葛根素治疗突发性耳聋的疗效观察

目的 观察葛根素治疗突发性耳聋的临床疗效.方法 突发性耳聋患者98例,分为治疗组49例(53耳),对照组49例(54耳),分别采用葛根素和川芎嗪ICU治疗,2组同时应用三磷酸胞苷二钠、氟美松及维生素B1和B12,10d为1个疗程,比较2组疗效.结果 治疗组治愈率50.94％,有效率88.68％;对照组组治愈率29.63％,有效率66.67％,2组比较差异有统计学意义(P＜0.05).结论 葛根素治疗突发性耳聋的效果良好,未发现明显不良反应.     

中西医结合治疗梅尼埃病98例临床观察

目的观察中西医结合治疗梅尼埃病的临床疗效。方法将98例患者随机分为2组,治疗组65例,采用中西医结合治疗,对照组33例以西药治疗。结果显效率、总有效率对照组分别为36.4%、84.8%,治疗组分别为81.5%、96.9%,2组比较,差异有非常显著性意义(P0.01)。结论中西医结合治疗梅尼埃病优于西药治疗。     

甲钴胺治疗突发性耳聋的疗效观察

目的 观察甲钴胺治疗突发性耳聋的疗效.方法 突发性耳聋52例,随机分2组,每组26例.甲钴胺组采用甲钴胺治疗;对照组常规治疗.结果 2组病例治疗后耳聋症状均有改善,甲钴胺组与对照组相比较,有效率差异有统计学意义(P<0.05).结论 甲钴胺治疗突发性耳聋的疗效令人满意.     

小脑前下动脉内灌注尿激酶治疗血管性突发性耳聋的疗效观察

目的 观察经微导管超选择小脑前下动脉尿激酶溶栓治疗血管性突发性耳聋之疗效.方法 74例血管性突发性耳聋患者随机接受动脉或静脉溶栓治疗,手术后辅助低分子肝素(0.40 m1)和阿司匹林(100mg)抗血小板聚集,分别于治疗后第1、3、6和10天复查电测听,以判定疗效.结果 治疗第10天时,动脉溶栓治疗组患者治疗总有效率达84.21%(32/38),静脉溶栓治疗组为58.33%(21/36).两组比较差异有统计学意义(X2=6.091,P:0.014).两组溶栓治疗后不同观察时间点电测听结果比较,动脉溶栓治疗组显著优于静脉溶栓治疗组,差异有统计学意义(均P<0.01).结论 超选择经动脉予以尿激酶可能是治疗血管性突发性耳聋的有效方法.     

中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态36例疗效分析

目的探讨中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态的方法与疗效.方法将70例一氧化碳中毒迟发性脑病痴呆状态患者随机分成中西医结合组36例,单纯西医组34例,中西医结合治疗组在西医治疗基础上采用大剂量醒脑静和针灸治疗,3～5个疗程后对2组疗效进行对照分析.结果中西医结合治疗组总有效率为94.4%,单纯西药对照组76.5%,经统计学处理,有显著性差异（P〈0.05）.结论中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态疗效优于单纯西药组     

中西医结合治疗外伤性癫痫的疗效观察

目的观察中西医结合治疗外伤性癫痫的临床疗效。方法将382例外伤性癫痫患者按随机数字表随机分为两组:西药组190例,采用西医常规抗癫痫药物治疗;中西医结合组192例,在西医治疗癫痫基础上加服中药痫停丸。结果总有效率:西药组69.5%,中西医结合组80.7%。两组比较差异显著(P<0.05)。结论中西医结合治疗癫痫的效果较单纯西药治疗好。     

中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态36例疗效分析

目的探讨中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态的方法与疗效。方法将70例一氧化碳中毒迟发性脑病痴呆状态患者随机分成中西医结合组36例,单纯西医组34例,中西医结合治疗组在西医治疗基础上采用大剂量醒脑静和针灸治疗,3～5个疗程后对2组疗效进行对照分析。结果中西医结合治疗组总有效率为94.4%,单纯西药对照组76.5%,经统计学处理,有显著性差异(P<0.05)。结论中西医结合治疗一氧化碳中毒迟发性脑病痴呆状态疗效优于单纯西药组     

银杏叶提取物治疗突发性耳聋61例临床观察

目的观察银杏叶提取物在突发性耳聋治疗中的作用。方法突发性耳聋患者发病1周内的患者61例,随机分为2组:对照组31例,36只患耳,予高压氧、盐酸丁咯地尔治疗;治疗组30例,36只患耳,在高压氧、盐酸丁咯地尔同时加用银杏叶提取物治疗。结果治疗组治愈率52.8%,显效率19.4%,有效率13.9%,总有效率86.1%;对照组治愈率50.0%,显效率16.7%,有效率13.9%,总有效率80.6%;2组比较,治愈率、显效率和总有效率差别有统计学意义(P<0.05)。结论银杏叶提取物在治疗突发性耳聋中有确切疗效。     

