A total of 29 patients were treated within 48 hours after acute subcortical cerebral infarction with Xuesaitong or Xuesaitong plus human urinary kallidinogenase for 14 days. Neurological deficits, activity of daily li...A total of 29 patients were treated within 48 hours after acute subcortical cerebral infarction with Xuesaitong or Xuesaitong plus human urinary kallidinogenase for 14 days. Neurological deficits, activity of daily living, and evaluations of distal upper limb motor functions at the 6-month follow-up showed that patients treated with Xuesaitong plus human urinary kallidinogenase recovered better than with Xuesaitong alone. In addition, functional MRI revealed that activation sites were primarily at the ipsilesional side of injury in all patients. Human urinary kallidinogenase induced hyperactivation of the ipsilesional primary sensorimotor cortex, premotor cortex, supplementary motor area, and contralesional posterior parietal cortex. Results showed that human urinary kallidinogenase improved symptoms of neurological deficiency by enhancing remodeling of long-term cortical motor function in patients with acute cerebral infarction.展开更多
In this study, stroke patients received constraint-induced movement therapy for 3 weeks. Before and after constraint-induced movement therapy, the flexibility of their upper limbs on the affected side was assessed usi...In this study, stroke patients received constraint-induced movement therapy for 3 weeks. Before and after constraint-induced movement therapy, the flexibility of their upper limbs on the affected side was assessed using the Wolf motor function test, and daily use of their affected limbs was assessed using the movement activities log, and cerebral functional reorganization was assessed by functional magnetic resonance imaging. The Wolf motor function test score and the movement activities log quantity and quality scores were significantly increased, while action performance time in the Wolf motor function test was significantly decreased after constraint-induced movement therapy. By functional magnetic resonance imaging examination, only scattered activation points were visible on the affected side before therapy. In contrast, the volume of the activated area was increased after therapy. The activation volume in the sensorimotor area was significantly different before and after therapy, and the activation area increased and appeared adjusted. In addition to the activated area around the lesions being decreased, there were also some new activated areas, including the supplementary movement area, premotor area and the ipsilateral sensorimotor area. Our findings indicate that constraint-induced movement therapy significantly improves the movement ability and daily use of the affected upper limbs in stroke patients and promotes cerebral functional reorganization.展开更多
Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebr...Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso- nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat- ment only. The intervention group received vertebral artery orifice angioplasty and stenting + identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.展开更多
Deactivation is common in cerebral functional imaging. However, the physiological mechanisms responsible for this phenomenon remain poorly understood. The present study analyzed 12 ischemic stroke patients, who were r...Deactivation is common in cerebral functional imaging. However, the physiological mechanisms responsible for this phenomenon remain poorly understood. The present study analyzed 12 ischemic stroke patients, who were randomly assigned to two groups: one group underwent sham needling and true needling at the Waiguan (SJ 5) in the healthy upper limb and the other group underwent sham and true needling at a sham point. Functional magnetic resonance imaging results showed no activation points in brain tissues following needling at SJ 5. However, compared with sham needling at SJ 5, true needling at SJ 5 deactivated Broadmann 4, 6, 24, and 32 areas. In addition, compared to needling at the sham point, true needling at SJ 5 deactivated bilateral hypothalamus. Results demonstrated that SJ 5 needling in the healthy upper limb resulted in specific directional brain action, as manifested by deactivation of cerebral areas related to motor (Broadmann 4 and 6), emotion (hypothalamus), and cognition (Broadmann 24, 32).展开更多
BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is imp...BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is important.AIM To investigate the diagnostic value of magnetic resonance multi-delay threedimensional arterial spin labeling(3DASL)and diffusion kurtosis imaging(DKI)in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia.METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included.All patients in the acute stage underwent magnetic resonance-based examination,and the data were processed by the system’s own software.The apparent diffusion coefficient(ADC),average diffusion coefficient(MD),axial diffusion(AD),radial diffusion(RD),average kurtosis(MK),radial kurtosis(fairly RK),axial kurtosis(AK),and perfusion parameters post-labeling delays(PLD)in the focal area and its corresponding area were compared.The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging(T2WI)was analyzed.RESULTS The DKI parameters of focal and control areas in the study subjects were compared.The ADC,MD,AD,and RD values in the lesion area were significantly lower than those in the control area.The MK,RK,and AK values in the lesion area were significantly higher than those in the control area.The MK/MD value in the infarct lesions was used to determine the matching situation.MK/MD<5 mm was considered matching and MK/MD≥5 mm was considered mismatching.PLD1.5s and PLD2.5s perfusion parameters in the central,peripheral,and control areas of the infarct lesions in MK/MD-matched and-unmatched patients were not significantly different.PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and-unmatched patients were significantly lower than those in peripheral and control areas.The MK and MD maps showed a lesion area of 20.08±5.74 cm^(2) and 22.09±5.58 cm^(2),respectively.T2WI showed a lesion area of 19.76±5.02 cm^(2).There were no significant differences in the cerebral infarction lesion areas measured using the three methods.MK,MD,and T2WI showed a good correlation.CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction.3DASL can effectively determine the changes in perfusion levels in the lesion area.There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.展开更多
Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤6 hours) were retrospectively analyzed.Six patients exhibited perfusion defects on negative enhancement integral maps,fou...Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤6 hours) were retrospectively analyzed.Six patients exhibited perfusion defects on negative enhancement integral maps,four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps,and three patients exhibited perfusion differences in pseudo-color on time to minimum maps.Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction.The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.展开更多
Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism...Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism remains unclear. Cerebral scans with functional magnetic resonance imaging (fMRI) have been used in the study of acupuncture and acupoint specifically. In this study, fMRI was used to detect the activation of the brain areas under different acupoints, matched along different meridians, to elucidate the acupoint combination via a modern medical approach. Forty healthy volunteers were randomly divided into the following groups: Waiguan point (SJ 5), Waiguan (SJ 5) + Zhigou (SJ 6) (2 acupoints come from the same meridian), Waiguan (SJ 5) + Neiguan (PC 6) (2 acupoints come from 2 meridians with the relationship of interior-exterior), Waiguan (SJ 5) + Yanglingquan (GB 34) (2 acupoints come from 2 meridians with the same name-Shaoyang Meridian), and sham point groups (needling in different points on the right hand). A real-time cerebral fMRI scan was simultaneously performed. The cerebral activation rate, and the number and strength of different regions of interest were compared among the groups. The fMRI cerebral imaging confirmed that there were some differences in the activation of cerebral areas by the needlings in SJ 5, and in combination with other acupoints. Needling at SJ 5 alone greatly activated the right cerebellum, while needling at both SJ 5 and different co-needling points activated different cerebral functional areas.展开更多
Tinnitus is an auditory disorder hardly assessable by clinical technology. PET imaging of the brain in 13 cases with and 10 without tinnitus was undertaken at 40 min after injection of 280-440 MBq 18F-FDG. To ensure t...Tinnitus is an auditory disorder hardly assessable by clinical technology. PET imaging of the brain in 13 cases with and 10 without tinnitus was undertaken at 40 min after injection of 280-440 MBq 18F-FDG. To ensure the quality of the PET study, all cases followed a normalized procedure with visual and auditory blockage. CT/MRI imaging and routine acoustic tests were carried out in all subjects. PET revealed that an increased uptake of 18F-FDG at left med-temporal lobe (primary auditory center, PAC) present exclusively in tinnitus, regardless the side of hearing hallucination. Significant asymmetry was noted between left and right PAC, but not at other cortex area. While control cases showed no asymmetric uptake between two hemispheres. The abnormal PAC uptake did not respond to external pure sound stimulus, nor did it relate to the seventy of hearing loss assessed by acoustic tests. No anatomical or morphological alteration could be proven on CT/MRI. In conclusion, PET/18F-FDG objectively revealed an increased metabolic change at left PAC in tinnitus, which is of diagnostic value; and there is evidence suggesting tinnitus is most likely induced by a functional change in the brain.展开更多
In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan (TE5). In ischemic stroke subjects, functional MRI showed enhance...In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan (TE5). In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.展开更多
