捻转和非捻转刺激太溪穴后脑激活状态的功能磁共振成像研究

目的：观察功能磁共振成像了解捻转刺激太溪穴和非捻转刺激所引起的脑激活区状态。 方法：纳入健康青年志愿者12名,选取右侧太溪穴,采用组块刺激模式,静息阶段与刺激阶段交替出现,重复3次,分为3个组块。刺激为手法捻转行针或非捻转,非捻转即手放在针柄,但不进行任何操作。扫描后图像使用SPM2进行后处理。 结果：捻转刺激太溪穴主要激活了右侧颞上回BA22,左侧的额中回BA46,其次为左右顶叶的中央后回BA2,BA3,左额叶的额下回BA45和左顶叶的顶下小叶BA40;而非捻转刺激则没有激活。 结论：捻转刺激太溪穴和非捻转刺激的激活不同,与本经相关的经络、脏腑联系密切相关。     

电针刺激脊髓损伤患者穴位的脊髓磁共振功能成像激活区特征****☆

背景：研究发现脊髓功能激活区域和电生理等理论对应区域相一致,多数学者认为使用功能磁共振技术检测脊髓神经功能是可行的。 目的：检测电针刺激脊髓损伤患者的脊髓磁共振功能成像激活区特征,验证使用脊髓磁共振功能成像技术来客观评价针灸治疗脊髓损伤疗效的可行性。 方法：使用电针同时刺激3例脊髓损伤患者和5名健康志愿者的右手合谷穴和曲池穴,采用组块设计方法,使用SPM2软件得到患者和健康志愿者脊髓内真实的激活区,分析激活区在矢状位和横断位上的分布特征,并与健康志愿者的激活分布对比,找出患者的激活分布差异。 结果与结论：5名健康志愿者在脊柱C2、C5段均重复出现激活信号,在C6段4名出现激活;3例脊髓损伤患者在脊柱C2,C6段均出现均重复出现激活,其中1例患者与健康志愿者激活分布特征基本一致。可以观察到针灸刺激脊髓损伤患者的脊髓功能激活,因此可以根据功能激活区的分布及强度,在一定程度上客观评价针灸治疗脊髓损伤的疗效。 关键词：磁共振功能成像;脊髓损伤;针灸;穴位;SEEP;数字化图像与影像     

静息态脑功能磁共振在精神障碍中的研究进展

脑功能磁共振是应用功能性磁共振成像(functional magnetic resonance imaging, fMRI)测量脑神经元活动所致血流动力学的改变,以确定脑功能的反应区域.fMRI一般采用血氧水平依赖性(blood oxygen level dependent, BOLD)信号[1].由于其无创性的最大优势,近十年来fMRI在精神疾病的研究中发挥越来越大的作用.目前大多数的fMRI研究通过执行任务或给予外在刺激得到脑功能的变化,对照静息状态以BOLD信号改变的形式反映在大脑的相应区域,称为任务态[2].1995年,Biswal等[3]最先报道在无任何运动行为的情况下,大脑左侧躯体运动皮层的自发BOLD信号波动与右侧躯体运动皮层的自发信号波动相关.这个观察结果说明自发的BOLD信号活动并不是无意义的,由此引发了一系列非任务态,即静息态的脑功能磁共振的研究.     

酒精使用障碍静息态功能磁共振成像研究进展

酒精使用障碍(alcohol use disorder, AUD)作为严重的社会公共卫生问题, 给患者、家庭、社会带来了巨大的疾病负担。目前越来越多的研究表明, AUD患者存在脑功能损害。近年来随着神经成像技术的不断发展, 静息态功能磁共振成像技术越来越多地应用于AUD相关的脑功能研究, 为AUD病理生理机制的认识提供了新的依据。本文就近年来静息态功能磁共振成像技术在AUD研究中的相关应用做一综述, 旨在为将来基于静息态功能磁共振成像对AUD机制的深入研究提供一定的参考依据。     

针刺健康人足三里穴脑功能成像研究初步分析

目的采用磁共振脑功能成像（fMRI）技术观察针刺足三里穴引起脑内功能区的变化,并与近年来相关的研究结果比较,分析研究存在差异的原因。方法15例健康志愿者,采用改良组块设计方案,针刺左侧足三里穴进行fMRI扫描,实验数据采用AFNI软件分析处理,采用Monte Carlo模拟阈值校正方法（P〈0.05,α〈0.05）确定脑功能激活区。结果针刺左侧足三里穴引起双侧海马旁回、额中回、扣带回前部、右侧颞叶、海马、杏仁核、左侧额下回、右侧小脑及脑桥区域信号减弱,右侧中央前回及右侧顶下小叶区域信号增高。结论针刺正常人左侧足三里穴主要引起颞叶和边缘系统的脑功能变化,并且以信号减弱为主。与其他类似研究的结果有较明显的差异,这种差异可能与多种因素有关,有待进一步深入研究分析。     

