Pub Date : 2021-01-01DOI: 10.3760/cma.j.cn113694-20210120-00052
Y. Han, C. Song
Coronavirus-NL63 is a common respiratory virus, which often causes severe respiratory symptoms such as fever, cough, expectoration, pneumonia and so on. The damage of central nervous system is rare. A case of acute necrotizing encephalitis caused by respiratory coronavirus-NL63 infection with cognitive impairment as the first symptom is reported, finding of CT/magnetic resonance imaging scanning indicating necrosis combined with a striated encephalomalacia of the corpus callosum and bilateral cerebral hemispheres.
{"title":"Acute necrotizing encephalitis caused by respiratory coronavirus-NL63: a case report","authors":"Y. Han, C. Song","doi":"10.3760/cma.j.cn113694-20210120-00052","DOIUrl":"https://doi.org/10.3760/cma.j.cn113694-20210120-00052","url":null,"abstract":"Coronavirus-NL63 is a common respiratory virus, which often causes severe respiratory symptoms such as fever, cough, expectoration, pneumonia and so on. The damage of central nervous system is rare. A case of acute necrotizing encephalitis caused by respiratory coronavirus-NL63 infection with cognitive impairment as the first symptom is reported, finding of CT/magnetic resonance imaging scanning indicating necrosis combined with a striated encephalomalacia of the corpus callosum and bilateral cerebral hemispheres.","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76663288","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 : 2020-03-08DOI: 10.3760/CMA.J.CN113694-20200302-00134
Liang Wang, J. Cai, H. Luo, H. Guan, Hongzhi Wang, Cheng Huang, F. Zhou
Novel coronavirus pneumonia, also known as coronavirus disease 2019 (COVID-19), is caused by a new coronavirus that infects the lungs. Although some patients with COVID-19 may be combined with neurological symptoms, there is no direct evidence that this new coronavirus can directly invade nerve system. A case of COVID-19 with tuberculous meningitis is reported to remind that when patients with COVID-19 present symptom of encephalitis or meningitis, a comprehensive pathogen examination is recommended. Key words: Corona virus disease 2019; Novel coronavirus pneumonia; Meningitis, tuberculous
{"title":"A case of coronavirus disease 2019 with tuberculous meningitis","authors":"Liang Wang, J. Cai, H. Luo, H. Guan, Hongzhi Wang, Cheng Huang, F. Zhou","doi":"10.3760/CMA.J.CN113694-20200302-00134","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113694-20200302-00134","url":null,"abstract":"Novel coronavirus pneumonia, also known as coronavirus disease 2019 (COVID-19), is caused by a new coronavirus that infects the lungs. Although some patients with COVID-19 may be combined with neurological symptoms, there is no direct evidence that this new coronavirus can directly invade nerve system. A case of COVID-19 with tuberculous meningitis is reported to remind that when patients with COVID-19 present symptom of encephalitis or meningitis, a comprehensive pathogen examination is recommended. \u0000 \u0000Key words: \u0000Corona virus disease 2019; Novel coronavirus pneumonia; Meningitis, tuberculous","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81007176","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 : 2020-03-05DOI: 10.3760/CMA.J.CN113694-20200220-00102
Qian Zhao, Caihong Hu, Renjie Feng, Yuan Yang
Objective To evaluate the status and influencing factors of the mental health of patients with COVID-19 during isolation treatment. Methods From February 2nd to 16th, 2020, 106 COVID-19 patients were anonymously investigated for their mental health status using onlinequestionnaires (including Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-15 scales). The patients were from Tongji Hospital Affiliated to Tongji Medical College ofHuazhong University of Science and Technology. After data processing, SPSS19.0 was used for statistical analysis. Results Of the 106 COVID-19 patients, 46 were male and 60 were female, with an age of (35.90±11.92) years. The detection rates of depression, anxiety and somatic symptoms in those patients were 49.06% (52/106) , 56.60% (60/106) and 69.81% (74/106) respectively. The severe cases of depression (scale score greater than 19) , anxiety (scale score greater than 14) and somatic symptoms (scale score greater than 14) accounted for 9.43% (10/106) , 15.09% (16/106) and 20.75% (22/106) respectively. In addition, 67.92% (72/106) of the patients had sleep problems, 24.53% (26/106) had self-mutilating or suicidal thoughts, and 28.30% (30/106) required psychological counseling—all of which were at significantly higher percentages than those of the general population. Only 39.62% (42/106) of the examined patients had neither deression nor anxiety. By using the non-parametric test of rank conversion for analysis, and the results showed that both married patients and nucleic-acid-positive patients had more severe depressions, and both married patients and anoxemicpatients had more severe somatic symptoms. Conclusion This mental health assessment showed that depression, anxiety, and various somatic symptoms exist among the COVID-19 patients, and therefore early identification and intervention should be conducted to avoid extreme events such asself-mutilating or suicidal impulsivity, with a greater focus on both married patients and patients with severe symptoms. Key words: COVID-19; Depression; Anxiety; Somatic symptoms
