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Graph-based Analysis to Predict Repetitive Transcranial Magnetic Stimulation Treatment Response in Patients With Major Depressive Disorder Using EEG Signals. 利用脑电图信号预测重度抑郁症患者重复经颅磁刺激治疗反应的图解分析法
IF 1 Q4 NEUROSCIENCES Pub Date : 2024-03-01 DOI: 10.32598/bcn.2023.2034.5
Behrouz Nobakhsh, Ahmad Shalbaf, Reza Rostami, Reza Kazemi

Introduction: Repetitive transcranial magnetic stimulation (rTMS) is a non-pharmacological treatment for drug-resistant major depressive disorder (MDD) patients. Since the success rate of rTMS treatment is about 50%-55%, it is essential to predict the treatment outcome before starting based on electroencephalogram (EEG) signals, leading to identifying effective biomarkers and reducing the burden of health care centers.

Methods: To this end, pretreatment EEG data with 19 channels in the resting state from 34 drug-resistant MDD patients were recorded. Then, all patients received 20 sessions of rTMS treatment, and a reduction of at least 50% in the total beck depression inventory (BDI-II) score before and after the rTMS treatment was defined as a reference. In the current study, effective brain connectivity features were determined by the direct directed transfer function (dDTF) method from patients' pretreatment EEG data in all frequency bands separately. Then, the brain functional connectivity patterns were modeled as graphs by the dDTF method and examined with the local graph theory indices, including degree, out-degree, in-degree, strength, out-strength, in-strength, and betweenness centrality.

Results: The results indicated that the betweenness centrality index in the Fp2 node and the δ frequency band are the best biomarkers, with the highest area under the receiver operating characteristic curve value of 0.85 for predicting the rTMS treatment outcome in drug-resistant MDD patients.

Conclusion: The proposed method investigated the significant biomarkers that can be used to predict the rTMS treatment outcome in drug-resistant MDD patients and help clinical decisions.

简介重复经颅磁刺激(rTMS)是治疗耐药性重度抑郁症(MDD)患者的一种非药物疗法。由于经颅磁刺激治疗的成功率约为 50%-55%,因此有必要在开始治疗前根据脑电图(EEG)信号预测治疗结果,从而确定有效的生物标志物,减轻医疗中心的负担:为此,研究人员记录了 34 名耐药 MDD 患者静息状态下 19 个通道的预处理脑电图数据。然后,所有患者都接受了20次经颅磁刺激治疗,并将经颅磁刺激治疗前后贝克抑郁量表(BDI-II)总分减少至少50%作为参考。本研究采用直接定向传递函数(dDTF)方法,从患者治疗前的脑电图数据中分别确定所有频段的有效脑连接特征。然后,用dDTF方法将大脑功能连接模式建模为图,并用局部图论指标(包括度数、外度数、内度数、强度、外强度、内强度和间度中心性)进行检验:结果表明,Fp2节点和δ频段的间度中心性指数是预测耐药MDD患者经颅磁刺激治疗结果的最佳生物标志物,其接收者工作特征曲线下面积值最高,为0.85:结论:所提出的方法研究了可用于预测耐药 MDD 患者经颅磁刺激治疗效果的重要生物标志物,有助于临床决策。
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引用次数: 0
Myasthenia Gravis and COVID-19: A Systematic Review and Meta-analysis. 肌无力与 COVID-19:系统回顾与元分析》。
IF 1 Q4 NEUROSCIENCES Pub Date : 2024-03-01 DOI: 10.32598/bcn.2023.4360.5
Amirhossein Nafari, Seyedpouzhia Shojaei, Reza Jalili Khoshnood, Mahsa Ghajarzadeh, Arash Tafreshinejad, Saeid Safari, Omid Mirmosayyeb

Introduction: Patients with myasthenia gravis (MG), an autoimmune disease affecting the neuromuscular junction, exhibits varying rates of COVID-19 infection across different studies. This systematic review and meta-analysis aim to estimate the pooled prevalence of COVID-19 infection in individuals with MG.

Methods: We systematically searched PubMed, Scopus, EMBASE, Web of Science, Google Scholar, and gray literature, including references to the research published before October 2021. The total number of participants, the first author, the publication year, the country of origin, the number of MG patients, their symptoms, hospitalization rates, and deaths were all extracted as study data.

Results: Our literature search yielded 253 articles, of which 75 remained after removing duplicates. Finally, 18 articles were included in the meta-analysis. The pooled prevalence of COVID-19 infection in MG cases was found to be 2% (95% CI, 1%, 3%; I2=85%, P<0.001). Additionally, the pooled prevalence of hospitalization among those with COVID-19 infection was 43% (95% CI, 26%, 60%; I2=97.6%; P<0.001), and the pooled prevalence of MG exacerbation was 33% (95% CI, 20%, 46%; I2=92.6%; P<0.001).

Conclusion: In summary, this systematic review and meta-analysis reveal that the pooled prevalence of COVID-19 infection in individuals with MG is 2%.

简介:重症肌无力(MG)是一种影响神经肌肉接头的自身免疫性疾病,在不同的研究中,患者的COVID-19感染率各不相同。本系统综述和荟萃分析旨在估算 COVID-19 在重症肌无力患者中的总体感染率:我们系统地检索了 PubMed、Scopus、EMBASE、Web of Science、Google Scholar 和灰色文献,包括 2021 年 10 月之前发表的研究参考文献。研究数据包括参与者总人数、第一作者、发表年份、来源国、MG 患者人数、症状、住院率和死亡人数:我们的文献检索共获得 253 篇文章,去除重复文章后,剩下 75 篇。最后,18 篇文章被纳入荟萃分析。MG病例中COVID-19感染的汇总患病率为2%(95% CI,1%,3%;I2=85%,P2=97.6%;P2=92.6%;PC结论:MG病例中COVID-19感染的汇总患病率为2%(95% CI,1%,3%;I2=85%,P2=97.6%;P2=92.6%):综上所述,本系统综述和荟萃分析显示,COVID-19 在 MG 患者中的总感染率为 2%。
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引用次数: 0
Disrupting Maternal Behavior and Inducing Cannibalism Due to Valproic Acid: An Unexplored Insight. 丙戊酸扰乱母性行为并诱导食人:未被探索的洞察力。
IF 1 Q4 NEUROSCIENCES Pub Date : 2024-03-01 DOI: 10.32598/bcn.2022.4410.1
Ashish Jain, Neha Dhir, Harvinder Singh, Amit Raj Sharma, Bikash Medhi, Ajay Prakash

Introduction: Valproic acid (VPA) is the most widely used chemical to develop the preclinical model of autism spectrum disorder (ASD). However, in addition to inducing autism, it causes different teratogenic effects like teeth malformation, tail kink, and abnormal body growth in offspring. So far, no study has explored VPA-induced maternal misbehavior, miscarriage, and maternal cannibalism. We aimed to determine the cannibalistic effects of VPA in pregnant female Wistar rats and VPA's influence on causing miscarriage frequency.

