Electroacupuncture at the Wangu (GB 12) acupoint suppresses expression of inflammatory factors in the hippocampus and frontal lobe of rats with post-stroke depression

Electroacupuncture was performed at the Wangu （GB 12） acupoint, whose position is similar to the cerebellar fastigial nucleus in rats with post-stroke depression. Results showed that the expression of nuclear factor-κB and the levels of tumor necrosis factor-α and interleukin-1β decreased. Simultaneously, the extent of edema in the hippocampus and frontal lobe decreased, and the morphology of the nerve cells recovered to near normal. In addition, fluoxetine treatment displayed a similar effect on post-stroke depression as electroacupuncture at GB 12 acupoint. The results indicate that electroacupuncture at GB 12 acupoint can reduce the levels of cytokines in the hippocampus and frontal lobe of rats with post-stroke depression, and thus provide a neuroprotective effect on post-stroke depression.

Combined effects of electroacupuncture and anti-depression drugs on the hippocampus and frontal lobe

Electroacupuncture （EA） has been clinically used to treat depression and has resulted in favorable effects in China. However, results from animal studies and pathology do not reflect the influence of electroacupuncture treatment on in vivo physiological functions. To thoroughly and dynamically observe pathological changes during depression, the present study established EA ＋ fluoxetine and fluoxetine groups to observe depression in patients. 1H-magnetic resonance spectroscopy was utilized to determine the correlation between hippocampal frontal lobe metabolite changes and mental disorder scale. Results revealed significantly increased N-acetylaspartate （NAA）/creatine （Cr） in the bilateral hippocampus and right frontal lobe of depression patients treated with EA compared with fluoxetine. Changes in NAA/Cr in bilateral hippocampus and right frontal lobe in both groups, before and after treatment, negatively correlated with severity and curative effects. Choline/Cr changes in the bilateral frontal lobes of both groups were significant before and after treatment, but negatively correlated with curative effects. Choline/Cr changes in the bilateral hippocampus were significant in the EA ＋ fluoxetine group before and after treatment, but negatively correlated with severity and the curative effects of depression. These results demonstrate abnormal biochemical metabolism in bilateral frontal lobes and hippocampus of depression patients, and show that EA significantly altered biochemical indices in the frontal lobes and hippocampus compared with fluoxetine.

Unilateral Bone Window Cerebral Falx Incision of Bilateral Frontal Lobes Cerebral Contusion and Laceration under Neuroendoscopy and Literature Review

Background: Bilateral frontal lobes cerebral contusion and laceration is one unique brain injury in neurosurgery department. It is characteristic of recessive attacking and develops quickly. The unilateral cerebral falx incision is a new minimally invasive surgery that can solve bilateral frontal lobes cerebral contusion and laceration in one surgery. However, it has some limitations in removal of contralateral frontal hematoma and hemostasis due to the limited field of view under the microscope. The unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy can acquire a good illumination and field of view. This is beneficial to complete removal of contralateral hematoma, effective hemostasis and retaining brain tissue functions to the maximum extent. Case Presentation: The patient, a 55-year-old man, was hospitalized for “consciousness disorder by 12 h because of car accident”. Physical Examination: Coma, GCS score of E1V2M5, bilateral pupil diameter of 2 mm, presence of light response, contusion of scalp at the left top, peripheral dysphoria and bilateral Bartter syndrome negative. The patient has a history of non-traumatic cerebral stroke 3 years ago. Head CT: Longitudinal fracture of frontal parietal occipital bone, bilateral frontal lobes contusion and laceration, subarachnoid hemorrhage. Diagnosis: Bilateral frontal lobes contusion and laceration, longitudinal fracture of frontal parietal occipital bone, subarachnoid hemorrhage and hematoma of scalp. In emergency treatment, unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy was performed. The surgery has achieved satisfying effect. Discussion: This case realized the goal of removing contralateral frontal hematoma through unilateral craniotomy under a neuroendoscopy. Due to the clear field of view, it retained extracerebral layer structures of contralateral olfactory nerve protection frontotemporal completely. Moreover, this surgical technique is conducive to intraoperative recognition of pericallosal arteries and lateral fractured blood vessels. It also involves protection, which conforms to the minimally invasive philosophy. The proposed surgical technology can eliminate contralateral frontal hematoma under a good field of view. However, it is suggested not to manage with the further operation on patients who have brain swelling and difficulties in exposure of cerebral falx. These patients need to determine causes of brain swelling and choose bilateral craniectomy if necessary. Conclusions: Unilateral bone window cerebral falx incision of bilateral frontal lobes cerebral contusion and laceration under a neuroendoscopy is a new application of minimally invasive philosophy in craniocerebral injury operation. It still needs further clinical verifications and experience accumulation.