{"title":"Investigation of the mental health of patients with novel coronavirus pneumonia/ 中华神经科杂志","authors":"Qian Zhao, Caihong Hu, Renjie Feng, Yuan Yang","doi":"10.3760/CMA.J.CN113694-20200220-00102","DOIUrl":"https://doi.org/10.3760/CMA.J.CN113694-20200220-00102","url":null,"abstract":"Objective \u0000To evaluate the status and influencing factors of the mental health of patients with COVID-19 during isolation treatment. \u0000 \u0000 \u0000Methods \u0000From February 2nd to 16th, 2020, 106 COVID-19 patients were anonymously investigated for their mental health status using onlinequestionnaires (including Patient Health Questionnaire-9, Generalized Anxiety Disorder Scale-7, Patient Health Questionnaire-15 scales). The patients were from Tongji Hospital Affiliated to Tongji Medical College ofHuazhong University of Science and Technology. After data processing, SPSS19.0 was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Of the 106 COVID-19 patients, 46 were male and 60 were female, with an age of (35.90±11.92) years. The detection rates of depression, anxiety and somatic symptoms in those patients were 49.06% (52/106) , 56.60% (60/106) and 69.81% (74/106) respectively. The severe cases of depression (scale score greater than 19) , anxiety (scale score greater than 14) and somatic symptoms (scale score greater than 14) accounted for 9.43% (10/106) , 15.09% (16/106) and 20.75% (22/106) respectively. In addition, 67.92% (72/106) of the patients had sleep problems, 24.53% (26/106) had self-mutilating or suicidal thoughts, and 28.30% (30/106) required psychological counseling—all of which were at significantly higher percentages than those of the general population. Only 39.62% (42/106) of the examined patients had neither deression nor anxiety. By using the non-parametric test of rank conversion for analysis, and the results showed that both married patients and nucleic-acid-positive patients had more severe depressions, and both married patients and anoxemicpatients had more severe somatic symptoms. \u0000 \u0000 \u0000Conclusion \u0000This mental health assessment showed that depression, anxiety, and various somatic symptoms exist among the COVID-19 patients, and therefore early identification and intervention should be conducted to avoid extreme events such asself-mutilating or suicidal impulsivity, with a greater focus on both married patients and patients with severe symptoms. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Depression; Anxiety; Somatic symptoms","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88723318","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 : 2019-02-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2019.02.006
Weihe Zhang, Wei Wang, Jie Luo, Geng Qin, J. Jiao, Yu Wang, Yi Jin, Zhengyun Li, W. Gu
Objective To investigate the clinical, imaging, intestinal pathological characteristics and prognosis of gluten ataxia (GA). Methods The clinical data, treatment and prognosis in a patient with GA that was confirmed by pathology and hospitalized in the Department of Neurology, China-Japan Friendship Hospital in July 2018, were analyzed retrospectively. The related literature was reviewed and the clinical feature was summarized. Results The patient is a 41-year old man. He suffered from progressive cerebellar ataxia, and the brain magnetic resonance imaging exhibited diffused cerebellar atrophy. Serum human leukocyte antigen (HLA) tests showed that the patient carried HLA-DQ2 genotype. IgA type anti-gliadin antibody was positive (39.39 RU/ml). Duodenoscopy biopsy revealed mild villus atrophy and lymphocytic infiltration, indicating celiac disease. The diagnosis of GA was established then and the patient was administered gluten-free diet combined with intravenous immunoglobulin, which markedly improved the cerebellar symptoms and signs of cerebellar speech, walk capability and daily living activities. He could do long distance driving independently two months later. Conclusions GA is one of immune-mediated reversible acquired cerebellar ataxia caused by gluten sensitivity. The genotype, serologic features, and clinical phenotype of GA in Chinese mainland population might be similar with those in European and American countries. Key words: Cerebellar ataxia; Glutens; Celiac disease; Biopsy; Anti-gliadin antibodies
{"title":"The clinical, imaging, intestinal pathological characteristics of gluten ataxia: a case report in Chinese mainland","authors":"Weihe Zhang, Wei Wang, Jie Luo, Geng Qin, J. Jiao, Yu Wang, Yi Jin, Zhengyun Li, W. Gu","doi":"10.3760/CMA.J.ISSN.1006-7876.2019.02.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2019.02.006","url":null,"abstract":"Objective \u0000To investigate the clinical, imaging, intestinal pathological characteristics and prognosis of gluten ataxia (GA). \u0000 \u0000 \u0000Methods \u0000The clinical data, treatment and prognosis in a patient with GA that was confirmed by pathology and hospitalized in the Department of Neurology, China-Japan Friendship Hospital in July 2018, were analyzed retrospectively. The related literature was reviewed and the clinical feature was summarized. \u0000 \u0000 \u0000Results \u0000The patient is a 41-year old man. He suffered from progressive cerebellar ataxia, and the brain magnetic resonance imaging exhibited diffused cerebellar atrophy. Serum human leukocyte antigen (HLA) tests showed that the patient carried HLA-DQ2 genotype. IgA type anti-gliadin antibody was positive (39.39 RU/ml). Duodenoscopy biopsy revealed mild villus atrophy and lymphocytic infiltration, indicating celiac disease. The diagnosis of GA was established then and the patient was administered gluten-free diet combined with intravenous immunoglobulin, which markedly improved the cerebellar symptoms and signs of cerebellar speech, walk capability and daily living activities. He could do long distance driving independently two months later. \u0000 \u0000 \u0000Conclusions \u0000GA is one of immune-mediated reversible acquired cerebellar ataxia caused by gluten sensitivity. The genotype, serologic features, and clinical phenotype of GA in Chinese mainland population might be similar with those in European and American countries. \u0000 \u0000 \u0000Key words: \u0000Cerebellar ataxia; Glutens; Celiac disease; Biopsy; Anti-gliadin antibodies","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82290676","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}