Methods: Our study was conducted on pregnant Wistar rats. On gestation day (GD) 12.5, they were treated with VPA (600 mg/kg intraperitoneal) dissolved in saline at 250 mg/mL concentration. The observations were mean litter size, mean male/female pups, mean mortality, maternal cannibalism, mean number of pups alive, cannibalism of malformed pups, miscarriage, survival analysis of pups, and odds and risk ratio were calculated for deaths observed in both study (control and VPA-treated) groups. The study was conducted till the weaning period.

Results: VPA-exposed pregnant females portrayed significantly decreased litter size (P<0.0001), significantly higher cannibalistic behavior (P=0.0023), and significantly higher cannibalism of malformed pups (P=0.0484) than the control group. VPA had caused complete pregnancy loss (miscarriage) in 5 pregnant females. Moreover, the VPA group's mortality percentage (P=0.0019) was significantly higher than the control group.

Conclusion: Overall, VPA has marked teratogenic effects (anatomical and morphological changes in offspring) with maternal behavior disruption, which causes cannibalism in Wistar female rats. The current manuscript findings can aid in investigating the novel mechanisms involved in maternal behavior disruption during the development of the VPA autism model.

简介丙戊酸(VPA)是开发自闭症谱系障碍(ASD)临床前模型最广泛使用的化学物质。然而,除了诱发自闭症外,它还会导致不同的致畸效应,如后代牙齿畸形、尾扭转和身体发育异常。迄今为止,还没有研究探讨过 VPA 诱导的母性行为不端、流产和母性食人行为。我们旨在确定 VPA 对怀孕雌性 Wistar 大鼠的食人效应以及 VPA 对导致流产频率的影响:我们的研究对象是妊娠 Wistar 大鼠。方法:我们的研究以妊娠 Wistar 大鼠为对象,在妊娠期(GD)12.5 天,用溶于 250 mg/mL 浓度生理盐水的 VPA(600 mg/kg,腹腔注射)对其进行处理。观察指标包括平均窝产仔数、平均雄性/雌性幼仔数、平均死亡率、母体食仔数、平均存活幼仔数、畸形幼仔食仔数、流产、幼仔存活率分析,并计算在两个研究组(对照组和 VPA 处理组)中观察到的死亡几率和风险比。研究一直进行到断奶期:结果:暴露于 VPA 的妊娠雌鼠的窝产仔数(PC)明显减少:总之,VPA 对 Wistar 雌性大鼠有明显的致畸作用(后代的解剖和形态变化),并会破坏母性行为,导致食人行为。本手稿的发现有助于研究 VPA 自闭症模型发育过程中母性行为紊乱的新机制。
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引用次数: 0
Prediction of Stroke After the COVID-19 Infection. COVID-19感染后的中风预测
IF 1 Q4 NEUROSCIENCES Pub Date : 2024-01-01 DOI: 10.32598/bcn.2022.3608.1
Mahsa Babaee, Karim Atashgar, Ali Amini Harandi, Atefeh Yousefi

Introduction: Although several studies have been published about COVID-19, ischemic stroke is known yet as a complicated problem for COVID-19 patients. Scientific reports have indicated that in many cases, the incidence of stroke in patients with COVID-19 leads to death.

Objectives: The obtained mathematical equation in this study can help physicians' decision-making about treatment and identification of influential clinical factors for early diagnosis.

Methods: In this retrospective study, data from 128 patients between March and September 2020, including their demographic information, clinical characteristics, and laboratory parameters were collected and analyzed statistically. A logistic regression model was developed to identify the significant variables in predicting stroke incidence in patients with COVID-19.

Results: Clinical characteristics and laboratory parameters for 128 patients (including 76 males and 52 females; with a mean age of 57.109±15.97 years) were considered as the inputs that included ventilator dependence, comorbidities, and laboratory tests, including WBC, neutrophil, lymphocyte, platelet count, C-reactive protein, blood urea nitrogen, alanine transaminase (ALT), aspartate transaminase (AST) and lactate dehydrogenase (LDH). Receiver operating characteristic-area under the curve (ROC-AUC), accuracy, sensitivity, and specificity were considered indices to determine the model capability. The accuracy of the model classification was also addressed by 93.8%. The area under the curve was 97.5% with a 95% CI.

Conclusion: The findings showed that ventilator dependence, cardiac ejection fraction, and LDH are associated with the occurrence of stroke and the proposed model can predict the stroke effectively.

