目的观察体外冲击波联合神经阻滞治疗颈源性头痛的临床疗效。方法回顾性分析2019年10月至2021年1月于首都医科大学附属北京天坛医院就诊的60例颈源性头痛患者的临床资料,根据治疗方法不同分为神经阻滞组和冲击波联合神经阻滞组(联合组)...目的观察体外冲击波联合神经阻滞治疗颈源性头痛的临床疗效。方法回顾性分析2019年10月至2021年1月于首都医科大学附属北京天坛医院就诊的60例颈源性头痛患者的临床资料,根据治疗方法不同分为神经阻滞组和冲击波联合神经阻滞组(联合组),每组各30例。比较分析两组患者治疗前、治疗2周后、治疗1个月后的视觉模拟评分法(visual analogue scale,VAS)评分、颈部活动度(range of motion,ROM)评分、睡眠质量(quality of sleep,QS)评分以及两组患者治疗期间的不良反应发生情况。结果与治疗前比较,两组患者治疗2周后、1个月后的VAS评分、ROM评分和QS评分均显著下降(P<0.05);与治疗2周后比较,两组患者治疗1个月后的VAS评分、ROM评分和QS评分均显著降低(P<0.05),且联合组显著低于神经阻滞组(P<0.05)。神经阻滞组有2例患者在首次注射药物后出现短暂性头晕,平卧休息30min后症状逐渐缓解至消失,2例患者在首次注射药物后出现短暂性血压不稳定。联合组有2例患者在首次进行冲击波治疗中出现短暂性恶心,1例患者在首次进行冲击波治疗中出现耳鸣伴心率加快,休息后症状均缓解。两组患者在后续治疗中均无不良反应发生。结论采用体外冲击波联合神经阻滞治疗颈源性头痛安全有效,可显著缓解疼痛,改善颈部活动情况和睡眠质量,且不良反应少,值得临床应用。展开更多
Objective The well-established planar multi-electrode array recording technique was used to investigate neural circuits and temporal plasticity in the hindlimb representation of the rat primary somatosensory cortex （...Objective The well-established planar multi-electrode array recording technique was used to investigate neural circuits and temporal plasticity in the hindlimb representation of the rat primary somatosensory cortex （S1 area） . Methods Freshly dissociated acute brain slices of rats were subject to constant perfusion with oxygenated artificial cerebrospinal fluid （95% O2 and 5% CO2） , and were mounted on a Med64 probe （64 electrodes, 8×8 array） for simultaneous multi-site electrophysiological recordings. Current sources and sinks across all the 64 electrodes were transformed into two-dimensional current source density images by bilinear interpolation at each point of the 64 electrodes. Results The local intracortical connection, which is involved in mediation of downward information flow across layers II-VI, was identified by electrical stimulation （ES） at layers II-III. The thalamocortical connection, which is mainly involved in mediation of upward information flow across layers II-IV, was also characterized by ES at layer IV. The thalamocortical afferent projections were likely to make more synaptic contacts with S1 neurons than the intracortical connections did. Moreover, the S1 area was shown to be more easily activated and more intensively innervated by the thalamocortical afferent projections than by the intracortical connections. Finally, bursting conditioning stimulus （CS） applied within layer IV of the S1 area could success-fully induce long-term potentiation （LTP） in 5 of the 6 slices （83.3%） , while the same CS application at layers II-III induced no LTP in any of the 6 tested slices. Conclusion The rat hindlimb representation of S1 area is likely to have at least 2 patterns of neural circuits on brain slices： one is the intracortical circuit （ICC） formed by interlaminar connections from layers II-III, and the other is the thalamocortical circuit （TCC） mediated by afferent connections from layer IV. Besides, ICC of the S1 area is spatially limited, with less plasticity, while TCC is spatially extensive and exhibits a better plasticity in response to somatosensory afferent stimulation. The present data provide a useful experimental model for further studying microcircuit properties in S1 cortex at the network level in vitro.展开更多
文摘目的观察体外冲击波联合神经阻滞治疗颈源性头痛的临床疗效。方法回顾性分析2019年10月至2021年1月于首都医科大学附属北京天坛医院就诊的60例颈源性头痛患者的临床资料,根据治疗方法不同分为神经阻滞组和冲击波联合神经阻滞组(联合组),每组各30例。比较分析两组患者治疗前、治疗2周后、治疗1个月后的视觉模拟评分法(visual analogue scale,VAS)评分、颈部活动度(range of motion,ROM)评分、睡眠质量(quality of sleep,QS)评分以及两组患者治疗期间的不良反应发生情况。结果与治疗前比较,两组患者治疗2周后、1个月后的VAS评分、ROM评分和QS评分均显著下降(P<0.05);与治疗2周后比较,两组患者治疗1个月后的VAS评分、ROM评分和QS评分均显著降低(P<0.05),且联合组显著低于神经阻滞组(P<0.05)。神经阻滞组有2例患者在首次注射药物后出现短暂性头晕,平卧休息30min后症状逐渐缓解至消失,2例患者在首次注射药物后出现短暂性血压不稳定。联合组有2例患者在首次进行冲击波治疗中出现短暂性恶心,1例患者在首次进行冲击波治疗中出现耳鸣伴心率加快,休息后症状均缓解。两组患者在后续治疗中均无不良反应发生。结论采用体外冲击波联合神经阻滞治疗颈源性头痛安全有效,可显著缓解疼痛,改善颈部活动情况和睡眠质量,且不良反应少,值得临床应用。
基金supported by the National Basic Research Development Program(973)of China(No.2006CB500800)National Innovation Team Program of Ministry of Education(No.IRT0560)National Natural Science Foundation of China(No.30670692 and 30770668)
文摘Objective The well-established planar multi-electrode array recording technique was used to investigate neural circuits and temporal plasticity in the hindlimb representation of the rat primary somatosensory cortex （S1 area） . Methods Freshly dissociated acute brain slices of rats were subject to constant perfusion with oxygenated artificial cerebrospinal fluid （95% O2 and 5% CO2） , and were mounted on a Med64 probe （64 electrodes, 8×8 array） for simultaneous multi-site electrophysiological recordings. Current sources and sinks across all the 64 electrodes were transformed into two-dimensional current source density images by bilinear interpolation at each point of the 64 electrodes. Results The local intracortical connection, which is involved in mediation of downward information flow across layers II-VI, was identified by electrical stimulation （ES） at layers II-III. The thalamocortical connection, which is mainly involved in mediation of upward information flow across layers II-IV, was also characterized by ES at layer IV. The thalamocortical afferent projections were likely to make more synaptic contacts with S1 neurons than the intracortical connections did. Moreover, the S1 area was shown to be more easily activated and more intensively innervated by the thalamocortical afferent projections than by the intracortical connections. Finally, bursting conditioning stimulus （CS） applied within layer IV of the S1 area could success-fully induce long-term potentiation （LTP） in 5 of the 6 slices （83.3%） , while the same CS application at layers II-III induced no LTP in any of the 6 tested slices. Conclusion The rat hindlimb representation of S1 area is likely to have at least 2 patterns of neural circuits on brain slices： one is the intracortical circuit （ICC） formed by interlaminar connections from layers II-III, and the other is the thalamocortical circuit （TCC） mediated by afferent connections from layer IV. Besides, ICC of the S1 area is spatially limited, with less plasticity, while TCC is spatially extensive and exhibits a better plasticity in response to somatosensory afferent stimulation. The present data provide a useful experimental model for further studying microcircuit properties in S1 cortex at the network level in vitro.
