脑缺血时大鼠大脑皮层乙酰胆碱含量变化的动态观察

本实验采用双侧颈总动脉夹闭（ＣＣＡＯ）和大脑中动脉闭塞（ＭＣＡＯ）两种脑缺血动物模型，分别用乙酰胆碱（ＡＣｈ）生物测定法检测皮层ＡＣｈ含量，ＡＣｈ离子选择性微电极（ＡＣｈ－ＩＳＭｓ）检测皮层ＡＣｈ释放量，乙酰胆碱酯酶（ＡＣｈＥ）生化测定法检测皮层ＡＣｈＥ活性，观察脑缺血时皮层ＡＣｈ含量的动态查化。结果发现：脑缺血可诱发皮层ＡＣｈ活度急剧上升，示ＡＣｈ突然大量释放，在ＣＣＡＯ组于缺血１０ｍｉｎ达到高峰（净增１．４４４ｍｍｏｌ／Ｌ），而ＭＣＡＯ组于缺血２ｍｉｎ即达高峰（净增１．５５３ｍｍｏｌ／Ｌ），随着缺血延长，二者均逐渐下降，于缺血３０ｍｉｎ时，虽较峰值要低，但明显高于缺血前水平，此时，ＡＣｈＥ活性巳明显低于缺血前，ＡＣｈ含量在ＣＣＡＯ组下降０．２５６μｇ／ｇ（Ｐ＞０．０５），在ＭＣＡＯ组则显著下降１．０１４μｇ／ｇ（Ｐ＜０．０１）。结果提示：皮层ＡＣｈ含量变化对缺血是敏感的；脑缺血时ＡＣｈ含量下降、释放增加、降解减弱，推测ＡＣｈ可能在缺血性脑损伤中起重要作用。     

Alzheimer病模型大鼠脑生长抑素表达与学习能力改变

目的:研究损伤脑胆碱能系ＡＤ模型大鼠学习能力及相关脑组化改变。方法:鹅膏蕈氨酸(ＩＢＡ)定位损伤大鼠脑建立ＡＤ模型,分光光度法、免疫组化法测定其脑胆碱酯酶(ＡＣｈＥ)活性及生长抑素(ＳＯＭ)表达。结果:与对照组比较,模型组大鼠显示学习能力明显下降(Ｐ＜０．０５),鼠脑ＡＣｈＥ活性显著降低(Ｐ＜０．０１);额叶皮质和海马区ＳＯＭ表达显著减少(Ｐ＜０．０１)。结论:模型鼠学习功能下降可能与中枢胆碱能系毁损导致的ＡＣｈＥ活性下降和ＳＯＭ表达减少有关。     

重症肌无力患者血乙酰胆碱酯酶活性测定及其临床意义

检测６３例重症肌无力患者和５０例正常健康人血浆乙酰胆碱酶（Ｐ－ＡｃｈＥ）活性、红细胞乙酰胆碱酯酶（Ｅ－ＡｃｈＥ）活性。结果，患者组的Ｐ－ＡｃｈＥ平均活性和Ｅ－ＡｃｈＥ平均活性皆显著高于对照组（Ｐ＜０．００１）。提示重症肌无力的发病机制除了自身免疫因素外，还有乙酰胆碱酯酶活性改变的因素。     

腺苷A1受体激动剂CHA对缺血后脑组织β—EP含量的影响

用放射免疫法测定土鼠半球缺血模型脑组织中β－ＥＰ（β－ｅｎｄｏｒｐｈｉｎ）含量，观察缺血后β－ＥＰ含量的变化及腺苷Ａ１受体激动剂ＣＨＡ（ｃｙｃｌｏｈｅｘｙｌａｄｅｎｏｓｉｎｅ）对缺血后β－ＥＰ含量变化的影响。结果显示：沙土鼠缺血８ｈ后β－ＥＰ含量明显增加，且与卒中症状呈正相关，与脑比重呈负相关，ＣＨＡ可以改善卒中症状，减轻脑水肿，抑制缺血后β－ＥＰ的升高，提示缺血后中枢β－ＥＰ增加会加重缺血性损伤     

