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Theta-gamma phase-amplitude coupling: physiological basics, analysis methods, and perspectives of translation into clinical practice θ - γ相幅耦合:生理基础、分析方法及临床应用的观点
Q3 Multidisciplinary Pub Date : 2022-12-23 DOI: 10.54101/acen.2022.4.9
A. Poydasheva, I. Bakulin, D. Sinitsyn, Alfiya H. Zabirova, D. Lagoda, N. Suponeva, M. Piradov
Studying rhythmic neural synchronization (cross-frequency coupling in various ranges) is an emerging topic in present-day neurophysiology. One of the best-studied cross-frequency couplings is theta-gamma phase-amplitude coupling that contributes to the cognitive function and may vary in patients with several conditions associated with cognitive impairment. Changes in theta-gamma coupling can be registered in a wide range of diseases associated with cognitive decline. The review covers the physiological basics of theta-gamma coupling, its registration and calculation, correlation with cognitive test results in healthy volunteers, and changes in patients. We have discussed the results of the preliminary studies of frequency-dependent non-invasive brain stimulation based on theta-gamma coupling.
研究节律性神经同步(不同范围的交叉频率耦合)是当今神经生理学的一个新兴课题。研究得最好的交叉频率耦合之一是θ - γ相位-振幅耦合,它有助于认知功能,并且在与认知障碍相关的几种情况下可能会有所不同。β - γ偶联的变化可以在一系列与认知能力下降相关的疾病中得到记录。本文综述了theta-gamma耦合的生理基础、其注册和计算、与健康志愿者认知测试结果的相关性以及患者的变化。我们讨论了基于theta-gamma耦合的频率依赖性非侵入性脑刺激的初步研究结果。
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引用次数: 1
Survival, cognitive functions, and brain MRI in patients with cSVD: 5-year observation cSVD患者的生存、认知功能和脑MRI: 5年观察
Q3 Multidisciplinary Pub Date : 2022-12-23 DOI: 10.54101/acen.2022.4.3
L. Dobrynina, Z. S. Gadzhieva, E. Kremneva, K. Shamtieva, M. M. Tsypushtanova, A. G. Makarova, V. V. Trubitsyna, E. T. Bitsieva, Aleksey S. Filatov, A. A. Byrochkina, M. Krotenkova
Introduction. Contributing to high disability and mortality, cerebral small vessel disease (cSVD) is a common condition in senior and elderly individuals. Objective: to assess the 5-year survival as well as cognitive and MRI changes in patients with cSVD and cognitive impairment (CI). Materials and methods. A prospective 5-year study included 54 patients (of them 37 women; mean age: 60.51 6.76 years) with cSVD, CIs, and white matter hyperintensities (WMHs; Fazekas 23). Twenty-two subjects were followed up to assess cognitive functions and a type of CI, cSVD MRI features, WMH, white and grey matter, and cerebrospinal fluid (CSF) volume as well as microstructural brain changes and correlate cognitive and MRI parameters at 5 years timepoint after the baseline. Results. Dementia developed in 14% of the subjects and 14% of the subjects died over a 5-year period. The subjects assessed twice had controlled hypertension (HTN). CIs worsened in the domain of executive functions and memory with mixed-type CI worsening. The follow-up showed that the WMH and CSF volume increased while the white matter volume decreased and axial diffusivity increased in the corpus callosum. The CSF volume correlated with the Stroop Test results and delayed memory (r = 0.803 and r = 0.701, respectively) and with white matter atrophy (r = 0.256) while the latter correlated with the axial diffusivity increased in the corpus callosum (r = 0.560). Conclusion. cSVD with advanced WMHs is associated with high mortality and dementia progression. General cognition assessment and MRI scan are not enough sensitive to assess disorder progression over a 5-year period. Stroop Test and Delayed 10-Word Recall Test results and transition to mixed-type CI indicate CI worsening and, therefore, can be used for the follow-up assessment. Cognitive decline in extensive cSVD is mediated by the brain matter atrophy and altered CSF circulation.
