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1.
Zhang S  Li CS 《NeuroImage》2012,59(4):3548-3562
Precuneus responds to a wide range of cognitive processes. Here, we examined how the patterns of resting state connectivity may define functional subregions in the precuneus. Using a K-means algorithm to cluster the whole-brain “correlograms” of the precuneus in 225 adult individuals, we corroborated the dorsal-anterior, dorsal-posterior, and ventral subregions, each involved in spatially guided behaviors, mental imagery, and episodic memory as well as self-related processing, with the ventral precuneus being part of the default mode network, as described extensively in earlier work. Furthermore, we showed that the lateral/medial volumes of dorsal anterior and dorsal posterior precuneus are each connected with areas of motor execution/attention and motor/visual imagery, respectively. Compared to the ventral precuneus, the dorsal precuneus showed greater connectivity with occipital and posterior parietal cortices, but less connectivity with the medial superior frontal and orbitofrontal gyri, anterior cingulate cortex as well as the parahippocampus. Compared to dorsal-posterior and ventral precuneus, the dorsal-anterior precuneus showed greater connectivity with the somatomotor cortex, as well as the insula, supramarginal, Heschl's, and superior temporal gyri, but less connectivity with the angular gyrus. Compared to ventral and dorsal-anterior precuneus, dorsal-posterior precuneus showed greater connectivity with the middle frontal gyrus. Notably, the precuneus as a whole has negative connectivity with the amygdala and the lateral and inferior orbital frontal gyri. Finally, men and women differed in the connectivity of precuneus. Men and women each showed greater connectivity with the dorsal precuneus in the cuneus and medial thalamus, respectively. Women also showed greater connectivity with ventral precuneus in the hippocampus/parahippocampus, middle/anterior cingulate gyrus, and middle occipital gyrus, compared to men. Taken together, these new findings may provide a useful platform upon which to further investigate sex-specific functional neuroanatomy of the precuneus and to elucidate the pathology of many neurological illnesses.  相似文献   

2.
目的 利用静息态fMRI技术,探讨原发性闭角型青光眼(PACG)患者丘脑-皮层通路功能连接的变化。方法 25例PACG患者(PACG组)和22名性别与年龄匹配的健康志愿者(对照组)均接受静息态fMRI。将双侧丘脑的各7个亚区作为ROI,分别为初级运动、感觉、枕叶、前额叶、前运动、后顶叶及颞叶丘脑ROI,与全脑皮层体素作静息态fMRI功能连接分析,并进行组间两独立样本t检验。结果 与对照组比较,PACG组丘脑与视觉传导通路(顶叶/楔前叶、额叶/额下回)及非视觉传导通路(中央旁小叶、中央后回、边缘叶/海马旁回)功能连接减低,丘脑与视觉传导通路(枕叶、顶叶/顶下小叶、颞叶/颞下回)以及非视觉传导通路(小脑前叶/山顶)功能连接增加。结论 PACG患者存在包括丘脑视觉传导通路及非视觉传导通路的连接异常,提示丘脑在PACG患者神经学发病机制中起着重要作用。  相似文献   

