Brain disorders & therapy最新文献

英文中文

Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A New Challenging Entity for Consultation-Liaison Psychiatrist 抗n-甲基- d -天冬氨酸受体脑炎:会诊联络精神病学家的新挑战

Brain disorders & therapy

Pub Date : 2016-05-01 DOI: 10.4172/2168-975X.1000215

G. Maccaferri, A. Rossetti, J. Dalmau, A. Berney

Background Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a relatively newly identified autoimmune neuropsychiatric disorder that predominantly affects children and young adults. Although psychiatric symptoms are highly prevalent and frequently severe, it has mainly been reported in neurological, but not psychiatric, literature. Understanding this form of encephalitis, its quick diagnosis and which treatment to provide are of utmost importance for consultation-liaison (C-L) psychiatrists. The aim of this paper was to describe a case of anti-NMDAR encephalitis with severe psychiatric manifestations, who showed impressive recovery but required intensive involvement of the C-L psychiatry team. We emphasise the behavioural aspects, psychiatric symptoms and challenges faced by the CL consultant across the different phases of the treatment. Methods We report the different treatment phases for a young woman with anti-NMDAR encephalitis who developed severe neuropsychiatric symptoms, with a focus on the role and challenges faced by the C-L psychiatrist. The literature is reviewed for each of these challenges. Results This case illustrated that even extremely severely affected patients may show impressive recovery, but require long lasting psychiatric care. C-L psychiatrists are faced with numerous challenges where only little literature is available. Conclusion C-L psychiatrists play a pivotal role throughout the multidisciplinary care of patients with anti-NMDAR encephalitis and should be informed about this entity.

抗n -甲基- d -天冬氨酸受体脑炎(anti-NMDAR)是一种相对较新发现的自身免疫性神经精神疾病，主要影响儿童和年轻人。虽然精神病学症状非常普遍，而且常常很严重，但主要在神经学文献中报道，而不是精神病学文献。了解这种形式的脑炎，它的快速诊断和治疗提供是最重要的咨询-联络(C-L)精神病学家。本文的目的是描述一个具有严重精神症状的抗nmdar脑炎病例，他的恢复令人印象深刻，但需要C-L精神病学团队的密切参与。我们强调行为方面、精神症状和在治疗的不同阶段CL顾问所面临的挑战。方法:我们报告了一名患有严重神经精神症状的抗nmdar脑炎的年轻女性的不同治疗阶段，重点介绍了C-L精神科医生的作用和面临的挑战。针对这些挑战，我们对文献进行了回顾。结果本病例表明，即使是极严重的患者也可能表现出令人印象深刻的恢复，但需要长期的精神护理。C-L精神科医生面临着无数的挑战，只有很少的文献可用。结论C-L精神科医生在抗nmdar脑炎患者的多学科护理中起着关键作用，应告知这一实体。

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引用次数: 6

Anti-N-Methyl-D-Aspartate Receptor Encephalitis: A New Challenging Entity for Consultation-Liaison Psychiatrist. 抗n-甲基- d -天冬氨酸受体脑炎:会诊联络精神病学家的新挑战。

Brain disorders & therapy

Pub Date : 2016-05-01 Epub Date: 2016-05-10

G E Maccaferri, A O Rossetti, J Dalmau, A Berney

Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a relatively newly identified autoimmune neuropsychiatric disorder that predominantly affects children and young adults. Although psychiatric symptoms are highly prevalent and frequently severe, it has mainly been reported in neurological, but not psychiatric, literature. Understanding this form of encephalitis, its quick diagnosis and which treatment to provide are of utmost importance for consultation-liaison (C-L) psychiatrists. The aim of this paper was to describe a case of anti-NMDAR encephalitis with severe psychiatric manifestations, who showed impressive recovery but required intensive involvement of the C-L psychiatry team. We emphasise the behavioural aspects, psychiatric symptoms and challenges faced by the CL consultant across the different phases of the treatment.

Methods: We report the different treatment phases for a young woman with anti-NMDAR encephalitis who developed severe neuropsychiatric symptoms, with a focus on the role and challenges faced by the C-L psychiatrist. The literature is reviewed for each of these challenges.

Results: This case illustrated that even extremely severely affected patients may show impressive recovery, but require long lasting psychiatric care. C-L psychiatrists are faced with numerous challenges where only little literature is available.

Conclusion: C-L psychiatrists play a pivotal role throughout the multidisciplinary care of patients with anti-NMDAR encephalitis and should be informed about this entity.