介绍。脑血管病(cSVD)是老年人的常见病,致残率和死亡率高。目的:评价cSVD合并认知功能障碍(CI)患者的5年生存率及认知和MRI变化。材料和方法。一项为期5年的前瞻性研究包括54例患者(其中37例女性;平均年龄:60.51岁(6.76岁),伴有心血管疾病、CIs和白质高信号(WMHs;法泽卡斯23)。22名受试者随访,评估基线后5年时间点的认知功能和CI类型、cSVD MRI特征、WMH、白质和灰质、脑脊液(CSF)体积、脑微结构变化及相关认知和MRI参数。结果。在5年的时间里,14%的研究对象患上了痴呆症,14%的研究对象死亡。两次评估的受试者均有高血压控制(HTN)。执行功能和记忆领域CI恶化,混合型CI恶化。随访显示胼胝体WMH和脑脊液体积增加,白质体积减少,轴向弥漫性增加。脑脊液体积与Stroop测试结果和延迟记忆相关(r = 0.803和r = 0.701),与脑白质萎缩相关(r = 0.256),脑白质萎缩与胼胝体轴向弥散性增加相关(r = 0.560)。结论。伴有晚期wmh的cSVD与高死亡率和痴呆进展相关。一般认知评估和MRI扫描对评估5年期间的疾病进展不够敏感。Stroop测试和延迟10字回忆测试结果以及向混合型CI的过渡表明CI恶化,因此可以用于后续评估。广泛性脑血管病的认知能力下降是由脑物质萎缩和脑脊液循环改变介导的。
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引用次数: 1
Insomnia and its management in patients with panic disorder 惊恐障碍患者的失眠及其处理
Q3 Multidisciplinary Pub Date : 2022-12-23 DOI: 10.54101/acen.2022.4.8
E. Korabelnikova, E. Yakovleva
Sleep disorder, especially insomnia, is one of the most common panic disorder (PanD) comorbidities, with PanD and insomnia being closely related. PanD severity is definitely associated with sleep disorder while sleep disorder is caused by abnormal anxiety. Insomnia management in PanD patients is based on a multidisciplinary approach to achieve emotional balance and includes both medicinal treatment and a wide range of psychotherapy methods. Successful insomnia management contributes to the effectiveness of PanD therapy, reduces relapse probability, and improves susceptibility to many anxiolytics.
睡眠障碍,尤其是失眠,是惊恐障碍(PanD)最常见的合并症之一,PanD与失眠密切相关。PanD的严重程度肯定与睡眠障碍有关,而睡眠障碍是由异常焦虑引起的。PanD患者的失眠管理基于多学科方法来实现情绪平衡,包括药物治疗和广泛的心理治疗方法。成功的失眠管理有助于PanD治疗的有效性,减少复发的可能性,并改善对许多抗焦虑药的易感性。
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引用次数: 0
The structural patterns of the potentiation and the blockade of inhibitory cys-loop receptors through the transmembrane domain 通过跨膜结构域增强和阻断抑制性cys-loop受体的结构模式
Q3 Multidisciplinary Pub Date : 2022-12-23 DOI: 10.54101/acen.2022.4.6
A. Rossokhin
Anion-conducting cys-loop receptors activated by -aminobutyric acid (GABAАRs) and glycine (GlyRs) have inhibitory activity in the brain and spinal cord. GABAАRs and GlyRs are targets for various substances that potentiate or inhibit the receptor functions. Many of these substances are clinically significant agents to treat neurological and psychiatric conditions. The review covers both our results and literature data on electrophysiology, mutations, and biochemistry of non-competitive antagonists, general anesthetics, barbiturates, and fenamates modulating GABAАRs and GlyRs. We focused on our own molecular modeling to determine the sites and the characteristics of binding of these substances to the GABAАR and GlyR transmembrane domain. With the structural patterns of the binding, we have identified possible molecular mechanisms of action for these substances.
