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Deficits in cerebellum-dependent learning and cerebellar morphology in male and female BTBR autism model mice. 雄性和雌性BTBR自闭症模型小鼠小脑依赖学习和小脑形态的缺陷。
Q3 CLINICAL NEUROLOGY Pub Date : 2022-12-01 DOI: 10.3390/neurosci3040045
Elizabeth A Kiffmeyer, Jameson A Cosgrove, Jenna K Siganos, Heidi E Bien, Jade E Vipond, Karisa R Vogt, Alexander D Kloth

Recently, there has been increased interest in the role of the cerebellum in autism spectrum disorders (ASD). To better understand the pathophysiological role of the cerebellum in ASD, it is necessary to have a variety of mouse models that have face validity for cerebellar disruption in humans. Here, we add to the literature on the cerebellum transgenic and induced mouse models of autism with the characterization of the cerebellum in the BTBR T+Itpr3tf/J (BTBR) inbred mouse strain, which has behavioral phenotypes that are suggestive of ASD in patients. When we examined both male and female BTBR mice in comparison to C57BL/6J (C57) controls, we noted that both sexes of BTBR mice showed motor coordination deficits characteristic of cerebellar dysfunction, but only the male mice showed differences in delay eyeblink conditioning, a cerebellum-dependent learning task that is also disrupted in ASD patients. Both male and female BTBR mice showed considerable expansion of and abnormal foliation in the cerebellum vermis--including significant expansion of specific lobules in the anterior cerebellum. In addition, we found a slight but significant decrease in Purkinje cell density in both male and female BTBR mice, irrespective of lobule. Furthermore, there was a marked reduction of Purkinje cell dendritic spines density in both male and female BTBR mice. These findings suggest that, for the most part, the BTBR mouse model successfully phenocopies many of the characteristics of the subpopulation of ASD patients that have a hypertrophic cerebellum. We discuss the significance of strain differences in the cerebellum as well as the importance of this first effort to identify both concordances and difference between male and female BTBR mice with regard to the cerebellum.

