帕金森病患者注意转换能力的研究:任务序列类型的影响(法)

Introduction. The aim of the present study was to investigate the origin of set-shifting deficits observed in Parkinson’s disease (PD). Methods. Seventeen patients diagnosed as having idiopathic PD were compared with 15 control subjects. We used a task-switching paradigm, including two tasks (task A and task B) so that subjects were required to switch either immediately after a switch-trial (i.e. alternating switch or ABA task sequence) or following one or two non-switch trials (ABBA or ABBBA task sequences). Results. In both groups, switch cost (SC) in ABA task sequence was larger than SC in ABBA task sequence (p < 0.05) and SC was larger in ABBA than ABBBA task sequence (p < 0.05). PD patients demonstrated an increased SC compared to controls for alternating switch trials (p < 0.01). Alternatively, when required to switch to a task abandoned two or three trials earlier (i.e. ABBA and ABBBA tasks sequences), patients did not demonstrate increased SC compared to controls. Discussion and conclusion. The fact that SC associated with alternating switch trials was exacerbated in PD patients may reflect difficulties for switching to a recently inhibited task-set. In conclusion, our results indicate that set-shifting deficits in PD patients may depend of the type of task sequence.

业余活动与认知功能障碍的风险:重庆老龄化研究

The authors followed 5,437 people aged 55 years and older with normal baseline Mini-Mental State Examination score annually for 5 years. The mean incidence of cognitive impairment was 2.3%per year. Cognitive activities in both the individual item (playing board games and reading) and the composite measure were associated with the reduced risk of cognitive impairment, while watching television was associated with an increased risk of cognitive impairment.

特立氟胺治疗复发性多发性硬化症安全性和有效性的Ⅱ期研究

Background: Teriflunomide, a dihydro-orotate dehydrogenase inhibitor, has immunomodulatory effects, including the ability to suppress experimental allergic encephalomyelitis. In this randomized, double-blind, placebo-controlled Phase II study, the authors examined the safety and efficacy of oral teriflunomide in multiple sclerosis (MS) with relapses. Methods: Patients (n = 179) with relapsing-remitting MS (n = 157) or secondary progressive MS with relapses (n = 22) were randomized to receive placebo, teriflunomide 7 mg/day, or teriflunomide 14 mg/day for 36 weeks. MRI brain scans were performed every 6 weeks. The primary endpoint was the number of combined unique active lesions per MRI scan. Secondary endpoints included MRI-defined disease burden, relapse frequency, and disability increase. Results: The median number of combined unique active lesions per scan was 0.5, 0.2, and 0.3 in the placebo, teriflunomide 7 mg/day (p < 0.03 vs placebo), and teriflunomide 14 mg/day (p < 0.01 vs placebo) groups during the 36-week double-blind treatment phase. Teriflunomide-treated patients also had significantly fewer T1 enhancing lesions per scan, new or enlarging T2 lesions per scan, and new T2 lesions. Patients receiving teriflunomide 14 mg/day had significantly reduced T2 disease burden. Teriflunomide treatment resulted in trends toward a lower annualized relapse rate and fewer relapsing patients (14 mg/day only) vs placebo. Significantly fewer patients receiving teriflunomide 14 mg/day vs placebo demonstrated disability increase. Treatment was well tolerated; numbers of adverse events and serious adverse events were similar in all treatment groups. Conclusion: Oral teriflunomide was effective in reducing MRI lesions and was well tolerated in patients with relapsing multiple sclerosis.

基底型偏头痛的临床、流行病学及遗传学特点

Background: It remains uncertain whether basilar-type migraine (BM) is a subtype of migraine with typical aura (MTA) or a distinct phenotype or genotype. Objective: To analyze the symptomatology, familial distribution, and genotype of BM. Methods: The authors recruited 105 families comprising 362 patients with MTA or BM (International Classification of Headache Disorders-1 criteria). Among these patients, 38 patients from 29 families had BM. In 12 of the families with BM with an apparently dominant inheritance the authors sequenced all exons of the CACNA1A (chromosome 19) and ATP1A2 (chromosome 1) genes responsible for most cases of the autosomal dominantly inherited familial hemiplegic migraine and performed a linkage analysis of chromosome 1 and 19 with a nonparametric or autosomal dominant parametric model using an affected only analysis. Results: BM occurred in 10%(38/362) of patients with MTA. The basilar-type aura had a median duration of 60 minutes and comprised vertigo 61%, dysarthria 53%, tinnitus 45%, diplopia 45%, bilateral visual symptoms 40%, bilateral paresthesias 24%, decreased level of consciousness 21%, hypacusia 21%, and ataxia 5%. The relative frequency of the individual basilar-type symptoms was not different from patients with hemiplegic migraine from a previous study. The patients with BM were equally distributed among the 105 families with MTA (p = 0.37). The attacks of MTA were identical in families with or without BM. No causative mutations and no linkage was identified. Conclusions: Basilar-type aura seemingly may occur at times in any patient with migraine with typical aura. There is no firm clinical, epidemiologic, or genetic evidence that BM is an independent disease entity different from MTA.