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Objective To collect the demographic,lifestyle and clinical factors of patients with cerebrovascular disease,and analyze the vascular cognitive impairment(VCI) factors and set up high-risk factors model.methods 505 patients with cerebrovascular disease hospitalization in department of geriatrics and neurology in hospital from October 2014 to October 2016 were enrolled.According to the questionaire survey data of demographics,lifestyle and clinical factors,the patients were divided into training set (421 cases) and test set (84 cases),and training set were divided into the non-VCI set (225 cases) and VCI set (196 cases).Analyzed the influence factors of VCI in patients with cerebrovascular disease by decision tree algorithm,and compared it with the Logistic regression analysis and chi-square and established the decision tree model for risk factors of VCI.Result sAccording to the VCI decision tree model,cross validation model recognition accuracy was 73.63%,while test set prediction accuracy was 73.81%.Alcoholism,hobbies,education level,tea drinking,diabetes,hypertension,diet,age,sleep and physical exercise were classification of node variables,while drinking was the root.The probability of VCI had significant difference (P<0.05) in the crowds with different risk factors.According to Result s of Logistic regression analysis,education level,drinking,exercise and diabetes were independent risk factors for VCI,while the model prediction accuracy was 66.98%,and test set prediction accuracy was 53.57%.According to the ROC curve of the decision tree model and the Logistic regression model,the decision tree model AUC was 0.737 (95%CI 0.688 to 0.786),and the Logistic regression model AUC was 0.664 (95%CI 0.612 to 0.717).Conclusion It is suggested that the decision tree model might be superior to logistic regression model in the prediction accuracy for VCI of patients with cerebrovascular disease.The alcoholism,diabetes,high blood pressure,high fat diet and insomnia are risk factors of VCI,while hobbies,high level of education,physical exercise and drinking tea can be the protective factors of the VCI.
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Objective To explore the decision-making process in different types of behavioral activation (BAS) individuals.Methods According to the behavioral inhibition/activation system scales of China,27 low BAS,32 moderate BAS and 26 high BAS individuals were enrolled.Three different kinds of decision tasks (low-risk,high-risk and ambiguity) were programmed with E-Prime,at the same time recorded the scores of earnings,preference selection,decision-making strategy.Results Under low-risk decision,there was significant differences among low,moderate and high BAS groups (low BAS group(54.00±8.15),moderate BAS group(32.63±8.94),high BAS group(27.69±12.12),F=2.240,P＜0.05).There was no significant difference in the three groups on preference selection (F=0.759-2.926,P＞ 0.05).Under low-risk decision,there were significant differences on stay strategy (low BAS＞moderate BAS,high BAS group,F=3.107,P＜0.05) and shift strategy(moderate BAS,high BAS＞low BAS group,F=2.309,P＜0.05).There was no statistically significant difference on quit strategy in the three groups (F=0.629-1.635,P＞0.05).Conclusion Under the low-risk decision-making,low BAS individuals are easier to get more earnings.Moderate and high BAS individuals are easier to change the decision-making strategy than low BAS individuals.
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Objective To investigate the association between norepinephrine transporter (NET)gene polymorphism and decision-making processing in patients with cerebral infarction.Methods A total of 145 patients with cerebral infarction and 188 normal controls were enrolled in our study.In all subjects,the polymerase chain reaction (PCR) for NET-T182C/G1287A polymorphism assay,gel electrophoresis,image analysis and enzymatic reaction,gene sequencing methods were used.The relationships of NET T182C/G1287A genotypes and alleles with decision-making processing were analyzed in patients with cerebral infarction.All participants completed six kinds of choice situational problems.Results There were significant differences in genotype and allele frequencies of T182C and G1287A polymorphism in NET between the patients with cerebral infarction and control group(for NET-T182C:genotype,x2 =4.437,P=0.049,allele frequency,x2=4.363,P=0.037,OR=0.625,95％CI:0.436-0.895;for NET-G1287A:genotype,x2=8.435,P=0.038,allele frequency,x2=2.765,P=0.036,OR=1.520,95％CI:1.053-2.193).The cerebral infarction patients with three NET-T182C genotypes and T/C alleles all completed six choice scenarios,and the scheme selection probability had no significant difference (all P＞0.05).In high-risk and no-risk loss situation (scenario 4),the scheme selection probability had significant difference in cerebral infarction patients with NET-G1287 A genotypes and G/A alleles (P＜0.05 and 0.05,OR=1.657,95％CI:1.149-2.390),and the patients with GG genotype tended to choose high-risk loss scheme,and the probability was obviously lower than that patients with other two genotypes,the patients with G allele tended to choose high-risk loss scheme,and the probability was obviously lower than that in patients with A allele (all P＜0.05).In other five choice scenarios,the scheme selection probability had no significant difference between the patients (all P ＞0.05).Conclusions NET-G1287A polymorphism may be associated with decision-making processing in patients with cerebral infarction.In the high-risk and no-risk loss condition,patients with GG genotype and G allele have more loss risk aversion.
