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Application of the life-size patient-specific three-dimensional cervical spine anatomical model for odontoid fracture fixation 真人大小患者特异性三维颈椎解剖模型在齿状突骨折固定中的应用
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-07-01 DOI: 10.4103/nsn.nsn_160_20
E. Ozgiray, M. Özer, Suzan Şirintürk, Figen Gùvsa, Emre Dursun, C. Eraslan, S. Hepgüler
Objective: Cervical fixation is the most common treatment of vertebral fractures, osteosarcoma, osteomyelitis, arthritis, and congenital disorders. Mortal complications, such as internal carotid artery, vertebral artery (VA), and spinal cord damages, may occur during the application. The aim of this study was to create the application of the actual three-dimensional (3D) personalized model which was exercised for screwing insertion in C2 damage patients. Methods: Two patients with Type II of C2 fractures were treated with personalized spine models. These models were investigated to achieve particular information of non- and bony elements such as the highness, thickness, and the field of pedicles and vascular diameters for an intraoperative reference. The model was to determine the probable variations and to observe the success of screw rate in the treatment of C2 fractures. The operation duration, instrumentation time, blood loss volume, and clinical and radiological assessment were done. The 3D model's perception was evaluated. Results: Cervical models were defined to secure intervention areas of the VA pedicles and screws. Neither vascular nor neurologic damages were happened in all cases. Besides, the cases did not include broken nails, screw pullout, fracture of bone structure, or infection. Cervical models demonstrated (1) examination of the VA pattern, (2) valuation of virtual screw trajectory line before screw fixation, (3) the application of prebent rods during procedure to contribute to the safety of the posterior instrumentation, (4) postsurgical confirmation, and (5) examined movements of the neck postoperatively. The perception of 3D model for treating C2 fracture was thereby diminishing surgical time, bleeding amount and operative complications. Survey perception of model was calculated in statistical significance (P < 0.05). Conclusion: Personalized model is active and confident in achieving an accurate and safe screw fixation during surgery, especially in anatomically abnormal cases. Cervical model provides an accurate representation of the fracture location, pedicle size, and VA shapes. It is therefore useful in surgical planning as it maximizes the possibility of ideal screw position, as well as providing individualized information concerning cervical spinal anatomy.
目的:颈椎固定是椎体骨折、骨肉瘤、骨髓炎、关节炎和先天性疾病最常见的治疗方法。在应用过程中可能发生致命并发症,如颈内动脉、椎动脉(VA)和脊髓损伤。本研究的目的是建立实际三维(3D)个性化模型的应用,并将其应用于C2损伤患者的螺钉置入。方法:对2例II型C2骨折患者进行个性化脊柱模型治疗。研究这些模型是为了获得非骨元素的特定信息,如高度、厚度、椎弓根场和血管直径,以供术中参考。该模型旨在确定可能的变化,并观察螺钉率治疗C2骨折的成功率。观察手术时间、器械时间、出血量、临床及影像学评价。评估三维模型的感知能力。结果:定义了颈椎模型,以固定VA椎弓根和螺钉的介入区域。所有病例均未发生血管或神经损伤。此外,这些病例不包括指甲折断、螺钉拔出、骨结构骨折或感染。颈椎模型展示了(1)对VA模式的检查,(2)在螺钉固定前对虚拟螺钉轨迹线的评估,(3)在手术过程中使用预弯曲棒以促进后路内固定的安全性,(4)术后确认,(5)术后检查颈部运动。采用三维模型治疗C2骨折,减少了手术时间、出血量和手术并发症。模型的调查知觉计算有统计学意义(P < 0.05)。结论:个性化模型对手术中实现准确、安全的螺钉固定具有积极和自信的作用,特别是在解剖异常的病例中。颈椎模型提供骨折位置、椎弓根大小和VA形状的准确表示。因此,它在手术计划中是有用的,因为它最大限度地提高了理想螺钉位置的可能性,并提供了有关颈椎解剖的个性化信息。
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引用次数: 0
Normative Values of Transcranial Magnetic Stimulation-Evoked Parameters for Healthy Developing Children and Adolescents 经颅磁刺激诱发参数对健康发育儿童和青少年的正常值
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/NSN.NSN_94_20
H. Tekgul, U. Saz, M. Polat, Nurdan Tekgul, T. Kose
