Alzheimer病的脑地形图和多项诱发电位研究

目的 探讨Ａｌｚｈｅｉｍｅｒ病（ＡＤ）的自发和诱发脑电特征。方法 对３９例ＡＤ及４０例正常对照进行脑电图（ＥＥＧ）、脑地形图（ＢＥＡＭ）、视觉和听觉诱发电位（ＶＥＰ和ＡＥＰ）、脑干听觉反应（ＡＢＲ）和认知电位Ｐ３００（Ｐ３００）检测。结果ＡＤ患者ＥＥＧ异常率达８７．５％；ＢＥＡＭ示：δ和θ功率增高，额、后颞、枕区α功率降低，额极、中、后颞及枕区β功率降低（Ｐ〈０．０５或〈０．０１）；ＶＥＰ、ＡＥ     

脑血管性痴呆局部脑血流的定量分析

目的探讨血管性痴呆的脑循环变化。方法采用单光子发射计算机断层显像（ＳＰＥＣＴ），９９ｍ－ＥＣＤ标记，定量测定血管性痴呆（ＶＤ）、多发性脑梗塞（ＭＩ）及正常老年人各１０例的局部脑血流量。结果ＶＤ组各脑叶及基底节区平均脑血流量均显著低于对照组（Ｐ＜０．０１）；ＶＤ组比ＭＩ组额颞叶皮质血流量明显减少（Ｐ＜０．０１，Ｐ＜０．０５）；ＶＤ额叶皮质脑血流量改变与神经心理测试ＭＭＳＥ呈正相关（ｒ＝０．６９２，Ｐ＜０．０５）。结论ＶＤ存在全脑广泛的脑血流灌注降低。额叶皮质血流灌注降低与痴呆的发生及痴呆的严重程度密切相关。ＳＰＥＣＴ局部脑血流定量测定对于ＶＤ的预测及早期发现有重要意义     

精神发育迟滞患者的单胺类物质代谢研究

用高效液相色谱法测定３３例精神发育迟滞（ＭＲ）患者及１２例对照者脑脊液（ＣＳＦ）和血清中单胺类物质，结果显示：精神发育迟滞患者ＣＳＦ中高香草酸（Ｃ－ＨＶＡ）和５－羟吲哚乙酸（Ｃ－５－ＨＩＡＡ）高于对照组（Ｐ＜０．０５）；先天愚型组Ｃ－ＨＶＡ明显高于其它三组（Ｐ＜０．０１），Ｃ－５－ＨＩＡＡ高于对照组和脆性Ｘ综合征组（Ｐ＜０．０１），而先天愚型组血清中５－羟色胺低于其它三组（Ｐ＜０．０１）；脆性Ｘ综合征组的游离色氨酸高于其它三组（Ｐ＜０．０５）。     

急性脑血栓形成不同时期一氧化氮含量的变化

探讨急性脑血栓形成不同时期一氧化氮（ＮＯ）含量的变化。测定３０例急性脑血栓形成患者发病不同时期血清中ＮＯ、ＳＯＤ、ＭＤＡ的含量。另选２８例性别、年龄组成相似的健康人作为正常对照。结果表明，脑血栓形成期，ＮＯ、ＳＯＤ含量显著降低（Ｐ＜０．０５），ＭＤＡ含量显著增高（Ｐ＜０．０１）；脑水肿期，ＮＯ含量较前显著增高（Ｐ＜０．０１）达正常水平（Ｐ＞０．０５），ＳＯＤ含量进一步降低（Ｐ＜０．０５），ＭＤＡ含量进一步增高（Ｐ＜０．０５）；进入稳定期后，ＮＯ较前稍降低（Ｐ＞０．０５）仍在正常水平（Ｐ＞０．０５），ＳＯＤ含量增高（Ｐ＜０．０１）仍低于正常（Ｐ＜０．０５），ＭＤＡ含量较前下降（Ｐ＜０．００１）仍高于正常（Ｐ＜０．０１）。提示：急性脑血栓形成早期ＮＯ含量降低与脑缺血损伤有关，脑水肿期ＮＯ参与脑损伤。     

