Journal of Clinical Neuroscience最新文献_第4页

Evaluating the safety and efficacy of proton radiotherapy for intracranial pediatric ependymomas: A single-arm meta-analysis 评价质子放疗治疗颅内儿科室管膜瘤的安全性和有效性：单臂荟萃分析。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.110977

Lucca B. Palavani , Gabriel Semione , Gustavo de Oliveira Almeida , Henrique L. Lepine , Pedro Borges , Bernardo Vieira Nogueira , Gisele Lúcia , Márcio Yuri Ferreira , Anna Pereira , David Abraham Batista da Hora , Matheus de Jesus Leone Pereira , Fabio Torregrossa , Fernando De Nigris Vasconcellos , Raphael Bertani , Raphael Bastianon , Carolina Benjamin , Cleiton Formentin

Background

Ependymomas account for 6% to 10% of childhood central nervous system tumors. This study aimed to evaluate the safety and efficacy of proton radiotherapy in intracranial ependymoma patients.

Methods

We performed a systematic review and single-arm meta-analysis. We searched Medline, Embase, Cochrane, and Web of Science for eligible trials. Random-effects model was used to calculate the risk ratios (RRs), with 95% confidence intervals (CIs). Statistical analyses were performed using RStudio version 4.2.3.

Results

Ten cohorts comprising 908 patients with ependymoma were included. The patient population had an average age of 3.5 years, and 53.4 % were male. In terms of proportion, nine outcomes were analyzed: 3-year Progression-Free Survival (PFS; Proportion = 0.63; 95 % CI [0.40–0.87]; I2 = 95 %), 5-year Local Control (LC; Proportion = 0.79; 95 % CI [0.69–0.90]; I2 = 85 %), 5-year Event-Free Survival (EFS; Proportion = 0.65; 95 % CI [0.52–0.78]; I2 = 95 %), 5-year Overall Survival (OS; Proportion = 0.83; 95 % CI [0.77–0.90]; I2 = 82 %), 2-year OS (Proportion = 0.91; 95 % CI [0.88–0.94]; I2 = 0 %), 3-year OS (Proportion = 0.92; 95 % CI [0.89;0.95]; I2 = 43 %). Additionally, neurological (Proportion = 0.17; 95 % CI [0.07–0.27]; I2 = 97 %), dermatological (Proportion = 0.20; 95 % CI [0.00–0.44]; I2 = 82 %), and brainstem complications (Proportion = 0.03; 95 % CI [0.01–0.04]; I2 = 31 %) were investigated.

Conclusion

While proton radiotherapy appears safe and effective based on current data, these results should be approached cautiously, as broad confidence intervals in some adverse event rates suggest variability in outcomes.

背景：室管膜瘤占儿童中枢神经系统肿瘤的6% ~ 10%。本研究旨在评价质子放疗治疗颅内室管膜瘤的安全性和有效性。方法：我们进行了系统回顾和单臂荟萃分析。我们检索了Medline、Embase、Cochrane和Web of Science来寻找符合条件的试验。采用随机效应模型计算风险比（rr），置信区间为95%。使用RStudio 4.2.3版本进行统计分析。结果：纳入10个队列，共908例室管膜瘤患者。患者平均年龄为3.5岁，男性占53.4%。就比例而言，分析了9个结果：3年无进展生存期（PFS）；比例= 0.63；95% ci [0.40-0.87]；I2 = 95%)， 5年局部控制(LC；比例= 0.79；95% ci [0.69-0.90]；I2 = 85%)， 5年无事件生存率(EFS；比例= 0.65；95% ci [0.52-0.78]；I2 = 95%)， 5年总生存率(OS；比例= 0.83；95% ci [0.77-0.90]；I2 = 82%)， 2年OS(比例= 0.91；95% ci [0.88-0.94]；I2 = 0%)， 3年OS(比例= 0.92；95% ci [0.89;0.95]；i2 = 43%)。此外，神经系统(比例= 0.17；95% ci [0.07-0.27]；I2 = 97%)，皮肤病学(比例= 0.20；95% ci [0.00-0.44]；I2 = 82%)，脑干并发症(比例= 0.03；95% ci [0.01-0.04]；I2 = 31%)。结论：虽然根据目前的数据，质子放疗似乎是安全有效的，但这些结果应该谨慎对待，因为一些不良事件发生率的广泛置信区间表明结果存在差异。

