Acupuncture can induce changes in the brain. However, the majority of studies to date have focused on a single acupoint at a time. In the present study, we observed activity changes in the brains of healthy volunteers before and after acupuncture atTaichong (LR3) andTaixi (KI3) using resting-state functional magnetic resonance imaging. Fifteen healthy volunteers underwent resting-state functional magnetic resonance imaging of the brain 15 minutes before acupuncture, then received acupuncture atTaichong andTaixi using the nail-pressing needle insertion method, after which the needle was retained in place for 30 minutes. Fifteen minutes after withdrawal of the needle, the volunteers underwent a further session of resting-state functional magnetic res-onance imaging, which revealed that the amplitude of low-frequency lfuctuation, a measure of spontaneous neuronal activity, increased mainly in the cerebral occipital lobe and middle occipital gyrus (Brodmann area 18/19), inferior occipital gyrus (Brodmann area 18) and cuneus (Brodmann area 18), but decreased mainly in the gyrus rectus of the frontal lobe (Brodmann area 11), inferi-or frontal gyrus (Brodmann area 44) and the center of the posterior lobe of the cerebellum. The present ifndings indicate that acupuncture atTaichong andTaixi speciifcally promote blood lfow and activation in the brain areas related to vision, emotion and cognition, and inhibit brain areas related to emotion, attention, phonological and semantic processing, and memory.

Voxel-based morphometry can be used to quantitatively compare structural differences and func-tional changes of gray matter in subjects. In the present study, we compared gray matter images of 32 patients with Parkinson’s disease and 25 healthy controls using voxel-based morphometry based on 3.0 T high-field magnetic resonance T1-weighted imaging and clinical neurological scale scores. Results showed that the scores in Mini-Mental State Examination and Montreal Cognitive Assessment were lower in patients compared with controls. In particular, the scores of visuospatial/executive function items in Montreal Cognitive Assessment were significantly reduced, but mean scores of non-motor symptoms significantly increased, in patients with Parkinson’s dis-ease. In addition, gray matter volume was significantly diminished in Parkinson’s disease patients compared with normal controls, including bilateral temporal lobe, bilateral occipital lobe, bilateral parietal lobe, bilateral frontal lobe, bilateral insular lobe, bilateral parahippocampal gyrus, bilateral amygdale, right uncus, and right posterior lobe of the cerebel um. These findings indicate that voxel-based morphometry can accurately and quantitatively assess the loss of gray matter volume in patients with Parkinson's disease, and provide essential neuroimaging evidence for multisystem pathological mechanisms involved in Parkinson’s disease.

Psychosis is a common non-motor symptom of Parkinson’s disease whose pathogenesis remains poorly understood. Parkinson’s disease in conjunction with psychosis has been shown to induce injury to extracorticospinal tracts as wel as within some cortical areas. In this study, Parkinson’s disease patients with psychosis who did not receive antipsychotic treatment and those without psychosis underwent diffusion tensor imaging. Results revealed that in Parkinson’s disease patients with psychosis, damage to the left frontal lobe, bilateral occipital lobe, left cingulated gyrus, and left hippocampal white-matter fibers were greater than damage to the substantia nigra or the globus pal idus. Damage to white-matter fibers in the right frontal lobe and right cingulate gyrus were also more severe than in the globus pal idus, but not the substantia nigra. Damage to frontal lobe and cingulate gyrus white-matter fibers was more apparent than that to occipital or hippocampal fiber damage. Compared with Parkinson’s disease patients without psychosis, those with psychosis had significantly lower fractional anisotropy ratios of left frontal lobe, bilateral occipital lobe, left cingu-lated gyrus, and left hippocampus to ipsilateral substantia nigra or globus pal idus, indicating more severe damage to white-matter fibers. These results suggest that psychosis associated with Par-kinson’s disease is probably associated with an imbalance in the ratio of white-matter fibers be-tween brain regions associated with psychiatric symptoms (frontal lobe, occipital lobe, cingulate gyrus, and hippocampus) and those associated with the motor symptoms of Parkinson’s disease (the substantia nigra and globus pal idus). The relatively greater damage to white-matter fibers in psychiatric symptom-related brain regions than in extracorticospinal tracts might explain why psy-chosis often occurs in Parkinson’s disease patients.

夜间发作性额叶癫癎

夜间发作性额叶癫癎(nocturnal frontal lobe epilepsy,NFLE)是以夜间丛集性短暂运动性发作为主要特征的癫癎综合征,儿童期起病并在成年后持续存在,神经系统及影像学检查一般正常,多表现出常染色体显性遗传的特征,又被称为常染色体显性遗传性夜间发作性额叶癫癎(autosomal dominant nocturnal frontal lobe epilepsy,ADNFLE).