最近,人们对小脑在自闭症谱系障碍(ASD)中的作用越来越感兴趣。为了更好地了解小脑在ASD中的病理生理作用,有必要建立多种具有人类小脑损伤有效性的小鼠模型。在此,我们通过BTBR T+Itpr3tf/J (BTBR)近交小鼠品系的小脑特征来补充关于小脑转基因和诱导的自闭症小鼠模型的文献,该品系具有提示患者ASD的行为表型。当我们将雄性和雌性BTBR小鼠与C57BL/6J (C57)对照进行比较时,我们注意到雄性BTBR小鼠都表现出小脑功能障碍特征的运动协调缺陷,但只有雄性小鼠在延迟眨眼条件方面表现出差异,延迟眨眼条件是一种依赖小脑的学习任务,在ASD患者中也被破坏。雄性和雌性BTBR小鼠在小脑蚓部均表现出相当大的扩张和异常叶状,包括小脑前部特定小叶的显著扩张。此外,我们发现雄性和雌性BTBR小鼠的浦肯野细胞密度轻微但显著下降,与小叶无关。此外,在雄性和雌性BTBR小鼠中,浦肯野细胞树突棘密度显著降低。这些发现表明,在很大程度上,BTBR小鼠模型成功地表现了具有肥厚小脑的ASD患者亚群的许多特征。我们讨论了小脑中菌株差异的重要性,以及首次努力确定雄性和雌性BTBR小鼠在小脑方面的一致性和差异的重要性。
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引用次数: 0
Power Spectrum and Connectivity Analysis in EEG Recording during Attention and Creativity Performance in Children 儿童注意力和创造力表现时脑电图记录的功率谱和连通性分析
Q3 CLINICAL NEUROLOGY Pub Date : 2022-06-02 DOI: 10.3390/neurosci3020025
D. Mateos, Gabriela Krumm, Vanessa Arán Filippetti, Marisela Gutiérrez
The present research aims at examining the power spectrum and exploring functional brain connectivity/disconnectivity during concentration performance, as measured by the d2 test of attention and creativity as measured by the CREA test in typically developing children. To this end, we examined brain connectivity by using phase synchrony (i.e., phase locking index (PLI) over the EEG signals acquired by the Emotiv EPOC neuroheadset in 15 children aged 9- to 12-years. Besides, as a complement, a power spectrum analysis of the acquired signals was performed. Our results indicated that, during d2 Test performance there was an increase in global gamma phase synchronization and there was a global alpha and theta band desynchronization. Conversely, during CREA task, power spectrum analysis showed a significant increase in the delta, beta, theta, and gamma bands. Connectivity analysis revealed marked synchronization in theta, alpha, and gamma. These findings are consistent with other neuroscience research indicating that multiple brain mechanisms are indeed involved in creativity. In addition, these results have important implications for the assessment of attention functions and creativity in clinical and research settings, as well as for neurofeedback interventions in children with typical and atypical development.
本研究的目的是通过对正常发育儿童的d2注意力测试和CREA测试来测量注意力和创造力,研究在集中表现期间的功率谱和探索功能性大脑连接/断开性。为此,我们对15名9- 12岁儿童的脑电图信号进行了相位同步(即相位锁定指数(PLI))检测。此外,作为补充,对采集到的信号进行了功率谱分析。我们的结果表明,在d2测试期间,整体gamma相位同步增加,并且存在整体alpha和theta波段不同步。相反,在CREA任务中,功率谱分析显示δ、β、θ和γ波段显著增加。连通性分析显示,θ、α和γ有明显的同步。这些发现与其他神经科学研究一致,表明多种大脑机制确实与创造力有关。此外,这些结果对临床和研究环境中注意力功能和创造力的评估以及典型和非典型发育儿童的神经反馈干预具有重要意义。
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引用次数: 3
Long COVID and the Autonomic Nervous System: The Journey from Dysautonomia to Therapeutic Neuro-Modulation through the Retrospective Analysis of 152 Patients. 长COVID与自主神经系统:通过对 152 名患者的回顾性分析,了解从自主神经失调症到治疗性神经调节的历程。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-05-23 eCollection Date: 2022-06-01 DOI: 10.3390/neurosci3020021
Joseph Colombo, Michael I Weintraub, Ramona Munoz, Ashish Verma, Ghufran Ahmad, Karolina Kaczmarski, Luis Santos, Nicholas L DePace

Introduction: The severity and prevalence of Post-Acute COVID-19 Sequela (PACS) or long-COVID syndrome (long COVID) should not be a surprise. Long-COVID symptoms may be explained by oxidative stress and parasympathetic and sympathetic (P&S) dysfunction. This is a retrospective, hypothesis generating, outcomes study.

Methods: From two suburban practices in northeastern United States, 152 long COVID patients were exposed to the following practices: (1) first, they were P&S tested (P&S Monitor 4.0; Physio PS, Inc., Atlanta, GA, USA) prior to being infected with COVID-19 due to other causes of autonomic dysfunction; (2) received a pre-COVID-19 follow-up P&S test after autonomic therapy; (3) then, they were infected with COVID-19; (4) P&S tested within three months of surviving the COVID-19 infection with long-COVID symptoms; and, finally, (5) post-COVID-19, follow-up P&S tested, again, after autonomic therapy. All the patients completed autonomic questionnaires with each test. This cohort included 88 females (57.8%), with an average age of 47.0 years (ranging from 14 to 79 years), and an average BMI of 26.9 #/in2.

Results: More pre-COVID-19 patients presented with sympathetic withdrawal than parasympathetic excess. Post-COVID-19, these patients presented with this ratio reversed and, on average, 49.9% more autonomic symptoms than they did pre-COVID-19.

Discussion: Both parasympathetic excess and sympathetic withdrawal are separate and treatable autonomic dysfunctions and autonomic treatment significantly reduces the prevalence of autonomic symptoms.

Conclusion: SARS-CoV-2, via its oxidative stress, can lead to P&S dysfunction, which, in turn, affects the control and coordination of all systems throughout the whole body and may explain all of the symptoms of long-COVID syndrome. Autonomic therapy leads to positive outcomes and patient quality of life may be restored.

