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@#Cognitive impairment is the most common non-motor symptom of Parkinson's disease (PD), which may associate with the disorders of transmitters, cortical atrophy, proteinosis, etc., and seriously influence the motor function, ability of daily life of the patients. Transcranial direct current stimulation (tDCS), which may adjust the cerebral excitability, regional blood flow, plasticity of synapses, etc., has been used for PD cognitive impairment.
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@#Objective To observe the effects of transcranial direct current stimulation (tDCS) on depression, anxiety and cognitive function in patients with post-stroke depression (PSD). Methods From February to August, 2017, 26 patients with PSD were randomly divided into control group (n=13) and treatment group (n=13). All the patients accepted sertraline, while the treatment group accepted tDCS, and the control group accepted sham stimulation. They were evaluated with Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA) and Mini-Mental State Examination (MMSE) before and after treatment. Results Twelve patients in the treatment group and ten patients in the control group completed the trial. The scores of HAMD, HAMA and MMSE improved in both groups (t>2.331, P<0.05), and there was no significant difference between two groups (t<1.642, P>0.05). The scores of anxiety/somatization factor, cognitive impairment factor, retardation factor and despair factor of HAMD improved in the treatment group after treatment (t>2.493, P<0.05), while only despair factor improved in the control group (t=2.862, P<0.05). The score of retardation factor was significantly different between two groups (t=2.354, P<0.05).Conclusion tDCS may work for the depression in PSD patients.
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Objective To investigate the characteristics of mental rotation in stroke patients and the relationship between mental rotation and visual-spatial cognitive function. Methods From March, 2012 to October, 2013, 30 stroke patients were selected as experimental group and 30 healthy subjects as control group. They were tested with hand mental rotation task, and assessed with visuospatial abilities from Mon-treal Cognitive Assessment (MoCA). Results The reaction time of hand mental rotation task was significantly longer in the experimental group than in the control group (F=95.6, P<0.001). The reaction time was longer with the increase of rotation angle in both groups, and was the longest as 180° of rotation (F=345.672, P<0.001). The response accuracy rate of hand mental rotation task was significantly lower in the experimental group than in the control group (F=6.444, P<0.05). The response accuracy rate was lower with the increase of rotation angle in both groups, and was the least as 180° of rotation (F=102.911, P<0.001). The reaction time negatively correlated with the score of visuospa-tial abilities, while the response accuracy rate positively correlated with it in the stroke patients (P<0.05). Conclusion The mental rotation ability is impaired in stroke patients, however, the respondent pattern is similar to healthy people. The mental rotation ability is correlated with visual-spatial cognitive functions in stroke patients.
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Objective To investigate the effect of heart rate variability (HRV) biofeedback training on patients with three types of insom-nia disorder. Methods From June, 2016 to March, 2017, 17 patients in simple insomnia group, 19 patients in insomnia with anxiety group, and 19 patients in insomnia with depression group were included. All the patients received HRV biofeedback training and same medication (zolpidem tartrate, 10 mg every night). They were assessed with Pittsburgh Sleep Quality Index (PSQI), Symptom Checklist 90 (SCL-90), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD), and HRV parameters were tracked before and after training. Re-sults After training, the scores of PSQI, SCL-90, HAMA , HAMD and the ratio of low frequency (LF) and high frequency (HF) (LF/HF) de-creased in all groups (t>1.446, P0.05). Conclusion HRV biofeedback training could improve the symptoms of patients with three types of insomnia disorder, especially for those with anxiety or depression.
