Pub Date : 2017-10-25DOI: 10.3969/CJCNN.V17I10.1678
X. Hao, Shicheng Yu
Ischemic stroke has a high disability rate, mortality and recurrence rate. The term of recurrent ischemic stroke is patient's conditions occur again after improvement or recovery of ischemic stroke. The disability rate and mortality of recurrent ischemic stroke will be significantly higher than those after the first onset. In this paper, the related risk factors for recurrent ischemic stroke were reviewed to provide the basis of secondary prevention for ischemic stroke, and to reduce the incidence of recurrent ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2017.10.011
{"title":"Research progress on risk factors for recurrent ischemic stroke","authors":"X. Hao, Shicheng Yu","doi":"10.3969/CJCNN.V17I10.1678","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1678","url":null,"abstract":"Ischemic stroke has a high disability rate, mortality and recurrence rate. The term of recurrent ischemic stroke is patient's conditions occur again after improvement or recovery of ischemic stroke. The disability rate and mortality of recurrent ischemic stroke will be significantly higher than those after the first onset. In this paper, the related risk factors for recurrent ischemic stroke were reviewed to provide the basis of secondary prevention for ischemic stroke, and to reduce the incidence of recurrent ischemic stroke. DOI: 10.3969/j.issn.1672-6731.2017.10.011","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"765-770"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42131216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1680
Yihan Yang, L. Cai, Haiwen Ma, Ying Wang, Yu-zhen Bai, Hao-lang Ming, Sheng-ping Yu, Bingcheng Ren, Yu Lin, Kai Zhang, Long Hai, Wen Wang, Cheng Cheng, Tao Li, Xuejun Yang
Objective To explore the value of MRI combined with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET and 11 C-methionine ( 11 C-MET) PET on differentiating tumefactive demyelinating lesion (TDL) and glioma. Methods Fourteen cases of TDL and 17 cases of glioma were confirmed by pathology directly or internal medicine treatment. MRI was used to observe the lesion boundary, T 1 WI, T 2 WI and diffusion - weighted imaging (DWI) signal intensity, enhancement (including ring enhancement and open - ring enhancement, etc.), mass effect, peripheral edema, and the presence of central venectasia, corpus callosum engagement, central necrosis and gray matter engagement. 18 F-FDG PET and 11 C-MET PET were used to calculate relative uptake values. Results Among all TDL cases, MRI showed that mass effect of 8 cases (8/14) were grade 0, 4 cases (4/14) gradeⅠ, one case (1/14) was gradeⅡ and one case (1/14) gradeⅢ; the peripheral edema of 12 cases (12/14) were gradeⅠand 2 cases (2/14) gradeⅡ. Among all glioma cases, the mass effect of 2 cases (2/17) were grade 0, 6 cases (6/17) gradeⅠ, 7 cases (7/17) gradeⅡand 2 cases (2/17) grade Ⅲ; the peripheral edema of 7 cases (7/17) were grade Ⅰ and 10 cases (10/17) grade Ⅱ. The differences between TDL and glioma were statistically significant (Fisher's exact probability: P = 0.032, 0.024). 18 F-FDG PET and 11 C-MET PET were not statistically significant in differentiating TDL and glioma (Fisher's exact probability: P = 0.182, 0.081). Conclusions Mass effect and peripheral edema showed in MRI can be used for the differential diagnosis of TDL and glioma. The value of PET-CT in differentiating TDL and glioma is unsure. DOI: 10.3969/j.issn.1672-6731.2017.10.009
{"title":"MRI combined with 18F -FDG PET and 11C -MET PET in differentiating tumefactive demyelinating lesion and glioma","authors":"Yihan Yang, L. Cai, Haiwen Ma, Ying Wang, Yu-zhen Bai, Hao-lang Ming, Sheng-ping Yu, Bingcheng Ren, Yu Lin, Kai Zhang, Long Hai, Wen Wang, Cheng Cheng, Tao Li, Xuejun Yang","doi":"10.3969/cjcnn.v17i10.1680","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1680","url":null,"abstract":"Objective To explore the value of MRI combined with 18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG) PET and 11 C-methionine ( 11 C-MET) PET on differentiating tumefactive demyelinating lesion (TDL) and glioma. Methods Fourteen cases of TDL and 17 cases of glioma were confirmed by pathology directly or internal medicine treatment. MRI was used to observe the lesion boundary, T 1 WI, T 2 WI and diffusion - weighted imaging (DWI) signal intensity, enhancement (including ring enhancement and open - ring enhancement, etc.), mass effect, peripheral edema, and the presence of central venectasia, corpus callosum engagement, central necrosis and gray matter engagement. 