阿尔茨海默病的神经心理学和单光子发射计算机断层扫描研究

目的验证单光子发射计算机断层扫描（ＳＰＥＣＴ）在阿尔茨海默病（ＡＤ）诊断中的价值,并了解其与神经心理测定的相关性。方法对２２例ＡＤ和２３名年龄、性别及教育程度均相匹配的正常人进行神经心理学有关量表的评定和ＳＰＥＣＴ检查。结果ＡＤ组各神经心理学测验量表评分及ＳＰＥＣＴ放射性计数比值均低于正常对照组。两组男性间ＳＰＥＣＴ放射性计数比值在左右颞上回的差异有非常显著性（Ｐ＜０．０１）,左颞下回、左右丘脑和扣带回的差异有显著性（Ｐ＜０．０５）。两组女性间ＳＰＥＣＴ放射性计数比值在左右颞上、颞下回及左右顶叶的差异有非常显著性（Ｐ＜０．０１）。轻度与中、重度ＡＤ之间右顶叶的差异有显著性（Ｐ＜０．０５）。ＡＤ患者的简易智能状态检查评分与右顶叶放射性计数比值相关（ｒ＝０．５１,Ｐ＜０．０５）。结论ＳＰＥＣＴ对ＡＤ早期诊断具有重要意义,并与神经心理测定值有一定相关性。     

缺血性脑血管病患者血浆CGRP,ANP含量表达

目的为了探讨神经肽与缺血性脑血管病的发病关系。方法应用放射免疫分析法检测脑血管病患者血浆中ＣＧＲＰ、ＡＮＰ的含量表达。结果急性期脑梗塞患者血浆ＣＧＲＰ含量低于恢复期及正常对照组，重型低于轻型及中型，差异显著（Ｐ＜０．０１）；急性期脑梗塞患者血浆ＡＮＰ含量高于恢复期及正常对照组（Ｐ＜０．０１），重型高于轻型（Ｐ＜０．０１）及中型（Ｐ＜０．０５）；正常对照组血浆ＣＧＲＰ、ＡＮＰ含量呈正直线相关关系，急性期脑梗塞患者血浆ＣＧＲＰ、ＡＮＰ含量无直线相关关系。结论神经肽参与脑血管病的发病过程，神经肽检测可以作为脑血管病的临床分型、判断预后的客观指标     

牛磺酸对鼠脑缺血再灌注谷氨酸转运体功能的影响

目的探讨牛磺酸对鼠脑缺血再灌注（ＩＲ）时皮层、海马、纹状体谷氨酸转运体功能的影响。方法采用３血管夹闭、松夹制作鼠ＩＲ模型。利用脑组织突触膜颗粒对３ＨＬ谷氨酸摄入量的测定及分光光度法观察谷氨酸转运体、丙二醛（ＭＤＡ）含量及超氧化物歧化酶（ＳＯＤ）活性的变化。结果与对照组相比，ＩＲ组皮层、海马及纹状体谷氨酸转运体的功能及ＳＯＤ活性低（Ｐ＜０．０５，０．０１），ＭＤＡ含量高（Ｐ＜０．０５，０．０１）。与ＩＲ组相比，牛磺酸组鼠脑皮层、海马及纹状体的功能及ＳＯＤ活性高（Ｐ＜０．０５，０．０１），ＭＤＡ含量低（Ｐ＜０．０５，Ｐ＜０．０１）。结论牛磺酸可改善ＩＲ后皮层、海马及纹状体谷氨酸转运体的功能，其机制可能与清除自由基有关     