Context: Normative data-containing transcranial magnetic stimulation (TMS) evoked parameters are essential for correctly interpreting healthy development and assessing neuroplastic changes in certain neurologic disorders. Aims: The aim is to investigate corticospinal pathways by applying TMS to healthy developing children and adolescents. Settings and Design: In this cross-sectional study, we measured TMS evoked parameters associated with cortical and spinal stimulation obtained from the four extremities of 46 healthy children and adolescents (21 boys and 25 girls; mean ± standard deviation age: 6.4 ± 1.2 years; range: 3.0–20.5 years). Statistical Analysis: Spearman's correlation coefficients were calculated for each variable (weight and height) as a function of motor evoked potential (MEP) response latency and central motor conduction time (CMCT). Pearson's Chi-square test was used to determine the inter-variable correlations. Results: Latencies of MEPs were correlated with age (P < 0.001, r = 0.6948) and height (P < 0.006, r = 0.7994). Amplitudes of active-state MEPs were significantly higher than those of resting-state MEPs associated with the upper and lower extremities. The mean values for active-state MEP latencies were lower than those for resting-state MEPs. The CMCT and magnitudes of latency jumps were calculated using reliable MEP data for children and adolescents. Additionally, the unresponsiveness rates were significantly higher for children aged below 7 years. Conclusion: The TMS evoked parameters investigated in this study are necessary to accurately assess corticospinal pathway development in healthy children and adolescents.
背景:包含经颅磁刺激(TMS)诱发参数的规范数据对于正确解释某些神经系统疾病的健康发育和评估神经可塑性变化至关重要。目的:利用经颅磁刺激研究健康发育的儿童和青少年的皮质脊髓通路。背景和设计:在这项横断面研究中,我们测量了46名健康儿童和青少年(21名男孩和25名女孩;平均±标准差年龄:6.4±1.2岁;范围:3.0-20.5年)。统计分析:计算各变量(体重和身高)与运动诱发电位(MEP)反应潜伏期和中枢运动传导时间(CMCT)的Spearman相关系数。采用皮尔逊卡方检验确定变量间的相关性。结果:MEPs潜伏期与年龄(P < 0.001, r = 0.6948)、身高(P < 0.006, r = 0.7994)相关。与上肢和下肢相关的激活状态MEPs的振幅显著高于静息状态MEPs的振幅。激活状态MEP潜伏期的平均值低于静息状态MEP潜伏期的平均值。使用可靠的MEP数据计算儿童和青少年的CMCT和潜伏期跳跃幅度。此外,7岁以下儿童的无反应率明显较高。结论:本研究所研究的经颅磁刺激诱发参数对于准确评估健康儿童和青少年皮质脊髓通路发育是必要的。
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引用次数: 0
Migraine and frontostriatal circuit disorders: What have we learned until now? 偏头痛和额纹状体回路障碍:到目前为止我们学到了什么?
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/nsn.nsn_9_21
A. Ozge, H. Genç, G. Aksu, D. Uludüz
Even though there is a recognized association, the causation between chronic migraine (CM) and frontostriatal circuit (FSC) disorders that were commonly presented as anxiety disorders, depression, tic disorders, and attention-deficit hyperactivity disorders in routine headache outpatient is yet to be fully disclosed. Medication-overuse headache (MOH) and CM recognizedly affect complex neural systems, including the FSC. Referenced circuits constitute a part of a circle that consists of the cortex, striatum, and thalamus regions and they transmit the data from the cerebral cortex to the subcortex. The above-mentioned circles end up once again in the determined region of the cerebral cortex. Five different FSCs have been described above which circulate among the specific parts of the cortex, namely supplementary motor area, frontal eye fields, dorsolateral prefrontal cortex, lateral orbitofrontal cortex, and anterior cingulate cortex with various subconnections and serve to various functions. Based on the scientific data with an emphasis on the clinical perspective, this paper aims to show the potential causative relationship between common FSC disorders and CM with or without MOH. The results also highlighted the importance of psychiatric comorbidities, as being far from a coincidence, and promoted the application of preventive medicine and interventions including lifestyle changes, cognitive–behavioral treatment, and neuromodulation. Integrative and multidisciplinary management strategies are essential for a comprehensive migraine coping approach in the society.