Objective To investigate alterations of permeability of surface (PS) in subacute stage patients with intracerebral hemorrhage (ICH) using computed tomography perfusion imaging (CTPI), and analyze relationships between PS and other factors. Methods CTPI was performed in 35 patients in subacute stage (4 days-2 weeks) after onset of ICH, who were recruited in the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University from November 2015 to June 2016. Hematoma and edema volumes were measured, and perfusion parameters of perihematoma and mirror hemisphere side of marginal zone and outer zone of hematoma, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), PS, and relative value (ipsilateral/contralateral) of CBF (rCBF), CBV (rCBV), MTT (rMTT) and PS (rPS), were calculated. Relationships between volumes of hematoma and edema, time from onset to CTPI performance, NIHSS scores and PS of perihematoma zone were analyzed by Pearson correlation analysis. Results The perihematoma PS ((1.87±0.48) ml·100 g-1·min-1) was higher than that in contralateral regions ((1.28±0.34) ml·100 g-1·min-1;t=-12.407, P 0.05). There were 20 patients with hematoma volume less than 10 ml and 15 patients with hematoma volume more than 10 ml, while the mean value of perihematoma PS of them showed no statistically significant difference (P>0.05). And there were no statistically significant correlations between perihematoma PS and NIHSS scores at the time of admission, CTPI examination and discharge (all P>0.05). Conclusions In subacute stage of ICH, the blood brain barrier permeability of perihematoma area is still abnormal, manifested as PS increases. The perihematoma PS positively correlates with the time of ICH onset. CTPI can accurately reflect this change, and potentially provide valuable information for evaluation and individual treatment of patients. Key words: Intracerebral hemorrhage; Tomography, X-ray computed; Perfusion; Capillary permeability; Subacute stage
{"title":"Study on CT perfusion surface permeability of cerebral hemorrhage in the basal ganglia region in subacute stage","authors":"Jincheng Wang, Haoli Xu, Shuailiang Liu, Yue Zhang, Jinjin Liu, Wenwen He, X. Qin, Yunjun Yang, Q. Zhuge, K. Jin, Weijian Chen","doi":"10.3760/CMA.J.ISSN.1006-7876.2017.03.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2017.03.009","url":null,"abstract":"Objective \u0000To investigate alterations of permeability of surface (PS) in subacute stage patients with intracerebral hemorrhage (ICH) using computed tomography perfusion imaging (CTPI), and analyze relationships between PS and other factors. \u0000 \u0000 \u0000Methods \u0000CTPI was performed in 35 patients in subacute stage (4 days-2 weeks) after onset of ICH, who were recruited in the Department of Neurology, the First Affiliated Hospital of Wenzhou Medical University from November 2015 to June 2016. Hematoma and edema volumes were measured, and perfusion parameters of perihematoma and mirror hemisphere side of marginal zone and outer zone of hematoma, including cerebral blood flow (CBF), cerebral blood volume (CBV), mean transit time (MTT), PS, and relative value (ipsilateral/contralateral) of CBF (rCBF), CBV (rCBV), MTT (rMTT) and PS (rPS), were calculated. Relationships between volumes of hematoma and edema, time from onset to CTPI performance, NIHSS scores and PS of perihematoma zone were analyzed by Pearson correlation analysis. \u0000 \u0000 \u0000Results \u0000The perihematoma PS ((1.87±0.48) ml·100 g-1·min-1) was higher than that in contralateral regions ((1.28±0.34) ml·100 g-1·min-1;t=-12.407, P 0.05). There were 20 patients with hematoma volume less than 10 ml and 15 patients with hematoma volume more than 10 ml, while the mean value of perihematoma PS of them showed no statistically significant difference (P>0.05). And there were no statistically significant correlations between perihematoma PS and NIHSS scores at the time of admission, CTPI examination and discharge (all P>0.05). \u0000 \u0000 \u0000Conclusions \u0000In subacute stage of ICH, the blood brain barrier permeability of perihematoma area is still abnormal, manifested as PS increases. The perihematoma PS positively correlates with the time of ICH onset. CTPI can accurately reflect this change, and potentially provide valuable information for evaluation and individual treatment of patients. \u0000 \u0000 \u0000Key words: \u0000Intracerebral hemorrhage; Tomography, X-ray computed; Perfusion; Capillary permeability; Subacute stage","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78509265","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 : 2017-01-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2017.01.007
Peng Pan, Li Xiaolu, C. Liying, Hou Bo, F. Feng, Shen Dongchao