导言:尽管已有多项关于 COVID-19 的研究,但缺血性中风仍是 COVID-19 患者面临的一个复杂问题。科学报告显示,在许多情况下,COVID-19 患者发生中风后会导致死亡:本研究获得的数学方程可帮助医生做出治疗决策,并识别影响早期诊断的临床因素:在这项回顾性研究中,收集了2020年3月至9月期间128名患者的数据,包括人口统计学信息、临床特征和实验室参数,并进行了统计分析。建立逻辑回归模型,以确定预测 COVID-19 患者脑卒中发病率的重要变量:128例患者(其中男性76例,女性52例;平均年龄(57.109±15.97)岁)的临床特征和实验室指标被视为输入变量,包括呼吸机依赖性、合并症和实验室检查,包括白细胞、中性粒细胞、淋巴细胞、血小板计数、C反应蛋白、血尿素氮、丙氨酸转氨酶(ALT)、天门冬氨酸转氨酶(AST)和乳酸脱氢酶(LDH)。接收者操作特征曲线下面积(ROC-AUC)、准确性、灵敏度和特异性被视为确定模型能力的指标。模型分类的准确率为 93.8%。曲线下面积为 97.5%,95% CI:研究结果表明,呼吸机依赖性、心脏射血分数和 LDH 与脑卒中的发生有关,所提出的模型能有效预测脑卒中。
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引用次数: 0
Menthol Dissolved in Dimethyl Sulfoxide Protects Against Epileptiform Activity Induced by Pentylenetetrazol in Male Rats. 溶于二甲基亚砜的薄荷醇可防止五苯四唑诱发雄性大鼠癫痫样活动。
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2022.3025.1
Yousef Panahi, Mohammad Amin Monazzah, Gholamreza Vafaei Saiah
<p><strong>Introduction: </strong>This research aims to investigate the protective action of menthol dissolved in dimethyl sulfoxide (DMSO) on experimental epileptiform activity induced by the intraperitoneal (IP) injection of pentylenetetrazol (PTZ) in male rats.</p><p><strong>Methods: </strong>Thirty adult male Wistar rats weighing 200-250 g were randomly assigned to five equal groups. The control animals received normal saline (200 μL) and the rest four cohorts were considered as treatment. Menthol was dissolved in DMSO and intraperitoneally injected at the doses of 100, 200, and 400 mg/kg into the first, second, and third groups (M100, M200, and M400 V=200 μL), respectively. The fourth treatment was injected with the solvent (200 μL). The animals were anesthetized, then underwent cranial surgery and a recording electrode was implanted in the stratum radiatum of the hippocampal carbonic anhydrase 1 (CA1) region (AP=-2.76 mm, ML=-1.4 mm and DV=3 mm). The seizure activity was induced by PTZ (IP) and assessed by counting and measuring amplitudes of the spikes for 10 minutes using the eTrace program.</p><p><strong>Results: </strong>Menthol was observed to significantly reduce the activity level of PTZ-induced epileptiform activity, as well as exert a protective and inhibitory action on proconvulsant effect of DMSO in a dose-dependent manner.</p><p><strong>Conclusion: </strong>Menthol can potentially be used as an adjuvant to prevent seizure activity.</p><p><strong>Highlights: </strong>Dimethyl sulfoxide (DMSO) induces proconvulsant effects, significantly increasing spike counts.Menthol 100 mg/kg also stimulates seizure activity, leading to a substantial spike count increase.Menthol 200 and 400 mg/kg exhibit inhibitory effects, decreasing seizure activity and spike counts.</p><p><strong>Plain language summary: </strong>In this study, we explored the potential protective effects of menthol, dissolved in dimethyl sulfoxide (DMSO), on experimentally induced epileptiform activity in male rats. Our research involved thirty adult male Wistar rats, divided into five groups. While the control group received normal saline, the remaining four groups were treated with different doses of menthol in DMSO. The rats underwent surgery, and electrodes were implanted in the hippocampal region for recording. Using pentylenetetrazol (PTZ) to induce seizure activity, we observed that menthol, administered at varying doses, significantly reduced the level of epileptiform activity triggered by PTZ. Notably, menthol also demonstrated a protective and inhibitory effect on the proconvulsant action of DMSO, and this effect was dose-dependent. In simpler terms, our findings suggest that menthol has the potential to be used as an additional treatment to prevent seizure activity. This means that incorporating menthol, especially at specific doses, may offer a protective influence against epileptic events. This research sheds light on a promising avenue for potential therapeutic
研究简介本研究旨在探讨溶于二甲基亚砜(DMSO)中的薄荷醇对雄性大鼠腹腔注射戊四唑(PTZ)诱发的实验性癫痫样活动的保护作用:将 30 只体重为 200-250 克的成年雄性 Wistar 大鼠随机分为 5 组。对照组接受生理盐水(200 μL),其余四组为治疗组。薄荷醇溶于二甲基亚砜,分别以 100、200 和 400 毫克/千克的剂量腹腔注射到第一、第二和第三组(M100、M200 和 M400 V=200 μL)。第四组注射溶剂(200 μL)。动物被麻醉后接受颅脑手术,记录电极被植入海马碳酸酐酶1(CA1)区域的放射状层(AP=-2.76 mm,ML=-1.4 mm,DV=3 mm)。癫痫发作活动由 PTZ(IP)诱发,并通过使用 eTrace 程序计数和测量 10 分钟的尖峰振幅进行评估:结果:观察到薄荷醇能明显降低 PTZ 诱导的癫痫样活动水平,并以剂量依赖的方式对 DMSO 的促惊厥效应产生保护和抑制作用:结论:薄荷醇可用作预防癫痫活动的辅助剂:重点:二甲基亚砜(DMSO)具有促惊厥效应,可显著增加尖峰计数。薄荷醇 100 mg/kg 还可刺激癫痫发作活动,导致尖峰计数大幅增加。薄荷醇 200 和 400 mg/kg 具有抑制作用,可降低癫痫发作活动和尖峰计数。我们的研究涉及三十只成年雄性 Wistar 大鼠,分为五组。对照组使用生理盐水,其余四组使用不同剂量的二甲基亚砜中的薄荷醇。老鼠接受了手术,电极被植入海马区进行记录。通过使用戊四唑(PTZ)诱导癫痫发作活动,我们观察到不同剂量的薄荷醇能显著降低 PTZ 引发的癫痫样活动水平。值得注意的是,薄荷醇对二甲基亚砜(DMSO)的促惊厥作用也有保护和抑制作用,而且这种作用与剂量有关。简单地说,我们的研究结果表明,薄荷醇有可能作为一种额外的治疗方法来预防癫痫发作活动。这意味着,加入薄荷醇,尤其是特定剂量的薄荷醇,可能会对癫痫事件产生保护性影响。这项研究为潜在的治疗干预提供了一个很有前景的途径,强调了进一步探索薄荷醇在癫痫预防中的作用的重要性。最终,我们的研究开启了一扇大门,将薄荷醇作为一种有价值的成分,用于制定减轻癫痫发作影响的策略。
{"title":"Menthol Dissolved in Dimethyl Sulfoxide Protects Against Epileptiform Activity Induced by Pentylenetetrazol in Male Rats.","authors":"Yousef Panahi, Mohammad Amin Monazzah, Gholamreza Vafaei Saiah","doi":"10.32598/bcn.2022.3025.1","DOIUrl":"10.32598/bcn.2022.3025.1","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;This research aims to investigate the protective action of menthol dissolved in dimethyl sulfoxide (DMSO) on experimental epileptiform activity induced by the intraperitoneal (IP) injection of pentylenetetrazol (PTZ) in male rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Thirty adult male Wistar rats weighing 200-250 g were randomly assigned to five equal groups. The control animals received normal saline (200 μL) and the rest four cohorts were considered as treatment. Menthol was dissolved in DMSO and intraperitoneally injected at the doses of 100, 200, and 400 mg/kg into the first, second, and third groups (M100, M200, and M400 V=200 μL), respectively. The fourth treatment was injected with the solvent (200 μL). The animals were anesthetized, then underwent cranial surgery and a recording electrode was implanted in the stratum radiatum of the hippocampal carbonic anhydrase 1 (CA1) region (AP=-2.76 mm, ML=-1.4 mm and DV=3 mm). The seizure activity was induced by PTZ (IP) and assessed by counting and measuring amplitudes of the spikes for 10 minutes using the eTrace program.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Menthol was observed to significantly reduce the activity level of PTZ-induced epileptiform activity, as well as exert a protective and inhibitory action on proconvulsant effect of DMSO in a dose-dependent manner.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Menthol can potentially be used as an adjuvant to prevent seizure activity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Highlights: &lt;/strong&gt;Dimethyl sulfoxide (DMSO) induces proconvulsant effects, significantly increasing spike counts.Menthol 100 mg/kg also stimulates seizure activity, leading to a substantial spike count increase.Menthol 200 and 400 mg/kg exhibit inhibitory effects, decreasing seizure activity and spike counts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;In this study, we explored the potential protective effects of menthol, dissolved in dimethyl sulfoxide (DMSO), on experimentally induced epileptiform activity in male rats. Our research involved thirty adult male Wistar rats, divided into five groups. While the control group received normal saline, the remaining four groups were treated with different doses of menthol in DMSO. The rats underwent surgery, and electrodes were implanted in the hippocampal region for recording. Using pentylenetetrazol (PTZ) to induce seizure activity, we observed that menthol, administered at varying doses, significantly reduced the level of epileptiform activity triggered by PTZ. Notably, menthol also demonstrated a protective and inhibitory effect on the proconvulsant action of DMSO, and this effect was dose-dependent. In simpler terms, our findings suggest that menthol has the potential to be used as an additional treatment to prevent seizure activity. This means that incorporating menthol, especially at specific doses, may offer a protective influence against epileptic events. This research sheds light on a promising avenue for potential therapeutic","PeriodicalId":8701,"journal":{"name":"Basic and Clinical Neuroscience","volume":"14 6","pages":"805-812"},"PeriodicalIF":1.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273200/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787186","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
Adverse Drug Reactions of Multiple Sclerosis Disease-modifying Drugs. 多发性硬化症改变病情药物的不良反应。
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2021.2848.2
Maryam Salehbayat, Roya Abolfazli, Niayesh Mohebbi, Seyed Mehrdad Savar, Gloria Shalviri, Kheirollah Gholami

