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Scientific basis and active ingredients of current therapeutic interventions for stroke rehabilitation. 当前脑卒中康复治疗干预措施的科学基础和有效成分。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-05-04 DOI: 10.3233/RNN-211243
R. Ranganathan, Carson Doherty, M. Gussert, Eva Kaplinski, M. Koje, C. Krishnan
BACKGROUNDDespite tremendous advances in the treatment and management of stroke, restoring motor and functional outcomes after stroke continues to be a major clinical challenge. Given the wide range of approaches used in motor rehabilitation, several commentaries have highlighted the lack of a clear scientific basis for different interventions as one critical factor that has led to suboptimal study outcomes.OBJECTIVETo understand the content of current therapeutic interventions in terms of their active ingredients.METHODSWe conducted an analysis of randomized controlled trials in stroke rehabilitation over a 2-year period from 2019-2020.RESULTSThere were three primary findings: (i) consistent with prior reports, most studies did not provide an explicit rationale for why the treatment would be expected to work, (ii) most therapeutic interventions mentioned multiple active ingredients and there was not a close correspondence between the active ingredients mentioned versus the active ingredients measured in the study, and (iii) multimodal approaches that involved more than one therapeutic approach tended to be combined in an ad-hoc fashion, indicating the lack of a targeted approach.CONCLUSIONThese results highlight the need for strengthening cross-disciplinary connections between basic science and clinical studies, and the need for structured development and testing of therapeutic approaches to find more effective treatment interventions.
背景尽管在中风的治疗和管理方面取得了巨大进展,但中风后恢复运动和功能结果仍然是一个重大的临床挑战。鉴于运动康复中使用的方法范围广泛,一些评论强调,不同干预措施缺乏明确的科学依据,这是导致研究结果不理想的一个关键因素。目的了解当前治疗干预措施的有效成分。方法:我们对2019-2020年2年期间中风康复的随机对照试验进行了分析。结果有三个主要发现:(i)与之前的报道一致,大多数研究没有提供为什么该治疗有效的明确理由,(ii)大多数治疗干预措施都提到了多种活性成分,并且所提到的活性成分与研究中测量的活性成分之间没有密切的对应关系,以及(iii)涉及一种以上治疗方法的多模式方法往往以特别的方式结合在一起,这表明缺乏有针对性的方法。结论这些结果强调了加强基础科学和临床研究之间跨学科联系的必要性,以及结构化开发和测试治疗方法以寻找更有效的治疗干预措施的必要性。
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引用次数: 1
Complex housing partially mitigates low dose radiation-induced changes in brain and behavior in rats. 复杂的住房部分减轻了低剂量辐射引起的大鼠大脑和行为的变化。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-04-30 DOI: 10.3233/RNN-211216
Anna Kovalchuk, R. Mychasiuk, A. Muhammad, S. Hossain, Abhijit Ghose, C. Kirkby, E. Ghasroddashti, O. Kovalchuk, B. Kolb
PURPOSEIn recent years, much effort has been focused on developing new strategies for the prevention and mitigation of adverse radiation effects on healthy tissues and organs, including the brain. The brain is very sensitive to radiation effects, albeit as it is highly plastic. Hence, deleterious radiation effects may be potentially reversible. Because radiation exposure affects dendritic space, reduces the brain's ability to produce new neurons, and alters behavior, mitigation efforts should focus on restoring these parameters. To that effect, environmental enrichment through complex housing (CH) and exercise may provide a plausible avenue for exploration of protection from brain irradiation. CH is a much broader concept than exercise alone, and constitutes exposure of animals to positive physical and social stimulation that is superior to their routine housing and care conditions. We hypothesized that CHs may lessen harmful neuroanatomical and behavioural effects of low dose radiation exposure.METHODSWe analyzed and compared cerebral morphology in animals exposed to low dose head, bystander (liver), and scatter irradiation on rats housed in either the environmental enrichment condos or standard housing.RESULTSEnriched condo conditions ameliorated radiation-induced neuroanatomical changes. Moreover, irradiated animals that were kept in enriched CH condos displayed fewer radiation-induced behavioural deficits than those housed in standard conditions.CONCLUSIONSAnimal model-based environmental enrichment strategies, such as CH, are excellent surrogate models for occupational and exercise therapy in humans, and consequently have significant translational possibility. Our study may thus serve as a roadmap for the development of new, easy, safe and cost-effective methods to prevent and mitigate low-dose radiation effects on the brain.
目的近年来,人们在制定预防和减轻辐射对健康组织和器官(包括大脑)不利影响的新战略方面做了大量工作。尽管大脑具有高度的可塑性,但它对辐射的影响非常敏感。因此,有害的辐射效应可能是潜在可逆的。由于辐射暴露会影响树突空间,降低大脑产生新神经元的能力,并改变行为,因此缓解措施应侧重于恢复这些参数。为此,通过复合住房(CH)和锻炼来丰富环境可能为探索脑辐射保护提供了一种可行的途径。CH是一个比单独运动更广泛的概念,它包括使动物暴露于积极的身体和社会刺激,这优于它们日常的住房和护理条件。我们假设CHs可能减轻低剂量辐射暴露对神经解剖和行为的有害影响。方法对饲养在环境富集公寓和标准住房的大鼠进行低剂量头部、旁观者(肝脏)和散射辐射照射后的脑形态进行分析和比较。结果丰富的公寓条件改善了辐射引起的神经解剖改变。此外,与饲养在标准条件下的动物相比,饲养在富含CH的公寓中的受辐射动物表现出较少的辐射引起的行为缺陷。结论基于动物模型的环境富集策略,如CH,是人类职业和运动治疗的优秀替代模型,因此具有重要的转化可能性。因此,我们的研究可以作为开发新的、简单的、安全的、经济有效的方法来预防和减轻低剂量辐射对大脑的影响的路线图。
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引用次数: 0
Management of gunshot wounds to the spine at Parakou University Teaching Hospital In Benin Republics 贝宁共和国帕拉库大学教学医院脊柱枪伤的处理
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1024
Quenum Kisito, Coulibaly Oumar, Yakhya Cisse, Padonou Christian, Quenum Hountondji Bernice, F. O. Holden
