The brain is a complex network system that has the capacity to support emotion, thought, action, learning and memory, and is characterized by constant activity, constant structural remodeling, and constant attempt to ...The brain is a complex network system that has the capacity to support emotion, thought, action, learning and memory, and is characterized by constant activity, constant structural remodeling, and constant attempt to compensate for this remodeling. The basic insight that emerges from complex network organization is that substantively different networks can share common key organizational principles. Moreover, the interdependence of network organization and behavior has been successfully demonstrated for several specific tasks. From this viewpoint, increasing experimental/clinical observations suggest that mental disorders are neural network disorders. On one hand, single psychiatric disorders arise from multiple, multifactorial molecular and cellular structural/functional alterations spreading throughout local/global circuits leading to multifaceted and heterogeneous clinical symptoms. On the other hand, various mental diseases may share functional deficits across the same neural circuit as reflected in the overlap of symptoms throughout clinical diagnoses. An integrated framework including experimental measures and clinical observations will be necessary to formulate a coherent and comprehensive understanding of how neural connectivity mediates and constraints the phenotypic expression of psychiatric disorders.展开更多
目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索...目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。展开更多
疼痛是一种不愉快的感觉和情感体验,其涉及到多级神经加工过程,神经活动模式十分复杂。非侵入性脑功能成像技术可以实现在全脑水平上解析人类疼痛的神经机制。其中,功能磁共振成像(functional magnetic resonance imaging,fMRI)技术因...疼痛是一种不愉快的感觉和情感体验,其涉及到多级神经加工过程,神经活动模式十分复杂。非侵入性脑功能成像技术可以实现在全脑水平上解析人类疼痛的神经机制。其中,功能磁共振成像(functional magnetic resonance imaging,fMRI)技术因具有高空间分辨率的优势,使其在探索人类疼痛的神经机制研究中得到了广泛的应用。本文聚焦于人类疼痛的fMRI研究,首先概述了疼痛相关的脑响应研究发现,梳理了与疼痛加工相关的多个脑区功能活动变化。然而,调节单一脑区的功能难以影响疼痛体验,提示疼痛加工涉及多脑区之间的协同作用。由此,本文综述了参与疼痛加工的脑区之间交互现象,这些研究揭示了多条神经通路以串行或并行的方式构成了复杂的疼痛神经网络,进而处理与疼痛相关的感觉、情绪和认知信息。基于上述研究,近年来不断更迭发展的超高场强f MRI及脑脊同步成像技术,助力人类疼痛研究深入到核团和脊髓层面,拓展了疼痛神经网络的精细度和全面性。综上,本文提出了人类疼痛的神经网络表征,并以此为基础指导神经调控技术调节异常的神经网络表征,进而实现缓解疼痛症状的目标。最后,本文讨论了当前疼痛神经表征研究的局限性,并提出了探索疼痛特异性表征,对比实验诱发性疼痛和临床自发性疼痛,以及疼痛个体化表征的研究展望。展开更多
文摘The brain is a complex network system that has the capacity to support emotion, thought, action, learning and memory, and is characterized by constant activity, constant structural remodeling, and constant attempt to compensate for this remodeling. The basic insight that emerges from complex network organization is that substantively different networks can share common key organizational principles. Moreover, the interdependence of network organization and behavior has been successfully demonstrated for several specific tasks. From this viewpoint, increasing experimental/clinical observations suggest that mental disorders are neural network disorders. On one hand, single psychiatric disorders arise from multiple, multifactorial molecular and cellular structural/functional alterations spreading throughout local/global circuits leading to multifaceted and heterogeneous clinical symptoms. On the other hand, various mental diseases may share functional deficits across the same neural circuit as reflected in the overlap of symptoms throughout clinical diagnoses. An integrated framework including experimental measures and clinical observations will be necessary to formulate a coherent and comprehensive understanding of how neural connectivity mediates and constraints the phenotypic expression of psychiatric disorders.
文摘目的评价不同康复锻炼方式改善乳腺癌术后肩关节功能的效果。方法检索中国知网、维普网、万方数据、SinoMed、PubMed、Embase、Cochrane Library、Web of Science数据库中关于锻炼方式改善乳腺癌术后患者肩关节功能的随机对照试验,检索时限为建库至2024年1月,采用Stata17.0软件进行文献的质量评价与数据分析。结果共纳入13项研究,涉及9种锻炼方式和994例患者。网状Meta分析结果表明,在改善肩部屈曲功能方面,水疗法和渐进式康复操的效果优于常规护理(均P<0.05),其中以水疗法的效果最佳;在改善肩部伸展功能方面,渐进式康复操、本体感觉神经肌肉促进术、推拿的效果优于常规护理(均P<0.05),其中以渐进式康复操的效果最佳;在改善肩部外旋功能方面,渐进式康复操的效果优于常规护理(P<0.05);在改善肩部内旋功能方面,涉及的锻炼方式两两比较均未产生统计学差异;在缓解疼痛方面,抗阻力训练的干预效果优于常规护理(P<0.05)。结论水疗法能更好地改善肩部屈曲功能,渐进式康复操在改善肩部伸展、外旋功能方面更具优势,抗阻力训练改善肩部疼痛的效果最优。
文摘疼痛是一种不愉快的感觉和情感体验,其涉及到多级神经加工过程,神经活动模式十分复杂。非侵入性脑功能成像技术可以实现在全脑水平上解析人类疼痛的神经机制。其中,功能磁共振成像(functional magnetic resonance imaging,fMRI)技术因具有高空间分辨率的优势,使其在探索人类疼痛的神经机制研究中得到了广泛的应用。本文聚焦于人类疼痛的fMRI研究,首先概述了疼痛相关的脑响应研究发现,梳理了与疼痛加工相关的多个脑区功能活动变化。然而,调节单一脑区的功能难以影响疼痛体验,提示疼痛加工涉及多脑区之间的协同作用。由此,本文综述了参与疼痛加工的脑区之间交互现象,这些研究揭示了多条神经通路以串行或并行的方式构成了复杂的疼痛神经网络,进而处理与疼痛相关的感觉、情绪和认知信息。基于上述研究,近年来不断更迭发展的超高场强f MRI及脑脊同步成像技术,助力人类疼痛研究深入到核团和脊髓层面,拓展了疼痛神经网络的精细度和全面性。综上,本文提出了人类疼痛的神经网络表征,并以此为基础指导神经调控技术调节异常的神经网络表征,进而实现缓解疼痛症状的目标。最后,本文讨论了当前疼痛神经表征研究的局限性,并提出了探索疼痛特异性表征,对比实验诱发性疼痛和临床自发性疼痛,以及疼痛个体化表征的研究展望。