导言:急性 COVID-19 后遗症(PACS)或长 COVID 综合征(long COVID)的严重性和普遍性不足为奇。氧化应激和副交感神经及交感神经(P&S)功能障碍可解释长 COVID 症状。这是一项回顾性、假设性、结果性研究:美国东北部两个郊区诊所的 152 名长期 COVID 患者接受了以下治疗:(1)首先,对他们进行 P&S 测试(P&S Monitor 4.0; Physio PS, Inc、美国佐治亚州亚特兰大市));(2) 在接受自主神经治疗后,接受 COVID-19 前的后续 P&S 测试;(3) 然后,感染 COVID-19;(4) 在感染 COVID-19 后三个月内接受 P&S 测试,并伴有长期 COVID 症状;最后,(5) COVID-19 后,在接受自主神经治疗后,再次接受后续 P&S 测试。所有患者在每次测试时都填写了自主神经问卷。结果显示,88 名女性患者(57.8%)的平均年龄为 47.0 岁(14 至 79 岁不等),平均体重指数为 26.9 #/in2:结果:COVID-19 前交感神经功能减退的患者多于副交感神经功能过剩的患者。COVID-19之后,这些患者的这一比例发生了逆转,自律神经症状平均比COVID-19前多49.9%:讨论:副交感神经功能亢进和交感神经功能减退都是独立的、可治疗的自律神经功能紊乱,自律神经治疗可显著降低自律神经症状的发生率:结论:SARS-CoV-2通过其氧化应激作用可导致P&S功能障碍,进而影响全身所有系统的控制和协调,并可解释长期COVID综合征的所有症状。自律神经疗法可带来积极的疗效,患者的生活质量也可得到恢复。
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引用次数: 0
The Role of Implicit Memory in the Development and Recovery from Trauma-Related Disorders. 内隐记忆在创伤相关障碍的发展和康复中的作用。
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-01-18 eCollection Date: 2022-03-01 DOI: 10.3390/neurosci3010005
Louis F Damis

Post-traumatic Stress Disorder is a chronic condition that occurs following a traumatic experience. Information processing models of PTSD focus on integrating situationally triggered sensory-emotional memories with consciously accessible autobiographical memories. Review of the nature of implicit memory supports the view that sensory-emotional memories are implicit in nature. Dissociation was also found to be associated with the development and severity of PTSD, as well as deficits in autobiographical memory. Moreover, disorganized attachment (DA) was associated with greater degrees of dissociation and PTSD, and like the defining neural activation in PTSD, was found to be associated with basal ganglia activity. In addition, subcortical neuroception of safety promotes a neurophysiological substrate supportive of social engagement and inhibition of fear-based responses. Furthermore, activation of representations of co-created imagined scenes of safety and secure attachment are associated with increases in this neurophysiological substrate. Repeated priming of secure attachment imagery was associated with modification of internal working models of DA along with reductions in dissociation and recovery from complex PTSD. In conclusion, it is posited that adequate recovery from extensive trauma experiences requires more than conscious elaboration of traumatic autobiographical memories and that the application of implicit nonconscious memory modification strategies will facilitate more optimal recovery.

创伤后应激障碍是创伤经历后出现的一种慢性疾病。创伤后应激障碍的信息处理模型侧重于将情境触发的感官情绪记忆与有意识获取的自传体记忆整合在一起。对内隐记忆性质的研究支持感觉-情绪记忆是内隐记忆的观点。研究还发现,分离与创伤后应激障碍的发展和严重程度以及自传体记忆的缺陷有关。此外,无组织依恋(DA)与更大程度的解离和创伤后应激障碍有关,并且与创伤后应激障碍中的定义神经激活一样,与基底神经节活动有关。此外,皮层下的安全神经感知促进了支持社会参与和抑制恐惧反应的神经生理基质。此外,激活共同创造的安全和安全依恋想象场景的表征与这种神经生理基质的增加有关。对安全依恋意象的重复引物与DA内部工作模型的修改有关,同时还能减少解离和从复杂创伤后应激障碍中恢复过来。总之,我们认为,要从广泛的创伤经历中充分恢复,需要的不仅仅是有意识地阐述创伤性自传记忆,应用内隐的非有意识记忆修正策略将促进更理想的恢复。
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引用次数: 0
A Retrospective Study of the Effects of Traumatic Brain Injury on Auditory Function: From a Clinical Perspective. 脑外伤对听觉功能影响的回顾性研究:从临床角度看创伤性脑损伤对听觉功能的影响
IF 1.6 Q3 CLINICAL NEUROLOGY Pub Date : 2022-01-14 eCollection Date: 2022-03-01 DOI: 10.3390/neurosci3010004
Mira White, Fauve Duquette-Laplante, Benoît Jutras, Caryn Bursch, Amineh Koravand

