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United Nations and World Health Organisation Engagement in TreatingGlobal Mental Health, with a Special Focus on Dementia 联合国和世界卫生组织参与治疗全球精神卫生,特别关注痴呆症
Pub Date : 2017-07-10 DOI: 10.4172/2161-0460.1000347
Daniela Fisichella
A sharp attention is devoted to mental health and mental illness by International Law and many International Organizations (IO’s) in XXI century. As a consequence of human rights huge extension, mental health is nowadays a target of international efforts striving to address both States national choices and international achievements. World Health Organization (WHO) is expressly engaged, but United Nations (UN) opened up the legal path in early nineties, by UN General Assembly (UNGA) 46/119 of 17 December 1991, The protection of persons with mental illness and the improvement of mental health care, where mental health care and facilities are pointed out; and if mental illness couldn’t be defined, Principle 4 (Determination of mental illness) of this Resolution is crucial to direct next improvements layout. From there, UN and WHO have been carrying on a unique approach to mental health, as proved by binding and non-binding international acts, surveys, guidelines – as the 2010 WHO mhGAP Intervention Guide, now updated in its 2016 version – adopted as a result of States consultation. UNGA Resolution 70/1 of 21 October 2015, Transforming Our World: the 2030 Agenda for Sustainable Development, envisaging 17 Sustainable Development Goals (and replacing past 8 Millennium Development Goals to be gained in 2015 at last) is the last step on the road of a global approach to health, both physical and mental in an holistic view of human beings. As stated in Declaration’s Introduction, “no one will be left behind”. This article aims to investigate mental health as an international legal issue on a broad sense, not only compared to lack of mental illness, but in a comprehensive view dealing with it by implementing International Law on Human Rights. Dementia prevention and care above other mental diseases is perceived in a global framework of domestic economic and social balance (2012 WHO Dementia, a Public Health Priority), even though national health care systems still depend upon national policies in investments assets. But States’ attitude to healthcare services in mental health should now be oriented by International Law current evolution.
21世纪以来,国际法和许多国际组织对精神卫生和精神疾病给予了高度关注。由于人权的广泛扩展,心理健康现在是国际努力的一个目标,努力处理国家的选择和国际成就。世界卫生组织(世卫组织)明确参与,但联合国(UN)在九十年代初开辟了法律途径,联合国大会(UNGA)于1991年12月17日通过了第46/119号决议,《保护精神病患者和改善精神保健》,其中指出了精神保健和设施;如果精神疾病无法定义,则本决议的原则4(确定精神疾病)对于指导下一步的改进布局至关重要。从那时起,联合国和世卫组织一直在采取一种独特的精神卫生方法,具有约束力和不具有约束力的国际行为、调查和准则证明了这一点,如经各国协商通过的2010年世卫组织《卫生和精神卫生行动计划干预指南》,现已更新为2016年版。2015年10月21日,联合国大会第70/1号决议《变革我们的世界:2030年可持续发展议程》提出了17项可持续发展目标(并最终取代了2015年将实现的8项千年发展目标),这是从人类整体观点出发,采取全球方法解决身心健康问题的最后一步。正如《宣言》导言所述,“不让任何人掉队”。本文旨在将精神健康作为一个广义的国际法律问题进行研究,不仅与精神疾病的缺乏进行比较,而且从实施国际人权法的角度全面看待这一问题。在国内经济和社会平衡的全球框架中,人们认为痴呆症的预防和护理高于其他精神疾病(2012年世卫组织将痴呆症列为公共卫生重点),尽管国家卫生保健系统在投资资产方面仍依赖于国家政策。但是,各国对精神卫生保健服务的态度现在应以国际法当前的发展为导向。
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引用次数: 0
Huntington's Disease: Unique Problems or Similar Impact to Other Degenerative Neurological Disorders? 亨廷顿舞蹈病:独特的问题还是其他退行性神经系统疾病的类似影响?
