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1.
Objectives
Super-refractory status epilepticus (SRSE) is one of the most challenging issues in intensive care units (ICUs) in that it is associated with high morbidity and mortality. Although the ketogenic diet (KD) has been reported to be effective in treating of SRSE, the use of the diet as therapy can be complicated by concomitant medical problems specific to critically ill patients. In this study, we aimed to describe our experience of the KD for SRSE patients in ICUs.Methods
We retrospectively reviewed the medical records of 16 patients (10 males, 6 females) with SRSE who were treated with the KD in the ICUs at Samsung Medical Center from July 2005 to July 2017.Results
The median age of seizure onset was 8?years (interquartile range 5–13.5). Prior to diet initiation, the patients were in convulsive or non-convulsive SRSE for a median of 23?days (range, 3–420). The median time to achieve ketosis was 3?days (range, 2–6). The KD was continued for a median of 2.1?months (range, 0.1–15.8). Of the 16 patients, nine (56.3%) achieved seizure freedom, six (37.5%) reported >50% seizure reduction, and one (6.2%) had <50% seizure improvement after the KD. There was no significant change in the number of antiepileptic drugs. The most commonly encountered complication during the KD was gastrointestinal disturbance.Conclusions
Our experience indicates that the KD is an effective alternative therapeutic strategy for SRSE patients in ICUs with adequate efficacy and safety in reducing seizure frequency and weaning from prolonged mechanical ventilation, although functional outcome was not favorable for most patients. Close monitoring and preventive management of potential adverse effects are critical elements for success with the KD in patients with SRSE. 相似文献2.
Mikako Enokizono Noriko Sato Miho Ota Yoko Shigemoto Emiko Morimoto Masatoshi Oba Daichi Sone Yukio Kimura Kenji Sugai Masayuki Sasaki Naoki Ikegaya Masaki Iwasaki Hiroshi Matsuda 《Brain & development》2019,41(6):507-515
Objective
Cerebellar dysmaturation and injury is associated with a wide range of neuromotor, neurocognitive and behavioral disorders as well as with preterm birth. We used diffusion tensor MR imaging to investigate a disruption in structural cortico-ponto-cerebellar (CPC) connectivity in children with infantile-onset severe epilepsy.Methods
We performed CPC tract reconstructions in 24 hemimegalencephaly (HME) patients, 28 West syndrome (WS) of unknown etiology patients, and 25 pediatric disease control subjects without a history of epilepsy nor brain abnormality on MRI. To identify the CPC tract, we placed a seeding ROI separately in each right and left cerebral peduncle. We evaluated the distribution patterns of the CPC tracts to the cerebellum and their correlation with clinical findings.Results
In control and WS of unknown etiology groups, both sides’ CPC tracts descended to bilateral hemispheres in 20 (80.0%) and 21 (75.0%); mixed (bilateral on one side and unilateral on the other side) in five (20.0%) and five (17.9%); and unilateral in zero (0.0%) and two (7.1%), respectively. However, in the HME, both sides’ CPC tracts descended to bilateral hemispheres in four (16.7%); mixed in 13 (54.1%); and unilateral in seven (29.2%). These CPC patterns differed significantly between the HME and other groups (p?<?0.001). Among HME patients, those with a unilateral cerebellar distribution on both sides had significantly earlier seizure onset (p?=?0.049) and more frequent seizures (p?=?0.052) at a trend level compared to those with bilateral and mixed distributions.Conclusion
Disrupted CPC tracts were observed more frequently in HME patients than in WS of unknown etiology patients and controls, and they may be correlated with earlier seizure onset and more frequent seizures in HME patients. DTI is a useful and non-invasive method for speculating the pathology in the developing brain. 相似文献3.
