脑涨落图检测精神分裂症患者无抽搐电休克治疗前后脑内神经递质功能的研究

目的探讨首发精神分裂症患者的神经递质功能特点及无抽搐电休克治疗对患者的神经递质功能的影响。方法采用脑涨落图仪(EFG)检测首发精神分裂症患者无抽搐电休克(MECT)治疗前后脑内神经递质功能。选取符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的首发精神分裂症患者24例,MECT治疗8~12次。在首次治疗前半小时,首次治疗之后半小时及24小时、末次治疗后24小时采用EFG检测脑内γ-氨基丁酸(GABA)、谷氨酸(Glu)、5-羟色胺(5-HT)、去甲肾上腺素(NE)、多巴胺(DA)、乙酰胆碱(Ach)六种神经递质的功率。在首次治疗前及疗程结束后24小时进行阳性与阴性症状量表(PANSS)测评。结果与治疗前比较,治疗后半小时患者的全部递质功率升高(P0.05),首次治疗与末次治疗后24小时,多巴胺功率降低(P0.05)。5-HT、Ach、NE、DA的功率与P分呈正相关(P0.05),GABA与G分、PANSS总评分呈负相关(P0.05),PANSS评分P分和PANSS总评分降低(P0.01)、G分降低(P0.05)。结论 MECT治疗能降低精神分裂症患者多巴胺功能。     

酒精中毒致精神障碍患者脑内神经递质功能研究

目的利用脑涨落图仪检测酒精中毒所致精神障碍患者脑内多种神经递质功能,探讨酒精中毒所致精神障碍的发病机制。方法筛选符合《中国精神障碍分类及诊断标准(第3版)》(CCMD-3)酒精所致精神障碍的诊断标准的患者为实验组,健康人员为正常对照组,对两组人员均进行脑涨落图仪检测,比较分析两组人员的检测结果。结果与正常组对比,实验组的9种神经递质功率均降低,差异有统计学意义(P0.05)。实验组的NE相对功率显著低于对照组(P0.05)。实验组的全脑总功率、运动指数和血管舒缩指数均显著低于对照组(P0.05)。结论酒精中毒所致精神障碍患者脑内多种神经递质功能降低,尤其是NE功能降低更为明显,同时还有脑血管舒缩功能障碍。脑涨落图仪能够检测分析脑内神经递质的功能和脑神经细胞的供血情况,对研究酒精中毒所致精神障碍发病机制有帮助。     

抑郁症患者脑电超慢涨落检测分析

目的:探讨抑郁症患者脑内神经递质活动变化。方法:应用中国北京ML2001脑电超慢涨落分析仪,通过对14例抑郁症患者于治疗前及治疗2、4周后脑电超慢涨落图(EFG),分析其谱线变化来反映脑内神经递质活动变化。结果:14例抑郁症患者治疗前脑内神经递质值与正常值对照比较,其5羟色胺(5HT)、乙酰胆碱(ACh)、去甲肾上腺素(NE)、多巴胺(DA)均降低,但以ACh、DA差异有显著性。治疗前及抗抑郁药治疗2、4周EFG值比较,其γ氨基丁酸(GABA)、谷氨酸(Glu)明显降低,而5HT、ACh、DA显著升高,差异有显著性。结论:脑内神经递质GABA、Glu、5HT、ACh、NE、DA间的协同不良可能导致了抑郁症发作,抗抑郁药治疗后脑内神经递质变化较大,单胺类递质活性增强。     

非痴呆性血管性认知功能障碍患者的脑电超慢涨落图表现

目的探讨主诉记忆力减退的非痴呆性血管性认知功能障碍(VCIND)患者脑内神经递质活动的变化及意义。方法选择2008—2012年第二炮兵总医院神经内科门诊患者716例,其中主诉记忆力减退的VCIND组370例,正常对照组346例。采用简易精神状态量表(MMSE)、蒙特利尔认知测评量表(MoCA)进行认知评估。应用脑电超慢涨落(EFG)分析仪测定S1γ-氨基丁酸(GABA)、S2谷氨酸(Glu)、S4 5-羟色胺(5-HT)、S5乙酰胆碱(Ach)、S7去甲肾上腺素(NE)、S11多巴胺(DA)等脑神经递质的活动。结果观察组GLU、5-HT的活动存在异常,GLU显著高于对照组(P<0.05),5-HT显著低于对照组(P<0.05);GABA、Ach、NE、DA的活动与对照组比较,差异无统计学意义(P>0.05)。结论主诉记忆力减退的VCIND人群脑内神经递质谷氨酸、5-羟色胺活动异常。EFG分析可作为一种有效的VCIND辅助诊断方法。     