18 F-FDG PET and 11 C-MET PET were used to calculate relative uptake values. Results Among all TDL cases, MRI showed that mass effect of 8 cases (8/14) were grade 0, 4 cases (4/14) gradeⅠ, one case (1/14) was gradeⅡ and one case (1/14) gradeⅢ; the peripheral edema of 12 cases (12/14) were gradeⅠand 2 cases (2/14) gradeⅡ. Among all glioma cases, the mass effect of 2 cases (2/17) were grade 0, 6 cases (6/17) gradeⅠ, 7 cases (7/17) gradeⅡand 2 cases (2/17) grade Ⅲ; the peripheral edema of 7 cases (7/17) were grade Ⅰ and 10 cases (10/17) grade Ⅱ. The differences between TDL and glioma were statistically significant (Fisher's exact probability: P = 0.032, 0.024). 18 F-FDG PET and 11 C-MET PET were not statistically significant in differentiating TDL and glioma (Fisher's exact probability: P = 0.182, 0.081). Conclusions Mass effect and peripheral edema showed in MRI can be used for the differential diagnosis of TDL and glioma. The value of PET-CT in differentiating TDL and glioma is unsure. DOI: 10.3969/j.issn.1672-6731.2017.10.009","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"754-761"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46161840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/CJCNN.V17I10.1673
Yu Zhang, Deng Chen, Lina Zhu, Da Xu, Haijiao Wang, Ling Liu
Objective To evaluate the efficacy of continuous positive airway pressure (CPAP) ventilation treatment for epilepsy with obstructive sleep apnea syndrome (OSAS). Methods The data were collected from the following words: sleep apnoea, obstructive sleep apnoea, OSA, obstructive sleep apnoea syndrome, OSAS, sleep apnoea syndromes, sleep-related breathing disorder, epilepsy, continuous positive airway pressure, CPAP. PubMed, EMBASE/SCOPUS and Cochrane Library retrieval on randomized controlled clinical trials, clinical guidelines, systematic review (including Meta-analysis), case controlled studies and retrospective cohort studies of CPAP ventilation treatment of epilepsy with OSAS from January 1, 1980 to February 28, 2017. Jadad Scale, Cochrane System Evaluation Handbook and RevMan 5.3 software were used for quality assessment and Meta-analysis. Results A total of 1197 English literatures were obtained, and 17 English articles were included in the study, including one clinical guideline, one systematic review, one Meta-analysis, one randomized controlled clinical trial, 10 case controlled studies and 3 retrospective cohort studies. The results showed that: 1) CPAP ventilation treatment can decrease the seizure frequency or even emarge seizure free in epilepsy with OSAS. 2) CPAP ventilation treatment can reduce the seizure frequency of refractory epilepsy with OSAS. 3) CPAP ventilation treatment can reduce the seizure frequency of elderly epilepsy patients with OSAS. 4) Meta-analysis on three clinical studies (153 epilepsy and OSAS patients) with Jadad ≥ 4 scores showed cases with reduction seizure frequency > 50% in CPAP group were more than those in unused CPAP group ( RR = 3.170, 95%CI: 1.650-6.090; P = 0.001). Conclusions CPAP ventilation treatment can reduce the seizure frequency of patients with epilepsy and OSAS. The effect of treatment depends on patients compliance. Sudden drug-withdrawl or pressure insuffiency may increase seizure frequency. This conclusion remains to be confirmed. DOI: 10.3969/j.issn.1672-6731.2017.10.005
