Brain & Development最新文献_第5页

Associations between cerebrospinal fluid pressure levels, clinical features, and MRI abnormalities in pediatric idiopathic intracranial hypertension: A retrospective study 儿童特发性颅内高压的脑脊液压力水平、临床特征和MRI异常之间的关系：一项回顾性研究

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-16 DOI: 10.1016/j.braindev.2025.104477

Hasan Emral , Tülay Kamaşak , İlker Eyüboğlu , Yusuf Emre Bostan , Ali Cansu

Background

Idiopathic intracranial hypertension (IIH) is a condition characterized by increased cerebrospinal fluid (CSF) pressure without an identifiable cause. Although neuroimaging features are often used to support diagnosis, the relationship between CSF pressure and MRI findings remains unclear, particularly in pediatric populations.

Objective

To investigate the association between CSF opening pressure and clinical as well as MRI features in children diagnosed with IIH.

Methods

We retrospectively reviewed 30 pediatric patients (aged 6–18 years) diagnosed with IIH between 2015 and 2020. Patients were divided into two groups based on CSF opening pressure: Group 1 (200–350 mm H₂O) and Group 2 (≥350 mm H₂O). Clinical symptoms and MRI features—including optic nerve sheath dilation, posterior globe flattening, optic nerve tortuosity, and transverse sinus stenosis—were compared between groups.

Results

The mean CSF opening pressure was 363.8 mm H₂O. No statistically significant differences were observed between groups with respect to demographic features, clinical symptoms, or MRI abnormalities (p > 0.05). The most frequent imaging findings were posterior globe flattening (73.3 %) and optic nerve sheath dilation (70 %). Spearman correlation analysis demonstrated a significant positive association between CSF opening pressure and optic nerve sheath dilation (r = 0.417, p = 0.022), with borderline correlations noted for optic nerve tortuosity (r = 0.358, p = 0.052) and transverse sinus stenosis (r = 0.438, p = 0.069).

Discussion

CSF opening pressure alone did not distinguish clinical or imaging features between groups. However, higher pressures correlated with optic nerve sheath dilation and showed trends toward tortuosity and venous stenosis, suggesting these may be secondary markers of disease severity.

Conclusion

Pediatric IIH appears multifactorial rather than purely pressure-driven. Multimodal evaluation is essential, and larger prospective studies are warranted to clarify the prognostic value of imaging correlates.

背景：特发性颅内高压（IIH）是一种以脑脊液（CSF）压力升高为特征的无明确原因的疾病。虽然神经影像学特征常用于支持诊断，但脑脊液压力与MRI结果之间的关系尚不清楚，特别是在儿科人群中。目的：探讨脑脊液开口压力与IIH患儿临床及MRI表现的关系。方法：我们回顾性分析了2015年至2020年间诊断为IIH的30例儿童患者（6-18岁）。根据脑脊液开口压力将患者分为两组：1组（200-350 mm H₂O）和2组（≥350 mm H₂O）。比较两组患者的临床症状和MRI表现，包括视神经鞘扩张、后球扁平、视神经扭曲和横窦狭窄。结果：脑脊液平均开口压力为363.8 mm H₂O。在人口学特征、临床症状或MRI异常方面，组间无统计学差异（p < 0.05）。最常见的影像学表现为后球变平（73.3%）和视神经鞘扩张（70%）。Spearman相关分析显示脑脊液开口压力与视神经鞘扩张呈显著正相关（r = 0.417, p = 0.022），视神经扭曲（r = 0.358, p = 0.052）和横窦狭窄（r = 0.438, p = 0.069）呈临界相关性。讨论：单独的脑脊液开口压力不能区分两组的临床或影像学特征。然而，较高的压力与视神经鞘扩张相关，并表现出扭曲和静脉狭窄的趋势，表明这些可能是疾病严重程度的次要标志。结论：儿童IIH是多因素的，而不是单纯的压力驱动。多模式评估是必要的，需要更大的前瞻性研究来阐明影像学相关因素的预后价值。