多梗塞性痴呆病人血浆内皮素和红细胞变形能力的研究

观察３６例多梗塞性痴呆和２０例非痴呆病人血浆内皮素含量和红细胞变形能力，并与２５例健康对照组比较。结果：（１）痴呆组和非痴呆组血浆内皮素含量均明显高于对照组（Ｐ＜０．００１；＜０．０１）；（２）两组红细胞变形能力均明显低于对照组（Ｐ＜０．００１；＜０．０５），而痴呆组又明显低于非痴呆组（Ｐ＜０．０５）。认为：血浆内皮素增高和红细胞变形能力下降与痴呆的形成和发展有关。     

老年期与中青年抑郁症生活事件比较研究

本研究分析生活事件在老年期抑郁症发病中的作用，并与中青年组对照研究，结果发现，老年组在病前生活事件的发生率与中青年组相似（Ｐ＞０．０５）。用ＤＳＭ－Ш－Ｒ轴和Ⅳ和我国的ＬＥＳ评定，老年组病前生活事件比中青年组严重（Ｐ＜０．０１）。在生活事件类型中，老年组的家庭方面和躯体疾病两项显著高于中青年组（Ｐ＜０．０１和Ｐ＜０．０５），中青年组的工作学习和个人方面两项高于老年组（Ｐ＜０．０１和Ｐ＜０．０５）。     

急性闭合性颅脑损伤患者血清髓鞘碱性蛋白及其抗体含量的研究

用酶联免疫吸附法（ＥＬＩＳＡ）测定３６例急性闭合性颅脑损伤（ＡＣＨＴ）患者、４０例其它神经系统疾病（ＯＮＤ）患者及３２名正常人的血清髓鞘碱性蛋白（ＭＢＰ）及其抗体（Ａｎｔｉ－ＭＢＰ）含量。结果表明：ＡＣＨＴ组患者血清ＭＢＰ含量显著高于ＯＮＤ组与正常人组（均Ｐ＜０．０１），ＡＣＨＴ患者中脑挫裂伤组和脑内血肿组血清ＭＢＰ含量较脑震荡组明显增高（均Ｐ＜０．０１）；而ＯＮＤ组与正常人组比较则无明显差异（Ｐ＞０．０５）。ＡＣＨＴ组患者血清Ａｎｔｉ－ＭＢＰ含量与ＯＮＤ组比较差别无显著性（Ｐ＞０．０５）。提示血清ＭＢＰ含量对判断颅脑损伤的病情有重要价值。     

颞叶癫痫患者磁共振弥散张量成像及记忆损害的研究

目的利用磁共振弥散张量成像技术(DTI)研究颞叶癫痫(TLE)患者脑内微观改变及记忆损害的相关脑区。方法对颞叶癫痫患者15例和健康对照者15例,进行DTI检查,利用韦氏记忆量表检测记忆功能。结果 TLE患者部分各向异性弥散(FA)值降低激活区域有颞叶、边缘叶、扣带回和岛叶,升高区有:额叶、顶叶、枕叶,表观系数(ADC)值升高激活区域在颞叶、额叶、枕叶、顶叶;无ADC值降低区域。与健康者相比,颞叶癫痫患者的记忆商数(MQ)(90.73±19.72)显著下降,P<0.01。对照组FA值在左岛叶、颞叶与MQ值正相关;患者组FA值在右额、顶、枕叶、左顶叶与MQ值正相关,在左颞叶与MQ值负相关。对照组ADC与MQ正相关区域在左边缘叶,与MQ成负相关区域在左顶叶、患者组正相关区域在左、右颞叶。结论初步证实TLE患者的脑内结构变化不局限于颞叶,还包括颞叶外网络结构;TLE患者全脑DTI与MQ存在着相关激活脑区,表明记忆功能损害与脑内相关结构改变有关。     