Pub Date : 2017-07-09 DOI: 10.4172/2161-0460.1000343
Steve Smith
Copyright: © 2017 Smith S. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Huntington’s disease (HD) is strikingly different from other progressive neurological disorders such as Alzheimer’s disease (AD) in many ways. For example, HD is inherited as a dominant genetic trait, with children of affected parents being at 50% risk of developing symptoms in their own midlife [1] whereas the etiology of AD is multifactorial [2]. First manifestation of HD symptoms at the age of 60 years is regarded as ‘late onset’ [3] while AD symptoms occurring prior to 65 years of age identifies ‘Early onset AD’ [4]. The choreic movement disorder, psychiatric problems and cognitive decline associated with HD are among the distinguishing features referred to as the ‘unique constellation of HD signs and symptoms’ [5]. Dorey et al. suggest that these HD features cannot be captured when attempting to measure quality of life in people with HD using a generic quality of life instrument, and suggested this supported the need for a HD diseasespecific tool.
版权所有:©2017 Smith S.这是一篇根据知识共享署名许可条款发布的开放获取文章,允许在任何媒体上不受限制地使用、分发和复制,前提是注明原作者和来源。亨廷顿氏病(HD)在许多方面与其他进行性神经系统疾病(如阿尔茨海默病(AD))截然不同。例如,HD是一种显性遗传特征,患病父母的孩子在中年时出现症状的风险为50%[1],而AD的病因是多因素的[2]。60岁时首次出现HD症状被认为是“晚发性”[3],而65岁之前出现AD症状则被认为是“早发性AD”[4]。与HD相关的舞蹈运动障碍、精神问题和认知能力下降是被称为“HD体征和症状的独特星座”的显著特征[5]。Dorey等人认为,当试图使用通用的生活质量仪器测量HD患者的生活质量时,无法捕捉到这些HD特征,并认为这支持了对HD疾病专用工具的需求。
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引用次数: 0
Ethnic Differences in Early Onset Alzheimer's Disease 早发性阿尔茨海默病的种族差异
Pub Date : 2017-07-07 DOI: 10.4172/2161-0460.1000346
Huei-Yang Chen, P. Panegyres
In a recent report published by World Health Organisation, it was estimated that there were 46 million people living with dementia around the world and this number is projected to be tripled by 2050 [1]. With the increasing proportion of minorities among elderly populations [2] and a higher prevalence of dementia observed among Hispanics [3-5], Latinos [6] and African Americans [3-6], the burden of dementia in minorities is a challenge for many health systems. Being the most prevalent form of dementia and similar ethnic disparities were reported in Alzheimer’s disease (AD) [7], AD should be a priority for countries where populations are composed of a significant proportion of Hispanics and African Americans, like the United States.
世界卫生组织最近发表的一份报告估计,全世界有4600万人患有痴呆症,预计到2050年这一数字将增加两倍[1]。随着老年人口中少数民族比例的增加[2],以及西班牙裔[3-5]、拉丁裔[6]和非裔美国人[3-6]中痴呆症的患病率较高,少数民族痴呆症的负担对许多卫生系统构成挑战。阿尔茨海默病(Alzheimer 's disease, AD)是最常见的痴呆症形式,据报道在AD中也存在类似的种族差异[7],对于人口中西班牙裔和非裔美国人占很大比例的国家,如美国,AD应优先考虑。
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引用次数: 2
The Prevention of Alzheimer's Disease and ParkinsonâÂÂs Disease byMonascus purpureus NTU 568-Fermented Compounds 紫红色红曲霉NTU 568发酵化合物预防阿尔茨海默病和ParkinsonâÂÂs疾病
Pub Date : 2017-07-05 DOI: 10.4172/2161-0460.1000342
Chun-Lin Lee, T. Pan
Alzheimer's disease (AD) and Parkinson’s disease (PD), which are senile neurodegenerative diseases, have become more common in recent year. An important cause for AD is currently the deposition of amyloid β (Aβ) in the brain, leading to severe oxidative stress and inflammation, as well as neuronal death and memory damage in AD patients. PD is a chronic degeneration of the central nervous system that mainly affects the motor system. Its symptoms usually appear gradually, and are most obviously tremors, body stiffness, slowed movement, and gait abnormality during early stage; though the mechanism for the death of dopaminergic neurons is not yet completely understood, oxidative stress has been shown to be a very important factor in triggering the development of PD in many human and animal studies. As has been revealed in past research, fermented products of Monascus and their extracts can effectively improve the course of AD and PD, possessing significant preventative and alleviating effects. The main effectors are confirmed to be monascin and ankaflavin for AD treatment, and dimerumic acid and deferricoprogen for PD treatment. This review, therefore, focuses on the analysis and comprehensive discussion of these four active components, for an overall understanding of their role in the AD and PD improvement function of Monascus fermented products.