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引用次数: 0

Reply to “Understanding cancer risk in severe motor and intellectual disabilities: The role of external influences” 回复“了解严重运动和智力残疾的癌症风险：外部影响的作用”。

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-16 DOI: 10.1016/j.braindev.2025.104470

Hiroshi Terashima , Yoshiaki Saito

引用次数: 0

Reply to: “Acute encephalopathy with biphasic seizures: Is cerebrospinal fluid glutamate truly specific?” 回复：“急性脑病伴双相癫痫：脑脊液谷氨酸真的是特异性的吗？”

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-16 DOI: 10.1016/j.braindev.2025.104471

Yasunari Sakai, Kenta Kajiwara

引用次数: 0

Acute encephalopathy with biphasic seizures: Is cerebrospinal fluid glutamate truly specific? 急性脑病伴双相癫痫发作：脑脊液谷氨酸真的是特异性的吗？

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-14 DOI: 10.1016/j.braindev.2025.104466

Christian Messina

引用次数: 0

A patient presenting with chapeau de gendarme and three phase-ictal EEG pattern: Suggesting a focus in the interhemispheric fissure 1例患者脑电图表现为三相脑电图：提示在半球间裂处有病灶。

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-14 DOI: 10.1016/j.braindev.2025.104467

Kensuke Kumazaki , Tohru Okanishi , Kento Ohta , Michiru Sasaki , Sotaro Kanai , Yoshihiro Maegaki

Introduction

We report a pediatric case of frontal lobe epilepsy with seizures characterized by the “chapeau de gendarme (CdG)” sign and a three phase-ictal scalp EEG (3Ph-EEG) pattern, suggesting a seizure focus in the interhemispheric fissure (IHF) cortex.

Case report

An 8-year-old boy with autism spectrum disorder (ASD) presented with daily episodes of impaired consciousness, staring, and bilateral tonic posturing of the upper limbs, accompanied by stiffening and drooping of both corners of the mouth. These episodes were initially misdiagnosed as behavioral disturbances in patients with ASD. Video-scalp EEG at age 11 revealed a 3Ph-EEG pattern: 1) brief β bursts in the left frontal region; 2) diffuse attenuation; and 3) rhythmic activity evolving from β to δ frequencies over the left fronto-centro-parietal regions. Seizure semiology and EEG findings were consistent with a seizure focus in the anterior IHF cortex, including the cingulate gyrus. Although valproate and levetiracetam were ineffective, lacosamide (LCM) effectively controlled the seizures, and its efficacy was sustained over a 3-year follow-up period.

Discussion

The combination of CdG and 3Ph-EEG patterns may serve as clinical and electrophysiological markers for seizures originating in the frontal IHF cortex. Therefore, LCM may be an effective treatment option for such cases. This case underscores the importance of detailed seizure semiology and EEG interpretation for accurate localization.

简介：我们报告一例额叶癫痫患儿，其癫痫发作的特征为“头盖骨（CdG）”征和三期脑电图（3Ph-EEG）模式，提示癫痫发作集中在半球间裂（IHF）皮层。病例报告：一名患有自闭症谱系障碍（ASD）的8岁男孩，每日表现为意识受损、凝视、双侧上肢强直姿势，并伴有嘴角僵硬和下垂。这些发作最初被误诊为ASD患者的行为障碍。11岁儿童头部视频脑电图显示3Ph-EEG模式：1)左侧额叶区出现短暂的β爆发；2)扩散衰减；3)左侧额-中-顶叶区节律性活动频率由β向δ演化。癫痫符号学和脑电图结果与癫痫集中在IHF前部皮层，包括扣带回一致。丙戊酸钠和左乙拉西坦均无效，而拉科沙胺（LCM）可有效控制癫痫发作，且其疗效持续3年以上。讨论：CdG和3Ph-EEG模式的结合可以作为源自额叶IHF皮层的癫痫发作的临床和电生理标记。因此，LCM可能是这类病例的有效治疗选择。这个病例强调了详细的癫痫符号学和脑电图解释对准确定位的重要性。

