关键词： 癫痫,颞叶   神经病学表现   情景重现先兆   定位  

摘要： 目的初步探讨情景重现先兆在癫痫发作定位中的作用。方法回顾性分析2015年1月至2020年6月首都医科大学宣武医院功能神经外科收治的8例以情景重现为先兆的癫痫发作患者的临床资料。基于临床症状、术前影像学资料、神经电生理结果进行癫痫发作定位诊断。8例患者中,5例行立体定向脑电图(SEEG)电极置入定位致痫灶及皮质电刺激定位功能区后手术切除致痫灶;另3例仅接受致痫灶切除术。术后分别于3、6、12及24个月进行门诊随访。根据改良Engel分级评估手术疗效。结果8例患者中,癫痫起源于左侧颞叶5例,右侧颞叶3例;颞底2例,颞上回3例,颞叶内侧3例。8例患者均顺利完成致痫灶切除术。8例患者术后随访1~5年。至末次随访,8例患者均无癫痫发作,疗效分级均为改良Engel分级Ⅰ级。结论初步观察发现,情景重现为先兆的癫痫发作多起源于颞叶,但未观察到明显的定侧作用。

关键词： 中国科协   科技工作者   期刊分级   中文期刊   神经病学   行为医学   专家评议   脑科学  

摘要： 《中华行为医学与脑科学杂志》入选全国高质量科技期刊分级目录,属临床医学神经病学学科。神经病学领域全球学术期刊共有70种入选,中文期刊仅有11种。根据中国科协、中宣部、教育部、科技部联合印发的《关于深化改革培育世界一流科技期刊的意见》,中国科协经过统一部署,开展了全国高质量科技期刊分级目录发布工作。遵照同行评议、价值导向、等效应用原则,国内各大学会、协会、组织机构通过科技工作者推荐、专家评议、结果公示等规定程序,形成了本领域科技期刊分级目录。

关键词： 课程思政   线上教学   医学   神经病学   脑梗死   临床实践  

摘要： 思想政治教育融入医学人才培养是线上授课的重点和难点,是全国医学教育系统教师的一项巨大的考验和重要的历史使命。本文以神经病学中脑梗死临床实践线上教学为例,探讨通过病例引导、小组讨论、角色扮演等多种线上教学方法,和录制视频、结合时事、讲人文故事等线上教学手段,实现思政教育与临床实践线上教学的有机融合,课后190份教学总体满意度调查问卷显示,非常满意达到32.11%,比较满意达到44.21%,一般满意达到22.11%,仅有1.58%不满意。思想政治教育融入医学人才培养是线上授课在帮助学生理解复杂难懂神经病学知识的同时,提高医患沟通能力,培养医学生职业素养、个人品德,树立医学生责任感和使命感、救死扶伤的价值观,时刻牢记不忘学医初心,护佑人民生命健康的爱国情怀。

关键词： electroencephalogram   physiological biomarker   advanced driver assistance system (ADAS)   mental workload   driving simulator  

摘要： Physiological signals are immediate and sensitive to neurological changes resulting from the mental workload induced by various driving environments and are considered a quantifying tool for understanding the association between neurological outcomes and driving cognitive workloads. Neurological assessment, outside of a highly-equipped clinical setting, requires an ambulatory electroencephalography (EEG) headset. This study aimed to quantify neurological biomarkers during a resting state and two different scenarios of driving states in a virtual driving environment. We investigated the neurological responses of seventeen healthy male drivers. EEG data were measured in an initial resting state, city-roadways driving state, and expressway driving state using a portable EEG headset in a driving simulator. During the experiment, the participants drove while experiencing cognitive workloads due to various driving environments, such as road traffic conditions, lane changes of surrounding vehicles, the speed limit, etc. The power of the beta and gamma bands decreased, and the power of the delta waves, theta, and frontal theta asymmetry increased in the driving state relative to the resting state. Delta-alpha ratio (DAR) and delta-theta ratio (DTR) showed a strong correlation with a resting state, city-roadways driving state, and expressway driving state. Binary machine-learning (ML) classification models showed a near-perfect accuracy between the resting state and driving state. Moderate classification performances were observed between the resting state, city-roadways state, and expressway state in multi-class classification. An EEG-based neurological state prediction approach may be utilized in an advanced driver-assistance system (ADAS).

关键词： Neurology   Psychopharmacology   Pharmacotherapy   Neurosciences   Psychiatry  

摘要： Secondary immunodeficiencies (SIDs) are acquired conditions that may occur as sequelae of immune therapy. In recent years a number of disease-modifying therapies (DMTs) has been approved for multiple sclerosis and related disorders such as neuromyelitis optica spectrum disorders, some of which are frequently also used in- or off-label to treat conditions such as chronic inflammatory demyelinating polyneuropathy (CIDP), myasthenia gravis, myositis, and encephalitis. In this review, we focus on currently available immune therapeutics in neurology to explore their specific modes of action that might contribute to SID, with particular emphasis on their potential to induce secondary antibody deficiency. Considering evidence from clinical trials as well as long-term observational studies related to the patients' immune status and risks of severe infections, we delineate long-term anti-CD20 therapy, with the greatest data availability for rituximab, as a major risk factor for the development of SID, particularly through secondary antibody deficiency. Alemtuzumab and cladribine have relevant effects on circulating B-cell counts;however, evidence for SID mediated by antibody deficiency appears limited and urgently warrants further systematic evaluation. To date, there has been no evidence suggesting that treatment with fingolimod, dimethyl fumarate, or natalizumab leads to antibody deficiency. Risk factors predisposing to development of SID include duration of therapy, increasing age, and pre-existing low immunoglobulin (Ig) levels. Prevention strategies of SID comprise awareness of risk factors, individualized treatment protocols, and vaccination concepts. Immune supplementation employing Ig replacement therapy might reduce morbidity and mortality associated with SIDs in neurological conditions. In light of the broad range of existing and emerging therapies, the potential for SID warrants urgent consideration among neurologists and other healthcare professionals.

