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Hypercapnia as a preventative therapeutic strategy: Unveiling the neuroprotective potential and mechanisms 高碳酸血症作为一种预防性治疗策略:揭示神经保护潜力和机制
Pub Date : 2025-04-08 DOI: 10.1016/j.dscb.2025.100219
K. Fazeli , S.B. Jameie , M. Farhadi
Hypercapnia, an increase in carbon dioxide (CO2) in the bloodstream, has been historically considered purely a pathological condition. However, based on several publications evaluating the adverse outcome of certain conditions with an additional hypercapnia, It was discovered that hypercapnia can be also utilized as a therapeutic strategy. The most common of these strategies is permissive hypercapnia, which is described by inducing PaCO2 in inhalation while breathing under a mechanical ventilator in order to reduce secondary lung injuries. Subsequently, hypercapnia was also discovered as an effective anti-apoptotic and anti-ischemic agent while evaluated on neurons in vitro and rat models. As a result, hypercapnia has been utilized as an intervention in several clinical trials regarding different neurological conditions, most notably Sub-Arachnoid Hemorrhage. Mild levels of induced Hypercapnia is capable of preventing serious delayed vasospastic ischemic attacks and increases the overall cerebral blood flow which leads to significantly better outcomes in patients with severe acute neurological conditions. The anti-apoptotic and neuroprotective characteristics of CO2 suggest induced hypercapnia as a potential strategy for preventing more chronic neuropathological conditions. This article aims to review the publications surrounding the neuro-therapeutic effects of hypercapnia and discuss the advantages, drawbacks, and future of hypercapnia as an impactful strategy in preventing and treating neurological pathologies.
高碳酸血症,血液中二氧化碳(CO2)的增加,一直被认为是纯粹的病理状态。然而,根据一些评估某些条件下额外高碳酸血症的不良后果的出版物,发现高碳酸血症也可以作为一种治疗策略。这些策略中最常见的是允许性高碳酸血症,通过在机械呼吸机下呼吸时诱导吸入PaCO2来减少继发性肺损伤。随后,高碳酸血症也被发现是一种有效的抗凋亡和抗缺血药物,并在体外和大鼠模型上对神经元进行了评估。因此,高碳酸血症已被用作几种不同神经系统疾病的临床试验的干预措施,最明显的是蛛网膜下腔出血。轻度的诱导性高碳酸血症能够预防严重的延迟性血管痉挛性缺血发作,并增加脑总血流量,从而显著改善严重急性神经系统疾病患者的预后。二氧化碳的抗凋亡和神经保护特性表明,诱导高碳酸血症是预防更多慢性神经病理疾病的潜在策略。本文旨在回顾有关高碳酸血症的神经治疗效果的出版物,并讨论高碳酸血症作为预防和治疗神经系统疾病的有效策略的优点,缺点和未来。
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引用次数: 0
rTMS for enhancing cognitive reserve: A case report rTMS增强认知储备1例
Pub Date : 2025-04-04 DOI: 10.1016/j.dscb.2025.100221
Chiara Di Fazio , Eugenio Scaliti , Mario Stanziano , Anna Nigri , Greta Demichelis , Marco Tamietto , Sara Palermo
Understanding the mechanisms underlying brain ageing and age-related pathologies is crucial for addressing cognitive decline. Non-invasive brain stimulation techniques such as repetitive transcranial magnetic stimulation (rTMS) have gained prominence due to their ability to modulate neurophysiological, affective and cognitive brain functions. In this case study, we present a 61-year-old woman who suffered from mood disturbances, sleep disturbances, fatigue and cognitive decline. A comprehensive neuropsychological assessment was performed to evaluate mood, cognition and quality of life. The elderly woman underwent rTMS treatment targeting the left dorsolateral prefrontal cortex (DLPFC), a region critical for executive functions and mood regulation. Significant improvements were observed in attention, processing speed, and cognitive flexibility, as evidenced by reductions in completion times on the Trail Making Test (TMT). In addition to clinical and cognitive outcomes, cortical excitability was assessed through motor-evoked potentials (MEPs) before and after the intervention. Modulation of MEPs amplitude was observed post-treatment, suggesting neurophysiological changes potentially linked to the normalization of cortical activity. Our findings suggest that rTMS may be a well-tolerated and potentially effective intervention for improving cognitive function and stabilizing mood in older adults experiencing age-related cognitive decline and mood disorders.