阴离子传导的-氨基丁酸(GABAАRs)和甘氨酸(GlyRs)激活的cys-loop受体在脑和脊髓中具有抑制活性。GABAАRs和GlyRs是增强或抑制受体功能的各种物质的靶标。这些物质中有许多是治疗神经和精神疾病的临床重要药物。这篇综述涵盖了我们的结果和非竞争性拮抗剂、全麻药、巴比妥酸盐和雌胺酸盐调节GABAАRs和GlyRs的电生理学、突变和生物化学方面的文献数据。我们将重点放在我们自己的分子模型上,以确定这些物质与GABAАR和GlyR跨膜结构域结合的位点和特征。通过结合的结构模式,我们已经确定了这些物质可能的分子作用机制。
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引用次数: 0
Differential diagnosis of stroke and vestibular neuritis in emergency neurology 急诊神经内科卒中与前庭神经炎的鉴别诊断
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.3
A. A. Monak, A. Kulesh, V. Parfenov, P. Astanin
Introduction. The differential diagnosis of vertebrobasilar stroke (VBS) and vestibular neuritis (VN) is important challenge for a neurologist when a patient presents to the emergency department with acute vertigo. Current approaches and algorithms of management need to be modified, taking into account clinical practice. The aim of the study was to identify the clinical features of acute vestibular syndrome that are the most helpful in the differential diagnosis of VBS and VN. Materials and methods. We examined 80 emergency admissions to the neurological ward with suspected stroke. A detailed otoneurological examination (including the STANDING and HINTS+ algorithms) and brain imaging (DWI MRI) were performed. Results. Out of 80 patients, 26 were diagnosed with VBS, 30 with VN, 11 with vestibular migraine and 2 with Meniere's disease, while the cause of vertigo could not be determined in 11 patients. The most powerful indicator of VBS in the differential diagnosis was gaze-evoked nystagmus, which had a 15.9-fold association with VBS. An increased likelihood of VBS was also associated with unsteadiness (6.3 times), age over 58 years (4.1 times), dysmetria in the finger-to-nose test (3.7 times), adiadochokinesia (3.1 times), and trunk ataxia (3 times). An increased likelihood of VN was associated with a positive unilateral head impulse test (6 times), nystagmus that followed Alexander's law (3.7 times), and presence of nausea (2.5 times). A model was developed for the differential diagnosis of VBS and VNin patients presenting with acute vertigo. The model accuracy was 100% in the validation sample. Conclusions. Clinical approach remains crucial when differentiating between VBS and VN. The most useful criteria for a differential diagnosis in emergency neurology were the patient's age, the type of nystagmus, head impulse test, and cerebellar dysfunction.
介绍。当急性眩晕患者出现在急诊科时,椎基底卒中(VBS)和前庭神经炎(VN)的鉴别诊断是神经科医生面临的重要挑战。目前的方法和算法的管理需要修改,考虑到临床实践。本研究的目的是确定急性前庭综合征的临床特征,这些特征对VBS和VN的鉴别诊断最有帮助。材料和方法。我们检查了80名疑似中风的神经病房急诊病人。进行详细的耳神经检查(包括STANDING和HINTS+算法)和脑成像(DWI MRI)。结果。在80例患者中,26例被诊断为VBS, 30例被诊断为VN, 11例被诊断为前庭偏头痛,2例被诊断为梅尼埃病,而11例患者的眩晕原因无法确定。在鉴别诊断中,VBS最有力的指标是凝视诱发的眼球震颤,与VBS有15.9倍的相关性。VBS的可能性增加还与不稳定(6.3倍)、年龄超过58岁(4.1倍)、手指到鼻子测试中的测量障碍(3.7倍)、脂肪运动障碍(3.1倍)和躯干共济失调(3倍)相关。VN的可能性增加与单侧头部冲动测试阳性(6次)、亚历山大定律下的眼球震颤(3.7次)和恶心(2.5次)有关。建立了以急性眩晕为表现的VBS和VNin患者的鉴别诊断模型。在验证样本中,模型准确率为100%。结论。临床方法仍然是区分VBS和VN的关键。在急诊神经病学中,鉴别诊断最有用的标准是患者的年龄、眼球震颤的类型、头部冲动试验和小脑功能障碍。
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引用次数: 0
The myoprotective effect of non-quantal acetylcholine: in vitro model of the myopathy component of chronic inflammatory demyelinating polyneuropathy 非量子乙酰胆碱的肌肉保护作用:慢性炎性脱髓鞘性多发性神经病肌病成分的体外模型
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.5
A. V. Gavrichenko, N. A. Pasatetckaia, Maria G. Sokolova, E. Lopatina
Introduction. Chronic inflammatory demyelinating polyneuropathy (CIDP) is one of the most common primary polyneuropathies. A degenerative process is the underlying cause of muscular atrophy in CIDP, while muscle strength may not fully recover in patients after pathogenesis-based treatment, thus extending the period of disability. Information about factors affecting the trophic function of muscles can be used to treat neuromuscular disorders. Study aim to examine the trophotropic properties of the study participants' blood plasma and the myoprotective effect of acetylcholine concentration equivalent to non-quantal release, using an in vitro model of the myopathy component of CIDP. Materials and methods. The study included 25 patients