癫痫是神经科常见的一种慢性脑部疾病,其对患者的身心健康危害极大,尤其是局灶性进展为双侧强直-阵挛发作(focal to bilateral tonic-clonic seizure,FBTCS),严重影响患者的生活质量。由于癫痫异常放电传播机制的复杂性和异质性,目前其...癫痫是神经科常见的一种慢性脑部疾病,其对患者的身心健康危害极大,尤其是局灶性进展为双侧强直-阵挛发作(focal to bilateral tonic-clonic seizure,FBTCS),严重影响患者的生活质量。由于癫痫异常放电传播机制的复杂性和异质性,目前其详细的神经网络传播机制尚不清楚。FBTCS的异常放电神经网络可能有丘脑、基底神经节、胼胝体、脑干、海马和前连合等结构参与。展开更多
Background: Mild cognitive impairment (MCI) is widely viewed as the transition phase between normal aging and Alzheimer disease (AD). Given that MCI can also result from cerebrovascular disease (CVD), the authors used...Background: Mild cognitive impairment (MCI) is widely viewed as the transition phase between normal aging and Alzheimer disease (AD). Given that MCI can also result from cerebrovascular disease (CVD), the authors used clinical,MRI, and cognitive measures of AD and CVD to test the hypothesis that CVD increases the likelihood of progression from MCI to dementia within 3 years. Objective: To examine the impact of CVD on progression of MCI to dementia. Methods: Fifty two consecutive patients with MCI (71% men) including many with symptomatic CVD were longitudinally evaluated for 3.1 ± 1.3 years. MCI was defined as a Clinical Dementia Rating Scale (CDR) score of 0.5. Dementia was defined as progression to a CDR score of ≥ 1.0. Results: Forty four percent of the MCI patients had MRI infarcts, 50% of which were symptomatic. Thirty three percent of patients progressed to dementia, and 37.8% of these had MRI infarcts. Clinically probable or possible AD was diagnosed in approximately 82% of converters. Of the clinical and MRI measures, only hippocampal volume was associated with increased risk to progression (hazard ratio = 0.31 [95% CI 0.1 to 0.92], p = 0.03). When neuropsychological measures were included in the analysis,memory (HR = 0.90 [95% CI 0.84 to 0.96], p = 0.002) and executive function (HR= 0.96 [95% CI 0.92 to 1.0] p=0.045)were associatedwith increased risk of dementia progression, whereas APOE genotype, cerebrovascular risk factors, clinical stroke, presence or absence of lacunes, and extent of white matter hyperintensities did not predict progression. Conclusion: Within a heterogenous group of MCI patients, including many with clinically significant CVD, baseline memory and executive performance significantly predicted likelihood to develop dementia.展开更多
文摘癫痫是神经科常见的一种慢性脑部疾病,其对患者的身心健康危害极大,尤其是局灶性进展为双侧强直-阵挛发作(focal to bilateral tonic-clonic seizure,FBTCS),严重影响患者的生活质量。由于癫痫异常放电传播机制的复杂性和异质性,目前其详细的神经网络传播机制尚不清楚。FBTCS的异常放电神经网络可能有丘脑、基底神经节、胼胝体、脑干、海马和前连合等结构参与。
文摘Background: Mild cognitive impairment (MCI) is widely viewed as the transition phase between normal aging and Alzheimer disease (AD). Given that MCI can also result from cerebrovascular disease (CVD), the authors used clinical,MRI, and cognitive measures of AD and CVD to test the hypothesis that CVD increases the likelihood of progression from MCI to dementia within 3 years. Objective: To examine the impact of CVD on progression of MCI to dementia. Methods: Fifty two consecutive patients with MCI (71% men) including many with symptomatic CVD were longitudinally evaluated for 3.1 ± 1.3 years. MCI was defined as a Clinical Dementia Rating Scale (CDR) score of 0.5. Dementia was defined as progression to a CDR score of ≥ 1.0. Results: Forty four percent of the MCI patients had MRI infarcts, 50% of which were symptomatic. Thirty three percent of patients progressed to dementia, and 37.8% of these had MRI infarcts. Clinically probable or possible AD was diagnosed in approximately 82% of converters. Of the clinical and MRI measures, only hippocampal volume was associated with increased risk to progression (hazard ratio = 0.31 [95% CI 0.1 to 0.92], p = 0.03). When neuropsychological measures were included in the analysis,memory (HR = 0.90 [95% CI 0.84 to 0.96], p = 0.002) and executive function (HR= 0.96 [95% CI 0.92 to 1.0] p=0.045)were associatedwith increased risk of dementia progression, whereas APOE genotype, cerebrovascular risk factors, clinical stroke, presence or absence of lacunes, and extent of white matter hyperintensities did not predict progression. Conclusion: Within a heterogenous group of MCI patients, including many with clinically significant CVD, baseline memory and executive performance significantly predicted likelihood to develop dementia.
