基于DTI影像图论分析的正常老化认知表现预测模型

目的 以磁共振扩散张量影像（diffusion tensor imaging,DTI）为基础进行大脑结构网络拓扑属性分析,选择与认知表现分数相关性较大的结构网络特征,并基于这些特征建立认知表现分数预测模型,藉以客观地估测老年人的大脑认知能力.方法 对94例正常老化的DTI影像进行结构脑网络构建,采用图论法分析结构连接矩阵,提取结构网络的特征,并将所有特征与受试者的简单智能状态检查量表（mini-mental status examination,MMSE）分数进行相关性分析,选取出与大脑认知高度相关的网络特征,再基于这些特征建立5种分析模型,预测受试者的认知表现分数,以进一步分析模型的预测效能.结果 通过相关性分析,在相关系数大于0.22且P值小于0.05的条件下,选取出与大脑认知高度相关的30个特征,这些特征分布在AAL（automated anatomical labeling）图谱中的12个脑区.而在模型建立与效能分析部分,以高斯回归模型的效能最佳,其训练组相关系数达0.89,预测误差最小为2.01,对受试者的认知表现分数预测较准确.结论 利用结构脑网络度量指标作为生物标记指针可建立正常老化认知功能预测模型,且能有效预测正常老年人的认知表现分数.     

静息态功能磁共振成像功能连接特异性指数模型在评估健康老年人认知分数中的应用

与传统量表法和任务态功能磁共振成像(fMRI)相比,静息态功能磁共振(rfMRI)在认知功能检测上有很大优势(特别是针对老年人),但脑老化功能影像学标记尚在探索中。提出功能连接特异性指数模型,试图与健康壮年人对照,分析健康老年人脑功能特异性,寻求区分认知分数的功能影像学指标,探索其分类认知分数优差的可能性,为替代提供研究基础。实验数据来自98名健康老年人和90名健康壮年人,前者来源于葡萄牙健康老年人认知功能的队列研究,在rfMRI扫描前,在认知量表测试分数最优和最差中,分别选出55名和43名作为实验组;后者数据来自哈佛医学院GSP影像组学,年龄在18～35岁之间,在rfMRI扫描前的认知功能评价分数居中,作为对照组。首先,对rfMRI预处理后,计算每人全脑功能连接,构建以脑区为单位的功能连接特异性指数模型,分析老年人脑功能连接与壮年人的偏移程度,统计、对比获得对优、差分数敏感的标志性脑区;然后,以其特异性指数值形成特征向量;最后,应用概率神经网络(PNN)模型对优、差分数组进行分类和N折交叉验证以检验所建指数模型的分类能力。健康老年人脑功能连接特异性指数模型可定位于健康老年人认知分数敏感的标志性脑区,分别处于额叶、颞叶、顶叶中的5个脑区;以这些脑区的指数为特征向量,可有效地区分优、差认知分数,准确度可达81.7%。通过对评价指数的建模并联合机器学习方法,可为rfMRI评估健康老年人认知分数提供有效的评价指标和新方法。     

基于体素的和基于形变的形态学测量在轻度认知障碍识别上的比较研究

目的 比较基于体素的形态学测量(voxel-based morphometry,VBM)和基于形变的形态学测量(deformation-based morphometry,DBM)在检测轻度认知功能障碍(mild cognitive impairment,MCI)灰质异常及相应分类识别性能上的差异,为结构态分析方法的选择提供依据.方法 利用VBM和DBM对27例MCI患者及30例健康对照的磁共振结构像进行分析,分别统计比较获得相应的组间结构异常脑区,并将异常脑区作为分类特征构建相应的MCI诊断识别模型,最终通过评价异常脑区的空间分布特征及分类识别准确率来评估两种方法的差异.结果 VBM和DBM均发现MCI患者在海马、海马旁回、杏仁核、岛叶等脑区发生结构改变,但VBM方法还在额中回、颞中回等脑区发现异常.VBM确定的结构异常得到了86.0％的最佳准确度,而DBM方法的准确度为77.2％,虽然在性能表现上稍差,但发现的特征与VBM的最优特征具有一致性.结论 VBM方法可以发现更多的MCI结构异常,而DBM方法则能发现具有较强敏感性的结构异常,因而提示在磁共振结构像研究中应将两者结合应用.     