3.
Resting state functional MRI (rs-fMRI) of the brain has the potential to elicit networks of functional connectivity and to reveal changes thereof in animal models of neurological disorders. In the present study, we investigate the contribution of physiological noise and its impact on assessment of functional connectivity in rs-fMRI of medetomidine sedated, spontaneously breathing rats at ultrahigh field of 11.7 Tesla. We employed gradient echo planar imaging (EPI) with repetition times of 3s and used simultaneous recordings of physiological parameters. A model of linear regression was applied to quantify the amount of BOLD fMRI signal fluctuations attributable to physiological sources. Our results indicate that physiological noise - mainly originating from the respiratory cycle -dominates the rs-fMRI time course in the form of spatially complex correlation patterns. As a consequence, these physiological fluctuations introduce severe artifacts into seed-based correlation maps and lead to misinterpretation of corresponding connectivity measures. We demonstrate that a scheme of motion correction and linear regression can significantly reduce physiological noise in the rs-fMRI time course, remove artifacts, and hence improve the reproducibility of functional connectivity assessment. In conclusion, physiological noise can severely compromise functional connectivity MRI (fcMRI) of the rodent at high fields and must be carefully considered in design and interpretation of future studies. Motion correction should be considered the primary strategy for reduction of apparent motion related to respiratory fluctuations. Combined with subsequent regression of physiological confounders, this strategy has proven successful in reducing physiological noise and related artifacts affecting functional connectivity analysis. The proposed new and rigorous protocol now opens the potential of fcMRI to elicit the role of brain connectivity in pathological processes without concerns of confounding contributions from physiological noise.  相似文献   

4.
A great improvement to the insight on brain function that we can get from fMRI data can come from effective connectivity analysis, in which the flow of information between even remote brain regions is inferred by the parameters of a predictive dynamical model. As opposed to biologically inspired models, some techniques as Granger causality (GC) are purely data-driven and rely on statistical prediction and temporal precedence. While powerful and widely applicable, this approach could suffer from two main limitations when applied to BOLD fMRI data: confounding effect of hemodynamic response function (HRF) and conditioning to a large number of variables in presence of short time series. For task-related fMRI, neural population dynamics can be captured by modeling signal dynamics with explicit exogenous inputs; for resting-state fMRI on the other hand, the absence of explicit inputs makes this task more difficult, unless relying on some specific prior physiological hypothesis. In order to overcome these issues and to allow a more general approach, here we present a simple and novel blind-deconvolution technique for BOLD-fMRI signal. In a recent study it has been proposed that relevant information in resting-state fMRI can be obtained by inspecting the discrete events resulting in relatively large amplitude BOLD signal peaks. Following this idea, we consider resting fMRI as ‘spontaneous event-related’, we individuate point processes corresponding to signal fluctuations with a given signature, extract a region-specific HRF and use it in deconvolution, after following an alignment procedure. Coming to the second limitation, a fully multivariate conditioning with short and noisy data leads to computational problems due to overfitting. Furthermore, conceptual issues arise in presence of redundancy. We thus apply partial conditioning to a limited subset of variables in the framework of information theory, as recently proposed. Mixing these two improvements we compare the differences between BOLD and deconvolved BOLD level effective networks and draw some conclusions.  相似文献   

5.
Resting state fMRI studies have found that cognitive decline in aging is associated with alterations in functional connectivity of distributed neural systems in the brain. While functional connections have been shown to rely on the underlying structural connectivity, direct structural connections have been studied in only a few distributed cortical systems so far. It is well known that subcortical nuclei have structural connections to the entire cortex. We hypothesized that structural subcortico-cortical connections may provide integral routes for communication between cortical resting state networks, and that changes in the integrity of these connections have a role in cognitive aging. We combined anatomical MRI, diffusion tensor MRI, and resting state fMRI in 100 healthy elderly to identify fiber bundles connecting cortical resting state networks to subcortical nuclei. In identified tracts, white matter fiber bundle integrity measures were compared to composite cognitive measures on executive function, processing speed, and memory performance. The integrity (FA values) in selected fiber bundles correlated strongly with cognitive measures on executive function and processing speed. Correlation was most pronounced between executive function and fiber bundles connecting the putamen to the dorsal attention network (r=0.73, p<0.001). Our findings show that unique cortico-subcortical fiber bundles can be identified for a range of cortical resting state networks, and indicate that these connections play an important role in cortical resting state network communication and cognition.  相似文献   