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引用次数: 0

Effects of therapeutic instrumental music performance on upper limb motor function of children with cerebral palsy: A systematic review 治疗性器乐演奏对脑瘫儿童上肢运动功能的影响：系统回顾。

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-13 DOI: 10.1016/j.braindev.2025.104468

Zhuolin Wu , Meijiao Wu

Therapeutic instrumental music performance (TIMP) can be used to improve limb motor function in children with cerebral palsy (CwCP). The purpose of this systematic review is to further analyze the potential therapeutic effects of TIMP on upper limb motor function in CwCP. We used the terms "“music,"” "“therapeutic instrumental music performance,"” "“musical instruments,"” "“cerebral palsy,"” "“children,"” "“upper limb,"” and "“upper extremity"” as our search keywords, and conducted a search of articles published in English and Chinese databases: PubMed, Cochrane, Web of Science, Wiley Online Library, CINAHL, and CNKI, Wanfang Data as of March 2025. Initially, 409 articles were retrieved. After screening titles and abstracts and assessing eligibility, eight studies were included in this review. All studies assessed hand fine motor function, and five also evaluated upper limb gross motor function. Three studies used only keyboard instruments, two exclusively percussion instruments, and three combined keyboard, percussion, and plucked instruments. The results demonstrated that TIMP effectively improves upper limb motor function in CwCP.

治疗性器乐演奏（TIMP）可用于改善脑瘫（CwCP）患儿肢体运动功能。本系统综述的目的是进一步分析TIMP对CwCP上肢运动功能的潜在治疗作用。我们以“音乐，“” “”治疗性器乐演奏，“” “”乐器，“” “”脑瘫，“” “”儿童，“” “”上肢”和“上肢”作为搜索关键词，检索了截至2025年3月在PubMed， Cochrane, Web of Science, Wiley Online Library， CINAHL， CNKI，万方数据等中英文数据库中发表的文章。最初，检索了409篇文章。在筛选标题和摘要并评估合格性后，本综述纳入了8项研究。所有研究都评估了手部精细运动功能，其中5项研究还评估了上肢大运动功能。三项研究只使用键盘乐器，两项研究只使用打击乐器，三项研究将键盘、打击乐器和弹拨乐器结合使用。结果表明，TIMP能有效改善CwCP患者上肢运动功能。

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引用次数: 0

Development of the human cerebellum from midgestation to the perinatal period: A morphological study 人类小脑从妊娠中期到围产期的发育：形态学研究

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-10 DOI: 10.1016/j.braindev.2025.104453

Katsuyuki Yamaguchi, Takuya Yazawa

Introduction

The human cerebellum has large hemispheres (HS) and develops slowly over the pre- and postnatal periods. Several morphological studies have reported regional differences during the fetal period. This study aimed to investigate these differences by evaluating serial brain sections.

Materials and methods

Ten cerebellar samples aged 21–43 postmenstrual weeks (PW) were analyzed. Horizontal serial sections were cut and stained using the Klüver–Barrera method. After microscopic observations, a volumetric analysis was performed for the cerebellar cortex and medulla among the HS, vermis (VM), and flocculus (FL).

Results

The lamina dissecans (LD) was more prominent and lasted longer in the HS than in the VM and FL. The maturation of Purkinje cells and the accumulation of granule cells in the internal granular layer started earlier in the latter than in the former. Cortical differentiation was most delayed in the inferior semilunar and tonsillar lobules. Volumetric analysis showed that volume increased more in the HS than in the VM and FL after midgestation, and that it increased more intensively in the cortex than in the medulla in each region.

Conclusions

The human cerebellar cortex may develop through three stages in fetal period: (1) three-layers stage (before 20 PW); (2) five-layers stage (20–30 PW); (3) four-layers stage (after 30 PW). Particularly, the second stage is characterized by a transient appearance of the LD, which is most evident in the HS. Regional differences should be carefully considered when interpreting morphogenetic data.

