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Communication, Feeding and Swallowing Disorders in Neurological Diseases 神经系统疾病中的沟通、进食和吞咽障碍
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-21 DOI: 10.1155/2022/9851424
G. Nasios, L. Messinis, E. Dardiotis, J. Kassubek
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引用次数: 0
Impact of the Aversive Effects of Drugs on Their Use and Abuse. 药物的厌恶效应对其使用和滥用的影响
IF 2.7 4区 医学 Q2 CLINICAL NEUROLOGY Pub Date : 2022-04-20 eCollection Date: 2022-01-01 DOI: 10.1155/2022/8634176
Anthony L Riley, Hayley N Manke, Shihui Huang

Drug use and abuse are complex issues in that the basis of each may involve different determinants and consequences, and the transition from one to the other may be equally multifaceted. A recent model of the addiction cycle (as proposed by Koob and his colleagues) illustrates how drug-taking patterns transition from impulsive (acute use) to compulsive (chronic use) as a function of various neuroadaptations leading to the downregulation of DA systems, upregulation of stress systems, and the dysregulation of the prefrontal/orbitofrontal cortex. Although the nature of reinforcement in the initiation and mediation of these effects may differ (positive vs. negative), the role of reinforcement in drug intake (acute and chronic) is well characterized. However, drugs of abuse have other stimulus properties that may be important in their use and abuse. One such property is their aversive effects that limit drug intake instead of initiating and maintaining it. Evidence of such effects comes from both clinical and preclinical populations. In support of this position, the present review describes the aversive effects of drugs (assessed primarily in conditioned taste aversion learning), the fact that they occur concurrently with reward as assessed in combined taste aversion/place preference designs, the role of aversive effects in drug-taking (in balance with their rewarding effects), the dissociation of these affective properties in that they can be affected in different ways by the same manipulations, and the impact of various parametric, experiential, and subject factors on the aversive effects of drugs and the consequent impact of these factors on their use and abuse potential.

药物使用和滥用是复杂的问题,因为两者的基础可能涉及不同的决定因素和后果,从一个问题过渡到另一个问题可能同样是多方面的。最近的一个成瘾周期模型(由Koob和他的同事提出)说明了药物服用模式如何从冲动性(急性使用)转变为强迫性(慢性使用),作为各种神经适应的功能,导致DA系统的下调,压力系统的上调以及前额叶/眶额皮质的失调。虽然在这些效应的启动和中介中,强化的性质可能不同(积极的和消极的),但强化在药物摄入(急性和慢性)中的作用是很有特点的。然而,滥用药物具有其他刺激特性,这些特性在其使用和滥用中可能很重要。其中一个特性是它们的不良作用,限制了药物的摄入,而不是开始和维持它。这些影响的证据来自临床和临床前人群。为了支持这一观点,本综述描述了药物的厌恶效应(主要在条件厌恶学习中评估),它们与奖励同时发生的事实,在味觉厌恶/位置偏好组合设计中评估,厌恶效应在吸毒中的作用(与它们的奖励效应平衡),这些情感特性的分离,因为它们可以通过相同的操作以不同的方式受到影响。以及各种参数因素、经验因素和主体因素对药物不良影响的影响,以及这些因素对药物使用和滥用潜力的影响。
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引用次数: 0
Mitigated Oxidative Stress and Cognitive Impairments in Transient Global Ischemia using Niosomal Selegiline-NBP delivery 使用Niosomal Selegiline-NBP减轻短暂性全身缺血的氧化应激和认知障碍
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-16 DOI: 10.1155/2022/4825472
Bahareh Jafari, Mahmoud Gharbavi, Yasamin Baghdadchi, H. Manjili, J. Mahmoudi, Iraj Jafari-Anarkoli, Shayan Amiri, M. Hosseini
Stroke is the most common reason for adult disabilities and the second ground for death worldwide. Our previous study revealed that selegiline serves as an alternative candidate in transient hypoxia-ischemia. However, aggressive and restless behavior was observed in stroke-induced rats receiving 4 mg/kg selegiline. In comparison, 1 mg/kg selegiline could induce negligible therapeutic effects on mitochondrial dysfunction and histopathological changes. Therefore, we designed oral noisome-based selegiline attached to 4-(4-nitrobenzyl) pyridine to improve transient global ischemia by attenuating cognitive impairments, oxidative stress, and histopathological injury. The investigation was performed in transient hypoxia-ischemia-induced rats by oral administration of nanoformulation containing selegiline (0.25-1 mg/kg) for 4 weeks (3 times a week). Novel object recognition (NOR) was considered to evaluate their cognitive dysfunction. Oxidative stress parameters and brain histopathological assessments were determined following the scarification of rats. Outstandingly, our data demonstrated slower selegiline release from niosomes relative to free drug, which was also in a controlled manner. Our data confirmed significant improvement in cognitive behavior in the NOR test, an increase in glutathione level and total antioxidant power, a decline in MDA and protein carbonyl level, as well as a decreased number of dead cells in histopathological assessment after being exposed to (0.5-1 mg/kg) selegiline-NBP nanoformulation. These data manifested that the selegiline-NBP nanoformulation (0.5-1 mg/kg) could significantly reduce oxidative damage, cognitive dysfunction, and histopathological damage compared to transient hypoxia-ischemia rats, which is 20 times lower than the therapeutic dose in humans. Therefore, the proposed nanoformulation would be capable as an alternative candidate without side effects in stroke.