尽管存在公认的关联,但慢性偏头痛(CM)和额纹状体回路(FSC)疾病之间的因果关系尚未完全揭示,这些疾病在常规头痛门诊中通常表现为焦虑症、抑郁症、抽动障碍和注意力缺陷多动障碍。药物过度使用头痛(MOH)和CM会影响复杂的神经系统,包括FSC。参考电路构成了一个由皮层、纹状体和丘脑区域组成的圆圈的一部分,它们将数据从大脑皮层传输到皮层下。上述圆圈再次出现在大脑皮层的确定区域。上面已经描述了五种不同的FSC,它们在皮层的特定部分之间循环,即补充运动区、额视野、背外侧前额叶皮层、外侧眶额皮层和具有各种亚连接的前扣带皮层,并起到各种功能。基于科学数据,重点从临床角度,本文旨在揭示常见FSC疾病与伴有或不伴有MOH的CM之间的潜在致病关系。研究结果还强调了精神病合并症的重要性,因为这远不是巧合,并促进了预防医学和干预措施的应用,包括生活方式的改变、认知-行为治疗和神经调控。综合和多学科的管理策略对于社会上全面应对偏头痛的方法至关重要。
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引用次数: 7
Anti-Myelin Oligodendrocyte Glycoprotein-Associated Disease with Recurrent Tumefactive Demyelinating Lesions 抗髓鞘少突细胞糖蛋白相关疾病伴复发性肿瘤性脱髓鞘病变
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/nsn.nsn_161_20
H. Ozdemir, C. Eraslan, A. Gökçay, F. Gökçay
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引用次数: 0
Evaluation of the ascending utricular and descending saccule pathway using cervical vestibular evoked myogenic potential and ocular vestibular evoked myogenic potential in diabetic polyneuropathy 应用颈前庭诱发肌源性电位和眼前庭诱发肌原性电位评价糖尿病多发性神经病的升囊和降囊状通路
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/NSN.NSN_155_20
O. Akan, G. Berkiten, B. Tutar, S. Karaketir, Ö. Tuna
Background: Chronic hyperglycemia can affect the vestibular system by causing injury in cells and neural structures. In addition to alterations in the microvasculature and connective tissues, changes in inner ear fluid metabolism can also contribute to otolithic damage in patients with diabetes. We aimed to evaluate the effects of neurovascular degeneration occurring in diabetic polyneuropathy (DPN) on the vestibular system. Methods: Thirty-five patients with DPN (n = 70 ears) and 34 (n = 68 ears) healthy controls were enrolled. Patients were classified into two subgroups as sensorial axonal PNP and sensory-motor axonal PNP. To assess vestibular functions, cervical vestibular evoked myogenic potential (cVEMP) and ocular vestibular evoked myogenic potential (oVEMP) testing were bilaterally performed. Results: Bilateral cVEMP and oVEMP P1 latency and N1 latency were significantly prolonged, whereas amplitude values were significantly decreased in patients with DPN compared with the controls (P = 0.001). The cVEMP amplitude asymmetry ratio (AAR) was statistically higher in the DPN group than in controls (P = 0.001); oVEMP AAR was not significant between the patient and control groups (P = 0.095). The cVEMP AAR values were found to be increased in both patient subgroups, and oVEMP AAR was elevated in the sensorineural PNP subgroup. In the DPN group, the nonresponse rate was 48.6% (n = 17) in cVEMP and 51.4% (n = 18) in oVEMP, significantly higher compared with the controls (P < 0.05). In cVEMP, nonresponse rates were found to be lower in both DPN subgroups. In oVEMP, the nonresponse rate was found to be higher in the sensory-motor PNP subgroup when compared with the sensorial PNP subgroup (P = 0.008 and P = 0.003, respectively). Conclusion: In diabetes mellitus with multisystemic effects, particularly in patients with polyneuropathy, vestibular testing before the onset of vestibular symptoms may be an early and beneficial diagnostic method for detecting the presence or degree of neurovascular degeneration.