6.
阿尔茨海默病(Alzheimerˊs disease,AD)是最常见的一种老年性痴呆,临床主要表现为进行性记忆力减退、认知障碍。AD发病隐匿,病程缓慢,发现时已经不可逆转,因此对其早期识别与干预至关紧要,血氧水平依赖(blood oxygen level dependent,BOLD)的静息态功能磁共振成像(resting state functional magnetic resonance imaging,rs-f MRI)已逐渐发展为探索AD脑功能改变的新途径之一,已有大量研究表明AD患者默认网络(default mode network,DMN)相关脑区局部功能活动及连接异常,作者就静息态BOLD-f MRI在AD脑功能研究中的应用予以综述。  相似文献   

7.
Changes of functional connectivity in prodromal and early Alzheimer's disease can arise from compensatory and/or pathological processes. We hypothesized that i) there is impairment of effective inhibition associated with early Alzheimer's disease that may lead to ii) a paradoxical increase of functional connectivity. To this end we analyzed effective connectivity in 14 patients and 16 matched controls using dynamic causal modeling of functional MRI time series recorded during a visual inter-hemispheric integration task. By contrasting co-linear with non co-linear bilateral gratings, we estimated inhibitory top-down effects within the visual areas. The anatomical areas constituting the functional network of interest were identified with categorical functional MRI contrasts (Stimuli>Baseline and Co-linear gratings>Non co-linear gratings), which implicated V1 and V3v in both hemispheres. A model with reciprocal excitatory intrinsic connections linking these four regions and modulatory inhibitory effects exerted by V3v on V1 optimally explained the functional MRI time series in both subject groups. However, Alzheimer's disease was associated with significantly weakened intrinsic and modulatory connections. Top-down inhibitory effects, previously detected as relative deactivations of V1 in young adults, were observed neither in our aged controls nor in patients. We conclude that effective inhibition weakens with age and more so in early Alzheimer's disease.  相似文献   

8.
Parkinson's disease (PD) is associated with abnormal hypersynchronicity in basal ganglia-thalamo-cortical loops. The clinical effectiveness of subthalamic nucleus (STN) high frequency stimulation indicates a crucial role of this nucleus within the affected motor networks in PD. Here we investigate alterations in the functional connectivity (FC) profile of the STN using resting state BOLD correlations on a voxel-by-voxel basis in functional magnetic resonance imaging (fMRI). We compared early stage PD patients (n=31) during the medication-off state with healthy controls (n=44). The analysis revealed increased FC between the STN and cortical motor areas (BA 4 and 6) in PD patients in accordance with electrophysiological studies. Moreover, FC analysis of the primary motor cortex (M1) hand area revealed that the FC increase was primarily found in the STN area within the basal ganglia. These findings are in good agreement with recent experimental data, suggesting that an increased STN-motor cortex synchronicity mediated via the so called hyperdirect motor cortex-subthalamic pathway might play a fundamental role in the pathophysiology of PD. An additional subgroup analysis was performed according to the presence (n=16) or absence (n=15) of tremor in patients. Compared to healthy controls tremor patients showed increased STN FC specifically in the hand area of M1 and the primary sensory cortex. In non-tremor patients, increased FC values were also found between the STN and midline cortical motor areas including the SMA. Taken together our results underline the importance of the STN as a key node for the modulation of BG-cortical motor network activity in PD patients.  相似文献   

9.
BackgroundGranger causality analysis (GCA) has been used to investigate the pathophysiology of migraine. Amygdala plays a key role in pain modulation of migraine attack. However, the detailed neuromechanism remained to be elucidated. We applied GCA to explore the amygdala-based directional effective connectivity in migraine without aura (MwoA) and to determine the relation with clinical characteristics.MethodsForty-five MwoA patients and forty age-, sex-, and years of education-matched healthy controls(HCs) underwent resting-state functional magnetic resonance imaging (fMRI). Bilateral amygdala were used as seed regions in GCA to investigate directional effective connectivity and relation with migraine duration or attack frequency.ResultsMwoA patients showed significantly decreased effective connectivity from right amygdala to right superior temporal gyrus, left superior temporal gyrus and right precentral gyrus compared with HCs. Furthermore, MwoA patients demonstrated significantly decreased effective connectivity from the left amygdala to the ipsilateral superior temporal gyrus. Also, MwoA patients showed enhanced effective connectivity from left inferior frontal gyrus to left amygdala. Effective connectivity outflow from right amygdala to right precentral gyrus was negatively correlated to disease duration.ConclusionsAltered directional effective connectivity of amygdala demonstrated that neurolimbic pain networks contribute to multisensory integration abnormalities and deficits in pain modulation of MwoA patients.  相似文献   