背景:抗n -甲基- d -天冬氨酸受体(anti-NMDAR)脑炎是一种相对较新发现的自身免疫性神经精神疾病，主要影响儿童和年轻人。虽然精神病学症状非常普遍，而且常常很严重，但主要在神经学文献中报道，而不是精神病学文献。了解这种形式的脑炎，它的快速诊断和治疗提供是最重要的咨询-联络(C-L)精神病学家。本文的目的是描述一个具有严重精神症状的抗nmdar脑炎病例，他的恢复令人印象深刻，但需要C-L精神病学团队的密切参与。我们强调行为方面、精神症状和在治疗的不同阶段CL顾问所面临的挑战。方法:我们报告了一名患有严重神经精神症状的抗nmdar脑炎的年轻女性的不同治疗阶段，重点介绍了C-L精神科医生的作用和面临的挑战。针对这些挑战，我们对文献进行了回顾。结果:本病例说明，即使是极严重的患者也可能表现出令人印象深刻的恢复，但需要长期的精神护理。C-L精神科医生面临着无数的挑战，只有很少的文献可用。结论:C-L精神科医生在抗nmdar脑炎患者的多学科护理中起着关键作用，应告知这一实体。

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引用次数: 0

New Bioethical Aspects of Ending of Life in Unresponsive Wakefulness Syndrome/Vegetative State Patients 无反应性觉醒综合征/植物人患者生命终结的新生物伦理方面

Brain disorders & therapy

Pub Date : 2016-04-25 DOI: 10.4172/2168-975X.1000213

F. Arcuri, M. D. Cortese, G. Dolce

The active abandonment of patients in Unresponsive Wakefulness Syndrome/Vegetative State (UWS/VS) [1] is a topic that has been widely discussed in recent decades by individual authors advocating directly opposite points of view.

无反应性清醒综合征/植物人状态(UWS/VS)患者的主动遗弃[1]是近几十年来被个别作者广泛讨论的一个话题，他们主张截然相反的观点。

引用次数: 1

Lamotrigine Induced Dystonia in a Patient with Bipolar Affective Disorder 拉莫三嗪诱导双相情感障碍患者肌张力障碍

Brain disorders & therapy

Pub Date : 2016-04-16 DOI: 10.4172/2168-975X.1000212

Ratan J. Lihite, M. Lahkar, D. Medhi, R. Mathur

Lamotrigine is a first drug since lithium approved for maintenance treatment of bipolar type I. Lamotrigine-induced extrapyramidal side effects are rarely reported in literatures. In this letter, we have presented a case of Bipolar disorder which has induced dystonia to lamotrigine. Lamotrigine is a phenyltriazine derivative [1] which was originally approved by USA Food & Drug Administration for partial complex and generalized seizures. It was also recommended for treating bipolar affective disorder by British association for psychopharmacology in 2009 [2]. Lamotrigine is generally well tolerated. However, the most common adverse effects due to lamotrigine are nausea, headache, dizziness, ataxia, diplopia, somnolence, and tremor. Beside these, skin eruptions, arthralgia, haematological abnormalities comprised of leucopenia and thrombocytopenia, and elevated liver enzymes are also reported [3]. Some psychiatric problems are also associated with lamotrigine use, which are rarely reported in literature.

拉莫三嗪是继锂离子离子后第一个被批准用于双相i型患者维持治疗的药物。拉莫三嗪引起的锥体外系副作用在文献中很少报道。在这封信中，我们提出了一个双相情感障碍的情况下，诱发张力障碍拉莫三嗪。拉莫三嗪是苯三嗪衍生物[1]，最初被美国食品和药物管理局批准用于部分复杂和全面性癫痫发作。2009年，英国精神药理学协会也推荐将其用于治疗双相情感障碍。拉莫三嗪一般耐受性良好。然而，拉莫三嗪最常见的不良反应是恶心、头痛、头晕、共济失调、复视、嗜睡和震颤。除此之外，皮肤出疹、关节痛、由白细胞减少和血小板减少组成的血液学异常以及肝酶升高也被报道。一些精神问题也与拉莫三嗪的使用有关，这在文献中很少报道。

引用次数: 0

DNA Methylation of Imprinted Loci on Autosomal Chromosomes and IGF2 are not Affected in Parkinson's Disease Patients Peripheral Blood Monocytes 帕金森病患者外周血单核细胞常染色体上印迹位点和IGF2的DNA甲基化不受影响

