腰骶神经磁共振成像的研究进展

磁共振神经成像(MRN)是对周围神经的临床体检和电生理学检查(如肌电图)的重要补充。多种局灶性病变和弥漫性病变均可累及腰骶神经丛。三维MR成像技术具有较高的空间分辨力和各项同性的特点,可进行任意角度重建,是显示腰骶神经丛的主要方法。本文综述了磁共振神经成像的主要技术,并介绍了腰骶神经丛常见疾病的MRN表现。     

强迫症患者脑神经通路的功能磁共振成像分析

分析强迫症患者皮质‐纹状体‐丘脑‐皮质环路可能存在的神经通路异常,应用功能磁共振成像技术,对强迫症患者的双侧前额叶、海马旁回等部位进行检测,分析这些异常与病程及疾病严重程度间的关系。本文基于功能磁共振成像研究强迫症神经环路的异常作一综述,旨在为探讨强迫症的发病机制提供帮助。     

前注意视觉皮层脑功能磁共振成像

目的 探讨前注意视觉皮层的非注意视觉偏差刺激自动加工脑功能解剖的分布及意义。方法 对20名健康右利手男性,采用经典oddball被动范式给予非注意视觉刺激,标准刺激为红色方块,概率为80%,偏差刺激为绿色方块,概率为20%,观察功能MRI影像学表现。结果 最终分析15名被试,fMRI检查前、中、后的按键正确率均≥95%,反应时间差异无统计学意义(P=0.470)。fMRI显示右侧梭状回(枕颞内侧回)、右侧部分颞叶、枕叶及海马旁回,左侧枕叶,双侧额上回、双侧额中回及左侧中央前回/后回脑激活区BOLD信号在偏差刺激出现后明显升高。结论 fMRI可以清楚显示前注意视觉皮层功能解剖分布,为临床诊断前注意视觉皮层受损情况提供更加直观的检查方式,为疾病研究提供相应的参考信息。     

磁共振成像的新近展

20年来MR成像技术在医学领域中发展相当迅速,取得了引人注目的进步。近年来其发展主要集中在功能性磁共振成像(functional magnetic rcsonance imaging, FMRI)和磁共振频谱分析(MR spectroscopy imaging, MRSI)方面。 功能性MR成像 目前功能性MR成像主要应用于探测脑的皮层功能。根据血氧依赖水平(blood oxygen level dependent, BOLD),对神经活动在不同刺激下的反应作出描述,如运动、语言、视觉或听觉信号。这些方法目前在功能性MR成像上被用于确定各种精神障碍所伴有的信号类型,如图雷特综合症(儿童期面肌     

臂丛神经磁共振成像技术初步研究

目的：探讨臂丛神经磁共振成像的技术方法及其可行性。方法：对15例正常志愿者行双侧臂丛神经成像：包括常规快速自旋回波序列T1加权（T1W/TSE）、快速自旋回波序列T2加权（T2W/TSE）、快速自旋回波序列T2加权加SPIR脂肪抑制（T2W/SPIR）冠状位扫描以及弥散加权背景抑制成像序列（DWIBS）轴位扫描。结果：T1W/TSE、T2W/TSE、及T2W/SPIR对臂丛节后神经同层显示率分别为53.3%、56.7%和83.3%;DWIBSMIP重建图像对臂丛神经的全貌显示较为完整、清晰、直观;T1W/TSE、T2W/TSE、T2W/SPIR及DWIBSMIP重建图像的对比噪声比分别为10.9±0.9、10.7±1.3、18.5±6.8和29.9±13.3,T2W/SPIR序列和DWIBSMIP重建图像的对比噪声比明显高于T1W/TSE和T2W/TSE序列。结论：T2W/SPIR序列对臂丛神经的同层显示率及图像的对比噪声比明显高于常规T1W/TSE、T2W/TSE序列,DWIBSMIP重建图像能够显示臂丛神经的全貌,两者为臂丛神经成像较为有效的技术方法,对于臂丛神经病变的诊断即具有十分重要的意义。     