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引用次数: 0

Massive pneumocephalus after Valsalva maneuver in sphenoidal meningocele 蝶骨脑膜膨出Valsalva手术后出现大量气脑。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.110973

Letizia Neri , Giulia Monti , Alberto Daniele Arosio , Maurizio Bignami

Pneumocephalus, defined as the presence of gas within the intracranial space, typically results from head trauma, surgery, or diagnostic/therapeutic procedures that disrupt the dura. However, spontaneous or non-traumatic pneumocephalus is rare. This video article presents a case report of a 64-year-old woman referred to the Department of Otolaryngology with a severe frontal headache and clear nasal discharge (rhinorrhea) after performing the Valsalva maneuver to relieve ear fullness. The patient had previously been diagnosed with sphenoidal meningocele and was awaiting skull base reconstruction surgery. A computed tomography (CT) scan of the brain and paranasal sinuses revealed significant pneumocephalus, with a defect in the sellar floor and cerebrospinal fluid (CSF) pooling in the sphenoid sinus. An endoscopic trans-sphenoidal repair of the CSF leak was promptly performed, and a post-operative CT scan showed complete resolution of the pneumocephalus. At the 2-month follow-up, the defect had healed optimally, with no intracranial complications observed. Pneumocephalus is a rare clinical condition, and prompt, accurate diagnosis, along with early intervention, is crucial to prevent neurological complications.

脑积气是指颅内空间存在气体，通常由头部创伤、手术或破坏硬脑膜的诊断/治疗程序引起。然而，自发性或非外伤性气胸并不多见。本视频文章介绍了一则病例报告：一名 64 岁的女性因严重的额部头痛和流清鼻涕（鼻出血）而转诊至耳鼻喉科，在做完瓦尔萨尔瓦手法以缓解耳部胀满后，患者又出现了头痛和流清鼻涕。患者之前曾被诊断为蝶骨脑膜囊肿，正在等待颅底重建手术。脑部和副鼻窦的计算机断层扫描（CT）显示患者有明显的气胸，蝶窦底缺损，脑脊液（CSF）在蝶窦内积聚。手术后的 CT 扫描显示气胸已完全消退。在两个月的随访中，缺损愈合良好，未发现颅内并发症。气胸是一种罕见的临床症状，及时、准确的诊断和早期干预对于预防神经系统并发症至关重要。

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引用次数: 0

The impact of frailty on patient selection and outcomes for open versus endovascular treatment of unruptured intracranial aneurysms: A propensity-score matched analysis 虚弱对未破裂颅内动脉瘤开放与血管内治疗的患者选择和结果的影响：倾向评分匹配分析。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.110988

Joanna M. Roy , Basel Musmar , Shiv Patil , Shyam Majmundar , Shray Patel , Stavropoula I. Tjoumakaris , Michael R. Gooch , Robert H. Rosenwasser , Christian Bowers , Pascal M. Jabbour

Background and Objectives

Endovascular treatment (EVT) has been demonstrated to have improved post-operative outcomes and fewer complications compared to open microsurgical clipping of unruptured intracranial aneurysms (UIAs). Our study analyzes patient selection and outcomes for open versus EVT stratified by frailty measured using the Risk Analysis Index (RAI).

Methods

This was a retrospective study of patients who underwent open or EVT for an UIA at our institution between March 2017 and June 2022. Propensity-score matching (PSM) was performed using the 1:1 nearest neighbour method to create two groups (open and EVT) matched by demographics and treatment modality. RAI-measured frailty was used to categorize patients into 4 tiers: robust (0–10), pre-frail (11–20), frail (21–30) and severely frail (≥31). Outcomes of interest were length of stay (LOS), functional dependence at discharge and 30-day readmission.