中风是造成成人残疾的最常见原因,也是世界范围内死亡的第二大原因。我们之前的研究表明,司来吉林在短暂缺氧缺血中是一种替代候选药物。然而,在接受4 mg/kg司来吉林。相比之下,1 mg/kg司来吉林对线粒体功能障碍和组织病理学变化的治疗作用可忽略不计。因此,我们设计了与4-(4-硝基苄基)吡啶连接的口服黑色素硒吉林,通过减轻认知障碍、氧化应激和组织病理学损伤来改善短暂性全身缺血。通过口服含硒吉林(0.25-1 mg/kg)持续4周(每周3次)。新对象识别(NOR)被认为是评估他们的认知功能障碍。氧化应激参数和脑组织病理学评估是在大鼠的划痕后确定的。值得注意的是,我们的数据表明,与游离药物相比,硒吉林从niosomes中的释放较慢,这也是以可控的方式进行的。我们的数据证实,在NOR测试中,认知行为显著改善,谷胱甘肽水平和总抗氧化能力增加,MDA和蛋白质羰基水平下降,以及暴露于(0.5-1 mg/kg)硒吉林NBP纳米制剂。这些数据表明,硒吉林NBP纳米制剂(0.5-1 mg/kg)可以显著减少氧化损伤、认知功能障碍和组织病理学损伤,这比人类的治疗剂量低20倍。因此,所提出的纳米制剂将能够作为一种替代候选药物,在中风中没有副作用。
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引用次数: 4
Applications of Theranostics for Detecting and Targeting CNS Injuries and Diseases Theranotics在检测和靶向中枢神经系统损伤和疾病中的应用
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-15 DOI: 10.1155/2022/9891859
Yu-Yo Sun, Horacio Soto, C. Kao, Cui Mei, Muh-Shi Lin
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引用次数: 0
Multimodal Medical Image Fusion of Positron Emission Tomography and Magnetic Resonance Imaging Using Generative Adversarial Networks. 利用生成对抗性网络实现正电子发射断层扫描和磁共振成像的多模式医学图像融合
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-14 eCollection Date: 2022-01-01 DOI: 10.1155/2022/6878783
R Nandhini Abirami, P M Durai Raj Vincent, Kathiravan Srinivasan, K Suresh Manic, Chuan-Yu Chang

Multimodal medical image fusion is a current technique applied in the applications related to medical field to combine images from the same modality or different modalities to improve the visual content of the image to perform further operations like image segmentation. Biomedical research and medical image analysis highly demand medical image fusion to perform higher level of medical analysis. Multimodal medical fusion assists medical practitioners to visualize the internal organs and tissues. Multimodal medical fusion of brain image helps to medical practitioners to simultaneously visualize hard portion like skull and soft portion like tissue. Brain tumor segmentation can be accurately performed by utilizing the image obtained after multimodal medical image fusion. The area of the tumor can be accurately located with the information obtained from both Positron Emission Tomography and Magnetic Resonance Image in a single fused image. This approach increases the accuracy in diagnosing the tumor and reduces the time consumed in diagnosing and locating the tumor. The functional information of the brain is available in the Positron Emission Tomography while the anatomy of the brain tissue is available in the Magnetic Resonance Image. Thus, the spatial characteristics and functional information can be obtained from a single image using a robust multimodal medical image fusion model. The proposed approach uses a generative adversarial network to fuse Positron Emission Tomography and Magnetic Resonance Image into a single image. The results obtained from the proposed approach can be used for further medical analysis to locate the tumor and plan for further surgical procedures. The performance of the GAN based model is evaluated using two metrics, namely, structural similarity index and mutual information. The proposed approach achieved a structural similarity index of 0.8551 and a mutual information of 2.8059.

