关键词： COVID-19   SARS-CoV-2   Neurology   NeuroCOVID  

摘要： A spectrum of neurological disease associated with COVID-19 is becoming increasingly apparent. However, the mechanisms behind these manifestations remain poorly understood, significantly hindering their management. The present review subsequently attempts to address the evolving molecular, cellular and systemic mechanisms of NeuroCOVID, which we have classified as the acute and long-term neurological effects of COVID-19. We place particular emphasis on cerebrovascular, demyelinating and encephalitic presentations, which have been reported. Several mechanisms are presented, especially the involvement of a "cytokine storm". We explore the genetic and demographic factors that may predispose individuals to NeuroCOVID. The increasingly evident longterm neurological effects are also presented, including the impact of the virus on cognition, autonomic function and mental wellbeing, which represent an impending burden on already stretched healthcare services. We subsequently reinforce the need for cautious surveillance, especially for those with predisposing factors, with effective clinical phenotyping, appropriate investigation and, if possible, prompt treatment. This will be imperative to prevent downstream neurological sequelae, including those related to the long COVID phenotypes that are being increasingly recognised.

关键词： Neurology   ClinicalTrials   gov   Randomized control trials   Research funding  

摘要： Background: Increasing neurological disease burden and advancing treatment options require clinical trials to expand the evidence base of clinical care. We aimed to characterize neurology clinical trials registered between October 2007 and April 2018 and identify features associated with early discontinuation and results reporting. Methods: We compared 16,994 neurology (9.4%) and 163,714 non-neurology comparison trials registered to ***. Trials therapeutic focus within neurology was assigned via combination programmatic and manual review. We performed descriptive analyses of trial characteristics, cox regression of early discontinuation, and multivariable logistic regression for results reporting within 3 years of completion. Results: Most neurology trials were academic-funded (58.5%) followed by industry (31.9%) and US-government (9.6%). Neurology trials focused more on treatment than prevention compared to non-neurology studies. Of neurology trials, 11.3% discontinued early, and 32.2% of completed trials reported results by April 30, 2018. In multivariable analysis accounting for time-to-event, neurology trials were at lower risk of discontinuation than non-neurology trials (adjusted hazard 0.83, p < 0.0001). Both academic and government-funded trials had greater risk of discontinuation than industry (adjusted hazard 0.57 and 0.46, respectively). Among completed trials, government-funded studies (adjusted odds ratio 2.12, p < 0.0001) had highest odds of results reporting while academic trials reported less (adjusted odds ratio 0.51, p < 0.0001). Conclusions: Funding source is associated with trial characteristics and outcomes in neurology. Improvements in trial completion and timely dissemination of results remain urgent goals for the field.

关键词： COVID-19   Neurological predictors  

关键词： COVID-19   Neurology   Mortality   Stroke   Dementia  

摘要： Background: Neurological involvement in Coronavirus disease-2019 (COVID-19) is widely recognized. However, the role of pre-existing neurological comorbidities in modulating COVID-19-related mortality still remains unclear. This cohort study evaluates the COVID-19-related case fatality rate (CFR) of patients with pre-existing neurological diseases. Methods: We retrospectively evaluated all patients consecutively admitted to our hospital with a diagnosis of COVID-19 between March and April 2020. We used a multivariate regression analysis to estimate the association between pre-existing neurological diseases and COVID-19-related mortality. Then, we compared the CFR and survival curves of two cohorts (patients suffering vs. those not suffering from pre-existing neurological disease), matched trough the propensity score (PS). Age and other comorbidities were considered for PS calculation. We applied a 1:1 matching for the entire neurological cohort and, separately, for cerebrovascular, neurodegenerative, and other neurological diseases. Results: Among 332 patients, 75 (22.6%) were affected by pre-existing neurological disease (n = 29 cerebrovascular, n = 26 neurodegenerative, n = 20 others). From the multivariate regression analysis, they resulted with a significant increase of COVID-19-related mortality (OR:2.559;95%CI 1.181-5.545;p < 0.017). From the cohort analysis, CFR resulted 2-fold higher in patients with neurological disease (48.0% vs. 24.0%;p = 0.002). CFR was significantly higher in patients with neurodegenerative diseases compared to matched individuals (73.9% vs. 39.1%;p = 0.017), while CFR increase in patients with cerebrovascular diseases did not reach statistical significance (48.3% vs. 41.4%;p = 0.597). Conclusions: Pre-existing neurological comorbidities, in particular neurodegenerative diseases, increase significantly COVID-19-related case fatality, indicating a clear priority for viral screening, access to care facilities and vaccination in these popul