Results

After PSM, 209 patients were stratified into two groups, open and EVT, respectively. Patients who received EVT were older compared to open surgery (mean ± SD: 62.6 ± 11.4 vs. 60.8 ± 10.6, P < 0.05), however, RAI-measured frailty did not differ significantly between the two groups (median (IQR) open: 3 (2–7), vs. EVT: 3 (2–9)), P = 0.090. Among robust and pre-frail patients, EVT was associated with significantly shorter LOS compared to open surgery, median (IQR): 1 (1–2) vs. 3 (2–4) and 1 (1–2), vs. 3 (2–6); P < 0.001, respectively). Neither functional dependence at discharge nor 30-day readmission rates were different after stratification by frailty.

Conclusion

Patients in the robust and pre-frail tiers experienced significantly shorter LOS after EVT compared to open surgery. We would like to encourage the use of frailty assessment as a pre-operative risk stratification tool patients undergoing treatment of UIAs.

背景和目的：与开放性显微手术夹持未破裂颅内动脉瘤（UIAs）相比，血管内治疗（EVT）已被证明具有更好的术后预后和更少的并发症。我们的研究用风险分析指数（RAI）对开放性和EVT的患者选择和结果进行了分析。方法：这是一项回顾性研究，纳入了2017年3月至2022年6月期间在我院接受开放或EVT治疗UIA的患者。采用1:1最近邻法进行倾向评分匹配（PSM），根据人口统计学和治疗方式创建两组（开放组和EVT组）。采用rai测量的虚弱程度将患者分为4个级别：健壮（0-10）、预虚弱（11-20）、虚弱（21-30）和严重虚弱（≥31）。关注的结果是住院时间（LOS）、出院时的功能依赖和30天再入院。结果：经PSM治疗后，209例患者分为切开组和EVT组。与开放手术相比，接受EVT的患者年龄更大（平均±SD: 62.6±11.4比60.8±10.6，P）。结论：与开放手术相比，健壮和虚弱前层患者EVT后的LOS明显更短。我们希望鼓励将衰弱评估作为接受uia治疗的患者的术前风险分层工具。

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引用次数: 0

Race/ethnicity-specific association between the American Heart Association’s new Life’s Essential 8 and stroke in US adults with nonalcoholic fatty liver disease: Evidence from NHANES 2005–2018 美国心脏协会的新生命基本标准8与美国非酒精性脂肪性肝病成年人中风之间的种族/民族特异性关联：来自NHANES 2005-2018的证据

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.111005

Nuo Xu , Xiaowen Lu , Cheng Luo , Junchen Chen

Background

The Life’s Essential 8 (LE8) is a recently introduced assessment of cardiovascular health (CVH) by the American Heart Association (AHA). Nonalcoholic fatty liver disease (NAFLD) is currently the most common chronic liver disease and is associated with an increased risk of stroke. We aimed to explore the association of LE8 with stroke in NAFLD using a national cross-sectional study.

Methods

Eligible participants with NAFLD aged 20–85 years in NHANES 2005–2018 were included. LE8 was assessed according to AHA criteria and categorized into metabolic and behavioral factors. US Fatty Liver Index (USFLI) ≥ 30 and exclusion of other chronic liver diseases suggested NAFLD. Stroke was diagnosed according to self-report on standardized questionnaires.

Results

After adjusting for all confounders, each point increase in LE8, LE8 metabolic factors, and LE8 behavioral factors was associated with a 4.4 %, 1.8 %, and 2.5 % reduction in stroke prevalence in NAFLD, respectively. Both moderate and high CVH assessed by LE8 and LE8 behavioral factors were associated with reduced odds of stroke compared with low CVH. Stroke prevalence declined progressively with increasing number of ideal LE8 components, with the lowest odds of stroke at 3 + ideal LE8 components for both LE8 metabolic and behavioral factors. Restricted cubic spline suggested dose–response associations. Race/ethnicity was a significant effect modifier, and this association was present only among non-Hispanic white population and other Hispanic population. FLI as a diagnostic indicator of NAFLD yielded generally consistent results.