Spatio-temporal expression of inducible nitric oxide synthase in and surrounding a region of rat frontal lobe damaged with a sharp instrument

BACKGROUND： Inducible nitric oxide synthase （iNOS） cannot be detected in the neurons and glial cells of normal rats, but iNOS can be found in some neurons and glial cells of rats following ischemic, traumatic, neurotoxic or inflammatory damage. OBJECTIVE： To investigate iNOS expression and iNOS-positive cell types at various time points following damage to the rat frontal lobe using a sharp instrument. DESIGN： A nerve molecular biology, randomized, controlled study. TIME AND SETTING： This experiment was performed at the Department of Human Anatomy, Institute of Neurobiology, Medical School of Nantong University, between April 2006 and December 2007. MATERIALS： Rabbit anti-iNOS antibody （Santa Cruz, USA）, biotin labeled goat anti-rabbit antibody （Sigma, USA）, reverse transcription kit （Biouniquer, Hong Kong, China） and horseradish peroxidase labeled goat anti-rabbit antibody （Pierce, USA） were used for this study. METHODS： A total of 112 healthy rats aged 3 months were randomly assigned into a sham operation group （n = 28） and a damage group （n = 84）. Rat models of frontal lobe damage were induced in the damage group using a sharp instrument to make an incision in the frontal lobe cortex. In the sham operation group, the rat bone window was opened but brain tissues were left intact. MAIN OUTCOME MEASURES： Parameters were measured at 3, 6, 12, 24, 72, 120 and 168 hours following damage in both groups. Pathological changes were observed using Nissl staining and hematoxylin-eosin staining. Expression of iNOS mRNA, iNOS protein and iNOS-positive cells were examined by RT-PCR, Western blot analysis and immunohistochemistry, respectively. RESULTS： A large number of inflammatory cells infiltrated the damaged region 12 and 24 hours following damage, iNOS mRNA and iNOS protein expression increased in and around the damaged region 3 hours following damage, reached a peak at 24 hours, and then gradually decreased. The changes in iNOS-positive cell number reflected the changes in iNOS mRNA and iNOS protein expression after damage, iNOS was mainly found in neural cells at 3 and 6 hours, in macrophages at 12 and 24 hours, and in glial cells at 72 and 120 hours after damage. iNOS-positive cells were few in and surrounding the damaged region at 168 hours. There were a few iNOS-positive neural cells in the rat frontal lobe cortex in the sham operation group. CONCLUSION： Neurons, macrophages and glial cells can express iNOS following rat frontal lobe damage caused by a sharp instrument. The levels of iNOS expression, and the cell types expressing iNOS, change with time.

Topographical Analysis of Frontal Lobe Executive Functions in Patients Following a Stroke

Objective: This study aimed to carry out a topographical analysis of frontal lobe executive function components in post-stroke patients. Methods: A descriptive, cross-sectional study. The assessment using the WCST (Wisconsin Card Sorting Test) included sixteen patients with a clinical diagnosis of CVA and frontal lobe impairment. Results from the two groups were compared (patients with right frontal lobe impairment and patients with left frontal lobe impairment). Statistical analysis was performed using the program “Statistical Package for Social Sciences” (SPSS) Version 20.0. For comparison between groups was used Mann-Whitney test and considered the alpha level of 0.05 on the statistically significant results. Results: There was no statistically significant difference between the groups, thus showing that executive functions are symmetrically distributed across the frontal lobes. Conclusion: Executive functions are symmetrically organized across the two frontal lobes, since the comparison between the groups did not demonstrate a statistically significant difference for any of the variables of WSCT.

