皮层下脑结构协变连接预测精神分裂症急性期治疗疗效

目的:探讨皮层下脑结构协变在预测精神分裂症急性期治疗疗效中的作用。方法:招募42例首发精神分裂症患者及38例对照,患者经8周利培酮治疗后评定疗效。采集受试者T1磁共振数据,经Freesurfer预处理及线性关联构建结构协变。结果:治疗后缓解组较未缓解组左侧半球丘脑与苍白球间协变连接较高(P=0.002, FDR校正);右侧壳核与尾状核间协变连接较低(P=0.023, FDR校正),右侧丘脑与苍白球间协变连接较高(P=0.003, FDR校正);左侧丘脑与右侧海马间协变连接较低(P=0.021, FDR校正)。与对照组相比,病人缓解组左侧丘脑与苍白球间协变连接较高(P=0.033, FDR校正);左侧丘脑与右侧海马间协变连接较低(P=0.014, FDR校正)。结论:精神分裂症急性期治疗缓解组与未缓解组在丘脑-苍白球-海马-壳核-尾状核环路存在结构协变差异。     

经椎间孔椎体间融合术与后路椎体间融合术治疗多节段腰椎管狭窄症的疗效比较

目的 比较经椎间孔椎体间植骨融合内固定术(TLIF)与后路椎体间融合内固定术(PLIF)治疗多节段腰椎管狭窄症的临床疗效。方法 回顾分析2013年1月—2014年6月第二军医大学附属长征医院脊柱外科,经手术治疗、术后随访时间超过1年的152例多节段腰椎管狭窄症患者的临床资料,按手术方式分为TLIF组(80例)和PLIF组(72例),比较两组患者的手术时间、术中出血量,并采用腰痛VAS和JOA评分标准进行疗效评定。结果 TLIF组和PLIF组术中出血量分别为(658±225)mL和(772±324)mL,差异有统计学意义(t=-2.534, P＜0.01);手术时间分别为(3.84±1.00)h和(3.94±0.99)h,差异无统计学意义(t=-0.596, P＞0.05)。两组患者术前及末次随访时腰痛VAS评分差异均无统计学意义(t=1.080、-0.770,P值均>0.05),但术后3个月时TLIF组VAS评分(3.6±1.4)分较PLIF组(4.3±1.1)分低,差异有统计学意义 (t=-3.351, P<0.05)。两组间JOA评分术前、术后3个月及末次随访时比较,差异均无统计学意义(t=-1.122、0.522、-1.070, P值均>0.05)。两组术后3个月和末次随访时腰痛VAS评分和JOA评分均较术前明显改善,差异均有统计学意义(P值均<0.05)。结论 TLIF和PLIF治疗多节段腰椎管狭窄症均能取得满意的临床疗效,TLIF具有术中出血少、术后腰痛恢复更快的优点。     

额叶-纹状体-丘脑神经环路功能连接与精神分裂症患者阳性症状的相关（英文）

目的:探讨纹状体的功能连接和精神分裂症临床症状的关系。方法:运用基于体素的功能连接分析法来识别精神分裂症患者纹状体与其他脑区功能连接的异常,入组对象为70位精神分裂症患者和60位年龄、性别相匹配的健康对照。结果:与健康对照比较,我们发现患者的左侧尾状核与左侧额中回、左侧额上回以及左侧丘脑,右侧尾状核与右侧额中回、左右两侧丘脑,右侧壳核与右侧楔叶均表现为功能连接减弱。相关分析发现,左侧尾状核和左侧额中回的功能连接强度与患者阳性症状量表的幻觉评分成负相关,右侧尾状核与右侧丘脑的功能连接强度与患者阳性症状量表的怪异行为呈正相关。结论:结果显示精神分裂症患者额叶-纹状体-丘脑环路静息态功能连接存在异常。并且此环路中的左侧尾状核与左侧额中回以及右侧尾状核与右侧丘脑的功能连接异常可能分别为精神分裂症患者幻觉和怪异行为的神经生物学基础。     