Brain disorders & therapy

Pub Date : 2016-03-05 DOI: 10.4172/2168-975X.1000211

O. Kaut, Amit Sharma, U. Wüllner

Genomic imprinting is an epigenetic phenomenon that results in differential expression of alleles depending on their parental origin. The functional significance of DNA methylation in genomic imprinting has been widely investigated and to date, around 100 imprinted genes have been identified in humans. To investigate, if methylation status of these “known” imprinting genes is associated with Parkinson's disease (PD), we analyzed methylation profile of all these “known” imprinting genes using an epigenome wide approach with Illumina's 450K methylation chip. Strikingly, none of these total autosomal annotated genes show changes of DNA methylation between PD and healthy individuals. We further refined our analysis by evaluating DNA methylation for maternally imprinted human gene encoding insulin-like growth factor 2 (IGF2) by using bisulfite sequencing PCR (BSP) and by considering different dosages of L-dopa. Our results demonstrate that methylation profiles specifically at exon 8-9 genomic region of IGF2 gene in PD are neither influenced by the dosage of L-dopa treatment nor by the disease itself. Thus loss or disruption of imprinting in autosomal chromosomes seems not to apparent in PD and is not relevant for the pathogenesis of the disease.

基因组印记是一种表观遗传现象，导致等位基因的差异表达取决于他们的亲本来源。DNA甲基化在基因组印迹中的功能意义已被广泛研究，迄今为止，在人类中已鉴定出大约100个印迹基因。为了研究这些“已知”印迹基因的甲基化状态是否与帕金森病(PD)相关，我们使用Illumina的450K甲基化芯片分析了所有这些“已知”印迹基因的甲基化谱。引人注目的是，这些常染色体注释基因中没有一个显示PD和健康个体之间DNA甲基化的变化。通过亚硫酸氢盐测序PCR (BSP)和考虑不同剂量的左旋多巴，我们进一步完善了我们的分析，评估了母体印迹人类基因编码胰岛素样生长因子2 (IGF2)的DNA甲基化。我们的研究结果表明，PD患者IGF2基因外显子8-9基因组区域的甲基化谱既不受左旋多巴治疗剂量的影响，也不受疾病本身的影响。因此，常染色体印迹的丢失或破坏似乎在PD中并不明显，与疾病的发病机制无关。

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引用次数: 7

Predicting Real-Life Cognitive Performance from Laboratory Data: A Case for Developmental Studies Using the Attentional Blink 从实验室数据预测现实生活中的认知表现:一个使用注意力眨眼的发展研究案例

Brain disorders & therapy

Pub Date : 2016-03-04 DOI: 10.4172/2168-975X.1000210

S. Heim, A. Keil

In an increasingly digital world, complex cognitive skills such as executive control and working memory capacity are crucial for adaptive behavior. In children and adolescents, methods are therefore needed for assessing and predicting strengths and weaknesses in these capacities, opening avenues for intervention and training regimes. This commentary argues that laboratory tasks in combination with suitable brain measures have the potential to address this need, having the potential to quantify and predict specific aspects of cognitive skills in the real world. The so-called attentional blink paradigm and its developmental trajectories are discussed as an example for such an approach.

在一个日益数字化的世界里，复杂的认知技能，如执行控制和工作记忆能力，对适应性行为至关重要。因此，在儿童和青少年方面，需要有方法来评估和预测这些能力的长处和弱点，为干预和培训制度开辟途径。这篇评论认为，实验室任务与适当的大脑测量相结合，有可能满足这一需求，有可能量化和预测现实世界中认知技能的具体方面。本文讨论了所谓的“注意眨眼”范式及其发展轨迹，作为这种方法的一个例子。

引用次数: 0

Auditory Processing Deficits Following Sport-Related or Motor VehicleAccident Injuries 运动相关或机动车事故伤害后的听觉处理缺陷

Brain disorders & therapy

Pub Date : 2016-01-30 DOI: 10.4172/2168-975X.1000204

S. Atcherson, Claire Steele

This brief clinical study was designed to investigate further the possible link between traumatic brain injury (TBI) and/or whiplash injury (WI) with acquired auditory processing disorder (APD). Other studies have shown long standing effects of TBI and WI, and a study by Turgeon et al., examined the link between sport-induced concussion and APD. Four participants ages 18 to 30 years of age who self-reported a history of sport-related or motor vehicle accident head injuries participated in the following procedures: case history, behavioral testing, electrophysiological testing including auditory brainstem responses (ABR) and middle latency responses (MLR), and self-report questionnaires of post head and/or whiplash injury symptoms. The results of the testing were individually analyzed to see if results were consistent with a diagnosis of APD, or some evidence of a non-sensory deficit to the auditory system. The overall results of this study were also compared with the results of Turgeon et al., study. The results of the study shows that electrophysiological testing may be outside of normal limits even when behavioral testing does not support an APD diagnosis. Furthermore, the degree of reported symptoms and difficulties in the participants’ case history does not always carry over to the behavioral and electrophysiological testing results.

