肝移植术后认知与脑改变的多模态神经成像

肝性脑病是终末期肝硬化的重要并发症,导致病人出现一系列神经及认知功能改变。肝移植术后病人在肝功能恢复的同时其认知功能也可明显改善。MRI可以从脑代谢、结构及功能方面更进一步揭示肝硬化病人移植术后认知及脑改变情况。综述肝移植术后认知改变的研究现状以及最新的多模态MRI技术在术后脑改变中的应用,及其在揭示术后认知恢复及残存损害的神经机制中的价值。     

脑转移瘤放射治疗后认知功能障碍机制及可能的防治策略

放射治疗一直是脑转移瘤有效的非手术治疗手段,随着脑转移瘤患者生存期的不断延长,潜在放疗相关的认知功能损伤逐渐被重视。在保证肿瘤有效控制的同时,对患者的生活质量和神经认知功能都有所关注,以改善患者的预后。本文主要针对脑转移瘤患者的放射治疗及神经认知功能保护的相关研究进行综述。     

身体活动促进脑的执行功能:行为、脑电和核磁共振研究

本文回顾了身体活动对执行控制和脑功能的积极影响。行为研究发现,身体活动对儿童、成人和老人的执行功能均有促进作用,身体活动特别有益于老人的认知保护;脑电研究发现,身体活动更多或体能更好有益于认知过程,这些认知过程与刺激编码过程中注意资源的分配和更快的认知加工以及更好的抑制与监控能力相关联;核磁共振研究发现,身体活动能促进脑的神经生长、神经执行功能和神经保护功能,从而影响脑的可塑性。未来研究应注意对执行功能结构进行细分、考察不同的执行功能成分与身体活动的关系,进一步探索身体活动与生活因素的交互作用。     

核医学影像在肌萎缩侧索硬化临床研究中的应用

肌萎缩侧索硬化（ALS）起病隐匿、进展迅速、诊断困难,其神经影像学改变目前尚缺乏明确特异性指征。SPECT和PET是最早应用于ALS的神经影像学技术。像素分析软件的运用（如SPM等）使SPECT、PET对ALS的研究更加方便和客观。近年来,脑受体PET显像不断发展,逐渐显示出其在ALS早期诊断及认知功能受损研究中的重要价值。     

癌症治疗、创伤和脑损伤远期后遗症的临床和神经核医学显像

神经核医学显像在近几十年中已被应用于原发性神经退行性疾病,如痴呆和帕金森综合征的临床和科研中。但是,其在对认知功能同样有远期影响的非神经退行性疾病的评估方面的应用相对较少。该文对近年来引起广泛关注的3种疾病,包括癌症和化疗相关认知功能障碍、创伤后应激障碍和创伤性脑损伤的临床和影像学表现进行综述,同时对目前应用神经影像学...     

病毒性脑炎患儿神经元特异性烯醇化酶和事件相关电位相关性分析

病毒性脑炎（病脑）是小儿神经系统疾病中最常见的感染性疾病之一．其病理改变主要表现为神经元或神经胶质细胞等脑细胞的变性坏死。患病脑后是否会造成患儿认知障碍成为人们关注的焦点之一。近年来,有研究表明血和脑脊液神经元特异性烯醇化酶（NSE）水平可作为脑外伤、窒息、低氧、脑炎、脑血管病等疾病脑损伤及预后判断指标。P300是一种认知事件相关电位（event—related potentials,ERP）,被认为是刺激过程中认知和记忆功能的“索引”,已广泛应用于神经心理认知功能障碍的研究。本研究旨在通过检测血、脑脊液中NSE水平变化．并结合恢复期患儿P300的情况,以探讨血和脑脊液NSE水平与远期病脑患儿认知功能障碍是否存在相关性。     

男性新兵认知神经心理功能基线实验研究

目的：探讨男性新兵认知神经心理功能的实验指标及基线情况。方法：基于一整套心理实验仪器，选择合理指标对新兵认知神经心理功能进行研究。结果：本研究最终选取了11个实验指标，并给出了各指标定义、态势分布及基线值。结论：本研究目标总体界定明确、代表性强、样本量适当，所获基线数据稳定、可靠，对后续研究具有较好参考价值。     