磁共振神经成像在外周神经鞘膜瘤的应用研究

目的探讨磁共振神经成像对外周神经鞘膜瘤诊断的临床价值。材料与方法回顾性分析27例经手术和病理证实的外周神经鞘膜瘤资料,所有病例均行MRI常规成像和结合短TI反转恢复时间成像(3D-STIR)增强序列扫描。分析和评价3D-STIR增强扫描序列对外周神经鞘膜瘤诊断的可行性和准确性,比较常规MRI成像及3D-STIR序列增强扫描对外周神经鞘膜瘤诊断的征象和价值。结果27例外周神经鞘膜瘤患者,磁共振常规成像可以显示病灶的部位、数目、形态、体积、信号特征。3D-STIR增强扫描序列上均可清晰显示周围神经走行及病变同周围神经关系。结论磁共振常规序列及3D-STIR增强扫描序列对外周神经鞘膜瘤的定位定性诊断有重要的临床应用价值。     

经前期焦虑障碍相关情感回路异常的脑功能成像研究进展

经前期焦虑障碍(premenstrual dysphoric disorder,PMDD)是一种女性独特的情感障碍性疾病,严重影响着育龄期女性的生活健康,目前其发病机制尚不明确。近年研究表明,以“前额叶-前扣带回-杏仁核-海马-小脑”构成的情感回路功能异常可能与PMDD发病密切相关。本文通过综述该情感回路相关脑区及脑区间的脑功能研究,为寻找PMDD的神经病变机制提供参考依据。     

实时功能磁共振成像神经反馈在肥胖症中的应用进展

肥胖症及减重后不能维持健康体质量的核心因素多为食物成瘾,食物成瘾在神经影像学中表现为奖赏网络与认知控制网络间神经环路的失衡。实时功能磁共振成像神经反馈（real time functional magnetic resonance imaging neurofeedback,rtfMRI-NF）作为一种新型生物反馈技术,已被应用于其他物质成瘾领域的临床研究和治疗中。在食物成瘾肥胖症中,rtfMRI-NF同样具有重塑异常脑功能、改善摄食行为并达到减重效果的潜力。本综述总结了肥胖患者食物成瘾的功能磁共振脑成像模型,探讨应用rtfMRI-NF作为其潜在治疗工具的可行神经靶点,并回顾了rtfMRI-NF在肥胖应用中的最新研究进展,为未来rtfMRI-NF在肥胖中的治疗策略和临床指导提供参考。     

Stroop任务的执行加工成分及其神经机制的功能磁共振研究

目的 采用事件相关功能磁共振（ER-fMRI）方法研究Stroop任务的执行加工成分及其相应的神经机制。方法对16例右利手的健康志愿者进行了冲突试次分别占不同比例的两种任务条件的Stroop色词一颜色命名任务。其中一种任务条件冲突试次占30％，一致试次占70％；另一种任务条件冲突试次占70％，一致试次占30％；，同时采用Phillips 3．0 T成像系统，采集其脑部的fMRI数据，图像后处理和分析采用SPM5分析软件得到脑功能活动的图像。结果 16例被试者中12例的资料符合研究条件而被采用。①两种Stroop任务条件的脑激活区域没有差别，与有关实验结果类似。②被试对两种任条件中的冲突试次分别形成了不同等级的冲突和策略加工，高冲突、低策略条件表现为左侧前扣带回（ACC），双侧VLPFC，双侧额极，双侧视区，左侧中颞叶，右侧顶下小叶（IPL），双侧小脑激活增强；高策略、低冲突条件右侧DLPFC，左侧SMA，右侧岛叶，双侧梭状回，右侧丘脑激活增强。③高抑制加工相应于VLPFC激活增强。结论揭示认知控制加工需要扣带-前额通路在内的PFC内不同亚区的功能协同，支持DLPFC和ACC的功能分离，提示抑制功能可能与控制加工分离。     

静息态功能磁共振成像观察正常人听觉皮层功能

目的 探讨正常人听觉皮层与全脑的正相关及负相关的功能连接.方法 采用静息态下平面回波成像技术采集44名健康受试者fMRI数据,分别以左侧及右侧AⅠ区为种子点,用功能连接的方法观察左、右大脑初级听觉皮层与全脑的正相关及负相关功能连接脑图.结果 分别以双侧AⅠ区为种子点时,正激活的脑网络主要包含双侧AⅠ、AⅡ、岛叶、辅助运动区及扣带回,以同侧为主;与右侧AⅠ区相关的正激活脑区还包括同侧背侧丘脑.与双侧AⅠ区相关的负激活脑网络与脑默认网络大体一致,主要包括双侧后扣带回/楔前叶、额叶内侧回、顶下小叶,双侧小脑半球可见明显激活.结论 静息态磁共振功能连接可满意显示听觉皮层的连接脑图.正相关功能连接主要局限在听觉系统内,负相关功能连接类似于默认网络.     