Conclusions

Higher LE8 score, especially LE8 behavioral factors, was associated with reduced prevalence of stroke in NAFLD, especially among non-Hispanic white population and other Hispanic population. The odds of stroke declined progressively with increased ideal LE8 component number. These findings underscore the preventive value of adherence to high CVH for stroke prevention in NAFLD.

背景：生命必需8 （LE8）是美国心脏协会（AHA）最近推出的心血管健康（CVH）评估。非酒精性脂肪性肝病（NAFLD）是目前最常见的慢性肝病，与卒中风险增加有关。我们的目的是通过一项全国性的横断面研究来探讨LE8与NAFLD卒中的关系。方法：纳入NHANES 2005-2018中年龄在20-85岁的NAFLD患者。LE8根据美国心脏协会的标准进行评估，并分为代谢和行为因素。美国脂肪肝指数(USFLI)≥30，排除其他慢性肝病提示NAFLD。卒中诊断依据标准化问卷自述。结果：在对所有混杂因素进行调整后，LE8、LE8代谢因素和LE8行为因素每增加一个点，NAFLD卒中患病率分别降低4.4%、1.8%和2.5%。与低CVH相比，LE8和LE8行为因素评估的中度和高CVH与卒中几率降低相关。随着理想LE8含量的增加，卒中患病率逐渐下降，在LE8代谢和行为因素中，理想LE8含量为3 +时卒中发生率最低。受限三次样条提示剂量-反应关联。种族/民族是显著的影响调节因素，这种关联仅存在于非西班牙裔白人和其他西班牙裔人群中。FLI作为NAFLD的诊断指标，结果基本一致。结论：较高的LE8评分，尤其是LE8行为因素，与NAFLD卒中患病率降低相关，尤其是在非西班牙裔白人人群和其他西班牙裔人群中。随着理想LE8成分数的增加，脑卒中的几率逐渐下降。这些发现强调了NAFLD患者坚持高CVH预防卒中的价值。

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引用次数: 0

Impact of perioperative cerebral blood flow evaluation using arterial spin labeling in a patient undergoing carotid artery stenting 应用动脉自旋标记法评价颈动脉支架植入术患者围手术期脑血流的影响。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.110974

Tomohiro Iida , Kentaro Yamashita , Yuki Kato , Rikiyoshi Yamamoto , Koudai Uematsu , Tatsuya Kuroda , Satoru Murase , Tsuyoshi Izumo

Background

Hyperperfusion syndrome (HPS) is one of the most serious complications after carotid artery stenting (CAS). Arterial spin labeling (ASL) is a noninvasive method for assessing cerebral perfusion. This study aimed to evaluate the utility of ASL compared to that of SPECT in evaluating changes in intracranial blood flow during the perioperative period of CAS.

Methods

We retrospectively reviewed prospectively collected data from 49 cases of CAS conducted for symptomatic and asymptomatic carotid artery stenosis. We calculated the relative cerebral blood flow (rCBF) from ASL (post labeling delay [PLD] of 1500 ms and 2500 ms) and SPECT, both pre- and post-CAS. Cerebrovascular reactivity (CVR) was assessed using SPECT with an acetazolamide challenge. We defined the change rate from PLD 1500 ms to 2500 ms before CAS as ΔrASL.

Results

Hyperperfusion phenomenon was observed in four cases (8.2 %), with one case (2.0 %) resulting in cerebral hemorrhage and diagnosed as HPS. Positive correlations were noted between ASL and SPECT at both pre- and post-CAS (r = 0.42–0.65, p < 0.01). A negative correlation was found between ΔrASL obtained from the two PLDs before CAS and CVR (r=-0.41, p < 0.01).

Conclusions

ASL using two PLDs is a useful method for evaluating changes in CBF during the perioperative period of CAS.

