关键词： 神经病学与神经康复学杂志   证明文件   缩略词   投稿声明  

摘要： 《神经病学与神经康复学杂志》(CN:31-1927/R;ISSN:1672-7061)由上海市卫生和计划生育委员会主管,上海市中西医结合学会、上海交通大学医学院附属仁济医院主办,是国内外公开发行的神经病学与神经康复学领域的专业学术期刊,以神经科、神经康复科和精神科临床医师及相关领域的科研人员及在校师生为主要读者对象。

关键词： 中西医结合神经病学   临床教学   临床思维   Midnights原则   鉴别诊断  

摘要： 中西医结合神经病学是运用传统中医理论结合现代神经病学,利用现代科技手段,研究神经系统疾病的发生、发展、变化规律和诊疗技术,是一门跨专业、跨学科的临床学科。该学科专业性强,内容复杂抽象难懂,临床病种繁多、病情多变,临床诊断思维方式特别,必须有定位诊断和定性诊断,往往是医学生学习的难点。"Midnights"原则临床思维可以针对临床实际病例轻松进行病因大类的排除鉴别诊断,代表着一种开放的、非固定、非封闭式的教学模式,让学生知识体系更完整,极大地激发学生对中西医结合神经内科学的兴趣,提高临床教学效果。

关键词： patients   experiences   mealtimes   interviews   Paul Ricouer   phenomenology   hermeneutic   qualitative research  

摘要： BackgroundMany patients suffering from a neurological disease experience eating difficulties during mealtimes in the hospital. Consequently, they often refrain from eating in public places to avoid potentially awkward situations. Eating is an essential part of life, providing patients with comfort during their hospitalisation. Therefore, attention should be paid to these patients, who encounter eating difficulties to foster a positive mealtime experience. AimTo study what patients afflicted with a neurological disease experience and assign meaning when participating in mealtimes during hospitalisation. MethodTen semi-structured interviews with patients were conducted and recorded. After transcription the text was analysed, and interpreted compromising three methodological steps inspired by the French philosopher, Paul Ricouer. FindingsThree themes were identified through data analysis and interpretation: i) The missing feeling of homeliness, ii) The battle between socialisation vs. isolation, and iii) The sense of time, rhythm, and presence. ConclusionsTo patients suffering from a neurological disease, mealtimes are not only a manageable task, but also a part of existential care that leads to positive experience. Aesthetic elements were shown to have the potential of making the patients feel comfortable and homely when hospitalised. This was important, as our study also identified that patients were longing for homeliness when participating in mealtimes during hospitalisation. Relevance to clinical practiceOur findings emphasised the need of proceeding to interventions that includes mealtime assistance and protects the mealtime activity. Hence, it informs hospital organisations of the importance of restructuring mealtime environment, so that existential care can take place.

关键词： arenavirus   enterovirus   herpes simplex virus   Mycoplasma pneumoniae   neuroborreliosis   parechovirus  

摘要： Directly-transmitted rodent-borne zoonotic viruses, such as lymphocytic choriomeningitis virus (LCMV) can cause nervous system infections. Rodent-borne Ljungan virus (LV) is considered potentially zoonotic possibly causing neurological symptoms. Our objective was to understand the role of these two viruses compared to other pathogens in causing neurological infections in Finnish patients. Routine screening data were available for 400 patients aged 5-50 years, collected from December 2013 to December 2014 with suspected neurological infection. Depending on symptoms, patients were variously tested for herpesviruses, enteroviruses, varicella zoster virus, and Mycoplasma pneumoniae, while those suspected of tick bite were further tested for Borrelia spp. and tick-borne encephalitis virus using antibody and/or nucleic acid tests. For 380 patients, we also screened the RNA and antibody prevalence of LCMV and LV in order to test if either of these viruses were the causative agent. Data collected indicated that the causative microbial agent was confirmed in only 15.5% of all Finnish patients with neurological symptoms, with M. pneumoniae (26 cases) being the most common causative agent found in sera, whereas Borrelia spp. (15), herpes simplex viruses (7), and enteroviruses (5) were the most common agents confirmed in the CSF. The seroprevalences for LV and LCMV were 33.8% and 5.0%, respectively, but no samples were PCR-positive. In this study, M. pneumoniae and Borrelia spp. were the most common causative agents of neurological infections in Finland. No LCMV or LV infections were detected. We conclude there was no association of LV with neurological diseases in this patient cohort.