Health benefits of resveratrol: Evidence from clinical studies

Resveratrol is a polyphenolic nutraceutical that exhibits pleiotropic activities in human subjects. The efficacy, safety, and pharmacokinetics of resveratrol have been documented in over 244 clinical trials, with an additional 27 clinical trials currently ongoing. Resveretrol is reported to potentially improve the therapeutic outcome in patients suffering from diabetes mellitus, obesity, colorectal cancer, breast cancer, multiple myeloma, metabolic syndrome, hypertension, Alzheimer's disease, stroke, cardiovascular diseases, kidney diseases, inflammatory diseases, and rhinopharyngitis. The polyphenol is reported to be safe at doses up to 5 g/d, when used either alone or as a combination therapy. The molecular basis for the pleiotropic activities of resveratrol are based on its ability to modulate multiple cell signaling molecules such as cytokines, caspases, matrix metalloproteinases, Wnt, nuclear factor-κB, Notch, 5′-AMP-activated protein kinase, intercellular adhesion molecule, vascular cell adhesion molecule, sirtuin type 1, peroxisome proliferator-activated receptor-γ coactivator 1α, insulin-like growth factor 1, insulin-like growth factor-binding protein 3, Ras association domain family 1α, pAkt, vascular endothelial growth factor, cyclooxygenase 2, nuclear factor erythroid 2 like 2, and Kelch-like ECH–associated protein 1. Although the clinical utility of resveratrol is well documented, the rapid metabolism and poor bioavailability have limited its therapeutic use. In this regard, the recently produced micronized resveratrol formulation called SRT501, shows promise. This review discusses the currently available clinical data on resveratrol in the prevention, management, and treatment of various diseases and disorders. Based on the current evidence, the potential utility of this molecule in the clinic is discussed.     

Validity of the life satisfaction questions, the life satisfaction questionnaire, and the satisfaction with life scale in persons with spinal cord injury

Post MW, van Leeuwen CM, van Koppenhagen CF, de Groot S. Validity of the Life Satisfaction questions, the Life Satisfaction Questionnaire, and the Satisfaction With Life Scale in persons with spinal cord injury.ObjectiveTo assess and compare the validity of 3 life satisfaction instruments in persons with spinal cord injury (SCI).DesignCross-sectional study 5 years after discharge from inpatient rehabilitation.SettingEight rehabilitation centers with specialized SCI units.ParticipantsPersons (N=225) with recently acquired SCI between 18 and 65 years of age were included in a cohort study. Data were available for 145 persons 5 years after discharge.InterventionsNot applicable.Main Outcome MeasuresThe Life Satisfaction questions (LS Questions), the Life Satisfaction Questionnaire (LiSat-9), and the Satisfaction With Life Scale (SWLS).ResultsThere were no floor or ceiling effects. Cronbach α was questionable for the LS Questions (.60), satisfactory for the LiSat-9 (.75), and good for the SWLS (.83). Concurrent validity was shown by strong and significant Spearman correlations (.59–.60) between all 3 life satisfaction instruments. Correlations with measures of mental health and participation were .52 to .56 for the LS Questions, .45 to .52 for the LiSat-9, and .41 to .48 for the SWLS. Divergent validity was shown by weak and in part nonsignificant correlations between the 3 life satisfaction measures and measures of functional independence and lesion characteristics.ConclusionsOverall, the validity of all 3 life satisfaction measures was supported. Despite questionable internal consistency, the concurrent and divergent validity of the LS Questions was at least as good as the validity of the LiSat-9 and the SWLS.     

The influence of post-polio syndrome on independence and life satisfaction

Purpose : The aim of the study was to find out the influence of the new symptoms on life satisfaction and independent living and the most frequent disabilities in patients with post-polio syndrome that are affecting the satisfaction and independence. Method : A questionnaire was sent to all the post-polio survivors (207) who visited the Rehabilitation Institute in Ljubljana at least once in the last ten years. We got 100 answers, which were analysed by SPSS (statistical package for social sciences). Results : Sixty nine reported that they had new symptoms that may be classified as post-polio syndrome. Conclusions : We have found that the new symptoms in postpolio survivors, which may be classified as post-polio syndrome, increased their walking and climbing stairs disability, increased their disability to perform daily activities and also decreased their satisfaction with life.     