Objective To explore diagnostic value of amplitude of low-frequency fluctuation (ALFF) on cognitive impairment in amyotrophic lateral sclerosis (ALS) using resting-state functional magnetic resonance imaging (MRI). Methods Sixteen ALS patients from neurological clinic in Peking Union Medical College Hospital were enrolled between November 2013 and April 2015. The patients were divided into two groups by the presence (ALSi, n=7) or absence (ALSu, n=9) of cognitive impairment. Routine MRI structural images and resting-state functional MRI were collected for comparison between groups through voxel-based morphometry (VBM) and ALFF. Results (1) Neuropsychological analysis showed significant differences in Montreal Cognitive Assessment score (22.9±2.0 vs 25.8±2.3, t=2.622, P=0.020), Frontal Assessment Battery score (12.4±1.6 vs 15.1±1.4, t=3.600, P=0.003), animal listing test (13.6±1.8 vs 16.7±2.9, t=2.482, P=0.026), naming test (2(1) vs 0(1), Z=-2.746, P=0.006), similarity test (7.9±3.7 vs 17.3±2.8, t=5.846, P=0.000)and clock drawing test (2(2) vs 3(0), Z=2.516, P=0.012). (2) VBM analysis showed no significant differences in both gray matter and white matter density between the two groups. (3) ALFF analysis showed significantly increased signals in widespread areas of bilateral cerebrum and cerebellum in ALSi group compared to ALSu group. Conclusion ALFF value has the potential to provide more valuable imaging basis for early diagnosis on cognitive impairment in ALS. Key words: Amyotrophic lateral sclerosis; Cognition disorders; Magnetic resonance imaging; Diagnosis
目的探讨静息状态功能磁共振成像(MRI)低频波动幅度(ALFF)对肌萎缩侧索硬化症(ALS)认知功能障碍的诊断价值。方法选取2013年11月至2015年4月北京协和医院神经内科收治的ALS患者16例。患者按存在(ALSi, n=7)或不存在(ALSu, n=9)认知障碍分为两组。收集常规MRI结构图像和静息状态功能MRI图像，通过体素形态学(voxel-based morphometry, VBM)和ALFF进行组间比较。结果(1)神经心理学分析显示，蒙特利尔认知评估评分(22.9±2.0 vs 25.8±2.3,t=2.622, P=0.020)、额叶评估电池评分(12.4±1.6 vs 15.1±1.4,t=3.600, P=0.003)、动物列表测试(13.6±1.8 vs 16.7±2.9,t=2.482, P=0.026)、命名测试(2(1)vs 0(1)， Z=-2.746, P=0.006)、相似性测试(7.9±3.7 vs 17.3±2.8,t=5.846, P=0.000)和钟画测试(2(2)vs 3(0)， Z=2.516, P=0.012)存在显著差异。(2) VBM分析显示，两组脑灰质和脑白质密度均无显著差异。(3) ALFF分析显示ALSi组双侧大脑和小脑广泛区信号明显高于ALSu组。结论ALFF值有可能为ALS认知功能障碍的早期诊断提供更有价值的影像学依据。关键词:肌萎缩性侧索硬化症;认知障碍;磁共振成像;诊断
{"title":"Initial exploration on clinical application of resting-state functional magnetic resonance imaging amplitude of low-frequency fluctuation method on cognitive impairment in amyotrophic lateral sclerosis","authors":"Peng Pan, Li Xiaolu, C. Liying, Hou Bo, F. Feng, Shen Dongchao","doi":"10.3760/CMA.J.ISSN.1006-7876.2017.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2017.01.007","url":null,"abstract":"Objective \u0000To explore diagnostic value of amplitude of low-frequency fluctuation (ALFF) on cognitive impairment in amyotrophic lateral sclerosis (ALS) using resting-state functional magnetic resonance imaging (MRI). \u0000 \u0000 \u0000Methods \u0000Sixteen ALS patients from neurological clinic in Peking Union Medical College Hospital were enrolled between November 2013 and April 2015. The patients were divided into two groups by the presence (ALSi, n=7) or absence (ALSu, n=9) of cognitive impairment. Routine MRI structural images and resting-state functional MRI were collected for comparison between groups through voxel-based morphometry (VBM) and ALFF. \u0000 \u0000 \u0000Results \u0000(1) Neuropsychological analysis showed significant differences in Montreal Cognitive Assessment score (22.9±2.0 vs 25.8±2.3, t=2.622, P=0.020), Frontal Assessment Battery score (12.4±1.6 vs 15.1±1.4, t=3.600, P=0.003), animal listing test (13.6±1.8 vs 16.7±2.9, t=2.482, P=0.026), naming test (2(1) vs 0(1), Z=-2.746, P=0.006), similarity test (7.9±3.7 vs 17.3±2.8, t=5.846, P=0.000)and clock drawing test (2(2) vs 3(0), Z=2.516, P=0.012). (2) VBM analysis showed no significant differences in both gray matter and white matter density between the two groups. (3) ALFF analysis showed significantly increased signals in widespread areas of bilateral cerebrum and cerebellum in ALSi group compared to ALSu group. \u0000 \u0000 \u0000Conclusion \u0000ALFF value has the potential to provide more valuable imaging basis for early diagnosis on cognitive impairment in ALS. \u0000 \u0000 \u0000Key words: \u0000Amyotrophic lateral sclerosis; Cognition disorders; Magnetic resonance imaging; Diagnosis","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80771502","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 : 2016-05-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2016.05.007
Xiang Gao, Xu Zhang, Huan Yang, Hongyu Zhou, Yan‐chen Xie, Wei Qiu, Li Xiao, Renhua Wang, Meng Xia, Lin Wang
Objective To evaluate the reliability and validity of the 4 myasthenia gravis (MG) scales widely used for assessing the grades of disease severity in Chinese MG patients. Methods Sixty MG patients were examined by a neurologist with the following four MG scales: Quantitative Myasthenia Gravis Score (QMGS), Myasthenia Gravis Composite (MGC), Myasthenic Muscle Scale (MMS), Absolute and Relative Score of MG (ARS-MG). The whole assessment process was videotaped. MG Activities of Daily Living (MG-ADL) score was acquired after the examination. The patients were examined by the same neurologist with the same MG scales within 24 hours after the first examination. The original videotapes of each patient were assessed by five other neurologists independently. Interobserver reliability of each item of the four MG scales was assessed with weighted Kappa test. Internal consistency of the scales was assessed with Cronbach ɑ. Test-retest reliability and interobserver reliability among the