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Integrating mind and body: Investigating differential activation of nodes of the default mode network. 身心一体化:研究默认模式网络节点的差异激活。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.3233/RNN-231334
Inbal Linchevski, Amber Maimon, Yulia Golland, Noa Zeharia, Amir Amedi, Nava Levit-Binnun

Background: The default mode network (DMN) is a large-scale brain network tightly correlated with self and self-referential processing, activated by intrinsic tasks and deactivated by externally-directed tasks.

Objective: In this study, we aim to investigate the novel approach of default mode activation during progressive muscle relaxation and examine whether differential activation patterns result from the movement of different body parts.

Methods: We employed neuroimaging to investigate DMN activity during simple body movements, while performing progressive muscle relaxation. We focused on differentiating the neural response between facial movements and movements of other body parts.

Results: Our results show that the movement of different body parts led to deactivation in several DMN nodes, namely the temporal poles, hippocampus, medial prefrontal cortex (mPFC), and posterior cingulate cortex. However, facial movement induced an inverted and selective positive BOLD pattern in some of these areas precisely. Moreover, areas in the temporal poles selective for face movement showed functional connectivity not only with the hippocampus and mPFC but also with the nucleus accumbens.

Conclusions: Our findings suggest that both conceptual and embodied self-related processes, including body movements during progressive muscle relaxation, may be mapped onto shared brain networks. This could enhance our understanding of how practices like PMR influence DMN activity and potentially offer insights to inform therapeutic strategies that rely on mindful body movements.

背景:默认模式网络(DMN)是一个与自我和自我参照处理密切相关的大规模脑网络,由内部任务激活,由外部任务去激活。目的:在本研究中,我们旨在研究进行性肌肉放松过程中默认模式激活的新方法,并检查不同身体部位的运动是否会导致不同的激活模式。方法:我们使用神经成像来研究DMN在进行渐进性肌肉放松时的活动。我们专注于区分面部运动和身体其他部位运动之间的神经反应。结果:我们的研究结果表明,不同身体部位的运动导致几个DMN节点失活,即颞极、海马、内侧前额叶皮层(mPFC)和后扣带皮层。然而,面部运动在其中一些区域精确地诱导了反向和选择性的阳性BOLD模式。此外,选择面部运动的颞极区域不仅与海马体和mPFC,而且与伏隔核显示出功能连接。结论:我们的研究结果表明,概念和具体的自我相关过程,包括渐进性肌肉放松过程中的身体运动,都可能被映射到共享的大脑网络中。这可以增强我们对PMR等实践如何影响DMN活动的理解,并可能为依赖正念身体运动的治疗策略提供见解。
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引用次数: 0
Targeted neurorehabilitation strategies in post-stroke aphasia. 脑卒中后失语症的针对性神经康复策略。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.3233/RNN-231344
Priyanka Shah-Basak, Olga Boukrina, Xin Ran Li, Fatima Jebahi, Aneta Kielar

Background: Aphasia is a debilitating language impairment, affecting millions of people worldwide. About 40% of stroke survivors develop chronic aphasia, resulting in life-long disability.

Objective: This review examines extrinsic and intrinsic neuromodulation techniques, aimed at enhancing the effects of speech and language therapies in stroke survivors with aphasia.

Methods: We discuss the available evidence supporting the use of transcranial direct current stimulation (tDCS), repetitive transcranial magnetic stimulation, and functional MRI (fMRI) real-time neurofeedback in aphasia rehabilitation.

Results: This review systematically evaluates studies focusing on efficacy and implementation of specialized methods for post-treatment outcome optimization and transfer to functional skills. It considers stimulation target determination and various targeting approaches. The translation of neuromodulation interventions to clinical practice is explored, emphasizing generalization and functional communication. The review also covers real-time fMRI neurofeedback, discussing current evidence for efficacy and essential implementation parameters. Finally, we address future directions for neuromodulation research in aphasia.

Conclusions: This comprehensive review aims to serve as a resource for a broad audience of researchers and clinicians interested in incorporating neuromodulation for advancing aphasia care.