了解大脑老化和年龄相关病理的机制对于解决认知能力下降至关重要。重复经颅磁刺激(rTMS)等非侵入性脑刺激技术因其调节神经生理、情感和认知脑功能的能力而受到重视。在这个案例研究中,我们介绍了一位61岁的女性,她患有情绪障碍、睡眠障碍、疲劳和认知能力下降。进行全面的神经心理学评估,以评估情绪、认知和生活质量。这名老年妇女接受了针对左背外侧前额叶皮层(DLPFC)的rTMS治疗,这是一个对执行功能和情绪调节至关重要的区域。在注意力、处理速度和认知灵活性方面观察到显著的改善,这可以从完成轨迹测试(TMT)的时间减少中得到证明。除了临床和认知结果外,在干预前后通过运动诱发电位(MEPs)评估皮质兴奋性。治疗后观察到MEPs振幅的调节,表明神经生理变化可能与皮层活动的正常化有关。我们的研究结果表明,rTMS可能是一种耐受性良好且潜在有效的干预措施,可改善认知功能,稳定老年人经历与年龄相关的认知衰退和情绪障碍。
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引用次数: 0
Vitamin B12 deficiency and cognitive impairment: A comprehensive review of neurological impact 维生素B12缺乏和认知障碍:对神经系统影响的全面回顾
Pub Date : 2025-04-02 DOI: 10.1016/j.dscb.2025.100220
Milind Umekar , Tanvi Premchandani , Amol Tatode , Mohammad Qutub , Neha Raut , Jayshree Taksande , Ujban Md. Hussain
Cognitive impairment, a prevalent issue in aging populations, significantly affects quality of life and public health systems. Among various contributing factors, Vitamin B12 deficiency emerges as a critical yet modifiable risk factor, impacting neurological and cognitive health. Vitamin B12, an essential micronutrient derived from animal-based foods, is vital for myelin integrity, neurotransmitter synthesis, and homocysteine metabolism. Its deficiency disrupts these processes, leading to neurotoxic effects such as oxidative stress, vascular damage, and neurodegeneration, which exacerbate cognitive decline. This review combines evidence from human and animal studies on the neurocognitive impacts of Vitamin B12 deficiency and evaluates supplementation strategies. It underscores the multifactorial nature of B12 deficiency, driven by dietary inadequacies, physiological changes, and environmental factors, especially in high-risk groups such as the elderly and vegetarians. Proactive measures, including routine screening, dietary adjustments, and early supplementation, are essential to prevent deficiency-related cognitive impairments. Advancements in biomarkers and neuroimaging also promise improved diagnosis and intervention strategies, highlighting an interdisciplinary approach to optimizing cognitive health outcomes.
认知障碍是老年人普遍存在的问题,严重影响生活质量和公共卫生系统。在各种因素中,维生素B12缺乏是一个关键但可改变的风险因素,影响神经和认知健康。维生素B12是一种从动物性食物中提取的必需微量营养素,对髓磷脂完整性、神经递质合成和同型半胱氨酸代谢至关重要。它的缺乏会破坏这些过程,导致氧化应激、血管损伤和神经变性等神经毒性作用,从而加剧认知能力下降。本综述结合了维生素B12缺乏对神经认知影响的人类和动物研究证据,并评估了补充策略。它强调了B12缺乏的多因素性质,由饮食不足、生理变化和环境因素驱动,特别是在老年人和素食者等高风险人群中。包括常规筛查、饮食调整和早期补充在内的积极措施对于预防与缺陷相关的认知障碍至关重要。生物标志物和神经影像学的进步也有望改善诊断和干预策略,突出了优化认知健康结果的跨学科方法。
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引用次数: 0
Binge eating disorder induced by venlafaxine and desvenlafaxine: A case report 文拉法辛与地文拉法辛致暴食症1例
Pub Date : 2025-03-29 DOI: 10.1016/j.dscb.2025.100216
Thales Pimenta de Figueiredo , Débora Marques de Miranda , Antônio Marcos Alvim-Soares Júnior , Miss Ana Clara Silva Melo Franco
