关键词： 办刊宗旨   中国医师协会   神经疾病   神经解剖学   普及与提高   神经病学   专业期刊   神经内外科  

摘要： 《中国现代神经疾病杂志》为国家卫生健康委员会主管、中国医师协会主办的神经病学类专业期刊。办刊宗旨为:理论与实践相结合、普及与提高相结合,充分反映我国神经内外科临床科研工作重大进展,促进国内外学术交流。所设栏目包括述评、专论、论著、临床病理报告、应用神经解剖学、神经影像学、循证神经病学、流行病学调查研究、基础研究、临床研究、综述、临床医学图像、病例报告、临床病理(例)讨论、新技术新方法等。

关键词： Cerebral palsy   Assistive technology   Brain-computer interface  

摘要： Cerebral palsy is a childhood condition in which there is a motor disability (palsy) caused by a static, non-progressive lesion in the brain (cerebral), produced by decreased brain oxygenation during pregnancy at birth or soon after birth. The rehabilitation of patients with disabilities such as cerebral palsy is usually accomplished through exercises performed by a team of several specialists so that the patient can act independently or minimize the need for third parties. The virtual reality environment called REHAB FUN was developed as a purpose to aid in the treatment of patients with cerebral palsy from 3 to 8 years. The REHAB FUN is composed of 10 phases (activities) and a web area for analysis of the specialists to follow the evolution of the patients. Seven patients were participated using the virtual environment twice a week for 3 months (20 sessions). We measured attention levels, errors, and time. The REHAB FUN has been shown to be a motivating tool for patients, and through the data acquired, the specialists can direct the treatment in an individualized way so that there are greater effectiveness and efficiency in the treatment of motor rehabilitation.

关键词： Outcomes research   Trauma  

摘要： Study design Cross-sectional survey. Objectives Most studies on neurological recovery after traumatic spinal cord injury (tSCI) assess treatment effects using the American Spinal Injury Association Impairment Scale (AIS grade) or motor points recovery. To what extent neurological recovery is considered clinically meaningful is unknown. This study investigated the perceived clinical benefit of various degrees of neurological recovery one year after C5 AIS-A tSCI. Setting The Netherlands. Methods By means of a web-based survey SCI patients and physicians evaluated the benefit of various scenarios of neurological recovery on a scale from 0 to 100% (0% no benefit to 100% major benefit). Recovery to AIS-C and D, was split into C/C+ and D/D+, which was defined by the lower and upper limit of recovery for each grade. Results A total of 79 patients and 77 physicians participated in the survey. Each AIS grade improvement from AIS-A was considered significant benefit (all p < 0.05), ranging from 47.8% (SD 26.1) for AIS-B to 86.8% (SD 24.3) for AIS-D+. Motor level lowering was also considered significant benefit (p < 0.05), ranging from 66.1% (SD 22.3) for C6 to 81.7% (SD 26.0) for C8. Conclusions Meaningful recovery can be achieved without improving in AIS grade, since the recovery of functional motor levels appears to be as important as improving in AIS grade by both patients and physicians. Moreover, minor neurological improvements within AIS-C and D are also considered clinically meaningful. Future studies should incorporate more detailed neurological outcomes to prevent potential underestimation of neurological recovery by only using the AIS grade.

关键词： Continuous health monitoring   classification processor   electroencephalogram (EEG)   emotion detection   machine learning   neurological disorder   support vector machine  

摘要： Chronic neurological disorders (CND's) are lifelong diseases and cannot be eradicated, but their severe effects can be alleviated by early preemptive measures. CND's, such as Alzheimer's, Autism Spectrum Disorder (ASD), and Amyotrophic Lateral Sclerosis (ALS), are the chronic ailment of the central nervous system that causes the degradation of emotional and cognitive abilities. Long term continuous monitoring with neuro-feedback of human emotions for patients with CND's is crucial in mitigating its harmful effect. This paper presents hardware efficient and dedicated human emotion classification processor for CND's. Scalp EEG is used for the emotion's classification using the valence and arousal scales. A linear support vector machine classifier is used with power spectral density, logarithmic interhemispheric power spectral ratio, and the interhemispheric power spectral difference of eight EEG channel locations suitable for a wearable non-invasive classification system. A look-up-table based logarithmic division unit (LDU) is to represent the division features in machine learning (ML) applications. The implemented LDU minimizes the cost of integer division by 34% for ML applications. The implemented emotion's classification processor achieved an accuracy of 72.96% and 73.14%, respectively, for the valence and arousal classification on multiple publicly available datasets. The 2 x 3mm(2) processor is fabricated using a 0.18 mu m 1P6M CMOS process with power and energy utilization of 2.04 mW and 16 mu J/classification, respectively, for 8-channel operation.