背景:慢性高血糖可通过损伤细胞和神经结构来影响前庭系统。除了微血管和结缔组织的改变外,内耳液代谢的变化也会导致糖尿病患者的耳石损伤。我们旨在评估糖尿病多发性神经病(DPN)中发生的神经血管变性对前庭系统的影响。方法:纳入35例DPN患者(n=70耳)和34例健康对照组(n=68耳)。患者分为感觉轴索PNP和感觉运动轴索PNP。为了评估前庭功能,双侧进行颈前庭诱发肌原电位(cVEMP)和眼前庭诱发肌源电位(oVEMP)测试。结果:与对照组相比,DPN患者双侧cVEMP和oVEMP P1潜伏期和N1潜伏期显著延长,振幅值显著降低(P=0.001);oVEMP AAR在患者组和对照组之间不显著(P=0.095)。发现两个患者亚组的cVEMP AAR值均增加,而在感觉神经性PNP亚组的oVEMP AA值升高。在DPN组中,cVEMP和oVEMP的无应答率分别为48.6%(n=17)和51.4%(n=18),显著高于对照组(P<0.05)。在oVEMP中,与感觉性PNP亚组相比,感觉运动PNP亚群的无反应率更高(分别为P=0.008和P=0.003)。结论:对于具有多系统影响的糖尿病,特别是多发性神经病患者,在前庭症状出现前进行前庭检查可能是检测神经血管变性存在或程度的早期有益诊断方法。
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引用次数: 0
Changes in the blink reflex during migraine with aura and the inter-attack period 先兆偏头痛发作期和发作间期眨眼反射的变化
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/nsn.nsn_176_20
M. Ateş, Sevgi Ferik, L. Pektezel, Hayat Guven, S. Çomoğlu
Introduction: This study aimed to investigate the possible excitability changes in the trigeminovascular system based on blink reflex (BR) in patients experiencing migraine and to compare migraine aura attacks and attack-free period. Materials and Methods: A total of 56 patients diagnosed with migraine headache with aura and 20 healthy individuals without migraine were evaluated electrophysiologically using the BR test. The BR test was repeated twice in patients with migraines during attacks with aura and attack-free period. Results: During the migraine attack with aura, R1 latencies were shorter, and R2 latencies were longer than in the interictal period. Likewise, R1 latencies were shorter, and R2 latencies were longer, in the interictal period compared to normal values obtained in the control group. Conclusion: The detected BR abnormalities have been thought to be able to reflect migraine-related dysfunction in the brainstem and trigeminovascular connections. Significance: It has been concluded that the detected BR abnormalities might reflect migraine-related dysfunction in the brainstem and trigeminovascular connections, indicating increased neuronal excitability in migraine.
引言:本研究旨在研究偏头痛患者基于眨眼反射(BR)的三叉神经血管系统可能的兴奋性变化,并比较偏头痛先兆发作和无发作期。材料和方法:使用BR测试对56名诊断为先兆偏头痛的患者和20名无偏头痛的健康人进行电生理评估。在有先兆发作期和无先兆发作期,对偏头痛患者重复BR测试两次。结果:先兆偏头痛发作期R1潜伏期短,R2潜伏期长。同样,与对照组获得的正常值相比,在发作间期,R1潜伏期更短,R2潜伏期更长。结论:检测到的BR异常被认为能够反映脑干和三叉神经血管连接中与偏头痛相关的功能障碍。意义:已经得出结论,检测到的BR异常可能反映了脑干和三叉神经血管连接中与偏头痛相关的功能障碍,表明偏头痛的神经元兴奋性增加。
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引用次数: 1
Effects of cellular phone electromagnetic field exposure on the hippocampi of rats in childhood and adolescence 手机电磁场暴露对儿童期和青春期大鼠海马的影响
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/NSN.NSN_206_20
Zeynep Okur, D. Sağir
Objective: The effects of the electromagnetic fields (EMFs) emitted from cell phones on living organisms and human health have become one of the most important topics for research because cell phones are widely used, even at early ages, all over the world. In this study, it was aimed to reveal the effects of exposure to EMFs emitted from cell phones on the hippocampus region of the brain during childhood and adolescence. Materials and Methods: In the study, newborn rats were divided into six groups as control 1–21, EMF 1–21, control 21–60, EMF 21–60, control 1–60, and EMF 1–60. The rats in the EMF groups were exposed to an EMF emitted from cell phones placed in cages every day. No procedure was performed in the control (C) groups. Sections taken from the brain tissues were evaluated using histopathologic, stereologic, and immunohistochemical methods. Results: According to the stereologic analysis results we obtained from the study, there was a significant decrease in the number of pyramidal cells and hippocampus volume in the EMF 1–60 group (P < 0.05). In the histopathologic examinations of the brain sections, it was observed that there were many damaged neurons with darkly stained cytoplasms among normal pyramidal cells in all age groups exposed to EMF. In addition, caspase 3 immunoreactivity was found to be statistically significantly increased in the EMF 1–60 group compared with all other groups (P < 0.05). Conclusion: Chronic cell phone exposure from birth to the end of adolescence causes neuronal damage and volume reduction in the developing hippocampus.