关键词： Nervous system diseases   Neurology   Health services administration   Telemedicine   COVID-19  

摘要： Background The COVID-19 pandemic leads to disruptions of health services worldwide. To evaluate the particular impact on neurological services a rapid review was conducted. Methods Studies reporting the provision of neurological services during the pandemic and/or adopted mitigation strategies were included in this review. PubMed and World Health Organization's (WHO) COVID-19 database were searched. Data extraction followed categories used by WHO COVID-19 pulse surveys and operational guidelines on maintaining essential health services during COVID-19. Findings The search yielded 1101 articles, of which 369 fulfilled eligibility criteria, describing data from 210,419 participants, being adults (81%), children (11.4%) or both (7.3%). Included articles reported data from 105 countries and territories covering all WHO regions and World Bank income levels (low income: 1.9%, lower middle: 24.7%, upper middle: 29.5% and high income;44.8%). Cross-sectoral services for neurological disorders were most frequently disrupted (62.9%), followed by emergency/acute care (47.1%). The degree of disruption was at least moderate for 75% of studies. Travel restrictions due to lockdowns (81.7%) and regulatory closure of services (65.4%) were the most commonly reported causes of disruption. Authors most frequently described telemedicine (82.1%) and novel dispensing approaches for medicines (51.8%) as mitigation strategies. Evidence for the effectiveness of these measures is largely missing. Interpretation The COVID-19 pandemic affects all aspects of neurological care. Given the worldwide prevalence of neurological disorders and the potential long-term neurological consequences of COVID-19, service disruptions are devastating. Different strategies such as telemedicine might mitigate the negative effects of the pandemic, but their efficacy and acceptability remain to be seen.

关键词： COVID-19   Residents in neurology   Training   Real-world experience   Early employment  

摘要： Background The coronavirus disease 2019 (COVID-19) pandemic has severely impacted the Italian healthcare system, underscoring a dramatic shortage of specialized doctors in many disciplines. The situation affected the activity of the residents in neurology, who were also offered the possibility of being formally hired before their training completion. Aims (1) To showcase examples of clinical and research activity of residents in neurology during the COVID-19 pandemic in Italy and (2) to illustrate the point of view of Italian residents in neurology about the possibility of being hired before the completion of their residency program. Results Real-life reports from several areas in Lombardia-one of the Italian regions more affected by COVID-19-show that residents in neurology gave an outstanding demonstration of generosity, collaboration, reliability, and adaptation to the changing environment, while continuing their clinical training and research activities. A very small minority of the residents participated in the dedicated selections for being hired before completion of their training program. The large majority of them prioritized their training over the option of earlier employment. Conclusions Italian residents in neurology generously contributed to the healthcare management of the COVID-19 pandemic in many ways, while remaining determined to pursue their training. Neurology is a rapidly evolving clinical field due to continuous diagnostic and therapeutic progress. Stakeholders need to listen to the strong message conveyed by our residents in neurology and endeavor to provide them with the most adequate training, to ensure high quality of care and excellence in research in the future.

关键词： Central nervous system infections   Meningitis   Microbiology   Medicine/Public Health   general   Neurology  

摘要： In India, the peak of SARS-CoV-2 infections in May 2021 was paralleled by an outbreak of rhino-oculo-cerebral mucormycosis (ROCM) - a fungal infection affecting the nose, eyes and brain. This outbreak provided a unique opportunity to study the neurological manifestations of ROCM and to investigate new treatments for the condition.

关键词： advocacy   COVID-19   disparity   equitable global health   neurology   primary prevention   SARS-CoV-2  

摘要： Coronavirus disease 2019 (COVID-19), a multi-organ disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to challenge health and care systems around the globe. The pandemic has disrupted acute neurology services and routine patient care and has impacted the clinical course in patients with chronic neurological disease. COVID-19 appears to have exposed inequalities of societies and healthcare systems and had a disproportionate impact on already vulnerable communities. The next challenge will be to set up initiatives to stop disparities in all aspects related to COVID-19. From the medical perspective, there is a need to consider inequalities in prevention, treatment and long-term consequences. Some of the issues of direct relevance to neurologists are summarised. With this appraisal, the European Academy of Neurology NeuroCOVID-19 Task Force intends to raise awareness of the potential impact of COVID-19 on inequalities in healthcare and calls for action to prevent disparity at individual, national and supranational levels.

摘要： Manganese is an essential trace metal. The dysregulation of manganese seen in a broad spectrum of neurological disorders reflects its importance in brain development and key neurophysiological processes. Historically, the observation of acquired manganism in miners and people who misuse drugs provided early evidence of brain toxicity related to manganese exposure. The identification of inherited manganese transportopathies, which cause neurodevelopmental and neurodegenerative syndromes, further corroborates the neurotoxic potential of this element. Moreover, manganese dyshomoeostasis is also implicated in Parkinson's disease and other neurodegenerative conditions, such as Alzheimer's disease and Huntington's disease. Ongoing and future research will facilitate the development of better targeted therapeutical strategies than are currently available for manganese-associated neurological disorders.