关键词： Polycyclic aromatic hydrocarbon   Neuroimaging   Neurotoxicity   Brain cortical thickness   Cognitive function  

摘要： Background: Although some studies have suggested that exposure to polycyclic aromatic hydrocarbons (PAHs) induces neurodevelopmental disturbances in children and neurodegeneration in animals, the neurotoxic effect of PAH exposure is unclear in adults. The aim was to examine the associations of PAH exposure with brain structure and neuropsychological function in adults without known neurological diseases. Methods: This study included 421 men and 528 women dwelling in four cities in the Republic of Korea. Urinary concentrations of four PAH metabolites (1-hydroxypyrene, 2-naphthol, 1-hydroxyphenanthrene, and 2-hydroxyfluorene) were obtained. Participants underwent brain 3 T magnetic resonance imaging and neuropsychological tests. Cortical thickness and volume were estimated using the region-of-interest method. Separate generalized linear models were constructed for each sex, adjusting for age, years of education, cohabitation status, income, tobacco use, alcohol consumption, and vascular risk factors. Results: The mean (standard deviation) age was 68.3 (6.6) years in men and 664 (6.1) years in women. In men, those in quartile 4 (versus quartile 1, the lowest) of urinary 2 -naphthol concentration had cortical thinning in the global (beta = -0.03, P = .02), parietal (beta = 0.04, P = .01), temporal (beta = 0.06, P < .001), and insular lobes (beta = -0.05, P = .02). Higher quartiles of urinary 2 -naphthol concentration were associated with cortical thinning in the global (P = .01), parietal (P = .004), temporal (P < .001), and insular lobes (P = .01). In women, those in quartile 4 (versus quartile 1) of urinary 1-hydroxypyrene concentration had cortical thinning in the frontal (beta = -0.03, P = .006) and parietal lobes (beta = -0.03, P = .003). Higher quartiles of urinary 1-hydroxypyrene concentration were associated with cortical thinning in the frontal (P = .006) and parietal lobes (P = .001). In both sexes, verbal learning and memory scores significantly declined with

关键词： 缺氧缺血,脑   神经病学检查   神经行为学表现   婴儿,新生  

摘要： 缺氧缺血性脑病是新生儿获得性脑损伤的主要原因,可能导致长期的神经后遗症或死亡。通过神经系统评估量表在住院期间对患儿在新生儿期进行早期专业化评估,可以使医务人员早期发现和及时治疗疾病。本文综述了近年来国内外应用于缺氧缺血性脑病研究的新生儿期神经行为评估量表,旨在为临床研究和新生儿科医师选择神经行为评估工具提供参考和借鉴。

关键词： 办公系统   网址   主管单位   官方网站   域名   南京脑科医院   .com   临床神经病学  

摘要： 《临床神经病学杂志》网络采编办公系统原网址(ht:/***)自2018年8月15日起停用本刊网址正式变更为http://***.您可以输入新网址域名http://***进行登录,也可以通过本刊主管单位——南京脑科医院的官方网站(http://***)的链接进行登录。

关键词： 科研诚信   ID码   临床神经病学   交流研究成果   标识码   增值服务   投稿须知   OSI  

摘要： 《临床神经病学杂志》从2019年8月起正式加入OSID(Open Science Identity)开放科学计划。将通过在文章上添加开放科学二维标识码(OSID码),为读者和作者提供一个与业界同行和专家进行学术交流研究成果的途径,同时提供系列增值服务,提升论文的科研诚信。投稿本刊的作者请查看本刊投稿须知,注册“OSID作者助手”工具账号,使用工具创建OSID码,按照要求将稿件中加人OSID码一起投到本刊。

关键词： 神经病学   网络课程   思维导图   教学  

摘要： 应用网络课程结合思维导图的方法对高校大学生进行神经病学的教学,实验组在期末成绩、出勤率、学习兴趣等方面优于对照组。网络课程结合思维导图有助于提高高校大学生的自主学习能力,加强对神经系统疾病的理解与认识,夯实神经病学基础知识,有利于提高神经病学的教学质量。

关键词： Simulation   Mastery learning   Education   Seizures   Status epilepticus  

摘要： Background: Appropriate and timely treatment of status epilepticus (SE) decreases morbidity and mortality. Therefore, skill-based training in the identification and management of SE is crucial for clinicians. Objective: The objective of the study was to develop and evaluate the impact of a simulation-based mastery learning (SBML) curriculum to train neurology residents on the identification and management of SE. Methods: We used pretest-posttest design with a retention test on SE skills for this study. Neurology residents in the second postgraduate year (PGY-2) were eligible to participate in the SE SBML curriculum. Learners completed a baseline-simulated SE skills assessment ( pretest) using a 26 item dichotomous skills checklist. Next, they participated in a didactic session about the identification and management of SE, followed by deliberate skills practice. Subsequently, participants completed another skills assessment (posttest) using the same 26-item checklist. All participants were required to meet or exceed a minimum passing standard (MPS) determined by a panel of 14 SE experts using the Mastery Angoff standard setting method. After meeting the MPS at posttest, participants were reassessed during an unannounced in situ simulation session on the medical wards. We compared pretest with posttest simulated SE skills performance and posttest with reassessment in situ performance. Results: The MPS was set at 88% (23/26) checklist items correct. Sixteen neurology residents participated in the intervention. Participant performance improved from a median of 4423% (Interquartile range (IQR): 34.62-55.77) at pretest to 94.23% (IQR: 92.13-100) at the posttest after SBML (p < .001). There was no significant difference in scores between the posttest and in situ test up to 8 months later (9423%;IQR: 92.31-100 vs. 92.31%;IQR: 88.46-96.15;p = .13). Conclusions: Our SBML curriculum significantly improved residents' SE identification and management skills that were largely re

