弥散张量成像在轻度认知功能障碍中的应用

轻度认知功能障碍（MCI）目前已经成为严重影响老年人健康的疾病，早期具有可逆性。近年来弥散张量成像（DTI）以其定量显示脑白质纤维束的优势，越来越多的应用于临床，成为了研究的热点。目前研究表明，MCI患者海马、穹隆、扣带回和胼胝体的DTI指标变化明显，可用于MCI的早期识别和病情评估及预测，且多个指标联用可能增加其准确性。MCI患者DTI表现与认知功能的下降程度具有相关性，尤其与记忆功能的相关性较为确定。MCI亚型中，遗忘型MCI （aMCI）发展为阿尔茨海默病（AD）的风险更高，其部分各向异性（FA）值越低、平均弥散度（ADC）值越高预示着转化为AD的可能性越大；DTI技术对AD与MCI患者脑白质的差异较为灵敏，AD的脑白质病变范围更广、程度更重。但目前关于DTI在MCI中的应用尚存在诸多问题，尚需进一步研究。     

轻度认知功能障碍的非药物干预——体育锻炼

轻度认知功能障碍（mild cognitive impairment,MCI）发生于阿尔茨海默病（Alzheimer disease,AD）的早期阶段，非药物干预手段是改善MCI患者认知功能的途径之一。在非药物干预方式中，体育锻炼正被越来越多人所关注。本文就体育锻炼对MCI患者认知功能改善做一综述，为MCI的治疗与管理提供思路。体育训练可分为有氧训练与阻力训练，两种训练方式均可以改善MCI患者的整体认知功能，但不同运动对不同认知领域的作用仍不明确。此外，体育训练联合其他非药物干预方式对MCI患者的认知功能改善也展现出一定潜力。另一方面，运动改善认知功能的机制与神经发生、神经元存活和突触可塑性有关，这既可以在分子细胞水平解读，也可以从器官等宏观角度分析。最后，本文指出进行同质性研究、运动处方的探索与远程运动管理的实施作为MCI与运动相关研究的可能方向。     

嗅觉障碍与常见神经认知障碍的研究进展

嗅觉障碍在老年人中患病率较高,不仅影响人的生活质量及心理健康,而且是多种神经精神疾病的临床表现,尤其是阿尔茨海默病(Alzheimer's disease,AD)等神经认知障碍。AD是一种常见的以进行性痴呆为主要表现的神经退行性疾病,无法治愈,给个人、家庭及社会带来沉重的负担。通过AD标志物检测,早期发现,早期干预,对延缓AD进展大有帮助。嗅觉障碍与AD及轻度认知障碍(mild cognitive impairment,MCI)密切相关,嗅觉功能检测或许能辅助早期识别MCI及AD,因此我们将重点综述嗅觉障碍与MCI及AD常规诊断手段相关联的最新研究进展,以评估嗅觉障碍在MCI及AD等常见神经认知障碍研究中的价值。     

轻度认知功能损害与Alzheimer病的脑功能检查

Alzheimer病(AD)的早期诊断是一个难题，大多数AD患者就诊时临床症状已经十分明显。实际上，在发生症状之前，大脑功能已经发生了改变，如果能早期发现这种改变，就抓住了早期诊断、治疗的关键。轻度认知功能损害(MCI)是AD的早期临床表现之一，可能是AD发病的先兆，被认为是正常老年人与早期AD之间的一个过渡阶段。尽早的诊断MCI并     

