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Objective To detect the metabolites of non-motor functional area in patients with Parkinson disease (PD) by proton magnetic resonance spectroscopy (1H-MRS).Methods Forty-two PD patients (PD group) tested with unified PD rating scale (UPDRS) and 20 healthy controls(normal control group) were enrolled in this study.MRI and 1H-MRS using a GE signa excite1.5T MR was obtained,and the ratios of metabolites such as N-acetylaspartate(NAA)/creatin(Cr),NAA/cholinecompounds(Cho) in the prefrontal lobe,hippocampus,cuneus gyrus and dorsal thalamus were compared.Correlations between brain metabolites and UPDRS were analyzed.Results The levels of NAA/Cr,and NAA/Cho in bilateral dorsal thalamus,cuneus gyrus,hippocampus,prefrontal lobe in PD group were significantly lower than those in normal control group (P ＜ 0.01).The level of Cho/Cr in right hippocampus,right cuneus gyms,and right dorsal thalamus in PD group was significantly higher than that in normal control group (P ＜ 0.05).The NAA/Cho in the left hippocampus (r =-0.388,P =0.011) and left cuneus gyrus (r =-0.325,P =0.036) was negatively correlated with UPDRS scores (P ＜ 0.05).Conclusions There is extensive neuronal damage and some glial proliferation in the non-motor functional areas including prefrontal lobe,hippocampus,cuneus gyrus,anddorsal thalamus in the PD patients.The degree of damage in left hippocampus and left cuneus gyms is positively correlated with the severity of the disease clinically.
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Objective To observe the effects of hyperbaric oxygen (HBO) on cerebral small vessel disease (CSVD) and on learning,memory and the expression of brain-derived neurotrophic factor (BDNF) and acetylcholine (Ach) in the cerebral cortex and hippocampus.Methods Sixty healthy,male Wistar rats were studied.Allograft thrombosis particles 48 to 74 μm in diameter were injected into the rats' external carotid arteries to create a CSVD model.The rats were then divided randomly into a hyperbaric oxygen group,a nimotop group and a control group.The hyperbaric oxygen group rats were given hyperbaric oxygen therapy 12 hours after the modeling.The nimotop group rats were given nimodipine by intragastric perfusion 12h after the modeling.The rats in the control group had no special intervention.At 7,14 and 28 days after the modeling,any changes in learning and memory were assessed with a Morris water maze test.Enzyme-linked immunosorbent assay (ELISA) was used to detect the expression of BDNF in the cerebral cortex and of Ach in the hippocampus at 28 days.Results At both 14 and 28 days the average escape latency of the rats in the hyperbaric oxygen group was significantly shorter than those of the nimotop and control groups.The average platform crossing time had increased significantly more than in the nimotop and control groups.At both 14 and 28 days the escape latency and platform crossing times of the nimotop group were significantly better than in the control group.Ach content and BDNF content were significantly higher in the HBO group than in the nimotop and control groups.Conclusions Hyperbaric oxygen treatment can promote BDNF release in CSVD,which is helpful to protect and repair neural mitochondria,to maintain the cortex and hippocampal neurotransmitters on a stable level,and to improve learning and memory.Its effect is better than that of nimotop.
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Objective By using 18F-deoxyglucose (18F-FDG) positron emission computed tomography (PET-CT) to measure the brain glucose metabolism of patients with severe traumatic brain injury before and after hyperbaric oxygen (HBO) therapy,and to investigate the mechanisms of H BO treating patients with traumatic brain injury.Methods Twenty-six patients suffered form severe traumatic brain injury with stable vital signs within 2 weeks were randomly divided into the HBO group and the control group.The patients of both groups received routine clinical interventions (including neuroprotection,dehydration,reducing intracranial pressure,anti-infection and other symptomatic treatments).Patients of the HBO group received the basic treatment combined with HBO therapy one tine per day for 7 days per week.In early stage and 4 weeks after treatment,all patients were examined with PET-CT scanning and Glasgow coma scale (GCS),disability rating scale (DRS) at the same time.Results There was standard uptake value (SUV) of significant difference between affected and unaffected brain areas in two groups before treatment(P＜0.01),but no significant difference between two groups (P＞0.05).After 4-week of treatment,SUV of affected and unaffected brain areas of two groups improved,the damaged area of HBO group improved obviously and the SUV was much better than before treatment and the control group (P＜0.0l).The GCS and DRS scores of HBO group were also significantly better than that of control group (P＜0.05).Conclusion The 18F-FDG PET-CT examination showed that HBO therapy can significantly improve glucose metabolism function of the brain damaged area,promote the brain functional recovery and awakening,and improve the prognosis in patients with severe traumatic brain injury.