10.
Multiple sclerosis (MS), a variable and diffuse disease affecting white and gray matter, is known to cause functional connectivity anomalies in patients. However, related studies published to-date are post hoc; our hypothesis was that such alterations could discriminate between patients and healthy controls in a predictive setting, laying the groundwork for imaging-based prognosis. Using functional magnetic resonance imaging resting state data of 22 minimally disabled MS patients and 14 controls, we developed a predictive model of connectivity alterations in MS: a whole-brain connectivity matrix was built for each subject from the slow oscillations (<0.11 Hz) of region-averaged time series, and a pattern recognition technique was used to learn a discriminant function indicating which particular functional connections are most affected by disease. Classification performance using strict cross-validation yielded a sensitivity of 82% (above chance at p<0.005) and specificity of 86% (p<0.01) to distinguish between MS patients and controls. The most discriminative connectivity changes were found in subcortical and temporal regions, and contralateral connections were more discriminative than ipsilateral connections. The pattern of decreased discriminative connections can be summarized post hoc in an index that correlates positively (ρ=0.61) with white matter lesion load, possibly indicating functional reorganisation to cope with increasing lesion load. These results are consistent with a subtle but widespread impact of lesions in white matter and in gray matter structures serving as high-level integrative hubs. These findings suggest that predictive models of resting state fMRI can reveal specific anomalies due to MS with high sensitivity and specificity, potentially leading to new non-invasive markers.  相似文献   

11.
Resting state functional connectivity MRI (fcMRI) has become a particularly useful tool for studying regional relationships in typical and atypical populations. Because many investigators have already obtained large data sets of task-related fMRI, the ability to use this existing task data for resting state fcMRI is of considerable interest. Two classes of data sets could potentially be modified to emulate resting state data. These data sets include: (1) "interleaved" resting blocks from blocked or mixed blocked/event-related sets, and (2) residual timecourses from event-related sets that lack rest blocks. Using correlation analysis, we compared the functional connectivity of resting epochs taken from a mixed blocked/event-related design fMRI data set and the residuals derived from event-related data with standard continuous resting state data to determine which class of data can best emulate resting state data. We show that, despite some differences, the functional connectivity for the interleaved resting periods taken from blocked designs is both qualitatively and quantitatively very similar to that of "continuous" resting state data. In contrast, despite being qualitatively similar to "continuous" resting state data, residuals derived from event-related design data had several distinct quantitative differences. These results suggest that the interleaved resting state data such as those taken from blocked or mixed blocked/event-related fMRI designs are well-suited for resting state functional connectivity analyses. Although using event-related data residuals for resting state functional connectivity may still be useful, results should be interpreted with care.  相似文献   

12.
目的 观察孤独症患者和正常人全脑功能网络的差异。方法 将30例孤独症患者和30名正常人分为两组,行静息态fMRI采集,数据进行预处理,利用自动解剖标记模板分割大脑区域,提取时间序列信号,计算脑区间的相关性。基于复杂网络理论计算各种图论指标。对两组指标进行统计分析。结果 孤独症患者全脑功能网络拓扑属性显著改变,聚类性显著降低,最短路径长度缩短;同时整体效率显著升高,局部效率/模块化和中介中心性降低。结论 与正常人相比,孤独症患者全脑网络功能整合能力升高,而功能分离能力所下降;全脑网络异常有助于理解孤独症患者脑功能障碍。  相似文献   