Objective: Describe the clinical features and bullet removal in gunshot wound (GSW) to the spine. Patients and methods: From 2015 to 2021 we present Case series of consecutive five cases of GSW with spinal cord injury treated at a single center of parakou university neurosurgery department. Results: Patient ages ranged from 16 to 40 yr (mean: 27.4 yr). All the patients were male. Three had complete thoracic spinal cord injury (ASIA A), two had lumbar level injury with cauda equina syndrome in one case. Surgical and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the thoracic spine. Decompression and bullet removal were performed using an open surgery. The patient with thoracic spinal cord lesion associated with extended injuries related to bullet fragmentation have a poor prognosis. The patients with incomplete injuries had a good follow-up and neurologic recovery. There were no postoperative wound infections, cerebrospinal fluid (CSF) fistulas, or other complications related to the procedure. Conclusion: Surgical decompression and bullet removal is a safe technique that may help reduce the risk of postoperative infections and CSF fistulas in patients with GSW to the thoracic and lumbar spine.
目的:探讨脊柱枪伤的临床特点及取出子弹的方法。患者和方法:从2015年到2021年,我们报告了在parakou大学神经外科单一中心连续治疗的5例GSW伴脊髓损伤的病例系列。结果:患者年龄16 ~ 40岁(平均27.4岁)。所有患者均为男性。3例完全性胸段脊髓损伤(ASIA A), 2例腰椎水平损伤伴马尾综合征。一例胸椎高速枪伤致持续性脊髓损伤患者的外科和康复治疗及其结果。采用开放手术进行减压和取出子弹。胸椎脊髓病变伴延伸性损伤的患者预后较差。不完全性损伤患者随访良好,神经功能恢复良好。术后无伤口感染、脑脊液(CSF)瘘或其他与手术相关的并发症。结论:手术减压和取出子弹是一种安全的技术,可以帮助降低胸腰椎GSW患者术后感染和脑脊液瘘的风险。
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引用次数: 0
Impact of Social Support on Mental Wellbeing among Internet Users In Nigeria During Covid-19 Pandemic 2019冠状病毒病大流行期间社会支持对尼日利亚互联网用户心理健康的影响
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1023
Emmanuel Sochukwuma Ezaka,, M. F. Asiegbu, O. P. Chibuike, Okpara Titus Chukwubuzo, Chime Peter Ekpunobi, Ozougwu Augustine Obumneme, Ofojebe Chukwuma Philip, Okoli Alexander Chinwike
This study investigated the role of social support on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria. A total of one hundred and six (106) participants (55 (51.9%) females, and 51 (48.9%) males participated in the study. The participant ages ranged from 19-29 years with a mean age of 28.68 and standard deviation of 8.14. Participants were drawn using convenience sampling technique and data were collated using the online Google form method. The link to the survey was shared across different platforms such: as Facebook, Whatsapp, and email list. The participants gave their consent and willingness to participate by checking a box in the online survey. Two instruments were used in data collection namely; a 15-item COVID-19 social support questionnaire (COVID-19- SSQ) and Warwick-Edinburgh Mental Well-being Scale (AWEMWBS). Two hypotheses were tested. The study adopted cross sectional design, while regression was employed for data analysis. The findings indicate that the presence of social support has significant influence on existence of mental wellbeing. It is recommended that social support factor should be sustained because of its buffer effect on mental wellbeing during COVID-19 Pandemic among internet users in Nigeria.
本研究调查了尼日利亚互联网用户在COVID-19大流行期间社会支持对心理健康的作用。共有106名参与者(女性55名(51.9%),男性51名(48.9%))参加了这项研究。参与者年龄19-29岁,平均年龄28.68岁,标准差8.14岁。参与者采用方便抽样法抽取,数据采用在线谷歌表格法整理。该调查的链接在不同的平台上共享,如Facebook、Whatsapp和电子邮件列表。参与者通过在在线调查中勾选一个方框来表示他们同意并愿意参与。数据收集使用了两种仪器,分别是;15项社会支持问卷(COVID-19- SSQ)和华威-爱丁堡心理健康量表(AWEMWBS)。测试了两个假设。本研究采用横断面设计,数据分析采用回归分析。研究结果表明,社会支持的存在对心理健康的存在有显著影响。建议维持社会支持因素,因为它对尼日利亚互联网用户在COVID-19大流行期间的心理健康具有缓冲作用。
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引用次数: 1
From Donation to Sharing, Experimental Study in Kanak Society : Methodology 从捐赠到分享:卡纳克社会的实验研究:方法论
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1025
Prou Jean-Pierre
Since Kanak social norms have a major influence on this endowment effect cognitive bias , I launched a second line of research to examine the extent to which Kanak children and adults exhibit an altruistic (qualified as such in the Western world) pro-social behavior. I switched from gift-giving to sharing, and I examined whether these two were correlated
由于卡纳克人的社会规范对这种禀赋效应认知偏见有重大影响,我开展了第二项研究,以检验卡纳克儿童和成人在多大程度上表现出利他主义(在西方世界被称为利他主义)的亲社会行为。我从送礼变成了分享,我检查了这两者是否相关
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引用次数: 0
A rare case of undulatory rhythmic lingual myoclonus in a patient with intracranial hemorrhage and diffuse pontine lesion 一例罕见的伴有颅内出血及弥漫性脑桥病变的舌性肌阵挛
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-03-30 DOI: 10.33425/2692-7918.1026
C. Zachariadi, Ioanna Alexandratou, V. Katsaros, S. Gatzonis
We describe a 35-year-old man, who suffered a severe intraventricular hemorrhage and was admitted to the intensive care unit of our tertiary clinic. Two weeks after the incident, while in ICU, a neurological examination revealed persistent, undulating, rhythmic, myoclonic tongue movements. The diagnostic evaluation via CT scan, MRI and EEGs elicited a diffuse brainstem lesion as well as multiple corpus callosum lesions as a considerable underlying etiology. This case presentation attempts to update the current investigation of the rare phenomenon of lingual myoclonus.
我们描述一个35岁的男人,谁遭受了严重的脑室内出血,并被承认在我们的三级诊所重症监护室。事件发生两周后,在重症监护室,神经学检查发现持续的,波动的,有节奏的,肌阵挛的舌头运动。通过CT扫描、MRI和脑电图的诊断评估显示,弥漫性脑干病变以及多发胼胝体病变是相当重要的潜在病因。本病例报告试图更新目前对舌肌阵挛罕见现象的研究。
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引用次数: 0
Restorative Neurology and Neuroscience: Celebrating the 40th volume of an academic journal. 恢复性神经病学和神经科学:庆祝学术期刊的第40卷。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.3233/RNN-239003
Bernhard A Sabel