背景:失语症是一种使人衰弱的语言障碍,影响着全世界数百万人。大约40%的中风幸存者会患上慢性失语症,导致终身残疾。目的:本文综述了外在和内在神经调节技术,旨在提高言语和语言治疗对脑卒中失语症幸存者的影响。方法:我们讨论了支持经颅直流电刺激(tDCS)、重复经颅磁刺激和功能磁共振成像(fMRI)实时神经反馈在失语康复中的应用的现有证据。结果:本综述系统地评估了关注治疗后结果优化和功能技能转移的专门方法的疗效和实施的研究。它考虑了增产目标的确定和各种靶定方法。探讨神经调节干预在临床实践中的转化,强调泛化和功能交流。该综述还涵盖了实时fMRI神经反馈,讨论了有效性和基本实施参数的当前证据。最后,我们展望了失语症神经调节研究的未来方向。结论:这篇全面的综述旨在为广泛的研究人员和临床医生提供资源,这些研究人员和临床医生对结合神经调节来推进失语症的治疗感兴趣。
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引用次数: 0
Comparative evaluation of rhFGF18 and rhGDF11 treatment in a transient ischemia stroke model. 一过性脑缺血中风模型中 rhFGF18 和 rhGDF11 治疗的比较评估。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.3233/RNN-231347
Alex Goraltchouk, Svetlana Mankovskaya, Tatjana Kuznetsova, Zhanna Hladkova, Judith M Hollander, Francesco Luppino, Alexey Seregin

Background: Pharmacological treatments for ischemic stroke remain limited to thrombolysis, which is associated with increased risk of potentially fatal hemorrhage. Treatments with Recombinant Human Fibroblast Growth Factor 18 (rhFGF18) and Growth and Differentiation Factor 11 (rhGDF11) appear promising based on different preclinical models. The goal of this study was to compare the effects of rhFGF18 and rhGDF11 directly on survival, behavioral deficits, and histological fingerprint of cerebral ischemia in the Wistar rat middle cerebral artery occlusion (MCAO) model of stroke.

Methods: Ischemia-reperfusion injury was induced using a 2-hour transient MCAO. Animals were administered rhFGF18 (infusion), rhGDF11 (multi-injection), or Phosphate Buffered Saline (PBS) vehicle control and followed for 42 days. Motor-Cognitive deficits were evaluated using the Morris Water Maze at Days 0 (pre-MCAO), 7, 21, and 42. Histopathological assessments were performed on Days 21 and 42.

Results: Day 7 post-ischemia water maze performance times increased 38.3%, 2.1%, and 23.1% for PBS, rhFGF18, and rhGDF11-treated groups, respectively. Fraction of neurons with abnormal morphology (chromatolysis, pyknotic nuclei, somal degeneration) decreased in all groups toward Day 42 and was lowest for rhFGF18. AChE-positive fiber density and activity increased over time in the rhFGF18 group, remained unchanged in the rhGDF11 treatment arm, and declined in the PBS control. Metabolic increases were greatest in rhGDF11 treated animals, with both rhFGF18 and rhGDF11 achieving improvements over PBS, as evidenced by increased succinate dehydrogenase and lactate dehydrogenase activity. Finally, rhFGF18 treatment exhibited a trend for reduced mortality relative to PBS (5.6%, 95% CI [27.3%, 0.1% ] vs. 22.2%, 95% CI [47.6%, 6.4% ]).

Conclusions: rhFGF18 treatment appears promising in improving survival and promoting motor-cognitive recovery following cerebral ischemia-reperfusion injury.