阿尔茨海默病(AD)和帕金森病(PD)是近年来越来越常见的老年性神经退行性疾病。目前,阿尔茨海默病的一个重要原因是β淀粉样蛋白(Aβ)在大脑中的沉积,导致阿尔茨海默病患者严重的氧化应激和炎症,以及神经元死亡和记忆损伤。PD是一种中枢神经系统的慢性变性,主要影响运动系统。其症状通常是逐渐出现的,早期最明显的是震颤、身体僵硬、行动迟缓和步态异常;虽然多巴胺能神经元死亡的机制尚不完全清楚,但在许多人类和动物研究中,氧化应激已被证明是引发帕金森病发展的一个非常重要的因素。既往研究表明,红曲霉发酵产物及其提取物能有效改善AD和PD的病程,具有显著的预防和缓解作用。治疗AD的主要效应器为monascin和ankaflavin,治疗PD的主要效应器为二聚酸和铁原。因此,本文将重点对这四种活性成分进行分析和综合讨论,以全面了解它们在红曲霉发酵产品AD和PD改善功能中的作用。
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引用次数: 2
New Insight into Alzheimer's Disease via Caspase 3-cleaved Tau: Pathogenic Role in Tau Oligomer Formation and Memory Deficits 通过Caspase 3-cleaved Tau对阿尔茨海默病的新认识:Tau寡聚物形成和记忆缺陷的致病作用
Pub Date : 2017-07-05 DOI: 10.4172/2161-0460.1000344
Y. Kima, Jisu Parka, Yong-Keun Jung
Alzheimer’s disease (AD) is the most common and leading cause of dementia. AD has two different pathological hallmarks, extracellular amyloid beta plaques and intracellular neurofibrillary tangles (NFT). NFTs consist of abnormally modified tau protein that forms protein aggregates. Tau protein aggregates are prevalently observed as disease progresses and are believed to cause neuronal dysfunction. The caspase-3 cleaved form of tau, TauC3, is generated in cultured neurons under stress and is found in the brains of patients with AD in the early stages of disease when patients are asymptomatic. TauC3 accelerates tau oligomerization in vitro and in vivo, and induces neuronal degeneration. Moreover, the neuronal expression of TauC3 in transgenic mice causes memory deficits at a young age, which is concomitant with the appearance of tau oligomers. The removal of TauC3-containing oligomers and aggregates using drug treatment improves both memory and synaptic function. These findings demonstrate that TauC3 is critical for the formation of tau oligomers and small aggregates and may ultimately play a role in the rapid memory impairments observed in AD. Overall, TauC3 may represent a new therapeutic target for the prevention of AD.
阿尔茨海默病(AD)是痴呆症的最常见和主要原因。AD有两种不同的病理特征,细胞外淀粉样蛋白斑块和细胞内神经原纤维缠结(NFT)。nft由异常修饰的tau蛋白组成,形成蛋白质聚集体。随着疾病的进展,Tau蛋白聚集体普遍被观察到,并被认为会导致神经元功能障碍。caspase-3切割形式的tau蛋白,TauC3,是在应激下培养的神经元中产生的,并且在阿尔茨海默病患者无症状的早期疾病阶段的大脑中发现。TauC3在体外和体内加速tau寡聚化,诱导神经元变性。此外,在转基因小鼠中,TauC3的神经元表达导致幼龄记忆缺陷,这与tau低聚物的出现是伴随的。使用药物治疗去除含有tauc3的低聚物和聚集体可以改善记忆和突触功能。这些发现表明,TauC3对于tau寡聚物和小聚集体的形成至关重要,并可能最终在AD中观察到的快速记忆障碍中发挥作用。总之,TauC3可能是预防AD的一个新的治疗靶点。
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引用次数: 0
Urine Formaldehyde: A Non-Invasive Marker for AlzheimerâÂÂs Disease? 尿甲醛:AlzheimerÃⅱÂÂs疾病的无创标志物?