Since the first issue of the academic journal Restorative Neurology and Neuroscience (RNN) was published in 1989, 40 volumes with a total of 1,550 SCI publications have helped advance basic and clinical sciences in the fields of central and peripheral nervous system rescue, regeneration, restoration and plasticity in experimental and clinical disorders. In this way RNN helped advance the development of a range of neuropsychiatric intervention across a broad spectrum of approaches such as drugs, training (rehabilitation), psychotherapy or neuromodulation with current stimulation. Today, RNN remains a focused, innovative and viable source of scientific information in the neurosciences with high visibility in an ever changing world of academic publishing.

自1989年创刊以来,《恢复性神经科学与神经科学》(RNN)共收录了40卷1550篇SCI论文,在中枢和周围神经系统的抢救、再生、修复和实验及临床疾病可塑性等领域,促进了基础科学和临床科学的发展。通过这种方式,RNN帮助推动了一系列神经精神干预的发展,包括药物、训练(康复)、心理治疗或当前刺激的神经调节。今天,RNN仍然是一个专注的,创新的和可行的神经科学科学信息来源,在不断变化的学术出版世界中具有很高的知名度。
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引用次数: 0
Retraction notice regarding several articles published in Restorative Neurology and Neuroscience. 关于发表在《恢复性神经病学》和《神经科学》上的几篇文章的撤回通知。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.3233/RNN-239001
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引用次数: 0
Retinal nerve fiber and ganglion cell complex layer thicknesses mirror brain atrophy in patients with relapsing-remitting multiple sclerosis. 视网膜神经纤维和神经节细胞复合体层厚度反映了复发缓解型多发性硬化症患者的脑萎缩。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.3233/RNN-211176
Paulina Glasner, Agnieszka Sabisz, Magdalena Chylińska, Jakub Komendziński, Adam Wyszomirski, Bartosz Karaszewski