背景:缺血性脑卒中的药物治疗仍局限于溶栓,而溶栓会增加潜在致命性出血的风险。根据不同的临床前模型,使用重组人成纤维细胞生长因子 18(rhFGF18)和生长与分化因子 11(rhGDF11)进行治疗似乎很有前景。本研究的目的是比较 rhFGF18 和 rhGDF11 对 Wistar 大鼠大脑中动脉闭塞(MCAO)脑卒中模型的存活率、行为障碍和脑缺血组织学指纹的直接影响:方法:使用 2 小时瞬时 MCAO 诱导缺血再灌注损伤。给动物注射 rhFGF18(输注)、rhGDF11(多次注射)或磷酸盐缓冲盐水(PBS)药物对照,并随访 42 天。在第 0 天(MCAO 前)、第 7 天、第 21 天和第 42 天使用 Morris 水迷宫评估运动认知障碍。第21天和第42天进行组织病理学评估:结果:缺血后第 7 天,PBS、rhFGF18 和 rhGDF11 处理组的水迷宫表现时间分别增加了 38.3%、2.1% 和 23.1%。所有组中形态异常(色素溶解、细胞核萎缩、体细胞变性)的神经元比例在第 42 天时都有所下降,而 rhFGF18 的下降幅度最小。随着时间的推移,rhFGF18 组 AChE 阳性纤维密度和活性增加,rhGDF11 治疗组保持不变,而 PBS 对照组则有所下降。rhGDF11治疗组动物的代谢增加幅度最大,rhFGF18和rhGDF11均比PBS组有所改善,这体现在琥珀酸脱氢酶和乳酸脱氢酶活性的增加上。最后,与 PBS 相比,rhFGF18 治疗显示出死亡率降低的趋势(5.6%,95% CI [27.3%,0.1% ] 对比 22.2%,95% CI [47.6%,6.4% ])。
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引用次数: 0
Feasibility of using fNIRS to explore motor-related regional haemodynamic signal changes in patients with sensorimotor impairment and healthy controls: A pilot study. 使用 fNIRS 探索感知运动障碍患者和健康对照组中与运动相关的区域血流动力学信号变化的可行性:试点研究。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.3233/RNN-221292
Lina Bunketorp Käll, Malin Björnsdotter, Johanna Wangdell, Carina Reinholdt, Robert Cooper, Simon Skau

Background: While functional near-infrared spectroscopy (fNIRS) can provide insight into cortical brain activity during motor tasks in healthy and diseased populations, the feasibility of using fNIRS to assess haemoglobin-evoked responses to reanimated upper limb motor function in patients with tetraplegia remains unknown.

Objective: The primary objective of this pilot study is to determine the feasibility of using fNIRS to assess cortical signal intensity changes during upper limb motor tasks in individuals with surgically restored grip functions. The secondary objectives are: 1) to collect pilot data on individuals with tetraplegia to determine any trends in the cortical signal intensity changes as measured by fNIRS and 2) to compare cortical signal intensity changes in affected individuals versus age-appropriate healthy volunteers. Specifically, patients presented with tetraplegia, a type of paralysis resulting from a cervical spinal cord injury causing loss of movement and sensation in both lower and upper limbs. All patients have their grip functions restored by surgical tendon transfer, a procedure which constitutes a unique, focused stimulus for brain plasticity.

Method: fNIRS is used to assess changes in cortical signal intensity during the performance of two motor tasks (isometric elbow and thumb flexion). Six individuals with tetraplegia and six healthy controls participate in the study. A block paradigm is utilized to assess contralateral and ipsilateral haemodynamic responses in the premotor cortex (PMC) and primary motor cortex (M1). We assess the amplitude of the optical signal and spatial features during the paradigms. The accuracy of channel locations is maximized through 3D digitizations of channel locations and co-registering these locations to template atlas brains. A general linear model approach, with short-separation regression, is used to extract haemodynamic response functions at the individual and group levels.

Results: Peak oxyhaemoglobin (oxy-Hb) changes in PMC appear to be particularly bilateral in nature in the tetraplegia group during both pinch and elbow trials whereas for controls, a bilateral PMC response is not especially evident. In M1 / primary sensory cortex (S1), the oxy-Hb responses to the pinch task are mainly contralateral in both groups, while for the elbow flexion task, lateralization is not particularly clear.

Conclusions: This pilot study shows that the experimental setup is feasible for assessing brain activation using fNIRS during volitional upper limb motor tasks in individuals with surgically restored grip functions. Cortical signal changes in brain regions associated with upper extremity sensorimotor processing appear to be larger and more bilateral in nature in the tetraplegia group than in the control group. The bilateral hemispheric response in the tetraplegia group may reflect a sign