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Objective To investigate the self-regulation of the autonomic nervous system following the cognitive stress tests after heart rate variability (HRV) biofeedback therapy in patients with post-stroke depression (PSD). Methods From May, 2013 to December, 2015, 48 patients with PSD were randomly divided into feedback group (n=25) and control group (n=23). The feedback group received HRV biofeed-back therapy, while the control group only received relaxation therapy without feedback signal. HRV parameters were tracked during the cognitive stress test in quiet baseline state, cognitive stress state, and resting state before and after treatment. Results Under the stress condi-tion, the low frequency of both groups increased during the first cognitive test, and the rate was higher in the control group than in the feed-back group (P=0.02). The heart rates during the second cognitive test decreased in the feedback group, while increased in the control group (P=0.05). After rest, the heart rate of the feedback group decreased below the baseline (P=0.02). Conclusion During the cognitive stress test, HRV biofeedback therapy can achieve a dynamic balance between sympathetic and parasympathetic nerves by reducing sympathetic sensibility, which improved patients' adaptive capacity to cope with their internal physiological environment and external environmental pressures.
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@#Objective To study the influence of obesity on outcome of rehabilitation for the hemiplegic post stroke. Methods 118 hospitalized stroke patients were divided into the normal weight, overweight and obesity groups according to the Body Mass Index. All the patients received rehabilitation for 12 weeks. They were assessed with National Institute of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS) and modified Barthel Index (MBI) before and after rehabilitation. Results The scores of NIHSS, FMA, BBS and MBI improved significantly after rehabilitation in all the groups (P<0.001), and improved the lest in the obesity group in the scores of NIHSS, BBS and MBI (P<0.05). There was no significant difference in FMA score among groups (P>0.05). Conclusion Obesity influences the outcome of rehabilitation, results in poor functioning.
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@#Objective To explore the influence of attention training on Chinese character processing capability in poststroke nonfluent aphasiacs. Methods 60 stroke patients with nonfluent aphasia and cognition dysfunction were divided into control group (n=30) and experimental group (n=30). The trainings (attention training and cognition training) were respectively 30 minutes each time, 5 times each week for 4 weeks. The change of reaction time and error rate were compared before and after they were performing the orthographic, semantic and phonological tasks. Results In the dual-task paradigm the change of reaction time and error rate in orthographic and semantic tasks of the experimental group were all higher than the control group (P<0.001). But there was no difference between the two groups in the phonological task (P>0.05). In the single task paradigm there was no difference between the two groups (P>0.05). Conclusion 1. Attention training can improve the processing capacity significantly in orthographic and semantic tasks in the dual-task paradigm because the volume and distributive ability of attention improve significantly. 2. Attention training can't improve the processing capacity in phonological tasks in the dual- task paradigm because reading aloud and judging are required to process the vowel simultaneously. So that the competion intensifies and it is more difficult to finish the task. 3. In the single task paradigm, there is no significant difference between the influence of the two trainings in poststroke nonfluent aphasiac because the single task needs little attention and the change in the control group is enough.
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@#Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference effect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respectively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by interference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateralization index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solving the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.
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@#Objective To explore the feature and rehabilitation of ataxia post 5 times recurrence of hemangioblastoma. Methods A case was reviewed combined with literatures. Results The patient presented cerebellar ataxia after 5 times recurrence of hemangioblastoma. The score of Fugl-Meyer Assessment of balance increased from 4 to 13, while the modified Barthel Index from 50 to 90 after 3 months of rehabilitation. Conclusion Rehabilitation may improve the activeties of daily living and balance for patient with ataxia after multiple recurrences of hemangioblastoma.
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Objective To investigate the effect of attention training on cortical activation area and lateralization index in interference ef-fect of dual-task paradigm as the poststroke nonfluent aphasiacs processing the Chinese character tasks. Methods 20 cases with nonfluent aphasia after stroke were divided into the training group and the control group, who accepted attention training and cognitive training respec-tively, 30 min a time, 5 times a week, for 4 weeks. They were investigated the cortical activation area and lateralization index caused by in-terference effect of dual-task paradigm under block design. Results The right inferior frontal gyrus, bilateral parietal and cerebellar cortex were activated before training in both groups, and more activated after attention training, but no change after cognitive training. Lateraliza-tion index suggested that the right brain was more activated before training, while the left side was activated after attention training, but no change after cognitive training. Conclusion The right inferior frontal gyrus, bilateral parietal and cerebellar cortex are very important in solv-ing the dual task interference in the attention stage, and they are activated after attention training. It indicates that attention training makes a significant functional reorganization on Chinese character processing in poststroke nonfluent aphasiacs.