This case report discusses an unmarried female in her middle-thirties with a history of Recurrent Depressive Disorder. After taking both venlafaxine and desvenlafaxine, she began to show symptoms of Binge Eating Disorder. To alleviate these symptoms, she discontinued the medications and switched to bupropion, which helped her overcome the eating-related issues. However, her depressive symptoms then returned. The report examines how serotonin and norepinephrine reuptake inhibitors work, which may explain the observer phenomenon and clarify the eating behaviors in this case that might initially appear paradoxical. Moreover, it suggests clinicians close monitor outcomes when using such medications, as symptoms worsening might be an adverse effect rather than a disease progression. A diagrammatic timeline of the case report can be observed in Fig. 1.
本病例报告讨论了一位35岁左右的未婚女性,有复发性抑郁症的病史。同时服用文拉法辛和地文拉法辛后,她开始出现暴食症的症状。为了缓解这些症状,她停止了药物治疗,转而服用安非他酮,这帮助她克服了与饮食有关的问题。然而,她的抑郁症状随后又出现了。该报告研究了血清素和去甲肾上腺素再摄取抑制剂是如何起作用的,这可能解释了观察者的现象,并澄清了在这种情况下最初看似矛盾的饮食行为。此外,它建议临床医生在使用此类药物时密切监测结果,因为症状恶化可能是不良反应,而不是疾病进展。在图1中可以观察到病例报告的图表时间表。
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引用次数: 0
Role of calcineurin and ionotropic glutamate receptors in Alzheimer's disease: A systematic review 钙调磷酸酶和嗜离子性谷氨酸受体在阿尔茨海默病中的作用:系统综述
Pub Date : 2025-03-28 DOI: 10.1016/j.dscb.2025.100218
Awgichew Behaile Teklemariam , Edgeit Abebe Zewde , Melaku Mekonnen Agidew , Sisay Ayalkibet Siyamrew , Lemlemu Maru , Zelalem Tilahun Muche
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and behavioral changes. Calcineurin (CaN), a calcium/calmodulin-dependent serine/threonine phosphatase, is hyperactivated in AD, leading to enhanced neuroinflammation, synaptic dysfunction, and tau hyperphosphorylation. Similarly, the dysregulation of ionotropic glutamate receptors (iGluRs), particularly NMDA receptors in the context of AD, aggravates excitotoxicity, which in turn contributes to neuronal damage and cognitive deficits. Moreover, AMPA and kainate receptors also play significant roles in synaptic plasticity and neurodegeneration.
The intricate interplay between CaN and iGluRs, specifically NMDA, AMPA, and kainate receptors, through various signaling pathways plays a crucial role in AD pathogenesis. Therapeutic approaches targeting the CaN-iGluR axis, including CaN inhibitors and iGluR modulators, have the potential to mitigate the progression of AD and improve cognitive functions associated with the disease.
This systematic review aims to consolidate current knowledge on the molecular mechanisms underlying CaN and iGluR dysregulation in AD and discuss their potential as therapeutic targets. Future investigations should prioritize elucidating the precise interactions between CaN and iGluRs, as well as developing selective modulators to enhance the efficacy and safety of therapeutic interventions for AD.
阿尔茨海默病(AD)是一种进行性神经退行性疾病,以认知能力下降、记忆丧失和行为改变为特征。钙调磷酸酶(CaN)是一种钙/钙调素依赖的丝氨酸/苏氨酸磷酸酶,在AD中过度激活,导致神经炎症增强、突触功能障碍和tau过度磷酸化。同样,嗜离子性谷氨酸受体(iGluRs)的失调,特别是在AD背景下的NMDA受体,会加重兴奋性毒性,进而导致神经元损伤和认知缺陷。此外,AMPA和kainate受体在突触可塑性和神经变性中也起着重要作用。CaN和iGluRs之间复杂的相互作用,特别是NMDA、AMPA和kainate受体,通过各种信号通路在AD发病中起着至关重要的作用。针对CaN-iGluR轴的治疗方法,包括CaN抑制剂和iGluR调节剂,有可能减缓AD的进展并改善与该疾病相关的认知功能。本系统综述旨在巩固目前关于AD中CaN和iGluR失调的分子机制的知识,并讨论它们作为治疗靶点的潜力。未来的研究应优先阐明CaN和iGluRs之间的确切相互作用,以及开发选择性调节剂以提高AD治疗干预的有效性和安全性。
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引用次数: 0
Non-perinatal hypoxic ischemic encephalopathy – Long term outcome and clinico-radiological correlation 非围产期缺氧缺血性脑病-长期预后和临床放射学相关性
Pub Date : 2025-03-27 DOI: 10.1016/j.dscb.2025.100217
Saraswathi Ramanathan , Prince Thakkar , Harshad Vanjare , Raji Thomas , George Tharion , Bijesh Yadav