常染色体显性遗传夜发性额叶癫痫

一、概述常染色体显性遗传夜发性额叶癫痫(autosomal dominant nocturnal frontal lobe epilepsy,ADNFLE)为一种部分性癫痫发作[1,2].Scheffer等[3,4]1994年报道澳大利亚5个家系并提出ADNFLE的概念.患者多见于澳大利亚、英国、加拿大、意大利、挪威,亚洲仅报道1个日本家系.呈常染色体显性遗传,外显率70%～80%,病情程度不等.发病常始于少年儿童,可见夜间、丛集性、简短运动性癫痫发作,典型发作短于1 min[5-8],持续于成年期,卡马西平治疗有效,停药后复发.ADNFLE为首次报道的单基因遗传癫痫综合征[8,9],临床并不少见,具有遗传异质性,某些家系与染色体20q、15q相关,而其他家系则与上述位点无关[8].

常染色体显性遗传性夜间额叶癫癎12例的临床及脑血流灌注观察

常染色体显性遗传性夜间额叶癫癎(Autosomal dominant nocturnal frontal lobe epilepsy,ADNFLE)是很具临床特征的一种癫癎综合征,国外自1994年开始陆续有一些病例报道[1],Phillips等[2]报道散发病例.近年来,国内虽有个案病例报道,但临床对其认识仍不足,现将我们自2002年以来诊治的12例ADNFLE患者的临床及脑血流灌注进行回顾,报道如下.

帕金森病时额叶认知功能改变的研究进展

帕金森病是一种常见的神经系统变性疾病,多发于老年人.我国帕金森病的标准化患病率为10.8/10万人,标准化发病率为每年0.9/10万人[1].其病理特征是黑质致密部多巴胺能神经元选择性变性、缺失.临床主要表现为强直、运动减少、震颤等运动障碍症状,常伴有抑郁、痴呆等精神行为的改变.近年研究表明,无痴呆的早期帕金森病患者即已存在认知功能变化,并且主要表现为额叶认知功能障碍.

中青年脑血管病后阗痫178例临床研究

1 Subject and method 1.1 Clinical data 178 middle aged patients suffered from epilepsy following cerebrovascular diseases were recriuited including 104 males,74 females aged from 20～ 59 years(mean age:48 years old).Among them,24 cases aged from 20～ 29 years,40 aged from 30～ 39 years,54 aged from 40～ 49 years,60 aged from 50～ 59 years. CT and MRI findings showed ischemic damage in 96 cases, hemorrhage damage in 82 cases.Lesions were located in frontal lobe in 42 cases,14 lesions were located in temporal lobe,8 in occipital lobe,10 in frontoparietal lobe,8 in frontotemporal lobe,4 in parietotemporal lobe,26 in internal capsule of basal nodule,6 in thalamus,4 in brain stem,30 in subarachnoid cavity.12 patients exhibited multiple lesions.

常染色体显性遗传性夜发性额叶癫痫一家系报告

常染色体显性遗传夜发性额叶癫痫(aut osomal dominant nocturnal frontal lobe epilepsy,ADNFLE)为一种部分性癫痫发作.Scheffer等1994年报道澳大利亚5个家系并提出ADNFLE的概念.ADNFLE呈常染色体显性遗传,外显率70%～80%.目前国内发现很少,现报道一家系.

单纯额叶挫裂伤的临床特点与治疗

脑外伤中单纯额叶挫裂伤或额叶血肿在临床上较为常见.其致伤的机制相对简单,多为枕部或枕顶部受力而导致的减速性创伤[1].

左额叶实质表皮样囊肿1例

患者男,27岁,因右上肢乏力半年,间歇性四肢抽搐伴意识丧失3次就诊.患者话语含糊,查体右侧膝腱反射减弱,右上肢肱二、三头肌腱反射减弱,病理反射未引出.CT检查:左额叶有一类圆形混杂 密度肿块,大小约6.5 cm×5.7 cm×6.8 cm,边界清楚,无分叶,平扫CT值约-32~41 HU(图1);周围未见水肿,邻近脑组织轻度受压,左侧脑室受压变窄,中线结构稍右移.增强扫描显示肿块无强化(囊壁轻度强化),CT值约-38~42 HU(图2),骨窗(图3)显示左顶骨增生、硬化并压迫吸收,多平面重组显示病灶位于左额叶(图4,5).脑电图:中度异常脑电图.其余实验室检查无特殊.