Akihisa Okumura Hirokazu Kurahashi Hideyuki Iwayama Shingo Numoto 《Brain & development》2019,41(6):516-521
Objective
This study measured the serum carnitine levels in patients with epilepsy and determined the factors contributing to low carnitine levels.Methods
We measured the serum carnitine levels in 94 consecutive patients with epilepsy, including the free carnitine (FC) and acylcarnitine fractions, using an enzyme cycling method. We defined a low FC as a serum FC level?<?36?μmol/L. Age, body mass index (BMI), standard deviation score of BMI (BMI-SDS), use of valproate, cognitive disorder, and feeding problems differed between patients with low and normal FC. In patients taking valproate, the associations of the serum FC level with the platelet count and serum ammonia and amylase levels were analyzed.Results
Univariate analysis showed that a low BMI and BMI-SDS, the use of valproate, and cognitive disorder were more frequent in patients with a low FC. Logistic regression analysis revealed that a low BMI-SDS and cognitive disorders were independently associated with a low FC. Among the patients taking valproate, a low BMI-SDS and age were associated with a low FC. The serum FC and ammonia levels were inversely correlated, whereas no correlation was observed between the serum FC level and platelet count or serum amylase level.Conclusion
A low BMI and cognitive disorders were related to a low FC in patients with epilepsy and the serum carnitine levels should be monitored in these patients. 相似文献4.
Akihito Takeuchi Takashi Yorifuji Mariko Hattori Kei Tamai Kazue Nakamura Makoto Nakamura Misao Kageyama Toshihide Kubo Tatsuya Ogino Katsuhiro Kobayashi Hiroyuki Doi 《Brain & development》2019,41(5):397-405
Objective
To examine the relationship between the catch-up growth of preterm, SGA children and their behavioral development.Methods
We analyzed data from a large Japanese, nationwide, population-based, longitudinal survey that started in 2001. We restricted the study participants to preterm children with information on height at 2?years of age (n?=?1667). Catch-up growth for SGA infants was defined as achieving a height at 2?years of age above ?2.0 standard deviations for chronological age. We then used logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (95% CIs) for the associations of SGA/catch-up status with neurobehavioral development both at 5.5 and 8?years of age, adjusting for potential infant- and parent-related confounding factors.Results
Twenty-six percent of preterm SGA infants failed to catch up. SGA children without catch-up growth were more likely to be unable to listen without fidgeting (OR 2.51, 95% CI: 1.06–5.93) and unable to focus on one task (OR 2.66, 95% CI: 1.09–6.48) compared with non-SGA children at 5.5?years of age. Furthermore, SGA children without catch-up growth were at significant risk for inattention at 8?years of age.Conclusions
SGA infants with poor postnatal growth were at risk for attention problems throughout preschool-age to school-age among preterm infants. Early detection and intervention for attention problems among these infants is warranted. 相似文献5.
Tomoki Maeda Hajime Iwata Kazuhito Sekiguchi Mizuho Takahashi Kenji Ihara 《Brain & development》2019,41(6):490-500
Aim
To clarify the morphologic characteristics of the brain, which are the foundation of the emergence of general movements (GMs) in very-low-birth-weight infants.Study design
Prospective cohort study. GMs were scored according to a semiquantitative scoring system: the GMs optimality score (GMOS) at preterm and term ages. Brain magnetic resonance imaging (MRI) at term-equivalent age was scored using a validated scoring system (MRI score). We examined the relationship between the two scores by multiple regression analysis with relevant clinical background.Subjects
We included 50 very-low-birth-weight infants cared for at Oita University Hospital from August 2012 to August 2018 who underwent MRI and GMs assessment. Their median gestational age and birth weight were 29w2d and 1145?g, respectively.Results
The MRI score and systemic steroid administration were related to preterm GMOS, and the MRI score was related to term GMOS. The component cerebellum score and cortical grey matter score of the MRI score were associated with preterm GMOS, and the cerebellum and the cerebral white matter scores were associated with term GMOS.Conclusion
The quality of GMs was associated with brain morphological development. The co-evaluation of GMs and brain morphology leads to accurate developmental prediction. 相似文献6.