Introduction: High frequency of adverse drug reactions (ADRs) challenges multiple sclerosis (MS) treatment. This study aims to assess the nature and frequency of ADRs induced by MS medications in an observational cross-sectional study.

Methods: ADRs of all outpatients who had seen a neurologist and had received at least one disease-modifying therapy (DMT) for MS during the last three months were investigated.

Results: A total of 484 ADRs were detected in these patients. The preventability rate was 5.9%, and 0.61% of reactions were serious.

Conclusion: The high frequency of adverse drug reactions in this study shows a strong need for strategy planning to increase patients' adherence to treatment.

Highlights: Adverse drug reactions (ADRs) are common in MS patients using disease modifying therapies.Such ADRs are more common in women than men.Various brand names of biosimilar disease-modifying therapy (DMT)s may have a different ADR profile.

Plain language summary: Multiple sclerosis (MS) is a condition that can be managed by using disease modifying medications. Such medication could trigger an adverse reaction in the patients., affecting their commitment to the treatment. By identifying these adverse reactions and educating the MS patients about these reactions and how the adverse effects can be managed, healthcare providers can improve the treatment process. This study recorded the adverse drug reactions in 250 MS patients who were receiving the medication for at least three months. Most of the patients (76.4%) experienced some kind of adverse reaction. A bigger proportion of women experienced adverse reactions than men. About 84% of these reactions occurred within the first 3 hours of receiving the medication. Depending on the medication's brand name, the rate of adverse drug reactions were different in some cases. The results of this study point out the fact that experiencing adverse drug reactions is common in MS patients and these experiences could be different for each medication with a different brand name. Therefore, it is important for the healthcare providers to inform the patients about such reactions and the patients should seek all the information they need to manage these adverse effects by consulting their physician.