Objective: Using methods of clinical scale assessment and cerebral functional imaging to compare the relative specificity of needling acupoints Baihui (DU20), Shuigou (DU26) and Shenmen (HTT) in intervening vas...Objective: Using methods of clinical scale assessment and cerebral functional imaging to compare the relative specificity of needling acupoints Baihui (DU20), Shuigou (DU26) and Shenmen (HTT) in intervening vascular dementia (VD) in different areas in the brain. Methods: Fifty patients with VD were randomized into 5 groups. Needling on conventionally used acupoints of hand and foot three Yang-meridians aiming at hemiplegia was applied to the patients in Group A, and needling on DU20 to Group B, on DU26 to Group C, on HT7 to Group D and on all the three to Group E was applied additionally. Assessments of Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Family Attitude Questionnaire (FAQ) were made. And the positron emission computerized tomography (PET) and single photon emission computerized tomography (SPECT) examinations were conducted in 5 selected patients from each group before and after treatment. Results: Needling on conventional acupoints plus DU20 could effect the inner temporal system, thalamencephalon system and prefrontal cortical system to improve memory and executive capacity of VD patients; conventional acupoints plus DU26 could effect more to the prefrontal cortical system to obviously elevate the executive capacity; that plus HT7 would reveal an effect similar to but rather weaker than plus DU20, and effect more to memory; and that plus all the three simultaneously could effect rather roundly multiple aspects of the nervous system related to intellectual activities, to elevate the recognition and enhance the executive capacity. Conclusion: Needling on various acupoints like DU20, DU26 and HT7 have effects on different brain areas.展开更多
We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was d...We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients' functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg's balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.展开更多
Objective:To identify the cerebral activation patterns associated with the processes that occur during viewing Chinese and English words in native Chinese English learners. Methods:12 right-handed Chinese English lear...Objective:To identify the cerebral activation patterns associated with the processes that occur during viewing Chinese and English words in native Chinese English learners. Methods:12 right-handed Chinese English learners were divided into two groups equally,namely English majors and non-English majors,and took semantic judgement tasks of both English and Chinese words, for whom the fMRI images were collected.Results:To various degrees, all subjects demonstrated activation of associated cerebral regions in both hemispheres and the left hemisphere activation was more significant for most subjects. Except for classical regions involved in language processing,such as Wernicke areas and Broca areas,there were other activated cerebral regions, including cerebellum, limbic system and basal ganglia nucleus, etc. To sum up,there were apparent overlap for cerebral activation distribution and no specific processing areas for both tasks. The analysis of ROI(region of interest)suggested that subjects in specialized group were more dependent on right hemisphere to perform English words task. Conclusion:Language cognition is dominated by left hemisphere,which is also shared by the right hemisphere to various degrees and thus two hemispheres work by ways of both dissociation and coordination. It is possible that working strategy of the right hemisphere in English task is related to proficiency of the second language. A variety of distinctions are shared by each subject for language cognitive patterns.展开更多
脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔...脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。展开更多
基金supported by the Science and Technology Program of Guangzhou,No.2006Z12E0119Guangzhou Science and Technology Key Project,No.122732961131543
文摘A total of 29 patients were treated within 48 hours after acute subcortical cerebral infarction with Xuesaitong or Xuesaitong plus human urinary kallidinogenase for 14 days. Neurological deficits, activity of daily living, and evaluations of distal upper limb motor functions at the 6-month follow-up showed that patients treated with Xuesaitong plus human urinary kallidinogenase recovered better than with Xuesaitong alone. In addition, functional MRI revealed that activation sites were primarily at the ipsilesional side of injury in all patients. Human urinary kallidinogenase induced hyperactivation of the ipsilesional primary sensorimotor cortex, premotor cortex, supplementary motor area, and contralesional posterior parietal cortex. Results showed that human urinary kallidinogenase improved symptoms of neurological deficiency by enhancing remodeling of long-term cortical motor function in patients with acute cerebral infarction.
