经颅直流电刺激对精神分裂症伴迟发性运动障碍患者空间工作记忆的影响

目的探讨经颅直流电刺激(tDCS)对精神分裂症伴迟发性运动障碍(TD)患者空间工作记忆的影响。方法选取2017年6月至2018年1月来源于苏州市广济医院、苏州市社会福利总院、太仓市精神卫生中心、南充市第六人民医院四家精神专科医院的38例住院精神分裂症伴TD患者,随机分为试验组(21例)和对照组(17例)。研究期间,两组患者均接受常规药物治疗,试验组予以tDCS治疗,采用的电流为2 mA,刺激部位为左侧背外侧前额叶皮质及对侧眶上缘;对照组相应地予以伪tDCS治疗。在基线期、治疗15次结束后及2周后进行随访,采用剑桥神经心理自动化成套测试(CANTAB)中的空间工作记忆(SWM)模块分别对两组患者进行认知测评。结果在完成15次治疗后,试验组SWM指标分析中的总错误数[31.00(28.50,49.00)]、平均第一次响应时间(4盒子)[3289.500(1871.750,5018.000)ms]、平均第一次响应时间(6盒子)[2862.500(2128.500,4672.250)ms]、平均第一次响应时间(8盒子)[3328.500(2611.250,5120.750)ms]与对照组比较,差异无统计学意义(P>0.05);试验组SWM指标分析中的策略分[19.00(17.00,20.00)]低于对照组[21.00(19.50,23.00)],差异有统计学意义(P<0.05)。在2周后的随访中,两组的SWM各指标比较,差异均无统计学意义(P>0.05)。结论tDCS可能对精神分裂症患者使用策略的能力有即刻改善效应。     

脑转移瘤临床特点手术疗效及预后分析

目的探讨脑转移瘤的临床特点、手术疗效并分析预后。方法选择2006-01—2014-01本院诊治的60例脑转移瘤患者为研究对象。结果 60例患者中单发病灶45例(75.0%),多发15例(25.0%);原发病为肺癌35例(58.3%),乳腺癌8例(13.3%),其他恶性肿瘤17例(28.4%);病灶周围水肿、环形强化及毛刷样征象是常见的影像学特点;60例患者1a及2a生存率分别为58.3%和18.3%;单因素分析显示:肿瘤数目、治疗方式、病灶大小与患者生存期相关(P0.05);Cox模型多因素分析结果显示:治疗方式及肿瘤数目是影响患者生存期的独立因素。结论脑转移瘤原发病以肺癌为最常见。治疗方式及肿瘤数目是生存期的影响因素,手术联合放化疗治疗效果最理想。     

128层CT灌注成像在脑胶质瘤分级的应用价值

目的探讨128层CT全脑灌注成像在脑胶质瘤术前分级的应用价值。方法回顾性分析32例脑胶质瘤病例资料,低级别组(WHOⅠ~Ⅱ级,21例)和高级别组(WHOⅢ~Ⅳ级,11例),均行CT灌注扫描,测量肿瘤实质部分和对侧正常脑组织的CBF、CBV及r CBF、r CBV。结果与低级别组比较,高级别组胶质瘤病灶区CBF、CBV及r CBF、r CBV均明显升高,两组间差异具有统计学意义(P0.05)。结论 128层CT灌注成像在胶质瘤术前分级具有较高的临床应用价值。     

Microstructural abnormalities of the brain white matter in attention-deficit/hyperactivity disorder

Background

Attention-deficit/hyperactivity disorder (ADHD) is an early-onset neurodevelopmental disorder with multiple behavioural problems and executive dysfunctions for which neuroimaging studies have reported a variety of abnormalities, with inconsistencies partly owing to confounding by medication and concurrent psychiatric disease. We aimed to investigate the microstructural abnormalities of white matter in unmedicated children and adolescents with pure ADHD and to explore the association between these abnormalities and behavioural symptoms and executive functions.

Methods

We assessed children and adolescents with ADHD and healthy controls using psychiatric interviews. Behavioural problems were rated using the revised Conners’ Parent Rating Scale, and executive functions were measured using the Stroop Colour-Word Test and the Wisconsin Card Sorting test. We acquired diffusion tensor imaging data using a 3 T MRI system, and we compared diffusion parameters, including fractional anisotropy (FA) and mean, axial and radial diffusivities, between the 2 groups.

Results

Thirty-three children and adolescents with ADHD and 35 healthy controls were included in our study. In patients compared with controls, FA was increased in the left posterior cingulum bundle as a result of both increased axial diffusivity and decreased radial diffusivity. In addition, the averaged FA of the cluster in this region correlated with behavioural measures as well as executive function in patients with ADHD.

Limitations

This study was limited by its cross-sectional design and small sample size. The cluster size of the significant result was small.

Conclusion

Our findings suggest that white matter abnormalities within the limbic network could be part of the neural underpinning of behavioural problems and executive dysfunction in patients with ADHD.     

Optimal concentration and time window for proliferation and differentiation of neural stem cells from embryonic cerebral cortex: 5% oxygen preconditioning for 72 hours

Hypoxia promotes proliferation and differentiation of neural stem cells from embryonic day 12 rat brain tissue, but the concentration and time of hypoxic preconditioning are controversial. To address this, we cultured neural stem cells isolated from embryonic day 14 rat cerebral cortex in 5% and 10% oxygen in vitro. MTT assay, neurosphere number, and immunofluorescent staining found that 5% or 10% oxygen preconditioning for 72 hours improved neural stem cell viability and proliferation. With prolonged hypoxic duration(120 hours), the proportion of apoptotic cells increased. Thus, 5% oxygen preconditioning for 72 hours promotes neural stem cell proliferation and neuronal differentiation. Our findings indicate that the optimal concentration and duration of hypoxic preconditioning for promoting proliferation and differentiation of neural stem cells from the cerebral cortex are 5% oxygen for 72 hours.     

Intercellular mitochondrial transfer in the brain,a new perspective for targeted treatment of central nervous system diseases

Aim

Mitochondria is one of the important organelles involved in cell energy metabolism and regulation and also play a key regulatory role in abnormal cell processes such as cell stress, cell damage, and cell canceration. Recent studies have shown that mitochondria can be transferred between cells in different ways and participate in the occurrence and development of many central nervous system diseases. We aim to review the mechanism of mitochondrial transfer in the progress of central nervous system diseases and the possibility of targeted therapy.

Methods

The PubMed databank, the China National Knowledge Infrastructure databank, and Wanfang Data were searched to identify the experiments of intracellular mitochondrial transferrin central nervous system. The focus is on the donors, receptors, transfer pathways, and targeted drugs of mitochondrial transfer.

Results

In the central nervous system, neurons, glial cells, immune cells, and tumor cells can transfer mitochondria to each other. Meanwhile, there are many types of mitochondrial transfer, including tunneling nanotubes, extracellular vesicles, receptor cell endocytosis, gap junction channels, and intercellular contact. A variety of stress signals, such as the release of damaged mitochondria, mitochondrial DNA, or other mitochondrial products and the elevation of reactive oxygen species, can trigger the transfer of mitochondria from donor cells to recipient cells. Concurrently, a variety of molecular pathways and related inhibitors can affect mitochondrial intercellular transfer.

Conclusion

This study reviews the phenomenon of intercellular mitochondrial transfer in the central nervous system and summarizes the corresponding transfer pathways. Finally, we propose targeted pathways and treatment methods that may be used to regulate mitochondrial transfer for the treatment of related diseases.