BACKGROUND： Previous studies have shown that lesions in the anterior limb of the internal capsule contribute to obsessive-compulsive symptoms in patients with refractory obsessive-compulsive disorder （OCD）. However...BACKGROUND： Previous studies have shown that lesions in the anterior limb of the internal capsule contribute to obsessive-compulsive symptoms in patients with refractory obsessive-compulsive disorder （OCD）. However, few reports have addressed the effects of lesions in the anterior limb of the internal capsule on cognition, learning, and memory functions in patients with refractory OCD. OBJECTIVE： To investigate the degree of damage to memory tasks in refractory OCD patients following lesions to the anterior limb of the internal capsule. DESIGN, TIME AND SETTING： A case-controlled, observational study was performed at the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008. PARTICIPANTS： A total of 10 refractory OCD patients were admitted to the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008 and were recruited for this study. The OCD patients were of equal gender, with an average age of （25.1 ± 9.6） years. An additional 10 healthy volunteers were enrolled from a community of Shanghai City as controls; they were of equal gender and aged （25.1 ± 8.6） years. METHODS： A total of 10 refractory OCD patients were subjected to lesions in the anterior limbs of the bilateral internal capsules. Wechsler Memory Scale-Chinese Revision （WMS-CR, as a task of explicit memory） and the Nissen Version （serial reaction time task） software （SRTT, as a task of implicit memory） were applied to determine memory functions and learning performance in pre- and post-operative OCD patients and controls. MAIN OUTCOME MEASURES： WMS scores, reaction time in SRTT, and Yale-Brown obsessive compulsive scale scores were measured in pre- and post-operative OCD patients and controls. RESULTS： Compared to controls, the pre-operative OCD patients exhibited reduced memory task scores （P = 0.005）, whereas scores for reciting numbers of backwards digits were greater （P = 0.000）. Figure recall and associative memory were less in OCD patients at 1 week following surgery than in the pre-operative OCD patients （P = 0.042, P = 0.002, respectively）. Reaction time in implicit SRTT was significantly longer in pre-operative OCD patients compared with controls and post-operative OCD patients （P = 0.01, P = 0.03, respectively）. These results suggested ameliorated SRTT following neurosurgery. Yale-Brown Obsessive Compulsive Scale results revealed significantly improved OCD following lesions in the internal capsule （P = 0.04）. Some post-operative OCD patients suffered from deficits in short-term memory and implicit memory. CONCLUSION： Lesions in anterior limbs of bilateral internal capsules improve obsessive- compulsive symptoms and implicit memory in OCD patients, but result in aggravated short-term memory deficits.展开更多
Neuro myelitis optica spectrum disorder(NMOSD) is an inflammatory demyelinating disease of the central nervous system.However,whether and how cortical changes occur in NMOSD with normal-appearing brain tissue,or wheth...Neuro myelitis optica spectrum disorder(NMOSD) is an inflammatory demyelinating disease of the central nervous system.However,whether and how cortical changes occur in NMOSD with normal-appearing brain tissue,or whether any cortical changes correlate with clinical chara cteristics,is not completely clear.The current study recruited 43 patients with NMOSD who had normal-appearing brain tissue and 45 healthy controls matched for age,sex,and educational background from December 2020 to February 2022.A surface-based morphological analysis of high-resolution T1-weighted structural magnetic resonance images was used to calculate the cortical thickness,sulcal depth,and gyrification index.Analysis showed that cortical thickness in the bilate ral rostral middle frontal gyrus and left superior frontal gyrus was lower in the patients with NMOSD than in the control participants.Subgroup analysis of the patients with NMOSD indicated that compared with those who did not have any optic neuritis episodes,those who did have such episodes exhibited noticeably thinner cortex in the bilateral cuneus,superior parietal co rtex,and pericalcarine co rtex.Correlation analysis indicated that co rtical thickness in the bilateral rostral middle frontal gyrus was positively correlated with scores on the Digit Symbol Substitution Test and negatively correlated with scores on the Trail Making Test and the Expanded Disability Status Scale.These results are evidence that cortical thinning of the bilateral regional frontal cortex occurs in patients with NMOSD who have normal-appearing brain tissue,and that the degree of thinning is correlated with clinical disability and cognitive function.These findings will help im prove our understanding of the imaging chara cteristics in NMOSD and their potential clinical significance.展开更多