人体下颈椎显微骨硬度体外测量的实验研究

目的 探讨人体下颈椎C₃~C₇椎骨显微骨硬度的分布特征及其临床意义。方法 3具新鲜成人尸体标本,分别为62岁男性(标本A)、45岁女性(标本B)、58岁男性(标本C),由河北医科大学解剖学教研室提供。取其下颈椎C₃~C₇段脊柱,剔除附着软组织。每个椎骨分为椎体区和附件区两部分,使用高精慢速锯分别经椎体中部垂直于椎体上下终板、右侧椎弓根长轴、左侧上下关节突长轴切割3 mm厚骨切片各1片, 并用砂纸打磨,15块椎骨共制成45片骨切片。应用维氏显微硬度测量仪测量骨组织切片不同区域皮质骨和松质骨的显微硬度值,每一个区域选取5个有效显微骨硬度值,全体有效值的平均值作为该区域的硬度值。结果 15块椎骨共计获得825个有效显微骨硬度测量值。 C₃~C₇总体骨硬度值为11.10～47.80 HV,其中皮质骨为(26.04±4.84) HV、松质骨为(22.92±4.78) HV。椎体区皮质骨硬度值为(25.46±4.86) HV、松质骨硬度值为(21.10±4.97) HV,附件区皮质骨硬度值为(26.50±4.78) HV、松质骨硬度值为(24.75±3.80) HV,附件区高于椎体区,差异均有统计学意义(t=2.800、4.978, P值均＜0.05)。3具尸体标本各自的下颈椎在不同部位的骨显微硬度值不同,但椎体区的皮质骨与松质骨骨硬度值均低于附件标本的皮质骨与松质骨骨硬度,其中松质骨之间的差异均有统计学意义(t_A=4.316、t_B=2.364、t_C=2.107, P值均＜0.05);而皮质骨中,仅标本B的差异有统计学意义(t=2.498,P＜0.05)。C₃~C₇各椎骨不同部位的硬度值分布规律与总体一致:椎体区的骨硬度值均低于附件区;其中C₃、C₅、C₆、C₇松质骨的骨硬度值差异具有统计学意义(P值均＜0.05)。 附件分区中,上关节突皮质骨骨硬度低于椎弓根、椎板、横突、下关节突皮质骨骨硬度,差异具有统计学意义(F=8.590, P＜0.05);椎体分区中,下终板皮质骨骨硬度高于上终板和外周终板皮质骨骨硬度,差异具有统计学意义(F=16.365, P＜0.05)。结论 下颈椎椎骨不同部位、不同区域的骨显微硬度存在差异,附件区的皮质骨/松质骨骨硬度分别高于椎体区的皮质骨/松质骨骨硬度。该分布规律是人体活动过程中适应应力应变的生理改变,可以为三维有限元分析、3D打印及术前模拟提供数据支持。     

MRI Schizas形态学分型对腰椎管狭窄症疗效的评价

目的 探讨MRI Schizas形态学B、C型退行性腰椎管狭窄症患者保守与手术治疗的临床疗效,以及Schizas形态学分型的临床应用价值。方法 回顾性分析2014年1月—2015年12月新疆医科大学第一附属医院骨科收治的62例Schizas形态学分型为B、C型腰椎管狭窄症患者的临床资料,其中男33例,女29例;年龄43～74岁。Schizas形态学B型39例,其中保守治疗20例(保守组)、手术治疗19例(手术组);C型23例,其中保守治疗13例(保守组)、手术治疗10例(手术组)。B、C型保守组和手术组患者一般资料比较差异均无统计学意义(P值均>0.05)。分别比较B、C型患者保守组和手术组治疗前及末次随访ODI、JOA评分、VAS及治疗期间住院时间、住院费用的差异。结果 所有患者治疗后随访9～16个月,平均随访12个月。Schizas B型腰椎管狭窄症的患者在保守组及手术组治疗后末次随访ODI分别为10.88%±2.84%和11.44%±2.80%,JOA评分分别为(22.41±2.26)分和(22.36±2.25)分,VAS分别为(0.84±0.52)分和(0.93±0.41)分,两组间比较差异均无统计学意义(t=-0.622、0.065、-0.646,P值均>0.05),与各组治疗前比较差异均有统计学意义(P值均<0.05);两组住院时间及住院费用比较差异均有统计学意义(Z=-3.530、-5.339,P值均<0.01)。Schizas C型腰椎管狭窄症患者在保守组和手术组治疗后末次随访腰椎ODI分别为16.72%±4.04%和10.10%±1.63%,JOA评分分别为(17.92±2.43)分和(22.75±2.99)分,VAS分别为(1.60±0.82)分和(0.70±0.25)分,两组间比较差异均有统计学意义(t=4.856、-4.271、3.713,P值均<0.01),与各组治疗前比较差异均有统计学意义(P值均<0.05);两组平均住院时间比较差异无统计学意义(Z=-1.853, P>0.05),住院费用比较差异有统计学意义(Z=-4.032, P<0.01)。结论 保守治疗及手术治疗均能不同程度地改善腰椎管狭窄症患者的症状,MRI Schizas形态学分型在治疗腰椎管狭窄症的方法选择上有参考价值。     