无抽搐电休克对精神分裂症和抑郁症患者P300及血浆神经递质影响的研究

目的 探讨无抽搐电休克(MECT)对精神分裂症和抑郁症患者P300及血浆神经递质的影响.方法 本研究共入组的15例患者,将其分为所有患者组,精神分裂症组和抑郁症组;在MECT治疗前后分别完成P300和血5-羟色胺(5-HT)、多巴胺(DA)、去甲肾上腺素(NE)检测,比较治疗前后三组患者P300和血浆神经递质的变化.结果 所有患者组P2、N2、P3波幅治疗后分别为(16.79±18.31,25.32±18.58,24.33±18.676)高于治疗前分别为(5.05±3.72,9.88±9.78,11.299±9.849),差异具有统计学意义(P＜0.05);而在精神分裂症组和抑郁症组N2波幅治疗后分别为(32.847±21.563,16.54±9.224)均高于治疗前分别为(13.72±12.14,5.40±2.77),差异具有统计学意义(P＜0.05).血浆神经递质在所有患者组以及精神分裂症组和抑郁症组治疗前后的差异均无统计学意义.结论 MECT对患者N2、P3波幅有一定程度的改善,但对血浆神经递质的影响不大.     

小柴胡汤改善抑郁症状及相关神经递质与神经营养因子分析

目的探索小柴胡汤对抑郁症状患者的疗效及脑内神经递质、神经营养因子变化关系。方法选取2013年4月~2015年4月于我院治疗的抑郁症状患者共计96例进行研究。按照入院顺序分为观察组和对照组,观察组患者应用小柴胡汤进行治疗,对照组患者应用西药进行治疗。观察两组患者治疗后的临床疗效及脑内神经递质、神经营养因子的变化。结果在接受治疗后,观察组患者的临床疗效显著,其总有效率达87.5%,明显高于对照组治疗后的总有效率41.67%,两组比较差异具有统计学意义(P0.05)。两组患者在接受治疗后均出现不同情况的副作用,但是观察组的不良反应发生率(4.17%)明显少于对照组的不良反应发生率(58.33%),两组比较差异具有统计学意义(P0.05);患者在应用小柴胡汤治疗后,两组患者的Ach、5-HT、NE及DA值在治疗前后差异具统计学意义(P0.05),且在5-HT、NE及DA值方面,观察组较对照组变化更显著,在Ach上,两组患者治疗效果无显著统计学差异(P0.05);两组患者治疗前后神经营养因子变化情况差异具有统计学意义(P0.05),观察组患者的神经营养因子的变化较对照组更大。结论小柴胡汤治疗抑郁症状的临床疗效显著,有抗抑郁作用,并对脑内神经递质、神经营养因子有一定的影响。     

利培酮联合达营片对精神分裂症血浆神经递质的影响

目的 探讨利培酮联合达营片对精神分裂症患者血浆神经递质的影响及与相关性分析。 方法 应用随机、双盲、对照研究,将67例符合ICD-10诊断标准的精神分裂症患者随机分为研究组30例, 对照组37例,分别予以利培酮合并达营片和利培酮合并安慰剂治疗,疗程12周。测定两组治疗前后血浆 神经递质多巴胺（DA）、5-羟色胺（5-HT）和5-羟吲哚乙酸（5-HIAA）的浓度,并采用PANSS量表评定疗效。 结果 治疗后研究组DA、5-HIAA 降低,而5-HT水平增加;对照组DA、5-HT和5-HIAA都增加;两组治 疗前后差值比较差异无统计学意义（P ＞ 0.05）。且两组DA、5-HT和5-HIAA含量变化与疗效无相关性 （P＞ 0.05）。结论 经治疗12周后,两组在DA、5-HT和5-HIAA这3个神经递质的变化未发现明显差异, 且与疗效之间不存在相关性。     

