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Influence of BDNF Genotype on the Effect of Neuromodulation on Pain Signalling and Pain Perception in Humans BDNF基因型对人类疼痛信号传导和疼痛感知的神经调节作用的影响
Pub Date : 2021-05-10 DOI: 10.23937/2378-3001/1410110
T. Magnus, S. Walker, S. Mats, Rahin Hedayat
Trans-spinal Direct Current Stimulation (tsDCS) can alleviate pain perception in humans through plastic processes. Brain Derived Neurotrophic Factor (BDNF) has been shown to influence a large number of physiological processes including those underpinning neural plasticity. A common polymorphism of BDNF (val66met), reduces the efficiency of plastic processes. We studied the effect of this BDNF polymorphism on the signalling and perception of thermal pain and to what degree these can be influenced by tsDCS in young healthy adults. For those carrying a less optimal form of BDNF, the pain mitigating effect of tsDCS was reduced. BDNF typing may be used to improve individualization in pain treatment using tsDCS, thereby reducing the variability regarding the effect of this technique.
经脊髓直流电刺激(tsDCS)可以通过可塑性过程减轻人类的疼痛感知。脑源性神经营养因子(BDNF)已被证明影响大量的生理过程,包括那些基础神经可塑性。BDNF (val66met)的常见多态性降低了塑料加工的效率。我们研究了BDNF多态性对年轻健康成人热痛信号传导和感知的影响,以及tsDCS对这些影响的程度。对于那些携带不太理想形式的BDNF的人,tsDCS的疼痛缓解效果降低。BDNF分型可用于改善使用tsDCS治疗疼痛的个体化,从而减少该技术效果的可变性。
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引用次数: 1
Multiple Mononeuropathy in Churg-Strauss Syndrome Presenting as a Subacute Ascending Polineuropathy: A Case Report Churg-Strauss综合征的多发性单神经病变表现为亚急性上行多神经病变1例报告
Pub Date : 2021-03-13 DOI: 10.23937/2378-3001/1410108
Pistacchi Michele, Gioulis Manuela, Ferrari Sergio, Cavallaro Tiziana, Marsala Sandro Zambito
Multiple mononeuropathy is not unusual in Churg-Strauss Syndrome. Presenting symptoms may be subacute and the differential diagnosis became complicated, particularly when neuropathy is the sole manifestation of disease. We report a clinical case of an adult man hospitalized complaining symptoms of subacute neuropathy successively recognized as multiple mononeuropathy. Histological examination of sural nerve showed the evidence of systemic necrotizing vasculitis with eosinophils infiltration, confirming the diagnosis of CSS. Clinical and neurophysiological findings are discussed.
多发性单神经病变在Churg-Strauss综合征中并不罕见。症状可能是亚急性的,鉴别诊断变得复杂,特别是当神经病变是疾病的唯一表现时。我们报告一个临床病例的成年男子住院主诉症状亚急性神经病变先后确认为多发性单神经病变。腓肠神经组织学检查显示全身坏死性血管炎伴嗜酸性粒细胞浸润,确诊为CSS。讨论了临床和神经生理学的发现。
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引用次数: 0
Peripheral Neuropathies after Bariatric Surgery: A Current Review 减肥手术后周围神经病变:最新综述
Pub Date : 2021-02-06 DOI: 10.23937/2378-3001/1410107
Stoll Aluísio, Neto Dedi Ferreira Alves, Silva Évelin Pereira da, Papes Kéli Daiane, MianoSelbach Maria Carolina, Souza Matheus Fellipe Nascimento de, Breis Letícia Caroline, Parolim Laura Fiuza, T. Jose, Gonçalves Marcus Vinícius Magno
Introduction: Bariatric surgery (BS) is an effective method for sustained weight loss and better quality of life. However, it has its complications. Among those, peripheral neuropathies are important, although underdiagnosed, complications after the surgery. Objective: The objective of this article is to describe the most prevalent peripheral neuropathies that may happen after BS, especially focusing on small fiber neuropathies, and the main nutritional deficits involved in these neuropathies. Methods: It was made a non-systematic review on PubMed/Medline database. Results: 32 articles were included. Conclusion: Further studies are needed to estimate the prevalence of peripheral neuropathies after BS, especially small fiber neuropathy. This lack of epidemiological studies corroborates to the underdiagnosis. We suggest researchers to make a prospective cohort about Small fiber neuropathy after BS.