Obese Adolescents with Type 2 Diabetes Mellitus Have Hippocampal and Frontal Lobe Volume Reductions

The rates of type 2 diabetes (T2DM) continue to parallel the rising rates of obesity in the United States, increasingly affecting adolescents as well as adults. Hippocampal and frontal lobe reductions have been found in older adults with type 2 diabetes, and we sought to ascertain if these brain alterations were also present in obese adolescents with T2DM. In a cross-sectional study we compared MRI-based regional brain volumes of 18 obese adolescents with T2DM and 18 obese controls without evidence of marked insulin resistance. Groups were matched on age, sex, school grade, ethnicity, socioeconomic status, body mass index, and waist circumference. Relative to obese controls, adolescents with T2DM had significantly reduced hippocampal and prefrontal volumes, and higher rates of global cerebral atrophy. Hemoglo-bin A1c, an index of long-term glycemic control, was inversely associated with prefrontal volume and positively associ-ated with global cerebral atrophy (both p < 0.05). Brain integrity is negatively impacted by T2DM already during ado-lescence, long before the onset of overt macrovascular disease. Paralleling the findings of greater vascular and renal complications among obese adolescents with severe insulin resistance and T2DM relative to their age-matched peers with type 1 diabetes, we find clear evidence of possible brain complications. Our findings call for aggressive and early intervention to limit the negative impact of obesity-associated insulin resistance leading to T2DM on the developing brains of adolescents.

Alterations of Cerebral Functional Connectivity in Patients with Frontal Lobe Epilepsy:A Graph Theory Study

The aim of the present study is to investigate the brain functional network changes of patients with frontal lobe epilepsy(FLE)by resting-state functional magnetic resonance imaging(rsfMRI)and graph theoretical analysis.rsfMRI is performed in 46 adult patients with FLE and 46 age matched healthy controls(HCs).A functional network is built from these subjects,and the topological properties of such network are analyzed quantitatively using graph theoretical methods.According to the results,both FLE patients and HCs exhibit prominent small world features.Compared with HCs,FLE shows a decrease in local efficiency(Eloc),clustering coefficient,nodal efficiency as well as nodal degree.Furthermore,FLE(seven)has fewer hubs than HCs(ten).The functional abnormalities in the network organization suggest functional disturbances in patients with FLE.This study helps to gain new insights into the functional disorder in patients with FLE.The networks built here can also be a set of potential biomarkers for the diagnosis,monitoring and the treatment of FLE.

Adult-Onset Adrenoleukodystrophy with Frontal Lobe Symptoms: A Case Report

ALD, which is the X-linked adrenoleukodystrophy (X-ALD), is a rare inherited metabolic disease caused by an enzyme deficiency leading to accumulation of saturated very long chain fatty acid (VLCFA), especially in brain and adrenal cortex. Its prevalence is currently estimated at 1:30,000 to 50,000 in males in Japan. We report a 34-year-old man, who acts of theft, peep and obscenity with adult onset cerebral adrenoleukodystrophy (ALD). An elevated VLCFA and a point mutation in the ABCD1 gene confirmed the diagnosis of ALD. Diffusion-weighted MRI revealed a high intensity area in the white matter of the frontal lobes. T2-weighted image revealed diffuse high signal intensity in the deep white matter. MR diffusion-weighted image revealed high signal intensity area in the white matter of the frontal lobes.?Proton magnetic resonance spectroscopy?(H-MRS) of the white matter of the frontal lobes revealed an extreme decrease of?N-acetylaspartate (NAA) and an increase of the choline (Cho)/creatinine (Cr) ratio. The mild?hypoperfusion was detected in the both cerebral hemispheres by the single photon emission CT (SPECT). The genetic phenotype was detected and he was diagnosed adult onset ALD. The only neurological sign was deviant behaviors as frontal lobe symptoms;despite a diffuse high signal intensity was detected in the deep white matter in the MRI examination. Psychiatric symptomatology is presented and may be one of the earliest manifestations of ALD. Psychiatrists as well as and physicians may encounter ALD.