ABC－ELISA法检测重症肌无力患者三种自身抗体的研究

本文利用ＡＢＣ－ＥＬＩＳＡ法检测了９７例ＭＧ病人血清内三种抗体：ＡｃｈＲａｂ、Ｐｒ－Ｍａｂ、ＣＡＥａｂ。结果发现：（１）全身型ＡｃｈＲａｂ、ｐｒ－Ｍａｂ阳性率明显高于眼肌型（Ｐ＜０．０１）；ＡｃｈＲａｂ与Ｐｒ－ＭａｂＰ／Ｎ值呈线性正相关（ｒ＝０．７９７Ｐ＜０．０１）。（２）合并胸腺异常者ＣＡＥａｂ阳性率为８４．２％，明显高于对照组（Ｐ＜０．０１）；此组病人ＡｃｈＲａｂ与ＣＡＥａｂＰ／Ｎ值呈显著正相关，Ｐｒ－Ｍａｂ与ＣＡＥａｂＰ／Ｎ值呈非常显著正相关。（ｒ＝０．５１２和ｒ＝０．５９８Ｐ＜０．０１）。（３）８例病人作了治疗前后抗体检测。激素治疗后或切除异常胸腺后，抗体滴度多数下降或有转阴趋势。     

脑干听觉诱发电位在阿尔茨海默病和老年精神分裂症患者中的应用

目的探讨阿尔茨海默病（ＡＤ）和老年精神分裂症（ＳＳ）脑干听觉诱发电位（ＢＡＥＰ）的特点。方法应用丹麦电生理仪及Ｃｌｉｃｋ短声刺激，测查３２例ＡＤ、３４例ＳＳ和４０名正常老年人（ＮＣ）的ＢＡＥＰ。结果ＡＤ组患者波形变异大，绝对潜伏期波Ⅲ、波Ⅳ和波Ⅵ明显延迟，主波绝对波幅波Ⅴ平均波幅分别低于ＳＳ组和ＮＣ组１８％和３４％，波Ⅱ、波Ⅳ、波Ⅴ、波Ⅵ和Ⅶ绝对波幅也显著低于ＳＳ组和ＮＣ组，与ＮＣ组间差异有显著性。ＳＳ组波Ⅲ、波Ⅵ绝对潜伏期较ＮＣ组延迟，绝对波幅波Ⅶ平均波幅低于ＮＣ组２０％。结论老年精神疾病ＢＡＥＰ异常表现在听神经至桥脑下段之间     

脑梗塞患者的诱发电位,经颅多普勒与CT等对照研究

对８６例脑梗塞患者的脑诱发电位和经颅多普勒（ＴＣＤ）进行分析，并与ＣＴ／ＭＲＩ检查作对照，体感诱发电位（Ｓｏｍａｔｏｓｅｎｓｏｒｙ Ｅｖｏｋｅｄ Ｐｏｔｅｎｔｉａｌ，ＳＥＰ）异常率８２．６％，脑干听觉诱发电位（Ｂｒａｉｎｓｔｅｍ Ａｕｄｉｔｏｒｙ Ｅｖｏｋｅｄ Ｐｏｔｅｎｔｉａｌ，ＢＡＥＰ）异常率７４．４％经颅多普勒（Ｔｒａｎｓｃｒａｎｉａｌ Ｄｏｐｐｌｅｒ，ＴＣＤ）为９０．７％。脑梗塞位于大脑半     

昏迷患者的脑干听觉诱发电位与耳蜗电图联合研究

预测及判断昏迷患者的预后。方法对２０例昏迷患者进行脑干听觉诱发电位（ＢＡＥＰ）与耳蜗电图（ＥｃｏｃｈＧ）联合测试，同时用格拉斯哥昏迷量表（ＧＣＳ）评分。结果这种联合测试可使ＢＡＥＰ的Ⅰ波分辨率提高１２．５％。ＢＡＥＰ示脑干严重病损者，预后肯定不良，无假阳性；而ＢＡＥＰ正常者则因多种原因（如仅早期检测１次等）而有一定的假阴性。ＧＣＳ无假阴性，但因病因关系有一定假阳性。结论ＢＡＥＰ预测昏迷患者的预后时最好同时测试ＥｃｏｃｈＧ，有助于临床提高其判断的准确性     