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Objective To find biological markers to predict the mathematical cognitive ability in order to set patients free from the pain and time-consuming behavioral tests. Methods 86 patients with stroke or brain traumatic injuries were recruited and acquired T1 and rest-ing-state functional MRI imaging data. And a mathematical task (7 calculation items, 2 counting items) and a word-reading task (140 items) was also finished. The partial correlative analysis was made between the score of mathematical task and the amplitude of low frequency fluc-tuation of each voxel of the whole brain with the word-reading performance as controlling task, and AlphaSim correction method was used with corrected P110 voxels). Results There were 5 cerebral regions whose amplitude of low frequency fluctuation significantly correlated with mathematical performance:left inferior parietal lobule (161 voxels, rpeak=0.34), left precu-neus/superior parietal lobule (141 voxels, rpeak=0.31), left middle temporal gyrus (359 voxels, rpeak=0.34), left middle frontal gyrus (491 vox-els, rpeak=0.36), and right middle frontal gyrus (156 voxels, rpeak=0.32). Conclusion The amplitude of low frequency fluctuation of left inferior parietal lobule, precuneus/superior parietal lobule, middle temporal gyrus, middle frontal gyrus, and right middle frontal gyrus could be used as predictors of mathematical cognitive ability for brain-damaged patients.
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Objective To observe the effect of bilateral movement training on upper extremities dysfunction in stroke patients in conva-lescent phase. Methods 52 patients with hemiplegia were randomly divided into treatment group (n=26) and control group (n=26). The treat-ment group accepted bilateral upper extremities movement training, and the control group accepted routine neurodevelopment training main-ly with affected upper extremities, for 6 weeks. They were assessed with Fugl-Meyer Assessment upper-extremity section (FMA-UE) and modified Barthel Index (MBI) before and after treatment. Results The FMA-UE and MBI scores improved in both groups after treatment (P<0.01), and improved more in the treatment group than in the control group (P<0.001). Conclusion Bilateral movement training may im-prove upper extremity function and activities of daily living more effectively for stroke patients in convalescent phase.
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Objective To explore the feature and rehabilitation of ataxia post 5 times recurrence of hemangioblastoma. Methods A case was reviewed combined with literatures. Results The patient presented cerebellar ataxia after 5 times recurrence of hemangioblastoma. The score of Fugl-Meyer Assessment of balance increased from 4 to 13, while the modified Barthel Index from 50 to 90 after 3 months of reha-bilitation. Conclusion Rehabilitation may improve the activeties of daily living and balance for patient with ataxia after multiple recurrences of hemangioblastoma.
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Objective To explore the influence of attention training on Chinese character processing capability in poststroke nonfluent aphasiacs. Methods 60 stroke patients with nonfluent aphasia and cognition dysfunction were divided into control group (n=30) and experi-mental group (n=30). The trainings (attention training and cognition training) were respectively 30 minutes each time, 5 times each week for 4 weeks. The change of reaction time and error rate were compared before and after they were performing the orthographic, semantic and phonological tasks. Results In the dual-task paradigm the change of reaction time and error rate in orthographic and semantic tasks of the ex-perimental group were all higher than the control group (P0.05). In the single task paradigm there was no difference between the two groups (P>0.05). Conclusion 1. Attention training can improve the processing capacity significantly in orthographic and semantic tasks in the dual-task paradigm because the volume and distribu-tive ability of attention improve significantly. 2. Attention training can't improve the processing capacity in phonological tasks in the du-al-task paradigm because reading aloud and judging are required to process the vowel simultaneously. So that the competion intensifies and it is more difficult to finish the task. 3. In the single task paradigm, there is no significant difference between the influence of the two train-ings in poststroke nonfluent aphasiac because the single task needs little attention and the change in the control group is enough.