多模态医学图像融合是目前应用于医学领域的一种技术,它将来自相同模态或不同模态的图像组合在一起,以改善图像的视觉内容,从而进行进一步的图像分割等操作。生物医学研究和医学图像分析对医学图像融合有很高的要求,需要进行更高层次的医学分析。多模式医学融合帮助医生可视化内部器官和组织。脑图像的多模态医学融合有助于医生同时可视化硬部分如颅骨和软部分如组织。利用多模态医学图像融合后得到的图像,可以对脑肿瘤进行准确的分割。利用正电子发射断层成像和磁共振成像的信息,可以在单一融合图像中准确定位肿瘤的区域。该方法提高了肿瘤诊断的准确性,减少了肿瘤诊断和定位的时间。大脑的功能信息可以在正电子发射断层扫描中获得,而脑组织的解剖结构可以在磁共振图像中获得。因此,使用鲁棒多模态医学图像融合模型可以从单个图像中获得空间特征和功能信息。该方法使用生成对抗网络将正电子发射断层扫描和磁共振图像融合为单个图像。从该方法获得的结果可用于进一步的医学分析,以定位肿瘤和计划进一步的外科手术。采用结构相似度和互信息两个指标对GAN模型的性能进行评价。该方法的结构相似性指数为0.8551,互信息为2.8059。
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引用次数: 5
Early Stroke Prediction Methods for Prevention of Strokes. 预防脑卒中的早期预测方法。
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-11 eCollection Date: 2022-01-01 DOI: 10.1155/2022/7725597
Mandeep Kaur, Sachin R Sakhare, Kirti Wanjale, Farzana Akter

The emergence of the latest technologies gives rise to the usage of noninvasive techniques for assisting health-care systems. Amongst the four major cardiovascular diseases, stroke is one of the most dangerous and life-threatening disease, but the life of a patient can be saved if the stroke is detected during early stage. The literature reveals that the patients always experience ministrokes which are also known as transient ischemic attacks (TIA) before experiencing the actual attack of the stroke. Most of the literature work is based on the MRI and CT scan images for classifying the cardiovascular diseases including a stroke which is an expensive approach for diagnosis of early strokes. In India where cases of strokes are rising, there is a need to explore noninvasive cheap methods for the diagnosis of early strokes. Hence, this problem has motivated us to conduct the study presented in this paper. A noninvasive approach for the early diagnosis of the strokes is proposed. The cascaded prediction algorithms are time-consuming in producing the results and cannot work on the raw data and without making use of the properties of EEG. Therefore, the objective of this paper is to devise mechanisms to forecast strokes on the basis of processed EEG data. This paper is proposing time series-based approaches such as LSTM, biLSTM, GRU, and FFNN that can handle time series-based predictions to make useful decisions. The experimental research outcome reveals that all the algorithms taken up for the research study perform well on the prediction problem of early stroke detection, but GRU performs the best with 95.6% accuracy, whereas biLSTM gives 91% accuracy and LSTM gives 87% accuracy and FFNN gives 83% accuracy. The experimental outcome is able to measure the brain waves to predict the signs of strokes. The findings can certainly assist the physicians to detect the stroke at early stages to save the lives of the patients.