人类小脑有较大的半球（HS），在产前和产后发育缓慢。一些形态学研究报告了胎儿时期的区域差异。本研究旨在通过评估连续脑切片来研究这些差异。材料与方法对21 ~ 43岁月经后小脑样本进行分析。水平序列切片采用kl ver - barrera法切割染色。显微镜观察后，对小脑皮层和髓质、蚓部（VM）和小叶（FL）进行体积分析。结果与VM和FL相比，HS的夹层更明显，持续时间更长，浦肯野细胞的成熟和颗粒细胞在内颗粒层的积累开始早于VM和FL。下半月小叶和扁桃体小叶的皮质分化最迟。体积分析显示，妊娠中期后脑区体积增加幅度大于后脑区和前脑区，且各区域皮层体积增加幅度大于髓质。结论胎儿期人小脑皮层发育可分为三个阶段：(1)三层发育阶段（20 PW前）；(2)五层阶段（20-30 PW）；(3)四层阶段（30pw后）。特别是，第二阶段的特征是LD的短暂出现，这在HS中最为明显。在解释形态发生数据时，应仔细考虑区域差异。

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引用次数: 0

Interaction with individuals with severe motor and intellectual disabilities and nurses' positive mental well-being 与严重运动和智力障碍患者的互动以及护士的积极心理健康

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-10 DOI: 10.1016/j.braindev.2025.104461

Yuto Arai , Sawako Ohba , Ryuki Kadekaru , Tohru Okanishi , Hisashi Noma , Yoshihiro Maegaki

Background

Severe motor and intellectual disabilities (SMID) involve intense physical and intellectual disabilities resulting in extreme dependence. Studies investigating the association between the experience of interacting with individuals with SMID and nurses' positive mental well-being are lacking. The comprehensive analysis of factors associated with the positive mental well-being of nurses who interact with individuals with SMID may enhance the nurses' quality of life and contribute to improving the quality of care provided to individuals with SMID.

Methods

We conducted a two-month cross-sectional online survey among 263 nurses at a university hospital in 2023. Happiness and resilience were measured using the Subjective Happiness Scale (SHS) and the short version of the Resilience Scale (RS-14), respectively. Multiple regression analysis was conducted to investigate the relationship between the interaction experience with individuals with SMID and the SHS and RS-14 scores, alongside other factors possibly influencing positive mental well-being.

Results

Regarding subjective happiness, no factor related to individuals with SMID was significantly associated with the SHS scores. However, regarding resilience, the number of years spent engaging with them was positively associated with the RS-14 scores [regression coefficient (B), 2.401; 95 % confidence interval (CI), 0.073 to 4.728; p = 0.043].

Conclusion

Interaction experiences with individuals with SMID were not associated with subjective happiness; however, they were associated with resilience. Our findings suggest the necessity for nurses to establish sustainable relationships with individuals with SMID.

重度运动和智力残疾（SMID）涉及严重的身体和智力残疾，导致极度依赖。调查与SMID患者互动的经验与护士积极心理健康之间关系的研究缺乏。综合分析与SMID患者互动的护士积极心理健康的相关因素，可以提高护士的生活质量，有助于提高对SMID患者的护理质量。方法对某大学附属医院263名护士进行为期2个月的横断面在线调查。幸福感和弹性分别采用主观幸福感量表（SHS）和短版弹性量表（RS-14）进行测量。通过多元回归分析，探讨与SMID个体的互动体验与SHS和RS-14评分的关系，以及其他可能影响积极心理健康的因素。结果主观幸福感方面，与SMID个体相关的因素与SHS得分无显著相关。然而，在弹性方面，与他们相处的年数与RS-14分数呈正相关[回归系数(B), 2.401；95%置信区间（CI）， 0.073 ~ 4.728；p = 0.043]。结论与SMID个体的互动体验与主观幸福感无关；然而，它们与适应力有关。我们的研究结果表明护士有必要与SMID患者建立可持续的关系。