导言:高频率的药物不良反应(ADRs)对多发性硬化症(MS)的治疗提出了挑战。本研究旨在通过一项观察性横断面研究,评估多发性硬化症药物引起的不良反应的性质和频率:方法:对过去三个月中所有接受过神经科医生诊治并接受过至少一种疾病修饰疗法(DMT)治疗的多发性硬化症门诊患者的药物不良反应进行调查:结果:在这些患者中共发现了 484 例 ADR。可预防率为 5.9%,严重反应占 0.61%:结论:本研究中药物不良反应的发生率很高,这表明亟需制定战略规划来提高患者的治疗依从性:药物不良反应(ADRs)在使用疾病调整疗法的多发性硬化症患者中很常见,女性比男性更易发生此类不良反应。这些药物可能会引发患者的不良反应,影响他们对治疗的承诺。通过识别这些不良反应并教育多发性硬化症患者了解这些不良反应以及如何控制不良反应,医护人员可以改善治疗过程。这项研究记录了 250 名接受药物治疗至少三个月的多发性硬化症患者的药物不良反应。大多数患者(76.4%)都出现了某种不良反应。出现不良反应的女性比例高于男性。其中约 84% 的不良反应发生在服药后的最初 3 小时内。根据药物品牌的不同,药物不良反应的发生率也有所不同。这项研究结果表明,多发性硬化症患者出现药物不良反应是很常见的,而且每种不同品牌名称的药物可能会有不同的不良反应。因此,医疗服务提供者有必要告知患者这些不良反应,患者也应通过咨询医生来了解处理这些不良反应所需的所有信息。
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引用次数: 0
The Antinociceptive Effects of Combined Treatment With Atorvastatin and Vitamin C in the Chronic Constriction Injury Model of Rats. 阿托伐他汀和维生素 C联合治疗对慢性缩窄性损伤模型大鼠的抗痛觉作用
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2022.895.2
Abolfazl Abbaszadeh, Najmeh Pirzadroozbahani, Mahmood Reza Moradkhani, Amin Hasanvand
<p><strong>Introduction: </strong>Neuropathic pain (NP) is caused by damage to the somatosensory system. Nerve damage often results in chronic pain states, including hyperalgesia and allodynia. This study aims to evaluate the anti-nociceptive effects of atorvastatin, vitamin C, and their combination on various laboratory tests in an experimental model NP in rats.</p><p><strong>Methods: </strong>To assess the analgesic effects of atorvastatin (5 and 10 mg/kg), vitamin C (500 mg/kg), and their co-administration on chronic constriction injury (CCI) was induced in rats. Behavioral tests, motor nerve conduction velocity (MNCV), pro-inflammatory cytokines, and oxidative markers were measured. Furthermore, histopathological examination was performed.</p><p><strong>Results: </strong>In the present study, it was found that the CCI model can significantly cause hyperalgesia and allodynia on the 21<sup>st</sup> postoperative day. It was found that the co-administration of vitamin C and atorvastatin has attenuating effects on allodynia and hyperalgesia. Co-administration of vitamin C and atorvastatin also improved MNCV. In the treatment groups, the inflammatory reactions and oxidative markers decreased. Moreover, the co-administration of atorvastatin and vitamin C decreased the perineural inflammation around the sciatic nerve.</p><p><strong>Conclusion: </strong>The results of this study showed that vitamin C potentiates the analgesic effects of atorvastatin in this model of experimental pain, and simultaneous consumption of these medications may be considered as effective therapeutics for NP. The protective properties of atorvastatin, and vitamin C, and their combination on the NP that were assessed can be regarded as a novelty for this study.</p><p><strong>Highlights: </strong>The co-administration of atorvastatin and vitamin C significantly decreases inflammatory cytokines.The co-administration of atorvastatin and vitamin C significantly decreases stress oxidant markers.The co-administration of atorvastatin and vitamin C significantly attenuated nociceptive effects.</p><p><strong>Plain language summary: </strong>Nerve damage causes the deposition of inflammatory factors and or oxidative stress at the site of injury, which in turn activates glial cells that are involved in increasing the inflammatory process by producing and releasing pro-inflammatory agents and oxidative stress. Among statins, atorvastatin is a drug to reduce inflammation, and its effectiveness has been recorded as an antioxidant effect. Vitamin C is known as a neuroprotective agent. Ascorbate inhibits the production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in monocytes in high doses (20 mM) by inhibiting them. The rats were randomly divided into 7 groups of 10 animals as follows: 1: Sham-operated, 2: Chronic constriction injury (CCI), 3: CCI+vitamin C (500 mg/kg), 4: CCI+atorvastatin (5 mg/kg), 5: CCI+atorvastatin (10 mg/kg), 6: CCI+vitamin C (500 mg/kg)+atorvastatin (5
简介神经性疼痛(NP)是由躯体感觉系统受损引起的。神经损伤通常会导致慢性疼痛状态,包括痛觉减退和异动症。本研究旨在评估阿托伐他汀、维生素 C 及其复方制剂在大鼠神经病理性疼痛实验模型的各种实验室测试中的抗痛觉效应:评估阿托伐他汀(5 毫克和 10 毫克/千克)、维生素 C(500 毫克/千克)及其联合用药对大鼠慢性收缩性损伤(CCI)的镇痛作用。对大鼠的行为测试、运动神经传导速度(MNCV)、促炎细胞因子和氧化标记物进行了测定。此外,还进行了组织病理学检查:本研究发现,CCI 模型可在术后第 21 天显著引起痛觉减退和异动症。同时服用维生素 C 和阿托伐他汀可减轻异感和痛觉减退。同时服用维生素 C 和阿托伐他汀还能改善 MNCV。在治疗组中,炎症反应和氧化标记物均有所下降。此外,同时服用阿托伐他汀和维生素 C 可减少坐骨神经周围的神经炎症:本研究结果表明,在这种实验性疼痛模型中,维生素 C 可增强阿托伐他汀的镇痛效果,同时服用这两种药物可被视为治疗 NP 的有效疗法。阿托伐他汀和维生素 C 的保护特性以及它们的组合对 NP 的评估可以说是这项研究的一个新亮点:联合应用阿托伐他汀和维生素 C 能显著降低炎性细胞因子。联合应用阿托伐他汀和维生素 C 能显著降低应激氧化标记物。白话摘要:神经损伤会导致炎症因子和氧化应激在损伤部位沉积,进而激活神经胶质细胞,神经胶质细胞通过产生和释放促炎因子和氧化应激,参与加剧炎症过程。在他汀类药物中,阿托伐他汀是一种减少炎症的药物,其抗氧化效果已被记录在案。维生素 C 是众所周知的神经保护剂。高剂量(20 mM)抗坏血酸可抑制单核细胞产生白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)。将大鼠随机分为以下 7 组,每组 10 只:1: Sham-operated;2: Chronic constriction injury (CCI);3: CCI+vitamin C (500mg/kg);4: CCI+atorvastatin (5mg/kg);5: CCI+atorvastatin (10mg/kg);6: CCI+vitamin C (500mg/kg)+atorvastatin (5mg/kg);7: CCI+vitamin C (500mg/kg)+atorvastatin (10mg/kg)。本研究结果表明,维生素 C 和阿托伐他汀的抗炎、抗氧化和神经保护特性改善了 CCI 对经验性神经病理性大鼠的影响。此外,研究还表明,维生素 C 和阿托伐他汀的联合治疗可降低 TNF-α 和 IL-6 等炎症因子以及谷胱甘肽过氧化物酶 (GPx)、超氧化物歧化酶 (SOD) 和丙二醛 (MDA) 等氧化标志物,而在组织学研究中,CCI 大鼠的神经传导速度提高,炎症减轻。
{"title":"The Antinociceptive Effects of Combined Treatment With Atorvastatin and Vitamin C in the Chronic Constriction Injury Model of Rats.","authors":"Abolfazl Abbaszadeh, Najmeh Pirzadroozbahani, Mahmood Reza Moradkhani, Amin Hasanvand","doi":"10.32598/bcn.2022.895.2","DOIUrl":"10.32598/bcn.2022.895.2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Neuropathic pain (NP) is caused by damage to the somatosensory system. Nerve damage often results in chronic pain states, including hyperalgesia and allodynia. This study aims to evaluate the anti-nociceptive effects of atorvastatin, vitamin C, and their combination on various laboratory tests in an experimental model NP in rats.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;To assess the analgesic effects of atorvastatin (5 and 10 mg/kg), vitamin C (500 mg/kg), and their co-administration on chronic constriction injury (CCI) was induced in rats. Behavioral tests, motor nerve conduction velocity (MNCV), pro-inflammatory cytokines, and oxidative markers were measured. Furthermore, histopathological examination was performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;In the present study, it was found that the CCI model can significantly cause hyperalgesia and allodynia on the 21&lt;sup&gt;st&lt;/sup&gt; postoperative day. It was found that the co-administration of vitamin C and atorvastatin has attenuating effects on allodynia and hyperalgesia. Co-administration of vitamin C and atorvastatin also improved MNCV. In the treatment groups, the inflammatory reactions and oxidative markers decreased. Moreover, the co-administration of atorvastatin and vitamin C decreased the perineural inflammation around the sciatic nerve.