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Association of Cerebrospinal Fluid Tau Protein in Patients with Alzheimer’s and Non Alzheimer’s Dementias in a Tertiary Level Hospital in Bangladesh 孟加拉国一家三级医院阿尔茨海默氏症和非阿尔茨海默氏症痴呆患者脑脊液Tau蛋白的相关性
Pub Date : 2017-07-19 DOI: 10.12691/ijcen-5-1-4
Imran Sarker, R. K. Khan, A. Haque, M. Hannan, R. Islam, A. N. Rizvi, A. Habib, S. Biswas
Background: Alzheimer’s disease is one of the common causes of dementia in our country. The growth of the elderly population, together with the rising incidence of dementia requires immediate attention. There is very limited data regarding how CSF Tau protein correlates with this group of people’s cognitive function. Objectives: To evaluate association of CSF Tau protein in different types of dementia patients (AD and non-AD) and to find out the correlation of CSF Tau with severity of dementia and duration of disease. Methods: This cross sectional analytical study was conducted in dementia clinic (OPD) and inpatient department of Neurology, BSMMU from March’2013 to September’2015. 48 both male and female adult subjects were included in this study. Then they were divided into 3 groups: Alzheimer’s disease (AD) group (n=15), non-AD other dementias (OD) group (n=18) and subjects having neither AD and/or OD were included as control (n=15). CSF Tau protein was measured and compared between 3 groups. Results: Mean age of dementia in AD group was 68.2±9.33 years and in OD group was 67.72±12.74 years. Mean MMSE score in AD group was 13.47± 4.72, in OD group 15.83±3.31 and in control group 28.60±1.12. This study showed that CSF Tau protein was highly elevated in AD group (315.30±279.68 pg/ml) than in OD (57.08±27.41pg/ml) and control (39.23±12.21) groups. Conclusion: The study found that CSF Tau levels are elevated in AD patients in comparison to non AD other dementias. So, CSF Tau protein can be an early biomarker of Alzheimer’s disease.
背景:阿尔茨海默病是我国老年痴呆症的常见病因之一。老年人口的增长以及痴呆症发病率的上升需要立即引起关注。关于脑脊液Tau蛋白如何与这群人的认知功能相关的数据非常有限。目的:评价不同类型痴呆(AD和非AD)患者脑脊液Tau蛋白的相关性,探讨脑脊液Tau蛋白与痴呆严重程度及病程的相关性。方法:对2013年3月至2015年9月在BSMMU痴呆门诊(OPD)和神经内科住院科室进行横断面分析研究。本研究共纳入48名成年男性和女性受试者。然后将其分为3组:阿尔茨海默病(AD)组(n=15)、非阿尔茨海默病其他痴呆(OD)组(n=18)和对照组(n=15)。测定3组脑脊液Tau蛋白含量并进行比较。结果:AD组痴呆患者平均年龄为68.2±9.33岁,OD组痴呆患者平均年龄为67.72±12.74岁。AD组MMSE平均评分为13.47±4.72,OD组为15.83±3.31,对照组为28.60±1.12。本研究显示AD组脑脊液Tau蛋白(315.30±279.68 pg/ml)明显高于OD组(57.08±27.41pg/ml)和对照组(39.23±12.21)。结论:研究发现,与非AD的其他痴呆相比,AD患者CSF Tau水平升高。因此,脑脊液Tau蛋白可能是阿尔茨海默病的早期生物标志物。
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引用次数: 1
Hyper Homocysteinemia Related Cerebral Venous Sinus Thrombosis –Presenting as Generalised Tonic-Clonic Seizure –A Case Report 高同型半胱氨酸血症相关脑静脉窦血栓形成-表现为全身性强直-阵挛性发作1例报告
Pub Date : 2017-03-23 DOI: 10.12691/ijcen-5-1-2
S. Chaudhuri, Deep Das, S. Bhattacharya, S. Chakraborty, Kingshuk Bhattacharjee
Cerebral venous sinus thrombosis (CVST) is a neuromuscular disorder with protean manifestation requiring a high index of suspicion. Early diagnosis is sometimes lifesaving. It is particularly challenging is to establish an accurate etiology as it guides the clinician for long term thrombo-prophylaxis. We report a young female with no conventional risk factors for CVST, who presented with headache, generalised seizures and prolonged loss of consciousness. Her work-up revealed an elevated serum homocysteine level which might be a possible causative association in the etiopathogenesis of this neuromuscular condition.