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Objective Based on the literatures published between 2005 and 2014,review the correlation between reward/loss of brain structure and neural network,and its relationship with physical and mental ailments,aim to reveal the neural structure and network of behavioral decision mechanism.Methods By retrieving literatures on PubMed,ScienceDirect,CNKI and Wanfang database in September 2014,we used decision making,reward,loss aversion and so on as the key words.Results Totally 40 papers were enrolled,the result reviewed the clinic meaning and the brain structure and neural network of the reward/loss process in decision making.Conclusion Most studies found the reward/loss decision making mechanism of the brain structure and the physical and mental ailments caused by the two systems imbalance,but related to the precise decision making neural mechanism has yet to be studied further.
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Objective To research the activated brain areas of decision making under uncertainty reward processing on healthy volunteers.Method The E-Prime programs were presented 3 kinds of tasks of the decision under uncertain reward processing.15 right-handed healthy volunteers made a response after receiving the task.At the same time,the GE 3.0T magnetic resonance scanner scanned the brains areas of subjects.Individual analysis and group analysis was done with SPM8 software,then the brain activating regions and the peak intensity were gotten.Results Orbitofrontal cortex was activated in certainty,peak intensity 2.4328 ± 0.1949 (P ＜ 0.05).Prefrontal cortex,occipital lobe,parietal lobe,posterior lobe of cerebellum,limbic lobe and midbrain were activated under the risk reward processing,peak intensity 2.4228 ± 1.3762 (P ＜ 0.05).When under ambiguity reward processing,prefrontal cortex,temporal lobe,occipital lobe,left inferior frontal gyrus and posterior lobe of cerebellum were activated,peak intensity 2.4056 ± 0.4222 (P ＜ 0.05).Compared with the task under certainty,posterior lobe of cerebellum,gyri subtemporalis and gyri fusiformis,inferior parietal lobule,anterior central convolution,orbitofrontal cortex,ventrolateral prefrontal cortex,both frontopolar and supramarginal gyrus were activated in task under risk (P ＜0.05) ;and both frontopolar were activated in task under ambiguity (P ＜ 0.05).Compared with the task under risk,dorsolateral prefrontal cortex and posterior lobe of cerebellum were activated in task under ambiguity (P ＜ 0.05).Conclusion There are differences in different types of reward processing of decision making.
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Objective To explore the decision-making processing changes of patients with cerebral infarction in different regions.Methods The patients with cerebral infarction were divided into 21 cases of frontal lobe infarction,11 cases of temporal lobe infarction,19 cases of the medial temporal lobe infarction,25 cases of basal ganglia infarction;25 cases of the anterior infarction,51 cases of the posterior infarction,62 cases of depression,64 cases of anxiety ;and there were 125 cases in normal control group.All subjects completed the test of the six kinds of choice situational problems,and used MMSE to evaluate cognitive function,the Hamilton Depression and anxiety Scale Evaluation to evaluate emotion.Results All cerebral infarction patients (CI group) and normal control group in low-risk and no-risk of loss situation(choice scenario 2),high-risk and the no-risk of gain or loss situation(choice scenario 3 and 4),high-risk and low-risk of gain or loss situation(choice scenario 5 and 6) tended to choose conservative scheme,and the selection probability of conservative scheme were obviously higher than that of the normal group,and the differences were statistically significant (P ＜ 0.05).In choice scenario 3,the basal ganglia infarction group with frontal lobe infarction group,the medial temporal lobe infarction group comparison,the conservative income scheme selection probability increased significantly,all difference were statistically significant (P ＜ 0.01,P ＜ 0.05).In choice scenario 5 of the posterior infarction group,a higher probability of conservative income scheme was selected than the anterior infarction,and the difference was statistically significant (P ＜0.05).Accompanied with depression and anxiety,the basal ganglia infarction tended to select more conservative income program than the frontal lobe infarction group and the medial temporal lobe infarction group in choice scenario 3,and the program infarction group selected a higher probability comparative differences were statistically significant (P＜ 0.01,P＜ 0.05).The posterior infarction group selected a higher probability of conservative income scheme than the anterior infarction in choice scenario 5,and the difference was statistically significant (P ＜ 0.05).Conclusion Cerebral infarction in patients exist decision-making processing abnormally,and perform as income conservative and loss risk averse.Whether associated with depression,anxiety,the basal ganglia infarction and posterior cerebral infarction patients are inclined to income conservative.