基金funded by Capital Medical Development Foundation, No. 2009-2098
文摘In this study, stroke patients received constraint-induced movement therapy for 3 weeks. Before and after constraint-induced movement therapy, the flexibility of their upper limbs on the affected side was assessed using the Wolf motor function test, and daily use of their affected limbs was assessed using the movement activities log, and cerebral functional reorganization was assessed by functional magnetic resonance imaging. The Wolf motor function test score and the movement activities log quantity and quality scores were significantly increased, while action performance time in the Wolf motor function test was significantly decreased after constraint-induced movement therapy. By functional magnetic resonance imaging examination, only scattered activation points were visible on the affected side before therapy. In contrast, the volume of the activated area was increased after therapy. The activation volume in the sensorimotor area was significantly different before and after therapy, and the activation area increased and appeared adjusted. In addition to the activated area around the lesions being decreased, there were also some new activated areas, including the supplementary movement area, premotor area and the ipsilateral sensorimotor area. Our findings indicate that constraint-induced movement therapy significantly improves the movement ability and daily use of the affected upper limbs in stroke patients and promotes cerebral functional reorganization.
基金supported by the Natural Science Foundation of Yongchuan District of Chongqing in China,No.Ycstc,2013nc8031the Foundation of Chongqing Municipal Health Bureau in China,No.2010-2-250+1 种基金the Foundation of Chongqing Health and Family Planning Commission in China,No.20143001the Soft Science Foundation of Yongchuan District of Chongqing in China,No.Ycstc,2011BE5004
文摘Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic reso- nance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treat- ment only. The intervention group received vertebral artery orifice angioplasty and stenting + identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.
基金the National Basic Research Program of China (973 Program), No. 2006CB504505, 2012CB518504the 3 re Key Construction Program of "211 Project" of Guangdong Province
文摘Deactivation is common in cerebral functional imaging. However, the physiological mechanisms responsible for this phenomenon remain poorly understood. The present study analyzed 12 ischemic stroke patients, who were randomly assigned to two groups: one group underwent sham needling and true needling at the Waiguan (SJ 5) in the healthy upper limb and the other group underwent sham and true needling at a sham point. Functional magnetic resonance imaging results showed no activation points in brain tissues following needling at SJ 5. However, compared with sham needling at SJ 5, true needling at SJ 5 deactivated Broadmann 4, 6, 24, and 32 areas. In addition, compared to needling at the sham point, true needling at SJ 5 deactivated bilateral hypothalamus. Results demonstrated that SJ 5 needling in the healthy upper limb resulted in specific directional brain action, as manifested by deactivation of cerebral areas related to motor (Broadmann 4 and 6), emotion (hypothalamus), and cognition (Broadmann 24, 32).