five neurologists were assessed with intraclass correlation coefficience (ICC). The construct validity was assessed with factor analysis. Criterion validity was assessed by Spearman correlation analysis. Results Interobserver reliability of items of the 4 MG scales was moderate (k 0.310-0.891, P<0.01). All 4 MG scales showed good internal consistency (Cronbach ɑ 0.701-0.734) with high test-retest reliability (ICC 0.887-0.948, P<0.01) and interobserver reliability (ICC 0.853-0.917, P<0.01). Factor analysis showed good construct validity (accumulative dedication rate 66.49%-72.64%). There was moderate to strong correlation between QMGS (as criterion) and the other three scales (r 0.792-0.840, P<0.01), and moderate correlation between MG-ADL (as criterion) and the four scales (r 0.693-0.766, P<0.01). Conclusion The 4 widely used MG severity scales can effectively assess the grades of disease severity of MG with good reliability and validity. Key words: Myasthenia gravis; Evaluation studies; Reproducibity of results; Validation studies
{"title":"Evaluation of the scales assessing the severity of myasthenia gravis","authors":"Xiang Gao, Xu Zhang, Huan Yang, Hongyu Zhou, Yan‐chen Xie, Wei Qiu, Li Xiao, Renhua Wang, Meng Xia, Lin Wang","doi":"10.3760/CMA.J.ISSN.1006-7876.2016.05.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2016.05.007","url":null,"abstract":"Objective \u0000To evaluate the reliability and validity of the 4 myasthenia gravis (MG) scales widely used for assessing the grades of disease severity in Chinese MG patients. \u0000 \u0000 \u0000Methods \u0000Sixty MG patients were examined by a neurologist with the following four MG scales: Quantitative Myasthenia Gravis Score (QMGS), Myasthenia Gravis Composite (MGC), Myasthenic Muscle Scale (MMS), Absolute and Relative Score of MG (ARS-MG). The whole assessment process was videotaped. MG Activities of Daily Living (MG-ADL) score was acquired after the examination. The patients were examined by the same neurologist with the same MG scales within 24 hours after the first examination. The original videotapes of each patient were assessed by five other neurologists independently. Interobserver reliability of each item of the four MG scales was assessed with weighted Kappa test. Internal consistency of the scales was assessed with Cronbach ɑ. Test-retest reliability and interobserver reliability among the five neurologists were assessed with intraclass correlation coefficience (ICC). The construct validity was assessed with factor analysis. Criterion validity was assessed by Spearman correlation analysis. \u0000 \u0000 \u0000Results \u0000Interobserver reliability of items of the 4 MG scales was moderate (k 0.310-0.891, P<0.01). All 4 MG scales showed good internal consistency (Cronbach ɑ 0.701-0.734) with high test-retest reliability (ICC 0.887-0.948, P<0.01) and interobserver reliability (ICC 0.853-0.917, P<0.01). Factor analysis showed good construct validity (accumulative dedication rate 66.49%-72.64%). There was moderate to strong correlation between QMGS (as criterion) and the other three scales (r 0.792-0.840, P<0.01), and moderate correlation between MG-ADL (as criterion) and the four scales (r 0.693-0.766, P<0.01). \u0000 \u0000 \u0000Conclusion \u0000The 4 widely used MG severity scales can effectively assess the grades of disease severity of MG with good reliability and validity. \u0000 \u0000 \u0000Key words: \u0000Myasthenia gravis; Evaluation studies; Reproducibity of results; Validation studies","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86986010","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 : 2016-04-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2016.04.005
Xueliang Li, Xianwen Chen, Shangpei Wang, M. Jiang, Ai-ping Feng, Qian Yang, P. Hu
Objective To investigate the characteristics and the correlative factors of constipation in Parkinson's disease (PD) patients. Methods The demographic information, clinical features and history of medications of 193 patients with idiopathic PD consulting in the outpatient department of the First Affiliated Hospital, Anhui Medical University were collected. Patients were evaluated using following scales: Unified Parkinson's Disease Rating ScaleⅢ(UPDRS Ⅲ), Hoehn-Yahr stage, Bristol Scoring Scale, Cleveland Constipation Scoring Scale (CCS), Scale for Outcomes in PD-autonomic for Autonomic Symptoms, Simple Food Frequency Questionnaire, Hamilton Depression Scale (HAMD), Mini Mental State Examination. The patients were divided into constipation group and non-constipation group based on Rome Ⅲ Criteria for Diagnosis of Functional Constipation, and the correlative factors of constipation were compared and analyzed between the two groups. The severity of constipation and influencing factors were also compared between patients with early onset constipation (occurred before present of motor symptoms) and patients with late onset constipation (occurred after present of motor symptoms). The impacts of anti-PD medication adjustments on constipation were assessed by observing the alteration of constipation severity in 41 PD patients. Results The incidence of constipation was 56.4% (109/193) in our cohort of PD patients, and 21.1% (23/109) of constipation was severe according to the assessing by CCS. The spectrum of constipation symptoms included defecation straining (89.9%, 98/109), poor stool output(67.9%, 74/109), reduced stool frequency (63.3%, 69/109) and dryness of stool (60.5%, 66/109). The age, disease duration, scores of Hoehn-Yahr stage, UPDRS Ⅲand