减肥手术(BS)是一种持续减肥和提高生活质量的有效方法。然而,它也有其复杂性。其中,周围神经病变是重要的,虽然诊断不足,术后并发症。目的:本文的目的是描述BS后可能发生的最常见的周围神经病变,特别是小纤维神经病变,以及这些神经病变所涉及的主要营养缺陷。方法:对PubMed/Medline数据库进行非系统评价。结果:纳入文献32篇。结论:BS后周围神经病变,尤其是小纤维神经病变的发生率有待进一步研究。流行病学研究的缺乏证实了诊断不足。我们建议研究人员对BS后小纤维神经病变进行前瞻性队列研究。
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引用次数: 1
A Novel Automated Algorithm Effectively Titrates Stimulation in an Implantable Vagus Nerve Stimulation Device 一种新的自动算法在植入式迷走神经刺激装置中有效地滴定刺激
Pub Date : 2020-11-11 DOI: 10.23937/2378-3001/1410105
I. Libbus, Enea Dede, S. Stubbs, L. DiCarlo, Scott T. Mazar, B. Amurthur, B. KenKnight
Background: Autonomic Regulation Therapy (ART) using chronic Vagus Nerve Stimulation (VNS) is in development for patients with heart failure who remain symptomatic despite standard care. In the ANTHEM-HF Pilot Study, a therapeutic VNS intensity was successfully achieved in patients with HFrEF using manually programmed VNS up-titration. An algorithm has been developed for automatically intensifying VNS in small increments to a programmable target intensity, and capable of adjustments during the up-titration process using a hand-held programmer or magnet. Methods: Six healthy canines were implanted with a pulse generator and lead for right cervical VNS. Device programming at implant activated the titration algorithm with (1) A 1-week start delay; (2) Initial stimulation intensity of 0.125 mA, 130 μsec pulse width, and 5 Hz frequency; (3) Target stimulation intensity of 2.5 mA, 250 μsec pulse width, and 5 Hz frequency; and (4) Trajectory to achieve the target intensity in approximately 10 weeks. Magnet placement over the pulse generator at scheduled intervals tested algorithm design intention to decrement VNS intensity, prolong the time to reach the target intensity, and/or temporarily inhibit VNS. Results: All animals underwent successful VNS system implantation and completed all scheduled activities. There was one transient implant-related adverse event (Horner’s Syndrome). The “TitrationAssist” algorithm performed as designed. The targeted VNS intensity was achieved as scheduled and automated titration was well-tolerated in all animals. There were no stimulation-related adverse events. ECG monitoring demonstrated no clinically significant cardiac findings. Detailed gross necropsy and macroscopic examinations revealed vagus nerves and all major organs to be normal in all animals. Conclusion: An implantable VNS device with Titration Assist algorithm for automatically increasing VNS to a target intensity, and capable of adjustment in response to specific magnet applications, was successfully tested in a preclinical study of healthy canines. Titration Assist performed as designed appears to be safe and could dramatically reduce the burden of titration in a clinical setting. BriEf rEPort