Pub Date : 2017-07-05 DOI: 10.4172/2161-0460.1000345
Zhiqian Tong
Given the dramatic increase in Alzheimer’s disease (AD) cases globally, the identification of a suitable biomarker in easily collectable samples (e.g. plasma, blood, saliva and urine) for diagnosing AD is therefore of utmost importance. Previous studies indicated that excess formaldehyde contributes to Aβ aggregation and Tau hyper phosphorylation, both phenomena directly linked to the progress of AD. Our 7 year’s cross-sectional survey showed that morning urine formaldehyde levels were correlated positively with the severe degree of sporadic dementia, suggesting that urine formaldehyde measurement most likely acts as a suitable non-invasive method to support diagnostic purposes. In this a short review article, we provide a short overview of the animal and clinical studies on the possible mechanisms of exogenous and endogenous factors cause formaldehyde accumulation, which plays a critical role in the pathogenesis of both genetic dementia and sporadic dementia. Urine formaldehyde will be of significant value for the non-invasive diagnosis of cognitive ability in AD, but the more sensitive method for detecting formaldehyde concentrations and a longitudinal (long-term follow-up) study would be required to prove conclusively such a relationship between urine formaldehyde and dementia.
鉴于全球范围内阿尔茨海默病(AD)病例的急剧增加,因此,在易于收集的样本(如血浆、血液、唾液和尿液)中确定合适的生物标志物用于诊断AD至关重要。先前的研究表明,过量的甲醛会导致Aβ聚集和Tau过度磷酸化,这两种现象与AD的进展直接相关。我们7年的横断面调查显示,晨尿甲醛水平与散发性痴呆的严重程度呈正相关,这表明尿甲醛测量最有可能作为一种合适的非侵入性方法来支持诊断目的。在这篇简短的综述文章中,我们简要介绍了外源性和内源性因素引起甲醛积聚的可能机制的动物和临床研究,甲醛积聚在遗传性痴呆和散发性痴呆的发病机制中都起着关键作用。尿甲醛对于AD患者认知能力的非侵入性诊断具有重要价值,但需要更灵敏的检测甲醛浓度的方法和纵向(长期随访)研究来最终证明尿甲醛与痴呆之间的这种关系。
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引用次数: 4
Synaptic Function and Dysfunction in AlzheimerâÂÂs Disease AlzheimerÃⅱÂÂs疾病的突触功能和功能障碍
Pub Date : 2017-06-27 DOI: 10.4172/2161-0460.1000341
N. Origlia, L. Domenici
Alzheimer’s disease (AD) is a multifactorial neurodegenerative disease, primarily affecting the elderly. Pathophysiological mechanisms have been elucidated in the past decades. First of all, AD is progressive leading to cognitive deficits till dementia. Pathologically, AD features synaptic dysfunction with changes of neuronal circuitry, progressive accumulation of protein aggregates such as the beta amyloid and tau. Herein we critically review neurobiological processes and factors involved in AD, in light of recent results on synaptic dysfunction and impairment of neuronal activity.
阿尔茨海默病(AD)是一种多因素神经退行性疾病,主要影响老年人。在过去的几十年里,病理生理机制已经被阐明。首先,阿尔茨海默病是进行性的,会导致认知缺陷直至痴呆。在病理学上,阿尔茨海默病的特点是突触功能障碍,神经回路改变,蛋白质聚集体如β -淀粉样蛋白和tau蛋白的进行性积累。在此,我们根据最近关于突触功能障碍和神经元活动损伤的结果,批判性地回顾了与阿尔茨海默病有关的神经生物学过程和因素。
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引用次数: 0
Peptides Derived from Neuronal Cell Cycle like Kinase 5 Activator p35, inNeurodegeneration; Pathology and Therapy 神经退行性疾病中神经元细胞周期激酶5激活因子p35衍生肽的研究病理与治疗
Pub Date : 2017-06-21 DOI: 10.4172/2161-0460.1000338
P. Grant, M. Bhaskar, B. Binukumar, H. Pant
Neurodegenerative disorders such as Alzheimer’s or Parkinson’s are diseases of aging. Mutations, lesions, neuronal insults, the genetic and stochastic “slings and arrows” of living, accumulate and downgrade organ function. Microarray analyses of aging brain identify patterns of genetic changes that correlate with neurodegenerative phenotypes. Genes involved in synaptic transmission, mitochondrial function and protein turnover are downregulated while significant numbers of genes regulating DNA repair, stress responses and inflammation are upregulated. This impact on the brain induces, a complex, multidimensional network of abnormal interactions leading to deposits of protein