运动通过线粒体介导发挥神经保护作用研究进展

<正>随着人口老龄化的日益加深,年龄相关的认知功能障碍以及神经退行性疾病日益增多,神经保护成为医学界关注的热门话题。大量文献证明,运动具有神经保护作用,在缓解衰老过程中出现的认知功能障碍以及神经退行性疾病方面起到至关重要的作用。其内在机制非常复杂,本文从线粒体与神经元的关系入手,通过运动对线粒体结构功能的影响来阐述运动的神经保护作用。     

认知功能障碍的帕金森病患者脑静息态功能连接

【摘要】帕金森病（PD）是一种常见的神经退行性疾病,其主要临床表现为运动症状（包括震颤、肌强直、运动迟缓和姿势不稳）以及一些非运动症状（NMS）,其中以认知功能障碍（PD-CI）较为多见。PD伴轻度认知功能障碍（PD-MCI）进展为PD伴痴呆（PDD）的风险很高,由于PDD患者的残疾率、住院率和死亡率较高,因此充分认识PD-CI对了解PD患者的病情进展至关重要。静息态功能磁共振成像（rs-fMRI）是研究脑功能连接（FC）的有效工具,可应用于健康人群及有神经或精神疾病的患者。最新证据显示PD-CI患者脑功能连接发生了改变。本文就静息态功能连接在PD-CI患者中的应用和研究进展予以综述。     

阻塞性睡眠呼吸暂停低通气综合征的神经影像学研究进展

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)以夜间间歇性缺氧和睡眠片断化为特征,常伴有不同程度的神经认知功能损伤,是一种发病率高、严重影响生活并危及生命的睡眠疾病.近年来,随着神经影像学成像方法和图像处理技术的进步,越来越多的研究发现OSAHS病人存在显著的脑结构、代谢和功能异常,从而为深入了解OSAHS神经认知功能改变的病理生理学机制提供了重要信息.综述了神经影像学技术在揭示OSAHS相关脑改变方面的研究进展.     

Role of functional imaging in the development and refinement of invasive neuromodulation for psychiatric disorders

Deep brain stimulation (DBS) is emerging as a powerful tool for the alleviation of targeted symptoms in treatment-resistant neuropsychiatric disorders. Despite the expanding use of neuropsychiatric DBS, the mechanisms responsible for its effects are only starting to be elucidated. Several modalities such as quantitative electroencephalography as well a intraoperative recordings have been utilized to attempt to understand the underpinnings of this new treatment modality, but functional imaging appears to offer several unique advantages. Functional imaging techniques like positron emission tomography, single photon emission computed tomography and functional magnetic resonance imaging have been used to examine the effects of focal DBS on activity in a distributed neural network. These investigations are critical for advancing the field of invasive neuromodulation in a safe and effective manner, particularly in terms of defining the neuroanatomical targets and refining the stimulation protocols. The purpose of this review is to summarize the current functional neuroimaging findings from neuropsychiatric DBS implantation for three disorders: treatment-resistant depression, obsessive-compulsive disorder, and Tourette syndrome. All of the major targets will be discussed (Nucleus accumbens, anterior limb of internal capsule, subcallosal cingulate, Subthalamic nucleus, Centromedial nucleus of the thalamus-Parafasicular complex, frontal pole, and dorsolateral prefrontal cortex). We will also address some apparent inconsistencies within this literature, and suggest potential future directions for this promising area.     

Determination of regional cerebral function with FDG-PET imaging in neuropsychiatric disorders

Functional brain imaging using 18F fluorodeoxyglucose (FDG) and positron emission tomography (PET) has greatly enhanced our understanding of brain function both in normal conditions as well as in a wide variety of neuropsychiatric disorders. We review the uses of FDG PET in the diagnosis, management, and follow-up of patients with neuropsychiatric disorders. This article will also explore what FDG-PET imaging has revealed in these neuropsychiatric disorders and how these findings relate to both research and clinical applications.     