背景:虽然功能性近红外光谱(fNIRS)可以让人们深入了解健康和患病人群在完成运动任务时大脑皮层的活动,但使用fNIRS评估四肢瘫痪患者恢复上肢运动功能时血红蛋白诱发反应的可行性仍然未知:本试验研究的主要目的是确定使用 fNIRS 评估手术后握持功能恢复者在上肢运动任务中皮层信号强度变化的可行性。次要目标是1)收集四肢瘫痪患者的试验数据,以确定通过 fNIRS 测量的皮层信号强度变化趋势;2)比较患者与适龄健康志愿者的皮层信号强度变化。具体来说,患者表现为四肢瘫痪,这是一种因颈部脊髓损伤导致的瘫痪,会造成上下肢失去运动和感觉。方法:使用 fNIRS 评估在完成两项运动任务(等长肘关节和拇指屈曲)时大脑皮层信号强度的变化。六名四肢瘫痪患者和六名健康对照者参加了研究。采用阻滞范式评估对侧和同侧运动前皮层(PMC)和初级运动皮层(M1)的血流动力学反应。我们在范式中评估光学信号的振幅和空间特征。通过对通道位置进行三维数字化,并将这些位置与模板图谱大脑共同注册,最大限度地提高了通道位置的准确性。采用一般线性模型方法和短间隔回归,提取个体和群体水平的血流动力学响应函数:结果:在捏和肘试验中,四肢瘫痪组的 PMC 氧血红蛋白(oxy-Hb)峰值变化似乎特别具有双侧性质,而对照组的 PMC 双侧反应并不特别明显。在M1/初级感觉皮层(S1)中,两组患者在捏拿任务中的氧-Hb反应主要是对侧反应,而在肘关节屈曲任务中,对侧反应并不特别明显:这项试验性研究表明,使用 fNIRS 评估手术后握力功能恢复者在自主上肢运动任务中的大脑激活情况是可行的。与对照组相比,四肢瘫痪组与上肢感觉运动处理相关的脑区的皮层信号变化似乎更大,且更具双侧性质。四肢瘫痪组的双侧半球反应可能反映了大脑适应性可塑性机制的特征。要证实这些发现并得出可靠的结论,还需要更大规模的研究。
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引用次数: 0
Abstracts from the 17th World Congress on Controversies in Neurology, March 23-25, 2023, in Dubrovnik, Croatia. 第17届世界神经病学争议大会,2023年3月23-25日,克罗地亚杜布罗夫尼克。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2023-01-01 DOI: 10.3233/RNN-239002
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引用次数: 0
Anti-Oxidative Property of Pennisetum Glaucum (Poaceae) Supplement Contributes To Its Anti- Convulsant Activity In Pentylenetetrazole- Kindled Wistar Rats 狼尾草(penisetum Glaucum)补充剂的抗氧化性与戊四唑点燃Wistar大鼠抗惊厥活性有关
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-12-30 DOI: 10.33425/2692-7918.1041
HD Muhammad, F. Dawud, J. Yau, J. Abdulazeez
Introduction: Oxidative stress is one of the prime pathogenic factors going on in both human epilepsy and experimental epileptogenic models. PTZ-Seizure has been associated with over production of superoxide anion, reduced GSH levels, increased lipid peroxidation and protein oxidation in the hippocampus. Methodology: Forty male wistar rats were divided into 5 groups (normal saline, 200 mg/kg sodium valporate, 25% PMS, 50 % PMS and 100 % PMS) with each group receiving PTZ (35 mg/kg) on every alternate day for 30 days. Thirty minutes after each PTZ injection rats were observed for seizure behavior using the Racine scale. The hippocampal tissues were isolated, homogenized and used to determine SOD, CAT, GSH and MDA level. Result: This result revealed significant increase in the mean hippocampal SOD activity of PTZ-kindled wistar rats fed with PMS [25% (18.90 ± 1.08), 50% (18.90 ± 1.08, 24.90 ± 1.37) and 100 % (11.06 ± 0.58 IU/ mg protein) when compared to normal saline group (8.84 ± 0.96 IU/ mg protein). PM Supplementation increased mean CAT activity at 25% and 50% [25% (12.68 ± 0.68), 50% (8.74 ± 0.92) and 100% (15.66 ± 1.12 µg/ mg protein)] Vs normal saline treated group (9.60 ± 0.72 µg/ mg protein). A significant increase in mean hippocampal GSH concentration was seen in all the PMS fed wistar rats [25 % (29.52 ± 0.44), 50 % (24.42 ± 1.51) and 100 % (40.32 ± 1.43 µg/ mg protein)] when compared to normal saline (10.88 ± 0.32 µg/ mg protein). PTZ-kindled wistar rats fed with PMS [25% (86.62 ± 2.81), 50% (73.86 ± 3.26) and 100% (73.56 ± 1.82 nmol/ mg protein) showed significant decrease in the mean concentration of hippocampal MDA when compared to normal saline (119.90 ± 2.34 nmol/ mg protein). Conclusion: Supplementation with PG inhibits hippocampal redox imbalance and reinforces it antioxidant system.