aggregates such as amyloid plaques, tau and neurofilament proteins tangles. For some, this pathology leads to neuron loss, behavioral defects, cognitive decline and death. Therapeutic approaches for AD, for example, target the molecular pathways leading to plaques and tangles; these include kinases and phosphatases. Among kinases, one stands out, Cdk5/p35, essential for neuronal migration, synapse formation, function and survival. Studies have shown that aging-induced neuronal stress deregulates and hyper activates Cdk5, a ubiquitous feature of neuronal disorders such as Alzheimer’s, Amyotropic lateral sclerosis (ALS) and Parkinson’s (PD). Among its many effects, hyperactive Cdk5 is implicated in the production of abnormal phosphorylated protein aggregates and is a therapeutic target. Roscovitine and related compounds inhibit Cdk5 activity but not specifically; cell cycle Cdks and other kinases are equally affected. In our laboratory two truncated peptides CIP (126a.a) and P5 (24a.a.), derived from p35, activator, of Cdk5 have been shown to specifically inhibit hyperactive Cdk5 in vitro, in cortical neurons and in AD, ALS and PD model mice. As a result the neurodegenerative phenotype was diminished; aggregates and inflammation were reduced, abnormal behavior was improved and increased animal’s longevity. We believe these peptides are excellent therapeutic candidates for those neurodegenerative disorders expressing hyperactive Cdk5 in the brain.
神经退行性疾病,如阿尔茨海默氏症或帕金森氏症,都是衰老引起的疾病。突变、病变、神经元损伤、遗传和随机的生活“投石器和箭”,积累和降低器官功能。衰老大脑的微阵列分析识别与神经退行性表型相关的遗传变化模式。参与突触传递、线粒体功能和蛋白质周转的基因下调,而大量调节DNA修复、应激反应和炎症的基因上调。这种对大脑的影响诱发了一个复杂的、多维度的异常相互作用网络,导致淀粉样斑块、tau蛋白和神经丝蛋白缠结等蛋白质聚集体的沉积。对一些人来说,这种病理会导致神经元丧失、行为缺陷、认知能力下降和死亡。例如,阿尔茨海默病的治疗方法针对导致斑块和缠结的分子途径;这些包括激酶和磷酸酶。在激酶中,Cdk5/p35尤为突出,它对神经元迁移、突触形成、功能和存活至关重要。研究表明,衰老诱导的神经元应激会解除对Cdk5的调节并过度激活,而Cdk5是阿尔茨海默病、肌萎缩性侧索硬化症(ALS)和帕金森病(PD)等神经疾病的普遍特征。在其众多作用中,过度活跃的Cdk5与异常磷酸化蛋白聚集体的产生有关,是一个治疗靶点。罗斯科维汀及相关化合物抑制Cdk5活性,但非特异性抑制;细胞周期Cdks和其他激酶同样受到影响。在我们的实验室中,两个截断的肽CIP (126a.a)和P5 (24a.a.),来源于Cdk5的激活剂p35,已经在体外,皮质神经元和AD, ALS和PD模型小鼠中被证明能够特异性抑制过度活跃的Cdk5。结果神经退行性表型减少;减少了聚集和炎症,改善了异常行为,延长了动物的寿命。我们相信这些多肽是大脑中表达过度活跃Cdk5的神经退行性疾病的极好治疗候选者。
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引用次数: 0
Beneficial Effects of Periodontal Ligament Stem Cells in Alzheimer'sDisease Cell Model 牙周韧带干细胞在阿尔茨海默病细胞模型中的有益作用
Pub Date : 2017-06-21 DOI: 10.4172/2161-0460.1000339
Feixiang Wang, Yali Jia, Jiajing Liu, Jinglei Zhai, N. Cao, W. Yue, Huixia He, X. Pei
Objective: Alzheimer's disease (AD) is a chronic neurodegenerative disease with multiple etiological factors, characterized by neurofibrillary tangles of hyperphosphorylated tau (pTau) protein. Periodontal ligament stem cells (PDLSCs) have been utilized to reconstruct tissues destroyed by chronic pathology, but the use of PDLSCs for treating AD remains unstudied. Methods: We investigated the in vitro effects of PDLSCs on the function of SH-SY5Y cells that had been established as models of AD via use of okadaic acid (OA). To this end, we utilized immunofluorescence, CCK-8 assay, flow cytometry, western blot, and confocal and transmission electron microscopy. Results: Co-culturing OA-treated SH-SY5Y cells with PDLSCs for 24 h was associated with improved cell shape, dendrites, cytoskeleton structure, and cell viability relative to the model without PDLSCs, while cell apoptosis and pTau protein levels were lower. Conclusion: These findings suggest that treatment of AD-model cells with PDLSCs promoted the recovery of cell shape, structure, and function. PDLSCs may be a novel research target for clinical treatment of patients with AD. Further investigations of the effect of PDLSCs in AD from the behavioral or molecular levels are warranted.