多层螺旋CT灌注成像对早期静脉溶栓治疗急性脑梗死的疗效评价

目的 探讨多层螺旋CT灌注成像(CTP)评价早期静脉溶栓治疗急性脑梗死的临床应用价值。方法 回顾性分析2015年6月—2016年12月黑龙江省医院 CT室收集的80例急性脑梗死患者的CT影像资料。80例中,男46例、女34例,年龄20~75岁,均采用多层螺旋CTP指导静脉溶栓治疗。采用SPSS 16.0统计学软件进行分析处理,比较患者治疗前后病灶边缘区局部脑血流量(rCBF)、局部脑血容量(rCBV)和对比剂平均通过时间(MTT)。结果 80例中,常规头部CT平扫显示责任病灶35例,灵敏度43.75%(35/80);多层螺旋CTP显示72例有责任病灶,灵敏度90.00%(72/80);两种方法灵敏度、特异度比较,差异均有统计学意义(χ²=38.625、21.818, P值均＜0.01)。常规CT平扫在脑缺血24 h后才能显示出病灶区,采用常规CT平扫敏感性低。CTP的参数对比显示,治疗后rCBF(t=8.335, P<0.01)和rCBV(t=3.016, P<0.01)明显优于治疗前, MTT明显降低(t=5.226, P<0.01),差异具有统计学意义。结论 多层螺旋CTP技术能够观察急性脑梗死患者治疗前后脑血流动力学指标变化,为评价急性脑梗死患者溶栓治疗疗效提供依据。     

扣带区的传入纤维联系

本文应用HRP法研究扣带区的传入纤维。结果表明扣带区膝前部25、32区接受同侧皮层3、1、2区及苍白球和双侧10、24区、尾壳核、下丘脑外侧核及终纹腔间核的纤维;膝上部(24区)接受同侧皮层32区、丘脑背内侧核外侧部的纤维,接受对侧4区及双侧10区、嗅前核、尾壳核和隔核的纤维;扣带后部(23、29区)接受同侧皮层24、17、18区及中脑吻侧线形核的纤维。扣带区广泛接受皮层、皮质下核、丘脑下部及中脑的传入联系,为解释其生理机能提供形态学依据。     