氧化应激是人类癫痫和实验性癫痫模型的主要致病因素之一。ptz发作与海马超氧阴离子过量产生、GSH水平降低、脂质过氧化和蛋白质氧化增加有关。方法:将40只雄性wistar大鼠分为生理盐水、200 mg/kg戊酸钠、25% PMS、50% PMS和100% PMS 5组,每组每隔一天给予PTZ (35 mg/kg),连续30 d。每次注射PTZ后30分钟,用拉辛量表观察大鼠癫痫发作行为。分离海马组织,匀浆,测定SOD、CAT、GSH和MDA水平。结果:与生理盐水组(8.84±0.96 IU/ mg蛋白)相比,经PMS喂养的ptz点燃wistar大鼠海马SOD平均活性分别有25%(18.90±1.08)、50%(18.90±1.08、24.90±1.37)和100%(11.06±0.58 IU/ mg蛋白)显著升高。与生理盐水处理组(9.60±0.72µg/ mg蛋白)相比,添加PM可使CAT活性分别提高25%和50%[25%(12.68±0.68),50%(8.74±0.92)和100%(15.66±1.12µg/ mg蛋白)]。与生理盐水(10.88±0.32µg/ mg蛋白)相比,经PMS喂养的wistar大鼠海马GSH平均浓度均显著升高[25%(29.52±0.44),50%(24.42±1.51)和100%(40.32±1.43µg/ mg蛋白)]。PMS[25%(86.62±2.81)、50%(73.86±3.26)和100%(73.56±1.82)nmol/ mg蛋白]灌胃ptz点燃wistar大鼠海马MDA平均浓度较生理盐水(119.90±2.34 nmol/ mg蛋白)显著降低。结论:补充PG可抑制海马氧化还原失衡,增强其抗氧化系统。
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引用次数: 0
Vascular Retinal Event Secondary to Ocular Ischemic Syndrome, Improved With QIAPI 1: Case Report 继发于眼缺血综合征的血管性视网膜事件,QIAPI改善1例报告
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-12-30 DOI: 10.33425/2692-7918.1039
Arturo Solís Herrera, P. E. Solís Arias
Ocular ischemic syndrome (OIS) is a rare condition, which is caused by ocular hypoperfusion due to stenosis or occlusion of the common or internal carotid arteries. Atherosclerosis is the major cause of changes in the carotid arteries. Since OIS is associated with atherosclerosis, patients usually have other related co-morbidities. Hypertension is found in 73% of the patients and diabetes mellitus in 56%. The first case of OIS was reported in 1963 by Hedges as a case with retinal hemorrhages and venous dilatation in a patient with complete occlusion of the internal carotid artery (ICA). The only therapy is to treat the neovascular complications. Recent studies suggest that OIS is associated with a significant risk of cerebrovascular, ocular, and systemic morbidity. OIS has a poor visual prognosis. It is imperative that the clinician be aware of the signs and symptoms of carotid disease to facilitate prompt diagnosis and appropriate referral, because OIS may be the presenting sign of serious ischemic cerebrovascular and ischemic heart disease. The 5-year mortality rate in OIS patients is as high as 40%. Most deaths are due to cardiac disease Controversy in the management of OIS arises from the fact that most patients reported in the literature are part of small retrospective series or case reports. Besides the uncertainty about the physio-pathogenic of the disease. Pan-retinal photocoagulation (PRP) is the accepted treatment for retinal ischemia predisposing to neovascularization due to retinal ischemia supposedly triggers the production of angiogenic growth factors. However, the main stimulus to abnormal angiogenesis is hypoxia more than ischemia, and opposite the best antiangiogenic factor is high levels of oxygen in tissues. Thereby, our discovery about the unexpected capacity of several organic molecules of the human body that can take the oxygen from intracellular water, like in plants, open a new way to treat these difficult cases, improving the prognosis.