遗忘型轻度认知损害患者和非痴呆血管性认知的损害患者认知功能比较

目的:探讨遗忘型轻度认知损害(amnestic mild cognitive impairment, aMCI)和非痴呆血管性认知损害(vascular cognitive impairment-no dementia, VCI-ND)的认知缺损的特征.方法:本研究为病例对照研究.2006年10月至2007年3月在本院神经内科"记忆障碍"或"中风"门诊选取遗忘型轻度认知损害者10人、非痴呆血管性认知损害者12人,在社区退休老人中随机抽取16人为正常对照组.所有受试年龄在50～80岁之间,教育程度在初中及初中以上,全部完成头颅CT或核磁共振、简易精神状态量表(Mini-mental State Examination, MMSE)及成套神经心理测验.结果:三种记忆测验中,aMCI组各项记忆得分均为最低,aMCI组和VCI-ND组各项得分均低于正常对照组[如,复杂图形测验延迟回忆:正常组(18.8±9.5)、aMCI组(5.6±5.6)、VCI-ND 组(9.6±7.0),P<0.01].执行功能测验中,反应耗时数测验VCI-ND组完成时间为最长,其次是aMCI组[如,连线测验B的耗时数:两组得分分别为 (266.6±109.9)、(199.2±48.6),P=0.034];而反应正确数测验VCI-ND和aMCI组表现均较正常组差[如,Stroop色词测验卡片C正确数正常组(46.8±2.9)、aMCI组(38.7±11.6)、VCI-ND 组(38.3±6.8),P<0.01].结论:遗忘型轻度认知损害患者以情景记忆损害为较早出现严重的认知损害,而非痴呆血管性认知损害患者以执行功能的定势转移障碍为主.这个结果反映了两者在病理机制上的差异.     

LightGBM算法在阿尔茨海默症结构磁共振成像分类中的应用

为更好地利用计算机技术分析阿尔茨海默症(AD)患者的大脑脑区变化,并对AD进行辅助诊断,本研究选择来自AD神经影像数据库的116名AD患者、116名轻度认知障碍患者和117名正常对照者的脑部结构磁共振成像,并利用spm软件对3组数据进行预处理和统计学相关性分析,得到差异性脑区。然后使用IBASPM软件提取病灶脑区体积作为特征样本。最后利用LightGBM算法对特征向量进行分类,并与支持向量机和XGBoost算法作对比实验。实验结果显示,利用LightGBM算法对病灶脑区的体积进行分类,准确率可达到83%。在这3种分类算法中,LightGBM更具有优势,分类结果更准确,可见,利用LightGBM算法可以有效地辅助医疗人员对AD进行早期诊断。     

基于熵算法的孤独症谱系障碍儿童脑电特征提取与分类

孤独症谱系障碍(ASD)儿童的早期诊断至关重要。脑电图(EEG)是最常用于神经成像的技术之一,其使用方便并且包含信息丰富。本文从ASD儿童和正常儿童的EEG信号中提取近似熵(ApEn)、样本熵(SaEn)、排序熵(PeEn)和小波熵(WaEn)四种熵特征,应用独立样本t检验分析组间差异,利用支持向量机(SVM)学习算法为不同脑区的每种熵测量建立分类模型,最后通过置换检验搜索优化子集,使SVM模型实现最佳性能。结果表明,与正常对照组相比,ASD儿童脑电复杂度较低;在所有四种熵中,WaEn的分类性能优于其他熵;分类效果在不同脑区表现出差异性,其中额叶区域表现最佳;最后经过特征选择,筛选出六个特征,建立分类模型,分类准确率最高提高到84.55%。本研究结果可为孤独症的早期发现提供帮助。     

