ABSTRACT
Objective To explore the correlation of electrophysiological features with clinical manifestation in patients with diabetic peripheral neuropathy (DPN).Methods The clinical data of 306 patients with DPN undergoing nerve conduction study (NCS) during May 2013 to June 2015 were retrospectively analyzed.Among 306 patients,304 were type 2,and 2 were type 1 diabetes with a mean age of 64.1 years and disease duration of 1 week-31 years.The relationship between the electrophysiological features and clinical manifestations was evaluated.Nerve conduction studies and F-wave and in sympathetic skin response were analyzed.Results ① NCS in lower limbs presented more abnormalities than that in upper limbs.There was the highest prevalence of not elicited sensory potential in Tibial nerve [56.9％(174/306),x2 =175.9] and the highest prevalence of not elicited motor potential in peroneal nerve [7.8％(24/306),x2 =1 103.1].Amplitude abnormality was more severe in sensory nerve than that in motor nerve[41.4％ (507/1 224) vs.10.8％ (132/1 224),x2 =559.2].The ratio of abnormal motor conduction velocity or distal latency was higher than that of amplitude decreased [22.9％ (280/1 224) vs.10.8％(132/1 224),x2 =1 077.4].② The abnormal ratios of the shortest F-wave latency was lower than that of the prolonged distal latency in median and tibial nerve [5.4％ (33/612) vs.20.6％ (126/612),x2 =607.6].③ The abnormal ratio of sympathetic skin response (SSR) in lower limbs were higher than that of upper limbs [40.2％ (246/612) vs.27.3％ (167/612),x2 =129.4,P ＜ 0.001],abnormal ratio of amplitude was higher than that of the prolonged latency [30.1％ (368/1 224) vs.4.7％ (58/1224),x2 =1040.5,P ＜0.001].Among the 99 cases presenting abnormal SSR in upper limbs,32 cases were normal in conventional NCS.Among the 127 cases presenting abnormal SSR in lower limbs,7 cases were normal in conventional NCS.④Disease course and glycosylated hemoglobin values were positively correlated with the distal motor latency,and negatively correlated with the nerve conduction velocity and amplitude.Conclusion Electrophysiological features of DPN is mainly shown in axon of the distal sensory nerve.Long duration and hyperglycemia may lead to more abnormalities in electrophysiological tests.
ABSTRACT
Objective To study the functional connectivity (FC) pattern of anterior cingulated cortex in patients with vascular cognitive impairment with no dementia (VCIND) after subcortical ischemic vascular disease,and to analyze the relationship between FC and cognitive function.Methods Resting state functional magnetic resonance imaging (MRI) data were acquired from 14 patients with VCIND and 16 healthy volunteers with normal cognition.The altered functional connectivity pattern in VCIND was valuated by comparing to normal control.Then a correlation analysis was performed between the strength of FC and the Montreal Cognitive Assessment (MoCA) scores in patients with VCICD.Results (1) The visual space or executive function (3.14 ± 0.29),attention or computing power (3.79 ± 0.37),language (1.14 ± 0.21),directional power (4.14 ± 0.53) items,and the total points of MoCA (17.29 ± 1.53) in VCIND were significantly lower than that in the normal control group (4.93 ± 0.07,5.93 ± 0.07,2.93 ± 0.26,5.93 ± 0.07,27.57 ± 0.33 ; t =31.62,32.50,28.51,12.00,39.71,all P ＜ 0.05).While the abstract ability or memory (4.36 ± 0.74),the naming (2.79 ± 0.11) items in VCIND were not significantly different with that in the control group (4.79 ± 0.80,2.93 ± 0.07 ; t =1.76,1.00,both P ＞ 0.05).(2) Compared with the control group,the patients showed FC decrease between the anterior cingulated cortex and several brain regions,including the left middle temporal gyrus/left superior temporal gyrus,the left superior frontal gyrus/left middle frontal gyrus/left inferior frontal gyrus,the left posterior cingulated cortex/left precuneus,the left inferior parietal lobule/left angular gyrus,the right middle temporal gyrus/right superior temporal gyrus,the right orbit frontal cortex/right inferior frontal gyrus,the right inferior parietal lobule/right angular gyrums,and the right superior frontal gyrus/right middle frontal gyrus.There were also some regions that showed increased FC,which included the right posterior lobe of the cerebellum,the calcarine fissure,the left middle frontal gyrus,and the left precentral gyrus.(3) In the VCIND patients,the brain regions which positively correlated with the MoCA scores were the left inferior parietal lobule,the right middle temporal gyrus,the right superior frontal gyrus,and the left superior temporal gyrus.The negativerelated brain regions were the right posterior limb of internal capsule,the left middle temporal gyrus,the left precuneus,and the right anterior limb of internal capsule.Conclusions VCIND patients show abnormal FC pattern of anterior cingulated cortex,which could be the pathological basis of VCIND,and have certain predictive value for VCIND.