背景：高灌注综合征（HPS）是颈动脉支架置入术（CAS）后最严重的并发症之一。动脉自旋标记（ASL）是一种评估脑灌注的无创方法。本研究旨在评估 ASL 与 SPECT 相比在评估 CAS 围手术期颅内血流变化方面的实用性：方法：我们回顾性分析了前瞻性收集的 49 例因无症状和无症状颈动脉狭窄而实施 CAS 的病例数据。我们通过 ASL（标记后延迟 [PLD] 为 1500 毫秒和 2500 毫秒）和 SPECT 计算了 CAS 术前和术后的相对脑血流量（rCBF）。脑血管反应性（CVR）通过使用乙酰唑胺挑战 SPECT 进行评估。我们将 CAS 前 1500 毫秒至 2500 毫秒的 PLD 变化率定义为 ΔrASL：结果：有四例（8.2%）观察到高灌注现象，其中一例（2.0%）导致脑出血，被诊断为 HPS。ASL和SPECT在CAS前后均呈正相关（r = 0.42-0.65，p 结论：ASL和SPECT在CAS前后均呈正相关（r = 0.42-0.65，p 结论：ASL和SPECT在CAS前后均呈正相关：使用两种 PLD 的 ASL 是评估 CAS 围手术期 CBF 变化的有效方法。

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引用次数: 0

C5 palsy following one- or two-level anterior cervical discectomy and fusion: Incidence and neurological recovery in a retrospective neurosurgical multicenter study 一节段或两节段颈椎前路椎间盘切除术和融合术后C5麻痹：发生率和神经系统恢复在一项回顾性神经外科多中心研究中

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.111000

Yoshiki Fujikawa , Naokado Ikeda , Kosuke Sakai , Ryokichi Yagi , Ryo Hiramatsu , Masahiro Kameda , Naosuke Nonoguchi , Motomasa Furuse , Shinji Kawabata , Kunio Yokoyama , Masahiro Kawanishi , Takahiro Fujishiro , Yangtae Park , Hideki Tanabe , Toshihiro Takami , Masahiko Wanibuchi

Background

C5 palsy is a frequent complication following cervical spine surgery, particularly after posterior approaches. Although several risk factors have been proposed, the incidence of C5 palsy after anterior cervical discectomy and fusion (ACDF) remains less well understood. This study aims to elucidate the risk factors and neurological recovery associated with C5 palsy following ACDF.

Methods

A total of 330 patients who underwent one or two-level ACDF between January 2018 and December 2022 across three institutions within the neurosurgical training program were retrospectively included and analyzed. Demographic, surgical, and radiological data were collected.

Results

Sixteen (4.8 %) patients developed postoperative C5 palsy, with a significantly high incidence observed in patients exhibiting preoperative symptoms (radiculopathy or radiculomyelopathy) and undergoing two-level ACDF (p-values 0.008 and 0.018, respectively). No other demographic or radiological factors were associated with C5 palsy. Eleven of 16 (68.8 %) patients experienced C5 palsy within 1 day post-surgery (early-onset group), whereas the remaining five developed symptoms between 4 to 15 days post-surgery (late-onset group). At one year post-surgery, the late-onset group demonstrated superior recovery from C5 palsy compared to the recovery noted in the early-onset group (100 % vs 44.4 %).

Conclusions

Surgeons should be cognizant of the potential for C5 palsy following one- or two-level ACDF, despite generally favorable neurological outcomes. The timing of C5 palsy onset post-ACDF, potentially influenced by mechanisms such as direct injury and ischemia–reperfusion injury, could impact the recovery prognosis. Careful surgical procedure might be the key to success.