Purpose: The main purpose of this retrospective study was to identify auditory dysfunctions related to traumatic brain injury (TBI) in individuals evaluated in an Audiology clinic.

Method: Peripheral and central auditory evaluations were performed from March 2014 to June 2018 in 26 patients (14 males) with TBI. The age of the participants ranged from 9 to 59 years old (34.24 ± 15.21). Six participants had blast-related TBI and 20 had blunt force TBI. Sixteen experienced a single TBI event whereas ten experienced several. Correlation analyses were performed to verify the relationship, if any, between the number of auditory tests failed and the number, type, and severity of TBIs.

Result: All participants failed at least one auditory test. Nearly 60% had abnormal results on degraded speech tests (compressed and echoed, filtered or in background noise) and 25% had a high frequency hearing loss. There was no statistically significant correlation between the number of auditory tests failed and the number, type, and severity of TBIs.

Conclusion: Results indicated negative and heterogenous effects of TBI on peripheral and central auditory function and highlighted the need for a more extensive auditory assessment in individuals with TBI.

目的:这项回顾性研究的主要目的是在听力学诊所接受评估的患者中确定与创伤性脑损伤(TBI)有关的听觉功能障碍:2014年3月至2018年6月期间,对26名创伤性脑损伤患者(14名男性)进行了外周和中枢听觉评估。参与者的年龄从 9 岁到 59 岁不等(34.24 ± 15.21)。6名参与者患有与爆炸相关的创伤性脑损伤,20名参与者患有钝性外力创伤性脑损伤。16人只经历过一次创伤性脑损伤,10人经历过多次创伤性脑损伤。我们进行了相关分析,以验证听觉测试失败次数与创伤性脑损伤次数、类型和严重程度之间是否存在关系:结果:所有参与者至少有一次听觉测试未通过。近 60% 的人在降级语音测试(压缩和回声、过滤或背景噪声)中出现异常结果,25% 的人出现高频听力损失。未通过的听力测试次数与创伤性脑损伤的次数、类型和严重程度之间没有统计学意义上的相关性:结果表明,创伤性脑损伤对外周和中枢听觉功能产生了负面的、不同程度的影响,并强调需要对创伤性脑损伤患者进行更广泛的听觉评估。
{"title":"A Retrospective Study of the Effects of Traumatic Brain Injury on Auditory Function: From a Clinical Perspective.","authors":"Mira White, Fauve Duquette-Laplante, Benoît Jutras, Caryn Bursch, Amineh Koravand","doi":"10.3390/neurosci3010004","DOIUrl":"10.3390/neurosci3010004","url":null,"abstract":"<p><strong>Purpose: </strong>The main purpose of this retrospective study was to identify auditory dysfunctions related to traumatic brain injury (TBI) in individuals evaluated in an Audiology clinic.</p><p><strong>Method: </strong>Peripheral and central auditory evaluations were performed from March 2014 to June 2018 in 26 patients (14 males) with TBI. The age of the participants ranged from 9 to 59 years old (34.24 ± 15.21). Six participants had blast-related TBI and 20 had blunt force TBI. Sixteen experienced a single TBI event whereas ten experienced several. Correlation analyses were performed to verify the relationship, if any, between the number of auditory tests failed and the number, type, and severity of TBIs.</p><p><strong>Result: </strong>All participants failed at least one auditory test. Nearly 60% had abnormal results on degraded speech tests (compressed and echoed, filtered or in background noise) and 25% had a high frequency hearing loss. There was no statistically significant correlation between the number of auditory tests failed and the number, type, and severity of TBIs.</p><p><strong>Conclusion: </strong>Results indicated negative and heterogenous effects of TBI on peripheral and central auditory function and highlighted the need for a more extensive auditory assessment in individuals with TBI.</p>","PeriodicalId":74294,"journal":{"name":"NeuroSci","volume":"3 1","pages":"52-62"},"PeriodicalIF":1.6,"publicationDate":"2022-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11523697/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559650","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
Predicting Fluid Intelligence via Naturalistic Functional Connectivity Using Weighted Ensemble Model and Network Analysis 利用加权集成模型和网络分析通过自然功能连通性预测流体智力
Q3 CLINICAL NEUROLOGY Pub Date : 2021-12-17 DOI: 10.3390/neurosci2040032
Xiaobo Liu, Su Yang, Zhengxian Liu
