BACKGROUND: Neonatal cerebral palsy is mainly caused by prenatal factors. At present, an animal model of prenatal infection and early postnatal hypoxia does not exist. OBJECTIVE: To observe morphology and motor perf...BACKGROUND: Neonatal cerebral palsy is mainly caused by prenatal factors. At present, an animal model of prenatal infection and early postnatal hypoxia does not exist. OBJECTIVE: To observe morphology and motor performance following prenatal infection and hypoxic insult-induced brain damage of neonatal rats to verify the feasibility to establish a model of cerebral palsy. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Laboratories of Xinjiang Center for Disease Control and Prevention from September 2007 to June 2008. MATERIALS: The hypoxic incubator was purchased from Shanghai Pediatric Medical Institute, China. Lipopolysaccharide (LPS, Escherichia coil, 055: B5) was purchased from Sigma-Aldrich (St. Louis, MO, USA). METHODS: A total of 27 Wistar rats, aged 7 days, were randomly assigned to sham-surgery group (n = 15) with no carotid artery incision or hypoxia treatment, hypoxia/ischemia (H/I) group (n = 12) undergoing ligature of the right common carotid artery followed by exposure to hypoxia at postnatal day 7 (P7), and LPS/H group (n = 19), in which pregnant rats were exposed in utero to LPS followed by prenatal hypoxia at embryonic day 16. MAIN OUTCOME MEASURES: Behavior, compound muscle action potential, and pathological changes were observed in 28-day-old rats. RESULTS: The footprint repeat space showed that left limb footprint repeatability in the H/I and LPS/H groups was lower than in the sham-surgery group (P 〈 0.05). The space between the footprints was larger and unstable. Hind limb quadricep compound muscle action potential in the H/I and LPS/H groups showed lower wave amplitude compared with the sham-surgery group (P〈 0.05) Hematoxylin and eosin staining showed irregular cells around the ventricle, as well as periventricular leukomalacia. CONCLUSION: An animal model of cerebral palsy was established, which simulated the human condition most likely associated with occurrence of this disease. This model could be used for experimental studies related to cerebral palsy.展开更多
BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 ...BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.展开更多
Animal models of cerebral palsy established by simple infection or the hypoxia/ischemia method cannot effectively simulate the brain injury of a premature infant. Healthy 17-day-pregnant Wistar rats were intraperitone...Animal models of cerebral palsy established by simple infection or the hypoxia/ischemia method cannot effectively simulate the brain injury of a premature infant. Healthy 17-day-pregnant Wistar rats were intraperitoneally injected with lipopolysaccharide then subjected to hypoxia. The pups were used for this study at 4 weeks of age. Simultaneously, a hypoxia/ischemia group and a control group were used for comparison. The results of the footprint test, the balance beam test, the water maze test, neuroelectrophysiological examination and neuropathological examination demonstrated that, at 4 weeks after birth, footprint repeat space became larger between the forelimbs and hindlimbs of the rats, the latency period on the balance beam and in the Morris water maze was longer, place navigation and ability were poorer, and the stimulus intensity that induced the maximal wave amplitude of the compound muscle action potential was greater in the lipopolysaccharide/hypoxia and hypoxia/ischemia groups than in the control group. We observed irregular cells around the periventricular area, periventricular leukomalacia and breakage of the nuclear membrane in the lipopolysacchadde/hypexia and hypoxia/ischemia groups. These results indicate that we successfully established a Wistar rat pup model of cerebral palsy by intraperitoneal injection of lipopolysaccharide and hypoxia.展开更多
Neonatal hypoxic-ischemic brain injury is the main cause of hypoxic-ischemic encephalopathy and cerebral palsy.Currently,there are few effective clinical treatments for neonatal hypoxic-ischemic brain injury.Here,we i...Neonatal hypoxic-ischemic brain injury is the main cause of hypoxic-ischemic encephalopathy and cerebral palsy.Currently,there are few effective clinical treatments for neonatal hypoxic-ischemic brain injury.Here,we investigated the neuroprotective and molecular mechanisms of exogenous nicotinamide adenine dinucleotide,which can protect against hypoxic injury in adulthood,in a mouse model of neonatal hypoxic-ischemic brain injury.In this study,nicotinamide adenine dinucleotide(5 mg/kg)was intraperitoneally administered 30 minutes befo re surgery and every 24 hours thereafter.The results showed that nicotinamide adenine dinucleotide treatment improved body weight,brain structure,adenosine triphosphate levels,oxidative damage,neurobehavioral test