{"title":"Systematic review of efficacy of continuous positive airway pressure in treatment of epilepsy with obstructive sleep apnea syndrome","authors":"Yu Zhang, Deng Chen, Lina Zhu, Da Xu, Haijiao Wang, Ling Liu","doi":"10.3969/CJCNN.V17I10.1673","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1673","url":null,"abstract":"Objective To evaluate the efficacy of continuous positive airway pressure (CPAP) ventilation treatment for epilepsy with obstructive sleep apnea syndrome (OSAS). Methods The data were collected from the following words: sleep apnoea, obstructive sleep apnoea, OSA, obstructive sleep apnoea syndrome, OSAS, sleep apnoea syndromes, sleep-related breathing disorder, epilepsy, continuous positive airway pressure, CPAP. PubMed, EMBASE/SCOPUS and Cochrane Library retrieval on randomized controlled clinical trials, clinical guidelines, systematic review (including Meta-analysis), case controlled studies and retrospective cohort studies of CPAP ventilation treatment of epilepsy with OSAS from January 1, 1980 to February 28, 2017. Jadad Scale, Cochrane System Evaluation Handbook and RevMan 5.3 software were used for quality assessment and Meta-analysis. Results A total of 1197 English literatures were obtained, and 17 English articles were included in the study, including one clinical guideline, one systematic review, one Meta-analysis, one randomized controlled clinical trial, 10 case controlled studies and 3 retrospective cohort studies. The results showed that: 1) CPAP ventilation treatment can decrease the seizure frequency or even emarge seizure free in epilepsy with OSAS. 2) CPAP ventilation treatment can reduce the seizure frequency of refractory epilepsy with OSAS. 3) CPAP ventilation treatment can reduce the seizure frequency of elderly epilepsy patients with OSAS. 4) Meta-analysis on three clinical studies (153 epilepsy and OSAS patients) with Jadad ≥ 4 scores showed cases with reduction seizure frequency > 50% in CPAP group were more than those in unused CPAP group ( RR = 3.170, 95%CI: 1.650-6.090; P = 0.001). Conclusions CPAP ventilation treatment can reduce the seizure frequency of patients with epilepsy and OSAS. The effect of treatment depends on patients compliance. Sudden drug-withdrawl or pressure insuffiency may increase seizure frequency. This conclusion remains to be confirmed. DOI: 10.3969/j.issn.1672-6731.2017.10.005","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"728-735"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42215794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1677
Zan Chen, Xing-hua Zhao, Zhi-yuan Xia
Spinal department of neurosurgery develops in an all-round way in many European and American countries. The amount spinal surgery can reach half of all the department of neurosurgery surgery. It can be seen that spinal department of neurosurgery has huge development potential. Because of historical reasons, department of neurosurgery in China is less involved in the treatment of spinal and spinal cord diseases, and the diagnosis and treatment techniques in related fields are relatively backward. It is urgent to develop the spinal department of neurosurgery in China, whereas the bottleneck is talent training and reserve. This training program of spinal department of neurosurgery talent development intends to solve this problem. DOI: 10.3969/j.issn.1672-6731.2017.10.010
{"title":"A few thoughts on the current situation of neurosurgery spinal subspecialty residency training","authors":"Zan Chen, Xing-hua Zhao, Zhi-yuan Xia","doi":"10.3969/cjcnn.v17i10.1677","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1677","url":null,"abstract":"Spinal department of neurosurgery develops in an all-round way in many European and American countries. The amount spinal surgery can reach half of all the department of neurosurgery surgery. It can be seen that spinal department of neurosurgery has huge development potential. Because of historical reasons, department of neurosurgery in China is less involved in the treatment of spinal and spinal cord diseases, and the diagnosis and treatment techniques in related fields are relatively backward. It is urgent to develop the spinal department of neurosurgery in China, whereas the bottleneck is talent training and reserve. This training program of spinal department of neurosurgery talent development intends to solve this problem. DOI: 10.3969/j.issn.1672-6731.2017.10.010","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"762-764"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48667222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1674
Hui-li Zou, Xianchao Zhao, Yingcong Jiang, Ge-sheng Lei, Weiyi Yang, C. Su