Objective

To study the long-term outcome of non-perinatal Hypoxic Ischemic Encephalopathy (HIE) and to co-relate clinical outcomes with neuroimaging findings.

Materials and Methods

Retrospective chart review and telephonic follow up study.
Family members of 72 patients, out of 101 screened patients (admitted to an inpatient rehabilitation facility with diagnosis of “HIE” within 6 months of hypoxic insult) were contactable and current telephonic modified Rankin Scale (mRS) was documented. mRS of 0–3 was considered as favorable clinical outcome and mRS of 4–6 as poor outcome. Neuroimaging (CT and MRI) were reviewed by a neuro-radiologist.

Results

The mean (SD) age was 34.06 (18.33) years. One year survival rate was 84.7 % (61/72 patients), with severe disability (mRS 5) in 78.6 % (n = 48) of survivors. At follow up, 60 patients (83.3 %) had poor outcome (mRS 6, 38.9 %, n = 28; mRS 5, 31.9 %, n = 23; mRS 4, 12.5 %, n = 9) and 12 patients (16.7 %) had favorable clinical outcome (mRS 2 and 3). Patients with favorable outcomes had normal imaging or subcortical involvement without diffusion restriction. Diffuse cortical and deep grey involvement, diffuse cortical white matter involvement, cerebellar involvement and brain stem involvement had worse prognosis.

Conclusion

HIE has an overall poor outcome in 83.3 % of the patients. Focal findings on MRI may have a slightly better prognosis than diffuse findings.
目的研究非围产期缺氧缺血性脑病(HIE)的长期预后,并探讨其临床预后与神经影像学表现的相关性。材料与方法回顾性图表复习和电话随访研究。101例筛查患者(在缺氧损伤后6个月内被诊断为“HIE”而入住住院康复机构)中,有72例患者的家庭成员被联系,并记录了当前的电话修改Rankin量表(mRS)。mRS 0 ~ 3分为临床预后良好,mRS 4 ~ 6分为临床预后不良。神经影像学检查(CT和MRI)由神经放射科医生检查。结果患者平均(SD)年龄为34.06岁(18.33岁)。1年生存率为84.7%(61/72例),重度残疾(mRS 5)者占78.6% (n = 48)。随访时,60例(83.3%)患者预后不良(mRS 6, 38.9%, n = 28;mRS 5, 31.9%, n = 23;mRS 4, 12.5%, n = 9)和12例患者(16.7%)有良好的临床结果(mRS 2和mRS 3)。结果良好的患者影像学正常或皮质下受累,无扩散限制。弥漫性皮质及深灰色受累、弥漫性皮质白质受累、小脑受累及脑干受累预后较差。结论83.3%的hie患者预后较差。MRI的局灶性表现可能比弥漫性表现预后稍好。
{"title":"Non-perinatal hypoxic ischemic encephalopathy – Long term outcome and clinico-radiological correlation","authors":"Saraswathi Ramanathan ,&nbsp;Prince Thakkar ,&nbsp;Harshad Vanjare ,&nbsp;Raji Thomas ,&nbsp;George Tharion ,&nbsp;Bijesh Yadav","doi":"10.1016/j.dscb.2025.100217","DOIUrl":"10.1016/j.dscb.2025.100217","url":null,"abstract":"<div><h3>Objective</h3><div>To study the long-term outcome of non-perinatal Hypoxic Ischemic Encephalopathy (HIE) and to co-relate clinical outcomes with neuroimaging findings.</div></div><div><h3>Materials and Methods</h3><div>Retrospective chart review and telephonic follow up study.</div><div>Family members of 72 patients, out of 101 screened patients (admitted to an inpatient rehabilitation facility with diagnosis of “HIE” within 6 months of hypoxic insult) were contactable and current telephonic modified Rankin Scale (mRS) was documented. mRS of 0–3 was considered as favorable clinical outcome and mRS of 4–6 as poor outcome. Neuroimaging (CT and MRI) were reviewed by a neuro-radiologist.</div></div><div><h3>Results</h3><div>The mean (SD) age was 34.06 (18.33) years. One year survival rate was 84.7 % (61/72 patients), with severe disability (mRS 5) in 78.6 % (<em>n</em> = 48) of survivors. At follow up, 60 patients (83.3 %) had poor outcome (mRS 6, 38.9 %, <em>n</em> = 28; mRS 5, 31.9 %, <em>n</em> = 23; mRS 4, 12.5 %, <em>n</em> = 9) and 12 patients (16.7 %) had favorable clinical outcome (mRS 2 and 3). Patients with favorable outcomes had normal imaging or subcortical involvement without diffusion restriction. Diffuse cortical and deep grey involvement, diffuse cortical white matter involvement, cerebellar involvement and brain stem involvement had worse prognosis.</div></div><div><h3>Conclusion</h3><div>HIE has an overall poor outcome in 83.3 % of the patients. Focal findings on MRI may have a slightly better prognosis than diffuse findings.</div></div>","PeriodicalId":72447,"journal":{"name":"Brain disorders (Amsterdam, Netherlands)","volume":"18 ","pages":"Article 100217"},"PeriodicalIF":0.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143791860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Early-onset oculogyric crises in an infant with self-limited familial neonatal epilepsy : A case report 自限性家族性新生儿癫痫患儿早发性眼部危象1例
Pub Date : 2025-03-26 DOI: 10.1016/j.dscb.2025.100215
Alise Skoromka , Sandis Kovaļovs