outcomes,and seizure threshold in experimental mice.Tandem mass tag proteomics revealed that numerous proteins were altered after nicotinamide adenine dinucleotide treatment in hypoxic-ischemic brain injury mice.Parallel reaction monitoring and western blotting confirmed changes in the expression levels of proteins including serine(or cysteine)peptidase inhibitor,clade A,member 3N,fibronectin 1,5'-nucleotidase,cytosolic IA,microtubule associated protein 2,and complexin 2.Proteomics analyses showed that nicotinamide adenine dinucleotide ameliorated hypoxic-ischemic injury through inflammation-related signaling pathways(e.g.,nuclear factor-kappa B,mitogen-activated protein kinase,and phosphatidylinositol 3 kinase/protein kinase B).These findings suggest that nicotinamide adenine dinucleotide treatment can improve neurobehavioral phenotypes in hypoxic-ischemic brain injury mice through inflammation-related pathways.展开更多
Spastic cerebral palsy is generally considered to result from cerebral cortical or pyramidal tract damage. Here, we precisely targeted the left pyramidal tract of 2-month-old Sprague-Dawley rats placed on a stereotaxi...Spastic cerebral palsy is generally considered to result from cerebral cortical or pyramidal tract damage. Here, we precisely targeted the left pyramidal tract of 2-month-old Sprague-Dawley rats placed on a stereotaxic instrument under intraperitoneal anesthesia. Based on the rat brain stereotaxic map, a 1-mm hole was made 10 mm posterior to bregma and 0.8 mm left of sagittal suture. A microsyringe was inserted perpendicularly to the surface of the brain to a depth of 9.7 mm, and 15 wL of ethanol was slowly injected to establish a rat model of spastic cerebral palsy. After modeling, the rats appeared to have necrotic voids in the pyramidal tract and exhibited typical signs and symptoms of flexion spasms that lasted for a long period of time. These findings indicate that this is an effective and easy method of establishing a rat model of spastic cerebral palsy with good reproducibility. Ethanol as a chemical ablation agent specifically and thoroughly damages the py- ramidal tract, and therefore, the animals display flexion spasms, which are a typical symptom of the disease.展开更多
OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2...OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION: Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.展开更多
BACKGROUND: In the process of early screening and interventions to high risk infants with brain damage, the occasion and choosing methods of interventions and the combined application of different interventions are s...BACKGROUND: In the process of early screening and interventions to high risk infants with brain damage, the occasion and choosing methods of interventions and the combined application of different interventions are still at the exploratory phase. OBJECTIVE: To observe the efficacy of early intervention using Vojta and Bobath combined treatment in high risk infants with brain damage, and investigate the effect of early rehabilitation on the prognosis. DESIGN: A randomized controlled comparative observation. SETTING: Daqing Oil Field General Hospital of Heilongjiang Province. PARTICIPANTS: Eighty-four high risk infants younger than l year were selected from the Department of Pediatrics, Daqing Oil Field General Hospital of Heilongjiang Province from October 2005 to October 2006, including 52 boys (62%) and 32 girls (38%). The treatment started at the age of 0 - 3 months in II cases (13%), 4 - 6 months in 28 cases (33%), 7 - 9 months in 35 cases (42%), and 10 - 12 months in 10 cases (1 2%). Infants with at least two of the followings were enrolled, including 7 Vojta abnormal postural reflexes, slow or disorder of motor development, increase of muscular tension, postural abnormality, primary reflection residual and CT/MRI abnormalities. Informed consents were obtained from their guardians. The 84 infants were randomly divided into treatment group (n =42) and control group (n =42). METHODS: All the children were intravenously injected with cerebroprotein hydrolysate injection or cattle encephalon glycoside and ignotin injection, 10 times as a course for 2 - 5 courses; Besides, the infants in the treatment group also received early rehabilitative training of Vojta and Bobath combined treatment, once a day, 40 minutes per time, 5 times a week followed by a 2-day rest, 1 month as a course, and totally 2 - 5 courses. The Vojta method was to facilitate the automatic regulation by reflexlocomotion. Bobath method was to inhibit abnormal posture but facilitate the normal one, thus it is also called neurodevelopmental therapy realized by reflex inhibition and facilitation. The rehabilitation was evaluated clinically using Gesell Development Schedules (GDS) after the courses when the infants were 1 year old. GDS included five aspects of adaptive behavior, gross motor, refine