背景：C5麻痹是颈椎手术后常见的并发症，尤其是后路手术后。虽然已经提出了几个危险因素，但颈椎前路椎间盘切除术和融合（ACDF）后C5麻痹的发生率仍然知之甚少。本研究旨在阐明与ACDF后C5麻痹相关的危险因素和神经功能恢复。方法：回顾性纳入并分析2018年1月至2022年12月期间在神经外科培训计划的三个机构中接受一级或二级ACDF的330例患者。收集了人口统计学、外科和放射学数据。结果：16例（4.8%）患者术后发生C5性麻痹，术前有症状（神经根病或神经根脊髓病）和二级ACDF （p值分别为0.008和0.018）的患者发生率明显较高。没有其他人口统计学或放射学因素与C5麻痹相关。16例患者中有11例（68.8%）在术后1天内出现C5麻痹（早发组），而其余5例在术后4至15天出现症状（晚发组）。术后1年，迟发组C5麻痹的恢复优于早发组（100% vs 44.4%）。结论：尽管神经系统预后良好，但外科医生应认识到一级或二级ACDF后C5麻痹的可能性。acdf后C5麻痹发生的时间可能受到直接损伤、缺血再灌注损伤等机制的影响，影响恢复预后。仔细的外科手术可能是成功的关键。

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引用次数: 0

Severe intracranial hypotension secondary to cerebrospinal-venous fistula in a patient with remote history of spinal decompression and fusion 有脊柱减压融合史的患者继发于脑脊静脉瘘的严重颅内低血压1例。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.111007

Julia Greenberg , Christina Kallik , Benjamin Jadow , Joseph Boonsiri , Svetlana Kvint , Eytan Raz , Ariane Lewis

引用次数: 0

Complete blood count and systemic inflammation indices in individuals with Alzheimer’s disease: A case-control study 阿尔茨海默病患者的全血细胞计数和全身炎症指数：一项病例对照研究

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.111011

Jéssica A.G. Tosatti , Jessica D. Pereira , Cristina M.G. Loures , Vanêssa G. Fraga , Carolina A. Magalhães , Rafaela D.A.C. Eugênio , Henrique C. Guimarães , Elisa de P.F. Resende , Leonardo C. de Souza , Maria das G. Carvalho , Paulo Caramelli , Karina B. Gomes

Alzheimer’s disease (AD) is the most common cause of dementia, characterized by progressive cognitive and functional decline and is associated with aging. Chronic inflammatory processes are also involved in its the etiology, as the consequence or cause of proteinopathy (amyloid and tau load in the brain). This study aimed to investigate the complete blood count and systemic inflammation indices in 61 individuals with AD, compared to 59 cognitively healthy individuals as controls. The diagnosis of AD dementia was based on the NIA-AA criteria and patients presented biomarkers in the cerebrospinal fluid compatible with the diagnosis of AD. The complete blood count (CBC) was conducted using an automated system. The neutrophil count (p = 0.011), neutrophil-to-lymphocyte ratio (p = 0.023), and Systemic Inflammation Response Index (SIRI) (p = 0.044) were significantly higher, whereas the lymphocyte count (p = 0.018) and platelet count (p = 0.038) were significantly lower in the AD group compared to the control group. After a multivariate generalized linear model analyses, neutrophils count and SIRI maintained significant difference between the groups, even after correcting for age, sex, body mass index and ApoE ε4 carrier status. The overall results suggest that AD is associated with a low-grade pro-inflammatory profile, characterized by alterations in blood inflammatory and immune cells, leading to a higher systemic inflammatory index. The CBC and its derived inflammatory indices, routinely obtained in clinical practice, have potential utility in the context of AD.

阿尔茨海默病（AD）是痴呆症的最常见原因，其特征是认知和功能的进行性下降，并与衰老有关。慢性炎症过程也参与其病因学，作为蛋白质病变（脑内淀粉样蛋白和tau蛋白负荷）的后果或原因。本研究旨在调查61例AD患者的全血细胞计数和全身炎症指数，并与59例认知健康个体作为对照。AD痴呆的诊断基于NIA-AA标准，患者脑脊液中出现与AD诊断相符的生物标志物。全血细胞计数（CBC）使用自动化系统进行。AD组中性粒细胞计数（p = 0.011）、中性粒细胞与淋巴细胞比值（p = 0.023）和全身炎症反应指数（SIRI）（p = 0.044）显著高于对照组，淋巴细胞计数（p = 0.018）和血小板计数（p = 0.038）显著低于对照组。在多元广义线性模型分析后，中性粒细胞计数和SIRI在校正年龄、性别、体重指数和ApoE ε4携带者状态后仍保持显著差异。总体结果表明，AD与低级别促炎相关，其特征是血液炎症和免疫细胞的改变，导致更高的全身炎症指数。CBC及其衍生的炎症指标在临床实践中经常获得，在AD的背景下具有潜在的用途。