最新技术的出现促进了无创技术在医疗保健系统中的应用。在四大心血管疾病中,中风是最危险、最危及生命的疾病之一,但如果能在早期发现中风,就能挽救病人的生命。文献显示,在中风真正发作之前,患者总是会出现小中风,也称为短暂性脑缺血发作(TIA)。大多数文献工作都是基于核磁共振成像和 CT 扫描图像来对包括中风在内的心血管疾病进行分类,这种诊断早期中风的方法成本高昂。在中风病例不断增加的印度,有必要探索诊断早期中风的非侵入性廉价方法。因此,这一问题促使我们开展了本文所介绍的研究。本文提出了一种早期诊断脑卒中的无创方法。级联预测算法在生成结果时非常耗时,而且无法处理原始数据,也无法利用脑电图的特性。因此,本文的目的是根据处理过的脑电图数据设计出预测脑卒中的机制。本文提出了基于时间序列的方法,如 LSTM、biLSTM、GRU 和 FFNN,这些方法可以处理基于时间序列的预测,从而做出有用的决策。实验研究结果表明,研究中采用的所有算法在早期中风检测的预测问题上都表现良好,但 GRU 的准确率最高,达到 95.6%,而 biLSTM 的准确率为 91%,LSTM 的准确率为 87%,FFNN 的准确率为 83%。实验结果能够通过测量脑电波来预测中风的征兆。这些发现无疑能帮助医生在早期阶段检测出中风,从而挽救病人的生命。
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引用次数: 51
Relationships between Personality Traits and Brain Gray Matter Are Different in Risky and Non-risky Drivers 风险和非风险司机的人格特征与脑灰质的关系不同
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-05 DOI: 10.1155/2022/1775777
Laura Mas-Cuesta, S. Baltruschat, A. Cándido, A. Catena
Personality traits such as impulsivity or sensitivity to rewards and punishments have been associated with risky driving behavior, but it is still unclear how brain anatomy is related to these traits as a function of risky driving. In the present study, we explore the neuroanatomical basis of risky driving behavior and how the level of risk-taking influences the relationship between the traits of impulsivity and sensitivity to rewards and punishments and brain gray matter volume. One hundred forty-four participants with different risk-taking tendencies assessed by real-life driving situations underwent MRI. Personality traits were assessed with self-report measures. We observed that the total gray matter volume varied as a function of risky driving tendencies, with higher risk individuals showing lower gray matter volumes. Similar results were found for volumes of brain areas involved in the reward and cognitive control networks, such as the frontotemporal, parietal, limbic, and cerebellar cortices. We have also shown that sensitivity to reward and punishment and impulsivity are differentially related to gray matter volumes as a function of risky driving tendencies. Highly risky individuals show lower absolute correlations with gray matter volumes than less risk-prone individuals. Taken together, our results show that risky drivers differ in the brain structure of the areas involved in reward processing, cognitive control, and behavioral modulation, which may lead to dysfunctional decision-making and riskier driving behavior.
冲动或对奖惩的敏感性等性格特征与危险驾驶行为有关,但目前尚不清楚大脑解剖结构与这些特征在危险驾驶中的关系。在本研究中,我们探讨了危险驾驶行为的神经解剖学基础,以及冒险水平如何影响冲动性和对奖惩的敏感性特征与大脑灰质体积之间的关系。通过真实驾驶情况评估,144名具有不同冒险倾向的参与者接受了核磁共振成像。人格特征通过自我报告测量进行评估。我们观察到,总灰质体积随着风险驾驶倾向的变化而变化,风险较高的人表现出较低的灰质体积。对于参与奖赏和认知控制网络的大量大脑区域,如额颞叶、顶叶、边缘和小脑皮层,也发现了类似的结果。我们还表明,对奖惩的敏感性和冲动性与灰质体积有不同的关系,灰质体积是危险驾驶倾向的函数。与风险较低的个体相比,高风险个体与灰质体积的绝对相关性较低。总之,我们的研究结果表明,风险驾驶员在参与奖励处理、认知控制和行为调节的区域的大脑结构不同,这可能导致决策功能失调和风险较高的驾驶行为。
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引用次数: 1
Classification of Myopathy and Amyotrophic Lateral Sclerosis Electromyograms Using Bat Algorithm and Deep Neural Networks. 基于Bat算法和深度神经网络的肌病和肌萎缩侧索硬化症肌电图分类
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-04-04 eCollection Date: 2022-01-01 DOI: 10.1155/2022/3517872
A Bakiya, A Anitha, T Sridevi, K Kamalanand

Electromyograms (EMG) are a recorded galvanic action of nerves and muscles which assists in diagnosing the disorders associated with muscles and nerves. The efficient discrimination of abnormal EMG signals, myopathy and amyotrophic lateral sclerosis, engage crucial role in automatic diagnostic assistance tools, since EMG signals are nonstationary signals. Hence, for computer-aided identification of abnormalities, extraction of features, selection of superlative feature subset, and developing an efficient classifier are indispensable. Initially, time domain and Wigner-Ville transformed time-frequency features were extracted from abnormal EMG signals for experiments. The selection of substantial characteristics from time and time-frequency features was performed using bat algorithm. Extensively, deep neural network classifier is modelled for selected feature subset using bat algorithm from extracted time and time-frequency features. The performance of deep neural network exerting selected features from bat algorithm was compared with conventional artificial neural network. Results demonstrate that the deep neural network modelled with layers 2 and 3 (neurons = 2 and 4) using time domain features is efficient in classifying the abnormalities of EMG signals with an accuracy, sensitivity, and specificity of 100% and also exhibited finer performance. Correspondingly, the developed conventional single layer artificial neural network (neurons = 7) with time domain features has shown an accuracy of 83.3%, sensitivity of 100%, and specificity of 71.42%. The work materializes the significance of conventional and deep neural network using time and time-frequency features in diagnosing the abnormal signals exists in neuromuscular system using efficient classification.