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Objective To investigate the effects of lower limb training combined with hyperbaric oxygen on motor function in a paretic lower limb and on the ability in the activities of daily living (ADL) of hemiplegic stroke survivors. Methods A total of 297 hemiplegic stroke patients received routine interventions and then were randomly divided into 3 groups. The hyperbaric oxygen group accepted hyperbaric oxygen, the training group accepted lower limb training, and the treatment group accepted both hyperbaric oxygen and lower limb training. Evalnations were carried out pretreatment and 30 d post treatment to assess the function of the paretic lower limb and ADL ability with the Fugl-Meyer assessment ( FMA), a modified Barthel index (MBI) , Berg's balance scale (BBS) and the timed up and go test (TUGT). Results FMA, MBI, BBS and TUGT scores in all 3 groups improved significantly compared with pretreatment. On the 30th day post treatment, the scores in the treatment group were significantly better than in the other two groups. Conclusions Lower limb training combined with hyperbaric oxygen can significantly improve motor function in the paretic lower limbs of stroke patients and their ADL performance.
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@#Objective To study the influence of center of gravity excursion in standing on function outcome of stroke patients.Methods46 stroke patients were assessed with static posturography in standing,Fugl-Meyer Balance Scale,Barthel Index and the time in hospital.The patients were divided into 2 groups according to posturography results:center of gravity was inclined to the normal side (normal group),center of gravity was inclined to the hemiplegia side (hemiplegia group).ResultsThe ability of balance,walking and activity of daily living(ADL)of the normal group patients were better than that of the hemiplegia group patients,and the in-hospital time was shorter (P<0.001).ConclusionThe center of gravity excursion in standing is highly correlated with functional outcome of stroke patients.
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@#ObjectiveTo study the effect of partial body-weight support and treadmill training in subacute stroke patients.Methods40 stroke patients were randomly arranged into 3 groups: group A (n=14) accepted 8 weeks of routine physical therapy, group B (n=13) accepted additional 6 weeks partial body-weight support and treadmill training at the 3rd week, group C (n=13) accepted additional 3 weeks partial body-weight support and treadmill training at the 6th week. The patients were evaluated with Fugl-Meyer Assessment of Physical Performance(FMA), Barthel Idex(BI) and the Berg Balance Scale(BBS). ResultsThe functional outcome of the initial evaluation with FMA, BI and BBS were no-significantly different, 8 weeks later, that of group B were better than that of group A and group C (P<0.05～0.01), and that of group C were better than that of group A (P<0.05).ConclusionEarly treatment of partial body-weight support and treadmill training can help to improve the lower extremities function.
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@#Objective To study the balance function of normal persons and to explore the differences in gender and age groups.Methods Forty parameters of 445 normal persons(16-70 years old, 205 of male, 240 of female ) were detected by static posturography while they were in seat, double foot standing with opening and closing eyes, and single foot standing with opening eyes. The results of male and female, standing with opening eyes and closing eyes, left foot standing and right foot standing were compared.Results Everyone's center of gravity was distributed in A zone while they were in seat. At standing with opening eyes and closing eyes, the center of gravity in A zone were in 429 subjects( 96.4%) and 436 subjects( 98.0%). Most parameters showed significant difference between the women and the men, opening eyes and closing eyes, left foot standing and right foot standing, different age groups. The stability in closing eyes was better than that in opening eyes, right foot standing was better than left foot standing. Most values of 20—39 years old group were the best, 70—79 years old group were the worst.Conclusion Static posturography can evaluate human balance function objectively and quantitatively. The stability is related to age and gender. To judge the balance function, the subject's age and sex must be taken into account.