目的:手机发出的电磁场对生物体和人体健康的影响已成为最重要的研究课题之一,因为手机在世界各地广泛使用,甚至在很小的时候。在这项研究中,其目的是揭示儿童和青少年时期暴露于手机发出的电磁场对大脑海马体区域的影响。材料与方法:将新生大鼠分为对照1-21组、EMF 1-21组、对照21-60组、EMF 21-60组、对照1-60组和EMF 1-60组。电磁场组的大鼠每天暴露在笼子里的手机发出的电磁场中。对照组(C)不做任何手术。采用组织病理学、体视学和免疫组织化学方法对脑组织切片进行评估。结果:根据本研究获得的体视学分析结果,EMF 1-60组大鼠锥体细胞数量和海马体积明显减少(P < 0.05)。在脑切片的组织病理学检查中,观察到所有年龄组暴露于电磁场的正常锥体细胞中有许多受损的神经元,细胞质呈黑色染色。此外,与其他各组相比,EMF 1-60组caspase 3免疫反应性显著升高(P < 0.05)。结论:从出生到青春期结束,长期使用手机会导致发育中的海马神经元损伤和体积减少。
{"title":"Effects of cellular phone electromagnetic field exposure on the hippocampi of rats in childhood and adolescence","authors":"Zeynep Okur, D. Sağir","doi":"10.4103/NSN.NSN_206_20","DOIUrl":"https://doi.org/10.4103/NSN.NSN_206_20","url":null,"abstract":"Objective: The effects of the electromagnetic fields (EMFs) emitted from cell phones on living organisms and human health have become one of the most important topics for research because cell phones are widely used, even at early ages, all over the world. In this study, it was aimed to reveal the effects of exposure to EMFs emitted from cell phones on the hippocampus region of the brain during childhood and adolescence. Materials and Methods: In the study, newborn rats were divided into six groups as control 1–21, EMF 1–21, control 21–60, EMF 21–60, control 1–60, and EMF 1–60. The rats in the EMF groups were exposed to an EMF emitted from cell phones placed in cages every day. No procedure was performed in the control (C) groups. Sections taken from the brain tissues were evaluated using histopathologic, stereologic, and immunohistochemical methods. Results: According to the stereologic analysis results we obtained from the study, there was a significant decrease in the number of pyramidal cells and hippocampus volume in the EMF 1–60 group (P < 0.05). In the histopathologic examinations of the brain sections, it was observed that there were many damaged neurons with darkly stained cytoplasms among normal pyramidal cells in all age groups exposed to EMF. In addition, caspase 3 immunoreactivity was found to be statistically significantly increased in the EMF 1–60 group compared with all other groups (P < 0.05). Conclusion: Chronic cell phone exposure from birth to the end of adolescence causes neuronal damage and volume reduction in the developing hippocampus.","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"135 - 142"},"PeriodicalIF":0.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42260051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Data mining analysis of demographic and clinical factors in turkish amyotrophic lateral sclerosis patients 土耳其肌萎缩侧索硬化症患者人口统计学和临床因素的数据挖掘分析
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/NSN.NSN_69_20
Nesrin Gulay, H. Uysal, P. Aliyeva, U. Bilge
Introduction: Amyotrophic lateral sclerosis (ALS) is a motor neuron disease that affects nerve cells in the brain and spinal cord, controlling voluntary muscle movement. Data mining is a discipline that provides meaningful conclusions from databases or implicit data. In this study, we examine the relationship between the clinical and demographic characteristics of ALS patients and a control group, using data mining techniques. Methods: In the study, data belonging to 235 patients diagnosed with ALS and a control group of 117 people consisting of relatives of ALS patients were used. The dataset contains 121 features that include clinical and demographic information for each patient. The patient group and the control group were examined together and separately to examine the relationship between the features. In the study the data mining methods of classification and clustering were used on R and WEKA software packages. Results: There were no significant differences between ALS patients and the control group in terms of environmental factors such as location, gender, smoking, exercise status, and clinical factors such as genetics, ALS involvement, course of the disease, disease in the family. The results also showed that there was no relationship between demographic and clinical features such as gender, occupation, age group, and concomitant disease between groups or within groups.