金纳多并针刺治疗突发性耳聋临床观察

目的观察金纳多并用针刺治疗突发性耳聋临床疗效。方法将36例突发性耳聋患者随机分为金纳多组(18例)和联合组(18例)进行治疗,对比分析2组的临床疗效。结果联合组疗效优于金纳多组,二者差异具有统计学意义。结论金纳多并用针刺是治疗突发性耳聋的有效方法之一。     

葛根素注射液治疗突发性耳聋的疗效观察

目的观察葛根素注射液治疗突发性耳聋的临床疗效.方法随机将住院突发性耳聋病人分为两组,治疗组30人,对照组28人.治疗组予以葛根素注射液400mg加入生理盐水250ml静滴;对照组予以复方丹参注射液20ml加入低分子右旋糖酐500ml静滴,观察疗效.结果治疗后两组临床疗效对比,总有效率治疗组90%,对照组71.43%,两组比较有统计学差异（P〈0.01）.结论葛根素注射液治疗突发性耳聋疗效好,值得进一步研究和应用.     

Voxel-based morphometry in the detection of dysplasia and neoplasia in childhood epilepsy: combined grey/white matter analysis augments detection

PURPOSE: Analysis of grey matter on MRI utilising voxel-based morphometry (VBM) may have insufficient sensitivity for routine clinical application. The aim of this exploratory study was to evaluate combined analysis of grey and white matter using VBM for detecting focal lesions underlying childhood epilepsy, and to establish the optimal statistical parameters in this context. METHODS: The patients were 16 children (10 boys) aged 5.9-15.2 years (11.3+/-2.8 years; mean+/-S.D.) with epilepsy and focal cortical dysplasia (FCD) or neoplasia. The control group comprised 24 normal children (12 boys), age matched to the patients. VBM was used to spatially normalise MRI volumes to a custom template and segment them into grey matter (GM) and white matter (WM). The combined GM/WM segments from each patient were contrasted with the control group. Three different VBM post-processing techniques of combined GM/WM were evaluated along with GM-only analysis. Maps showing increased/decreased GM or GM/WM concentration were generated and compared with visually identified lesions. Rates of detection and true/false positives voxels were calculated. RESULTS: The GM-only lesion detection rate was equal for FCD and neoplasia at 5/8, whereas the best combined GM/WM technique detected 8/8 FCD and 6/8 neoplasia. The combined technique also produced a higher overall rate of true positives (87%) than GM-only (44%) with a similar low rate of false positives. CONCLUSIONS: These preliminary data suggest that VBM is ineffective for precise delineation of lesion margins, but could potentially be used to detect subtle dysplasia in MRI negative and equivocal cases.     

Developmental relations between working memory and inhibitory control.

Working memory (WM) and inhibitory control (IC) are general-purpose resources that guide cognition and behavior. In this study, the developmental relations between WM and IC were investigated in 96 typically developing children aged 6 to 17 years in an experimental task paradigm using an efficiency metric that combined speed and accuracy performance. The ability to activate and process information in WM showed protracted age-related growth. Performance involving WM and IC together was empirically distinguishable from that involving WM alone. The results indicate that developmental improvements in WM are attributable to increased processing efficiency in activation, suppression, and strategic resource deployment, and that WM and IC are best studied in novel, complex situations that elicit competition among those resources.     

Positive effects of a computerised working memory and executive function training on sentence comprehension in aphasia

Aphasia, the language disorder following brain damage, is frequently accompanied by deficits of working memory (WM) and executive functions (EFs). Recent studies suggest that WM, together with certain EFs, can play a role in sentence comprehension in individuals with aphasia (IWA), and that WM can be enhanced with intensive practice. Our aim was to investigate whether a combined WM and EF training improves the understanding of spoken sentences in IWA. We used a pre–post-test case control design. Three individuals with chronic aphasia practised an adaptive training task (a modified n-back task) three to four times a week for a month. Their performance was assessed before and after the training on outcome measures related to WM and spoken sentence comprehension. One participant showed significant improvement on the training task, another showed a tendency for improvement, and both of them improved significantly in spoken sentence comprehension. The third participant did not improve on the training task, however, she showed improvement on one measure of spoken sentence comprehension. Compared to controls, two individuals improved at least in one condition of the WM outcome measures. Thus, our results suggest that a combined WM and EF training can be beneficial for IWA.     