静息态功能磁共振在认知障碍中的应用

静息态功能磁共振成像技术是近年来研究脑功能,特别是脑网络连接的一种重要方法,广泛应用于认知障碍的研究中。本文综述了静息态功能磁共振在各种类型的认知障碍(轻度认知障碍、阿尔茨海默病、血管性认知障碍、帕金森病认知障碍)中的应用进展。     

重症肌无力患者静息态脑功能研究

目的探索重症肌无力(MG)患者的静息态脑功能情况。方法选择30例MG患者,以及性别、年龄和文化程度相匹配的20例正常对照组(NC)进行静息态功能磁共振成像(rs-fMRI)扫描。采用局部一致性(ReHo)方法,分析计算MG组和NC组的ReHo改变的脑区,并比较两组间ReHo值差异,从而探索MG患者脑功能ReHo的变化情况。结果与NC相比,MG组在双侧小脑、双侧尾状核等脑区ReHo值下降。结论可通过静息态功能磁共振的角度研究MG患者的脑功能变化。     

脑功能磁共振成像技术对脑神经功能损伤诊断的价值

目的探讨脑功能磁共振成像及其处理分析技术对脑神经功能损伤诊断的价值。方法选择2013-06-2015-02入住我院接受治疗的18例神经外科脑损伤患者进行研究。保守治疗16例,手术治疗2例。对患者实施电针刺激功能磁共振成像(fMRI),分析得出静息状态信号(R)和刺激状态(A)的脑功能对比图。计算出每次刺激侧对侧的脑激活簇偏侧指数LI,并同时对相应的神经功能缺损状况进行评分。所有患者康复治疗时,除对症治疗外,还需接受按摩、高压氧、功能锻炼等康复措施。结果 14例患者做前后两期检查,取得两期的完整资料;4例患者仅做了1期检查,获得1期资料。18例患者共获得50次功能磁共振成像图像,剔除伪影较多的图像,最终选择符合条件的33次图像进行研究。33次成像图像显示,血氧水平依赖性增强(BOLD)均获得清晰的激活簇,且前后两期的LI变化值均有不同程度的提高,28次LI值为正值,5次LI值为负值,正值率为84.85%(28/33),但前后两期的LI变化值比较差异无统计学意义(P0.05)。前后两期的LI的改变值△LI以及相应的神经缺损评分△S为正值,且△LI与△S呈现正相关(P0.001)。结论通过电针刺激的脑功能磁共振成像能动态监测到患者脑激活簇的变化,并经数据处理分析后对脑神经功能损伤程度的诊断具有一定的判定价值。     

卒中后抑郁的磁共振影像学研究进展

卒中后抑郁（post-stroke depression,PSD）是卒中的常见并发症。加强对PSD的识别,提高对PSD机制和诊断手段的理解,有助于提高对PSD的诊断和治疗水平。现就PSD磁共振影像学,包括磁共振波谱成像、磁共振扩散张量成像及静息态脑功能磁共振成像的研究进展予以综述。     

大鼠视觉皮层动态锰离子增强磁共振功能成像研究

目的 应用动态锰离子增强磁共振技术行大鼠视觉皮层功能成像,为神经系统功能的研究提供方法.方法 成年雄性Wistar大鼠6只,右颈外动脉插管后于连续的4个时段分别进行不同处理,第一时段(5 min)不给予药物,无视觉刺激;第二时段(10 min)经右颈外动脉注射甘露醇和氯化锰,无视觉刺激;第三时段(15 min)仅注射氯化锰,给予视觉刺激;第四时段(5 min)注射氯化锰与谷氨酸混合液,无视觉刺激.每一时段处理后立即进行大鼠头颅磁共振成像,应用SPM软件进行图像的配准和平滑处理,应用Matlab软件得出图像的配色图及等高线图;选取视觉皮层进行兴趣区(ROI)分析,观察不同处理后磁共振图像中脑内特异性增强区域并比较大鼠视觉皮层的信号强度.结果 磁共振图像分析显示第一、二时段处理后大鼠脑内未发现特异性增强区域,第三时段处理后大鼠右侧视觉皮层特异性增强,第四时段处理后大鼠右侧脑内多个核团特异性增强;ROI分析显示第三时段处理后的视觉皮层信号强度(1.897±0.172)明显强于第二时段(1.549±0.163),差异有统计学意义(P<0.05).结论 动态锰离子增强磁共振成像技术能分析大鼠视觉皮层功能活动,可做为研究神经系统功能的新方法.     

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.     

Summary of legislation of 1935 of interest to the department of Mental Hygiene

Psychiatric Quarterly -