑郁评分明显增高(P＜0.05);但两组人群血清中IL-6及TNF-α浓度差异没有统计学意义(P＞0.05).结论 iRBD与帕金森病有类似的非运动障碍特点,早期干预iRBD人群有利于帕金森病患者的预防和治疗.     

IL-17、胱抑素C、同型半胱氨酸在帕金森病患者中的表达及意义

目的：探讨白细胞介素17(IL-17)、胱抑素C (Cys C)、同型半胱氨酸(Hcy)在帕金森病患者中的表达及意义。方法选择2010年1月至2013年12月期间68例帕金森病(PD)患者为观察组。选择健康人群42例为对照组。将68例PD患者按病情进展分为早期20例(H-Y分期<2)；中期22例(2≤H-Y分期<3)和晚期26例(H-Y分期≥3)。将68例PD患者分为认知功能障碍组32例(A组)和无认知功能障碍组36例(B组)。统计两组受试者血清IL-17、Cys C、Hcy含量，对血清IL-17、Cys C、Hcy与年龄、患病年限、H&Y评分、BMI进行相关性分析。结果 A组、B组血清Cys C、IL-17、Hcy水平明显高于对照组(P<0.01)，且A组血清Cys C、IL-17、Hcy水平高于B组(P<0.01)；晚期组血清Cys C、IL-17、Hcy水平最高(P<0.01)，中期组血清Cys C、IL-17、Hcy水平均高于早期组(P<0.01)；观察组患者血清IL-17、Cys C、Hcy水平与患病年限呈正相关(P<0.05)，与H-Y分期呈正相关(P<0.05)；血清IL-17、Cys C、Hcy水平之间均呈正相关(P<0.05)。结论 IL-17、Cys C、Hcy与PD的发病及进展密切相关，可反应病情的严重程度，在PD的进展中起一定作用。     

小白菊内酯对PD小鼠黑质区NF-κB和FLIP表达的影响

目的 探讨在1-甲基-4-苯基-1,2,3,6-四氢吡啶(MPTP)制备的帕金森病(pD)小鼠模型中核因子NF-κB与FADD样白细胞介素1-转化酶样抑制蛋白(FUP)之间的关系,研究核因子信号通路在PD发病中的作用机制.方法 将C57BL/6N小鼠随机分为模型组、干预组和对照组.观察小鼠行为学变化,采用免疫组织化学和免疫蛋白印迹法观察小鼠黑质酪氨酸羟化酶(TH)、NF-κB、FLIP和caspase-3的表达变化,以及给予小白菊内酯后对上述变化的影响.结果 与对照组相比,模型组小鼠出现典型PD症状,TH阳性神经元明显丢失,蛋白水平下降,核因子信号通路被激活,其阳性表达明显增多,FLIP和caspase-3表达也明显增加;经小白菊内酯干预处理后,上述变化均减轻.结论 核因子信号通路可能参与激活FLIP对PD模型小鼠黑质区凋亡有重要调控作用,小白菊内酯对PD模型小鼠有一定的神经保护作用.     

脐带源间充质干细胞治疗帕金森病的临床研究

目的 探讨脐带源间充质干细胞(human umbilical cord mesenchumal stem cells,HUMSCs)移植治疗帕金森病患者神经功能的疗效.方法 取胎儿脐带组织体外培养扩增并进行鉴定,将3 ～6 mL含有细胞5×106～1×107的细胞悬液,通过颈动脉移植途径植入10例帕金森病患者体内.每周1次,移植3次后,对患者进行移植前后帕金森病统一评分量表(UPDRS)和改良的Webster评分,并评估移植后不良反应.结果 脐带源间充质干细胞贴壁成漩涡状生长,CD73,CD90,CD105呈阳性表达;CD14,CD19,CD34,CD45,HLA-DR呈阴性表达.经颈动脉移植后,患者移植前后UPDRS评分具有显著性差异(P＜0.01),Webster评分有效改善患者行走姿势、震颤程度,自主运动及坐、起运动能力得到提高.结论 患者移植HUMSCs后能够有效控制帕金森病的发病进程,有效改善受损的脑组织功能,提高患者生活质量.     

利用诱导性多能干细胞技术研究环境致病因素诱导帕金森病发病的进展

帕金森病是一种十分普遍的中枢神经系统退行性疾病,以中脑黑质纹状体多巴胺能神经元丢失为主要特征,诱发因素较多。本文简述帕金森病的环境及职业致病因素和诱导性多能干细胞(i PScs)技术的研究进展,并分析了i PScs技术在研究环境、职业致病因素诱导帕金森病发病机制中的应用前景,提出了将i PScs技术应用于研究帕金森病的发病机制具有重要意义。     

帕金森病的神经保护治疗

帕金森病是一种常见的中枢神经系统变性疾病,其神经退变进行性加重,会导致患者严重残疾,寿命缩短,目前尚无有效的预防和根治措施.大量研究表明,帕金森病的发病机制涉及到线粒体功能和氧化应激,免疫反应,营养因子缺乏,细胞凋亡,蛋白质异常表达等.神经保护治疗能够延缓或终止帕金森病的进展,预防残疾的进一步加重.     