关键词： Cardiac arrest   Transfusion   Hemoglobin outcome   Prognosis  

摘要： Introduction: Hemoglobin (Hb) is a main determinant of tissue oxygen delivery and anemia could be particularly harmful in post-anoxic brain injury. The aim of this study was to evaluate the association of Hb and venous Hb oxygen saturation (SvO(2)/ScvO(2)) with long-term neurological outcome in patients admitted after cardiac arrest (CA). Methods: Analysis of adult CA patients admitted to the Department of Intensive Care of the Erasme University Hospital (Brussels, Belgium) over 9 years. We retrieved all data concerning CA characteristics as well as Hb during the first 48 h since injury as well as the need for red blood cells transfusions (RBCT). Minimum Hb and Hb oxygen saturation values were recorded. Neurological outcome was evaluated 3 months after CA. Unfavorable neurological outcome (UO) was defined as a Cerebral Performance Categories (CPC) score of 3-5. Results: We treated 414 patients patients with CA, including 231 (56%) out-of-hospital cardiac arrest (OHCA) and 158 (38%) with an initial shockable rhythm. Median Hb concentration on admission was 12.0 [9.9-13.7] g/dL and the lowest Hb concentration was 10.0 [8.1-11.0] g/dL;127 patients (31%) received at least one RBCT. Hb oxygen saturation on admission was 67 [59-74]%, while the lowest value was 60 [53-68]%. Low Hb and Hb oxygen saturation values were independently associated with UO;the optimal cut-off to predict UO was <9.9 g/dL and <60%, respectively. Conclusions: Low hemoglobin values and low values of oxygen venous saturation are significantly associated with unfavorable neurological outcome in adult patients resuscitated from cardiac arrest.

关键词： animal-assisted therapy   dog-assisted therapy   neurorehabilitation   child   dog  

摘要： Background Dog-assisted therapy (DAT) is increasingly applied in neurorehabilitation of patients with severe neurological impairments. To date, there are only anecdotal reports investigating its effects. Objectives This study was aimed to evaluate the potential of DAT in pediatric inpatient neurorehabilitation for severely neurologically impaired children and adolescents, to identify characteristics of patients receiving this therapy, characteristics of the therapy sessions, and to evaluate feasibility and extent of goal achievement. Methods We retrospectively analyzed 850 DAT sessions performed between 2010 and 2017 at an inpatient neurorehabilitation center. The dataset included 196 children and adolescents (Md = 5.50, 0.58-20.33 years) suffering from severe neurological impairments (disorders of consciousness in 37 patients) of various etiologies. We extracted information regarding patient and session characteristics, analyzed the predefined goals with content analysis, and examined to what extent the goals were met during DAT. Data were analyzed using descriptive statistics. Results Patients received an average of 4.34 therapy sessions. A total of 247 of 392 predefined goals (63%) were reached during DAT. The most frequently achieved goal was "enhancing fun" (83%), followed by "establishing contact and communication" (81%), and "relaxation" (71%). Only one critical incident regarding the dogs' safety occurred. Conclusion DAT is a feasible approach and appears to facilitate emotional, social, and psychological goals in children and adolescents with severe neurological impairment.