13.
Colonnese M  Khazipov R 《NeuroImage》2012,62(4):2212-2221
The immature brain spontaneously expresses unique patterns of electrical activity that are believed to contribute to the development of neuronal networks. Certain electrographic features of this activity, particularly modulation on an infraslow time scale, resemble activity patterns observed in the mature brain at 'rest', loosely defined as the absence of an investigator imposed task. However, it is not clear whether the immature activity patterns observed at rest are precursors of the spontaneous neuronal activity that forms resting state networks in the adult. Here, we review recent studies that have explored the generative mechanisms of resting state activity during development in the primary sensory systems of premature human neonates and neonatal rodents. The remarkable hypothesis suggested by this work is that while resting state activity during the pre- and possibly near-term period can bear superficial resemblance to adult activity it is fundamentally different in terms of function and origin. During early development spontaneous thalamocortical activity in primary sensory regions is determined largely by transitory generators in the sensory periphery. This is in contrast to the adult, where spontaneous activity generated within thalamocortex, particularly by cortico-cortical connections, dominates. We therefore suggest a conservative interpretation of developmental mapping studies which are based on indirect measurement of activity (e.g. fMRI), or on the partitioning of EEG frequency using bands derived from adult studies. The generative mechanisms for brain activity at early ages are likely different from those of adults, and may play very different roles; for example in circuit formation as opposed to attention.  相似文献   

14.
Imaging cerebral glucose metabolism with positron emission tomography (PET) in Alzheimer's disease (AD) has allowed for improved characterisation of this pathology. Such patterns are typically analysed using either univariate or multivariate statistical techniques. In this work we combined voxel-based group analysis and independent component analysis to extract differential characteristic patterns from PET data of glucose metabolism in a large cohort of normal elderly controls and patients with AD. The patterns were used in conjunction with a support vector machine to discriminate between subjects with mild cognitive impairment (MCI) at risk or not of converting to AD. The method was applied to baseline fluoro-deoxyglucose (FDG)-PET images of subjects from the ADNI database. Our approach achieved improved early detection and differentiation of typical versus pathological metabolic patterns in the MCI population, reaching 80% accuracy (85% sensitivity and 75% specificity) when using selected regions. The method has the potential to assist in the advance diagnosis of Alzheimer's disease, and to identify early in the development of the disease those individuals at high risk of rapid cognitive decline who could be candidates for new therapeutic approaches.  相似文献   

15.
Jiang GH  Qiu YW  Zhang XL  Han LJ  Lv XF  Li LM  Lin CL  Zhuo FZ  Hu SY  Tian JZ 《NeuroImage》2011,57(1):149-154
Functional neuroimaging studies have revealed abnormal functional organization of the heroin users' brain, including reward circuit, cognitive control circuit, memory circuit, motivation and salience evaluation circuits and so on. In the current study, we aimed to explore the functional changes in the regional brain of heroin users using the amplitude of low-frequency oscillations in the Blood Oxygenation Level Dependent (BOLD) signals. With fMRI data acquired during resting state from 24 chronic heroin users (all subjects were being treated with methadone) and 24 non-addicted controls, we investigated addiction related altered in the amplitude low-frequency fluctuate (ALFF) between the two groups. Compared with controls, we found that heroin addicts had decreased ALFF in the bilateral dorsal anterior cingulate cortex (dACC), bilateral medial orbit frontal cortex (mOFC), left dorsal lateral prefrontal cortex (dlPFC), left middle temporal gyrus, left inferior temporal gyrus, posterior cingulate cortex and left cuneus as well as increased ALFF in the bilateral angular gyrus, bilateral precuneus, bilateral supramarginal gyrus, left post cingulate cortex and left middle frontal gyrus. Moreover, we also found that the increased ALFF in the bilateral parietal lobe had a significantly positive correlation with the methadone does, thus we inferred that the reduced ALFF may due to heroin consumption, nevertheless, the increased ALFF in the bilateral parietal lobe may have resulted from the methadone treatment. This resting-state fMRI study suggests that the changed spontaneous neuronal activity of these regions may be implicated in the underlying pathophysiology of heroin addicts.  相似文献   

