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@#Rapid eye movement sleep behavior disorder(RBD) is one of the most typical concomitant symptoms of Parkinson disease(PD). Studies have shown that RBD is related to the deterioration of motor and non-motor symptoms,which seriously affects the prognosis and quality of life of patients with PD. However,the pathogenesis of PD with RBD(PD-RBD+) remains unclear. With the development of neuroimaging techniques in recent years,more and more studies have focused on the neuroimaging changes of PD-RBD+ to identify specific imaging markers for the diagnosis and treatment of the disease. This article reviews the research on neuroimaging related to PD-RBD+.
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Parkinson disease (PD) is a common neurodegenerative disease with motor and non-motor symptoms that seriously affect the quality of life and social function of patients. The current non-invasive techniques in PD brain function studies mainly include functional magnetic resonance imaging and electroencephalography, which made it difficult to assess brain function under motor state or magnetoelectric treatment. As an emerging functional neuroimaging technique, functional near-infrared spectroscopy (fNIRS) can monitor the real movement-related cortical responses of PD patients in real time, providing a safe and non-invasive method with high ecological validity for direct monitoring of brain activity. This article presented a review of recent advances in the application of fNIRS technology in PD research, intending to provide new ideas for functional neuroimaging studies in PD. The results suggested that PD gait and balance deficits were closely associated with abnormal activation of the cerebral cortex, particularly the prefrontal cortex, involving a compensatory strategy of cortical cognitive resources for basal ganglia dysfunction. Drugs, deep brain stimulation, and other interventions could be applied to fNIRS techniques to evaluate neurorehabilitation effects and reveal the neural basis of intervention effects. This area of research is currently in its infancy, but the evidence provided supports for the translation of fNIRS into clinical practice. Future research should develop multimodal imaging techniques and in-depth studies of broad areas of the cerebral cortex to obtain more valuable findings for clinical practice.
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Objective:To investigate the relationship between mental resilience and quality of life in patients with Parkinson ′s disease and provide basis for paying attention to the mental health of this group. Methods:A total of 190 in patients with Parkinson ′s disease (PD) were selected from April to July 2017 in the First Affiliated Hospital of Dalian Medical University. The general data questionnaire, Mental Resilience Scale and 39-Item Quality of Life (QOL) Questionnaires were used to investigate among the patients. Results:The mental resilience score of PD patients was 48.0 (29.8, 62.2) points and the quality of life score was 56.0 (27.8, 82.0) points. There was a significant negative correlation between mental resilience and quality of life score ( r value was -0.538, P<0.01). Multivariate linear regression analysis showed that with the increase of psychological elasticity score, the score of quality of life decreased ( b value was -0.002, P<0.001). Conclusions:The mental resilience and quality of life of PD patients are both at a low level, the improvement of mental resilience is beneficial to improve their quality of life.
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Objective To investigate the current status of hardiness and quality of life (QoL) among patients with Parkinson disease (PD) and analyze the correlation between hardiness and QoL.Methods By convenience sampling,243 patients with PD were recruited from a tertiary hospital in Dalian during February 2017 and May 2017.General Scale,Hardiness Scale for Chinese Adults and Parkinson disease Questionnaire-39 item Version (PDQ39) were employed to measure hardiness and QoL among patients with PD.Results The hardiness score was (1.96±0.66) and the PDQ39 score was (35.46±20.38).The hardiness score was negatively correlated with PDQ39 score (r=-0.434,P＜0.01).Conclusion Patients with PD have a low level of hardiness and QoL.The higher the level of hardiness,the better the QoL.
