脑部磁共振结合静息态fMRI方法在卒中患者认知障碍中的应用

本研究主要探讨脑部磁共振结合静息态fMRI方法在卒中患者认知障碍中的应用。本研究将符合卒中认知障碍患者25例设为患者组,将25例健康者设为对照组。采用脑部静息态核磁共振对实验者进行扫描,以脑部双侧海马为种子点进行功能连接分析,并通过软件分析两组实验者静息态双侧海马差异。结果发现,与对照组相比,患者组右侧海马与左右侧额中回、左侧额下回等的连接减少;右侧海马与左侧颞上中回、双侧丘脑的连接增加;左侧海马与左侧颞额中回、右侧颞额上回、右侧额下回的连接减少;左侧海马与右侧顶下回连接增加。总之,本研究发现卒中患者海马脑区与颞叶皮层、额叶皮层之间的连接减少,可能是由卒中患者脑损害导致。     

联合低频振幅和度中心性的高度近视患者脑功能研究

探讨联合低频振幅(ALFF)和度中心性(DC)方法在高度近视(HM)患者静息状态下局部大脑的功能变化。选取45例患者作为HM组,选择与之匹配的46例双眼正常视力参与者作为对照组。所有被试进行静息态功能磁共振成像扫描。ALFF和DC的方法进行局部脑功能差异的分析。组间比较采用基于体素层面的独立样本t检验。结果显示与对照组相比,HM组在左眶部额下回、右距状裂周围皮层、右前扣带与旁扣带脑回、左丘脑、左顶下缘角回、右顶下缘角回和左中央旁小叶的ALFF值存在统计学差异(P<0.05);HM组在右颞下回、左颞下回、右前扣带与旁扣带脑回、左眶内额上回、左距状裂周围皮层、右梭状回、左顶下缘角回和左中央旁小叶的DC值存在统计学差异(P<0.05)。联合低频振幅和度中心性在HM患者大脑神经元活动及脑功能网络改变判断中具有较高的应用价值。     

3D-ASL灌注成像与静息态功能MRI在癫痫诊断及鉴别中的价值

选取123例癫痫患者作为研究组,同期69例健康体检者作为对照组,均行三维动脉自旋标记技术(3D-ASL)灌注成像与静息态功能MRI(rs-FMRI)检查,研究二者在癫痫病诊断及鉴别中的价值.结果发现,研究组全面发作脑血流量(CBF)、低频振幅(ALFF)＜部分发作和对照组,全面发作血清脑源性神经细胞营养因子(BDNF)...     

rfMRI在首发原发性癫痫患者治疗效果评估中的应用

本文探讨了静息态功能磁共振成像(rfMRI)在首发原发性癫痫患者治疗效果评价中的应用。选取在2017年8月～2018年8月期间来我院诊治的首发原发性癫痫患者62例(观察组)和同期的健康志愿者(对照组)62例进行研究。两组受试者均进行rfMRI检查,观察组患者在进行为期3个月的药物治疗后再次行rfMRI检查。之后计算每例受试者的全脑比率低频振幅(fALFF)值,同时将观察组治疗前后的数据分别与对照组进行比较。结果显示,在治疗前,观察组患者的双侧丘脑、双侧后扣带回、左侧角会及左侧顶下小叶的fALFF值显著高于对照组(P0.05);观察组的双侧前额叶及双侧前扣带回的fALFF值显著低于对照组(P0.05)。在治疗后,与对照组相比,观察组双侧丘脑的异常激活脑区消失,双侧后扣带回、左侧角回的异常激活脑区的范围减少,然而左侧顶下小叶激活脑区的范围变大(P0.05);观察组在治疗后,双侧额叶、双侧楔前叶及左侧楔叶的fALFF值显著高于对照组(P0.05)。由此可知,rfMRI结合fALFF可以有效观察首发原发性癫痫患者在治疗前后的脑功能变化情况,同时也为临床药物治疗癫痫的疗效评估提供了参考。     