diagnosed with typical CIDP in accordance with the EFNS/PNS 2010 criteria. The control group consisted of 25 healthy individuals. Serum antibody levels to the nicotinic acetylcholine receptor were measured in all study participants. A method for organotypic cultivation of skeletal muscle tissue and an in vitro model of the myopathy component of CIPD were developed. The effect of the study participants' blood plasma on the growth of skeletal muscle explants in organotypic culture was assessed. Results. Patients with CIPD were found to have symmetrical sensorimotor polyneuropathy of varying severity (100%); muscle atrophy (88%), and sensory ataxia (84%). The median INCAT Overall Disability Sum Score was 2 [1; 3] for the arms and 3 [2; 5] for the legs. The median Neurological Impairment Scale (NIS) score was 17 [10; 34]. The nicotinic acetylcholine receptor antibody levels were higher in patients with CIDP (0.47 [0.31; 0.54] nmol/l) than in the control group (0.02 [0.01; 0.03] nmol/l). For the first time, a myotoxic effect of the blood plasma from patients with CIDP was observed in organotypic skeletal muscle culture. Using 1:70 and 1:100 dilutions, patient blood plasma inhibited the growth of explants by 27% (n = 120; p 0.001) and 21% (n = 120; p 0.001), respectively. This myotoxic effect removed acetylcholine at a concentration equivalent to non-quantal release (108 М). Conclusion. These results expand our understanding of skeletal muscle damage in CIPD and the role of non-quantal acetylcholine in regulating skeletal muscle growth.
介绍。慢性炎性脱髓鞘性多神经病变(CIDP)是最常见的原发性多神经病变之一。退行性过程是CIDP中肌肉萎缩的根本原因,而在基于病因的治疗后,患者的肌肉力量可能无法完全恢复,从而延长了残疾期。有关影响肌肉营养功能的因素的信息可用于治疗神经肌肉疾病。研究目的:通过体外模型研究受试者血浆的营养特性,以及等效于非定量释放的乙酰胆碱浓度对肌肉的保护作用。材料和方法。该研究纳入了25例按照EFNS/PNS 2010标准诊断为典型CIDP的患者。对照组由25名健康个体组成。在所有研究参与者中测量了烟碱乙酰胆碱受体的血清抗体水平。建立了骨骼肌组织器官型培养方法和CIPD肌病成分体外模型。评估了研究参与者的血浆对器官型培养骨骼肌外植体生长的影响。结果。CIPD患者有不同程度的对称感觉运动多神经病变(100%);肌肉萎缩(88%),感觉共济失调(84%)。INCAT总残疾积分中位数为2 [1];3]代表手臂,3 [2;[5]腿部。神经功能损害量表(NIS)中位评分为17 [10];34)。烟碱乙酰胆碱受体抗体水平在CIDP患者中较高(0.47;0.54] nmol/l)比对照组(0.02 [0.01;0.03 nmol / l)。首次在器官型骨骼肌培养中观察到CIDP患者血浆的肌毒性作用。使用1:70和1:100稀释,患者血浆对外植体生长的抑制作用为27% (n = 120;P 0.001)和21% (n = 120;P 0.001)。这种肌毒性作用以相当于非量释放的浓度去除乙酰胆碱(108 М)。结论。这些结果扩大了我们对CIPD骨骼肌损伤和非量乙酰胆碱在调节骨骼肌生长中的作用的理解。
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引用次数: 0
The cerebrovascular, neuroprotective and antiarrhythmic properties of the anxiolytic fabomotizole 抗焦虑药法莫替唑的脑血管、神经保护和抗心律失常特性
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.8
R. Mirzoyan, Marine G. Balasanyan, Hakop V. Topchyan, V. Hakobyan, T. S. Gan'shina, Nikita A. Khaylov, I. N. Kurdyumov, A. I. Turilova, Тatyana A. Antipova, Valentina A. Kraineva, S. Seredenin
Aim. To examine the cerebrovascular, neuroprotective and antiarrhythmic properties of fabomotizole (brand name Afobazole). Materials and methods. A comprehensive study of fabomotizole's effects on the blood supply, morphology and neuropsychology of the rat brain in various experimental disorders. We recorded cerebral blood flow and studied brain morphology in models of local permanent and global transient ischaemia, haemorrhagic brain damage, combined cerebrovascular and cardiovascular pathology, cardiac arrhythmias, and assessed the neuropsychological status. We measured the levels of GABA, glutamic acid, nerve growth factor, and heat shock protein (HSP70). Results. Fabomotizole improves blood supply, limits the area of injury, normalizes pathological brain changes in localized cerebral ischaemia, and eliminates neuropsychological damage in models of ischaemic and haemorrhagic stroke. The drug increases cerebral blood flow in ischaemic and haemorrhagic stroke, myocardial infarction and, to a greater extent, in combined cerebrovascular and coronary disease. Fabomotizole acts through the cerebrovascular GABAAergic system, as well as having significant antiarrhythmic properties. Conclusions. Fabomotizole should be considered not only as an anxiolytic, but also as a drug with potential clinical efficacy in cerebrovascular disease, with concomitant coronary disease and cardiac arrhythmias.