Intracranial pressure monitoring for special patterns of frontal lobe contusions

Objective： To study the effect and indications ofintracranial pressure （ICP） monitoring for frontal lobe contusion patients. Methods： During January 2005-December 2008, 34 cases of frontal lobe contusion received ICP monitoring in our department （monitoring group）. Different treatment protocols were adopted according to the results of ICP. Mean-while 46 cases of same type of head-injured patients who did not undergo ICP monitoring served as control group. Results： We found that ICP elevated dramatically within 24 hours after head injury if the contusions were located in frontal longitudinal dehiscence, bilateral undersurface of frontal lobe or dispersed in bilateral lobe. After half a year follow-up and on the basis of Glasgow Coma Scale assessment, the monitoring group showed better outcome than the control group with good recovery in 24 cases （70.6%）, moderate disability in 7 cases （20.6%）, severe disability in 2 （5.88%） and death in 1 （2.94%）. The outcome of control group displayed good condition in 25 cases （54.3%）, moderate disabilities in 8 （17.4%）, severe disability in 7 （15.2%）, and death in 6 （13.0%）. Conclusions： Frontal lobe contusions are vulnerable and complex head injuries, especially when the contusions are located in frontal longitudinal dehiscence, bilateral undersurface of frontal lobe or diffused in bilateral lobes. These patients should undergo ICP monitoring regardless of their consciousness status. IflCP elevates over 25 mm Hg, the craniotomy is mandatory and will markedly reduce the mortality and disability of these patients.

Frontal lobe position after single-layer cadaveric dermal matrix repair of large anterior skull base defects

Objective:Endoscopic repair of large anterior skull base(ASB)defects has excellent results when using multilayered repairs with a nasoseptal flap.However,in extensive intranasal tumors,a nasoseptal flap may not always be available.One alternative option is a flexible single-layer ASB repair.Initial studies indicate low cerebrospinal fluid leak rates with a single-layer repair.However,the level of frontal lobe support,particularly the propensity for a significant inferior displacement of the frontal lobe,is not known.The goal of this study is to determine the frontal lobe position after single-layer acellular dermal allograft repair in large ASB defects.Study Design:Retrospective cohort study.Setting:Tertiary care medical center.Subjects and Methods:This cohort study compares the frontal lobe position in adults who underwent endoscopic endonasal ASB tumor resection and single-layer cadaveric dermal matrix repair(ASB cohort)with control subjects without intracranial abnormalities(control cohort).The ASB cohort includes subjects with an ASB defect of≥5 cm anterior/posterior and≥1.5 cm wide and who had imaging at least 2 months after surgery.The frontal lobe position is measured on sagittal CT/MRI using a reference line from the base of the sella to the nasion.A value of zero indicates that the inferior-most aspect of the frontal lobe is at the level of the nasion-sellar line.A positive value indicates that the frontal lobe is inferior to the nasion-sellar line.The ASB cohort frontal lobe position is compared with the control cohort using the Mann-WhitneyU test.A priori we set an absolute difference of 5 mm as a clinically significant difference.Results:The ASB cohort includes 47 subjects who are 57%male with an average age of 60 years(range:31-89 years).The most common ASB pathology is esthesioneuroblastoma(n=21)and 81%of the ASB cohort had postoperative radiation.The control cohort includes 20 subjects who are 60%male,with a mean age of 45 years(range:19-74 years).The majority of controls underwent imaging for head trauma(n=13).The ASB mean frontal lobe position is-0.2 mm superior to the nasion-sellar line(range:-9.2 to 10.4 mm),while the control’’s mean frontal lobe position is 1.1 mm inferior to the nasion-sellar line.This difference is not statistically significant(P=0.13)and does not reach our a priori definition of clinical significance.The frontal lobe position of ASB subjects who had radiation is closer to the nasion-sellar line as compared with those who did not undergo radiation.Conclusions:Single-layer acellular dermal graft repair maintains frontal lobe support and position in large ASB defects.

Frontal assessment battery: A tool for screening minimal hepatic encephalopathy?