轻度认知功能障碍淋巴细胞及炎症蛋白检测

目的探讨MCI认知功能与淋巴细胞及炎症蛋白的关系。方法研究阿尔茨海默病（AD,36例）、轻度认知障碍（MCI,34例）及认知功能正常老年人（认知正常组,36人）的外周血淋巴细胞亚群、免疫球蛋白及炎性蛋白的差异。结果认知正常组、MCI组与AD患者的免疫球蛋白G（IgG）浓度中位数依次为10.5g/L、10.6g/L、13.1g/L（χ2=14.28,P〈0.01）;辅助性T淋巴细胞（TH）比例的中位数依次为41%、35%、37%（χ2=9.96,P〈0.01）;三组间差异有统计学意义。其中认知正常组与MCI组的IgG差异无统计学意义（Z=0.64,P=0.52）,而AD组IgG水平高于MCI组（Z=3.26,P〈0.01）和认知正常组（Z=3.22,P〈0.01）;认知正常组TH高于AD组（Z=2.55,P〈0.05）和MCI组（Z=2.95,P〈0.01）,而MCI组与AD组的TH差异无统计学意义（Z=0.18,P=0.86）。结论 IgG可能在AD与MCI、认知功能正常者的鉴别方面具有重要意义;TH水平降低可能是认知功能受损的标志。     

轻度认知功能障碍老年人的失匹配性负波研究

目的研究轻度认知功能障碍老年人(MCI)失匹配性负波(MMN)的特征.方法应用美国Nicolet BRAVO脑电生理仪,对36例MCI和30例阿尔茨海默病(AD组)及45名正常老人(NC组)的MMN作了检测.结果(1)与正常老年组比较,AD组MMN潜伏期延迟,波幅降低.(2)MCI组无上述变化.(3)AD组MMN潜伏期延迟及波幅低于MCI组.结论MMN技术可作为P300检测的一种补充手段,而用于老年精神科临床.     

认知训练在遗忘型轻度认知功能障碍患者中应用的 研究进展

阿尔茨海默病（AD）是常见的进行性中枢神经系统退行性疾病,以进行性认知功能下降为 主要临床特征,是导致痴呆的主要原因。遗忘型轻度认知功能障碍（a-MCI）是轻度认知功能障碍（MCI） 的一种亚型。研究表明,a-MCI 大多会进展为 AD,积极干预 a-MCI 是延缓或减少 AD 发生的关键。目前 用于治疗 a-MCI 的药物均缺少大样本的循证医学证据,临床科研工作者越来越关注认知训练在 a-MCI 非 药物治疗领域的研究。认知训练的研究在 a-MCI 患者的非药物干预方面具有广阔的应用前景。现就认 知训练在 a-MCI 患者临床中应用的研究进展进行综述。     

Alzheimer病的嗅觉功能障碍

目的 探讨Alzheimer病（AD）的嗅觉功能障碍特点及其在AD早期诊断中的作用。方法 对24例可能AD患者和正常老年人分别行简易智能状态检查（MMSE）、日常生活活动量表（ADL）评定、气味感知阈值测定和图片介导的气味识别试验检查。结果 可能AD患者气味感知能力低于正常老年人（t=5.38,P＜0．001）;确诊的气味数目少于正常老年人（t=15.54,P＜0．001）,可能AD患者的识别和气味感知能力与MMSE得分呈正相关（r分别为0．646与0．467,P＜0．01）。结论 可能AD患者存在嗅觉功能损害,缺损程度与痴呆严重程度有关。嗅觉功能检查可用于早期AD的诊断。     

轻度认知功能障碍的神经心理学研究

轻度认知功能障碍（Mlid cognitive imairment,MCI）是近年来提出的新概念,是一种介于正常老化的认知改变和阿尔茨海默病（Alzheimer＇s Disease,AD）之间的中间状态,是目前人们关注的焦点问题.     

帕金森病嗅觉障碍研究进展

帕金森病（Parkinsondisease，PD）的主要临床特征为运动症状，但近年来其非运动性症状日益收到重视。嗅觉功能障碍是PD主要的非运动症状之一。据统计，90％的PD患者运动症状出现前表现有不同程度嗅觉功能减退或完全性嗅觉丧失。     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Efficacy and Effectiveness of Child and Adolescent Psychotherapy and Pharmacotherapy

Decades of intervention research have produced a rich body of evidence on the effects of psychotherapies and pharmacotherapies with children and adolescents. Here we summarize and critique that evidence. We review findings bearing on the efficacy of psychosocial treatments and medications under controlled experimental conditions. We also report evidence, where available, on the effectiveness of both classes of treatment with clinically referred youth treated in real-world clinical contexts. In general, the large body of evidence on efficacy contrasts sharply with the small base of evidence on effectiveness. Addressing this gap through an enriched research agenda could contribute importantly to linking scientific inquiry and clinical practice—to the benefit of both ventures. This is one element of a multifaceted agenda for future research and for synthesis of research, which will require the interplay of multiple disciplines related to child and adolescent mental health.     