16.
Sasai S  Homae F  Watanabe H  Taga G 《NeuroImage》2011,56(1):252-257
Analyses of spontaneous hemodynamic fluctuations observed on functional magnetic resonance imaging (fMRI) have revealed the existence of temporal correlations in signal changes between widely separated brain regions during the resting state, termed "resting state functional connectivity." Recent studies have demonstrated that these correlations are also present in the hemodynamic signals measured by near infrared spectroscopy (NIRS). However, it is still uncertain whether frequency-specific characteristics exist in these signals. In the present study, we used multichannel NIRS to investigate the frequency dependency of functional connectivity between diverse regions in the cerebral cortex by decomposing fluctuations of oxygenated hemoglobin (oxy-Hb) and deoxygenated hemoglobin (deoxy-Hb) signals into various frequency bands. First, within a wide frequency range (0.009-0.1Hz), we observed that both oxy-Hb and deoxy-Hb signals showed functional connectivity within local regions and between contralateral hemispheric regions of the cortex. Next, by decomposing measured fluctuations into narrower frequency components, we determined that only oxy-Hb signals showed frequency-specific functional connectivity between the frontal and occipital regions, emerging in a narrow frequency range (0.04-0.1Hz). To clarify the coherency of functional connectivity, we calculated the average coherence values between selected channel pairs. This approach demonstrated that functional connectivity based on the oxy-Hb signals between homologous cortical regions of the contralateral hemisphere (homologous connectivity) showed high coherence over a wide frequency range (0.009-0.1Hz), whereas connectivity between the prefrontal and occipital regions (fronto-posterior connectivity) showed high coherence only within a specific narrow frequency range (0.04-0.1Hz). Our findings suggest that homologous connectivity may reflect synchronization of neural activation over a wide frequency range through direct neuroanatomical connections, whereas fronto-posterior connectivity as revealed by high coherence only within a specific narrow frequency range corresponding to the time scale of typical hemodynamic response to a single event may reflect synchronization of transient neural activation among distant cortical regions. The present study demonstrated that NIRS provides a powerful tool to elucidate network properties of the cortex during resting state.  相似文献   

17.
Diffusion tensor imaging (DTI) and resting state temporal correlations (RSTC) are two leading techniques for investigating the connectivity of the human brain. They have been widely used to investigate the strength of anatomical and functional connections between distant brain regions in healthy subjects, and in clinical populations. Though they are both based on magnetic resonance imaging (MRI) they have not yet been compared directly. In this work both techniques were employed to create global connectivity matrices covering the whole brain gray matter. This allowed for direct comparisons between functional connectivity measured by RSTC with anatomical connectivity quantified using DTI tractography. We found that connectivity matrices obtained using both techniques showed significant agreement. Connectivity maps created for a priori defined anatomical regions showed significant correlation, and furthermore agreement was especially high in regions showing strong overall connectivity, such as those belonging to the default mode network. Direct comparison between functional RSTC and anatomical DTI connectivity, presented here for the first time, links two powerful approaches for investigating brain connectivity and shows their strong agreement. It provides a crucial multi-modal validation for resting state correlations as representing neuronal connectivity. The combination of both techniques presented here allows for further combining them to provide richer representation of brain connectivity both in the healthy brain and in clinical conditions.  相似文献   