Objective To investigate the incidence, occurrence time and electrophysiological characteristics of rapid eye movement behavior disorder (RBD) in patients with early Parkinson's disease (PD), and the characteristics of motor symptoms and non . motor symtoms (NMS). Methods Sixty PD patients were divided into PD + RBD group (N = 42) and control group (N = 18) according to whether they were complicated with RBD or not. Unified Parkinson's Disease Rating Scale (UPDRS)Ⅱ andⅢ, Hoehn-Yahr Stage, Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), RBD Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS) and polysomnography (PSG) were used in 60 patients. Results Among 60 patients, 42 (70% ) were accompanied by RBD. PSG showed that PD + RBD patients mainly presented upper limb stretching and gripping, body twitching, laughing, shouting, cursing and other non.violent actions, except 2 cases presented violent actions, such as hitting, kicking, etc. In PD + RBD group, the age was older (P = 0.024), duration was longer (P = 0.000), and UPDRSⅡ (P = 0.005)，UPDRSⅢ(P = 0.001), the scale values of Hoehn-Yahr Sotage 2 (P = 0.007), anxiety (P = 0.044) and depression (P = 0.001) ratio were all higher than control group. There were significant differences in density of mandible myoelectric activity (P = 0.000) and ratio of rapid eye movement (REM) without atonia (P = 0.000) between 2 groups. In PD + RBD group, 16 patients (38.10% ) had symptoms of RBD, earlier than PD occurred 5.20 (3.91, 6.51) years. Conclusions PD patients with older age, longer duration, more severe motor symptoms and non?motor symptoms were more likely to be accompanied by RBD. The severity of RBD in PD patients accompanied with RBD is higher than that in PD without RBD. RBD may be the early manifestation of PD. PSG has important value in the diagnosis of PD with RBD. DOI: 10.3969/j.issn.1672-6731.2017.10.006
{"title":"Study on rapid eye movement sleep behavior disorder in patients with Parkinson's disease at early stage","authors":"Hui-li Zou, Xianchao Zhao, Yingcong Jiang, Ge-sheng Lei, Weiyi Yang, C. Su","doi":"10.3969/cjcnn.v17i10.1674","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1674","url":null,"abstract":"Objective To investigate the incidence, occurrence time and electrophysiological characteristics of rapid eye movement behavior disorder (RBD) in patients with early Parkinson's disease (PD), and the characteristics of motor symptoms and non . motor symtoms (NMS). Methods Sixty PD patients were divided into PD + RBD group (N = 42) and control group (N = 18) according to whether they were complicated with RBD or not. Unified Parkinson's Disease Rating Scale (UPDRS)Ⅱ andⅢ, Hoehn-Yahr Stage, Montreal Cognitive Assessment (MoCA), Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), RBD Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS) and polysomnography (PSG) were used in 60 patients. Results Among 60 patients, 42 (70% ) were accompanied by RBD. PSG showed that PD + RBD patients mainly presented upper limb stretching and gripping, body twitching, laughing, shouting, cursing and other non.violent actions, except 2 cases presented violent actions, such as hitting, kicking, etc. In PD + RBD group, the age was older (P = 0.024), duration was longer (P = 0.000), and UPDRSⅡ (P = 0.005)，UPDRSⅢ(P = 0.001), the scale values of Hoehn-Yahr Sotage 2 (P = 0.007), anxiety (P = 0.044) and depression (P = 0.001) ratio were all higher than control group. There were significant differences in density of mandible myoelectric activity (P = 0.000) and ratio of rapid eye movement (REM) without atonia (P = 0.000) between 2 groups. In PD + RBD group, 16 patients (38.10% ) had symptoms of RBD, earlier than PD occurred 5.20 (3.91, 6.51) years. Conclusions PD patients with older age, longer duration, more severe motor symptoms and non?motor symptoms were more likely to be accompanied by RBD. The severity of RBD in PD patients accompanied with RBD is higher than that in PD without RBD. RBD may be the early manifestation of PD. PSG has important value in the diagnosis of PD with RBD. DOI: 10.3969/j.issn.1672-6731.2017.10.006","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"736-740"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46120565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1672
Y. Huang, Hong-lin Hao