高信号血管征与大脑中动脉狭窄程度和脑梗死面积的关系研究

本文探讨急性大脑中动脉供血区脑梗死磁共振成像T2液体衰减反转恢复序列(MRI T2-FLAIR)上高信号血管征(HVS)出现情况及与大脑中动脉狭窄情况、脑梗死面积的关系。选取125例急性大脑中动脉供血区脑梗死患者,均给予MRI T2-FLAIR序列扫描,分析HVS阳性和阴性患者临床资料、大脑中动脉狭窄程度、脑梗死面积及侧支循环等差异。HVS阳性患者美国国立卫生研究院卒中量表(NIHSS)评分明显高于HVS阴性患者(P<0.05)。HVS阳性患者大脑中动脉狭窄程度、脑梗死面积、有侧支循环比例明显高于HVS阴性患者(P<0.05)。HVS与NIHSS评分、大脑中动脉狭窄、脑梗死面积及侧支循环呈正相关(P<0.05)。远端HVS阳性患者NIHSS评分、大脑中动脉狭窄程度明显低于近端HVS阳性患者(P<0.05)。急性大脑中动脉供血区脑梗死患者MRI T2-FLAIR上存在HVS,其大脑中动脉狭窄程度较重,脑梗死面积较大。     

MRI在AD患者诊断及病情程度评估中的应用

本研究探讨磁共振成像(MRI)检查脑叶体积变化、脑白质疏松程度在诊断阿尔茨海默病(AD)患者及病情评估中的应用价值。选取确诊的90例AD患者为AD组、另外选取同期接受健康体检的90例志愿者作为对照组,两组研究对象均接受MRI检查,对比各项指标及脑白质疏松(LA)严重度分级差异,分析各项指标在诊断AD患者中的价值;并根据临床痴呆评定量表(CDR)将患者分为轻中度、重度,进行分层对比。AD组患者顶叶、枕叶及颞叶体积比例小于对照组(P<0.05);AD组患者的海马高度测定值小于对照组(P<0.05);AD组与对照组的LA分级情况比较,差异具有统计学意义(P<0.05);重度AD患者的顶叶体积比例、枕叶体积比例、颞叶体积比例、海马高度值小于轻中度AD患者(P<0.05);重度AD组患者LA分级以2级、3级为主,轻中度AD患者主要为0级、1级患者为主,重度AD组与轻中度AD患者的LA分级比较,差异具有统计学意义(P<0.05)。AD患者的脑叶体积、海马高度均发生变化,脑白质疏松变化较为明显,临床上采用MRI进行检查评估具有一定的价值。     

3D-ASL评估慢性期脑梗死脑血流量及与认知功能的相关性

本文研究了3D动脉自旋标记灌注成像(3D-ASL)评估慢性期脑梗死脑血流量(CBF)及与认知功能的相关性。选取64例慢性期脑梗死患者作为慢性期组,同时选取60例急性期脑梗死患者作为急性期组,50例亚急性期脑梗死患者作为亚急性期组,比较三组患侧及健侧CBF、相对脑血流量(rCBF)差异。慢性期组患侧CBF、rCBF明显低于亚急性期组和急性期组(P<0.05)。慢性期组患者简易智能精神状态量表(MMSE)评分、蒙特利尔认知评估量表(MoCA)评分和Fugl-Meyer评分明显低于亚急性期组和急性期组(P<0.05)。患侧CBF、rCBF与MMSE评分、MoCA评分呈正相关(P<0.05)。经Logistic回归分析显示：年龄、糖尿病、患侧CBF和rCBF是慢性期脑梗死患者发生认知功能障碍的影响因素(P<0.05)。慢性期脑梗死患者CBF与患者认知功能相关,3D-ASL评估CBF有助于了解慢性期脑梗死患者认知功能受损情况。     

DSA、CTA联合MR影像评估AIS患者脑支循环及预后性关系

探讨数字减影血管成像(DSA)、计算机断层扫描血管成像(CTA)联合磁共振(MR)影像评估急性缺血性卒中(AIS)患者脑支循环及预后性关系。选取60例大脑中动脉M1段急性闭塞所致AIS患者为研究对象,根据DSA、CTA与MR影像对其脑侧支循环评估,比较患者基线资料、结局指标等,并分析预后性。结果发现:基于DSA、CTA与MR影像对AIS患者脑侧支循环评估结果一致性良好;3种影像模式下脑侧支循环良好组与不良组结局资料差异显著(P<0.05);多因素分析显示,FVH-ASPECTS评分、rLMC评分、ASITN/SIR分级量表均为AIS患者神经功能预后的独立影响因素。总之,DSA、CTA、MR影像对AIS患者脑侧支循环评估具有一致性,且FVH-ASPECTS评分、rLMC评分、ASITN/SIR分级量表均为AIS患者神经功能预后的独立影响因素。     