肌电图(EMG)是记录的神经和肌肉的电流动作,有助于诊断与肌肉和神经相关的疾病。由于EMG信号是非平稳信号,因此对异常EMG信号(肌病和肌萎缩侧索硬化症)的有效识别在自动诊断辅助工具中起着至关重要的作用。因此,对于异常的计算机辅助识别,特征提取、最高级特征子集的选择和开发有效的分类器是必不可少的。最初,从异常EMG信号中提取时域和Wigner-Ville变换的时频特征用于实验。使用bat算法从时间和时间-频率特征中选择实质特征。从广义上讲,使用bat算法从提取的时间和时间-频率特征中为选定的特征子集建模深度神经网络分类器。将深度神经网络与传统人工神经网络的性能进行了比较。结果表明,使用时域特征用第2层和第3层(神经元=2和4)建模的深度神经网络在分类EMG信号异常方面是有效的,具有100%的准确性、敏感性和特异性,并且还表现出更好的性能。相应地,所开发的具有时域特征的传统单层人工神经网络(神经元=7)显示出83.3%的准确率、100%的灵敏度、,特异性为71.42%。该工作具体化了利用时间和时间-频率特征的传统和深度神经网络在利用有效分类诊断神经肌肉系统中存在的异常信号方面的意义。
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引用次数: 4
Clinical Factors Predicting Voluntary Driving Cessation among Patients with Parkinson's Disease 预测帕金森病患者自愿停车的临床因素
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-03-20 DOI: 10.1155/2022/4047710
Hidetada Yamada, M. Nakamori, T. Nezu, Teppei Kotozaki, Juri Kitamura, T. Ohshita, Y. Sueda, H. Maruyama
Factors that influence the decision of voluntary driving cessation in patients living with Parkinson's disease (PD) are still unclear. We aimed to reveal the factors affecting the decision of voluntary driving cessation in patients with PD. This hospital-based cross-sectional study recruited consecutive outpatients with PD. Data on sociodemographic and clinical characteristics and medication use were collected from the patients using semistructured interviews. Cognitive function was evaluated using the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We excluded patients with dementia or motor impairment (Hoehn − Yahr stage > 3). We divided the patients into two groups, with and without voluntary driving cessation (D: driver; RD: retired driver), and conducted investigations using multivariate logistic regression analyses. Of the 40 patients, 8 (20.0%) voluntarily retired from driving. Patients who decided on driving cessation had a higher prevalence of freezing of gait (FOG) (D vs. RD, 25.0% vs. 87.5%; P = 0.001) and tended to have lower scores for attention in the MoCA-J (D vs. RD, 5.0 ± 1.2 vs. 4.1 ± 1.4; P = 0.086). Multivariable analysis showed that FOG was independently associated with driving cessation (odds ratio: 14.46, 95% confidence interval: 1.91–303.74). FOG was associated with voluntary driving cessation in patients with PD without dementia or severe motor impairment. Physicians should consider providing extensive social support to maintain patients' mobility and independence, especially if the patients have these clinical factors.