Research shows that autoimmune encephalitis is associated with sleep disorders. Paraneoplastic neurological syndrome (PNS) with Ma2 antibodies can cause sleep disorders, particularly narcolepsy and rapid eye movement sleep behavior disorder (RBD). Limbic encephalitis (LE) and Morvan syndrome, associated with voltage - gated potassium channel (VGKC)-complex antibodies, which include leucine-rich glioma-inactivated 1 (LGI1) antibody and contactin-associated protein 2 (Caspr2), can result in profound insomnia and other sleep disorders. Central neurogenic hypoventilation are found in patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, whereas obstructive sleep apnea (OSA), stridor and parasomnia are prominent features of encephalopathy associated with IgLON5 antibodies. Sleep disorders are cardinal manifestations in patients with autoimmune encephalitis. Immunotherapy possiblely can improve clinical symptoms and prognosis in a positive way. DOI: 10.3969/j.issn.1672-6731.2017.10.004
{"title":"Autoimmune encephalitis and sleep disorders","authors":"Y. Huang, Hong-lin Hao","doi":"10.3969/cjcnn.v17i10.1672","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1672","url":null,"abstract":"Research shows that autoimmune encephalitis is associated with sleep disorders. Paraneoplastic neurological syndrome (PNS) with Ma2 antibodies can cause sleep disorders, particularly narcolepsy and rapid eye movement sleep behavior disorder (RBD). Limbic encephalitis (LE) and Morvan syndrome, associated with voltage - gated potassium channel (VGKC)-complex antibodies, which include leucine-rich glioma-inactivated 1 (LGI1) antibody and contactin-associated protein 2 (Caspr2), can result in profound insomnia and other sleep disorders. Central neurogenic hypoventilation are found in patients with anti-N-methyl-D-aspartate (NMDA) receptor encephalitis, whereas obstructive sleep apnea (OSA), stridor and parasomnia are prominent features of encephalopathy associated with IgLON5 antibodies. Sleep disorders are cardinal manifestations in patients with autoimmune encephalitis. Immunotherapy possiblely can improve clinical symptoms and prognosis in a positive way. DOI: 10.3969/j.issn.1672-6731.2017.10.004","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"723-727"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46206698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1671
Haiyang Jiang, Jinsha Huang, Tao Wang
Rapid eye movement sleep behavior disorder (RBD) is a sleep disorder characterized by the disappearance of muscle relaxation and enacting one's dreams during rapid eye movement (REM), with most of the dreams being violent or aggressive. Prevalence of RBD, based on population, is 0.38%-2.01%, but it becomes much higher in patients with neurodegenerative diseases, especially α - synucleinopathies. RBD may herald the emergence of α-synucleinopathies by decades, thus it may be used as an effective early marker of neurodegenerative diseases. In this review, we summarized the progress on the pathogenesis of RBD and its relationship with neurodegenerative diseases. DOI: 10.3969/j.issn.1672-6731.2017.10.003
{"title":"Research progress on the pathogenesis of rapid eye movement sleep behavior disorder and neurodegenerative diseases","authors":"Haiyang Jiang, Jinsha Huang, Tao Wang","doi":"10.3969/cjcnn.v17i10.1671","DOIUrl":"https://doi.org/10.3969/cjcnn.v17i10.1671","url":null,"abstract":"Rapid eye movement sleep behavior disorder (RBD) is a sleep disorder characterized by the disappearance of muscle relaxation and enacting one's dreams during rapid eye movement (REM), with most of the dreams being violent or aggressive. Prevalence of RBD, based on population, is 0.38%-2.01%, but it becomes much higher in patients with neurodegenerative diseases, especially α - synucleinopathies. RBD may herald the emergence of α-synucleinopathies by decades, thus it may be used as an effective early marker of neurodegenerative diseases. In this review, we summarized the progress on the pathogenesis of RBD and its relationship with neurodegenerative diseases. DOI: 10.3969/j.issn.1672-6731.2017.10.003","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"717-722"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46664599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/CJCNN.V17I10.1669