Shih-Yun Lan Cheng-Yen Kuo Cheng-Che Chou Shu-Sing Kong Po-Cheng Hung Hsin-Yu Tsai Yi-Ching Chen Jainn-Jim Lin I-Jun Chou Kuang-Lin Lin 《Brain & development》2019,41(5):428-435
Background
Nitrous oxide (N2O) is a commonly used inhaled anesthetic in outpatient dental procedures. However, the increasing recreational use of N2O may result in vitamin B12 deficiency-related neurologic and psychiatric symptoms. The aim of this study was to demonstrate the clinical features of chronic N2O abuse in pediatric patients.Methods
Patients under 20?years of age who were diagnosed with N2O-induced subacute combined degeneration of the spinal cord from 2012 to 2018 were enrolled in this study. Clinical presentations, laboratory, imaging, ancillary studies, treatments and outcomes were analyzed.Results
Nine patients were included, all of whom presented with symptoms of myeloneuropathy including limb numbness, limb weakness or unsteady gait. Six patients had low or low-normal vitamin B12 (cyanocobalamin) levels. Eight patients had evidence of subacute combined degeneration of the spinal cord via neuroimaging studies. All of the patients received vitamin B12 supplementation as treatment. All had full recovery of muscle power within 2?months. Five patients had persistent sensory deficits.Conclusion
Chronic N2O abuse can cause permanent neurological damage if not treated promptly. Clinical staff should be aware of the various presentations of neurotoxicity related to N2O abuse. 相似文献7.
Giovanna Lenci Maria Grazia Calevo Roberto Gaggero Giulia Prato Livia Pisciotta Elisa De Grandis Maria Margherita Mancardi Maria Giuseppina Baglietto Monica Vigano&#x; Edvige Veneselli 《Brain & development》2019,41(6):522-530
Introduction
Epilepsy with continuous spike-waves during slow sleep syndrome (CSWSS) is characterized by various seizure types, a characteristic EEG pattern and neuropsychological disorders. The main purpose of this study was to evaluate the long-term outcome of CSWSS occurred in childhood and to evaluate the variables that could influence the quality of social adaptation and the personality profile.Material and methods
This is a prospective study on 24 young adults with previous CSWSS (median age 24.5?yrs) who were enrolled between January and July 2011 at the G. Gaslini Children’s Hospital, Genoa, Italy. Patients were divided into two groups: twelve with previous spike-wave index (SWI?>?85%) defined as typical CSWSS (T-CSWSS) and twelve with previous SWI?=?50–85% defined as atypical CSWSS (A-CSWSS). All the subjects were submitted to Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Psychological General Well-Being Index (PGWBI), and to a structured interview.Results
A correlation was observed with the severity of EEG abnormalities expressed by the SWI and outcome. The T-CSWSS group showed a significantly lower perceived well-being. Similarly in the T-CSWSS group the percentage of MMPI-2 clinical scales with T-scores ≥65 was higher than in the A-CSWSS group. Finally, a significant lower schooling in the T-CSWSS group was observed.Conclusion
There seem to be two forms of the same disease, with similar onset and clinical evolution but a different outcome regarding the social and psychological conditions. The outcome of the social adaptation and of the personality consciousness was related with the severity of the EEG abnormalities: more favorable in patients with less intense SWI activity (A-CSWSS) compared those with a more severe EEG impairment (T-CSWSS). 相似文献8.
Sayaka Okuzono Ryoko Fukai Marie Noda Noriko Miyake Sooyoung Lee Noriyuki Kaku Masafumi Sanefuji Satoshi Akamine Shunsuke Kanno Yoshito Ishizaki Hiroyuki Torisu Ryutaro Kira Naomichi Matsumoto Yasunari Sakai Shouichi Ohga 《Brain & development》2019,41(4):378-381
Background
Cardio-facio-cutaneous syndrome (CFCS) is a rare genetic disorder characterized by cardiovascular anomalies, dysmorphic faces, ectodermal abnormalities and developmental delays. Mutations in BRAF and other RAS-MAPK pathway-associated genes are commonly identified in patients with CFCS. While this molecular pathway is known to be associated with neuro-inflammatory conditions, only one case with CFCS has been reported thus far to develop acute encephalopathy in childhood.Case report
A 3-year-old boy with dysmorphic features and mild psychomotor delay developed acute encephalopathy. After a 45-min long, generalized seizure, the magnetic resonance imaging revealed that the restricted diffusion signals spread to the bilateral subcortical white matters on day 1 of illness. Despite the 14?days of intensive care, the acute symptoms of encephalopathy left him intractable epilepsy and severe neurocognitive impairments. The whole-exome sequencing analysis identified a de novo heterozygous mutation of BRAF (NM_004333:p.Thr241Met) in this case.Conclusion
The present case suggests that the hyperactive condition of ERK signals might augment the development of acute encephalopathy and post-encephalopathic epilepsy in childhood. 相似文献9.