Spatiotemporal distribution pattern of white matter lesion volumes and their association with regional grey matter volume reductions in relapsing‐remitting multiple sclerosis

The association of white matter (WM) lesions and grey matter (GM) atrophy is a feature in relapsing‐remitting multiple sclerosis (RRMS). The spatiotemporal distribution pattern of WM lesions, their relations to regional GM changes and the underlying dynamics are unclear. Here we combined parametric and non‐parametric voxel‐based morphometry (VBM) to clarify these issues. MRI data from RRMS patients with progressive (PLV, n = 45) and non‐progressive WM lesion volumes (NPLV, n = 44) followed up for 12 months were analysed. Cross‐sectionally, the spatial WM lesion distribution was compared using lesion probability maps (LPMs). Longitudinally, WM lesions and GM volumes were studied using FSL‐VBM and SPM5‐VBM, respectively. WM lesions clustered around the lateral ventricles and in the centrum semiovale with a more widespread pattern in the PLV than in the NPLV group. The maximum local probabilities were similar in both groups and higher for T2 lesions (PLV: 27%, NPLV: 25%) than for T1 lesions (PLV: 15%, NPLV 14%). Significant WM lesion changes accompanied by cortical GM volume reductions occured in the corpus callosum and optic radiations (P = 0.01 corrected), and more liberally tested (uncorrected P < 0.01) in the inferior fronto‐occipital and longitudinal fasciculi, and corona radiata in the PLV group. Not any WM or GM changes were found in the NPLV group. In the PLV group, WM lesion distribution and development in fibres, was associated with regional GM volume loss. The different spatiotemporal distribution patterns of patients with progressive compared to patients with non‐progressive WM lesions suggest differences in the dynamics of pathogenesis. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

Common capacity-limited neural mechanisms of selective attention and spatial working memory encoding

One characteristic feature of visual working memory (WM) is its limited capacity, and selective attention has been implicated as limiting factor. A possible reason why attention constrains the number of items that can be encoded into WM is that the two processes share limited neural resources. Functional magnetic resonance imaging (fMRI) studies have indeed demonstrated commonalities between the neural substrates of WM and attention. Here we investigated whether such overlapping activations reflect interacting neural mechanisms that could result in capacity limitations. To independently manipulate the demands on attention and WM encoding within one single task, we combined visual search and delayed discrimination of spatial locations. Participants were presented with a search array and performed easy or difficult visual search in order to encode one, three or five positions of target items into WM. Our fMRI data revealed colocalised activation for attention-demanding visual search and WM encoding in distributed posterior and frontal regions. However, further analysis yielded two patterns of results. Activity in prefrontal regions increased additively with increased demands on WM and attention, indicating regional overlap without functional interaction. Conversely, the WM load-dependent activation in visual, parietal and premotor regions was severely reduced during high attentional demand. We interpret this interaction as indicating the sites of shared capacity-limited neural resources. Our findings point to differential contributions of prefrontal and posterior regions to the common neural mechanisms that support spatial WM encoding and attention, providing new imaging evidence for attention-based models of WM encoding.     

Effects of acute psychosocial stress on working memory related brain activity in men

Acute psychosocial stress in humans triggers the release of glucocorticoids (GCs) and influences performance in declarative and working memory (WM) tasks. These memory systems rely on the hippocampus and prefrontal cortex (PFC), where GC‐binding receptors are present. Previous studies revealed contradictory results regarding effects of acute stress on WM‐related brain activity. We combined functional magnetic resonance imaging with a standardized psychosocial stress protocol to investigate the effects of acute mental stress on brain activity during encoding, maintenance, and retrieval of WM. Participants (41 healthy young men) underwent either a stress or a control procedure before performing a WM task. Stress increased salivary cortisol levels and tended to increase WM accuracy. Neurally, stress‐induced increases in cortical activity were evident in PFC and posterior parietal cortex (PPC) during WM maintenance. Furthermore, hippocampal activity was modulated by stress during encoding and retrieval with increases in the right anterior hippocampus during WM encoding and decreases in the left posterior hippocampus during retrieval. Our study demonstrates that stress increases activity in PFC and PPC specifically during maintenance of items in WM, whereas effects on hippocampal activity are restricted to encoding and retrieval. The finding that psychosocial stress can increase and decrease activity in two different hippocampal areas may be relevant for understanding the often‐reported phase‐dependent opposing behavioral effects of stress on long‐term memory. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

Working memory in school-aged children with attention-deficit/hyperactivity disorder combined type: are deficits modality specific and are they independent of impaired inhibitory control?