F. Han, F. Xiao
Focus on interoperation between sleep medicine and neurology HAN Fang, XIAO Fu⁃long Sleep Medicine Center, Department of Respiratory Medicine, Peking University People's Hospital, Beijing 100044, China Corresponding author: HAN Fang (Email: hanfang1@hotmail.com) This study was supported by the National Basic Research Development Program of China (973 Program, No. 2015CB856405) and Key International (Regional) Cooperation Program of National Natural Science Foundation of China (No. 81420108002). ·专论·
{"title":"Focus on interoperation between sleep medicine and neurology","authors":"F. Han, F. Xiao","doi":"10.3969/CJCNN.V17I10.1669","DOIUrl":"https://doi.org/10.3969/CJCNN.V17I10.1669","url":null,"abstract":"Focus on interoperation between sleep medicine and neurology HAN Fang, XIAO Fu⁃long Sleep Medicine Center, Department of Respiratory Medicine, Peking University People's Hospital, Beijing 100044, China Corresponding author: HAN Fang (Email: hanfang1@hotmail.com) This study was supported by the National Basic Research Development Program of China (973 Program, No. 2015CB856405) and Key International (Regional) Cooperation Program of National Natural Science Foundation of China (No. 81420108002). ·专论·","PeriodicalId":10113,"journal":{"name":"中国现代神经疾病杂志","volume":"17 1","pages":"705-707"},"PeriodicalIF":0.0,"publicationDate":"2017-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49528362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-10-25DOI: 10.3969/cjcnn.v17i10.1675
F. Wang, Zhaoyang Huang, Yan Ding, Ning Li, Yuping Wang, S. Zhan
Objective To study the characteristics of sleep architecture and sleep - disordered breathing (SDB) in patients with amyotrophic lateral sclerosis (ALS) using polysomnography (PSG). Methods A total of 36 patients with ALS were recruited in this study. According to symptoms of medulla oblongata, the patients were divided into limb involvement group (N = 14) and bulbar palsy group (N = 22). Detailed record of the patients was made including general information and chief complaints of sleep dysfunction and SDB, which covered sleep initiation and maintenance disorders, arousals, difficulty in breathing and snoring, nocturnal polyuria, restless legs syndrome (RLS) and muscle soreness. Appel Amyotrophic Lateral Sclerosis (AALS) Scores were used to assess bulbar function, breathing function,myodynamia and limbs function. PSG was performed to monitor EEG, EOG, EMG, ECG, position, snore, gas flow of mouth and nose, chest breathing, pulse oxygen saturation (SpO 2 ) and sleep-related parameters including total sleep time (TST), sleep efficiency (SE), sleep latency (SL), awakening times, percentage of different non-rapid eye movement (NREM) and rapial eye movement (REM), and apnea hypopnea index (AHI). Pearson correlation analysis evaluated the relationship between AHI of REM, periodic limb movements (PLM) and clinical information, AALS Scores. Results Bulbar palsy group had higher scores in AALS Scores ( P = 0.007), bulbar function ( P = 0.000) and breathing function ( P = 0.000), and lower score in upper limb myodynamia ( P = 0.016) than limb involvement group. Both 2 groups showed disturbed sleep architecture in the performance of sleep fragmentation. Bulbar palsy group had more awakening times ( P = 0.027), lower percentage of REM sleep ( P = 0.009) and less PLM ( P = 0.020) than limb involvement group. The main respiratory event of 2 groups was hypopnea. Bulbar palsy group had higher AHI (P = 0.038) and AHI of REM and NREM ( P = 0.031, 0.049) than limb involvement group. Pearson correlation analysis showed that AHI of REM was positively correlated with duration ( r = 0.654, P = 0.028), AALS total score ( r = 0.458, P = 0.034), bulbar function score ( r = 0.572, P = 0.030) and breathing function ( r = 0.756, P = 0.002). PLM was also positively correlated with duration ( r = 0.574, P = 0.030), AALS total score ( r = 0.321, P = 0.042), upper limb function ( r = 0.656, P = 0.028) and lower limb function ( r = 0.754, P = 0.015). Conclusions Patients with ALS have many types of sleep disorders including insomnia, SDB and periodic limb movements disorder (PLMD). PSG can monitor respiratory event thus providing clinical evidence for the non-invasive ventilation intervention. DOI: 10.3969/j.issn.1672-6731.2017.10.007