亚急性期脑桥梗死脑默认网络的静息态fMRI研究

目的 探讨亚急性期脑桥梗死后脑默认网络(DMN)连接是否异常及可能的代偿机制.方法 23例亚急性脑桥梗死患者与23例年龄、受教育程度相匹配的健康受试者参加了本研究.在Philips Achieva 3.0T MRI上采集所有被试者静息态功能磁共振成像(rs-fMRI)数据.以后扣带回(PCC)为种子点,分别提取脑桥梗死组与对照组的DMN,分析相关脑区的功能连接(FC)情况.组间采用双样本t检验进行统计学分析.结果 与正常组相比,亚急性期脑桥梗死组FC增强的脑区包括:右侧中央后回、左侧内侧前额叶和左侧楔叶;FC减弱的脑区包括:双侧岛叶、左侧小脑后叶、右侧海马旁回、左侧枕下回.结论 亚急性期脑桥梗死患者的 DMN存在异常,FC的变化提示相关脑区皮质功能重组或代偿.     

Metabotropic glutamate receptor 5 – a promising target in drug development and neuroimaging

This review summarizes the contributions by various teams of scientists in assessing the metabotropic glutamate receptor 5 (mGluR5) as a biomarker in neuropsychiatric disorders and diseases. Development of positive and negative allosteric modulators of mGluR5 is reviewed, as is the development of PET radioligands that have the potential to measure mGluR5 receptor density in neurological disorders and during therapeutic interventions. PET imaging provides an effective tool to assess the specificity of new drugs, select dose regimens in clinical trials, and study drug mechanisms of action. We summarize and deliver comparative analyses of mGluR5-specific PET radiotracers and their applications in understanding the pathophysiology of mGluR5-related nervous system disorders and to speed up drug development.     

Trastorno de Tourette y de la lectura en un niño con disrupción del tracto parietofrontal izquierdo

We present the case of a nine-year-old boy with Tourette syndrome and reading disorder with a history of a severe infectious process in the late neonatal period. Brain MRI showed a left parietal malacotic cavity and diffusion tensor imaging and tractography showed a striking disruption of the white matter bundle that joins the left parietal region with the ipsilateral frontal region with involvement of the left superior longitudinal fasciculus and of the left arcuate fasciculus. Although Tourette syndrome and reading disorder are fundamentally hereditary neuropsychiatric disorders, they can also occur secondary to cerebral alterations like those existing in this boy. The introduction of modern neuroimaging techniques in patients with neuropsychiatric disorders (or the risk of developing them) can be very useful in the diagnosis and prognosis in the future.     

精神分裂症患者脑结构及功能的多模态影像Meta分析

目的 研究在未用药物干扰前提下精神分裂症患者的脑结构及功能变化及两者之间的关系.方法 系统地从PubMed、Embase、Web of Science和The Cochrane Library数据库上检索相应文献.多模态分析方法采用软件"Seed-based d Mapping".结果 纳入14篇结构研究,包括446例患者和461例正常对照.纳入的15篇功能MRI及PET研究中,共有360例患者和396例正常对照.多模态结果分析表明结构和功能大部分重叠的脑区在额颞叶,双侧扣带回/扣带旁回,双侧岛叶,基底节及左侧小脑.结论 排除药物干扰后发现精神分裂症患者结构和功能重叠的脑区大部分在默认网络(DMN)和听觉网络(AN).在这2种网络中,结构和功能变化的方向不一致,可能反映了精神分裂症患者大脑不同的病理生理改变.     