的目标。目的:探讨法莫替唑(商品名:阿伏巴唑)的脑血管、神经保护和抗心律失常特性。材料和方法。法莫替唑对各种实验性疾病大鼠脑血供、形态学和神经心理影响的综合研究。我们记录脑血流,研究局部永久性和全面性短暂性缺血、出血性脑损伤、脑血管心血管合并病理、心律失常模型的脑形态学,并评估神经心理状态。我们测量了GABA、谷氨酸、神经生长因子和热休克蛋白(HSP70)的水平。结果。法莫替唑改善血液供应,限制损伤区域,使局部脑缺血的病理性脑改变正常化,并消除缺血性和出血性中风模型中的神经心理损伤。该药增加缺血性和出血性中风、心肌梗死的脑血流量,并在更大程度上增加脑血管和冠状动脉合并疾病的脑血流量。法莫替唑通过脑血管gaba能系统起作用,并具有显著的抗心律失常特性。结论。法莫替唑不仅是一种抗焦虑药,而且在脑血管疾病、合并冠心病和心律失常中也有潜在的临床疗效。
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引用次数: 0
Inflammation and endothelial toxicity: pathogenetic aspects of central nervous system damage due to novel coronavirus disease 炎症和内皮毒性:新型冠状病毒病引起的中枢神经系统损伤的病理方面
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.2
M. V. Prokhorova, A. Yakovlev, I. Voznyuk, E. M. Morozova, E. A. Gogoleva, L. Pivovarova
Introduction. There are inconsistent data on the incidence of stroke in patients with COVID-19, including acute cerebrovascular accidents in younger people without obligate risk factors, as well as the risk of SARS-CoV-2 infection in patients with acute stroke. The aim of the study was to evaluate the features of concomitant stroke and COVID-19, and the role of inflammation and endothelial toxicity in cerebral damage. Materials and methods. The study included 1,524 patients admitted to vascular clinics across St. Petersburg in 20202021, including 1,068 people with confirmed COVID-19 infection and 551 death cases. The patients were divided into four groups depending on disease severity, for clinical and laboratory data analysis. Results. There were marked changes in the laboratory markers of inflammation, haemostasis, fibrinolysis, cytolysis, iron metabolism, cerebral ischaemia, proteolysis, immunodeficiency (lymphocytopenia, monocytopenia, elevated white blood cell count, elevated levels of C-reactive protein, fibrinogen, D-dimer, creatine kinase, ferritin and neutrophil elastase), with statistically significant differences when compared with patients without COVID-19. Changes in inflammatory markers in the first 2472 hours provided the most information. A multifold increase (escalation) in the marker values was always correlated with an imminent adverse outcome and was usually accompanied by subsequent laboratory confirmation of COVID-19 infection or specific signs of viral pneumonia. Conclusion. COVID-19 should be considered an independent risk factor for acute stroke, while the virus-induced thrombosis, manifesting in an escalation in inflammatory factors and products of endothelial damage, should be considered a pathogenetic link leading to cerebral tissue damage.