Background

Oculogyric crises have been less commonly reported in KCNQ2-related disorders. This case report aims to illustrate the clinical variability of KCNQ2-related disorders and emphasize the importance of genetic diagnostics in neonatal epilepsy.

Objective

To present a unique case of self-limited familial neonatal epilepsy associated with an inherited KCNQ2 mutation, highlighting the occurrence of oculogyric crises.

Methods

Clinical evaluation, electroencephalography, magnetic resonance imaging, and genetic testing via whole-exome sequencing was utilized.

Results

A female infant exhibited early-onset seizures and atypical oculogyric crises. Genetic analysis revealed a pathogenic KCNQ2 duplication inherited from the mother. Treatment with valproic acid led to seizure control, and follow-up demonstrated normal psychomotor development.

Conclusion

This case underscores the phenotypic variability of KCNQ2-related disorders and the role of genetic testing in refining diagnosis and management.
背景眼球震颤危象在 KCNQ2 相关疾病中较少报道。本病例报告旨在说明 KCNQ2 相关疾病的临床变异性,并强调基因诊断在新生儿癫痫中的重要性。目的介绍一例与遗传性 KCNQ2 基因突变相关的独特的自限性家族性新生儿癫痫,强调眼球震颤危机的发生。方法采用临床评估、脑电图、磁共振成像和全外显子组测序进行基因检测。基因分析显示,她的母亲遗传了一个致病的 KCNQ2 重复基因。该病例强调了 KCNQ2 相关疾病的表型变异性以及基因检测在完善诊断和管理中的作用。
{"title":"Early-onset oculogyric crises in an infant with self-limited familial neonatal epilepsy : A case report","authors":"Alise Skoromka ,&nbsp;Sandis Kovaļovs","doi":"10.1016/j.dscb.2025.100215","DOIUrl":"10.1016/j.dscb.2025.100215","url":null,"abstract":"<div><h3>Background</h3><div>Oculogyric crises have been less commonly reported in KCNQ2-related disorders. This case report aims to illustrate the clinical variability of KCNQ2-related disorders and emphasize the importance of genetic diagnostics in neonatal epilepsy.</div></div><div><h3>Objective</h3><div>To present a unique case of self-limited familial neonatal epilepsy associated with an inherited KCNQ2 mutation, highlighting the occurrence of oculogyric crises.</div></div><div><h3>Methods</h3><div>Clinical evaluation, electroencephalography, magnetic resonance imaging, and genetic testing via whole-exome sequencing was utilized.</div></div><div><h3>Results</h3><div>A female infant exhibited early-onset seizures and atypical oculogyric crises. Genetic analysis revealed a pathogenic KCNQ2 duplication inherited from the mother. Treatment with valproic acid led to seizure control, and follow-up demonstrated normal psychomotor development.</div></div><div><h3>Conclusion</h3><div>This case underscores the phenotypic variability of KCNQ2-related disorders and the role of genetic testing in refining diagnosis and management.</div></div>","PeriodicalId":72447,"journal":{"name":"Brain disorders (Amsterdam, Netherlands)","volume":"18 ","pages":"Article 100215"},"PeriodicalIF":0.0,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143740030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of phytochemical composition of aqueous extract of Annona reticulata and assessment of its neuroprotective activity on Paraquat-induced neurodegeneration in Drosophila melanogaster Oregon R 番麻水提物的植物化学成分评价及其对百草枯致黑腹果蝇神经退行性变的保护作用
Pub Date : 2025-03-25 DOI: 10.1016/j.dscb.2025.100214
Shubha, Vaibhavi Bhardwaj, Naomi Varghese, Sowmya Kumar
Neurons are essential for maintaining physiological balance, and abnormalities in neuronal activity or communication can lead to medical disorders. The term “neurodegenerative diseases” refers to a broad category of neurological disorders that affect different subsets of neurons in different functional anatomical systems. The term “neurodegenerative diseases” refers to a broad category of neurological disorders that affect different subsets of neurons in different functional anatomical systems. The Oregon R strain of Drosophila melanogaster was used in the study to examine the neuroprotective effects of Annona reticulata Linn. leaf extract against Paraquat-induced neurotoxicity. As per the results of the phytochemical analysis, the Annona reticulata Linn aqueous leaf extract included many phytochemicals like flavanones, phenols, steroids, quinones, coumarins, and flavonoids. Pursuit a toxicity test on the Drosophila melanogaster Oregon R strain, the aqueous extract's antioxidant and neuroprotective activities were evaluated after choosing the ideal paraquat concentration to cause neurodegeneration in the flies. The extract improved the survival rates and greatly decreased locomotor impairment in the treated flies. Additionally, it demonstrated beneficial modulatory effects on the activity of antioxidant enzymes as well as ameliorative effects on the levels of oxidative stress indicators. However, further study is needed to fully understand the molecular pathways behind the extract's neuroprotective activity and to investigate its potential applicability as a medication.
神经元对维持生理平衡至关重要,神经元活动或通讯异常可导致医学疾病。“神经退行性疾病”一词是指影响不同功能解剖系统中不同神经元亚群的一大类神经系统疾病。“神经退行性疾病”一词是指影响不同功能解剖系统中不同神经元亚群的一大类神经系统疾病。本研究以俄勒冈州黑腹果蝇R株为研究对象,研究了黄麻的神经保护作用。叶提取物抗百草枯诱导的神经毒性。根据植物化学分析的结果,番荔枝叶水提取物含有许多植物化学物质,如黄酮、酚类、类固醇、醌类、香豆素和类黄酮。通过对黑腹果蝇俄勒冈R品系的毒性试验,选择理想的百草枯浓度,评价其水提物的抗氧化和神经保护活性。提取物提高了果蝇的存活率,并大大减少了运动障碍。此外,它对抗氧化酶的活性有有益的调节作用,并对氧化应激指标水平有改善作用。然而,需要进一步的研究来充分了解提取物的神经保护活性背后的分子途径,并调查其作为药物的潜在适用性。
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引用次数: 0
The effectiveness of the Halliwick concept hydrotherapy and Bobath (Neurodevelopmental Treatment-NDT) in the treatment of children with cerebral palsy–A randomised controlled trial Halliwick概念水疗法和Bobath(神经发育治疗- ndt)治疗儿童脑瘫的有效性-一项随机对照试验
Pub Date : 2025-03-18 DOI: 10.1016/j.dscb.2025.100213
Konstantinos Chandolias , Eleni Argyroula Tsounia , Nikolaos Strimpakos , Efthalia Zogka , Thomas Besios , Georgios Marios Kyriakatis , Panagiotis Tsimeas , Athanasios Tsiokanos