椎前髂静脉通道大小和下腰椎前凸角与性别、年龄的关系及其临床意义

目的 探讨椎前髂静脉通道矢状径(IVTD)和下腰椎前凸角(LLLA)与性别、年龄的关系及其临床意义。方法 收集2009年7月—2014年12月解放军第一七五医院(厦门大学附属东南医院)CT数据库中行腹盆部CT检查患者的资料进行回顾性分析。按年龄和性别分层简单随机抽样方法抽取320例为正常组,每年龄段(1～15,16～25,26～35,36～45,46～55,56～65,66～75及≥76岁)各40例,男女均等。收集同期55例(男18例,女37例)髂静脉压迫综合征(IVCS)患者的CT资料为IVCS组。分别在CT横断面和重建矢状面上测量椎前IVTD和LLLA。统计分析评估正常组LLLA和IVTD在男女性别间和各个年龄组间的差异采用方差分析和Bonferroni检验,Pearson相关分析LLLA和IVTD与年龄的相关性。在正常组中选择与IVCS组同年龄段者为对照组,采用独立样本t检验分别比较对照组与IVCS组中男性组、女性组间LLLA、IVTD的差异,分别建立预测男性和女性罹患IVCS风险的IVTD狭窄阈值。结果 正常组总体LLLA为128.1°±6.7°,椎前IVTD(4.9±1.2)mm,与年龄均呈负相关(r=-0.673、-0.662,P值均＜0.01);LLLA与IVTD呈正相关(r=0.812, P＜0.01)。其中,男性LLLA 为130.6°±6.1°、IVTD为(5.4±1.2)mm;女性LLLA为125.5°±6.0°、IVTD为(4.3±1.0)mm,男性LLLA和IVTD值均高于女性(t=7.426、9.103,P值均＜0.05)。IVCS组中,男性LLLA为123.3°±2.3°,IVTD为(2.5±0.3)mm ,与对照组男性的128.1°±2.7°、(5.0±0.8)mm比较,差异均有统计学意义(t=6.993、12.604, P值均<0.01);女性LLLA为122.1°±5.8°,IVTD为(2.3±0.4)mm,与对照组女性的125.1°±4.9°、(4.1±0.8)mm比较,差异均有统计学意义(t=2.898、12.906, P值均<0.01)。ROC预测IVCS的IVTD最适风险阈值,男性为2.98 mm,女性为2.96 mm,曲线下面积分别为0.99、0.98,其诊断敏感性分别为99%、93%,特异性均为100%。结论 LLLA和椎前IVTD在不同性别与年龄间存在差异, CT成像可以准确评估通道狭窄情况,预测罹患IVCS的风险。     

抑制miR-218的表达对人去势抵抗型前列腺癌C4-2细胞增殖、侵袭及迁移能力的影响及其机制

目的 探讨抑制miR-218的表达对人去势抵抗型前列腺癌C4-2细胞增殖、侵袭及迁移的影响及其机制。方法 培养人去势抵抗型前列腺癌C4-2细胞,分为空白组、阴性对照组(NC组)、miR-218组;空白组未予以任何处理,NC组转染阴性对照序列,miR-218组转染miR-218抑制剂。各组细胞处理后继续培养5 d,然后收集细胞,采用实时荧光定量PCR(qPCR)检测转染后各组细胞miR-218的表达情况,采用WST-1细胞增殖实验和细胞平板克隆形成实验检测转染后各组C4-2细胞增殖、活性情况,采用划痕实验检测各组C4-2细胞迁移距离,采用Transwell小室检测细胞侵袭数量和迁移数量,采用半定量逆转录PCR(RT-PCR)检测TOB1基因mRNA表达情况,采用Western blot检测TOB1基因蛋白表达情况。结果 qPCR结果显示:转染后NC组、miR-218组人去势抵抗型前列腺癌C4-2细胞miR-218的相对表达量分别为1.02±0.06、0.38±0.04,miR-218组中miR-218的表达明显低于NC组,差异有统计学意义(t=15.372, P＜0.05)。WST-1细胞增殖实验结果显示:(1)转染后空白组、NC组随着时间的延长,光密度(OD)值呈上升趋势,而miR-218组OD值在24、48 h时呈上升趋势,72 h时OD 值开始明显下降;(2)空白组、NC组、miR-218组组间比较,OD 值在0、24 h时3组间差异均无统计学意义(P值均＞0.05),48、72 h时miR-218组OD 值均小于空白组、NC组,差异均有统计学意义(F=12.615、24.523,P值均＜0.05)。细胞平板克隆形成实验结果显示:转染后空白组、NC组和miR-218组克隆形成数分别为(42.2±1.2)个、(41.3±2.4)个、(20.6±1.2)个,miR-218组明显少于空白组、NC组,差异均有统计学意义(F=155.530,P＜0.05)。划痕实验和Transwell小室细胞侵袭、迁移实验结果显示:转染后,miR-218组细胞迁移距离、侵袭细胞数和迁移细胞数均低于空白组和NC组,差异均有统计学意义(F=17.625、48.625、38.352,P值均＜0.05);而空白组和NC组间细胞迁移距离、侵袭细胞数和迁移细胞数比较,差异均无明显统计学意义(P值均＞0.05)。RT-PCR和Western blot检测结果显示:转染后空白组、NC组、miR-218组TOB1基因mRNA的相对表达量分别为 0.20±0.02、0.19±0.03、0.35±0.02,TOB1基因蛋白的相对表达量分别为0.22±0.01、0.23±0.02、0.68±0.02,miR-218组细胞中TOB1 mRNA和蛋白水平均明显高于空白组和NC组,差异均有统计学意义(F=18.615、22.523,P值<0.05);而空白组细胞中TOB1 mRNA和蛋白水平与NC组比较,差异均无统计学意义(P值>0.05)。结论 抑制人去势抵抗型前列腺癌C4-2细胞miR-218的表达,可抑制该细胞的增殖和活性,并抑制其侵袭和迁移能力,其机制可能与上调TOB1基因mRNA和蛋白表达有关。     