背景:使用慢性迷走神经刺激(VNS)的自主调节疗法(ART)正在开发中,用于标准治疗后仍有症状的心力衰竭患者。在ANTHEM-HF试点研究中,通过手动编程的VNS上升滴定,HFrEF患者成功达到了治疗性VNS强度。已经开发了一种算法,用于以小增量自动增强VNS到可编程的目标强度,并且能够在使用手持式编程器或磁铁的上滴定过程中进行调整。方法:对6只健康犬进行右颈VNS脉冲发生器和导联植入。植入时的设备编程以(1)1周的启动延迟激活滴定算法;(2)初始刺激强度为0.125 mA,脉宽为130 μsec,频率为5 Hz;(3)目标刺激强度为2.5 mA,脉宽250 μsec,频率为5 Hz;(4)在大约10周内达到目标强度的轨迹。在脉冲发生器上按预定间隔放置磁铁,测试了算法设计意图,以降低VNS强度,延长达到目标强度的时间,和/或暂时抑制VNS。结果:所有动物均成功植入VNS系统并完成所有预定活动。有一个短暂的与种植体相关的不良事件(霍纳综合征)。“TitrationAssist”算法按设计执行。靶标VNS强度如期达到,自动滴定在所有动物中耐受良好。没有刺激相关的不良事件。心电图监测未显示有临床意义的心脏发现。详细的大体解剖和肉眼检查显示,所有动物的迷走神经和所有主要器官均正常。结论:在健康犬的临床前研究中,一种可植入的VNS装置成功地进行了临床前试验,该装置具有滴定辅助算法,可自动将VNS增加到目标强度,并能够根据特定的磁铁应用进行调整。按照设计进行滴定辅助似乎是安全的,并且可以显着减少临床环境中滴定的负担。简短的报告
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引用次数: 0
Migraines and CGRP Monoclonal Antibodies: A Review of Cardiovascular Side Effects and Safety Profile 偏头痛和CGRP单克隆抗体:心血管副作用和安全性综述
Pub Date : 2020-07-31 DOI: 10.23937/2378-3001/1410101
B. Kimberly, Butala Nitin
Migraine headaches are a common complaint described by patients and few medications have been designed solely for their treatment. Current knowledge of migraine pathogenesis relates to various neuropeptides, including calcitonin gene related peptide (CGRP), acting on blood vessels within the brain, causing vasodilation. Sensory fibers detect this change and perceive it as pain. This understanding has led to the development of CGRP monoclonal antibodies as a possible migraine treatment. This class of migraine medication causes concern for possible cardiovascular side effects. Blocking CGRP and the vasodilatory process of migraines may pose a risk for exacerbating cardiovascular disease. CGRP has also demonstrated protective effects on the cardiovascular system by preventing against heart failure, deleterious cardiac remodeling, hypertension, and cell death. Additionally, patients with migraines are also believed to be at greater baseline risk for cardiovascular and cerebrovascular disease. Assessment of a cardiovascular risk profile is essential for the continued use of this medication class. Various trials within phase II or III of study were analyzed for the risk profiles of CGRP monoclonal antibodies. At this time, no serious cardiovascular adverse effects have been found. The CGRP monoclonal antibodies did not increase rates of cardiovascular adverse events, when compared to placebo. The CGRP monoclonal antibodies were shown to be safe in patients with previous cardiovascular risk as well as those stressed to provoke an adverse cardiovascular event. Many of the phase II and phase III trials had significant female participation, representing a safe cardiovascular profile for those most commonly affected with migraines. This demonstrated that the medication class does not increase risk of cardiovascular side effects in its users.