Background

Children with cerebral palsy (CP) often face challenges in motor function, balance, and daily activities. While land-based therapies such as the Bobath concept are widely used, complementary water-based therapies, including the Halliwick concept, offer unique opportunities to enhance rehabilitation outcomes.

Objective

This study aimed to evaluate the effectiveness of Halliwick concept hydrotherapy on gross motor function, balance, speed, and daily life skills in children with CP. A secondary objective was to compare the combined intervention of Halliwick hydrotherapy and Bobath therapy (NDT) with Bobath therapy (NDT)alone.

Methods

A total of 80 children with CP (mean age: 7.53 years) participated in this 9-month long randomised controlled trial. Participants were divided into three groups: the intervention group (n = 40), which received one session per week of both Halliwick hydrotherapy and Bobath therapy; control group 1 (n = 35), which received two sessions of Bobath therapy (NDT)per week; and control group 2 (n = 5), which did not receive any intervention. Two-way repeated measures ANOVA was conducted to compare the GMFM, PEDI, PBS, and TUG between time and groups, while a paired t-test to assess water-based (WOTA 1 & 2, SWIM, HAAR) through time.

Results

Statistically significant improvements were observed in the intervention group when compared with control groups across all measures. The intervention group demonstrated greater gains in gross motor function, balance, daily activities, and speed, using the TUG test, compared to control group 1, with minimal changes observed in control group 2. Notable improvements included increased GMFM scores (6points improvement in the intervention group compared to 3.36 in control group 1(Wilks's Lambda = 0.807, F = 9.222, partial η2 = 0.193, p < 0.001)), balance (PBS: +3.8 points(Wilks's Lambda = 0.778, F = 11.002, partial η2 = 0.222, p < 0.001)), and daily activities (PEDI: +6.32 points(Wilks's Lambda = 0.849, F = 6.854, partial η2 = 0.151, p = 0.002)). Water-based assessments further highlighted substantial improvements in aquatic skills.