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The results of this study showed that vitamin C potentiates the analgesic effects of atorvastatin in this model of experimental pain, and simultaneous consumption of these medications may be considered as effective therapeutics for NP. The protective properties of atorvastatin, and vitamin C, and their combination on the NP that were assessed can be regarded as a novelty for this study.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Highlights: &lt;/strong&gt;The co-administration of atorvastatin and vitamin C significantly decreases inflammatory cytokines.The co-administration of atorvastatin and vitamin C significantly decreases stress oxidant markers.The co-administration of atorvastatin and vitamin C significantly attenuated nociceptive effects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Plain language summary: &lt;/strong&gt;Nerve damage causes the deposition of inflammatory factors and or oxidative stress at the site of injury, which in turn activates glial cells that are involved in increasing the inflammatory process by producing and releasing pro-inflammatory agents and oxidative stress. Among statins, atorvastatin is a drug to reduce inflammation, and its effectiveness has been recorded as an antioxidant effect. Vitamin C is known as a neuroprotective agent. Ascorbate inhibits the production of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) in monocytes in high doses (20 mM) by inhibiting them. The rats were randomly divided into 7 groups of 10 animals as follows: 1: Sham-operated, 2: Chronic constriction injury (CCI), 3: CCI+vitamin C (500 mg/kg), 4: CCI+atorvastatin (5 mg/kg), 5: CCI+atorvastatin (10 mg/kg), 6: CCI+vitamin C (500 mg/kg)+atorvastatin (5","PeriodicalId":8701,"journal":{"name":"Basic and Clinical Neuroscience","volume":"14 6","pages":"727-739"},"PeriodicalIF":1.0,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11273201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787187","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
Alterations in Diffusion Tensor Imaging-derived Indices of Auditory Pathway-related Fiber Tracts in Children With Sensorineural Hearing Loss. 感音神经性听力损失儿童听觉通路相关纤维束的弥散张量成像衍生指标的改变
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2023.3593.2
Samira Sadeghinasab, Ali Reza Eftekhari Moghadam, Nader Saki, Arash Bayat, Ghasem Saki
<p><strong>Introduction: </strong>Hearing loss is the most common sensory-neurological defect in humans. The most common hearing impairment is sensorineural hearing loss (SNHL) caused by the inner ear and related nerves. Diffusion tensor imaging (DTI) is an advanced MRI technique that can provide valuable information about auditory neural pathways and their microstructural changes. The present study was designed to investigate the microstructural changes in auditory pathways-related fiber tracts in children with SNHL.</p><p><strong>Methods: </strong>Twenty-two children including 11 subjects with SNHL aged 1-4 years and 11 healthy children were examined as controls. Then, DTI-derived parameters, such as fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AxD), and radial diffusivity (RD), and volume of fiber tracts were extracted from the inferior longitudinal fasciculus, acoustic radiation, and uncinate fasciculus.</p><p><strong>Results: </strong>The results showed an increase in MD, RD, and AxD as well as a decrease in FA, volume, and diameter of auditory-pathway-related fiber tracts. Interestingly, there was an increase in the FA of acoustic radiation.</p><p><strong>Conclusion: </strong>White matter connections in the auditory canal decrease and AR integrity increases due to compensatory effects. These probably reflect atrophy or degradation as well as compensatory cross-modal reorganization in the absence of auditory input and the use of sign language.</p><p><strong>Highlights: </strong>Diffusion tensor imaging (DTI) plays an important role in preoperative planning.Anatomical knowledge of the auditory tract is essential for lacrimal drainage surgeries, such as cochlear implantation.DTI-based biomarkers for brain changes and allows us to better understand the pathophysiological changes of auditory tract.Microstructural changes in the fiber tracts associated with the auditory pathway can distinguish sensorineural hearing loss (SNHL) from healthy subjects.</p><p><strong>Plain language summary: </strong>Sensorineural hearing loss (SNHL) is the most common type and accounts for the majority of all hearing loss. SNHL is a congenital deficit and refers to any cause of hearing loss due to a pathology of the cochlea, auditory nerve, or central nervous system. One of the chief treatment planning is cochlear implant for these patients. So, it is necessary to evaluate the auditory system by imaging devices such as MRI (magnetic resonance imaging) before treatment. Diffusion tensor imaging tractography, or diffusion tensor imaging (DTI) tractography, is an MRI technique that measures the rate of water diffusion between cells to understand and create a map of the body's internal structures; it is most commonly used to provide imaging of the brain. The purpose of the present research was to assess the auditory system and its nerve routs in children before cochlear implant. This study showed that DT imaging is a novel approach for assessment
导言听力损失是人类最常见的感觉神经缺陷。最常见的听力损伤是由内耳和相关神经引起的感音神经性听力损失(SNHL)。弥散张量成像(DTI)是一种先进的磁共振成像技术,可提供有关听觉神经通路及其微结构变化的宝贵信息。本研究的目的是调查 SNHL 儿童听觉通路相关纤维束的微观结构变化:方法:以22名儿童为对照组,其中包括11名1-4岁的SNHL患者和11名健康儿童。然后,从下纵束、声辐射和钩状束提取 DTI 衍生参数,如分数各向异性(FA)、平均扩散率(MD)、轴向扩散率(AxD)和径向扩散率(RD)以及纤维束的体积:结果表明,听觉通路相关纤维束的 MD、RD 和 AxD 增加,FA、体积和直径减少。有趣的是,声辐射的 FA 有所增加:结论:由于补偿效应,听道白质连接减少,听觉通路完整性增加。结论:由于补偿效应,听觉管中的白质连接减少,而AR的完整性增加,这可能反映了在缺乏听觉输入和使用手语的情况下,白质的萎缩或退化以及补偿性的跨模态重组:弥散张量成像(DTI)在术前规划中发挥着重要作用。听道的解剖学知识对于人工耳蜗植入等泪道引流手术至关重要。基于 DTI 的大脑变化生物标志物让我们更好地了解听道的病理生理变化。与听觉通路相关的纤维束的微结构变化可将感音神经性听力损失(SNHL)与健康人区分开来.Plain language summary: 感音神经性听力损失(SNHL)是最常见的类型,占所有听力损失的大多数。感音神经性听力损失是一种先天性听力损失,是指由于耳蜗、听神经或中枢神经系统病变引起的任何原因的听力损失。这些患者的主要治疗方案之一是植入人工耳蜗。因此,有必要在治疗前通过磁共振成像(MRI)等成像设备对听觉系统进行评估。弥散张量成像(DTI)牵引成像是一种核磁共振成像技术,通过测量细胞间水的弥散速度来了解和绘制人体内部结构的地图;它最常用于提供大脑的成像。本研究的目的是评估植入人工耳蜗前儿童的听觉系统及其神经线路。这项研究表明,DT 成像是评估 SNHL 儿童治疗前和治疗后情况的一种新方法。
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引用次数: 0
Brain MRI Volumetric Assessment of Patients With Multiple Sclerosis: The Volume of Basal Ganglia, Thalamus, and Posterior Fossa. 多发性硬化症患者的脑核磁共振容积评估:基底节、丘脑和后窝的体积
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2023.1324.4
Sima Fallah Arzpeyma, Sara Janeshin, Niusheh Soofi Afshar, Alia Saberi, Hamidreza Ghalyanchi Langroodi, Mohammad Ebrahim Ghaffari, Kamal AmirAshjei