HAMD, levodopa equivalent dose (LED), frequency of urination disturbance in constipation group were significantly higher than those in non-constipation group, while the daily quantities of vegetable and water intake in constipation group were significantly lower than those in non-constipation group. Age and HAMD scores were the independent risk factors of constipation (OR=1.049, 95% CI 1.014-1.086, P=0.006; OR=1.316, 95% CI 1.185-1.461, P=0.000). Among the 109 constipation patients, the course of PD, scores of Hoehn-Yahr stage, UPDRSⅢ and LED were positively correlated with the severity of constipation (r=0.269, 0.338, 0.315, 0.341, 0.371, all P<0.05), with HAMD score being the independent risk factor of constipation severity (OR=1.175, 95% CI 1.044-1.322, P<0.05). The severity of constipation and risk factors of constipation in patients with early onset constipation were not distinct from those with late onset constipation. Conclusions The incidence of constipation increases with the increment of age, disease duration, Hoehn-Yahr stage, UPDRSⅢ scores, LED, HAMD scores, urination disorder severity and the decrement of daily water and vegetable intakes. The severity of constipation is posit
目的探讨帕金森病(PD)患者便秘的特点及相关因素。方法收集安徽医科大学第一附属医院门诊就诊的193例特发性帕金森病患者的人口学资料、临床特点及用药史。采用以下量表对患者进行评估:统一帕金森病评定量表Ⅲ(UPDRSⅢ)、Hoehn-Yahr分级、Bristol评分量表、Cleveland便秘评分量表(CCS)、自主神经症状pd -自主神经结局量表、简单食物频率问卷、汉密尔顿抑郁量表(HAMD)、迷你精神状态检查。根据罗马Ⅲ功能性便秘诊断标准将患者分为便秘组和非便秘组，比较分析两组患者便秘的相关因素。比较早发性便秘(出现运动症状前)和晚发性便秘(出现运动症状后)患者的便秘严重程度及影响因素。通过观察41例PD患者便秘严重程度的变化，评估抗PD药物调整对便秘的影响。结果本组PD患者便秘发生率为56.4%(109/193)，其中重度便秘发生率为21.1%(23/109)。便秘症状包括排便紧张(89.9%，98/109)、排便不良(67.9%，74/109)、排便次数减少(63.3%，69/109)和大便干燥(60.5%，66/109)。便秘组患者的年龄、病程、Hoehn-Yahr期评分、UPDRSⅢ和HAMD评分、左旋多巴当量剂量(LED)、排尿障碍频次均显著高于非便秘组，而每日蔬菜摄取量和饮水量均显著低于非便秘组。年龄和HAMD评分是便秘的独立危险因素(OR=1.049, 95% CI 1.014-1.086, P=0.006;Or =1.316, 95% ci 1.185-1.461, p =0.000)。109例便秘患者中，PD病程、Hoehn-Yahr分期评分、UPDRSⅢ、LED与便秘严重程度呈正相关(r=0.269、0.338、0.315、0.341、0.371，均P<0.05)， HAMD评分是便秘严重程度的独立危险因素(OR=1.175, 95% CI 1.044 ~ 1.322, P<0.05)。早发性便秘患者的便秘严重程度和便秘危险因素与晚发性便秘患者无明显差异。结论便秘的发生率随年龄、病程、Hoehn-Yahr分期、UPDRSⅢ评分、LED评分、HAMD评分、排尿障碍严重程度及每日饮水和蔬菜摄入量的减少而增加。便秘的严重程度与运动症状的严重程度、抗pd药物的日剂量和抑郁程度呈正相关。PD患者早发性便秘与晚发性便秘在严重程度和危险因素上没有明显区别。抗pd药物对便秘的影响是可变的，这取决于所使用的具体药物和个人体质。针对PD患者便秘的具体危险因素，提出个体化治疗方案。关键词:帕金森病;便秘;抑郁症;疾病影响概况;对照临床试验
{"title":"Clinical characteristics and correlative factors of constipation in patients with Parkinson's disease","authors":"Xueliang Li, Xianwen Chen, Shangpei Wang, M. Jiang, Ai-ping Feng, Qian Yang, P. Hu","doi":"10.3760/CMA.J.ISSN.1006-7876.2016.04.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2016.04.005","url":null,"abstract":"Objective \u0000To investigate the characteristics and the correlative factors of constipation in Parkinson's disease (PD) patients. \u0000 \u0000 \u0000Methods \u0000The demographic information, clinical features and history of medications of 193 patients with idiopathic PD consulting in the outpatient department of the First Affiliated Hospital, Anhui Medical University were collected. Patients were evaluated using following scales: Unified Parkinson's Disease Rating ScaleⅢ(UPDRS Ⅲ), Hoehn-Yahr stage, Bristol Scoring Scale, Cleveland Constipation Scoring Scale (CCS), Scale for Outcomes in PD-autonomic for Autonomic Symptoms, Simple Food Frequency Questionnaire, Hamilton Depression Scale (HAMD), Mini Mental State Examination. The patients were divided into constipation group and non-constipation group based on Rome Ⅲ Criteria for Diagnosis of Functional Constipation, and the correlative factors of constipation were compared and analyzed between the two groups. The severity of constipation and influencing factors were also compared between patients with early onset constipation (occurred before present of motor symptoms) and patients with late onset constipation (occurred after present of motor symptoms). The impacts of anti-PD medication adjustments on constipation were assessed by observing the alteration of constipation severity in 41 PD patients. \u0000 \u0000 \u0000Results \u0000The incidence of constipation was 56.4% (109/193) in our cohort of PD patients, and 21.1% (23/109) of constipation was severe according to the assessing by CCS. The spectrum of constipation symptoms included defecation straining (89.9%, 98/109), poor stool output(67.9%, 74/109), reduced stool frequency (63.3%, 69/109) and dryness of stool (60.5%, 66/109). The age, disease duration, scores of Hoehn-Yahr stage, UPDRS Ⅲand HAMD, levodopa equivalent dose (LED), frequency of urination disturbance in constipation group were significantly higher than those in non-constipation group, while the daily quantities of vegetable and water intake in constipation group were significantly lower than those in non-constipation group. Age and HAMD scores were the independent risk factors of constipation (OR=1.049, 95% CI 1.014-1.086, P=0.006; OR=1.316, 95% CI 1.185-1.461, P=0.000). Among the 109 constipation patients, the course of PD, scores of Hoehn-Yahr stage, UPDRSⅢ and LED were positively correlated with the severity of constipation (r=0.269, 0.338, 0.315, 0.341, 0.371, all P<0.05), with HAMD score being the independent risk factor of constipation severity (OR=1.175, 95% CI 1.044-1.322, P<0.05). The severity of constipation and risk factors of constipation in patients with early onset constipation were not distinct from those with late onset constipation. \u0000 \u0000 \u0000Conclusions \u0000The incidence of constipation increases with the increment of age, disease duration, Hoehn-Yahr stage, UPDRSⅢ scores, LED, HAMD scores, urination disorder severity and the decrement of daily water and vegetable intakes. The severity of constipation is posit","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89976658","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 : 2016-01-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2016.01.007