血管性痴呆患者SPECT脑血流灌注显像特点

目的　探讨血管性痴呆 (VD)患者 SPECT局部脑血流灌注显像特点 ,为 VD的早期诊断和痴呆严重程度的评估寻找客观的生物学指标。方法　分别对 45例 VD、3 0例卒中无痴呆 (SWD)和 3 0例正常对照者 (NC)3组进行 SPECT局部脑血流灌注显像 ,半定量分析各脑区血流灌注情况。结果　 VD组额叶、顶叶、颞叶和基底节局部脑血流灌注比 SWD组减少 (P<0 .0 5 ) ;并以额叶、颞叶血流灌注的减少最为显著 (P<0 .0 1)。与 NC组相比 ,SWD组额叶、顶叶、颞叶和基底节局部脑血流灌注均减低 (P<0 .0 5 )。额叶、颞叶血流灌注减低与 MMSE评分间存在正相关关系 (r=0 .75 5 ,P<0 .0 1)。结论　 VD患者存在明显的脑血流灌注减低 ,以额叶、颞叶最为显著 ,且与MMSE评分间存在正相关 ,SPECT脑血流灌注显像有助于 VD的诊断和病情评估     

Analysis of cognitive function and regional cerebral blood flow in Parkinson's disease by 123I-IMP SPECT]

To investigate the relationship between the alterations of regional cerebral blood flow (rCBF) and the cognitive impairment in parkinsonian patients, I studied forty-one patients affected by Parkinson's disease (19 men and 22 women) using single photon emission computed tomography (SPECT) and N-isopropyl-p-[123I] iodoamphetamine (123I-IMP) as a tracer. I evaluated the cognitive function with the Mini-Mental State examination (MMS), the Hasegawa's Dementia Scale (HDS), the Kana-pick up test (KT), and the figure drawing test (FDT). I evaluated the motor impairment with the Hoehn and Yahr stage. SPECT scanning was performed with a rotating digital gamma camera TOSHIBA 901-A. A semiquantitative method of assessing regional tracer uptake was used. Regions of interest (ROI; 3 x 3 pixels, 15.9 x 15.9 mm2) were drawn on the cerebellar hemispheres, cortical regions (frontal, temporal, parietal and occipital), and basal ganglia bilaterally. The RI count index was expressed as a ratio of activity in each ROI to mean counting rate over cerebellar regions. I considered the RI count index as the index of rCBF in each ROI. There were strong positive correlations between MMS and rCBF of frontal, parietal and occipital lobes (p less than 0.001). There were positive correlations between HDS and rCBF of frontal (p less than 0.01), parietal (p less than 0.001) and occipital lobes (p less than 0.01). There were positive correlations between KT and rCBF of frontal (p less than 0.01), occipital (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)     

脑卒中后认知损害与影像学分型的相关研究

目的探讨不同部位缺血性脑卒中急性期患者认知功能损害的特点。方法收集230例脑梗死急性期（1～14 d）患者,包括额叶31例,颞叶27例,顶叶26例,枕叶21例,基底节47例,丘脑35例,小脑23例,脑干20例;采用中文版蒙特利尔认知评估量表（Montreal Cognitive Assessment,MoCA）对受试者进行认知功能测评。结果 （1）各病变部位认知障碍的发生率不同;额叶组、颞叶组及丘脑组MoCA总分低于其他各组（P〈0.05）,顶叶组、枕叶组MoCA总分与基底节组、小脑组和脑干组比较有显著性差别（P〈0.05）;（2）额叶组在视空间及执行功能、注意认知域及MoCA总分值低于其他各组（P〈0.05）;颞叶组在命名、延迟回忆认知域分值低于其他各组,MoCA总分与顶叶组、枕叶组、基底节组、小脑组、脑干组有显著性差异（P〈0.05）;顶叶组及枕叶组MoCA总分低于基底节、小脑、脑干组（P〈0.05）;丘脑组在视空间及执行功能、注意认知域及MoCA总分低于顶叶、枕叶、基底节、小脑和脑干组,语言及定向认知域分值低于其他各组（P〈0.05）。结论不同部位脑梗死患者认知障碍的发生率及认知损害的特点不同。     