下腰痛患者脑网络的动态功能连接

目的:探究下腰痛（LBP）患者脑网络功能连接的动态变化。方法:对20例LBP患者及20例健康志愿者进行静息态 脑功能核磁共振扫描,采用连接数目熵（CNE）比较LBP患者与健康志愿者大脑的动态功能连接变化,分析LBP患者各独立 脑区的功能灵活性与年龄和日本骨科协会（JOA）量表评分的相关性。结果:全脑水平,LBP患者CNE低于正常人（P＜0.05）, 显著改变的脑区集中在额叶皮层、颞叶皮层、皮质下核团及部分枕叶皮层。脑区水平,LBP 患者中AAL 15（r=-0.525 5, P=0.020 8）、AAL32（r=-0.529 2,P=0.019 8）、AAL41（r=-0.546 9,P=0.015 4）、AAL62（r=0.601 5,P=0.006 4）、AAL76（r=-0.513 3, P=0.024 6）、AAL89（r=0.461 9, P=0.046 5）和AAL90（r=0.508 5, P=0.026 2）与年龄有临床相关性。LBP患者AAL17（r=-0.499 1, P=0.029 6）、AAL 47（r=0.481 4, P=0.036 9）、AAL 82（r=-0.554 8, P=0.013 7）、AAL 90（r=-0.562 1, P=0.012 3）与临床JOA量 表评分有相关性。结论:LBP患者全脑功能网络的功能灵活性是降低的。CNE动态功能连接的测量不仅为量化大脑活动 的时间与空间行为提供了一个新的框架,而且可以探索LBP脑功能变化的机理。     

基于动态图论特征的阿尔茨海默病早期预测

目的阿尔茨海默病是常见的神经退行性疾病,而主观认知下降可发生于阿尔茨海默病临床前期,但传统磁共振数据分析对于主观认知下降的区分度较低。本研究通过动态图论特征在磁共振数据中的应用,研究主观认知下降患者脑动态功能连接的变化。方法随机纳入30例主观认知下降患者以及年龄、性别等相匹配的30例健康受试者的静息态磁共振数据,分别计算两组受试者时域变换灵活性和空间分布广泛性两个动态图论特征,同时构建基于支持向量机的分类器,研究动态图论特征的分类效果,分析两组受试者动态图论特征的主要分类贡献脑区的变化差异。结果研究发现主观认知下降患者在额上回、楔前叶等认知相关脑区的动态图论特征较之于正常受试者有显著减弱,且动态图论特征在分类中能够获得较高的准确度,优于传统静态图论特征。结论动态图论特征能够分析主观认知下降患者脑动态功能连接的变化,为阿尔茨海默病的早期诊断提供理论依据。     

青少年肌阵挛癫痫患者的大尺度脑网络研究

采用静息态功能性磁共振成像(rs-fMRI)数据探究青少年肌阵挛癫痫(JME)患者大尺度脑网络的变化。采集17例JME患者和15名正常志愿者的脑部静息态功能磁共振成像数据,两组均使用偏相关系数构建静息态脑网络。分别计算JME患者组与正常对照组的阈值,构建二值化脑网络。计算两组被试各个脑区的介数值,采用双样本t检验对比两组脑网络介数值的差异(Bonferroni 校正,P<0.01),找出介数值发生显著变化脑区。结果表明,偏相关系数构造的脑网络具有小世界属性。JME患者组脑网络中脑区的介数值相比正常对照组有显著性差异。与正常对照组相比,JME患者组介数值显著降低的脑区有2个,介数值显著升高的脑区有17个。其中属于默认模式网络(DMN)的脑区有8个,属于突显网络(SN)的脑区有5个。JME患者组介数值显著降低的脑区有右侧中央旁小叶和右侧后扣带回,介数值显著增高脑区主要是右侧背外侧额上回、左侧枕中回、右侧楔前叶和右侧舌回等。JME患者介数值发生显著改变的脑区主要属于默认模式网络和突显网络。可以推断出默认模式网络和突显网络内部脑区间连接发生改变,信息传递产生变化。由此可能会导致JME患者大脑功能发生改变,造成患者的认知能力与执行能力等功能受损。     