AIMTo apply the Frontal Assessment Battery to cirrhotic patients with or without overt hepatic encephalopathy (OHE) and controls. METHODSThe frontal assessment battery (FAB) was applied to 87 patients with liver cirrhosis (16 with and 71 without OHE) and 40 control subjects without cirrhosis treated at the alcohol and liver outpatient clinics and the gastroenterology ward of the Cassiano Antônio de Moraes University Hospital (Hospital Universit&aacute;rio Cassiano Antônio de Moraes - HUCAM), Esp&iacute;rito Santo, Brazil. RESULTSThe average FAB score was lower for the cirrhotic than for the non-cirrhotic patients (10.6 &plusmn; 3.67 vs 12.25 &plusmn; 2.72, P = 0.015). The FAB score was lower for the cirrhotic patients with OHE than for the patients without OHE (8.25 &plusmn; 4.55 vs 11.14 &plusmn; 3.25, P = 0.027). The total FAB score was lower for the cirrhotic patients without OHE than for the non-cirrhotic patients, although this difference was not significant (11.14 &plusmn; 3.25 vs 12.25 &plusmn; 2.72, P = 0.067). Nevertheless, the difference in the scores on the subtest that assessed the ability to inhibit a response previously conditioned to a stimulus was significant (1.72 &plusmn; 0.93 vs 2.2 &plusmn; 0.85, P = 0.011). CONCLUSIONThe present study indicates that the FAB is a promising tool for outpatient minimal HE screening and the assessment of HE severity.

原发性早泄中枢丘脑-额叶-躯体感觉皮层环路MRI研究进展

原发性早泄(lifelong premature ejaculation,LPE)是男性最常见的性功能障碍疾病,但中枢发病机制尚不明确。近年来,研究人员借助多模态磁共振成像(magnetic resonance imaging,MRI)技术检测和分析了LPE患者大脑结构和功能的特定变化,尤其是与奖赏系统相关的丘脑-额叶环路,以及参与射精周期的躯体感觉皮层。本文将基于丘脑-额叶-躯体感觉皮层环路对LPE患者的大脑MRI研究发现进行综述,探寻丘脑-额叶-躯体感觉皮层环路在LPE中枢神经系统中的作用机制,为开辟新的早泄评估和疗效评价方法提供科学依据。

强迫症反应抑制缺陷(综述)

强迫症是一种常见的高致残性精神障碍,伴随多种认知功能的缺陷。其中,反应抑制缺陷可能是强迫症的一种潜在的内表型,对于理解强迫症的病理生理机制和开发新的临床治疗方法具有重要意义。本文综述了强迫症反应抑制缺陷及其神经机制和临床干预效果,以期为进一步理解强迫症反应抑制缺陷和促进强迫症的临床诊疗提供依据。

经外侧裂-岛叶入路显微手术与经额叶入路血肿清除术对高血压性基底节区脑出血患者神经功能损伤的影响

目的探讨高血压性基底节区脑出血患者应用经外侧裂-岛叶入路显微手术与经额叶入路血肿清除术对神经功能损伤的影响。方法回顾性分析广西河池市人民医院2019-01—2022-12收治的121例高血压性基底节区脑出血患者的临床资料,分为A组61例(经外侧裂-岛叶入路显微手术)与B组60例(经额叶入路血肿清除术)。比较2组患者神经功能损伤指标水平及其他相关指标。结果2组患者手术时间、住院时间比较无统计学差异(P>0.05);A组术后意识恢复时间(5.11±0.89)h,短于B组的(6.03±0.73)h,术中出血量(37.21±4.27)mL,少于B组的(39.82±4.41)mL,48 h血肿清除率(90.06±3.44)%,大于B组的(88.69±4.02)%,差异均有统计学意义(t=6.178、3.299、2.017,P<0.05);A组临床总有效率98.36%(60/61),高于B组的86.67%(52/60)(χ^(2)=4.460,P=0.035);术后3 d,2组患者S-100β蛋白(S-100β)、神经元特异性烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)水平均较术前下降,且A组低于B组(P<0.05);2组患者术后并发症发生率比较无统计学差异(P>0.05);术后3个月,A组格拉斯哥预后量表(GOS)评分高于B组(P<0.05);2组患者术后6个月GOS评分比较无明显差异(P>0.05)。结论相比于经额叶入路血肿清除术,应用经外侧裂-岛叶入路显微手术可更有效促进高血压性基底节区脑出血患者神经功能损伤恢复,减少术中出血量,提高血肿清除率及临床疗效,且能够显著改善患者近期预后。