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引用次数: 0

Effect of cannabis on brain activity in males: Quantitative electroencephalography and its relationship with duration, dosage, and age of onset 大麻对男性脑活动的影响：定量脑电图及其与持续时间、剂量和发病年龄的关系。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.110982

Neda Vahed , Mohammad Bagher Saberizafarghandi , Hamed Bashirpour , Hamid Reza Ahmadkhaniha , Reza Arezoomandan

Objective

Brain function changes as a result of cannabis use. This study examined the brain activity of cannabis users compared to a healthy group and nicotine smokers, focusing on the age of onset, duration of use, and dosage.

Method

Demographic and quantitative electroencephalography (QEEG) data of 15 healthy individuals, 20 patients with chronic cannabis use, and 15 nicotine smokers were collected and recorded during the eyes-closed and eyes-open conditions in the resting state. The data were analyzed using MATLAB software and the EEGLAB toolbox.

Results

In the eyes-closed condition, cannabis users exhibited significantly elevated relative theta band power in widespread brain regions compared to both the healthy group and nicotine smokers. They showed decreased relative power in the beta and gamma bands in the parietal and occipital regions when compared to nicotine smokers. In the eyes-open condition, cannabis users displayed increased relative theta band power in widespread brain regions relative to both groups. Additionally, lower relative power in the beta and gamma bands was observed in cannabis users compared to the healthy group in the frontal region, as well as in various brain regions compared to nicotine smokers. A significant relationship was identified between gamma-band power, age of onset, and dosage of cannabis use.

Conclusion

These findings suggest that cannabis use leads to changes in brain wave patterns during the resting state, which may be linked to cognitive impairments affecting functions. Understanding these associations is essential for developing effective intervention programs aimed at mitigating cognitive deficits related to cannabis use.

目的：脑功能的变化是大麻使用的结果。这项研究将大麻使用者的大脑活动与健康人群和尼古丁吸烟者进行了比较，重点是发病年龄、使用时间和剂量。方法：收集15例健康人、20例慢性大麻吸食者和15例尼古丁吸食者静息状态下睁眼和闭眼状态下的人口统计学和定量脑电图（QEEG）数据。使用MATLAB软件和EEGLAB工具箱对数据进行分析。结果：在闭眼状态下，与健康组和尼古丁吸烟者相比，大麻使用者在广泛的大脑区域中表现出显著提高的相对θ波段功率。与尼古丁吸烟者相比，他们在顶叶和枕叶区域的β和γ波段的相对能力有所下降。在睁着眼睛的情况下，大麻使用者在大脑广泛区域的θ波段功率相对于两组都有所增加。此外，与健康组相比，大麻使用者的额叶区和脑各区域的相对强度都较低，与尼古丁吸烟者相比，大麻使用者的相对强度也较低。确定了伽马波段功率、发病年龄和大麻使用剂量之间的显著关系。结论：这些发现表明，大麻的使用会导致静息状态下脑电波模式的变化，这可能与影响功能的认知障碍有关。了解这些关联对于制定有效的干预方案至关重要，旨在减轻与大麻使用有关的认知缺陷。

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引用次数: 0

Quantitative pupillometry as a potential biomarker in early concussion assessment 定量瞳孔测量作为早期脑震荡评估的潜在生物标志物。

IF 1.9 4区医学 Q3 CLINICAL NEUROLOGY

Journal of Clinical Neuroscience

Pub Date : 2025-02-01 DOI: 10.1016/j.jocn.2024.111003

Moez M.I. Bashir , DaiWai M. Olson , Natassia T. Miller , Stephen C. Bunt , C. Munro Cullum

Background

There are limited objective methods when it comes to identifying and diagnosing concussion. Pupil assessment is performed routinely as a standard-of-care following traumatic brain injury (TBI). Unlike the highly subjective and limited reliability of pupil assessment using penlights and flashlights, Quantitative pupillometry (QP) is an established, valid, and reliable method of pupillary assessment. This study aims to investigate the use of QP values in concussion evaluation.