免疫应答期间大鼠部分脑区内乙酰胆碱酯酶活性的变化

用绵羊红细胞（ＳＲＢＣ）免疫大鼠，在免疫后第３天至第６天，分别检测大鼠下丘脑、丘脑、中脑和脑桥内乙酰胆碱酯酶（ＡＣｈＥ）活性的变化。其中丘脑、中脑和脑桥在免疫后第３至６天，ＡＣｈＥ活性与对照组比较均无显著差异。而下丘脑内ＣＡｈＥ活性从第３天开始下降，至第６天均明显降低．本实验说明，在免疫应答期间，下丘脑中ＡＣｈＥ活性降低，由此提示体液免疫应答可影响下丘脑中乙酰胆碱（ＡＣｈ）的含量。我们以往的实验表明，中枢ＡＣｈ可调控体液免疫功能。综合两者结果，可以推断中枢ＡＣｈ与免疫之间存在相互作用。     

遗传性运动感觉性神经病合并肥厚性心肌病的3D—TCD,rCBF,BAEP…

目的了解遗传性运动感觉性神经病（ＨＭＳＮ）合并肥厚心肌病（ＨＣＭ）的经颅多普勒（ＴＣＤ）局部脑血流量（ｃＣＢＦ），脑干听觉诱发电位（ＢＡＥＰ）和心电图（ＥＣＧ）的变化。方法，对一家三代ＨＭＳＮ合并ＨＣＭ１２例患者和１例无症状者常规进行了这四项检查，结果ＴＣＤ，ｒＣＢＦ，ＢＡＥＰ和ＥＣＧ的异常率分别为８５％，７６％，９２％和９２％。结论绝大多烽ＨＭＳＮ合并ＨＣＭ患者的ＴＣＤ，ｒＣＢＦ，ＢＡＥＰ和ＥＣ     

香港远志提取物对拟阿尔茨海默病大鼠学习记忆的影响及机制

目的探讨香港远志提取物对拟阿尔茨海默病(AD)模型大鼠学习记忆能力的影响及机制。方法SD大鼠随机分4组:假手术组、模型组及治疗A、B组。双侧海马CA1区注射Aβ25～35建立拟AD大鼠模型,治疗组按设定方式给药,假手术组、模型组给1%吐温溶液。给药28d,Morris水迷宫方法测定大鼠学习记忆能力,定量分析海马区乙酰胆碱酯酶(AChE)、超氧化物歧化酶(SOD)活力及丙二醛(MDA)含量。结果与假手术组比较,模型组大鼠的学习记忆能力、SOD活力显著降低,AchE活力、MDA含量显著增高(P<0.01)。与模型组比较,治疗组大鼠的学习记忆能力、SOD活力显著增高,AchE活力、MDA含量显著降低(P<0.05,或P<0.01)。结论香港远志乙酸乙酯提取物,可有效改善拟AD大鼠学习和记忆功能障碍,作用机制可能与降低AchE活力、调节胆碱能系统平衡;降低MDA含量、增强SOD活力,减少氧自由基产生,缓解氧化应激损伤有关。     

痉挛性脑瘫患儿脑脊液胆碱酯酶的研究

目的 研究痉挛性脑性瘫痪(CP)患儿肌痉挛形成机制及选择性脊神经后根切断术(SPR)治疗机制。方法 采用改良的Ellman法测定45例痉挛性脑瘫患儿。30例非神经系统疾病儿童及18例SPR术后脑瘫患儿脑脊液中乙酰胆碱酯酶(AchE)和丁酰胆碱酯酶(BchE)的水平。结果 SPR术前脑瘫组脑脊液AchE明显低于对照组，且与病情程度相关，BchE和对照组无显著差异；SPR术后脑瘫患者脑脊液AchE比术前明显升高，BchE与术前无显著差别。结论 痉挛性脑瘫患儿胆碱能神经元功能降低可能在痉挛性脑瘫肌痉挛及智力障碍的形成中起重要作用，SPR术后胆碱能神经元功能增强与肌痉挛解除和全身症状改善有关。     

Kinematic and kinetic analysis of running in children with cerebral palsy

Computer-based analysis of gait was used to study walking and running in 19 children with spastic-diplegic cerebral palsy (CP) and 15 healthy control children. Temporospatial parameters, kinematic and kinetic data were compared and contrasted between groups for both types of gait. The majority of children with diplegic CP, who are independent ambulators, are able to run. These children increase their velocity by increasing their cadence, a mechanism that is distinct (and presumably less energy efficient) from that used by healthy children. Sagittal-plane kinematic and kinetic profiles at the ankle in children with CP were more similar to normal profiles in running than in walking, suggesting that the primary deviations at the ankle associated with CP are better tolerated at greater velocities. Relative power analysis showed that, like healthy children, those with CP depend more upon the proximal musculature about the hip for power generation as the velocity of gait increases. Children with CP achieve energy transfer between adjacent joints during walking and running in a manner comparable to unaffected children. Running is an important activity for children and should be considered in the functional assessment of those with CP.     