简介:肌萎缩性侧索硬化症(ALS)是一种运动神经元疾病,影响大脑和脊髓中的神经细胞,控制随意肌运动。数据挖掘是一门从数据库或隐式数据中提供有意义结论的学科。在这项研究中,我们使用数据挖掘技术研究了ALS患者和对照组的临床和人口学特征之间的关系。方法:本研究采用235例ALS患者和117例ALS患者亲属作为对照组的数据。该数据集包含121个特征,包括每个患者的临床和人口统计信息。将患者组与对照组合并检查,并分别检查各特征之间的关系。本研究在R和WEKA软件包上使用了分类和聚类的数据挖掘方法。结果:ALS患者与对照组在地理位置、性别、吸烟、运动状况等环境因素,以及遗传、是否累及ALS、病程、家族病史等临床因素上均无显著差异。结果还显示,人口统计学和临床特征,如性别、职业、年龄组、组间或组内的伴发疾病之间没有关系。
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引用次数: 0
Investigation of the complex structure between the severity of alzheimer's disease and influencing factors using latent class cluster analysis 应用潜在类聚类分析研究阿尔茨海默病严重程度与影响因素之间的复杂结构
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/NSN.NSN_92_20
D. Yildirim, Mumine Kiraz, B. Taşdelen, A. Ozge
Objective: The cognition of Alzheimer's disease (AD) has a heterogeneous pattern. It is useful to obtain more information about specific subgroups of patients to prevent disease progression. For better identification of the population, we aimed to detect latent groups based on cognitive test scores using latent class (LC) cluster analysis and influencing factors of latent severity groups to assist practitioners in outpatient departments who have restricted time and instrumentation. Materials and Methods: Data for 630 patients with AD in the Mersin University Dementia Outpatient Unit were collected, and cognitive test scores, demographic variables, and other factors such as comorbidities and family history of dementia were obtained. Initially, LC cluster analysis was performed to distinguish subgroups considering clinical dementia scores, age, and sex as covariates. Second, univariate analysis was used to detect the relationship between latent subgroups and influencing factors. Finally, multinomial logistic regression was performed to identify the magnitude of risk for significant factors. Results: Four severity groups were defined as mild, moderate, severe, and very severe cases of AD, and severity was significantly related to educational level, hyperlipidemia, diabetes mellitus, and sarcopenia (P < 0.001, P = 0.001, P = 0.043, and P < 0.001, respectively). Family history also influenced severity (P = 0.024). Disease severity increased with decreased education levels. Family history predicted a 1.555-fold increase in the risk of being in the moderate group versus the mild group. Moreover, diabetes mellitus predicted a 3.690-fold increase of being in the very severe group versus the mild group. Conclusion: LC cluster analysis is effective for determining severity groups for AD, and study results will help prepare a guide for an optimum evaluation tool for the disease.
目的:阿尔茨海默病(AD)的认知模式具有异质性。获得关于特定亚组患者的更多信息以预防疾病进展是有用的。为了更好地识别人群,我们的目的是利用潜在类别(LC)聚类分析和潜在严重程度组的影响因素,根据认知测试分数检测潜在群体,以帮助门诊时间和仪器有限的医生。材料与方法:收集Mersin University痴呆门诊630例AD患者的数据,获得认知测试分数、人口统计学变量以及痴呆合并症、家族史等其他因素。最初,将临床痴呆评分、年龄和性别作为协变量,进行LC聚类分析以区分亚组。其次,采用单因素分析检测潜在亚群与影响因素之间的关系。最后,进行多项逻辑回归以确定重要因素的风险程度。结果:将AD分为轻度、中度、重度、极重度4组,其严重程度与文化程度、高脂血症、糖尿病、肌肉减少症相关(P < 0.001、P = 0.001、P = 0.043、P < 0.001)。家族史也影响严重程度(P = 0.024)。疾病严重程度随受教育程度的降低而增加。家族史预测,与轻度组相比,中度组的风险增加了1.555倍。此外,重度糖尿病组与轻度糖尿病组相比,患糖尿病的风险增加了3.690倍。结论:LC聚类分析可以有效地确定AD的严重程度分组,研究结果将有助于为AD的最佳评估工具提供指导。
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引用次数: 0
Late-onset myasthenia gravis: Is it a different clinical entity? 迟发性重症肌无力:是一种不同的临床实体吗?