Conclusion

Incorporating Halliwick hydrotherapy into rehabilitation programs for children with CP yields significant benefits, enhancing motor skills, balance, and daily functioning beyond what is achieved with land-based interventions alone. These findings highlight the importance of integrating complementary aquatic therapies into routine clinical practice for children with CP. Further research with larger, homogeneous samples and extended intervention durations is recommended to refine these therapeutic approaches.
背景:脑瘫儿童经常面临运动功能、平衡和日常活动方面的挑战。虽然Bobath概念等陆地疗法被广泛使用,但包括Halliwick概念在内的互补水基疗法为提高康复效果提供了独特的机会。目的本研究旨在评估哈利威克水疗法对CP儿童大运动功能、平衡、速度和日常生活技能的影响。第二个目的是比较哈利威克水疗法和浴缸疗法(NDT)联合干预与单独浴缸疗法(NDT)的效果。方法共80例CP患儿(平均年龄7.53岁)参加为期9个月的随机对照试验。参与者被分为三组:干预组(n = 40),每周接受一次Halliwick水疗和Bobath水疗;对照组1 (n = 35),每周接受两次Bobath疗法(NDT);对照组2 (n = 5)不进行任何干预。采用双向重复测量方差分析比较时间和组间的GMFM、PEDI、PBS和TUG,采用配对t检验评估水基(wota1 &;游泳,穿越时间。结果与对照组相比,干预组在所有指标上均有统计学上的显著改善。通过TUG测试,与对照组1相比,干预组在大运动功能、平衡、日常活动和速度方面表现出更大的进步,而对照组2的变化很小。显著改善包括GMFM评分增加(干预组提高6分,对照组提高3.36分)(Wilks’s Lambda = 0.807, F = 9.222,偏η2 = 0.193, p <;0.001)),平衡(PBS: +3.8点(Wilks’s Lambda = 0.778, F = 11.002, partial η2 = 0.222, p <;0.001)和日常活动(PEDI: +6.32点(Wilks’s Lambda = 0.849, F = 6.854,偏η2 = 0.151, p = 0.002))。基于水的评估进一步强调了水生技能的重大改进。结论:将哈利威克水疗纳入儿童脑瘫的康复计划中,可以显著提高运动技能、平衡能力和日常功能,而不仅仅是陆地干预。这些发现强调了将补充水生疗法整合到CP儿童常规临床实践中的重要性。建议采用更大、均匀样本和延长干预时间的进一步研究来完善这些治疗方法。
{"title":"The effectiveness of the Halliwick concept hydrotherapy and Bobath (Neurodevelopmental Treatment-NDT) in the treatment of children with cerebral palsy–A randomised controlled trial","authors":"Konstantinos Chandolias ,&nbsp;Eleni Argyroula Tsounia ,&nbsp;Nikolaos Strimpakos ,&nbsp;Efthalia Zogka ,&nbsp;Thomas Besios ,&nbsp;Georgios Marios Kyriakatis ,&nbsp;Panagiotis Tsimeas ,&nbsp;Athanasios Tsiokanos","doi":"10.1016/j.dscb.2025.100213","DOIUrl":"10.1016/j.dscb.2025.100213","url":null,"abstract":"<div><h3>Background</h3><div>Children with cerebral palsy (CP) often face challenges in motor function, balance, and daily activities. While land-based therapies such as the Bobath concept are widely used, complementary water-based therapies, including the Halliwick concept, offer unique opportunities to enhance rehabilitation outcomes.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the effectiveness of Halliwick concept hydrotherapy on gross motor function, balance, speed, and daily life skills in children with CP. A secondary objective was to compare the combined intervention of Halliwick hydrotherapy and Bobath therapy (NDT) with Bobath therapy (NDT)alone.</div></div><div><h3>Methods</h3><div>A total of 80 children with CP (mean age: 7.53 years) participated in this 9-month long randomised controlled trial. Participants were divided into three groups: the intervention group (<em>n</em> = 40), which received one session per week of both Halliwick hydrotherapy and Bobath therapy; control group 1 (<em>n</em> = 35), which received two sessions of Bobath therapy (NDT)per week; and control group 2 (<em>n</em> = 5), which did not receive any intervention. Two-way repeated measures ANOVA was conducted to compare the GMFM, PEDI, PBS, and TUG between time and groups, while a paired <em>t</em>-test to assess water-based (WOTA 1 &amp; 2, SWIM, HAAR) through time.</div></div><div><h3>Results</h3><div>Statistically significant improvements were observed in the intervention group when compared with control groups across all measures. The intervention group demonstrated greater gains in gross motor function, balance, daily activities, and speed, using the TUG test, compared to control group 1, with minimal changes observed in control group 2. Notable improvements included increased GMFM scores (6points improvement in the intervention group compared to 3.36 in control group 1(Wilks's Lambda = 0.807, <em>F</em> = 9.222, partial η<sup>2</sup> = 0.193, <em>p</em> &lt; 0.001)), balance (PBS: +3.8 points(Wilks's Lambda = 0.778, <em>F</em> = 11.002, partial η<sup>2</sup> = 0.222, <em>p</em> &lt; 0.001)), and daily activities (PEDI: +6.32 points(Wilks's Lambda = 0.849, <em>F</em> = 6.854, partial η<sup>2</sup> = 0.151, <em>p</em> = 0.002)). Water-based assessments further highlighted substantial improvements in aquatic skills.