The influence of post-polio syndrome on independence and life satisfaction

PURPOSE: The aim of the study was to find out the influence of the new symptoms on life satisfaction and independent living and the most frequent disabilities in patients with post-polio syndrome that are affecting the satisfaction and independence. METHOD: A questionnaire was sent to all the post-polio survivors (207) who visited the Rehabilitation Institute in Ljubljana at least once in the last ten years. We got 100 answers, which were analysed by SPSS (statistical package for social sciences). RESULTS: Sixty nine reported that they had new symptoms that may be classified as post-polio syndrome. CONCLUSIONS: We have found that the new symptoms in post-polio survivors, which may be classified as post-polio syndrome, increased their walking and climbing stairs disability, increased their disability to perform daily activities and also decreased their satisfaction with life.     

Predictors of life satisfaction: perceptions of older community-dwelling adults

The purpose of this study was to investigate variables that predict life satisfaction in elderly individuals. A convenience sample of 70 older community-dwelling adults participated in the study. Instruments used included the Life Satisfaction Index A Scale, three subscales from the Self-Evaluation of Life Function Scale, the Perceived Control Scale, Hollingshead's Two Factor Index of Social Position, and the Self-Rated Health Subscale of the Philadelphia Geriatric Center Multilevel Assessment Instrument. When the influence of health and social position was held constant, social interaction was the only additional significant predictor of life satisfaction. When health and social position were not held constant, social interaction, perceived control, and social position were significant predictors of life satisfaction. The findings indicate that nursing practice, education, and research should focus on assessment and interventions relative to promoting and maintaining health, perceived control, and social interaction among elderly individuals living in the community.     

Quality of life studies in nursing science (2). Community adjustment of chronic schizophrenics: effects on life satisfaction and self-esteem (2)]

The purpose of this study was to test two community adjustment models of the chronically mentally ill developed by this author. The study was to determine the effects of daily living, work, family, and social adjustment on life satisfaction and self-esteem as well as to determine the effects of chronicity and symptomatology on the four adjustments. Twenty schizophrenic inpatients and 120 schizophrenic outpatients from a psychiatric hospital in Tokyo participated in the study: the former group was used for a pilot study of the instruments and the latter for the model testing. Seven instruments were used; two self-administered questionnaires of the Life Satisfaction Scale and the Rosenberg Self-Esteem Scale, two structured interview schedules of the Adjustment Scales and a modified version of the Psychiatric Evaluation Form, the Demographic and Psychiatric History Form, the Cantril Ladder of Satisfaction, and the Global Assessment Scale. Two direct effects of family and social adjustment (beta = 0.326 and 0.262 respectively) explained 22.2% of the variance in life satisfaction. Two direct effects of symptomatology (beta = -0.216) and family adjustment (beta = 0.185) accounted for 10.6% of the variance in self-esteem. It was assumed that dropping of symptomatology as a direct effect on life satisfaction was a type two error. In addition, chronicity and social adjustment failed to enter into the equation of self-esteem due to the type two error as well. The culturally characteristic pattern that emerged was that relationship-oriented variables were directly effective on life satisfaction and self-esteem. However, task-oriented variables of daily living adjustment and work adjustment did not account for life satisfaction and self-esteem despite the hypothetical links in the models. It was concluded that interpersonal relationships were especially important for the well-being of Japanese schizophrenics living in the community. The lack of direct effects of daily living and work adjustment suggested that autonomy in living did not heighten the well-being of the subjects, a result that was different than the findings of American studies. It was probably because that Japanese people in general value interdependence among family members, therefore, relatives of the mentally ill tend to play more roles to take care for them.     

首发精神分裂症患者治疗前后主观生活满意度评估

目的探讨首发精神分裂症患者的主观生活满意度。方法对63例首发精神分裂症患者应用新型非典型抗精神病药物治疗。观察6mo。于治疗前及治疗后6mo末采用阳性和阴性症状量表、生活满意度量表,以及临床疗效总评量表进行评定分析。结果治疗生活满意度量表总分及各因子分（自我评价因子分除外）均较治疗前显著提高（P均〈0．01）。多元逐步回归分析显示,患者的生活满意度与治疗前阳性和阴性症状量表总分呈显著负相关（P〈0．05）,与治疗前生活满意度量表总分呈显著正相关（P〈0．01）。结论首发精神分裂症患者经新型非典型抗精神病药物治疗后主观生活满意度显著提高。