motor, speech, individual-social behavior. The developmental quotient (DQ) could be calculated according to their development. DQ=developmental age/actual age × 100, 〈 85 points was taken as abnormal; The higher the DQ value, the better the development. (2) Evaluation of efficacy: Cured: Developmental order reached normal or generally normal, abnormal posture disappeared, muscular tension ameliorated, symmetric limbs' motor function, free movement, normal intelligence, powerful reaction, and clear speech. Significant effect: Developmental order tended to normal, abnormal posture disappeared incompletely, muscular tension ameliorated incompletely, transient pause in the flexion and extension of limbs, good reaction, and improved intelligence. Effective: Developmental order improved to a certain degree, muscular tension ameliorated, limbs' motor function and posture improved as compared with before treatment, but still under control, intelligence improved a little. Invalid: No obvious changes before and after treatment. Total significant effective rate=(cured cases+cases of significant effect)/total cases × 100%. (3) The enumeration data and measurement data were compared with chi-square test and t test respectively. MAIN OUTCOME MEASURES: Clinical efficacy and GDS results at 1 year old in both groups. RESUTLS: All the 84 infants were involved in the analysis of results. (1) Efficacy: The total significant effective rate in the treatment group was higher than that in the control group (93%, 74%, x^2=4.2, P 〈 0.05). (2) Results of GDS evaluation: The DQ values of individual intercourse and social adaptation in the treatment group (93.57±11.23, 95.13±9.32) were higher than those in the control group (88.27±10.18, 90.10±10.67, t =2.267, 2.301, P 〈 0.05); The DQ values of gross motor, fine motor and speech in the treatment group (90.78±10.20, 98.63±9.23, 93.69±11.31) were higher than those in the control group (84.32± 11.33, 87.80±8.61, 85.52±10.61, t =2.746, 5.560, 2.746, P 〈 0.01). The interventional effects on each functional area were significant, especially the gross motor, fine motor and speech. CONCLUSION: The Vojta and Bobath combined treatment on the basis of drug therapy can improve the general developments of abilities in motor, intelligence, social intercourse, social adaptation and speech of high risk infants with brain damage, also can improve the curative efficacy.展开更多
There is great interest in the regenerative potential of the neural stem cells and progenitors that populate the subventricular zone(SVZ). However, a comprehensive understanding of SVZ cell responses to brain injuri...There is great interest in the regenerative potential of the neural stem cells and progenitors that populate the subventricular zone(SVZ). However, a comprehensive understanding of SVZ cell responses to brain injuries has been hindered by the lack of sensitive approaches to study the cellular composition of this niche. Here we review progress being made in deciphering the cells of the SVZ gleaned from the use of a recently designed flow cytometry panel that allows SVZ cells to be parsed into multiple subsets of progenitors as well as putative stem cells. We review how this approach has begun to unmask both the heterogeneity of SVZ cells as well as the dynamic shifts in cell populations with neonatal and pediatric brain injuries. We also discuss how flow cytometric analyses also have begun to reveal how specific cytokines, such as Leukemia inhibitory factor are coordinating SVZ responses to injury.展开更多
The physiological markers of 310 individuals aged 2 through 19 were evaluated for the effects of the Masgutova Neurosensorimotor Reflex Integration Method on their four body systems: respiratory, cardiovascular, diges...The physiological markers of 310 individuals aged 2 through 19 were evaluated for the effects of the Masgutova Neurosensorimotor Reflex Integration Method on their four body systems: respiratory, cardiovascular, digestive, and nervous systems of individuals with neurodevelopmental deficits—cerebral palsy (CP), seizures, traumatic and acute brain injury, attention deficit and hyperactive disorders (ADD, ADHD), autism spectrum disorders, anxiety, post-trauma and post-traumatic stress disorders. We found that 53.33% of physiological markers and 66.67% of reflex patterns on the pre-test demonstrated to be poorly functioning. Both evaluation results showed statistically significant improvements after 8-days of intensive training using the Masgutova Neurosensorimotor Reflex Integration Method. Improvements according to 60.0% of the physiological markers positively correlated with functionality gains in 77.5% of reflex patterns in all four study groups compared to the control group, which did not receive the Reflex Integration training program (p-value < 0.05). The magnitude of improvement depended upon the severity of symptoms indicating the essentiality for individualized training in accordance with the diagnosis and individual neurological deficits. Results of this study show that reflex integrative techniques can lead to a reduction of stress and other negative factors blocking health homeostasis, limiting perception, and causing dysregulation in behavior and emotions, especially following traumatic events. Positive changes in physiological markers and reflex pattern functions indicate potential benefits for survival and stress resiliency through supporting neuro-physiological and neuro-psychological aspects of overall health and well-being in individuals with neurological deficits.展开更多