全膝关节置换术与单髁置换术治疗膝关节单间室骨关节炎的疗效比较

目的 比较全膝关节置换术(TKA)与膝关节单髁置换术(UKA)治疗膝关节单间室骨关节炎的临床疗效。方法 对2012年3月—2015年3月徐州医科大学附属医院骨科88例行TKA或UKA治疗单间室骨关节炎并获得随访患者的临床资料进行回顾性分析,依据不同手术方法分为TKA组48例(48膝)和UKA组40例(40膝)。采用美国特种外科医院(HSS)膝关节评分,评价疗效。比较两组患者手术时间、术中出血量、术后引流量,术后第1天、3天、1周血红蛋白水平和术后第3天血红蛋白较术前的下降量,以及末次随访时关节活动度和疗效。结果 两组患者手术顺利,88例患者获随访6~36个月,平均20.25个月。TKA组手术时间(85.77±7.61)min多于UKA组的(80.50±6.82)min,术中出血量(103.54±17.68)mL多于UKA组的(74.75±11.82)mL,术后引流量(420.21±68.80)mL多于UKA组的(241.75±53.05)mL,差异均有统计学意义(t=3.389、t'=8.787、t'=13.411,P值均＜0.01)。两组术前血红蛋白水平差异无统计学意义(P＞0.05);TKA组术后第1天、3天、1周血红蛋白均低于UKA组,术后第3天血红蛋白较术前的下降量高于UKA组,差异均有统计学意义(P值均＜0.05)。UKA组术后膝关节屈曲至90°所需时间为(7.33±3.02)d,短于TKA组的(12.63±3.10)d(t=8.086,P＜0.01);末次随访UKA组患者膝关节屈曲角度为116.98°±13.71°,大于TKA组的125.13°±15.95°(t=2.576,P＜0.01)。TKA组和UKA组HSS评分优、良、可、差者分别为25、19、3、1例和23、15、2、0例,其优良率分别为91.67%(44/48)和95.00%(38/40),差异无统计学意义(Z=0.603,P＞0.05)。两组患者中仅TKA组发生深静脉血栓1例,经介入治疗后痊愈;其余患者无手术并发症发生。结论 UKA与TKA治疗膝关节单间室骨关节炎均能获得满意的临床疗效,但UKA具有出血少、手术时间短、功能恢复快等优点。     