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Objective To investigate demography of sensory tricks in cervical dystonia (CD),and to discuss the relationship between sensory tricks and the function of sensorimotor integration of cerebral cortex,meanwhile to explore potential worthiness using sensory tricks in the management of CD.Methods We recruited 75 patients (23 male,52 female,male female ratio:1:2.26;aged 19-72 years,mean (42.45 ± 13.09) years) admitted to the Dystonia Clinic Center of the First Affiliated Hospital of Dalian Medical University from March 2016 to April 2013.Standardized questionnaire on sensory tricks was used to investigate the sensory tricks first recognized in 75 patients retrospectively.Median nerve somatosensory evoked potential via multipoint recording was measured in 43 CD patients who manifested as simple rotation of neck.Bilateral amplitudes of P22/N30 derived from F (3,4) were compared.Results Frequency of sensory tricks in CD was 85.53％ (64/75) in our research.As disease progressed,the type of sensory tricks used by patients may transform from one to another or even disappear.No statistically significant differences were found in ages among patients using classic sensory tricks,forcible tricks and patients without sensory tricks,whereas the complexity of the disease showed increased tendency among the three groups.Bilateral P22/N30 amplitudes of patients with classic sensory tricks showed no significant differences.P22/N30 amplitudes contralateral to the head turn were significantly higher than ipsilateral in patients using forcible tricks ((3.16 ± 1.71) μV vs (2.47 ± 1.28) μV,t =2.243,P=0.038) and patients without sensory tricks ((3.62 ±1.58) μV vs (2.73 ±1.14) μV,t=2.893,P=0.023).Tsui scores among patients using classic sensory tricks (9.36 ± 3.52) and forcible tricks (12.67 ± 5.00) or patients without sensory tricks (15.18 ± 4.07) had statistically significant differences (classic sensory tricks vs forcible tricks,t =-3.020,P =0.004;classic sensory tricks vs patients without sensory tricks,t =-4.452,P =0.000).Conclusions Types of sensory tricks used by patients are associated with severity of the disease.Different types of sensory tricks may reflect status of adaptive compensatory mechanism of the cerebral cortex.
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Objective To understand the quality of life and self-efficacy of Parkinson patients and explore the relationship between them. Methods A cross-sectional study was conducted on 155 Parkinson patients. The instruments included a self-designed general information questionnarie, the 39-item Parkinson's disease questionnaire (PDQ-39) and self-efficacy scale for chronic patients. Results The total score of the quality of life was 26.12 ± 16.31.The total score of self-efficacy was 5.46 ± 1.87, and the scores of symptom management and disease management were 5.23 ± 1.98 and 5.94 ± 1.96. The quality of life was positively correlated with self-efficacy (r=0.800, P < 0.01). Conclusions Parkinson patients' overall the quality of life and self-efficacy remain a low level, and the quality of life was closely correlated with self-efficacy. The score of patients' self-efficacy was higer, the quality of life was better. Medical and nursing personnel can through strengthening patients' self-efficacy, optimizating of the patient' s health behavior, and improving negative emotion and attitude, so as to improve their quality of life.
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Present data achieving from collecting showed it should be pay attention to the intimate connection between rapid eye movement sleep behavior disorder( RBD) and neurodegenerative diseases such as Parkinson’ s disease( PD) ,there is a scholar who has announced that RBD is the mark of alpha-synucle-in,and the PD patients who also have the RBD may appear some certain clinical features.To integrate exist-ing data and analyze the research progress of Parkinson's disease with REM sleep behavior disorder,it’ s ex-tremely close between PD and RBD,however,their exact mechanism and the accurate relationship remains to be further defined so that we can correspond treatment such as nerve protection as soon as possible,to help delay occurrence or progress about disease.
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Objective To investigate the characteristics of cerebral glucose metabolism (CGM) in PD patients with cognitive impairment (PD-CI) using 18F-FDG PET/CT,and to analyze the correlation between the progress of PD-CI and CGM changes.Methods A total of 31 idiopathic PD patients (14 males,17 females,aged 37-77 years) from May 2013 to February 2014 were divided into 3 groups based on Montreal cognitive assessment (MOCA):none CI in PD (PD-NC) group (MOCA＞26 scores),mild CI in PD (PD-MCI) group (MOCA 21-26 scores),PD with dementia (PDD) group (MOCA＜21 scores).The normal controls (NC) group included 12 age-and gender-matched healthy adults (7 males,5 females,aged 40-76 years).All subjects underwent PET/CT imaging after intravenous injection of 18F-FDG(5.55 MBq/kg).MIMneuro software was used to analyze the data.The correlation between the CGM and cognitive function was analyzed using Pearson or Spearman correlation analysis.Results (1) Compared with NC group,PDD group presented a widespread cortical metabolism decrease in frontal,parietal,temporal,occipital 19bes and the limbic lobe;PD-MCI group showed hypometabolic areas in the parietal and occipital lobes,and with less extent in the frontal and temporal lobes;PD-NC group showed no significant cerebral hypometabolism.(2) Compared with PD-NC group,PDD group showed widespread cortical metabolism decrease in occipital lobe,temporal lobe,partial parietal cortex and the posterior cingulated cortex.Compared with PD-MCI group,PDD group had lower metabolism,mainly in posterior brain areas (parietal,occipital and temporal lobes).Compared with PD-NC group,PD-MCI group showed hypometabolism in right supramarginal gyrus and the left parahippocampal gyrus.(3) There were positive correlations between visuospatiaL/executive function and visual cortex metabolism,angular gyrus metabolism or superior parietal lobule metabolism (r =0.535,0.443,0.395;all P＜0.05).A positive correlation was also found between delayed memory and heschl's gyrus metabolism (r=0.337,P＜0.05).Conclusions The cerebral glucose metabolism detected with 18F-FDG PET/CT is well correlated with MOCA assessments.Thus it may be helpful in evaluation of the progress of cognitive impairments in PD.