柴胡对肝郁证大鼠脑内单胺类神经递质的影响

目的探索柴胡对肝郁证大鼠中枢神经递质的作用。方法利用中医证候模型,研究柴胡对单胺类神经递质的作用。结果肝郁证模型组大鼠脑内去甲肾上腺素(NE)与多巴胺(DA)水平与对照组比较下降明显(P<0.05),肝郁证模型加逍遥散组大鼠脑内NE与DA水平与对照组比较差异无统计学意义(P>0.05),肝郁证模型加柴胡组大鼠脑内NE与DA水平与对照组比较差异无统计学意义(P>0.05)。结论肝郁证大鼠脑内NE与DA水平明显降低,柴胡舒肝解郁,有增加肝郁证大鼠脑内NE、DA神经递质的作用。     

病毒性脑炎患者脑脊液5-羟色胺、多巴胺改变及其与精神异常的关系

目的探讨病毒性脑炎患者脑脊液5-羟色胺(5-HT)、多巴胺(DA)等的改变及其与精神异常的关系。方法采用高效液相色谱法(HPLC)检测69例病毒性脑炎患者和21例其他疾病患者对照脑脊液的5-HT、DA及其代谢产物5-羟吲哚乙酸(5-HIAA)和高香草酸(HVA)的水平。结果①患者组脑脊液的5-HT、5-HIAA和5-HIAA/HVA比值明显低于对照组(P<0.01),5-HT/DA比值低于对照组(P<0.05),而HVA明显高于对照组(P<0.01)。②患者组划分亚组后进一步比较的结果显示,除无精神异常组的5-HT和对照组的差异无统计学意义外(P>0.05),其余上述指标有或无精神异常组与对照组的差异均有统计学意义(P<0.05);有精神异常组脑脊液中的5-HIAA低于无精神异常组(P<0.05);阳性症状为主组脑脊液中的5-HT、5-HIAA、5-HT/DA和5-HIAA/HVA比值低于阴性症状为主组(P<0.05),5-HT、5-HIAA和5-HIAA/HVA比值低于无精神异常组(P<0.05),而阴性症状为主组与无精神异常组各指标差异无统计学意义。结论病毒性脑炎患者脑脊液中可能存在5-HT和DA功能失衡,且这种失衡可能与患者出现的精神症状有关。     

超低频经颅磁刺激对焦虑症的疗效

目的 探讨超低频经颅磁刺激（ILF-TMS）对焦虑症患者的疗效.方法 对符合〈中国精神障碍分类与诊断标准（第3版）〉（CCMD-3）焦虑症诊断标准的40例住院患者采用ILF-TMS治疗2周,每天治疗1次,每次治疗时间为30～60分钟.分别在治疗前、后行多功能脑神经递质检测仪（EFG）检查和汉密尔顿焦虑量表（HAMA）评定.结果 治疗后EFG总功率较治疗前升高[（710.3±1731.5）vs.（1465.9±334.2）],HAMA总分评分降低[（13.5±6.3）vs.（9.3±4.7）],差异有统计学意义（t=2.709、3.385,P＜0.05）.运动指数、兴奋抑制指数、血管舒缩指数治疗前后差异无统计学意义（P＞0.05）.结论 ILF-TMS治疗可能缓解焦虑症症状.     