影响帕金森病患者自愿停止驾驶决定的因素尚不清楚。我们旨在揭示影响帕金森病患者自愿停止驾驶决定的因素。这项基于医院的横断面研究招募了连续的帕金森病门诊患者。使用半结构访谈从患者中收集社会人口统计学、临床特征和药物使用的数据。认知功能使用日本版的蒙特利尔认知评估(MoCA-J)进行评估。我们排除了患有痴呆症或运动障碍的患者(Hoehn−Yahr 阶段>3)。我们将患者分为两组,有和没有自愿停止驾驶(D:驾驶员;RD:退休驾驶员),并使用多元逻辑回归分析进行调查。在40名患者中,8人(20.0%)自愿退出驾驶。决定停止驾驶的患者步态冻结(FOG)的发生率较高(D与RD,25.0%与87.5%;P=0.001),并且在MoCA-J中的注意力得分较低(D与。RD分别为5.0±1.2和4.1±1.4;P=0.086)。多变量分析显示,FOG与驾驶停止独立相关(优势比:14.46,95%置信区间:1.91-303.74)。在没有痴呆或严重运动障碍的PD患者中,FOG可与自愿驾驶停止相关。医生应该考虑提供广泛的社会支持,以保持患者的行动能力和独立性,尤其是在患者有这些临床因素的情况下。
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引用次数: 0
Platelet P2Y12 Inhibitor in the Treatment and Prevention of Migraine: A Systematic Review and Meta-Analysis 血小板P2Y12抑制剂治疗和预防偏头痛的系统评价和荟萃分析
IF 2.8 4区 医学 Q2 Psychology Pub Date : 2022-03-20 DOI: 10.1155/2022/2118740
Fengzhi Wang, Yu Cao, Yanjie Liu, Zhanxiu Ren, Fuyong Li
There have been speculation and research linking migraine with abnormalities of platelet aggregation and activation. The role of the P2Y12 platelet inhibitor in the treatment of migraine has not been established. We aim to evaluate the efficacy of the platelet P2Y12 inhibitor in the treatment of migraine and prevention of new-onset migraine headache (MHA) following transcatheter atrial septal defect closure (ASDC). We searched the PubMed, Web of Science, and Cochrane Library databases for relevant studies. The primary outcomes were the headache responder rate and the rate of new-onset migraine attacks following ASDC. Four studies for a total of 262 migraine patients with or without patent foramen ovale (PFO) and three studies involving 539 patients with antiplatelet treatment in the prevention of new-onset migraine following ASDC were included. The pooled responder rate of the P2Y12 inhibitor for migraine was 0.64 (95% CI: 0.43 to 0.81). For patients who underwent ASDC, the use of antiplatelet regimens including the P2Y12 inhibitor, compared with regimens excluding P2Y12 inhibitor, resulted in a lower rate of new-onset migraine (OR: 0.41, 95% CI: 0.22 to 0.77, P = 0.005). We concluded that the P2Y12 platelet inhibitor may have a primary prophylactic role in migraine patients with or without PFO and prevent new-onset MHA after ASDC. The responsiveness of the P2Y12 inhibitor could help select candidates who would benefit from PFO closure. It warrants further large-scale research to explore the role of the P2Y12 inhibitor, particularly in a proportion of migraine patients.
有人猜测和研究将偏头痛与血小板聚集和活化异常联系起来。P2Y12血小板抑制剂在偏头痛治疗中的作用尚未确定。我们的目的是评估血小板P2Y12抑制剂在经导管房间隔缺损封堵术(ASDC)后治疗偏头痛和预防新发偏头痛(MHA)的疗效。我们在PubMed、Web of Science和Cochrane图书馆的数据库中搜索了相关研究。主要结果是ASDC后头痛反应率和新发偏头痛发作率。包括对262名患有或不患有卵圆孔未闭(PFO)的偏头痛患者的四项研究,以及对539名接受抗血小板治疗的患者进行的三项研究,以预防ASDC后新发偏头痛。P2Y12抑制剂对偏头痛的总有效率为0.64(95%CI:0.43至0.81)。对于接受ASDC的患者,与不包括P2Y12抑制物的方案相比,使用包括P2Y1 2抑制物在内的抗血小板方案,导致新发偏头痛发生率降低(OR:0.41,95%CI:0.22-0.77,P=0.005)。我们得出结论,P2Y12血小板抑制剂可能对有或没有PFO的偏头痛患者具有主要预防作用,并预防ASDC后新发MHA。P2Y12抑制剂的反应性可以帮助选择从PFO封闭中受益的候选者。值得进一步进行大规模研究,以探索P2Y12抑制剂的作用,特别是在一定比例的偏头痛患者中。
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引用次数: 5
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Behavioural Neurology
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