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Objective To investigate the impairment and the effect factors of encoding of episodic memory in patients with cerebral infarction. Methods 112 cases cerebral infarction patients and 115 healthy elders as controls were tested for episodic memory encoding with episodic pictures accomplished in computer, and compare the differences of encoding of episodic memory between the two groups. Results The remember indexes ( REM )of encoding memory test in patient group was significantly lower than that in control group( (70.81 ± 6.08 )vs (84.67 ± 4.49), P ＜ 0.01 ). The REM in patients with different impaired areas was significantly different ( (65.88 ± 5.73 ), (68.92 ± 4.65 ), (73.39 ± 6.20), ( 73.53 ± 3.44), P ＜ 0. 01 ). The REM in frontal lobe infarction group was significantly lower than that in temporal lobe infarction group (P ＜ 0.05 ), and in temporal lobe infarction group was significantly lower than that in basal ganglia infarction group and corona radiate infarction group (P＜0.05, P＜0. 01). The REM in cortex infarction group was significantly lower than that in under cortex group ( ( 67.37 ± 5.40 ), ( 73.46 ± 4.99 ), P ＜ 0.01 ). The REM in small cerebral infarction group was significantly higher than that in large cerebral infarction group( (72.67 ±4.47 ), (67.56 ± 6.18 ), P＜0.01 ). The size of cerebral infarction diameter was related with the REM( r= -0.39, P＜0. 01 ). The REM among control group,infarction with atrophy group, and infarction without atrophy group were significantly different( (67.03 ± 6. 17 ),( 72.84 ± 5. 00 ), ( 84.67 ± 4.49 ), P ＜ 0. 01 ). The REM in infarction with atrophy group was significantly lower than that in infarction without atrophy group and control group( both P＜0.01 ) ,The REM in infarction without atrophy group was significantly lower than that in control group (P ＜ 0.01). Conclusion The encoding of episodic memory was impaired in cerebral infarction patients. The infarction parts,size of infarction area and atrophy was related with the impairment of encoding of episodic memory.
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BACKGROUND: The choline acetyltransferase (CHAT) is the key synthetic enzyme for acetylcholine, and is the important symbol of the functional activity of the cholinergic system. There was a relationship of the cholinergic neurons damage with the pathogenesis of Alzheimer disease (AD) and the mild cognitive impairment (MCI). Whether or not the fimbria/fornix transection may affect the expressive variety of ChAT in different cerebral regions of rats (cortex, hippocammpi CA1, amygdala, Meynert nucleus) is very important for the recognition of the pathogenesis of AD and MCI and the establishment of experimental animal model of AD.OBJECTIVE: To observe the expressive variety of ChAT in different cerebral regions of rats with fimbria/fornix transection and discuss exploratorily the methods of simulative experimental AD.DESIGN: A randomized and control study.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College and the Department of Neurology, No. 1People' s Hospital of Jining.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of the Qingdao University Medical College from March to December 2003. Totally 14 adult healthy female Wistar rats aged 5 months were randomly divided into model group and control group with 7 in each group.METHODS: ① The bilateral fimbria-fornix of brain in model group were transected on the stereotaxic apparatus to set animal model. After opening the skull, at the coordinates, along the bregma posterior 2.2 mm-2.5 mm and lateral 1.0 mm according to the atlas of Paxinos and Watson, and the dorsal fornix, the anterior part of hippocampus and the fimbria were cut off with a double blade under visual inspection. Rats in the control group were not performed with fimbria/fornix transection, and the other procedures were completed as those in the model group. ② On the 28 day after the surgery, all rats were killed under anesthesia to take out the brain tissues and make coronary sections for histochemical observation in a immunohistochemical way. The expressions of the ChAT positive neurons were observed in the cortex, hippocammpi CA1, amygdala, Meynert nucleus, and the brown neurons under microscopy was the ChAT positive neurons.MAIN OUTCOME MEASURES: Expressions of ChAT positive neurons in the cortex, hippocammpi CA1, amygdala, Meynert of the basal forebrain in the model group and the control group.RESULTS: All the rats entered the final analysis without any loss. The expression of ChAT positive neurons in the cortex, hippocammpi CA1,amygdala, Meynert of the basal forebrain in the model group were distinctly decreased than that in the control group (2.97±1.45, 32.60±7.33, t=10.51,P ＜ 0.01); (6.83±2.41, 50.57±5.85, t=1 8.30, P＜ 0.01); (14.43±6.75, 35.43±10.49,t=4.47, P ＜ 0.01); (5.77±6.62, 48.77±7.10, t=1 1.72, P ＜ 0.01), and the differences were significant.CONCLUSION: Finbria/fomix transection can decrease the expression of ChAT positive neurons in many cerebral regions of rats, and can be used in a method of setting the experimental animal model of AD.