Background: Multiple sclerosis (MS) is associated with progressive brain atrophy, which in turn correlates with disability, depression, and cognitive impairment. Relapsing-remitting multiple sclerosis (RRMS) is a type of MS in which relapses of the disease are followed by remission periods. This is the most common type of the disease. There is a significant need for easy and low-cost methods to these cerebral changes. Changes in retinal layer thickness may reflect alterations in brain white and gray matter volumes. Therefore, this paper aims to determine whether retinal layer thickness, measured using optical coherence tomography (OCT), correlates with volumetric brain assessments obtained by magnetic resonance imaging (MRI).

Methods: This retrospective cohort study recruited 53 patients with relapsing-remitting MS who underwent MRI and OCT examinations for evaluation of brain compartment volumes and thickness of retinal layers, respectively. OCT parameters, including central retinal thickness; retinal nerve fiber layer thickness (RNFL, peripapillary thickness); ganglion cell complex thickness (GCC, macular thickness); and Expanded Disability Status Scale (EDSS) results were compared with MRI parameters (cerebral cortex; cerebral cortex and basal ganglia combined; brain hemispheres without the ventricular system; and white matter plaques). We also checked whether there is a correlation between the number of RRMS and OCT parameters.

Objective: Our primary objective was to identify whether these patients had retinal thickness changes, and our secondary objective was to check if those changes correlated with the MRI brain anatomical changes.

Results: RNFL and GCC thicknesses were strongly (p-value < 0.05) associated with (i) cerebral cortex volume, (ii) combination of brain cortex and basal ganglia volumes, and (iii) the hemispheres but without the ventricular system. White matter plaques (combined) showed only weak or no correlation with RNFL and GCC. There was no correlation between central retinal thickness and brain compartment volumes, and there were weak or no correlations between the summary EDSS scores and OCT results.

Conclusions: Retinal layer thickness measured by OCT correlates with select volumetric brain assessments on MRI. During the course of RRMS, the anatomo-pathological structure of the retina might serve as a surrogate marker of brain atrophy and clinical progression within selected domains.