Ali Izadi Aleksandr Pevzner Darrin J. Lee Arne D. Ekstrom Kiarash Shahlaie Gene G. Gurkoff 《Brain stimulation》2019,12(3):735-742
Background
Temporal lobe epilepsy is most prevalent among focal epilepsies, and nearly one-third of patients are refractory to pharmacological intervention. Persistent cognitive and neurobehavioral comorbidities also occur due to the recurrent nature of seizures and medication-related side effects.Hypothesis
Electrical neuromodulation is an effective strategy to reduce seizures both in animal models and clinically, but its efficacy to modulate cognition remains unclear. We hypothesized that theta frequency stimulation of the medial septum would increase septohippocampal oscillations, increase seizure threshold, and improve spatial learning in a rat model of pilocarpine-induced epilepsy.Methods
Sham and pilocarpine rats were implanted with electrodes in the medial septum, hippocampus and prefrontal cortex. EEG was assessed days prior to and following stimulation. Sham and pilocarpine-treated rats received either no stimulation, continuous (throughout each behavior), or pre-task (one minute prior to each behavior) 7.7?Hz septal stimulation during the Barnes maze spatial navigation test and also during assessment of flurothyl-induced seizures.Results
Both continuous and pre-task stimulation prevented epilepsy-associated reductions in theta oscillations over time. Additionally, both stimulation paradigms significantly improved spatial navigation in the Barnes maze, reducing latency and improving search strategy. Moreover, stimulation led to significant increases in seizure threshold in pilocarpine-treated rats. There was no evidence of cognitive enhancement or increased seizure threshold in stimulated sham rats.Conclusion
These findings have profound implications as theta stimulation of the septum represents a single frequency and target that has the potential to both improve cognition and reduce seizures for patients with refractory epilepsy. 相似文献10.
Emiko Momoki Tatsuo Fuchigami Yuki Kasuga Kaori Kimura Wakako Ishii Ayumi Fukuda Yukihiko Fujita Ichiro Morioka 《Brain & development》2019,41(6):559-562
Background
Confusional migraine is a rare type of migraine presenting as an acute confusional state. However, the mechanism of this confusional state remains unclear.Subject and methods
We examined an 11-year-old girl with confusional migraine, using electroencephalography, brain magnetic resonance imaging, cerebrovascular magnetic resonance angiography, and single-photon emission computed tomography to investigate cerebral blood flow changes.Results
Our findings revealed vessel narrowing in the left middle and posterior cerebral artery territory, indicating vasospasm and suggesting that the confusion was caused by hypoperfusion. However, abnormal increased cerebral blood flow in the left middle and posterior cerebral artery territory was observed during the non-confusional state.Conclusion
The recorded cerebral blood flow changes are similar to those associated with migraine attacks, gradually changing from abnormally low to abnormally high during the confusional and post-confusional state. 相似文献11.
Purpose
Motor skill screening tools are essential for the early detection of developmental coordination disorder (DCD). The present study aimed to examine any cultural and rater effects on these tools. This then enabled us to judge the validity of the original cut-off values for identifying diagnosable children.Methods
A community sample survey was performed in Japan; 3852 children aged 6–9?years were recruited. Both parents and teachers evaluated the motor skills of their children using the Movement Assessment Battery for Children – Second Edition Checklist. The psychometric properties were evaluated and the scoring characteristics examined based on the type of rater and country of origin, as compared to data originally sampled in the UK.Results
High reliability and validity of the Japanese samples were confirmed. The Japanese adults evaluated their children’s motor skills more rigorously than the Europeans. Additionally, there was a large disagreement between parent and teacher rating scores; the degree of agreement varied depending on the severity of motor deficits in the child.Conclusion
The first findings from a Japanese sample suggest that the assessment of motor skills in children is significantly affected by culture and rater. These cultural characteristics and rater biases strongly suggest that new cut-off values, reflecting country and rater type, be introduced for identifying children at risk of DCD. 相似文献12.