偏头痛是一种常见的抱怨,很少有药物是专门为治疗偏头痛而设计的。目前对偏头痛发病机制的认识与多种神经肽有关,包括降钙素基因相关肽(CGRP),它们作用于脑内血管,引起血管舒张。感觉纤维检测到这种变化并将其感知为疼痛。这种认识导致了CGRP单克隆抗体的发展,作为一种可能的偏头痛治疗方法。这类治疗偏头痛的药物可能引起心血管方面的副作用。阻断CGRP和偏头痛的血管舒张过程可能有加重心血管疾病的风险。CGRP还通过预防心力衰竭、有害的心脏重塑、高血压和细胞死亡,证明了其对心血管系统的保护作用。此外,偏头痛患者患心脑血管疾病的基线风险也更高。评估心血管风险概况对继续使用这类药物至关重要。在研究的II期或III期的各种试验中,分析了CGRP单克隆抗体的风险概况。目前,没有发现严重的心血管不良反应。与安慰剂相比,CGRP单克隆抗体没有增加心血管不良事件的发生率。CGRP单克隆抗体被证明对既往有心血管风险的患者以及应激引起不良心血管事件的患者是安全的。许多II期和III期试验都有显著的女性参与,这对于那些最常受偏头痛影响的人来说,代表了一种安全的心血管特征。这表明这类药物不会增加使用者心血管副作用的风险。
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引用次数: 4
Single Stage Debridement and Titanium Mesh Cranioplasty in Patients of Compound Depressed Skull Fracture, an Institutional Experience 一期清创配合钛网颅骨成形术治疗复合性凹陷性颅骨骨折的临床经验
Pub Date : 2020-07-01 DOI: 10.21088/IJNNS.0975.0223.12320.11
S. Das
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引用次数: 0
Therapeutic Benefit of Palmitoylethanolamide in the Management of Trigeminal Neuralgia 棕榈酰乙醇酰胺治疗三叉神经痛的疗效观察
Pub Date : 2020-07-01 DOI: 10.21088/IJNNS.0975.0223.12320.10
I. Chaurasia
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引用次数: 0
AL-TENS as Quantitative Measure for the Feasibility of IASNP in AIS for Physiological Recovery -A Pilot Study of 27 Cases AL-TENS作为iisnp在AIS中生理恢复可行性的定量指标——27例初步研究
Pub Date : 2020-07-01 DOI: 10.21088/IJNNS.0975.0223.12320.8
V. Tewari
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引用次数: 0
Aneurysmal Bone Cyst at Dorsal Spine: Case Report and Review of Literature 脊背动脉瘤样骨囊肿一例报告及文献复习
Pub Date : 2020-07-01 DOI: 10.21088/IJNNS.0975.0223.12320.12
A. Chhabra
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引用次数: 0
COVID-19 and Nervous System: Under Estimated Clinical and Prognostic Aspects COVID-19和神经系统:低估临床和预后方面
Pub Date : 2020-06-24 DOI: 10.23937/2378-3001/1410100
Goés Alyne Barreto Mesquita de, Cardoso Bruno Barreira, Tavares Francisco de Assis Fernandes, Monte Rebecca Renata Lapenda do, Melo Renata Carneiro, Araújo-Neto Irami, Pinheiro Renato Serquiz Elias, Rêgo Amália Cinthia Meneses, Araújo-Filho* Irami
The coronavirus pandemic transformed the world abruptly due to the speed of transmission and high morbidity and mortality. Many deaths have been quantified, and the scientific community intensifies the search for molecular targets, protein sequences and polymorphismson SARS-CoV-2, to improve the clinical evolution and survival of patients. Initially, COVID-19 was described with respiratory changes, flu, and fever. With the spread of the disease, clinical manifestations were observed in other organ systems, still unknown. In this sense, the present study describes the main neurological changes and laboratory findings. The literature review was identified in the central databases: Scielo, Google Scholar, PubMed/MedLine, Embase, and Cochrane Database. Twenty-five articles related to the theme were chosen, including reviews, case series, cohort, and retrospective studies. Neurological manifestations were predominantly anosmia/hyposmia, dysgeusia, ataxia, and seizures. According to the latest published studies, attention must be paid to isolated initial neurological events.
由于传播速度快、发病率和死亡率高,冠状病毒大流行突然改变了世界。许多死亡已经被量化,科学界加强了对SARS-CoV-2的分子靶点、蛋白质序列和多态性的研究,以改善患者的临床进化和生存。最初,COVID-19被描述为呼吸系统变化、流感和发烧。随着疾病的扩散,在其他器官系统是否有临床表现尚不清楚。在这个意义上,本研究描述了主要的神经学变化和实验室结果。文献综述在中央数据库:Scielo, Google Scholar, PubMed/MedLine, Embase和Cochrane数据库中确定。选择了25篇与该主题相关的文章,包括综述、病例系列、队列和回顾性研究。神经学表现主要为嗅觉缺失、语言障碍、共济失调和癫痫发作。根据最新发表的研究,必须注意孤立的初始神经事件。
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引用次数: 6
期刊
International journal of neurology
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