瘢痕子宫再次剖宫产后盆底功能变化的观察研究

本研究探讨具有剖宫产病史的瘢痕子宫再次妊娠实施剖宫产后盆底结构、盆底功能及肌力特征。选取100例瘢痕子宫再次妊娠且实施剖宫产手术的产妇作为观察组,再选取100例同期接受剖宫产手术分娩的初产妇作为对照组。采用经会阴盆底超声检查,对两组患者静息状态至Valsalva状态下的盆腔脏器移动参数、肛提肌厚度、盆膈裂孔参数及肌力进行评估对比。观察组静息状态至Valsalva状态下的膀胱颈移动距离、子宫颈外口移动距离、直肠壶腹移动距离均大于对照组(P<0.05);静息状态、Valsalva状态、缩肛状态下,观察组产妇肛提肌厚度小于对照组,同时,盆腔裂孔横径、盆腔裂前后径、盆腔裂孔面积大于对照组(P<0.05);观察组产妇的盆底肌Ⅰ类肌纤维和Ⅱ类肌纤维表面电信号小于对照组,观察组产妇的阴道压力异常、盆底肌肌力异常患者占比大于对照组(P<0.05);产后2周,观察组改良牛津肌力分级(MOS)盆底肌肌力分级整体低于对照组(P<0.05)。具有剖宫产病史的瘢痕子宫再次妊娠实施剖宫产后盆底结构、盆底功能及肌力较首次剖宫产产妇损伤更加严重,应该针对这部分人群加强产后康复。     

CTA和CTP评价AIS患者侧支循环建立及脑灌注的研究

本研究探讨CT血管成像(CTA)、全脑CT灌注成像(CTP)在评估急性缺血性脑卒中(AIS)患者侧支循环建立及脑灌注情况的价值,并分析CTA、CTP与患者预后的关系。选取139例AIS患者接受256层螺旋CT扫描;根据格拉斯哥预后评分(GOS)将患者分为良好组(95例)和不良组(44例)。以DSA侧支循环检出结果作为诊断金标准,CTA诊断AIS患者颅内动脉侧支循环建立的灵敏度为95.12%、特异度为91.23%;良好组患者的侧支循环程度评分、脑血容量(CBV)、脑血流速度(CBF)、达峰时间(TTP)、平均通过时间(MTT)测定值均高于不良组(P<0.05);AIS患者入院时NIHSS评分高、梗死灶面积较大、脑血管闭塞是其不良预后的独立危险因素(P<0.05);良好的侧支循环、CBV及CBF脑灌注水平较高,有利于患者后期的预后恢复(P<0.05)。CTA对AIS患者颅内动脉侧支循环建立的检出敏感度较高,同时,早期观察患者侧支循环建立及脑灌注水平,对评估患者预后恢复具有一定的临床价值。     

Expression patterns of antioxidant proteins in brains of patients with sporadic Creutzfeldt-Jacob disease

Using two-dimensional gel electrophoresis (2-DE) and Western blot analysis, we were able to identify and quantify six antioxidant proteins, peroxiredoxin (Prx) I, Prx II, Prx III, 1-Cys Prx, putative peroxisomal antioxidant enzyme (PLP), and mitochondrial Mn superoxide dismutase (Mn-SOD) in two individual brain regions, cerebellum and frontal cortex of patients with sporadic Creutzfeldt-Jacob (sCJD). Among six antioxidant proteins, 1-Cys Prx showed significant increase (P > 0.05) in sCJD frontal cortex whereas Prx I was decreased (P > 0.01). In cerebellum, levels of all antioxidant proteins studied were comparable to those of controls. Our findings provide evidence for the link between aberrant expression of antioxidant proteins, 1-Cys Prx and Prx I and CJD neuropathogenesis and we discuss the neuropathological meaning of these dysregulated antioxidant proteins in sCJD brain.     