脑静脉窦血栓形成(CVST)是一种神经肌肉疾病与变异性的表现需要高度的怀疑指数。早期诊断有时可以挽救生命。它是特别具有挑战性的是建立一个准确的病因,因为它指导临床医生长期血栓预防。我们报告一位年轻女性,没有CVST的传统危险因素,她表现为头痛,全身性癫痫发作和长期意识丧失。她的检查显示血清同型半胱氨酸水平升高,这可能是这种神经肌肉疾病发病机制的一个可能的病因。
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引用次数: 2
Correlation between Levels of Transforming Growth Factor Beta 1 (TGF-β1) serum with Clinical Outcome on Acute Anterior Circulation Ischemic Strokes 急性前循环缺血性脑卒中患者血清转化生长因子β1 (TGF-β1)水平与临床预后的关系
Pub Date : 2017-01-11 DOI: 10.12691/IJCEN-5-1-1
V. Puspitasari, S. Wahid, Amiruddin Aliah, Budhianto Suhadi
Transforming Growth Factor Beta (TGFβ) was a major regulatory molecule to suppress the immune response in the inflammatory process. TGFβ was also a growth factor that affects growth, homeostasis, angiogenesis and tissue repair. In the acute phase of stroke, astrocytes were activated and the cells were able to produce anti-inflammatory cytokines such as TGFβ. The purpose of this study was to determine whether there is a correlation between serum levels of TGFβ at acute phase of ischemic stroke and patients’ clinical outcomes. The study was conducted in patients with acute anterior system ischemic stroke who came to Siloam Hospital in Tangerang, Indonesia. Blood samples were taken to measure the levels of TGFβ-1serum at ≤ 72 hours and the 3rd day of onset. Clinical severity of stroke assessed using the National Institute of Health (NIH) Stroke Scale at 72 hours, 7th days and 30th days after stroke. The mean serum levels of TGFβ-1 at ≤ 72 hours in the group of subjects with mild NIH Stroke Scale degree was higher than in the group of subjects with moderate/severe NIH Stroke Scale degree (p = 0.046). The subjects with elevated levels of TGF-β1 in the acute phase of stroke had better clinical degrees at the 30th day after the stroke, although statistically was not significant (p = 0.241). Result of this study showed that TGFβ-1 may act as a neuroprotector against brain tissue damage after ischemic stroke.
转化生长因子β (TGFβ)是炎症过程中抑制免疫反应的主要调控分子。TGFβ也是一种影响生长、体内平衡、血管生成和组织修复的生长因子。在中风的急性期,星形胶质细胞被激活,这些细胞能够产生抗炎细胞因子,如TGFβ。本研究的目的是确定缺血性卒中急性期血清TGFβ水平与患者临床预后之间是否存在相关性。该研究是在印度尼西亚坦格朗西罗亚医院的急性前系统缺血性中风患者中进行的。在发病≤72小时和第3天采血检测tgf - β-1血清水平。采用美国国立卫生研究院卒中量表在卒中后72小时、第7天和第30天评估卒中的临床严重程度。轻度NIH卒中评分组≤72小时血清tgf - β-1平均水平高于中度/重度NIH卒中评分组(p = 0.046)。脑卒中急性期TGF-β1水平升高的受试者在脑卒中后第30天临床程度较好,但差异无统计学意义(p = 0.241)。本研究结果表明tgf - β-1可能对缺血性脑卒中后脑组织损伤具有神经保护作用。
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引用次数: 1
Neurological Complications in Sickle Cell Disease 镰状细胞病的神经系统并发症
Pub Date : 2016-08-12 DOI: 10.12691/IJCEN-4-1-2
H. Al-Jafar, R. Alroughani, T. Abdullah, Fatma Al-Qallaf
Sickle cell disease is a common inherited blood disorder that affects red blood cells. It is a hemoglobinopathy characterized by hemoglobin polymerization, erythrocyte stiffening, and subsequent vaso-occlusions. These changes can lead to microcirculation obstructions, tissue ischemia, infarction and acute stroke. In addition, chronic cerebral ischemia and cerebral vascular anomalies are considered among the most disabling problems in sickle cell disease. Neurological complications of sickle cell disease include, Ischaemic Stroke, hemorrhagic stroke, transient ischemic attack, silent cerebral infarction, headache, Moyamoya disease, neuropathic pain, and neurocognitive impairment. Early diagnosis and proper management of sickle cell disease neurological complications require specialised hematological and neurological experties. The newly used medications under ongoing research foster the hope to overcome this devastating disease and its complications.