目的:阿尔茨海默病(AD)是一种多病因的慢性神经退行性疾病,其特征是过度磷酸化的tau蛋白(pTau)的神经原纤维缠结。牙周韧带干细胞(Periodontal ligament stem cells, PDLSCs)已被用于重建被慢性病理破坏的组织,但PDLSCs在治疗AD方面的应用仍未得到研究。方法:利用冈田酸(OA)建立AD模型,研究PDLSCs对SH-SY5Y细胞功能的体外影响。为此,我们使用了免疫荧光、CCK-8测定、流式细胞术、western blot、共聚焦和透射电子显微镜。结果:与不含PDLSCs的SH-SY5Y细胞共培养24 h相比,经oa处理的SH-SY5Y细胞形状、树突、细胞骨架结构和细胞活力均有所改善,细胞凋亡和pTau蛋白水平均较低。结论:PDLSCs处理ad模型细胞可促进细胞形态、结构和功能的恢复。PDLSCs可能成为临床治疗AD患者的一个新的研究靶点。从行为或分子水平进一步研究PDLSCs在AD中的作用是必要的。
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引用次数: 0
Cerebral Vasoreactivity in Parkinson's Disease: A Cross-Sectional Pilot Study in a Hispanic Cohort 帕金森氏病的脑血管反应性:西班牙裔队列的横断面试点研究
Pub Date : 2017-06-20 DOI: 10.4172/2161-0460.1000336
A. Ojeda, H. R. Martinez, F. G. Rivera, J. Garza, Hector Canfield Medina, S. Davila
Background: Abnormalities in cerebral vasomotor reactivity (CVR) in patients with idiopathic Parkinson’s disease (IPD) have not been well determined; nonetheless, a vascular mechanism may be involved in some patients with this neurodegenerative disorder. The objective of this study was to compare CVR in IPD patients and subjects without Parkinson’s disease. Methods: A cross-sectional pilot study was conducted including Hispanic IPD patients and a control group. CVR in the middle cerebral arteries (MCA) was measured by transcranial Doppler ultrasonography (TCD) at rest and after inhalation of 7% CO2. A comparison of CVR in the MCA of both groups was performed. Results: 27 IPD Hispanic patients with a recent brain MRI were evaluated. The CVR showed a significant difference between the two groups (p=0.044). The CVR in 70% of the IPD patients was low in comparison to control subjects. Conclusion: IPD patients are prone to exhibit diminished CVR in comparison with control group. Further studies may demonstrate this tendency and its implication in disease severity.
背景:特发性帕金森病(IPD)患者的脑血管运动反应性(CVR)异常尚未得到很好的确定;尽管如此,这种神经退行性疾病的一些患者可能与血管机制有关。本研究的目的是比较IPD患者和非帕金森病患者的CVR。方法:对西班牙裔IPD患者和对照组进行横断面初步研究。静息和吸入7% CO2后,采用经颅多普勒超声(TCD)测量大脑中动脉(MCA) CVR。比较两组MCA的CVR。结果:27例近期脑部MRI的西班牙裔IPD患者进行了评估。两组间CVR差异有统计学意义(p=0.044)。70% IPD患者的CVR低于对照组。结论:IPD患者CVR较对照组明显降低。进一步的研究可能会证明这种趋势及其对疾病严重程度的影响。
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引用次数: 5
期刊
Journal of Alzheimers Disease & Parkinsonism
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