Methods

This observational study analyzed data collected by the North Texas Concussion Registry (ConTex). ConTex enrolls subjects who are >5-years of age and clinically diagnosed with concussion. Subjects are excluded if they had moderate or severe traumatic brain injury, spinal cord injury with an American Spinal Injury Association score of C or worse, or if the injury occurred > 6 months from enrollment. Data included demographics, medical history, time since concussion, the Sport Concussion Assessment Tool (SCAT5©) post-concussion symptom scale (PCSS), and QP assessment using the PLR3000® (Neuroptics Inc.) hand-held pupillometer. This study identified all subjects clinically diagnosed with concussion who had completed QP assessment, totaling 162. We created tertiles to describe the lowest (0–20), middle (21–43), and the highest (44–113) symptom score groupings to examine QP data.

Results

Of 162 subjects, 88 were female (54.3%), with a mean age of 15.8 (SD=6.9) years. Most (49.4%) occurrences were sport-related injuries. The mean time since injury was 21 (SD=28.6) days. The mean SCAT5 PCSS score was 37.3 (SD=25.6). A significant difference within average and maximum constriction velocities (p=.041 and 0.034, respectively) was found between subjects seen early (<2weeks) versus late (>2weeks) after injury. Pupillometry values were statistically different across SCAT5 PCSS tertiles for anisocoria after light exposure (p=.046).

Conclusions

This exploratory study is among the first to show that certain QP values — latency of constriction, constriction velocity, and average dilation velocity — may be useful in providing objective metrics when evaluating more symptomatic concussion.

背景：有有限的客观方法，当涉及到识别和诊断脑震荡。作为创伤性脑损伤（TBI）后的标准护理，瞳孔评估是常规进行的。与使用钢笔和手电筒进行瞳孔评估的高度主观和有限的可靠性不同，定量瞳孔测量（QP）是一种成熟、有效和可靠的瞳孔评估方法。本研究旨在探讨QP值在脑震荡评估中的应用。方法：本观察性研究分析了北德克萨斯州脑震荡登记处（ConTex）收集的数据。ConTex招募的受试者年龄在50到50岁之间，临床诊断为脑震荡。如果受试者患有中度或重度创伤性脑损伤，美国脊髓损伤协会评分为C或更差的脊髓损伤，或者在入组后6个月内发生损伤，则受试者被排除。数据包括人口统计学、病史、脑震荡后时间、运动脑震荡评估工具（SCAT5©）脑震荡后症状量表（PCSS）和使用PLR3000®（Neuroptics Inc.）手持式瞳孔计进行的QP评估。本研究确定了所有临床诊断为脑震荡并完成QP评估的受试者，共计162人。我们创建了分位数来描述最低（0-20）、中间（21-43）和最高（44-113）症状评分分组，以检查QP数据。结果：162例患者中，女性88例（54.3%），平均年龄15.8岁（SD=6.9）。大多数（49.4%）为运动相关损伤。平均伤后时间21天（SD=28.6）。SCAT5 PCSS平均评分为37.3分（SD=25.6）。平均收缩速度和最大收缩速度之间的显著差异(p=。041和0.034)，损伤后早期（2周）受试者间差异无统计学意义。光暴露后，SCAT5 PCSS各组的瞳孔测量值有统计学差异（p= 0.046）。结论：这项探索性研究首次表明，某些QP值——收缩潜伏期、收缩速度和平均扩张速度——可能在评估更多症状性脑震荡时提供客观指标。

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