基金the National Natural Science Foundation of China,No.30960393Key Foundation in Science and Technology of Xinjiang Uygur Autonomous Region,No.200633128(2)the Youth Science and Technology Foundation of Health Department of Xinjiang Uygur Autonomous Region,No.2007Y26
文摘BACKGROUND: Neonatal cerebral palsy is mainly caused by prenatal factors. At present, an animal model of prenatal infection and early postnatal hypoxia does not exist. OBJECTIVE: To observe morphology and motor performance following prenatal infection and hypoxic insult-induced brain damage of neonatal rats to verify the feasibility to establish a model of cerebral palsy. DESIGN, TIME AND SETTING: A randomized, controlled, animal experiment was performed at the Laboratories of Xinjiang Center for Disease Control and Prevention from September 2007 to June 2008. MATERIALS: The hypoxic incubator was purchased from Shanghai Pediatric Medical Institute, China. Lipopolysaccharide (LPS, Escherichia coil, 055: B5) was purchased from Sigma-Aldrich (St. Louis, MO, USA). METHODS: A total of 27 Wistar rats, aged 7 days, were randomly assigned to sham-surgery group (n = 15) with no carotid artery incision or hypoxia treatment, hypoxia/ischemia (H/I) group (n = 12) undergoing ligature of the right common carotid artery followed by exposure to hypoxia at postnatal day 7 (P7), and LPS/H group (n = 19), in which pregnant rats were exposed in utero to LPS followed by prenatal hypoxia at embryonic day 16. MAIN OUTCOME MEASURES: Behavior, compound muscle action potential, and pathological changes were observed in 28-day-old rats. RESULTS: The footprint repeat space showed that left limb footprint repeatability in the H/I and LPS/H groups was lower than in the sham-surgery group (P 〈 0.05). The space between the footprints was larger and unstable. Hind limb quadricep compound muscle action potential in the H/I and LPS/H groups showed lower wave amplitude compared with the sham-surgery group (P〈 0.05) Hematoxylin and eosin staining showed irregular cells around the ventricle, as well as periventricular leukomalacia. CONCLUSION: An animal model of cerebral palsy was established, which simulated the human condition most likely associated with occurrence of this disease. This model could be used for experimental studies related to cerebral palsy.
文摘BACKGROUND Perinatal complications may result in life-long morbidities,among which cerebral palsy(CP)is the most severe motor disability.Once developed,CP is a nonprogressive disease with a prevalence of 1-2 per 1000 live births in developed countries.It demands an extensive and multidisciplinary care.Therefore,it is a challenge for our health system and a burden for patients and their families.Recently,stem cell therapy emerged as a promising treatment option and raised hope in patients and their families.AIM The aim is to evaluate the efficacy and safety of stem cell treatment in children with CP using a systematic review and meta-analysis METHODS We performed a systematic literature search on PubMed and EMBASE to find randomized controlled clinical trials(RCT)investigating the effect of stem cell transplantation in children with CP.After the review,we performed a randomeffects meta-analysis focusing on the change in gross motor function,which was quantified using the gross motor function measure.We calculated the pooled standardized mean differences of the 6-and/or 12-mo-outcome by the method of Cohen.We quantified the heterogeneity using the I-squared measure.RESULTS We identified a total of 8 RCT for a qualitative review.From the initially selected trials,5 met the criteria and were included in the meta-analysis.Patients’population ranged from 0.5 up to 35 years(n=282).We detected a significant improvement in the gross motor function with a pooled standard mean difference of 0.95(95%confidence interval:0.13-1.76)favoring the stem cell group and a high heterogeneity(I2=90.1%).Serious adverse events were rare and equally distributed among both intervention and control groups.CONCLUSION Stem cell therapy for CP compared with symptomatic standard care only,shows a significant positive effect on the gross motor function,although the magnitude of the improvement is limited.Short-term safety is present and further highquality RCTs are needed.
