一氧化氮与帕金森病小鼠模型神经损害的研究

目的　研究一氧化氮（ＮＯ） 在帕金森病（ＰＤ）小鼠模型神经损害中的作用。方法　用比色分析、高效液相色谱电化学及免疫组化法检测１甲基４苯基四氢吡啶（ＭＰＴＰ）和７硝基吲唑（７ＮＩ）对Ｃ５７ＢＬ小鼠纹状体一氧化氮合酶（ＮＯＳ） 活性,多巴胺（ＤＡ）、二羟基苯乙酸（ＤＯＰＡＣ）、高香草酸（ＨＶＡ） 水平和酪氨酸羟化酶（ＴＨ） 免疫阳性神经纤维的影响。结果　注射ＭＰＴＰ后Ｃ５７ＢＬ小鼠纹状体ＮＯＳ活性增加,７ＮＩ能明显抑制ＭＰＴＰ引起的ＮＯＳ活性的升高（ 分别为０ ．９３ ±０．２４ 和０．５４ ±０．１６,ｎｍｏｌ·ｍｉｎ－１·ｇ－１ 组织,Ｐ＜０．０１） 。７ＮＩ能明显减轻ＭＰＴＰ引起的Ｃ５７ＢＬ小鼠纹状体ＤＡ（ 分别为０ ．８ ±０ ．２ 和６．８±０．５,μｇ／ｇ 组织,Ｐ＜０．０１） 、ＤＰＯＡＣ（ 分别为０．３ ±０．１ 和０ ．９ ±０ ．３ ,μｇ／ｇ 组织,Ｐ＜ ０ ．０１）、ＨＶＡ（分别为０．４±０．２ 和０．９ ±０ ．２,μｇ／ｇ 湿组织,Ｐ＜ ０．０１） 的降低及ＴＨ 阳性神经纤维损害。结论神经元来源的ＮＯ 参与了ＭＰＴＰ的毒性机制,神经元型ＮＯＳ抑制剂可能有益于ＰＤ的治疗。     

一氧化氮与帕金森病大鼠模型神经损伤的研究

目的 研究一氧化氮（ＮＯ）在帕金森病（ＰＤ）大鼠模型神经损伤中的作用。方法 用高效液相色谱电化学法（ＨＰＬＣ－ＥＴ）及还原型辅酶Ⅱ（ＮＡＤＰＨ）黄递酶组化法观察ＮＯ在ＰＤ大鼠模型神经损伤中的作用。结果 神经型一氧化氮合成酶（ｎＮＯＳ）抑制剂７－硝基吲唑（７－ＮＩ）明显减少６－羟基多巴胺（６－ＯＨＤＡ）引起的纹状体多巴胺及其代谢产物的降低（Ｐ〈０．０１）；纹状体ＮＡＤＰＨ黄递酶阳性神经元可抵抗６－Ｏ     

颈动脉注射辣椒素激活脑干心血管相关核团的儿茶酚胺神经元

在外周压力感受器去神经支配的大鼠上，用Ｆos蛋白和酪氨酸羟化酶（ＴＨ）的双重免疫组化方法，研究辣椒素的效应是否通过激活脑干核团内儿茶酚胺能神经元而诱发。结果显示，颈动脉注射辣椒素诱发脑干中最后区（ＡＰ）、孤束核（ＮＴＳ）、巨细胞旁外侧核（ＰＧＬ）和蓝斑（ＬＣ）等多个部位出现大量ＦOS样免疫反应（ＦＬＩ）神经元和双标神经元，辣椒素受体阻断剂钌红（ＲＲ）或ＮＭＤＡ受体阻断剂ＭＫ－８０１可明显减弱此效应。以上结果表明，辣椒素的兴奋效应通过激活儿茶酚胺能神经元而诱发，辣椒素受体和／（或）谷氨酸介导这一效应。     

实验性癫痫时大鼠海马内兴奋性氨基酸受体对阿片肽含量的影响

应用免疫组织化学方法观察了青霉素致痫及海马内微量注射ＮＭＤＡ受体拮抗剂ＭＫ８０１（５－ｍｅｔｈｙ１－１０，１１－ｄｉｈｙｄｒｏ－５Ｈ－ｄｉｂｅｎｚｏ（ａ，ｄ）ｃｙｃｌｏｈｅｐｔａｎ－５，１０－ｉｍｉｎｅｍａｌｅａｔｅ）和非ＮＭＤＡ受体拮抗剂ＤＮＱＸ＊（６，７－ｄｉｎｉｔｒｏｑｕｉｎｏｘａｌｉｎｅ－２，３－ｄｉｏｎｅ）后，大鼠海马内吗啡肽Ａ１－１７和亮啡肽的含量变化，结果发现，在青霉素致痫４ｈ后，海     