关键词： Neurodegeneration  

摘要： Celia's encephalopathy (progressive encephalopathy with/without lipodystrophy, PELD) is a recessive neurodegenerative disease that is fatal in childhood. It is caused by a c. 985C>T variant in the BSCL2/seipin gene that results in an aberrant seipin protein. We evaluated neurological development before and during treatment with human recombinant leptin (metreleptin) plus a dietary intervention rich in polyunsaturated fatty acids (PUFA) in the only living patient. A 7 years and 10 months old girl affected by PELD was treated at age 3 years with metreleptin, adding at age 6 omega-3 fatty acid supplementation. Her mental age was evaluated using the Battelle Developmental Inventory Screening Test (BDI), and brain PET/MRI was performed before treatment and at age 5, 6.5, and 7.5 years. At age 7.5 years, the girl remains alive and leads a normal life for her mental age of 30 months, which increased by 4 months over the last 18 months according to BDI. PET images showed improved glucose uptake in the thalami, cerebellum, and brainstem. This patient showed a clear slowdown in neurological regression during leptin replacement plus a high PUFA diet. The aberrant BSCL2 transcript was overexpressed in SH-SY5Y cells and was treated with docosahexaenoic acid (200 mu M) plus leptin (0.001 mg/ml) for 24 h. The relative expression of aberrant BSCL2 transcript was measured by qPCR. In vitro studies showed significant reduction (32%) in aberrant transcript expression. This therapeutic approach should be further studied in this devastating disease.

关键词： anxiety   ADHD   PANESS   Stroop   TMT  

摘要： Objective:To compare the neuro-cognitive profiles among initial clinic referred medication naive sample of children with anxiety disorders (ANXs) and ADHD in a youth sample. Method: Three groups of patients, ANX (n = 40), ADHD (n = 48), and ANX + ADHD (n = 33), aged 7 to 12 years, were compared with respect to their Physical and Neurological Examination for Subtle Signs (PANESS) and cognitive measures (digit span, digit symbol, Trail Making Test [TMT]-A and TMT-B, Stroop test). Results: ADHD group performed worse than the other two groups with regard to soft signs and cognitive test performance;ANX + ADHD were impaired relative to ANX but better than ADHD. Significant differences were found for gait and station problems, overflows and timed movements, TMT error points, and Stroop interference scores. ADHD patients had more difficulty in warding off irrelevant responses and lower speed of time-limited movements. Conclusion: This clinical evaluation study suggested that ANX and ADHD seem to have significantly different neuro-cognitive features: Poorest outcomes were observed among children with ADHD;rather than problems of attention, inhibitory control deficits were the most prominent differences between ANX and ADHD;and the presence of ANX appears to have mitigating effect on ADHD-related impairments.

关键词： magnetic resonance imaging (MRI)   surgery   spinal arachnoid diverticula  

摘要： Spinal cord dysfunction secondary to spinal arachnoid diverticula (SAD) has been widely reported in the veterinary literature and there is some suggestion that surgical treatment may provide better outcomes than medical treatment. Despite this, previous reports have mentioned cases with recurrence of clinical signs following surgical treatment but the cause for this has not been further investigated. The medical records of seven dogs and one cat which presented for investigation of recurrence of neurological deficits at least six months after surgery for SAD were retrospectively reviewed. Median time to relapse of the neurological deficits was 20.5 months after surgery. On repeated imaging, 3/8 cases showed clear regrowth of diverticulum, 2/8 cases showed dorsal compression at the previous laminectomy site (presumed to be the laminectomy membrane), and 3/8 cases showed herniation of the spinal cord through the laminectomy defect associated with a stellate appearance to the spinal cord with small multiloculated areas of dilation of the subarachnoid space. Repeat surgical intervention was most successful in the cases where SAD recurrence was identified while medical treatment resulted in either subtle improvement or stabilisation on the clinical signs, sometimes followed by slow deterioration.