基金funded by the National Natural Science Foundation of China,No.30960393the Key Foundation in Science and Technology of Xinjiang Uygur Autonomous Region,No.200633128(2)+1 种基金the Youth Science and Technology Foundation of Health Department of Xinjiang Uygur Autonomous Region,No.2007Y26the Science and Technology Foundation of Health Bureau of Wuxi,No.ML201211
文摘Animal models of cerebral palsy established by simple infection or the hypoxia/ischemia method cannot effectively simulate the brain injury of a premature infant. Healthy 17-day-pregnant Wistar rats were intraperitoneally injected with lipopolysaccharide then subjected to hypoxia. The pups were used for this study at 4 weeks of age. Simultaneously, a hypoxia/ischemia group and a control group were used for comparison. The results of the footprint test, the balance beam test, the water maze test, neuroelectrophysiological examination and neuropathological examination demonstrated that, at 4 weeks after birth, footprint repeat space became larger between the forelimbs and hindlimbs of the rats, the latency period on the balance beam and in the Morris water maze was longer, place navigation and ability were poorer, and the stimulus intensity that induced the maximal wave amplitude of the compound muscle action potential was greater in the lipopolysaccharide/hypoxia and hypoxia/ischemia groups than in the control group. We observed irregular cells around the periventricular area, periventricular leukomalacia and breakage of the nuclear membrane in the lipopolysacchadde/hypexia and hypoxia/ischemia groups. These results indicate that we successfully established a Wistar rat pup model of cerebral palsy by intraperitoneal injection of lipopolysaccharide and hypoxia.
基金supported by the National Natural Science Foundation of China,Nos.81871024 (to HN),82301957 (to XW),82001382 (to LL),62127810 (to HN)the Natural Science Foundation of Jiangsu Province of China,No.SBK2020040785 (to LL)。
文摘Neonatal hypoxic-ischemic brain injury is the main cause of hypoxic-ischemic encephalopathy and cerebral palsy.Currently,there are few effective clinical treatments for neonatal hypoxic-ischemic brain injury.Here,we investigated the neuroprotective and molecular mechanisms of exogenous nicotinamide adenine dinucleotide,which can protect against hypoxic injury in adulthood,in a mouse model of neonatal hypoxic-ischemic brain injury.In this study,nicotinamide adenine dinucleotide(5 mg/kg)was intraperitoneally administered 30 minutes befo re surgery and every 24 hours thereafter.The results showed that nicotinamide adenine dinucleotide treatment improved body weight,brain structure,adenosine triphosphate levels,oxidative damage,neurobehavioral test outcomes,and seizure threshold in experimental mice.Tandem mass tag proteomics revealed that numerous proteins were altered after nicotinamide adenine dinucleotide treatment in hypoxic-ischemic brain injury mice.Parallel reaction monitoring and western blotting confirmed changes in the expression levels of proteins including serine(or cysteine)peptidase inhibitor,clade A,member 3N,fibronectin 1,5'-nucleotidase,cytosolic IA,microtubule associated protein 2,and complexin 2.Proteomics analyses showed that nicotinamide adenine dinucleotide ameliorated hypoxic-ischemic injury through inflammation-related signaling pathways(e.g.,nuclear factor-kappa B,mitogen-activated protein kinase,and phosphatidylinositol 3 kinase/protein kinase B).These findings suggest that nicotinamide adenine dinucleotide treatment can improve neurobehavioral phenotypes in hypoxic-ischemic brain injury mice through inflammation-related pathways.
文摘Spastic cerebral palsy is generally considered to result from cerebral cortical or pyramidal tract damage. Here, we precisely targeted the left pyramidal tract of 2-month-old Sprague-Dawley rats placed on a stereotaxic instrument under intraperitoneal anesthesia. Based on the rat brain stereotaxic map, a 1-mm hole was made 10 mm posterior to bregma and 0.8 mm left of sagittal suture. A microsyringe was inserted perpendicularly to the surface of the brain to a depth of 9.7 mm, and 15 wL of ethanol was slowly injected to establish a rat model of spastic cerebral palsy. After modeling, the rats appeared to have necrotic voids in the pyramidal tract and exhibited typical signs and symptoms of flexion spasms that lasted for a long period of time. These findings indicate that this is an effective and easy method of establishing a rat model of spastic cerebral palsy with good reproducibility. Ethanol as a chemical ablation agent specifically and thoroughly damages the py- ramidal tract, and therefore, the animals display flexion spasms, which are a typical symptom of the disease.