18.
Dhond RP  Yeh C  Park K  Kettner N  Napadow V 《Pain》2008,136(3):407-418
Previous studies have defined low-frequency, spatially consistent networks in resting fMRI data which may reflect functional connectivity. We sought to explore how a complex somatosensory stimulation, acupuncture, influences intrinsic connectivity in two of these networks: the default mode network (DMN) and sensorimotor network (SMN). We analyzed resting fMRI data taken before and after verum and sham acupuncture. Electrocardiography data were used to infer autonomic modulation through measures of heart rate variability (HRV). Probabilistic independent component analysis was used to separate resting fMRI data into DMN and SMN components. Following verum, but not sham, acupuncture there was increased DMN connectivity with pain (anterior cingulate cortex (ACC), periaqueductal gray), affective (amygdala, ACC), and memory (hippocampal formation, middle temporal gyrus) related brain regions. Furthermore, increased DMN connectivity with the hippocampal formation, a region known to support memory and interconnected with autonomic brain regions, was negatively correlated with acupuncture-induced increase in a sympathetic related HRV metric (LFu), and positively correlated with a parasympathetic related metric (HFu). Following verum, but not sham, acupuncture there was also increased SMN connectivity with pain-related brain regions (ACC, cerebellum). We attribute differences between verum and sham acupuncture to more varied and stronger sensations evoked by verum acupuncture. Our results demonstrate for the first time that acupuncture can enhance the post-stimulation spatial extent of resting brain networks to include anti-nociceptive, memory, and affective brain regions. This modulation and sympathovagal response may relate to acupuncture analgesia and other potential therapeutic effects.  相似文献   

19.
目的利用基于体素的功能连接密度(functional connectivity density,FCD)图方法观察视神经脊髓炎(neuromyelitis optica,NMO)患者静息状态下脑网络水平各脑区重要程度的异常改变,并评价其与临床评分、病程等的相关性。材料与方法搜集20例NMO患者及20例年龄、性别相匹配的健康志愿者静息态功能磁共振(resting state functional MRI,rs-f MRI)数据,所得数据利用基于Matlab平台的DPARSFA软件进行图像预处理,然后利用其度中心度(degree centrality,DC)选项计算出FCD值,用SPM8软件进行平滑处理,得到二值化的平均FCD值,组间进行双样本t检验比较两组之间FCD有差异的脑区,分析有差异的脑区FCD值与临床扩展残疾评分量表(expanded disability status scale,EDSS)评分及病程的相关性。结果与健康对照组相比,NMO患者FCD增加的脑区以左侧小脑半球(下半月小叶)为主;FCD减低的脑区主要包括双侧额叶(BA11)、左侧舌回、双侧小脑半球(方形小叶后部)(P0.001,未校正,体素30)。NMO患者的病程与左侧小脑半球(下半月小叶)FCD呈正相关(r=0.6,P=0.005)。结论 NMO患者脑功能网络连接属性存在异常,表现为多个脑功能区FCD增高或减低,可能与NMO患者肢体及认知功能障碍发生的神经病理机制有关。  相似文献   

20.
Purpose: Many patients with early symptoms of Alzheimer's disease (AD) first seek help from their primary care providers (PCPs). PCPs must therefore be watchful for signs and symptoms of AD, and should screen elderly patients who complain of memory and cognitive problems for dementia.
Data sources: Published literature on case detection, diagnosis, and treatment of AD.
Conclusions: There are a number of simple, accurate, and fast tools to facilitate case detection, including the Mini-Mental State Examination. Once a diagnosis has been made, healthcare providers, patients, and caregivers can evaluate treatment options. Several medications are available for symptomatic treatment of AD, including the cholinesterase inhibitors donepezil, galantamine, and rivastigmine, and for later stage disease, the N-methyl D-aspartate (NMDA) receptor antagonist, memantine.
Implications for Practice: Early intervention is critical because a delay in treatment is associated with nonreversible symptom progression. Realistic treatment expectations include reduction in symptom severity and slowed decline in cognition, function, and behavior. Treatment may allow patients to retain independence longer and reduce the burden that advanced AD places on caregivers.  相似文献   

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