特发性全面性癫痫患者大脑结构异常改变的MRI研究

目的 基于深度学习脑龄预测方法和FreeSurfer图像分析软件,探讨特发性全面性癫痫（IGE）患者大脑形态结构的异常改变。方法 回顾性病例对照研究。纳入2020年1月—2021年12月山东省立医院及寿光市人民医院神经内科确诊的144例IGE患者。其中男84例、女60例,年龄10~70岁。基于公共脑成像数据库（人类连接组项目、中国人类连接组项目）建立正常人脑T₁加权像（T₁WI）MRI训练深度学习脑龄预测模型,并输入脑皮质及脑白质脑图。将IGE患者T₁WI MRI输入脑龄预测模型,获取预测脑龄。将27例未经治疗的早期IGE患者设为观察组,男18例、女9例,年龄（16.1±3.2）岁;招募与观察组年龄、性别匹配的29名健康志愿者作为对照组,男19例、女10例,年龄（16.4±4.5）岁,均行MR检查。观察项目：（1）比较IGE患者不同年龄段（10~20岁、>20~30岁、>30~40岁、>40~50岁、>50~60岁、>60~70岁）大脑的预测年龄与实际年龄的差异。（2）利用FreeSurfer软件,分析和比较观察组与对照组大脑皮质体积、厚度和表面积,以及局部形态的差异。结果 （1）IGE患者的不同年龄段中,除>30~40岁外（t=-1.58,P=0.138）,脑龄预测值均大于实际年龄,差异均有统计学意义（P值均<0.05）。（2）观察组与对照组的年龄、性别、教育程度等基线资料差异均无统计学意义（P值均>0.05）。与对照组比较,观察组大脑左、右半球皮质厚度略变薄,差异有统计学意义（t=3.91、3.40,P值均<0.01）;2组大脑半球皮质体积、表面积无明显变化,差异均无统计学意义（P值均>0.05）。与对照组相比,观察组脑区中右侧眶额皮质体积增大,无脑区皮质体积减小;右侧中央后回、左侧中央沟附近中央后回、右侧舌回后部分、左侧舌回及楔叶的皮质厚度均增加,右侧中央前回、双侧额上回（背侧）、右侧内嗅皮质的皮质厚度均减小;右侧海马旁回的皮质表面积增大,无脑区的皮质表面积减小。观察组左、右侧苍白球及右侧丘脑体积较对照组缩小,差异均有统计学意义（t=4.01、4.23、2.12,P值均<0.05）。2组左侧丘脑及双侧尾状核、壳核、海马及杏仁核体积比较,差异均无统计学意义（P值均>0.05）。结论 IGE患者在多个年龄段其脑结构都会发生异常改变。早期IGE患者的大脑皮质及皮质下核团仅发生细微结构的异常改变。     

Processing of temporal information and the basal ganglia: new evidence from fMRI

Temporal information processing is a fundamental brain function, which might include central timekeeping mechanisms independent of sensory modality. Psychopharmacological and patient studies suggest a crucial role of the basal ganglia in time estimation. In this study, functional magnetic resonance imaging (fMRI) was applied in 15 healthy right-handed male subjects performing an auditory time estimation task (duration discrimination of tone pairs in the range of 1,000–1,400 ms) and frequency discriminations (tone pairs differing in pitch, around 1,000 Hz) as an active control task. Task difficulty was constantly modulated by an adaptive algorithm (weighted up-down method) reacting on individual performance. Time estimation (vs rest condition) elicited a distinct pattern of cerebral activity, including the right medial and both left and right dorsolateral prefrontal cortices (DLPFC), thalamus, basal ganglia (caudate nucleus and putamen), left anterior cingulate cortex, and superior temporal auditory areas. Most activations showed lateralisation to the right hemisphere and were similar in the frequency discrimination task. Comparing time and frequency tasks, we isolated activation in the right putamen restricted to time estimation only. This result supports the notion of central processing of temporal information associated with basal ganglia activity. Temporal information processing in the brain might thus be a distributed process of interaction between modality-dependent sensory cortical function, the putamen (with a timing-specific function), and additional prefrontal cortical systems related to attention and memory. Further investigations are needed to delineate the differential contributions of the striatum and other areas to timing. Electronic Publication     

Changes of Brain Structure and Function in ADHD Children

To explore the changes of brain structure and function in attention-deficit/hyperactivity disorder (ADHD), fifteen ADHD patients (inattention subtype) and 15 normal control participants were recruited, the brain structure and function of these subjects were investigated by combining structural magnetic resonance imaging (MRI), diffusion tensor imaging and resting-state functional MRI. The results showed that ADHD patients had a significant decrease in the volume of the white matter (P?=?0.04), and a trend toward decreased volume of brain structures except for the putamen and globus pallidus. The visualization of statistical difference maps of the cortical thickness showed that ADHD patients had focal thinning in bilateral frontal regions and the right cingulate cortex (P?相似文献   