这项简短的临床研究旨在进一步探讨创伤性脑损伤(TBI)和/或鞭伤(WI)与获得性听觉加工障碍(APD)之间的可能联系。其他研究也显示了TBI和WI的长期影响，Turgeon等人的一项研究调查了运动诱发的脑震荡和APD之间的联系。4名年龄在18 ~ 30岁的自述有运动相关或机动车事故头部损伤史的参与者，参与了以下程序:病例史、行为测试、包括听觉脑干反应(ABR)和中潜伏期反应(MLR)在内的电生理测试，以及自述头部和/或颈部损伤症状问卷。对测试结果进行单独分析，看看结果是否与APD的诊断一致，或者听觉系统的非感觉缺陷的一些证据。本研究的总体结果也与Turgeon等人的研究结果进行了比较。研究结果表明，即使行为测试不支持APD诊断，电生理测试也可能超出正常范围。此外，在参与者的病史中报告的症状和困难的程度并不总是延续到行为和电生理测试结果。

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引用次数: 5

Synchronous Morphologically Distinct Craniopharyngioma and Pituitary Adenoma: A Rare Collision Entity 颅咽管瘤和垂体腺瘤:一种罕见的碰撞实体

Brain disorders & therapy

Pub Date : 2016-01-29 DOI: 10.4172/2168-975X.1000207

H. Bhatoe, P. Deb, S. Sengupta

While pituitary tumors and craniopharyngiomas share a common lineage, their simultaneous occurrence is distinctly rare. We present one such patient, an adult male with two distinct tumors, that were excised by two different approaches. Relevant literature is briefly reviewed.

虽然垂体瘤和颅咽管瘤有共同的谱系，但它们同时发生是非常罕见的。我们提出一个这样的病人，一个成年男性有两个不同的肿瘤，切除了两种不同的方法。本文简要回顾了相关文献。

引用次数: 6

Tyrosine Kinase and Mitogen Activated Protein (MAP) Kinase Pathway onCerebral Vasospasm after Aneurysmal Subarachnoid Hemorrhage 动脉瘤性蛛网膜下腔出血后脑血管痉挛的酪氨酸激酶和丝裂原活化蛋白激酶途径

Brain disorders & therapy

Pub Date : 2016-01-23 DOI: 10.4172/2168-975X.1000205

F. Romero, M. Zanini

Cerebral vasospasm is a severe complication after an aneurysm rupture. Many efforts have been done to understand the complexity signaling pathways involved in this condition. MAP kinase has been suggested to be one of the most important signaling pathways involved in cerebral vasospasm. This pathway is clinically important as it has both outcome and therapeutic implications.

脑血管痉挛是动脉瘤破裂后的严重并发症。许多努力已经完成，以了解复杂的信号通路涉及这种情况。MAP激酶被认为是参与脑血管痉挛的最重要的信号通路之一。这一途径在临床上具有重要意义，因为它具有结果和治疗意义。

引用次数: 1

Deep Brain Stimulation for Alzheimer's Disease 深部脑刺激治疗阿尔茨海默病

Brain disorders & therapy

Pub Date : 2016-01-23 DOI: 10.4172/2168-975X.1000202

A. Lavano, A. Torre, G. Guzzi, F. Deodato, F. Lavano, G. Volpentesta

Alzheimer’s disease (AD) is a debilitating neurological illness of increasing prevalence. Accumulations of abnormal proteins (beta amyloid and tau protein), inflammatory cascades, abnormal responses to oxidative stress and alteration in oxidative metabolism have been implicated in AD. There are few therapeutic options available for this disorder. Latest research indicates that deep brain stimulation (DBS) may be a method for improving cognitive functions. Many aspects remain unclear, particularly with regard to the optimal target structure. In this review the pathophysiology, neural circuitry and potential neuromodulation options in patients with AD are resumed.

阿尔茨海默病(AD)是一种日益流行的衰弱性神经系统疾病。异常蛋白(β -淀粉样蛋白和tau蛋白)的积累、炎症级联反应、氧化应激的异常反应和氧化代谢的改变都与AD有关。治疗这种疾病的方法很少。最新研究表明，脑深部电刺激(DBS)可能是改善认知功能的一种方法。许多方面仍不清楚，特别是关于最佳目标结构。本文回顾了阿尔茨海默病患者的病理生理、神经回路和潜在的神经调节选择。

引用次数: 7

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