血小板活化因子对神经细胞内游离钙离子作用的研究

目的观察脑损害时病理活性介质血小板活化因子（ｐｌａｔｅｌｅｔａｃｔｉｖａｔｉｎｇｆａｃｔｏｒ,ＰＡＦ）及其拮抗剂对神经细胞内游离钙离子（［Ｃａ２＋］ｉ）浓度的影响,探讨ＰＡＦ致使神经细胞内［Ｃａ２＋］ｉ超载的途径及其作用机制。方法采用ＡＲＣＭＭＩＣ阳离子检测系统,观察不同浓度的ＰＡＦ以及其特异性受体拮抗剂ＢＮ５２０２１和非特异性拮抗剂ＭＫ８０１对体外培养１４天的大鼠皮层神经元［Ｃａ２＋］ｉ浓度的影响。结果５×１０－６ｍｏｌ／Ｌ的ＰＡＦ可使培养神经细胞［Ｃａ２＋］ｉ浓度明显增高,与对照组比较差异有显著意义（Ｐ＜０．０１）;ＢＮ５２０２１可明显阻止ＰＡＦ所致的神经细胞内［Ｃａ２＋］ｉ超载,在此基础上加用ＭＫ８０１可使神经细胞内［Ｃａ２＋］ｉ水平下降的更为明显。结论ＰＡＦ可通过多种渠道致使神经细胞内钙离子超载。     

尼莫地平、MK-801对海马迟发性神经元坏死治疗作用的实验研究

采用大鼠全脑缺血模型、观察脑缺血再灌流过程中海马神经元的病理变化，并用尼莫地平（钙拮抗剂）及ＭＫ－８０１（ＮＭＤＡ受体拮抗剂）治疗，观察其对迟发性神经元坏死的疗效，旨在探讨钙及兴奋性氨基酸在海马神经元缺血损害中的作用，为缺血性脑损伤的治疗探索新的途径。     

尼莫地平,MT—801对海马迟发性神经元坏死治疗作用的实验研究

采用大鼠全脑缺血模型、观察脑缺血再灌注过程中海马神经元的病理变化，并用尼莫地平（钙拮抗剂）及ＭＫ－８０１（ＮＭＤＡ受体拮抗剂）治疗，观察其对迟发性神经元坏死的疗效，旨在探讨钙及兴奋性氨基酸在海马神经元缺血损害中的作用，为缺血性脑损伤的治疗探索新的途径。     

褪黑激素,5—羟色胺对大鼠中脑导水管周围灰质薄片神经元自发？…

运用细胞外电生理记录方法，研究了褪黑激素（ＭＥＬ），５－羟色胺（５－ＨＴ）对大鼠中脑导水管周围灰质（ＰＡＧ）薄片神经元自发放电的影响，ＰＡＧ神经元对ＭＥＬ和５－ＨＴ的主要反应分别为抑制和兴奋，ＭＥＬ的效应能被５－ＨＴ的拮抗剂噻庚啶（ＣＰＤ）所阻断，结果提示，ＭＥＬ不仅能通过自身受体，而且部分通过５－ＨＴ受体起作用。     

帕金森病大鼠黑质纹状体中氨基酸含量的变化

目的：观察帕金森病大鼠黑质纹状体中氨基酸神经递质的变化。方法：将６－羟多巴胺（６－ＯＨＤＡ）注入鼠右侧黑质内以建立偏侧帕金森病模型,检测其黑质和纹状体中四种氨基酸的含量。结果：帕金森病大鼠损毁侧谷氨酸（Ｇｌｕ）、天门冬氨酸（Ａｓｐ）、甘氨酸（Ｇｌｙ）、和ｒ－氨丁酸（ＧＡＢＡ）的含量较未损毁侧显著增加（Ｐ〈０．０１）。结论：兴奋性氨基酸可能参与了６－ＯＨＤＡ所致的黑质纹状体内神经元损伤。     

人神经生长因子对大鼠中枢胆碱能神经元损伤后作用的实验研究

目的　研究人神经生长因子（ Ｈ Ｎ Ｇ Ｆ） 对大鼠中枢胆碱能神经元轴突切断后的保护作用。方法　向双侧海马伞切断所致的痴呆大鼠脑室内注入 Ｈ Ｎ Ｇ Ｆ， 采用穿梭箱训练， 检测大鼠学习记忆功能恢复状况， 对脑内隔斜带复合体（ Ｓ Ｄ Ｂ） 中隔区（ Ｍ Ｓ） 胆碱能神经元采用胆碱乙酰基转移酶（ Ｃ Ｈ Ａ Ｔ） 免疫组化法观察其存活状态。结果　 Ｈ Ｎ Ｇ Ｆ 组大鼠术后两周内穿梭箱回避次数高于对照组（ Ｐ＜ ００１） ， 回避潜伏期短于对照组（ Ｐ＜ ００１） 。免疫组化及图像分析显示， 其胆碱能神经元存活状态优于对照组。结论　 Ｈ Ｎ Ｇ Ｆ 对大鼠中枢胆碱能神经元损伤具有短期保护作用； 减缓轴突切断引起的退行性变， 对痴呆大鼠学习记忆功能恢复有促进作用。     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.