基于全脑功能连接的网络游戏障碍分类研究

目的：利用静息态磁共振数据构建全脑功能连接网络，通过多元模式分析建立诊断模型，实现网络游戏障碍(internet gaming disorder, IGD)和正常对照组之间的分类识别。方法：采集71例IGD患者及88例正常对照的大脑静息态磁共振数据，采用功能连接分析技术构建全脑功能连接网络。将大脑功能连接作为分类特征，采用支持向量机和多种特征选择方法，探索IGD患者区别于正常人的异常网络模式。综合多种特征选择方法筛选的共有特征最终确定IGD客观识别的影像学标志。结果：基于全脑功能连接建立的分类模型准确率最高可达80.6%（敏感性为78.5%，特异性为81.2%）。用于区分IGD患者和正常对照的神经影像学标记主要位于左侧背外侧前额叶、右侧前扣带回、左侧眶额回、右侧海马旁回和双侧颞叶等负责认知控制、动机和学习记忆的脑区。结论：基于静息态全脑功能连接的诊断模型对IGD有较好的区分能力，未来可以为临床智能诊断提供补充手段。     

Serum MCP-1 levels are increased in mild cognitive impairment and mild Alzheimer's disease

Upregulation of a number of chemokines, including monocyte chemotactic protein-1 (MCP-1), is associated with Alzheimer's disease (AD) pathological changes. Emerging evidence suggests that inflammatory events precede the clinical development of AD, as cytokine disregulation has been observed also in patients with mild cognitive impairment (MCI).

MCP-1 levels were evaluated in serum samples from 48 subjects with MCI, 94 AD patients and 24 age-matched controls. Significantly increased MCP-1 levels were found in MCI and mild AD, but not in severe AD patients as compared with controls. mRNA levels in peripheral blood mononuclear cells (PBMC), evaluated by quantitative RT-PCR analysis, paralleled serum MCP-1 levels. Moreover, a progressive MCP-1 decrease was observed over a 1-year follow up in a subgroup of MCI subjects converted to AD. MCP-1 upregulation is likely to be a very early event in AD pathogenesis, by far preceding the clinical onset of the disease. Nevertheless, as MCP-1 is likely to play a role in several pathologies with an inflammatory component, a possible usfulness as an early AD biomarker would be possible only in combination with other molecules.     

Subjective cognitive decline in idiopathic Parkinson´s disease: A systematic review

Cognitive symptoms of Parkinson’s disease (PD) have been long underestimated, but are some of the most disabling non-motor features of the disease. In order to establish signs that allow for earlier detection of cognitive decline in PD, the concept of `subjective cognitive decline´ (SCD) has gained a growing interest. SCD refers to patients who report a decline in subjective cognitive capacities, while their results on neuropsychological tests are within the normal performance range, indicating adequate cognitive functions. The aim of this review was to evaluate the concept of SCD in PD and give an overview of the current research. A systematic literature search in PubMed was performed to identify articles published before December 2020. We included 18 studies with a total of n = 2,654 patients. While there is currently no consensus on research or clinical criteria for SCD in PD, this review presents the accumulated evidence for SCD in PD patients and supports the importance of early identification of cognitive deficits, due to the relatively high prevalence for SCD in PD and the added risk of future cognitive impairment it entails. The publications included in this review indicate that SCD may be part of the PD spectrum but further research is needed. Expanding research on SCD in PD will allow for earlier detection of cognitive impairment and may foster preventive interventions.     