This study examines differences between children with attention-deficit/ hyperactivity disorder combined type (ADHD-C) and normal controls on verbal and visuospatial working-memory (WM) tasks. The extent to which WM deficits in children with ADHD-C are independent of impaired inhibitory control was also examined. Two groups of 7- to 12-year-old boys participated in this study. The first group included 31 boys diagnosed with ADHD-C, and the second group included 34 boys without ADHD. Various verbal and visuospatial WM tasks and two inhibitory control tasks--prepotent response inhibition and interference control--were used. Overall, our results suggest impaired verbal and visuospatial WM processes in children with ADHD-C, as well as a lower level of performance on prepotent response inhibition. WM deficits in ADHD have previously been suggested to be particularly salient in the spatial domain; our results instead showed the largest effect for a verbal WM task thought to put heavy load on the executive or attentional control component of the WM system. An interpretation of this finding is that it is variation in terms of difficulty level or load on the executive WM processes, rather than variation in modality (verbal versus visuospatial), that is important in demonstrating WM deficits in ADHD-C. Finally, findings from logistic regression analyses showed that deficits in WM and inhibitory control seem to be semi-independent in children with ADHD-C, at least with regard to the elementary school age.     

Effects of concurrent nicotinic antagonist and PCPA treatments on spatial and passive avoidance learning.

The present study investigates the effects of concurrent manipulations of nicotinic cholinergic receptors (mecamylamine 10 mg/kg, i.p.) and serotonin neurons (PCPA, 400 mg on each of 4 days) on spatial navigation (water maze, WM) and passive avoidance (PA) performance. PCPA treatment had no effect on WM navigation or PA performance of intact rats, but greatly aggravated mecamylamine induced performance deficit. Either single or combined treatments with hexamethonium (5.0 mg/kg, s.c.) and PCPA had no effect on WM or PA performance. These findings may suggest that nicotinic cholinergic receptors are also importantly involved in the cholinergic-serotonergic regulation of cognitive functioning.     

Frontal and parietal theta burst TMS impairs working memory for visual-spatial conjunctions

In tasks that selectively probe visual or spatial working memory (WM) frontal and posterior cortical areas show a segregation, with dorsal areas preferentially involved in spatial (e.g. location) WM and ventral areas in visual (e.g. object identity) WM. In a previous fMRI study [1], we showed that right parietal cortex (PC) was more active during WM for orientation, whereas left inferior frontal gyrus (IFG) was more active during colour WM. During WM for colour-orientation conjunctions, activity in these areas was intermediate to the level of activity for the single task preferred and non-preferred information. To examine whether these specialised areas play a critical role in coordinating visual and spatial WM to perform a conjunction task, we used theta burst transcranial magnetic stimulation (TMS) to induce a functional deficit. Compared to sham stimulation, TMS to right PC or left IFG selectively impaired WM for conjunctions but not single features. This is consistent with findings from visual search paradigms, in which frontal and parietal TMS selectively affects search for conjunctions compared to single features, and with combined TMS and functional imaging work suggesting that parietal and frontal regions are functionally coupled in tasks requiring integration of visual and spatial information. Our results thus elucidate mechanisms by which the brain coordinates spatially segregated processing streams and have implications beyond the field of working memory.     

Magnetic resonance spectroscopy of fiber tracts in children with traumatic brain injury: A combined MRS – Diffusion MRI study

Traumatic brain injury can cause extensive damage to the white matter (WM) of the brain. These disruptions can be especially damaging in children, whose brains are still maturing. Diffusion magnetic resonance imaging (dMRI) is the most commonly used method to assess WM organization, but it has limited resolution to differentiate causes of WM disruption. Magnetic resonance spectroscopy (MRS) yields spectra showing the levels of neurometabolites that can indicate neuronal/axonal health, inflammation, membrane proliferation/turnover, and other cellular processes that are on‐going post‐injury. Previous analyses on this dataset revealed a significant division within the msTBI patient group, based on interhemispheric transfer time (IHTT); one subgroup of patients (TBI‐normal) showed evidence of recovery over time, while the other showed continuing degeneration (TBI‐slow). We combined dMRI with MRS to better understand WM disruptions in children with moderate‐severe traumatic brain injury (msTBI). Tracts with poorer WM organization, as shown by lower FA and higher MD and RD, also showed lower N‐acetylaspartate (NAA), a marker of neuronal and axonal health and myelination. We did not find lower NAA in tracts with normal WM organization. Choline, a marker of inflammation, membrane turnover, or gliosis, did not show such associations. We further show that multi‐modal imaging can improve outcome prediction over a single modality, as well as over earlier cognitive function measures. Our results suggest that demyelination plays an important role in WM disruption post‐injury in a subgroup of msTBI children and indicate the utility of multi‐modal imaging.