{"title":"Interaction with individuals with severe motor and intellectual disabilities and nurses' positive mental well-being","authors":"Yuto Arai , Sawako Ohba , Ryuki Kadekaru , Tohru Okanishi , Hisashi Noma , Yoshihiro Maegaki","doi":"10.1016/j.braindev.2025.104461","DOIUrl":"10.1016/j.braindev.2025.104461","url":null,"abstract":"<div><h3>Background</h3><div>Severe motor and intellectual disabilities (SMID) involve intense physical and intellectual disabilities resulting in extreme dependence. Studies investigating the association between the experience of interacting with individuals with SMID and nurses' positive mental well-being are lacking. The comprehensive analysis of factors associated with the positive mental well-being of nurses who interact with individuals with SMID may enhance the nurses' quality of life and contribute to improving the quality of care provided to individuals with SMID.</div></div><div><h3>Methods</h3><div>We conducted a two-month cross-sectional online survey among 263 nurses at a university hospital in 2023. Happiness and resilience were measured using the Subjective Happiness Scale (SHS) and the short version of the Resilience Scale (RS-14), respectively. Multiple regression analysis was conducted to investigate the relationship between the interaction experience with individuals with SMID and the SHS and RS-14 scores, alongside other factors possibly influencing positive mental well-being.</div></div><div><h3>Results</h3><div>Regarding subjective happiness, no factor related to individuals with SMID was significantly associated with the SHS scores. However, regarding resilience, the number of years spent engaging with them was positively associated with the RS-14 scores [regression coefficient (B), 2.401; 95 % confidence interval (CI), 0.073 to 4.728; <em>p</em> = 0.043].</div></div><div><h3>Conclusion</h3><div>Interaction experiences with individuals with SMID were not associated with subjective happiness; however, they were associated with resilience. Our findings suggest the necessity for nurses to establish sustainable relationships with individuals with SMID.</div></div>","PeriodicalId":56137,"journal":{"name":"Brain & Development","volume":"47 6","pages":"Article 104461"},"PeriodicalIF":1.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145271504","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

Structural brain alterations in persistent developmental stuttering: a whole-brain voxel-based morphometry (VBM) analysis of grey and white matter 持续性发育性口吃的脑结构改变：灰质和白质的全脑体素形态学分析

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-08 DOI: 10.1016/j.braindev.2025.104464

Seyedehsamaneh Shojaeilangari , Mohammad Ehsan Taghizadeh , Narges Radman

Objective

Persistent developmental stuttering (PDS), also known as childhood-onset speech fluency disorder, is characterized by involuntary disruptions in normal speech fluency, such as sound repetitions, prolongations, and silent pauses. Although structural neuroimaging techniques, particularly voxel-based morphometry (VBM), have been widely used to explore brain abnormalities in PDS, the precise brain regions predominantly affected remain unclear. This study aimed to investigate grey matter (GM) and white matter (WM) volumetric differences in adults with PDS compared to fluent speakers.

Methods

Magnetic resonance imaging (MRI) scans were obtained from 15 adults with PDS and 15 fluent control participants matched for age, sex, education, and hand preference. Whole-brain VBM analysis was conducted to assess GM and WM volume differences between the two groups.

Results

Compared to fluent speakers, adults with PDS demonstrated reduced WM volume in the cerebellum. GM alterations included increased volumes in the right postcentral gyrus and the left middle temporal gyrus (MTG), while decreased volumes were observed in the left superior frontal gyrus (SFG), bilateral paracentral lobule, right cuneus, and right cerebellum.

Conclusion

These findings provide evidence of both grey and white matter abnormalities in adults with PDS, highlighting the involvement of specific cortical and subcortical regions. The results support the significance of structural brain differences in understanding the neurobiological basis of persistent stuttering.