Introduction: Multiple sclerosis (MS) is an inflammatory demyelinating and neurodegenerative disorder of the central nervous system, which is associated with brain atrophy and volume changes in some brain structures. This study aimed to compare the volume of the basal ganglia, thalamus, cerebellum, and brainstem in patients with relapsing-remitting MS with that of the control group using magnetic resonance imaging (MRI).

Methods: In this cross-sectional study, MRI brain scans were obtained from 25 patients with relapsing-remitting MS and 25 healthy control subjects. Volumetric analyses were performed using Brain Suite software.

Results: The mean age of the MS and the control groups was 33.96±8.75 and 40.40±8.72, respectively. No statistically significant difference was found in gender (P=0.747). The bilateral putamen and caudate nuclei volumes were significantly higher in the case group than in the control group (P<0.001). Moreover, lower the volume of the brainstem, cerebellum, bilateral thalamus, and globus pallidus were identified in the MS patients compared to the control group (P<0.001). There was an inverse correlation between the disease and treatment duration with the thalamus and cerebellum volume in MS patients (P=0.001). Treatment duration also had an inverse correlation with brainstem volume (P=0.047).

Conclusion: The volume of some structures of the brain, including globus pallidus, thalamus, cerebellum, and brainstem is lower in MS and can be one of the markers of disease progression and disability among MS patients.

Highlights: Due to the degenerative process in multiple sclerosis, some cerebral structures may face volume change.The present study demonstrated that the volume of globus pallidus, thalamus, cerebellum, and brainstem is lower in MS patients compared to the controls.

Plain language summary: Multiple sclerosis (MS) is defined as an inflammatory disease involving the white matter of the brain, but experience has shown that many non-white matter structures also change in MS. In this study, we aimed to examine some parts of the brain, such as the thalamus, basal ganglia, brainstem, and cerebellum, for volume changes. The results showed that all these structures can have a smaller volume in MS patients than in healthy people. Especially in the case of the thalamus and cerebellum, this difference increases with increasing the disease duration. Changes in the size of these structures can be the result of degeneration of the neurons in these areas. These changes can cause significant disability in patients; however, there may not be significant changes in the number of plaques in patients. Attention to these changes can be essential in interpreting patients' clinical changes, including motor and cognitive disabilities.