目的应用多导睡眠图(PSG)研究肌萎缩侧索硬化症(ALS)患者的睡眠结构及睡眠呼吸障碍(SDB)特征。方法选取36例ALS患者作为研究对象。根据延髓症状分为受累肢体组(N = 14)和球麻痹组(N = 22)。详细记录患者的一般情况及睡眠功能障碍和SDB的主诉，包括睡眠启动和维持障碍、觉醒、呼吸困难和打鼾、夜间多尿、不宁腿综合征(RLS)和肌肉酸痛。应用Appel肌萎缩性侧索硬化症(AALS)评分评估患者的球功能、呼吸功能、肌动力学和肢体功能。采用PSG监测脑电图(EEG)、脑电图(EOG)、肌电图(EMG)、心电图(ECG)、体位、打鼾、口鼻气体流量、胸部呼吸、脉搏血氧饱和度(spo2)及睡眠相关参数包括总睡眠时间(TST)、睡眠效率(SE)、睡眠潜伏期(SL)、觉醒次数、不同非快速眼动(NREM)和快速眼动(REM)百分比、呼吸暂停低通气指数(AHI)。Pearson相关分析评估REM、周期性肢体运动(PLM) AHI与临床信息、AALS评分之间的关系。结果球性麻痹组AALS评分(P = 0.007)、球功能评分(P = 0.000)、呼吸功能评分(P = 0.000)高于肢体受累组，上肢肌力评分(P = 0.016)低于肢体受累组。两组在睡眠片段化表现中均表现出紊乱的睡眠结构。与肢体受累组相比，球麻痹组觉醒次数多(P = 0.027)， REM睡眠比例低(P = 0.009)， PLM较少(P = 0.020)。两组患者呼吸事件均以低通气为主。球性麻痹组AHI (P = 0.038)及REM、NREM期AHI (P = 0.031、0.049)均高于肢体受累组。Pearson相关分析显示，REM期AHI与病程(r = 0.654, P = 0.028)、AALS总分(r = 0.458, P = 0.034)、球功能评分(r = 0.572, P = 0.030)、呼吸功能(r = 0.756, P = 0.002)呈正相关。PLM与病程(r = 0.574, P = 0.030)、AALS总分(r = 0.321, P = 0.042)、上肢功能(r = 0.656, P = 0.028)、下肢功能(r = 0.754, P = 0.015)呈正相关。结论ALS患者存在失眠、SDB、周期性肢体运动障碍(PLMD)等多种类型的睡眠障碍。PSG可监测呼吸事件，为无创通气干预提供临床依据。DOI: 10.3969 / j.issn.1672-6731.2017.10.007
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Patient female, 22 years old. Due to recurrent fever for over a year and weakness in both lower limbs for over 20 days, he was admitted to our hospital on October 26, 2016. The patient experienced recurrent fever without any obvious cause more than a year ago (May 2015), with a maximum body temperature of 40 ° C. Laboratory examination in an external hospital showed a blood routine white blood cell count of 1.04 × 10 9/L [(3.50~9.50) × 10 9/L], reticulocyte ratio 0.0145 (0.80-2.00), hemoglobin 92 g/L (110-150 g/L), platelet count 72 × 10 9/L [(100~350) × 10 9/L]; Detection of EB virus DNA in peripheral blood 416 × 10 3 copies/ml; Abdominal ultrasound shows that the right oblique diameter of the liver is 16.10 cm, the inner diameter of the portal vein is 1.30 cm, the thickness of the spleen at the splenic hilum is 7.40 cm, the inner diameter of the splenic vein is 1 cm, the lateral position is 16 cm below the splenic rib, and the supine position is 5 cm above the midline of the spleen, indicating liver enlargement, diffuse changes in the liver parenchyma, enlarged spleen, and mild dilation of the portal vein system; Chest CT shows multiple nodular shadows in both lungs, indicating inflammatory changes; Bone marrow cytology examination showed three lines of proliferative bone marrow, with an increase in the proportion of red blood cells; Bone marrow biopsy indicates that bone marrow hyperplasia is generally normal, while tertiary hyperplasia with mild abnormalities in megakaryocyte morphology; JAK2 V617F quantification 0%, CALR Exon9 and MPL Exon10 mutations negative; Flow cytometry showed an increase in the proportion of granulocytes, nuclear shift to the left, and downregulation of CD13 expression; Immunohistochemical staining showed a count of 1391 CD41+megakaryocytes, including 1238 normal megakaryocytes. Neutrophil alkaline phosphatase (NAP) and glycogen periodate Schiff (PAS) staining were negative, and the positive rate of sideroblasts was 2% (27%~94%). Clinically, EB virus infection was considered, and anti infection, liver protection, and intravenous immunoglobulin (specific plan unknown) treatment were given. After 2 months, the fever symptoms gradually relieved. Afterwards, regular blood routine examinations showed a decrease in whole blood cell count; Abdominal ultrasound shows that the liver and spleen are enlarged, and the portal vein system continues to expand. More than 20 days ago, the patient had no obvious cause of weakness in both lower limbs, and when walking, both lower limbs were heavy and stiff, with symptoms gradually worsening; Before the 14th day, it is necessary to walk with assistance and not squat on your own, as there may be occasional falls; Symptoms slightly relieved 7 days ago, with no dizziness, headache, nausea, vomiting, blurred vision, blurred speech, coughing when drinking water, numbness in limbs, or bowel and bowel movements during the course of the disease. The MRI examination of the thoracic spine in
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