关键词： TBL教学模式   神经病学   效果  

摘要： 观察TBL教学模式在神经病学教学中的应用价值。方法:选取医学生96例(2019年8月至2020年11月),随机分为TBL教学模式的观察组(48例)与传统教学的对照组(48例),观察考核成绩、学生满意度及依从性。结果:与对照组相比,观察组考核成绩高,学生满意度评分高,依从性好,P<0.05。结论:在神经病学教学中应用TBL教学模式,能使学生掌握更多的学习,且学生满意度高,依从性好,值得借鉴。

关键词： 中华医学会   罕见病   中国医学科学院   神经病学   重大疾病   脑血管病   北京协和医院   学术会议  

摘要： 近年来,我国神经病学领域发展迅速,除脑血管病等重大疾病取得了诸多研究成果外,罕见病也开始逐渐被关注,在政策层面也越来越受到重视在中华医学会第二十四次全国神经病学学术会议召开前夕,为了更好地了解神经系统罕见病的研究进展,本刊特遨采访了中华医学会神经病学分会前任主任委员、中国医学科学院北京协和医院崔丽英教授.

摘要： The proceedings contain 228 papers. The topics discussed include: risk mitigation behaviors to prevent infection in the mitochondrial disease community during the COVID19 pandemic; early heart rate variability correlates with pre-operative brain injury score in infants with congenital heart disease; rapid exome and genome sequencing in critically ill patients: 3-year experience from a single center; neurologic outcomes in neonatal extracorporeal cardiopulmonary resuscitation; validation of TUBB4A severity score as a prediction tool for neurologic outcomes; national, data insights for Krabbe disease burden, costs, disparities, and incidence; a phase I study of oral vitamin d supplementation in 21 boys with X-linked adrenoleukodystrophy; the current landscape of inpatient child neurology: a survey of North American programs; genomics curriculum during child neurology residency: results of a national survey; adult neurology rotations for child neurology residents: a survey of program directors; and non-cell autonomous hyperexcitability underlies focal epileptogenesis mediated by low-level brain somatic mutations in MTOR.

关键词： 神经病学恐惧症   神经科学   神经病学   住培医师   现状调查   医学教育  

摘要： 目的了解住院规培学员中“神经病学恐惧症”存在情况,分析发生的原因,以及探讨有效改进神经病学教学的对策。方法本研究采用问卷调查方法,海南医学院第一附属医院内科基地189名住培医师完成相关利克特量表,结果用(x±s)表示。结果大部分住培医师认为神经病学是诊断最困难的学科。他们对神经病学疾病的治疗信心低于其他医学亚专科。神经解剖学的复杂性被认为是造成神经学相关困难的最大原因。加强床边教学,增加患者接触量,可以提高教学质量。结论“神经病学恐惧症”确实存在于住培医师中,与神经解剖的复杂性、患者接触量有限,以及与神经学相关的教学时间不足有关。加强床边教学,增加患者接触,可以提高教学质量。

关键词： 神经精神疾病   康复医学   神经遗传学   精神病学   神经内科   精神科   神经病学   科研方法  

摘要： 《中国神经精神疾病杂志》为我国神经病学与精神病学核心期刊,国内外公开发行。本刊以广大神经内科、神经外科、精神科及相关学科(包括神经生物学、神经遗传学及康复医学等)医师为主要读者,报告神经精神学科领域领先的科研方法、科研成果和临床诊疗经验,以及对神经精神疾病临床有指导意义的基础理论研究。