Association Between the Basal Ganglia and Large-Scale Brain Networks in Epilepsy

Epilepsy may affect connectivity between the putamen and cortex even during the resting state. Putamen is part of the basal ganglia resting state network (BG-RSN) which is anti-correlated with the default mode network (DMN) in healthy subjects. Therefore, we aimed at studying the functional brain connectivity (FC) of the putamen with the cortical areas engaged in the DMN as well as with the primary somatomotor cortex which is a cortical region engaged in the BG-RSN. We compared the data obtained in patients with epilepsy with that in healthy controls (HC). Functional magnetic resonance imaging (fMRI) was performed in 10 HC and 24 patients with epilepsy: 14 patients with extratemporal epilepsy (PE) and 10 patients with temporal epilepsy (PT). Resting state fMRI data was obtained using the 1.5 T Siemens Symphony scanner. The Group ICA of fMRI Toolbox (GIFT) program was used for independent component analysis. The component representing the DMN was chosen according to a spatial correlation with a mask typical for DMN. The FC between the putamen and the primary somatomotor cortex was studied to assess the connectivity of the putamen within the BG-RSN. A second-level analysis was calculated to evaluate differences among the groups using SPM software. In patients with epilepsy as compared to HC, the magnitude of anti-correlation between the putamen and brain regions engaged in the DMN was significantly lower. In fact, the correlation changed the connectivity direction from negative in HC to positive in PE and PT. The disturbed FC of the BG in patients with epilepsy as compared with HC was further illustrated by a significant decrease in connectivity between the left/right putamen and the left/right somatomotor cortex, i.e. between regions that are engaged in the BG-RSN. The FC between the putamen and the cortex is disturbed in patients with epilepsy. This may reflect an altered function of the BG in epilepsy.     

Changes of functional connectivity of the motor network in the resting state in Parkinson's disease

We used functional MRI (fMRI) and a network model based on graph theory to measure functional connectivity of brain motor network in the resting state in patients with Parkinson's disease (PD). FMRIs were acquired in 22 PD patients before and after levodopa administration, and in age- and sex-matched normal controls. The total connectivity degree of each region within the motor network was calculated and compared between patients and controls. We found that PD patients at off state had significantly decreased functional connectivity in the supplementary motor area, left dorsal lateral prefrontal cortex and left putamen, and had increased functional connectivity in the left cerebellum, left primary motor cortex, and left parietal cortex compared to normal subjects. Administration of levodopa relatively normalized the pattern of functional connectivity in PD patients. The functional connectivity in most of regions in the motor network correlated with the Unified Parkinson's Disease Rating Scale motor score in the patients. Our findings demonstrate that the pattern of functional connectivity of the motor network in the resting state is disrupted in PD. This change is secondary to dopamine deficiency, and related to the severity of the disease. We postulate that this abnormal functional connectivity of motor network in the baseline state is possibly an important factor contributing to some motor deficits in PD, e.g. akinesia.     

Interactions of prefrontal cortex during eyeblink conditioning as a function of age

Changes in regional cerebral blood flow (rCBF) in eleven elderly subjects during pairings of tone and air puff were compared to rCBF changes during pairings in young subjects. Although all subjects reported being aware of the relationship between tone and air puff, elderly subjects did not condition as well as young subjects and their rCBF measures were attenuated. Covarying the performance differences between young and old subjects did not change this conclusion suggesting that differences in neural activation during learning are related to binding of CS-US information prior to the impact of the association on performance. Both groups showed learning-specific rCBF changes in cerebellum, inferior right prefrontal cortex and posterior cingulate. However, only in young subjects were there learning-specific changes in rCBF in left temporal cortex, midbrain, caudate, and inferior left prefrontal cortex. Analysis of learning-dependent patterns of functional connectivity of inferior left prefrontal cortex showed only young subjects had a strong left prefrontal functional connectivity with cerebellum, hippocampus, thalamus and temporal cortex. Thus, beyond changes in regional activity, these data also suggest that age may alter the operations of functional networks underlying learning and memory.     

Cortico-striatal-thalamic network functional connectivity in hemiparkinsonism

Cortico-striatal-thalamic network functional connectivity (FC) and its relationship with levodopa (L-dopa) were investigated in 69 patients with hemiparkinsonism (25 drug-naïve [n-PD] and 44 under stable/optimized dopaminergic treatment [t-PD]) and 27 controls. Relative to controls, n-PD patients showed an increased FC between the left and the right basal ganglia, and a decreased connectivity of the affected caudate nucleus and thalamus with the ipsilateral frontal and insular cortices. Compared with both controls and n-PD patients, t-PD patients showed a decreased FC among the striatal and thalamic regions, and an increased FC between the striatum and temporal cortex, and between the thalamus and several sensorimotor, parietal, temporal, and occipital regions. In both n-PD and t-PD, patients with more severe motor disability had an increased striatal and/or thalamic FC with temporal, parietal, occipital, and cerebellar regions. Cortico-striatal-thalamic functional abnormalities occur in patients with hemiparkinsonism, antecede the onset of the motor symptoms on the opposite body side and are modulated by L-dopa. In patients with hemiparkinsonism, L-dopa is likely to facilitate a compensation of functional abnormalities possibly through an increased thalamic FC.     