Cortical sources of resting state electroencephalographic alpha rhythms deteriorate across time in subjects with amnesic mild cognitive impairment

Cortical sources of resting state electroencephalographic (EEG) rhythms are abnormal in subjects with mild cognitive impairment (MCI). Here, we tested the hypothesis that these sources in amnesic MCI subjects further deteriorate over 1 year. To this aim, the resting state eyes-closed EEG data were recorded in 54 MCI subjects at baseline (Mini Mental State Examination I = 26.9; standard error [SE], 0.2) and at approximately 1-year follow-up (13.8 months; SE, 0.5; Mini Mental State Examination II = 25.8; SE, 0.2). As a control, EEG recordings were also performed in 45 normal elderly and in 50 mild Alzheimer's disease subjects. EEG rhythms of interest were delta (2–4 Hz), theta (4–8 Hz), alpha1 (8–10.5 Hz), alpha2 (10.5–13 Hz), beta1 (13–20 Hz), and beta2 (20–30 Hz). Cortical EEG sources were estimated using low-resolution brain electromagnetic tomography. Compared with the normal elderly and mild Alzheimer's disease subjects, the MCI subjects were characterized by an intermediate power of posterior alpha1 sources. In the MCI subjects, the follow-up EEG recordings showed a decreased power of posterior alpha1 and alpha2 sources. These results suggest that the resting state EEG alpha sources were sensitive—at least at the group level—to the cognitive decline occurring in the amnesic MCI group over 1 year, and might represent cost-effective, noninvasive and widely available markers to follow amnesic MCI populations in large clinical trials.     

基于极限学习机的阿尔兹海默病辅助诊断

阿尔兹海默病是一种渐进发展式的痴呆疾病, 其脑部随着病情发展逐渐出现萎缩。利用磁共振脑图像解剖学特征的变化, 提出一种使用极限学习机来诊断阿尔兹海默病以及轻度认知障碍的方法。采用FreeSurfer软件, 分析从ADNI数据库的818份磁共振图像中得到的脑部解剖学特征。首先对这些特征使用线性回归模型来估计正常衰老引起的萎缩因素, 并将其从特征中去除;随后采用极限学习机作为分类器, 使用处理后的特征来诊断阿尔兹海默病和轻度认知障碍。在实验过程中, 通过十折交叉验证来测试该方法的诊断准确率、敏感度、特异度和曲线下面积。通过100次实验求平均的方式计算得出, 该方法诊断阿尔兹海默病的准确率达到87.62%, 曲线下面积达到94.25%;诊断轻度认知障碍的准确率达到73.38%, 敏感度达到83.88%, 其中年龄矫正能有效提高轻度认知障碍诊断的准确率。实验结果表明, 该方法能有效诊断阿尔兹海默病和轻度认知障碍。     

Electrophysiological correlates of error processing in borderline personality disorder

The electrophysiological correlates of error processing were investigated in patients with borderline personality disorder (BPD) using event-related potentials (ERP). Twelve patients with BPD and 12 healthy controls were additionally rated with the Barratt impulsiveness scale (BIS-10). Participants performed a Go/Nogo task while a 64 channel EEG was recorded. Three ERP components were of special interest: error-related negativity (ERN)/error negativity (Ne), early error positivity (early Pe) reflecting automatic error processing, and the late Pe component which is thought to mirror the awareness of erroneous responses. We found smaller amplitudes of the ERN/Ne in patients with BPD compared to controls. Moreover, significant correlations with the BIS-10 non-planning sub-score could be demonstrated for both the entire group and the patient group. No between-group differences were observed for the early and late Pe components. ERP measures appear to be a suitable tool to study clinical time courses in BPD.     