Fundamental movement skills and physical activity among children with and without cerebral palsy

Fundamental movement skills (FMS) proficiency is believed to influence children's physical activity (PA), with those more proficient tending to be more active. Children with cerebral palsy (CP), who represent the largest diagnostic group treated in pediatric rehabilitation, have been found to be less active than typically developing children. This study examined the association of FMS proficiency with PA in a group of children with CP, and compared the data with a group of typically developing children. Five FMS (run, jump, kick, throw, catch) were tested using process- and product-oriented measures, and accelerometers were used to monitor PA over a 7-day period. The results showed that children with CP spent less time in moderate to vigorous physical activity (MVPA), but more time in sedentary behavior than typically developing children. FMS proficiency was negatively associated with sedentary time and positively associated with time spent in MVPA in both groups of children. Process-oriented FMS measures (movement patterns) were found to have a stronger influence on PA in children with CP than in typically developing children. The findings provide evidence that FMS proficiency facilitates activity accrual among children with CP, suggesting that rehabilitation and physical education programs that support FMS development may contribute to PA-related health benefits.     

Visual function and execution of microsaccades related to reading skills, in cerebral palsied children

This article investigates the ability of cerebral palsied (CP) children to execute microsaccades. One-hundred and five congenitally CP school aged children (6 to 15 years old), without severe mental retardation, were classified into three groups: those with spastic quadriplegi, spastic diplegics, and spastic hemiplegics on the basis of: (1) patient anamnesis, (2) IQ estimation, (3) evaluation of the microsaccadic skills with the Developmental Eye Movement test (DEM). Their performance in these tests was compared with a control group from the general pediatric population. IQ of the CP children ranged between 70 and 100; the microsaccadic skills were severely affected: only 19% of the CP children had normal function, 20.9% of the CP children appeared with a pure oculomotor problem, 32.4% of the CP children had a visual-perceptual problem, and 27.7% of the CP children had a combined oculomotor and visual perceptual problem. CP children, in the absence of severe mental retardation, have disturbed visual skills and visual perception that usually leads to reading difficulties. It is also suggested that microsaccadic skills of CP children is an identifiable factor compounding the adverse effects of mental retardation on reading skills.     

CSF acetylcholinesterase activity in central neurological diseases involving cholinergic systems]

The enzymatic activity of acetylcholinesterase (AchE) in the cerebrospinal fluid (CSF) is considered to be a marker of central cholinergic neuron integrity. Then, we evaluated CSF AchE activity in 90 cases of neurological diseases involving cholinergic system and their related disease, and 28 control cases without central organic lesions or abnormal findings in routine CSF study. AchE activity was evaluated according to Ellman's method using acetylthiocholine iodide as a substrate and tetraisopropyl-pyrophosphoramide, a specific inhibitor of butyrylocholinesterase. CSF AchE of Alzheimer type dementia (AD/SDAT, N = 12: 21.9 +/- 4.7 nmol/ml/min) showed no significant change from those of both control group (22.1 +/- 3.9) and vascular dementia (9: 21.7 +/- 6.7). In extrapyramidal diseases, reduction of the activity was observed in Huntington's chorea (HC, 4: 16.3 +/- 1.4) and progressive supranuclear palsy (PSP, 4: 17.6 +/- 1.7), whereas normal activity was shown in Parkinson's disease (PD, 19: 22.5 +/- 4.6), dentatorubropallidoluysian atrophy (DRPLA, 4: 22.6 +/- 4.2) and striatonigral degeneration (SND, 4: 20.4 +/- 4.3). In olivopontocerebellar atrophy (OPCA, N = 16), we disclosed reduced CSF AchE activity (15.8 +/- 2.4) which had significant correlations with the atrophy of the pontine base (r = 0.6017, p less than 0.02) and cerebellar vermis (r = 0.5450, p less than 0.05) in MRI. AchE activity in cerebellar cortical atrophy (CCA, 5: 20.6 +/- 2.2) remained within the control values. Normal activity was demonstrated in both amyotrophic lateral sclerosis (6: 24.3 +/- 7.3) and spinal muscular atrophy (4: 22.9 +/- 3.9).(ABSTRACT TRUNCATED AT 250 WORDS)     