镰状细胞病是一种常见的遗传性血液疾病,影响红细胞。这是一种以血红蛋白聚合、红细胞硬化和随后的血管闭塞为特征的血红蛋白病。这些变化可导致微循环阻塞、组织缺血、梗死和急性卒中。此外,慢性脑缺血和脑血管异常被认为是镰状细胞病最致残的问题。镰状细胞病的神经系统并发症包括缺血性卒中、出血性卒中、短暂性脑缺血发作、无症状性脑梗死、头痛、烟雾病、神经性疼痛和神经认知障碍。镰状细胞病神经并发症的早期诊断和适当管理需要专门的血液学和神经学专业知识。正在进行的研究中使用的新药物为克服这种毁灭性疾病及其并发症带来了希望。
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引用次数: 11
Posterior cortical atrophy. 后皮质萎缩。
Pub Date : 2016-03-21 DOI: 10.1016/b978-0-323-44781-2.50197-2
D. Rs, J. Harrison, M. Field, Boyle Rs
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引用次数: 522
Age-related Volumetric Changes of Prefrontal Gray and White Matter from Healthy Infancy to Adulthood 健康婴儿期至成年期前额叶灰质和白质与年龄相关的体积变化
Pub Date : 2016-02-20 DOI: 10.12691/IJCEN-4-1-1
M. Matsui, Chiaki Tanaka, Lisha Niu, K. Noguchi, W. Bilker, Michael R. Wierzbicki, R. Gur
Despite increasing evidence of the role of the prefrontal cortex in providing the neural substrate of higher cognitive function and neurodevelopment, little is known about neuroanatomic changes in prefrontal subregions during human development. In this prospective study, we evaluated prefrontal gray and white matter volume in healthy infants, children, adolescents, and adults. Magnetic resonance imaging was performed on 107 healthy people aged one month to 25 years. Gray and white matter volumes of the dorsolateral, dorsomedial, orbitolateral, and orbitomedial prefrontal cortex were quantified. The results indicated that both children and early adolescents had larger dorsolateral gray matter volume than infants and adults. Dorsolateral white matter volumes in children, early adolescents, and late adolescents were larger than those of infants. Dorsomedial white matter volumes of early adolescents, late adolescents, and adults were also larger than those of infants. There was no significant difference among age groups in both orbital prefrontal regions. These findings suggest that there are two important stages of structural change of the prefrontal cortex from infancy to young adulthood. First, growth spurts of both gray matter and white matter during the first 2 years of life have been shown to occur specifically in the dorsal prefrontal cortex. Second, gray matter changes have been shown to be regionally specific, with changes in the dorsal, but not orbital, prefrontal cortex peaking during late childhood or early adolescence. Thus, developmental differences within sectors of the prefrontal lobe and evidence of neural pruning and myelination may be useful in understanding the mechanisms of neurodevelopmental disorders.
