OBJECTIVE:To examine the brain effects of transcutaneous auricular vagus nerve stimulation(ta VNS)treatment of recurrent depression based on the functional brain network by using resting-state functional magnetic reso...OBJECTIVE:To examine the brain effects of transcutaneous auricular vagus nerve stimulation(ta VNS)treatment of recurrent depression based on the functional brain network by using resting-state functional magnetic resonance imaging(f MRI).METHODS:Twenty-five patients with recurrent depression were enrolled in a single-arm trial of ta VNS treatment for eight weeks.Clinical results were assessed by 17-item Hamilton Depression Rating Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),and Ruminative Response Scale(RRS)scales.Resting-state f MRI was conducted to explore the brain effects before and after treatment.For the functional connectivity(FC)analysis,the bilateral nucleus accumbens,globus pallidus,caudate,and putamen were selected as seeds.Finally,the correlations between FC and the clinical scale scores were calculated.RESULTS:After treatment,the patients’scores of HAMD-17,HAMA,SDS,SAS,and RRS were significantly decreased(P<0.05).FC was considerably decreased between the following areas:the left globus pallidus and the right postcentral gyrus,inferior parietal gyrus,the right globus pallidus and the left superior marginal gyrus,postcentral gyrus,superior parietal gyrus,inferior parietal gyrus,precuneus,right postcentral gyrus,superior marginal gyrus,and inferior parietal gyrus,between the right caudate and the right lingual gyrus,calcarine gyrus,and cerebellum.Changes in FC between the right globus pallidus and the left inferior parietal gyrus,between the left globus pallidus and the right postcentral gyrus were negatively correlated with HAMD-17 scores change before and after treatment(before,P=0.003,r=-0.6;after,P=0.009,r=-0.54).The change of FC between the right globus pallidus and the right postcentral gyrus was negatively correlated with the change in SDS(P=0.026,r=-0.474).The difference in FC between the right globus pallidus and the right postcentral gyrus was negatively correlated with the change in SAS(P=0.016,r=-0.513).CONCLUSIONS:Recurrent depression could be effectively treated with ta VNS.The changes in brain FC involving the basal ganglia,default mode,and sensorimotor networks provide insight into the effects of ta VNS treatment on recurrent depression.展开更多
BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found bef...BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found before,and the persistent pathological changes have rarely been reported.CASE SUMMARY A 10-mo-old Chinese female patient with a free previous medical history but with poor physical and athletic development had received the haemophilus influenzae vaccine and then developed a low fever 2 d prior.She was initially diagnosed with severe brain injury,central respiratory failure,metabolic acidosis complicated with respiratory alkalosis,hyper-IgE,etc.With further examination,a definite diagnosis ofβ-KTD was made.Symptomatic treatment was adopted.Ten days later,the dyspnea was improved evidently and the ventilator was removed,but there were still obvious abnormalities on magnetic resonance imaging(MRI).The lesions mainly invaded the corpus striatum but were not limited to the basal ganglia.Then,the patient’s disease improved and discharged approximately 1 mo later,and the abnormal lesions on MRI had partially improved.However,for about 1 year,the residual irreversible lesions were observed on MRI,the mental and physical development of the patient was obviously regressive,and extra rehabilitation training was needed.CONCLUSION The case highlights the critical importance of one view that the range of lesions in some patients may be more extensive than previously thought in someβ-KTD patients.In addition to biochemical tests,genetic tests and magnetic resonance imaging are not only conducive to quickly diagnosingβ-KTD but also to partially evaluating the short-and long-term outcomes.Moreover,more attention should be paid to the two mutations(c.478 C>G;c.951 C>T)that may be associated with severeβ-KTD.展开更多
The basal ganglia have been implicated in a modulation role in idiopathic generalized epilepsy （IGE） by an invasive electrophysioigic means. This paper investigates the basal ganglia functional connectivity by using...The basal ganglia have been implicated in a modulation role in idiopathic generalized epilepsy （IGE） by an invasive electrophysioigic means. This paper investigates the basal ganglia functional connectivity by using the region-wise functional connection analysis in resting-state functional magnetic resonance imaging （fMRI） in IGE. The increased functional connectivity within basal ganglia, and between the basal ganglia and the thalamus, and decreased functional connectivity between basal ganglia and motor cortex are found in IGE compared with the controls. These findings not only implicate dysfunctional integration in the motor loop in IGE and the enhanced interaction in the modulated loop, but also suggest that the basal ganglia modulate the generalized epileptic discharges with the influence over thalamus in the corticothalamus network.展开更多