文摘OBJECTIVE: To identify global research trends in three therapies for children with cerebral palsy. DATA RETRIEVAL: We performed a bibliometric analysis of studies on therapies for children with cerebral palsy from 2002 to 2011 retrieved from Web of Science. SELECTION CRITERIA: Inclusion criteria: (a) peer-reviewed published articles on botulinum toxin, constraint-induced movement therapy, or acupuncture for children with cerebral palsy indexed in Web of Science; (b) original research articles, reviews, meeting abstracts, proceedings papers, book chapters, editorial material, and news items; and (c) publication between 2002 and 2011. Exclusion criteria: (a) articles that required manual searching or telephone access; (b) documents that were not published in the public domain; and (c) a number of corrected papers from the total number of articles. MAIN OUTCOME MEASURES: (1) Number of publications on the three therapies; (2) annual publication output, distribution by journals, distribution by institution, and top-cited articles on botulinum toxin; (3) annual publication output, distribution by journal, distribution by institution, and top-cited articles on constraint-induced movement therapy; (4) annual publication, distribution by journal, distribution by institution, and top-cited articles on acupuncture. RESULTS: This analysis, based on Web of Science articles, identified several research trends in studies published over the past 10 years of three therapies for children with cerebral palsy. More articles on botulinum toxin for treating children with cerebral palsy were published than the articles regarding constraint-induced movement therapy or acupuncture. The numbers of publications increased over the 10-year study period. Most papers appeared in journals with a focus on neurology, such as Developmental Medicine and Child Neurology and Journal of Child Neurology.Research institutes publishing on botulinum toxin treatments for this population are mostly in the Netherlands, the United States of America, and Australia; those publishing on constraint-induced movement therapy are mostly in Australia and the United States of America; and those publishing on acupuncture are mostly in China, Sweden and the United States of America.CONCLUSION: Analysis of literature and research trends indicated that there was no one specific therapy to cure cerebral palsy. Further studies are still necessary.
文摘BACKGROUND: In the process of early screening and interventions to high risk infants with brain damage, the occasion and choosing methods of interventions and the combined application of different interventions are still at the exploratory phase. OBJECTIVE: To observe the efficacy of early intervention using Vojta and Bobath combined treatment in high risk infants with brain damage, and investigate the effect of early rehabilitation on the prognosis. DESIGN: A randomized controlled comparative observation. SETTING: Daqing Oil Field General Hospital of Heilongjiang Province. PARTICIPANTS: Eighty-four high risk infants younger than l year were selected from the Department of Pediatrics, Daqing Oil Field General Hospital of Heilongjiang Province from October 2005 to October 2006, including 52 boys (62%) and 32 girls (38%). The treatment started at the age of 0 - 3 months in II cases (13%), 4 - 6 months in 28 cases (33%), 7 - 9 months in 35 cases (42%), and 10 - 12 months in 10 cases (1 2%). Infants with at least two of the followings were enrolled, including 7 Vojta abnormal postural reflexes, slow or disorder of motor development, increase of muscular tension, postural abnormality, primary reflection residual and CT/MRI abnormalities. Informed consents were obtained from their guardians. The 84 infants were randomly divided into treatment group (n =42) and control group (n =42). METHODS: All the children were intravenously injected with cerebroprotein hydrolysate injection or cattle encephalon glycoside and ignotin injection, 10 times as a course for 2 - 5 courses; Besides, the infants in the treatment group also received early rehabilitative training of Vojta and Bobath combined treatment, once a day, 40 minutes per time, 5 times a week followed by a 2-day rest, 1 month as a course, and totally 2 - 5 courses. The Vojta method was to facilitate the automatic regulation by reflexlocomotion. Bobath method was to inhibit abnormal posture but facilitate the normal one, thus it is also called neurodevelopmental therapy realized by reflex inhibition and facilitation. The rehabilitation was evaluated clinically using Gesell Development Schedules (GDS) after the courses when the infants were 1 year old. GDS included five aspects of adaptive behavior, gross motor, refine motor, speech, individual-social behavior. The developmental quotient (DQ) could be calculated according to their development. DQ=developmental age/actual age × 100, 〈 85 points was taken as abnormal; The