Corpus callosum atrophy and cerebral blood flow in chronic alcoholics

The corpus callosum atrophy and cerebral blood flows were investigated in chronic alcoholics without Marchiafava-Bignami disease. Fifteen cases of chronic alcoholics and 15 age-matched healthy controls were studied. The sagittal plane of magnetic resonance imaging of the head was scanned into a computer and the corpus callosum was measured and the callosal index was calculated. Cerebral blood flows were measured using stable xenon computed tomography (CT) method. Regional cerebral blood flows in the frontal, temporal, parietal and occipital cortex, frontal, temporal and occipital white matter, caudate nucleus, putamen and thalamus were measured. The corpus callosum area, the thickness of the genu, the thickness of the trunk, the thickness of the splenium, and the callosal index were significantly smaller in the chronic alcoholic group than in the healthy control group. Blood flows in the cerebral cortex, thalamus and putamen were significantly lower in the chronic alcoholic group than in the healthy control group. Significant positive correlations were present between the corpus callosum atrophy and the cerebral cortex blood flows. Corpus callosum atrophy and decreased cerebral blood flows may be seen in chronic alcoholics without Marchiafava-Bignami disease.     

The association of magnetoencephalography high-frequency oscillations with epilepsy types and a ripple-based method with source-level connectivity for mapping epilepsy sources

Objective

To explore the association between high-frequency oscillations (HFOs) and epilepsy types and to improve the accuracy of source localization.

Methods

Magnetoencephalography (MEG) ripples of 63 drug-resistant epilepsy patients were detected. Ripple rates, distribution, spatial complexity, and the clustering coefficient of ripple channels were used for the preliminary classification of lateral temporal lobe epilepsy (LTLE), mesial temporal lobe epilepsy (MTLE), and nontemporal lobe epilepsy (NTLE), mainly frontal lobe epilepsy (FLE). Furthermore, the seizure site identification was improved using the Tucker LCMV method and source-level betweenness centrality.

Results

Ripple rates were significantly higher in MTLE than in LTLE and NTLE (p < 0.05). The LTLE and MTLE were mainly distributed in the temporal lobe, followed by the parietal lobe, occipital lobe, and frontal lobe, whereas MTLE ripples were mainly distributed in the frontal lobe, then parietal lobe and occipital lobe. Nevertheless, the NTLE ripples were primarily in the frontal lobe and partially in the occipital lobe (p < 0.05). Meanwhile, the spatial complexity of NTLE was significantly higher than that of LTLE and MTLE and was lowest in MTLE (p < 0.01). However, an opposite trend was observed for the standardized clustering coefficient compared with spatial complexity (p < 0.01). Finally, the tucker algorithm showed a higher percentage of ripples at the surgical site when the betweenness centrality was added (p < 0.01).

Conclusion

This study demonstrated that HFO rates, distribution, spatial complexity, and clustering coefficient of ripple channels varied considerably among the three epilepsy types. Additionally, tucker MEG estimation combined with ripple rates based on the source-level functional connectivity is a promising approach for presurgical epilepsy evaluation.     

Comparison of cerebral glucose metabolism between multiple system atrophy Parkinsonian type and Parkinson's disease