Objectives: Functional connectivity triggered by naturalistic stimuli (e.g., movie clips), coupled with machine learning techniques provide great insight in exploring brain functions such as fluid intelligence. However, functional connectivity is multi-layered while traditional machine learning is based on individual model, which is not only limited in performance, but also fails to extract multi-dimensional and multi-layered information from the brain network. Methods: In this study, inspired by multi-layer brain network structure, we propose a new method, namely weighted ensemble model and network analysis, which combines machine learning and graph theory for improved fluid intelligence prediction. Firstly, functional connectivity analysis and graphical theory were jointly employed. The functional connectivity and graphical indices computed using the preprocessed fMRI data were then all fed into an auto-encoder parallelly for automatic feature extraction to predict the fluid intelligence. In order to improve the performance, tree regression and ridge regression models were stacked and fused automatically with weighted values. Finally, layers of auto-encoder were visualized to better illustrate the connectome patterns, followed by the evaluation of the performance to justify the mechanism of brain functions. Results: Our proposed method achieved the best performance with a 3.85 mean absolute deviation, 0.66 correlation coefficient and 0.42 R-squared coefficient; this model outperformed other state-of-the-art methods. It is also worth noting that the optimization of the biological pattern extraction was automated though the auto-encoder algorithm. Conclusion: The proposed method outperforms the state-of-the-art reports, also is able to effectively capture the biological patterns of functional connectivity during a naturalistic movie state for potential clinical explorations.
目的:由自然刺激(如电影片段)触发的功能连接,加上机器学习技术,为探索大脑功能(如流体智力)提供了很好的见解。然而,功能连接是多层次的,传统的机器学习是基于个体模型的,不仅性能有限,而且无法从大脑网络中提取多维、多层次的信息。方法:本研究受多层大脑网络结构的启发,提出了一种将机器学习与图论相结合的加权集成模型与网络分析相结合的改进流体智能预测方法。首先,将功能连通性分析与图形理论相结合。利用预处理后的fMRI数据计算功能连通性和图形指数,然后将其并行输入自编码器进行自动特征提取,以预测流体智能。为了提高性能,将树回归和脊回归模型与加权值自动叠加融合。最后,将自动编码器层可视化以更好地说明连接体模式,然后对其性能进行评估以证明脑功能的机制。结果:该方法的平均绝对偏差为3.85,相关系数为0.66,r平方系数为0.42;这个模型优于其他最先进的方法。同样值得注意的是,生物模式提取的优化是通过自编码器算法自动完成的。结论:所提出的方法优于最新的报道,也能够有效地捕捉在自然电影状态下功能连接的生物学模式,为潜在的临床探索。
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引用次数: 1
GSK3β Activity in Reward Circuit Functioning and Addiction GSK3β在奖赏回路功能和成瘾中的活性
Q3 CLINICAL NEUROLOGY Pub Date : 2021-12-17 DOI: 10.3390/neurosci2040033
Jakub Turlik, Ewa Wąsikiewicz, Aleksandra Domaradzka, Gabriela Chrostek, Weronika Gniadzik, Mikołaj Domagalski, Przemysław Duda
Glycogen synthase kinase-3β (GSK3β), primarily described as a regulator of glycogen metabolism, is a molecular hub linking numerous signaling pathways and regulates many cellular processes like cytoskeletal rearrangement, cell migration, apoptosis, and proliferation. In neurons, the kinase is engaged in molecular events related to the strengthening and weakening of synapses, which is a subcellular manifestation of neuroplasticity. Dysregulation of GSK3β activity has been reported in many neuropsychiatric conditions, like schizophrenia, major depressive disorder, bipolar disorder, and Alzheimer’s disease. In this review, we describe the kinase action in reward circuit-related structures in health and disease. The effect of pharmaceuticals used in the treatment of addiction in the context of GSK3β activity is also discussed.
糖原合成酶激酶-3β (GSK3β)主要被描述为糖原代谢的调节剂,是连接众多信号通路的分子枢纽,调节许多细胞过程,如细胞骨架重排、细胞迁移、细胞凋亡和增殖。在神经元中,该激酶参与与突触增强和减弱相关的分子事件,这是神经可塑性的亚细胞表现。GSK3β活性失调在许多神经精神疾病中都有报道,如精神分裂症、重度抑郁症、双相情感障碍和阿尔茨海默病。在这篇综述中,我们描述了在健康和疾病中奖赏回路相关结构中的激酶作用。在GSK3β活性的背景下,用于成瘾治疗的药物的作用也进行了讨论。
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引用次数: 1
A National Survey Evaluating the Impact of the COVID-19 Pandemic on Students Pursuing Careers in Neurosurgery. 一项评估COVID-19大流行对神经外科学生职业影响的全国调查。
Q3 CLINICAL NEUROLOGY Pub Date : 2021-12-01 DOI: 10.3390/neurosci2040023
Roxanna M Garcia, Rebecca A Reynolds, Hannah K Weiss, Nathan A Shlobin, Lola B Chambless, Sandi Lam, Nader S Dahdaleh, Gail Rosseau