VENTILATION AND SWALLOWING INTERACTIONS OF NORMAL CHILDREN AND CHILDREN WITH CEREBRAL PALSY

The respiratory inductance plethysmograph was used to analyse the ventilatory cycle during drinking, chewing and swallowing of normal and cerebral-palsied children aged between five and 12 years. 33 children were divided equally into three groups: normal, spastic CP and athetoid CP. A few of the children with spastic CP and over half of those with athetoid CP were unable to perform the 'big breath' task. In the remaining trials, the children with CP held their breath for a shorter time than normal children. Many children with CP required multiple swallows to consume 5mL of liquid. In the majority of trials, normal children swallowed liquids at or near the peak of inspiration, whereas the children with CP did not. Supplementary swallows and solid-bolus swallows occurred at any point in the ventilatory cycle in all groups. The children with CP had a greater need to inspire at the end of liquid tasks, especially during the 75mL task.     

Linear and nonlinear analysis of brain dynamics in children with cerebral palsy

This study was carried out to determine linear and nonlinear changes of brain dynamics and their relationships with the motor dysfunctions in CP children. For this purpose power of EEG frequency bands (as a linear analysis) and EEG fractality (as a nonlinear analysis) were computed in eyes-closed resting state and statistically compared between 26 CP and 26 normal children. Based on these characteristics accuracy of the classification between the two groups was obtained by enhanced probabilistic neural network (EPNN). Severity of gross motor and manual disabilities was determined by standard systems and the relation between the deficient brain dynamics and severity of the motor dysfunctions was obtained by Pearson's correlation coefficient. A definitely higher delta and lower theta and alpha powers, and higher EEG complexity in CP patients. As such a high accuracy of 94.8% in distinguishing the two groups was obtained. Moreover significant positive correlations were found between beta power and severity of manual disabilities and gross motor dysfunctions in the boys with CP. It is concluded that the obtained brain dynamics’ characteristics are useful in diagnosis of CP. Furthermore severity of the motor dysfunctions in boys with CP could be evaluated by the beta activity.     

Postural balance in children with cerebral palsy

Postural control deficits have been suggested to be a major component of gait disorders in cerebral palsy (CP). Standing balance was investigated in 23 ambulatory children and adolescents with spastic diplegic CP, ages 5 to 18 years, and compared with values of 92 children without disability, ages 5 to 18 years, while they stood on a force plate with eyes open or eyes closed. The measurements included center of pressure calculations of path length per second, average radial displacement, mean frequency of sway, and Brownian random motion measures of the short-term diffusion coefficient, and the long-term scaling exponent. In the majority of children with CP (14 of 23) all standing balance values were normal. However, approximately one-third of the children with CP (eight of 23) had abnormal values in at least two of the six center of pressure measures. Thus, mean values for path length, average radial displacement, and diffusion coefficient were higher for participants with CP compared with control individuals with eyes open and closed (p<0.05). Mean values for frequency of sway and the long-term scaling exponent were lower for participants with CP compared with control participants (p<0.05). Increased average radial displacement was the most common (nine of 23) postural control deficit. There was no increase in abnormal values with eyes closed compared with eyes open for participants with CP, indicating that most participants with CP had normal dependence on visual feedback to maintain balance. Identification of those children with impaired standing balance can delineate factors that contribute to the patient's gait disorder and help to guide treatment.     

Regional variation in bone mineral density and motor function in children with cerebral palsy

Bone mineral density (BMD) and motor activity of the upper extremities, were studied in 18 children with spastic cerebral palsy (CP group) and 12 age-matched normal boys (control group). The motor activity was monitored by a piezoelectric transducer. Whole body BMD as well as BMD of the head, upper limbs, ribs, spine, pelvis, and lower limbs was evaluated by dual energy x-ray absorptiometry. In the CP group, BMDs were lower compared to control group in the whole body and in all the body regions (except for the head) especially in the pelvis and lower limbs. BMDs of these regions were higher in walking patients than in bed-ridden, rolling, and crawling patients. Motor activities in the upper extremities were lower in the CP than in the control group. BMD increased with developing motor activity in the upper extremities. These results implicate diminished BMDs of the lower limbs and pelvis, which are associated with standing and walking, to the high incidence of femur fractures in CP.