OBJECTIVE: To investigate the difference in the regional cerebral glucose metabolism between multiple system atrophy Parkinsonian type (MSA-P) and Parkinson's disease (PD). MATERIAL AND METHODS: Fifteen patients with MSA-P, 32 patients with PD and eight cases of healthy control underwent positron emission tomography (PET) with (18)F-fluorodeoxyglucose ((18)F-FDG) showing glucose metabolism. Glucose metabolism ratios of various cerebral regions were compared as an indicator of regional cerebral glucose metabolic patterns. RESULTS: The metabolism ratios of frontal lobe/occipital lobe, parietal lobe/occipital lobe, temporal lobe/occipital lobe and corpus striatum/occipital lobe in patients with MSA-P were lower than those in patients with PD and control, respectively (p<0.01). For patients with MSAP, the metabolism ratio in thalamus was higher than those in lenticular nucleus and anterior cortical brain, respectively (p<0.01) and the changes of metabolism ratio in cortex, corpus striatum and thalamus were symmetric. For patients with PD, the metabolism ratio in corpus striatum was higher than that in thalamus and two side of the basal ganglia show asymmetric change of metabolism (p<0.01). CONCLUSION: This study suggests that significant differences exist in the patterns of regional cerebral glucose metabolism between MSA-P and PD. (18)F-FDG PET might be a useful adjunctive method for differential diagnosis between MSA-P and PD.     

Cerebral cortex: an MRI-based study of volume and variance with age and sex.

The aim of the present study was to examine quantitative differences in lobar cerebral cortical volumes in a healthy adult population. Quantitative volumetric MRI of whole brain, cerebral and cerebellar volumes was performed in a cross-sectional analysis of 97 normal volunteers, with segmented frontal, temporal, parietal and occipital cortical volumes measured in a subgroup of 60 subjects, 30 male and 30 female, matched for age and sex. The right cerebral hemisphere was larger than the left across the study group with a small (<1%) but significant difference in symmetry (P<0.001). No difference was found between volumes of right and left cerebellar hemispheres. Rightward cerebral cortical asymmetry (right larger than left) was found to be significant across all lobes except parietal. Males had greater cerebral, cerebellar and cerebral cortical lobar volumes than females. Larger male cerebral cortical volumes were seen in all lobes except for left parietal. Females had greater left parietal to left cerebral hemisphere and smaller left temporal to left cerebral hemisphere ratios. There was a mild reduction in cerebral volumes with age, more marked in males. This study confirms and augments past work indicating underlying structural asymmetries in the human brain, and provides further evidence that brain structures in humans are differentially sensitive to the effects of both age and sex.     

Single photon emission computed tomography in Alzheimer's disease. Abnormal iofetamine I 123 uptake reflects dementia severity

To determine whether abnormalities in regional cerebral functional activity estimated by iofetamine hydrochloride I 123 and single photon emission computed tomography can be detected in mild or moderate as well as severe cases of Alzheimer's disease (AD), we performed iofetamine I 123-single photon emission computed tomography in 37 patients with probable AD (nine patients with mild, 18 patients with moderate, and ten patients with severe dementia) and nine age-matched control subjects. Iofetamine I 123 uptake was measured in right and left frontal, temporal, parietal, and occipital cortices. Mean (right and left) iofetamine I 123 activity was lowest in the parietal region of patients with AD and was significantly reduced in the other three regions compared with control subjects. Only in the parietal region was lower relative iofetamine I 123 activity associated with an impaired level of patient function and with cognitive deficit.     

强迫症与抑郁症的脑单光子发射计算机断层扫描对照研究

目的探讨强迫症、抑郁症局部脑血流量(rCBF)特点。方法应用单光子发射计算机断层扫描(SPECT)技术,对首发且未经治疗的39例强迫症患者、36例抑郁症患者和39名正常人于静息状态下行脑血流显像。以小脑皮质的放射性计数值为参考,对局部脑血流进行半定量分析。结果强迫症组两侧前额叶、前颞叶rCBF高于正常组(P<0.01);抑郁症组两侧前额叶、枕叶、扣带回及右前颞叶、右顶叶rCBF低于正常组(P<0.05);在两侧前额叶、前颞叶、顶叶、枕叶及右后额叶、扣带回,强迫症组rCBF高于抑郁症组(P<0.05)。结论强迫症组的前额叶及前颞叶呈高灌注改变,抑郁症组脑血流普遍低灌注,SPECT技术可望作为二者鉴别诊断的客观依据之一。