尽管越来越多的证据表明前额叶皮层在提供高级认知功能和神经发育的神经基质方面的作用,但在人类发育过程中,前额叶亚区的神经解剖学变化知之甚少。在这项前瞻性研究中,我们评估了健康婴儿、儿童、青少年和成人的前额叶灰质和白质体积。对107名年龄在1个月至25岁之间的健康人进行了磁共振成像。量化前额皮质背外侧、背内侧、眶外侧和眶内侧的灰质和白质体积。结果表明,儿童和早期青少年的背外侧灰质体积大于婴儿和成人。儿童、青少年早期和青少年晚期的背外侧白质体积大于婴儿。青少年早期、青少年晚期和成人的背内侧白质体积也大于婴儿。两组年龄组眼眶前额叶区无显著性差异。这些发现表明,从婴儿期到青年期,前额叶皮层的结构变化有两个重要阶段。首先,在生命的头2年里,灰质和白质的生长突增已经被证明特别发生在前额皮质背侧。其次,灰质的变化已被证明是区域特异性的,在儿童晚期或青春期早期,前额叶皮层的背侧而不是眶部的变化达到峰值。因此,前额叶各部分的发育差异以及神经修剪和髓鞘形成的证据可能有助于理解神经发育障碍的机制。
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引用次数: 5
Neuropsychiatric Symptoms of Urbach-Wiethe Disease Urbach-Wiethe病的神经精神症状
Pub Date : 2015-10-22 DOI: 10.12691/IJCEN-3-2-3
Richard P. Conti, J. Arnone
Urbach–Wiethe (or lipoid proteinosis) disease (UWD) is a rare autosomal recessive disorder characterized by dermatological, psychiatric, and neurological symptoms. Presentation occurs during childhood, but can be observed from birth. While benign, the disease is progressive and chronic with no known cure. Treatment modalities are palliative for symptoms. The extant literature consists mainly of anecdotal reports and case studies that are limited by small sample sizes and paucity of controlled studies. Incidence and prevalence rates are unknown. There are less than 500 documented cases reported worldwide, and of those, less than 50 cases demonstrate neurological and neuropsychiatric conditions. Worldwide occurrence of the disease is documented, with the largest cohort living in a remote area of South Africa. The affected individuals are mainly Caucasian, born to consanguineous parents, and from Dutch or German heritage. Patients affected have been reported in China, Pakistan and Iran. Current and earlier studies focus primarily on the most visible signs of disease, dystonia and dermatological symptoms, while other studies have reported calcification in the amygdala, hippocampus, parahippocampal gyrus, and the striatum. While central nervous system involvement can lead to a wide range of clinical manifestations such as epilepsy and neuropsychiatric symptoms, there is not a consensus of reported cases with amygdala calcifications accompanied by neurological symptoms. Quantitative research is warranted to further identify the role and relationship between amygdala calcification and neurologic and neuropsychiatric symptoms, while qualitative research will afford insights into the lived experience of individuals and families living with UWD.