Changes of voltage-dependent anion-selective channel proteins VDAC1 and VDAC2 brain levels in patients with Alzheimer's disease and Down syndrome

Voltage-dependent anion-selective channel proteins (VDACs) are pore-forming proteins found in the other mitochondrial membrane of all eukaryotes and in brain postsynaptic membranes. VDACs regulate anion fluxes of a series of metabolites including ATP, thus regulating mitochondrial metabolic functions. We determined protein levels of VDACs in individual post-mortem brain regions of patients with Down Syndrome (DS) and Alzheimer's disease (AD) using two-dimensional electrophoresis (2-DE) and matrix-assisted laser desorption/ionization-mass spectroscopy (MALDI-MS). VDAC1 (SWISS-PROT accession number P21796) and VDAC2 (P45880) were unambiguously identified and quantified, but VDAC3 was not found. The spots representing VDAC1 were separated with different p/s (p/7.5, 8.5, and 10.0) probably caused by post-translational modifications as, e.g., phosphorylation. In DS cerebellum, total VDAC1 protein was elevated significantly whereas VDAC2 did not show any significant alterations. In AD brains, VDAC1 p/10.0 was significantly reduced in temporal, frontal, and occipital cortex with the p/7.5 form elevated in occipital cortex. Total VDAC1 was significantly decreased in frontal cortex and thalamus. VDAC2 was significantly elevated in temporal cortex only. The biological meaning of our results may be derangement of voltage-dependent anion-selective channel function and reflecting impaired glucose, energy, and intermediary metabolism as well as apoptotic mechanisms.     

A Positron Emission Tomography Analysis of Glucose Metabolism in Alzheimer's Disease Brain Using [18F] Fluorodeoxyglucose: A Parallel Study with Elemental Concentrations

Alzheimer's disease (AD) is a debilitating form of dementia which leads to impaired memory, thinking and behavior. This work examines elemental concentrations between "normal" and AD subjects as well as the hemispherical differences within the brain. Tissue samples from both hemispheres of the frontal lobe in both AD and normal subjects were examined for their trace element concentrations using PIXE and RBS analyses. Elemental concentrations were seen to differ between AD and normal brain tissue samples. While in the normal group concentrations were found to be significantly higher in the right hemisphere than in the left the converse was true in AD. A change in elemental concentrations may indicate possible alterations in the function of the blood brain barrier. This was examined by determining regional cerebral metabolic rates of glucose (rCMRGlu) using the in vivo technique of positron emission tomography (PET). Again variations between both hemispheres and between AD and normal were found.     

Orbitrap mass spectrometry for monitoring the ganglioside pattern in human cerebellum development and aging

We have developed here a superior approach based on high‐resolution (HR) mass spectrometry (MS) for monitoring the changes occurring with development and aging in the composition and structure of cerebellar gangliosidome. The experiments were focused on the comparative screening and structural analysis of gangliosides expressed in fetal and aged cerebellum by Orbitrap MS with nanoelectrospray ionization (nanoESI) in the negative ion mode. The employed ultrahigh‐resolution MS platform allowed the discrimination, without the need of previous separation, of 159 ions corresponding to 120 distinct species in the native ganglioside mixtures from fetal and aged cerebellar biopsies, many more than detected before, when MS platforms of lower resolution were employed. A number of gangliosides, in particular polysialylated belonging to GT, GQ, GP, and GS classes, modified by O‐fucosylation, O‐acetylation, or CH₃COO^? were discovered here, for the first time in human cerebellum. These components, found differently expressed in fetal and aged tissues, indicated that the ganglioside profile in cerebellum is development stage‐ and age‐specific. Following the fragmentation analysis by high‐energy collision‐induced dissociation (HCD) tandem MS (MS/MS), we have also observed that the intimate structure of certain compounds has not changed during the development and aging of the brain, an aspect which could open new directions in the investigation of ganglioside biomarkers in cerebellar tissue.     