基金Supported by the National Natural Science Foundation of China:Neuroimaging Study of Transcutaneous Auricular Vagus Nerve Stimulation in Treatment of Refractory Depression Based on Emotion Cognition Circuit(No.81774433)Prediction of Curative Effect of Transcutaneous Auricular Vagus Nerve Stimulation on Depression based on MRI and Machine Learning Technology(No.82174282)Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences:Study on the Mechanism and Efficacy Prediction of Transcutaneous Auricular Vagus Nerve Stimulation in the Treatment of Depression based on MRI Brain Imaging and Intestinal Flora(No.CI2021A03316)。
文摘OBJECTIVE:To examine the brain effects of transcutaneous auricular vagus nerve stimulation(ta VNS)treatment of recurrent depression based on the functional brain network by using resting-state functional magnetic resonance imaging(f MRI).METHODS:Twenty-five patients with recurrent depression were enrolled in a single-arm trial of ta VNS treatment for eight weeks.Clinical results were assessed by 17-item Hamilton Depression Rating Scale(HAMD-17),Hamilton Anxiety Scale(HAMA),Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),and Ruminative Response Scale(RRS)scales.Resting-state f MRI was conducted to explore the brain effects before and after treatment.For the functional connectivity(FC)analysis,the bilateral nucleus accumbens,globus pallidus,caudate,and putamen were selected as seeds.Finally,the correlations between FC and the clinical scale scores were calculated.RESULTS:After treatment,the patients’scores of HAMD-17,HAMA,SDS,SAS,and RRS were significantly decreased(P<0.05).FC was considerably decreased between the following areas:the left globus pallidus and the right postcentral gyrus,inferior parietal gyrus,the right globus pallidus and the left superior marginal gyrus,postcentral gyrus,superior parietal gyrus,inferior parietal gyrus,precuneus,right postcentral gyrus,superior marginal gyrus,and inferior parietal gyrus,between the right caudate and the right lingual gyrus,calcarine gyrus,and cerebellum.Changes in FC between the right globus pallidus and the left inferior parietal gyrus,between the left globus pallidus and the right postcentral gyrus were negatively correlated with HAMD-17 scores change before and after treatment(before,P=0.003,r=-0.6;after,P=0.009,r=-0.54).The change of FC between the right globus pallidus and the right postcentral gyrus was negatively correlated with the change in SDS(P=0.026,r=-0.474).The difference in FC between the right globus pallidus and the right postcentral gyrus was negatively correlated with the change in SAS(P=0.016,r=-0.513).CONCLUSIONS:Recurrent depression could be effectively treated with ta VNS.The changes in brain FC involving the basal ganglia,default mode,and sensorimotor networks provide insight into the effects of ta VNS treatment on recurrent depression.
文摘BACKGROUNDβ-ketothiolase deficiency(β-KTD)is an inherited disease,and insufficient attention has been paid to imageology due to its lower morbidity.Therefore,few lesions outside the basal ganglia have been found before,and the persistent pathological changes have rarely been reported.CASE SUMMARY A 10-mo-old Chinese female patient with a free previous medical history but with poor physical and athletic development had received the haemophilus influenzae vaccine and then developed a low fever 2 d prior.She was initially diagnosed with severe brain injury,central respiratory failure,metabolic acidosis complicated with respiratory alkalosis,hyper-IgE,etc.With further examination,a definite diagnosis ofβ-KTD was made.Symptomatic treatment was adopted.Ten days later,the dyspnea was improved evidently and the ventilator was removed,but there were still obvious abnormalities on magnetic resonance imaging(MRI).The lesions mainly invaded the corpus striatum but were not limited to the basal ganglia.Then,the patient’s disease improved and discharged approximately 1 mo later,and the abnormal lesions on MRI had partially improved.However,for about 1 year,the residual irreversible lesions were observed on MRI,the mental and physical development of the patient was obviously regressive,and extra rehabilitation training was needed.CONCLUSION The case highlights the critical importance of one view that the range of lesions in some patients may be more extensive than previously thought in someβ-KTD patients.In addition to biochemical tests,genetic tests and magnetic resonance imaging are not only conducive to quickly diagnosingβ-KTD but also to partially evaluating the short-and long-term outcomes.Moreover,more attention should be paid to the two mutations(c.478 C>G;c.951 C>T)that may be associated with severeβ-KTD.
基金supported by the National Natural Science Foundation of China under Grant No. 81071222
文摘The basal ganglia have been implicated in a modulation role in idiopathic generalized epilepsy （IGE） by an invasive electrophysioigic means. This paper investigates the basal ganglia functional connectivity by using the region-wise functional connection analysis in resting-state functional magnetic resonance imaging （fMRI） in IGE. The increased functional connectivity within basal ganglia, and between the basal ganglia and the thalamus, and decreased functional connectivity between basal ganglia and motor cortex are found in IGE compared with the controls. These findings not only implicate dysfunctional integration in the motor loop in IGE and the enhanced interaction in the modulated loop, but also suggest that the basal ganglia modulate the generalized epileptic discharges with the influence over thalamus in the corticothalamus network.