Denervation study of synapses of organ of corti of old world monkeys

Fine structural characteristics of synapses in the spiral organ of Corti were examined, with reference to differences between inner and outer haircell systems, and to location of neurons of origin of efferent axons. Surgical interruption of crossed olivocochlear bundle, of vestibular nerve, of facial nerve, and excision of superior cervical ganglia were used to determine the pathways of efferent axons. Interruption of the vestibular nerve near the brainstem results in degeneration of all efferent terminals on outer hair cells. Mid-line lesions at, and caudal to, the facial colliculus result in degeneration of about half of these efferent terminals. Efferent synaptic bulbs to the inner hair-cell system are small, of the order of one micron, and form type 2 junctions with afferent dendrites. They tend to have more large dense-core vesicles (about 80 nm) than the large efferent terminals of the outer hair-cell system, and appear to be the terminals of axons in the habenula perforata, which exhibit varicosities laden with large dense core vesicles. The varicosities are unaffected by excision of the superior cervical ganglia. So far as our material can reveal, it appears that the varicosities in the habenula perforata do not survive vestibular root interruption, nor do the efferent processes in the internal spiral bundle or at the base of inner hair cells. Most interestingly, the afferent processes of the inner hair-cell system, as identified for example by their relation to pre-synaptic bodies in the inner hair cells, are subject to a trans-synaptic reaction after severance of the vestibular root. They undergo a dramatic cytological transformation, characterized by increase of volume, engorgement with microtubules, microfilaments, microvesicles of various sizes, and clusters of lysosomes. Thus, both the efferent and afferent terminals of the inner hair-cell system show marked cytological differences from the corresponding terminals of the outer hair cell system.     

Mechanism of action of tubocurarine on nicotinic cholinoreceptors of neurons of the sympathetic ganglia of rats

Tubocurarine (Tc) effect on membrane currents elicited by acetylcholine (ACh) was studied in isolated superior cervical ganglion neurons of rat using patch-clamp method in the whole-cell recording mode. The "use-dependent" block of ACh current by Tc was revealed in the experiments with ACh applications, indicating that Tc blocked the channels opened by ACh. Mean lifetime of Tc-open channel complex, tau, was found to be 9.8 +/- 0.5 s (n = 7) at -50 mV and 20-24 degrees C. tau exponentially increased with membrane hyperpolarization (e-fold change in tau corresponded to the membrane potential shift by 61 mV). Inhibition of the ACh-induced current by Tc (3-30 microM/1) was completely abolished by membrane depolarization to the level of 80-100 mV. Inhibition of ACh-induced current was augmented at increased ACh doses. It is concluded that the open channel block produced by Tc is likely to be the only mechanism for Tc action on nicotinic acetylcholine receptors in superior cervical ganglion neurons of rat.     

The effect of age of onset of PD on risk of dementia

Background Dementia occurs in the majority of patients with Parkinson’s disease (PD). Late onset of PD has been reported to be associated with a higher risk for dementia. However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age. Methods Two community-based studies of PD in New York (n = 281) and Rogaland county, Norway (n = 227) and two population-based groups of healthy elderly from New York (n = 180) and Odense, Denmark (n = 2414) were followed prospectively for 3–4 years and assessed for dementia according to DSM-IIIR. All PD and control cases underwent neurological examination and were followed with neurological and neuropsychological assessments. We used Cox proportional hazards regression based on three different time scales to explore the effect of AAO of PD on risk of dementia, adjusting for age at baseline and other demographic and clinical variables. Findings In both PD groups and in the pooled analyses, there was a significant effect of age at baseline assessment on the time to develop dementia, but there was no effect of AAO independent of age itself. Consistent with these results, there was no increased relative effect of age on the time to develop dementia in PD cases compared with controls. Interpretation This study shows that it is the general effect of age, rather than AAO that is associated with incident dementia in subjects with PD. Received in revised form: 22 December 2005     

Limits of deinstitutionalization--perspectives of relatives of psychiatric patients

After a hopeful beginning, the social process of the reintegration of those with severe mental illness has come to a standstill. I am led to wonder whether "the community" really wants to live together with people suffering from severe mental illness, and if so, how closely? As long as the medical treatment of mental illness provided by the general practitioners is fundamentally deficient, as they are not able to prescribe the necessary interventions--such as out-patient psychiatric nursing, and service providers in the out-patient sector are content with offering increasingly intensive forms of care for the less seriously ill at the cost of the Social Welfare System--the reintegration of those with serious mental illness remains an illusion--which is mainly to the benefit of providers of residential care in homes and hostels.