Background: The COVID-19 pandemic has profoundly disrupted medical education and the residency application process.

Methods: We conducted a descriptive observational study in April 2020 of medical students and foreign medical graduates considering or pursuing careers in neurosurgery in the United States to examine the impact of the pandemic.

Results: A total of 379 respondents from 67 medical schools completed the survey. Across all participants, 92% (n = 347) stopped in-person didactic education, and 43% (n = 161) experienced basic science and 44% (n = 167) clinical research delays. Sixty percent (n = 227) cited a negative impact on academic productivity. Among first year students, 18% (n = 17) were less likely to pursue a career in neurosurgery. Over half of second year and third year students were likely to delay taking the United States Medical Licensing Examination Steps I and II. Among third year students, 77% (n = 91) reported indefinite postponement of sub-internships, and 43% (n = 53) were unsatisfied with communication from external programs. Many fourth-year students (50%, n = 17) were graduating early to participate in COVID-19-related patient care. Top student-requested support activities included access to student-focused educational webinars and sessions at upcoming conferences.

Conclusions: Medical students pursuing careers in neurosurgery faced unique academic, career, and personal challenges secondary to the pandemic. These challenges may become opportunities for new initiatives guided by professional organizations and residency programs.

背景:新冠肺炎疫情严重扰乱了医学教育和住院医师申请流程。方法:我们于2020年4月对在美国考虑或从事神经外科职业的医学生和外国医毕业生进行了一项描述性观察研究,以检查大流行的影响。结果:共有来自67所医学院的379名受访者完成了调查。在所有参与者中,92% (n = 347)停止了面对面的教学教育,43% (n = 161)经历了基础科学,44% (n = 167)经历了临床研究延迟。60% (n = 227)的人认为这对学术生产力产生了负面影响。在一年级学生中,18% (n = 17)不太可能从事神经外科工作。超过一半的二年级和三年级学生可能会推迟参加美国医疗执照考试步骤一和步骤二。在三年级学生中,77% (n = 91)的学生表示不确定推迟子实习,43% (n = 53)的学生对外部项目的沟通不满意。许多四年级学生(50%,n = 17)提前毕业,参与与covid -19相关的患者护理。最受学生欢迎的支持活动包括参加以学生为中心的教育网络研讨会和即将举行的会议。结论:继大流行之后,从事神经外科职业的医学生面临着独特的学术、职业和个人挑战。这些挑战可能成为由专业组织和住院医师项目指导的新举措的机会。
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引用次数: 4
Status Epilepticus and Neurosyphilis: A Case Report and a Narrative Review 癫痫持续状态与神经梅毒:1例报告及叙述回顾
Q3 CLINICAL NEUROLOGY Pub Date : 2021-12-01 DOI: 10.3390/neurosci2040031
G. Giovannini, S. Meletti
Neurosyphilis is a rare but life-threatening complication of syphilis that can develop even decades after the primary infection and can be unrecognized. Seizures and status epilepticus (SE) may represent the first manifestation in a previously undiagnosed syphilitic patient. We present an exemplification case of a new onset refractory status epilepticus caused by neurosyphilis and we reviewed the existing literature. We selected all studies reporting cases of SE in the context both of patients with a known diagnosis of syphilis