ABSTRACT
Objective To investigate the electrophysiological characteristics of carpal tunnel syndrome (CTS) and CTS-associated cervical spondylotic radiculopathy (CSR),and to examine the relationship between CTS and CSR. Methods The clinical characteristics and electrodiagnostic features of 81 patients with CTS and 20 patients with both CTS and CSR (the double crush,DC) were analyzed and compared.The data were analyzed according to the severity of the deficit in median nerve conduction using electromyography. Results The 81 patients with CTS had 123 median nerves with abnormal conduction (39 cases with unilateral abnormalities and 42 cases with bilateral abnormalities).The 20 patients with DC had 31 median nerves with abnormal conduction (9 cases with unilateral abnormalities and 11 cases with bilateral abnormalities).The rate of abnormal sensory nerve conduction velocity (SCV) was 100％ in C6 and C7 level radiculopathies.The rate of abnormal distal motor latency (DML) was 92.31％ in C5 level radiculopathies.There was a statistically significant difference between CTS and DC in the rate of abnormal SCV from the middle finger to the wrist.The other electrodiagnostic data were not significantly different between the CTS and DC patients.Neurophysiological tests were used to grade CTS into categories according to the American Association of Electrodiagnostic Medicine's criteria,but there was no statistically significant difference between CTS and DC. Conclusions CSR lesions on a proximal nerve root may cause the nerve to be more susceptible to distal injury and increase the risk of CTS.The findings support the DC hypothesis,but DC on a median nerve did not result in more severe injury than a single crush.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the association between quality of life (QOL) and sociodemographic factors, clinical seizure factors, depression and anxiety in patients suffering from epilepsy.</p><p><b>METHODS</b>We examined 141 consecutive patients with epilepsy (mean age 25.8±9.6, 61.7% male). All patients completed the Self-Rating Depression Scale, Self-Rating Anxiety Scale, WHOQOL-BREF and QOLIE-31(Chinese version). Multiple linear regression analyses were applied to investigate factors impact on QOL.</p><p><b>RESULTS</b>The results revealed that scores on two domains of the WHOQOL-BREF (i.e., physical and psychological domains, P<0.05) were significantly lower in the epilepsy group compared with the control group. Multiple regression analyses showed that anxiety, depression and course explained approximately 40% of the variance in patients' QOL. Anxiety was consistently the strongest predictor of lower scores on almost all QOL domains. In addition, the severity of depressive symptoms was significantly associated with lower scores across many QOL domains.</p><p><b>CONCLUSION</b>Our findings suggest that QOLIE scores might be substantially affected by the presence and severity of anxiety symptoms and, to a lesser degree, of depressive symptoms and prolonged course of illness. In contrast, clinical seizure variables had a weaker association with QOL. Healthcare professionals should be aware of the significance of patients' emotional state and of the role it plays in their QOL.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , Anxiety , Pathology , Depression , Pathology , Epilepsy , Psychology , Quality of Life , Surveys and QuestionnairesABSTRACT
Objective To assess health-related quality of life and the mood disorder in adults with epilepsy,and to evaluate factors contributing to the quality of life.Methods Quality of life was measured by the Quality of Life in Epilepsy Inventory(QOLIE-31)and the World Health Organization Quality of Life Assessment-Bref(WHOQOL-BREF).Psychotic conditions were evaluated by Self-rating Depressive Scale (SDS)and Self-rating Anxious Seale(SAS).The multivariate analysis was used to assess the determinant factors.Results The study included 141 epilepsy patients in the teat group and 59 sex,age,and education matched normal controls. WHOQOL-BREF scores in the physical and psychological aspects were significantly lower in epilepsy patients(12.7 ±1.8 and 12.4±1.9,respectively)than those in the normal controls(15.1 ±2.3 and 13.9 ±1.9,respectively,t value were 11.75 and 8.625.both P<0.05).The survey reported that 57.4 % of the epilepsy patients suffered with depression.and 39.7 % anxiety.The patients with both anxiety and depression scored lower in all aspects in QOLIE survey except medical effect.Multivariate analysis showed that factors that effect the overall quality of life in order were anxiety.depression and disease duration.Conclusion Our results support that complications of anxiety and depression and long disease duration are key factors affecting the quality of life in epilepsy patients.
ABSTRACT
Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.
ABSTRACT
Objective To investigate the inhibiting effect of interleukin-10 on the expressions of intercellular adhesion molecule-1(1CAM-1)and P-selectin in cerebral ischemia and reperfusion foci(I/R)in rats. Methods Sixty adult male Sprague-Dawley rats were assigned to 4 groups randomly:Sham operated group(n=6),cerebral I/R group(6,24,48 hours post I/R,each had 6 rats),vehicle group(6,24,48 hours post I/R,each had 6 rats)and IL-10 treatment group(6,24,48 hours post I/R,each had 6 rats).I/R rat model was established by middle cerebral artery occlusion(MCAO)with Longa's thread method. Immunohistochemical staining and retro-transcriptase polymerase chain reaction were used to detect the expressions of ICAM-1 and P-selectin. Results ICAM-1(31.60±1.85,54.11±2.32,48.61±2.30)and P-selectin(29.39±5.16,50.44±4.38,37.89±4.74)expressions on endothelial cells 6,24 and 48 hours post I/R were significantly upregulated as compared with sham group(7.61±1.14,0,respectively)(alI P＜0.01),and the expressions of ICAM-1 (24.06±2.42,42.00±3.26,45.28±2.91)and P-selectin(27.28±1.84,42.78±2.51,36.00±3.22)on endothelial cells of IL-10 treatment group 6h,24h,48 h post I/R were significantly suppressed at any timepoint in comparison with vehicle group(P＜0.05). Conclusions IL-10 could inhibit the expressions of ICAM-1 and P-selectin on endothelial cells of cerebral I/R foci in rats.