higher the DQ value, the better the development. (2) Evaluation of efficacy: Cured: Developmental order reached normal or generally normal, abnormal posture disappeared, muscular tension ameliorated, symmetric limbs' motor function, free movement, normal intelligence, powerful reaction, and clear speech. Significant effect: Developmental order tended to normal, abnormal posture disappeared incompletely, muscular tension ameliorated incompletely, transient pause in the flexion and extension of limbs, good reaction, and improved intelligence. Effective: Developmental order improved to a certain degree, muscular tension ameliorated, limbs' motor function and posture improved as compared with before treatment, but still under control, intelligence improved a little. Invalid: No obvious changes before and after treatment. Total significant effective rate=(cured cases+cases of significant effect)/total cases × 100%. (3) The enumeration data and measurement data were compared with chi-square test and t test respectively. MAIN OUTCOME MEASURES: Clinical efficacy and GDS results at 1 year old in both groups. RESUTLS: All the 84 infants were involved in the analysis of results. (1) Efficacy: The total significant effective rate in the treatment group was higher than that in the control group (93%, 74%, x^2=4.2, P 〈 0.05). (2) Results of GDS evaluation: The DQ values of individual intercourse and social adaptation in the treatment group (93.57±11.23, 95.13±9.32) were higher than those in the control group (88.27±10.18, 90.10±10.67, t =2.267, 2.301, P 〈 0.05); The DQ values of gross motor, fine motor and speech in the treatment group (90.78±10.20, 98.63±9.23, 93.69±11.31) were higher than those in the control group (84.32± 11.33, 87.80±8.61, 85.52±10.61, t =2.746, 5.560, 2.746, P 〈 0.01). The interventional effects on each functional area were significant, especially the gross motor, fine motor and speech. CONCLUSION: The Vojta and Bobath combined treatment on the basis of drug therapy can improve the general developments of abilities in motor, intelligence, social intercourse, social adaptation and speech of high risk infants with brain damage, also can improve the curative efficacy.
文摘There is great interest in the regenerative potential of the neural stem cells and progenitors that populate the subventricular zone(SVZ). However, a comprehensive understanding of SVZ cell responses to brain injuries has been hindered by the lack of sensitive approaches to study the cellular composition of this niche. Here we review progress being made in deciphering the cells of the SVZ gleaned from the use of a recently designed flow cytometry panel that allows SVZ cells to be parsed into multiple subsets of progenitors as well as putative stem cells. We review how this approach has begun to unmask both the heterogeneity of SVZ cells as well as the dynamic shifts in cell populations with neonatal and pediatric brain injuries. We also discuss how flow cytometric analyses also have begun to reveal how specific cytokines, such as Leukemia inhibitory factor are coordinating SVZ responses to injury.
文摘The physiological markers of 310 individuals aged 2 through 19 were evaluated for the effects of the Masgutova Neurosensorimotor Reflex Integration Method on their four body systems: respiratory, cardiovascular, digestive, and nervous systems of individuals with neurodevelopmental deficits—cerebral palsy (CP), seizures, traumatic and acute brain injury, attention deficit and hyperactive disorders (ADD, ADHD), autism spectrum disorders, anxiety, post-trauma and post-traumatic stress disorders. We found that 53.33% of physiological markers and 66.67% of reflex patterns on the pre-test demonstrated to be poorly functioning. Both evaluation results showed statistically significant improvements after 8-days of intensive training using the Masgutova Neurosensorimotor Reflex Integration Method. Improvements according to 60.0% of the physiological markers positively correlated with functionality gains in 77.5% of reflex patterns in all four study groups compared to the control group, which did not receive the Reflex Integration training program (p-value < 0.05). The magnitude of improvement depended upon the severity of symptoms indicating the essentiality for individualized training in accordance with the diagnosis and individual neurological deficits. Results of this study show that reflex integrative techniques can lead to a reduction of stress and other negative factors blocking health homeostasis, limiting perception, and causing dysregulation in behavior and emotions, especially following traumatic events. Positive changes in physiological markers and reflex pattern functions indicate potential benefits for survival and stress resiliency through supporting neuro-physiological and neuro-psychological aspects of overall health and well-being in individuals with neurological deficits.