慢性失眠患者大脑蓝斑的异常静息态功能连接

目的:利用功能连接方法观察慢性失眠患者静息态下蓝斑的异常功能连接。方法:采集49例慢性失眠患者以及47例性别年龄和受教育程度相匹配的健康对照组的功能磁共振图像,以蓝斑为感兴趣区域,与全脑其他体素进行功能连接分析,得到两组之间功能连接的差异脑区,再对异常连接脑区的功能连接值与临床量表分数做相关分析。结果:与对照组相比,慢性失眠患者蓝斑与右楔前叶皮质、右后扣带回皮质、左颞中回皮质、左距状沟周围皮质、右眶部额上回皮质之间的功能连接增强（P<0.05, FDR校正）,并且蓝斑与左颞中回皮质之间功能连接值与抑郁自评量表呈正相关（P=0.021）。结论:慢性失眠患者蓝斑与多个脑区（主要是默认模式网络）出现的异常功能连接,可能有助于更好地理解慢性失眠的神经生物学机制,可能为失眠的高度唤醒假说提供新的影像学证据。     

Subcortical and deep cortical atrophy in Frontotemporal Lobar Degeneration

Though neuroimaging, pathology and pathophysiology suggest a subcortical and deep cortical involvement in Frontotemporal Lobar Degeneration (FTLD), no studies have comprehensively assessed the associated gray matter (GM) volume changes. We measured caudate, putamen, thalamus, and amygdala GM volume using probabilistic a-priori regions of interest (ROIs) in 53 early FTLD patients (38 behavioral variant FTD [bvFTD], 9 Semantic Dementia [SD], 6 Progressive Non-Fluent Aphasia [PNFA]), and 25 age-matched healthy controls (HC). ANOVA showed significant (P < 0.001) main effect of diagnosis, and significant interactions for diagnosis and region, and diagnosis and hemisphere. Post-hoc comparisons with HC showed bilateral GM atrophy in the caudate, putamen and thalamus, in bvFTD; a left-confined GM reduction in the amygdala in SD; and bilateral GM atrophy in the caudate and thalamus, and left-sided GM reduction in the putamen and amygdala in PNFA. Correlation analyses suggested an association between GM volumes and language, psychomotor speed and behavioral disturbances.This study showed a widespread involvement of subcortical and deep cortical GM in early FTLD with patterns specific for clinical entity.     

Striatal and cortical midline activation and connectivity associated with suicidal ideation and depression in bipolar II disorder

Background

Considerable evidence implicates dysfunction of striatal and cortical midline structure (CMS) circuitry in mood disorders. Whether such aberrations exist in bipolar II depression is unknown.

Methods

Sixteen unmedicated subjects with bipolar II depression and 19 healthy controls were studied using functional MRI and a motor activation paradigm. Analyses of both activation and functional connectivity were conducted.

Results

A history of suicidal ideation (SI) was negatively correlated with activation of the left putamen while depression severity was positively correlated with activation of the left thalamus. The superior bilateral putamen was simultaneously correlated with depression severity and anti-correlated with SI. Striatal functional connectivity was altered with the bilateral CMS and right inferior parietal lobule. Depression severity was correlated with strength of connectivity between the bilateral striatum and the right lingual gyrus and left cerebellum.

Limitations

Only males experiencing an episode of major depression were studied.

Conclusions

Striatal and CMS circuit abnormalities likely contribute to the neurobiology of bipolar II depression. Altered connectivity of the striatum may directly impact depression severity. Further, dissociable components of activation associated with depression severity and suicidal ideation may exist. Finally, the motor activation paradigm used in this study appears to be a useful probe of some neural processes underlying bipolar II depression.