Ryuki Matsuura Shin-ichiro Hamano Jun Kubota Atsuro Daida Satoru Ikemoto Yuko Hirata Reiko Koichihara 《Brain & development》2019,41(5):413-419
Objective
To evaluate the efficacy and safety of pyridoxal for treating West syndrome.Methods
We retrospectively investigated pyridoxal’s efficacy and safety in 117 patients with West syndrome at Saitama Children’s Medical Center from July 1993 to May 2016. Pyridoxal was administered at doses of 10–50?mg/kg/day. We evaluated seizure outcomes and electroencephalographic findings at 4?weeks after pyridoxal therapy. The responders were those with complete cessation of spasms for more than 4?weeks and those with resolution of hypsarrhythmia on EEG at 1–4?weeks after pyridoxal therapy.Results
Five of the 117 patients (4.3%) were responders. The median duration between pyridoxal therapy to spasm cessation was 6 (5–13) days. Among the responders, four had hypsarrhythmia resolution, no spasm relapse, and no other seizure types more than 2?years after pyridoxal therapy. One responder had partial seizures and spasm relapse. No serious adverse effects occurred. There were no significant differences in sex, etiologies, complication, other seizure types preceding the spasms, onset age of spasms, age of pyridoxal therapy, treatment lag, initial and maintenance doses of pyridoxal, and adverse effects between pyridoxal responders and non-responders.Conclusions
The efficacy rate of pyridoxal monotherapy as first-line treatment for West syndrome was low. However, pyridoxal therapy showed a rapid response within 1?week and was safe. We consider pyridoxal therapy as a kind of challenge therapy during the evaluation period concerning differential diagnosis and etiologies of West syndrome and immunological risks before adrenocorticotrophic hormone therapy or vigabatrin therapy. 相似文献13.
Chenxi Dai Gang Chen Bihua Chen Juan Wang Changlin Yin Jianjie Wang Yushun Gong Liang Wei Yuanyuan Huang Yongqin Li 《Brain stimulation》2019,12(3):659-667
Background
Transcranial direct current stimulation (tDCS) modulates neuronal activity and is a potential therapeutic tool for many neurological diseases. However, its beneficial effects on post cardiac arrest syndrome remains uncertain.Objective/hypothesis
We investigated the effects of repetitive anodal tDCS on neurological outcome and survival in a ventricular fibrillation (VF) cardiac arrest rat model.Methods
Cardiopulmonary resuscitation was initiated after 6?min of VF in 36 Sprague-Dawley rats. The animals were randomized into three groups immediately after resuscitation (n?=?12 each): no-treatment control (NTC) group, targeted temperature management (TTM) group, and tDCS group. For tDCS, 1?mA anodal tDCS was applied on the dorsal scalp for 0.5?h. The stimulation was repeated for four sessions with 1-h resting interval under normothermia. Post-resuscitation hemodynamic, cerebral, and myocardial injuries, 96-h neurological outcome, and survival were evaluated.Results
Compared with the NTC group, post-resuscitation serum astroglial protein S100 beta and cardiac troponin T levels and 96-h neuronal and myocardial damage scores were markedly reduced in the tDCS and TTM groups. Myocardial ejection fraction, neurological deficit score, and 96-h survival rate were also significantly better for the tDCS and TTM groups. The period of post-resuscitation arrhythmia with hemodynamic instability was considerably shorter in the tDCS group, but no differences were observed in neurological outcome and survival between the tDCS and TTM groups.Conclusions
In this cardiac arrest rat model, repeated anodal tDCS commenced after resuscitation improves 96-h neurological outcome and survival to an extent comparable to TTM by attenuating post-resuscitation cerebral and cardiac injuries. 相似文献14.
Guoqiao Wang Dean Coble Eric M. McDade Jason Hassenstab Anne M. Fagan Tammie L.S. Benzinger Randall J. Bateman John C. Morris Chengjie Xiong 《Alzheimer's & dementia》2019,15(4):506-514
Introduction
Staging preclinical Alzheimer disease (AD) by the expected years to symptom onset (EYO) in autosomal dominant AD (ADAD) through biomarker correlations is important.Methods
We estimated the correlation matrix between EYO/cognition and imaging/CSF biomarkers, and searched for the EYO cutoff where a change in the correlations occurred before and after the cutoff among the asymptomatic mutation carriers of ADAD. We then estimated the longitudinal rate of change for biomarkers/cognition within each preclinical stage defined by the EYO.Results
Based on the change in the correlations, the preclinical ADAD was divided by EYOs ?7 and ?13 years. Mutation carriers demonstrated a temporal ordering of biomarker/cognition changes across the three preclinical stages.Discussion
Duration of each preclinical stage can be estimated in ADAD, facilitating better planning of prevention trials with the EYO cutoffs under the recently released FDA guidance. The generalization of these results to sporadic AD warrants further investigation. 相似文献15.