Q. Lu, H. Guan, H. Ren, Qing Liu, J. Niu, B. Peng, L. Cui
Objective To investigate the efficacy and safety of rituximab in the treatment of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods Three patients with anti-NMDAR antibodies in cerebrospinal fluid and serum hospitalized from May 2012 to July 2014 were retrospectively reviewed. The clinical syndrome, investigations, and therapeutic interventions by rituximab when first line immunotherapy failed were evaluated. Results All 3 patients were females with median age of 17 years (12, 17, and 22 years). One patient had ovarian teratoma. All 3 patients presented with psychiatric symptoms and movement disorders, 2 of which developed into a state of unresponsiveness. Brain magnetic resonance imaging of 2 patients was unremarkable, and 1 showed T2 and FLAIR hyperintensity among the areas of medulla, pons, caudex cerebri and callosum. Fluoro-2-deoxy-D-glucose-PET showed variable multifocal cortical and subcortical abnormalities that changed during the course of the disease. Electroencephalograms were abnormal in all patients, showing non-specific, slow, and disorganised activity, 1 showing extreme delta brush. The cerebrospinal fluid showed lymphocytic pleocytosis. All patients showed no response to treatment with first line immunotherapy (corticosteroids, intravenous immunoglobulin (400 mg·kg-1·d-1×5 d, 2-3 courses of treatment)). After the administration of rituximab, 1 patient responded slower, whereas the other 2 patients who recovered dramatically (375 mg/m2 every week for 3-4 weeks)continued immunosuppression with mycophenolatemofetil for 1 year. Relapse occurred in 1 patient when the immunotherapies discontinued 6 months later. During the treatment of rituximab, 2 patients had grade 3 infectious adverse events (hospitalization and intravenous administration of antibiotics). Conclusions Rituximab is effective for the patients with anti-NMDAR encephalitis who fail to respond to the first line immunotherapy. However the utility of rituximab is still a challenge due to the risk of infectious complications and off-label use. Key words: Anti-N-methyl-D-aspartate receptor encephalitis; Immunotherapy; Antibodies, monoclonal, murine-derived; Therapies, investigational; Infection
目的探讨利妥昔单抗治疗抗n -甲基- d -天冬氨酸受体(NMDAR)脑炎的疗效和安全性。方法回顾性分析2012年5月至2014年7月住院治疗的3例脑脊液及血清抗nmdar抗体患者。评估一线免疫治疗失败时的临床症状、调查和利妥昔单抗的治疗干预。结果3例患者均为女性，中位年龄为17岁(12、17、22岁)。1例患者有卵巢畸胎瘤。3例患者均出现精神症状和运动障碍，其中2例发展为无反应状态。2例脑磁共振成像无明显异常，1例髓质、脑桥、脑尾、胼胝体等区域出现T2和FLAIR高信号。氟-2-脱氧-d -葡萄糖- pet显示在疾病过程中发生变化的多灶皮质和皮质下异常。所有患者的脑电图均异常，表现为非特异性、缓慢和无组织的活动，1表现为极端的三角刷。脑脊液淋巴细胞增多。所有患者对一线免疫治疗(皮质类固醇、静脉注射免疫球蛋白(400 mg·kg-1·d-1×5 d, 2-3个疗程)均无反应。在给予利妥昔单抗后，1例患者反应较慢，而另外2例患者明显恢复(每周375 mg/m2，持续3-4周)，持续使用霉酚酸莫非特1年。6个月后停止免疫治疗，1例复发。在利妥昔单抗治疗期间，2例患者发生3级感染不良事件(住院和静脉给药抗生素)。结论利妥昔单抗对一线免疫治疗无效的抗nmdar脑炎患者是有效的。然而，由于感染并发症和标签外使用的风险，利妥昔单抗的实用性仍然是一个挑战。关键词:抗n -甲基- d -天冬氨酸受体脑炎;免疫治疗;单克隆抗体，鼠源性;疗法,临床实验;感染
{"title":"Clinical observation of rituximab in three patients with anti-N-methyl-D-aspartate receptor encephalitis","authors":"Q. Lu, H. Guan, H. Ren, Qing Liu, J. Niu, B. Peng, L. Cui","doi":"10.3760/CMA.J.ISSN.1006-7876.2016.01.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2016.01.007","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of rituximab in the treatment of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. \u0000 \u0000 \u0000Methods \u0000Three patients with anti-NMDAR antibodies in cerebrospinal fluid and serum hospitalized from May 2012 to July 2014 were retrospectively reviewed. The clinical syndrome, investigations, and therapeutic interventions by rituximab when first line immunotherapy failed were evaluated. \u0000 \u0000 \u0000Results \u0000All 3 patients were females with median age of 17 years (12, 17, and 22 years). One patient had ovarian teratoma. All 3 patients presented with psychiatric symptoms and movement disorders, 2 of which developed into a state of unresponsiveness. Brain magnetic resonance imaging of 2 patients was unremarkable, and 1 showed T2 and FLAIR hyperintensity among the areas of medulla, pons, caudex cerebri and callosum. Fluoro-2-deoxy-D-glucose-PET showed variable multifocal cortical and subcortical abnormalities that changed during the course of the disease. Electroencephalograms were abnormal in all patients, showing non-specific, slow, and disorganised activity, 1 showing extreme delta brush. The cerebrospinal fluid showed lymphocytic pleocytosis. All patients showed no response to treatment with first line immunotherapy (corticosteroids, intravenous immunoglobulin (400 mg·kg-1·d-1×5 d, 2-3 courses of treatment)). After the administration of rituximab, 1 patient responded slower, whereas the other 2 patients who recovered dramatically (375 mg/m2 every week for 3-4 weeks)continued immunosuppression with mycophenolatemofetil for 1 year. Relapse occurred in 1 patient when the immunotherapies discontinued 6 months later. During the treatment of rituximab, 2 patients had grade 3 infectious adverse events (hospitalization and intravenous administration of antibiotics). \u0000 \u0000 \u0000Conclusions \u0000Rituximab is effective for the patients with anti-NMDAR encephalitis who fail to respond to the first line immunotherapy. However the utility of rituximab is still a challenge due to the risk of infectious complications and off-label use. \u0000 \u0000 \u0000Key words: \u0000Anti-N-methyl-D-aspartate receptor encephalitis; Immunotherapy; Antibodies, monoclonal, murine-derived; Therapies, investigational; Infection","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85751108","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 : 2015-10-08DOI: 10.3760/CMA.J.ISSN.1006-7876.2015.10.011