背景:多发性硬化症(MS)与进行性脑萎缩相关,而脑萎缩又与残疾、抑郁和认知障碍相关。复发缓解型多发性硬化症(RRMS)是多发性硬化症的一种类型,其中疾病复发后会出现缓解期。这是最常见的一种疾病。目前迫切需要一种简单、低成本的方法来治疗这些大脑变化。视网膜层厚度的变化可能反映了脑白质和灰质体积的变化。因此,本文旨在确定使用光学相干断层扫描(OCT)测量的视网膜层厚度是否与磁共振成像(MRI)获得的脑容量评估相关。方法:本回顾性队列研究招募了53例复发缓解型MS患者,他们分别接受了MRI和OCT检查,以评估脑室体积和视网膜层厚度。OCT参数,包括中央视网膜厚度;视网膜神经纤维层厚度(RNFL,乳头周围厚度);神经节细胞复合体厚度(GCC,黄斑厚度);和扩展残疾状态量表(EDSS)结果与MRI参数(大脑皮层;大脑皮层与基底节区合并;没有脑室系统的大脑半球;和白质斑块)。我们还检查了RRMS数目与OCT参数之间是否存在相关性。目的:我们的主要目的是确定这些患者是否有视网膜厚度变化,我们的次要目的是检查这些变化是否与MRI脑解剖变化相关。结论:OCT测量的视网膜层厚度与MRI对脑容量的评估具有相关性。在RRMS过程中,视网膜的解剖病理结构可以作为脑萎缩和特定领域临床进展的替代标志物。
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引用次数: 6
Activity dependent stimulation increases synaptic efficacy in spared pathways in an anesthetized rat model of spinal cord contusion injury. 在脊髓挫伤损伤的麻醉大鼠模型中,活性依赖性刺激增加了备用通路中的突触功效。
IF 2.8 4区 医学 Q2 Medicine Pub Date : 2022-01-01 DOI: 10.3233/RNN-211214
Jordan A Borrell, Dora Krizsan-Agbas, Randolph J Nudo, Shawn B Frost

Background: Closed-loop neuromodulation systems have received increased attention in recent years as potential therapeutic approaches for treating neurological injury and disease.

Objective: The purpose of this study was to assess the ability of intraspinal microstimulation (ISMS), triggered by action potentials (spikes) recorded in motor cortex, to alter synaptic efficacy in descending motor pathways in an anesthetized rat model of spinal cord injury (SCI).

Methods: Experiments were carried out in adult, male, Sprague Dawley rats with a moderate contusion injury at T8. For activity-dependent stimulation (ADS) sessions, a recording microelectrode was used to detect neuronal spikes in motor cortex that triggered ISMS in the spinal cord grey matter. SCI rats were randomly assigned to one of four experimental groups differing by: a) cortical spike-ISMS stimulus delay (10 or 25 ms) and b) number of ISMS pulses (1 or 3). Four weeks after SCI, ADS sessions were conducted in three consecutive 1-hour conditioning bouts for a total of 3 hours. At the end of each conditioning bout, changes in synaptic efficacy were assessed using intracortical microstimulation (ICMS) to examine the number of spikes evoked in spinal cord neurons during 5-minute test bouts. A multichannel microelectrode recording array was used to record cortically-evoked spike activity from multiple layers of the spinal cord.

Results: The results showed that ADS resulted in an increase in cortically-evoked spikes in spinal cord neurons at specific combinations of spike-ISMS delays and numbers of pulses. Efficacy in descending motor pathways was increased throughout all dorsoventral depths of the hindlimb spinal cord.

Conclusions: These results show that after an SCI, ADS can increase synaptic efficacy in spared pathways between motor cortex and spinal cord. This study provides further support for the potential of ADS therapy as an effective method for enhancing descending motor control after SCI.

背景:闭环神经调控系统作为治疗神经损伤和疾病的潜在治疗方法,近年来受到越来越多的关注。目的:本研究旨在评估由运动皮层记录的动作电位(尖峰)触发的椎管内微刺激(ISMS)在麻醉大鼠脊髓损伤(SCI)模型中改变下行运动通路突触功效的能力。方法:在T8中度挫伤的成年雄性Sprague-Dawley大鼠中进行实验。对于活动依赖性刺激(ADS)会话,使用记录微电极检测运动皮层中触发脊髓灰质ISMS的神经元尖峰。SCI大鼠被随机分配到四个实验组中的一个,其不同之处在于:a)皮层尖峰ISMS刺激延迟(10或25 ms)和b)ISMS脉冲的数量(1或3)。SCI后四周,连续三次进行为期1小时的ADS训练,共3小时。在每次条件反射训练结束时,使用皮质内微刺激(ICMS)评估突触功效的变化,以检查在5分钟的测试训练中脊髓神经元中诱发的尖峰数量。多通道微电极记录阵列用于记录脊髓多层皮层诱发的棘突活动。结果:在特定的尖峰ISMS延迟和脉冲数组合下,ADS导致脊髓神经元皮层诱发的尖峰增加。下行运动通路的疗效在后肢脊髓的所有背中央深度都得到了提高。结论:这些结果表明,SCI后,ADS可以提高运动皮层和脊髓之间备用通路的突触效能。本研究为ADS治疗作为增强SCI后下行运动控制的有效方法的潜力提供了进一步的支持。
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引用次数: 3
期刊
Restorative neurology and neuroscience
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