关键词： Brain lesion   Cryptogenic neurological disease   Diagnostic workup   Neuropathology   Neurosurgery  

摘要： Background: For nonneoplastic neurological diseases, no recommendation exists regarding the place or appropriate timing of brain biopsy. The aim of this study was to evaluate the diagnostic yield and safety of brain biopsies from patients with neurological diseases of unknown etiology. Methods: We performed a retrospective cohort study from January 1, 2008 to December 31, 2018. We analyzed 1847 brain-biopsied patients, including 178 biopsies indicated for neurological diseases of unknown etiology. Specific histological and final diagnosis rates, positive diagnosis-associated factors, complication rate and complication-associated factors were assessed. Results: Specific histological diagnosis and final diagnosis rates were 71.3% and 83.1%, respectively, leading to therapeutic management change(s) for 75.3% of patients. Brain- biopsy-related mortality and permanent neurological morbidity occurred in 1.1% and 0.6% of the patients, respectively. The multivariable logistic-regression model retained (odds ratio [95% CI] only immunodepression (2.2 [1.1-4.7];P = .04) as being independently associated with specific histological diagnosis, while supratentorial biopsy-targeted lesions (4.1 [1.1-15.2];P = .04) were independently associated with a final diagnosis. Biopsies obtained from comatose patients were less contributive to the diagnosis (0.2 [0.05-0.7];P = .01). Prebiopsy platelet count <100 G/L (28.5 [1.8-447];P = .02), hydrocephalus (6.3 [1.2-15.3];P = .02) and targeted lesions <1 cm (4.3 [1.2-15.3];P = .03) were independently associated with brain biopsy-related complications. Conclusion: For highly selected patients with neurological diseases of unknown etiology, brain biopsy has a high diagnostic yield and low frequency of severe complications. We advocate that this procedure be considered early in the diagnosis algorithm of these patients.

关键词： COVID-19   SARS-CoV-2   encephalitis   ADEM  

摘要： Preliminary clinical data indicate that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is associated with neurological and neuropsychiatric illness. Responding to this, a weekly virtual coronavirus disease 19 (COVID-19) neurology multi-disciplinary meeting was established at the National Hospital, Queen Square, in early March 2020 in order to discuss and begin to understand neurological presentations in patients with suspected COVID-19-related neurological disorders. Detailed clinical and paraclinical data were collected from cases where the diagnosis of COVID-19 was confirmed through RNA PCR, or where the diagnosis was probable/possible according to World Health Organization criteria. Of 43 patients, 29 were SARS-CoV-2 PCR positive and definite, eight probable and six possible. Five major categories emerged: (i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only;(ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin;one made a full recovery, 10 of 12 made a partial recovery, and one patient died;(iii) ischaemic strokes (n = 8) associated with a pro-thrombotic state (four with pulmonary thromboembolism), one of whom died;(iv) peripheral neurological disorders (n = 8), seven with Guillain-Barre syndrome, one with brachial plexopathy, six of eight making a partial and ongoing recovery;and (v) five patients with miscellaneous central disorders who did not fit these categories. SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some ca

摘要： Mutations of SOX10 result in a broad range of phenotypes including Waardenburg syndrome (WS types 2 and 4) that can be found in association with peripheral demyelinating neuropathy and/or central dysmyelinating leukodystrophy. Here, we generated induced pluripotent stem cells (iPSCs) from a patient carrying a de novo heterozygous missense mutation in the SOX10 gene (MIM* 602229, NM006941.3c.523C > G;***175Ala) presenting with deafness, depigmentation and progressive neurological impairment. Cells were reprogrammed by non-integrative viral transduction from blood sample, have normal karyotype, express pluripotency markers and are able to differentiate into the three germ cell layers.

关键词： Eugenics   Feebleminded   Medical ethics   Epilepsy   Huntington disease   Friedreich ataxia   Eugenics Record Office   Nuremberg Code  

摘要： Background: In 1936, the American Neurological Association (ANA) published the book "Eugenical Sterilization: A Reorientation of the Problem" in response to what the first author of the book described as a positive reception to a paper presented at the ANA's 1935 annual meeting. The conclusions of the presentation were approved by the organization during the same meeting. As evidenced by the publication of several book reviews in a variety of medical journals, the book garnered some attention. Methods: Reviews of the ANA's book were sought using PubMed, Google Scholar, and Embasa. Also, the book's title was used to search the World Wide Web. Results: The search yielded four reviews, all published in 1937. The reviews make evident a positive opinion of the ANA's book's authors' recommendations including the option for "selective sterilization" of patients with conditions such as Huntington disease, Friedreich ataxia, and epilepsy. In addition, reviewers highlighted the book's authors' assessment that "the feebleminded [breed] docile, servile, useful people who do the dirty work of the race, [as] servants fulfilling a social function." Conclusions: Although the book's authors did not advocate for all-out eugenical sterilization, they did little to counter the popular opinion that patients with certain neurological diseases were a drain on society. In addition, they espoused a positive vision of the feebleminded's role as servants who can do undesirable work. This message was disseminated through book reviews. (C) 2020 Elsevier Inc. All rights reserved.