Urbach-Wiethe病(或称脂质蛋白沉积症)是一种罕见的常染色体隐性遗传病,以皮肤、精神和神经系统症状为特征。发病发生在儿童时期,但可以从出生时观察到。虽然是良性的,但这种疾病是进行性和慢性的,目前尚无治愈方法。治疗方式是缓解症状。现有文献主要由轶事报告和案例研究组成,受样本量小和缺乏对照研究的限制。发病率和患病率尚不清楚。全世界报告的有记录的病例不到500例,其中不到50例表现出神经和神经精神疾病。该疾病在世界范围内的发病率是有记录的,最大的群体生活在南非的一个偏远地区。受影响的个体主要是由近亲父母所生的高加索人,以及荷兰或德国血统。中国、巴基斯坦和伊朗都报告了受影响的患者。目前和早期的研究主要集中在最明显的疾病迹象、肌张力障碍和皮肤症状上,而其他研究报道了杏仁核、海马体、海马体旁回和纹状体的钙化。虽然中枢神经系统受累可导致广泛的临床表现,如癫痫和神经精神症状,但杏仁核钙化伴神经症状的报告病例尚未达成共识。定量研究有必要进一步确定杏仁核钙化与神经和神经精神症状之间的作用和关系,而定性研究将提供对患有UWD的个人和家庭的生活经历的见解。
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引用次数: 0
Behavioral and Neurochemical Characteristics of Two Months Old WAG/Rij Rats with Genetic Absence Epilepsy 2月龄遗传性缺失性癫痫WAG/Rij大鼠的行为和神经化学特征
Pub Date : 2015-08-21 DOI: 10.12691/IJCEN-3-2-2
E. Fedosova, K. Sarkisova, V. Kudrin, V. Narkevich, A. Bazyan
WAG/Rij rats are genetic animal model of absence epilepsy with comorbidity of depression. The first spike-wave discharges (SWDs) in WAG/Rij rats begin to appear at the age of 2-3 months and are fully manifested by 5-6 months. Occurrence of SWDs in the EEG is the main index of absence epilepsy. Previously it has been shown that the extensive absence epilepsy in 5-6 months old WAG/Rij rats is accompanied by decrease of dopamine and its metabolites concentrations in the meso-cortico-limbic and nigro-striatal dopaminergic brain systems, resulting in the expression of depression-like behavioral symptoms, and impairments of the learning and memory processes. In 36 days old WAG/Rij rats, SWDs are not manifested, deficiency of the mesolimbic dopamine is not revealed, and symptoms of depression-like behavior are not expressed. In this study, behavior in the open field, light-dark choice, forced swimming tests, monoamines and their metabolites concentrations in 5 brain structures (prefrontal cortex, nucleus accumbens, hypothalamus, striatum, hippocampus) were investigated in two months old WAG/Rij rats in comparison with age-matched Wistar rats. Reduced concentration of the dopamine and its metabolites, and increased concentration of the serotonin was found in WAG/Rij rats compared with Wistar rats only in the prefrontal cortex, indicating that the prefrontal cortex is the brain structure where neurochemical abnormalities appear first. No substantial changes in the monoamine and their metabolites concentrations have been revealed in other brain structures. Two months old WAG/Rij rats didn’t exhibit depression-like behavior in the forced swimming test, and learning/memory deficits in the passive avoidance test, but they showed behavioral changes, indicating increase anxiety/stress-reactivity, and alterations in learning/memory in the active avoidance test. Results suggest that two month-old WAG/Rij rats are at the stage of so called “pre-pathology” (increased anxiety and stress reactivity) preceding the development of depression-like behavior and substantial cognitive impairments which are co-morbid to fully expressed absence epilepsy in 5-6 months old rats of this strain.