Blood fatty acids in Alzheimer’s disease and mild cognitive impairment: A meta-analysis and systematic review

Plasma fatty acids have been reported to be dysregulated in mild cognitive impairment (MCI) and Alzheimer’s disease (AD), though outcomes are not always consistent, and subject numbers often small. Our aim was to use a meta-analysis and systematic review approach to identify if plasma fatty acid dysregulation would be observed in case control studies of AD and MCI. Six databases were searched for studies reporting quantified levels of fatty acids in MCI and/or AD individuals, relative to cognitively normal controls. Docosahexaenoic (DHA) and vaccenic acids were significantly lower and higher respectively in MCI relative to controls. Total fatty acids were 27.2% lower in AD relative to controls, and this was reflected almost uniformly in all specific fatty acids in AD. Changes to plasma/serum fatty acids were identified in both MCI and AD relative to age and gender matched controls. Differences were greatest in AD, in both total number of fatty acids significantly altered, and the degree of change. Docosahexaenoic acid was lower in both MCI and AD, suggesting that it may be a driver of pathology.     

The impact of task load on the integration of explicit contextual priors and visual information during anticipation

There is limited knowledge about the impact of task load on experts’ integration of contextual priors and visual information during dynamic and rapidly evolving anticipation tasks. We examined how experts integrate contextual priors––specifically, prior information regarding an opponent's action tendencies––with visual information such as movement kinematics, during a soccer-specific anticipation task. Furthermore, we combined psychophysiological measures and retrospective self-reports to gain insight into the cognitive load associated with this integration. Players were required to predict the action of an oncoming opponent, with and without the explicit provision of contextual priors, under two different task loads. In addition to anticipation performance, we compared continuous electroencephalography (EEG) and self-reports of cognitive load across conditions. Our data provide tentative evidence that increased task load may impair performance by disrupting the integration of contextual priors and visual information. EEG data suggest that cognitive load may increase when contextual priors are explicitly provided, whereas self-report data suggested a decrease in cognitive load. The findings provide insight into the processing demands associated with integration of contextual priors and visual information during dynamic anticipation tasks, and have implications for the utility of priors under cognitively demanding conditions. Furthermore, our findings add to the existing literature, suggesting that continuous EEG may be a more valid measure than retrospective self-reports for in-task assessment of cognitive load.     

Early event-related potentials changes during simple mental calculation in Chinese older adults with mild cognitive impairment: A case–control study

The aim was to examine early event-related potential (ERP) changes during mental arithmetic calculation task in mild cognitive impairment patients compared to healthy elderly. 16 mild cognitive impairment (MCI) subjects and 16 healthy Chinese older adults were studied. Event-related potentials were elicited using a simple mental calculation task. Performance on arithmetic calculation task, and the latency and amplitude of early event-related potential components (N1, P1, N170, and P2) were compared between the two groups. The reaction time of MCI group was significantly longer than that of control group (1691.03 ± 94.59 vs. 1539.55 ± 27.76, P < 0.01). The correct rate of MCI group (0.9463 ± 0.04) was significantly lower than that of control group (0.9776 ± 0.02, P < 0.01). The latency of temporal–occipital N170 and central–prefrontal P2 of MCI group were significantly prolonged compared to controls. MCI subjects presented significantly higher P2 amplitude. Compared with healthy controls, N170 was significantly lower at left temporal–occipital region and higher at right temporal–occipital region in mild cognitive impairment. Mild cognitive impairment patients had deficit on simple calculation. The early arithmetic calculation processing mechanism of mild cognitive impairment patients may be different from normal people.     

成人注意缺陷多动障碍的心理治疗(综述)

成人注意缺陷多动障碍(ADHD)对患者的社会功能存在持续不良影响,需要在药物治疗基础上进行包括心理治疗在内的综合性治疗.本文总结了针对成人ADHD不同种类的心理治疗方法,包括认知行为治疗、辩证行为治疗、正念冥想、训练治疗、婚姻家庭治疗,并对不同的治疗方法进行了研究、比较和总结.目前,中枢兴奋剂联合针对症状的心理治疗是多部治疗指南推荐的成人ADHD治疗方法,而在多种心理治疗方法中,认知行为治疗被证明对ADHD核心症状及与焦虑、抑郁相关的合并症状最为有效.最后本文分析了目前研究存在的问题和未来可能的研究方向,希望有助于成人ADHD的相关研究和临床治疗.