介绍。关于COVID-19患者卒中发生率的数据不一致,包括无特定危险因素的年轻人发生急性脑血管事故,以及急性卒中患者感染SARS-CoV-2的风险。本研究的目的是评估合并卒中和COVID-19的特征,以及炎症和内皮毒性在脑损伤中的作用。材料和方法。该研究包括20202021年圣彼得堡血管诊所收治的1524名患者,其中包括1068名确诊的COVID-19感染者和551例死亡病例。根据疾病严重程度将患者分为四组,用于临床和实验室数据分析。结果。炎症、止血、纤维蛋白溶解、细胞溶解、铁代谢、脑缺血、蛋白溶解、免疫缺陷(淋巴细胞减少症、单核细胞减少症、白细胞计数升高、c反应蛋白、纤维蛋白原、d -二聚体、肌酸激酶、铁蛋白、中性粒细胞弹性酶水平升高)等实验室指标发生显著变化,与无COVID-19患者相比差异有统计学意义。前2472小时炎症标志物的变化提供了最多的信息。标记值的倍数增加(升级)总是与即将发生的不良结果相关,并且通常伴随着随后的实验室确认COVID-19感染或病毒性肺炎的特定体征。结论。COVID-19应被视为急性卒中的独立危险因素,而病毒诱导的血栓形成,表现为炎症因子和内皮损伤产物的升级,应被视为导致脑组织损伤的病理环节。
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引用次数: 0
Risk factors for falls in different age groups of patients with chronic cerebral ischaemia 不同年龄组慢性脑缺血患者跌倒的危险因素
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.1
Lyudmila A. Geraskina, Amina A. Galaeva, Rabiyat D. Sheikhova, A. Fonyakin, M. Maksimova
Introduction. Cognitive impairment, gait and balance disorders are the most important risk factors for falls in older persons. These neurological impairments are the main clinical manifestations of chronic cerebral ischaemia (CCI), and can develop at a younger age. Aim: to evaluate the risk factors for falls in patients with CCI in different age groups and to identify the most significant predictors of falls. Materials and methods. We examined 104 patients with CCI. Patients were divided into three age groups: middle age (4059 years old; n = 13), older age (6074 years old; n = 62), and the elderly (75 years and older; n = 29). We assessed the frequency of falls and the presence of risk factors. Results. Thirty-seven (36%) patients had a history of falls, with its incidence increasing from 8% in the middle-aged group to 37% in the older persons and 45% in the elderly. Some patients had multiple risk factors for falls, while the presence of 5 risk factors increased the risk of falling fourfold. The most common factors in middle age were pain due to degenerative spine conditions (85%), anxiety (54%), and visual impairment (31%); in older age back pain (77%), cognitive impairment (45%), visual impairment (39%), and decreased walking speed (23%); in the elderly visual impairment (76%), cognitive impairment (69%), back pain (69%), decreased walking speed (38%), and orthostatic hypotension (28%). Discriminant analysis revealed that the best predictors of falls in CCI were female sex, age over 69 years, depression, cognitive impairment, and a walking speed below 1 m/sec. Conclusion. Falls were observed in all age groups of people with CCI. Not only the presence of a specific risk factor for falls, but the presence of multiple risk factors, has predictive value. The presence of five or more risk factors, as well as a walking speed below 1 m/sec, can indicate a high risk of falls.