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Parkinson's disease (PD),one of the most common neurodegenerative diseases,is characterized by motor symptoms,like static tremor,rigidity,bradykinesia and postural balance disorder,and some non-motor symptoms such as cognitive impairment,sleep disturbance,depression,emotional problems.The pathogenesis of PD is related to the synthesis and metabolism ofdopamine in the brain.In recent years,more and more studies have indicated that the non-dopaminergic nervous system plays an important role in the pathogenesis of PD.The EFNS and the MDS-ES refer that PET can assist the diagnosis of PD in clinical application,thus,PET provides powerful tools for PD.We reviewed the application for the progression of PET imaging in PD.
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Objective To investigate the change of the cerebral glucose metabolism in Parkinson's disease(PD) with cognitive impairment.Methods Fifty patients with PD and twenty normal controls were enrolled in this study.Based on MMSE score,the PD patients were divided into PD-NC(n=25) and the PDD(n=25) group.Twenty age-and sex-matched physical health examinationer were colleted as control group.Using the SPM to analyze the characteristics of the metabolism in different cognitive level io PD patients.Results (1) Compared with control group,P D-NC group showed significant hypermetabolism in occipital (-24,-92,10),parietal (-48,12,-16) and temporal lobe(52,8,-32).(2)Compared with control group,the glucose metabolism of PDD group decreased in most cerebral cortex and subcortex.(3)Compared with PD-NC group,the metabolism of parietal lobe (-42,-48,40),occipital lobe (-22,-96,-6) and tetnporal lobe (-42,-58,16) reduced in PDD group.Conclusion Cortical brain metabolism decreases in PD-NC group.The degree and scope of glucose metabolism of PDD group will increase with the progress of cognitive dysfunction.These features could help with the diagnosis and differential diagnosis of cognitive dysfunction in Parkinson's disease.
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<p><b>BACKGROUND</b>Hemifacial spasm (HFS) is a facial nerve disorder characterized by episodic involuntary ipsilateral facial muscle contraction. Information on Chinese patients with HFS has not been well-characterized. This study aimed to evaluate the clinical feature and the treatment status of HFS across China.</p><p><b>METHODS</b>A cross-sectional study including 1003 primary HFS patients had been carried out in 15 movement disorder clinics in China in 2012. The investigated information was acquired from questionnaires and medical records including demographic data, site of onset, aggravating and relieving factors, treatments prior to the investigation, etc.</p><p><b>RESULTS</b>In this study, the ratio of male to female was 1.0:1.8, the mean age at onset was (46.6 ± 11.5) years. About 1.0% patients were bilaterally affected. The most often site of initial onset was the orbicularis oculi muscle. The most often affected sites were orbicularis oculi, zygomatic, and orbicularis oris muscles. Stress/anxiety and relaxation were most often aggravating and relieving factors, respectively; 2.3% patients had family history, 28.4% cases were combined with hypertension, and 1.4% patients were with trigeminal neuralgia. Botulinum toxin type A (BTX-A) injection was the most commonly used treatment, followed by acupuncture and oral medication. BTX-A maintained the highest repeat treatment ratio (68.7%), while 98.4% patients gave up acupuncture. The mean latency of BTX-A effect was (5.0 ± 4.7) days, the mean total duration of the effect was (19.5 ± 11.7) weeks, and 95.9% patients developed improvements no worse than moderate in both severity and function. The most common side effect was droopy mouth.</p><p><b>CONCLUSIONS</b>The onset age of HFS in China is earlier than that in western countries. The most often used two treatments are BTX-A injection and acupuncture, while the latter kept the poor repeat treatment ratio because of dissatisfactory therapeutic effect.</p>