眼缺血综合征(OIS)是一种罕见的疾病,是由于颈总动脉或颈内动脉狭窄或闭塞而引起的眼部灌注不足。动脉粥样硬化是颈动脉改变的主要原因。由于OIS与动脉粥样硬化相关,患者通常有其他相关合并症。73%的患者有高血压,56%的患者有糖尿病。第一例OIS是由Hedges于1963年报道的,是一例内颈动脉(ICA)完全闭塞的患者视网膜出血和静脉扩张。唯一的治疗方法是治疗新血管并发症。最近的研究表明,OIS与脑血管、眼部和全身疾病的显著风险相关。OIS的视力预后较差。临床医生必须了解颈动脉疾病的体征和症状,以便及时诊断和适当转诊,因为OIS可能是严重缺血性脑血管和缺血性心脏病的表现。OIS患者5年死亡率高达40%。大多数死亡是由心脏病引起的OIS的管理争议源于这样一个事实,即文献中报道的大多数患者都是小型回顾性系列或病例报告的一部分。此外,该疾病的生理致病机理尚不确定。泛视网膜光凝(PRP)是公认的治疗视网膜缺血易发新生血管的方法,因为视网膜缺血可能引发血管生成生长因子的产生。然而,引起血管生成异常的主要刺激因素是缺氧,而不是缺血,而相反的最佳抗血管生成因子是组织中高水平的氧。因此,我们对人体几种有机分子的意想不到的能力的发现,可以从细胞内的水中吸收氧气,就像在植物中一样,为治疗这些困难的病例开辟了一条新的途径,改善了预后。
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引用次数: 0
Ischemic Cerebrovascular Accidents in HIV Patients on Antiretroviral Therapy: Clinical, Paraclinical And Prognostic Aspects in The Neurology Department of The University Hospital Center of Conakry 抗逆转录病毒治疗的HIV患者缺血性脑血管事故:科纳克里大学医院中心神经内科的临床、临床旁和预后方面
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-12-30 DOI: 10.33425/2692-7918.1040
Barry Souleymane Djigué, Doré Malé Wenceslas Sossa, Diawara Karinka, Condé Mohamed Lamine, Mohamed Lamine Touré, Bognon Victor, F. Cissé
Introduction: Ischemic stroke (Stroke) constitute, due to the demographic and epidemiological transition, a real challenge for developing countries and HIV infection, a real public health problem in these countries. The objective of our study was to describe aspects of clinical, paraclinical and prognostic ischemic stroke in people living with HIV (PLHIV) on antiretrovirals (ARVs). Material and methods: This was a prospective study of the descriptive type lasting 6 months from January 1, 2022 to June 31, 2022, relating to ischemic cerebrovascular accidents (DALYs) in HIV patients on ARVs.Were included patients admitted or hospitalized in the service for seropositive ischemic stroke under ARV for an average duration of 35.5 months. Patients recently put on ARVs and those with an obvious cause of DALY such as (diabetes, uncontrolled hypertension, emboligenic heart disease) were excluded. Results: During our study period, 336(94%) patients were listed. Among them, 20 have ischemic stroke associated with HIV on ARVs, i.e. 6%. This study showed that the average age of onset of ischemic stroke in PLHIV on ARV was 49 ± 11.6 years with a sex ratio F/M of 1.22. The risk factors were high blood pressure 13 (65%), diabetes 05 (25%), followed by alcohol 04 (20%). HIV type 1 was represented at 100%, then 16 (80%) of our patients were at WHO stage III with a CD4 count between 200 and 300 cells/µl09 (45%). The therapeutic line of ARVs was dominated by TDF+3TC+EFV at 14 (70%) followed by AZT+3TC+LPV/r at 04 (20%) and the average duration of patients on ARV was 35.5 months. The favorable evolution was marked 13 (65%), followed by a death in (10%) or 02. The location on the cerebral scanner was dominated by the sylvian artery in 12 (60%) of cases followed by the anterior cerebral artery (ACA) 06 (30%) and the posterior cerebral artery ( PCA) 02 (10%). Conclusion: Ischemic stroke in HIV patients on ARVs requires early management and regular monitoring