关键词： A-to-I editing   Alzheimer's disease   Brain connectome   Epigenetics   Mitochondria   Mosaic brain   Parkinson's disease  

摘要： Alu elements are a highly successful family of primate-specific retrotransposons that have fundamentally shaped primate evolution, including the evolution of our own species. Alus play critical roles in the formation of neurological networks and the epigenetic regulation of biochemical processes throughout the central nervous system (CNS), and thus are hypothesized to have contributed to the origin of human cognition. Despite the benefits that Alus provide, deleterious Alu activity is associated with a number of neurological and neurodegenerative disorders. In particular, neurological networks are potentially vulnerable to the epigenetic dysregulation of Alu elements operating across the suite of nuclear-encoded mitochondrial genes that are critical for both mitochondrial and CNS function. Here, we highlight the beneficial neurological aspects of Alu elements as well as their potential to cause disease by disrupting key cellular processes across the CNS. We identify at least 37 neurological and neurodegenerative disorders wherein deleterious Alu activity has been implicated as a contributing factor for the manifestation of disease, and for many of these disorders, this activity is operating on genes that are essential for proper mitochondrial function. We conclude that the epigenetic dysregulation of Alu elements can ultimately disrupt mitochondrial homeostasis within the CNS. This mechanism is a plausible source for the incipient neuronal stress that is consistently observed across a spectrum of sporadic neurological and neurodegenerative disorders.

关键词： Bipolar disorder   Unipolar depression   Neurological Soft Signs  

摘要： Neuropsychiatric disorders are associated with neurological soft signs (NSS), including motor, sensory, and inhibitory dysfunction. The present study aims at determining the prevalence of NSS and explore the association of sociodemographic characteristics with the occurrence of NSS in patients with bipolar disorder and unipolar depression compared to healthy controls. A case-control study included a sample of 50 bipolar and unipolar patients and 50 healthy controls. NSS subscales of the Neurological Evaluation Scale (NES) were administered to each participant. Significant differences were found in the total NES score, motor coordination, sensory integration, sequence of complex motor act and other subscales among the three groups. Compared with healthy controls, patients with bipolar disorder showed significantly more total NSS signs, motor coordination signs and sensory-integration signs. When compared with patients with unipolar disorder, patients with bipolar disorder showed significantly more sensory integration signs and a trend of difference in the sequencing of complex motor acts and other subscales. Our findings suggest that NSS may be specifically associated with bipolar disorder but not unipolar depression. The specificity of NSS expression has the potential to help the discrimination of bipolar disorder from disorders less likely to have a neurodevelopmental component such as major depression.

摘要： Study design A cross-sectional study. Objectives To explore the need of upper limb contribution during sit-to-stand (STS) in ambulatory participants with spinal cord injury (SCI) and compare the lower limb loading during the sit-to-stand (LLL-STS) in those with SCI who performed the task with or without hands as compared to able-bodied individuals. In addition, the study assessed the correlation between the LLL-STS, and sensorimotor scores and functional ability in ambulatory participants with SCI. Setting A tertiary rehabilitation center and community hospitals, Thailand. Methods Forty-three participants with SCI who could perform STS with or without hands, and 10 able-bodied individuals were interviewed and assessed for their demographics, STS, and LLL-STS ability. Moreover, participants with SCI were assessed for SCI characteristics, sensorimotor scores, and functional ability relating to independent walking. Results More than half of participants with SCI (58%) performed STS using hands. Their LLL-STS, sensorimotor, and functional ability were significantly lower than those with SCI who performed the task without hands. The LLL-STS of participants with SCI, particularly amount, was significantly associated with their sensorimotor scores and functional ability (P < 0.05). Conclusions The findings indicated that those with marked lower limb muscle weakness and sensory impairments used their hands during STS. As such, the use of the hands during STS can be used as an indicator of neurological and functional impairments in ambulatory individuals with SCI.