and as the first manifestation of neurosyphilis. We identified 50 patients, mostly composed of immunocompetent, middle-aged males. Thirty-nine patients (83%) presented a new onset SE. A history of subtle and rapidly progressive mood and/or cognitive impairment suggesting a limbic encephalitis-like presentation was frequently observed. Focal frontal or temporal SE was reported in 26. Brain MRI frequently showed T2/FLAIR hyperintensities widely involving the medial temporal structures and the frontal lobes. This review should increase the clinician’s awareness of neurosyphilis as a possible etiology of a new onset SE of unknown etiology, especially in the context of a “limbic encephalitis”-like clinical presentation. Prompt recognition and treatment for neurosyphilis partially or completely reverse neurologic sequelae, changing the natural history of the disease.
神经梅毒是一种罕见但危及生命的梅毒并发症,它可以在初次感染后几十年发展,并且可能无法识别。癫痫发作和癫痫持续状态(SE)可能是先前未确诊的梅毒患者的第一表现。我们提出了一个由神经梅毒引起的新发作的难治性癫痫持续状态的例子病例,并回顾了现有的文献。我们选择了所有报道SE病例的研究,这些病例既包括已知梅毒诊断的患者,也包括神经梅毒的首次表现。我们确定了50例患者,主要由免疫功能正常的中年男性组成。39例(83%)出现新发SE。经常观察到细微和快速进展的情绪和/或认知障碍病史,提示边缘脑炎样表现。26例报告了局灶性额叶或颞叶SE。脑MRI频繁显示T2/FLAIR高信号广泛累及内侧颞叶和额叶。本综述应提高临床医生对神经梅毒作为不明病因新发SE的可能病因的认识,特别是在“边缘脑炎”样临床表现的背景下。及时发现和治疗神经梅毒可部分或完全逆转神经系统后遗症,改变疾病的自然史。
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引用次数: 0
The Case for Octopus Consciousness: Unity 章鱼意识的理由:团结
Q3 CLINICAL NEUROLOGY Pub Date : 2021-11-25 DOI: 10.3390/neurosci2040030
J. Mather
Birch et al. suggest that consciousness in any animal group must involve four aspects—perceptual richness, evaluative richness (affectivity), integration at one time (unity), and integration across time (temporality). This review will evaluate integration at one time in cephalopods, an area that offers many challenges. First, like most animals with a bilateral nervous system, cephalopods have laterality of brain function, and this challenges unity of function. Second, unlike most mammals, cephalopods have a heavy allocation of both neural and behavioural control to the periphery, especially in the case of octopuses. Third, like all animals, cephalopods gather information through several senses and there can be both unity within and competition between such information, challenging unity. Information gained across all these areas needs to be evaluated both in terms of the methodology used to gather information and the results of the investigation.
Birch等人认为,任何动物群体的意识都必须涉及四个方面——感知丰富性、评估丰富性(情感)、同一时间的整合性(统一性)和跨时间的整合性(时间性)。这篇综述将评估头足类动物的一次性整合,这是一个具有许多挑战的领域。首先,像大多数具有双侧神经系统的动物一样,头足类动物的大脑功能具有偏侧性,这挑战了功能的统一性。其次,与大多数哺乳动物不同,头足类动物的神经和行为控制都集中在外围,尤其是章鱼。第三,像所有动物一样,头足类动物通过多种感官收集信息,这些信息之间既可以存在统一,也可以存在竞争,挑战统一。需要从收集资料所用的方法和调查结果两方面对所有这些领域所获得的资料进行评价。
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引用次数: 7
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NeuroSci
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