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@#Objective To construct the Chinese Semantic Battery and evaluate the significance of clinical application. Methods 45 normal subjects and 100 patients with brain damage finished the Chinese Semantic Battery, including Oral Picture Naming, Picture Pyramids and Palm Trees Test, Word Pyramids and Palm Trees Test, Word Picture Verification and Word Reading. The scores of normal subjects were as norms, and the sensibility, specificity, and Youden's index of the patients were calculated. Results The sensitivity of the battery was 0.96,and the sensitivity of each task was 0.78, 0.68, 0.66, 0.72 and 0.64, respectively. The specificity was 0.96, 0.96, 0.98, 0.96 and 1.00, respectively.Youden's index was 0.60, 0.46, 0.42, 0.39 and 0.50, respectively. Conclusion The validity of norms of Chinese Semantic Battery is acceptable for semantic impairments and can be applied to clinical diagnoses and scientific researches.
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@#Objective To explore the features and rehabilitation of dystonia after cerebral venous sinus thrombosis. Methods A case was reviewed combined with literatures. Results and Conclusion The patient presented deformation dystonia after thrombolysis, and the function improved after botulinum toxin injection and rehablitation.
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Objective To investigate the Chinese characters processing in healthy subjects with functional magnetic resonance imaging (fMRI). Methods 10 healthy subjects were asked to finish the dual-task paradigm Keying/Reading and single-task paradign Keying or Read-ing. The active area and partial lateralization index in brains of them were investigated with fMRI with block design. Results and Conclu-sion The tasks activated the right inferior frontal gyrus, bilateral parietal and cerebellar cortex. The laterality index showed that the left brains were more active in the tasks.
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Objective To explore the clinical efficacy of aztreonam in combination with cefepime for the treatment of urinary tract infections.Methods A randomized block grouping,123 cases of urinary tract infections were divided into observation group,aztreonam group and cefepime group,41 cases in each group.The observation group was treated with aztreonam (2.0g) and cefepime (2.0g),control group were given aztreonam and cefepime,respectively.The treatment time lasted 7 days.Results The total effective rate of observation group was 95.1％,compared with cefepime(85.4％)or aztreonam(82.9％) group,the difference was statistically significant(x2 =12.89、13.56,all P ＜ 0.05).After the end of treatment,the observation group bacterial clearance rate (94.3％) was slightly higher than that of cefepime group or aztreonam group.Each group had only minor adverse reaction,which did't affect the continued medication.And the difference in the incidence was not statistically significant(P ＞0.05).Conclusion Cefepime joint aztreonam in the treatment of urinary tract infection can improve the therapeutic efficacy,and adverse events doesn't increase.
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@#A 22-year-old woman with bilateral perisylvian schizencephaly was reported. She presented only mild right hemiplegia. The motor function improved after constraint-induced movement therapy.
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@#Objective To analyze the clinical features and prognosis of central pontine myelinolysis. Methods 20 cases with CPM diagnosed in last 10 years were reviewed and compared with those patients of foreign studies. Results 10 patients with hemoptysis were treated with hypophysin, which resulted in severe hyponatremia and osmotic myelinolysis. The main syndrom were dysarthria and dysphagia (secondary to corticobulbar fiber involvement), flaccid quadriparesis (as corticospinal tract involved) which later became spastic. The myelinolysis distrubuted symmetrically along the myelin disruption in the center basal, as well as independently in other brain areas (extrapontine myelinolysis or EPM), including the cerebellar and neocortical white/gray junctional areas, thalamus and striatum. Conclusion Supplement of sodium should be slower and more persistent for hyponatremia, the selection of drugs should be based on the patients' specific conditions.