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BACKGROUND: Cholinergic nervous system has a site which is affected by both blineurine and nerve growth factor receptor tyrosine kinase A (NGF-RTK-A). Whether cholinergic injury can affect the changes of tyrosine kinase A (TrKA) is significant to the application of nerve growth factor (NGF) to interfere cognitive disorder disease.OBJECTIVE: To observe the expressive variety of TrKA in different cerebral regions of rats with bilateral fimbria/fornix transection, and comprehend the effect of fimbria/fornix transection on nerve growth factor receptor system.DESIGN: A completely randomized and controlled study on the basis of animals.SETTING: Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College.MATERIALS: The experiment was completed in the Institute of Cerebrovascular Disease, Affiliated Hospital of Qingdao University Medical College from March to December 2003. Totally 14 male Wistar rats were randomly divided into control group and model group with 7 in each group.METHODS: The bilateral fimbria/fornix transection was performed on rats in the model group, but rats in the control group were treated with the same methods except fimbria/fornix transection. Twenty eight days after operation, rats in the two groups were killed under anesthesia to take out brain tissues to stain with immunohistochemical staining.MAIN OUTCOME MEASURES: The number of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in both groups.RESULTS: Totally 14 rats entered the final analysis. The numbers of positive TrKA cells in the hippocammpal CA1, cortex, amygdala and Meynert of the basal forebrain of rats in the model group were obviously smaller than those in the control group [(18.91 ±6.27), (15.17±5.23),(18.71±9.05), (8.03±2.33); (54.77±11.84), (59.69±10.40), (49.23±15.84),(21.49±15.54), t=4.17-10.00; P ＜ 0.01].CONCLUSION: The expression of TrkA positive neurons is decreased in many sections of the brain in the rats with fimbria/fornix transection.Possibly it is the cause leading to the cognitive disorder and senile dementia.
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Objective To observe the expression of brain derived neurotrophic factor(BDNF) mRNA after nerve trunk stimulation by electroacupuncture in rats' cortex with cerebral ischemia/reperfusion. Methods The MCAO model was established by ligation of the artery for 1 hour, and then reperfusion was conducted for 2h, 6h, 12h, 24h, 2d, 3d, 7d and 14d.The expression of BDNF mRNA after the cerebral ischemia/reperfusion injury (MCAO group) was observed and comparison was made between the electroacupuncture group and the control group. Results The number of cells with positive expression of BDNF mRNA in the cortex after 2h, 6h, 12h, 24h, 2d and 3d of reperfusion was more than that in the control group (all P0.05). At 2h of reperfusion, the amount of the positive cells peaked and was much more than that at the 6h and 12h time points (P0.05),but after 6h reperfusion, a significant increase of expression of BDNF mRNA was observed against the MCAO group and control group, and the increase lasted to 14d after reperfusion. Conclusion Nerve trunk stimulation with electroacupuncture could improve and maintain the expression of BDNF mRNA for a long time, and this might contribute to the protection effect of electroacupuncture against the brain ischemia/reperfusion injury.
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@#Objective To evaluate the effect of early rehabilitation and acupuncture on acute stroke. Methods125 cases stroke patients were divided into 4 groups: the early rehabilitation and acupuncture group, 34 cases(Group A); the early rehabilitation group, 39 cases(Group B); the early acupuncture group, 21 cases(Group C); and the control group, 31 cases. Bobath therapy and acupuncture were used. The CNS Damage Scale, Fugl Meyer Assessment(FMA), Modified Barthel Index(MBI), Clinical Therapeutic Effectiveness and Rehabilitation Efficiency were observed in all patients at the beginning, middle and end of the course. Results Rehabilitation Efficiency was the highest in Group A among all groups, and higher in Group B than in Group C and the control group, and higher in Group C than in the control group. The Clinical Therapeutic Effectiveness was better in Group A,B and C than in the control group, and better in Group C than in the control group. Conclusion It is a main and effective therapy to improve the patient\'s condition that early rehabilitation is combined with early acupuncture on acute stroke patients.