导言:由于人口和流行病学的转变,缺血性中风(中风)对发展中国家构成了真正的挑战,艾滋病毒感染是这些国家真正的公共卫生问题。本研究的目的是描述抗逆转录病毒药物(ARVs)治疗的HIV感染者(PLHIV)的临床、临床旁和预后缺血性卒中的各个方面。材料和方法:这是一项为期6个月的描述性前瞻性研究,从2022年1月1日至2022年6月31日,涉及抗逆转录病毒药物治疗的HIV患者缺血性脑血管事故(DALYs)。纳入在ARV治疗下因血清阳性缺血性中风入院或住院的患者,平均持续时间为35.5个月。最近服用抗逆转录病毒药物的患者和有明显DALY原因的患者(如糖尿病、未控制的高血压、栓塞性心脏病)被排除在外。结果:在我们的研究期间,共有336例(94%)患者入选。其中,在抗逆转录病毒药物治疗中发生与HIV相关的缺血性中风20例,占6%。本研究显示,抗逆转录病毒感染者发生缺血性卒中的平均年龄为49±11.6岁,性别比F/M为1.22。危险因素是高血压13(65%),糖尿病05(25%),其次是酒精04(20%)。艾滋病毒1型占100%,然后16例(80%)患者处于世卫组织III期,CD4细胞计数在200至300个细胞/ μ l09之间(45%)。ARV的治疗线以TDF+3TC+EFV为主,占14(70%),其次是AZT+3TC+LPV/r,占04(20%),患者平均服药时间为35.5个月。有利的进化标记为13(65%),其次是死亡(10%)或02。脑部扫描位置以左动脉为主12例(60%),其次为大脑前动脉(ACA) 06例(30%)和大脑后动脉(PCA) 02例(10%)。结论:抗逆转录病毒药物治疗的HIV患者缺血性卒中需要早期治疗和定期监测
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引用次数: 0
Basilar Heart-Shaped Aneurysm: Case Illustration 基底动脉心形动脉瘤:病例说明
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-12-30 DOI: 10.33425/2692-7918.1038
José Renan Miranda Cavalcante-Filho, Bruno Gonzales Miniello, J. M. de Almeida Silva, Andre Luiz Resende, Marcus Alexandre Cavalcanti Rotta
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引用次数: 0
Syphylitical Myelopathies: Study of 8 observations at National Hospital Ignace Deen, University of Conakry 在科纳克里大学国立医院Ignace Deen进行的8项观察研究
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-09-30 DOI: 10.33425/2692-7918.1037
Touré Ml, Carlos Othon G, Baldé Th, Diallo Sm, Ballo BKJB,, A. Djibo Hamani, F. Sakadi, A. Sakho, DF Kassa, FA Cissé, A. Cissé
Introduction: Myelopathies occurring in the context of neurosyphilis have been poorly studied clinically, radiologically and in tropical settings. The diagnostic certainty of the syphilitic etiology of myelopathy is difficult to establish because of the multiplicity of causes of spinal cord damage. Patients and Methods: We carried out a retrospective study of 269 patients hospitalized for spinal cord disorders between January 2015 and December 2021, among whom 8 (eight) patients were identified for progressive syphilitic myelopathy diagnosed by the positivity of VDRL-TPHA serological reactions in the blood and cerebrospinal fluid and radiological data. Magnetic resonance imaging was performed in all patients. Results: The neurological signs were limited to the existence of a sensory-motor spinal semiology in particular, paraparesis with sphincter disorders, especially moderate urinary disorders, without an obvious infectious syndrome in a context of positive serological reactions VDRL-TPHA in the blood and cerebrovascular fluid. spinal. Lumbar puncture shows hypercellularity with lymphocyte predominance on average 65% and hyperproteinorachia varying from 0.98 to 1.36 g/l. magnetic resonance imaging performed in all patients contributed to the diagnosis by showing hypersignals in T2, expression of more or less extensive lesions on several segments.
在临床、放射学和热带环境中,神经梅毒背景下发生的脊髓病研究很少。由于脊髓损伤的病因多种多样,脊髓病的梅毒病因诊断的确定性很难确定。患者和方法:我们对2015年1月至2021年12月期间因脊髓疾病住院的269例患者进行了回顾性研究,其中8(8)例患者通过血液和脑脊液中VDRL-TPHA血清学反应阳性和放射学资料诊断为进行性梅毒性脊髓病。所有患者均行磁共振成像检查。结果:神经学症状仅限于感觉-运动脊柱符会学,特别是括约肌疾病,特别是中度泌尿系统疾病,在血液和脑血管液中VDRL-TPHA血清学反应阳性的情况下,没有明显的感染综合征。脊髓。腰椎穿刺显示淋巴细胞增多,平均65%为淋巴细胞为主,高蛋白血症为0.98 ~ 1.36 g/l。所有患者的磁共振成像均显示T2高信号,多个节段或多或少有广泛病变的表达,有助于诊断。
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Restorative neurology and neuroscience
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