Kanae Suzuki Shu Takagai Masatsugu Tsujii Hiroyuki Ito Tomoko Nishimura Kenji J. Tsuchiya 《Brain & development》2019,41(4):341-351
Background
Sensory processing difficulties, which commonly occur in autism spectrum disorder (ASD), are expected to have negative effects on the primary caregiver’s mental health. The aim of this study was to examine the association between sensory processing difficulties in children with ASD and the mental health of primary caregivers.Methods
A total of 707 primary caregivers (mothers in the present study) and their children with ASD (4–18?years of age) participated in this study. Sensory processing difficulties were indexed using the Short Sensory Profile (SSP). The mental health of primary caregivers was indexed using the General Health Questionnaire (GHQ12).Results
Higher scores on Auditory Filtering as measured with the SSP were associated with poorer mental health of primary caregivers, even after an adjustment for ASD symptom severity. Analyses of two age sub-groups, a young (4–10?years) and an old age group (11–18?years), revealed that higher scores on Tactile Sensitivity and Auditory Filtering were associated with poorer mental health of primary caregivers in younger children, whereas only higher scores on Auditory Filtering were associated with poorer mental health of primary caregivers in older children.Conclusions
Our findings suggest that practitioners who support primary caregivers of children with ASD need to focus not only on the social and communication-related symptoms of the child but also on their specific sensory processing difficulties. 相似文献16.
Tomoko Egashira Mizuko Hashimoto Tada-aki Shiraishi Akinori Shichijo Masakazu Egashira Tomoko Mizukami Toshimitsu Takayanagi 《Brain & development》2019,41(4):313-319
Aim
To clarify the influence of intra- and extra-uterine growth on subsequent psychomotor development in very-low-birth-weight (VLBW) infants.Methods
Two hundred and eighty VLBW infants (28.4?±?2.6?weeks, 1000?±?294?g) were enrolled. Psychomotor development was determined at 37.1?±?2.1?months after birth using the Kyoto Scale of Psychological Development (KSPD), which includes Postural-Motor (P-M), Cognitive-Adaptive (C-A) and Language-Social (L-S) subscales. Subjects were divided into two groups based on whether each developmental quotient (DQ) was ≥85, and the perinatal variables that contributed to a DQ of ≥85 (for each DQ) were determined. The twelve variables that were evaluated included the z scores for body weight (zBW), body length (zBL), head circumference (zHC), which were obtained at birth and at term.Results
The median P-M, C-A, L-S values and total DQ were 92, 83, 81 and 83, respectively, and the percentage of patients with a DQ of ≥85 were 53%, 44%, 35% and 39%, respectively. A multivariate analysis revealed significant associations between the following variables and the DQs: P-M?≥?85, GA [odds ratio; OR?=?1.11] and zBL at term [OR?=?1.26]; C-A?≥?85, male gender [OR?=?0.30], GA [OR?=?1.14] and zHC at term [OR?=?1.84]; L-S?≥?85, male gender [OR?=?0.55], GA [ OR?=?1.20] and zHC at term [OR?=?1.45]; total DQ?≥?85, male gender [OR?=?0.39], GA [OR?=?1.19] and zBL at term [OR?=?1.69].Conclusion
In addition to less prematurity and female gender, a longer body length and larger head circumference at term were important indicators that influenced better psychomotor development in VLBW infants at three years of chronological age. 相似文献17.