Hemispherical dominance of glucose metabolic rate in the brain of the 'normal' ageing population

In the 'normal' ageing brain a decrease in the cerebral metabolic rate has been determined across many brain regions. This study determines whether age differences would affect metabolic rates in regions and different hemispheres of the brain. The regional metabolic rate of glucose (rCMRGlu) was examined in a group of 72 subjects, ages 22 to 82 years, with 36 regions of interest chosen from both hemispheres of the cortex, midbrain and cerebellum. To determine metabolic rates the in-vivo technique of positron emission tomography (PET) was employed. Three age groups were chosen to compare hemispherical differences. In both young and intermediate age groups the left hemisphere had higher rCMRGlu values than those of the right for the majority of regions with, although less pronounced in the intermediate group. Importantly, the older age group displayed little difference between hemispheres. This revised version was published online in August 2006 with corrections to the Cover Date.     

Positive Effect of α-Asaronol on the Incidence of Post-Stroke Epilepsy for Rat with Cerebral Ischemia-Reperfusion Injury

In the present study, we confirmed that α-asaronol, which is a product of the active metabolites of alpha Asarone, did not affect n-butylphthalide efficacy when n-butylphthalide and α-asaronol were co-administered to rats with cerebral ischemia-reperfusion injury. Our research revealed that the co-administration of α-asaronol and n-butylphthalide could further improve neurological function, reduce brain infarct volume, increase the number of Nissl bodies, and decrease the ratios of apoptotic cells and the expression of the caspase-3 protein for cerebral ischemia-reperfusion injury model compared to n-butylphthalide alone. Additionally, α-asaronol could significantly decrease the incidence of post-stroke epilepsy versus n-butylphthalide. This study provides valuable data for the follow-up prodrug research of α-asaronol and n-butylphthalide.     

Evidence for the relation of herpes simplex virus type 1 to Down syndrome and Alzheimer's disease

The peripheral and central nervous system are harbouring herpes simplex virus type 1 (HSV-1) and this virus has been proposed to be implicated in the aetiology of Alzheimer's disease (AD). We tested whether the HSV-1 genome is found indeed in the brain of controls, patients with AD and Down syndrome (DS) and whether HSV-1 infectious proteins in brain were induced. Moreover, we tested whether interleukin (IL)-6, a marker for neuroinflammation, is found in brains of AD and DS. HSV-1 glycoprotein D gene, as well as viral phosphoprotein and glycoprotein were detected in all brain samples. IL-6 was detectable in seven out of the eight AD and all of the eight DS patients, but only three out of ten controls in the frontal cortex. IL-6 in cerebellum was detectable in all AD and DS patients, but only three out of nine controls. In conclusion, we propose that the detection of HSV-1 genome and HSV-1 inducible protein IL-6 not only shows the presence in human brain, but may indicate a role for HSV-1 in the process of neuroinflammation and apoptosis, known to occur in both neurodegenerative disorders, AD and DS.     

Hierarchical clustering of Alzheimer and “normal” brains using elemental concentrations and glucose metabolism determined by PIXE, INAA and PET

Brain tissue samples, obtained from the Alzheimer Disease Brain Bank,Institute of Psychiatry, London, were taken from both left and right hemispheresof three regions of the cerebrum, namely the frontal, parietal and occipitallobes for both Alzheimer and 'normal' subjects. Trace elementconcentrations in the frontal lobe were determined for twenty six Alzheimer(15 male, 11 female) and twenty six 'normal' (8 male, 18 female)brain tissue samples. In the parietal lobe ten Alzheimer (2 male, 8 female)and ten 'normal' (8 male, 2 female) samples were taken along withten Alzheimer (4 male, 6 female) and ten 'normal' (6 male, 4 female)from the occipital lobe. For the frontal lobe trace element concentrationswere determined using proton induced X-ray emission (PIXE) analysis whilein parietal and occipital regions instrumental neutron activation analysis(INAA) was used. Additionally eighteen Alzheimer (9 male, 9 female) and eighteenage matched 'normal' (8 male, 10 female) living subjects wereexamined using positron emission tomography (PET) in order to determine regionalcerebral metabolic rates of glucose (rCMRGlu). The rCMRGlu of 36 regions ofthe brain was investigated including frontal, occipital and parietal lobesas in the trace element study. Hierarchical cluster analysis was applied tothe trace element and glucose metabolism data to discover which variablesin the resulting dendrograms displayed the most significant separation betweenAlzheimer and 'normal' subjects.