文摘BACKGROUND Early thrombolytic therapy is crucial to treat acute cerebral infarction,especially since the onset of thrombolytic therapy takes 1-6 h.Therefore,early diagnosis and evaluation of cerebral infarction is important.AIM To investigate the diagnostic value of magnetic resonance multi-delay threedimensional arterial spin labeling(3DASL)and diffusion kurtosis imaging(DKI)in evaluating the perfusion and infarct area size in patients with acute cerebral ischemia.METHODS Eighty-four patients who experienced acute cerebral ischemia from March 2019 to February 2021 were included.All patients in the acute stage underwent magnetic resonance-based examination,and the data were processed by the system’s own software.The apparent diffusion coefficient(ADC),average diffusion coefficient(MD),axial diffusion(AD),radial diffusion(RD),average kurtosis(MK),radial kurtosis(fairly RK),axial kurtosis(AK),and perfusion parameters post-labeling delays(PLD)in the focal area and its corresponding area were compared.The correlation between the lesion area of cerebral infarction under MK and MD and T2-weighted imaging(T2WI)was analyzed.RESULTS The DKI parameters of focal and control areas in the study subjects were compared.The ADC,MD,AD,and RD values in the lesion area were significantly lower than those in the control area.The MK,RK,and AK values in the lesion area were significantly higher than those in the control area.The MK/MD value in the infarct lesions was used to determine the matching situation.MK/MD<5 mm was considered matching and MK/MD≥5 mm was considered mismatching.PLD1.5s and PLD2.5s perfusion parameters in the central,peripheral,and control areas of the infarct lesions in MK/MD-matched and-unmatched patients were not significantly different.PLD1.5s and PLD2.5s perfusion parameter values in the central area of the infarct lesions in MK/MD-matched and-unmatched patients were significantly lower than those in peripheral and control areas.The MK and MD maps showed a lesion area of 20.08±5.74 cm^(2) and 22.09±5.58 cm^(2),respectively.T2WI showed a lesion area of 19.76±5.02 cm^(2).There were no significant differences in the cerebral infarction lesion areas measured using the three methods.MK,MD,and T2WI showed a good correlation.CONCLUSION DKI parameters showed significant difference between the focal and control areas in patients with acute ischemic cerebral infarction.3DASL can effectively determine the changes in perfusion levels in the lesion area.There was a high correlation between the area of the infarct lesions diagnosed by DKI and T2WI.
基金supported by the National Key Project of Scientific and Technical Supporting Program funded by the Ministry of Science and Technology of China during the 11~(th) Five-Year Plan,No. 2007BAI05B07the Zhejiang Health Science and Technology Plan Project,No.2011KYB050+1 种基金the Wenzhou Science and Technology Plan Project,No.Y2004A014the Wenzhou Significant Scientific Research Project,No.Y20070038
文摘Magnetic resonance imaging (MRI) data of 10 patients with hyperacute cerebral infarction (≤6 hours) were retrospectively analyzed.Six patients exhibited perfusion defects on negative enhancement integral maps,four patients exhibited perfusion differences in pseudo-color on mean time to enhance maps,and three patients exhibited perfusion differences in pseudo-color on time to minimum maps.Dynamic susceptibility contrast-enhanced perfusion weighted imaging revealed a significant increase in region negative enhancement integral in the affected hemisphere of patients with cerebral infarction.The results suggest that dynamic susceptibility contrast-enhanced perfusion weighted imaging can clearly detect perfusion abnormalities in the cerebellum after unilateral hyperacute cerebral infarction.
基金the National 973 Program of China, No. 2006CB504505the National Nature Science Foundation of China, No. 90709027
文摘Acupoint combination is a method used for acupoint treatment of patients. Traditionally, acupoints are matched along the meridian distribution, which is a common rule in clinical practice, but the underlying mechanism remains unclear. Cerebral scans with functional magnetic resonance imaging (fMRI) have been used in the study of acupuncture and acupoint specifically. In this study, fMRI was used to detect the activation of the brain areas under different acupoints, matched along different meridians, to elucidate the acupoint combination via a modern medical approach. Forty healthy volunteers were randomly divided into the following groups: Waiguan point (SJ 5), Waiguan (SJ 5) + Zhigou (SJ 6) (2 acupoints come from the same meridian), Waiguan (SJ 5) + Neiguan (PC 6) (2 acupoints come from 2 meridians with the relationship of interior-exterior), Waiguan (SJ 5) + Yanglingquan (GB 34) (2 acupoints come from 2 meridians with the same name-Shaoyang Meridian), and sham point groups (needling in different points on the right hand). A real-time cerebral fMRI scan was simultaneously performed. The cerebral activation rate, and the number and strength of different regions of interest were compared among the groups. The fMRI cerebral imaging confirmed that there were some differences in the activation of cerebral areas by the needlings in SJ 5, and in combination with other acupoints. Needling at SJ 5 alone greatly activated the right cerebellum, while needling at both SJ 5 and different co-needling points activated different cerebral functional areas.