持续性发展性口吃（PDS），也被称为儿童期言语流畅障碍，其特征是正常言语流畅性的不自觉中断，如声音重复、延长和沉默停顿。尽管结构神经成像技术，特别是基于体素的形态测量（VBM），已被广泛用于探索PDS的大脑异常，但主要受影响的精确大脑区域仍不清楚。本研究的目的是研究成人半失语症患者与流利说话者相比灰质（GM）和白质（WM）体积的差异。方法对15名成年PDS患者和15名年龄、性别、教育程度和手部偏好相匹配的流利对照者进行磁共振成像（MRI）扫描。全脑VBM分析评估两组间GM和WM体积差异。结果与说流利英语的人相比，患有PDS的成人小脑WM体积减少。GM改变包括右侧中央后回和左侧颞中回（MTG）体积增加，而左侧额上回（SFG）、双侧中央旁小叶、右侧楔叶和右侧小脑体积减少。结论：这些发现为成人PDS患者的灰质和白质异常提供了证据，突出了特定皮层和皮层下区域的参与。研究结果支持了大脑结构差异对理解持续性口吃的神经生物学基础的重要性。

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引用次数: 0

Cancers in an aging population with severe motor and intellectual disabilities: a single-center retrospective cohort study. 患有严重运动和智力残疾的老年人群中的癌症：一项单中心回顾性队列研究。

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development

Pub Date : 2025-10-01 Epub Date: 2025-08-09 DOI: 10.1016/j.braindev.2025.104416

Hiroshi Terashima, Yoshiaki Saito, Nagahisa Takahashi, Masashi Mizuguchi, Eiji Kitazumi

Objective: To investigate the characteristics of cancers in aging individuals with severe motor and intellectual disabilities (SMID).

Methods: This is a retrospective cohort study conducted at a single center. Clinical records of 186 individuals residing in the SMID ward between January 2002 and December 2022 were reviewed. For colorectal cancer, which showed high incidence, statistical comparisons were performed with an age- and sex-matched non-cancer control group.

Results: Among 48 recorded deaths, cancer was the most common cause (13 cases, 27 %; median age at death, 57 years), followed by pneumonia (12 cases, 25 %; median age at death, 51 years). Among the 20 patients diagnosed with cancers (affecting 22 organs), colorectal cancer accounted for eight cases (36 %) and breast cancer for six cases (27 %). The standardized incidence ratios for both cancers exceeded 1. Colorectal cancer incidence was significantly associated with frequent gross hematochezia and the number of preceding years with positive fecal occult blood test results, as well as marginally with the frequency of enemas. Four patients with colorectal cancer underwent surgery, and three were alive at the end of the study period.

Conclusion: As individuals with SMID age, cancer has become a leading cause of death. The incidence rates of colorectal and breast cancers exceed those in the general population. It is justifiable to apply the same screening protocols to this population as in the general population, but strategies to enhance diagnostic specificity and reduce the invasiveness of confirmatory tests are desirable. Surgical treatment for colorectal cancer may improve the survival outcomes.

目的：探讨老年重度运动智力障碍（SMID）患者的癌症特点。方法：这是一项单中心回顾性队列研究。回顾了2002年1月至2022年12月期间居住在SMID病房的186名患者的临床记录。对于高发病率的结直肠癌，与年龄和性别匹配的非癌症对照组进行了统计比较。结果：在记录的48例死亡中，癌症是最常见的原因(13例，27%；死亡时中位年龄为57岁，其次是肺炎(12例，25%；死亡年龄中位数为51岁)。在被诊断为癌症（影响22个器官）的20例患者中，结直肠癌占8例（36%），乳腺癌占6例（27%）。两种癌症的标准化发病率比均超过1。结直肠癌的发病率与频繁的总便血和粪便潜血检查阳性的年数显著相关，与灌肠次数也有轻微关系。四名结直肠癌患者接受了手术，其中三人在研究结束时仍然活着。结论：随着SMID患者年龄的增长，癌症已成为导致其死亡的主要原因。结直肠癌和乳腺癌的发病率高于一般人群。对这类人群采用与普通人群相同的筛查方案是合理的，但提高诊断特异性和减少确诊性检测的侵入性的策略是可取的。结直肠癌的手术治疗可能会提高生存率。

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引用次数: 0