Bilateral striopallidal calcinosis secondary to systemic lupus erythematosus

Bilateral symmetric striatopallidal calcinosis with or without deposits in dentate nucleus, thalamus, and white matter is reported in patients ranging from asymptomatic, metabolic, toxic, and genetic autosomal dominant, familial or sporadic forms. Of the connective tissue diseases, it has been reported in very few cases in patients with systemic lupus erythematosus, many incorrectly labeled as Fahr syndrome without even having hypoparathyroidism. Here we describe a 30-year-old female patient with neuropsychiatric systemic lupus erythematosus manifested at diagnosis with mood disorders and anxiety, and 1-year later develops Lupus headache; Incidentally, an aneurism of the right middle cerebral artery and bilateral and symmetric calcifications of the caudate and lenticular nuclei were noted; this finding is a rarely reported manifestation of neuropsychiatric systemic lupus erythematosus.A review of the literature based on this case was carried out in electronic databases. There are approximately 29 patients reported in the literature, with calcifications in the basal ganglia associated with systemic lupus erythematosus occurs almost exclusively in young women (96.5%) with a mean age of 33.36 years (2 months-76 years), with a race predilection for Asians (65.5%). Regarding the neuropsychiatric syndromes defined by the American College of Rheumatology, the most frequently associated are movement disorders; followed by cognitive dysfunction, seizure disorders, mood disorders, cerebrovascular disease, psychosis, and acute confusional state, transverse myelitis, and demyelinating syndrome. The mean duration time of the SLE to detection of the basal ganglia calcification is 7.62 years (3 days-31 years).     

Neuropsychiatric disorders: Investigation of schizophrenia and substance abuse

Because neuropsychiatric disorders involve functional and neurochemical cerebral abnormalities, positron emission tomography (PET) is ideally suited for their investigation. The use of tracers to measure regional brain glucose metabolism and/or blood flow has allowed the evaluation of brain function in psychiatric patients. The use of radioligands to assess receptor concentration has enabled an evaluation of the extent to which specific neurotransmitter systems are involved in the pathogenesis of mental illness. This article reviews the application of PET technology to the understanding of schizophrenic disorders and substance abuse.     

Neuropharmacological studies with SPECT in neuropsychiatric disorders

The last decade saw a rapid development of single photon emission computed tomography (SPECT) from a tool to assess cerebral blood flow to the study of specific neurotransmitter systems. Because of the relatively long half-life of SPECT radioisotopes, it is practical to measure the availability of neuroreceptors and transporters in conditions approaching equilibrium. The cost-efficiency of SPECT allowed studies in relatively large samples of patients with various neuropsychiatric disorders. We have applied this approach in studies of dopaminergic, serotonergic, and muscarinergic neurotransmission in patients with dementia, extrapyramidal disorders, schizophrenia, and alcoholism. No simple associations were observed between a single defect in one neurotransmitter system and a certain neuropsychiatric disease. Instead, complex dysfunction of several neurotransmitter systems in multiple, partially connected brain circuits have been implicated. Treatment effects also have been characterized. Microdialysis and neurotransmitter depletion studies showed that most radioligands and endogenous neurotransmitters compete for binding at receptors and transporters. Future research directions include the assessment of endogenous neurotransmitter concentrations measured by depletion studies and of genetic effects on neuroreceptor and transporter expression.     

TIPS术后脑默认网络的静息态功能磁共振成像研究

目的：运用静息态功能磁共振成像（rs—fMRI）研究经颈静脉肝内门体分流术（TIPS）对肝硬化患者脑默认网络（DMN）的影响。方法：10例拟行TIPS治疗的肝硬化患者（患者组）和10例正常对照者（对照组）纳入本研究。10例正常对照者及10例患者术前、术后（平均8天）均行rs-fMRI。利用独立成分分析方法分离得到各受试者的默认网络脑区,采用单样本t检验对患者术前和对照组进行组内分析,观察各自的DMN空间分布模式;分别对患者TIPS术前与正常对照组、患者TIPS术后与术前的DMN功能连接进行组间比较,观察静息状态下脑默认网络的改变情况。结果：TIPS术前肝硬化患者和正常对照组均显示出典型的静息态脑默认网络空间分布模式。与正常对照组相比,TIPS术前肝硬化患者默认网络脑区功能连接既有降低也有增高,降低脑区包括左侧额中回背外侧、双侧顶下小叶及颞叶;增高的脑区主要位于双侧后扣带回、楔前叶及内侧前额叶。与TIPS术前相比,患者术后出现双侧楔前叶及角回功能连接增强,而后扣带回及内侧前额叶功能连接度减低。结论：静息状态下,TIPS术后早期肝硬化患者脑默认网络功能连接即出现改变,既有功能连接减低也有增强,提示TIPS对肝硬化患者脑默认网络既有功能损伤又有代偿机制。