Wu Guoping, Wang Dayong, Kang Wenyan, L. Jun
Objective To investigate the association between the single nucleotide polymorphisms (SNPs) rs894278 and rs11931074 of α-synuclein (SNCA) and non motor symptoms in Parkinson' s disease (PD).Methods One hundred and twenty PD patients and 100 healthy controls enrolled from Tonglu Hospital Affiliated to Ruijin Hospital and Ruijin Hospital,Shanghai Jiaotong University School of Medicine from 2012 to 2014 were recruited and the motor subscale of the Unified Parkinson' s Disease Rating Scale Ⅲ (UPDRS-Ⅲ) was used to evaluate motor function.The Mini-Mental State Examination (MMSE),17-item Hamilton Rating Scale (HAMD-17),the Rapid Eye Movement Behavior Disorder Screening Questionnaire (RBDSQ) and the ROME-Ⅲ criteria for chronic constipation were used to evaluate non motor symptoms.SNCA SNPs (rs894278,rs11931074) were genotyped by direct sequencing.Results There was no statistically significant difference in age,sex,non motor symptoms scores among the three genotypes of the two SNPs in control group.There was no statistically significant difference in age,sex,UPDRS-Ⅲ scores and Hoehn-Yahr stage among the three genotypes of the two SNPs in PD group.The results demonstrated that there was no association between the two SNPs and RBDSQ scores,HAMD-17 scores,MMSE scores and constipation in PD patients.However,additional analysis showed that patients with GG rs894278 had a greater proportion of clinical probable RBD than those with GT and TT types (GG 52.2％,12/23;GT 18.2％,10/55;TT 21.4％,9/42;x2 =9.254,P=0.002;x2 =6.424,P=0.005).In Logistic regression analyses adjusting for age and sex,we observed that rs894278 GG genotype could increase the risk of RBD in PD patients (OR =5.367,95％ CI =1.607-17.925,P =0.006).There was no association of RBD with allelic and genotypic distributions of SNCA rs11931074.Conclusion The results indicate that the rs894278 polymorphism correlates with RBD,while rs11931074 does not.
目的探讨α-突触核蛋白(SNCA) rs894278和rs11931074单核苷酸多态性与帕金森病(PD)非运动症状的关系。方法选取2012 - 2014年在瑞金医院附属桐庐医院和上海交通大学医学院瑞金医院入组的PD患者120例和健康对照100例，采用统一帕金森病评定量表Ⅲ(UPDRS-Ⅲ)的运动分量表评估运动功能。采用简易精神状态检查(MMSE)、17项汉密尔顿评定量表(HAMD-17)、快速眼动行为障碍筛查问卷(RBDSQ)和ROME-Ⅲ慢性便秘标准评估非运动症状。SNCA snp (rs894278,rs11931074)通过直接测序进行基因分型。结果对照组两种snp基因型患者的年龄、性别、非运动症状评分差异均无统计学意义。PD组两种snp基因型在年龄、性别、UPDRS-Ⅲ评分和Hoehn-Yahr分期上差异均无统计学意义。结果显示，这两个snp与PD患者的RBDSQ评分、HAMD-17评分、MMSE评分和便秘无相关性。然而，进一步分析显示，GG rs894278型患者临床可能发生RBD的比例高于GT和TT型患者(GG 52.2%，12/23;GT 18.2%，10/55;TT 21.4%，9/42;x2 =9.254,P=0.002;x2 =6.424,P=0.005)。在调整年龄和性别的Logistic回归分析中，我们观察到rs894278 GG基因型可增加PD患者RBD的风险(OR =5.367,95% CI =1.607-17.925,P =0.006)。RBD与SNCA rs11931074的等位基因和基因型分布没有关联。结论rs894278多态性与RBD相关，rs11931074与RBD无关。
{"title":"Association study of α-synuclein gene polymorphism and non motor symptoms in Parkinson's disease","authors":"Wu Guoping, Wang Dayong, Kang Wenyan, L. Jun","doi":"10.3760/CMA.J.ISSN.1006-7876.2015.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1006-7876.2015.10.011","url":null,"abstract":"Objective To investigate the association between the single nucleotide polymorphisms (SNPs) rs894278 and rs11931074 of α-synuclein (SNCA) and non motor symptoms in Parkinson' s disease (PD).Methods One hundred and twenty PD patients and 100 healthy controls enrolled from Tonglu Hospital Affiliated to Ruijin Hospital and Ruijin Hospital,Shanghai Jiaotong University School of Medicine from 2012 to 2014 were recruited and the motor subscale of the Unified Parkinson' s Disease Rating Scale Ⅲ (UPDRS-Ⅲ) was used to evaluate motor function.The Mini-Mental State Examination (MMSE),17-item Hamilton Rating Scale (HAMD-17),the Rapid Eye Movement Behavior Disorder Screening Questionnaire (RBDSQ) and the ROME-Ⅲ criteria for chronic constipation were used to evaluate non motor symptoms.SNCA SNPs (rs894278,rs11931074) were genotyped by direct sequencing.Results There was no statistically significant difference in age,sex,non motor symptoms scores among the three genotypes of the two SNPs in control group.There was no statistically significant difference in age,sex,UPDRS-Ⅲ scores and Hoehn-Yahr stage among the three genotypes of the two SNPs in PD group.The results demonstrated that there was no association between the two SNPs and RBDSQ scores,HAMD-17 scores,MMSE scores and constipation in PD patients.However,additional analysis showed that patients with GG rs894278 had a greater proportion of clinical probable RBD than those with GT and TT types (GG 52.2％,12/23;GT 18.2％,10/55;TT 21.4％,9/42;x2 =9.254,P=0.002;x2 =6.424,P=0.005).In Logistic regression analyses adjusting for age and sex,we observed that rs894278 GG genotype could increase the risk of RBD in PD patients (OR =5.367,95％ CI =1.607-17.925,P =0.006).There was no association of RBD with allelic and genotypic distributions of SNCA rs11931074.Conclusion The results indicate that the rs894278 polymorphism correlates with RBD,while rs11931074 does not.","PeriodicalId":10143,"journal":{"name":"中华神经科杂志","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82350028","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}
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