</div></div><div><h3>Conclusion</h3><div>Incorporating Halliwick hydrotherapy into rehabilitation programs for children with CP yields significant benefits, enhancing motor skills, balance, and daily functioning beyond what is achieved with land-based interventions alone. These findings highlight the importance of integrating complementary aquatic therapies into routine clinical practice for children with CP. Further research with larger, homogeneous samples and extended intervention durations is recommended to refine these therapeutic approaches.</div></div>","PeriodicalId":72447,"journal":{"name":"Brain disorders (Amsterdam, Netherlands)","volume":"18 ","pages":"Article 100213"},"PeriodicalIF":0.0,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143681300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Differential effects of cerebellar and basal ganglia pathology on the coordination of bilateral arm movements 小脑和基底神经节病理对双侧手臂运动协调的不同影响
Pub Date : 2025-03-15 DOI: 10.1016/j.dscb.2025.100211
Chang-Ha Im , Jinsung Wang , Yong-Gwan Song
The objective of this study was to compare coordination deficits between Parkinson's disease (PD) and cerebellar dysfunction (CD) patients during in- and anti-phase bilateral movements with their forearms. 48 participants were divided into four groups: recently diagnosed (de novo) PD patients; PD patients with an advanced stage of the disease; CD patients; age-matched controls. All participants performed in-phase and anti-phase bilateral coordination movements at two pacing frequencies (1 and 1.55 Hz). For interlimb coordination, relative phasing accuracy was measured; for individual limb movements, oscillation frequency, movement amplitude and harmonicity (smoothness) of each limb movement were examined. Results indicated that advanced PD patients showed larger relative phasing deviations than all other groups, but only at the higher pacing frequency in the anti-phase mode; de novo PD and CD patients were not different from controls. Regarding oscillation frequency, no patient group could move in synchrony with required pacing frequency as well as the controls. Both controls and CD patients tended to overshoot the target, while both PD groups undershot the target. In terms of movement smoothness, CD patients were the worst. These findings suggest that the basal ganglia and the cerebellum pathology may affect bilateral coordination differently: motor deficits observed during bilateral coordination tasks in PD patients may be related more directly to the deficits in interlimb coordination, while those observed in CD patients may be related more to the deficits in inter-joint coordination within each limb, which in turn may affect interlimb coordination during bilateral tasks.
本研究的目的是比较帕金森病(PD)和小脑功能障碍(CD)患者在正期和反期双侧前臂运动时的协调缺陷。48名参与者分为四组:新近诊断的PD患者;PD晚期患者;CD患者;年龄组。所有参与者在两个起搏频率(1和1.55 Hz)下进行同相和反相双侧协调运动。对于肢间协调,测量相对相位精度;对于单个肢体运动,检测每个肢体运动的振荡频率、运动幅度和和谐度(平滑度)。结果表明,晚期PD患者的相对相位偏差大于其他各组,但仅在反相位模式的高起搏频率下;新发PD和CD患者与对照组没有差异。在振荡频率方面,没有一个患者组的运动能与要求的起搏频率同步。对照组和乳糜泻患者均倾向于超过目标,而PD组均低于目标。在运动平稳性方面,乳糜泻患者最差。这些结果提示,基底神经节和小脑病理对双侧协调的影响可能不同:PD患者在双侧协调任务中观察到的运动缺陷可能与肢体间协调缺陷更直接相关,而CD患者观察到的运动缺陷可能与每条肢体的关节间协调缺陷更相关,而关节间协调缺陷又可能影响双侧任务中的肢体间协调。
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Brain disorders (Amsterdam, Netherlands)
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