磁共振波谱MEGA-PRESS序列检测帕金森病纹状体γ-氨基丁酸的研究

目的 探讨MEGA-PRESS波谱编辑序列结合LCModel软件检测帕金森病(PD)患者双侧纹状体γ-氨基丁酸(GABA)浓度的价值.方法 选取符合诊断标准的45例PD患者和47例正常对照组作为研究对象,均行MEGA-PRESS波谱编辑序列扫描,获取GABA/Cr值;再应用LCModel软件获取GABA浓度.结果 (1)与对照组相比,PD组双侧纹状体GABA平均浓度升高,差异有统计学意义(P=0.045);GABA/Cr值均值升高,但无统计学意义(P=0.183).(2)PD患者症状严重侧的同侧、对侧纹状体GABA/Cr值及GABA浓度比较,无显著性差异(P＞0.05).(3) PD组双侧纹状体GABA浓度均值与临床病程、统一帕金森病评定量表(UPDRS)评分无显著相关性(r=0.108,0.031;P-0.438,0.823).结论 MEGA-PRESS序列结合LCModel软件可以较准确、客观检测PD患者纹状体GABA浓度.     

Force transition control within a movement sequence in parkinson's disease

Summary An experiment was performed which examined movement planning and force transition control in six patients with Parkinson's disease (PD) during a sequence of five finger taps at either a fast (200 ms) or slow (600 ms) temporal speed. The patients acted as their own controls and performed finger taps under three task conditions: (1) where all taps had to be of the same force intensity: no stress; (2) where it was known that one of the taps had to be executed with an augmented force: stress simple reaction time (SRT); and (3) where it was not known prior to initiation which one of the taps was to be more forcefully produced: stress choice reaction time (CRT). Reaction time data revealed a between-condition effect where stress SRT was faster than stress CRT and no stress was faster than both. Under both speed conditions, the interval after the stressed tap was profoundly lengthened. It was found that the lengthening was due to increases in both lift and dwell times for the slow tapping rate. In contrast, at the fast tapping rate, proportionately more of the interval increase was due to the increase in lift time. These findings suggest that patients with Parkinsons disease, when performing under a motor program mode, have difficulty in initiating a sequence and making a transition to lighter force levels after a stressed tap.This research was supported by the National Institute of Neurological Diseases and Stroke, grant no. NS17421     

Xenografting of fetal pig ventral mesencephalon corrects motor asymmetry in the rat model of Parkinson's disease

Summary A suspension of cells from embryonic day 21 fetal pig ventral mesencephalon was transplanted into the striatum of 20 immunosuppressed rats with 6-hydroxydopamine-induced lesions of the nigrostriatal dopamine pathway. Of these rats, 15 showed reduction of amphetamine-induced ipsilateral rotation by 9 weeks and complete reversal of rotation by 14–17 weeks. Animals maintained stable reversal of rotations (contralateral direction) until cessation of Cyclosporin A (CyA) treatment at 15–20 weeks. Within 4–9 weeks after CyA removal, these rats showed exclusively ipsilateral rotations during behavioral testing which were comparable to pre-transplant levels, suggesting that the grafts were rejected upon cessation of CyA treatment. Rats were sacrificed and tyrosine hydroxylase (TH) immunohistochemistry was performed at several time points, both on and off CyA, to examine a possible correlation between the degree of rotational behavior and the number of TH- positive surviving grafted cells. Staining showed large numbers (230–12,329) of TH-positive surviving cells in animals displaying a high degree of rotational correction (1.6 to -9.6 net ipsilateral rotations/min) after cessation of CyA treatment. Two control groups, those transplanted with nonneuronal cells from the pig ventral mesencephalon (n=5) and those receiving only daily CyA injections (n=4) showed no significant reduction of net ipsilateral rotations throughout the experiment. No TH-positive surviving cells were seen in the one non-neuronal transplant analyzed. This data demonstrates long-term retention of xenografted tissue with immunosuppression and its concomitant restoration of normal motor behavior in the rat model of Parkinson's disease.     

巴金森氏病智力损害与年龄、病程、运动障碍的关系

巴金森氏病病人的年龄、起病年龄、病程、运动障碍的严重程度与其智力损害的关系至今仍存有争议。为此用定量的临床评定方法、标准化的韦氏成人智力测验对31名连续收选的特发性巴金森氏病进行了研究。结果发现缓动的严重程度与智力损害明显相关,而震颤严重程度与智力损害呈反相关。病人的年龄、起病年龄、病程及强直的程度与智力损害无明显相关。这些结果提示引起缓动的皮层下脑损害同样可能引起智力损害,而有明显震颤的巴金森氏病可能属于该病的早期或属于智力损害较轻的一种巴金森氏病亚型。