目的研究人格解体患者认知功能损害及与临床症状和社会功能的相关性。方法对符合精神障碍诊断标准与统计手册第5版(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,DSM-V)中诊断标准以及剑桥人格解体量表(Cambri...目的研究人格解体患者认知功能损害及与临床症状和社会功能的相关性。方法对符合精神障碍诊断标准与统计手册第5版(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,DSM-V)中诊断标准以及剑桥人格解体量表(Cambridge Depersonalization Scale,CDS)评分≥70分的48例人格解体障碍患者,以及32例健康被试者分别采用连线测验(Trail Making Test A,TMTA)、符号编码、霍普金斯词语学习测验(Hopkins Verbal Learning Test Revised,HVLT-R)、简易视觉记忆测验(Brief Visuospatial Memory Test Revised,BVMT-R)、持续操作测验(Continuous Performance Test,CPT)和Stroop色-词测验进行认知功能评估,采用功能大体评定量表(Global Assessment Function,GAF)对社会功能进行评估,并采集一般人口学资料、临床信息后对相关信息进行分析。结果人格解体患者组与健康对照组在认知功能的TMTA(P=0.03)、HVLT-R(P=0.01)、BVMT-R(P=0.01)、Stroop测验(P=0.01)等方面差异有统计学意义;人格解体患者组内用药组与未用药组对认知功能的差异无统计学意义(P>0.05)。人格解体患者组与健康被试组GAF评分差异有统计学意义(P=0.00);认知功能中Stroop测验、CPT与临床症状呈负相关(r=-0.455,P<0.05;r=-0.292,P<0.05),TMTA与社会功能呈负相关(r=-0.300,P<0.05),Stroop测验、BVMT-R与社会功能呈正相关(r=0.352,P<0.05;r=0.344,P<0.05),但关系密切程度偏弱。结论人格解体患者存在认知功能损害及社会功能下降,认知功能中注意/警觉能力与临床症状评分呈负相关,认知功能与社会功能有相关性,认知功能受损可导致社会功能下降。展开更多
基金the Key Program of International Communication Foundation of Psychiatry and Neurology Department of Shanghai Jiao-Tong University, No. 200901
文摘BACKGROUND： Previous studies have shown that lesions in the anterior limb of the internal capsule contribute to obsessive-compulsive symptoms in patients with refractory obsessive-compulsive disorder （OCD）. However, few reports have addressed the effects of lesions in the anterior limb of the internal capsule on cognition, learning, and memory functions in patients with refractory OCD. OBJECTIVE： To investigate the degree of damage to memory tasks in refractory OCD patients following lesions to the anterior limb of the internal capsule. DESIGN, TIME AND SETTING： A case-controlled, observational study was performed at the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008. PARTICIPANTS： A total of 10 refractory OCD patients were admitted to the Department of Functional Neurosurgery, Ruijin Hospital, Shanghai Jiao-Tong University, China from May 2007 to March 2008 and were recruited for this study. The OCD patients were of equal gender, with an average age of （25.1 ± 9.6） years. An additional 10 healthy volunteers were enrolled from a community of Shanghai City as controls; they were of equal gender and aged （25.1 ± 8.6） years. METHODS： A total of 10 refractory OCD patients were subjected to lesions in the anterior limbs of the bilateral internal capsules. Wechsler Memory Scale-Chinese Revision （WMS-CR, as a task of explicit memory） and the Nissen Version （serial reaction time task） software （SRTT, as a task of implicit memory） were applied to determine memory functions and learning performance in pre- and post-operative OCD patients and controls. MAIN OUTCOME MEASURES： WMS scores, reaction time in SRTT, and Yale-Brown obsessive compulsive scale scores were measured in pre- and post-operative OCD patients and controls. RESULTS： Compared to controls, the pre-operative OCD patients exhibited reduced memory task scores （P = 0.005）, whereas scores for reciting numbers of backwards digits were greater （P = 0.000）. Figure recall and associative memory were less in OCD patients at 1 week following surgery than in the pre-operative OCD patients （P = 0.042, P = 0.002, respectively）. Reaction time in implicit SRTT was significantly longer in pre-operative OCD patients compared with controls and post-operative OCD patients （P = 0.01, P = 0.03, respectively）. These results suggested ameliorated SRTT following neurosurgery. Yale-Brown Obsessive Compulsive Scale results revealed significantly improved OCD following lesions in the internal capsule （P = 0.04）. Some post-operative OCD patients suffered from deficits in short-term memory and implicit memory. CONCLUSION： Lesions in anterior limbs of bilateral internal capsules improve obsessive- compulsive symptoms and implicit memory in OCD patients, but result in aggravated short-term memory deficits.