文摘Tinnitus is an auditory disorder hardly assessable by clinical technology. PET imaging of the brain in 13 cases with and 10 without tinnitus was undertaken at 40 min after injection of 280-440 MBq 18F-FDG. To ensure the quality of the PET study, all cases followed a normalized procedure with visual and auditory blockage. CT/MRI imaging and routine acoustic tests were carried out in all subjects. PET revealed that an increased uptake of 18F-FDG at left med-temporal lobe (primary auditory center, PAC) present exclusively in tinnitus, regardless the side of hearing hallucination. Significant asymmetry was noted between left and right PAC, but not at other cortex area. While control cases showed no asymmetric uptake between two hemispheres. The abnormal PAC uptake did not respond to external pure sound stimulus, nor did it relate to the seventy of hearing loss assessed by acoustic tests. No anatomical or morphological alteration could be proven on CT/MRI. In conclusion, PET/18F-FDG objectively revealed an increased metabolic change at left PAC in tinnitus, which is of diagnostic value; and there is evidence suggesting tinnitus is most likely induced by a functional change in the brain.
基金supported by the National Basic Research Program of China(973 Program),No.2006CB504505,2012CB518504the Third Key Construction Program of "211 Project" of Guangdong Province
文摘In the present study, 10 patients with ischemic stroke in the left hemisphere and six healthy controls were subjected to acupuncture at right Waiguan (TE5). In ischemic stroke subjects, functional MRI showed enhanced activation in Broadmann areas 5, 6, 7, 18, 19, 24, 32, the hypothalamic inferior lobe, the mamiilary body, and the ventral posterolateral nucleus of the left hemisphere, and Broadmann areas 4, 6, 7, 18, 19 and 32 of the right hemisphere, but attenuated activation of Broadmann area 13, the hypothalamic inferior lobe, the posterior lobe of the tonsil of cerebellum, and the culmen of the anterior lobe of hypophysis, in the left hemisphere and Broadmann area 13 in the right hemisphere. In ischemic stroke subjects, a number of deactivated brain areas were enhanced, including Broadmann areas 6, 11,20, 22, 37, and 47, the culmen of the anterior lobe of hypophysis, alae lingulae cerebella, and the posterior lobe of the tonsil of cerebellum of the left hemisphere, and Broadmann areas 8, 37, 45 and 47, the culmen of the anterior lobe of hypophysis, pars tuberalis adenohypophyseos, inferior border of lentiform nucleus, lateral globus pallidus, inferior temporal gyrus, and the parahippocampal gyrus of the right hemisphere. These subjects also exhibited attenuation of a number of deactivated brain areas, including Broadmann area 7. These data suggest that acupuncture at Waiguan specifically alters brain function in regions associated with sensation, vision, and motion in ischemic stroke patients. By contrast, in normal individuals, acupuncture at Waiguan generally activates brain areas associated with insomnia and other functions.
基金Supported by China Postdoctoral Science Foundation (No 2004035593)
文摘Objective: Using methods of clinical scale assessment and cerebral functional imaging to compare the relative specificity of needling acupoints Baihui (DU20), Shuigou (DU26) and Shenmen (HTT) in intervening vascular dementia (VD) in different areas in the brain. Methods: Fifty patients with VD were randomized into 5 groups. Needling on conventionally used acupoints of hand and foot three Yang-meridians aiming at hemiplegia was applied to the patients in Group A, and needling on DU20 to Group B, on DU26 to Group C, on HT7 to Group D and on all the three to Group E was applied additionally. Assessments of Mini Mental State Examination (MMSE), Activities of Daily Living (ADL) and Family Attitude Questionnaire (FAQ) were made. And the positron emission computerized tomography (PET) and single photon emission computerized tomography (SPECT) examinations were conducted in 5 selected patients from each group before and after treatment. Results: Needling on conventional acupoints plus DU20 could effect the inner temporal system, thalamencephalon system and prefrontal cortical system to improve memory and executive capacity of VD patients; conventional acupoints plus DU26 could effect more to the prefrontal cortical system to obviously elevate the executive capacity; that plus HT7 would reveal an effect similar to but rather weaker than plus DU20, and effect more to memory; and that plus all the three simultaneously could effect rather roundly multiple aspects of the nervous system related to intellectual activities, to elevate the recognition and enhance the executive capacity. Conclusion: Needling on various acupoints like DU20, DU26 and HT7 have effects on different brain areas.