介绍。认知障碍、步态和平衡障碍是老年人跌倒的最重要危险因素。这些神经损伤是慢性脑缺血(CCI)的主要临床表现,并且可以在较年轻的年龄发展。目的:评估不同年龄组CCI患者跌倒的危险因素,并确定最重要的跌倒预测因素。材料和方法。我们检查了104例CCI患者。患者分为三个年龄组:中年(4059岁;N = 13),老年(6074岁;N = 62),老年人(75岁及以上;N = 29)。我们评估了跌倒的频率和危险因素的存在。结果。37例(36%)患者有跌倒史,其发生率从中年组的8%增加到老年人的37%和老年人的45%。一些患者有多种跌倒危险因素,而5种危险因素的存在使跌倒风险增加了4倍。中年人最常见的原因是脊柱退行性疾病引起的疼痛(85%)、焦虑(54%)和视力障碍(31%);老年人背痛(77%)、认知障碍(45%)、视力障碍(39%)和行走速度减慢(23%);老年人视力障碍(76%)、认知障碍(69%)、背痛(69%)、行走速度减慢(38%)和体位性低血压(28%)。判别分析显示,女性、年龄大于69岁、抑郁、认知障碍和步行速度低于1 m/sec是CCI下降的最佳预测因子。结论。在所有年龄组的CCI患者中均观察到跌倒。不仅存在特定的跌倒风险因素,而且存在多种风险因素,具有预测价值。如果存在5个或更多的危险因素,以及步行速度低于1米/秒,则表明跌倒的风险很高。
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引用次数: 0
Effects of tumor necrosis factor α on the structure of brain networks and cognitive functions in patients with chronic cerebral ischemia 肿瘤坏死因子α对慢性脑缺血患者脑网络结构及认知功能的影响
Q3 Multidisciplinary Pub Date : 2022-10-10 DOI: 10.54101/acen.2022.3.4
Vitaliy F. Fokin, Аlla А. Shabalina, N. Ponomareva, R. Konovalov, R. Medvedev, O. Lagoda, M. Krotenkova, M. Tanashyan
Introduction. The processes of cognitive decline, which are typical for elderly and senile people, as well as for patients with chronic cerebral circulation insufficiency, involve pro-inflammatory cytokines, such as tumor necrosis factor (TNF-), interleukin-6, etc. The aim of this work was to study the association of TNF- with brain network structure and cognitive functions in patients with chronic cerebral ischemia (CCI). Materials and methods. We examined 101 patients with CCI (5085 years old, men and women) who were assessed for the saliva levels of TNF- during cognitive testing. The status of resting-state networks was analyzed in 55 patients using functional magnetic resonance therapy. Results. After cognitive tasks, the saliva level of TNF- increased by 17.6 6.2 pg/mL. Half of the CCI patients older than 60 years showed a significant increase in the level of TNF-. This cytokine correlated with delayed word recall and the ratio of delayed recall to their performance on the Luria Memory Words Test. The change in TNF- saliva levels correlated with the status of the resting-state network, mainly with the salience network. An increase in TNF- levels was associated with a higher frequency of negative correlations than at lower values of TNF- (less than 80 pg/mL). TNF--sensitive connectivities correlated with cognitive tasks, not only memory tests, but also with the Montreal Cognitive Assessment Scale, verbal fluency test scores, etc. Discussion. The study revealed two significant facts: an increase in the TNF- saliva level during cognitive performance and a lower success rate of cognitive performance associated with an increase in the levels of this cytokine. The central mechanism for the implementation of this relationship includes the restructuring of the salience network, namely the additional increase of negative correlations within the connective structure of the salience neural network of the right hemisphere. Conclusions. A change in the saliva level of TNF- affects the connectivity of resting-state networks, mainly the salience network
介绍。认知能力下降的过程涉及促炎因子,如肿瘤坏死因子(TNF-)、白细胞介素-6等,是老年人和慢性脑循环不全患者的典型特征。本研究的目的是研究TNF-与慢性脑缺血(CCI)患者脑网络结构和认知功能的关系。材料和方法。我们检查了101例CCI患者(5085岁,男性和女性),在认知测试期间评估了唾液中TNF-的水平。对55例应用功能磁共振治疗的患者进行静息状态网络状态分析。结果。认知任务后,唾液中TNF-水平升高17.6 - 6.2 pg/mL。在60岁以上的CCI患者中,有一半的患者TNF-水平显著升高。这个细胞因子与延迟回忆单词和延迟回忆与他们在Luria记忆单词测试中的表现的比率相关。TNF-唾液水平的变化与静息状态网络的状态相关,主要与显著性网络相关。TNF-水平升高与较低TNF-值(低于80 pg/mL)时的负相关频率较高。TNF敏感连接与认知任务相关,不仅与记忆测试相关,还与蒙特利尔认知评估量表、语言流畅性测试分数等相关。讨论。该研究揭示了两个重要的事实:认知表现期间TNF-唾液水平的增加和认知表现的较低成功率与该细胞因子水平的增加有关。实现这种关系的核心机制包括显著性网络的重构,即右半球显著性神经网络连接结构中负相关的额外增加。结论。唾液中TNF-水平的变化影响静息状态网络的连通性,主要是显著性网络
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Annals of Clinical and Experimental Neurology
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