基金Clinical Research Center for Medical Imaging in Hunan Province,No.2020SK4001Science and Technology Innovation Program of Hunan Province,No.2021RC4016Accurate Localization Study of Mild Traumatic Brain Injury Based on Deep Learning Through Multimodal Image and Neural Network,No.2021gfcx05 (all to JL)。
文摘Neuro myelitis optica spectrum disorder(NMOSD) is an inflammatory demyelinating disease of the central nervous system.However,whether and how cortical changes occur in NMOSD with normal-appearing brain tissue,or whether any cortical changes correlate with clinical chara cteristics,is not completely clear.The current study recruited 43 patients with NMOSD who had normal-appearing brain tissue and 45 healthy controls matched for age,sex,and educational background from December 2020 to February 2022.A surface-based morphological analysis of high-resolution T1-weighted structural magnetic resonance images was used to calculate the cortical thickness,sulcal depth,and gyrification index.Analysis showed that cortical thickness in the bilate ral rostral middle frontal gyrus and left superior frontal gyrus was lower in the patients with NMOSD than in the control participants.Subgroup analysis of the patients with NMOSD indicated that compared with those who did not have any optic neuritis episodes,those who did have such episodes exhibited noticeably thinner cortex in the bilateral cuneus,superior parietal co rtex,and pericalcarine co rtex.Correlation analysis indicated that co rtical thickness in the bilateral rostral middle frontal gyrus was positively correlated with scores on the Digit Symbol Substitution Test and negatively correlated with scores on the Trail Making Test and the Expanded Disability Status Scale.These results are evidence that cortical thinning of the bilateral regional frontal cortex occurs in patients with NMOSD who have normal-appearing brain tissue,and that the degree of thinning is correlated with clinical disability and cognitive function.These findings will help im prove our understanding of the imaging chara cteristics in NMOSD and their potential clinical significance.
文摘目的研究人格解体患者认知功能损害及与临床症状和社会功能的相关性。方法对符合精神障碍诊断标准与统计手册第5版(Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition,DSM-V)中诊断标准以及剑桥人格解体量表(Cambridge Depersonalization Scale,CDS)评分≥70分的48例人格解体障碍患者,以及32例健康被试者分别采用连线测验(Trail Making Test A,TMTA)、符号编码、霍普金斯词语学习测验(Hopkins Verbal Learning Test Revised,HVLT-R)、简易视觉记忆测验(Brief Visuospatial Memory Test Revised,BVMT-R)、持续操作测验(Continuous Performance Test,CPT)和Stroop色-词测验进行认知功能评估,采用功能大体评定量表(Global Assessment Function,GAF)对社会功能进行评估,并采集一般人口学资料、临床信息后对相关信息进行分析。结果人格解体患者组与健康对照组在认知功能的TMTA(P=0.03)、HVLT-R(P=0.01)、BVMT-R(P=0.01)、Stroop测验(P=0.01)等方面差异有统计学意义;人格解体患者组内用药组与未用药组对认知功能的差异无统计学意义(P>0.05)。人格解体患者组与健康被试组GAF评分差异有统计学意义(P=0.00);认知功能中Stroop测验、CPT与临床症状呈负相关(r=-0.455,P<0.05;r=-0.292,P<0.05),TMTA与社会功能呈负相关(r=-0.300,P<0.05),Stroop测验、BVMT-R与社会功能呈正相关(r=0.352,P<0.05;r=0.344,P<0.05),但关系密切程度偏弱。结论人格解体患者存在认知功能损害及社会功能下降,认知功能中注意/警觉能力与临床症状评分呈负相关,认知功能与社会功能有相关性,认知功能受损可导致社会功能下降。