基于静息态功能磁共振成像观察电针治疗AIS患者的即刻脑网络变化

目的采用静息态功能磁共振成像(resting-state functional magnetic resonance imaging,rs-fMRI)技术及独立成分分析(independent component analysis,ICA)方法探讨急性缺血性脑卒中(acute ischemic stroke,AIS)患者即刻感觉运动网络(sensory motor network,SMN)及默认网络(default mode network,DMN)变化。材料与方法纳入27例AIS患者和27例健康对照(health controls,HC),评估每位受试者相关临床量表并采集基线rs-fMRI数据,对AIS组进行电针刺激治疗后即刻进行磁共振扫描,采集相关rs-fMRI数据。运用ICA方法提取出SMN及DMN网络成分。比较患者与健康对照者的功能连接变化,以及针刺前后的功能连接变化;将变化值与临床量表评分变化值进行相关性分析;再将差异脑区作为种子点,计算其与全脑的功能连接(functional connectivity,FC)。结果针刺前,AIS组左侧前额叶相对于HC组功能连接增加(P<0.001),左侧顶下小叶(Z=4.38,P<0.001)、右侧后扣带回(Z=4.87,P<0.001)功能连接减低;左侧顶下小叶(P<0.001)、左侧后扣带回(P<0.001)、左侧额叶(P<0.001)FC值增加,部分小脑区域FC值增加(P<0.001)。针刺后,AIS组右侧前额叶功能连接明显增加(P<0.001),针刺前后差值与Fugl-Meyer运动功能评分(Fugl-Meyer Assessment,FMA)差值呈强正相关(r=0.842,P<0.001);AIS组右侧丘脑(Z=4.38,P<0.001)及左额叶(P<0.001)FC值显著增加。结论AIS患者存在边缘系统(后扣带回、海马)-丘脑-皮层(顶下小叶-额叶)神经环路脑功能活动异常;电针治疗可即刻调节AIS患者的脑自发活动,涉及运动完成相关脑区,可能是电针治疗AIS的脑功能潜在靶点脑区。

功能近红外光谱技术应用于脑老化前额叶功能特征分析的研究进展

脑老化是与年龄增长相关的正常的中枢神经系统退行性改变,与认知、步行和平衡功能的退化密切相关。前额叶(PFC)是参与功能代偿的主要脑区之一,对脑老化带来的功能退化有主要调控作用。利用近年来新兴的功能性近红外光谱技术(fNIRS),同步认知、步行和平衡任务可进行动态监测前额叶和其他脑区的皮质血流氧合血红蛋白和脱氧血红蛋白的浓度,并进一步结合血管耦合机制进行脑功能分析,可深入探讨前额叶在脑老化中的调控机制,旨在为今后相关临床实践和研究提供参考。

磁共振扩散张量成像对卒中后抑郁的诊断价值

目的应用扩散张量成像研究卒中后抑郁(PSD)患者小脑、额叶及边缘系统(扣带回、海马、杏仁核)结构发生的改变,进一步证实小脑参与PSD的发生,并研究小脑与传统抑郁相关部位如额叶、边缘系统(扣带回、海马、杏仁核)的相关性。资料与方法回顾性选取2020年10月—2021年10月锦州医科大学附属第一医院首次基底节区梗死患者39例,行汉密尔顿抑郁量表(HAMD)评定后分为PSD组19例与非PSD组20例,随机选取入组基础信息差异无统计学意义的20人作为正常对照组,应用扩散张量成像扫描测定感兴趣区的各向异性分数(FA)值及表观扩散系数。比较3组病灶及病灶对侧感兴趣区的FA值,并分析其与HAMD评分的相关性。结果PSD组前额叶、海马、扣带回及胼胝体膝部的病灶侧,小脑中脚、小脑下脚的病灶对侧,与非PSD组及正常对照组相应感兴趣区的FA值比较,差异有统计学意义(t=0.12~0.06,P<0.05)。小脑、额叶、边缘系统的FA值改变与HAMD评分均呈显著负相关(R^(2)_(调整)=0.954,P<0.05)。PSD患者小脑中脚对侧FA值与病灶侧的前额叶、海马、扣带回及胼胝体膝部FA值呈显著正相关(r=0.977、0.752、0.637、0.539,P均<0.05)。结论PSD患者小脑白质纤维束可能发生改变,且与传统抑郁相关部位具有相关性。