Julie Chi Chow Chen-Sen Ouyang Ching-Tai Chiang Rei-Cheng Yang Rong-Ching Wu Hui-Chuan Wu Lung-Chang Lin 《Brain & development》2019,41(4):334-340
Background
Attention-deficit hyperactivity disorder (ADHD) is a common childhood neuropsychiatric disorder. Diagnosis of ADHD is based on core symptoms or checklists; however, practitioner subjectivity inevitably results in instances of over- or under-diagnosis. Although an elevated theta/beta ratio (TBR) of the electroencephalography (EEG) band has been approved by the Food and Drug Administration as a factor that may be used in diagnosis of ADHD, several studies have reported no significant differences between the TBR of patients with ADHD and controls.Purpose
In this study, a method was developed based on Hjorth Mobility (M) analysis of EEG to compare patients with ADHD and controls.Methods
Differences in the presentations of ADHD between boys and girls are well established; therefore, separate investigations are required. The present study enrolled 30 girls with ADHD and 30 age-matched controls.Results
The results revealed that the control group had significantly higher Hjorth M values in most brain areas in EEG readings compared with the values for the ADHD group. Compared with TBR, our method revealed a greater number of more significant differences between the girls in the ADHD group and the controls. Moreover, our method can produce the higher average sensitivity (0.796), average specificity (0.796), average accuracy (0.792), and average area under the curve of receiver operating characteristic curve (AUC) value (0.885). Therefore, compared with TBR, Hjorth M possessed the better potential for differentiating between girls with ADHD and controls.Conclusion
The proposed method was more accurate than the TBR in diagnosing ADHD. Therefore, Hjorth M may be a promising tool for differentiating between children with ADHD and controls. 相似文献18.
Dalia Khammash Molly Simmonite Thad A. Polk Stephan F. Taylor Sean K. Meehan 《Brain stimulation》2019,12(3):702-704
Background
Transcranial magnetic stimulation (TMS) is a non-invasive method to stimulate localized brain regions. Despite widespread use in motor cortex, TMS is seldom performed in sensory areas due to variable, qualitative metrics.Objective
Assess the reliability and validity of tracing phosphenes, and to investigate the stimulation parameters necessary to elicit decreased visual cortex excitability with paired-pulse TMS at short inter-stimulus intervals.Methods
Across two sessions, single and paired-pulse recruitment curves were derived by having participants outline elicited phosphenes and calculating resulting average phosphene sizes.Results
Phosphene size scaled with stimulus intensity, similar to motor cortex. Paired-pulse recruitment curves demonstrated inhibition at lower conditioning stimulus intensities than observed in motor cortex. Reliability was high across sessions.Conclusions
TMS-induced phosphenes are a valid and reliable tool for measuring cortical excitability and inhibition in early visual areas. Our results also provide appropriate stimulation parameters for measuring short-latency intracortical inhibition in visual cortex. 相似文献19.
Naoki Hashizume Yoshiaki Tanaka Motomu Yoshida Suguru Fukahori Shinji Ishii Nobuyuki Saikusa Daisuke Masui Naruki Higashidate Saki Sakamoto Shiori Tsuruhisa Kotaro Yuge Takashi Ohya Minoru Yagi Yushiro Yamashita 《Brain & development》2019,41(4):352-358
Introduction
Resting energy expenditure (REE) is expected to be lower in with severe motor and intellectual disabilities (SMID) patients than in healthy subjects because of their relatively low fat-free mass (FFM). Therefore, an REE predictive equation for SMID patients may be required. The aim of this study was to validate existing REE predictive weight-based equations (Harris-Benedict, WHO, Mifflin, Owen, Schofield) and FFM-based REE equations (Mifflin, Owen and Cunningham) and to develop a new SMID patient-specific FFM-based REE equation.Methods
Twenty-eight (22 males, 6 females) SMID patients over 18?years of age were included. The REE was measured using indirect calorimetry. FFM were measured using bioelectrical impedance analysis. A multiple linear regression analysis was used to develop a new FFM-based REE predictive equation. The accurate predictions compared the measured REE and root mean square error.Results
The median measured REE was 950 (25th,75th percentile:712.75, 1102.75) kcal/day. The new FFM-based equation was as follows: REE (kcal/day)?=?550.62?+?16.62 FFM (kg). The new FFM-based REE resulted in the highest percentage of accurate predictions within 10% of measured REE (42.9%). The root mean square errors were the smallest for the new FFM-based REE and largest for Harris-Benedict (91.00 and 185.22?kcal/day).Conclusion
For SMID patients, the REE cannot accurately be predicted using the existing weight-based REE equations. Furthermore, the existing FFM-based REE equations are less accurate with regard to the measured REE than the new FFM-based REE equation. The new FFM-based equation is advised for use in SMID patients. 相似文献20.
Huipan Wu Xiaojian Yin Xiaojiang Chai Yuqiang Li Guodong Wang Xiaofang Yang Yi Sun Sien Ren Cunjian Bi Ming Li Yuan Liu 《Annales médico-psychologiques》2019,177(4):313-318