WAG/Rij大鼠是缺失性癫痫伴抑郁的遗传动物模型。WAG/Rij大鼠的第一次尖峰波放电(SWDs)在2-3月龄开始出现,并在5-6月龄时完全表现出来。脑电图中SWDs的出现是癫痫缺失的主要指标。先前的研究表明,5-6月龄WAG/Rij大鼠的广泛缺失癫痫伴随着中脑皮质边缘和黑质纹状体多巴胺能脑系统多巴胺及其代谢物浓度的下降,导致抑郁样行为症状的表达,以及学习和记忆过程的损害。在36日龄的WAG/Rij大鼠中,SWDs未表现出来,未显示中边缘多巴胺缺乏,未表现出抑郁样行为的症状。在本研究中,研究了两个月龄WAG/Rij大鼠的野外行为、明暗选择、强迫游泳试验、前额叶皮质、伏隔核、下丘脑、纹状体、海马等5个脑结构的单胺及其代谢产物浓度,并与年龄匹配的Wistar大鼠进行了比较。与Wistar大鼠相比,WAG/Rij大鼠的多巴胺及其代谢物浓度降低,血清素浓度升高,仅在前额皮质出现,表明前额皮质是神经化学异常首先出现的大脑结构。在其他脑结构中未发现单胺及其代谢物浓度的实质性变化。两个月大的WAG/Rij大鼠在强迫游泳测试中没有表现出抑郁样行为,在被动回避测试中没有表现出学习/记忆缺陷,但在主动回避测试中表现出行为改变,表明焦虑/压力反应性增加,学习/记忆改变。结果表明,两个月大的WAG/Rij大鼠处于所谓的“病理前”阶段(焦虑和应激反应增加),随后出现抑郁样行为和实质性认知障碍,这与5-6个月大的WAG/Rij大鼠的完全表达性缺失癫痫共病。
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引用次数: 2
Cyclooxygenase Expression in Canines Following Peripheral Nerve Injury 犬周围神经损伤后环氧合酶的表达
Pub Date : 2015-01-23 DOI: 10.12691/IJCEN-3-2-1
Shigeru Kobayashi, Yoshihiko Suzuki, S. Yamada, N. Al-khudairi, A. Meir
In order to investigate the mechanism of neurogenic pain, this study used a median nerve compression model in dogs. The nerve was compressed with a clip for three weeks. Immunohistochemistry was done by the avidin-biotin-peroxidase complex method to observe the changes of T cells (CD45) and macrophages (Mac-1) after compression. Antibodies against cyclooxygenase (COX)-1 and 2 were used to examine the localization and changes of these mediators caused by nerve compression. In control animals, resident T cells were detected, but there were no macrophages. COX-2 was positive in the Schwann cells and vascular endothelial cells, while COX-1 was detected in the vascular endothelial cells. After nerve compression, numerous T cells and macrophages appeared among the demyelinized nerve fibers. The macrophages were positive for COX-2. COX-2 may be deeply involved in neuritis arising from mechanical compression, and this mediator seems to be important in the manifestation of neurogenic pain.
为了探讨神经源性疼痛的机制,本研究采用犬正中神经压迫模型。神经被夹紧了三周。免疫组化采用亲和素-生物素-过氧化物酶复合物法,观察压迫后T细胞(CD45)和巨噬细胞(Mac-1)的变化。用抗环氧化酶(COX)-1和COX - 2抗体检测神经受压引起的这些介质的定位和变化。在对照动物中,检测到驻留T细胞,但未检测到巨噬细胞。COX-2在雪旺细胞和血管内皮细胞中呈阳性,COX-1在血管内皮细胞中检测到。神经受压后,脱髓鞘神经纤维中出现大量T细胞和巨噬细胞。巨噬细胞COX-2阳性。COX-2可能深度参与机械性压迫引起的神经炎,这种介质似乎在神经性疼痛的表现中很重要。
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引用次数: 0
Synkinesis of Facial Musculature in a Patient with Facial Paralysis 面瘫患者面部肌肉的联合运动
Pub Date : 2015-01-23 DOI: 10.12691/IJCEN-3-1-1
K. Mattoo, M. Singh, P. Arora
Facial Synkinesis is a clinical condition that is the sequel to facial nerve paralysis which develops during nerve repair like axon myelination and regeneration. Involuntary muscle activity is accompanied by voluntary muscle activity and may involve facial and extra ocular muscles. This article describes an uncommon variation of facial Synkinesis that manifested clinically in weak voluntary chewing and frequent cheek biting in the form of mucosal erosion on the buccal mucosa. Managing a case of facial paralysis that has associated facial Synkinesis has also been discussed.
面神经联动症是面神经麻痹的一种临床症状,在神经修复如轴突髓鞘形成和再生过程中发生。不随意肌活动伴随着随意肌活动,可能累及面部和眼外肌。这篇文章描述了一种罕见的面部联动性变异,临床表现为弱自主咀嚼和频繁的脸颊咬伤,口腔粘膜糜烂的形式。处理面瘫的情况下,有相关的面部联动性也已讨论。
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引用次数: 1
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Clinical and experimental neurology
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