导言:多发性硬化症(MS)是中枢神经系统的一种炎症性脱髓鞘和神经退行性疾病,与脑萎缩和某些脑结构的体积变化有关。本研究旨在通过磁共振成像(MRI)比较复发性多发性硬化症患者与对照组的基底节、丘脑、小脑和脑干的体积:在这项横断面研究中,对 25 名复发缓解型多发性硬化症患者和 25 名健康对照者进行了磁共振成像脑部扫描。结果:复发性多发性硬化症患者和健康对照组患者的平均年龄分别为 35 岁和 35 岁:多发性硬化症组和对照组的平均年龄分别为(33.96±8.75)岁和(40.40±8.72)岁。性别差异无统计学意义(P=0.747)。病例组的双侧丘脑和尾状核体积明显高于对照组(P=0.747):包括苍白球、丘脑、小脑和脑干在内的一些大脑结构的体积在多发性硬化症患者中较低,可作为多发性硬化症患者疾病进展和残疾的标志之一:本研究表明,与对照组相比,多发性硬化症患者的苍白球、丘脑、小脑和脑干的体积较小。白话摘要:多发性硬化症(MS)被定义为一种累及大脑白质的炎症性疾病,但经验表明,多发性硬化症患者的许多非白质结构也会发生变化。在这项研究中,我们旨在检查大脑的一些部位,如丘脑、基底节、脑干和小脑的体积变化。结果显示,多发性硬化症患者所有这些结构的体积都可能小于健康人。尤其是丘脑和小脑,这种差异随着病程的延长而增大。这些结构体积的变化可能是这些区域神经元退化的结果。这些变化可能会导致患者严重残疾,但患者体内斑块的数量可能没有明显变化。关注这些变化对于解释患者的临床变化(包括运动和认知障碍)至关重要。
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引用次数: 0
Mapping the Cortical Representation of Paraspinal Muscles Using Transcranial Magnetic Stimulation Optimized in People With Chronic Back Pain. 利用经颅磁刺激绘制脊柱旁肌肉的皮层表征图,并对慢性背痛患者进行优化。
IF 1 Q4 NEUROSCIENCES Pub Date : 2023-11-01 DOI: 10.32598/bcn.2023.4419.1
Solaleh Saraiepour, Sedigheh Kahrizi, Mojdeh Ghabaee, Babak Bazrgari
<p><strong>Introduction: </strong>Chronic low back pain (CLBP) is a global burden with an unknown etiology. Reorganization of the cortical representation of paraspinal muscles in the primary motor cortex (M1) may be related to the pathology. Single-pulse transcranial magnetic stimulation (TMS), commonly used to map the functional organization of M1, is not potent enough to stimulate the cortical maps of paraspinal muscles in M1 in CLBP patients with reduced corticospinal excitability (CSE) with intensities even as high as maximum stimulator output (100% MSO). This makes TMS mapping impractical for these patients. The aim of this study was to increase the practicality of TMS mapping for people with CLBP.</p><p><strong>Methods: </strong>This study included eight men and ten women who had CLBP for over three months. A biphasic paired-pulse TMS paradigm, conjunct anticipatory postural adjustment (APA), and maximal voluntary activation of paraspinal muscles (MVC) were used to facilitate TMS mapping.</p><p><strong>Results: </strong>TMS mapping was possible in all CLBP participants, with TMS intensities <50% of the MSO. Reorganization in terms of an anterior and lateral shift of the center of gravity (COG) of the cortical maps of paraspinal muscles was observed in all participants with CLBP, and a reduced number of discrete peaks was found in 33%.</p><p><strong>Conclusion: </strong>The facilitation of the CSE to paraspinal muscles makes TMS mapping more practical and tolerable in people with CLBP, lowering the risk of seizure and discomfort associated with high-intensity TMS pulses.</p><p><strong>Highlights: </strong>Conventional transcranial magnetic stimulation (TMS) brain mapping is not optimal for patients with Chronic low back pain (CLBP).Paired-pulse TMS dramatically lessens the energy needed for brain mapping.Maximal voluntary contraction of back muscles facilitates TMS mapping.Anticipatory postural activity of back muscles enhances the efficacy of TMS mapping.</p><p><strong>Plain language summary: </strong>Chronic low back pain (CLBP) is a social, emotional, and economic burden and the leading cause of disability worldwide. Yet the etiology of the CLBP is unknown. The persistence of aberrant or antalgic movement patterns observed in people with CLBP has been suggested as a possible cause of pain chronification by inducing continuous damage to sensitive structures of the lumbar spine. It is well known that the brain is in charge of the production and planning of movements, so it is likely that abnormal movement patterns also stem from the abnormalities in the brain. However, until recently, human knowledge about the structure and function of the brain has been very limited. The invention of noninvasive and painless brain imaging and stimulating techniques such as transcranial magnetic stimulation (TMS) during the last decades has augmented our knowledge about the structure and function of the brain. Modification in terms of shift, shrinkage, or e
导言:慢性腰背痛(CLBP)是一种病因不明的全球性负担。初级运动皮层(M1)中脊柱旁肌肉的皮层表征重组可能与病理有关。单脉冲经颅磁刺激(TMS)通常用于绘制 M1 的功能组织图,但对于皮质脊髓兴奋性(CSE)降低的 CLBP 患者,其强度即使高达最大刺激器输出(100% MSO),也不足以刺激 M1 中脊髓旁肌肉的皮质图。这使得 TMS 测绘对这些患者不切实际。本研究的目的是提高 TMS 测绘对 CLBP 患者的实用性:这项研究包括 8 名男性和 10 名女性,他们都患有慢性脑卒中三个月以上。研究采用了双相成对脉冲 TMS 范式、联合预期姿势调整(APA)和最大自主激活脊柱旁肌肉(MVC)来促进 TMS 图谱的绘制:结果:所有 CLBP 参与者都能进行 TMS 图谱绘制,TMS 强度均为 0.1:CSE对脊柱旁肌肉的促进作用使TMS映射对CLBP患者更加实用和可耐受,降低了癫痫发作的风险和与高强度TMS脉冲相关的不适感:传统的经颅磁刺激(TMS)脑图谱并不适合慢性腰背痛(CLBP)患者.成对脉冲TMS显著降低了脑图谱所需的能量.背部肌肉的最大自主收缩有利于TMS脑图谱的绘制.背部肌肉的预期姿势活动提高了TMS脑图谱的疗效.原文摘要:慢性腰背痛(CLBP)是一种社会、情感和经济负担,也是全球致残的主要原因。然而,慢性腰背痛的病因尚不清楚。有人认为,在慢性腰背痛患者身上观察到的持续异常或反常运动模式可能是导致疼痛慢性化的一个原因,因为它会对腰椎的敏感结构造成持续性损伤。众所周知,大脑负责动作的产生和规划,因此异常的运动模式也可能源于大脑的异常。然而,直到最近,人类对大脑结构和功能的了解还非常有限。近几十年来,无创、无痛脑成像和经颅磁刺激(TMS)等刺激技术的发明增加了我们对大脑结构和功能的了解。通过这些技术,我们记录了慢性阻塞性脑脊髓膜炎患者大脑中负责运动控制或背部肌肉感觉的区域发生了移动、收缩或扩张等变化,这些变化被认为与疼痛的慢性化有关,但还需要进一步澄清。然而,通过 TMS 监测慢性阻塞性脑脊髓膜炎的病程尽管有很多潜力,但仍具有挑战性。这可能是由于CLBP患者大脑皮层对背部肌肉的驱动力减弱,以及大脑中专门用于控制背部肌肉的区域较小,从而增加了CLBP患者大脑对TMS的阈值。本研究的目的是量身定制一种方法,通过降低 TMS 的阈值,使 TMS 更适用于 CLBP 患者。要做到这一点,可以让背部肌肉参与预期姿势活动,同时最大限度地自愿激活这些肌肉,再配合诱导皮层内促进的 TMS 范例。
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Basic and Clinical Neuroscience
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