IF 0.4 4区 医学 Q4 NEUROSCIENCES Pub Date : 2021-04-01 DOI: 10.4103/nsn.nsn_201_20
H. Tireli, G. Yuksel, K. Tutkavul
Objective: The increase in the average life expectancy of humans has resulted in an increased occurrence of late-onset myasthenia gravis (LOMG). It is noticeable that the clinical, immunologic, and prognostic features of patients with LOMG are different than those of the patients with early-onset myasthenia gravis (EOMG). The present study aimed to establish the dissimilar features of patients with EOMG and LOMG. Subjects and Methods: The study retrospectively compared 93 patients with EOMG and LOMG in terms of clinical and immunologic features and response to medical treatment and thymectomy. Results: Of the 93 patients with MG, 56 had EOMG and 37 had LOMG. The EOMG group was dominated by female patients and generalized MG, whereas male patients and ocular MG were predominant in the LOMG group. Both groups tested positive for acetyl choline receptors antibodies. The number of patients undergoing thymectomy was higher in the EOMG group than in LOMG group. Responses to thymectomy and immunosuppressive treatment in LOMG group were lower compared with the EOMG group. Conclusion: The present study concludes that the clinical prognosis of patients with LOMG is better, and thymectomy may not be quite necessary for patients in this group who do not have thymomas (nonthymomatous patients).
目的:人类平均寿命的增加导致晚发型重症肌无力(LOMG)的发生率增加。值得注意的是,早发型重症肌无力患者的临床、免疫学和预后特征与早发型重症肌无力(EOMG)患者不同。本研究旨在确定EOMG和lomo患者的不同特征。研究对象和方法:回顾性比较93例EOMG和LOMG患者的临床和免疫学特征以及对药物治疗和胸腺切除术的反应。结果:93例MG患者中,56例为EOMG, 37例为LOMG。EOMG组以女性患者和全身性MG为主,LOMG组以男性患者和眼部MG为主。两组乙酰胆碱受体抗体均呈阳性。EOMG组胸腺切除术患者数量高于LOMG组。与EOMG组相比,LOMG组对胸腺切除术和免疫抑制治疗的反应较低。结论:本研究认为LOMG患者临床预后较好,本组无胸腺瘤(非胸腺瘤患者)患者可能不太需要胸腺切除术。
{"title":"Late-onset myasthenia gravis: Is it a different clinical entity?","authors":"H. Tireli, G. Yuksel, K. Tutkavul","doi":"10.4103/nsn.nsn_201_20","DOIUrl":"https://doi.org/10.4103/nsn.nsn_201_20","url":null,"abstract":"Objective: The increase in the average life expectancy of humans has resulted in an increased occurrence of late-onset myasthenia gravis (LOMG). It is noticeable that the clinical, immunologic, and prognostic features of patients with LOMG are different than those of the patients with early-onset myasthenia gravis (EOMG). The present study aimed to establish the dissimilar features of patients with EOMG and LOMG. Subjects and Methods: The study retrospectively compared 93 patients with EOMG and LOMG in terms of clinical and immunologic features and response to medical treatment and thymectomy. Results: Of the 93 patients with MG, 56 had EOMG and 37 had LOMG. The EOMG group was dominated by female patients and generalized MG, whereas male patients and ocular MG were predominant in the LOMG group. Both groups tested positive for acetyl choline receptors antibodies. The number of patients undergoing thymectomy was higher in the EOMG group than in LOMG group. Responses to thymectomy and immunosuppressive treatment in LOMG group were lower compared with the EOMG group. Conclusion: The present study concludes that the clinical prognosis of patients with LOMG is better, and thymectomy may not be quite necessary for patients in this group who do not have thymomas (nonthymomatous patients).","PeriodicalId":48555,"journal":{"name":"Neurological Sciences and Neurophysiology","volume":"38 1","pages":"127 - 134"},"PeriodicalIF":0.4,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41863693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
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Neurological Sciences and Neurophysiology
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