基金supported by the Basic Scientific Research Program of National Research Foundation of Korea Funded by Ministry of Education, Science and Technology, No.2011-0003426
文摘We report a patient with severe ataxia due to Dandy-Walker malformation, who showed functional recovery over 10 months corresponding to a change in a cerebellar peduncle lesion. A 20-month-old female patient who was diagnosed with Dandy-Walker syndrome and six age- and sex-matched healthy control subjects were enrolled. The superior cerebellar peduncle, the middle cerebellar peduncle, and the inferior cerebellar peduncle were evaluated using fractional anisotropy and the apparent diffusion coefficient. The patients' functional ambulation category was 0 at the initial visit, but improved to 2 at the follow-up evaluation, and Berg's balance scale score also improved from 0 to 7. Initial diffusion tensor tractography revealed that the inferior cerebellar peduncle was not detected, that the fractional anisotropy of the superior cerebellar peduncle and middle cerebellar peduncle decreased by two standard deviations below, and that the apparent diffusion coefficient increased by two standard deviations over normal control values. However, on follow-up diffusion tensor tractography, both inferior cerebellar peduncles could be detected, and the fractional anisotropy of superior cerebellar peduncle increased to within two standard deviations of normal controls. The functional improvement in this patient appeared to correspond to changes in these cerebellar peduncles. We believe that evaluating cerebellar peduncles using diffusion tensor imaging is useful in cases when a cerebellar peduncle lesion is suspected.
文摘Objective:To identify the cerebral activation patterns associated with the processes that occur during viewing Chinese and English words in native Chinese English learners. Methods:12 right-handed Chinese English learners were divided into two groups equally,namely English majors and non-English majors,and took semantic judgement tasks of both English and Chinese words, for whom the fMRI images were collected.Results:To various degrees, all subjects demonstrated activation of associated cerebral regions in both hemispheres and the left hemisphere activation was more significant for most subjects. Except for classical regions involved in language processing,such as Wernicke areas and Broca areas,there were other activated cerebral regions, including cerebellum, limbic system and basal ganglia nucleus, etc. To sum up,there were apparent overlap for cerebral activation distribution and no specific processing areas for both tasks. The analysis of ROI(region of interest)suggested that subjects in specialized group were more dependent on right hemisphere to perform English words task. Conclusion:Language cognition is dominated by left hemisphere,which is also shared by the right hemisphere to various degrees and thus two hemispheres work by ways of both dissociation and coordination. It is possible that working strategy of the right hemisphere in English task is related to proficiency of the second language. A variety of distinctions are shared by each subject for language cognitive patterns.
文摘脑小血管疾病(cerebral small vessel disease,CSVD)的部分患者会出现认知功能下降并可能进展为痴呆,严重降低患者的生活质量。目前关于CSVD影像学标志物与认知功能障碍的相关性研究表明,脑白质高信号、血管周围间隙扩大、脑微出血、腔隙性脑梗死的分布位置、严重程度对各认知域产生不同影响,CSVD导致的认知功能障碍可能与炎症因子间接影响和脑组织纤维束破坏等机制相关。但CSVD影像学标志物与认知功能的关系及其相关机制还需要更进一步研究加以验证。