Presence and severity of anorexia and bulimia among male and female Omani and non-Omani adolescents

OBJECTIVE: The population of Oman is a heterogeneous mix of nationalities providing a natural setting for studying the cross-cultural differences in the presence and severity of eating disorders as well as an opportunity for evaluating the performance of measurement instruments for these disorders. METHOD: Disordered eating screening instruments (the Eating Attitude Test and the Bulimic Investigatory Test) were administered to Omani teenagers, non-Omani teenagers, and Omani adults. RESULTS: On the Eating Attitude Test, 33% of Omani teenagers (29.4% females and 36.4% males) and 9% of non-Omani teenagers (7.5% of males and 10.6% females) showed a propensity for anorexic-like behavior. On the Bulimic Investigatory Test, 12.3% of Omani teenagers showed a propensity for binge eating or bulimia (13.7% females and 10.9% males). Among the non-Omani teenagers, 18.4% showed a tendency toward bulimia, with females showing a slightly greater tendency than males. In contrast, barely 2% of Omani adults showed either a presence of or a severity of disorderly behavior with food. CONCLUSION: Omani teenagers scored significantly higher than other ethnic groups and Omani adults. This finding is discussed in the light of emerging evidence from many parts of the world suggesting that cultural transition, compounded by demographic constraints, plays a significant role in abnormal eating attitudes.     

Physical and Sexual Abuse and Neglect and Eating Disorder Symptoms

Abstract

For eating-disordered patients with a history of post-traumatic stress, childhood abuse and neglect, and dissociative disorder, eating behavior symptoms may function as a rational response to unmetabolized traumatic experiences. This paper will review trauma-based theory, dissociation, abreactive, and ego-states therapy as they apply to eating disorder patients.     

Micro-affirmations and Recovery for Persons with Mental Health and Alcohol and Drug Problems: User and Professional Experience-Based Practice and Knowledge

Recurrent factors contributing to a recovery process from co-occurring mental health and addiction problems mentioned by users and professionals have been analyzed as part of working alliances and helpful relationships. Still, we lack knowledge about how helpful relationships are developed in daily practice. In this article, we focus on the concrete construction of professional helpful relationships. Forty persons in recovery and fifteen professionals were interviewed. The interviews were analyzed according to thematic analysis, resulting in three themes presented as paradoxes (1) My own decision, but with the help of others; (2) The need for structures and going beyond them; and (3) Small trivial things of great importance. Micro-affirmations have a central role in creating helpful relationships by confirming the individuals involved as more than solely users or professionals. More attention and appreciation should be paid to practices involving micro-affirmations.

     

Opiate and digitalis receptor assays distinguish between neuroexcitant and inactive organochlorines and between anesthetics and convulsants

Specific binding of [3H]naloxone to rat brain tissue in vitro was inhibited by the excitant organochlorinated insecticides (OCI), by ether (E) and octanol (OCT), and by the convulsant indoklon (IND) and its anesthetic isomer, isoindoklon (ISO). In the presence of 100 mM NaCl the inhibition of naloxone binding by E, OCT and ISO was greatly potentiated, whereas that by OCI and IND was attenuated. KCl (100 mM) was equally effective as NaCl on the action of anesthetics, but the effect of the excitant drugs was, in contrast to NaCl, unaffected by KCl. Specific binding of [3H]ouabain in the absence of Na, was depressed by anesthetics and enhanced by neuroexcitants. In the presence of NaCl, which by itself inhibits ouabain binding to brain, both anesthetics and excitants enhanced ouabain binding. DDE, a non-insecticidal analog of DDT, and the dimethyl derivative of the OCI, lindane, were inactive in the receptor assays. These observations point to a unique isolated system which responds consistently to anesthetic agents as a class and, in a different way, to neuroexcitant compounds.