左侧额叶CT值与偏执型精神分裂症患者阳性和阴性症状量表评分病程的相关性

目的分析左侧额叶CT值与偏执型精神分裂症患者阳性和阴性症状量表(PANSS)评分、病程的相关性。方法选定平顶山市精神病医院2022年1月至2024年1月就诊的120例偏执型精神分裂症患者设为观察组,以及同期体检中心120名健康体检者设为健康组,均给予头颅CT扫描,比较2组左侧额叶CT值,比较PANSS阳性(PANSS>1分)、阴性组(PANSS≤1分)患者左侧额叶CT值,比较不同病程(<1年、≥1年)组左侧额叶CT值,Pearson分析左侧额叶CT值与PANSS评分、病程的相关性。结果观察组左侧额叶CT值较健康组更低(P<0.05)。PANSS阳性组左侧额叶CT值与PANSS阴性组比较,差异无统计学意义(P>0.05)。病程≥1年组左侧额叶CT值与病程<1年组比较,差异无统计学意义(P>0.05)。左侧额叶CT值与PANSS评分、病程均呈负相关性(r=-0.441、-0.409,P=0.025、0.031)。结论偏执型精神分裂症患者左侧额叶CT值异常偏低,左侧额叶CT值与PANSS评分、病程均呈负相关性,可辅助临床对患者病情作出评价。

从针刺太冲穴治疗抑郁症探讨肝经与额叶联系的静息态功能磁共振研究

目的探讨针刺太冲穴治疗抑郁症的机制及肝经与额叶的联系。方法将符合美国精神疾病诊断与统计手册第4版(DSM-Ⅳ)抑郁症诊断标准的42例首发中度抑郁症患者分为药物组(氟西汀)、针药组(太冲穴联合氟西汀)及针刺组(太冲穴),每组14例,疗程均为1个月,运用3.0T磁共振方法,分别对相应脑区治疗前后进行静息态功能磁共振扫描,采用比率低频振幅(fractional amplitude of low frequency fluctuations,fALFF)的方法分析数据,各组治疗前后进行配对t检验比较,并将治疗后的图像与汉密尔顿(HAMD)评分做相关分析。结果与本组治疗前比较,针药组左侧额叶(BA6、BA9、BA48)、右侧额叶(BA4、BA46)、双侧顶下小叶(BA40、BA48)、楔前叶(BA7)、后扣带回(BA31)、左侧枕叶(BA17)及右侧枕叶中部(BA18)的fALFF值降低(P<0.05);药物组右侧顶下小叶(BA40)和右侧枕叶(BA17)的fALFF值降低(P<0.05);针刺组左侧额叶(BA10)、右侧额叶(BA45)、左侧枕叶(BA19)、右侧枕叶中部(BA17)、左侧楔前叶(BA7),后扣带回(BA31)的fALFF值降低(P<0.05)。针药组及针刺组的左侧额叶fALFF值均与HAMD评分呈正相关;药物组左侧额中回、左侧顶叶、左侧枕叶fALFF值与HAMD评分呈正相关。结论针刺联合抗抑郁药的疗效优于单一的针刺或药物治疗;额叶功能的改变与病情程度相关;肝经与额叶之间存在较为广泛的联系,可能是针刺太冲穴治疗抑郁症的机制。

额叶癫癎的临床特征和脑电图分析

目的 分析和总结额叶癫的临床特征、脑电图特点及临床意义。方法 对 94例额叶癫患者的临床和脑电图资料进行分析 ,并对 42例患者进行 6个月至 4年的随访观察。结果 94例患者中 ,无明确病因者 61例 ,有明确病因者 33例 ,头颅外伤、脑炎、肿瘤是最常见的因素。额叶癫临床发作形式复杂多样 ,有局灶性运动发作、不对称强直以及伴过度运动的额叶发作等 ,睡眠中发作多见 ,脑电图也表现为多在睡眠中出现的异常放电。 42例随访的病人 ,30例临床得到很好控制 ,1 2例有难治性趋势。结论 额叶癫是一组临床表现复杂多样具有特征性的综合征 。