摘要： The European Academy of Neurology is 6 years old: challenges, opportunities and strategic priorities for the future European Academy of Neurology 2014-2019: foundation and growth The birth of the European Academy of Neurology (EAN) took place in Istanbul in 2014, on the occasion of the last (and joint) meeting of the ENS and EFNS. Front row: Prof. Fanz Fazekas (EAN President 2018-2020), Prof. Hanna Cock, Prof. Günther Deuschl (EAN President 2014-2018), Prof. Paul Boon and Prof. David Vodusek. [Extracted from the article]

关键词： KCND3   SCA19   22   ataxia   Kv4   3   neurodevelopmental disorder   cerebellum   movement disorders   parkinsonism   dystonia  

摘要： KCND3encodes the voltage-gated potassium ion channel subfamily D member 3, a six trans-membrane protein (Kv4.3), involved in the transient outward K(+)***3defect causes both cardiological and neurological syndromes. From a neurological perspective, Kv4.3 defect has been associated to SCA type 19/22, a complex neurological disorder encompassing a wide spectrum of clinical features beside ataxia. To better define the phenotypic spectrum and course ofKCND3-related neurological disorder, we review the clinical presentation and evolution in 68 reported cases. We delineated two main clinical phenotypes according to the age of onset. Neurodevelopmental disorder with epilepsy and/or movement disorders with ataxia later in the disease course characterized the early onset forms, while a prominent ataxic syndrome with possible cognitive decline, movement disorders, and peripheral neuropathy were observed in the late onset forms. Furthermore, we described a 37-year-old patient with a de novoKCND3variant [c.901T>C (***301Pro)], previously reported in dbSNP as rs79821338, and a clinical phenotype paradigmatic of the early onset forms with neurodevelopmental disorder, epilepsy, parkinsonism-dystonia, and ataxia in adulthood, further expanding the clinical spectrum of this condition.

关键词： cutis laxa   neurological findings   vascular tortuosity  

摘要： Cutis laxa is a heterogeneous group of diseases, characterized by abundant and wrinkled skin and a variable degree of intellectual disability. Cutis laxa, autosomal recessive, type IIIA and autosomal dominant 3 syndromes are caused by autosomal recessive or de novo pathogenic variants inALDH18A1. Autosomal recessive variants are known to lead to the most severe neurological phenotype, and very few patients have been described. We describe a 13-month-old patient with cutis laxa, autosomal recessive, type IIIA, with an extremely severe phenotype, including novel neurological findings. This description enlarges the neurological spectrum associated to cutis laxa, autosomal recessive, type IIIA, and provides an additional description of this syndrome.

关键词： COVID-19   SARS-CoV-2   Neurological manifestations   Neurological symptoms   Coronavirus  

摘要： Background As the COVID-19 pandemic developed, reports of neurological dysfunctions spanning the central and peripheral nervous systems have emerged. The spectrum of acute neurological dysfunctions may implicate direct viral invasion, para-infectious complications, neurological manifestations of systemic diseases, or co-incident neurological dysfunction in the context of high SARS-CoV-2 prevalence. A rapid and pragmatic approach to understanding the prevalence, phenotypes, pathophysiology and prognostic implications of COVID-19 neurological syndromes is urgently needed. Methods The Global Consortium to Study Neurological dysfunction in COVID-19 (GCS-NeuroCOVID), endorsed by the Neurocritical Care Society (NCS), was rapidly established to address this need in a tiered approach. Tier-1 consists of focused, pragmatic, low-cost, observational common data element (CDE) collection, which can be launched immediately at many sites in the first phase of this pandemic and is designed for expedited ethical board review with waiver-of-consent. Tier 2 consists of prospective functional and cognitive outcomes assessments with more detailed clinical, laboratory and radiographic data collection that would require informed consent. Tier 3 overlays Tiers 1 and 2 with experimental molecular, electrophysiology, pathology and imaging studies with longitudinal outcomes assessment and would require centers with specific resources. A multicenter pediatrics core has developed and launched a parallel study focusing on patients ages <18 years. Study sites are eligible for participation if they provide clinical care to COVID-19 patients and are able to conduct patient-oriented research under approval of an internal or global ethics committee. Hospitalized pediatric and adult patients with SARS-CoV-2 and with acute neurological signs or symptoms are eligible to participate. The primary study outcome is the overall prevalence of neurological complications among hospitalized COVID-19 patients, wh